What's New In Plastic Surgery

2006-11-28T11:05:00.000-08:00

FDA APPROVAL OF SILICONE BREAST IMPLANTS!

All patients over the age of 22 or patients currently with saline implants can now get the FDA approved silicone gel breast implants. Please call our office today and ask about our 0% interest for 24 months payment plan. 310-315-0121.

2006-11-16T09:22:00.000-08:00

A BOOB JOB FOR BRITNEY?
from InTouch Magazine

After two back-to-back pregnancies, breast-feeding two children and a speedy weight loss, Britney Spears is noticing some changes in her body -- and she's not happy about it.

"Since the second baby, her boobs are really sagging," says a family insider. She told her husband, Kevin Federline, that "she wants her breasts redone and he agreed that they need a lift."

According to the insider, Britney plans to consult with LA's top plastic surgeons including Dr. Michael McGuire and Dr. 90210's Dr. Robert Rey, in December. "Britney is definitely doing this," her pal confirms. "She just can't wait to get her breasts back."

This wouldn't be her first cosmetic surgery. Although she denies getting breast implants back in 2002, the family insider says rumors that she had an augmentation three years earlier when she was about 18 are true. "It was all very quiet," the family insider says.

BACK IN THE SPOTLIGHT
Despite losing most of her pregnancy weight since Jayden arrived on September 12, Britney has been struggling to regain her perfect body through diet and exercise. And she's hoping her hard work -- and surgery -- will help her regain her superstar status.

"Britney's body made her famous," her pal says. "Her voice was good, but her body was even better. She knows that if she's going to have a comeback, she's going to need to get her body back -- and that includes her boobs."

Britney has set aside all of February for the procedure and recovery, but she may be facing a delay. The pop star, whose next album, Fears Within, is due out in mid-2007, may not be able to get a lift until after she's done breast-feeding.

"There's tons of bacteria in the breast milk," says Dr. Randal Hayworth, a plastic surgeon in LA, who doesn't work with Britney. "If you have surgery too soon, it can cause an infection."

Since Britney has told a pal that she wants to keep breast-feeding for a few more months, she may be frustrated that she'll have to wait until at least the summer. "Britney wants this to happen fast," the family insider says. "She knows what it takes to be on top of the entertainment world."

2006-10-27T09:10:00.000-07:00

DANGEROUS CURVES
The trial of a Beverly Hills doctor suspected of using illegal implants reveals a plastic-surgery secret: Women want silicone, FDA be damned. By Ginny Graves for Allure Magazine (November 2006)

Photos of well endowed women embellish the website of Frederic Corbin, a board-certified plastic surgeon with offices in Beverly Hills and Brea, California. What's more surprising, however, is a shot of Corbin meeting with the Dalai Lama and a personal essay titled, "A Virtuous Act: Dr. Corbin's Charitable Journey to India," that chronicles his visit to the country to repair cleft palates. It remains to be seen if federal prosecutors will be swayed by Corbin's virtue during his current trial. His alleged crime is smuggling illegal silicone breast implants from Mexico into the United States and falsifying patients' medical records so they could receive American-made silicone implants that are typically available only through tightly regulated clinical studies.

The reason for his backdoor methods: Silicone implants have been accessible only to select women who are part of a clinical trial since 1992, when the Food and Drug Administration pulled the devices from the market over concerns that leaking gel was causing a number of illnesses, including cancer and auto-immune diseases. Demand at the time slowed. But it never died, and over the years, silicone has rebounded--and become increasingly coveted. "silicone looks and feels more natural than saline, especially in women who are thin," says Laurie Casas, associate professor of plastic surgery at Feinberg School of Medicine in Chicago.

Corbin allegedly began his blackmarket surgeries in 1996. According to court documents, he imported French-made gel implants from Tijuana after a patient bought a pair there and asked him to perform her surgery. Over the next few years, court records allege, he placed contraband implants in at least five women. Meanwhile, as a clinical-trial investigator for Mentor Corporation, one of the two American companies who manufacture silicone implants (the other is Inamed) and are vying for FDA approval, Corbin also had access to legal silicone. More than 2,000 doctors in the country are eligible to give patients silicone through Mentor's study. Once a physician is an approved investigator in the study, they may perform surgery with silicone-gel implants if the patient meets all the criteria. Once the surgery is complete, the physician is required to send paperwork to Menton. The physician also has to see the patient at scheduled intervals and provide follow-up documents to Mentor for each visit. Women having reconstruction after a mastectomy quality for the implants, as do those with chest-wall deformities and asymmetrical breasts.

When patients didn't fall into one of those categories, Corbin allegedly created fake medical profiles for them. For instance, in the records of one 21-year old patient, he allegedly changed her chief complaint from "small breasts" to "small, drooping breasts" (she wore a 34B), because women who require a surgical breast life that will include the removal of some tissue are also allowed, by the rules of the clinical study, to receive gel implants.

The FDA began investigating Corbin's practices in 2001, when staffers began to share damning stories. His operating-room technician's statement to law enforcement officers, for instance, was particularly graphic. She told investigators that in early 2001, prior to a routine audit by Mentor, in which the company examines doctors' records to make sure they're adhering to the rules of the clinical trial, she warned Corbin that the office logbook contained notations about the imported French implants. He allegedly responded, "I can't believe you kept such good records...You could f*ck me with these...You're gonna have to rewrite all this." Neither Corbin nor his attorney responded to requests for comment.

To potential patients, Corbin undoubtedly appeared upstanding. He maintains officers in two tony locations, and his website touts his 20 years of experience as well as his membership in the American Society of Plastic Surgeons (ASPS). But if anyone chooses to search the Medical Board of California website, they would find that he has run afoul of the law before. In 1992, he was arrested and accused of fabricating as office visit to help a patient commit insurance fraud. He pleaded no contest to a misdemeanor (a reduced charge), paid a $4,000 fine, and performed 25 hours of community service, Still, the Medical Board of California placed him on two years' probation. Then, several years later, St. Jude Medical Center in Fullerton, California, revoked his staff privileges, because he failed to mention the charges against him during a routine application process at the hospital. In 1999 the state medical board issued a Public Letter of Reprimand, which defined the infraction and is available to the public on the board's website.

The question of why a successful plastic surgeon would jeopardize his practice over a few surgeries is open to speculation, but financial gain is the leading theory among some plastic surgeons. Doctors pay more for silicone than saline, but in Los Angeles, where women are savvy about implants, establishing a reputation as the surgeon to go to for silicone could be lucrative. Can a doctor gain a competitive edge by offering silicone when other doctors wouldn't? "I'd say the answer is yes," says Steven Teitelbaum, a plastic surgeon in Santa Monica. Another doctor explains that patients can be quite persuasive in their requests: "I've had patients says, 'I don't know why you won't put silicone in me, because there are other doctors who will,'" says Michael McGuire
, associate clinical professor of plastic surgery at the University of California in Los Angeles. "I'm sure I've lost patients because I wasn't willing to go out on a limb to give them silicone."

If the allegations are true, Corbin isn't the first doctor to bolster his practice (or fatten his wallet) by providing patients with illegal implants. In 1995, a federal grand-jury returned a 15-count indictment against J. Dan Metcalf, a family practitioner in Oklahoma City, who bought hundreds of silicone implants from Brazil, using them not only in his own patients but also selling them to other doctors. "Importing an unauthorized medical device is potentially dangerous," says Bruce Cunningham, president of the American Society of Plastic Surgeons. "There's no way to know the provenance of the device. It could be a blackmarket imitation that doesn't meet U.S. standards with respect to design or production."

Blatant lawbreaking is rate, experts believe. But many plastic surgeons admitted that a number of doctors bend the rules regarding silicone by exploiting unintended loopholes in the clinical-study guidelines. "There is some wiggle room, and some doctors are willing to wiggle more than others," McGuire says. For instance, doctors are allowed to use silicone implants in patients with severe asymmetry, but the guidelines don't specify how asymmetrical the breasts have to be. "The truth is, all women's breasts are asymmetrical, and the road from normal to abnormal is subjective," says one doctor who asked not to be identified. "A lot of surgeons liberally interpret those requirements to give patients silicone."

Doctors also are allowed to replace saline implants with silicone for a number of reasons--if the breasts look rippled, say, or the implants leak--a gray area that even some patients know to use to their advantage. "A woman can say, 'My left breast is smaller than it used to be, and I'm sure the implant is leaking,'" McGuire says. "The doctor may suspect she's doing it to get silicone, because usually a saline leak is obvious. But saline can also leak slowly over time, and if a woman believes her breast size has changed, it's hard for a doctor to disagree. After all, a woman lives with her breasts every day."

The clinical-study guidelines for reconstruction after a mastectomy are more clear-cut, but some doctors feel they indicate an inconsistency by the FDA. After all, they ask, if silicone is dangerous, why would women who have had cancer be allowed to use it? "The FDA knew they couldn't deny silicone to the breast-cancer population, because saline is generally not as effective in reconstruction patients," says Scott Spear, professor and chairman of surgery at Georgetown University Hospital and, as a consultant for implant manufacturer Inamed, one of the few plastic surgeons who attended the first FDA panel meetings about silicone. "The ethicist on the FDA's scientific panel in the early 90's pointed out that if they're safe for some women, they should be safe for all, but the FDA didn't see it that way," Spear says. Over the past decade, dozens of scientific studies have not been able to demonstrate silicone as a cause of illness, according to Casas. In 1999, the National Academy of Science's Institute of Medicine reviewed the scientific studies on the safety of silicone and concluded that women with gel implants are no more likely than anyone else to develop cancer, connective-tissue diseases, or neurological problems, findings that were echoed by a study on connective-tissue diseases published in the New England Journal of Medicine the following year.

Based on the evidence, a scientific panel convened by the FDA in April 2005 voted to reapprove Mentor's gel implants. In the summer of 2005, the FDA declared both Mentor and Inamed breast-implant devices approvable, provided that plastic surgeons receive training to use them, and the companies establish an independent committee to review the results of its ongoing clinical trials. Most experts believe that the FDA, which typically follows the advice of its scientific panels, is poised to greenlight gel-filled implants for the widespread use again once the public-comment period expires in October.

Still, detractors exists. Most recently a study found platinum in the blood, hair, urine, and breast milk of 16 women with implants, some of whom had the implants removed because of health problems. (Platinum is used to transform silicone into a harder, gel-like form.)In a letter dated June 30 to Acting FDA Commissioner Andrew von Eschenbach, Rosa DeLauro, a Democratic congresswoman from Connecticut, cited the study and said it demonstrates the need for more research. Although the FDA review on the subject, on June 16, 2006, said that the research so far suggests that platinum in implants poses very little risk, DeLauro's letter may carry some weight because she sits on the committee that decides the FDA's funding. "When she sends a letter of this type, it's important," says Diana Zuckerman, an epidemiologist and expert on women's health who is president of the National Research Center for Women & Families, a nonprofit organization. "We'd like the FDA to do its own research, rather than relying on research funded by implant manufacturers."

Plastic surgeons point out that the Institute of Medicine research was funded by the government. The biggest problem with silicone implants, from their point of view, is how to tell when an implant ruptures. "Silicone is a thick gel and doesn't pour out when the sack breaks, so most ruptures aren't obvious," Casas sys. "The best thing we can do is see patients regularly, preferably every year. If the implant remains soft, and you can displace it evenly in all four directions, it's probably intact."

Even if an implant leaks, most doctors don't believe it would cause severe health problems, because the gel is so thick it usually doesn't migrate far. When the ASPS surveyed nearly 1,000 plastic surgeons in 2005, 93 percent says there were rarely a significant problem with rupture. "Silicone is legal in every other country except Canada and has been for years," McGuire says. Silicone implants account for over 90 percent of the augmentation market outside this country, and assuming they receive approval, most experts say their use is likely to soar in the United States and Canada, as well. "Our surveys indicate that the vast majority of plastic surgeons plan to use them in their practice," Cunningham says.

It's quite possible that Corbin won't be among the, however. If the jury finds him guilty, he could face up to ten years in jail and lose his license to practice medicine. Many of his colleagues view this kind of infraction with mixed feelings. "We've all been frustrated by the ban on silicone," Casas says. "Having only one type of implant limits our ability to give each patient the best possible results--it's like living in a country with only one type of car." Teitelbaum adds, "The ban put doctors in a compromised position. We're obligated to abide by the law, but ethically, we should follow the science, and the science of silicone shows not only that it's safe, but also that it's a better implant. If the Hippocratic oath is about doing what's right for the patient, in one sense Corbin did the right thing."

2006-09-13T12:32:00.000-07:00

DR. McGUIRE'S TIPS ON HOW TO AVOID PLASTIC SURGERY

1. RELAX

2. STAY ACTIVE - MENTALLY AND PHYSICALLY

3. DON'T OVEREAT - DON'T GO ON "FAD" DIETS - EAT ALL TYPES OF FOOD

4. DON'T JOG - LOW IMPACT EXERCISE ONLY

5. DON'T SMOKE

6. DON'T DO FACIAL EXERCISES

7. DON'T GET A TAN - OUTDOORS OR IN A MACHINE

8. AVOID SMOG

9. AVOID CONTACT SPORTS

10. DON'T GET PREGNANT

11. DON'T GO TO UNQUALIFIED, GREEDY "QUACK" SURGEONS

12. SELECT YOUR PARENTS CAREFULLY

MYTHS ABOUT PLASTIC SURGERY

1. Plastic surgery is the same as cosmetic surgery.

2. Plastic surgery is vanity surgery.

3. Plastic surgery is called that because they use plastic materials.

4. Breast implants, especially silicone ones, are dangerous.

5. Liposuction is dangerous.

6. Plastic surgery can:
a. Save my marriage
b. Get me a better job
c. Change my life

7. I cannot afford plastic surgery - it's just for the very rich.

8. There is no need for liposuction - you just need to diet and exercise.

9. There is no way to delay the aging process.

10. Chemical peels are harmful and worthless.

11. Lasers can do anything.

12. Real men don't have plastic surgery.

13. If you want to have your nose done, then you should go to someone who only does nose surgery; if you want to have your eyelids done, then go to an eye plastic surgeon, etc.

2006-09-06T08:01:00.000-07:00

OPERATION CELEBRITY: Part 2

Starstruck physicians and their staffs sometimes overlook routine procedures when someone well-known arrives at the office. "There have been times when I had to chastise a colleague or employee for asking for an autograph," Polis says. And while she is supposed to do a full-body cancer check as part of every initial consultation, Polis admits that when she first started her practice, she was too intimidated to demand them from celebrities. "Can you imagine a new, young dermatologist asking a major box-office star to disrobe for a skin exam when he just came in to get a pimple injected?" she asks.

Barron Lerner, a physician and medical historian at Columbia University, calls this condition the "VIP syndrome." Lerner has studied famous patients for his forthcoming book, When Illness Goes Public (Johns Hopkins Press), and says "Celebrity patients may get worse care because they intimidate their physicians. Doctors, enamored of their patients and distracted by their fame, may not be willing to speak up when they disagree with their patients'
requests or demands."

When bad plastic surgery happens to celebrities; their respective spin machines go into high gear. Sophia Loren was rumored to have had a heart attack after getting liposuction, but she denied it, saying she had just accompanied a friend to the doctor. After a big television star was allegedly burned by an ultrasonic liposuction cannula, her publicist filled the gossip columns with news about a traffic accident. One of the longest-running stories involves Star Jones Reynolds and her near-fatal complications following a breast lift. After losing 150 pounds from unconfirmed gastric-bypass surgery, the talk-show host had allegedly been turned down for the breast procedure by one surgeon because she had a low blood count. Jones found a doctor willing to perform the surgery, but after the procedure, she began to bleed uncontrollably. A transcript of the 911 emergency tape obtained by the New York Daily News quotes someone from the clinic saying, "We have a patient who is on our surgery table who we cannot stop from bleeding." And although initially Jones tried to deny the incident, she confirmed it on The View a few days later, saying "I did not almost die...[the doctors] knew I was anemic and, just in case I ended up needing some blood, which I did, they were prepared. They gave me the blood, and literally I was fine right afterward."

Even when the surgery itself is a success, the recovery can go awry when the patient disregards doctor's orders-and celebrities seem to be especially guilty of this. "They will squeeze major liposuction into insufficient recovery time," Hoefflin says. "You can't do a movie a week later and keep within the safety box." They've also been known to ignore orders to quit smoking or drinking, which can compromise healing.

And some stars simply cry to bulldoze over their physicians' advice. Patrick
Sullivan, a plastic surgeon in Providence, operated on a 42-year-old Broadway
actress who wanted to bring her own staff to care for her after her procedures--accept that they were fellow actresses with no nursing experience (she trusted only her friends to keep her confidence). Sullivan balked end insisted that she have a registered nurse visit her daily during her recovery.

Despite confidentiality agreements signed by hospital personnel, photographers and reporters often seem to find out when a celebrity is leaving a surgical facility. Plastic surgeon John Grossman recalls one dramatic departure from his Denver clinic when a singer had to put on green scrubs and walk out flanked by nurses all dressed identically, just so she could slip past the paparazzi waiting outside. Soon after her marriage to Michael Jackson, Lisa Marie Prealey had some body surgery performed by Edward Terino, a doctor with a practice in Thousand Oaks, California. But with photographers hiding behind every bush, Presley fled with a blanket over her head. {Terino is popular with fellow Scientologists because he practices "silent surgery"-no conversation or music is allowed in the operating room on the principle that it might be heard by the anesthetized patient subconsciously and affect her later.)

After all the complicated arrangements to keep everything quiet, famous patients often slip up and give away their own identity. Gerald Pitman, who practices in Manhattan, remembers a world-renowned pop star who called the doctor at home after having surgery. When Pitman's young son answered and asked who was calling, the patient gave his real name, and the child's jaw dropped. Pitman had to lecture his son on the importance of honoring patient privacy. "I'd as soon give a name of a patient as jump off a bridge," Pitman says. Another of Pitman's famous patients checked into the hospital under a pseudonym and promptly forgot to use it. Later, one of Pitman's colleagues let him know that "the lady who pushes the gurney tells me you're operating on so-and-so."

Because of their patients' need for secrecy, surgeons can rarely get praise for their work on famous faces and sometimes another doctor will take the credit, because the real doctor can't protest without revealing confidence". According to one surgeon, the only benefit to operating on a star besides the financial one-if the star actually pays-is "the occasional free ticket to a concert." The downside is that celebrities can take advantage of their doctors, asking them to rush to Malibu in the middle of the night to stitch up their child's cut knee. (One surgeon was allegedly called out of drug rehab to give Botox to a star halfway around the world on a concert tour.)

The very rich and titled can be even more difficult. Grossman has several patients who are Middle Eastern royalty. "Once, on vacation in Santa Fe, I got a call that 'Her Highness needs to see you tomorrow,'" Grossman remembers. "I flew to Beverly Hills and sat for several hours in a garage with her security people. Finally, I said, `I don't have any more time' and left. Afterward, there were great apologies and gifts.

"For some doctors, its easier to discuss celebrity plastic surgery than to actually perform it--and just as beneficial. One publicist advises his surgeon clients to send out press releases speculating about whether Tom Cruise got Botox or Ashlee Simpson had a recent nose job. The fact that these doctors have never met the celebrity in question is immaterial, says the publicist: "The public thinks they did. It's less headache, and the doctors themselves bccome celebrities." Two different plastic surgeons even have websites devoted entirely to gossip about stars they have never touched. However, this can backfire, as it did with Sharon Stone and Renato Calabria, a Beverly Hills plastic surgeon. When articles in Us Weekly and In Touch about Calabria's
alleged work on Stone later appeared on Calabria's website, Stone took legal action. Though he wasn't quoted as the source of the information, Stone sued Calabria for defamation. Stone later dropped the suit, and Calabria agreed to perform surgery on disadvantaged children. Naomi Campbell is suing Jean-Louis Sebagh, a French dermatologist, in a London court for £50,000 for ads in Hello! magazine that implied that she endorsed his products. In her snit against the doctor, Campbell denied needing or having any cosmetic procedures, and has used the popular expression, by way of explanation,
'Black don't crack.' (At press time, the suit was still pending.)

With all of these problems, many doctors wondcr if celebrities are worth the trouble. While being chosen by a star is flattering, Baker says, "You'll get more referrals working on a housewife who'll tell her friends." Therefore, he says, if a superstar wants surgery, he puts a financial premium on it. "They rake a lot of extra time," Baker explains, "They expect it, and they demand it." So when a celebrity tells reporters that her youthful figure is a product of exercise and healthy living,
and not her liposuction, doctors tend to understand the subterfuge. "When you are a patient on a TV talk show ascribing her good looks to clean living and genetics," says Craig Foster, a Manhattan-based plastic surgeon, "it gives you a small degree of satisfaction knowing you gave God and Mother Nature a little boost."

2006-09-03T11:38:00.000-07:00

OPERATION CELEBRITY

They want to look young and they demand the best doctors, but they don't want to follow orders or pay their bills. When stars get plastic surgery, they have a list of requests-and some of them could prove risky. By Joan Kron

It looks so wholesome, in a Hollywood sort of way-a beautiful actress walking across a soccer field in a Beverly Hills park with her young son, lugging a folding chair to his weekly game. But nothing is what it seems. While the paparazzi try to get a shot of Tom and Rita or Warren and Annette and their little athletes, this actress looks around furtively for one of the soccer dads, who happens to be a publicist for a local cosmetic surgeon. He has arranged a face-lift consultation for the 35-year-old right here on the sidelines. After an introduction, some small talk, and a few cheers for the kids, the doctor says to her, "Face me, but look straight ahead." She lifts her chin and flips her hair out of her eyes, pretending to watch the game. The doctor examines her inconspicuously and pronounces his diagnosis sotto voce. The actress nods and whispers to him that she'll send her assistant around on Monday to make arrangements.

Celebrity plastic surgery is a clandestine world unto itself with its own rules, lies, codes of behavior, disguises, assumed names, and risks. Its driving force is a simple truth, best articulated by Cher in an interview on her sixtieth birthday: "Looking your age is not a great thing in our business." With that in mind, many stars do whatever is necessary to keep their youthful appearances--and their jobs. "Almost nobody [in Hollywood] doesn't get surgery," says Michael McGuire, a Santa Monica plastic surgeon and former president of the California Society of Plastic Surgeons. But he says that famous people approach the process differently than civilians. "They don't want dramatic changes," he explaxos. "They do their cosmetic surgery in small bites."

It would seem that celebrities, who have the best of everything, would also have the finest medical care that money and their considerable influence can buy, but that's not always the case. Stars often put themselves at risk by their demands for anonymity, their insistence on special treatment and rushed recoveries, and their tendency toward impulsiveness. Daniel Baker, a New York City plastic surgeon, says that he spends as much time talking stars out of surgery as he does actually perating on them. "Sometimes when actors aren't busy, they think, maybe I'd better do some-
thing-and then they screw themselves up." Many of them want after-hours consultations when a doctor's full staff is not present (which removes another safety measure), or they want the surgeon to visit them on movie locations or at home. Essentially, they want the work done, but without any publicity, inconvenience, or detectability.

While most people believe that celebrities are completely within their rights to keep their cosmetic procedures private, "the obsession with secrecy is probably the main obatacle to good patient care," says Steven Hoefflin, a Santa Monica plastic surgeon who has worked on many famous faces. Hoefflin says the use of aliases, for example, turns office visits into a nightmare. Once in his practice, the book that decoded all of the Hollywood pseudonyms got lost, so no one could get patients' charts when
they returned for checkups and more work. According to Hoefflin, celebrity patients often won't even submit to regular physical exams and blood tests. And forget about stars filling out their patient-history forms themselves. "They just assume it will be `taken care of'" says Laurie Palis, a New York City dermatologist. 'They routinely leave off personal contact information from forms, presumably to insure their privacy. But after finding ourselves unable to follow up without a lot of hassle, we
realized that was not acceptable."

While many performers wouldn't dream of dickering about price (in some cases, according to McGuire, they fee(the more expensive the work is, the better it will be), others expect to receive surgery gratis, as if it were a pair of Joe's
Jeans or Dior sunglasses. Hoefflin recalls the ingenue who switched to another doctor when she discovered he was actually going to charge her, Anthony Griffin a Beverly Hills plastic surgeon featured on Exrreme Makeover, is still smarting from the actress who wanted a breast reduction right before a big awards event. "She said, 'I need it done tomorrow,'" the doctor remembers. "We moved things around to accommodate
her, made home calls on Sundays, and when I sent the bill, she never paid it."

PART TWO TO BE CONTINUED...

2006-08-22T09:17:00.000-07:00

THIN LIPS SINK SELF-ESTEEM
Despite all of the great advances in facelift surgery, eyelid rejuvenation, and surgery to improve the contour of the neck, one area in the face that has remained a problem for cosmetic plastic surgeons has been the upper and lower lips and the surrounding skin. Many changes occur in the lips with time, and to improve the appearance of the checks and forehead, eyelids, and neck without including the area around the mouth is an incomplete success. The aging lips unmask the "secret" that the "natural" improvements achieved in the rest of the face were actually the result of surgery: The lips do not match the rest of the face.

The changes that occur in this area include wrinkle lines, into which lipstick may "bleed" thinning of the red lip vermilion and elongation of the upper lip skin so that the teeth are completely covered. Even younger people who have not yet faced he ravages of time may have lips that are not full enough or shapely enough. They resort to "fillers" which include collagen, fat, or muscle fascia, all of which tend to disappear in a relatively short period of time. Alternatives include various implants, most of which are a type of plastic and may result in a very stiff, immobile, numb, and misshapen lip contour that can be difficult to correct. While I have used all of these materials in the past, I always said that fillers and implants either disappear too quickly, or you wish they would disappear.

For both groups of patients, the goal is a lip that is more shapely, fuller, and yet natural in appearance, motion, and probably most important, feeling. The lip has an extremely important role in our interaction with others and anything that interferes with the motion and feeling of the lip is certainly not worth a superficial improvement in appearance. Until recently, there was no procedure or technique that answered the two basic requirements for lip improvement; to improve the appearance and appeal of the lips while preserving the normal, subtle, supple motion and feeling of the lips.

About six years ago, based on my earlier work with lip reconstruction, including children with cleft lip, and after studying the anatomy of the problems in lips due to aging or other reasons, I developed two procedures for lip enhancement and rejuvenation, which I call the lip lift and the lip tuck.

The lip lift is a procedure to shorten the skin of the upper lip for people who have an unattractive balance between the upper and lower lip areas due either to aging changes, or familial tendencies. As the lip skin elongates with age, patients develop a very undesirable creasing across the upper lip area just below the nose with smiling. This is the first procedure that I know of that can treat this problem, and shorten the skin length so that it has a more aesthetic balance and youthful appearance. The surgery is done at the base of the nose in the natural crease, and the scar is virtually invisible.

The other procedure is the lip tuck which is done at the junction between the red vermilion and the skin of the upper lip at a place where I've discovered that the scar is excellent and usually invisible. A strip of skin can be removed, eliminating most of the deep wrinkle lines in people who have that problem. A "tuck" can be taken in the underlying muscle to give a fuller upper lip, while at the same time rolling the red vermillion outward to give a slightly bigger, and more aesthetic upper lip shape and contour. In those people lacking much of a shape to the upper lip --
thc "Cupid's bow" -- this can be improved with the surgery, and there are numerous possible applications. In older people who virtually lack any red vermillion at all, it can provide a natural modest vermilion so that lipstick can once again be worn. In younger people who lack lip fullness and shape, it can enhance the lip and improve its shape much better than collagen or any other filler or implant ever could. The surgery uses your own tissues so there is no foreign material, and nothing to dissolve. The effect is long-lasting, since I now have patients who are six or seven years post-op, and they have maintained the shape and fullness of their lip. I have done this procedure in people of all ages. both men and women, and the results have been extraordinary.

Both the lip lift and the lip tuck can be done under a local anesthesia with very little pain involved, using a gel anesthetic. Mild sedation can be used if desired, but general anesthesia is never necessary. I have performed this surgery on dozens of patients, without a single complication. I've even salvaged some patients who were "victims" of implants done by other surgeons that had left them with stiff, misshapen lips.

In this area of "unsolved" aesthetic problems, I think a real solution has been found and I'm really excited about the dramatic results that can be obtained with this surgery. A lower lip tuck can also be done at the same time, to enhance and enlarge the lower lip with similar excellent results. For those of you tired of painful, expensive and frequent collagen or fat injections, and those who have undesirable shape and stiffness following implants in their lips,
this is an alternative to seriously consider, and I would be happy to show you numerous results of the surgery in all kinds of situations. Thin, misshapen lips no longer have to sink your self-esteem, and you can have more beautiful lips to enhance your beautiful smile, reflecting your lifted self-confidence.

Be sure to visit Dr. Michael McGuire's site for before and after cosmetic surgery pictures at: http://www.michaelmcguiremd.com/

2006-08-11T12:12:00.000-07:00

BREAST ENLARGEMENT and BREAST AUGMENTATION

Note: click here to view breast enlargement procedure pictures and breast augmentation information

Now that the controversy and fear surrounding breast implants have been eliminated, surgery to enlarge the breast size has once again become one of the most popular procedures done in cosmetic plastic surgery. Last year, over 260,000 procedures were performed, a 24% increase over the last three years.

Women have breast implants placed for several reasons, principally to increase the volume of the breasts on both sides, but in some cases to restore a breast that has been removed for malignancy, and in other cases to improve symmetry when one breast fails to develop fully. For the past 14 years, implants used to enlarge both breasts could only be filled with saline (salt water), while the silicone gel implants were restricted for use in patients with significant asymmetry, or for reconstructive purposes only. Recent hearings before the Food and Drug Administration, at which Dr. McGuire testified about the safety of the implants, recommended that silicone gel implants again be available to all patients, just as they were prior to the controversy that began in the early 1990s. The final decision has not yet been made, but most patients clearly prefer the feel and more natural qualities of the silicone gel implant. In Europe, Japan, and the rest of the world where the implants have never been restricted, over 90% of women choose silicone gel implants. Their safety has been demonstrated by numerous studies over the past 15 years, and they do not interfere with mammography, or increase the risk of breast cancer.

The surgery is individualized for each patient depending on her goals, and the size of the implant is determined in discussions with the patient well before the surgery is performed.

There are a number of options regarding exactly how the surgery is done, all of which will be outlined for you by Dr. McGuire during your initial extensive and comprehensive consultation. Please bring your questions with you at the time of the consultation, and allow enough time for a thorough discussion with Dr. McGuire and his staff.

http://www.michaelmcguiremd.com/

2006-08-11T12:03:00.000-07:00

LIPOSUCTION (LIPOPLASTY) The Most Common Operation Performed In Cosmetic Plastic Surgery Today

Note: click here to view Liposuction procedure pictures and Liposuction information

Liposuction; Los Angeles Area Office.
The most common operation performed in cosmetic plastic surgery today is liposuction, which is a safe, effective, and long-lasting method to remove unwanted fatty tissue from multiple areas of the body. It is not a weight loss procedure, but rather designed for those areas that are resistant to normal diet and exercise in patients who are generally not obese. Multiple areas of the body can be treated at one time, depending on the volumes involved, and the result can be a true transformation of the patient's body shape and size.

Liposuction is dependent on skin tone for contour improvement, since nothing is done to the skin with the surgery. Small incisions are used for the various areas of the body, and most of them are well-hidden in creases or other inconspicuous locations. The tube used for the liposuction, or cannula, is very small, so only a small incision is needed for each area treated. The surgery is done under a light general anesthesia, and modern light general anesthesia is extremely safe and effective, with minimal postoperative problems and quick recovery. A compressive garment is worn for the first month after surgery to maximize skin contraction, and minimize swelling.

During your extensive consultation with Dr. McGuire, he will evaluate your skin tone to determine if you are an appropriate candidate for liposuction, or if other body contouring surgery is needed. The areas to be treated would be discussed with him, just as they would be marked on the day of surgery while you are still awake before any anesthesia. Bring all of your questions with you when you come for your consultation, and be prepared to discuss everything with Dr. McGuire and his staff.

Change your life with liposuction. Los Angeles based office is taking appointments for consultations today.

http://www.michaelmcguiremd.com/

2006-08-11T11:41:00.000-07:00

FACELIFT / NECKLIFT. What Is A Natural Facelift or Necklift

Note: click here to view face lift procedure pictures and facelift information

Over time, many changes occur in the tissues of the face and neck, including gradually increasing skin laxity, loss of muscle tone, and progressive descent of the fatty tissues of the face. The full cheekbones of youth gradually fall towards the corners of the mouth, creating creases between the nose and mouth, as well as below the lips. Fat in the cheeks gradually falls into the jowl area, and loss of muscle tone creates the bands that gradually appear under the chin in the neck area. There is loss of jawline definition, a "double chin" may develop, and all of these changes are exacerbated by sun damage, which accumulates over many years.

Unlike the old facelift, which concentrated only on tightening the skin, the modern approach addresses all of the components of the changes that occur, including the muscles and the fatty tissues. By tightening the muscles and elevating the fat, less tightening is necessary in the skin, which therefore avoids the artificial, tight appearance of the older facelift, and gives a much more natural, and even more dramatic, improvement. The improvement is less artificial, and longer lasting, since the result is not dependent on pulling the skin. The skin-type facelift was not effective around the mouth, and the long-term results were not very significant, since the real problems of the fatty tissue and lax muscles were never addressed. The goal of the surgery today is to make patient's look dramatically better, but not different. They look more like they used to look, since the surgery reverses many of the changes that have occurred over time. The best result occurs when friends and acquaintances notice that you look much better after the procedure, while not recognizing why you look better. It is usually not a good result when someone says, "Oh, you had a facelift," since people principally notice artificial change, an unusual appearance, or a "done" look.

The "natural" facelift, which Dr. McGuire helped develop, is a dramatic improvement, and his patients have been thrilled with the results. The same approach is used in the neck area, tightening the muscles that create the bands, reducing the fatty tissue that gives the double chin, and tightening the skin in the neck to restore the normal contours, jawline definition, and chin shape. Face and neck lift surgeries are frequently combined, although they can be done separately, and surgery on the eyelids and eyebrows can be done under the same anesthesia. The surgery is done under a light general anesthesia, which is extremely safe today, especially since all of the anesthesiologists in Dr. McGuire's Pacific Coast Plastic Surgery Center are board-certified physicians that specialize in outpatient anesthesia. Patients wake up more quickly after the surgery is completed, with much less nausea than before, and return to normal activities sooner with less drug effect. Dr. McGuire is extremely meticulous in performing the surgery, which takes a number of hours to perform correctly, but with the modern anesthetic techniques, the length of surgery is no longer a factor. Postoperative pain is minimal, and the visible sutures are all removed within the first week.

Each patient is different, and the surgery that is performed on each patient varies slightly depending on the specifics of a patient's skin, fatty tissue, and muscle tone. Dr. McGuire evaluates each patient at the initial consultation, and a specific proposal for surgery to improve the problems of each patient is developed at that initial visit. Please allow adequate time for a thorough consultation and discussion with Dr. McGuire and his staff, as well as to review pictures of typical results from this truly dramatic and advanced technique.

Specializing in the "natural" facelift. Santa Monica office is taking appointments for consultations now.

http://www.michaelmcguiremd.com/

2006-08-09T10:38:00.000-07:00

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