A new crop of medical students will begin a residency in plastic surgery this summer. They have worked long and hard to secure these coveted spots.  As a service to them and to the profession, I wanted to take this opportunity to help make their path a little easier by offering a bit of advice.

When asked what you do, simply say that you are a surgeon. I avoid saying plastic surgeon because it invariably prompts awkward facial expressions and comments to the effect that I am just the person they’ve been waiting to meet, nod nod, wink wink! In many people’s minds, plastic surgery is synonymous with cosmetic surgery, yet I do no cosmetic surgery. This usually strikes people as very odd. A plastic surgeon who doesn’t do cosmetic surgery is like an auto-mechanic who doesn’t fix cars, or a teacher who doesn’t teach.

So what do I do? Strictly speaking I should describe myself as a reconstructive microsurgeon, although that usually draws blank stares. The truth is that while cosmetic surgery is probably the most visible and perhaps the most glamorous aspect of plastic surgery, it’s a relatively small part of the specialty. The breadth of the specialty fills a six-volume Plastic Surgery textbook I edited this year.  Only one of these volumes is dedicated to aesthetic surgery.

Some say that plastic surgeons are the last general surgeons. We don’t own a disease like cancer doctors do, and we don’t own a part of the body like heart surgeons do. We work all over the body on all kinds of diseases and frequently with other physicians in a multidisciplinary group. We’re not only misunderstood by the public, but also by many of our medical colleagues.

- See more at: http://www.kevinmd.com/blog/2013/06/plastic-surgeon-requires-lot-explaining.html#sthash.NrdBecS5.dpuf

These are some interesting statistics from the American Society for Aesthetic Plastic Surgery.  I do a lot of lifting procedures and find that these have some of the highest satisfaction rates in plastic surgery.  One thing that surprised me, 80% of people who lose weight gain it back!  That’s a disappointing number.  I wonder how these numbers may be applied to the various diets?  Some probably have higher rates of recurrent weight gain than others.

‘I never fixed my eyes, but I spent more  money to stretch the skin of my testicles. I did not like the wrinkles. It’s a new  technique, many people in Hollywood have done it. It’s called ‘ball  ironing.’”

Now a Beverly Hills nurse beautician actually offers a similar treatment, called the “Male Laser Lift” or “Tighten The Tackle.”  The $900 procedure consists of evening out skin tone, removing discoloration from ingrown hairs, removing skin tags  and providing an overall tightening to the external skin.

Is this is come on?  The article in the Daily Mail is pretty detailed, and even includes Top Ten Male Beauty Secrets that are pretty much on the mark.  You can read the article HERE.

Photo credit: prphotos.com

The video says it all. So why did this man’s doctor remove his nose? This is pure speculation, but an infection of the cartilage of the nose, such as by MRSA, could result in the cartilage being destroyed. This could cause the nose to collapse, and necessitate actual removal. So what should people take away from this?

This man’s surgeon is not certified by the American Board of Plastic Surgery. I’ve written it before many times: A cosmetic surgeon is not the same as a plastic surgeon! Make sure to do your homework. If you want plastic surgery, see a REAL plastic surgeon. If you aren’t sure if your doctor is one, then visit www.surgery.org or www.plasticsurgery.org. If you are having plastic surgery of the face, then a surgeon certified by the American Board of Facial Plastic Surgery is considered an equivalent in all states.

I’m a fan of Jimmy Fallon, and look forward to the day when he replaces Jay Leno at the Tonight Show. Some of you may have heard that Jimmy and Bruce Jenner had a run-in at the Olympics, where Bruce showed his displeasure at jokes that Jimmy made about his plastic surgery. Here is a video of Bruce’s recent appearance on Jimmy Fallon’s Late Night, where he basically takes the show over and gives Jimmy a bit of payback!

Darn, does Bruce look waxy!

From 2001 to 2011, eyelid lifts charged to Medicare more than tripled to 136,000 annually, according to a review of physician billing data by the Center for Public Integrity. In 2001, physicians billed taxpayers a total of $20 million for the procedure. By 2011, the price tag had quadrupled to $80 million. The number of physicians billing the surgery more than doubled.

Plastic surgeons say there are a number of legitimate reasons for the spike, including a tendency among the elderly to seek fixes for real medical issues they might have quietly suffered through even a decade ago. But surgeons also acknowledge an increased awareness of the surgery fueled by reality television, word-of-mouth referrals, and advertising often including dramatic before-and-after photographs that promises a more youthful appearance. And doctors concede they face increased pressure from patients to perform eyelid lifts, even when they do not meet Medicare’s requirement that peripheral vision actually be impaired.

In my practice, I haven’t seen an increase in the number of seniors having this covered by Medicare.  Medicare has specific guidelines for what is needed to get an eyelid lift covered.  That being said, it’s possible for some patients (and doctors) to game the system by falsifying visual field testing.  I’ve had more than one patient ask me to bill insurance for their eyelid lift when it’s not indicated.  I just tell them that I don’t commit fraud.

Here is a video I did for Fox News of an eyelid lift that was billed to insurance (appropriately!):

For more on this story, visit Salon.com.
 

So what do I think?  Currently, there isn’t enough scientific data to confirm or deny safety of Botox in pregnancy.  Not surprising, since what mother-to-be in her right mind would enter a trial that exposed her developing fetus to one of the most powerful toxins in the world?  So IF Kim is using Botox while pregnant, then she seriously needs to get her head examined, and her plastic surgeon needs to be reprimanded!

I bet the lack of wrinkles that we see on Kim’s face is probably just due to good makeup and youthful skin.

Photo credit: prphotos.com

This is a fascinating video from Newsy about a new trend in Korean plastic surgery: the double jaw surgery. This is an operation where the jaw is broken in two places, reshaped, and wired shut for six weeks. Apparently, many South Koreans are having this done in order to thin their jawlines to look more ‘attractive.’ It’s an excruciatingly painful, invasive operation. I should know. I’ve had it done.

I wrote about this in my book “In Stitches,” but during high school my jaw grew to epic proportions. I had trouble closing my mouth and eating. I thought I looked deformed. So I underwent surgery to break my jaw and set it back. And voila! It worked.

But it hurt like hell.

To anyone who is considering double jaw surgery and really, truly does not need it: Don’t Do It! Watch the video about to hear stories from people who’ve regretted it. If you do have a real orthognathic problem, though, make sure you see a reputable oral and maxillofacial surgeon. Don’t trust this surgery to just anyone.

I am really excited about the newest treatment we have at my office in Troy, Michigan. We’re now offering Miradry, the only FDA-approved, non-surgical solution to excessive underarm sweating, or hyperhidrosis. I’m actually the ONLY board-certified plastic surgeon in the entire state of Michigan to offer Miradry.

So what’s the scoop with Miradry? The device uses electro-magnetic energy (microwaves) to permanently destroy the sweat glands in the armpits. Local anesthetic is needed, and the procedure is performed in the office in about an hour. You can return to normal activities very shortly afterwards.

The studies so far are showing an 80-90% reduction in sweating at 2 years, with every indication that the results are permanent. RealSelf.com has greater than a 90% “worth it” rating. I’m really excited to offer my patients this revolutionary, game-changing treatment. If you have problems with excessive sweating of your armpits, then this treatment is for you!

To learn more about Miradry, feel free to call my office at (248) 273-7700 to schedule your complimentary Miradry consultation with my staff. Trust me, it really works.

Photo credit: prphotos.com

On April 27, I finished the three months of medical procedures that the mastectomies involved. During that time I have been able to keep this private and to carry on with my work.

But I am writing about it now because I hope that other women can benefit from my experience. Cancer is still a word that strikes fear into people’s hearts, producing a deep sense of powerlessness. But today it is possible to find out through a blood test whether you are highly susceptible to breast and ovarian cancer, and then take action.

My own process began on Feb. 2 with a procedure known as a “nipple delay,” which rules out disease in the breast ducts behind the nipple and draws extra blood flow to the area. This causes some pain and a lot of bruising, but it increases the chance of saving the nipple.

Two weeks later I had the major surgery, where the breast tissue is removed and temporary fillers are put in place. The operation can take eight hours. You wake up with drain tubes and expanders in your breasts. It does feel like a scene out of a science-fiction film. But days after surgery you can be back to a normal life.

Nine weeks later, the final surgery is completed with the reconstruction of the breasts with an implant. There have been many advances in this procedure in the last few years, and the results can be beautiful.

I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer. It is my hope that they, too, will be able to get gene tested, and that if they have a high risk they, too, will know that they have strong options.

Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of.

I applaud Angelina for coming forward and revealing her diagnosis and treatment.  Hopefully this helps to inform people not only about the potential diagnosis and treatment options for breast cancer, but also inform women about their reconstructive options.  Studies show that women who undergo immediate reconstruction after mastectomy benefit psychologically a great deal.

To read the rest of Angelina Jolie’s op-ed piece, click HERE.

If you’ve ever wondered how plastic surgeons reconstruct a woman’s breast after mastectomy, there is a very well-written article in CNN.com HERE.  I’m quoted in the article, which also describes how Angelina’s reconstruction was likely performed.

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“Dr. Youn, I want the works.”
Carol, an attractive Caucasian woman in her mid-forties, sat across from me in the consultation room. Her eyes stared into mine, unwavering.
“What do you mean by ‘the works?’”
“I want to enlarge my breasts, flatten my tummy, lift my neck, and skinny my thighs. Oh, and I want my eyes to tilt like Megan Fox’s, and I want you to plump my lips like Angelina Jolie’s.” She puckered and smacked her lips.
“Carol, that’s a lot of plastic surgery. Are you sure you need all this? Why do you want to have so much done?”
She paused. Her face flushed a bright shade of crimson red.
“Because,” she seethed, “My husband left me for a younger woman.
“And I want revenge.”

Revenge plastic surgery is becoming more and more common. A survey by the Transform Plastic Surgery Group in the United Kingdom found that over a quarter (26%) of their patients were recently divorced women. Eleven percent of their patients were newly single men.

Even Hollywood is getting involved in revenge surgery. The Real Housewives of Beverly Hills star Brandi Glanville recently revealed in her book, Drinking and Tweeting and Other Brandi Blunders, that she spent $12,000 to undergo rejuvenation of her private parts after breaking up with her then-husband Eddie Cibrian. She even paid for it with his credit card.

To read the rest of my article, click HERE to go to CNN.com

Crazy story about a plastic surgeon in Florida. Why does it seem that so many of the bizarre plastic surgery stories come out of Florida?

There are 17 individual sunscreen ingredients that are FDA approved: 15 of these are clear chemicals that absorb UV light and two are made of minerals that reflect UV light. Of these 15, nine are known endocrine disruptors. To be effective, chemical sunscreens need to be rubbed into their skin 20 minutes before sun exposure. They do a pretty good job at blocking UV light, but they actually get used up as the sun shines on them. In fact, some sunscreens lose as much as 90% of their effectiveness in just an hour, so they need to be reapplied often. This is not the case with zinc oxide and titanium dioxide, the two mineral, or physical, sunscreens. These two work very differently – they sit on the surface of the skin and physically block UV light.

Chemical sunscreens don’t sit on the surface of the skin – they soak into it and quickly find their way into the bloodstream. They scatter all over the body without being detoxified by the liver and can be detected in blood, urine, and breast milk for up to two days after a single application. That would be just fine if they were uniformly safe – but they’re not.

As I mentioned, nine of the 15 chemical sunscreens are considered endocrine disruptors. Those are chemicals that interfere with the normal function of hormones. The hormones most commonly disturbed are estrogen, progesterone, testosterone, and thyroid. Endocrine disruptors, like some ingredients in chemical sunscreens, can cause abnormal development of fetuses and growing children. They cause early puberty and premature breast development in girls, and small and undescended testicles in boys. They cause low sperm counts and infertility. Endocrine disruptors that act like estrogen can contribute to the development of breast and ovarian cancers in women, and other endocrine disruptors may increase the chance of prostate cancer in men.

Pretty scary stuff, isn’t it?  To be completely transparent, Dr. Perry does have his own line of skin care products, which include the sunscreen Zinc Oxide.  However, I’ve met Dr. Perry, read some of his books, and am in a committee with him for the American Society for Aesthetic Plastic Surgery (ASAPS).  He’s a solid guy and a very well-respected, board-certified plastic surgeon in New York City.  To learn about his line of skin care products, go to www.drperrys.com.

To read the rest of his article, click HERE.

Intouch used a photo from years ago on their cover and I hate it! The reason I’ve asked all magazines and blogs to stop using old photos of me is I don’t look like that anymore! I had a nose job to remove skin that was like a webbing in between my eyes. I wasn’t going to tell anyone, but I look so much prettier in my new photos that I don’t want old photos used anymore! I’m so sick of magazines and blogs using old photos! When will they stop? I will never look like that again! Having surgery was the most amazing thing for my confidence!

I’d consider that to be a nice endorsement for good plastic surgery, had she not come across lately as a troubled soul.  According to the Daily Mail, she’s also recently admitted to an eating disorder and has shaved half her head!  Hopefully she gets some help before something really bad happens.

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The former and now bankrupt America’s Next Top Model judge sits down with In Touch and dishes about going broke, planning her comeback — and the only surgical procedure she won’t consider — “butt implants!”

Despite recently declaring bankruptcy — a chunk of that stemming from “press whore doctors that offered to give me Botox and fix my teeth for free and then slapped me with bills” — Janice says she can’t recall exactly how much she’s spent on surgeries to date. “I don’t remember — all my ex-husbands paid for them!” she confesses to In Touch.

And although Janice admits to her first and only breast augmentation when she was 32 or “in the Jurassic era,” as she refers to her youth, she says her surgery list is short compared to other woman in Hollywood. “I had a tummy tuck and face-lift and currently do Botox and Restylane,” she reveals to In Touch, on newsstands now.

The rest of her face is hands-off! “I don’t get anything in my cheeks. I have perfect bone structure,” the buxom brunette tells the mag, adding, “My lips are mine!”

So she claims that her doctors performed the procedures for free, then billed her afterwards?  If true, that’s a strange practice.  The only time I bill patients afterwards is if insurance is involved, and they owe for copays or deductibles.

You’ve gotta admit that Janice is pretty hilarious and outrageous.  Hopefully she gets back on her feet again soon.

Photo credit: prphotos.com

“Arm lifts” have become one of the fastest-growing varieties of plastic surgery, a new study shows.

More than 15,000 women underwent an arm lift in 2012, an increase of more than 4,000% since 2000, according to a report out Monday from the American Society of Plastic Surgeons.

The popularity of the procedures isn’t driven by a desire to look as good as Michelle Obama does in a sleeveless sheath.

Instead, the surgeries are growing because more people are losing massive amounts of weight, usually through obesity surgery, says David Reath, a plastic surgeon in Knoxville, Tenn., and chairman of the public education committee for the plastic surgeon society.

About 200,000 Americans a year undergo some kind of weight-loss procedure, such as gastric bypass, says Jack Fisher, president of the American Society for Aesthetic Plastic Surgery, from Nashville.

While surgery can help people lose weight and fat, it doesn’t decrease the amount of skin, Reath says. People who lose 100 pounds or more can be left with a lot of extra skin.

“Once skin is stretched out, it becomes like a broken rubber band,” Fisher says. “Even when you lose weight, the skin doesn’t go back to its normal shape.”

The number of cosmetic surgeries increased by 3% last year, to nearly 1.7 million,  according to the American Society for Aesthetic Plastic Surgery. When non-surgical options such as botox injections are included, Americans had more than 10 million cosmetic procedures last year.

Arm lifts aren’t for everyone.

The surgeries can cost $5,000 or more out-of-pocket, Fisher says. And they leave patients with a scar that stretches from their elbow to their armpit.

The problem with the arm lift (aka brachioplasty) is that it leaves a long scar that extends from elbow to armpit.  The scar is visible when you wave at someone and lift your arm up.  For this reason, it’s usually reserved for people with a lot of excess skin, such as massive weight loss patients.  It’s typically combined with liposuction for an optimal result.

For the rest of the USA Today article, click HERE.

1) Eliminate unhealthy fat intake. Avoid margarine, deep fried foods and foods with trans-fat and saturated fat.

2) Increase your intake of monounsaturated oils. Use extra virgin olive oil, walnut, canola or flaxseed oils.

3) Eliminate the unhealthy “white” carbs. Avoid refined flours, sugars, white rice and foods high on glycemic index.

4) Eat plenty of whole grains. Brown rice and bulgur wheat.

5) Avoid refined and processed foods.

6) Include plenty of fruits and vegetables high in antioxidants.  Blueberries, strawberries and dark leafy greens like spinach and kale.

7) Hold the salt and spice it up.  Use more anti-inflammatory herbs and spices for seasoning. Curry, ginger, turmeric, cayenne, garlic and onions are all anti-inflammatory.

Eat lean protein sources like chicken. Reduce red meat and avoid full fat dairy products.

9) Eat fish high in omega-3 fatty acids. Salmon, arctic char, sardines, anchovies, black cod, mackerel and even oysters are excellent sources.

10) Drink red wine in moderation. One or two glasses daily

I like it.  It’s similar to dermatologist Dr. Jessica Wu’s Feed Your Face diet, which also focuses on avoiding foods with a high glycemic index.  To read the rest of Dr. Tornambe’s article “The Plastic Surgery Diet,” click HERE.

“I don’t think he’s found the Fountain of Youth, but I think he’s done the next best thing — found a good plastic surgeon,” says Youn,  a regular contributor to msnbc.com and TODAY.com. “He looks like someone who has had a plethora of the best cosmetic treatments available.”

Youn, who hasn’t treated Cruise, believes he’s had multiple procedures done. “To look as good as he does, it’s not possible to have had just one thing done.”

For more of my analysis, check out the link HERE.

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1. I was privileged to be invited to be on the Media Relations committee for ASAPS, along with several other very prominent plastic surgeons.  Although our committee is small, it’s a virtual who’s who in famous ‘media’ plastic surgeons today, including Dr. Andrew Ordon from “The Doctors,” Dr. Brent Moelleken from “Extreme Makeover” and “Plastic Wives,” Dr. Arthur Perry who co-authored the “Me” books with Dr. Mehmet Oz, and Dr. Steve Teitelbaum, chair of the committee and frequent television commentator.  I look forward to working with these great doctors to exert a positive influence on today’s media.

2. “Hot Topics” is my favorite session at the annual meeting, as this five hour course reveals the most newsworthy items in our field.  Some highlights included Exparel (a new medication that might make pain pumps obsolete), the Lifestyle Lift, Nonsurgical Fat Reduction, and the award for the worst, overhyped gimmick of all (the fad of thread lifts).

3. Two of the most talked-about subjects in plastic surgery are the new FDA-approved Natrelle 410 breast implants (aka the gummy bear implants) and use of Strattice for treating breast implant capsular contracture.  My old friend and colleague, Dr. Brad Bengtson, revealed his experience using Strattice to treat recurrent capsular contractures, with impressive results.  If only the Strattice wasn’t so expensive!

4. I had the pleasure of reconnecting with Dr. John Trupiano, an old friend who is now a practicing plastic surgeon in Fargo, North Dakota.  We had a nice dinner together and then watched “Oz: The Great and Powerful.”  If you’re in Fargo, he’s a great guy to see.

I’m looking forward to the next ASAPS meeting next year, scheduled to take place in San Fran!

For more about ASAPS, or to find an ASAPS doctor in your area, visit www.surgery.org.