Top 10 Amazing-But-True Facts about the 2007 Holiday Season

During the recent holiday season, alert Internet readers sent us amazing-but-true facts they have learned about the 2007 Christmas season.

We present the top 10 herewith:

1. For the first time in history, Santa Claus is being forced to relocate his North Pole headquarters. The reason? Global warming. The irony is that global warming is rapidly accelerating due to a small percentage of Americans who insist on decorating their homes with tens of thousands of Christmas lights.

2. The Norwegian word for "fruitcake" translates literally to "delicacy of questionable sensibilities."

3. The only human to ever be awarded honorary status by Santa's elves is film composer and former Oingo Boingo front man Danny Elfman.

4. In 2006, three shopping-mall Santas suffered severe facial lacerations while using cats as beards. (The toll for 2007 hasn’t been tallied yet.)

5. Santa's Christmas Eve schedule now takes into account his mandatory TSA inspection upon entering the U.S., as well as airspace congestion over New York La Guardia, Chicago O'Hare and London Heathrow airports.

6. Played in reverse, the opening line of "A Christmas Song" ("Chestnuts roasting on an open fire...") eerily predicts John Lennon's untimely demise.

7. Working for the Allies during World War II, Santa Claus lifted sensitive documents from the homes of Nazi officials each Christmas Eve.

8. Seventy-five percent of holiday plane crashes are caused by pilots mistaking for overly decorated neighborhood streets for airport runways.

9. "The Twelve Days of Christmas" was originally thirteen days. Superstition resulted in the modern version leaving off the verse about "thirteen broken mirrors."

10. During the long, cold Decembers of the Great Depression, many parents encouraged their kids to misbehave because they needed the coal.

(Source: Chris White, TopFive.com)

Top 10 Reasons Women Undergo Rejuvenation Surgery:

1. Smooth Facial Wrinkles.
Botox did the job over four million times in 2006.

2. Remove Unwanted Hair.
Lasers took it off for 887,000 people. More

3. Increase Breast Size.
329,396 women opted for breast augmentation. More think silicone implants rule!

4. Suction fat from the stomach, butt, hips, and thighs.
302,000 people had liposuction in 2006 to reduce problems fatty spots that just will not go away.

5. Remove a bump from the nose.
307,302 people had nose surgery during ’06. Some removed a bump.

6. Fix a Crooked Nose.
Others straightened the schnozzola. Yet others corrected impaired breathing, narrowed the nostrils or fixed a botched rhinoplasty.

7. Remove bags from around the eyes.
233,000 people in 2006 removed the bags under the eyes or nipped drooping eyelids. Some did both.

8. Remove extra skin from the stomach area.
Thanks to the growing acceptance of “Mommy makeovers,” 146,240 tummy tuck cases were done. It’s a big surgery. More.

9. Plump up lips.
At least 25,626 people fattened up their kissers. The trend is growing as more facial injectables are approved for the lips. Lip implants are also available.

10. Improve the appearance of sun-damaged skin.

Isn’t payback a bear? People who spent too much time in the sun include:


(SOURCE: American Society of Plastic Surgeons. Figures represent both men and women. Statistics for 2007 will be released sometimes around March, 2008.)

PORTAL and your Surgeon - The Cake is a Lie.


In October I wrote about spatial perception and the concept of being left or right brained as it applied to your surgeon. While generalities about artistic taste or surgical ability being associated with left/right dominant brained people and the like as it applies to individuals is a silly idea, I definitely think the ability to understand and intuit spatial relations is important.

Much like a pool hustler understands the geometry and physics of a bank shot without getting a compass and calculating force vectors, surgeons process symmetry, proportion, and volumetric relationships. With laparoscopic surgical techniques utilizing small cameras and long, remote instruments there are several studies suggesting that people who are good at video games tend to be better at laparoscopy. Researchers found that surgeons who spent at least three hours a week playing video games made about 37 percent fewer mistakes in laparoscopic surgery and performed the task 27 percent faster than their counterparts who did not play video games.

I think I've discovered a great video-game proxy for Surgery. Valve Software published the title PORTAL this Fall as a under-publicized throw-in for their blockbuster video game, Half-Life 2. Portal is a unique puzzle game that is a real mind-bender in the way you have to understand spatial relations, momentum, physics, and inertia. It is also a really, really creepy experience in artificial intelligence (AI) paranoia. The phrase in the title of this post, "The cake is a lie....", is a critical plot device in the story. You can read plot spoilers on Wikipedia's Portal Page.


So next time you go to surgery, forget those questions about their experience, training, or board certification. Rather, find out how good they are at Portal :)


Portal's trailer is visible below via YouTube.





Rob

There's an article in the Arizona Daily Star (click here) which goes into more detail on the events surrounding the patient in the MSNBC story I referred to in my last post, who could not find a Plastic Surgeon in the city of Tucson (pop. 946,362+) to take care of her leg injury.

The patient in this instance, Mary Jo McClure chronicled her experience with this episode on the web by starting a website "My Severe Wound.com". You can actually see photos of the wound during her treatment which required two surgeries to treat.

Rob

Botox Injections -- Fast, Fast Relief!

Remedies Writer’s Cramp, Scars, Sweaty Palms and Bladder Woes.



Ironing out facial wrinkles with Botox is only one of its actual uses.

Medical researchers continue finding new uses for Botox -- which leads the pack of noninvasive procedures with 3.9 million uses in 2006. It’s now a good treatment for relieving writers’ cramp. According to the Journal of Neurology, Neurosurgery and Psychiatry, three to seven of every 100,000 people suffer from writer’s cramp. Read more. Besides the cramping, if your fingers and hands ever become wrinkled, you’ve got that covered, too!

Plastic Surgery Incisions

Researchers at the Mayo Clinic found that treating a facial wound --like a plastic surgery incision -- early in the healing phase with Botox improves the appearance of a scar later. More. Al Capone shoulda been alive for this, huh?

Salesmen and others are handicapped if they have sweaty palms. It’s bad enough listening to a sales pitch but who wants to shake hands with a glad handing sales person whose paw feels like a wet washcloth?



One woman sufferer had drops of perspiration dripping from one hand. She usually suffered five sweaty palm outbreaks a day, with each lasting about half an hour. Just try selling a Lexus or a beachfront condo with water pouring off your hands! Stress, exercise, coffee or alcohol brought on her damp palm attacks. Read more.

Botox Injections


Again, Botox rode to the rescue and stopped the wet palms.

Researchers at UT Southwestern University in Dallas wanted to treat overactive bladder victims to help them regain control. Some were spinal cord injury victims whose injured nerves sent the bladder the wrong message at the wrong time. Like in church, at weddings, giving a major speech, while asking for a raise and so on. Others were MS patients, spina bifida and interstitial cystitis sufferers who, well, hey, you’ve got the idea by now. An associate professor of urology uses Botox to stop the leaks and embarrassing incidents. More.

Last summer I wrote a post "What's going to happen when you need a plastic surgeon in the E.R.?" about the worsening crisis in E.R. coverage among many specialists including Plastic Surgeons.

As we end the year, I've been seeing a number of articles referring to this come up again in our professional journals and on the news wires. MSNBC today highlights this again in a story "Emergency rooms find on-call specialists rare: Seriously ill suffer as relationship between physician and hospital unravels." Surveys of Emergency Room around the country have reported that as many as 75% have had issues about coverage for services like Orthopedics, Neurosurgery, Obstetrics, Hand Surgery, Oral Surgery, and Plastic Surgery.


In the MSNBC story, they profiled a patient who had trouble finding treatment from a plastic surgeon

Retiree Mary Jo McClure, 74, experienced the problem firsthand one Friday afternoon in January when she fell down some concrete steps, tearing large chunks of flesh from one leg. The plastic surgeon on call for Tucson Medical Center refused to leave her private-practice patients to come to the emergency department to treat McClure, who has health insurance. The doctor said instead she would see the injured woman in her office the next Monday.

But over the weekend, the specialist telephoned the family to say that she could not treat McClure after all because she performs only cosmetic procedures and is not trained to handle severe wounds, McClure said.


I can remember seeing this scenario multiple times during residency, and in this instance it is B.S.. This doctor may not want to or like to treat wounds but she is certainly over-qualified to. After examining it, she may determine that the extent of it requires surgical techniques she is no longer proficient in (eg. microsurgical techniques). This particular doctor is going to have to decide if staying on staff at that hospital is worth it to her for exposure to these issues from the ER. She may choose not to, but it looks real bad to behave like she did in this instance. Now for patients who present with hand issues, complex facial fractures, and mangled extremities I do feel it is more appropriate to defer treating if you don't do those types of procedures as the skill sets for treatment are more advanced and the resources required for their global care do not always exist at all hospitals.

I, for example, do not do any hand surgery (beyond smaller burns and occasional peripheral nerve procedures) in my elective practice and I do not take ER call for hand. Out of the nearly 40 Plastic Surgeons in my city, maybe 5 do any amount of hand surgery with most of those working at the University-affiliated level I trauma center. Outside the University, you may be SOL if you're trying to find a plastic surgeon doing hand injuries. As many orthopedic surgeons are following plastic surgeons out of the hand business, we're reaching critical mass for coverage of that specialty.

Traditionally, many specialists agreed to pull on-call duty in exchange for admitting privileges and use of a general hospital's facilities to perform operations and other procedures as part of their regular practice, O'Malley said. But the rise of physician-owned specialty hospitals and outpatient surgical centers over the past 15 years has reduced doctors' reliance on the general hospital.

"The historic relationship between physicians and hospitals is unraveling," O'Malley said.


I think that last sentence says it all. Surgeons en mass have reached a breaking point about being bullied by hospitals and insurers and now have some opportunities to walk away from uncompensated and unreasonable demands for ER coverage. In years past, the ER was a reliable practice builder for many plastic surgeons but in many instances it's now a reservoir of uninsured patients and offers less then cost reimbursement on insured patients with significant exposure of malpractice liability. What's not to like?

Much like I suggested when talking about specialty hospitals, the relationships between doctors and hospital ER's is going to have to be renegotiated. It's clear that hospitals will be having to pay stipends for ER coverage (which is perfectly reasonable to me) and that there will have to be increased medical malpractice tort reform for ER coverage to halt (if not reverse) this trend.


Rob

Top 10 Saving Banks for Cosmetic Plastic Surgery

While there are many payment plans available to consumers of plastic surgery -- even the Royal Bank of Scotland takes part through a plastic surgery loan program -- people are finding ever more clever ways to fork over for that long awaited surgical rejuvenation.

Some forget about making a down payment on a new car and keep the old family bus for another year; others take a part-time job and still others dump it all onto a credit card while yet others do it the hard way, saving up week by excruciating week.

That must be why there has been such an explosion of piggy banks on the Internet.

Here are the top 10:

1. Exploding Bank



The most recent is a special Japanese savings bank -- although it doesn’t have anything to do with a pig. The clever bank induces you to save by shaking and beeping hourly to remind you it needs to be fed some coins.

If you don’t feed it, the bank blows up and throws what few coins you have saved all over the floor. Well, O.K., it doesn’t explode explode; it just slams open a trap door and scatters your coins all over the floor. Seems like an explosion.

Japanese Toy Maker Tomy Co, Ltd. offers it for about $27.00

2.Coins Stop the Alarm Bank



Another savings device from the Land of the Rising Sun:

TokyoMango offers an alarm clock that won’t shut off unless you put coins in it. Want to sleep another 15 minutes or half hour? Yeah? What’s it worth to you?

3. Money Eating Monsters



O.K., no more Mr. Nice Guy Piggy Bank! Some banks are literal monsters that demand to be fed! Or else!

The Money Monster Bank gobbles up both coins and bills, then follows with 20 more-or-less age-appropriate comments (“Money, money in my tummy!”) while their eyes flash and ears wiggle. After the money is consumed, the saving monsters let out a mighty belch, letting you know your funds are secure and probably tasted good, too. Available soon for about $24.00 from Firebox via Pocket-lint. The Monster banks even heckle passers-by if they walk by without giving up some cash.

4. The Face Bank Robotic Piggy Bank.

This bank also eats money but with realistic munching motions. Just don’t get your fingers too close or you’ll need a plastic surgeon who specializes in hand reconstruction! Watch the Face Bank in action on YouTube. Go to:

http://weirdscience.ca/2007/06/10/coin-eating-piggy-bank/

How does it work? The Face Bank has motion sensors embedded in its eyes. The sensors detect your approaching hand, then latch onto the money, (hopefully!) gobble it up and swallow it for safekeeping. Depending on where you find them, the bank will deplete your plastic surgery savings by at least $14.95.

5. Digital Piggy Banks



According to the Chinese calendar, it’s the year of the pig. So that's another reason we're seeing so many piggy banks. The DigiBank from Keian takes piggy banking another step into geekdom.

You can program the bank just by showing it a coin, be it a dime or a Drachma, a half a buck or a Hallalah. After that, the bank is smart enough to recognize what type of coin it’s getting and how many coins are dropped in. It tallies your savings and displays a running total on its LCD display.
It costs around $15.00 at better piggy bank stores everywhere. (Chinese and more astute readers will note the middle bank is not a pig at all but a Panda.)

6. Economy Model Coin Counter



No programming is necessary -- or possible -- on this model. Just attach it to the top of a glass jar and let it track the amount you’re socking away for that upper eyelid surgery. The bank only costs $8.00 but, then it only recognizes Japanese Yen. (1 Yen is just about $.01.) Hey, we did say it was the economy model. Leaves more for your surgery. MORE »

7. Gold-plated piggy bank.



If you are headed to Beverly Hills for your surgical rejuvenation, here’s a bank that’s more appropriate to where you are: a gold-plated piggy bank from Jonathan Adler for $130.00. Or not. Maybe just stash 130 clams in an old sock toward your surgery?

8. Bankabank piggy banks



No, these are not the lastest iPods. They are just round, soft, supremely low-tech banks which don’t require batteries. The bank can hold $75.00 in U.S. quarters. Part with 48 of those quarters and one can be yours. From Gizmodoa.com.


9. Upscale Bank



This device also has not a shred of porcine influence and is a saving bank meant to resemble, well, a bank. Or, at least an ATM machine at a bank. But get out of the habit of withdrawing money -- it’s designed for inserting loose change. And just like its grownup, real life counterpart, you have to have an access card and a pass code.

10. Bank of Life



The Jinsei Ginkou (Bank of Life) from Takara Tomy is also called the “Tamagotchi Bank” because it has a console screen that shows the virtual lifestyle of a virtual man. When the bank is empty, the man lives in a tiny, unkempt hovel. But as you add more money, the character on the screen starts upgrading his environment all the way to a virtual fancy digs and a more lavish lifestyle. (He is also looking so much better after his surgery in this stage.) It’s designed to save $850 (real time, not virtual bucks!) but you have to save with 500 Yen coins.

BONUS BANK: Because you’re reading this on a computer screen, the last of the top saving devices hardly resembles anything else. But we’re sure you’ll appreciate having it next to your computer.



This cleverly designed piggy bank looks like a giant key from a computer keyboard, emblazoned with word “Save.”

The oversize plastic computer key (4.5″ x 4.5″ x 2.25″) serves as a constant reminder to save those spare coins you found under your desk or the couch cushions. The Auto Save Bank is just $10 from Uncommon Goods.

(While you’re recovering from surgery, here’s a head start on your next round of Trivial Pursuit: Why are many coin banks shaped like, and named after, pigs? (Hint: Doesn’t have a thing to do with hogging money.) Give up? Here’s the story, dug from the dustbin of history:

Long ago in Europe, dishes and cookware were made of a dense orange clay known as “pygg.” When people saved coins in jars made of the clay, the containers became known as “pygg” banks. An English potter misunderstood the word and made a bank that looked like a pig.

The rest, as they say, is history. Anyhow, good luck with your savings plan. Here’s more about financing your plastic surgery.

Researchers: Caffeine Reduces Thighs!



Don’t you just hate it when you’re holding a full cup of coffee and the driver zooms away from a stop light, spilling the coffee all over your lap? Can’t you sue the seller of the coffee or the car manufacturer for something like that?

Sure, the coffee is scorching and makes you look funny when you get to work but that spilled coffee -- or at least the caffeine in the coffee -- just could be a blessing in disguise

Here’s why: Brazilian researchers studied a type of cream containing seven percent caffeine rubbed onto the thighs of 99 women twice daily for 30 days. At the end of the test, the researchers measured the womens’ thighs and found 80 percent had reduced their upper and lowers thighs. An unexpected bonus finding: 68 percent also reduced their hips.

(We are not making this up! Read the scientific article in the Journal of Cosmetic Dermatology.)

This has to be truly groundbreaking research! The high-priced coffees we drink in the United States must be somewhere around 75 or 80 percent caffeine. So the obvious no-brainer application is to let the coffee cool, ask your friend to pull over, get out and apply the coffee directly to your thighs. U.S. coffee sales will skyrocket once the word gets out!



Meanwhile, Professor Omar Lupi, M.D., Ph.D. of the Federal University of Rio de Janeiro had some bad news we must unfortunately deliver, much as we dislike bearing woeful tidings: Alas, the cream did not work on cellulite. “The caffeine cream may help women who want to look thinner, but exercise is still the best way to go,” says Professor Lupi.

Until more people pick up on the caffeine thing, read what plastic surgeons can do for thighs.

Got a Bald Patch? See Your Dentist!



Researchers at the University of Granada in Spain have found the bald patches on both women and men might be because of bad dental health.

Known to doctors as Alopecia, the hairless spots usually occur on the scalp, beard or eyebrows. The malady affects one of every 1000 people.

Wrote Professors Jose Antonio Gil Montoya: “The typical pattern is one or more round bald patches appearing on the scalp, beard or in the eyebrows or to undergo loss of eyelashes.”

Researchers say this is the first time a relationship between dental disease and hair loss has been established. Read more.

One of the least known -- but very popular -- plastic surgery procedures is hairline lowering for women. It happens when a woman’s hair line recedes and shows too much forehead. Read more.

Many plastic surgery patients are also concerned with their eyelashes. Some are transplanted. Read more about eyelash transplants.

St. Louis Mesotherapy clinic chain (FIG) filing for bankruptcy


The first major casualty in the American experience with mesotherapy has arrived with reports that FIG, the first franchised mesotherapy clinic company, is closing it's doors in the wake of hundreds of complaints from unhappy clients.


FIG had operated over a dozen clinics in seven states that promoted a package of mesotherapy injections, costing almost $2,000 per body part, to reduce fatty deposits on the thighs, abdomen, buttock, and neck. Its clinics reportedly performed over 100,000 mesotherapy-style treatments across the nation.


Now all this doesn't mean that mesotherapy can't or doesn't work, but it clearly shows what happens when you put the cart in front of the horse with new technology or techniques. It's to the credit of the Plastic Surgery Education Foundation that they've taken the lead in trying to study the safety and efficacy of standardized regimens for these injection lipolysis treatments. The inaction of other medical groups who have dabbled in this is disturbing.

Hopefully this will temper the enthusiasm for people experimenting with these kinds of injections until we have more information. Remember that the active components of all these treatments are cyto-toxic medications being used in a way far from their accepted indications.



Taken from Actual Hospital Charts Entries

Physicians have a lot to do and make the occasional mistake. Besides, unless you have a Ph.D. in deciphering doctors’ handwriting, how are you supposed to know for sure what notes they have entered onto charts?



Anyhow, here are a few gems pulled from various hospital charts, as best as we could make them out, anyhow.

10. She is numb from her toes down.

9. While in E.R., she was examined, X-rated and sent home.

8. Patient’s medical history has been remarkably insignificant with only a 40 pound weight gain in the past three days.

7. Discharge status: Alive but without my permission.

6. She has no rigors or shaking chills, but her husband states she was very hot in bed last night.



5. The patient refused autopsy.

4. Patient has two teenage children, but no other abnormalities.

3. Skin: somewhat pale but present.

2. The patient has no previous history of suicides.

1. Lab tests indicated abnormal lover function.

(Courtesy of Alex Denes, M.D.)


Quote of the day: “You may not be able to read a doctor's handwriting and prescription, but you'll notice his bills are neatly typewritten.” Earl Wilson.

Can “Miracle” Plastic Surgery Tape Beat Actual Surgery?

We recently found a likely alternative to expensive and time-consuming plastic surgery in the form of inexpensive beauty tape. For only $14.95 a roll, (plus a small charge for delivery right to your doorstep) the smart consumer can him-or-herself apply a secret formula tape that literally strips away the years, according to information about the tape.

To scientifically test it for our readers, Chas., chief correspondent for your humble blog, was volunteered for the experiment.
Chas. has a 28-year-old son going on about, oh, 11 or 12, so there are considerable, deep worry lines on his, Chas.’s, forehead. Lots of tape there.

He is also an editor who reads and writes tiny lines of print all day so he squints all the time. More tape on and near the eyes.
Chas. has additionally -- and unwisely -- spent far too much time in the sun, so lots and lots of tape goes on his mid face. And just in case anything else threatens to droop or sag, we carefully followed the instructions and put generous amounts of the plastic surgery tape everywhere else to insure a completely positive patient outcome.

Before.
Chas. as he normally looks.



During.
Our subject has been instructed to keep the special tape in precisely determined positions for exactly 20 minutes to obtain the maximum possible cosmetic results. He reported little to no pain while wearing the tape.



After.
Voila! Look at the difference! The tape has magically swept away 25 years! Is not life in a highly technological society a wondrous, amazing thing?



Outcome

So, does the plastic surgery tape really work? Should we recommend it to our many readers who are also interested in surgical rejuvenation? As well as saving time and money? Of course, we would not be so bold as to skew the outcome by judging our own test.

So we organized a panel of 10 highly placed expert plastic surgeons -- representing almost 300 years of higher education and a combined I.Q. of 14,000 -- to study all the data in question, analyze the pictures and draft a carefully considered and worded analysis to officially judge our test.

They wrote: “Would you people also buy the Brooklyn Bridge on the Internet?”

(O.K., time to ‘fess up. You’ve been had! Thanks for bearing with us, but the “after” picture was actually taken 25 years ago when our subject was a junior in college. I know it’s hard to believe, but the tape did not do a thing except slim down our wallet.)

The issue of whether or not hospitals run better when the doctor's who work there own all or part of it has been a contentious issue. A provision ram-rodded into a 2006 deficit-reduction bill was a mandate that could put a moratorium on hospitals that are partly owned and run by doctors by denying eligibility for medicare/medicaid reimbursement for services (a condition that makes running a hospital impossible). There's compelling arguments on both sides of this.There are almost 130 physician owned hospitals in the United States versus approx. 5000 plus general hospitals.

"General Hospitals", who offer wide ranges of service and exist as either not-for-profit or for-profit hospitals, claim that doctor's face conflicts of interest over patient referral and will "cherry pick" healthier patients in higher-profit areas of medicine (usually cardiac medicine/surgery and orthopedic surgery) while eschewing medicaid patients and money losing endeavors (like emergency room services).

Physician investors in hospitals meanwhile argue that existing hospital corporations fear competition, and that they've built highly efficient facilities which have a tendency to have more nurses on patient floors, invest more in high-technology, and provides amenities and levels of service not available at general hospitals.

There's data from the feds which actually show both arguments to be true simultaneously.

My personal take is that physician ownership is both necessary and will become increasingly common unless prohibited by congress (as the hospital lobby has worked towards in Washington). As the margins of the economics of organized medicine become tighter, hospital-based physicians are going to demand a "piece of the action" to offset the savaging of their income by medicare and corporate medicine reimbursement. Hospital-Physician partnerships will be necessary for institutions to attract and maintain their medical staff in some profitable specialties. When doctors have a stake and more input into operating decisions, I can't help but think we'll all be better off at the end of the day.

Will this affect Plastic Surgery much? Not really I suspect. Our specialty has been marginalized for years by hospitals as we don't generate near as much revenue as other surgical specialties like orthopedics, cardiac surgery, or transplant surgery. With outpatient cosmetic surgery now the horse pulling the cart for the public face of our specialty, I think more and more Plastic Surgeons will feel like they don't have much of a stake in that fight. That may be kind of myopic and narrow-minded, but it's true. Except for outpatient surgery centers, I don't think there's a lot of doctor's going to be lining up to throw money at the full-service hospital business.

There's a great blog on WebMD, "Mad About Medicine" which has a number of related articles on the economics of medicine. Good stuff!

Rob

Top Five Clubs for People who Want Cheap Plastic Surgery



On almost a daily basis, wannabe plastic surgery patients are told to check the credentials of a cosmetic plastic surgeon BEFORE the operation.

A carefully conducted, highly scientific nation-wide survey done at these cut-rate surgery offices has revealed many of these bargain hunting patients also belong to the same social clubs. Imagine the coincidence!

Below are the top five clubs for people who pick the cheapest surgeon.

Club Number 5: The Oxford Dangerous Sports Clubs

Club members are the people who started extreme sports in the 1980s and 1990s by skiing down Swiss ski slopes in bathtubs, stepladders and, in one case, a grand piano, all attached to skis. These club members could generously be described as “action junkies.”



Club Number 4: The Dallas Bonehead Club

For the last 86 years, the Dallas Bonehead Club makes an annual award to the person who most clearly lives up to the ideals of the club.

The most famous award was to Larry Walters, the California man who attached an aluminum lawn chair to 43 helium balloons and sailed the contraption to 16,000 feet. Read more.

The Bonehead Club is a good choice for anybody who ever picked a plastic surgeon because he once did a wonderful boob job on your girl friend’s cousin’s aunt. Or maybe it was one of the aunt’s friends. Whatever.


Club Number 3: The Flat Earth Society

Members of this club claim to have solid scientific evidence that the world is flat as a board. They can also prove Columbus used mirrors to convince his sponsors about the round earth myth.

Most Flat Earthers believe that cosmetic surgery is only for the vain, selfish and super ego-centered and that rejuvenation surgery will never catch on with the general public.



Club Number 2: The Procrastinator’s Club of America

Its four thousand members celebrate Christmas in July and protested the War of 1812 in 1970. Membership is open to anybody who does not fill out and return their application too quickly.

(Motto: if procrastination were bad, they would not have the “pro” before the “crastination.”)

The Procrastinator’s Club is perfect for people who look at their faces in the mirror and then say “ouch!” Next, they think about going to a plastic surgeon for an initial consultation for at least ten years. If they do put money down on the procedure, they back out at the last moment.



Club Number 1: DENSA

The top club for people who want the cheapest plastic surgery possible is DENSA (It stands for “Diversely Educated, not Seriously Affected”) Society.

DENSA takes anybody with any I.Q., especially people who have been rejected by MENSA, the organization for very bright people.

People who join this club do what you would expect from a low I.Q. club: they pick any old cosmetic surgeon from the T.V. or radio, skip the part about reading the surgeon’s medical credentials and just hope they will look better afterwards.

The usual procedure is to flip open the yellow pages, find Dr. Catch M. Cheatem, the local credit cosmetic surgeon, and jawbone him down on the price

O.K., so why should anybody go to all the trouble of looking up credentials? For one, it takes a long time to learn this stuff. Like at least 10 to 14 years. While plastic surgery is as complicated as rocket science, any med school grad can hang out a shingle that says “Cosmetic Surgeon.”

Learn more about better ways to choose plastic surgeons.

NEXT: We perform a special experiment with the “secret plastic surgery tape” that claims it will do everything surgery will do -- at a fraction the price!

English Women Paint Plates with Bare Breasts

Ha! And you thought that breast plates were something that Roman soldiers wore on their chests. Not any more.

There’s a new way to make a breast plate. And some of the proceeds go to charity. In Country Durham, England, women at Buttercups Ceramic Studio splash paint on their breasts, press an ordinary plate to their chests and then design some type of figure around the imprint.

Actually, it’s all innocent because the bare breast plate pressing is made in private -- the studio is a family centered facility with lots of kids around. A finished plate costs 12 pounds ($24.80) with three pounds being donated to the fight against beast cancer.

Common plate designs include Pandas, owls, the front of cars, twin cherries, bumble bees, well, you get the idea -- anything that seems to have a pair of wide set eyes.

Here is an entirely G-rated video showing how a breast plate is created: http://www.thenorthernecho.co.uk/audiovideo/news/index.var.10153.0.0.php


Intrepid Northern Echo reporter Lauren Pyrah
with her finished breast plate.

A study was presented at our major Plastic Surgery meeting in Baltimore which came to the conclusion that breast-feeding did not cause ptosis (drooping) of the breasts.

While I haven't seen the published manuscript yet, I find this conclusion somewhat implausible clinically and flawed based on the thumbnail descriptions of the methods of study used.

The researchers interviewed 132 women who consulted for a breast lift or breast augmentation. The women were, on average, 39 years old; 93 percent had had at least one pregnancy, and most of the mothers--58 percent-- had breastfed at least one child. Also evaluated were the patients' medical history, body mass index, pre-pregnancy bra cup size, and smoking status.

The results suggested no difference in the degree of breast ptosis (the medical term for sagging of the breast) for those women who breastfed and those who didn't. However, researchers found that several other factors did affect breast sagging, including age, the number of pregnancies, and whether the patient smoked.

Quantifying something as subjective as this is hard to do under most circumstances (and I give the doctor's credit for writing something interesting), but unless you study these women prospectively (rather then retrospective as was done here) and get better characterization of their baseline breasts size/shape, skin quality, body weight, and breast tissue tone (ie. firm vs fatty) then you really can make no valid conclusions about their hypothesis.

You get breasts that hang for a number of reasons including:


  • gravity (no explanation needed!)

  • thinning of the skin with age

  • attenuation of the internal soft tissue support of breast tissue (aka Cooper's Ligaments)

  • "tissue expansion" phenomena from weight gain or engorgement during lactation

Now in re. to ptosis and lactation, the tissue expansion effect is what I'd say predominates. Now as a lactating breast will be swollen for a longer time, it's pretty intuitive and obvious that it's going to affect the breast shape more. I'm skeptical from this intuitive POV plus an (occupational) observational basis on this idea that there's no difference after breast feeding.


One of the more common sub-groups in the breast augmentation or breast lift group are women in their early or mid 30's who present with "involutional ptosis" (our fancy words for saggy breasts after pregnancy). During my residency at the University of Louisville (KY), I can remember spending time with one of my favorite surgeons, Dr. Marc Salzman, who was kind enough to let me accompany him during his cosmetic surgery consults. There was a pretty girl ~ 33 years old who came in, and when describing what she did not like about her breast declared, "Dr. Salzman, after having my babies, my breasts now look like Squidworth's nose!". He was kind of puzzled by her comment, but I burst out laughing aware (due to having small children) that Squidworth is Sponge Bob Squarepant's boss on the popular cartoon show.


Pictured below is Squidworth. And you know what? Her breast looked exactly like Squidworth's nose. :)




Rob

Study: Wireless Gizmo Helps You Lose 3 Times More Weight

One of the fastest growing surgeries is the body shaping procedure that removes excess skin because the patient has lost some serious weight -- often, 100, 150 or more pounds. Doctors know it as MWL -- Massive Weight Loss.

MWL patients lost so much because each had his or her stomach stapled into a smaller pouch that holds very little food. The procedure reduces a stomach from the size of a football to the size of a tennis ball.

But a new wireless gadget could make both those operations passé.

A new study at Germany’s Magdeburg University reveals that subjects who wore an
ApierMotion activity sensor tripled their weight loss. Read more.

The device records the subjects’ movements, calories and weight and wirelessly sends the vital information to the professor overseeing the test.

If the professor sees too much sloth or mindless eating, he calls the subject and gets him or her back on the straight and narrow. And don’t forget -- this professor is a no-nonsense German. Ein-Zwei! Ein-Zwei! Ein-Zwei! Watch Sunday Football? Nein!! Eat Deserts? Verboten!! Beer? Niemals!! Choo will work-work-work.!!

The three-month study observed seventy-one families; 20 wore the monitoring device and enjoyed the weight loss so much they forgot all about catching up with the professor in a dark alley somewhere.



ApierMotion activity sensor tells your workout guru exactly how much, when where and if you are getting exercise.

New Mirror Shows Your Future Look (Probably!)

The mirror has probably driven more people to the offices of plastic surgeons than anything else except reunions and weddings.

But if you hate looking in the mirror now, just wait a few years.

Soon, you can see what your reflection looks like a quarter or half century into the future. So, maybe you can use the mirror to get an idea when to schedule some cosmetic plastic surgery. After all, you never know how far in advance your favorite plastic surgeon is going to be booked!

It works like this: cameras are mounted all through your home. They see you when you’re naughty and nice and while you are:

  • puffing away on cigarettes

  • pigging out on twinkles, cookies and colas

  • having beer and chips for dinner

  • living on the couch

(Remember, we make up nothing around here! Read the report for yourself.)

Next, the high-tech gizmos process all that information through special computers, add what your parents look like and plaster a picture of what you are very likely to look like on your mirror, given known aging patterns and your current habits.

Say, you haven’t quite dropped the cigarette habit. You get up one day and say “Mirror, mirror on the wall,…” or whatever and presto! There, before your unbelieving eyes is you, 30 years later, gray and haggard from smoking and coughing.



On the other hand, those cameras also see you eating well, getting proper sleep, lacing up your running shoes and carrying your gym bag out the door four or five times a week.

In that case, when you go to the mirror, the future image popping up next to your current self is slim and trim, has rosy cheeks and just a little gray hair. Older, but probably kinda distinguished and very, very healthy.

Stop and think. What will your reflection show in 2032? If you have unhealthy habits or choose the wrong plastic surgeon, it could be something like the picture below! Yes, be afraid! Very afraid!



Do you suppose we will still say YIKES! then?

Top Ten U.S. Cities for Plastic Surgery

A recent Forbes Magazine recently counted the number of top plastic surgeons in large U.S. cities and compared them to the population. Read more.

The survey turned out differently than what you are probably thinking. Beverly Hills, often consider the Mecca of global plastic surgery, does not lead the list.

The only surgeons counted in the article are board certified by the American Board of Plastic Surgery. So cosmetic surgeons were not included. What’s the difference between the two types of surgeons and the work they do? Read about it here.


Here are the top ten:

1. Salt Lake City

There are six plastic surgeons per 100,000 people there. 45 plastic surgeons live in Salt Lake City.

2. San Francisco

The city by the Bay has 5.4 plastic surgeons per 100,000 population. That means 175 surgeons do the work.

3. San Diego,

With 115 plastic surgeons in San Diego, the numbers crunch to 5.2 surgeons per 100,000 citizens.

4. San Jose, California

The silicone valley town has 5.2 plastic surgeons per 100,000 people. 70 plastic surgeons handle the rejuvenations.

5. Miami, Florida

Even though the wacky T.V. show Nip/Tuck started in Miami, there are 5.2 board- certified, very non-wacky surgeons per 100,000 citizens. 218 plastic surgeons live in Miami.

6. Louisville, Kentucky

Forty one plastic surgeons live in Louisville which boils down to 4.4 surgeons for every 100,000 people.

7. Nashville, Tennessee

Same again. With 48 plastic surgeons in and around Nashville, there are 4,4 surgeons per 100,000 population.

8. Virginia Beach, Virginia.

With 51 plastic surgeons, the population of Virginia Beach offers 4.1 surgeons to every 100,000 people.

9. New York, N.Y.
A whopping 591 plastic surgeons have set up shop in the Big Apple but The City is so big, it boils down to 4.1 plastic surgeons for every 100,000 New Yorkers.

10. Los Angeles

Gotcha! You probably thought fad crazy Los Angeles would lead the list! Actually, the 384 plastic surgeons living and working there creates a ratio of 4.1 surgeons to do the heavy lifting for every 100,000 Angelinos.

It's hard to outsmart mother nature.


Just thinking about the human body today.....

Reports in the medical literature continually reinforce my belief that it's nearly impossible to outsmart mother nature in terms of the bodies inflammatory response. The inflammatory response is critical to your bodies compensatory mechanisms for stress or infection, but it has a tendency to go haywire and (apparently) make things worse. Billions of research dollars have been invested in characterizing (and manipulating) this cascade of biochemical processes. Every time we think we've figured out the big picture, eventually we are humbled by the bodies' "counter offensive".

In an international study (summarized awhile back here ) comparing bare metal versus the fancy new metal stents coated with medicines to inhibit re-occlusion of the artery showed dramatic increases in post procedural deaths as these patients were followed out from their procedure. When these drug-eluding stents were first introduced in 2003, they became the fastest-selling medical device in recent history despite being nearly 400% more expensive then the older bare metal stents.

We've witnessed a lot of similar outcomes in the trauma and septic response literature as multiple stages of the inflammatory cascade are suppressed or modulated, only to come back with a vengeance thru alternate "work around" pathways that must exist somewhere in the body.

When you see diagrams of what we think the immune response looks like, it is a frighteningly busy graphic. Despite millions of man hours in labor and billions of research dollars, complete understanding of these processes is elusive.

Rob

The White Smile Diet

An English study is something you can use daily, according to The British Academy of Cosmetic Dentistry which has developed an eating regime known as The While Smile Diet. The routine promises to keep your pearly whites more pearly. The Academy claims eating more of the foods listed below can keep your “gnashes” (British slang for “teeth”) gleaming instead of gray.

Thus, just consume more of the following:

  • More raw veggies. They help remove surface stains on your teeth. (Besides, no cooking is involved!)

  • Strawberries also help whiten your gnashes.

  • Avoid stain producing foods and drink, most notably:


    • Coffee and tea

    • Red wines

    • Cola soft drinks

    • Blueberries


  • Drink from a straw and let liquids bypass your teeth.
    (Does that mean you can have coffee, tea, red wine and cola drinks after all? They wouldn’t say. But, hey, if you don’t feel silly in a restaurant drinking wine or coffee through a straw, go for it. As for the blueberries, I imagine they would be hard to fit through the straw. Just use your own best judgment on that one.)

  • Use sugarless chewing gum. It stimulates saliva which cleans the surface of your teeth.

  • Don’t smoke. If you didn’t already know, smoking stains your teeth and is hard on your gums and everything else in and around your body. Even your plants and pets will give up the ghost. Termites have been known to succumb to second hand smoke.
For more on what cosmetic dentistry is all about on this side of the big pond, check out this section.

Also, we here in the Colonies can offer something in dentistry you don’t find very often in Merrie Olde England. You can get a facelift via dentistry !

Tattoo Removal Docs Barely Keep Up!

Newer Tats are in Braille, on Eyes and Even Used on
Fingers to Create Instant Moustaches


Many plastic, cosmetic and dermatological surgeons offer tattoo removal for those times when people regret ever getting the body art in the first place. (READ: Grew up and got a job!)



Laser tattoo removal. It usually requires three to five or more
appointments to completely vaporize the tattoo ink.

If you’re in the market, read more about tattoo removal. (HINT: You’ll burn far more time and money taking it off than that mad, crazy moment back in the day when you first got it!)

Despite that booming trade in removal, more tats are being applied and in more creative areas of the body. No longer restricted to bulging biceps or on a lady’s trim ankle, tattoos are starting to appear on eyeballs and in Braille, too. Yet another trend is tattooing moustaches on fingers.

Hey, I know what you’re thinking. What’s that part about Braille tattoos? How does that work?

Well, say, you want “Mom” inked onto your bulging bicep. Or your best gal or guy’s name delicately inscribed onto your ankle.

It’s done with a series of raised dots, just like in regular Braille. Only no ink is used. The surgeon (if you can find one) just inserts implantable surgical steel, titanium or medical plastic under the skin.


“Mom” in Braille

And that naturally leads to another one of those “Why-did-nobody-ever-think-of-this-before!” moments.

If you have Braille tats on your hand like in the picture below, you can instantly learn the name of the person with whom you are shaking hands. Just don’t assume everybody is named “Mom.!”



Can’t you win some sort of prize for outside-the-box thinking like that?

And here’s another thought:
You gotta admit writing a “Mom” tattoo in dots, saying “This is mom’s name in a red heart with a wavy wreath and an arrow through it” in Braille is going to take up a lot of arm or ankle space. Not to mention all those hands feeling your biceps and ankles.

It probably would look something like this:



But, hey, more power to them. The sightless have enough challenges in life so if they want Braille tattoos, bring ‘em on!

Removal of Braille tattoos: top scientists have carefully analyzed the issues and ramifications involved and have announced they will think of something soon.

One of the hottest new trends in Tattoos is for men and women who want a moustache -- but only some of the time.

It works like this: just ask your favorite skin ink artist to tattoo your choice of moustaches onto your index finger.

Then, say, you want a disguise or you’re at the guest of honor at the annual Moustache Convention. Why, just hold your finger over your lip.
Presto! Instant soup strainer! How easy could things be?


Removal: Put your hand down.

Tattoos on your eyeball probably would not be your doctor’s favorite choice of body art for you. Besides, it gets unsettling with the needle in the eye and all so we’ll just skip that part.



One guy getting an eyeball Tat, concluded his description about creating a tattoo on his eyeball with the following words of wisdom:

“Now that this experiment has been started, please wait for us to either heal or go blind before trying it!”

Removal of eye tattoos?
No known method. Start by crying a lot.

Speaking of dots: at least one tattoo aficionado and artist had inked, numbered dots on the length of her lower leg, below. If you connect all 16,581 dots from the lowest to the highest number, the outline of a giraffe appears. Reason? She’s absolutely nuts about giraffes and has been since childhood. Plus, artists do things entirely for reasons of their own.

Unfortunately, the dots are not raised so the artwork is not accessible to readers of Braille. But with legs like that…..whoops! Never mind! Gee, I almost let loose with some highly politically incorrect male chauvinist pig sexism there. But you get the general concept, I’m sure.


Removal? Basic tattoo removal.

Top Five Weird Things that Happen to Doctors

The lives of doctors aren’t all yachts, golf courses, winter vacations in Monaco, Bentleys and high end dressing rooms for their own T.V. shows.

They actually go to work to work every day and interact with other people. So the occasional weird, embarrassing or you-won’t-believe-what-happened-to-me-today moments occur in their lives, too.

Here are the top five weird things that have happened to doctors, sent in by the physicians themselves!

1. A man comes into the ER and yells, "My wife's going to have her baby in the cab!" I grabbed my stuff, rushed out to the cab, lifted the lady's dress, and began to take off her underwear. Suddenly I noticed that there were several cabs -and I was in the wrong one.
Submitted by Dr. Mark MacDonald



2. At the beginning of my shift I placed a stethoscope on an elderly and slightly deaf female patient's anterior chest wall. "Big breaths," I instructed. "Yes, they used to be," replied the patient.
Submitted by Dr. Richard Byrnes

3. During a patient's two week follow-up appointment with his cardiologist, he informed me, his doctor, that he was having trouble with one of his medications. "Which one?” I asked. "The patch. The nurse told me to put on a new one every six hours and now I'm running out of places to put it!" I had him quickly undress and discovered what I hoped I wouldn't see. Yes, the man had over fifty patches on his body! Now, the instructions include removal of the old patch before applying a new one.
Submitted by Dr. Rebecca St. Clair

4. While acquainting myself with a new elderly patient, I asked, "How long have you been bedridden?" After a look of complete confusion, she answered..."Why, not for about twenty years - when my husband was alive."
Submitted by Dr. Steven Swanson



5. As a new, young MD doing his residency in obstetrics, I was quite embarrassed when performing female pelvic exams. To cover my embarrassment I had unconsciously formed a habit of whistling softly. The middle-aged lady upon whom I was performing this exam suddenly burst out laughing and further embarrassing me. I looked up from my work and sheepishly said, "I'm sorry. Was I tickling you?"
She replied, "No doctor, but the song you were whistling was, 'I wish I was an Oscar Meyer Wiener'!"
Dr. wouldn't submit his name

Give me you hungry, tired, and poor. Hold the fat, please!


Want to see a logical extension of federalized health care and the kind of rationing choices that will be made?

This story here is fascinating.

Richie Trezise, 35, a rugby-playing Welshman, lost weight to gain entry to New Zealand after initially being rejected for being overweight and a potential burden on the health care system.

His wife, Rowan, 33, a photographer, has been battling for months to shed the pounds so they can be reunited and live Down Under but has so far been unable to overcome New Zealand’s weight regulations.

Robyn Toomath, a spokesman for Fight the Obesity Epidemic and an endocrinologist, said the BMI limit was valid in the vast majority of people. She said she was opposed to obese people being stigmatised. "However, the immigration department’s focus is different," she said. "It cannot afford to import people into the country who are going to be a significant drain on our health resources.

"You can see the logic in assessing if there is a significant health cost associated with this individual and that would be a reason for them not coming in."
blockquote>


The implications of this are interesting. Is it discrimination or is it making people take personal responsibility when you treat someone different based on what are (often) controllable health risk factors?

We've already clearly made this value judgement with smokers and we're moving that direction with obesity. It's clear that obesity (as opposed to be merely overweight), much like smoking, is a devastating drain on our resources from a systems level. This was federally recognized in this example from New Zealand. Expect to see some incentives for BMI parameters to more frequently appear in your health insurance policy or be sponsored by your employer, as they've clearly fingered this subgroup as an area for cost containment in their employee costs.

Rob

Our New Plastic Surgery Gift Card

At Rodeo Drive Plastic Surgery we want plastic surgery to be as rewarding and convenient as shopping with our neighbors here on Rodeo Drive. In this spirit, we are pleased to present the Rodeo Drive Plastic Surgery gift card. The card is available for all amounts and can be used to give a present of any of our services.

Inspired by Patients

Our patients gave us the idea for the gift card. Many of our patients bring friends in for consultations that lead to plastic surgery with positive results and lifestyle improvements. Our patients do seem to enjoy giving friends and loved ones a gift of our services. Husbands give plastic surgery as a present to their wives, and wives give to their husbands. Children give to their parents. We see more and more people giving plastic surgery presents.

The gift Card can be used for any of our services -- from consultations to nonsurgical rejuvenation with Botox and skiin fillers and aesthetician services to our signature plastic surgery procedures such as Beverly Hills breast augmentation. You can even use it to give mom our Rodeo Drive Mommy MakeoverTM as a Mother's Day Present!

An Elegant and Memorable Present

To make the giving process as elegant and memorable as possible, we designed our electronic gift card. The card comes packaged in a custom-designed card holder insert and envelope, designed by a local artist. We hope that when you give friends and family this present, it will provide an opening glimpse of the attentive and caring service we deliver throughout the plastic surgery process. Of course our plastic surgeon will examine the recipient of your gift to decide if they are a candidate for a given procedure, and make recommendations based on their goals, exam, and overall medical status.

A Product of Our Rodeo Drive Environment

As the only plastic surgery center on Rodeo Drive, we are very attuned to the service imperatives of our neighbors – the finest tastemakers and stylists in the world. Our goal is to bring this same superb taste and service to our plastic surgery. We designed our plastic surgery gift card in consultation with managers from several neighboring Rodeo Drive shops to provide you with the same elegance you find at Rodeo Drive boutiques.

Happy Turkey Day!



Happy Thanksgiving to you and yours! I've got a lot of ideas floating around for some interesting (to me) writing coming up here on Plastic Surgery 101

Stay Tuned!

Scalpel! Clamp! Crochet hook!

To develop a new technique, Peter Lawrence, M.D., chief of vascular surgery at University of California, Los Angeles, bought a size 7 crochet hook.

However, Dr. Lawrence wasn’t knitting; he saw a way to use a crochet hook as a new surgical tool to remove varicose veins.

The old surgical methods involve some pain, stitches and time off for recovery. Lasers and radio frequency, using heat and energy are also employed along with vein stripping, tying off the vein or injecting a solution that would make the varicose vein whither and die.



This crochet hook is for knitting,
not surgery.

Using the crochet hook method, Dr. Lawrence has done 268 cases in the last two years. He makes a very small incision, reaches in with the crochet hook (which has been adapted for surgery) and snags and pulls out the vein. The incision is so small, no stitches are needed and the resulting scar looks like a freckle. Read more.

Some English doctors are using the same method to pull large veins out of aging hands but Dr. Lawrence advises against it. Many other plastic surgeons routinely make older hands look younger.

“The day may come when you will very much need those veins in your hands to insert I.V. needles,” says the doctor.
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