What's New at Pacific Plastic Surgery - Santa Barbara

I just finished reading a new book about skin care that anyone should read who wants to learn more about their skin and sort through the confusion about skin care. That’s pretty much everyone, so go out and get this book! …

“The New Science of Perfect Skin” by Daniel Yarosh, PH.D., Broadway Books, New York, 2008.

The author, Daniel Yarosh, is the brains behind AGI Dermatics, a company that makes a high-end line of skin care products that goes by the name of Remergent (No , I don’t carry this product line, but dermatologist Gary Novatt, M.D. here in Santa Barbara does). Although understandably supportive of his own line of products, and others containing AGI Dermatic’s compounds, Yarosh is not over the top about it, and has good (and bad) things to say about many other competing products as well. He explains the science of skin care well, on a level that is easily understandable, and pulls no punches when commenting on many of the too-good-to-be-true youth-in-a-bottle products and ingredients. This is a refreshing change from another well-known skin care book that came out a few years ago (“The Wrinkle Cure” by Nicholas Perricone, M.D.) which had a tiny bit of science and a whole lot of hype. Perricone has a new book out, which seems to be more of a wholistic health book, but I haven’t read that one yet so I can’t comment on it.

One of the most useful things you will learn after reading Yarosh’s book is to dissect a skin care product’s ingredient list and have a pretty good idea of what you will be putting on your skin. (You read the ingredient list off the food packages you buy, don’t you? Why not for that skin moisturizer, too?). He also tells you how to avoid spending exorbitant amounts of money on ridiculous products that do nothing, and how to find good products that are reasonably priced.

He thankfully puts to rest the idea that topical potions can do what Botox does, and describes both Botox and fillers in the context of an overall skin rejuvenation plan. Some of this information is already a little dated, but that speaks to how quickly the non-surgical rejuvenation options are expanding and changing.

He goes into a good amount of detail on how the sun damages skin, how sunscreens work, and why no one uses sunscreens properly. I wish he would have gone into more detail on smoking’s harmful effects and pathological changes on skin. This is something I see in my practice frequently, and it seems patients aren’t always that knowledgeable about it. I can tell the facial “signature” of a smoker who has smoked for at least 10 or 15 years. The look is different from that of photoaging (sun damage), although often occur together. It’s no mystery how to stop the harmful effects of smoking, but we could all do better with sun protection. He tells how the Australians, with the highest rate of skin cancer, are emphasizing more physical sun protection (wide brimmed hats, long sleeved shirts, etc) in addition to sunscreens, as they’ve probably got all the benefits they can out of their current use of sunscreen. Here in Southern California, we should be doing the same. So buy a beach umbrella and use it while you read this book!

Welcome to our new blog! My first post is a recent article I wrote for Health & Beauty Santa Barbara Directory about plastic surgery myths and misinformation…

Plastic Surgery – Sorting through Misinformation: 10 Common Myths Revealed

The field of plastic surgery has seen significant changes in aesthetic surgical procedures over the last several years, and increased media exposure has made people much more aware of these changes. Television has certainly taken a huge interest in plastic surgery, with a flood of fictional dramas, reality shows, and “educational” programs. Unfortunately, because television needs to be entertaining to keep viewers from switching the channel, sober facts often suffer under the heavy boot of titillation. The viewer comes away with a warped perception of what is really the truth.

Other media outlets are similar – on any given newsstand you’ll find several fashion magazines with article titles touting the latest and greatest instant-youth-in-a-cream product, or lunchtime procedure to make you look ten years younger with no downtime. As the old saying goes, “If it sounds too good to be true…”

So here are ten myths, debunked to help make you a savvier patient:

1) Plastic surgeons can close wounds without scars

Even after years of medical school and surgical training, there is not one plastic surgeon in the world that can do surgery or repair an injury without a scar (unless operating on a fetus still in the womb, but that’s another story). This is perhaps the most pervasive myth plastic surgeons see, especially when repairing lacerations after injuries. Patients frequently request a plastic surgeon to repair their injury and are often surprised and disappointed when they hear they will have a scar - mostly because of the misinformation they’ve received from watching television.

2) A cigarette or two doesn’t matter

Show your plastic surgeon you’re serious about looking better and more youthful by first quitting that pack-a-day smoking habit. You have to do your part to heal after the surgery, and having healthy habits will help a lot. Even one or two cigarettes a day will measurably hurt your chances for a smooth recovery. Body contouring surgery and liposuction is best done if you can get down close to your ideal weight. Liposuction is not a good weight loss technique, and you shouldn’t waste money on it if there’s a good chance you’ll gain weight again. So try and develop healthy habits first.

3) Getting it all done at once will be more convenient, and just as safe

Even though no one has yet died on reality television undergoing extremely long surgeries, it is not a very safe thing to do. The incidence of complications rises significantly after several hours of surgery, and do you really want your surgeon operating on you all day long? Unless you’re having all your organs separated from your conjoined twin, keep elective surgical procedures to a reasonable time frame. If you need that much surgery, it’s probably best to stage it into more than one procedure anyway.

4) If the surgeon is careful, nothing will go wrong

If your plastic surgeon tells you he has never had a complication doing the procedure he is planning on you, it is either because he has never done one before, or he is lying. All surgeons have complications. Despite precautions taken before and during surgery, some people will develop an infection, or bleed in the recovery room, or have an implant that leaks. Help your surgeon to minimize complications by telling him about all your medical issues, your smoking history, and about those herbs you’ve been taking to lose weight.

5) People with facelifts always look “pulled”

Gravity is not your friend, but at least we now know which direction it goes. The tissues of the body, particularly the breasts and face, drop with age. They are also three dimensional, which has an especially significant importance with facial rejuvenation surgery. Modern techniques of facial surgery use multiple vectors for lifting tissue, different planes of dissection, and added volume for rejuvenation. One certain celebrity tends to make fun of herself, and patients often say “I don’t want to look like Joan Rivers”. There are ways of avoiding that look.

6) It must be good if it’s advertised

If the procedure has a slick name with a trademark symbol next to it, beware! There’s nothing wrong with a surgeon trying to promote a procedure she’s developed, but it’s nice when that procedure offers a distinct benefit, or advances the field of plastic surgery. Many of these procedures are simply minor variations of established procedures. Some are taught to non-surgeons with minimal training, who perform them on the cheap and are marketed by the company who owns the trademark. Some are very secretive about what the procedure does and restrict the contracted surgeon from revealing the “secret technique”. Weird!

7) A limited procedure is always preferable

A mini-procedure is fine as long as you have a mini-problem. Be realistic about the problems you have and what it will take to correct them. If you sunbathed on top of tin foil in your twenties, and you smoked until you were fifty, and now you’re sixty, you probably won’t be too happy after your “weekend facelift”. A comprehensive approach for rejuvenation is often needed: Botox™ and fillers for lines, intense pulsed light or peels for sun damage, surgery for gravitational changes. Any approach needs to be customized to your needs and goals.

8.) The surgery will allow me to get ____ (fill in the blank)

You will be happier if you do surgery for the right reasons. Having the surgery will not get your girlfriend back. To have better self esteem is a realistic goal, but thinking that you’ll do better in your auditions if you had a better nose is not a healthy outlook. The surgery may or may not help you compete with the younger prospects for that job you want. What you expect on the outside should match what you feel on the inside, and it should come from you – not from your spouse, your peers, or your boss.

9) I can get what she got

Your friend is really happy with her surgery, and you want the same thing. If you don’t have the exact same body as your friend, you may need different sized implants, or more. Taking breast implantation as an example, the existing breast shape will largely dictate the shape following the breast implant surgery. If you both have B cups and both want to be C cups, but she’s 5 inches taller and 25 pounds heavier than you, you will both need different sized implants. And if you nursed three babies, you will probably need a breast lift too.

10) The surgeon must be good, he was on TV

Don’t get fooled by the stuff that doesn’t matter. Choose a Board Certified surgeon. Yes, you’ve read this in any number of “How to Choose Your Plastic Surgeon” articles, but it will at least provide you with the knowledge that the surgeon passed some level of competency evaluation. Go on from there – check state medical board websites, and his professional society’s website. The medical board will reveal actions taken against doctors, but don’t necessarily throw the baby out with the bathwater – good doctors get sued too. Ask your other doctors who they recommend.

There are many resources to learn about plastic surgery and individual surgeons. Do your homework, and try to be wary when sorting between facts and hype.