Plastic Surgery Seattle Blog

A Florida doctor’s medical license was recently suspended by the Florida Board of Medicine following an investigation that stemmed from a complaint made by a 2009 liposuction patient.  The doctor was also fined $50,000 and may be subjected to a three-year probationary period of supervised practice after the license suspension is up.

According to the medical board, the penalized physician, Dr. Yves N. Jean-Baptiste, allowed two unlicensed medical assistants to perform liposuction in an unregistered surgical facility.

The board also found that Jean-Baptiste failed to perform a proper pre-operative exam and did not appropriately document important surgical details, including the amount of anesthesia used and the amount of fat removed.

The serious penalties doled out by the Florida Board of Medicine in this case, such as increasing the physician’s fine from $10,000 to $50,000, highlight the board’s concerns regarding unqualified physicians performing cosmetic procedures.

Although Jean-Baptiste is “board certified,” the certification awarded is for family medicine specialization, not plastic surgery, and his liposuction training consisted of only a single three-day course.

“I think he’s in a lot of trouble because he doesn’t have a surgical background,” said Dr. Trina Espinola, a St. Petersburg surgeon and Florida medical board member.

The Florida Board of Medicine’s focus on consumer safety in cosmetic medicine and awareness of the inherent risk of unqualified practitioner participation in this cash-only industry is due in large part to the involvement of the state’s medical community.

Chris Nuland, a Jacksonville attorney representing Florida’s plastic surgeons and dermatologists, commented that in recent years, the state’s community of plastic surgery and dermatology specialists has grown concerned about the rise of untrained professionals, whose patients they end up treating when complications arise.

“This kind of case underscores how a weekend of coursework doesn’t prepare physicians to perform procedures such as liposuction,” said Nuland.

Be sure to seek a board certified Seattle plastic surgeon for liposuction, laser liposuction or any cosmetic surgery procedure, as surgeons certified by the American Board of Plastic Surgery are uniquely qualified and extensively trained to perform these procedures.

Cosmetic medicine is a “buyer beware” industry full of unqualified, unscrupulous practitioners promising cosmetic enhancement for a fraction of the usual cost.

All too often, cosmetic procedures offered at too-good-to-be-true prices prove to be at least twice as expensive as treatment performed by a qualified specialist in aesthetic medicine because of the poor aesthetic results they produce, which require additional revision surgery.

As highlighted in recent news featured by CBS Atlanta and the Orange County Register, sometimes discount cosmetic treatment can even cost far more than money.

See a board certified specialist for plastic surgery

Take for instance Kenyatta Brown, an Atlanta-area mother of four who nearly bled to death during a routine breast augmentation procedure performed by an ophthalmologist, or eye doctor, hoping to make a few quick bucks in the lucrative, cash-upfront business of cosmetic surgery by offering deep discounts.

Brown will likely spend thousands more on revision breast surgery than breast augmentation performed by a board certified plastic surgeon would have cost in the first place.

Brown’s story also illustrates the reality that medical authorities, such as state licensing boards, do not monitor or restrict medical practice based on specialty training or experience, so any licensed physician is legally allowed to practice plastic surgery or any other medical specialty regardless of his or her training or experience level.

Always seek cosmetic treatment at a licensed medical facility

Mayra Lissette Contreras, 22, of Pacoima, Calif. was duped into seeking treatment at an unlicensed back-alley cosmetics clinic run out of the San Fernando Valley home of sisters Guadalupe Viveros, 53, and Alejandra Viveros, 50.

After receiving silicone injections for buttocks enlargement, Contreras became ill and eventually died of respiratory problems.  The Viveros sisters are wanted by police but have fled to Mexico to avoid being prosecuted for Contreras’s death.

The cautionary stories of Kenyatta Brown and Mayra Contreras underscore the importance of researching your practitioner prior to undergoing cosmetic treatment and seeking an experienced Seattle plastic surgeon operating out of a licensed Seattle medical facility for breast augmentation, body sculpting or any other procedure.

Sci-Fi Skin, Algae Injectables & Fly Tape

Scientists are taking cues from nature in developing some of the latest innovations in cosmetic and reconstructive medicine.  Some of the most widely discussed new medical devices in research and production phases include hi-tech skin regeneration, soft tissue augmentation and surgical wound closure products with unlikely biological foundations.

Biochemists create sci-fi skin

New Zealand research and development company Mesynthes recently announced the release of its new Endoform Dermal Template, an FDA-approved skin tissue substitute used for wound care and dermal reconstruction.

This new hi-tech skin will be ideal for reconstructive surgery patients suffering from flesh wounds and tissue damage caused by severe burns and other accidents, and it will likely make skin grafting, the process of transplanting skin tissue, largely unnecessary.

The Endoform Dermal Template can effectively re-grow skin because it is composed of extracellular matrix material, which provides a unique mix of biological macromolecules that actively promote the cell regeneration and blood vessel formation to improve wound healing.

The Endoform Dermal Template is also purported to decrease healing time along with the length and expense of hospital stays after reconstructive surgery, as well as improve the quality of skin reconstruction results.

Due in large part to the FDA approval of the Endoform Dermal Template, Mesynthes recently received the NZ Trade and Enterprise’s “Focus on Health” award and is also on the fast track to receiving FDA approval for Endoform Infection Control, another Endoform product designed to prevent high risk post-operative infection.

Algae injectables

German pharmaceutical company Merz recently launched Novabel, a new injectable filler product available in Europe that is unlike any other.  While most other temporary injectable fillers are made of collagen or hyaluronic acid, Novabel is composed of spherical, flexible structures called Geleons, which are formed from marine brown algae extract.

This patented Geleon technology reportedly makes Novabel injections easy to administer and virtually pain-free.  Novabel is also purported to cause very little swelling and improve skin elasticity, so it will likely become popular for adding volume to facial areas with thin skin, such as the lower eyelids and tear troughs.

Caddisflies give new meaning to “Fly Tape”

Researchers from the University of Utah claim that the design and properties of silk spun underwater by caddisfly larvae could be mimicked to design a sort of wet Band-Aid that could close incisions much like a surgical suture.

The advantage of this caddisfly-inspired surgical tape would be dramatically increased adhesive bond strength, which would potentially lower incidence of suture failure in plastic surgery patients.

Scientific discovery and innovation is an important part of development in the field of plastic and reconstructive surgery, so staying up-to-date on all the latest research and technology is a top priority for Seattle plastic surgeon Dr. Jourdan Gottlieb.

According to a study published by the American Journal of Surgery, breast surgery procedures performed in Ambulatory Surgery Centers (ASC) are faster and more efficient than breast surgery procedures performed in hospitals.

The study found that performing breast surgery in an ASC rather than a hospital saved 69 minutes on average, and most of the time savings was attributable to decreased preoperative time, or time spent preparing for surgery.

Key time-saving advantages of the ASC include:

• Avoidance of unscheduled surgeries, such as add-on cases and emergency cases common in hospitals
• Better case flow as a result of having a surgeon assigned to a single room in the ASC
• Smaller, more consistent ASC staffing
• Smaller physical ASC facility that makes it easier to move patients and equipment

This study began in 2005 when the authors’ ASC was closed, which forced all breast surgeries to be performed alternatively in a hospital setting.  Study authors were then able to compare the amount of time breast surgery patients spent in the hospital facility versus the ASC facility.

In total, the records of 92 patients who had breast surgery performed in an ASC facility between January 2004 and December 2005 were compared with the records of 92 patients who had breast surgery performed in a hospital setting starting January 2006.

All patients were women of similar age, with similar recovery room times, and all of the breast surgeries were performed by the same two salaried surgeons who did not receive additional bonus pay for productivity.

Although preoperative time-savings are significant in an ASC, the study also noted that breast surgery patients spend an almost identical amount of time in an ASC and a hospital once they reach the operating room.

The type of anesthesia used during surgery can also affect discharge time, or the time from when surgery is complete to when a patient leaves the hospital or surgical facility, however this did not significantly affect overall start to finish time of surgery from the preparation stage to the patient discharge stage.

So, while the study certainly supports the common perception that outpatient surgery can be far more efficiently performed in dedicated outpatient surgical centers outside of hospitals, it identifies that the time savings benefits of an ASC are only offered during the preoperative, or preparation, stage of a breast surgery procedure.

Dr. Jourdan Gottlieb performs all breast augmentation, breast lift and breast reduction surgeries in two state-of-the-art ASC facilities to ensure every procedure is performed as safely and efficiently as possible.

Otoplasty, commonly known as “ear pinning surgery” is a surgical procedure that corrects abnormal ear protrusion.  Surgical techniques generally involve an incision behind the ear, reshaping of the ear cartilage, and placement of a suture to maintain the correction.

Surgeons in Lithuania recently studied the success rate of different suture types used in Otoplasty.  A 3-year study was conducted with 100 patients.  They were divided into these groups based on the suture materials chosen:

• PDS
• Monocryl
• Mersilene

Patients (48 men and 52 women) had a median age of 20 years.  After analyzing the data for each group, the doctors found that 3 patients in the PDS group and 3 patients in the Monocryl group had unsatisfactory aesthetic outcomes requiring revision surgery.  Patients in the Mersilene suture group had the lowest rate of recurrence.

• Read more about this study on PubMed
• Read more about otoplasty at Plastic Surgery Seattle

A tummy tuck tightens the lower abdominal muscles (if they are sagging), removes excess loose skin, and resculpts the abdomen.  Today, I want to share some reasons why mini abdominoplasty might be a good idea for you – and some reasons why you might be better off waiting to have your surgery.

5 indicators for abdominoplasty

1. If you regularly exercise, eat a healthy diet and are within 10% of the ideal weight for your age and height but can’t get rid of a sagging lower belly and loose skin below the navel, abdominoplasty can often correct the problem. It’s a fact that exercise and diet alone are not enough if you have muscle laxity and excess skin on your lower abdomen.

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Before you move ahead on that long-awaited breast augmentation, tummy tuck or liposuction procedure, take some time to get all the facts. Knowing all the necessary information will ensure your decision is the right one. Here’s why:

1. You’ll know which plastic surgery procedures get consistently good results and which procedures do not.

2. By weighing the risks and benefits in light of your individual values and goals, you’ll know if plastic surgery is truly a good fit for you.

Where can I get objective information?

People often look in the wrong places for legitimate answers to their plastic surgery questions. We recommend getting scientific and objective information from reputable sources.

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The American Society of Plastic Surgeons sent out a special bulletin to members today, urging them to voice opposition to the so-called “Botox tax” that was included on the latest healthcare reform bill.

ASPS members were asked to contact their representatives in congress or login at capitolconnect.com to take action.

Who would be affected by this tax?  The society is objecting to it on multiple levels, calling it discriminatory, arbitrary, and a “potential auditing nightmare” due to the often-unclear distinction between cosmetic and reconstructive surgeries.

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1. Be open

Don’t hide your medical history, past procedures, goals or motivations.  Some patients feel as if they need to be defensive during the consultation, which really isn’t necessary.  Just remember that a consultation is just that – there’s no commitment and you can take as much time as you need to consider your options afterward.

Openness and effective communication are important from the first consult all the way through the surgery.  If it’s difficult for you to communicate your goals, use pictures!  You can view our before and after photos or bring examples that you think are appealing.  Better communication about your desires and specific needs will help Dr. Gottlieb ensure that they are met, so use whatever tools you think will help.

2. Be prepared

If there are simple questions that you can’t find answers for on our site, email us before your consultation and we’ll try to respond in a timely manner.  Then if there are more specific facts that you need clarified, your consultation will be the perfect opportunity to do so.  Make a list of questions that are particularly important for you.

Part of being prepared is simply knowing what you want to achieve with cosmetic surgery.  Because many patients research their procedure extensively (sometimes for years) before they schedule an appointment, it is common for us to see people that know exactly what they want.  However, that’s not a requirement; if you are just curious about plastic surgery and want straight answers rather than questionable information from the internet, go ahead and schedule a consultation.

Seattle will be home to the American Society of Plastic Surgeons this weekend as the annual meeting kicks off October 23rd.  If the event turns out anything like last year, we can expect about 6000 surgeons and medical professionals to be in attendance.

The weekend will offer plastic surgeons a chance to attend lectures, view innovative products from over 300 companies, and network with others in the industry.

Panels and lectures related to cosmetic surgery include topics such as “Rejuvenation of the Upper Eyelid: Is Less Really More?” and “Lipoplasty 2009: Technical Advances to Maximize Results.”

Click on the icon above to visit the ASPS home page, where you’ll find resources related to the weekend’s events.