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PSP Podcast Episode 1: Beginnings in Body Contouring

July 26th, 2010

A few weeks ago, we posted about Dr. Cuzalina’s participation in a PSP Podcast series titled “Body Contouring: Looking into the Future.”  Although the previous post was about episode 3, the first podcast in the series is also worth a listen.

Jeffrey Frentzen, editor of Plastic Surgery Practice, asked 3 experts about their beginnings in the body contouring cosmetic surgery.  Participants included Dr. Cuzalina of Tulsa Surgical Arts, Greensburg cosmetic surgeon Michael Kluska and plastic surgeon Dr. Steven R. Cohen of San Diego.

The question posed for this episode was, “How did you become interested in body contouring and what were the first tools you used when working in this area?”

Dr. Cuzalina said the following:

Two years into my practice I met a doctor in Oklahoma who was doing 14 gastric bypass surgeries a week.  We became friends and he’d seen some of my other work on tummy tucks so he began referring me patients.  All of a sudden, I was inundated with all these patients who had open gastric bypass surgery.  At that time with the vertical scar down the middle of their belly, the common solution was to do the inverted T tummy tuck, what’s known as the “fleur-de-lis.”  It worked very well, and it [the surgery scar) was ok because you already had a vertical scar so you can get some really nice tightening around the abdomen.  You end up doing a lot of surgery because they all need not only their belly, but their breasts, arms, thighs and everything done.

Listen to the podcast to catch the rest of the series and hear responses for the other surgeons who participated.  Click here to read more about body contouring surgery in Tulsa, Oklahoma.

Is Beauty A Significant Career Advantage? A Newsweek Special Report

July 25th, 2010

A “special report” was recently published on Newsweek.com, which explores the pursuit of good looks and the advantages that beautiful people have in the workplace and in other areas of life.

The report explores a dilemma such as this:  Do we judge a person on his or her personality, character, or competence in the workplace?  Or do we allow a sort of beauty-bias to affect our judgment?  Writers for Newsweek uncover many examples of the latter and theorize about their causes and consequences.

“Looking good is no longer something we can ignore or dismiss as frivolous or vain,” argues reporter Jessica Bennet.  Questions of fairness aside, the statistics support her argument:

  • “A good-looking man will make some $250,000 more than his least-attractive counterpart, according to economist Daniel Hamermesh.”
  • “Fifty-seven percent of hiring managers told Newsweek that qualified but unattractive candidates are likely to have a harder time landing a job.”
  • “More than half of those hiring managers advised spending as much time and money on “making sure they look attractive” as on perfecting a résumé.”

More surprising statistics are cited throughout the report, but what’s more interesting are the biological and psychological explanations for the beauty advantage.  Is our bias an appreciation of the Platonic ideal form?  Are we unconsciously surrounding ourselves with attractive people in order to produce healthy offspring?  It’s unlikely that a single answer can satisfy our curiosity on this topic.

For many people in our generation, it comes down to an individual choice: how far will you go in your pursuit of beauty?  In the continuum of choices you can make to change your appearance, it’s not always clear where to draw the line.  Many people are quite satisfied with little more than a stylish wardrobe or haircut, but not every person begins their pursuit with the same beauty advantage.

Model Experiences Complications After Augmentation With Extra Large Implants

July 19th, 2010

Sheyla Hershey, a Brazilian model who underwent breast augmentation to have the largest breasts in the world, is experiencing complications after her most recent surgical procedure.  Fox news reports that Hershey has a staph infection in both breasts, which could be life threatening if it reaches the bloodstream.

According to Dr. Cuzalina, complications like this are uncommon but often problematic.

Any infection in a breast implant is unwanted by both patient and surgeon.  They are fortunately very rare (just less than 3 in 1000 patients), but a breast implant infection is difficult to deal with when they do occur and almost always require implant removal.  Having massive implants just complicates the problem further due to the excess skin after removal.

Certain infections such as methocillin resistant staph (MRSA) are becoming more common in today’s society and require more aggressive treatment.  Patients should let their surgeon know if redness or unusual pain occurs along with fever combined with a general feeling of extreme malaise during the first few weeks following breast augmentation.

In an interview with her local television station, Ms. Hershey expressed regret for choosing extremely large breast implants and suggested that reaching her goal of having the world’s largest breasts wasn’t actually satisfying.  Demonstrating her daily routine on video, it’s clear that she’s a very dedicated and strong-willed woman.

“Sheyla takes her craft seriously,” says the model’s official website.  After 32 surgical procedures on her breast, lips and buttocks, she seems very comfortable going under the knife and talking about it publicly.

Fox News has a series of video interviews with Sheyla Hershey and you can read regular updates about her status on her website, sheylahershey.net

From Collagen to Fibroblasts: the Evolution of Dermal Fillers

July 9th, 2010

The last two years have seen a decrease in the use of collagen-based dermal fillers—and it shows in the announcements by two leading makers, Allergan and Johnson & Johnson, that they will no longer produce their respective collagen products (the human-derived CosmoDerm and CosmoPlast, the bovine Zyderm and Zyplast for Allergan; the porcine Evolence for Johnson & Johnson). For more than two decades, collagen has been the preferred filler for many cosmetic surgeons. Considering the origins of donor tissue, it is understandable that questions could arise. Plus, collagen-based fillers require skin allergy testing and are relatively short-lived compared to the next generation of fillers.

As in many markets, money drives the evolution of new products, and dermal fillers are no exception. The popularity of non-animal hyaluronic acid (HA) dermal fillers (known as replacement fillers because they replace lost volume) and PLLA and PMMA fillers (known as stimulatory fillers because they stimulate collagen and fibroblast production) has been strong in the recent past. Radiesse, Juvéderm, Perlane, Restylane, and Sculptra currently dominate the US market. Dermatologists report HA, PMMA, and PLLA fillers as being more versatile, longer-lasting, bulkier, and better for deep-volume filling than collagen.

But what about fine and thin line use, such as for foreheads or smokers lines around the mouth? Collagen was usually considered better for those applications. But Restylane Fine Lines is one HA product that makers hope to take over what used to be collagen territory.

What will the world of dermal fillers look like in the future?  Change is certainly underway. Although fillers that indirectly stimulate fibroblast production are holding sway, direct injection of fibroblasts with Human Dermal Fibroblasts (HDFs) may be a trend. UK dermatologists are currently testing Valveta, a filler derived from the foreskins of male babies that is reputed to repopulate skin with healthy young cells and be long-lasting, if not permanent.

Dr. Cuzalina Featured in LA Times

June 23rd, 2010

Dr. Cuzalina was featured in last week’s Sunday LA Times, discussing what to expect following some the most popular cosmetic surgery procedures – body liposuction, abdominoplasty, and breast surgery. He also shared his secrets for scar care and minimizing scars after cosmetic surgery.

A New Latisse Campaign to Benefit Make-A-Wish

June 16th, 2010

Allergan Inc just announced their latest Latisse promotion to benefit the Make-A-Wish Foundation.  In the Latisse Wishes Challenge, they’re asking people to donate $20 or more to the Make-A-Wish foundation in exchange for a Latisse free trial certificate.  However, only the first 10,000 people who donate will receive the Latisse free trial certificate.

You may remember last year’s campaign led by Brooke Shields.  This year, the campaign is led by lifestyle designer Kathy Ireland, professional ballroom dancer Chelsie Hightower and style guide Bobbie Thomas.

“With approximately 1.5 million bottles sold since launching the product a little more than a year ago, LATISSE is giving back by helping the Make-A-Wish Foundation grant the wishes of children. Through the campaign, we will double each individual’s donation, with a maximum donation of $250,000, through October 31,” said Robert Grant, President of Allergan Medical, a division of Allergan, Inc.

Read more about purchasing Latisse in Tulsa, Oklahoma

Dr. Cuzalina Talks Body Contouring on PSP Podcast

June 12th, 2010

On a recent podcast from plasticsurgerypractice.com, Dr. Cuzalina is asked to comment on the future of body contouring and liposuction procedures. The question posed to three surgeons was this:  “What does the future hold for body contouring and related liposuction procedures?”

Dr. Cuzalina says this:

Over the last five years, when the change happened from open gastric bypass surgery to laparoscopic bypass, I [began] doing very few inverted T tummy tucks and a lot more butt lifts.  So I tend to do the tummy tuck first and the butt lift later, combined with a thigh lift.  But I really don’t like the idea of a circumferential body lift because they are two opposing forces.  It got popular [because] everybody likes to talk about a body lift or belt lipectomy, but when you pull down on the stomach and up on the buttocks, you’re flexing the patient two different directions and can’t get them as tight as you would like.

That’s the one thing that has really changed significantly over the last five years for me.  I’ve stopped doing as many inverted T tummy tucks and I’ve stopped doing as many belt lipectomies. I think I give the patient a much better result if I just do their breast and tummy initially, combined together.  Then later on in a separate stage do their butt lift and possibly thigh lifting.

Dr. Michael Kluska, a cosmetic surgeon in Pittsburgh, and Steven Cohen MD of California are also featured on the podcast discussing this topic.

Listen to it

Waist to Hip Ratio and the Brazilian Butt Lift: A Study

June 7th, 2010

Waist-Hip ratio is a measurement of fat distribution in the lower body.  In past studies of WHR, doctors analyzed its correlations with reproductive age, fertility, health, and perceptions of female attractiveness.

A study from 2009 (recently published online) examines this latter category by analyzing pre and post-operative photographs from patients who underwent liposuction and fat transplantation into the buttocks – a procedure known as the Brazilian Butt Lift.

To analyze perceptions of female attractiveness, male and female subjects from four different geographical areas (or societies) were asked to complete a questionnaire referencing 20 before and after photos of patients who had undergone enhancement with the Brazilian Butt Lift.  In all post-operative photographs, patients showed a reduced Waist-to-Hip ratio without a significant change in body mass index.

“All four populations tested judged postoperative photographs to be significantly more attractive,” wrote authors of the study.  What’s interesting about these results is not simply that post-operative photographs were judged as more attractive; it’s the cross-cultural element, which lends objectiveness to the entire process.  A similar preference for low Waist-Hip ratio was demonstrated, regardless of the ethnic and socioeconomic differences present in the study participants.

You can read this study, “Cross-cultural consensus for waist-hip ratio and women’s attractiveness” through sciencedirect.com

Lumenis Laser Treats Sun Damage, Acne Scars on Dark Skin

June 7th, 2010

Even on patients with darker skin types, the fractional CO2 laser can be an effective treatment for sun damage and acne scars.  According to a recent article in Cosmetic Surgery Times, the success of this treatment was discussed during the 2010 annual meeting of the American Society for Laser Medicine.

A study analyzed outcomes of 45 Brazilian patients who underwent laser skin resurfacing with the Lumenis DeepFX and ActiveFX treatment modes.

Aside from the (mostly positive) cosmetic outcomes, a large part of the study focused on avoidance of “pigmentary changes” in patients with dark skin types.  Previous studies had shown that when darker skin types were treated with fractional CO2 laser treatment, there was a relatively low occurrence of post-inflammatory hyperpigmentation.

In the Brazilian population, where sun damage is a prevalent condition, these findings are significant.  Here in Tulsa, the Lumenis laser can be used for a variety of similar therapies.

As mentioned in the article, sun damage and acne scars are a common indication for CO2 laser skin resurfacing.  But with multiple treatment modes provided through the Lumenis platform, even superficial conditions can be treated.  Using IPL or the YAG component, problems such as lesions, blemishes and minor textural irregularities can be reduced or eliminated.

Otoplasty Study Measures Success of Different Sutures

June 1st, 2010

Otoplasty is a cosmetic surgery procedure that improves the proportion of the ears, often bringing them closer to the patient’s head.  Cosmetic surgeons may use several techniques to accomplish this goal; each will typically involve an incision behind the ear and reshaping of the ear cartilage, followed by the placement of sutures to maintain the new ear shape.

Surgeons in Lithuania recently studied the success rate of different suture types used in Otoplasty.  A 3-year study was conducted with 100 patients, who 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 online on PubMed: “Comparison of otoplasty outcomes using different types of suture materials