Heidi Montag’s Cosmetic Surgery

Posted on January 29, 2010 by admin

The Heidi Chronicles. Heidi Montag’s Cosmetic Surgery Still Getting Press. It Has Legs. And Breasts. And Thighs. And Necks. And Noses.

I thought it would be over by now. A quick blast – like the Los Angeles rainstorms – and then gone. Heidi Montag’s cosmetic surgery marathon and PR juggernaut is still rolling.

I was wrong. Heidi was on ABC Television’s Nightline Friday night, January 22. The interview was rather insipid. The interviewer kept pounding away at Heidi, hoping to get her to say her chosen cosmetic procedures, all ten of them, were not appropriate, not wise or whatever would make all the viewers feel better.

Heidi held her ground. And, told us something that further explains the rash of PR she is getting. Just so happens, she has a new record album coming out. Amazing coincidence.

I won’t say anything else. I thought I said it all on my WebMD blog which is currently posted. What I did not know at the time I wrote the blog was that the great album since Thriller was about to hit the stores.

My original contention that this was a deftly-executed publicity stunt has been confirmed. Heidi became January’s “Balloon Boy”. Anything for press, including a trip to the operating room.

Incidentally, Heidi treated a post-op near miss it as a minor sideshow. She reported that she was found to have had too much Demerol (a narcotic pain-killer) on board while at a recovery retreat, that she “was taking only five breathes per minute (normal is 12-16). If such is true, that was not good. Luckily for Heidi and the PR campaign, one of her security detail, moonlights as an Emergency Medical Technician. He recognized the problem, took action and the campaign then continued to roll on.

Finally, don’t anyone try to deny the power of good public relations. A top publicist is a magician. Getting a wannabe anything on national TV and in the national magazine with a two million circulation, PEOPLE, is not easy. Now, it seems everyone knows Heidi. Of course, then the question: What will Heidi do now?

Be sure to link to my WebMD blog; it’s had more comments from readers than any other blog I have written in nearly two years. So, I guesss that says it all.

Los Angeles Rhinoplasty

Posted on January 27, 2010 by admin

What’s With the Five Hour Rhinoplasty?

I am hearing some amazing stories from patients. While we always learn from listening to our patients, I am not only learning but becoming a bit dismayed with respect to what I am hearing about nasal cosmetic plastic surgery. Patients report operations taking three, four and even five hours that ultimately were unsatisfactory for the patient. It seems the operations become longer as more grafting and transplantation of tissue takes place. Now certainly there are indications for adding on tissue into the nose, particularly if there has been previous surgery or if there has been an accident that has destroyed some of the tissue. But, even if that is the case, why are these operations taking so long? I am not sure of the answer, except, my sense is that some surgeons are making the operation much more complicated and complex than need be. For many of the grafting or transplanting needs, there is adequate tissue inside the nose itself. This of course makes it very economical and efficient to be able to harvest the tissue since it is coming right from the area that we are working on. Often, we use cartilage and bone from the nasal septum because we are taking it out anyway to correct the deviated nasal septum and improve the airway, and correct problems that might lead to sinusitis and other serious complications. While only very rarely is it necessary to take cartilage from the ear, I am now hearing stories of almost routine harvesting of rib cartilage and even rib bone to be place inside the nose, and of course, that makes for a very involved, complicated and long duration operation since other surgical sites besides the nose must be operated upon. I guess I am just from the old school. We do nearly all our surgeries from inside the nose using completely hidden incisions, closed with absorbable stitches. That is called a “closed rhinoplasty“. The “open rhinoplasty” requires an external incision, and I just don’t see the need for that very often. And I have done over 4,000 cases in my career which now spans nearly forty years. The other issue is that some surgeons are not efficient. It just takes them too long to get the job done. I would attribute that to less-than-optimal training in the residency programs as well as inexperience. Generally, inexperienced surgeons are slower than veteran surgeons. The “occasional nasal surgeon”, the doctor who spends more time doing other cosmetic plastic surgeries such as breast augmentation, tummy tuck, breast reduction and liposuction just doesn’t develop the facility for rhinoplasty because he doesn’t operate on the nose often enough. He cannot become a master nasal surgeon. In my experience, most cosmetic nasal surgery or rhinoplasty procedures could be done within an hour. If you need to add on the functional or breathing operation, that adds another 20-30 minutes. The total time in the operating room, including going to sleep and waking up from the anesthetic, should rarely be more than two hours.

Recovery From Beverly Hills Cosmetic Surgery

Posted on January 21, 2010 by admin

Some Surgeons Make Recovery From Cosmetic Surgery Much Easier Than Others. How is That Possible?

Patients come in a consultation and ask “Is there going to be a lot of swelling and bruising?” This always weighs heavily on their minds. Often, they related friends and family histories of having massive bruising, swelling and even facial distortion.

Frankly, that should be rare in today’s high-tech, modern cosmetic nasal surgery environment. Typically, the most experienced and narrow-focused surgeons, the cosmetic nasal surgery superspecialists have techniques and the talent in performing the surgery such that it will take less time on the operating table. That translates directly into less trauma to the tissues and, therefore, less swelling and bruising.

In addition, we now have at our disposal a large range of medications to help reduce swelling and bruising. There are prescription medications to reduce swelling and non-prescription, homeopathic medicines that are thought to reduce bruising. Even what you eat can have a benefit as foods such as fresh pineapple and fresh papaya can be helpful in reducing swelling and bruising. And, of course, ice packs immediately after surgery are a long-standing aid in preventing or reducing the swelling and bruising.

It is very important that blood pressure be controlled after surgery and typically blood pressure rises because of pain. So every surgeon who is a master of cosmetic nasal surgery has long recognized that it is very important to provide adequate pain medication. You see, if pain is present, blood pressure goes up, and if blood pressure goes up, there is more leakage of blood from the tiny blood vessels that were inadvertently severed during the operation. All bruising is the result of leakage of blood from open blood vessels.

Don’t forget that too much activity immediately after surgery may well cause additional swelling and bruising. That is why we recommend, for the first 24 hours, that patients pretty much relax and not do very much in the way of activity.

By the second post-operative day, the rules change. By then, it is generally wise to start walking and thereby increase the circulation. People feel better if they do not stay in bed where they tend to start feeling more tired and a sense of lassitude envelops them.

Sleeping is important. If pain is not controlled, it is hard to sleep. Therefore, we pay close attention to pain control which could interfere with sleep. No reason to spare the paid meds. However, some pain medicines may cause stimulation and, therefore, they have trouble sleeping. In that case, we change the pain medication. However, if despite pain control, the patient reports that sleep is poor, we prescribe a sleeping medication. The world looks a lot better and happier after a good night’s sleep!

I have always felt that the care of the patient after surgery is just as important as the operation itself. It must be conducted with the same attentiveness and focus. In cosmetic plastic nasal surgery, the results, and the patient experience are all about detail, detail, detail.

Rhinoplasty Prices in Beverly Hills

Posted on January 14, 2010 by admin

Has the Recession Affected Rhinoplasty Prices in Beverly Hills?

The recession has affected nearly every business, industry and profession in the United States – including Beverly Hills. While Beverly Hills remains a cosmetic plastic surgery destination for many people from the United States and throughout the world, the reality is that in a recessionary environment, fees are reduced.

However, it is important to understand that a low fee by itself should not be the decision-making factor when considering having cosmetic plastic nasal surgery. The price range of rhinoplasty encompasses both the less experienced, younger practitioners and the veteran superstars and super specialists of the cosmetic surgery world.

It is accepted that young doctors, eager to build their practices will charge less for their services and hope to attract patients in that manner. For patients, there sit risks. Because, often, the younger surgeons do not have the talent and long line of experience to handle anything but the most simple case.
But, few nasal plastic surgery cases are simple. Often, there are breathing or sinus problems that should be corrected. Nasal septoplasty and turbinate resection to improve the airway should be considered in such cases. Does the young surgeon have the training, talent and experience to handle all those issues?

The reality is that rhinoplasty fees in Beverly Hills may be higher than they are in Omaha, Nebraska or Oshkosh, Wisconsin, but of course, that reflects the cost of doing business including rent, salaries, etc.

One should always inquire from the office as to what the cost of the rhinoplasty is and to ask if, in fact, there are some ways to be granted a courtesy. Don’t expect to get a courtesy reduction in the fee just for asking, however, because that is not likely. What will help you get a reduction in the fee is being able to schedule your case at the time that is convenient for the outpatient surgery center and the surgeon’s office. That is the most common and proper reason for fees to be reduced.

Remember that rhinoplasty prices also reflect the complexity of the case and the time involved in performing the surgery. Particularly, if you need revision rhinoplasty in addition to that septoplasty and turbinate resection to help you breather, the fee will be higher than that for just shaving a bulbous tip.