News & Features

Plastic Surgery News: World Roundup December 2005

Melanie Griffith: Too Much Plastic Surgery?
Winter Hibernation: Torpedoes Liposuction
U.K.: When Cups Runneth Over; Dox Misjudge Breast Size
U.S.: Living Fat Facelifts
Chewing Gum -- Speeds Surgery Recovery!
Arguing Slows Healing after Surgery

Melanie Griffith: Too Much Plastic Surgery?

Plastic Surgery News: World Roundup, December, 2005

Melanie Griffith

Anthony Youn, MD., a board-certified plastic surgeon in Rochester Hills, Michigan, has studied pictures of actress Melanie Griffith taken 15 years ago alongside some more recent photos. Dr. Youn's findings:

"Melanie is becoming a classic example of a Hollywood starlet who has attempted to use plastic surgery to unsuccessfully retain her youthful beauty. During "Working Girl," she had a very nice look, which has been tampered with too much since then. The most obvious feature is her overly large, misshapen lips. She has augmented her lips too much, causing her to lose the Cupid's bow part of her upper lip. This is likely a sign of a gortex lip implant (a type of plastic that some plastic surgeons use to augment the lips, whereas I use it for the covering on my jacket). The easiest way to spot a gortex implant is to see how the lip moves while the person is talking. The gortex does not allow the lip to move normally, and therefore the lip looks too stiff. I find that the vast majority of patients who get gortex lip implants will later have them removed. Her lip augmentation is a misguided attempt to look young, as a sign of youth is larger lips. However, there is a fine line between "bee stung" and youthful, and she has crossed it. Interestingly enough, the person in Hollywood with the largest, most luscious lips, Angelina Jolie, appears to have had them all her life. While some actresses get their lips overly enlarged in order to look younger and keep up with the younger Hollywood stars, it usually doesn't help keep their careers going. While other actresses of Melanie's generation such as Susan Sarandon and Geena Davis have continued with successful acting careers, Melanie Griffith's career appears to have stalled in the early 90's.

"In addition to the lips, she appears to have had some Botox to smooth her forehead, and laser treatments and a probable facelift to over tighten her face. This makes her facial movements appear too tight (à la Joan Rivers) and is a sign of too much plastic surgery.

"Melanie has had so much work done that, reportedly, husband Antonio Banderas has forbidden her to have any more plastic surgery. She would look much more natural and glamorous, in my opinion, if she just had the implants removed from her lips."

Winter Hibernation: It Torpedoes Liposuction

Plastic Surgery News: World Roundup, December, 2005 When the blue finger of winter lays its chilly fingers on you, physicians recommend that post liposuction patients take a long look at their lists of holiday and winter eats and head for the gym on a regular basis.

While some liposuction is mistakenly viewed by some as a quick fix for weight loss, liposuction patients are three times more likely to gain weight if they do not adhere to a proper diet and four times more likely to gain weight without regular exercise. So declares a study printed in the December issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (A.S.P.S.) Patients who don't carefully monitor their food choices and eating patterns - along with their workout routines -- may be considerably less happy with the outcome of their procedure, the study found.

"Ultimately, it's a lifestyle choice," said Rod Rohrich, M.D., an A.S.P.S. past president and author of the study which looked at how 200 liposuction patients fared after their procedures. Findings? 43 percent gain weight after the operation, with the majority gaining weight after six months. Twentyfive percent actually lost pounds while 32 percent experienced no weight change.

"Liposuction should be used as an adjunct to a healthy lifestyle rather than as only a weight loss tool," says Dr. Rohrich. "My practice actually turns away about one in five people requesting liposuction because, if they are not making appropriate eating and exercise choices, they are not good candidates for the operation. Many are 50 to 70 pounds overweight."

In the U.S., liposuction is the most popular cosmetic plastic surgery procedure with almost half a million patients having undergone it during 2004.

But the study also holds good news: liposuction patients who do adhere to a proper diet after the procedure are two times more likely to lose more weight. Those patients also have a 96 percent chance of a decrease in clothing size, causing them to be 15 times more likely to be happy with their results and have good long-term outcomes.

Of course, no procedure or diet known to science can remove all the fat from your body because the brain is entirely fat.

And, as George Bernard Shaw once observed, without a brain, you still might look pretty good, but all you could do is run for public office.

When Cups Runneth Over; Dox Miss Real Breast Size

In England, the National Health Service (NSF) will pay for breast reductions IF a surgeon finds there is a possibility the woman will have spinal abnormalities, back pain and disability. The typical procedure removes about 500cc, or one full measuring cup, from each breast. (The NSF also covers breast asymmetry.) Until now, the decision to operate has always been the surgeon's personal assessment. But when a test was conducted of physicians actually guestimating breast size and volume on a mannequin, they found 30 percent missing the mark widely. About 15,000 women yearly are considered for breast reduction or an operation to correct asymmetry.

Says Mr. Mark Henley, Council member of the British Association of Plastic Surgeons (B.A.P.S.) and the British Association of Aesthetic Plastic Surgeons (B.A.A.P.S. :) (In England, an M.D. is known as "Mr.") "There is an inequality of healthcare provisions for patients with large breasts. They are currently assessed 'by eye' by surgeons who may or may not recommend them for the operation based on a flawed assessment."

Solution? It was found in the fashion industry. Body Aspect, a three-D body scanning device originally designed to determine body types and sizes for clothing manufacturers, was adapted for medical use to pinpoint accurate breast sizes. So far, 13 clinics in Nottinghamshire and Southern Derbyshire using the device have resulted in an 80 percent reduction in patients referred to surgeons for assessment and shorter waiting times for those who need the operation. Testing on 900 women revealed, when the scanner is used to determine breast size, variability is reduced to less than five percent. Thus, British plastic surgeons are able to more accurately tell who really needs the breast reductions.

Of course, if - as columnist Dave Berry asserts - the true biological purpose of the female breast is to make males stupid, there is still no guarantee that husbands' I.Q.s will increase as the wives' breast sizes decrease.

Living Fat Facelifts

Plastic Surgery News: World Roundup, December, 2005

The surgical markings show where strips of fat have been inserted under the skin.
Photo, Dr. Moelleken.

Given all the trouble, woe and worry it causes, human fat is actually a delicate and fragile substance.

Many plastic and cosmetic surgeons offer fat transfer procedures by taking fat from more fleshy parts of the body and depositing it elsewhere to plump things up. Lips, hands, hollow places in the face and, especially, the female derrière are often subjected to fat transfer.

But the actual fat itself is extremely feeble. It can't be exposed to air. Fat cells will also die if the wand extracting the fat is too large or if the needle reinserting the fat cells is too narrow. Another critical step happens when the blood-fat mixture is spun in a centrifuge to separate the two substances. If the device is spun too long or too fast, the frail fat cells will also give up the ghost.

Outcome? All too often, only about 15 percent of the transplanted fat remains alive in its new location while the remainder is reabsorbed by the body. Several years after a fat transfer, chances may be good no changes at all will be visible.

Now, Beverly Hills plastic surgeon, Brent Moelleken, M.D., has developed a new way to transfer living fat to make aging faces look more refreshed. To perform his trademarked "LiveFill" facelift, Dr. Moelleken removes thin, long strips of fat from more flabby places in patients' bodies and inserts the strips under the skin to create younger, fresher looking faces.

To insert the strips, the surgeon makes small incisions in the facial skin, creates a pocket under the skin and then implants the fat strands. The new addition survives better -- and usually, for life -- because it develops a new blood supply as a part of the body's normal wound healing process.

"Within 72 hours, the body knows the strips are alive and that they belong to the patient," Dr. Moelleken says.

Dr. Moelleken's studies show new blood vessels growing in and through the fat strips years after the procedure.

Because Dr. Moelleken says he is the only surgeon doing LiveFill, he let his plastic surgery colleagues know more about the procedure by studying 119 LiveFill patients and presenting the results in an article with a tongue-twisting name ("Disarticulated Facial-Fat Grafts Offer Superior Viability and Constancy Compared to Fat Injection for Facial Filling: Clinical, Histological and 3-D CT Correlation") that compares the older method of fat transfer against his method. Upshot? Even before being injected, only 25 percent of traditional fat grafts are alive. But 88 percent of LiveFill survives; over the long haul, 75 percent remains, alive and well, in the patient.

Common LiveFill facial fat transfers include plumping out the fold of skin that runs from the bottom of the nose to the corner of the mouth (the nasolabial fold;) the marionette lines that run from the corner of the mouth down the chin; the upper and lower lips; cheeks, eyebrows and the areas next to the eyes where crow's feet appear.

Chewing Gum -- Speeds Surgery Recovery!

Plastic Surgery News: World Roundup, December, 2005 During the annual meeting of The American College of Surgeons in San Francisco, new research was presented revealing that chewing gum after colon surgery can help you leave the hospital quicker.

Dr. James McCormick of the Western Pennsylvania Hospital in Pittsburg led a study of 102 patients who had elective colon resection surgery, with a laparoscope, an instrument surgeons use to see and work inside the body. Half the subjects followed the usual post operative routine: they chewed ice and drank clear liquids. The other half also ate ice and had liquids but they also chewed gum. Outcome? The gum chewers went home from the hospital one day sooner than the others.

Dr. McCormic says it's because of something known as "sham feeding."

Because of all the jaw movement while chewing gum, the body thinks you are sitting at a table having a meal and not stuck in a hospital bed, listening to the tinny sound of a bad T.V. all day. Said one researcher: "The sooner the body thinks it's normal, the sooner it will act normally. And the sooner you get to go home."

But wait, there's more! The authors did the study because hospitals - if you didn't already know - are hugely expensive and if every colon patient could come home one day sooner after the operation, something like one billion dollars yearly in the U.S. would be saved. It works because the digestive system remains inactive for a period of time following surgery. But chewing gum after surgery can also prevent or reduce post operation Ileus, a condition where the digestive system remains inactive too long after surgery. And it's the Ileus that causes post operative woes and prolonged hospital stays.

Saving money is all well and good but the study entirely skips the serious matter of who is supposed to scrape off all those wads of chewing gum stuck under the beds.

Bickering Slows Healing after Surgery

Plastic Surgery News: World Roundup, December, 2005 Do your New Year resolutions include going ahead with that cosmetic or plastic procedure you've been thinking about? If so, you might heal faster if you smooth things over with your mate and make sure there are no squabbles in the house before or after the operation. Why? Because science has found that quarreling with your spouse slows down the body's ability to heal.

A new study reveals the stress a typical married couple feels during an ordinary half-hour spat is enough to slow their bodies' ability to heal from wounds at least a day. Moreover, according to Ohio State University professors Janice Kiecolt-Glaser and Ronald Glaser, if the couple's relationship is routinely mutually hostile, the delay in healing can even be doubled.

After studying the ways stress can affect human immunity for 30 years, the married study authors sum up their findings: "We have enough data now from all our studies to suggest that hospitals need to modify…ways to reduce stress prior to surgery."

Both researchers say stopping the preoperative tiffs and fussing can lead to shorter hospital stays, lower medical bills and a reduced risk of infections.

The study was based on real life scenarios. In the most recent test, the researchers studied 42 married couples who had been together at least 12 years. Each couple then remained in the university's General Clinical Research Center for two, 24-hour visits. Both were given eight small blisters on their arms and hooked up to other medical monitoring devices. During one visit, the couple talked about pleasant things. But during the second visit, the couples concentrated on an area of disagreement. The interactions were video taped and the subjects were asked to fill out questionnaires that gauged their stress levels.

When all the factors were put together, the researchers found blisters took a day longer to heal after arguments. However, the highly hostile couples required two days for the small wounds to heal.

Of course, couples who have been together as long as 12 years already know the all-purpose way around a household face-off is a simple, noncommittal and nonthinking, "Yes, dear."

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