Thursday, May 10, 2007

Welcome New York Times readers


Plastic Surgery 101 merited mention in the New York Times Fashion & Style section of all places today. Click here to read.

Welcome all new visitors!
Rob Oliver Jr. MD

7 comments:

goose said...

Nice article Rob. Plane loads of New Yorkers will be coming your way, not to mention old lady aunts from MN.

Dr. Tony Youn said...

Nice mention in the article. I didn't know about it myself until someone phoned my office to mention it. Glad to see you got some extra publicity and hits!

Julie said...

I'm one of the new visitors who stumbled upon your blog thru The New York Times. Interesting blog!

Faith said...

“Half of our half of the population, it seems, gets implants as a high school graduation gift. Our glands serve wonderful, useful purposes, get massively annihilated in the process of reproduction, and suffer further degradation as we try to stay active and in shape. Yet there is nothing, absolutely nothing short of surgical intervention that has any restorative value. It disturbed me that such a critical part of my anatomy seemed to have the shelf life of a carton of heavy whipping cream, and I wanted to reclaim it - but all the youthful largesse and eager male [physician] assistance in creating such mammary abundance had somehow tainted the whole prospect.”

I write a magazine column about vanity and the midlifer. The above is a portion of text to be published in July. I’m sending it to you for one reason only: Doctors, if they hear anything much past insurance premium quotes, might listen to another doctor.

For example, there is a known correlation between breast augmentation surgery and higher suicide rates (73% higher by the American Journal of Epidemiology, vol 164, p 334). Yet doctors aren’t pushing for a psych clearances when a nineteen year old wants a breast larger than the average buttocks. Perhaps someone considering implants should know that 73% statistic just in case they are thinking the figure altering surgery is going to make everything better. Perhaps the plastic surgery medical societies would be addressing this issue more affirmatively by now, but mostly what we see is Dr 90210’s “What size did you decide on today, Sweetie,” over and over and over. Just extend enough of a superficial ear to earn the fee, then cut.

There is nothing wrong with keeping an eye on the profession. More and more the public depends on bloggers such as you to help them make decisions. Don’t back away if someone starts putting pressure on you. The first rule is, do no harm. Sometimes that is best served through information.

Dr. Rob Oliver said...

Faith,

I think you've taken the wrong conclusion away from some of the data re. implants & suicide rates. It's not a causal relationship, and depending upon whom you use as a control group (the population as a whole, breast reduction patients, other cosmetic surgery patients, etc...), it may not even be a statistical relationship at all.

Body image is part (maybe 1/3 or more according to experts)of self esteem, and at least in the case of augmentation patients, there's a good deal of published work on the area-specific body image outcome. Figuring out what's actually valid or what beneficial psychologic effects persist is a whole other issue full of confusing data. I've touched on that before in some other blog posts.

You get into briefly the areas about what's truly informed consent when you mention pschiatric screening which could be asked for any elective surgery or other procedures (body piercing? Permanent makeup? tatoos? Hair removal?). In the real world there is no mechanism (or more importantly funding)for screening pschiatric issues other then choosing not to operate on people who flagrantly display stereotypical behavior of BDD and other psychiatric problems.

Myself and other Plastic Surgeons would agree with you 100% that show like "Dr. 90210", "Nip/Tuck", or "The Swan" can trivialize cosmetic surgery and professionalism in medicine. Keep in mind that such shows are edited to be glib and sensationlistic for TV purposes.

coleridge said...

Good blog. Now, can we ask you questions? For example, I am a young looking 66 year old and want to have a procedure to help my jowls and sagging neck. Is face lift the only choice or are there other less drastic choices and also, am I too old for any of this to be good?

Dr. Rob Oliver said...

Coleridge,

it's a little hard to dispense off the cuff advice on people you've never seen.

The less invasive options for neck surgery be it liposuction alone, "thread lifts", or cutaneous laser-like treatments (Thermage, Titan, & others)will not work well for most patients with 60+ year old skin as it just doesn't snap back. Only the most subtle aging changes would do really well with those kind of things.

A "neck lift" or tightening is really akin to the lower 1/2 of a facelift and can do remarkable things to the neckline. Such procedures when do for focal problems (like the jowl) can be effective and have fairly modest downtime as compared to full-face lifts. On the other hand, if you need a facelift and just get your neck done it draws even more attention to the rest of the face as it starts to look less harmonious and more patch-work.

cheers
Rob