Intelligent Plastic Surgery

Are Stem Cells the Future of Plastic Surgery?

2011-05-25T11:43:00.000-07:00

Much has been made over the past several years regarding the healing potential of stem cells. This has not been without some controversy, and that controversy has been related to the use of embryonic stem cells. The harvest of these cells results in the destruction of an embryo and thus have not been used in clinical applications. Fortunately, another source of stem cells exist in the adult. Stem cells can be taken from the bone marrow as well as another recently discovered source - fat! Liposuction is a particularly good means to acquire adult derived stem cells, and you get the simultaneous benefit of improving your body contour as we acquire the tissues needed to process.

Stem cells have been purported to enhance the survival of fat grafts, improve the quality of damaged skin, enhance the thickness of skin and soft tissues, and, most notably, been employed in the creation of organs, heart valves and blood vessels in the laboratory. Potentially serving as a cellular “fountain of youth.”

Stem cells retain the ability to differentiate (grow and develop) into nearly every cell type under the proper cellular growth factors. As we learn more about what makes a cell grow or change, it is likely that science will continue to expand the role of stem cells in clinical medicine.

Plastic surgery has already adopted the technology and is actively researching its effects. However, the marketing of these “techniques” have progressed far beyond the current scientific understanding. There are “stem cell face-lifts” and “supercharged fat grafts” but none of this has been proven to be as effective as the advertisements might claim. Thus, a consumer must approach these situations with a healthy degree of skepticism regarding the claims. This is not to discount the techniques as a whole, but we don’t understand them to the degree that is required to make the statements commonly advertised.

What does the future hold? It is likely that we will be able to inject stem cells in your IV which will be targeted to the area of concern and then help your body rebuild itself with a new heart muscle or liver, kidney, spinal cord, or even breast.

Stay tuned for the future, but beware of “snake oil” salesmen selling it before its ripe!

Vincent Marin, MD, FACS
San Diego Plastic Surgeon

The Skinny on Fat

2011-05-16T20:45:00.000-07:00

The latest rage in Plastic Surgery is fat transfer or fat grafting. Fat transfer to your butt, breasts, face and lips – really wherever you need volume. Fat has a number of advantages to its use. Firstly, the fact that it is harvested via liposuction techniques allows you to rid yourself of unwanted fat in certain areas in your body. There is no risk of rejection as it’s your tissue and it’s free – well at least the fat is, getting it is a labor-intensive process. As we age, we lose volume, and many patients are born with deficiencies where they could use more oomph.

Well, what’s the down side? Fat grafting is a procedure where we remove tissues from where they live with a bloody supply, nutrients and oxygen and then re-inject them in another area hoping they survive long enough for new blood vessels to reconnect. The fat cells need to survive by diffusion – absorbing all the food and oxygen – until they are supplied by another, new blood vessel. Unfortunately, about 40-50% of all of these cells will die before this happens. Once this fat cell hangs around long enough to get its own capillary, it will likely survive forever. Permanently becoming part of the new location.
If we are going to lose half of the fat grafts, why not just put in twice as much? Great question, and here’s why. The diffusion process relies on the fact that each “grafted” fat cell is near a blood vessel or other cell that it can borrow from for awhile. The bigger the injection of fat, the more likely the fat is going to be next to more fat and will not survive. Thus, all we end up with is more fat loss.
It seems really complicated. How do we make this work? The success lies in a technique called micro-fat grafting. Meaning that very small amounts are placed in different layers of the skin and muscle to increase the chances that each fat cell is close to another cell it can borrow from. The more this happens, the better the overall success rate. This leads to increased volume and happier patients.
What’s next? Next on the horizon is the use of adult stem cells to enhance the survival of the fat grafts by making them “super-charged fat grafts.” The stem cell effect is still under investigation and not currently approved outside of a study in the US. Stay tuned for our next blog post where we will discuss the latest on stem cells and their use in cosmetic surgery.
If you want to know more about your fat grafting options, call today for your free consultation 858-638-9800 or visit our website for a virtual consultation.
Dr. Vincent Marin
San Diego Plastic Surgeon

Heidi Montag Regrets Her Plastic Surgery

2011-02-14T16:37:00.000-08:00

In a recent interview with Life and Style magazine, Heidi Montag claims "This is not what I signed up for, parts of my body definitely look worse than they did presurgery." Among her complaints on the one year anniversary of her shocking procedures are unsightly scars including a two-inch raised blemish from her chin reduction, a jagged line behind her ears, two "caterpillar-size" bald spots from her brow lift, breasts that are not symmetrical, scars on her nipples and a bright red mark inside her nostril. "People have fewer scars from car accidents than I have on my body," Montag laments to the mag.

Despite Ms. Montag's intentions regarding her now third media blitz relating to her plastic surgery endeavors, she brings to light a number of very important considerations. First of all, most plastic surgeries come with some scar. Any time skin is removed or an implant is inserted, we need to create a scar. The key is that the end result with a scar outweighs the pre-op appearance. It is always a trade-off. Secondly, combining surgeries is not wrong or uncommon, however, it needs to be done safely and with the patients overall health as our primary concern. Of course her 10 procedures left her with a significant recovery, her surgery must have taken at least 6-8 hours. Finally, the key to a successful plastic surgery procedure is communication. A doctor must understand what the patient would like to achieve, and the patient must understand what the doctor can produce. Just because you want it or someone else has it doesn't mean it's possible on you!

Thus, it is easy for Ms. Montag to now discuss her procedure, but since Dr. Frank Ryan has since passed, he cannot defend himself. There are two sides to every story and the truth likely rests somewhere in-between. So do your research and use common sense, and it is likely that plastic surgery (if its something we can fix) can make a difference in your life. Just choose to do it for the right reasons.

Vincent Marin, MD, FACS
San Diego Plastic Surgeon

How Did Cyndi Lauper Look So Good at the Grammys?

2011-02-14T15:28:00.000-08:00

In a recent post by the London Daily Mail the following was said about 80s rocker Cyndi Lauper: "She might have undergone an abrasive beauty treatment in an attempt to turn back the clock.
But clearly something is working for Cyndi Lauper who looked much younger than her 57 years as she rocked the Grammys last night.

Her face looked silky smooth and wrinkle free in minimal make-up and blonde hair extensions piled on top of her head, a far cry from the woman who was snapped two weeks ago.
The 80s legend was seen with a bright red face that had been brought on due to a bad reaction to a spa treatment, as she jetted out of Los Angeles.
But last night, her radiant and dewy complexion was all to clear to see, even under the harsh glare of the flashbulbs, suggesting that she may have changed her beauty regime.
Either that or the old adage - no pain, no gain - really does ring true."

Cyndi demonstrated the immediate redness and skin changes seen either with a chemical peel or laser resurfacing. These are procedures performed to remove excess superficial skin and cause an inflammatory response which generates the formation of new collagen. This can help to reduce fine lines and give a brighter glow to the skin - which Cyndi had as she walked the red carpet. These procedures are safe, but do have real downtime as seen with Cyndi's red and flaky face. This is normal and heals, but also very difficult to hide in public. Laser resurfacing and chemical peels are the best way to improve fine lines, texture and pigment issues in the skin. Check it out!

Dr. Vincent Marin
San Diego Plastic Surgeon

Do Breast Implants Cause Lymphoma?

2011-02-14T15:17:00.000-08:00

In a recent publication, the FDA indicated that there is a small risk between breast implants and a rare form of blood cancer. The type of cancer is called anaplastic large cell lymphoma (ALCL) which is a form of non-Hodgkins lymphoma, a cancer of the T-cell lymphoctyes cells in the blood.

The most important aspect of this recent FDA announcement is relating to the personal risk to each patient who has undergone a breast augmentation. Fortunately, the risk is very small. Only 50 cases have been reported (some may be duplicates) in the estimated 5-10 million breast augmentations that have been employed worldwide. That puts an individuals risk at 0.0012-0.0006 percent. Keep in mind that 1 in every 7 women will be diagnosed with breast cancer alone. That is a 14% chance that can be as high as 50% in certain women with higher genetic risk factors or positive family history.

This relationship has been seen with both types of implant textures, smooth and textured, but more commonly in the textured type. Fortunately, this type is no longer on the US market and had been infrequently used in the United States. Most implants in the US are smooth, round saline or silicone implants.

No true association has been established between breast implants and lymphoma through multiple studies.

The potential association of breast implants and lymphoma has been evaluated in several studies with long term follow up, and the published epidemiological evidence does not support an increased risk of non-Hodgkin's lymphoma in patients with breast implants:

An epidemiological study reviewed evidence from five long term studies of 43,000 women with breast implants and followed for up to 37 years and noted no difference in the incidence ratio of non-Hodgkin’s lymphoma in implant patients (Lipworth, March 2009).
A Scandinavian cancer incidence study evaluated 6,222 women with breast implants including 3,336 women with 15 or more years of follow-up and 827 with 25 or more years of follow up and found no excess of lymphoma in subjects with implants (Lipworth, Jan 2009).
A large, controlled Canadian cancer study followed 24,558 breast augmentation patients and 15,893 women who received other cosmetic surgeries and found a similar incidence of non-Hodgkin’s lymphoma after over 600,000 person years of follow-up (Brisson, 2006).
A Dutch study concluded there may be an association of ALCL and breast implants but suffered methodologically (Evens 2008) by having controls that were not comparable to the cases (ALCL) since the controls were lymphomas other than ALCL (de Jong, 2008). They reported that 6 of 11 primary breast ALK1-negative ALCLs had no history of silicone breast implantation, while 5 did, and 1 patient developed ALCL one year after cosmetic implantation. In addition, the author’s analysis was based on 5 saline-filled breast implants—including 2 initially observed or “trigger” cases of women with both ALCL and breast implants over a 17 year period.
The results of the Allergan Breast implant sponsored clinical trials have been reported at the ASPS meeting in Toronto (October 2010). For all 89,382 patients, with 204,681 patient years of follow-up, the number of lymphomas observed divided by those expected (26/43) yields a standardized incidence ratio (SIR) of 0.6.

Several studies have shown that women with breast implants have an overall lower risk of breast cancer than the general population. (Deapen DM, 1997 & 2007) ALCL comprises a very small percentage of all lymphomas and is an extremely rare pathological entity (0.2 per 100,000 person years) (SEER 2008).

With the extremely rare incidence of ACLC, there is limited ability to make any formal conclusions relating to lymphoma and breast implants. Active, ongoing research is underway to understand the relationships relating to breast implants and the development of lymphoma, but little evidence currently suggests any causal relationship.

Some of the unlikely events that might happen in ones life that are MORE likely than getting ALCL cancer relating to breast implants are:

0.054% – chance of dying from a car accident

0.0012 % – chance of dying from an accidental drowning

0.0012 % – chance of dying from a fire or smoke inhalation

0.0012-0.0006% – ALCL from breast implants

12.2% - chance of breast cancer with or without implants (1 in 8 women)

The chance of breast cancer appears to be 10,000 times more likely with the current information we presently have available.

In conclusion, although it has come to light that there have been a number of patients who developed ALCL in the setting of having a previous breast augmentation, no causal or linked relationship has been demonstrated. The risks are extremely low and are not currently linked to the presence of breast implants. Both the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery has not recommended a change in current practice or in how breast augmentation procedures are performed.

Dr. Vincent Marin

San Diego Plastic Surgeon

Leann Rimes - A Recent Example of the Divorce Makeover

2011-01-04T15:56:00.000-08:00

Its safe to say that country singer Leann Rimes is looking a bit curvier these days. She is my first recent example of the divorce makeover phenomenon. After her recent public divorce and then hook up with actor Eddie Cibrian, it seems she has added some strategically placed curves. Leann is a beautiful woman and a perfect candidate for a breast augmentation in that she is in good shape with little excess body fat - and unlikely to develop additional breast tissue unless she put on weight. She now shows a rounder, fuller breast shape with the characteristic "upper pole" fullness on her breasts. Very few women naturally achieve this phenomenon without implants.

Divorce can frequently be a motivator for patients to finally decide to proceed with plastic surgery, expecially when it has been something they have considered for a long time. Frequently a spouse doesn't want the procedure to be done, can be insecure about the results, or patients are too busy committing their free time to a difficult relationship. Whatever the cause, divorce often makes a woman (or man) redirect their attention to themselves and their appearance. They might be looking for a new job or more commonly a new mate which brings this to the forefront.

Leann looks great, and it appears that the implants are appropriately sized for her frame. She will see the implants become more natural and less prominent over the subsequent few months.

Vincent Marin, MD, FACS
Marinaesthetics.com

The Divorce Makeover - A New Start for a New You

2011-01-04T15:13:00.000-08:00

Divorce rates in the United States are higher than any other developed country in the world. Statistics suggest that nearly half of all marriages will result in divorce. According to life-stress scales, divorce only trails the death of a spouse as the most traumatic time in a person’s life. (Holmes TH, 1967) Nearly 67% of second marriages and 75% of third marriages will end in dissolution, making divorce nearly epidemic in modern society.

Stress has long been a major factor in the process of aging, and this combined with a difficult divorce, infidelity, personal neglect, lack of sleep and maintaining small children or a full time job surely accelerates this process.

In my plastic surgery practice, I regularly see patients who decide to undergo surgical procedures relating to major events in their lives; both positive and negative. These are routinely a wedding, an upcoming class reunion, after the birth of a child (commonly termed “mommy makeover”), and frequently after a divorce.

I think this last area is quite significant and under-reported.

Many women (and men) neglect themselves when a relationship turns sour. So much emphasis is spent on trying to make it work, fighting, apologizing and attending to children during this process that most individuals overlook themselves. Simultaneously, the stress itself will, result in weight loss or gain, poor skin quality and lack of adequate hydration, “bags” appearing under the eyes or merely a generalized “tired” appearance.

After the divorce is finalized, the former combatants emerge as tired, aged, figments of their former selves. There can be a significant emotional relief with the finalizing of the divorce, the fights have ended, a new routine has been established, and child visitation is arranged, but the physical damage has already taken its toll.

Fortunately, after the split, there is new-found time to re-dedicate to oneself. So much of a divorcee’s energy had previously been outwardly directed at making the marriage “work,” that many of my patients don’t know where to begin. Reentering the dating scene, looking for a new job after many years away, or just tired of looking “tired” are all reasons that patients enter my office after divorce. I rarely see this as an act of revenge, as much as an act of restoring oneself and repairing the damage done. Patients need an extra boost of confidence and self-esteem when reentering the harsh realities of dating and job interviews.

Physical Improvements

Since divorce spans many generations, the “divorce makeover” isn’t one or two specific procedures, but the restoration of a “new you.” This process can range from fillers and Botox for the younger divorcee to a breast augmentation or tummy tuck for those who have lost weight to stress to even a full face and neck lift. The specifics need to be discussed in detail with you and your board certified plastic surgeon as to what you need, want or can afford. I see this as the surgical and non-surgical rejuvenation of areas worn down by stress, sleepless nights or a generalized lack of enjoyment in life.

Emotional Benefits

As much as we change the exterior of a patient with plastic surgery, where we can truly make a difference is with the associated emotional boost or restoration of self-confidence that goes along with feeling that you look “good.” Studies have shown that most women experience a significant decrease of their stress levels after divorce, relating to the lack of continual worry regarding marital issues. The “wrong” relationship not only results in unfavorable physical appearance, but there is a progressive loss of self confidence relating to abuse, lack of support or just no one telling you “you’re beautiful” on a regular basis. Plastic surgery doesn’t change who you are, but it can help you become who you were meant to be. We want the surgical result to “reflect the beauty within” and help you develop the confidence to achieve the goals you have set out for you and your children. I commonly see patients using these life-changing events as motivation to do something they have always considered.

Men

Making changes to one’s appearance is not for women only. We are also seeing a number of men who suffer the same ill effects as women during stressful events in their lives. Men can gain or lose weight, show the stress in their face and eyes or even just need a simple filler or Botox. Men will not only be reentering the dating world, but often have additional financial responsibilities sometimes necessitating a new job or even career change.

Stress is not gender specific and will affect both spouses negatively through the difficult process of a contentious divorce.

Divorce is one of the most devastating life stressors one can experience. Although your appearance can often take a back seat to the realities of life as a single parent, it can make a major difference in helping you get back on your feet and into the game. A “divorce makeover” is designed to give you the self-confidence to proudly take that first step and start the first day of the next phase of your life.

Vincent Marin, MD, FACS

Marinaesthetics.com

Christina Aguilera and Breast Augmentation?

2010-12-07T13:25:00.000-08:00

In a recent article from the Daily Mail (a UK publication), at a public appearance by the Grammy award winning singer Christina Aguilera, there was some evidence of a scar in her axilla or arm pit area.

"Christina Aguilera has never commented on speculation her buxom figure has had a helping hand from a plastic surgeon. But as the star waved to fans at the Tokyo press conference for her new film, Burlesque, an apparent scar under her arm may have given her secret away. The small line could be the result of a transaxillary endoscopic breast augmentation - a breast enlargement technique where implants are placed through an armpit incision. Experts say the popular method usually leaves an inch-long scar and is the preferred option for patients who want to avoids scars on the breast."

I don't think that there is any question that Ms. Aguilera has had a breast augmentation in the past. Older photographs clearly demonstrate much less breast tissue, and although she has had children as well as perhaps at a more "normal" weight, her breasts are larger than one would expect. Traditionally, three incisions are regularly used for breast augmentation (areola/nipple, breast crease, axilla/armpit). This scar, if true, looks to be relatively new and perhaps Christina has had a recent revision or secondary/re-do augmentation procedure. This scar does not appear to have the characteristics of an older, well matured scar, and it makes it suspicious for a more recent procedure.

The teaching point with this post is that it is a concern for women who undergo a breast augmentation through the axillary approach could risk unwanted/unintended visibility of their scars in a sleeveless dress, bikini or tank top. Although the other scars are on the breast, they are more regularly concealed in almost any clothing allowing for more "privacy" regarding the procedures someone may or may not have had. An important consideration in choosing what is the right incision for you (check out the blog for more).

Vincent Marin, MD, FACS
San Diego Plastic Surgeon
www.Marinaesthetics.com

Dr. Marin Discusses Buttock Augmentation on Fox 5 San Diego

2010-12-03T16:12:00.000-08:00

Dr. Marin Discusses Crazy Plastic Surgery Procedures with Ali The Bachelorette on Fox 5 San Diego

2010-11-30T12:52:00.000-08:00

Janice Dickinson Doesn't Regret Her Head to Toe Plastic Surgery

2010-11-30T11:03:00.000-08:00

In a recent special by ABC news, the Hollywood addiction to plastic surgery was explored. Self proclaimed "addict" Janice Dickinson was quoted in Celebrity Plastic Surgery: Gone Too Far, the 55-year-old admits she has undergone procedures such as a boob job, a tummy tuck, collagen implants and 'plenty' of botox injections. But she insists she is not addicted to plastic surgery - and defends her love for it. 'Surgery is good for you,' the former model said. 'I've done just about as much as every other actress and model out there. 'I'm just willing to talk about it. Trust me, I'm not going to name any names but they know who they are.'

Janice, like many of the celebrities in Hollywood, have had regular cosmetic procedures to continue to look like they haven't aged since they emerged on the scene. Much of this work is subtle and quite good, making most of us think "did she or didn't she?" Smaller more frequent procedures have become the norm allowing us to make subtle changes and keeping the cosmetic improvements from being frankly obvious to the public.

However, these procedures "add up." Janice, now we would assume having undergone multiple procedures in many areas, is starting to look odd. She has that characteristic "done" appearance and one that is difficult to repair. Once patients have gone too far, it is very challenging to return them to a normal appearance. Janice likely looks better than if she would have decided to "age gracefully" but there has to be an endpoint or she will be another version of the "cat lady" Jocelyn Wildenstein.

Vincent Marin, MD, FACS
La Jolla Plastic Surgeon

Heidi Montag Blames Her Plastic Surgeon for Excessive Surgery

2010-11-28T20:32:00.000-08:00

In a recent story from Radar online (click here), Heidi was quoted "I definitely think I should have been way more informed," Montag said. "I think that doctors should really walk you through all aspects of it, not just the glamorous side of it. Doctors, it's like they're selling you cookies or something.”

Informed consent and fully understanding your surgery is very important to a successful outcome. A patient must understand the surgery, expectations, recovery and planned outcome before ever deciding on a procedure. There are benefits to combining procedures, but 10 would almost always be considered excessive. Despite the benefits of limiting anesthesia, safety must be the primary concern. It is quite expected that Heidi would have looked as she did after her surgery relating to the extent of areas covered with surgery and the need for dressings and recovery. Whether this was discussed or not can never be fully proven, but one must be suspect of the decisions that Heidi Montag has made over the years relating to prolonging her fame. There is some evidence that Heidi's surgeon, Dr. Frank Ryan (now deceased), had some interest in taking advantage of Heidi's celebrity - assuming the recent released emails are true.

Despite all of this information, the key to a successful surgical procedure is a patient and surgeon who are able to communicate and fully understand the extent of the procedures they are deciding upon.

Vincent Marin, MD, FACS
La Jolla Plastic Surgeon

2010-11-18T10:53:00.001-08:00

Botox parties by unlicensed providers is on the rise in this struggling economy, be careful where you get your fix! http://ping.fm/bbtDm

2010-11-16T12:40:00.001-08:00

Answers to Real Patient questions by Board Certified San Diego Plastic Surgeon Dr. Vincent Marin - http://ping.fm/rAIua

2010-11-11T13:12:00.001-08:00

Thank you to all the veterans and active military who risk their lives every day to keep us safe! http://wapo.st/b7SpYP

Lisa Rinna's Lip Reduction Isn't Healing!

2010-11-08T14:22:00.000-08:00

From a recent tabloid post on the web:

Lisa Rinna's painful and revealing corrective plastic surgery to attempt to restore normalcy to her mouth has gone badly. With the help of girlfriends Denise Richards and “The Insider’s” Lara Spencer, plus a brutally honest casting director, Lisa confronts her insecurities about her appearance and discovers that it may be possible to correct the silicone injections she had in her lip 24 years ago.

Harry and Lisa are incredibly concerned about how her lips are healing after opting for corrective surgery. The doctor's news isn't good, and now Harry wonders if his wife will 'look weird for the rest of her life.'

See a video of her office visit with Dr. Garth Fisher - http://bit.ly/drhXrY

Lisa Rinna's trademark larger than life lips were just that - artificially enhanced with liquid silicone. Silicone has long been a filler used to plump and enhance deflated areas of the face. It works permanently which is its blessing and curse. What Lisa wanted as a young Hollywood actress, isn't now what she wants as she ages in Hollywood - no longer able to look age appropriate. Lisa didn't have to make numerous trips to the plastic surgeons office for a filler such as Juvederm, but now has had to undergo a surgical excision of the silicone in her lips. This has caused problems with her healing thus far as the silicone and associated scar tissue limits blood flow and can impair healing.
Choosing temporary fillers such as Juvederm and Restylane can be a great alternative which provides soft, full lips with the freedom to make changes without long term consequences. There is even a product to completely reverse the changes if you are unhappy with the result. Thus, I wouldn't take Lisa's advice to avoid plastic surgery entirely, but just make smarter, more educated decisions and way the risks and benefits.

Vincent Marin, MD, FACS
MarinAesthetics.com
La Jolla Plastic Surgeon

2010-11-08T11:29:00.001-08:00

Mixed reviews on "Fat Freezing" techniques in the LA Times- "results of CoolSculpting will be modest at best" full txt: http://lat.ms/dkGz8X

Breast Implants 101 - what you need to know: Incisions

2010-11-04T16:38:00.000-07:00

Breast augmentation has overtaken liposuction as the most commonly performed cosmetic procedure in the United States. In my San Diego practice, breast augmentation also leads the way as the most requested. I am embarking on the third installment in the Breast Augmentation What You Need to Know series – incisions.
There are several incisions commonly employed for the placement of saline and silicone breast implants: around the nipple, breast crease and axillary – (belly button incisions are also employed, but I do not use this technique because of the high rate of problems associated with this approach). Each of these incisons has different benefits and limitations, which we will discuss below.
Periareolar (nipple) incision:
This incision is one of the most common approaches that patients request in my office. The incision is located at the junction between the pigmented areolar skin and the lighter breast skin. It usually extends from approximately 3 o’clock to the 9 o’clock position. This incision tends to heal well and is easily camouflaged in the natural color change that exists in this location. This incision is well concealed in any clothing or bikini and does not run the risk of exposure. It does sit on the most prominent aspect of the breast, but is well hidden as a result of strategic placement. If the areola is very small, it may be difficult to place a silicone implant because these implants are pre-filled. This, however, is rarely a concern and I can give you additional information at the time of the consultation. Studies have shown that the incidence of nipple sensation changes after surgery is equal to that of the breast crease approach.
Inframammary (breast crease) incision:
This is as frequently requested as the periareolar approach and one I feel equally comfortable with. This allows direct access to place the implant in either location (above or below the muscle) and avoids any scarring on the breast itself. This allows the breast proper to remain without any scarring, but there is a scar seen underneath the breast itself. This could be seen in a bikini if the lower edge rides up inadvertently. The scar is a straight line and there is no limitation with a patients’ particular anatomy. With most women, the augmentation procedure will help to create a fold underneath the breast, even if one does not exist prior. This will help hide the incision in a natural fold making it invisible from a frontal view. As previously stated, the incidence of nipple sensation changes is equal with a peri-areolar approach.
Axillary (armpit) incision:
The axillary approach avoids any scarring on the breast whatsoever which is attractive to many patients. There are several issues with the procedure itself. The surgery requires endoscopic equipment and is further away from the most important cosmetic areas of the breast. This makes the surgery technically more challenging and often less effective. The goal is not to limit scar but to achieve a naturally beautiful breast. If there is any problem or need for revisions, it is almost certain that you will need to have a separate new breast crease or areolar incision. Also, the placement of silicone implants through the axilla is not recommended as the scar becomes longer and thus more visible. Also, women in tank tops, sun dresses or bikinis run the risk of unwanted exposure of the scar with their arms raised.
Umbilical (belly button) incision:
This technique was designed to address all of the problems with the above techniques. However, the surgery is performed with absolutely no visibility whatsoever and has the highest complication and revision rate of any of the above approaches. As a result, I do not even offer this as an option to my patients as I don’t feel that this is a reliable surgical technique.
In summary, 90-95% of women who undergo a breast augmentation will likely have their implants placed through a breast crease or areolar incision. These surgical approaches have led to many extremely happy women who wonder why it took them so long to finally decide to go forward with their desire for larger, fuller breast – stay tuned for our final installment: size.

2010-11-04T15:32:00.001-07:00

Interesting study showing a 19% increase in breast aug infections with only one dose of antibiotics. Don't under treat http://bit.ly/a9tkRP

2010-11-02T18:38:00.001-07:00

Anyone see the new reality show "Bridal-Plasty" where future brides compete for a pre-wedding makeover? take a look http://bit.ly/aZBh5v

2010-11-02T15:47:00.001-07:00

Marin Aesthetics is on ping.fm and trying to keep up with technology! More to come...

Cosmetic Surgery and the Modern Workplace

2010-09-22T12:24:00.000-07:00

Newsweek recently published and article about the benefits of looking good in the modern day workplace. And in the words of a New York recruiter “This is the new reality of the job market,” says one New York recruiter, who asked to have her name withheld because she advises job candidates for a living. “It’s better to be average and good- looking than brilliant and unattractive.” You can read the full article here: http://www.newsweek.com/2010/07/19/the-beauty-advantage.html

Unfortunately, the world we live in is based upon a modest degree of superficial opinions. But this truly has persisted for many reasons since the dawn of human civilization - this is only the most modern version and permutation. People often choose their partners, employees or friends based upon genetic code. Indicating what "traits" have been the most successful over the ages.

Over the past several years, I have seen an increase in the number of patients who lost their jobs as a result of the economy and came to my office looking for a way in which they can be more competitive and look "younger." There is a proven unconscious bias that people will more likely select a less qualified, more attractive candidate for a position. Certain cosmetic procedures can help individuals look younger, more vibrant, and possibly help someone successfully reenter the workplace.

Newsweek put together a great "slider" cataloging our societal ideals of "beauty" over the past century: http://www.newsweek.com/feature/2010/the-beauty-advantage.html

It is interesting on how little this has changed over the years - I only disagree with the example they used for the present day.

Breast Implants 101 - Above or Below the Muscle

2010-06-28T15:01:00.000-07:00

In San Diego, breast augmentation is one of the most popular cosmetic surgical procedures I perform. San Diego and Southern California have sunshine most all year long, and I commonly see people on the beach through Thanksgiving! As a result, I wanted to help educate patients about breast augmentation and their options through a series of blog posts about different aspects of the procedure.
Above or Below the Muscle
Initial breast augmentation surgeries were exclusively performed with the implant being placed under the breast tissue alone. The initial implants were silicone, very soft and thin walled and, thus, almost imperceptible. Unfortunately, since the implant wall was so thin there was a higher incidence of rupture and breakage. As the implants became thicker and stronger to be more resilient, they were more noticeable through the skin.
Additionally, women requesting a breast augmentation normally have little breast tissue, and the breast implant is a significant percentage of the overall breast. Thus, with less breast tissue to cover a saline or silicone implant we need additional tissue to help camouflage the underlying implant. This is where the chest muscle can be very helpful in breast augmentation. The upper half of the breast implant sits beneath the chest muscles which helps soften and hide the implant – giving a more natural look. Most women have less breast tissue on the upper half of the breast and thus, the muscle is critical in its location.
Other benefits of placement beneath the muscle are several. The incidence of capsular contracture has been shown to be slightly less in this location as well as breast cancer surveillance is improved, as there is a distinct barrier between the implant and the breast tissue. Thus, it makes it easier for radiologists to distinguish each distinct layer of tissue.
Subglandular (under the breast only, or over the muscle) remains a good option for the properly selected patient. If women have larger breasts (C or D) cup, the need to “hide” or camouflage the breast implant is less necessary as there is enough breast tissue to do the work of the chest muscle. The recovery is faster and there is no risk to have movement of the implants with contraction of the chest. Also, since the implant is directly underneath the breast, there is more of a “breast lift” effect with the placement beneath the breast tissue.
In summary, 80-90% of women who undergo a breast augmentation will likely have the implant placed beneath the muscle. It is a great operation and one with some very happy patients. Stay tuned for the next installment – incisions.

Breast Implants 101 - Saline vs. Silicone

2010-06-28T14:17:00.000-07:00

In San Diego, breast augmentation is one of the most common procedures I perform. Breast augmentation patients are some of the most well informed of any cosmetic surgery, but I would like to start a series of educational topics that, I hope, will help you make the best decision regarding your breast augmentation surgery.
Type of implant
Breast implants options in the United States are currently limited to either saline implants or a silicone gel breast implant. Both implants are made of a surrounding silicone “shell” and filled with different solutions. Saline is basically salt water and what we normally use in IV fluid. These implants are empty and filled in surgery to the desired volume. This allows us to make fine adjustments during the procedure to accommodate slight asymmetries that most women have between their breasts.
Silicone implants contain a cohesive silicone gel within the same exterior shell. These implants come pre-filled with specific amounts of fluid that cannot be changed. These implants are inserted filled through the incision into their desired location. I am somewhat limited in the adjustments that can be made with silicone implants as the fine-tuning is made in predetermined increments.
Saline breast implants are produce a look that is a bit more round and firmer to the touch. Silicone implants are much softer and behave more like a natural breast. Saline and silicone implants can demonstrate “rippling” or visibility of the implant beneath thin skin, but this is much more common with the saline option. I see approximately 90% of my patients choosing silicone implants for their breast augmentation.
Both saline and silicone implants are produced in different “profiles.” The low profile implant is slightly wider and projects less out from the chest giving a very subtle augmentation. A moderate profile implant is a bit narrower with more projection – the most common implant used in the US, and this fits most women’s needs. A high profile implant is designed to produce a more dramatic change with allowing for more volume to be placed in a smaller area, and as a result even more projection. Finally, there is an ultra high profile implant (Allergan only) that will produce a very round shape – needed in rare circumstances.
Stay tuned for our next installment of the “Breast Augmentation Need to Know Series” where we will discuss the pros and cons of each implant.

Holly Madison is Giving Up on Plastic Surgery

2010-06-22T00:31:00.000-07:00

In a recent article at the examiner.com, Holly Madison, one of the "girls next door" has given her take on the benfits and perils of plastic surgery (photo from the examiner).

Reality TV star Holly Madison, who underwent a drastic plastic surgery makeover years ago, is done going under the knife. For now, at least.

"Maybe when I'm older [I'll get more surgery], but I'm done with it for now," Madison, 30, recently told E! "I don't like when people inject a lot of stuff in their faces because then their faces move all weird."

'I OWE EVERYTHING TO PLASTIC SURGERY'

Madison, 30, previously credited plastic surgery for giving her an entertainment career and a glamorous life in Hollywood, which included being the girlfriend of Playboy founder Hugh Hefner for 7 years.

But Holly, who has gotten a nose job, breast implants (and reportedly some liposuction) says just looking around at some of the overdone faces at Hollywood parties deters her from undergoing more surgeries.

"I think when young girls are thinking about plastic surgery they need to go to a very wealthy house party in Beverly Hills," Madison suggests. "All they need to do is look at all the old people in the room and be like, ‘Oh, maybe I don't want to get my lips done. Maybe I don't want to get Botox,' because you see how it ages you."

Holly has a point in that too much plastic surgery is a challenge to undo, but anyone looking at her before and after comparisons can clearly see Holly owes the magic of plastic surgery for her career. It is unlikely she would have become a household name not looking the way she does. As for Botox making you "look old" according to Holly - it actually will slow down the aging process related to the chronic movement of your skin. Too much plasti surgery doesn't age you as much as make you look "done" and this is an effect we work hard to avoid.

Vincent Marin, MD
La Jolla Plastic Surgeon

Designer Dimples - the Latest Plastic Surgery Trend?

2010-06-12T14:55:00.000-07:00

The NY Daily News is reporting on a new plastic surgery trend - designer dimples! Reportedly, patients are asking to look like Mario Lopez and duplicate his trademark smile.

The latest must-have facial enhancement, called a dimpleplasty, takes 10 minutes and is as popular with guys as it is with girls. After undergoing a dimpleplasty, "Every time you smile, you'll get that little Mario Lopez dimple,"

So how is an artificial dimple created? The surgeon makes a tiny cut in the skin to create a small depression. A stitch is used to tack the underside of the skin in that area down to a deeper layer in the skin. It's held in place with a long lasting temporary suture.

Although trends are very popular when at their peak, what is hot today may not be next year or sometimes even next month (see belly button rings). Dimples on the appropriate face are attractive, but external scars on your skin are there forever, and I would caution anyone to consider this seriously before proceeding. If you find out that you don't like the result you will be stuck with the scars. Also, an important question is what will happen when the temporary suture resolves? Scar tissue formation is not always predictable!

Vincent Marin, MD
San Diego Plastic Surgeon

Your Sunburned Past May Catch Up With You

2010-06-08T10:17:00.000-07:00

In today's OC Register there is a good article reviewing the tendencies that have made skin cancer one of the most frequent cancers we see every day in the medical profession, and tips to avoid the problems with our children and the next generation. Here is an excerpt (click here for the full story)

I grew up in the ’70s, when we worried more about sharks than sunburns.... My mother was a professional tanner, and I’d sometimes borrow her suntan oil. Which is not sunscreen. More like Crisco on your skin. I remember post-facto burn remedies like aloe and Solarcane. I used those more times than I can remember.

And I know that all those burns could come back to haunt me. The evidence says that the more severe burns we suffer as children (when the system of skin cells that produce the pigment melanin are not yet fully developed), the greater our risk of melanoma later in life.

Adults can still protect themselves from the UV rays responsible for most skin cancers: Wear sunscreen (SPF 30 or higher) that stays effective after getting wet; avoid the midday sun (unlike me); and wear a hat and T-shirt. A recent study found that blue is the most effective color for sun protection.

Do self-inspections for irregular moles and lesions.

Vincent Marin, MD FACS
San Diego Plastic Surgeon

Dr. Marin Nominated as Best Cosmetic Surgeon in San Diego

2010-06-05T17:13:00.000-07:00

We are excited to announce that Dr. Vincent Marin received a nomination for Best Cosmetic Surgeon in San Diego by the readers of the Union Tribune in San Diego! Thanks to all of you who voted for us. Unfortunately, now the real work begins - take a few seconds and click our link, click on Dr. Marin and vote - it's that easy and we need your help!

Best of San Diego - Cosmetic Surgeon

Liposuction Death in Tijuana

2010-05-26T11:47:00.000-07:00

10 News San Diego is reporting the recent death of a Chula Vista woman who underwent liposuction by a physician in Tijuana, Mexico.

CHULA VISTA, Calif. -- A local doctor who may have overstated his credentials is being held responsible for the death of a Chula Vista woman he operated on recently.

According to family members, 48-year-old Lourdes Trinidad underwent a liposuction procedure performed by Dr. Louis May Villanueva of Bonita.Family members said Trinidad was a healthy and active pharmacy technician who opted for liposuction and went to May's Millennium Cosmetic and Laser Institute in Tijuana for the procedure.

"The doctor assured her it was real simple, it was a real simple procedure," said Trinidad's brother, Sergio Salazar.It ended up becoming a deadly procedure, although Trinidad's family has yet to receive a good explanation as to why it turned out that way.... The family said May disappeared."He was nowhere to be found ... The doctor was gone," said Salazar....May said he is a member of the American Academy of Cosmetic Surgery, but 10News learned from academy officials that he is not a member.Additionally, May also claims membership in the American College of Phlebology, but any member of the public who wants to learn about leg veins is allowed to join....Trinidad's family will bury her Thursday, and they continue to question whether it was a complication or incompetence that led to her death.10News contacted May's clinic and they said they did not have any information right now.10news also contacted the Ministry of Health in Tijuana to determine if May is fully licensed, but there has been no response.

Checking the credentials, training and education of your doctor is paramount when choosing a plastic surgeon. Do your research and make every effort to understand what exactly your doctor is "certified" in. There are many different specialties (some not even recognized by The American Board of Medical Specialties) of which your doctor can be certified in - make sure it related to the surgery you are undergoing. As for medical tourism, I think the last line in the article speaks for itself - "10news also contacted the Ministry of Health in Tijuana to determine if May is fully licensed, but there has been no response."

Vincent Marin, MD, FACS
MarinAesthetics.com

Heidi Pratt Loves Her Plastic Surgery

2010-05-25T17:26:00.000-07:00

In an article posted today in US magazine, Heidi Pratt reinforces her claim that her recent foray into plastic surgery was the "best decision of her life."

Since cutting ties with Lauren Conrad years ago, Heidi Pratt has been in the market for a new BFF.

"I have no friends!" Heidi, 23, Twittered early Monday morning. "The ones who are pretending to be 'friends' or 'family,' are crazy, angry, broke and BITTER. This is why they haven't been in my life for years. Liars!"

As Heidi continues to alienate friends and family with her bizarre behavior -- including spending $400,000 on healing crystals and undergoing 10 plastic surgeries in just one day -- the aspiring singer has become increasingly defensive.

"My last surgery was the best decision of my life!" she Twittered. "Anything anyone else says (family members who are trying to make money off of me) is a lie! I have never felt sexier, happier, or more amazing in my own skin. I truly look the way I have always dreamed."

The most important thing to realize in this story is that plastic surgery can make you feel better about yourself, more confident and happier in your own skin. However, it does not change who you are as a person, and your relationships are a result of communication and hard work. Patients who expect plastic surgery to improve relationships will be sorely disappointed unless the strain on the relationship was related to their being too self-conscious or overly concerned about a physical aspect of their appearance.

Vincent Marin, MD
La Jolla Plastic Surgeon

Marin Aesthetics and Google Video

2010-05-16T15:48:00.000-07:00

We thought we'd take advantage of the new Google service and make our own video in honor up upcoming bikini season. Hope you like it.

Vincent Marin, MD
MarinAesthetics.com

Jamie Pressly and Breast Augmentation

2010-05-11T14:55:00.000-07:00

The New York Daily News is reporting that My Name is Earl star Jamie Pressly has recently undergone cosmetic breast surgery. (click here for the full story: http://ow.ly/1JPdb)

According to UsMagazine.com, Jaime Pressly got a boob job "a couple of weeks ago." Photo evidence shows the actress sporting a larger bust size while out in public.

"They look amazing!" a source said of the actress, who is rumored to have already had a breast enhancement in 2004.

Ironically enough, Pressly criticized her Hollywood peers in 2006 for wanting to alter their looks by undergoing a nip-tuck.

If the story is correct, this is a very common scenario for new moms (which Jamie is). Pregnancy and breast feeding will significantly change one's breasts often resulting in too much skin and not enough breast tissue. This combination leads to the appearance of "droopy," not youthful breasts. Fortunately, a surgery combining a breast lift and implant (augmentation mastopexy) can restore women to often a "better than pre-pregnancy" appearance. If this sounds like you, give us a call, we can help you determine what options are right for you.

Vincent Marin, MD, FACS

Marinaesthetics.com

Mother Daughter Plastic Surgery

2010-05-07T12:17:00.000-07:00

In a article on MSNBC posted today, the concept of mother/daughter plastic surgery was addressed. Many women who consult with me in the office of describe themselves as "looking more and more like their mother." As much as we love our mother's (especially with Mother's day right around the corner), most women don't necessarily want to look like her. (here's the full article http://www.msnbc.msn.com/id/36993283/ns/health-skin_and_beauty/)

When Pam Fry, a 57-year-old teacher from Owasso, Okla., had a tummy tuck and breast lift to tighten up her sagging skin after losing 127 pounds, the procedures had a huge impact on her life.

But they also had an impact on her daughter.

“I’d talked about getting a breast lift for years,” says Tami Fry, a 31-year-old single mother who also lives and teaches in Owasso. “[After giving birth], my chest just went flat and down. When I saw how beautiful my mom looked, I said, ‘That’s it. I’m doing it.’”

One of the biggest motivators for patient's to pursue plastic surgery is seeing how dramatically it changed someone's life - often, that someone is a person close to them or a family member. It not only can change the physical aspect of someone's appearance, but also how a patient sees themselves, and most importantly how they feel inside. It's always easier when someone else "jumps" first.

Vincent Marin, MD

MarinAesthetics.com

Hollywood is Anti-Plastic Surgery

2010-04-29T13:37:00.000-07:00

A recent article in the New York Times discussed a trend in Hollywood moving away from plastic surgery. Casting directors have expressed a desire for "real" women and "Independent casting directors... are urging talent agents to discourage clients from having surgery, particularly older celebrities who, she contends, are losing jobs because their skin is either too taut or swollen with filler."

Over the course of the article, and it took two pages before I found one item that finally made sense to me "Youthful perfection is prized in Hollywood despite the seeming canonization of older actresses like Meryl Streep, Helen Mirren and Betty White. But a talented 35-plus actress who has had particularly good surgery can still find work. At that age the backlash is not against plastic surgery or Botox itself — everyone seems to be doing it, right? — but its poor execution."

The issue isn't necessarily plastic surgery, but it being over-done or its poor execution. That has always been the case, and what I routinely emphasize to my patients is that the only plastic surgery that you can recognize is the bad or overdone work. Thus, choose your plastic surgeon wisely, and understand that there are consequences with any procedure and you should discuss this fully before surgery.

I can't imagine with HD TV rapidly becoming the industry standard that actresses in Hollywood will be less interested in cosmetic surgery no matter what the New York Times says.

Vincent Main, MD
Marin Aesthetics

Kate Hudson and Breast Augmentation

2010-04-26T14:03:00.000-07:00

The internet has been abuzz with rumors of "did she" or "didn't she" regarding Kate Hudson and the recent increased size of her breasts. Kate has been fairly flat chested for her career and the recent "fuller" appearance has everyone talking.

The OC Register recently discussed the topic "Actress Kate Hudson, 31, apparently decided she didn’t want to be so flat-chested any more. In recent photos, she shows signs of having gotten small breast implants in a recent operation, reportedly last month.

Previously she had implied that she wasn’t concerned about her breast size. In 2002, for example, she said “I have small breasts, obviously. It’s nice to be able to wear a plunging neckline and have it be elegant.” But an acquaintance of hers is quoted in Us magazine as saying that she was bothered by her proportions: “Kate makes jokes about her boobs, but her chest has always been one of her biggest insecurities.”

From my perspective, Kate is an ideal candidate for a breast augmentation. She is in good shape and never had significant breast tissue development. A silicone breast augmentation placed beneath the chest muscle could "feminize" her "boy-ish"chest, and quickly make her insecurities a thing of the past. The key to a successful operation is whether this bothers the patient, or is the person motivated for other reasons. Kate Hudson is a beautiful woman who doesn't "need" implants, but it could solve a long standing problem for her if the rumors are right.

Vince Marin, MD, FACS
MarinAesthetics.com

Lack of Training in the Cosmetic Surgical Marketplace

2010-04-12T12:05:00.000-07:00

A recent article published in the LA Times recounted the lack of surgical training (nearly 40%!) in practitioners performing liposuction in California. (for full story - LA Times story link)

The study, published in the April issue of the journal Plastic and Reconstructive Surgery, examined 1,876 cosmetic practitioners from San Diego to Los Angeles. Only 495 of them were trained in plastic surgery. Primary care physicians made up the fourth-largest group of liposuction providers following plastic surgeons, dermatologists and otolaryngologists.
There is no law to prevent doctors from offering these services, especially in a doctor's office (doctors need to apply for privileges to perform services in hospitals). Many non-surgeons take a course or participate in some form of limited training to perform liposuction or inject fillers. But such training is not required and is often inadequate, according to the American Society of Plastic Surgeons.

The most important take away message from this is that not all "cosmetic surgeons" are created equal and the training can range from 2 days in some to 6 years in a fully trained, Board Certified plastic surgeon. It is the patients responsibility to understand who their doctor is, what specific training he or she has had, what specialty are they actually Board Certified in??? A Board Certified dentist in oral surgery and wisdom tooth extraction isn't going to be a wise choice for your breast augmentation. However, in California you might just end up in their office.

Do your research, understand your procedure and if you don't get it, keep asking questions until it makes sense. This is YOU we are talking about.

Vince Marin, MD

La Jolla Plastic Surgeon

MarinAesthetics.com

Botox and Fillers for the Under 30 Crowd

2010-03-07T21:48:00.000-08:00

In a recent article in Chicago Now, a blogger Eliza Siep recounted her decision to pursue a foray into cosmetic surgery starting with Botox and a soft tissue filler - Juvederm - and yes, she is under 30! Here is a brief quote that sums up her feelings:

I think that we are told that until we "look old" to others we are not allowed to say that we are looking older. People think that if you notice an actual change in your face or body for the worse that you are "freaking out" or that "you might have a problem." Nah, the truth is that if you don't like something about yourself and it is within your means to change it. Go change it! If you want to be blonde and if you want Botox, then go out and get it! No one should be stopping you!

She brings up a few points that I try and stress to my patients that are often missed at first glance.

Number one, the right time is when you are ready - meaning, that you have unwanted lines on your face and a plastic surgeon also feels that they can help you this. (There are some lines that we just cant fix!)

Number two, botox or a filler doesn't hurt you long term (at least that we have seen since the introduction of Botox in April of 2002), and if you don't like it then just don't do it again. For fillers such as Restylane and Juvederm, there is a product that we can inject to make it completely disappear in hours.

Finally, one of the most important benefits for women in their 20s and 30s - Botox acts to PREVENT the onset of lines on the face. The lines that we all have at rest, are a result of years and years of muscle movement, thus, if you prevent the muscle movement, you will preserve your skin and delay the onset of the aging process (along with regular sun screen and appropriate skin care.) Thus, if you feel that you are interested in improving a few lines or even preventing them from ever showing up, go see a board certified plastic surgeon and get an opinion. You never know until you try.

Vince Marin, MD, FACS
Marin Aesthetics

Italy Bans Breast Augmentation for Women Under 18

2010-02-22T21:34:00.000-08:00

In a recent article first published by the UK Telegraph, the Italian Welfare Ministry decided that they would make it illegal for patients under the age of 18 to have breast implant surgery.

The Italian government has banned breast enhancement surgery for girls under 18. Francesca Martini, an undersecretary within Italy's welfare ministry, said the ban is targeted at teens who have don't understand the health implications of the procedure:

"Far too many adolescent girls are unaware of the fact that there are risks with this type of surgery and it should not be used purely for fashion and looks. At the moment we have a Wild West, cowboy style system of plastic surgery for young women and this must stop."

And the Italian Society of Plastic Surgeons agrees. Francesco D'Andrea explained, "Banning under 18's from having the surgery is also a good idea because these girls are just too young to be operated on. Some surgeons have no idea what they are doing and create huge risks."

There are 85,000 breast enhancement operations per year in Italy, with 70 percent for aesthetic reasons and 30 percent after cancer treatment. Approximately 10,000 teenage girls worldwide had the surgery performed in 2008.

There is value in limiting the age of women who undergo breast augmentation surgery, but not necessarily that the women are too young to be operated on or that "some surgeons have no idea what they are doing." Most board certified plastic are well aware of the risks and young women are relatively low risk for elective surgery. However, the issues are primarily that women's breast are not necessarily fully developed at age 18, and it is very important that women are fully aware of both the benefits, as well as the risks of elective surgery. The key to a successful operation is communication between the surgeon and patient. There are many reconstructive or developmental scenarios where it is appropriate for young women, under the age of 18, to undergo some form of breast surgery. As always, keep the lines of communication open and I think that there is value in flexibility without having the government impose a specific restriction based upon age alone.

Vincent P. Marin, MD, FACS

MarinAesthetics.com

Sophia Loren Claims She's Never Had Plastic Surgery

2010-01-06T22:40:00.000-08:00

In a recent article in People magazine, Sophia Loren, at age 75, claims she has never had plastic surgery, and her looks are "totally natural." Here's the story: http://bit.ly/6hd0ES

Sophia Loren is co-starring in the upcoming musical Nine -- and looking at the photos, it's clear that the 75-year-old Italian bombshell still has what it takes. How has she stayed so beautiful? By saying "no" to cosmetic surgery.

The actress, who became an international sensation in the '60s, has told PEOPLE magazine that her looks are 100% natural. "I don't believe in having work done, because then everybody looks the same," she says.

As for Loren, she's always defied industry standards of how an actress should behave. When asked how she maintained her figure, she once famously said "Everything you see I owe to spaghetti!"

As much as I'd like to think that Sophia is telling the truth, there are very few women in this world who have made it over 70 years without a noticeable wrinkle, droop or sag. It's hard to imagine that anyone - no matter what your genetics - could pull this off! I think that this does a disservice to most women, as it sets up an unrealistic aging expectation that she is just naturally is "that much more beautiful" than most women in this world. I understand her desire to want to be "naturally beautiful," but I think people would still appreciate her beauty no matter what the source in the context of her honesty. The controversy as to whether she has or hasn't had plastic surgery should make you at least feel better that it can be successfully done in a natural manner that improves your overall appearance without be extreme or obvious. (photo from good plastic surgery.com)

Vincent Marin, MD, FACS
San Diego Plastic Surgeon
MarinAesthetics.com

Greta Van Susteren Discusses Plastic Surgery

2010-01-04T14:46:00.000-08:00

On her blog at Fox News, news anchor Greta Van Susteren discusses her past foray into cosmetic surgery and the "buzz" it generated.

I switched jobs - from CNN to Fox (that is not strange, people change jobs all the time.) I unexpectedly had a month between jobs and so I had plastic surgery on the area around my eyes (that is not strange - thousands and thousands have it done every year.) ...my thought: if you spent money on changing something, would you not want it to be noticeable? why the big secret? you are not paying for it to be the same!

But what was REALLY strange was the media reaction to me having it done and not hiding it. It was bizarre! In my wildest dreams I never would have thought people would be the least bit interested in plastic surgery or in me. ...and even a mention at the Oscars which is broadcast around the world! For me? for having plastic surgery? What a riot! It was funny how people in the media got consumed with it! I even heard people discussing it on TV who themselves had had plastic surgery but kept that secret. (Yes, I confessed, that also did amuse me.)

Here's the full story - http://bit.ly/6sCPfC

One of the most common requests I get at consultation is that patients "don't want anyone to know" that they have undergone plastic surgery no matter how mild, or sometimes even functionally necessary. In reality, there are millions of women who undergo some form of plastic surgery every year (yes, even when the economy is down). Most women who are open to talk about their previous surgery often find that there are a number of their close friends who are VERY interested in the details (for themselves) or admit to having undergone some surgery in the past and just never admitted it. The key in the process is that it is relatively easy to not make your surgery obvious (you really only notice the "overdone" patients), and if you decide to talk about it, you may find yourself the center of attention.

Vincent Marin, MD, FACS
www.MarinAesthetics.com

Tiger and Plastic Surgery? You be the judge

2009-12-29T17:13:00.000-08:00

It is being reported that Tiger Woods flew to Phoenix after being released from the hospital in Florida for some "plastic surgery" to repair the damage from his wife and her 9 iron. A well known golf journalist, Furman Bisher, claims to know the details.

"The doctors tell Mark [Steinberg, Tiger's manager] there is not much they can do to repair the teeth and the gash, but the doctor knows a cosmetic dentist and plastic surgeon in Phoenix who will make Tiger look as if nothing happened. Tiger tells Mark to get the jet ready and let's head to Phoenix to get this done. Friday after Tiger is released from the hospital, he does not return home; he and Mark board the plane for Phoenix," the letter claims.

Here's the full story - http://bit.ly/5JUOxk

It is likely that Tiger suffered some cosmetic damage (or could have even suffered a fracture) to his face and possibly teeth after getting struck with a golf club. Whether he made a clandestine jaunt to Phoenix to have this repaired is up for debate. I would assume that there are plenty of good physicians (and dentists) within a stones throw from his home that would have been more than willing to help him. But, there may have been some benefit to getting out of his home as soon as possible. This is likely a story we will never fully know the truth of what happened but it seems to keep going and going.

Additional Questions Answered by Dr. Marin on Real Self

2009-12-28T21:46:00.000-08:00

Q & A with Vincent P. Marin, MD:

View all answers from Vincent P. Marin, MD on RealSelf.com

Bo-Tax and the Possible Unwanted Side Effects

2009-12-07T21:43:00.001-08:00

The current proposed tax on elective cosmetic surgery indicates that there is a 5% tax on all cosmetic surgery procedures performed by licensed medical professionals. I have several concerns about this proposal. Firstly, this will hit working, middle class women harder than any other demographic, as this is the primary patient population. Next, these taxes are very difficult to administer (just ask New Jersey), often not generating the income proposed. Finally, since the tax distinguishes that this must be administered by a licensed medical professional, there is the obvious loop-hole where non licensed individuals are not subject to the tax - pushing patients into the hands of a non-trained individual compromising their health and safety to save money. Click on this link at the American Society of Plastic Surgeons website for more information.

Vincent Marin, MD
San Diego Plastic Surgeon

Panel Changes Long Standing Mammogram Recommendations

2009-11-17T16:56:00.002-08:00

In a well publicized article in the New York Times yesterday, a panel changed long standing recommendations on screening mammograms for non high risk women (no family or personal histrory of breast cancer).

Most women should start regular breast cancer screening at age 50, not 40, according to new guidelines released Monday by an influential group that provides guidance to doctors, insurance companies and policy makers. The new recommendations, which do not apply to a small group of women with unusual risk factors for breast cancer, reverse longstanding guidelines and are aimed at reducing harm from overtreatment, the group says. It also says women age 50 to 74 should have mammograms less frequently — every two years, rather than every year. And it said doctors should stop teaching women to examine their breasts on a regular basis.

This may come as a shock to most women who had previously been told by their physicians to obtain their first screening mammogram at the age of 40 (30 if you had a family history) and every 1-2 years following. The panel based its decision on survival of patients as a direct result of their screening mammogram: "The task force concluded that one cancer death is prevented for every 1,904 women age 40 to 49 who are screened for 10 years, compared with one death for every 1,339 women age 50 to 59, and one death for every 377 women age 60 to 69."

There is no question that women of advancing age will likely have more of an incidence of breast cancer, but the question at hand is what if that one death prevented in 1900 mammograms (or 526 deaths per million screened women) was your mother, wife, sister or friend? This is a debate that will likely continue in the medical community for months to come. Currently, the American Cancer Society and American College of Radiology both have decided to continue along with the old standard currently in practice.

For all patients who undergo elective cosmetic breast surgery, I routinely obtain preoperative mammograms (or recent reports) to ensure that there are no undiagnosed breast abnormalities that could be compromised with elective surgery. I plan to continue to abide by the current standard until there is a consensus among the medical community to not put my patients at unnecessary risk.

Vincent Marin, MD, FACS
San Diego Plastic Surgeon

Mentor Breast Implant Free Extended Warranty through 2009

2009-10-22T15:41:00.004-07:00

If you needed any encouragement to finally decide and undergo a long desired breast augmentation procedure - this may be it!

Mentor (one of the main manufacturers of breast implants in the US) provides a lifetime guarantee on the their breast implants if you suffer a rupture, break or deflation of the implant, Mentor would replace it for free. Over the course of the first 10 years, Mentor also provides financial assistance that is applied to the cost of the revision surgery - previously, for $100 dollar fee Mentor would provide up to $2400 - often covering a large percentage of the OR and anesthesia fees. This makes any re-do surgery related to implant rupture much less financially challenging for a patient.

Mentor, however, has recently changed their warranty policy for the dates between May 1, 2009 and December 31, 2009, Their new warranty program called The Mentor Premier Advantage pays up to $3,500 applicable to the replacement surgery and is FREE until January 1, 2010.

After January 1, 2010, the extended warranty will cost $100.00 to the patient, and Mentor will pay only $2,400.00 toward a deflation surgery for the first 10 years.

Here's the link for more information: Mentor Premiere Advantage

Vincent Marin, MD, FACS
San Diego Plastic Surgeon

Dr. Marin's Cosmetic Surgery Answers on RealSelf.com

2009-10-22T15:29:00.001-07:00

Q & A with Vincent P. Marin, MD:

View all answers from Vincent P. Marin, MD on RealSelf.com

Dr. Marin Discusses an Ideal Rhinoplasty Consultation

2009-10-19T13:46:00.006-07:00

California Gov. Signs into Effect "Donda West Law"

2009-10-19T13:12:00.004-07:00

As reported by the LA Times, Gov. Arnold Schwarzenegger recently signed into effect the "Donda West Law." This law was proposed in response to the recent death of rapper Kanye West's mother Donda after elective cosmetic surgery.

--The Donda West Law, named after the mother of rap artist Kanye West, who died from complications after she underwent cosmetic surgery. AB 1116 by Assemblywoman Wilmer Amina Carter (D-Rialto) prohibits elective cosmetic surgery unless the patient first is cleared by a physical examination.

I feel that this is a good law, but unfortunately something that should have been taken as relatively routine with any surgical procedure. Elective surgery is still surgery and must be treated as such. Any time someone undergoes a procedure, even under local anesthetic, there are still risks. Our patients not only undergo a full history and physical examination, we will regularly draw routine blood tests, perform an EKG and obtain a chest X-ray where indicated. If a patient has a complicated medical history, we will have their regular physician give surgical clearance as well as have our board certified anesthesiologists review the medical history. If you are electing to undergo cosmetic surgery and do not receive this degree of preoperative evaluation - ask your surgeon "why? " There may be a perfectly good reason, but this is a discussion that you should have before surgery - NOT AFTER.

Vincent Marin, MD
San Diego Plastic Surgeon

Elle Magazine and Rhinoplasty

2009-09-18T08:54:00.003-07:00

Secondary or revision rhinoplasty is one of the most complicated cosmetic surgeries that we perform. Often requiring additional cartilage from a patient's ear or rib to help rebuild missing or damaged nasal cartilage. Read an interesting story profiled in ELLE Magazine about one woman's path through the process.

A great quote by Dr. Hidalgo regarding the difference between an open, closed and revision rhinoplasty: “An open rhinoplasty is like opening your closet door wide to see everything hanging on the rod together,” Hidalgo analogizes. “This allows you to select, edit, and rearrange freely. Closed rhinoplasty only opens the door a crack, so you have to reach in and pull items out one at a time. It’s dark in there, and you never see everything at once. Open rhinoplasty is especially useful in secondary operations, where often all the clothes have been pulled off the hangers and lie in a crumpled heap inside.”

Full article

Vincent Marin, MD, FACS

Lindsey's New Lips

2009-09-13T21:58:00.003-07:00

In a recent article posted in London's Daily Mail, there was much speculation as to the new "fullness" to Lindsey Lohan's lips.

There has been much speculation about what's been going on with Lindsay Lohan's lips recently.

But as the actress was spotted out and about in New York yesterday, it appeared she had taken things to new heights.

The 23-year-old's lips looked swollen, sparking speculation she could have been at the collagen again.

As collagen had long been the standard for soft tissue fillers in the past, it has since been eclipsed by other newer products such as hyaluronic acids (HAs) as well as several other formulations such as Radiesse, Sculptra and Artefill and there has been a resurgence of the use of the permanent silicone gel. I have found that the lips are best filled by one of the HA products with my preference to be Juvederm secondary to the "soft" nature of the filler. Radiesse is actually contraindicated in the lips and should be routinely avoided there. Finally, lips can easily be filled in a subtle way to enhance the volume without producing the over-filled "trout pout" that everyone fears. Just choose your physician wisely and make sure you communicate your desires.

Just for comfort, there also is a chemical (hyaluronidase) which, when injected, can dissolve the HA products within an hour or so. This usually allows a doctor to correct any problem that may arise by having too much product in the soft tissues.

Dysport - The Second Coming?

2009-09-12T18:45:00.003-07:00

Medicis recently received FDA approval to introduce Dysport into the cosmetic surgery market to compete with the industry standard Botox. Both of these products act to paralyze "frown muscles" in the forehead to soft lines that occur with normal facial expressions. Last year over 3 million patients underwent a treatment with Botox with great success. In satisfaction surveys, over 95% of patients are highly satisfied with the treatment.

The introduction of another product into the doctor's offices, patients now have even more choices to help improve their appearance. The product works in a similar fashion by inhibiting a nerve's ability to release the chemical that causes a muscle to contract. It is important to remember that the dosages ARE NOT equivalent and you need roughly double the "units" to get the same results. Fortunately, the cost is less and the end cost to the patient is roughly the same. Where I see the largest benefit is in patients who do not respond well to Botox (patients that do not respond or it wears off quickly). As we get more experience with the product, it is likely to benefit our patients by offering them more choices to achieve their aesthetic goals - and who doesn't like more choices!

Vincent Marin, MD, FACS
San Diego Plastic Surgeon

Botox, A Higher Calling?

2009-09-12T18:26:00.004-07:00

The New York Daily News published an interesting story about a Staten Island Episcopal Priest who stole money form his church to fund a personal habit for Botox, fancy clothes and plastic surgeons.

NEW YORK (NBC NEWS) - A New York priest is accused of stealing nearly $85,000 and spending it on Botox, booze, plastic surgery and nice clothes.
The Reverend William Blasingame, 66, recently resigned from Staten Island's St. Paul's Memorial Episcopal Church.
Investigators say Blasingame took the money over a three-year period.
"The investigation arose from a phone call from church leaders about disparities in the church books," a source told the New York Daily News.
The funds were to have been used for maintenance of the church's grounds, as well as to help struggling parishioners.
Blasingame was arraigned Friday after turning himself in.
He'd resigned in January and is scheduled to appear in court next month.

Despite the downturn in the economy, we have had a steady stream of patients who continue to keep up their Botox and filler maintenance. Despite the many benefits of neurotoxins and soft tissue fillers, we frown on illegal means of procuring these items. If money is an issue, just delay your next appointment! There are no long term consequences to waiting until there is a special at your local plastic surgeons office, or until your bank account can easily "afford" it.

Vincent Marin, MD, FACS

Lifestyle Lift Sanctioned by the NY Atty General

2009-09-12T18:00:00.005-07:00

If you've watched TV late at night or over the weekends, you're almost guaranteed to see an ad for the "Lifestyle Lift." Middle aged women rave about the life changing results they have had after undergoing a procedure that is marketed as an ideal solution for most anyone with facial aging changes. As there is only one procedure, all patients seemingly must then fit into that treatment, not individualizing the treatment to fit the patient's needs. Recently, the New York Attorney General sanctioned the company for encouraging its employees to write favorable results about the procedure on patient focused web sites. This was highlighted in a recent New York Times article:

"Lifestyle Lift, a cosmetic surgery company, has reached a settlement with the State of New York over its attempts to fake positive consumer reviews on the Web, the New York attorney general’s office said Tuesday.

The company had ordered employees to pretend they were satisfied customers and write glowing reviews of its face-lift procedure on Web sites, according to the attorney general’s statement. Lifestyle Lift also created its own sites of face-lift reviews to appear as independent sources."

As a plastic surgeon, I find it absolutely imperative to help tailor my recommendations to the needs of my patients. As you know, all people, although similar, age differently. Some people complain about their neck, others the jowls, perhaps midface and some complain about it all. Thus, no one patient ages excatly the same as another. I would then recommend to be extremely suspicious of any "named" or "patented" procedure that is designed to fit every patient. Do your research, use common sense and have several consults to find the surgeon who is right for you.

Vincent Marin, MD, FACS
San Diego Plastic Surgeon

Saline vs. Silicone: How do you choose?

2009-03-10T15:37:00.001-07:00

The first silicone breast implant was developed in 1961 by two surgeons (Cronin and Gerow) from the program where I was trained in Houston, Texas. Since that time, millions of women have been extremely satisfied with a simple one hour procedure.

Currently, women have many options with respect to their breast implant procedure (incisions, above or below the muscle, size of the implant and saline vs. silicone), with one of the most important decisions you must make is whether you prefer a silicone gel or saline (salt water) filled implant.

How do you decide?

Saline implants are clearly the “safest” implant as the fluid placed in the implant is IV fluid and completely harmless. Saline implants are placed empty or with little fluid in them allowing for a smaller incision (1 inch) as compared to the silicone implants which are pre-filled. Once the saline implants are filled, adjustments can be made in how much fluid is added to each implant – this makes these particularly well suited to correct small asymmetries between your breasts. The post-op appearance of these implants is often more of a “round” look, slightly firmer to the touch, and the edges of the implant can be more “visible” than their silicone counterparts.

Silicone implants are pre-filled and the size must be selected either by you at your consult or by me at the time of surgery if there is a question as to what you would like. These implants need a slightly larger incision (1½ inches) to accommodate the placement of the full implant, but they are more natural in their appearance and feel. These implants are filled with a silicone gel, and although not as “safe” as IV fluid, dozens of studies have looked at thousands of women and never found a link between the silicone and any health related problems.

If you are considering a breast augmentation, do not hesitate to call us at LJCSC [(858)452-2066]. After surgery, many of my patients question why they waited so long to solve a problem that has bothered them for years – with a simple procedure that is completed in less than an hour.

Dr. Vincent Marin, MD, FACS

Usher's wife Tameka remains hospitalized for plastic surgery complications

2009-02-18T12:23:00.001-08:00

In a recent article by the New York Daily News, further information has become available on the medical status of Usher's wife.

Usher's wife is still being treated in a Brazilian hospital 10 days after suffering complications from plastic surgery.

The R&B singer has repeatedly been photographed this week visiting his spouse of a little more than a year Tameka Foster Raymond at the prestigious Hospital Sirio Libanes, where she is recuperating after suffering a heart attack during a liposuction procedure.

"The patient's family has requested complete privacy on the case and we cannot comment on her current health situation," a rep for the hospital tells the Daily News, adding, "like any patient she will be released eventually."

Raymond's complications could be related to the fact that she gave birth to her second son Naviyd Ely only two months ago - not four months ago as she reportedly told her surgeon. Her older son Usher Raymond V is a year old.

Raymond is still recovering from her surgery and is taking antibiotics to fight a lung infection,which is common in these cases.

Cosmetic Surgery, despite the fact that it is elective, is still surgery and must be treated as such. Many patients want a procedure with "no downtime" and limited bruising and swelling. That would be ideal, but it is very important that patients do not have unrealistic expectations, and we do not "cut corners," in both our preparation pre-op as well as the planned recovery post-op. Surgery that is rushed can result in unanticipated complications, such as that suffered by Tameka Foster Raymond.

After obtaining a full medical history, I routinely have patients undergo laboratory and EKG testing where appropriate. If there is any hint of untreated medical issues, we will have patients address this with their primary medical doctor to ensure that the patient is "optimized" in preparation for surgery. There is no excuse for rushing into surgery and ignoring important medical issues.

Additionally, after pregnancy a woman's body will undergo a number of changes including the reset of hormonal and fluid balances as well as the contraction of her abdominal wall skin - this can take months to occur. These imbalances can cause the body to react differently to stresses or medications. We normally like to have women wait at least 6 months from their pregnancy prior to proceeding with any elective surgery - I would not hesitate to wait longer if needed.

Once again - do your research and do not take unnecessary risks with your health.

Dr. Vincent Marin

Usher's Wife Tameka has Complications from Medical Tourism

2009-02-08T14:58:00.003-08:00

In a story published today by Access Hollywood, Ushers' wife has suffered complications from plastic surgery in Brazil:

"Usher has canceled his performance at Clive Davis’ pre-Grammy party due to a family emergency, Access Hollywood has learned.

His wife, Tameka, is in Brazil and has experienced complications from plastic surgery. A neurosurgeon, Dr. Gabriel Hunt of LA’s Cedars-Sinai Medical Center, is on the way to South America.

A rep for Usher had no comment at this time. Josh Groban filled in for the R&B star at Davis’ annual event.

Foster, a 37-year-old stylist, recently gave birth to the couple’s second child, Naviyd Ely Raymond. The couple’s first child, Usher Raymond V, was born in November 2007.

The couple announced their engagement in February 2007, marrying on August 3 of that year."

We wish Usher and his family the best during this difficult time and without any formal details on his wife's condition.

Medical Tourism has become increasingly more popular in recent years - especially with the downturn in the economy. People are constantly looking for a "cheaper" alternative to procedures offered in the United States. I routinely see patients from the San Diego area who have travelled to Tijuana for bargain plastic surgery procedures. Unfortunately, the reason I see these patients are for issues or complications associated with the procedures they originally sought.

There are plenty of circumstances where procedures performed outside of the US are successful and the patients are very happy with their results. However, my biggest concern is when there is a complication - such as that suffered by Usher's wife. The involvement of a neurosurgeon further complicates the scenario - with a possible serious issue suffered by the patient.

Issues with medical tourism are highlighted in these circumstances where there is a problem. Insurance will not cover any of the costs, the facilities are often not as equipped as those in the US and patients are taking a tremendous risk with their health. Plastic Surgery is still surgery - and should be treated as such. Thus, there are things to do to save money during tough economic times, but sacrificing on your health and well being is not one of them. Again, this is why I continually suggest to patients to do their research and find a board certified plastic surgeon who is experienced in the procedures you are considering. And, someone who will be there if a problem arises. Despite this being elective, it is not magic and complications can arise in the best of hands - do your research and take your health seriously.

San Diego Plastic Surgeon - Dr. Vincent Marin

Lisa Rinna and too Much Plastic Surgery

2009-01-11T14:27:00.002-08:00

In a recent article in the New York Post, Lisa Rinna discussed her "over use" of cosmetic surgery.

It's no secret that Lisa Rinna is a fan of plastic surgery.

But in a shockingly un-celebrity-like disclosure, the 45-year-old "Dancing With the Stars" alum has admitted she's gone too far.

"I saw a picture of myself and thought, 'Uh-oh.'" Rinna told In Touch Magazine.

"You have to be careful. I'm a perfect example of that! There are many things you can do to make yourself look better."

So what, exactly, went wrong? Rinna fell victim to too much filler.

She injected her face with a filler called Juvéderm, which, Rinna says she used as a way to stay in the biz.

"At my age, you have to look good if you want to continue working. Sometimes we do things to help, and I did. I had tried Botox, and then fillers came into the plastic surgery world, and you think, 'That's not a bad idea.'"

Fillers (Juvederm, Restylane etc.) and botox are often the first entry point for many women into the arena of cosmetic surgery. I have found these to be great and subtle ways to enhance a patients beauty without producing an "overdone" look. Softening the lines on the forehead or filing thin lips can be done in many ways to produce an attractive outcome. Unfortunately, there are some women who insist on an "overdone" look, but these are few and far between. Most women who I see in my office a asking for subtle improvements. The important thing to remember is that the plastic surgery that is obvious is the "bad" surgery; everyone is missing all of the good outcomes because they produce subtle and natural results. Anyone who "over-consumes" on plastic surgery is almost guaranteed to look unnatural. It is the responsibility of both the plastic surgeon and the patient to work together to achieve the best and most natural results. Anyone considering fillers shouldn't be dissuaded by Ms. Rinna, but SHOULD have a comprehensive discussion with your board certified surgeon before undergoing any elective cosmetic procedure.

Board Certified La Jolla Plastic Surgeon Dr. Vincent Marin, MD, FACS

www.MarinAesthetics.com

Even the New York Times is concerned with cosmetic Surgery "Putting Vanity on Hold"

2008-12-19T18:52:00.007-08:00

In an article from the New York Times on December 17, much was discussed about the decent decline in the use of cosmetic surgery as the economic downturn has hit the US over the past year. Here is a brief segment:

“In Orange County, where plastic surgery is a part of their culture, doctors told me business is down 30 to 40 percent,” said Thomas Seery, the president of realself.com, a site devoted to reviewing vanity-medicine procedures. “That tells me something is fundamentally changing there.”

Even a few celebrities, those early adopters of appearance technology, have started to deride the plasticized look that sometimes accompanies cosmetic interventions, a harbinger perhaps of a new climate of restraint in which overt augmentation seems like bad taste.

Call it a Botox backlash. Last month in interviews with different magazines, the actresses Courteney Cox and Lisa Rinna said that they did not like the look of excessive facial injections.

“It’s not that I haven’t tried Botox — but I hated it,” Ms. Cox said in an interview in Marie Claire. “You know you’ve messed up when people who are close to you say, ‘Whoa, what are you doing?’ ”

Meanwhile, Ms. Rinna, late of “Dancing With the Stars,” said that she had gone overboard with skin-plumping injections and planned to cut back. Full New York Times Story

Since I had already discussed some of the economic issues, I thought I would address some of the celebrity opinions about cosmetic surgery, like those of Courtney cox and Lisa Rinna above.

I never get a patient who comes to my office and asks to look "fake" or "overdone." Thus, it is not my goal to produce a patient who looks unnatural after botox, a filler or even surgery. There are times when extreme changes in one's appearance are difficult to make subtle, but it can still be natural. Patients frequently complain that they frequently see ladies on the street who are overdone, or whose lips are "way too big." My answer to them is that some women will over-do cosmetic surgery as will some physicians. However, that is not me and that is not my intent. The most important thing about their statement is that what they don't realize is all the good botox, fillers and surgery that women have had who just look "better." Not operated or "done."

There is a way to have procedures without looking fake - you just have to find the right combination of patient and doctor who can agree on a common sense approach. As for Ms. Cox, I'd be interested to know if you know any other 45 year old women with skin that looks like hers and avoided any and all "cosmetic interventions." As for the photo on the top, which one looks better to you?

Dr. Marin is Featured in ABC News story

2008-12-18T18:45:00.004-08:00

Cosmetic Surgery Desperation and Depression

I was recently one of several board certified plastic surgeons featured in an ABC news story about patients who need revision surgery after undergoing a failed first operation. The article was designed to highlight some of the many dangers that can result from "price-shopping" for cosmetic surgery and not doing your proper research on your physician prior to going "under the knife." Images from one of my revision nose surgeries was illustrated as well.

Here is a small segment of the article:

"Especially with this market, it's become a bigger issue with the economy in the last year," said Dr. Vincent Marin, a surgeon certified with the American Board of Plastic Surgery.

"The cheaper price sometimes brings with it lesser quality," said Marin, who practices at the La Jolla Cosmetic Surgery Centre in La Jolla, Calif. Marin said he's noticed that many of his patients shop for price first, but only start researching to find a quality surgeon after they've had a botched surgery.

Click here for the full story.

Non Invasive Cosmetic Procedures on the Rise

2008-12-16T22:01:00.004-08:00

In a recent article seen on the web stated "As the economy slides south, does that mean our foreheads have to follow suit? Not in Hollywood. Beverly Hills Aesthetics reports that non-surgical cosmetic services like Botox(R) Cosmetic are growing more popular, even in the down economy.

Getting Botox in Los Angeles has become about as common as getting a haircut or going to the gym. What used to be a hush-hush procedure deflected by starlets who credited their smooth skin to good genes and sunscreen is now so common that even young actresses regularly admit to using Botox.

"There is certainly nothing wrong with using Botox to look fresh and rested," as "Full House" television series alum and "90210" actress, Lori Loughlin, said in the latest issue of People Magazine. Loughlin is among many famous actresses profiled in the magazine who discuss using Botox to help keep them looking fresh in front of the camera.

"I believe in getting just a little bit," said actress, Jenny McCarthy. "It allows you to keep mobility in your face, it's a great little secret.'"

Despite the downturn in the economy, people still haven't given up on their beauty. Many patients have merely shifted their focus to more affordable options. I have seen growth in the botox and filler side of my practice over the past several months. Patients are still having surgery, but many people are opting to wait until the economy is on firmer footing before proceeding further with cosmetic surgery. Botox is a great way to not only look better in the immediate future, but also prevent the further development of fine lines and wrinkles over time. I have found that patients who regularly use botox are not seeing the progression of problem areas as rapidly as before their botox use. thus I teach my patients that botox can have have the benefit of delivering both immediate and long term results. Something to consider. San Diego Plastic Surgeon Dr. Vincent Marin

Breast Augmentations Create Demand for Bigger Bras

2008-10-01T16:26:00.003-07:00

A recent article from the UK's Telegraph newspaper reviewed the need for larger bra sizes with the recent increase in breast augmentations in the UK.

Sales figures from Debenhams, the High Street retailer, indicate that British women now have bigger busts than in previous generations.

The company disclosed that the average bra sold is now an entire size bigger than it was just five years ago.

Demand for G cups has risen sharply in recent years and larger sizes - those in size D and above - now make up the majority of the company's entire bra sales (63 per cent).

New ways of measuring customers' figures accounts for some of the increase but greater acceptance of cosmetic surgery, once the preserve of Hollywood celebrities, is also thought to be a major factor.

Many women visit my office requesting breast augmentation surgery. It is not uncommon for patients to ask for a specific cup size with the most frequent surgical "destination" being a "full C." One of the most important things I feel I can teach my patients is how unscientific the cup sizing is. In short, it is the measurement around the chest at the most projecting part of the breast minus the measurement around the chest. If the difference is 1 inch then you are an "a" cup, two inches a "b" etc. etc. Thus, it depends on who is measuring, how tight they pull the tape, where you are on your period, all of these could have an effect on the final outcome. I often tell patients that they may be different cup sizes depending upon which maker of bra they wear. Thus, I feel that using such an unscientific measurement is not the most appropriate for a surgical procedure.

We use silicone gel breast implant sizers and allow patients to "try on" different implant volumes, and this helps to give them an idea on how they will look in clothes. It is only an estimate, and I ask them to ignore the volume and cup size request and concentrate on how each implant makes them look. We have been very successful in sizing patients this way with the only real problem being that most women can be a bit too conservative and say afterwards, "I could have gone just a little bit bigger."

San Diego Plastic Surgeon, Vince Marin, MD, FACS

Schwarzenegger vetoes cosmetic surgery bill

2008-09-30T16:03:00.004-07:00

In a recent move by the California governor, Arnold Schwarzenegger, a bill intended to reduce deaths associated with elective cosmetic surgery was vetoed. The bill was prompted by the untimely death of Kanye West's mother Donda West in late 2007. The LA Times article cited the pressures on the California budget as the reason for the approval of only absolutely necessary projects considering the economic environment. (click here for the story).

"The cosmetic surgery bill, AB 2968 by Assemblywoman Wilmer Amina Carter (D-Rialto), would have required people to undergo a physical examination, give a complete medical history and get a doctor's clearance before undergoing plastic surgery. It received almost-unanimous support in the Legislature."

Avoiding unwanted complications is of paramount importance in elective cosmetic surgery. By nature, these surgeries are elective and we as surgeons are not correcting a problem or ridding a patient of disease. Thus, I will err on the side of being overly cautious to avoid missing an undiagnosed, or frequently an omitted medical issue to prevent postoperative complications. This bill was designed to ensure that patients had a thorough and complete medical work-up before proceeding with surgery. I would consider this standard in any elective procedure. This phenomenon further illustrates the wide range of physicians who are able to perform cosmetic surgery - especially in California. Gov. Schwarzenegger also approved a bill (in 2006) that allowed "dental surgeons" to perform elective cosmetic surgery. Yes, your dentist can put in your breast implants.

Thus, anyone considering elective cosmetic surgery should be very careful in selecting a fully trained, board certified plastic surgeon to perform their surgical procedure. Patients who are looking for "revision specialists" for postoperative problems do volumes more research than those considering surgery for the first time. Be an educated consumer - this is your health you're dealing with.

San Diego Plastic Surgeon, Vince Marin, MD, FACS

Eva Mendes isn't opposed to plastic surgery

2008-09-22T15:03:00.005-07:00

In a recent article from This is London Eva Mendes was quoted with this response related to plastic surgery:

"With the pressure to look good there comes the temptation of plastic surgery. This is something Eva wouldn't rule out. “I would never say I am anti surgery,” she says. “If you reach a certain age and need a little lift just make sure you research your doctor and go for it. I don't like it when people impose their morals on others and say it is wrong. I am not there yet but if I get there then I do. I don't think people need to do that stuff till their 50s or 60s. Maybe they start too young in Hollywood.”

Eva has a very good perspective on the subject. It is clear that there are many pressures on those in the public eye to remain "youthful" in their appearance; and, it is not uncommon for many of Hollywood's top actors and actresses to rely on their plastic surgeon to help them maintain their beauty. Eva hits on two very important points regarding this decision. One: this is a very personal decision for the patient, and the primary motivation should be personal. Surgery will not change who you are, or fix problems in your personal life - unfortunately there are people who feel this way. Secondly, it is very important to research your doctor prior to proceeding with any cosmetic surgery. The restrictions on this aspect of medicine are surprisingly lenient, and the government has adopted a "buyer beware" attitude. Ideally, you would like to have a board certified plastic surgeon perform your cosmetic procedure. There are many specialties who have creatively renamed their profession to seem more adept at cosmetic surgery. Thus, look for doctors who are both fully trained and certified in the procedure you are looking to undergo.

Dr. Vincent Marin, MD
San Diego Plastic Surgery

The Plastic Surgery Disease: Body Dismorphic Disorder - BDD

2008-09-15T13:56:00.004-07:00

In a recent article from the Australia Herald Sun:

Everyone says they can’t see it, but I don’t believe it. I’m deformed,” he says. “When I look in the mirror, I automatically sense that I’m worthless.”
O’Neill, 24, a massage therapist from Melbourne, first started to obsess over his face at age 16.
At first, he took to wearing make-up to hide his “flaws”.
Later, he became addicted to plucking his eyebrows, often spending six hours a day in front of the mirror, but he still never got the results he wanted.
“About 90 per cent of the time, I’d lock myself away. It was torture,” he says.
Then one day, he read the book The Broken Mirror (Oxford University Press) by Dr Katharine Phillips, which is about body dysmorphic disorder (BDD), a severe psychiatric condition in which a person becomes so preoccupied with an imagined or minor “flaw” that it becomes a compulsion.

Body Dysmorphic Disorder (BDD) is not at all uncommon in the plastic surgery population. I frequently have patients who present to me with complaints of problems that I have trouble even finding on exam. There are patients who become obsessed with certain aspects of their appearance that become all consuming. To the outside observer, these are often barely detectable or quite subtle - but to the patient who suffers from BDD, these obsessions can become paralyzing and sometimes prevent patients from leaving their homes, or going to public places.

These patients attribute many of the problems in their life to the specific "cosmetic flaw" that they focus on. If this is corrected, these patients feel like all their "day to day" problems they have previously associated with this physical "abnormality" will then disappear. As a matter of rule, when these issues are unresolved after a surgical procedure, the patients can fall into an even deeper state of the disease.

As a board certified plastic surgeon, it is our duty to constantly be on the look-out for patients who suffer from BDD, and make every effort to educate our patients regarding what will and WILL NOT change with elective cosmetic surgery. This is true for the physical as well as the emotional well being of our patients.

MarinAesthetics.com

I've moved!

2008-09-12T12:44:00.003-07:00

As a native of San Diego, CA, I have always had a desire to return home. I recently was given the opportunity to join a well respected and established practice in San Diego - The La Jolla Cosmetic Surgery Centre. Serving as director of the Gunter Center for Aesthetics and Cosmetic Surgery was a wonderful opportunity where I had the chance to meet hundreds of wonderful patients. However, the pull to sunny Southern California was too great and the chance to take the next step to achieving my goals was too hard to resist.

I now serve as one of the staff surgeons at the LJCSC located in beautiful La Jolla, CA and am very excited about my new "home" as well as my actual return home. I will miss the staff at the Gunter Center and recommend to anyone looking for a rhinoplasty in the south to make the effort to visit with both Dr. Gunter or Dr. Cochran. Looking forward to continuing with my blog in the future and from a little bit further west.

Injection for Breast Augmentation - click for ABC news link

2008-09-12T11:40:00.003-07:00

What if getting bigger breasts was as simple as getting a shot?
The idea is not a new one, and it stands to reason that pumping the breasts full of fat or fillers would offer an alternative to breast implant surgery -- all without the scars. Traditionally, doctors performing such procedures have used the fat harvested from other areas of the body, such as the buttocks and thighs. By purifying this fat and reinjecting it into the breasts, they say, they can offer their patients a safe enhancement using the body's own spare materials. But in reality, the procedure is not nearly as simple as it appears.
"On the surface, the concept of using liposuction to remove unwanted fat from one's own thighs and buttocks, and then injecting it into the breasts to make them larger, has appeal," the American Society for Aesthetic Plastic Surgery noted in a past statement on the procedure. "However, aesthetic surgeons certified in plastic surgery have long maintained that injection of fat, or any substance, into or behind the breast tissue can be potentially dangerous."
Dangerous, because there exists the potential for the reinjected fat to calcify, creating a scarred mass buried within the breast tissues. These calcifications can either mask or mimic the presence of breast cancer. And since between 7 and 14 ounces of fat are needed for the enlargement of a breast, there is no shortage of relocated fat to make the detection of breast cancer difficult, or even impossible.
It would be great if we could use your own tissue to reinflate the deflated post-pregnancy breasts or even transfer fat from where you don't want it to where you "need it." The only problem with fat injections to the breast is that although it is your own tissue - there is a risk that the post-injection calcifications could be mistaken for breast cancer and result in a misdiagnosis - with unnecessary surgery or surgery inappropriately delayed resulting in advanced disease.
My biggest hesitation with this procedure is that fat cells are often used as a source of "stem cells" in other areas of medicine. They have the ability to "stimulate" other cells to grow or themselves morph into different types of cells. Thus, injecting fat cells containing the "stem cell" precursors- there is a risk that it could transform one of the breast cells into one that has uncontrolled growth - which is cancer! Thus, I recommend that patients should wait until this is further studied prior to proceeding any further.
http://marinaesthetics.com

Madonna, who art thou?

2008-09-12T10:09:00.005-07:00

There has been speculation over the years as to whether Madonna has had previously undergone plastic surgery. At nearly 50, she looks remarkably young. Her brother has recently indicated that she "may have undergone a face-lift" but he was closed-mouthed on the details. Also, there have been reports that she underwent fat grafting to her face and cheeks.

In my practice, many older women who lose weight (as Madonna has continued to over time and with a rigorous yoga routine), they tend to look more aged and gaunt as the weight continues to come off. We have known for many years that youthful faces are fuller - and facial analysis of patients over time demonstrate a progressive loss of facial "volume" and fullness. Thus, there has been a resurgence in fat grafting in the plastic surgery community.

What is fat grafting? It is a procedure where fat is harvested from somewhere in the body - hips, tummy, thighs - rinsed of the associated impurities and then re-injected into the area where additional "fullness" is desired. There is good news and bad news with this technique: the good news is that what fat survives, you keep forever. New blood vessels grow into the fat and keep it alive in its new location. The bad news is that only about 40-50% of the fat survives and often this procedure has to be repeated 2-3 times to achieve the desired result.

Thus, with the excessive fullness that Madonna has demonstrated recently - it is likely the she has received some soft tissue filler - like fat or Restylane, Juvederm etc. The extreme "puffiness" she has makes fat more likely - The only problem with that is where would you get it on a physique like Madonna's with very little body fat?

www.marinaesthetics.com

La Jolla Plastic Surgery

2008-04-01T20:50:00.001-07:00

Vincent P. Marin, MD

What happened to Priscilla Presley?

2008-04-01T20:23:00.003-07:00

Priscilla Presley's recent appearance on "Dancing with the Stars" has generated quite a bit of interest regarding her "new look." Through numerous reports it appears that Ms. Presley has undergone numerous silicone injections into her lips, face, cheeks and jawline. This was performed by an unlicensed physician from Argentina using material not approved by the FDA.

Many women want a 'permanent fix" to some of their aging problems, but this comes with inherent risks. The main problem with today's fillers is that they are temporary - so too is this their biggest asset. I always begin with fillers that have the shortest duration (Restylane/Juvederm) before proceeding with a more "permanent" filler such as Radiesse, Perlane or the most recent addition Artefill. The best thing about the non-permanent products is that they correct what you need at the present time. What you need today is not necessarily what you will need five years from now. Thus, my ideal filler wold last about 2-3 years and allow for constant small adjustments to continually produce a result that harmoniously blends with a patients age and aesthetic needs.

Most importantly, everyone who is considering cosmetic surgery should fully examine the training, credentials, education, certification and results of the "surgeon" who is performing their operation. In many states, VERY LITTLE training is required for a "medical professional" to perform elective cosmetic surgery. The impetus is on the consumer - YOU. So do your research.

www.marinaesthetics.com

Has U2's Bono had Plastic Surgery?

2007-04-29T21:52:00.000-07:00

London's Daily Mail reports, "Bono is almost as well known for his distinct wraparound sunglasses as he is for his music. But now the glasses have gone.... as has a recently seen plaster.

Which rather begs the question - has international superstar Bono had a little remedial eyework?

Beaming from ear to ear, the 46-year-old musician took the incredibly rare step of removing his distinctive orange shades and posing for photographers.

Boasting a fresh-faced complexion, and no hint of any under eye bags, the U2 frontman has every reason to smile.

It has long been rumored that Bono's constant use of sunglasses has been to hide unfavorable results from past plastic surgery. Perhaps the Daily Mail has additional information that he has had a revision blepharoplasty (eye-lift) to improve his appearance. The no sunglasses look is a new one and may be based on the fact that his results are better than his last.

Again, this is all speculation. Secondary blepharoplasty is a very difficult procedure and should not be undertaken lightly. The eyelids are incredibly delicate and scarring from previous surgery can profoundly affect the function and form of the eyes. Thus, do your research before any secondary eyelid surgery.

www.marinaesthetics.com

MTV Hills star Montag has plastic surgery

2007-04-29T21:37:00.000-07:00

Twenty-year old starof MTV’s reality show, The Hills, while not confirming the rumors, supported by pictures that she has had cosmetic surgery is quoted in US Weekly as saying, that "whatever women need to feel sexy, they should do".

The reality TV celebrity and aspiring singer is said to have had both a nose job (rhinoplasty) and breast enhancement.

It is not uncommon for up and coming actresses or singers to feel the need to "update" their appearance for a future in front of the camera. The pressures of Hollywood are intense, and we will not infrequently see patients in the office who were told that they needed a certain procedure (by the casting agent etc.) to be successful. Despite this pressure, I feel that it is very important to have the patient alone be the primary motivator for any plastic surgery procedure.

www.marinaesthetics.com

A little wisdom from Ashlee Simpson

2007-04-29T21:18:00.000-07:00

Ashlee Simpson believes plastic surgery should be a "personal choice".

The young star, who refuses to deny or confirm reports she had a nose job in April 2006, insists if people want to change their appearance it's fine as long as they do it for themselves.

Ashlee, 22, told Harper's Bazaar magazine: "I don't get bothered by people saying what they say. I'm a happy person and I'm happy with my looks. I'm not an insecure person.

"I believe if somebody chooses plastic surgery it should be for themselves, not for anyone else."

It was claimed last year that Ashlee turned to surgery because she felt like an "ugly duckling" next to her elder sister, singer-and-actress Jessica, 26.

Of all the recent comments out of Hollywood lately, it is quite ironic that the youngest, Ms. Simpson, demonstrates the most wisdom on the subject. Cosmetic surgery is a tremendously "personal" decision and should be for the individual having the procedure. Plastic surgery with the "wrong" motivation is where many of the unfavorable associations develop. I couldn"t agree more with her quote, "I believe if somebody chooses plastic surgery it should be for themselves, not for anyone else."

www.marinaesthetics.com

Hunter Tylo threatens "Awful Plastic Surgery" with a lawsuit

2007-04-29T20:56:00.001-07:00

The website www.awfulplasticsurgery.com was recently threatened with a lawsuit by attorneys representing actress Hunter Tylo. Comments were made regading the "shelf-like" quality of her breasts (Aug 2005). Her representative "Connie Gondeck of Grecon Associates" has no real presence on the web.

With a little research, it appears that www.awfulplasticsurgery.com has nothing to worry about, click here. I recall that Hunter Tylo also sued and won a multi-million dollar lawsuit for wrongful termination of her job as an actress on Melrose Place (vs. Aaron Spelling). This continues in the recent theme of Hollywood have a love/hate releationship with plastic surgery as well as their celebrity.

Image courtesy of awfulplasticsurgery.com

www.marinaesthetics.com

Jane Fonda is "disturbed" by Hollywood's addiction to Plastic Surgery

2007-04-29T20:34:00.000-07:00

Washington, Apr 29 : Hollywood veteran Jane Fonda has started dreading every trip she takes into tinsel town, for she hates the way an increasing number of young people in the town are going under the knife. The 'Monster-In-Law' star insisted that though even she had gone under the knife a few times, she was astounded and "disturbed" by the numbers of people, men and women, who were turning to plastic surgeryto hold on to their looks. "I have had plastic surgery in the past but I don't want to do it anymore. I get so disturbed when I come out here (Los Angeles) and I see everybody kind of looking alike," Contactmusic quoted her, as saying. The star has now decided never to go under the knife again, for she believes that a message needs to be sent out to young women that growing old and getting wrinkles is an important part of life that should not be tampered with. "We've got to show young girls that you can grow old and still live and have sex, and be erotic, and have fun - and have wrinkles," she said.

Hollywood has an interesting love/hate relationship with plastic surgery. I find it hard to belive that Ms. Fonda understands the motivation behind ALL women who choose to have some form of aesthetic surgery. Cosmetic improvements have had a profound impact on many of my patients' lives; not in who they are, but in how they feel about themselves. Under theses circumstances, I find that these changes or enhancements are enough to push women out of a rut and give them confidence in every part of their lives. Ms. Fonda is entitled to her opinion, but I am confident that most women can make up their own minds without the help from "celebrities."

www.marinaesthetics.com

So they gave you a topical anesthetic for your laser hair removal... Is it risky?

2007-04-08T18:25:00.000-07:00

I have included a segment of the FDA Health Advisory issued December 2006 regarding the use of topical anesthetics in cosmetic procedures. (The full link is also included for your information). It is very important to use these products under the close supervision of a physician. Take a look for additional details, and be careful when using these products as they are not without risk despite their ease of use.

FDA Public Health Advisory
Life-Threatening Side Effects with the Use of Skin Products Containing
Numbing Ingredients for Cosmetic Procedures

FDA is issuing this advisory to alert you to the potential hazards of using skin numbing products, also known as topical anesthetics, for cosmetic procedures. These topical anesthetics contain anesthetic drugs such as lidocaine, tetracaine, benzocaine, and prilocaine in a cream, ointment, or gel. Topical anesthetics are widely used to numb the skin for medical and cosmetic procedures, and to relieve pain and burning and itching due to a variety of medical conditions. FDA has approved many products for these uses. Some must be prescribed by a doctor; others may be purchased without a prescription. Applying topical anesthetics for a medical procedure is usually done in a doctor’s office by a trained medical professional. However, FDA is aware that use of these products before a cosmetic procedure may not be supervised by trained health professionals. Without this supervision, a patient may apply large amounts of topical anesthetics to their skin. This application can result in high levels of these products in the blood causing life-threatening side effects, such as an irregular heartbeat, seizures, and death.

Topical anesthetics are sometimes used in ways not approved by FDA and at doses that may pose a risk for serious harm to consumers. FDA is aware of two instances where women, aged 22 and 25 years old, applied topical anesthetics to their legs to lessen the pain of laser hair removal. These women then wrapped their legs in plastic wrap, as they were instructed, to increase the creams’ numbing effect. Both women had seizures, fell into comas, and subsequently died from the toxic effects of the anesthetic drugs. The skin numbing creams used in these two cases were made in pharmacies and contained high amounts of the anesthetic drugs lidocaine and tetracaine. FDA also has received reports of serious and life-threatening side effects such as irregular heart beat, seizures and coma, and slowed or stopped breathing following the use of these numbing products. These effects happened in both children and adults and when the anesthetic drug was used both for approved and unapproved conditions.

Full FDA article link
www.marinaesthetics.com

Kate Moss and Plastic Surgery?

2007-04-03T16:22:00.002-07:00

Looking at pictures of one of the world's most famous supermodels, it is hard not to notice some of the changes that have taken place. Excluding the natural progression, it is hard not to appreciate her smaller, more petite nose. One of the factors that confuse the issue is that she is smiling in the preoperative photo which naturally widens the nose at its base. However, it does appear to be much more streamline and this would not be expected as a natural progression.

Good plastic surgery is not noticed, unless the patient is constantly in the public eye. Our goal as surgeons is to produce a natural, usually subtle improvement that enhances one's overall facial beauty and is not obvious. We are seeing more and more younger women asking for surgery much sooner than their mother's generation. This has a benefit in that the changes we can make are mild as there is less "wrong" to start, and as a result virtually nobody notices the specific change only that something is better. There is a drawback in that starting too early in one's life can result in the scenario where a patient has had too much surgery and (like I stated in earlier posts) does not look natural. Your surgeon can help you make an educated decision on what is right for you depending upon your goals as well as your physical characterisitics.

www.marinaesthetics.com

Too much surgery

2007-04-02T15:34:00.000-07:00

Both Melanie Griffith and Barry Manilow look more like each other than their former selves recently. Clearly they have both had facial surgery - and almost certainly more than one procedure. This brings up two very important points that all patients must consider before considering plastic surgery: it is almost impossible to make multiple surgeries look "natural" or "un-operated," and very few people don't want to look like themselves.

Another unique thing with both Griffith and Manilow is the height and fullness of their cheeks especially considering their earlier appearances. This is often the result of a mid-face lift where the cheek tissues are suspended upward often to the bone or fascia overlying muscles. This is designed to restore a youthful "fullness" of the cheeks, but it not infrequently results in a "different" appearance that changes the way people look (and you can assume that both of these celebrities had the pick of any plastic surgeon they wanted).

Thus, there is no magic bullet for aging and it is important to approach cosmetic surgery with this in mind. We are able to make great improvements and "set the clock back," often many years. But the incessant quest for youth - or at least youthful appearance - can result in the almost uncorrectable consequence of not looking like yourself.

www.marinaesthetics.com

Helen Mirren Refused Free Plastic Surgery?

2007-04-02T11:44:00.000-07:00

"Helen Mirren refused to accept free plastic surgery and Botox injections ahead of the Academy Awards in Los Angeles. The 61-year-old, favorite to win Best Actress for her performance as British monarch Queen Elizabeth II in The Queen, received a free pre-Oscars goodie bag containing vouchers for free facial treatments.

But Mirren preferred to attend the event covering her wrinkles with the aid of make-up alone.

She said, "I'm very vain, which initially made playing Elizabeth Windsor in all those tweeds pretty daunting. But I'm not fond of all those needles and scalpels. I'll try to get away with make-up, jewelry and a nice frock."

Looking at a history of facial photos from Ms. Mirren over the past several years, either she has found the fountain of youth or perhaps that above quote may be a little white lie. Many women want to look beautiful, but have it seem effortless in reaching this goal. Ms. Mirren looks great, unoperated and appropriate but she may have had a little help getting there.

www.marinaesthetics.com

Courtney Love returns to a more "natural" result

2007-04-02T11:26:00.000-07:00

Courtney Love recently admitted to a revision rhinoplasty as the results from her first surgery did not look natural.

"Courtney Love has undergone a second rhinoplasty procedure to enlarge her nose and [have] her previously enlarged lips reduced. Courtney wrote on her blog: “I have my old nose back. I hated that nosejobby nose, it was like a little beak. I’ve had my nose fixed. It looks like the one God gave me so I’m happy not to have crazy lips and a crazy teensy unnatural little nose. All I care about is that my self esteem is limitless and intact, and that nothing and no situation affects my self esteem.”

In our office, we perform hundreds of rhinoplasties a year, many of which are revisionary procedures. I can't tell you how many times we hear "I just wish I had my old nose back." Rhinoplasty is a difficult operation and thus it is highly recommended that any prospective patient do their homework before embarking on a nasal surgery. Have several consults and make sure you have a connection to your surgeon. All the bells and whistles, digital imaging and technology doesn't mean that your surgeon can actually get you to that image. The goal of any primary (first time) rhinoplasty should be a natural, unoperated appearing nose. Ideally, this is what Ms. Love should have had on her first procedure. However, revisionary procedures with rhinoplasty are not uncommon and this should be discussed with your surgeon.

www.marinaesthetics.com

MRI becoming the standard for breast cancer detection

2007-03-28T07:16:00.000-07:00

In a today's New York Times, an article was published demonstrating superiority of MRI in detecting cancer in the opposite breast that traditional mammograms miss.

"Two reports being published today call for greatly expanded use of M.R.I. scans in women who have breast cancer or are at high risk for it. One report is a set of new guidelines for using M.R.I. in women at high risk for breast cancer, and the other is a study in The New England Journal of Medicine showing that in women who have newly diagnosed cancer in one breast, M.R.I. can find tumors in the other breast that mammograms miss."

"The new guidelines, from the American Cancer Society, are being published in the society’s journal CA: A Cancer Journal for Clinicians. They recommend scans and mammograms once a year starting at age 30 for high-risk women."

Who is high risk?

"The high-risk group includes women who are prone to breast cancer because they have certain genetic mutations, BRCA1 or BRCA2, or those whose mothers, sisters or daughters carry those mutations, even if the woman herself has not been tested. These mutations are not common — they cause less than 10 percent of all breast cancers — but they greatly increase a woman’s risk, to 36 percent to 85 percent. Others at high risk include women from families in which breast cancer is common, especially in their close relatives, even if no genetic mutation has been identified. Women and their doctors can estimate their odds by using one of several online risk calculators that factor in the medical history of both the woman and her family. A simple calculator is available at http://www.cancer.gov/bcrisktool /."

This is relevant to cosmetic surgery as one of the FDA recommendations after approving the use of silicone gel implants was that the federal government recommended MRI scans every 3 years to follow the implants for signs of "silent rupture". MRI can detect this in over 90% of cases and is the gold standard in medicine.

www.marinaesthetics.com

Anyone interested in Silicone Gel Breast Implants

2007-03-26T17:54:00.000-07:00

The FDA has approved the use of silicone gel breast implants with some restrictions. First, all women must be over the age of 22 years. Why? I'm not totally sure, but I can only assume that there was concern regarding the unrestricted use to teens. Secondly, there is a required one to two week wait period before one can schedule surgery after your initial consultation. Finally, you must read and sign a 50-60 page document indicating all of the risks associated with the implants and breast augmentation surgery. [Also, there is a requirement for both major implant manufacturers to carry out a 10 year study on over 80,000 patients, but this has no direct impact on a patients initial choice - only long term follow-up] I have included a link to each of the manufacturers websites where this information is available to all breast augmentation candidates.

Mentor breast augmentation manual - pdf
Inamed/Allergan breast augmentation manual - pdf

Tori Spelling plans for post baby Botox and more....

2007-03-25T20:19:00.000-07:00

After their 6-pound, 6-ounce son Liam Aaron arrived on March 13, sources say Tori made appointments for her and Dean to get facial touch-ups. "Tori and Dean are marching in to get Botox injections. She'll also have her lips plumped with Restylane," an insider told the ENQUIRER. "While Tori usually gets injections every two months, she put them on hold after she got pregnant. But the last time she went in, she took Dean along for some Botox and made a convert out of him." And Tori, who's admitted to having breast implants and a nose job, has told pals that she may undergo yet another procedure called mesotherapy. The treatment uses combinations of different medications injected into the fat layer under the skin in small quantities. It was originally used to treat osteoarthritis and chronic pain, but doctors found it also helped reduce cellulite, wrinkles, hair loss and fat deposits. Mesotherapy injections typically contain a mix of vitamins, homeopathic medicines, herbal extracts and pharmaceuticals. "Although it's still a controversial treatment, many people feel it's potentially less dangerous than liposuction," said the insider.

Mesotherapy is a VERY controversial procedure of hundreds of injections of "homeopathic" remedies to help treat subcutaneous fatty deposits. This has never been proven in the scientific literature and the "homeopathic" nature of the injections always makes me concerned as there is very little science or consistency in what is injected. Many of the patients I see who have previously had the procedure are not satisfied with their results and have only rid themselves of extra cash - not fat or cellulite. There is no question that there are risks with liposuction, but we know that the results are real and attainable in the right candidate. Consult first with your physician and ask to see his/her results before proceeding with any procedure.

www.marinaesthetics.com

Aniston joins the party.....

2007-03-25T13:13:00.000-07:00

Jennifer Aniston admitted to a recent septoplasty (straightening of the septum) to improve her breathing. Although, on frontal view her nose appears to be noticeably thinner than earlier in her career. On close inspection, it also has a rightward (the patient's right) lean at the middle of the nose giving it a "C" shaped appearance.

Rhinoplasty is the most difficult of all cosmetic surgeries. Very subtle irregularities can be quite noticeable on the nose and there is no way in which you can hide this. Thus, it cannot be stressed enough to do your research prior to having any surgery, but especially rhinoplasty. I recommend not only a board certified plastic surgeon, but also one who performs nasal surgery regularly (American Board of Plastic surgery). We would assume that Jennifer Aniston had every resource at her disposal. It is rumored that she went to the same surgeon as Ashlee Simpson with some variability in their results.

More Fake or Real....

2007-03-25T13:02:00.000-07:00

Kellie Pickler, a recent American Idol, has demonstrated a noticeable improvement in her assets since her days as a contestant. She is relatively fuller in the appearance of her face, but her cleavage has disproportionately grown as well.

The recent FDA approval of the silicone gel implants has allowed women to have more options than ever for breast enhancement. These implants are softer and more natural feeling than the traditional saline implants. The most significant drawback is the need for a larger incision to place the implant as they are inserted full - not inflated like the saline option.

www.marinaesthetics.com

Fake or Real? You decide....

2007-03-25T12:52:00.000-07:00

Looks to me like Jessica Simpson has had some fillers and Botox since her 2001 days. Her lips were likely filled with a hyaluronic acid product such as Restylane and the newly arched brows are probably a result of Botox to achieve a non-surgical "brow-lift."

Both of these products are temporary and last anywhere from four to six months. Botox and Restylane have a short recovery and I find that most of my patients' only complaints are that they would like the products to last longer. The temporary nature of the products does have some advantage in that if you don't like it it will go away.

www.marinaesthetics.com

Scarlett says no to becoming an "old hag"

2007-03-24T21:08:00.000-07:00

Hollywood beauty Scarlett Johansson plans to go under the knife in a bid to avoid becoming an "old hag"--as she insists she has no problems with beauty-enhancing surgery.

The Lost in Translation star, who is the face of cosmetics giant L'Oreal, admits she isn't afraid to use surgery in the future to avoid growing old ungracefully.

She says, "I will definitely have plastic surgery--I don't want to become an old hag!

We increasingly see younger patients in the office looking to enhance their looks. It is not uncommon to have patients requesting to have a facelift after the appearance of their first wrinkle. Our job is to prevent women from abusing surgery, as there are many long term consequences to multiple surgical procedures. It is VERY difficult to make patients look unoperated and natural after too many procedures.

http://www.marinaesthetics.com/

Michelle Pfeiffer not against plastic surgery...

2007-03-24T17:39:00.000-07:00

One of the most beautiful women in the world, Michelle Pfeiffer was recently quoted saying "I don't have anything against it [Plastic Surgery] and I think there is a lot of real pressure on ageing women these days," in an interview with Contactmusic. She has denied ever having surgery and credits her good genes for her ageless beauty. Plastic Surgery is not for everyone and should not be billed as such. Cosmetic surgery will not change your life and should be looked at as a source of help for people with a problem area or as the 'icing on the cake'.

Just take a look at her nose....right above the right nostril (not ruling out photoshop)

www.marinaesthetics.com

Ashlee's new nose and lips?

2007-03-22T16:16:00.001-07:00

Ashlee Simpson has clearly undergone a recent rhinoplasty that has enhanced her overall facial beauty. The goal of a good rhinoplasty is to deliver a nose that complements the facial features of a patient. There is no one nose for all patients and the treatment plan should be individualized to meet their needs. Rhinoplasty is the most difficult and challenging procedure in all of cosmetic surgery and has been descibed as a surgery of millimeters....yes millimeters. We recommend that every patient do their homework before proceeding with a rhinoplasty to find a board certified surgeon who regularly performs this operation (American Board of Plastic Surgery). In cosmetic surgery - it is always buyer beware as you never have as good a chance as your first operation.
www.marinaesthetics.com

Brooke Burke isn't afraid of Restylane

2007-03-22T15:54:00.000-07:00

Brooke Burke was recently spotted exiting a Los Angeles Surgery center with evidence of a recent filler treatment. The bag (with her name on it) reads Restylane - the most frequently used hyaluronic acid (HA) filler on the market.

It is commonly used to fill deeper lines in the face, restore lost volume and plump deflated lips. All of the HA products are temporary, and last anywhere from 4 - 6 months depending upon the location and volume. They are a great way to fight the initial signs of the aging process and are usually a woman's first introduction to the age management process.

www.marinaesthetics.com

Soft Tissue Fillers

2007-03-22T15:44:00.000-07:00

Soft tissue fillers have become commonplace for any woman concerned with her age. These products have allowed plastic surgeons to help women fight the unwanted effects of aging without surgery. Most products are injected into the tissues in areas where facial volume is deficient. Products such as Restylane and Juvederm are made of a substance called hyaluronic acid (HA). This works by absorbing your own body’s water and this result s in a “plumping” effect on the lips or facial lines.

Other products, such as Radiesse and Sculptra, act both fill the tissues and stimulate the production of collagen. Advocates say that this results in a more long lasting solution to the problem.

Permanent fillers are also on the horizon. Artefill has recently been approved by the FDA as the first permanent filler . Dr. Marin urges caution with permanent fillers as ”where you want them today may not be where you want them five years from now.”

Using your own fatty tissue as a filler remains another solution to the progressive loss of facial volume with age.

Dr. Marin is encouraged about the future of non-invasive options, “this is a very exciting time in plastic surgery. We have more choices available to us than ever before to help restore your youthful, natural beauty.”

Silicone Gel Implants, are they safe?

2007-03-22T15:33:00.000-07:00

Patients’ concerns over the safety of silicone still exist, but all potential breast augmentation candidates should feel comfortable that these implants are the most studied device for human implantation – EVER. A web site has been created by the American Society of Aesthetic Plastic Surgeons (ASAPS) to help educate patients on their options when it comes to breast augmentation. Dr. Marin encourages all his patients to visit: breastimplantsafety.org prior to a consultation to help them become fully educated consumers.

www.marinaesthetics.com

Saline vs. Silicone: you finally have a choice

2007-03-22T13:44:00.000-07:00

Never has there been a better time for patients to consider breast augmentation. With the recent approval of silicone gel implants by the FDA, women have never had more options available to them. Presently, any woman over the age of 22 is a candidate for silicone gel implants, and standard saline implants remain available and unrestricted as they have been in the past. Some of the benefits of silicone gel implants include a softer, “more natural” feel of the implant as well as the implant being more easily hidden beneath the patients own breast tissue.

Your surgical options should be based on scientific measurements indicating the needs of your body. You should also get to feel the implants and “try them on” to get a sense of what size is right for you. “I want my patients to be part of the decision making process,” says Dr. Marin. Women understand their bodies better than anyone else, and it is important to incorporate that knowledge into the surgical plan.

www.marinaesthetics.com

Clooney admits, as cosmetic surgery on the rise for men

2007-03-22T13:19:00.000-07:00

The “Sexiest Man Alive” recently admitted to a little ‘nip/tuck’ of his own. He stated in a recent interview with Julia Roberts that the biggest change in his life was "I had my eyes done. Can you tell? I think it's important to look awake."

Dr. Marin said “plastic surgery has become increasingly more common in men, and often the first surgery they undergo is eyelid surgery.” Blepharoplasty can have an almost immediate effect on improving chronically “tired eyes.” Men have gradually become more comfortable with the idea of cosmetic surgery. They tend to be slower to commit and often physical limitations - such as visual obstruction - are the impetus for men to seek help.

www.marinaesthetics.com

Why do I have dark circles under my eyes no matter how much sleep I get?

2007-03-22T12:38:00.000-07:00

Dark under-eye circles are a result of the thin eyelid skin overlying eye muscles and blood vessels. This is made worse as the fat in the lower lid begins to bulge. And finally, overhead lighting helps to cast a shadow that makes those circles seem even worse.

Fortunately, there is a solution. “Youthful lower eyelids are full, not hollow,” says Dr. Marin. “The goal here is to restore the lower lid appearance to that younger, fuller look.”
We are regularly using fillers, such as Restylane and Juvederm, to help hide the lower lid “hollow” and restore the appearance that patients had in their twenties.

This is in-office procedure that takes about 30 minutes to perform and swelling is usually gone after a weekend.

www.marinaesthetics.com

Restylane, could your results be permanent?

2007-03-22T12:10:00.000-07:00

Researchers from the University of Michigan recently published the results of a study performed on the hyaluronic acid (HA) filler Restylane. Published in the journal Archives of Dermatology, they found that there is increased collagen production after three weeks of treatment. The Wall Street Journal quoted the author of the study, Dr. Voorhees as stating “ ...the stretching [caused by the introduction of Restylane] caused the cells to make collagen like they did when they were young. "

“These findings are the first to demonstrate ‘long term’ results with the temporary filler Restylane,” says Dr. Marin. Although preliminary, results like these may allow us to offer patients the longer-lasting results they have desired with filler products. Stimulating your own cells to produce more of their own collagen is the safest and most permanent solution from the filler market since its introduction.

http://www.marinaesthetics.com

ASAPS Statistics: By The Numbers

2007-03-21T19:59:00.000-07:00

TRENDS AND DEMOGRAPHIC DATA

Top surgical and nonsurgical cosmetic procedures among men and women in 2006:
Surgical	# procedures	Nonsurgical	# proced.
Liposuction	403,684	Botox	3,181,592
Breast augmentation	383,886	Hyaluronic Acid (Hylaform, Restylane)	1,593,554
Eyelid surgery	209,999	Laser Hair Removal	1,475,296
Abdominoplasty	172,457	Microdermabrasion	993,071
Female breast reduction	169,314	Laser Skin Resurfacing	556,172

Top cosmetic procedures for WOMEN:
Surgical	# procedures	Nonsurgical	# proced.
Breast augmentation	383,885	Botox	2,881,119
Lipoplasty	350,420	Hyaluronic Acid (Hylaform, Restylane)	1,519,923
Eyelid surgery	182,397	Laser Hair Removal	1,308,739
Abdominoplasty	164,800	Microdermabrasion	921,970
Breast Reduction	145,822	Sclerotherapy	541,291

Women had 92 percent of cosmetic procedures. The number of procedures (surgical and nonsurgical) performed on women was over 10.5 million, an increase of 1 percent from the previous year. Surgical procedures decreased 9 percent; nonsurgical procedures increased 4 percent. Since 1997, surgical procedures increased 123 percent, while nonsurgical procedures have increased 749 percent.

Top cosmetic procedures for MEN:
Surgical	# procedures	Nonsurgical	# proced.
Liposuction	53,263	Botox injection	300,472
Rhinoplasty	33,143	Laser hair removal	166,557
Eyelid surgery	27,602	Hyaluronic Acid (Hylaform, Restylane)	73,634
Male breast reduction	23,670	Microdermabrasion	71,102
Facelift	14,051	Laser Skin Resurfacing	48,451

Men had 8 percent of cosmetic procedures. The number of procedures (surgical and nonsurgical) performed on men was nearly 1 million.

Frequency of cosmetic procedures by AGE GROUP:
% of total	Age	# procedures	Top surgical procedure	Top nonsurg. procedure
47%	35-50	4.5 million	Liposuction	Botox
26%	51-64	2.9 million	Eyelid Surgery	Botox
20%	19-34	2.5 million	Breast Augmentation	Laser Hair Removal
5%	65 and over	589,229	Eyelid Surgery	Botox
1%	18 and under	178,041	Rhinoplasty	Laser Hair Removal

http://www.marinaesthetics.com

11.5 Million Cosmetic Procedures in 2006!

2007-03-21T18:04:00.000-07:00

The statistics are in and over 11.5 million cosmetic surgery procedures were performed in 2006. These results are from the American Society of Aesthetic Plastic Surgeons (ASAPS) who surveyed plastic surgeons, facial plastic surgeons (ENT) and dermatologists who perform cosmetic procedures.

Topping the list for women were 1. breast augmentation (silicone implants were up 18%) 2. liposuction 3. eyelid surgery 4. tummy tuck 5. breast reduction.

Botox continued to lead all procedures with nearly 3 million men and women having undergone treatment for facial lines. Soft tissue fillers increased as well with over 1.5 million patients over the past year.

Minorities also had more cosmetic procedures than ever before reaching nearly 22% of all procedures performed.

www.surgery.org, www.marinaesthetics.com