Doctor808 Plastic Surgeon Honolulu Hawaii

Here is great word -as I try to learn Japanese. I always likes this word   オタク  it means geek in Japanese and pronouced O-TA-KU. It has a lot more negative meaning in Japanese then the American word Geek however. Geek in american culture is like Bill Gates. In Japan , オタク almost is like a bum , sorta of a useless creature who lives in the computer world in his parents upstairs room.  A true オタク will also go down to Akahebara which is the electronic section of Tokyo and hang out perhaps at a Maid Cafe. If you want look into this weirdness (hen na no in Japanese) search on “maid cafe Tokyo”. The maids cafe concept is now in many coutries inculuding one I found in Singapore. Its hard to explan you just have to expierence it.

Well as my web design company starts to produce more web sites and handle our clients I am feeling more like an Otaku than a Plastic Surgeon which I guess is the point of this rambling. The next step for me is to hang out at the Maid’s Cafe and get some Moee. Moee is something you will have to find on your own and once you know what it is let me know.

Until next time

drmap

As a plastic surgeon performing surgery for over twenty years I thought I had heard everything. Well a few years ago I was suprised. A 64 year old Japanese lady came in my office sit down at the consultation and I asked her how I could help. Without a blink or stutter she asked quickly ” doctor can you cut my nipples off?”. Well my first thought, great my receptionist let a mentally I’ll person through the gate. Every plastic surgeon has people come to their office who are better served by psychiatrist, but we all try to screen ahead of time. My receptionist is pretty astute so maybe she slipped up I thought.

Well after examination I noted the woman indeed had nipple length of 2 centimeters. So after all she was right. We preformed the reduction later and she was happy.

The punchline is I asked her why she waited till age 63? Her answer was she just left her husband of 40 year marriage and wanted to find a new boyfriend !

Well one secret to staying fit and youthful is not plastic surgery in itself. Though I should be saying plastic surgery is your answer to all of life’s problems, I can’t.

plenty of water during exercise

So many of my patients expect me to change with one operation years of neglect, but it’s not going to happen. As I have learned good exercise and diet can do more than I can. Plastic surgery can help, but a sound foundation of a good lifestyle cannot be beat.

My personal reccomendation is to mix up your program with cardio, resistance training and a stretching such as Yoga. It takes time and discipline but will take years off of you. I kick box muay Thai style 3-5 times a week and weight lift 3-4 times a week.

Diet I keep on the high protein low carb. This keeps my weight down. I actually had some liposuction around my mid line which allowed me get a six pack finally. I could lose the fat around my belly but when I did my face looked hollow. So liposuction did the trick.

Well as a bit of a geek or as the Japanese say, an otaku I own an Iphone. This I suppose is a mark of a geek, much like having a gmail address early. I am trying out this blog program and will publish from my Iphone. I did want to say, that as our web company grows to stay ahead of the game no time can be wasted. So since I am waiting for my ride to lunch the Iphone helps me save time, as I blog from the phone. As to advise to my clients, if your going to blog check  the Iphone to help with no waste time blogging.

Dr. Pasquale thinks this is Dumb

Transumbilcal Breast Augmentation Hype without Sanity

A blog like this is more casual and of course , these are opinions of one Plastic Surgeon. Although  in a different forum I may be demonized and my argument rebutted profusely, here I take the liberty to say what I want.  This is definitely not  a scientific forum,  thus I can mutter under my breath very effectively and without fear.  I recall when I hear about placing a breast implant through an incision at the belly button.  Like many at first I thought how clever and how technology has advanced.

Then after seeing this procedure and trying two myself  ( on patients not me)  I realized that this is the dumbest operation in cosmetic plastic surgery.  I mean the entire argument used to promote the procedure is a falacy. The central theme of those who claim this to be the greatest idea since adding creamer to Starbucks coffee is patently absurd.  They claim it is “scarless” . Well this is a bold lie. As anyone with a small amount of surgical knowledge knows it is impossible to cut any skin without leaving a scar. Yes its true it is far away from the breast, but there is still a scar and also a scar inside the tissues which were transversed with the pipe used to insert the implant.  Those who promote the procedure also fail or withhold the information that a properly executed breast augmentation procedure through the axillary or para-areola (around the nipple) scar should be practically invisible as well. 

The other fact that I realized is that when we as plastic surgeons try to create a beautiful breast for our patients its much like an artist or sculpture.  One does not create art working as far away from the art work as possible. I mean how stupid would you think someone was who tried to sculpt a statue 20 feet away from the stone. Same principle applies here. Why would someone want to create a breast from 1 foot away when they could do so right at the previous breast area?  Well i think anyone who stops and thinks for minute could easily conclude the obvious.

All this rambling does not mean that it is impossible nor have many patients had nice outcome from a the belly button approach. Yet just because something is possible does not mean we should do it. I mean it is easier to walk up one flight of steps to the second floor than it is to scale a the wall with a pick and ropes.  You could do that but why would you want to?

Finally another point I find silly about this belly button approach is the concept of placing a silicone shell implant through a metal tube. Then  pushing it thorugh with another metal tube to the position a foot away. Plastic Surgeons  are taught to minimize the amount of touching of the implant when they place it in the tissue which is known as a “no touch technique”. This is thought to prevent micro scratches or contamination of the implant. Well how many scratches on the implant do you think are made when we shove it through a metal tube for distnace of  over one foot. This could lead to early deflation as thsoe micro scratches leave potential weak points in the shell of the implant. Hmmm does this make since to you?

If you want to see a more formal opinion please see my newsletter here : http://www.nerve.org/doctor808/beautygram002.html   there are some great photos of the result of this  approach as well.

So these are my ramblings on this procedure as one of the dumbest things I have seen.

what me worry?

Well I have been in cosmetic surgery now for over 20 years, but only in the last 8 years have I limited myself to cosmetic surgery. This is considered by some to be a waste of talent and training. Yet I do agree that it is somewhat of waste of my years of  formal training in microsurgery and hand recostruction. Yet I definetly disagree that somehow cosmetic surgery requires less skill or training. In fact my knowledge gained by microsurgery is one reason i get referrals from other plastic surgeons for facial cases where the facial nerve has ben damaged. So this has helped my face lifts, borw lifts and other facial cosmetic surgery practcie. So nothing could be further from the truth.  The problem is  there have been few surgeons formally trained in microsurgical reconstruction in the  Hawaiian Islands. In fact Queens Medical Center did have  a shortage where they could not find a hand surgeon to come in and replant a finger. That is better now.

Well the truth of the matter is that if a surgeon was paid appropriately for this type of work they would have no shortage of hand or micro-surgeons.  I recall spending 12 hours in the operating room with one such case and when I received my check from the insurance company it was $500.  My god any plastic surgeon can spend less than an hour injecting BOTOX  TM and earn that. Well that is society where values are dictated by bling. I cant fight it so I just do the best I can….drmap

DrMap Muay thai

As many of you know I have trained and continue to train in Muay Thai which is also the national kickboxing style sport of Thailand. I have searched for good training for years here in Hawaii and though there is good kickboxing training the specifics of Muay Thai have been lacking. This last few months I came across an new instructor and dojo. This is called Tiger Muay Thai located at Sand Island Access Road.  Last night they held what is known as a “smoker” nothing to do with tobacco. It is a quick exhibition of fighting Muay Thai by our Dojo. I must say from the music to the actual fights I felt I was back in Thailand a little. I would encourage anyone interested in this sport to come to see our next smoker. Its not for everyone.

Kru Doug and Fighter Dan Tiger Muay Thai

Dr. Pasquale

Welcome to Doctor808  my blog about many of my interest and helpful information I hope to share with you. I hope to make this entertaining as well and most of all we hope you will contribute. Our friends are from around the world and this blog will be in English and hopefully translated to Japanese and Chinese and other languages as we go along.

Allow me first the privilege of introducing myself . My name is Michael Anthony Pasquale and I am Plastic Surgeon located in Honolulu , Hawaii. I have been in practice about 20 years , first with microsurgery, facial and extremity reconstruction now exclusively in cosmetic surgery ( beautification procedures).  I was also a trauma surgeon as well at one point in my career, in New York and Hawaii with some time spent with Army. I have had intense interest in the Internet for years. I was one of the original compuserv members over 27 years ago. I have watched the Internet grow from nothing. As this interest as grown , I started  web design/marketing company was well which specializes in cosmetic surgery and beauty industry known as 3D-plasticsurgery.com.  There will be more information on this endeavor as we go along. Our company does  virtual world design , traditional web design and marketing functions such as SEO.

We hope you will find this usefull and be patient with us as we learn as we go along. Comments will be welcome.