Doctor808 Plastic Surgeon Honolulu Hawaii

Another Fountain of Youth ?

I was a trip to Europe for two months last year. I was intensely interested in Fat transfer , Fat Transfer with Stem Cells, Stem Cells alone and the like. There I had the opportunity to visit a few surgeons and a factory that makes an interesting device. This factory was in Lausanne ,  Switzerland. I spent the greater part of the day with a CEO after a train ride who was Italian Swiss. He convinced me that his device works and from what I have been speaking to some of my Colleagues in Asia it seems to be well accepted.

Regen Platelet Rich Plasma Kit

The kit shown above is used to Harvest the blood and separate the components. RegenKit will help  prepare Autologous Platelet Rich Plasma by centrifuge.. This device and system will  produces 4 to 5 ml of Platelet Rich Plasma from 9 ml of whole blood in less than 10 minutes.

So now that you have the Platelet Rich Plasma from the system what is it and what does it do?

Well the good thing is it comes from your own blood, so no harm there. Its non surgical and we like that. The concentrate is thought by some to contain a rich substances such as stem cells and growth factors which may regenerate at some level what you inject it in. Orthopedic surgeons use it for one thing, and cosmetic plastic surgeons use it for another.

In my practice,  I think the best potential use is on the facial skin. This appears in some patients to bring back a youthful glow and lightening effect. By no means is this standard or what we call traditional therapy,  but I believe it may prove to be useful in our quest for anti aging and plastic surgery. It is interesting !

Standard therapy or not I can see little harm coming about and its yet another component of our plastic surgeons arsenal which may be if use.

Till next Time

Doctor808

Yes I have a Mother

Well like most people I have a mother. Simple fact. My mother is from North Carolina, she is a tar heal as they are called. Actually and oddly enough even though I think of myself as Italian as that is my strongest linage,  I also know the North Carolina side. My mother’s mother also know as Grandmother as well as nana was a typical southern bell. My grandfather was a woodsman, a hunter and salt of the earth type. No one was educated really until my generation. I became a “doctor” almost a foreign entity to my family, a plastic surgeon in Hawaii no less–how weird I am to them.

Mother 8 years ago when I took her to Vegas "I hate flying" was all she said.

They cope and are independant

My sister called me to tell me that my Mother was in the hospital recently , the last few years she had throat cancer and seems that she has some issues now with breathing. Well my sister lives with her and keeps in touch so I do not worry much. However,  if it was not for my sister I may not have known she is in the Hospital. Its not that I do not keep in touch with my mother, she is just kinda “tough and stubborn” which would be expected of true a North Carolina born bread individual. She actually told my sister not to tell me. Typical !

Moral of the story

So I called my mother in the hospital and she answered, “Hello Son” , “Hi Mom”…”why are you not in surgery?”. So from there the discussion went to everything but her illness. This I thought is typical of her generation. They went through hard times , delt with them and kept going.I compare that to today when many people use any excuse they can  to do get something for nothing, take no personal responsibility  and expect our government to help. I remember my days as a trauma surgeon in New York City when the healthiest most “well fed” people would call the ambulance to take them to the hospital. They would then choose the hospital they wanted to go and then arrive  get out and and go shopping at Macey’s down the street. Yes they would use the $1200.00 ambulance call as a simple taxi service. My mother on the other hand , my sister had force my mother to go to the hospital (‘which I cant afford” she said) when she simply was ready to die right there due to lack of oxygen. Such a contrast. Its no wonder we have become what we have today.

Conclusion

Well after talking with my mother while she was in the Hospital and realizing I will have to visit her soon,  I thought about today and the nature of America. We have changed and now have become something I did not grow up with. That is , dependance on others. Well that is the key concept of libertarianism–Independence. My real mother illustrates it well.

My Uncle Sam today does not nor does his nephews and nieces. They are all codependant unlike the libertarian view I hold.

doctor808

My Stock Harley "the rocker"

Well as many of my readers know I am somewhat of a motorcycle enthusiast. I think what has me interested more then the   speed, power and pure hedonistic pleasure is the History. Many cultures around the world look down on the American Culture as “cowboys” or non-sophisticates. Yet at the same time envy for America to the point of saying all types of bad things is the norm. Believe me when I say,  I have plenty of bad things to say about the USA as well. However I do respect what was the pioneer spirit and the inventiveness of the few here  although that has changed it seems recently. In the early 1900′s when most of the world was running around drowning in protocols, inbred governments bureaucratic nightmares and politics the American scene was full of freedom lack of restrictions social and other wise for most Americans. I suppose because the country was still fairly new and had not yet become the Roman empire in decay.

Out of the freedom new inventions , new ideas and many companies came about by “doers” who had ideas. One can simply search on patents that arose during that time to see the wide variety of new ideas. In 190o William S. Harley, age 21, completed a blueprint drawing of an engine designed to fit into a bicycle. This later evolved into Harley Davidson briefly preceeded by only a few years by the “Indian” and a french design of motorized bicycle and the bone crusher of Gottlieb Daimler . His idea took off.

Harley Biker Bar

Well the American version of the motorized bicycle eventually evolved into one of the most solid companies and more importantly a solid “cult” grew up around it. There simply is no match to the “Culture of Harley” in the world today. The Japanese bikes such as the Honda and the Suzuki etc were all world war 2 spin offs of the American ideas. In some ways better engineering, better performance and indeed more owners. Yet the cult of Harley is unmatched anywhere. The Harley Davidson is a personal statement about the individual to some degree. It means different things to different people. All I can say is that I have rode Harleys, Hondas and other Asian bikes in various parts of the world but the Harley people seem to have the most cohesive ideas, -independence, honor and some rugged individualism. If a harley was a profession it would be soldier or a cowboy while if a honda was a person it would be lawyer or politician. You can draw your own conclusions from there. One has honor as a high idea a rugged independence and the other gets along to get along. Truth and Honor type things like the Roman legion before the decay with Harley guys.

THOUGHT EXPERIMENT

Let me create a small thought expieriment to illustrate what I mean. Pretend for a second your alone with your  children in a bad neigborhood. Some local gangsters come around and if your woman start making remarks and teasing your kids and in general being local type rif raf types harassing you. Your alone and you have two buttons on a device. one summons two different gangs. The red button if you push it , ten guys on Hondas show up to help you. If you push the black button ten guys on Harley’s show up to help you. Which button do you push? See my point –somehow the ratty tat ratty tat sound of ten hondas coming to your side  is just not quite as reassuring as ten rumbling Harley Davidson’s. It is just something you know in your gut.

HARLEY RIDERS

WE ARE COMING TO HELP

I guess what got me thinking about all of this was my recent purchase of some parts to take my Harley to the next level. Now I am customizing it making it with my “Signature” and not the stock issue parts. Every Harley guy does it to some degree. I guess that is why there really are no stock Harleys out there after a few years of age. However i do not know of any customized Hondas. ( there are I just do not know any).

Do not take me wrong I like the speed of the Japanese bikes and some the European bikes as well. So in the future I may even obtain a nice Decati or BMW as these are interesting fun machines. Yet for me I had to customize a Harley first as that is a motorcycle.

DOCTOR808

Back from Europe and had a pretty good refurbishing of my attitude and knowledge. I spent close to 60 days there, except a brief trip to Korea.i was an invited speaker at the Korean Cosmetic Surgery Society again. I read a lot in Europe, almost every day 3-6 hours on Plastic Surgery Topics, some web stuff and looked at the condo and real estate sales market there.

Fat Transfer and stem cell notes

Yet one of the new areas I looked into was fat transfer with or with out stem cells. There is a process manufacturer in Europe (at undisclosed location) that has quite a bit of knowledge his company share with me about the use and abuse of stem cells. We spent a good day discussing the controversial issues around this topic. I as many of my readers know went to a stem cell conference in Coranado Island last summer as well as attended the Vegas meeting. One of the top research firms is in my building having to do with stem cells as well, so I frequently visit with them or they visit me.

My point is:  somehow I being drawn into this stem cell thing rather rapidly as the field is accelerating. What will these stem cells do? Well according to some things you see on the internet–they will do everything ! Of course that’s is typical hype one sees and only a fool believes. Yet what I have noticed is with fat injection to the facial area (which has some stem cells naturally in the fat that is transferred) is a remarkable change in complexion. It seems to rejuvenate the skin to some degree -actually a big degree. As to the exact mechanism or scientific proof ? I do not have that data to share. What I am sharing is simple observation within my own clinical practice. More study is needed. so I am not formally ready to convert my practice to a “stem cell ” practice , but I am committing to learning more. It does   seem very  promising for face rejuvenation and cosmetic breast tissue regeneration. More on the stem cell issue later. Yet I wanted to introduce you to that concept  here. I might add this IS NOT embryonic stem cells which is the very controversial issue you may hear about.

I have had my web company create a web site about fat injection and as I lean more I will place what I learn there. Its not ready yet,  so do not ask.

Speaking of Regeneration

One of the  most regenerative almost magical places I know and recently visited is The Big Island of Hawaii. I took a few photos and visited with John Turner MD,  a former associate and neurosurgeon. He and I handled some of the bigger trauma cases together on the Big Island when I was working there many years ago. It was great to visit with John and talk about old times. He can be described as a bit of spiritualist/paranormal -doctor recently coming back from a sojourn in South America. Dr. Turner went his way years ago,  but stayed on the Big Island, I came to Honolulu and focused on Cosmetic Surgery.

Here are some picture of the Big Island…you can see the lush greenery and some waterfalls –Boiling Pots on the Hilo side. Please enjoy the scenery as I did.

Hilo Airport View

Boiling Pots Hilo

Hilo is always Green Green Green !

Hilo Streams everywhere

As promised I will continue to keep the post to my blog up. Today I had to find a suitable back pack for traveling on my bicycle around. The grocery stores do not give you a bag when you buy groceries as they do in the states so most people have their own. I need a back pack for carrying around my plastic surgery study guide and other items.

The stores here for this type of thing only seem to carry American Brands as I could not find any European Back Backs. The brands I examined were North Face, Timberline and Oneil ( an American surf board company which became a boutique store) and Quick Silver ( same thing).

Quick Silver Bags

North Face Back Packs

The nap sack I finally decided upon was the North Face a little expensive but had a great space for my 13″ macbook pro. This was well constructed and will last a life time. So I am happy about that.

Yet on the way to the store I found something which is common in Amsterdam maybe we can call it “street art” its on the sidewalks and walls etc. There are many local artist here and the art community flourishes. Since living here is not too expensive the area attracts a lot of “starving artist”.

Wall Art ? Looks like an EYE !

The next thing I noticed as I went to study plastic surgery is the fact that all the apartments here (well its rare) do not have elevators. I showed you my stairs in the previous post. So what people do to move things upstairs is hire a “cherry picker” and this is very common here. Seems they bring everything up this way from Refrigerators to Pianos. Well this is another interesting fact for your Amsterdam Knowledge base.

How we move things in Amsterdam

Well finally I have most of the requirements to be comfortable here. A Bike, A Back Pack and A Gym with a nice apartment. The only other thing I need to do is to get some plastic surgery facts stuffed in my brain for the re-certification exam.

I have been studying about 3-4 hours every day trying to review facts I never use in actual practice anymore. Lets take for example “Otoplasty” which is what we do to make ears less protuberant, the dumbo the elephant look. Although Otoplasty means simply plastic surgery of the ear.

There are many techniques which have been written about. So for a exam one needs to know all of these plastic surgery techniques, advantages or disadvantages etc.  Yet for me I have developed my own technique in most cases after 20 years of doing this operation and I very satisfied with the results as are my patients. So even though I know these other procedures I typically use my procedure. Yet for the boards for re certification I have to make sure I know all of them. With that thought in mind I will get back to studying. I will write more later.

Regards Doctor808

Study and Cappucino

Well  I finally over came the Jetlag to some degree and as promised I will start to write a bit about my Sabbatical here. This is my base of operation in which to explore my interest in Stem Cells and Fat Transfer for cosmetic surgery. As with any good plan I needed a base of operation so I rented a home here for two months. I will be here and travel to rest of Europe such as Italy to check out various cosmetic surgery issues as far as the Europeans go. So my humble home for the next two months is located on a canal here. This is common as the Amsterdam has lots of canals. You will also note house boats in front of my home.

My Street Amsterdam

The above picture is the street I live on here. It has a nice view and many flowers  with two house boats right in front. House boat living is common here along the canals. My apartment is right behind the red smart car you can see behind the house boat.

The door is only the beginning of a long steep entrance way which is basically like doing a “stairmaster”. I may not have to jog if I use these steps more than once a day. There is no elevator here. These are typical dutch steps.

The stairs are extremely steep as you can  see and they go on for about 2.5 floors. Never the less its navigable. There is a special light that one has to creep along the wall to find and turn on otherwise its very dark. All of these nuances one has to learn.

Ok now the living quarters are taken care of next will be transportation. Remember I am in Amsterdam which is the Bicycle Capital of the  world so I bought a bicycle of course

After a Bicycle the most important thing to me is a good gym. I found one less than two blocks away and I signed up today ! The cost was about 100 euros for month but this is a high end gym with some great equipment and staff. Its name is a little funky.

Well other than that I laid out my study material to start on. First topic for review is basic sciences as it relates to plastic surgery. Let me see how many strands are there in Collagen molecule is it two or three?  Oh yes and what about Glycine is that the major component I think so. Well I will be sure by the time the exam takes place. Seems in every day cosmetic surgery practice I do not think much about how many strands there are in Collagen.

Well that’s what I will be doing and this the start.

Until next time

doctor808

The Dam Square Amsterdam Netherlands

As usual I have been so busy the last few months I have not had time to write or to do much but work really. I even allowed myself for the first time in years to stop exercising for a while. I decided to take a short sabbatical in Europe to refresh myself for a few months. I wanted to learn some more about stem cells and Europe is the place to be. Switzerland has some of the newest and “bestest” research going on.  So I decided to make the Netherlands my home for short while before returning to Hawaii and practice again.

First order of business was to find a place to rent for a few months. This I found near one of the canals. Its on the second floor which is more like 2.5 floors up with very steep narrow steps. This is typical of these canal homes which this one has been here since the 1880 or thereabout.  This is great place with a view to study during the day with a great bay window. Did I say study ? Yes I decided to take my re-certification exam in plastic surgery so that is what I am studying. A doctor has to keep up !

Well now that I am on sabbatical for short while I will write more and hopefully bring you some interesting news.

doctor808

Another Motorcycle Event

The traditions in Hawaii are rather unique to some degree. Today is the second largest motorcycle event here,  the first is the Toys for Tots- both held every year. I went to this event with PatoPato Motorcycle Club and evil club of unspeakable acts and old crusty men with military history. Yet some how they asked me to join with them on this ride. This event is known as the “Motorcycle Blessing” which is done by an Hawaiian Priest or Kahuna. In this case a Priestess.

Motorcycle Hawaiian Blessing

PatoPato Motorcycle Club Hawaii

You can see their web site at www.patapato.com. I originally met this group at what they refer to as “The Office” formally known as Wards Starbucks. It seems most of the evil plans are hatched here. Unlike most motorcycle clubs this one it is said to have no rules, so therefore it could be considered “unruly” I suppose a expected of a motorcycle club.

Interesting group who I have known for years at “The Office”.

OverView of the Event

Food was served

Roasted Kailua Pig Open Fire

I did not eat any and although they tell me this way of cooking the pig is the most flavorable.

This comes from the wood they use to cook which embarks some special flavor.

Generally Hawaiian Food  is not my cup of tea but this looks pretty good !

Other Photos Of The Event

My Bike with Hawaii Tea Leaves for Blessing

Mountain View Motorcycle Blessing

rest at beach on way home

Well that is a nice summary of the events of today. Please return for other updates from

doctor808

As an official “Otaku” I keep up with internet things. The internet in Asia has consumed many lives ( as well as in America), in fact in Korea they have set up special “deprogramming ” camps to help certain afflicted youth. Seems some people become so addicted they forget to eat or go to the bathroom and develop pressure sores on their buttocks.

The reason it affects so many including myself at times is that the internet is a perfect example of Pavlov’s Dogs Expieriments. You may recall that is when– Dr. Pavlov would ring a bell every time he fed some lab dogs food.  He then found out that he could make them salivate after a while just ringing a bell with no food given. Further and more interesting is the fact that  if he rang the bell but did  not every time he feed them the salivation response for the bell ring would even be stronger. This fact maybe why the internet may be so addictive. You may not find what you want every time you look on the internet so the desire and response to go to the Internet is even stronger. This is the same pavlov training as when he rang a bell not all the time and found that dogs response was the stronger than if he rang the bell everytime they received food. You may not find the answer and be rewarded on the first search or the romance you want on the dating site or the nice person to chat with. All of  this is intermittent so the pavolvian response is strong. Take facebook for example you do not get a message everytime you look….but the fact that you will eventually get a message or comment keeps you coming back. Strong Pavolivian Training here.

Now what prompted me to write about this was an interesting device I saw on YouTube. This thing may solve all our romance problems across the world. The Japanese have now invented a device which allows you to kiss someone across the internet. WOW think of the possibilities from here ……

My thoughts on this are pretty simple. What is this? Are we starting to all live in a virtual world where human to human contact is no longer needed?  Perhaps we are. So my worry as a Plastic Surgeon is if we no longer have to actually see each other in person then appearance may not matter so much anymore ?  If you are only meeting people virtually , or living in the internet world then the computer can take your image and project any one you want it to. It can turn a guy into a girl as far as the other side of the connection will see. So my fear is will I have a job in few years???

Well I am saying this in half jest but looks like we are heading there.

If you do not believe me check out this YouTube Video.

Check Out Video here.

Doctor808

Choose GOOD OR BAD ?

I do not want to go and rant about this topic and will not after this,  but I really want some people to understand the Hard Truth of this World. The world as I know it is not simply a choice between GOOD and BAD. Sometimes it is but,  not so often. One can always pretend that it is that way,  but it is not. Pretending is not living in reality and every thing we do or DO NOT DO –has consequences.

The Celebration of Ben Laden’s Death

Well I have watched the news of Americans in the street having a party , celebrating and having ceremony over the successful mission to capture or kill Osama Ben Laden. I am slightly ashamed of this as it is displayed around the world. Americans should not be celebrating like its a party and the war has ended as in the case of WW II.  This is the emotion of a revenge ? The killing of Ben Laden is not what I consider murder as the same as some person comes up and kills another for personal reasons like stealing money. The killing of Ben Laden as I have explained previously seems to me to be an act that takes place in war. This is not the same as murder I believe. Killing is bad  I agree (evil). Killing anyone is evil I believe.

Which brings me to my next point in this discussion.

The point which is missed by my pacifist friends in University and some  friends here today is this.  Sometimes this life in this real world brings us to pick between two evils. That is we only have bad choices and must somehow find a way to make a decision. Either choice is not good, but we must decide between our remaining choices which are all bad. We must determine which bad choice to pick. We must choose between two evils. Yet one must recognize that not making a decision is a choice with its own consequences. In medicine,  we deal with this often. Should we amputate the patients leg or allow them to die of infection of that leg ? Nobody wants to cut off a leg that is a bad thing.

To bring this fact to a point of clarity allow me to give you a made up situation. Thought experiments if you will.

Case # 1

Imagine for a moment that you have three children. You and the three children are in a room. A man enters and has a gun. He hands you another gun and states he will kill your children,  unless you kill him. He is crazy but will do that you believe. What choice do you make?

Case #2

Imagine you have a button in front of you that will set off a bomb in subway. This bomb will explode the minute you push the button and kill everyone on a train. Estimated deaths from this will be 100 people,  most innocent.  A person whom you trust comes to you and states, if you push that button at 5 pm it will kill everyone on train #3. He then tells you that on that train is a man with another bomb but this is a nuclear bomb and is taking the train to the large city where he will blow it up. The number of people killed if the nuclear bomb goes off is 1,000,000 estimated deaths. He tells you this at 4:49 and there is no other choice but to decide to push the button or train #3 or allow it to pass and he then can set off his nuclear bomb killing 1,000,000 people. So with in the constraints of this thought expiriement you have to choose between YOU killing 100 people or doing nothing and allowing the fellow with the nuclear bomb to kill 1,000,000 people. What do you do ?

My argumentative friends will come up with all types of things such as “this would never happen” or “I will fight with the guy and save my children” or some other imaginative way out. Yet to participate in this you must recognize that these are the situations and the choices in these thought experiments are limited. These people will do all they can to AVOID the issue. Yet avoiding this does not solve anything the outcomes are as stated so you must choose. Others will give the responsibility to God and say let God decide and this may be valid to some. My Mennonite friends would take this true religious pacifistic position.

Military commanders and intelligence agents and the President etc must make such decisions. That is what they do and its their job. Unless you have been in that position to make such choices,  its easy to criticize and be holier than thou. However, the decisions and their outcomes are not to be celebrated as I have seen. How can you celebrate a bad choice , but given the circumstances one has to choose between two evils. In case #1 do nothing and your children die. In case #2  do nothing and a million people die. So decide ….the decision is yours. You may hope God intervenes or decides,  but history has proven God allows things to happen and does not intervene so it seems. I cannot argue with what God decides as I have no idea really.

My point made is that sometimes life is difficult and the decisions one must make are between something horrible and something else horrible. As physician you learn to think that way. When I was in trauma ( I was not always a plastic surgeon) I made these choices often. It was not easy deciding to cut off some young mans leg and it was difficult,  but when i realized I either cut the leg off or he would die I made the decision to cut off the leg ( or help the family make that decision really). You never know until you are in such position and have as much information.  In the case of leg amputation was I 100% sure the young man would die if his infected leg remained? No I was not 100% sure , but if I did not choose I knew it may be too late. You cant wait till he is dead to know 100%. That is bringing home the choice between two evils well. I have been there.

So when one simply says “killing is bad” and therefor we should not do that we must realize also that not to take an action may have worse consequences. In the Osama Ben Laden case I do not have the information that the people who made the decision have. So I cannot condemn them nor can I celebrate the death of even an evil man. I wish my fellow Americans would not either. Revenge is never a good reason for such celebration.

doctor808