Akhihabara also known as Electric City or Otaku town is famous because of the electronic industry and animae (animated characters like sailor moon) that fills the town. An Otaku used to be a derogatory word which was a negative description for some weird computer geek. These Otaku were famous for anti -social behavior and living in computer world. A entire section of Tokyo has developed about this. Most famous is the maids cafe s in the area. To understand this you really have to see that. I have been and what it basically is cute very young japanese girls dressed as 19th century maids or some modification of that who greet you as “Master” and serve you in such a way. They have coffee cake and play games like rock -paper -scissors. They also get on the stage and sing songs laugh etc with all the Otaku’s in the crowd.

It seems many of these true Otaku’s do not have much human interaction,  so when they come to the maid cafe’s its a real treat. I noted some very very strange people there and not just young men or older men but some woman. One in fact was talking to herself an obvious mentally ill individual and another male had pictures of all the maids on his hat and seemed to be a regular. Very strange indeed. Well the maid cafe is I believe is an out growth of this entire virtual world of computers. In this world you can be somewhat anything you want and I have spent some time reading blogs and other venues and actually myself developed an entire virtual world “plastic surgery isle” a few years ago as part of a project and fun too. I owened a cafe called Hell’s cafe and had a staff of 14 Japanese Waitresses all virtual in a 3 d world. It was quite fascinating actually and I think the internet will advance to that more later. I stopped the project as it was clear we it would show not profit as an advertising venue just yet. I believe it will later.

Virtual Plastic Surgery World Created by me 2007

Sometimes I see things on the internet which are rather sad and I see people who are escape and live so much in the internet they loose touch with normal values and etiquette. Its easy to do because of what may be perceived as a shield of anonymity.

The use of such shield brings out certain characteristics I believe which are somewhere in core. The bad side of this is there is no true anonymity on the internet and all information can and at times is found. Employers such as myself will many times look up information on people who apply for a job on the internet and we are not just talking about a google search, there are very sophisticated programs which will search and find out much what appears to be hidden information.

Well that aside there is so much to come in the future of virtual worlds and Akehabara , Japan is one place it will be seen to grow,

The meaning for plastic surgery is yet to be seen but my early experiment was enlightening. I will eventually start again into this venue but for now we need to stick to more traditional web marketing.

As soon as I can will be bringing you more information about vairous meetings we have planned both for the Web Development Firm and Plastic Surgery Practice. As example we have another meeting in Tokyo next week for cosmetic surgery where we will be launching a new web based product one of AiMiYo’s programmers has recently finished. We have two more meetings plannned this summer primarily for the web company but in the fall its back to China for a cosmetic surgery conference.

Seems my name has become some what known in China as a teacher of cosmetic surgery. This picture of a chinese web site below has me featured but as far as what it says I have no idea.

Dr Pasquale Featured In China

Speaking of China there simply is not enough time to write about that place in my schedule yet I have so many photos and events there to discuss.

I promise in the future I will write more detail , yet for now I will simply say as far as cosmetic surgery goes—-look east its going to be a huge wave coming. As this society grows more affluent consumer demand is growing for such services.

Our plastic surgery chinese web is developed and completed.

Well that is all I have time for now. I have to get ready for the Japanese conference next week.

Until next time

Doctor808

Excellent Italian Food was made by Miguel

Well tonight I went to a very interesting dinner party. It was with regard to the Cancer Center at the University of Hawaii held at one the Black Point homes of one of the leading cancer center researchers. My good friend and fellow Italian Miguel and his wife Elizabeth. It was a very nice party for me because it had authentic Italian food cooked by Miguel !

This was only part of the treats of the evening, we had fine wine and great conversations with some of the University guest either Doctors, organizers , bankers and significant others. All brought together to honor one of the men of science who contributed greatly to world health and people associated with an institution who shows great potential to contribute to the health of mankind.

What we have is the potential , that is what will be the future-cancer cures and proof in the flesh that science can and has made our world significantly better.

On the one hand the University of Hawaii Cancer Center may be on the verge of the next great breakthrough to cure cancer and on the other we have the Man who won a Nobel prize for his contribution to science. The one I am speaking about is Dr. Blumberg who won a Nobel prize for both discovery of the virus and the cure which we call Hepatitis B. You can read about this mans remarkable achievement at the Nobel’w web site.,

I was very greedy at this party and after the speech by our host and the president of the University of Hawaii I stole him and occupied all his time. It was a fascinating talk about his discovery , his life and he gave me very good advice on life. He said that I should be more of an optimist about the future as I admittedly am somewhat of a cynic. We spoke of Jefferson, Hamilton and Benjamin Franklin for some hours along with to my surprise Ayn Rand author of the Virtue of Selfishness and Atlas Shrugged.  This talk went on for a while and it was unusual in that he spoke as knowledgeable about Ayn Rand as anyone I have ever spoke with before. Most people I know have no idea who she was or the philosophy she put forth. Ah then I discovered he is not only a scientist but a philosopher in the official club for philosopher.  I was impressed with this amazing man.

Yet what thought humbled me the most was something Miguel said in his introduction of him. This man has saved at least a million lives a year since his discovery. I as a surgeon and as a surgeon in the past at war time could not have saved a million lives a year even if I operated 100 times a day and each operation was life saving. Yet Dr. Blumberg did and is still saving lives when his vaccine is administered to people who would other wise one day die of hepatitis or liver cancer. I am truly humbled.

Here is is picture and he is the gentleman to the left of me–truly amazing evening !!!

Myself and Dr. Blumberg Nobel Prize Winner

Well until next time

Doctor808

Cynthia, Kiyoko, me and Rire

Well its been a while since I have been writing on my blog because I have been insanely busy! With plastic surgery–unfortunately NO –February is the worse month for Plastic Surgeons in Hawaii. For plastic surgery its a slow month !

Maybe elsewhere I do not know. I have been busy with my web company. I have received more request for work than I thought possible for web sites and the like. Looks like AiMiYo LTd will be a success. In fact its overwhelming as we get our staff built up. As for me,  I over see the company and make sure its on the right track, that people are doing their jobs and every customer is happy.  Its creative and we try to maintain the highest standards, believe me when I say there are some shadowy companies out there. We are preparing report to place on our company web site  comparing what we have found.

Well enough about business for now, its my birthday, I am in my  mid fifties  , I did not think I would ever be this old. Yet here I am old guy–except I don’t feel like an old guy. Then I compare my self to other “old guys” my age and I don’t feel so bad. This may be due to a life time of surfing and my kick boxing to some degree. Well what should I do,  re evaluate my life and give a reflection to the past and vision to the future. Ok that took a full 24 seconds to review, now its time for action. I guess I could say there is nothing I would change.

Well what happens in my life today on birthday?  Part of my staff is here around me and they gave me a nice birthday cake , a cheesecake. I had a lot of people on face book wish me a happy birthday from around the world. I was surprised at the number of emails I received from close friends and colleagues. I even received one of those e-cards which are easy to do and require little effort,  but at least it was nice thought.  I enjoy the emails from old friends. I received an email from  a lady I have not spoken to in well over twenty five years. She called me my child hood nickname. She wrote about stories from her memory of those days. Interesting story there were 5 of us who all hung around in high school,  all boys, all surfers and all somewhat trouble makers. Not really bad boys, but borderline. Well this lady was dating one of the gang of 5 and  then married another of the gang of 5 not the original one. It was not a steal your girlfriend thing at all,  it just happened that way  Although stealing girlfriends was a fun sport at one time this was not the case.  I was just suprised and delighted to hear from her and cannot wait  to hear how more than 25 years has passed for her and people we knew then. She has the inside scoop.

My good friends on face book like Guillaume, Nancy Law, Latrenta Barrett, Hyenwon Kang and others all had to weigh in wish me a happy birthday ….or remind me how old I am. It was nice to hear from them and I even received a tweet or two, which is what wired people like me get–tweets as in twitter land, no phone calls –geeks don’t use the phone except for text messages and tweets. This is the law of geeks or otaku’s like myself.

Speaking of birthdays I feel lucky today. In that I did not die last night. My friends next door to where we live had a famous Japanese sushi chef fly in from Tokyo the day before my birthday. He brought with him off the plane a famous delicacy in Japan which many know as the puffer fish and they call” Fugu”. This fish reportedly kills many Japanese each year ( up to 30 some years) when they eat the wrong part which is poison. ” I want to eat Fugu but I dont want to die” is what I say. So the night before my birthday I ate it and did not die so I think this is good sign of my year??

Fugu Poisonous Fish from Japan

The fish plate shown to left is filled with Fugu made by the sushi chef. He has a special license to cut this up and serve it.

We ate this fish and the only American there beside myself first declined,  then he saw that I ate it and he said “Well I will try it’” . He told me since I was a doctor he felt safe eating it. What a joke…if he only knew the things I have eaten in the past and I honestly must say I have no idea what I was doing or who this “famous sushi chef ” was. With my limited knowledge this chef might as well been Jack The Ripper Japanese Version and he was ready to poison us all just for fun.

The other famous guy there was a famous “Japanese Elvis Presely” he was in his later years,  but from what I understood he was very famous in his twenties for his elvis.  He is shown below eating fugu too. Well Elvis lives !! Well he actually in his early years dressed as Elvis and was very famous in Japan apparently.

Elvis Lives After Fugu !!

Pianist/Opera Singer a Fugu Death Party

Well even though I did not die from Fugu poisoning the night before my birthday,  I still could face some bad luck I suppose. Yet the good luck is that my staff remembered my birthday. I am not sure if they did so because they are kind or it was because they want to make me more miserable?

Interesting there was a Japanese Singer and Pianist for entertainment as well. So we ate the death fish and listen to music while sipping saki , not  bad way to go for a neigborhood party ne.

Today I will go surfing as all things start in the water for Pisces such as myself so I will renew my spirit there as I have been overworked lately and then enjoy a nice dinner with my wife who asked me earlier today. I think I will eat some  Italian food which is my favorite. The most deadly thing about Italian food is choking on  a meatball I suppose.

Below is some assorted photos of me and I my staff on my birthday which was we enjoyed and excellent cheese cake !!

What me have Jet Lag?

When you travel as much as I do you soon learn to over come jet lag as quickly as possible. Living in Hawaii there is no such thing as a three hour plane ride to somewhere. There is a twenty minute, a forty minute and ninty minute plane ride to the other Hawaiian Islands , but the next closest place is 5 hours plus I think.

Jet lag for most of trips is problem. China, Amsterdam, Bangkok Thailand, Tokyo Japan are the places I have been in the last 6 months several times to some of them. Amsterdam is twenty hours away, Tokyo is seven hours and Bangkok is twelve hours of flight time away. This is a lot of time and the air and plenty of time to develop jet lag.

Jet lag scientist define as the disturbance of circadian rhythm due to time zone changes from jet travel. Yes that about sums it up but I think of it as more of “dead man walking” for a few days after a trip. That means it feels like 8am when its actually midnite or you wake up at 4 am and you cant sleep again until noon when you feel like you will pass out.

So I thought of ten thinks one can do which I tried this trip from my condo in Bangkok.

1. Watch movies , the same one 47 times. In this case I was in Japan Airline and I watched GI-Joes over and over. This will make you go into a trance and you will actually feel rested although you will recite lines from the movie over and over again instead of orginal speech.

2. When your in a town like Tokyo make sure you stay on the same time zone that is from the town you left from. So when its 2 pm in one place make sure you are up in the other place even though it may be 3 am. Act like everyone in the new town is off not you.

3.  Dont sleep the entire time and when you get back sleep for 3 days straight and you will not feel abnormal.

4.  Sleep the entire time you are gone and you feel well rested when you get back.

5. Dont travel and stay home !

Well these are the best ways I can come up with to over come jet lag. Number 5 is a great way, unfortunately I cannot do that and will be traveling more this  year with two business ventures launched which will take some time away from Hawaii.  The Bangkok condo business takes some time and the Hong Kong based web company AiMiYo International takes a bit as well. With AiMiYo even though my web team works across the internet from home I get to go to meetings with clients etc. So ….who is more lucky I dont know.

doctor808

Dr. Michael Pasquale CEO AiMIYO LTD

Well I have been exceptionally busy over these holidays with some business issues other than Plastic Surgery. The office has been closed which has given me some time to put into my web development business personally rather than delegate. As many of you know and as my title of this blog states I am web designer and Internet geek. The team I have assembled and our web company is very unique. From the start we decided one of our area of expertise would be multilingual web sites. I would also add another important point which is that we believe that multilingual is not enough. A translation of a web page is not enough   because what is a web site  but a sales and marketing doorway. Even if the company we represent is not a classical sales of products type company,  it is still about sales. This means any company wants the web site we build to represent them in a most positive light. So in that sense it is selling an image to the viewer.

As I mentioned, multicultural- not simply translation of language. So what I mean by that is when we put a companies words into another language we do not just translate the words , but make the cultural message adjust to our audience as well. This is very important because the sensibilities of the Chinese for example , may not be the same as the French so the way material is presented may change , not just the words.

When we design a web site for different languages  our company AiMiYo LTD has the translation staff and the design staff from the culture (country ) on board with us  as a team approach. This multilingual, multicultural team is what makes our web sites different I believe. Please follow us as this grows. We are now building our new company web site at www.aimiyo.com for english, and in Japanese at www.aimiyo.jp. We will be adding languages over the next year such as Chinese , Korean , French and other  European languages as well.

Until next time

doctor808

Well back to my report from China Trip. The second part of the China Trip was at a conference in a place called Hangzhou which is outside a few hours of Shanghai. This is almost a resort university town. This was a big meeting of cosmetic surgeons from all over Asia. The talks were good and meeting various surgeons was fantastic.

Lots of Meals in China with Doctor808

The most memorable aspects were the people. I met so many people some old friends and some new. My friend and travel buddy is Dr. Cuvo who is a Genza Cosmetic Surgeon who I have known well for many years. Taka as I call him also gave a lecture in Dalian China with me,  as well his lecture here. His specialty is Asian eyes.

There were many of my Korean Colleagues there as well. One thing about Korea Doctors I know is that no matter what town or city we are in they always know the best places to go. So when in a foreign country I follow them as for what ever reason they are in the know.

Well rather than fill these pages with words I will just show you as they say… a picture is worth a million words.

We will start with a nice video of the entertainment. Notice the mask carefully that the entertainer is wearing. Watch it or you will miss it !

There are some great photos of this event. One is of my long time friend Dr. Woffles Wu from Singapore. His first name is like the famous Hotel there. His dad was a pretty well known lawyer in that remarkable city state.

Dr. Wu and Doctor808

I have known Dr. Wu for many years and he is well known in Asia, he produced a movie in Singapore. We have not seen each other since I visited him in Singapore many years ago. Seems my recent trips to Singapore never had the time.

Again as the only ‘white guy” the Chinese treated me with extreme graciousness and of course and took my picture every where I went. The food was excellent as well. There was special liquor we drank called Mau Tai and it was very strong. This we set on fire before we drank, so we drank fire !!!. I ordered snake which was unfortunately boiled. I have had snake before barbecued and it was very good. Yet boiled I do not recommend at all.

Dr Cuvo enjoyed some snake

Overall My visit to yet another Chinese City was very informative and again growth was every where. As a visiting plastic surgeon from Hawaii it was a great adventure. I will simply share some more photos of the event.

A Cosmetic Surgery Clinic in Hanzhao

Chinese food dumplings

One thing I noticed is China is a huge place with a huge population. Thus the amount of doctors for this workshop was large. Typically specialized work shops will be held and there may be 20 surgeons in attendance. At this work shop there were over 100 Chinese physicians there all interested in cosmetic surgery of the face.

The enthusiasm for the lecture and the dissection of fresh cadaver heads was amazing. They were eager students, knowledgeable and were very serious about learning their chosen art of cosmetic surgery. China only recently has had a growing interest in cosmetic procedures as the population is becoming more affluent. They like all economically well off societies move beyond the need for just food and basics of living but now are seeking the life style enhancements of cosmetic surgery. Make no mistake about China,  has an excellent medical history -advancement and plastic and reconstructive surgery has been no exception. Yet only recently has there been great interest in cosmetic surgery.

The dissection lab

To the left is one photo of the many I will be showing you over the next week or so. I am waiting for my colleague’s to email me these to me. The dissection lab was about 40 minutes by car away from Dalian where the lectures were given and other ceremonies. This is inside the Hoffen Biotechnique Co. LTD China which was courteous enough to allow the dissection in their state of the Art facility.

That name may not be familiar to many of you unless I explain that this the company which has the famous exhibits around the world from Honolulu to Paris of incredibly well dissected and preserved human bodies. They use techniques which preserve the anatomy specimens including entire specimens in a plasticized form.

I am sure most of you have heard  of, if not seen their exhibits called “Bodies” or “Body Worlds’ which is the real exhibition of these plastinated bodies

You can search on Google for more of their exhibits and work or follow this link www.bodyworldexhibition.com .

The link for eng  lish and listing of their exhibits is  http://www.bodyworlds.com/en.html . I had a private tour of their facility and I must say I was amazed. They had an incredible number of exhibited specimens such as humans, horses , fish , sharks, monkeys all well preserved and more importantly visually preserved by their plastination process. Below I have a few more photos of the exhibits in their facility.

Human Plastinated

A Plastinated Ostrich is shown above and a Plastinated Human is shown as well

The facility was ultra modern with state of the art equipment which made it the perfect place to have a fresh cadaver dissection for these over 100 doctors from china and 4 I believe from Japan.

There were approximately 20 human heads for the students to perform their dissection all freshly preserved so that the facial nerve and other anatomy was could be dissected and seen well. If they are preserved as with other techniques the dissections cannot be carried out for small detailed anatomy. Fresh cadaver is the best way for surgeons to learn anatomy unlike the in medical schools where they will dissect older processed cadavers. These specimens were excellent and so the surgeons could learn well.

We did get to know some the regular staff at the facility and they were very educated helpful and great facilitators for the learning. One young lady , Chinese of course has studied in London and she was very helpful due to the fact I do not speak Chinese. Her name was Yee-Lyn I believe is how it is pronounced she said she will read this blog so please send me a correction if I made a mistake. My apology for butchering the wonderful Chinese language.

Staff at the facility who has done english translations there

There are simply not enough words to express my gratitude to this company and the use of their facility.

I will be writing more about the China Lectures and this Dissection on my next post. When I recieve the pictures from my collegques I will be posting a more detailed account of this expirence

Doctor808

The main drag in Waikiki is filled with…… well crazy people. So this year I decided to avoid that all together.

To give you and idea of the sights you may see I borrowed these photos from a blog called photolulu.com which I discovered.

At any rate you can find these type photos all over the internet if your interested. Just take my word for it Waikai on Halloween is out of control and is not for the weak hearted.

If you like this type of madness then this is the place for you.

Greenwhich Village in New York City may rival this scene but I must say having attended both I think Waikiki wins the contest.

As I stated I decided simply to have a quite evening as far away from the Saturday night madness as possible. So a few of my staff members Zak, Kiyoko, Amber and myself went to Zaks apartment. We each brought some nice food and consumed and excellent Italian meal with wine. The great thing about the evening was very quite conversation and a few laughs with my close staff members. It was fun and light entertainment.

Zack is well , Zack as he says and a very good host. He makes a very good speghetti suace and I brought some Italian Chicken which I make which everyone enjoys. Well this was nice for me as I had been up all night in the emergency room. I still take emergency calls at the Queens Hospital and this was my call so I had to go in  for a few emergencies. Why I do this as I am not required but I do it still. Seems doctors should do this so I do it.

Back to the dinner. We consumed two bottles of nice red wine , cheeses of two types and spegehtti with my italian style chicken breast.

the famous host zack and k

Yes that is a whole foods paper bag there . Kinda cliche I suppose but they do have the best cheese. The red things are persimmons not tomatoes.

K of course who is a cheese lover is eating that.

Then for the main course.

Quite Evening on Halloween

Italian Chicken by doctor808, spaghetti by the Zack and cheese by Kiyoko. A great combination for a plastic surgeons office.

Well my mission was accomplished and I avoided this year the Mad House called Waikiki on Halloween. Maybe next year I will go down there and dress as something like an old plastic surgeon.

Well Monday will be back to the usual. We have a few cases to perform before my trip. Sunday I was planning on surfing but had to prepare the lecture for China on face lifts. We have made a very nice video of the surgical technique I use for face lifting.  This technique has become my standard after about 20 years of trying various techniques. However I always modify my technique to the individual face.

You can learn much more about face lift and facial appearance on my web site devoted to that. You can find that on my facial web site.

Well wishing my readers a quite Halloween until next post……

Doctor808

Of course these are all physicians from China and Japan –maybe some other assorted cosmetic surgeons from Korea and who knows where else. I doubt there will be many westerners.  Yet the face has extremely complex anatomy so I cant waste time even with Doctors. So I decided I will call my lecture “Essential Face Lift Anatomy”. What I will do is skip all the esoteric anatomical details and just get to pure essence. Maybe I should entitle this lecture “FACE LIFTING FOR DUMMIES” as I will give only the details that one needs to know when doing a face lift.

As far as complexity goes I am showing you a picture below which only shows a few of the details.

A few details

This picture from Netter’s textbook only shows the sensory nerve anatomy of the face. So you get an idea of how complex the face is. Then there are the muscles, the blood vessels , motor nerves,  bone and other soft tissues.

We will have cadavers there to dissect to further the study for these plastic surgeons. I had done a facial nerve (and peripheral nerve) fellowship for one year under Dr. Julia Terzis at the microsurgical research center, so I guess that is why they asked me to teach.  In face lifting the most important structure is the nerve as injury to the facial nerve is the worse complications. I am very happy that I spent a entire year focused on that and it has certainly helped me in face lifting. I do get referrals from other surgeons who have injured the facial nerve during cosmetic surgery but fortunately this is very rare and they for the most part of been temporary.

At any rate I will enjoy a quick look at China and  see how cosmetic surgery is done there. I will let you know about this as it unfolds.

Doctor808

NEWER !! COOLER !! WOW !!!

In my honest and sincere opinion most of these things are driven by marketing and not by solid medical science. It seems to me that even though cosmetic plastic surgery is more consumer driven and not medically required for health it should be based in a solid foundation. Money drives this market as with a Holywood movie and this produces what we may call “Hype”. So surrounding all of these new techniques is a onslaught of Madison Avenue Public Relations and marketing hype.  Medical and surgical breakthroughs should be studied and the results analyzed first not get a quick aproval from the FDA and then loudly marketed.  Unfortunatedly this is not always the case.

Hype Central

In the case of LASER assisted liposuction the marketing hype is very rich. “go back to work the next day” or “less pain” or ‘faster healing”. All of these crys of better newer faster are more appropriate for Tide clothes washing detergent than for a medical procedure. Marketers know that using these key words like “NEWER” Or “IMPROVED” will grab consumer attention so they of course utilize these keywords as much as possible.

Yet what is really behind LASER assisted lipo, smart lipo or any of the other brand names? I have spoken with many of the LASER liposuction advocates and detractors , looked at the results and feel I have a good understanding of the procedures.  Basically a very small cannula , which is a tube has a LASER at the end which produces heat. This “melts” some of the fat which turns it to an oily liquid. This is then sucked out with  the cannula. Rather simple concept really. The same thing was done (sorta)  with ultrasonic liposuction which was the latest greatest thing a few years ago. The problem with this LASER lipo is that the cannula’s so far are very very small. So each practioner tells me in any sizeble area  of fat , they still have to use traditional liposuction. —–HUH@#$%^&* !!!????.

I am not a “hater” but my gosh these pencil thin cannulas cannot take out any appreciable amount of fat. So that is exactly why the LASER lipo doctors have to go over the area with traditional liposuction technique.  Now the advanatage is lost completely as you are still doing traditional liposuction in the area. So what is the purpose of using the LASER lipo? I have heard skin tightening, which may be true in a small area like under the chin but for abddominal or thigh or any  larger area there does not to be any benifit what so ever to my eyes and the cases I have seen. So I conclude that the only advantage of LASER lipo suction in most cases is simply marketing.

Well marketing is potent stuff. If you do not have any patients you cannot do any liposuction,  be it LASER, Ultrasonic or traditional.  So I see the reason why many surgeons like this idea , it is great marketing. Yet for me I have seen these trends come and go and until someone shows me an advantage that I consider worthy,  I will stick to the techniques which I have used for many years with so much success. Maybe I am old fashion, but somehow I cannot stomach doing something just for marketing or 90% marketing. I know Plastic Surgery is suppose to slick and whiz bang,  but again I like the traditional well proven techniques  over marketing . Thats me.

doctor808