Doctor808 Plastic Surgeon Honolulu Hawaii

Well ……I am sorry my dear and loyal readers I did not keep my blog up during my travels,  as time was so limited. So, I will briefly go over things here to catch my millions of readers up  (I think I have only  two readers ). I will probably have less readers after this post.

First as previously stated, I was going to Amsterdam which is one of my favorite haunts. The reasons are many. First are the people , I love the dutch as they are always friendly like the Thai people. They are straight forward and get along well. The other Europeans are so…. shall I say snobby (over nothing)  that I dont care for them as a whole. Of course many are quite nice and good descent people , but the Dutch it seems as whole are the way I like people.  Lets take the Swiss in Geneva which are a French speaking people. Some are very friendly,  but overall I would rate that town as a small town with small minded people pretending to be important. If it were not for the bankers hiding the worlds money the place would be just another dying European city in my view. No new life. As the first President Bush would say “old Europe”. They tell me that you have to live there to appreciate Geneva and perhaps,  as I only visited but…..not my cup of tea.  That is my simple minded dumb American view. In this blog I dont review the great history ( like Nazi Germans influence ?) but that’s my basic feeling.  What I do like about Geneva is the kick boxing which is why I went and I will tell you more about that later.

Part one Amsterdam

Well we arrive in Amsterdam and  get there at our usual time of 7 am in the morning from a flight from Seattle. We have to wait for the hotel as check in is at 11 am. This is no problem becuase we can get a great breakfast at the usual spot.  This time we also wanted to look at property for a possible retreat so we scout around. This place is easy to scout as there is one way to see Amsterdam –Bycycle. We rent a couple at 15 euros a day and start to scout around. If you go please rent a bike.

As you can see there is no shortage of bicycles in Amsterdam. In fact they number over 5 times the population but no one knows for sure. There are  so many and they are everywhere. Anyone and everyone old, young , crippled , athletic and entire families use them as their main source of transportation’s. The bike roads are great and easy to use. Don’t wast your time with any other means of transportation.

This is one thing I love about this place everything is so easy to do. No traffic jams, no crazy people or homeless that you can see in the central part of the city. Its clean, organized and easy to navigate around on foot or bike.

I like it because of the people I meet and the kick boxing. Rose likes it because of the Art and Museums and Food. There are great restaurants and since Rose is Malaysian Chinese she has a chance to get real Malaysian food and eats there almost every day. Below is a picture of that restaurant located next to the Red light District. That’s the famous place with hooker on display in the windows. Sort of a another type of take out menu.

The food at the Malaysian restaurant is authentic and quite good. Here you can study Malaysian Chinese, in their natural habitat eating good Malay food. This I believe  is their normal “in the wild ” behavior to eat eat eat.  Such are the Chinese…did you know that when you go into a Chinese persons home they don’t ask how are you,  but the first thing they ask is “Did you eat yet?”. If you find a Chinese person in the wild some day just ask them.  They will tell you its true. The couple at the Top are the owners by the way- her name is “Candy and his is Buddha” , I am not kidding.

Amsterdam is famous for legal drugs ( not hard ones) and everywhere you go are the “coffee houses” where you can buy either hash or marijuana cigarettes and smoke it right there while you drink coffee. Not that I would know,  but I was able to observe this. It appeared fun and seemed harmless enough. Yet I think it must appeal to a different crowd as I am a doctor. Everyone knows doctors don’t smoke pot. In case you want to know what these places look like I have several pictures below. They tell me that its cheap to buy and is high quality.

These establishments are everywhere scattered among the sex shops. I have a picture of one sex shop and of some of the evil weed that people smoke. Why people make such a big deal about a silly plant I can still cannot figure out. Its like anything else in my view–abuse it and it may cause problems. So I remind my readers that as I am a libertarian I am against government regulation of such. Amsterdam has no crime attributable to rampant drug use like we do in The States. The criminalization of this plant and other such drugs is why in my view we waste so much money. Libertarians believe if you want to kill yourself who are we to stop you, as a freedom loving bunch. We believe in a freedom to self destruct.

Well the above is only a very small part of Amsterdam,  there is something for everyone there. Art , Museums , food , drugs, sex, business deals, Muslim and Buddhist temples, churches and and a wide variety of everything. That sums up Amsterdam ,  which is a city of extreme diversity and more important— tolerance for diversity. I watched one night at 5 am the practicality of the place as the party goers were in one square when some drunken hell raisers started a fight. The police cleared them out in less than ten minutes with Horse Riding police they were there in seconds appearing from nowhere. They were professional,  efficient and cleared the crowd with out any evidence of brutality nor disrespect. They did their job quickly and the party on the street continued. I was impressed.

Bicycling around I looked over many properties and potential places to live. Signs were posted as shown :

Ideally one would not need a large place,  but some place to call home in Europe so you could have a home base. A base camp if you will.

Yet there are catches in the Amsterdam’s real estate market. Interestingly, one must be careful about what are some unusual laws.

If you buy a place and leave it empty , squatters may take over and inhabit there and you may have a ridiculous time trying to get them out. They in some case have more rights then the owners who they are not paying rent too. Crazy?  Well yes, but that is Amsterdam. I never saw such a bad deal for property owners. The original idea was that the city did not want empty buildings around by absentee land holders or something like that. Well it seems to work and the properties are all well kept. Yet maybe its been taken to far. I have more research to do in these laws.

Geneva

Well I went to a kick boxing place in Geneva where my old instructor from Thailand recommended as he was recruited in his younger years as a Swiss Muay Thai fighter. There he went on to be a Swiss national champion before returning to his home in Thailand where I first met him.

This gym was quite busy with over twenty fighter level members and huge intermediate level trainees in Muay Thai. They take their fighters to Thailand once a year for training. This gym is run by a Swiss fellow and his Thai wife. Very nice place I recommend to anyone. Unfortunately back in Amsterdam I could not find the Merijo Gym which is the famous gym there I trained at before a few times. This gym apparently moved location and due to time limitations I could spend too much time looking. So I trained on my own while in Amsterdam jumping rope , weights and shadow boxing and of course cycling hours a day.

That’s about it for Geneva to me that’s all the two itself offers. I did meet a few people and had brief conversations shall I say. The Swiss don’t speak much english There main languages are German and french. They also have that attitude of your stupid if you only speak french. As example I asked a cab driver to take me to the Hotel Savoy. He looked at me like I was nuts. I pronounce Savoy as most Americans would like rhymes with “JOY”. So he finally figured out what I was saying as he pronounced as Sav-0-aaa a definite french accent. But what I found most ridiculous was the scolding he gave me. “I have been driving a cab for 15 years and never once have I heard that way to say Savoy” he said in a most condescending manner. I could not help but tell him back—” I believe that you have not in your limited life experience of driving a cab in Geneva heard any other variation”  as I chuckled to myself. Score one for the American verses the Geneva Red neck cab driver with a “limited ” small mind. So it goes. I left Geneva vowing never to come back…well maybe I will for the Muay Thai.

Other than these issues of looking for property , relaxing and Muay Thai the most memorable issues was the Bicycling. I truly loved that around Amsterdam and I will do it again and again its a bike paradise. I also thought I will take a motorcycle trip around the country and maybe to others next time I go.  That will be fun. As far as business goes , well I did see some plastic surgeons in Geneva and was impressed but the Swiss are known for a long History of cosmetic plastic surgery. I also spoke with some Web Designers and found out about the local community in terms of Web design and marketing as well as in Amsterdam. There will be some of the best Internet and media conferences coming up these next few years like next fall which I will plan for.

Well my dear readers I don’t want to bore you with too much, so I will go over some other details in later blogs as I am still suffering from jet lag. As always enjoy.

Doctor 808

Many of you may not have known that I invented a special instrument that I have used for over 12 years for my Axillary and Buttock Augmentation cases to place the implants. I have been selling this instrument and teaching other surgeons to use it as well. This instrument is patent pending , trademarked and FDA approval pending payment of their fee.

The instrument is excellent for a consistant dissection of the breast pocket or the pocket to place the buttock implant. I will show you a picture of it here. Then you will know why I call it the Butt-a-rang and the Boob-a-rang. Though this may sound like a joke that is what I named it.

So now you know it looks like the Australian boom-a- rang so that is why I call it the boob-a-rang or butt-o-rang depending on its use. This instrument we manufacture and ship all over the world. Surgeons are using them in Korea, Japan and Europe. Its simple design and simpler use makes it do fine for beginner surgeons to use. Yet I will save that part  to tell them.

The funny part- I want to tell you my dear readers. Today I had to pick up some that were manufactured for me so that I can ship them to the surgeons who ordered them. I went to the machine shop where all the fancy LASER cutting equipment is for metal and of course I was late. The only people who were in the shop were the craftsmen who do such fine work for me. It was funny becuase it was at the end of their day. So they know me and said  ”Hey Doc how about making us some boobs?” .  Typical workers who were enjoying a beer after they closed their shop on a Friday night. So fun and I recall when I was 18 and worked in construction. At the end of the week working hard with physical labor al week in the heat—nothing is better than sitting around drinking a beer with your fellow workman. It great because you dont do anything no hard work, just laugh and joke. I know there frame of mind completely. So it did not suprise me when they all got up and started teasing me and making jokes about Botox on their private parts, giving them one breast or having to come to the operating room and personally ,,,,,I mean them inspecting how my instruments work on my beuatiful young female patients. Sorry boys but that would be against the law!!

Well so much for my Friday , I took their jokes and good natured harassment and went to Muay Thai. If any of you are interested in seeing these instruments and how they are used check my web site  www.boob-a-rang.com !!!

Till next time

Doctor808

Recently,  I hijacked my cosmetic surgery friend’s ( in Tokyo)  –Mixi.jp  account. I did this for various reasons , one being that since I have a web development firm that works in all cultures and languages I wanted to gain an understanding of this. Secondly,  its very hard to get your own mixi.jp account unless you have a Japanese cell phone so I just stole his. Sorry Taka.

Mixi by the way is a Facebook on steroids , for those of you who want some understanding of this. It has a login page which list , your profile , friends and what your friends are saying in their blogs. The blog summary  is a very popular item. If you see something interesting you can click and follow that persons journal. There is one the big differences I noticed between the myspace type things and the facebooks of the world and Mixi. The Japanese take their blogs very seriously and there are millions of them. Many Japanese house wives entire world seem to be blog-o-centric.

One other thing I noted is that “everyone is paranoid” which means that not only are the internal security controls very tight,  but most people unlike Face book or Myspace will not put their own picture up. Its Iconic images or many men for example will have woman’s pictures as theirs probably of some models. Also of course there are  the Japanese Pokeman type images seen,  as well as flowers , fruits vegetables etc. This makes it difficult to tell who you are clicking on. In my case its even more difficult because I do not read Hiragana, Katakana or Kanji,  as of this date. So I spend half my time with translation software trying to guess what they are saying. This can be most difficult. Take for example the case of a place called First Kitchen which is a food store in Japan. The Japanese have a funny habit of abbreviating many things so they shorten the words– like Family Mart becomes Fami-ma. Well according to some sources First Kitchen becomes ” fukkin” when they speak abbreviated format. So as you are reading someone’s blog it is feasible that they say ” My friend and I went fukkin”. Sorry for that,  but it illustrates my point of possible miscommunication very well. So when I translate I do not get the full meaning of the blogs.

最初の台所  or  パイズリ I apologize to those offended,  but I think I have this right.

I am also informing you that unless you know Japanese well you probally will not make any friends. I have two friends, my  Japanese web designer and someone who I have no idea or what they are.

The other interesting thing is you can see who visited your page unlike facebook or myspace. I for example was like an elephant in a china shop clicked around not even know what I was clicking and someone told me their friend asked them why I left my footprint? Perhaps they thought I was a trouble maker?  At any rate I suppose one must be senistive to these issues.

Overall I like this mixi. From a web development point of view I did see some advertisments from some cosmetic surgeons and other things. I dont know if viral type marketing like one can see in Youtube or Myspace is possible. Yet I think is see some value but not like in American Social Media.

I have not discussed with my Japanese associate yet but at some point we will find an answer with regard to using Mixi.jp as a marketing tool for our clients. As far as plastic surgery marketing–well like I said I did see two Japanese cosmetic surgeons advertise. I will keep you updated in any significant issues of Mixi but dont expect much until I can learn more Japanese language.

Doctor 808

Time to Load up the Hummer for camping !

Well we now have the big plans together and this will be interesting. The entire office staff has agreed to go as a giant family for an overnight camping trip. I am not sure whose idea it was but we all agreed to do this.  This big event will occur the weekend after next and we will go to the North Shore of Hawaii on Friday and stay overnight in the darkness of star studded sky.

Well I think the issue here is the mix of people that will be going some never been camping in their lives. Yet everyone voted today to go. Families and friends are invited , children , grandmothers and fathers whomever wants to come is welcome.

The main event will be food , maybe some volleyball and maybe some exploration of the North Shore. Yet the underlying event is the exploration of each other outside the natural habitat of work. Who will shine and who will be the leaders and the followers or the complainers or what have you. Out of the “natural office habitat” it sure will be revealing and perhaps entertaining.

I have my coleman stove, my coleman lantern and my tents with sleeping bags. I know how to be comfortable outdoors, but I wonder who in my office will not be ? They cannot fight over the air conditioning being too low or too high so what will be the issue in this 36 hours of isolation.  I will be sure to keep you informed.

I hope this plastic surgeon can see this

My main goal is to see a starry night with out city lights. You may know what I am talking about where the pitch blackness is pierced by about a million billion small twinkles of light. The shooting stars and all that you can see. This is peacefully to me. I hope its a clear night.

I have not been camping probably in 4 years way too long. So I am really looking forward to this. We must get all the stuff ready such as

* Sleeping bag, camping chairs, extra blankets and cushions

* Tent, pegs , poles, bungi cord, shovel , hammer , axe

*  Ice cooler, Ice, Food, camping dishes,coleman stove, coleman lanterns, flash light , fuel,

I am sure I will forget something but thats ok. Although we pretend we are roughing it the seven-eleven store is 15 minutes away.

Well in the office lately,  we have been carrying on as usual , liposuction , breast augmentation and today we removed a nasal implant from a Japanese gal who had her surgery in Japan 3 weeks ago from a famous clinic. The implant had come through the skin on the bridge of her nose .  When this occurs the implant ( made of silicone) must come out. Of course being a student traveler she had little money so I am forcing her to pay me,  by writing content for some of Internet Japanese web sites. I could not leave her with an infected nose so I made that deal.  This happens. We are in a resort city and people come from all over the world. My question is why if she had the 3000 or 4000 to pay the surgeon who put it in …..why do I get stuck with the end result. Well to answer I do live in a resort and these things happen all the time. No one could predicted this. So I hope she is good writer. We will see.

Speaking of Japanese our new Japanese Plastic Surgery Web Site is being worked on now ハワイ美容整形.  This site when completed will be a good example of our ability to design web sites in Multiple Languages for plastic surgeons. The graphics are very nice but we also seek to capture the Japanese mind.

Doctor808

One of the more interesting things living in Hawaii is the soldiers , sailors , marines and their dependents. I was in the military as many of my readers know, in fact I was in some high speed units as infantry , as well as doctor. I really miss the military and now basically live through the tales and the sharing of these stories by  those who just got back from Afghanistan or Iraq.

Can you guess who this is?

One problem I noticed was the concern to pass the military tape test. This is some diabolical method by which the military member is judged if they are too fat or not ,for the promotion or retention board. It never ceases to amaze me the super fit GI who would come in my office  having  failed his tape test because his neck -waist line ratio was off.  Yet he looked like godzilla and or Mr. America muscle bound. Yet that is the way it goes some time, the tape test has been determined to be fair and the best way. There are also those who just have an abnormal area of too many fat cells which throw the tape off.

Well for those types I am always happy as most times I can change that, really change the results on the next tape test. They get their promotion or pass the standard and everyone is happy! Plastic Surgeon is happy, Military member is happy, Commander is happy and life is good and I am the hero plastic surgeon.  The reason why it works so well,  is that it simply is taking inches off the problem area,  typically its the waist on men, hips on woman and the liposuction does the job. Get rid of those inches. The 25 th infantry here in Honolulu Hawaii I see often enough and some of the Primary Care Docs have sent me their soldiers.  However,  I will not pick on the Army,  the Navy is more often the ones who come in. I guess navy ships food is very good.

Yet I shall not forget the marines, these tough guys are the ones who are most often the most nervous about the procedure. It seems the bigger they are the more nervous they are. Liposuction may make them nervous but the tape test is anxiety can be worse !

Well back to the quiz of who the guy who is loading mortar shells in the picture. Its the same guy who is the picture below on the far left. Yes thats me. I am on the far left of your screen actually the only American as a “military advisor”. I could tell you where but then I would have to ……..you

Doctor808 19 years ago----can you guess where?

doctor808

American Eagle

Today we completed http://www.militaryplasticsurgery.com which is our newest web site creation for Plastic Surgery and Military Members ( yes including military discounts) . Appropriate I would say for the 4th of July!

Military Plastic Surgery Website

Many Americans hardly know anymore why we celebrate the 4th of July. This day in 1776 is thought (although there is some debate) that the Declaration of Independence was made and signed. The story is very interesting, in that the founding fathers of the USA were taking an extreme risk to  discuss such a thought as to gain independence from the British Empire. They easily could have been hung or drawn and quartered for such treasonous act.  We today in the USA forget how much freedom we have now ,to say what we want and to discuss freely ideas. This simply was not possible in 1776.  A person who spoke against the King of England at that time could have paid for his or her words with his or her life. It is unfortunate today we have taken our freedom for granted and there is high risk of  losing that freedom . President Reagen said we are only at any time one generation from losing our freedom.

Our military , the young men and woman who serve to protect that freedom seem to be a group who know well what freedom lost can mean. They have seen it with their own eyes and heard it with their own ears in Afghanistan,. Iraq and elsewhere,  the misery brought on by dictatorship and years of lack of freedom. We need to really look around and see the world as it is, learn history and current events and see what leads to loss of freedom to prevent that from happening here. It can happen and is happening as you read this. The Romans did not notice either,  until it was too late and they lost their republic. It seems a republic ( USA is not a democracy , never was but  a republic) like ours can only last maybe two hundred years…??

I just hope our young people will take the time to really learn something about our history, not just about what is cool or the trend of the day. I do both so can you. You can do cool things and learn history , keep current at the same time.

Plastic Surgeons 4th of July

On the fourth of July, this plastic surgeon does what many Americans will do, that is barbecue outdoors. In fact,  I just finished two of the most juicy hamburgers I have ever known. I cooked them myself on my lanai on a charcoal grill. I dont care for the gas grills which are popular, it just does not taste the same. Also we had pork-n-beans and potato chips with a side of pickles,,,hmmm good.

I don’t eat that way often,  other wise I would need liposuction myself,  but on occasional holiday its fine. Its a sorta of traditional issue on the 4th of July for this plastic surgeon in  Hawaii. I wonder if the military in Afghanistan and Iraq are having hamburgers and hot dogs too?

I think many are and we hope they are safe!

So for any of my readers who follow this blog either for Muay Thai Kickboxing , for Web design or Plastic Surgery in Hawaii—yes its cool,  but lets take a minute and really appreciate what today is. Take a few minutes and look up some facts about Thomas Jefferson, John Adams, Ben Franklin and others who signed that declaration on this day in 1776. It a day that changed  the world.

doctor808

Michael Jackson dies and the television and media go crazy. so what the heck …I might as well get my two cents in.

I personally feel very sorry for Mr. Jackson, as he in my eyes,  has been a tragedy. Its obvious to me he had body dysmorphic          disorder. Thats a condition where there are psychological reasons for wanting to change the physical self, thus all the physical  changes made , never are satisfactory the patient. Plastic Surgeons I believe can be enablers and codependent as well.

I don’t know  who did Michael Jackson’s Plastic Surgery or if many different surgeons participated, but basically I think they should be ashamed  of themselves. Thats my personal opinion and not some medical or expert opinion to be used by others. I have no data nor do I have any facts,  its simple conjecture and speculation.

As plastic surgeons,  we all have patients who demand more and more procedures to either make corrections on what we have done or to continue to try and improve another surgeons work. We have to recognize these patients as a problem, in that we see either something like a nose which looks good and they still are unhappy and want more surgery. Sometimes the patients become so convinced that there good nose job,  is not good they can start to convince the surgeon and he then becomes “codependent”. After all plastic surgeons always want to think they can make everyone happy and especially when a competitors patient comes in the door,  the tendency is to think you can always do better than the guy next door.  This ego effect can cause real problems.

Nine out of ten times if you operate you will not improve the other surgeons work and if not careful you can end up with a Michael Jackson situation. This is not the same as correcting obvious or major problems with previous surgery like a breast implant deflation or if you have a really bad outcome , then by all means it needs corrective surgery. The cases I am discussing are the cases where the work looks good and you try to make it better . I always remember the saying..”the enemy of good is better!” . That refers to someone coming in for a correction and it turns out worse. So I always make sure that its something that is realistic in my mind and the patients before proceeding.

One case comes to mind where I battled with a patient for serveral years in which she came to me because one breast implant was less than 1 cm lower on one side. No one would notice but the patient was seeing herself in the mirror and becoming rather obssessed with this very minor issue. Well I evaluated  her told her the other surgeon did what I would consider a good job. She still insisted and finally came back in almost begging me to fix what she thought was a disaster and I told her..NO. Its hard to do that as you know the patient will not be happy. I was strong and told her she was welcome to find someone else if she were not happy with my opinion. Well she did.

To make a long story short she was back in my office three months later complaining about the outcome of the surgeon she found to attempt to make such a correction. Unfortunately she went on to get an infection and overall the breast now did look bad. The well intentioned surgeon I am sure had thought he could help this patient and fell into that trap. Well at this point I told her she should return to him and see what he could do. Sad case but something we as plastic surgeons must be careful about.  I wanted to help her but felt the last surgeon should be given the chance to correct his own work. I have not heard back from her. If only Michael Jackson;s surgeons would have stopped earlier I suppose, but again I am only speculating.

Forest Gump

Well as Forest Gump would say  ”Thats all I have to say about that”.
Yet on this topic and with some interesting photos there is web site devoted to bad outcomes in plastic surgery. Mostly it looks to me like patients who had one plastic surgery too many.

This  is www.awfulplasticsurgery.com and they have discussed   the Michael Jackson issue and plastic surgery many times.

doctor808

Plastic Surgeon Dr. Pasquale

The latest buzz on the internet is Smart Lipo, or LASER Assisted Lipo which is a new fangled device where a small cannula is inserted through the skin and utilizes LASER technology to perform liposuction. Now as many of my patients know,  I am not one for “new fangled devices” having been in plastic surgery for twenty years. I have seen everything come and go ( mostly go). Check my web site  www.nerve.org.

As example,  after the silicone breast implant hysteria about  15 years ago they developed “soy oil based breast implants ” which were actually used in England for a while. These new fangled devices were the latest, the greatest newest technology to use on patients as advanced plastic surgery technique. After all the soy (yes from soy beans) was ORGANIC so it must be good right? Well shortly after serveral patients reported the leaking of smelly rancid oil from their breast. How could this be? The latest greatest technology was used and it was NEW so must be better. Well the fact is , this was a poorly conceived idea, brought to you by marketing and latest greatest new fangled plastic surgery technique promoters. My point is simply the newest idea is not always the best idea. I approach all new plastic surgery technology with a very critical eye. Maybe I am jaded after many years of listening to every salesman in the world come in my door and tell me “Doc this will change your practice and you will be ahead of your peers!!!”. Yet for me expierence with a procedure or technology says it all and that is why I don’t jump on very new bandwagon. Salesman and marketing hype says nothing, but does show you someone wants to sell you a new product or technology for good or bad.

So I have some initial impressions I want to share after researching this new fangled procedure of Smart Lipo or any of the “me too” LASER Liposuction techniques. First what is this. Well according to one web site :

“SmartLipo is by far the best kind of liposuction available today. It is a method that offers the best results with less trauma and less downtime. It has a fast recovery time and the cost is very competitive.

SmartLipo uses laser technology to melt and liquefy the fat within the fat cells. In addition, it smoothes and tightens the skin to decrease the looseness that one sometimes sees with traditional liposuction. It can be utilized alone to treat smaller areas of fat, such as below the chin, or in combination with liposuction to remove larger areas of fat such as in the abdomen, flanks and thighs.”

In my analysis of this and knowing what liposuction really is in detail,  I have a few thoughts on this. First any web site that claims that something is the “BEST” as they do, is not medical advice but salesmanship. Plastic surgery be it liposuction or face lifting there is no such thing as “the best”. If there was truly the one and only “best” everyone would use that as plastic surgeons want the best. Its the same as those web sites that claim that transumbilical breast augmentation is the “best” procedure or this plastic surgeon is the “best” etc. To me this automatically tells me something is not right and I should look carefully and recoginze this all as marketing hype. Yes we all want to put our best face forward but come on “the best”.

Next I see a very key statement used: “It can be utilized alone to treat smaller areas of fat, such as below the chin, or in combination with liposuction to remove larger areas of fat such as in the abdomen, flanks and thighs” . Translation is simple, we can use Smart Lipo for very small area but we have to go back to traditional lipo for any area larger than under the chin or combine it.  That says it all. The great benifits they state such as quicker recovery time are nullified when you then have to combine it with traditional liposuction as the surgeon has to o over the same area with a regular liposuction technique. I actually spoke to a Smart lipo practioner recently and asked him as a peer what is the advantage of this then. I mean you take the smart lipo cannula and insert it and then imediately after that insert the traditional device so why in the world would you do that. Well he said “marketing and patients like that”. He then told me that the big advantage was that it does do some skin tightening under the chin in this small area it  can be used without combing it with traditional liposuctio technique.

Well to my way of thinking that seems reasonable under the chin,  but most patients need liposuction that I see in my Hawaii plastic surgery practice other areas such as the abdomen, flanks and thighs. So few patients need that I  cannot see buying an expensive machine to serve one small purpose maybe better. I suppose its a good idea for marketing —so you can say “Hey folks I have the latest greatest new fangled device” but I dont need that in my practice. People know me and know who I am which I try to have a consistent good quality reliable and ethical practice. I suppose if I was new surgeon and needed some gimmick to help my practice , maybe it would be worth it,  but I am not so for me ….its a no go at this point.

The problem with these newer technologies is that they have not been around for years and we really dont know yet all the effects. We do know with all the energy generating  liposuction devices they can burn the skin. Now Smart Lipo may be different, but the ultrasonic techniques ( we have treated complications of  this in the past ) were a energy generating in the form of  heat that could damage the skin and did in some cases. In the case of smart lipo the energy generated producing heat from the LASER is how the skin is tightened.

Patients write about this procedure , the Doctors who promote this procedure create the buzz around the internet. The smart lipo procedure is then a great marketing tool I suppose. Yet call me old fashion. I would have a plastic surgery procedure for result, proven safety and to do what I want it to,  not to have the  have the best marketing  as a consumer. Thats me.  As a doctor on the other hand maybe its good for their practice to be part of this buzz and brig in many patients.

Well these are some of my thoughts on this new fangled procedure. Its not that I am against anything new, its simply that I rather use traditional and proven technology which I have used for years and take a wait and see approach o the new stuff. As with the soy based breast implants, this  prooved to me the latest greatest and newest is not always the best. When something sounds too good to be true it probally is. So bottom line is do your research  and dont be a dumb consumer. Plastic surgery like any business is business which you need to be a smart comsumer with or without smart lipo.

Doctor808

Dr. Michael Pasquale

I have not written for a while about the progress our web development company is making. We have now a few clients,  as we expect a slow start and this is intentional. Our concept is to give a ethical quality product at a reasonable price to those in the beauty industry ( although we will take on other projects , this is our primary focus).

Many in the beauty industry such as Cosmetic Surgeons, Plastic Surgeons and Spa and Skin Care professionals are actually very naive about the internet. Consequently we see a lot of our friends being taken advanatge of by unethical internet hawkers. As example , one of our clients was paying her “internet guy” about 300 dollars per month for web site maintenance and putting a few pictures up. 

She was a real estate agent and she asked me to look at her web site and see if  i could make any improvements. I set down with the client and she tried to pull up the site. Suddenly she says “Oh thats right my internet guy told me hackers had gotten into it and messed it up”. I then asked the client when this occured and she told me about two months ago. I inquired further and asked her why was it not back up after 2 months. She explained that her internet guy had told her it was French Hackers who really destroyed a lot. 

Well that is one of the best song and dance routines I have head from an “Internet guy ” yet. Those french must be pretty good hackers to keep a web site off line for two months. Two months of maintenance fees to her Internet guy with out any web site visible??? Needless to say that seems very odd indeed. 

The point I am making is that to someone without much Internet knowledge, such tactics to get paid for not actually doing some work can and do work. Yet I think as professionals , these unethical types stain all of us and make us look bad. I told her to give me his number and I would happy to help him for free  get rid of these “french hackers”.  

There are so many victims of if not down right fraud , lazy excuses and needless delays. Who knows how much money she lost in those two months? In her business one sale could be 100,000 us dollars as she dealt with high end properties. I know I have in my early years lost quite a bid of money by simply listening to my “web guy”.  

I am not sure what advice to give to new people who are starting to realize how much a good web presence can add to a business to avoid scammers. Yet i think the best is….if it does not seem right it probably is not. What to do? Well just like in medicine get a second opinion!! This could save you thousands of dollars. If the second opinion is different than the first , well then get a third opinion. I know I get questions all the time and have no problem with a “free consultation” if you will. 

Our company is taking things slow, declining a few clients for reasons that we know we cannot offer them anything of value at this point. We are taking on clients who we feel confident we can benefit. That is our approach , slow steady growth. We try to under promise and over deliver. I hope that will make for a successful formula. 

Doctor808

 As I mentioned last post,  I would give you some details on Thailand. specifically Bangkok,  instead of about my reasons for going. To review–I go to train in Muay Thai and to reassess my life and changes-much like a retreat. Yet many of you may not be interested in that. So you want to know more about Bangkok? Well allow me to be your eyes.

First Bangkok,  Thailand is huge population, Estimated people in the city during business hours is 15 million ( yes the official census is  8 million, not counting ilegals). Its a city of where you can find anything….legal, illegal, moral , amoral what ever your fancy. You want high class —well its there, you want low class scum its there too. Yet most Thai people are like anywhere else. They go to work , come home and see their families and then go to work again.

A lot has been written about the sex trade,  but that is probally less of a percentage than any other American or European City probably , its  just more open and visible. One of my plastic surgery colleques wife has claimed she will never allow her husband to go Thailand becasue of the sex trade. Well I have news for her, go down to Wakiki in Honolulu and anything you have in Thailand is right here. Even though that is what many times is written about, believe me its not what Bangkok is about. 

In the many years I have been going there,  I have met some of the most interesting people on earth. These range from local Thais,  such as our friend who is the daughter of ex-Thai diplomat who speaks 3 languages fluently, educated in the best American and European Universities to my Muay Thai instructor who has no education except Muay Thai and his one travel experience is to fight in Switzerland. Japanese business people to American retiree’s are all there. They come for the change and to do business in the Kingdom. A Kingdom it is ..do not speak in negative manner about the King or his family or you may end up in jail.

Yet I think the best way to understand this place is to see photos. A picture is worth a thousand words they say, so I will show you some with some comments.

Beggars are seen as with most of South East Asia on the street.

The poverty around is seen , yet when you think about it its not a “bad poverty”.Many of these beggars are actually brought in by Asian mafia to work and earn money from other countries. Sad to see, but at least they are not starving as you will see in some African countries. Most Thais have an excellent diet. Fruits and street food such as grilled chicken are abundant and very very cheap. No one starves in Thailand. The weather is tropical so no one freezes and did you know the government clinics provide health care at least  the basics. Yet at the same time there is no welfare as we know it in the west so everyone works or there is no help except from churches or the like. This I think is good, they do not have generations of welfare recipients who are dependant on the State as virtual slaves.

Overall to be a “poor person” in Thailand is not that bad from what I can see. Maybe you will not own a car, but people are happy for the most part , eat well and respect each other. Certainly most of us  would rather have that,  then be a member of some street gang in L.A. California. Life is simple and its a world of difference here to be poor than to be some inner American City poor. At least that is the way I see it.

The life in Thailand is easy going, land of smiles most happy. Seems it has never changed much in many many years. 

Little Fish drying in sun

There is food all over Thailand sold on the street and cheap. I calculated to survive you can live on about 1 us dollar a day. Not at Starbucks or the fancy places but you can live. That’s for food. Rent I do not know what the cheapest way to go is for living.

Communication is easy,  they are used to tourist and English is spoken by enough. Yet to accomplish something complex maybe need a good translator. Most activities do not require complex language. All the street vendors and sales people know how to tell you english numbers like “thirty two baht” instead of ”sahm-sip sorng baht” which is 32 in Thai. So that money is not a problem when you want to buy something. 

You can buy anything in Bangkok. They have the best department stores with all the brands if your into that or the weirdest stores and street shops in the world with everything from fried insects to your favorite flavor in ice creme. Its all there and if you look you can truly find anything you could possibly want.

One area which is easy for new tourist is called Kao San Road and this is shown in the picture below. This is one of the main “back packer” areas with all types of tourist. There are lot of hostels there and the crowd is mostly Caucasian hip types and a few from Korea and Japan. The Thais there are mainly to sell what they can to these tourist. I don’t care for that area much because its a tourist spot and I like the natural environment of the Thais.

Want to buy sunglasses??

Yet there is a lot for tourist to do. Temples are all over the place and historic places to see.  The textile industry with Thai silk is excellent as is the gold and precious stone shops all over.  You can check any travel book on Thailand and find the current districts to shop in for what you want. 

As for me,  I do not buy much so I can not offer such advice and if I were to buy gold or jewels I would probably be ripped off. I don’t know that industry so I stay away but for people who do know it can be a bonanza.

Its a circus like atmosphere in some places day and night

The places you go will depend on what you want to do. The tourist areas are like a three ring circus. So many people selling the strangest stuff and westerners drinking beer.  This will be 24 hours a day in some places as with so many people arriving at all times of day and night it never stops.

The night life as in night clubs and discos etc are endless as well. There are the “entertainment districts where you can buy ladies ( if they are ladies) such as nana plaza a real western man hang out for those seeking cheap female company.  There are traditional disco and DJ music places for Thais and westerners to enjoy music and drink. Personally when I travel I prefer the places that the local people go. There are two night clubs I have found suitable to my taste. One is the Q-bar and the other is Hollywoods. The Q bar is owned by a guy from New Jersey who opened his first club in Viet Nam until he was run out of there and now he is Bangkok. We have had drinks together a few times and his place does sport some of the best Dj’s in South East Asia. The HollyWoods is almost 100 percent Thai.  I go sometime and have been welcomed by the Thais. Its fun to watch the Thai Stage show with their version of go go dancers  ( not nude) and music and light show is very good . The most unnerving thing is to to the rest room. There a guy will come up to you as you stand in front of the Urinal doing your thing and he will give your back a massage. Its weird but apparently accepted by the Thais. You must tip him of course. For you that are less adventurous stick to the Q bar. Yet for me what is the point in traveling if your going to a place you could go to a similar place like in your home town.

HollyWoods Night Spot

There are so many bars and night spots in Bangkok ranging from the  most eloquent sophisticated to the most simple girly beer bars.  The variety in my opinion surpasses New York and Tokyo where I have spent a lot of time.  So like shopping in Bangkok, the night life is ….what ever you want to find its there–its there!

My advice to you don,t be afraid to check out some place which is not for tourist. You should be polite and when in Rome live like the romans not like the American ,Japanese or European that you may be.  Thais are very nice people but of course always use common sense as far as safety goes, I have found Bangkok safer than most American cities by far.

How to get to various places is the huge challenge for most visitors. Try to get some help to explain to Taxi drivers where your going. The sky train is excellent and easy to use, but is very limited on where you can go in Bangkok. The water taxi is little more difficult to use but its what so many Thais use and I found it cuts hours off my travel time.  The Thai people get a kick out of watching an American travel by Water Taxi.

Well there is so much to do in Bangkok and so much written on the internet I do not want to bore you with these things yet I hope I gave you a little insight into Bangkok. As stated the pictures tell more than my words So here are a few more….

draw your own conclusions