Doctor808 Plastic Surgeon Honolulu Hawaii

Well my Dear readers, it has been a few weeks since I have had a chance to make a new entry. The reason is that I was swamped with surgical cases, web projects and then getting ready for my trip to give lectures in Korea and China. Now I have a day to catch my breath and I am Bangkok Thailand. Here is Me , the Red Shirts,  as well as 11 million other assorted Thais and Foreigners. All one big happy Bangkok family.

For you with lack of initiative, the red shirts are the other party opposed to the yellow shirts in Thailand and and its a mess. It is not bad at all for tourist as long as you use common sense and stay away from protest areas. In these places  as our beloved embassy advises , a peaceful crowd can turn into an angry mob so as long as you stay away from these areas which are small compared to the country and city your fine. Problem is my condo is 1 block away from the action and 32 stories up,  so I can see and hear and be above it all.

Well I am only here for a few days so it really does not matter to me what takes place as long as it ends rather quickly and peacefully. I will be off to China in 24 hours. There I have been invited by the head plastic surgeon in China to lecture at one of their hugh conferences which my talk will be on Breast Augmentations. What I am talking about is the “Tips and Tricks in Breast Augmentation. Well let me say I have a few after 20 years of doing that so I might as well share it with Chinese eh?

Oh no !!!! Not another breast augmentation lecture !!!

Well like I said I should be able to have something to say about Breast Augmentation after 20 years of doing them.  When you do something that long you learn all the mistakes and more importantly how to fix them. In fact we devoted and entire web site to that topic called  FixYourBreast.com . I mean can you imagine such as name for a web site. Well all I can say about that is — we design web sites so why not.

The people I met on this first leg of the trip were a lot of fun and I will be telling you some interesting stories in a later post. Korea always fascinates me, as it reminds me of my own Italian culture somewhat. Contrast that to the  easy going , no tempered Japanese colleagues of mine there such as Dr. Cuvo , Dr. Ashida and Dr. Kure all mild mannered and polite.  Well at least to you get to know them anyway and then they may change ?  The Koreans like me can be loud , determined and a lot of fun. One of my Korean friends told me the reason for this was that Italians like Koreans live on a peninsula. So that means we are always attacked from many sides. Seems like an interesting theory.

The meeting went well in Korea and I will come back to this topic in later post. I need to go see my business partner here now and get back to work. I just felt guilty for not writing for a while. Till next time.

doctor808

Dailin University President last trip to China

Last time I went to China I gave a lecture on Face Lifting, this time I have a world wide lecture circuit on Breast Augmentation. This will be a three country tour starting in Korea , this stop will be for my lecture called  ” A simple technique for breast axillary breast augmentation with a new surgical instrument the “boob-a-rang”. Although this may sound like a joke for name of an instrument its not. Many years ago I invented a instrument to perform the axillary dissection for breast implants. This device works well and is shaped some what like a boom-a-rang thus the name. I have had great success without complication compared to other instruments I have used. I manufacture, designed and sell this to other surgeons and it is FDA approved.

Well that is the first leg of the tour, then next its on to China City of Fuzhou. There will be a huge meeting where I will again to present several lectures on my breast augmentation technique.  I was invited by the head Plastic Surgeon personally for all of China. That is huge as in country like China so large but only one Chief. Well I am very excited  about this invitation and I will let my readers know about this at progresses.

Finally I will end up in Bangkok Thailand at my safe zone where I will relax a few days and check on my other business interest there. Then back to Hawaii home sweet home.

Well thats all for now and I will let you know what is next.

Doctor808

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

On Thursday my staff and I gave a event at Fort Schafter an Army Miltary base.  We invited the public to this lecture and question and answer period about Plastic Surgery in Hawaii. We had it sponsored by Mentor Breast Implant Company and Company which makes Dysport. There were about 50 people who showed up. There were three lectures given. One by me, one by each of the representatives. We also had door prizes and live injections of fillers and Dysport. The best prize was a free pair of breast implants dontated by Mentor Corporation.

The crowd was fun and interested

My staff had put a lot of work into this event and I think it was a success. The most important issue to me was I tried to evaluate something new we call the Aloha Dysport Lift. This is where I inject in the superficial layer of the skin Dysport in a special pattern. For reasons I will not dicuss here the facial skin is lifted to a small degree and lines will dissapear. I will be writing more about this later on a web site we are in the process of building. So for now I will tell you what we did. We did this on three patients from the audience but only on the right side of the face. We then waited 30 minutes. I then under High Density Video we asked the audience to raise their hands if they could see a difference. Amazingly every one raised their hands and all agreed that they could see the changes in each of the three patients. I actually begged them to not to go along with the crowd if they doubted what they saw. Still they all agreed that they could see the changes. This to me was amazing. We will show the pictures on the web site at a later date so stay tuned.

My Staff was available to answer questions

The staff stood by to answer questions. Many good questions came from the audience about Breast Augmentation. Liposuction and all the various fillers such as restylene, juviderm and the like.

The food was great and we really enjoyed this event and learned a lot about the Aloha Dysport Lift.

We hope to have future events such as this and we thank our sponsors.

Doctor 808

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

Military Plastic Surgery and Plastic Surgery In Hawaii

Many of you may not known I was in the military for many years. I spent most of time  in the reserves. In fact, I spent a lot of that time with the 20th special forces group which at the time was a reserve unit (NG) and we were based out of Maryland. During my time I met some of the greatest people anyone could meet, dedicated, smart. most spoke at least two languages.

As a plastic surgeon in Hawaii I meet many military members and their families from the marines , the army and navy as well as special operations. I always share with them war stories and understand their military life. It was some of the best experiences I have had. As a Hawaii plastic surgeon we also have patients from Guam, Japan and Korea who are in the American Military. Interesting to note we have many patients who fly back in have their plastic surgery in Hawaii and fly back to their Pacific bases.

I think one of the most interesting time,  was when we received 6 emails from Afghanistan from 6 female soldiers who some how had heard about us. They all flew back at the same time when their tour of duty ended and we performed 6 breast augmentations,  Wow —talk about beautifying the country. In a more serious light my hat goes off to these dedicated individuals who sacrifice for our freedom in some of the most harshest conditions on earth. I think 4th of July coming up is an excellent time to salute them. They are in hearts and minds as they serve heroically.

Our web development company has even devoted a web site specifically to these service members about plastic surgery and we offer a discount. This can be found at www.militaryplasticsurgery.com . This web site about military and plastic surgery will offer discounts and address some of  the issues we have seen. So Please take a look.

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

Well the recent troubles with Ushers wife going to Brazil and having a cardiac arrest make this a very topical topic. Many people travel to places other than their home towns to have  procedures. Here in Hawaii I have spoken to many patients who come to my office after travel for cosmetic procdures. Some go to Korea, Thailand and other parts of Asia. Recently a woman told me she was going to Mexico to have the procedure we discussed at half the cost. 

Basically there are good plastic surgeons all over the world which is not the problem. You can find good surgeons in Mexico or in any of the other countries I mention no doubt. The problem is when there is some difficulty. Not only are you miles away from family or any support, but the money you would have saved now is lost  and most likely has become so much more than the original cost quoted locally.

What comes to mind was doctor and her husband who went to Brazil to have the LASIk procedure done to correct some vision problem. She and her husband both had the procedure at a substantially reduced cost,  than they would have in the States. Yet she had a problem after surgery which she had to travel to London eventually to correct. As london indeed had the only expert in her problem. Although she saved money with the initial surgery it cost her over 8 times more and she is still receiving treatment.

This story has been repeated many times in my practice a girl who traveled to Thailand who had some rubber unknown sack used as a breast implant which I took out for example. She wasted her money. Even when people have quality plastic surgery done away from home if they have a problem they have to fly back to the place which cost additional money.  It can work but dont think you will save in long run , the numbers do not work out.

I have patients fly in to see me as well. Yet we require them to stay till everything is ok. Even then we tell them that if they are from Japan for example  we may have a doctor they can see there,  but it may require a plane trip back to Hawaii. Its not that I condemn the practice,  but I want to make sure they are appraised of the risk and know that in long run saving money will not be one of the benefits.

Well these are some of my thoughts Summary: You can fly far away to have plastic surgery and it may be good idea if you find the right surgeon. Yet do not think you will save money and you best be able to be prepared if something goes wrong to pay extra. The only reason I can see to take this risk is that you are traveling for special expertise. You pay for that, so going for cheap is not a good reason.

Doctor808

Dr. Pasquale thinks this is Dumb

Transumbilcal Breast Augmentation Hype without Sanity

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

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

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

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

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

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

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