Doctor808 Plastic Surgeon Honolulu Hawaii

Doctor808 Dr. Pasquale

Time passes  fast as one gets older. Each day seems to merge into the next and there is no end to the amount of work that I need to do. I will be leaving back to Thailand in 10 days or so for some business and to attend a aesthetic conference and later in May an anti aging conference. This brings to mind what has the medical establishment really done in this field called anti aging?  Well in my humble opinion a lot and very little. The main advancements have been in healthy living, exercise, good diet, no smoking and proper common sense like not to take job in active toxic waste dump. So in common sense measures I would say we as doctors have done very well. Yet in term of scientific advances like some miracle with super anti aging drugs. There is simply no proven by science medication, injection , pill or other miracle potion which I know of. As a plastic surgeon I do things to reverse or hide some the effects of aging appearance but the DNA is still damaged, older people will still grow more extra skin that we cut off and illness will prevail ultimately.

Face lifts in Hawaii I do ,  for example can change the lines of aging and the remove the jowels of the jaw line . They can really make one look better , more rested and in turn make one feel better which may give the illusion of being younger. Yet in final analysis your still getting older as depressing as it may be. It can be done well or done poorly as for me I plan to do it well. The one organization which seems to toot the whistle year after year is A4M which is the short name for the American Academy of Ant Aging Medicine ( see the 4 A’s). This organization I was a member of at one time just like I was member of the American Academy of Cosmetic Surgery. I was also a member of the American Academy of Facial Plastic Surgery as well and about 1/2 dozen of other professional groups. All of these organizations I allowed my membership to lapse for various reasons. They were all good organizations I suppose , but seemed so politically controlled by a few and the same thing being said year after year I guess I was tired of the same old stuff. Lets take A4M for example.. The same names appear over and over year after year as leadership. Not that this bad as I suppose as they are the ones who stay most involved. Yet its not my cup of tea. What I want to see is new really NEW advances and some progress in anti aging. Please Dr. Goldstein and Dr. Katz show me something new  in the field. Maybe its my bitterness with aging that makes me say this but I thought by now A4M would have me 24 years old again ! I say this all tongue in cheek so please accept my apology at A4M as the reality is , at least you are trying !!! So congratulations on your persistence. When I attend the meeting in Bangkok this year maybe I will be surprised and I will come back to Hawaii with ways to make myself 2o years younger ! Nothing would please me more.  This meeting will be held in Bangkok Thailand , May 2010.  I will stay at a condominium there.

chemical peels for age spots

The meeting in January this year is the International Congress of Aesthetic Dermatology January, 21 to 23, 2010 in Bangkok. I leave next week for that and other business as well. It will be along the lines of skin care , treatment and I believe some scientific care. There may be some anti aging but little plastic surgery in the traditional surgical venue. What I hope to learn is the latest treatments for age spots which affect so many of my asian patients. These age spots can be tough to treat, yet my Asian patients are lucky as they can be treated with patients and finding the proper treatment which may vary. Its a bit of trial and error. The same cannot be said about aging in general , as plastic surgeons we find ways to hide that but we cannot stop it.

doctor808

As mentioned earlier I was invited lecture and “professor” for Face lifting and cadaver dissection in the Peoples Republic of China and I finally arrived in Dalian on Saturday. Unfortunately, due to circumstances beyond my control I arrived a day late. However, my host were able to rearrange my lecture and I did not miss the cadaver instruction /dissection lab.  They were also kind enough to schedule a special session for my lecture so I still was able to present the information I had prepared on my technique for face lifting.

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

Last year I went to Halloween in Waikiki. I was dressed as some sort of self described witch doctor. I am sorry I have no photos of that. I was with a Witch and a Harajuku girl and some normal male. If you have never been to Honolulu on Halloween you have missed a sight to see. The only place I have been which is more out control is Las Vegas on New Years eve.

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

Well I have not been able to write much these days in this blog,  as I was preparing to teach in China next week. I was invited to a gathering of cosmetic and plastic surgeons in Dialin China to give a lecture on and hold a work shop on face lifting. My assigned task is to teach facial anatomy and facial nerve. This is a very difficult task in that some how I have to figure out how to do this as it relates to face lifting and teach it in less than two days. Well I finally decided and completely my presentation.

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

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

Dysport Package

Dysport Face Lifting is a new procedure I am investigating. This is a non surgical procedure which uses Botox Cosmetic’s Competitor . Dysport is a new approved product by the FDA. They are both botulism A toxins which act in a  manner to paralyze muscle so that one does not develop dynamic wrinkles. These are wrinkles which are caused by the movement of the facial muscles as opposed to sagging of the skin.  The Dysport, as well as the Botox, both stop the muscle movement and the wrinkles do not form or relax and go away.

This new procedure I will call the Aloha Dysport Lift or ADL for short. What the ADL appears to be is a non surgical chemical face lift. Of course its not a true face lift as compared to surgical face lifting,  but from what I have observed is it does produce noticible change rather quickly. We have done the procedure on three patients and everyone in the office was rather amazed.  You could see actual changes before your eyes.  The face was done so that the full right side was done and then compared to the left and so far with the three patients with in thirty minutes you can see the difference between the two sizes. Simply amazing. I will be showing the photos when we have  5 patients completed so stay tuned.

doctor808

Life transitions amaze me. I graduated private catholic school, had my first date , army, college ,medical school and married lived through conflicts between countries and so on. Next was practice and for me next will be retirement. Life is quick , you blink and its over.

Front: Dr.Lee, Dr. Flowers-Back: Dr. Peterson, Dr. Pasquale

Tonight was one of those nights that make me think about   “the speed we go through life” and done. No more –game over!

One of my teachers who is also my friend is on his way to the next step which is retirement.  But first let me tell you who I am talking about my Dear Reader. In the picture above you will see three younger ( over 45 all of us ) and one older gentleman. The elder in the crowd the only one  world famous is Dr. Robert Flowers.  The Asian man is Beverly Hills Plastic Surgeon Charles Lee , behind him is Honolulu Plastic Surgeon Dr. Robert Peterson and then there is ME.

Now as I was saying life is stages and life is quick. Dr. Flowers is leaving Hawaii and entering his retirement phase. After becoming a true  icon in the world of Plastic Surgery he has decided to leave. Its a field he has loved,will always love and  one that he has made dynamically change and will forever live in plastic surgery history.  I can speak for the other two younger ones and we agree he has influenced our lives. We learned from him, we listened to him, talked about him and admired him. Sometimes even mad at him , or laughed with  him…….but always felt awe and respected him.

The reason us three Charlie, Bob and myself were out with him tonight is because of a special relationship from the last ten years. Charlie ( the asian ) Bob ( the one behind charlie)  and me have all “hung out” if that is what you call it. Like college roommates in the world of plastic surgery we chat all the time, compare notes, teach each other tricks and gossip behind each others back in good humor.  We were all in Dr. Flowers office as a group at one time. We know each other well. Dr. Flowers  was always the father figure to some degree to us. We were the prodigal sons at times, other times the we were the younger ones helping out the family or something like that.  In a nut shell we know each others secrets, strengths and weaknesses. Yet even when competitors in the same community I suppose it was never like that, never felt that and I appreciate that.

Dr. Charles Lee left the Hawaii family on to La and then to Beverly Hills , Dr. Bob Peterson  and I stayed as we have always been more established here as Dr Lee is the younger brother.  This is my take on things. What does it meant? It just seems interesting that many years ago we were planning a group practice which broke up for various reasons and now much later we are all sitting at dinner , as a family.  When a group practice breaks up to most doctors its like a bad divorce. When this group departed it was more like kids leaving home to make it on their own. The home being the group. That does not happen often in the medical setting. Yet it did this time and I think I know the reason. It has something to do with Dr. Flowers. His presence seems to prevent any bad feelings only good memories.

I recall one day I was in a local hardware store looking for some tool to fix my car. Up pops Dr. Flowers and with a grin on his face says to me….”Michael looking for some new instruments for surgery?”  Well funny I thought, many surgeons of his era proabally did just that. Found useful items to use in surgery in a hardware store back before it became a modern industry. When he started there was not much in the way of plastic surgery instruments and many like him fashioned their own. Today my generation has everything for them spoiled we are. Yet at the same time he was lucky, he did not have everything prepackaged so creative ability  was exercised more easily. Such  a great time in history to be a plastic surgeon.

Finally I am sad to have him leave Hawaii. He was great for advice for myself and Dr. Peterson as he was only up a 6 floors from my office and few blocks from Dr. Peterson’s Office.  We lose a senior surgeon locally but he has a phone where he is going I suppose.

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

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