Doctor808 Plastic Surgeon Honolulu Hawaii

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

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

I went to Korea some time ago,  perhaps  1 year and met some marvelous Korean Cosmetic Surgeons. I was the invited instructor to teach my technique in Buttock Augmentation. It was a great country and I was of course happy to have my way paid and teach some plastic surgery technique.  Well many of the doctors asked me if they could spend some time in my clinic to observe and learn.

This brings me to Dr. Yeom who had our mutual contact who I know as “Maverick” had emailed me about his desire to come here. In fact I knew he was sincere in his quest to learn more from me. The reason was when I was in Korea he could not speak English so he spent the last year learning English so he could communicate here.

Troy Wilson, Dr. Yeum, ME

He arrived about two weeks ago, unfortunately the clinic is slow,  but we did have enough cases to keep him occupied. So he learned enough to make his trip worth while. We performed several breast augmentation surgeries and he assisted and learned some technique. He also observed Rhinoplasty some facial surgeries and liposuction.

Dr. Yeum has his own clinic in Korea which he names Dr. Beauty Clinic. The problem is he says no one in Korea knows the english term “beauty”, so he is unsure of how effective it is. Never the less Dr. Yeum likes the term so he will keep it.

I have met a lot of plastic and cosmetic surgeons in my 20 years in the field and I must say he is indeed one of the most pleasant I have met. For me as teacher of techniques it was a nice experience, Additionally Dr. Yeum taught some of his non-surgical techniques to me. During his visit we had a new product come in called Dysport. Dysport is now a FDA approved competitor to Botox cosmetic sold by Allergan. Both products are similar yet we had no experience with Dysport. Well with Dr. Yeums visit we had an experienced Dysport teacher for myself and the staff. It seems that dysport has been used in Korea for about 3 years while we just received approval here this year. So we were able to get the scoop and all the insight on the use.  Another potential aspect of Dysport which we learned and actually now have tried on a few patients is something called “dermatox lift” we call it a” dysport lift” until I complete my study of this and then I will give it a catchy name. We noted that by injecting small amounts of Dysport in the dermis ( skin ) it produces a lifting of the skin. This by no means is like a surgical face lift,  but indeed all agreed that they could see a slight lift on all the patients we tried. Originally when Dr. Yeum mentioned this we thought it sounded very strange. Yet when he demonstrated the technique we were all amazed.  I will be writing more about this technique later once our “mini-study” is completed but initial indications are it looks very good.

One more thing about Dr. Yeum is that he likes karaoke and he can really really sing. In fact we were amazed at his wonderful voice.

Dr Yeum as lounge singer !!

Well all I can say is that this was impressive even though he sang a Korean Song which I could not understand. I think he is a baratone. Everyone at our table and entire strangers were simply amazed. The one musician with our group stated that Dr. Yeum missed his calling and should have been a singer instead of a doctor.

I agree though he seemed to be a good doctor as well.

His visit ended with our presentation of certificate stating that he completed a two week preceptorship in cosmetic surgery at our clinic.

We will be having other surgeons visit our clinic in the furture as we have in the past for learning and exchanging the latest techniques. This is always enjoyable and educational.

Doctor808

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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

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

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

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