Thursday, July 02, 2009

Drive-thru Plastic Surgery and Michael Jackson

Like many people around the world, I've been giving some thought to all the coverage of the recent untimely death of pop superstar, Michael Jackson. Among the controversies in his life has been criticism of the number and extent of facial cosmetic procedures Mr. Jackson endured over his career. What's bothered me, though, is that most often the scorn and ridicule has been directed at Michael Jackson himself. Surprisingly little of it has been directed at his surgeon(s) and dermatologist(s).

Remember, Michael Jackson did not do this to himself. Never once did he himself operate on his own nose, or eyelids, or chin. He had to find willing accomplices in his doctors. Which brings me to the following point:

Plastic Surgery is not a McDonald's Drive-Thru!


Now, I don't mean any disrespect to the McDonalds restaurants [as my staff will attest, I probably eat there more often than most Americans]. My point is that as doctors we have a different responsibility to our patients than simply filling their order. If a 400 pound person orders a couple of Big Mac Meals at McDonalds, when he pulls up to the drive through he'll be given two Big Macs, large fries, and drinks. It is not the duty of the McDonalds staff to say, "Wait a minute, buddy. We're not going to give you these Big Macs. You're overweight and you really would be better off just having a small side salad and a diet soda."

As surgeons, however, our duty is to evaluate whether patients will be properly served with what they're requesting. If we feel that their desires are inappropriate or their expectations are unrealistic, we need to advise them against surgery, against an injection, against a prescription.

Body Dysmorphic Disorder

In fairness, I have never examined Mr. Jackson as a patient, so my analysis is necessarily limited by what I've seen in the media about him. But in all likelihood, the pop star suffered from Body Dysmorphic Disorder, a psychiatric condition in which patients imagine themselves as ugly and obsess about minor or nonexistent flaws. Its treatment is medication and psychotherapy, not plastic surgery. It's like the anorexia nervosa patient who thinks she needs to lose more weight.

Why Michael Jackson's surgeons didn't say no to him is beyond me. Money is a reasonable guess. Physicians and surgeons—regardless of speciality—need to be the guardians of reality for our patients, lest the Oath of Hippocrates become regarded by the public as the Oath of Hypocrisy as far as plastic surgery is concerned. Again, Michael Jackson didn't act alone.


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Thursday, January 29, 2009

Latisse™ for longer, thicker eyelashes!



Did you know that the quest for beautiful eyelashes dates back at least 6,000 years! But if you'd asked us a couple of years ago about the best way to get longer and thicker eyelashes, the answer would have been uninspiring: apply mascara or false eyelashes.

Now patients have a new option for lash enhancement: Latisse®. Just approved by the FDA, Latisse is a topically applied prescription medication that actually helps you grow longer eyelashes!

The story behind it is interesting. The prescription medication in Latisse, bimatoprost, was originally developed to treat glaucoma (a condition of increased pressure of fluid in the eye). A side-effect noticed by many patients and their physicians was that the eyelashes of patients using this eye drop became longer, thicker, and darker. In subsequent clinical studies of Latisse™, 78% of patients saw significant increases in these three measures after 16 weeks of use.



So what's the catch? Although Latisse is applied with a small applicator brush, patients should avoid getting it in the eye itself as it may also cause the iris to hyperpigment (darken) in some patients, thus adding some brown to those baby blues. Now, in fairness, the clinical studies of Latisse did not show an increase in iris pigmentation, but the same drug when instilled directly into the eye has shown this side-effect.

You can read more about Latisse or watch a video on how to apply Latisse on our website here:


Better yet, give us a call to see if Latisse could help enhance the beauty of your eyelashes: 904-215-PFPS.


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