Élan Institute for Plastic Surgery 2010 East First Street, Suite 270 Santa Ana, CA 92705
December 30th, 2008 Michael A. Jazayeri M.D.
O.K., this blog has nothing to do with plastic surgery…or does it? I will let you decide…please read on.
A friend of mine send me a YouTube video and it compelled me to write this blog. I think the topic is relevant, especially now with new year’s resolutions coming up.
A few years ago, around Christmas time, I was in the operating room and the subject of wishes came up. The surgical technician asked me if I could have only one wish, what would it be? I thought about it for a few seconds and said “I just want to be happy.”
I just want to be happy. It seems such a simple concept, and yet, why most of us have such a hard time acheiving happiness?
I can’t tell you what should make you happy. But I do know this: happiness is a state of mind.
Happy people, for the most part, see the glass as half full and not half empty. When hardship or failure occurs, happy people try to learn from the experience and find a positive aspect as a result. To quote the famous German philosopher, Nietzsche, “What does not destroy me, makes me stronger.”
Happy people set realistic goals, with a higher chance of success. Do not confuse this with laziness! Happy and successful people work hard. Yet they succeed because they have realistic expectations.
Do not stress over factors which are beyond your control. For example, none of us have the power to improve the economy. The key, therefore, is to modify things we can control, in order to survive.
Exercise! I have touted the benefits of exercise before, and I will mention it every opportunity I get! Exercise improves blood flow to the brain and body. It also increases the levels of endorphin (your body’s own morphine), resulting in a natural high. It is much easier to achieve a happy state of mind when your are on drugs (naturally, of course!).
A common misconception is that wealth is directly proportional to happiness. In fact, this is not the case. Several studies, comparing different countries and cultures reached the same conclusion: once a person’s income passes the poverty level, there is no correlation between income and happiness.
Some of us are genetically gifted to have a happy state of mind. For most of us our brain needs to be retrained to reach that state. It is not easy, but worth the effort.
If you are unhappy all the time, the easiest thing to do is to rule out any medical condition which may be causing your unhappiness. Thyroid conditions are perhaps the most common cause. You may also consider seeing a psychiatrist for a few sessions. No, you do not have to be crazy to see one! What a good psychiatrist will do, however, is to find the source of your unhappiness and help you retrain your thought process.
Many of you reading this blog are thinking what does Dr. Jazayeri know about unhappiness! He is a plastic surgeon…he is set! It took an incredible sequence of events for all us to be born into this world. We are all, therefore, very special. I am no more special than you are. Like all human beings, I have had my ups and downs, I have my ups and downs now, and will continue to have ups and downs in the future. The important thing is what I choose to do and how I choose to react to my downs.
As a plastic surgeon I can help you achieve “outer happiness”, but only you can help yourself with your inner happiness.
Enough blogging! The link to the video is below. It has a simple and important message, and it brought a smile to my face. I hope you will put “I just want to be happy” on the top of your new year’s resolution list.
http://www.youtube.com/watch?v=Cbk980jV7Ao
Dr. Jazayeri is a board certified plastic surgeon and a member of American Society of Plastic Surgeons, with over 10 years of experience. His office is centrally located in Orange County, in the city of Santa Ana. To schedule a complimentary consultation, please call 714-834-0101.
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December 19th, 2008 Michael A. Jazayeri M.D.
The first face transplant in the United States was performed this week at the Cleveland Clinic. What is significant other than being the first face transplant in the U.S. is the amount of defect which was reconstructed. Approximately 80% of the face (including skin and bone) was reconstructed with the transplant. The previous three face transplants performed in the world only covered small areas of the face.
The surgery lasted 23 hours, involving multiple teams, which is predictable, given the complexity of the face. Multiple small vessels and nerves have to be attached to the patient’s face to assure survival of the transplant, and to have some hope of facial movement. These vessels and nerves are attached using an operating room microscope, using sutures which are thinner than a human hair.
As remarkable as this surgery is, several areas of concern remain. We are not technologically at the level to obtain a result such as in the movie Face-Off, where Nicolas Cage had a face transplant. In the movie, the new face looks completely natural, without any scars from the surgery, and the actor has perfect facial movement. The result of this surgery is unpredictable. There is no way to predict how much of the facial movement will return, and if it will be symmetrical. There will be scars where the transplant is attached to the patient’s face and only time will tell if the scars will be noticeable or not. There is also the potential long-term psychological effect on the patient. We have to remember, the patient has lost 80% of her face, and, therefore, the new transplant will result in a drastic change in the patient’s facial characteristics. How is the patient going to cope with this dramatic change? Only time will tell.
The final issue which was not discussed in the article or the video is the long term effect of immunosuppression. Since the patient has received a transplant from a different person, her immune system must be suppressed to minimize (not eliminate) the risk of rejection. Therefore, she is at risk of infections and cancers typically seen in AIDS patients. Even with immunosuppression, there is always the potential of graft failure or rejection.
Face transplant is and will remain a controversial topic until technology and surgical techniques improve. However, I think we must push the envelope in order to progress. This procedure was done in an academic environment, where the latest technology exists. The patient was carefully selected and had a defect which permitted face transplant to be considered as a viable option.
Who knows what lies in the future: brain transplants any one!?
To read and watch the video about this procedure, please click here.
Michael Jazayeri, M.D. is a board certified plastic surgeon and member of American Society of Plastic Surgeons, with over 10 years of experience. His office is centrally located in Orange County, in the city of Santa Ana. To schedule a complimentary consultation, please contact 714-834-0101.
Posted in Face, Face Transplant | No Comments »
December 17th, 2008 Michael A. Jazayeri M.D.
Breast Augmentation is the most common aesthetic surgical procedure performed in the United States, with over 300,000 surgeries annually.
There are basically three styles of implants available. For a detailed discussion about saline vs. silicone implants, please click here.
The most common style, which is used by majority of plastic surgeons, is the smooth, round implant. As the name implies, the implant is round in shape and has a smooth surface. In my practice, I have exclusively used this type of implant without any complaints from patients. The post-operative results have been very good. Please visit my photo gallery for before and after photos.
The second type is the textured implant. As the name implies, the surface of the implant is rough to touch due to a textured surface attached to the smooth surface. The theory about this surface is to decrease the risk of capsular contracture. What is capsular contracture? Any foreign material placed inside our body will eventually form a capsule around it. The body forms this “shell” as a way of ignoring this foreign object. With time, many breast implants will develop a tightening of the capsule. If the degree of contracture is severe, the implant will become visibly distorted and may even feel hard to touch. Surgery may be required to correct the condition. Based on animal studies, the textured surface of the implant breaks up the formation of an organized, neatly arranged scar tissue thus minimizing the risk or degree of capsular contracture. Clinically, however, the risk of capsular contracture is essentially similar for both smooth and textured implants. The major disadvantage of textured implants is that breast tissue becomes stuck to the rough surface, increasing the risk of rippling. Rippling occurs when the patient moves and causes “ripples” in the skin around the breast. Another factor is the cost, textured implants are more expensive. For these reasons, majority of plastic surgeons do not use textured implants.
The third style of implant is the anatomical type. Anatomical implants are flatter on the top half and fuller in the bottom half. The rationale is to obtain a more natural look. However, in my experience, surgical technique is a better prediction of whether an implant will look and behave naturally or not. There are three main issues with this type of implant. The first is the cost; anatomical implants are much more expensive. The second is the risk of rotation of the implant. When a breast implant is placed, there is always some movement of the implant before the capsule forms. If the anatomical implant should rotate, surgery is required to reposition the implant. As a result, these implants only come with a textured surface to minimize the chance of rotation. However, as mentioned previously, this increases the risk of rippling. In my opinion, anatomical implants are better suited for breast reconstruction, where the implant is completely covered by muscle and the goal is to match the reconstructed breast to the other side.
The last style is the adjustable implant. The size of the implant can be adjusted up to six months after surgery by injecting saline through a port which is placed under the skin. I personally do not have any experience with this type of implant and am not aware of many surgeons using this type of implant. One concern, although small, is the risk of infection by injecting the port through the skin. In my experience, this type of implant is primarily used in breast reconstruction to adjust the final volume to match the non-operated side. For more information about this type of implant, please click here.
Dr. Michael Jazayeri is a board certified plastic surgeon and a member of American Society of Plastic Surgeons. His office is centrally located in Orange County, in the city of Santa Ana. To schedule a complimentary consultation, please call 714-834-0101.
Posted in Breast Augmentation, Breast Implants | 1 Comment »
December 11th, 2008 Michael A. Jazayeri M.D.
The economy is gloomy. We are in a recession and experts agree the economy will not rebound for the next 1-2 years.
It is time to be frugal! I have recommended this regimen for 10 years now, and it seems like a good time to put my advice in the blog.
The cheapest plastic surgery you, as a patient, can do is to limit your skin exposure to the sun and stop smoking.
Any degree of tanning means your skin’s defense mechanism has been activated to minimize the damage to your skin cells. However, there is always some damage. As you can imagine, the damage is cumulative: the longer the tanning, the more advanced the damage. Therefore, tanning salons are just as bad as the sun. Your tanned skin may look cute at age 17, but as we age, we lose water, collagen and elastin from our skin cells. The damage from sun or tanning booth will compound the aging process, resulting in thick, leathery skin. Even the most aggressive face lift or laser procedure cannot reverse this aging process, and may result in an unnatural, “operated on” result.
Skin cancer is also another potential side effect of chronic tanning. If you have pale skin, red hair, freckles and green eyes, you are especially prone to developing melanoma. As you may recall, Senator Mc Cain recently had extensive surgery to remove a melanoma from the left side of his face. To read more about melanoma, please click here.
The nicotine in cigarette, along with thousand of other compounds cause vasoconstriction (“choke” the blood vessels) throughout the entire body. This means the largest artery and the smallest artery in our body will constrict from smoking. This is also a cumulative effect and the degree of damage is proportional to the amount of cigarettes and the number of years consumed. As you can imagine, the blood vessels to the skin will also be affected, limiting the oxygen supply to the cells and thus accelerating the aging process. Furthermore, one can save hundreds to thousands of dollars a year if smoking is discontinued.
Exercise! We have all heard the benefits of exercise and time has not disproven any of the claims. Exercise works! It improves the blood supply to your skin and produces endorphin (your body’s own morphine) which gives one a natural high. You do not have to join any gym either. I have found walking to be one of the best exercises available. All it requires is a good pair of walking shoes. Walking briskly for one hour, 5-6 days a week is the only exercise you may need.
Drink plenty of water. Remember, as part of the aging process, our skin cells lose water. Dehydration is certainly not going to help. My rule of thumb is to drink enough water so the color of my urine is light yellow or clear.
The advice I have recommended assumes you are healthy. If you have any medical condition which may affect your ability to exercise or drink fluids, please check with your physician.
There you have it. I hope this will make you take better care of yourself. Remember, no body is going to take better care of you than yourself. As the Kaiser Permanente commercial says: Live long and thrive!
Dr. Jazayeri is a board certified plastic surgeon with over 10 years of experience. To schedule a complimentary consultation, please call 714-834-0101.
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December 10th, 2008 Michael A. Jazayeri M.D.
I recently read an article on British patients going to other countries for plastic surgery. The same phenomenon happens here as well. I have seen many patients travel to Mexico, South America, or even Middle East for plastic surgery procedures.
I understand the primary reason is the cost. The same procedure in the United States can cost twice as much or perhaps even more. What about safety, quality of work, and adequate follow-up after surgery for any possible complications? Are these included in the price as well…in my opinion, no. For one, the distance becomes an issue. If a patient develops an infection or wound break-down, is he or she willing to travel to the country the surgery was performed and remain there until the issue is resolved? The logistics alone may prevent this.
Is there any method of checking the credentials of the surgeon you have chosen for your surgery? Are there any issues with this physician’s license? Is the physician board certified? Does the country you are travelling to have the infrastructure to provide some level of medical “quality control”? What about the surgical facility and after care? Are they licensed and monitored as they are in the United States?
I recently saw a patient who had a tummy tuck performed in another country. The usual tummy tuck incision was extended and went up all the way to her lateral breast area on both sides. The scar, therefore, looked like a “U”. She wanted to see if I can eliminate the side scars, which of course is impossible. Her surgical cost was significantly less, but at what cost? She was hoping to wear a bikini this summer, and her dream has been shattered.
There are many plastic surgeons outside of the United States who perform excellent surgery. However, in my opinion, it is much more difficult to find the right surgeon when the above mentioned infrastructure does not exist. In my experience, the cost for plastic surgery in countries which do provide high quality care is near or sometimes more than the U.S.
Remember, there is always a chance (although small) of complications after elective surgery. The potential risk to your health (and your wallet) may off-set the discounted price.
Dr. Jazayeri is a board certified plastic surgeon with over 10 years of experience. His office is located in Santa Ana, California. To schedule a complimentary consultation, please call 714-834-0101.
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December 10th, 2008 Michael A. Jazayeri M.D.
Liposuction was initially introduced in the late 1970’s by a French Gynecologist. American Plastic Surgeons visited France and the technique was brought and further refined in the United States. Since this is an effective and safe technique (with current modifications) it has stood the test of time and the results are reproducible.
The current technique involves making small stab incisions next to the area of liposuction and infiltrating a solution containing salt water, local pain medication (xylocaine) and epinephrine. The purpose of the solution is to blow up the fat for easier removal, pain control and to minimize bruising and bleeding (due to the epinephrine). The fat is then aspirated with specialized instruments designed specifically for this procedure.
Although fat can be removed from any patient, the ideal candidate is at or near their ideal body weight and has localized areas of fat collection which are resistant to diet and exercise.
Studies have shown liposuction can remove as much as 85% of fat cells, which means out of every 100 fat cells, 15 remain in the body. Liposuction, therefore, is not a substitute for continued diet and exercise. With weight gain, the remaining fat cells will become enlarged, off-setting the final result.
The most common areas for liposuction are the neck, male breast (gynecomastia), abdomen, flanks (love handles), inner and outer thighs, and inner knees.
Currently, newer procedures are being marketed as an alternative to liposuction. These include mesotherapy and laser-assisted liposuction (Smart Lipo). These techniques have not been proven as safe, effective or reproducible as traditional liposuction. I have provided the links from American Society of Plastic Surgery regarding these procedures. Please click for link to mesotherapy and to Smart Lipo. Since these techniques currently are not endorsed, I do not perform them.
I have attached before and after photos to illustrate the effectiveness of this procedure.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon and member of American Society of Plastic Surgeons. His office is centrally located in Orange County, in the city of Santa Ana.
To schedule a complimentary consultation, please call 714-834-0101.
Posted in Liposuction | 1 Comment »
December 8th, 2008 Michael A. Jazayeri M.D.
Breast Augmentation is the most common aesthetic surgical procedure performed in the United States, with over 300,000 surgeries annually.
The goal of breast augmentation is to enhance the size of the breast and mainly provide fullness to the upper portion of the breast.
Currently, there are two types of implant available: saline and silicone. For a detailed discussion about these implants, please click here.
The implant can be placed above or below the pectoralis muscle (by flexing the muscle one can make the breasts move up and down), and many factors will determine which approach is better. Generally, I prefer to place the implant under the muscle because of more protection, less palpability, and less interference with mammography in the future.
For breast augmentation, majority of plastic surgeons perform the surgery either through an incision around the areola or underneath the breast crease. The advantage of the inframmamary fold incision (at the breast crease), is that the scar is not visible unless the patient is lying down. Also, the dissection causes minimal injury to the breast tissue when the implant is placed under the muscle. The final result is independent of the type of incision used, and is dependent on the surgical skill of the surgeon.
My goals is to recommend an implant which is proportional to the patient’s body, and make the implant look, feel, and behave as naturally as possible.
If the patient has loose skin in the lower portion of the breast and the nipple position is low relative to the center of the breast, a breast lift (mastopexy) is then required. This breast ptosis (sagging of breast tissue) becomes even more critical to correct with an augmentation. Remember, for the best result, the nipple must be positioned at the center (the highest point of the implant); otherwise the breast shape will look unnatural. Therefore, it is imperative to correct any ptosis present.
I perform three types of mastopexy, and each is chosen to give the best result for an individual patient.
The first is a peri-areolar mastopexy (donut lift). In this procedure, a circle of skin is removed around the areola and the skin in closed in a circle. This results in the incision being around the areola.
The second type is a vertical mastopexy. Not only is a donut lift performed, but some skin is removed in a vertical fashion from the breast as well. The final incision looks like a lollipop. There is an incision around the areola, and an incision going down from the areola towards the base of the breast.
The most aggressive lift is used for patients who have a lot of loose skin and the nipple is at the lowest portion of the breast. The incision is a vertical mastopexy with the addition of an incision underneath the base of the breast. This type of mastopexy is also called an anchor lift, since the final incision looks like an anchor. In all cases, the size of the areola can be reduced, if needed.
My goal is to obtain the best result with the minimum amount of scarring. Patients are always afraid of the final shape of the scars. Fortunately, unsightly scars are rare. I have performed hundreds of breast augmentation and lift procedures, and the risk of noticeable scar formation is less than 1% in my experience.
For better visualization, I have attached a link to our web-site which explains these procedures through 3-D animation. Please click here.
I have attached before and after photos to illustrate the effectiveness of these procedures.
Dr. Jazayeri is a board certified plastic surgeon with over 10 years of experience. To schedule a complimentary consultation at our Santa Ana office, please call 714-834-0101.
Posted in Breast Augmentation, Breast Lift | 4 Comments »
December 2nd, 2008 Michael A. Jazayeri M.D.
Rhinoplasty (nose surgery) is one of the most challenging, yet satisfying procedures in plastic surgery.
Improving the shape of the nose has a dramatic and positive effect on the face. Yet, nasal surgery is not as simple as it seems. Many patients think that just “shave the hump and make my tip a little smaller” is easy to do.
In fact, rhinoplasty requires patience and attention to the smallest detail. Remember, the nose is a small anatomical structure to begin with, so even a few tenths of an inch taken too much or too little will have a great impact on the final result.
The nasal structures (both visible and not visible to the eye) are linked together like a chain. If one loosens or tightens the chain at some point, it will have an effect further down the link. For example, shaving the hump on the nose will almost always make the nose look wider from the front view. Therefore, the nasal bones will need to be narrowed to give a balanced look. However, if the inside of the nose is not addressed (patients frequently have crooked septum or enlarged structures inside the nose), then the patient’s breathing may become compromised. Therefore, it is crucial for your surgeon to examine and address these issues during your consultation and the procedure.
Choosing the right surgeon for your nasal surgery will ensure the highest chance of success. Rhinoplasty is a rewarding procedure. Many of my patients have morphed from shy and quiet to confident and out going. The other benefit of this procedure is its longetivity. Nose surgery is not affected dramatically by weight gain/loss or the aging process.
I have enclosed before and after photos to illustrate the effectiveness of this procedure.
Dr. Jazayeri is a board certified plastic surgeon and a member of American Society of Plastic Surgeons. He has more than ten years of experience in the specialty of Plastic Surgery. Dr. Jazayeri’s office is centrally located in Orange County, in the city of Santa Ana. To schedule a complimentary consultation, please contact 714-834-0101.
Posted in Face | 3 Comments »
December 2nd, 2008 Michael A. Jazayeri M.D.
Many patients are frustrated by the loose skin/stretch marks and protuberant (“beer belly”) appearance of their abdomen after pregnancy or significant weight loss.
One can exercise 24 hours a day, seven days a week, but the loose skin and the weak abdominal muscle will remain. Only plastic surgery can address these issues.
The abdominoplasty (tummy tuck) procedure involves separating the abdominal skin above the pubic hair line, all the way to the costal margin (the lowest ribs which you can feel). The skin around the umbilicus (belly button) is cut, so the umbilicus is attached to the abdominal wall. After elevating the skin, the abdominal muscles (six-pack muscles) are brought together by suturing the fascia (thick) layer on top of the muscles. This, in effect, gives the same result as when one sucks their stomach in. The patient is then placed in a semi-sitting position, and the excess skin is removed. A new hole is made for the umbilicus to come through. The new abdomen, therefore, will have little or no stretch marks and be flatter, due to improving the abdominal muscle weakness. Typically, two drains are placed under the skin to remove any leakage after the surgery. The drains are usually removed at 7-9 days. The addition of a pain pump catheter (a catheter which drips pain medication slowly over 3 days), has significantly lessened the pain patients experience after surgery. Patients may resume light exercise after 4 weeks, but it will take 2-3 months or longer before normal routine can be reached.
In addition to abdominoplasty, liposuction of the flanks (love handles) can be performed at the same time. This will improve the waist-line.
I have attached before and after photos to illustrate the effectiveness of this procedure.
Michael Jazayeri, M.D. is a board certified plastic surgeon with over ten years of experience. He is certified by the American Board of Plastic Surgery and is a member of American Society of Plastic Surgeons. To schedule a complimentary consultation with Dr. Jazayeri, please call 714-834-0101.
Posted in Tummy tuck | 4 Comments »
