Tuesday, July 30, 2013


Plastic Surgery

It is a frightening trend, and a fact that more plastic surgery procedures are being performed by doctors that may not be qualified.
I could even perform brain surgery in my office if a patient was foolish enough to agree to it, but I would not do so because I'm not properly trained to do it." Said Dr. Braun H. Graham of Sarasota Plastic Surgery Center in Sarasota.
"As long as you're a doctor you can perform any procedure that you want to do in the confines of your office." Said Dr. Scott J. Engel, also of Sarasota Plastic Surgery Center. Dr. Graham Added, "It's legal in the State of Florida to perform surgery in your office if the patient is willing to submit themselves to the procedure."
This information came too late for Julie Rubenzer, who died in 2003 following a breast augmentation performed in Sarasota
"The problem we have here in town is we have untrained people in the operating room helping the doctor" Said Dr. James W. Marsh, of James W. Marsh M.D.P.A., Plastic and Reconstructive Surgery, "And, they weren't trained well enough to take care of the problem when the problem came up."
More recently 44 year-old Christine Patterson of Sarasota is charged with practicing medicine without a license, accused of performing a post-operative procedure on a patient after a cosmetic surgery.
So what should you know to protect yourself?
"Make sure that it says the American Board of Plastic Surgery, "Said Dr. Engel, "and that they see that symbol, if that's not on there then they need to question whether or not that person is adequately trained to do these procedures."
Check that your surgeon is affiliated with a hospital. it could make a difference between life and death.
Dr. Engel said, "Hospital have the highest standards of any practice and so they need to make sure that you are qualified to do these procedures" and, Dr. Marsh added, "And they're going to require you to have training to pass boards and to be monitored before you start working in their hospital."
If your procedure is performed at a private center, make sure that its accredited. AHCA is one of the certifications you can look for. But, here's one of the top things you need to know.
"The biggest red flag would probably be saying that they are board certified but not saying what they're board certified in." Said Dr. Engel.
So, when choosing a plastic surgeon do your research and don't be scared to ask questions.


After the birth of a child, it takes several months for your body to return to its pre-pregnancy form. During pregnancy, the body makes hormones and changes to allow for the birth and growth of the new child. Not only does the abdomen have to stretch to accommodate the growing child, but breasts engorge to help provide milk for the baby. Once these changes are no longer necessary, the skin will contract to varying degrees in an effort to return the body to its pre-pregnancy state.
Following pregnancy, despite regular diet and exercise, some women may find that they have excess skin in the lower abdomen, and others may find that they have breasts that have lost volume and "sag," even after returning to their pre-baby weight. A mommy makeover describes the surgical procedures done to correct these changes and may include an abdominoplasty (also known as a "tummy tuck"), liposuction, and either a breast lift, breast reduction or breast augmentation.
These surgeries are body contouring procedures, not weight loss procedures. To ensure that you have a long-lasting result, you should be at your goal weight for at least six months and have stopped breast-feeding for 6 months. It's important to have stopped breast-feeding because your breasts need to return to their normal size and shape and stop producing milk. Additionally, I advise patients to have completed childbearing before proceeding with a "mommy makeover." You can have a successful pregnancy after a "mommy makeover," but you may require more procedures if you have more children or large weight fluctuations after your initial surgeries.


UM medical school creates plastic surgery professorship with $2.5 million gift

Face transplant doctor to be invested later this year

July 23, 2013|By Andrea K. Walker
A Swiss businessman has given the The University of Maryland School of Medicine $2.5 million to create a professorship in plastic and reconstructive surgery with the first awarded to the doctor who recently performed a groundbreaking face transplant.
Dr. Eduardo D. Rodriguez will be invested at a ceremony later this year. He led a team last year in a 36-hour face transplant that included replacement of both jaws, teeth, tongue, skin and underlying nerve and muscle tissue from the scalp to the neck.


FRIDAY, July 26 (HealthDay News) -- About half of patients take herbal and other supplements before undergoing cosmetic facial plastic surgery, according to a new study.
Many of these supplements can put patients at risk during surgery and they should stop taking them at least two weeks before their procedure, Dr. Bahman Guyuron and colleagues at Case Western Reserve University advised.

The investigators examined the medication lists of 200 patients scheduled for cosmetic facial plastic surgery -- such as a facelift or nose job -- and found that 49 percent of the patients were taking at least one type of supplement.
Overall, the patients were taking 53 different types of supplements. The average number of supplements was nearly three per patient, but one patient was taking 28 different supplements, according to the study in the July issue of the journal Plastic and Reconstructive Surgery.
Older patients and women were most likely to be taking supplements, according to a journal news release.
One-quarter of the patients were taking vitamin and mineral supplements only, most commonly multivitamins, vitamin D, calcium and vitamin B. Twenty-two percent were taking animal- and plant-based supplements -- most often fish oil -- in addition to vitamins and minerals. Just 2.5 percent of patients were taking animal- and plant-based supplements only.
Thirty-five patients were taking supplements linked with an increased risk of bleeding, such as bilberry, bromelain, fish oil, flaxseed oil, garlic, methylsulfonylmethane (MSM), selenium and vitamin E.
In addition to the supplements linked to bleeding risk, other popular supplements with potential harmful effects include echinacea, ephedra (ma huang), ginkgo, ginseng, kava, St. John's wort, valerian, feverfew and ginger.
The patients in the study were told to stop taking supplements two to three weeks before surgery.
"These high-risk supplements . . . are quite commonly used and the surgeon must elicit a complete history in order to avoid the known adverse consequences of supplement use on surgical outcome," the researchers wrote.


Three women are facing charges, accused of practicing medicine without a license. Investigators say they were injecting people with toxic chemicals.
Investigators say this isn't the first time that one of the women at a clinic in west Harris County has faced charges. Prosecutors confirm there is a lengthy criminal history involving this particular clinic, and charges pending against it. In this latest allegation, in court documents a patient testified that she was lied to and severely injured. Maria Teran is not a medical doctor, but a patient who saw her at a west Houston office says Teran told her she was one. "She went there thinking Maria Teran is a doctor," said Harris County prosecutor Justin Keiter. "She is anything but." The incident happened at Teran's "Le Femme's Clinic" on June 27, when Harris County prosecutors say Teran, assisted by her two daughters, Victoria and Camille Urgiles, who are also charged with felonies, injected Argiform -- a Russian-made gel filler that is not FDA approved -- into the woman's buttocks and her genital area. The patient was charged $4,000 and said she immediately suffered extreme pain and was seen by another doctor who said the substance was toxic. Keiter said, "She had several problems in her buttocks. She had them inject her there. The results in the pictures speak for themselves." Maria Teran has a long history in Harris County. In 2011, she was charged with delivery of a dangerous substance twice -- once for Botox and a second time, for Amoxicillin, an antibiotic. She was also charged with practicing medicine without a license.In April, she was charged again with practicing medicine without a license. Now she has these two latest charges. She was still out on bond for the previous charges.   Attorney Chip Lewis represents Teran and her daughters, and says the allegations are untrue.  "We have reams and reams of interviews of patients who have said that she made it very clear that she and her daughters, when they administered Botox or the like, were doing so under the direction of a doctor," Lewis said. Because of the previous charges against them, Maria Teran and one of her daughters, Victoria Urgiles, are being held without bond. Their next court appearance will be Thursday. Teran's other daughter Camille Urgiles is out on a $100,000 bond.

Sunday, July 21, 2013


                               Bad Augmentation and Liposuction

Addictions to distorted body image aren’t only seen in Hollywood. They are seen among our friends and family. Beauty is a huge industry, and women suffer from the loss of perceived beauty as they age. There are limited mentors in magazines or on television who allow themselves to age naturally. This continues the illusion that aging is unacceptable or a problem that needs to be fixed rather than allowing the changes and appreciating beauty at all ages. The problem with having a distorted body image and using cosmetic surgery to repair the perceived flaw is that it will never be enough. When your view is distorted you continue to find other areas of your body that need tweaking, tucking and cut away. A face pulled tight by surgery is not attractive; it’s unnatural and gives a waxy appearance that isn’t human. The objective viewer notices the alien look, but to the person with the tight skin face the focus quickly shifts to other areas that are slack and need tightening. It’s scary when adults have this addiction, but when our teenagers and younger children begin saying they need cosmetic changes to be happy with their looks, it becomes a tragedy.
What causes this addiction to begin with? It’s complicated. People who want to change dissatisfaction with their body or face seek cosmetic surgery, and instead of being satisfied with the new look they begin focusing on their expectations not being met, and this leads them to identifying another imperfection. Once the cycle of addiction begins it is vicious and continues through numerous surgeries, a loss of income, and many times severe depression.
There are many reasons people seek plastic surgery, and identifying your reasons can help you decide if this is something you need for your self-esteem, or if your self-esteem is based more on distorted emotional issues that counseling may be more effective handling.
  1. Plastic surgery works well for those with an average to healthy self-esteem, know exactly what they want, and have many other interests in their life besides their looks.
  2. If you have a low self-esteem and you think cosmetic surgery will give you more confidence and make you happier and content, this may be a red flag. Happiness is an inside job, and external factors don’t bring happiness. You may feel content after the surgery, but if you believe surgery will change your life and make your dreams come true, you are probably going to be disappointed.
  3. The people most likely to become addicted lack self-worth. They feel content immediately after the surgery, but that is followed with emptiness and dissatisfaction. They seek out another surgery as a way to feel better. Those affected by a low self-worth believe that enhancing their body by way of surgery will make them happier with jobs, success, love, sex, and a younger appearance. Denial with the addiction helps to keep this illusion in place. The media furthers the denial by sending messages that beauty and youth are linked to competitiveness, success, love, sex and happiness.
People that are addicted, no matter what the addiction, suffer from a constant doubting of themselves. They are constantly in need of being reassured that they are good enough. They don’t have the ability to see their own potential, so they look to others for approval. Society has helped enable the importance of our appearance. You see normal human imperfections powdered, photo-shopped and airbrushed no matter where you look. However, our childhood also influences our addictions. A child who doesn’t grow up feeling that their emotional needs were met suffers low self-esteem. When the inside is broken, no plastic surgeon can make you a new one. Counseling is the only way you can re-parent yourself and build a healthy self-esteem.  Plastic surgery is a wonderful option. However, if you are expecting it to make you happy, heal a broken relationship or give you a renewed self-esteem, think again!!!!Mary Jo Rapini


HOUSTON—Two local women wanted to save money on plastic surgery, so they went to Mexico.
However, their trip cost them more than they could have imagined.
“Hi, my name is Mimi Valdez, and this is my first time to the Jerusalem Hospital. I’m very excited,” one of the women said in a YouTube video shot in Tijuana, Mexico.
Valdez was excited, because she could not wait to reshape her body after losing 130 pounds.
“You’re tired. It’s heavy, it’s loose skin and it’s just hard to live like that,” Valdez said.
Valdez and her niece, Chrissy said they chose Hospital Jerusalem in Tijuana, because doctors there promised the work would be done for $5,000. They thought they had found the perfect place.
“Your happiness is right around the corner,” a man said in a video on the hospital’s website.
But the Houston women said nothing could have been further from the truth. They sent KHOU 11 News some graphic photos to help prove their point.
“Immediately after the bandages were removed, and I took a look in the mirror at my breasts, I had skin hanging out of the incisions,” Chrissy said.
Chrissy, who that her last name not be revealed, had lost 150 pounds. The mommy makeover she wanted so badly was a disaster. Valdez also complained saying her tummy tuck left her disfigured.
Two weeks after their surgeries, both women were having major medical problems.
“When I went to the hospital, they said we don’t know if we can save her,” Valdez said.
KHOU 11 News tried calling Hospital Jerusalem for a response.
“We can’t acknowledge if a patient was in the hospital. We decline based on the Patient Privacy Act,” Ivan Arafat, spokesman for Jerusalem Hospital, said in a statement released to KHOU 11 News.
The women said the clinic, located in a strip center, did not look like the hospital on the website. They said surgeries were being performed 24 hours a day.
“I was already there. I knew I wasn’t going to get my money back and I made a very, very wrong decision to go through with it. And I should have listened to my intuition but I didn’t,” Valdez said, when asked why she went through with the procedure after noticing the red flags.
Valdez and Chrissy are by no means alone. A group called Patients Beyond Borders estimates that last year anywhere from 200,000 to more than a million people traveled to Mexico to have procedures done.
Patients Beyond Borders said people should look for a clinic’s seal which will prove whether or not the facility has met strict international medical standards.
Foreign doctors are fighting more than ever to get patients from the United States by offering medical procedures at a lower price.
“General speaking the surgeon who is providing a deeply discounted fee is not the surgeon who is well qualified,” Dr. Christopher Patronella, president of the Houston Plastic Surgery Association, said.
Valdez and Chrissy did a lot of research before risking their lives in Mexico. Now they say the clinic won’t even acknowledge they were patients.
“Many times I said ‘Why did I do this?’ I should have saved enough money and had it done with a doctor in Texas” Valdez said.
The women have no legal recourse. They just want to tell their story, and perhaps save a life.

Saturday, July 6, 2013


Despite all the political and social problems we face in this country, it is still an honor and privilege to be a citizen of the U.S.A.  We should all remember the sacrifices of the 56 gentleman who signed the Declaration of Independence.  They indeed dedicated their "Lives, Fortune, and Sacred Honor" in the birth of this country.


  • In 2011, fireworks caused an estimated 17,800 reported fires, including 1,200 structure fires, 400 vehicle fires, and 16,300 outside and other fires.
  • These fires resulted in an estimated 40 civilian injuries and $32 million in direct property damage, with no reported fire deaths.
  • Sparklers, fountains and novelties alone accounted for 34 percent of the emergency room fireworks injuries in 2011

    BALTIMORE (AP) - In the 15 years between a shotgun blast that ravaged the bottom half of Richard Norris' face and the face transplant that ended a hermit-like life for him, the man from rural southwest Virginia faced cruelty from strangers, fought addiction and contemplated suicide.

    In this AP photo taken June 25, 2013 Richard Norris ties a fishing fly at his home in Hillsville, Va. The man whose face was disfigured by a gunshot spent 15 years as a recluse, but now the 37-year-old is doing things he never would have before.

    But even if he could go back in time, he's not sure he would erase the accident that left him severely disfigured. "Those 10 years of hell I lived through, it has given me such a wealth of knowledge," Norris recently told The Associated Press, one of only two news outlets granted interviews since his transplant last year. "It's unreal. It has put some of the best people in my life."
    Now, at 38, he's starting a new life: taking online classes in pursuit of a degree in information systems and contemplating a foundation to help defray future transplant patients' everyday expenses during treatment. He also has been working with a photojournalist who just completed a book about his journey, titled "The Two Faces of Richard." He hopes his story sends a message of hope to people in similar situations and encourages empathy in others. "I've heard all kinds of remarks," he said. "A lot of them were really horrible." After the 1997 accident at his home, Norris had no teeth, no nose and only part of his tongue. He was still able to taste but could not smell. When he went out in public, usually at night, he hid behind a hat and mask. Norris had dozens of surgeries to repair his face, but eventually reached the limits of what conventional surgery could do for him, said Dr. Eduardo Rodriguez, who performed some of those operations and later led the surgical team that performed Norris' face transplant. Some parts of the anatomy, such as eyelids and lips, are just too complex to recreate, he noted. "You can create a semblance of something, but I can guarantee you it's not normal by any means." Just weeks after Norris was told by another doctor that there was little else that could be done for him, Rodriguez presented him with another option: a transplant. The doctor, who is head of plastic surgery at the University of Maryland Medical Center's R Adams Cowley Shock Trauma Center, had been following advancements in the face transplant field for years. An Office of Naval Research grant for the purpose of helping wounded warriors made it possible for him and his team to attempt their first face transplant, an operation that previously had been performed by only two other centers in the United States. The world's first partial face transplant was performed in France in 2005 on a woman who was mauled by her dog. Of the 27 other transplants that have followed, four recipients have died, and the survivors face a lifetime of immunosuppressant drugs, which can take a toll on their health. Unlike most organ transplant recipients, who need their surgeries to live, face transplant patients are risking death to eliminate a non-life-threatening condition, noted Dr. Mark Ehrenreich, the psychiatric consultant to Norris' transplant team. Rodriguez says patients are well aware of the situation. "If you talk to these patients, they will tell you it is worth the risk," he said.
    The team carefully lays out all of the dangers for patients: Norris' mother, Sandra, remembers Rodriguez saying there was a 50-50 chance her son would survive the surgery. "We looked at Richard and we told him we loved him the way he was and it didn't matter to us, but it was his life," she said. "That was what he wanted to do and we supported him." Norris said he is humbled by the gift he received from the family of 21-year-old Joshua Aversano, who died after being struck by a minivan while crossing the street. The Maryland family, which agreed to donate his organs, declined to be interviewed by the AP. In a statement, the family said, "We are grateful Joshua's legacy continues through the lives of the individuals he was able to save with gifts of organ and tissue donation."Norris said he speaks to the family regularly and keeps them updated on his life and health.
    Norris' 36-hour transplant operation is still considered the most extensive ever conducted because it included transplantation of the teeth, upper and lower jaw, a portion of the tongue and all of the tissue from the scalp to the base of the neck, Rodriguez said. "The real main limitation ... is that patients are dependent on medication for life," he said. The immunosuppressant medications carry risks for the patients, who don't know how long the transplant will last. Rodriguez said if all goes well, a transplanted face could last 20 to 30 years. For Norris, who makes daily visual checks, the risk of rejection is never far from his mind. "Every day I wake up with that fear: Is this the day? The day I'm going to go into a state of rejection that is going to be so bad that the doctors can't change it?"
    But he said he can't let himself worry about it too much, and he knows that he's in good hands.
    Norris has come far in the past 15 months, learning how to eat and talk again and adjusting each time his face gains more feeling. He continues with therapy, travels to Baltimore from his home in Hillsville, Va., regularly to see doctors, and still takes pain and immunosuppressant medications. He says his faith in God has carried him through it all; that he has maintained a sense of humor and remained the same person inside. And he agrees with doctors, who dismiss a commonly held belief that face transplant patients are likely to experience an identity crisis. "When I look in the mirror, I see Richard Norris," he said remembering the immediate connection he felt with his new face.
    The bigger issue for Norris is being able to appear in public again. Facial disfigurement tends not to engender sympathy, leaving patients feeling shunned, Ehrenreich noted.  "Unfortunately, with severe facial disfigurement, people recoil and make comments they would never make to someone in a wheelchair," he said. The transplant marks "such a significant improvement, that they're welcome to be in public." Since his surgery, Norris says the gawking has disappeared. "When I was disfigured, just walking the sidewalk, I was surprised that more people didn't walk into telephone poles or break their necks to stare at me," he said. "Now ... there's no one paying attention. Unless they know me personally, they don't know I am a face transplant patient. That right there is the goal we had."