Cosmetic Surgery Center, Dallas | Dr. Rai

Most often, ear surgery (otoplasty) is done either to flatten the ears more against the head, or to reduce large ears. Less often, the cartilage curves might be modified. The ears are fully grown by the time a child is about five years old and this is one of the few cosmetic procedures performed on children.

In the interests of protecting the child from ridicule at school, many parents have otoplasty done when their children are between five and fourteen years old. Adults can have it done at any age.

It is an outpatient procedure and for adults and teens uses local anesthesia with a mild sedative to help with anxiety. For young children general anesthesia may be used. If it is not a complex case, the surgery takes between two and three hours.

The Procedure

Typically Dr. Rai makes one incision at the back of the ear where it joins the head, to gain access to the cartilage. He will then trim the cartilage, removing just enough to enable the ears to lie flatter against the head. He may reshape the cartilage contours using permanent stitches to hold it in place. In some cases he does not remove any cartilage but just stitches it into a new shape. Finally he will wrap the head in a soft dressing.

A headband may be worn for about two weeks to hold the ears in place as they heal. The scar will be well-hidden behind the ear. Otoplasty is one of the most risk-free cosmetic surgeries.

If you would like to bring your child for a consultation with Dr. Rai, please call or email our office. We will schedule a time for you to have him examine your child and answer your questions.

Japanese Geisha girls traditionally cared well for their facial skin, and now a spa in New York is offering Geisha Facials using an unusual recipe. Apparently in eighteenth century Japan, Geisha girls and actresses who wore heavy white makeup used a cream containing nightingale droppings to remove it and clean their faces.

These droppings have been found to contain a useful enzyme. At the New York spa, nightingale droppings were hand-collected and then sterilized with ultraviolet rays. When they were completely dry they were ground into a powder and mixed with rice bran powder and water to make a paste.

In a 50-minute procedure, the paste is applied to the face and the face covered with a warm towel. After the paste is removed, the skin is noticeably brightened and retexturized. It has a luster to it, as all the pores have been thoroughly and gently cleaned. It feels soft and youthful.

Chemical Peels

At our Cosmetic Surgical Center we can offer skin improvement using a chemical peel. You can choose a mild peel or a deep peel, meaning that different peels penetrate the skin to different depths.

If you choose a mild peel, no anesthetic is needed. The surface skin layer will peel off, taking the surface defects with it, such as superficial discoloration and minor blemishes. New skin cells replace the lost skin, freshening the facial appearance. Best results are obtained after a series of three to six peels.

A Phenol peel does require anesthetic and penetrates deeply enough to cause "injury" in the dermis, the second skin layer. It has the effect of realigning the fibers of elastin and collagen which form a support matrix for the skin.

In young skin, the matrix is strong, giving the skin a smooth surface. As we age, the body produces less collagen and the matrix weakens. This is a contributing cause to wrinkle formation, as the skin subsides into the matrix gaps.

As your skin heals itself after the Phenol peel, it produces new collagen, strengthening the matrix and rejuvenating the skin’s appearance. The healing takes several weeks and results are dramatic

Please contact our office if you’d like to know more about how to keep your skin young-looking.

One of the professional associations that Dr. Rai belongs to is the American Society of Plastic Surgeons (ASPS). The ASPS Annual Meeting will be between October 31 and Nov 5 this year, in Chicago, and the attendance estimate is 6,000 doctors. ASPS membership is about 6,700.

Plastic surgery of the future will be highlighted. There will be reports on research results, demonstrations of new technology, and ideas on new procedures.

• Reports on how facial injuries sustained by our soldiers in Iraq have been repaired, and how these techniques can be used for assault or accident victims
• How fat injections can enhance breast reconstruction
• Facial re-animation procedures to restore a lost ability to smile
• Ideas on body contouring after massive weight loss
• How stem cells (adult, not embryonic) can improve fat transfer
• New ways of performing a facelift
• New non-surgical uses for lasers

Over 360 companies will have booths to display and teach about new products such as new breast implants, new injectable fillers, body contouring technologies, and new skin care products.

The ASPS was founded in 1931 and now includes over 90 percent of all board-certified plastic surgeons in the U.S. It is the largest plastic surgery organization worldwide and holds its members to high ethical and professional standards. It offers continuing education for its members, including online education, special events, programs for doing volunteer work throughout the world, many publications, a job opportunity board, and much more.

Cosmetic surgery is plastic surgery done for cosmetic reasons rather than for reconstruction or medical reasons.

For the best in cosmetic surgery, both invasive and non-invasive, please call or email our office. We will be happy to set up a personal consultation for you.

Although the economy is supposed to be slumping and bringing cosmetic surgeons down with it, there are a lot of news items about cosmetic surgery continuing to surge and prosper. One new procedure has been drawing many potential patients: another type of cosmetic "lift".

Cosmetic "lifts" have always been popular, as the force of gravity and aging continue to cause unattractive drooping. You can have a:

• Face Lift,
• Thigh Lift,
• Arm Lift, or
• Buttock Lift,

and now you can have the bra-line back lift. This is a procedure to smooth out the rolls of fat that develop on the back and make it hard to look good in swimsuits or close-fitting clothes. The incision is made beneath the bra line, so the resulting scar will be well-hidden.

Back rolls cannot be corrected with exercise. You can be a superbly fit aerobics instructor and still get back rolls and bulges. Lower back lifts have been performed for some years now, and the ASPS reports that in 2007 about 19,500 such procedures were performed. But this new procedure focuses on the mid-to-upper back.

The American Society of Plastic Surgeons (ASPS) issues a medical journal and in last October’s issue there was a report of a small study done on the bra-line back lift. Researchers followed seven patients for 22 months who had this procedure done between 2001 and 2007. Recovery took two weeks and brought few complications. All seven patients were very pleased with their results. The study concluded that a bra-line back lift is safe and an excellent way to restore lost contours to the middle and upper back areas.

If you would like to schedule a personal consultation with Dr. Rai, please call or email our office.

A French plastic surgeon, one Michel Maure, was arrested in Spain after he breached his bail conditions in France. An international manhunt found him in Catalonia. He was awaiting sentencing for having performed several dozen surgeries, including breast augmentation and liposuction which left the patients badly scarred and with complications.

Not Trained in Plastic Surgery

His specialist training was in anesthesiology, not in surgery, but French law had a loophole which he used to get away with doing cosmetic surgery. France has closed that loophole. Despite his training in administering anesthesia, many of his patients reported that they had feel agonizing pain during their surgeries, because of having insufficient anesthesia.

Maure was arrested in 2004 and at that time, assured the police that he was "one of the great aesthetic surgeons of the world". He claimed that jealous rivals were victimizing him, and that the plaintiffs in the lawsuit against him were just women who had refused to pay for their surgeries.

The French court where he was tried found him guilty of mutilating and endangering the lives of over 90 women, and required that he pay a large fine and compensate each of his ex-patients with amounts not yet agreed upon. He will now be extradited to France for his sentencing.

Choose Your Surgeon Carefully

This news item points up the importance of choosing your cosmetic surgeon wisely. Maure attracted patients by charging very low fees and offering easy payment schedules. When you choose your cosmetic surgeon, it's more important to check into the background and education, and to make sure that they are board-certified.

Also find out what professional associations the surgeon belongs to, as these organizations have strict standards for their members. They also keep a surgeon in touch with his peers, and with the latest and improved methods and technologies.

Dr. Rai is Chief of Plastic Surgery at Medical City Dallas Hospital, and on the staff of three other hospitals. He is certified by the American Board of Plastic Surgery. Please see the Testimonials page for comments made by some of his ex-patients. You will be in safe and competent hands with him, no matter which particular cosmetic surgery you would like to have.

In the July/August issue of the Aesthetic Surgery Journal, published by the ASAPS, there is a report about a study of obesity and surgical outcomes. Researchers followed 129 patients who had a body contouring procedure between 1993 and 2002.

The patients were grouped according to their Body Mass Index (BMI):

• Ideal weight -- BMI less than 25
• Overweight -- BMI 25 to 30
• Obese -- BMI 31 to 35
• Morbidly obese -- BMI 36 to 40
• Severely morbidly obese -- BMI 41 and up

Surgical complications were recorded as being either:

• Minor -- such as post-op wound infection and pockets of fluid or blood at the wound site (seromas and hematomas respectively)
• Major -- such as problems requiring hospital re-admission, prolonged hospital stays, problems requiring follow-up procedures, and death

Results Not Surprising

Researchers found a statistically significant connection between increased BMI and increased complications (that is, poorer outcomes).

• Minor complications increased from 3.3 percent in the ideal weight group to 46.9 percent in the severely morbidly obese group
• Major complications increased from 6.6 percent to 43.7 percent in those groups

No surgical procedure is a good option for everybody. There is always a screening process done by each cosmetic surgeon to filter out poor candidates. It would seem from these results that a person's BMI is a clear parameter to use in that screening.

Obese people tend to have many secondary conditions -- that is, health problems arising from their obesity. Common examples are high blood pressure, diabetes, heart disease, poor healing ability, and sleep apnea (which itself gives rise to secondary conditions because of the reduced oxygen taken into the body).

Two conclusions would seem obvious:

• Surgeons need to be strict in their candidate screening, despite the pressure of so many people wanting cosmetic surgery
• More such research would be a good idea, to establish stronger medical evidence. This would help surgeons with patient screening and yield better outcomes overall

Dr. Rai has over 20 years of cosmetic surgery experience and places a high priority on thorough patient screening. You can read more here about his credentials, professional memberships, and work with the media and his community. You will be in safe and highly competent hands with Dr. Rai.

The American Society for Dermatologic Surgery (ASDS) did a recent study and found that demand for non-invasive cosmetic procedures is increasing. This is despite what many journalists have described as a weakening or slumping economy, making predictions that cosmetic surgery will slide downhill along with the economy.

The study examined 562 ASDS members, asking questions about their patient volume and which procedures are less or more popular. Almost 63% of the members reported a consistent volume of cosmetic patients compared to what they had six months ago. About one-third of the members reported having nearly a third more cosmetic patients than six months ago.

A New Sub-Set of Patients

The ASDS president, Dr. Darrell Rigel, stated that a new group of patients has been contacting the ASDS members -- those who have recently lost their jobs. These people are regarding cosmetic procedures as an investment in their future careers. According to Rigel, they are saying:

"I'm back on the job market again, and I've got to look good."

They are asking for procedures such as BotoxR injections, injectable fillers like RestylaneR, SculptraTM and RadiesseR, and chemical peels. Non-invasive procedures cost less than surgical procedures such as a full facelift, which might run to $10,000 or more, depending on exactly how it is done and what it includes.

But for a more youthful facial appearance and a fresher, more alert look, these non-invasive procedures are very effective. Botox and fillers must be repeated after a few months, at differing intervals depending on which filler you had. But for an unemployed person who expects to have a new job shortly, that would not necessarily be important. Chemical peels do not need regular repeating unless you neglect your skin or expose it to too much sunlight.

To learn more about the various ways of rejuvenating the face, please contact us for a personal consultation.

Since cosmetic surgery has become known and affordable for the general public, television producers have sniffed drama and higher ratings in this "appearance medicine". A rash of makeover-type shows have resulted, not only in the U.S., but also in the U.K, Australia, and New Zealand.

Research Done in New Zealand

Recently, some studies were done by the University of Auckland Department of Psychological Medicine to discover what sort of influence the TV programs were having on people who opted to have cosmetic surgery.

One study showed that of each five patients who went for their first cosmetic surgery, four stated that they were influenced by "reality" TV. It also showed a similar dynamic working with cosmetic dentistry and "smile makeovers". Other studies showed that numbers of people having cosmetic surgery, especially for weight reduction, is rising in the U.K., U.S., and Australia.

How TV Misleads

However, Professor Keith Petrie, speaking for himself and his co-authors, stated that TV programs are misleading. They:

• Focus only on people who achieve the most dramatic results
• Have a short duration which gives the false impression that cosmetic surgery produces fast appearance improvements with virtually no healing time
• Barely mention complications or failed procedures, making it seem that they don't exist
• Photograph their participants in flattering light conditions, having used personal trainers, hair stylists and makeup artists

One result of all this is that the TV participants themselves often suffer a lot of stress, trying to meet filming schedules, maintain their weight loss, and appear perhaps more delighted than they feel. Another result is that viewers get a falsely happy-go-lucky impression of the cosmetic surgery experience and take that with them to a cosmetic surgeon in their area.

Professor Petrie recommends that ethical safeguards be put in place for these misleading programs, and that there be more research done on their effects for all involved.

Not Everyone is a Good Cosmetic Surgery Candidate

All reputable cosmetic surgeons will take time with a new patient to listen to what that person wants done, and why. Having realistic expectations is part of being a good candidate for cosmetic surgery.

At the Cosmetic Surgical Center, Dr. Rai will always explain your options to make sure that you understand the pros and cons of each one, and that you have only the best and most appropriate surgical work done. Everyone on our staff believes that a good education makes for the best type of patient and we will answer your questions clearly. Please email or call if you would like a personal consultation.