Cosmetic Surgery Center, Dallas | Dr. Rai

On November 25, 2008 this space discussed the early history of breast augmentation and ended where doctors were experimenting in the 1950s with ivory balls, wool, and ox cartilage. Part 2 will bring things up to date.

Silicone Gel

In 1961, two Houston surgeons developed the first silicone gel implants, marketed by Dow Corning. They used silicone rubber shells and over the next thirty years, made successively improved models with thicker gel and thinner shells.

Saline Implants

Meanwhile a French doctor developed inflatable saline implants in 1965, also with a silicone rubber shell. But too often the shell broke, deflating the implants, and in any case people thought that silicone gel felt more natural than liquid-filled implants.

Fourteen Years of FDA Restriction

In the 1980s, implants were given a polyurethane foam coating in hopes that this would prevent capsular contracture. About 1990 it was found that this foam could break down in the body, forming a carcinogen, and this type of implant was abandoned.

But the media had a field day with some women who claimed that silicone itself could cause cancer and autoimmune diseases such as lupus and rheumatoid arthritis. In 1992 the FDA was pressured by this negative coverage into declaring a moratorium and restricting silicone gel implants to reconstructive use only. Cosmetic augmentation was done only with saline implants. A class action lawsuit brought by lawyers for 170,000 women bankrupted Dow Corning by requiring that company to pay $3.2 billion in compensation.

In 1999, the Institute of Medicine (the medical arm of the National Academy of Sciences) issued a 400-page report which concluded that silicone implants do not cause any major illnesses. At worst they might rupture and leak, causing infection and hardening of breast tissue.

In 2001, a new idea was tried that involved a bra-like device fitted over the breasts. Air was sucked out, creating a vacuum that was said to stimulate growth of breast tissue by about one cup size. A woman had to wear these for ten hours each day for several months. Another idea was developed in 2001 which had a better future: silicone cohesive gel implants.

FDA Re-Approval

In 2006 the FDA approved for cosmetic use the improved silicone gel implants made by two California corporations: Allergan Corp. and Mentor Corp. As of 2008, post-approval safety studies are ongoing. Many still feel that silicone implants look and feel more natural than saline implants, and these new silicone implants have become popular. Please see More on Silicone Gel Implants for further detail

At Cosmetic Surgical Center, we offer both saline and silicone implants and find them both to be effective and reliable. To learn more about breast augmentation issues, please call or email our cosmetic surgery office today and we will be glad to schedule a personal consultation for you.

The desire for larger breasts may appear currently to be a product of Hollywood mania, but the first attempts at breast augmentation were in the 1890s in Austria. Paraffin injections were performed and continued until about 1920. But infections became too frequent, along with the formation of hard lumps.

Fat Transplants

So in the 1920s and 1930s, fat transplants were tried instead. Fat was taken from the buttocks or abdomen and placed in the breasts, which at first seemed promising. But too often the body simply absorbed the fat and left asymmetrical lumps and calcifications. When these were removed an unsightly scar remained.

Liquid Silicone Injections

During World War II, Japanese prostitutes began having injections of liquid silicone to compete with each other for American servicemen. Since this was usually done with industrial-grade silicone instead of medical grade, and by people without any medical training, risks were high. Even so, it went on to become favored by California topless dancers in the early 1960s, with complications such as chronic inflammation, hard lumps and infections. In some cases this non-medical silicone migrated and caused organ damage in the body.

Plastic Sponges

In the 1950s, because of the clear riskiness of liquid silicone, doctors experimented with implants of sponges made of polyvinyl, nylon, polyurethane and Teflon. At first this approach had some success, but again, the implants hardened and also shrank. Removing them was difficult as the breast tissue grew into the sponge pores. Again, infection and inflammation were common and after a study linked polyvinyl to cancer in rats, this approach was abandoned.

Instead, experiments were done with glass, ivory balls, wool, ox cartilage, and gutta percha. Gutta percha is a latex made from the sap of a tropical tree of that name and is also used in dentistry to fill the root canals of severely decayed teeth.

Please watch this space for Part 2 of A Glance at Breast Augmentation History later this week. Meanwhile, if you would like to schedule a personal consultation with Dr. Rai, please contact our cosmetic surgery office today.

Has there ever been a time or a culture where women did not want to look their best? If so, historians, anthropologists and archaelogists have not yet found it. There have always been beauty aids in use, whether paint for the eyes, shells for the hair or hoops and beads for the ears.

But all the makeup, hairstyling and jewelry in the world cannot address problems which are structural in nature. Cosmetic surgery has become a worldwide, multi-billion dollar industry because it can do just that. It is not a new industry either.

Plastic surgery beginnings have been traced to ancient India, where the Ayurvedic surgeon Sushrutha around 500 B.C. described surgeries to rebuild the nose and ears. This was a valuable service at the time because amputation of the nose and ears was a punishment for traitors and unfaithful women. It was intended to stigmatise those offenders for life.

There must have been many of those offenders, or at least enough to stimulate surgeons to develop reconstructive procedures. Forehead and cheek skin was used and it was grafted to the nose and ear stubs to build a replacement structure. Luckily for us, surgical techniques have improved since then, anesthetics have been introduced, and the reason people want nose and ear reconstruction has changed.

Rhinoplasty

Rhinoplasty (a nose job) can be customized to address both cosmetic and breathing problems. It can use the Open method of two incisions or the Closed method of one incision, depending on what needs to be done. You can have the nose reduced in size, straightened, flattened, raised, upturned, or made narrower. Almost any size or shape issue can be addressed in this outpatient treatment, using only local anesthetic and a sedative.

Otoplasty

Otoplasty (ear surgery) can be done on children and often is, to save them having to endure endless teasing at school. The ears can be flattened against the head, reduced in size, or given missing creases or a new shape. This is an outpatient procedure like rhinoplasty and uses local anesthesia for adults, although for children a general anesthesia is more common.

To learn more about how your facial features can be cosmetically enhanced, please call or email our office for a personal consultation with Dr. Rai.

The cosmetic surgery wave seems to have flooded most of the world, including China with its 1.3 billion people. Competition for jobs is motivating more Chinese people to have cosmetic procedures done, most often eye and nose surgeries. About one million such people have procedures done each year and the cosmetic surgery industry is estimated at $2.4 billion annually and growing.

One Shi Sanba, a former opera singer and now 55 years old, went so far as to become a plastic surgeon herself. She has had upwards of fifty procedures done on herself, so many that she can no longer remember the number. Although she was pretty from childhood, she has had her eyelids folded, nose raised, skin smoothed out, belly flattened, breasts made firmer, and many other improvements.

Her Own Clinic

She now runs her own cosmetic surgery clinic in Beijing, employing about 80 nurses and doctors. According to a Reuters report, she explains her multiple surgeries this way:

"I have to continue to try different, new materials for plastic surgery so I can tell my clients first-hand information, such as how I feel when I have them inside my body."

Shi Sanba grew up poor under a Communist rule which disapproved of female beauty. But as China's standard of living has risen, more people are pushing for personal success and competing harder for the best jobs. Personal appearance can make a difference in this.

Shi Sanba practiced cosmetic surgery for about ten years before she opened her own clinic. It is one of thousands of such clinics throughout China but is well-known because of Shi Sanba's extensive advertising. One enters a white lobby filled with long mirrors, surgical posters, and post-surgery photos of previous clients. The clinic treats a continuous influx of women looking to improve their appearance for a competitive edge.

A Handsome Income

Shi Sanba's income has enabled her to buy a home in one of Beijing's fashionable areas and to send her son to school in the U.S. When compared to Michael Jackson in regard to her extensive cosmetic surgery, she responds:

"The key difference between me and Michael Jackson is that he violated the laws of nature, while I am following them."

One has to wonder how undergoing 50+ cosmetic surgeries is a way of following the laws of nature.

At Cosmetic Surgical Center Dr. Rai is careful about screening people for good candidacy. Some people do have multiple procedures and may have them all done at the same time. This reduces anesthesia and surgery time, makes for fewer incisions and requires less recovery time overall. Moderation is a wise policy, however.

If you would like to know more about certain procedures, and whether you would be a good candidate for them, please contact our Dallas, Texas cosmetic surgery office today.

A news report this week concerns a Korean woman aged 48 who for twenty years has been having cosmetic surgery procedures. She moved to Japan so she could have more but eventually surgeons drew the line and would not give her more.

At that point she returned to Korea where her family didn't recognize her, so much had her face been changed. Her parents saw that she was addicted to cosmetic surgery and took her to a doctor for addiction treatment. Whatever was tried did not last very long and she found a cosmetic surgeon who gave her silicone injections.

He went so far as to also give her a syringe and a supply of silicone so she could do her own injections. After her silicone supply was used up, she began to inject cooking oil into her face. This swelled her face up so large in comparison to her petite body that local children apparently came up with the nickname for her: "standing fan".

She was featured on Korean television and compassionate viewers sent donations in to pay for some face reduction procedures. She then had several such operations, the first of which released 60 grams of oil from her face and 200 grams from her neck.

Now her face is so disfigured and scarred that she is saying she would like her old face back.

How Not to Approach Cosmetic Surgery

This story illustrates dramatically the misuse of cosmetic surgery. When Dr. Rai first meets with a new patient, he makes an assessment as to their candidacy for the procedure(s) they are interested in. Part of being a good candidate is having realistic expectations. No cosmetic surgery, invasive or non-invasive, can make you into a different person. A certain amount of self-acceptance is part of being realistic.

Another element of good candidacy is understanding the risks of any given procedure. No reputable cosmetic surgeon should ever hand equipment over to an out-of-control patient and allow them to do self-treatments.

If you have an interest in any of the procedures we offer, such as facial fillers, treatment for a turkey neck, or breast augmentation and would like to know more about them, please contact our cosmetic surgery office to schedule a personal consultation.

As the field of cosmetic surgery has grown in popularity, it has correspondingly expanded in numbers of options. For rejuvenating the face there is an array of facelift types. There are also many injectable fillers which give quick but temporary rejuvenation and must be repeated periodically for long-lasting results. Then there is BOTOX, a very popular option worldwide for smoothing wrinkles.

But despite the many existing options, researchers continue to look for new and better and quicker ways to restore facial youthfulness.

What is a Stem Cell Facelift?

It refers to adult stem cells, not embryonic. There is no surgery, but instead, a person's own stem cells are taken from the lower abdomen and transplanted to the face.

The transplanted stem cells are contained in abdominal fatty tissue. When injected into facial areas, specific "stem cell growth factors" stimulate the local skin and fatty tissue and local stem cells to create more of their own cells. This has a plumping and rejuvenating effect on the face, smoothing out the skin, restoring youthful contours, and evening out the coloring.

Long-Term Results

Fat cells have been found to be a source of hormone-like substances which enhance skin quality. When activated by this stem cell facelift procedure, they produce long-term results. That is because it is your own skin which is rejuvenating itself, spurred on by the injected stem cells. In contrast, current injectable fillers give short-term results because they are gradually absorbed and excreted by the body's metabolism.

A stem cell facelift takes about an hour and is done with local anesthetic. Recovery takes about one week, as the slight swelling and pinkness subsides.

This procedure was first devised four years ago by one Vincent Giampapa, MD and presented in France in October, 2008. In the U.S. it was presented on November 2 at the American and International Academy of Aesthetic Medicine, in Miami, Florida.

Dr. Giampapa is an Assistant Clinical Professor at UMDNJ Medical Center in Newark, New Jersey and also directs his own plastic surgery center. He has a best-selling book on the market entitled The Gene Makeover: The 21^st Century Anti-Aging Breakthrough.

This procedure has not been tested and approved by the U.S. FDA and therefore is not legally available yet. It remains to be seen whether it is a safe and widely effective procedure.

Meanwhile, Dr. Rai offers a traditional facelift plus several injectable fillers and BOTOX. Other cosmetic surgeries also enhance the face: blepharoplasty for the eyelids, rhinoplasty for the nose, chin implants, etc.

If you would like to schedule a personal consultation, please contact our office today.

Wind and cold are harsh for the skin and we're facing several months of it coming up. If you already have some skin dryness, or even if you don't, it will help keep your skin in better shape if you take some winter precautions.

The following tips are basic and easy to implement, and will help counteract winter's aging effects. Facial skin is especially sensitive, being exposed to the elements while the hands are gloved, neck is wrapped, and the entire body covered.

Tips for Winter Skin Care

• Use a good moisturizer daily, at least once. The face can be moisturized morning and night and the hands any time. If your skin is extra sensitive choose a moisturizer with no lanolin. In general, a cream moisturizer is more effective than a lotion.
• When cleansing the skin, be gentle and try not to remove the natural moisture. Rather than scrubbing or using any type of standard soap, use a specially-formulated facial cleanser which does not dry the skin. The torso, arms and legs do not need to be soaped every day, but can be just rinsed some days.
• Use warm water rather than hot water, even though in winter a hot bath or shower is gratifying. The hot water will dry the skin out further. After bathing or showering, just pat the skin dry rather than rubbing. Many people use a mineral oil or petroleum jelly type of moisturizer to seal in moisture.
• Use a humidifier, or more than one. You could even just simmer water on the stove although that may mist up the windows. The skin repairs itself as we sleep so night is a good time to turn on a humidifier.
• Use a lip balm when outdoors, especially if it is windy. Use one with a sunscreen.
• You may want to jog or run according to your exercise routines, but be aware that severe cold can cause skin problems, and even frostbite. A mineral oil moisturizer on the face could help.
• Continue using your sunscreen through the winter, with a protection factor of at least 15. Shorter exposure times still add up and cause sun damage, even in winter.

No extra time or energy is needed for implementing these tips. A few daily habits are all that is needed, and you can protect your skin from winter withering and stress.

Please contact our office if you would like to learn more about skin rejuvenation. We offer a variety of facial fillers which are quick and simple ways to restore some lost youthfulness.

In many people's mind, good cheek bones are "to die for". They are a staple of contemporary beauty standards and although beauty ideals change over the years, good cheekbones are also a useful friend in fighting off the appearance of aging.

Strong cheekbones help to maintain the "Y" shape, or triangular shape, that is thought to exemplify a beautiful female face: width in the upper area tapering to the chin area. With aging, the cheeks tend to slip so that the triangle becomes more of a square. The cheek pads slide below the bones and those nasolabial folds form between the nose and corners of the mouth. This can be particularly aging in a face born without strong cheek bones.

What are Cheek Implants?

They are either solid or semi-solid implants that come in an array of sizes and shapes. They are made of silicone, the same substance that is used in silicone gel breast implants, and which was researched so thoroughly for safety between 1992 and 2006.

The Procedure

Cheek implants can be done along with other procedures such as a facelift or eyelid surgery. When that happens, they may be inserted through an incision that is already made. If done alone, they are inserted through incisions either inside the top lip or below the lower eyelid. Dr. Rai places them in a specially-made pocket and anchors them either on or a little below the cheekbones.

Stitches will dissolve by themselves within about ten days. The procedure takes only 30 to 45 minutes and is an outpatient one with local anesthetic and a sedative. During recovery chewing will have to be kept at a minimum for about ten days. Talking and smiling will also be difficult. You might want to stock up on liquid or very soft foods like yogurt for that early recovery period. Total recovery time runs up to six weeks.

One important point about cheek implants is that it is a reversible procedure. You could have them exchanged later on for implants of a different size or shape.

To learn more about cheek implants and whether they might be a good option for you, please contact our office for a personal consultation.