Tickle Lipo?

Smart Lipo, Slim Lipo, Cool Lipo, now Tickle Lipo?

Tickle Lipo is the name of one of the newest forms of liposuction. According to the company, it involves Nutational Infrasonic Liposuction, an FDA approved technique that utilizes low frequency infrasonic vibrations to aid in allowing both easier removal of fat and less motion/work for the surgeon. The company also claims "reduced risk, less trauma, bruising, and swelling, greater comfort, and faster recovery." Is this true? Will Tickle Lipo make all the other types of liposuction obsolete?

I have never used this machine, but it sounds somewhat similar to PAL (power assisted liposuction). PAL utilizes a vibrating cannula that allows a plastic surgeon to remove fat easier, faster, and with overall less effort. It'll be interesting to see how Tickle Lipo distinguishes itself from Power Assisted Lipo.

On Tickle Lipo's website, there is a local news segment with a doctor who combines Tickle Lipo with Smart Lipo to achieve a large amount of fat removal with maximal skin tightening. Sounds all good and dandy, huh? Too bad he's an internal medicine specialist, and not a real plastic surgeon. I'd feel much better if there was a real, board-certified plastic surgeon on their website instead of an internist!

For Tickle Lipo's website, click here.

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Michigan-based Plastic Surgeon

Anthony Youn, M.D.

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Elf Ears - The Newest Plastic Surgery Trend?

I read an interesting article today introducing one of the newest trends in plastic surgery: Creating Elf Ears. There is a Hungarian plastic surgeon practicing in New York City who created this procedure and even claims that it can "improve the experience of listening to music." Apparently there are "music faun clubs" which are dance clubs that only allow entrance to those with pointy ears.

This is a new one for me! By looking at the photos I can see how the procedure is done. It's a variation of the types of surgeries we do to reconstruct an ear after part of it is removed for cancer. Instead of making your ear look normal, however, it makes you look like Spock.

I'd rather my daughter get a tramp stamp than one of these!

Story and photo source

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Michigan-based Plastic Surgeon

Anthony Youn, M.D.

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The Thong Lift?

There is an interesting article in the Daily Mail today announcing:

Bottoms up! The facelift is old hat, the tummy tuck's yesterday's news - the latest craze is the bum lift!

The article goes on to describe the Thong Lift, the name given by a Miami plastic surgeon for fat grafting to the buttocks (a.k.a. Brazilian Butt Lift). Here's more:

The difference between this is and other sorts of fat augmentation is that the surgeon injects fat between layers of muscle, so there is more blood supply to the fat and less of it dies.
The scars left by the incisions needed to inject the fat are hidden, says Mendieta, ‘in the grand canyon where the thong goes’, hence the name of the procedure.

"Grand Canyon?" That's a strange term to use!

I perform fat grafting to the buttocks, but am always concerned about being too aggressive with grafting it into the actual muscles, which have large blood vessels and nerves. This would make me more concerned about a major bleeding episode. The surgeon is definitely well-known for his gluteal work, however, and probably does a few more of these than I do.

Click here for the article.

Thanks for reading.

Michigan-based Plastic Surgeon

Anthony Youn, M.D.

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Facial Filler Foul Ups Article on MSNBC.com

There is an alarming and interesting article on MSNBC.com regarding the growing incidence of complications with facial filler injections. Facial fillers (like Restylane, Juvederm, and Sculptra) are now the second most common plastic surgery procedure in the country. It's inevitable that as these procedures grow in popularity, the number of people having complications will also increase.

While this article is alarming, it's important for consumers to realize that the most popular injectables (hyaluronic acids like Restylane, Perlane, Juvederm, and Prevelle) have a near-antidote called Hyaluronidase if too much is injected. That's one big reason I prefer these injectables over Radiesse or Artefil. Even so, if you are considering having facial fillers injected, make sure you have it performed in the office of a board-certified plastic surgeon or dermatologist.

For the MSNBC.com article, click here.

Thanks for reading.

Michigan-based Plastic Surgeon

Anthony Youn, M.D.

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Want to Heidi Yourself?

Want to see what you would look like after undergoing Heidi Montag's ten plastic surgeries? A Miami plastic surgeon has posted a website which allows you to do just that. It's called Heidi Yourself, and the page looks like a combination of an advertisement for The Hills and for his iPhone plastic surgery app. Check it out here.

Photo source

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Michigan-based Plastic Surgeon

Anthony Youn, M.D.

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E! To Debut New Bridal Plastic Surgery Series "Bridalplasty"

E! has ordered episodes of a new program that mixes a wedding competition with extreme plastic surgery. Bridalplasty combines elements of a game show competition, dream wedding, and plastic surgery documentary. Read about it in the Hollywood Reporter:

Each week, a group of women competes head-to-head in such challenges as writing wedding vows and planning honeymoons. The winner receives the chance to choose a plastic surgery procedure from her "wish list." She's given the procedure immediately, and results are shown at the start of the following week's episode. One by one, the women are voted out by their competitors and, according to the show's description, "possibly walking away with nothing and losing [their] chance to be the perfect bride." The last bride standing will receive a "dream wedding," where she will reveal her new appearance to friends, family and the groom. "Viewers will witness his emotional and possibly shocked reaction as they stand at the altar and he lifts her veil to see her for the first time following her extreme plastic surgery," E! said.

The plastic surgeon from the Swan will be performing all the procedures, and the host of the show is Shanna Moakler.

No, I have nothing to do with this program, but I have heard from a few Hollywood producers that there are a few plastic surgery-related programs currently in the works. This one sounds quite similar to the Swan, which aired several years ago for one full season. I bet there will be a lot of people watching, especially since these brides have got to be absolutely crazy to be featured in a program like this!

Thanks for reading.

Michigan-based Plastic Surgeon

Anthony Youn, M.D.

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Politician Raffles Off a Breast Augmentation to Raise Money!

No, this politician is not in the United States. Gustavo Rojas, who is campaigning to be an alternate in Venezuela's General Assembly is raffling off a boob job at $6 a ticket as a fundraising tool. He claims it's no different than raffling off a TV set.

The American Society of Plastic Surgeons (ASPS) would disagree. This society (which I am a proud member of) has ruled that offering plastic surgery services as part of a promotion or raffle is unethical, since it trivializes the serious nature of plastic surgery and may influence people to undergo surgery they may not want or be a good candidate for. I can see the rationale behind this ethical rule, but don't necessarily agree with it.

That being said, there are radio stations which have raffled off free breast augmentations as their "Breast Christmas Ever" promotions using questionable non-ASPS surgeons. Is it really a "prize" to have one of these surgeons operate on you? Sounds more like a punishment to me!

Story source

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Michigan-based Plastic Surgeon

Anthony Youn, M.D.

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Dr. Frank Ryan Has Died

Celebrity plastic surgeon Dr. Frank Ryan died yesterday when his Jeep crashed off the Pacific Coast Highway near Los Angeles. Dr. Ryan is best known for being the plastic surgeon who performed Heidi Montag's 10 plastic surgeries in one day. He was a classic Hollywood plastic surgeon, with patients including Gene Simmons, Vince Neil, and many others. He was also very active in philanthropic pursuits, including the Dr. Frank Ryan Foundation.

I've never met Dr. Frank Ryan so cannot comment on his personality. I don't agree with the surgeries he performed on Heidi Montag, but I have always respected him as a fellow plastic surgeon. He was a man who, I'm sure, touched many, many lives.

My condolences go to his family, friends, and staff.

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Michigan-based Plastic Surgeon
Anthony Youn, M.D.

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"Superbug" Coming From India on Cosmetic Surgery Patients?

There are alarming reports that a gene which causes bacteria to be resistant to nearly all antibiotics is being brought overseas on patients undergoing cosmetic surgery in India. I will have more on this tomorrow, but here is an article from the Examiner addressing this scary finding:

http://www.examiner.com/plastic-surgery-in-chicago/plastic-surgery-brings-a-super-bug-to-united-states

Cartoon source

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Michigan-based Plastic Surgeon

Anthony Youn, M.D.

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Suspects Flee After Buttock Injections Result in Death

Two women are sought by the authorities after allegedly performing illegal silicone injections into the buttocks of a woman who subsequently died. Guadalupe Viveros and Alejandra Viveros are believed to have fled to Mexico after posting $20,000 bail. This story has achieved national headlines with CNN's Nancy Grace focusing on it this week. If you have info on these fugitives, click here.

These types of illegal injections are unfortunately more common than most people realize. It seems that many of these phony plastic surgeons come from other countries to prey on immigrants here in the States. On a recent trip to Boston's Chinatown, I was shocked at the number of Botox and other cosmetic surgery clinics located in dingy storefront windows next door to stinky fish markets. Not the place I would go for plastic surgery! Or food, for that matter...

Link: In Your Face Blog

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Michigan-based Plastic Surgeon

Anthony Youn, M.D.

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Botox in a Cream Form?

Can Botox be applied as a cream? Yes, if the company Revance Therapeutics has its way. They are currently testing a cream form of botulinum toxin to the crow's feet. I've heard that initial results are promising, although the product appears to be at least 2 years away from potential FDA approval. There are a lot of questions surrounding this product, such as: Should patients be allowed to take it home? What other applications are there? How long will it last?

Here are my thoughts:
1. I would be concerned with patients taking it home and mistakenly applying the cream to potentially harmful areas. What would happen if a patient applied it with his finger to his crow's feet and then accidentally rubbed his eyelid? Would he get a droopy eyelid? Maybe. What if someone ingested it?
2. I think a huge application of this topical botulinum toxin is in sweat reduction. Could you imagine an antiperspirant stick with this product that lasts several months with each application and leaves no residue? I'd buy it!
3. It's currently being tested on the crow's feet, which has thin skin. Would it work in the forehead where the skin is thicker?

This product could definitely be a 'game changer' if and when it comes out. There are a lot of places I'd consider applying it 'off-label' for myself...

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Michigan-based Plastic Surgeon
Anthony Youn, M.D.

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The Vampire Facelift?

Vampires and sucking blood have gone mainstream... even in plastic surgery. One of the newest procedures is called the Vampire Facelift. This is based off an FDA approved product called Selphyl, a kit which allows a plastic surgeon to draw a sample of a patient's blood, remove the platelets and fibrin from the blood, and reinject this Platelet-Rich Fibrin Matrix (PRFM) into the face. According to the company, the PRFM causes an increase in the thickness of collagen, filling in wrinkles and plumping up facial depressions. It's the newest type of facial filler, and the only one based entirely off a patient's own tissue. No foreign substances are injected into the face, unlike every other popular filler. Early reports give the Selphyl a longevity of 12 months or longer.

Unlike some of the other injectable fillers that have come and gone (Evolence, anyone?), Selphyl does bring something different to the table. Platelet-rich plasma is known to be filled with growth factors and even stem cells, and therefore it is theoretically possible that the Vampire Facelift can create new, younger skin, in addition to just filling in the wrinkles. While it may not make you immortal, it can make you look younger!

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Michigan-based Plastic Surgeon
Anthony Youn, M.D.

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Woman Almost Dies When Eye Doctor Performs Breast Augmentation

CBS Atlanta News is reporting that a woman almost bled to death during a breast augmentation performed by an opthalmologist (an eye doctor). According to their accounts, the woman was awake during the procedure and experienced her 'surgeon' calling 911 for help. Luckily, a real plastic surgeon was on staff at the ER and helped save her life. See the disturbing news report here.

I have documented in numerous posts the scary trend of immoral doctors masquerading as real plastic surgeons. Unfortunately, in most states there is no law against physicians performing whatever procedure they choose, whether they are properly trained to perform that procedure or not. Because hospitals will not allow these phony plastic surgeons to perform plastic surgery in their facilities, they bypass this by building OR's in their own offices. In fact, there is no law against me, a board-certified plastic surgeon, performing a cataract surgery on someone in my office, even though I have no training in it.

If you are considering plastic surgery, make sure your surgeon is certified by the American Board of Plastic Surgery. If he or she is not, then be very, very cautious. It's not enough for an eye doctor to have stayed at a Holiday Inn Express the night before your surgery.

To read a post about an alleged horrible laser liposuction result from an ER doc just down the street from me, click here.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.

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12 Ridiculous Plastic Surgeries?

The Daily Beast and the OC Register have interesting articles on 12 Crazy Plastic Surgeries. Are these really crazy? Are people doing them? Do I do them? Here we go!

1. Creation of dimples - This is being done, just not be me or most plastic surgeons.

2. Chin cleft surgery - same as #1. Michael Jackson reportedly had this done.

3. Abdominal etching (liposuctioning fat to make it look like a six-pack) - This is being done by a handful of surgeons. My concern is, will that six-pack turn into a party ball in 15 years?

4. Eyebrow and eyelash transplants - unusual procedure. The only doctor I know of who does this is my friend Dr. Alan Bauman in Florida.

5. Toe shortening - Is this really necessary? Only if someone has a foot fetish, I guess.

6. Cankle liposuction - I will rarely perform this procedure. It has a higher complication rate compared to liposuction of other areas, but can really help those with severe cankles.

7. Toddler teeth whitening - Anyone who does this to their kid should be visited by social services... or at least by Supernanny.

8. Collagen feet fillers - This is being done, especially before Red Carpet appearances, although Restylane is now the injection of choice. I spoke about it on the CBS Early Show. See a clip of it here.

9. Pubic hair transplants - Seriously?? Yuck!

10. Belly button surgery - Otherwise known as umbilical hernia repair. I do this all the time during tummy tucks. I turn an 'outie' into an 'innie.'

11. Iris implants - Sounds pretty ridiculous. Only about 250 people have undergone this procedure worldwide, as a way of giving a different eye color. I prefer colored contacts over taking a knife to my eyeball!

12. Gummy bear breast implants - These are not crazy or ridiculous at all, as they are being widely used in other countries. These firm, form-stable implants are not FDA-approved yet, and my inside sources tell me that it may be a long, long time before we are using them routinely. Click here to see a segment of the CBS Early Show where I discuss them.

With any of these procedures, make sure you consult a surgeon certified by the American Board of Plastic Surgery and a member of the American Society for Aesthetic Plastic Surgery.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.

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Why Are Teens Getting 'Toxed?

There's an interesting article in MSNBC.com on the recent trend towards teenagers getting Botox. According to the American Society for Aesthetic Plastic Surgery (ASAPS), last year over 12,000 Botox or Dysport treatments were performed on people under the age of 18. One plastic surgeon quoted in the article claimed that 5-8% of his Botox patients are teenagers! What percentage of my Botox patients are 18 or under?

Zero!

I guess this would need to be taken on a case-by-case basis, but to date I've never seen a teenager whom I thought would benefit from Botox. The good thing is that Botox injections are temporary with relatively minor side effects or complications. I have no problem with other plastic surgeons performing the procedure. It's just that I choose not to do it. I feel much more strongly against certain surgeries in teens, however, like breast augmentation, which create permanent changes and have consequences that can last for life.

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Michigan-based Plastic Surgeon

Anthony Youn, M.D.

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Do Eye Creams Really Work?

The Beauty Brains Blog has an interesting post called "Do Eye Creams Really Work?" This blog looks at various cosmetics from a scientific and chemist's point of view. Check it out here.

Do I think eye creams work? Yes... to an extent. Here is how I describe the three major causes (and treatments) of dark undereye circles:

1. Cause: thinning of the undereye skin, making it transparent and allowing the blood vessels underneath to be seen. Treatment: eye creams that thicken the skin, making it appear less transparent and smoother (such as Obagi's Elastiderm).
2. Cause: excess pigmentation (mainly seen in people with darker skin, not usually a concern in Caucasians). Treatment: creams with skin lightening agents.
3. Cause: shadowing from puffy bags under the eyes. Treatment: lower blepharoplasty surgery, which removes the fat that causes the puffiness and hence, the shadowing. Click here for before-and-after blepharoplasty photos.


Removing undereye wrinkles is not an easy task. Unfortunately, there is no 'magic bullet' even when surgery is involved that can make a wrinkled, droopy, puffy lower eyelid look perfect afterwards. If you are considering a lower eyelid blepharoplasty, make sure to avoid bargain-basement cosmetic surgeons, otherwise you may end up with an ectropion. Click here for the gruesome image of it (don't say I didn't warn you!).

Photo credit: beautybrains

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Michigan-based Plastic Surgeon
Anthony Youn, M.D.

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Zeltiq - Noninvasive Fat Loss - Too Good To Be True? No...

One of the hottest things in plastic surgery today, and what I consider the Holy Grail of plastic surgery, is Noninvasive Fat Loss. One of the latest to claim this is Zeltiq. This is a device which is FDA approved in the U.S. for other purposes, but many physicians are using it 'off-label' to remove fat without needles or surgery. How does it work?

Zeltiq chills the surface temperature of the skin, causing the fat below it to become irreversibly damaged. The body's natural clearing mechanisms then get rid of the fat over time, creating actual inch loss. According to an introductory study:

- Subjects were comfortable during the procedure and did not require pain medication.
- Cryolipolysis results in a visible contour change in a majority of subjects.
- 100% of a subset of ultrasound-evaluated subjects demonstrated a measurable reduction; the average for the group was 22.4% fat layer reduction 4 months post-procedure.
- Noticeable cosmetic efficacy was more consistently observed in properly selected subjects.
- 27 of 28 (96%) properly selected subjects (discrete fat bulges) had discernable efficacy.

Do I think this works?
Actually, yes. We've seen in certain types of reconstructive surgery (such as pressure sores) that the skin is much more resistant to damage than the underlying fat. Therefore, it makes sense that the chilling can destroy the fat but leave the skin viable. The before and after photos I've seen, however, have not been very impressive. 22.4% fat loss is pretty modest compared to what can be achieved with liposuction. For now, I consider it a modality with promise but limited effectiveness. It may be helpful for people who are not good candidates for liposuction.

For more on Zeltiq, click here for their website.

Thanks for reading.

Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

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"In Stitches" - Dr. Youn's Memoir Hitting Shelves in April 2011!

I'd like to announce that I've signed a contract with Gallery Books (A Division of Simon & Schuster) to write my medical school memoir, In Stitches. From Publisher's Weekly:

Kara Cesare at Gallery Books took world rights, at auction, to Dr. Anthony Youn's memoir, In Stitches. Youn, currently a world-renowned plastic surgeon, is writing with Alan Eisenstock and recounts his experiences growing up the sole Korean-American in a small Michigan town. Agent Wendy Sherman brokered the deal, and Gallery is planning a summer 2011 publication.

I'm really excited about my book coming out, as it's been over five years in the making. Thanks to Kara Cesare, Wendy Sherman, and Alan Eisenstock for making this dream come true. It's a funny, yet touching coming-of-age story of how a young Asian-American kid with big glasses and a huge jaw became a nationally-recognized plastic surgeon. (There's much more to the story, but this is all I can reveal right now)

You'll all be hearing more about this over the coming months!

Thanks for reading.


Michigan-based Plastic Surgeon


Anthony Youn, M.D.:

Some quick links

Here are links to a couple interesting articles about plastic surgery:

1. Are more and more men having plastic surgery as a way to keep competitive in the workplace? 'Fraid So! Click here for the article from Lan Nguyen at AOL Walletpop.

2. Has Botox Jumped the Shark? I don't think so! Click here for the article from Lan Nguyen at AOL Walletpop.
3. How Do You Get Your Body Red Carpet Ready? Check out a video of my recent appearance on the CBS Early Show by clicking here. If you look closely you may see me striking a rather strange pose right at the end. Now I know what NOT to do on TV!

Thanks for reading.
Michigan-based Plastic Surgeon

Anthony Youn, M.D.:

ASAPS Annual Meeting 2010

I just returned from the annual meeting for the American Society for Aesthetic Plastic Surgery in Washington, D.C. It was an excellent meeting, attended by a "who's who" in aesthetic plastic surgery. Some interesting topics covered in the first few days:
1. Biofilms as a cause of capsular contracture - the bane of my existence as a breast augmentation surgeon is capsular contracture, or excess scar tissue that can build up around a breast implant. This can make the breast look round, hard, and painful. One potential cause is biofilm, or a coating of bacteria that can cover an implant. Techniques to limit biofilms were addressed, including the interesting Keller Funnel. If there is any way to reduce the amount of capsular contracture, I'm all for it.
2. Acellular Dermal Matrices (ADM) in breast revision surgery - We are now using several different types of radiated skin (from cadavers, pigs, etc.) as a way to prevent breast implants from bottoming out, moving into the armpit, or creating a una-boob (symmastia). My good friend Dr. Brad Bengtson gave two great talks on using these ADM's for preventing capsular contracture.
3. Laser Liposuction - Does laser liposuction really tighten the skin? Depends on who you talk to. There really wasn't a consensus on whether it visibly tightens skin, but there was a consensus on the need for more scientific studies to see if it does.
4. Lipodissolve injections actually work? One study sponsored by ASAPS/ASERF appeared to show a visible decrease in the thickness of fat in people injected with substances typically used for lipodissolve. There were no major adverse events, although the changes were subtle and the treatments did entail dozens of injections over several weeks/months. Another study didn't show any significant changes in their patients. So the jury is still out on that one.
5. I did a small talk on the eMatrix for International Hot Topics in Plastic Surgery. This is one of the newest fractional skin treatments I demo'd on the Rachael Ray Show.

There were more great topics than I can cover in a blog post. The meeting is actually still going on! I left early because I missed my family and have surgery to do tomorrow. It's always nice to sleep in my own bed next to my beautiful wife!

Thanks to everyone on the ASAPS meeting planning team for putting on a great meeting.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.: