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Cosmetic Surgery

Robert Kotler, MD, FACS, is here to share the secrets of a Beverly Hills cosmetic surgeon. He has tips and information about aging well, skin care, facelifts, rhinoplasty and more.

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WebMD Health News

Friday, July 27, 2007

Why Do Some Celebrities Look So Bad After Cosmetic Surgery?
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That's a question often asked by prospective patients. The common assumption is that money, power, and access should automatically guarantee garnering top cosmetic surgery talent. Not always.

I see three reasons why some celebrities look so bad after cosmetic surgery. Bad luck is not one of them.
  1. Bad decision making. Celebrities - like the rest of us - are not immune from making bad purchasing decisions. They are not anointed with special wisdom because of their fame. They may not do enough research to sort out the most talented practitioners for their particular needs. Or they rely on a manager or adviser to conduct the search. Off the screen, away from the studio, they own no magic, no divining rod to lead them to the right offices. They need to do their homework; just like you.

  2. Not knowing when to stop. When you see obvious and overdone cosmetic surgery on a celebrity, it usually announces that they did not know when to stop.

    For example, Meg Ryan's over-puffed, trout-like lips were a neon-sign for an obvious over-extreme makeover. The Michael Jackson nose became the poster subject for ridiculously overdone cosmetic surgery. Victoria Beckham's breasts could only be described as "bolt-ons", not original equipment. Courtney Love's admitted two nose jobs might well be one too many. Former Olympian Bruce Jenner's multiple procedures rendered his face nearly unrecognizable. Kenny Rogers' overdone eye and brow surgery changed not only his appearance but his image.

    They kept going beyond reason. Perhaps the celebs were unwisely shooting for perfection, for immortality. But they are on a hopeless chase. Regardless of who one is - famous or otherwise - the same rules of life govern us all.

  3. A cosmetic surgeon who falls into the celebrity trap. He, too, drops common sense. He forgets that mantra his mentors hammered into his memory bank: "The pursuit of perfection is the ultimate enemy of good." Overdoing is always worse than underdoing. It is easier to add on later, but almost impossible to "put back that which you took off." But why does an ordinarily objective and wise doctor temporarily discard the sound advice his teachers gave him? Because, he, too, has a chance to be a celebrity, however vicarious. An opportunity to bask in that special glow we Americans are so good at fostering is often too hard to pass up.

Media personalities are attractive, smart and charming; that is how they reached their level of success and fame. They can be very manipulative, very convincing in their arguments. Isn't that their craft? That is why, it is hard to say "no" to the lady or gentleman sitting in front of you whose face may be recognized by billions of people. And, perhaps subconsciously, the doctor wants to say yes, wants to satisfy this important person, to ingratiate himself, to join the club, to be part of that special world. It can be heady stuff.

Consulting with famous people is very difficult. I have been there many times. The doctor must harness his best instincts, his purest motives, his strongest common sense to do the right thing for every patient regardless of status. Not for himself, his ego, his office's "wall of fame" photo display, or his bank account.

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Posted by: Robert Kotler, MD, FACS at 7/27/2007 06:35:00 PM

Friday, July 6, 2007

Cosmetic Surgery or Plastic Surgery: What's the Difference?
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In my experience, I have found that most people - including MDs - use the terms plastic surgery and cosmetic surgery interchangeably. They do not mean the same thing; they are not synonyms.

Plastic surgery describes any surgery, on any part of the body that changes form and/or function. The root word, plas, from Greek, means "to form or to shape." And, by the way, contrary to common opinion, plastic surgery does not infer that "plastic" parts are automatically used. Plastic surgery was performed thousands of years before man invented "plastic."

Plastic surgery is a two-component specialty: reconstructive surgery and cosmetic surgery. Reconstructive surgery seeks to restore appearance and function to a pre-injury or pre-tumor state. You are already familiar with the more common reconstructive procedures: skin grafting for burns; covering bed sores with natural tissue; correcting congenital deformities, such as cleft lip and palate; management of burns, repairing auto injuries; limb transplantation; cancer removal and tissue reconstruction.

Reconstructive plastic surgery has been performed for hundreds of years; some rudimentary repair procedures were done thousands of years ago during the time of Hippocrates (460-370 B.C.).

Cosmetic surgery is a much more limited branch of plastic surgery. Cosmetic procedures aim to surpass nature by improving our natural appearance or by reversing the signs of aging. Facelifting, breast augmentation, wrinkle removal, and nasal cosmetic surgery are among the procedures performed daily that either make us look better and/or younger.

The first documented cosmetic surgical procedures upon the face, for example, were performed late in the nineteenth century. But most of the long strides in cosmetic surgery have occurred only in the last 40 years.

Now you understand that all cosmetic surgery is plastic surgery, but not all plastic surgery is cosmetic. Knowing that, you are wiser than 95% of the population.

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Posted by: Robert Kotler, MD, FACS at 7/06/2007 02:15:00 PM

Thursday, July 5, 2007

Before and After: Computer Imaging
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"Doctor, how would I look after cosmetic surgery?"

That's the question that every consultation needs to address. I believe that a consultation without computer imaging has limited value. You need to see, on a computer screen, what you will look like "after."

During your consultation's computer imaging session, a standard video camera captures two identical photos of your face or body and freezes them onto a computer screen. Then using special morphing software, the screen on the right will show the predicted results. The "before" and the "after" side-by-side.

While it cannot predict final result with 100% accuracy, computer imaging is unquestionably the best technique available today to help you clearly understand what the doctor can -- or cannot -- do for you. Once you are clear on the procedure suggested, or combination of procedures, computer imaging is a must. That computer screen becomes your personal crystal ball and will graphically demonstrate what you can expect.

You deserve to utilize this latest technology, allowing you to visualize the surgeon's proposal. Computer imaging is a fantastic communication tool that affords a "meeting of the minds." A consultation without it is incomplete. After all, you need to get a sense of the doctor's art form and what he believes he can deliver for you. If you are uncomfortable with what is demonstrated, then perhaps that is a sign that this particular doctor does not have the talent to achieve what you desire. If, on the other hand, the doctor presents a reasonable rendition of what he thinks he can achieve and you are uncomfortable with it, it may also indicate that perhaps you are a bit unrealistic about what can be accomplished.

I advise patients to spend the time in the doctor's office looking at the visual "possibilities" of their cosmetic surgery. By the time you leave the consultation, you should be comfortable that you have clearly communicated your desire to the doctor and he, in turn, has indicated that he understands those desires and has graphically demonstrated the result that he intends to deliver for you.

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Posted by: Robert Kotler, MD, FACS at 7/05/2007 02:00:00 PM

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