On this blog, Dr. Gregory T. Fisher, MD, FACS, provides useful intormation to his patients. Please contact us with your inquiries. You may also make an appointment by calling Dr.Fisher's office at 562-865-9600.
Pursuant to our internal research conducted from January 1, 2010 to January 1, 2011, out of 512 patients who chose to answer our questionnaire, over 400 came upon their friends’ recommendations. All the respondents looked up our website prior to visiting us. 170 came for a major procedure, 186 for a minor surgery. Almost one half of the patients stated that they prefered complete anesthesia, while the other half did not have any preference in this regard. More than 360 patients have stated that they will “definitely recommend” Dr.Fisher’s services to their friends. The rest simply stated that they would recommend us, without qualifications. All the patients regarded our staff as professional and kind, in all cases (that is 100 per-cent !) answering the patients’ questions; but at the same time gave more weight to the doctor’s attitude and experience. 92% of the respondents stated that being able to trust Dr.Fisher was the most important reason for their coming to us, sometimes repeatedly, for advice and help. 85% stated that they did not find anyone within 25 miles with equal experience and skill. 63% of responding patients came to us because we had “very competitive prices.” Of course no-one would want to associate the adjective “cheap” with anything that they might receive in/on/for the benefit of their body. The body is just as important as the mind, and no-one wants to be “cheap” when their body/mind is concerned. Thus, we purposefully and intentionally completely omitted this word from our questionnaire.
In today’s hurried world, you should find some time for yourself and make yourself happy. One of the most obvious choices can be by improving your visage. An experienced, skilled plastic surgeon, such as Dr.Fisher, can take 15-20 years off your face overnight, as if it were the doing of a swift magic wand, not a gentle hand of a mere mortal.
Patients are often surprised how plastic surgery can improve their face – eradicate wrinkles, spots, lines… all those unpleasant signs of aging; and since the outer self molds the inner self equally well as it is often the case the other way round, plastic surgery can add to your mental composure and well being.
Out there, we sometimes see people who did not exercise their choice of a plastic surgeon wisely, and consequently ended up with an equally profound obverse effect: their skin is pulled too tight, unnaturally, ungracefully, or they may even have physical deformities and problems. That is what happens when you do not use your best judgment with respect to your inner satisfaction, but your best judgment with regard to economic concerns. Our advice? If you cannot afford to invest into your well-being and happiness, cannot save a few bucks here, a few bucks there… forget it! Do not give yourself pains. Do not go for the second best – because that might cause just as poor a result as the last – you never know – especially when you have the best one waiting for you.
Dr.Fisher will personally explain to you where the Hollywood starlets – or even erstwhile starlets who, now in their 40s, 50s and 60s, have undergone artful cosmetic procedures to maintain the image of youth – defaulted. Surgery is art – much more than a little nip-and-tuck here and there!
Why, you can see yourself when a facelift goes wrong how even people’s characters alter… Such unfortunate patients will never extol any plastic surgeon. Therefore, ask for the best, look at satisfaction.
During an interview at the 2009 meeting of the American Society of Plastic Surgeons, Dr.Fisher explained the most common pitfalls of facial plastic surgery, and shared some little-known trade secrets for avoiding them.
“During the typical facelift operation, the patient’s ears are subjected to a lot of tension, which causes some drooping of the ear canal,” Dr.Fisher noted. “As the surgeon adjusts the patient’s facial skin and muscle during the face lift, the altered ear drops down, producing extra skin to deal with and dispose of. Patching the patient back up from this usually means producing the ‘pulled’ look. Signs of surgery are conspicuous, as well. If they have a lot more skin to remove, the incision is longer,” he adds emphatically, “and if it’s longer, it is visible.” Shaking his head, Dr.Fisher continues: “We have to do two things: The ear is little higher and there’s more volume. We still do the muscle work, but is there less or more skin? There’s less. And if there’s less skin, the incision is shorter and can be hidden inside the ear.”
Dr.Fisher’s result? A perfectly natural facelift, which will not alter your natural characteristics, will emphasize the beauty of your face, and whose surgical evidence is well concealed. Again: look in the mirror. You deserve better. Why not the best?!
“Can the scars from previous my operation be eliminated by a new surgery?” (Fiona B., Montebello)
Perhaps surprisingly, yes. Scars in the abdominal area (and this also applies to stretch marks) can be entirely eliminated by a skilled surgeon. I have done hundreds, if not thousands of operations where the substantial reason the patient expressed for the surgery was that she, in many cases he, wanted to improve the results of a previous surgery.
Usually, the main objective is to be economical while remaining efficient and equally esthetic. This means finding a fair proportion between maximum gain and maximum loss, so to speak. If there is still excess or mal-distributed fat in the area or perhaps lax or over-hanging skin, the main objective is to eradicate those. This objective must be viewed in proportion to the overall bodytype and size of the patient. Sometimes, even a master surgeon, such as myself, finds it almost impossible to remove entirely evidence of an improperly performed surgical procedure.
The tummy tuck operation itself may also be done in such a way as to remove scars or stretch marks. However, the higher the position of the scar, the more difficult it is to deal with it. It is also generally known that scars heal worse in smokers, not to mention people who use drugs. Scars interfere with the blood supply to the skin in general and sometimes may severely complicate a subsequent or reparative tummy tuck. There is no rule of thumb on this issue here.
Every reparative operation is a compromise of esthetic and pragmatic nature. A personal consultation is absolutely necessary. Unfortunately, many people look at cost of the surgery rather than the skills of the surgeon. In most cases, saving $500 or $1,000 in the short run, will cost you ten times that much in the long run. It is sad but – true.
In the 1980s, Replicon implants were the most popular. Replicon is an anatomically shaped, polyurethane coated, silicone gel-filled implant. Many surgeons felt that the initial results were very beautiful, but short-lived, because the polyurethane, which was bonded to the surface of the shell helped to maintain the anatomic shape of the implant, eventually deteriorated, and once it was absorbed off of the shell, the remaining thin and pliable shell could not hold the silicone gel in place, and so its shape was lost. Further, gravity forced the gel to the bottom of the shell, collapsing the upper breast, and expanding the lower breast. Folds developed in the collapsed upper pole. The shell was very thin, and with time, the shell weakened along those folds, and eventually could break, allowing the relatively liquid-like contents of the implant to leak outside of the shell. In addition to the effects of gravity, the forces of the breast acted upon the implant, deforming its initial anatomical shape. The implant accommodated to the shape of the breast, rather than the breast taking on the shape of the implant.
Dr.Fisher was directly involved in a long and tedious process – far beyond the scope of this article, or this site, to describe in detail – which involved experimentation with diverse silicone gel fillers. Silicone can be made in virtually any firmness, from a liquid lubricant to almost a rock-hard solid. The aim was achieved in making the filler more stable and avoiding collapse of the shell. Further, the modern cohesive shell can be formed into a particular shape and maintain it.
In the past, shape was of only moderate importance, because the forces of the body and of gravity would shape the implant. However, the modern cohesive filler allows for various ratios of width, height, and projection.
The FDA moratorium on silicone gel filled breast implants in 1992 also contributed to increase in competitiveness and invention in this area. The type of implants that were available before the ban are available today as part of an “adjunct study,” which is open to patients with congenital deformities or having a revision for particular reasons.
What distinguishes the modern cohesive implants is that the silicone gel is firmer, essentially a soft solid. If a cohesive implant is cut in half, there is no gross movement of gel, and the implant maintains its shape. The way these are made is that the company uses more “crosslinker” in the making of the implant. The ingredients are the same, but with more crosslinker added, it makes the gel firmer.
Cohesive breast implants implies form stability, or form retention. That means that in any position, the implant maintains its shape. That is an important distinction, because it means that the shell should not fold, and that it will maintain a particular shape. All breast implants are “cohesive” to a different extent. More cohesive are not necessarily better. The bottom line here is the desirability of shape and firmness, which must be in proportion to the body’s natural qualities.