Saw this article today which was pretty remarkable- a ton of food for each American is amazing.  We are now seeing our Santa Barbara post-CoolSculpting patients back in the office and the before and after photos are remarkable.  It’s a great way to remove fat effectively without liposuction, without surgery, and with a significantly lower cost.  HAPPY NEW YEAR EVERYONE!!!

I just watched a plastic surgery segment on E! which was, again, very disappointing.  In discussion about plastic surgery trends with respect to breast implants, the show interviewed two plastic surgeons.  After hearing what they had to say, I looked them up on the internet, to find that while they are good looking and charismatic, they are not certified by the American Board of Plastic Surgery.  The next segment about revision face lifts interviewed another surgeon who was, thankfully Board certified.

As I am heading to Phoenix next week to give the oral examinations for the American Board of Plastic Surgeons, I am astonished that television shows such as E! don’t utilize plastic surgeons who have gone through the rigorous certification required for the American Board of Plastic Surgery.  Our job as examiners of the young plastic surgeon candidates to the American Board of Plastic Surgery is to make sure that they are practicing in a safe, responsible, and ethical manner.

Why would a television show or media outlet not go out of their way to find an expert that is certified by a medical Board created to ensure public safety and quality of care?  There are plenty of excellent, Board Certified plastic surgeons in Beverly Hills.  I would hope that the Hollywood crowd has the sense to seek them out, just as I hope that patients in Santa Barbara know to look for one of the plastic surgeons with that same qualification.  Dr. Mackenzie, Dr. Gross, Dr. Soares, Dr. Buchanan, Dr. Chapple, and myself are all certified by the American Board of Plastic Surgery.  It matters.

This recent USA Today article highlights several tragic but avoidable situations in which unqualified and dangerous physicians who were not boarded by the American Board of Plastic Surgery- and not properly trained in plastic surgery- caused the deaths of patients who were seduced by a sales pitch and a discount.

Particularly with liposuction, the overdose of patients with drugs used during this operation is avoidable and a major point of teaching during the vigorous residency training in plastic surgery.  Non-plastic surgeons who tout themselves as cosmetic surgeons can perform such operations without oversight in their non-accredited offices.  It is crucial that patients are aware to look for accreditation of both their plastic surgeon as well as their surgery centers.

Surgery centers such as ours are certified by the American Association for Accreditation of Ambulatory Surgery Facilities which provides rigorous standards.  Certification by the American Board of Plastic Surgery assures adequate training of your doctor.  Locally, Dr. Howard Gross, Dr. Douglas Mackenzie, Dr. Julio Soares, Dr. David Buchanan, and myself (Dr. Lowenstein) are all fully trained plastic surgeons certified by the American Board of Plastic Surgery and operate in highly standardized and certified Surgery Centers.  For liposuction, breast augmentation, abdominoplasty (tummy tucks), face lifts and all other types of plastic surgery, it is important to seek out the right surgeon and the right facility.

In the course of my discussions about creating the most natural appearing breast augmentations, I always review the reasoning that I use the dual plane technique with my patients.  A lot of information about breast implants can be found on the breast pages of my website, but I want to reiterate why this technique seems to give the best  and most natural breast contour.

The pectoralis muslce is a broad, flat muscle that extends from the proximal humerus, at the top of the arm near the shoulder, down to the breast bone and central rib cage.  Classically, breast implants have been placed either above or below this muscle.  Most often breast implants are currently placed under this pectoralis muscle because it tends to have a lower rate of complications.  This is called the sub-muscular position.  The disadvantage to putting the breast implant in this position is that the attachment of the pectoralis muscle to the rib cage and the breast tissue can tend to hold the implant in a relatively high position, giving the un-natural appearance of excess fullness, or a shelf, in the upper portion of the breast.

While some plastic surgeons will release the lower portions of the muscle in order to aid in preventing the breast implant from remaining high, the dual plane technique adds a further dissection releasing the lower portions of the breast from the muscle.  This allows the implant to fall into the relaxed breast tissue behind the nipple.  With the implant in this position, the apex of the breast implant lies where the best projection of the breast should be- at the region of the nipple.  The muscle remains to cover the upper portion of the breast implant, and creates a lovely transition from the breast apex to the upper chest wall.  The resulting tear drop form allows a very natural appearing breast augmentation, and a very happy patient.  Best of all, this dual plane technique retains a very low complication rate.

Feel free to come and have some further discussion on this breast augmentation technique, and be sure to review our photo gallery for some examples of woman who have had natural appearing breast augmentation with me in Santa Barbara.

Having just come across the show called Bridalplasty, I’m so thoroughly disgusted that I felt I had to write about it.  It seems that Dr. Terry Dubrow has involved himself in this television show in which women will compete for the opportunity to have a plastic surgery makeover.  I fully agree with the opinion of my friend, Dr. Mike McGuire, the former president of the American Society of Plastic Surgery.  In an article by ABC news, Dr. McGuire calls the show embarrassing to the field, and says the American Society of Plastic Surgery frowns upon taking a “well-recognized specialty down into this level of entertainment.”

As a plastic surgeon that takes my practice extraordinarily seriously, I find it very disappointing that any one of my “peers” would think it was in a patient’s best interest to encourage her to compete against others for a plastic surgery procedure.  I feel that this show devalues the doctor-patient relationship, and is at best marginal in its ethics.

As a consumer and prospective patient, I sincerely hope you do not associate my practice with this type of sensationalist “entertainment.”  My patients are carefully evaluated, thoroughly educated, and meticulously cared for in a manner that is in their best interest.  I will continue to do my best to provide patients with aesthetic and reconstructive surgical care that emphasizes the best in plastic surgery and leave the “entertainment” to those more interested in entertaining.

As some of you might have heard, one of Santa Barbara’s excellent plastic surgeons, Dr. Russell Stokes, recently relocated to North Carolina. Dr. Stokes is a well respected peer, and I’m sorry to have had him leave town. The North Carolina opportunity is an excellent one, and as an avid golfer, Dr. Stokes is sure to enjoy his new location in Pinehurst- a golf mecca. As Dr. Stokes had a substantial patient population that came from Bakersfield for plastic surgery, we will be happy to provide the same high level of plastic surgery care to Bakersfield patients. In fact, we have seen a gradual increase of patients coming to our practice from the Bakersfield area, and I have very much enjoyed taking care of these very pleasant patients.
The additional advantage that our practice has gained from Dr. Stokes move is that two of his staff have joined ours! As we have become so busy over the past months, we have needed to add two positions- an operating room technician and a patient coordinator.
Our new operating room technician is Nena Santoyo, and she is fantastic. She has extensive experience in plastic surgery from both Dr. Stokes’ operating room and additionally work at the Santa Barbara Surgery Center. Nena is bright and pleasant and we are very fortunate to have her on board. She is a joy to work with and makes my job in the operating room so much easier- she seems to know what I need without me even needing to ask for it.
Our other new addition is Nicole Roden, our new patient coordinator. Nicole worked with Dr. Stokes for several years and comes with rave reviews. In addition to being a quick learner with our advanced MAC based electronic medical record, she is a great “people person” and our patients love her. But there’s more… Nicole is also a registered nurse, and I’m pretty comfortable saying that our staff is now comprised of the most qualified personnel around- With our long time outstanding nurse Susanne, we now have two full time nurses available to help our plastic surgery patients, answer questions, and facilitate an extraordinarily safe, comfortable plastic surgery experience for all of our patients- from Santa Barbara, from Bakersfield, or from overseas!

Today we did two breast augmentations and a rhinoplasty at our surgery center. I’m very grateful for the outstanding team we’ve assembled here- everyone got a great operation and should be very pleased with their results. Our newest team member’ Nena Santoyo, is an extraordinary operating room technician who has come to work with us after many years of working with Dr. Russel Stokes, who has recently closed his practice. Nena brings a great energy and abundant plastic surgery experience to the operating room, and we are all very glad to have her on board. She seems to be arriving just in time, as our operating schedule is packed with multiple face lifts, rhinoplasties, and a world of breast surgery. Yesterday’s face lift patient certainly appreciated everyone’s work- she was thanking everyone involved. Every day is rewarding for us all at Montecito Plastic Surgery in Santa Barbara- I’m a very fortunate plastic surgeon!

I’m heading back east today, after another short week of plastic surgery in Santa Barbara.  Last week was a bit of vacation in Aspen, and I was swamped for the short time that I was in Santa Barbara early in the week.  Today, I’m actually running back home to see my mother who is having a bit of surgery tomorrow morning, and will be back on Sunday… for another two whole days before I leave again for Miami.  Next week in Miami is the renowned Baker-Gordon Aesthetic Meeting, which is one of the premier meetings on cosmetic plastic surgery in the world.  While I’m looking forward to exchanging ideas with friends, I’m sorry it is so hard to get in to see me, and I want to apologize to those several patients who are trying to get in for consultations and surgeries. I operated all day yesterday, and squeezed a few new consults between cases- Next week’s Monday and Tuesday are nearly filled, though I’ve asked my staff to try and accommodate patients as much as possible.  I seem to have dozens of new patients to see when I get back, and I want to thank everyone for their patience.

As many of you know, following Dr. Sheffield’s retirement at the end of last year, some gentle transformations have kept us busy at Montecito Plastic Surgery. New paint adorns the walls, and new furniture can be found throughout the office. This week, the finishing touches will be placed with new flooring in two exam rooms. Several new pieces of art will be received from the framers, and will be heading for our newly painted walls.

The hardest part, and yet the best part, has been that throughout this transition, we have remained clinically as busy as ever. Two and often three operating days per week have been filled through much of February by the ongoing interest in having plastic surgery in Santa Barbara by some old, but many new patients. I will be performing several face lift operations, rhinoplasty operations, liposuction, and breast augmentations in the coming weeks on both men and women from Santa Barbara and beyond.

We are thrilled at the response that patients have given on the new look to the office. It appears lighter, larger, and more aesthetic. Additionally, computers placed in each room allow increased access to the new electronic medial record, as well as plastic surgery imaging programs that aid in patient education. We couldn’t be more pleased with the enhancements to Montecito Plastic Surgery, and we invite you to stop by and see what all of the excitement is about.

Help fight a bad idea!!  Congress is soon to debate the Health Care Reform Bill, which is a great move towards increasing the number of insured Americans.  Unfortunately, it is filled with several bad ideas, like a taxation on patients who undergo cosmetic surgery.

This has been attempted previously in New Jersey, and has failed miserably- A government auditor will be the one to decide whether your surgery is cosmetic or reconstructive, a necessity or a luxury.  This tax additionally discriminates against women and the middle class, who are the two groups most likely to undergo aesthetic surgery.  Finally and most concerning, this taxation will encourage more patients to go overseas for their plastic surgery, inevitably resulting in more complications in patients returning to the US.  With treatment of these medical and surgical complications, health care spending with respect to these botched plastic surgeries is likely to INCREASE, rather than decrease.

Please- email and call your congressional representatives and Senators, and encourage them to oppose this taxation- it’s not only unfair, but unsafe for Americans.

Effective ways to reach your Members of Congress include:

1. Call your Senators and Representative’s District Office this week. Most legislators are home this week for the holiday break.
2. Call Your Senator and Representative’s Washington, DC Office (early and often).
3. E-Mail Your Senators and E-Mail your Congressperson.
4. For Patients: The U.S. Capitol switchboard is 202-225-3121 where your patients can be connected to their Senators and Representatives. NOTE: The patient must know the name of their Senator prior to calling the switchboard; this information can be found at www.senate.gov (scroll by state). They can determine the name of their representative by going to www.house.gov where they can enter their zip code.