Nature doesn’t have
final say in quest for
‘better’ bodyCheck up on your surgeon
By Alisa Lavelle
Star-BulletinJamie Perreida was sitting around with three friends, channel surfing when a plastic surgery commercial came on.
"I thought it was funny," Perreida, 18, said.
The commercial shows a woman stuffing her bra with tissue after tissue. The music in the background sets a tone of comedy and frustration. Then, comes the line: "Need more."
The Straub Clinic & Hospital commercials -- six in all, touting face lifts to liposuction -- aim at letting people know about its plastic surgery unit. Free consultations will be given through September if the appointment is made by Saturday, at 522-4370. Normal cost is $55.
The commercial stirred up debate about breast surgery for Perreida and her friends. This is exactly what Straub intended.
"There has been an increase in people coming in for consultations," said Straub plastic and reconstructive surgeon Dr. James H. Penoff, who said all calls so far have been positive.
But Tara Inay, 28, said she thought the commercials sent the wrong message to teen-age girls.
Plastic surgery seems "scary and unnecessary," said Inay, who is married with one son.
"I think they are playing with Mother Nature and should let things be," said Christy Aailiehu, 20.
But not all accept Mother Nature's handiwork. Nationally, cosmetic surgery procedures increased 50 percent over the last two years, according to the American Society of Plastic and Reconstructive Surgeons. The two top procedures are liposuction and breast augmentation. Eyelid surgery, facelift and chemical peel follow in that order.
The organization reported 946,784 procedures were performed on women last year. Liposuction and breast augmentation made up 30 percent of that number.
The national average for liposuction for a single area is about $1,872, breast augmentation runs about $3,292.
"It averages $3,000 to $4,000 for the out-patient surgeries," Penoff said about Straub's breast augmentation procedures.
Plastic surgery falls outside of medical insurance coverage. Dr. Gregory Caputy, chief surgeon of Aesthetica, said only the medical condition of male gynecomastia (the abnormal formation of breast tissue), breast reconstruction and some breast reduction procedures are covered.
"Liposuction is not covered and should not be covered," Caputy said.
Liposuction reduces local deposits of fat by surgically vacuuming it out. Penoff said the surgery has a low complication rate with good results.
"But this is not for a fat person," he said. The ideal patient has only pockets of fat, good skin elasticity and normal weight for their size.
One of Caputy's patients said frustration with her hereditary "pear shape" led her to getting the surgery. "It's embarrassing," she said, about her unwillingness to give her name. "I think, 'Why can't I do this with normal exercise or good dieting?' "
Incisions near the woman's pubic bone, over her belly button's tubal ligation scar, on the inside of both thighs, on both hips and outer thighs, and one over a past surgery scar were almost invisible two months after the surgery.
She lost only eight pounds through the procedure, but feels she fits her clothes better.
"Only inexperienced doctors take out too much," Penoff said about liposuction risks.
Touni Harner, 35, represents the ideal patient for breast augmentation. She believed her breasts were too small and just wanted improvement, not perfection. She has stayed active by biking and running since high school and maintained realistic expectations about her appearance.
She understood the procedure would enhance her appearance and self-confidence, not change her looks or get people to treat her differently.
Both Penoff and Caputy question patients' motives and state of mind before agreeing to perform surgery. Penoff said patients who expect surgery to change their lives get his recommendation for counseling rather than surgery.
Harner debated the need for surgery for nine years. "The timing was good," she said, about finally going from barely filling a 32-A cup to almost a 32-C cup.
She valued her doctor's feedback and suggestions regarding a size that would fit her body proportions, at 5-foot-2 and 93 pounds.
"It takes two yesses, a patient's and a surgeon's," Penoff said. "Most people want proportional. You can buy shoes that are too big, but do they fit is the question."
Caputy said the common sense approach means being conservative. "There are some bridges that cannot be reconstructed," Caputy said about going too huge. "Doctors need to look at the long term, not just for short term goals."
There is pain in these procedures. When Harner woke up from her surgery done a year ago, her chest felt tight from the bandages and she had difficulty breathing. Pain in her right breast came seven hours later.
Then, came a burning sensation in one nipple that lasted about 16 hours. Her doctor told her a nerve was touched, always a possibility, during her surgery.
Some patients suffer excessive bleeding leading to swelling and pain. A small percentage of women develop an infection around the implant. Both require another surgery to correct.
"The pain felt like a work out where you get very sore," Harner said.
The pain wore off in three days and scarring is barely visible in the crease of skin beneath her breast. The only problem Harner encounters now comes from ripples in the saline implant liquid in cooler weather, now that she has moved to San Francisco.
Occasionally, breast implants break or rupture. For saline implants, the saline absorbs into the body and the man-made shell deflates.
For gel-filled implants, there are two possibilities. The silicone gel moves into the surrounding tissue or collects in the breast and forms a new scar. Both breaks require a surgery and possible replacement.
"I am so happy with my size, so perfect," she said.
Of patients who opt for plastic surgery, "about 90 percent or higher are very happy," Caputy said.
Of the rest he said, "Some patients you can't make happy."
Because plastic surgery is cosmetic and optional, patients should shop around and check out a doctor's background, said Dr. Gregory Caputy, head plastic surgeon at Aesthetica. Check up on your surgeon
Dr. James Pentoff of Straub Clinic and Hospital said patients should feel comfortable with their choice of doctor.
Both recommend:
Get two or three consultations before doing a procedure.
By Alisa Lavelle, Star-Bulletin
