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Cosmetic Surgery Larceny

June 2nd, 2009

Today The Orange County Register reported the surrender of the “Big Busted Bandit  ” to the police.  Allegedly she stole a breast enlargement surgery through identity theft.   She was tracked down through her implant manufacturer serial numbers, according to the paper.   It makes sense that with the advent of relatively inexpensive cosmetic medicine procedures popping up in some retail settings rather than established clinics and hospitals, this kind of thing has become more “popular.”   I am sure that difficult economic times have played a role as well.

Cosmetic surgery larceny is nothing new.     I first saw this occur in my practice some 20 years ago.   A breast enlargement patient stopped payment on her check, on the very afternoon after having surgery.   I was unable to re-collect the fee even though I tried.   A difficult and expensive lesson to learn as a new plastic surgeon in practice.

All goods and services including cosmetic surgery and cosmetic medicine are at risk for theft.   Most long standing plastic surgery practices have been victims at some level and recognize the risk.  Measures  are often taken to reduce the risk of this type of fraud.  Requiring prepayment by 7-10 days if paying by check is a common practice and credit card payments may also be limited, as these charges can be contested by less than honorable patients.  The last responsibility  needed by a physician is chasing after a fee!

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Painless Breast Enlargement?

June 1st, 2009

Painless breast enlargement surgery is impossible to fulfill but it is the ideal for which we strive at my office.   Melissa’s recovery course is typical for most of my patients.     We have completed breast enlargement surgeries for eleven women during the past two weeks.     All but one have taken only acetaminophen and Celebrex ® for pain control.  None of the patients have had pain pumps.

Using less drugs directly corresponds to fewer complications after surgery.   Strong pain pills (narcotics) after surgery sedate you.   This sedation reduces your energy to get up and around.   I know it is counter intuitive but being out of bed after surgery actually reduces pain levels and shortens the recovery time.  In fact, Melissa was up and about the afternoon following surgery.

Another common side effect of narcotics is nausea and vomiting.   Vomiting and retching can cause bleeding around the breast implants.   Any blood collection around the implant is known to increase the risk of breast firmness (capsular contracture) and infection.

Please understand, all of my patients are welcome to necessary pain medications if necessary.   We always prescribe   pain pills when a patients asks for them.   You do not have to be a “hero” to get through the recovery after surgery.  However, most of my patients experience no need for pain medication during their recovery.

There are two main reasons I believe why we see less pain in our patients.   First is the administration of Celebrex ® prior to starting surgery.  We have noticed a 50% reduction in narcotic use when we began prescribing a   pre-op dose of Celebrex ®.   We continue it after surgery as well.

The second reason is the elimination of all dressings after surgery.   This means no bra, wrap or strap after surgery.   One of the first things I learned as a medical student was surgical sites are tender when touched.  Of course, we all learn this as children as a result of minor scrapes and bruises.   For this reason, any elastic type dressing or dressings which put pressure on the breasts causes pain.

Cosmetic surgery, particularly breast enlargement does not need to be painful nor does the convalescence need to be long.  Melissa is a wonderful example of the quick recovery that most of my patients experience, as shown in the video blog last week.  Her post-operative appointment, was only 3 days following surgery and she met a friend for lunch after her check-up with me.  As I have instructed Melissa, patients need to take it easy for 2-3 weeks, but I strongly discourage patients from laying around in bed during their recovery.

Please check back to read Melissa’s final thoughts on her choice to have breast surgery, her recovery and personal reflections.

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