Recreational Diprovan
July 6th, 2009
General anesthesia is used in my operating room to complete cosmetic surgeries like breast enlargement, tummy tucks, and liposuction. There are many drugs used in during these cases. They can be categorized by how they work. Muscle relaxants paralyze muscle tissue. Narcotics help reduce pain. Vasopressors restore low blood pressure. General anesthetic agents induce sleep and maintain the sleep state during anesthesia.
There are two main general anesthetic agents that I use. One is a gas called Ultane (sevoflurane). It is administered by trained professional medical staff through a breathing tube through the lungs. The other is Diprivan or propofol.
Diprovan is administered through the vein. It is frequently used to induce sleep in the operating room, intensive care unit, and emergency room. Patients may stop breathing when Diprovan is given. In all of the settings where Diprovan is used appropriately, the medical staff has the training and capacity to care for this cessation of breathing when it occurs. Accredited surgical facilities must have this capacity.
Prior to this past week, I was unaware of ANY use of Diprovan outside the clinical settings that include access to immediate breathing support. We procure this drug through our medication provider. It is certainly not part of any formulary outside hospitals or surgery clinics. You simply cannot go to your local pharmacy to fill a prescription for Diprovan. They do not have it! So, how Jackson supposedly gained access to it remains for law enforcement to figure out.
Recreational use of Diprovan obviously is extremely dangerous. Yet I can understand its appeal. Many patients who awaken after surgery where Diprovan was the only general anesthetic agent used, report extreme euphoria and pleasure. Still, I am shocked at the reports of the possible use of Diprovan by Michael Jackson. I will be truly dismayed if his personal medical staff were complicit in accessing the drug and facilitated its use by Jackson. It is my opinion that this would be a devastating embarrassment for most American physicians who take an oath when becoming doctors, “to do no harm.” Jackson’s untimely death is a tragedy that most likely could have been prevented.
Over Plumping
May 5th, 2009
Foster Farms vintage ad campaign for their chicken products uses a parody of over-plumping with artificial fillers. In their television commercial, chickens are seen in a plastic surgeon’s office receiving injections to make them plumper. It is quite obvious that they are way too plump.This situation is underscored by the distorted facial appearance of the surgeon’s nurse when she finally reveals her face to the camera. This crazy parody pokes fun at the sometimes over-zealous use of fillers in Hollywood.
I see over-plumping all the time, especially in the lips. The individuals, usually women, lose all of their natural lip shape. The over-injection usually masks all natural proportion. The television commercial effectively uses this phenomenon for optimum comedic effect. However, I agree with the tagline, “over-plumping” is never good.
A word of caution, the over-injection of any area of the body can lead to skin loss and terrible, uncorrectable scarring. The large volume of material simply reduces the blood flow to the treated area in such a way that the skin, muscle and fat die. Fortunately, this complication is very rare when only modest amounts of filler materials are used.
Finally, please avoid all silicone injections for cosmetic reasons. The risk of chronic long term inflammation which arises is not worth it. Fat Grafting is a natural technique used more commonly now for facial rejuvenation and avoids the use of artificial fillers. See more on fat grafting injections.
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