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In 20 Years as a Plastic Surgeon, I’ve never seen this!

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I had a patient today with a situation I have never seen in my 20 years as a plastic surgeon. A 31-year-old female was referred to my office by the local hospital because of an oily discharge from her breast. The female had solicited a breast augmentation in Mexico  in 2009, believing it to be the cheaper option.

Fast forward three years.

She’s sitting at work and noticed a spot on her shirt near her breast. As the day goes on the spot gets bigger. She went to the bathroom once the spot on her shirt became quite wet. Her breast, as well, was covered in an oily liquid.

Bra 235x300 In 20 Years as a Plastic Surgeon, Ive never seen this!She immediately went to the hospital, but they could not diagnose as a problem. The hospital placed a call to our office, requesting a consult.

She showed up at our office a short time later, and I examined her to quite a puzzlement.

I did all the routine checks that I preform on my breast augmentation patients; politely informed her that she could have spent the same to have a procedure here in the states; but could not find the cause of the problem.

Although her breast was still covered in an unknown oily liquid, it was not coming from her breast as far as I could tell.

After talking for a few more minutes about her symptoms, I asked to see her bra. She had told me earlier that it was not a push-up, but upon inspection I noticed that while one cup had a puffy sack at the bottom to gently boost the breast, the side of the unsolved leaky breast, was deflated.

It only took a second to solve the oily mystery, as I looked up at her and said, “well your implant did leak … but it wasn’t the one you were expecting!”

She took her bra in embarrassed amazement, and I told her that I couldn’t accept payment for my astute investigation skills. I did ask to use her story as a moral to pass on …

                                     … before you freak, check your bra for the leak!

 

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Symmastia is a Rare, but Fixable Complication of Breast Augmentation

symmastia 300x227 Symmastia is a Rare, but Fixable Complication of Breast Augmentation

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Symmastia is a rare congenital defect in which soft tissue connects, or webs, both breasts together at the sternum (breast bone). Symmastia seems to be more prevalent among thin women, mostly due to the minimal tissue and/or fat covering the sternum.

In very rare instances, Symmastia can also occur as a defect of breast augmentation surgery. When implants are inserted too close to the midline of the body, it causes a lifting of the skin away from the chest, creating an unattractive connected appearance sometimes referred to as “breadloafing.”

In our experience, Symmastia generally occurs due to aggressively cutting open the chest muscle during an implant operation. In the early years of breast augmentation, surgeons would attempt to release some of the chest tissue in order to get the implants closer together, which can cause the defect as well.

I must give a kind word of caution to everyone reading this and having second thoughts about getting a breast procedure done. Symmastia is the least common of all cosmetic breast augmentation complications.

Today we take a much less invasive approach to altering the body. Our goal is to nip and tuck, not cut and stretch.

In the following video, Dr. Moliver walks you through a procedure to fix a Symmastia case.

WARNING: The following video contains graphic surgical footage, and may not be suitable for all audiences. Viewer discretion is advised.

VIDEO: Let us Introduce you to the Smiling Faces of Dr. Moliver’s Office

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surgicenter1 VIDEO:  Let us Introduce you to the Smiling Faces of Dr. Molivers Office

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When it comes to choosing the right doctor for your cosmetic procedure, of course the focus is on the doctor. We do a lot of messaging on the qualifications, training, certification, beliefs, lifestyle and even diet choices of Dr. Moliver because it is important to know that he is one of the good guys here to help.  The Plastic Surgeon is justly placed in the hot seat because he or she will be the one wielding the knife, but what about everyone else involved in the process?

You can go to the best doctor in the world, but if your interaction with the receptionists, nurses, coordinators, Anesthesiologists and assistants is horrible, then your experience will most likely be remembered as horrible. To us, this is unacceptable.

We put as much focus into cultivating a knowledgeable, pleasant, dedicated staff as we do in promoting the talents of our doctor. That’s why we had Dr. Moliver walk around his office to introduce you to the wonderful faces that will be with you from consultation, to pre-op, to surgery, to the recovery room, to post-op care. These are the people that will get you back to feeling good after Dr. Moliver gets you back to looking good!

 

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Safe Aesthetic Plastic Surgery takes more than a Dermatology Degree

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The difference between an Aesthetic Surgeon and a Plastic Surgeon is one of perspective and degree. All Plastic Surgeons have the ability to do aesthetic work. However, many Aesthetic Surgeons do not have the training and experience to do reconstructive work like hand surgery, trauma correction, or breast / head / neck reconstruction after injury or cancer.

IMG 3045 200x300 Safe Aesthetic Plastic Surgery takes more than a Dermatology DegreeAbove all, I am a trained and certified Plastic Surgeon. We have many high profile doctors in the greater Houston area, and unfortunately, in Texas the rules for what a doctor – or Dentist for that matter – may describe themselves as, is unclear.  We have seen patients come in with many complications from aesthetic surgery done by dermatologists, oral surgeons, and even dentists!

The American Board of Plastic Surgery is the basic qualifier one should look for to determine if a doctor is certified. READ about the 11 things you should ask a Plastic Surgeon before surgery.

During a plastic surgery residency, doctors receive training in reconstructive plastic surgery for congenital defects such as:  cleft lip and palate; head and neck deformities; hand reconstruction; trauma reconstructive surgery; aesthetic surgery; etc, etc.

After this work, many go on to specialize in cosmetic or aesthetic surgery to become a well-rounded Aesthetic Plastic Surgeon.

Oh, and those transplant surgeons that can sew together a new face are all certified Plastic Surgeons – not talented dermatologists. Isn’t that what you should expect from someone putting you under the knife?

Sometimes people have the false impression that “Cosmetic Surgeons” are fake or superficial doctors – “beauty doctors” as some may call them. The disheartening truth is that far too many are. Unfortunately the public buys into the fluff that isn’t a great doctor, but a great PR campaign.

American Society for Aesthetic Plastic Surgery ASAPS  Safe Aesthetic Plastic Surgery takes more than a Dermatology DegreeThere is a very prestigious society called the American Society for Aesthetic Plastic Surgery (ASAPS) (www.surgery.org).  You only become a member by first being Board Certified by The American Board of Plastic Surgery (www.abplsurg.org), and then doing a large volume of only aesthetic surgery, followed by a recommendation from a current member.

I am a proud member of all the above boards and societies.

Unfortunately in America, anyone can call themselves a cosmetic, aesthetic or plastic surgeon. I call myself an Aesthetic Surgeon because I earned the right to do so in all of the ways that are respected by the most revered societies.

Aesthetic surgery may be my only focus now. However, for years I paid my dues as a Doctor of Plastic Surgery, making bodies function normally again. Now I make bodies young and beautiful once more.

There are people who want to be artists, and then there are artists. Not only must an excellent Aesthetic Surgeon be an experienced physician and technically proficient surgeon, he or she must have a good eye for balance and harmony.

There are intangibles that make a good doctor; like knowing when to operate, and when to say no. A doctor must know which procedure will produce a natural, pleasing result without looking fake or overdone.

A good Aesthetic Surgeon is an artist that places a few brush strokes, and suddenly the picture jumps off the canvas. However, a good Aesthetic Plastic Surgeon knows functionally how the body structure works best naturally.

And natural is beautiful.

 

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What is the Difference between Saline vs. Silicone Breast Implants?

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A recent question on Facebook prompted a longer response than we expected, so we thought we’d share it here!

The textbook answer to this debate is:

  • Saline breast implants. Saline implants are filled with saline, generally during your surgery. Saline implants are often criticized for feeling hard or unnatural, but improved surgical techniques — such as placing the implant behind the chest muscle and slightly overfilling it — have helped these complaints. Saline breast implants are available for women 18 and older looking for breast augmentation, or women of any age for breast reconstruction.
  • Silicone breast implants. Silicone implants are pre-filled with silicone gel — a thick, sticky fluid that closely mimics the feel of human fat. Some women feel that silicone breast implants look and feel more like natural breast tissue. Silicone breast implants are available to women age 22 and older for breast augmentation, or women of any age for breast reconstruction.

Silicone implants constitute 80% of the breast augmentations completed by our office in the Houston area over the past few years. We find that saline implants on women with petite frames or A-cup breasts often look very fake, and have a much higher incidence of rippling and folds being either palpable or visible.

Silicone implants are softer to touch, and much firmer. If the patient has a moderate amount of her own breast tissue, and the implant isn’t too large, there may not be any difference to the feel.

Finally, two similar sized implants, one saline, the other silicone – will have different projections to the cup size your breasts will become. The saline implants typically have a 10-20% greater amount of projection, hence the somewhat more “fake” look in smaller framed women.

If a discussion on price is what you’re looking for, generally gel (silicone) implants run about $1,000 more than saline in the Houston market.

Special Offer from Dr. Moliver for Intense Pulsed Light (IPL) Treatments

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SpecialOffer Special Offer from Dr. Moliver for Intense Pulsed Light (IPL) Treatments

If you are not familiar with Intense Pulsed Light (IPL) therapy, it is the most innovative skin treatment system we have seen in years. It involves specially constructed Xenon Flash Lamp bulbs and focusing optics to rapidly discharge high energy light on to your skin.

The pulses of light produced by IPL equipment are very short in duration, so discomfort and damage to non-target tissues is minor. IPLs work more directly on the top layers of the skin, and generally do not penetrate deep enough to damage the epidermis.

Although some salons use IPL for hair removal, we have the best technology in the industry for laser hair removal, The Lumenis LightSheer Duet. We choose other uses for this therapy.

Our IPL machine is the Lumenis One, and we use it for removing brown spots and red areas primarily on the face. In addition to, IPL can be used to treat:

  • Sun Damage and Vascular Changes
  • Acne
  • Rosacea
  • Broken capillaries
  • Telangiectasias (Visible Blood Vessels)
  • Pigmentation and Birth Marks

CLICK HERE FOR TREATMENT PRICING

We also offer package prices that include 1 FREE TREATMENT, as well as monthly specials on a selected service or two. Just give us your email address and we will add you to the list to receive our specials!

The U.S. is Safe once again after Hack NY Plastic Surgeon sent back to Dominican

It’s back to the Dominican Republic for a hack plastic surgeon who lured Latina women from Manhattan salons to Santo Domingo for cheap liposuctions that left them near death and permanently disfigured.

020411cabral1sh174533  300x300 The U.S. is Safe once again after Hack NY Plastic Surgeon sent back to Dominican

“He promised me that he was going to transform me, make me more beautiful, more confident,” victim Lissette Mejjia, 36, of The Bronx, remembered at the sentencing today of Hector Cabral, 52.

Then came life-threatening infections that left them hospitalized for weeks.

“I cannot even show myself, my body” sobbed victim Francisca Fernandez, 48, of The Bronx. “I am scared to even see myself in the mirror. When I see my scar, I see his face.”

Hector Cabral is licensed to practice plastic surgery in the Dominican Republic, but not the United States.

He pleaded guilty in October to unauthorized practice of medicine — for signing women up for the surgeries in New York — but couldn’t be prosecuted further because the actual procedures were done in Santo Domingo.

Under a deal struck with the State Attorney General’s office, he cannot return to the United States for three years. He additionally was ordered today to pay $23,000 in total restitution to his seven victims.

 

11 Questions you NEED to ask before Plastic Surgery

The best way to keep yourself safe is to know exactly what you’re getting into, and who you are trusting to lead the way. If your doctor does not have straight forward answers to the following questions, there’s a problem.

1.) Are you Board Certified?

2.) How many times have you done this procedure?

3.) What other medical staff will assist you?

4.) Where will the procedure be performed?

5.) Do you have hospital privileges to perform this procedure, and which? 

6.) What type of anesthesia will be used during the procedure?

7.) What are the risks associated with this procedure?

8.) Can I see multiple before and after pictures of your previous patients?

9.) What is your complication rate with this procedure?

10.) Can you provide me with 3-6 references on whom you have performed this procedure? 

11.) What exactly do the fees for this service pay towards?

 

Don’t hesitate to give us a call if you feel something is not right, we are always available for free advice and consultations.

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Photo Courtesy:  Steven Hirsch
NY Information Courtesy:  Laura Italiano, NY Post

The Road to being Healthy is not always Plastic Surgery

vegan gun The Road to being Healthy is not always Plastic SurgeryI consider myself a health conscious Plastic Surgeon. Yes, I do use surgical techniques to alter the body. However, I believe and preach that we must first be healthy before we can make cosmetic alterations. Liposuction is for certain situations, not a massive weight loss plan.

I went vegan nearly nine months ago. My motivation for this diet change came after reading The China Study by T. Colin Campbell, which was also made into a documentary called Forks over Knives. Campbell broke down his eight principles of food and health:

  1. Nutrition represents the combined activities of countless food substances.
  2. Vitamin supplements are not a panacea for good health.
  3. There are virtually no nutrients in animal-based foods that are not better provided by plants.
  4. Genes do not determine disease on their own. Genes function only by being activated, and nutrition plays a critical role in determining this.
  5. Nutrition can substantially control the adverse effects of noxious chemicals.
  6. The same nutrition that prevents disease in early stages can also reverse it in later stages.
  7. Nutrition that is truly beneficial for one chronic disease will support health across the board.
  8. Good nutrition creates health in all areas of our existence. All parts are interconnected.

There is a huge wave rolling through America, not just about healthy eating, but specifically about the diet part of veganism. Sticking to plant-based foods can lower your saturated fats and add a plethora of vitamins to your diet like: Potassium, Foliate, Antioxidants, Vitamins C & E, and surprisingly protein.

In addition, veganism lowers the risk of diseases such as: Diabetes, High Blood Pressure, High Cholesterol, Prostate Cancer, Colon Cancer, Breast Cancer, Cataracts, Arthritis and Osteoporosis … just to name a few.

The physical changes that you will see in your body far outweigh the hassle of changing your diet. I’m talking about lower body mass, significant weight loss, more energy, glowing skin, no body or breath odor, strengthened nails and hair, reduction in migraines, and relief from allergies. Who wouldn’t want to see those results?

Although I love and hold great respect for our furry animal friends, I do still wear leather shoes and use leather products. This is not a moral stance for me. I made this change to affect my diet and personal health, and did not totally commit to the vegan lifestyle.

I am, however, totally convinced that the vegan diet is the way to go. We need to stand up and take responsibility for our bodies. You only receive one in this life, and although I can work wonders to restore and repair the outside, I cannot make you healthy on the inside.

 

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VIDEO: Reverse Abdominoplasty (Tummy Tuck) with Dr. Moliver

Dr. Moliver walks us through a Reverse Abdominoplasty procedure – from drawing out the “Body Blue Print,” to making the first cut in the operating room.

WARNING: The following video contains surgical footage that may not be suitable for all audiences.

 

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Dr. Moliver Addresses Recent Facial Transplant Success

face transplant 300x169 Dr. Moliver Addresses Recent Facial Transplant Success

This past week The University of Maryland announced the successful outcome of the most extensive full face transplant ever. There are several fascinating things about the recent wave of Complex Composite Allograft Transfers (translated:  transferring tissue from one human to another as a mass of different types of tissues in one large block – i.e. skin, fat, muscles, bones, teeth, nerves, etc.). The most recent trend is towards face and hand transplants.

It’s so easy to overlook the complexities and intricacies of a massive surgery such as this when viewing before-and-after photos from a computer; gushing over the transformation, and gasping at the surgery length of time. It’s fun to imagine exchanging looks with a supermodel, but no one ever talks about the impact that a surgery such as this would have on a person’s day-to-day life. Now I do want to preface that a decision about surgery is simple when facing an injury such as a gunshot to the head. However, these advances in technology make me envision a time in our future when transplanting one’s face is as common as liposuction. What will we take for granted then, and what will we not consider?

First is the psychological effect of having a completely different face. The “who am I factor” would be overwhelming to the recipient. As would the haunting feeling of the other person who gave his face, and is now peering back in the mirror. Someone, somewhere would look at this person and see a loved one who is actually dead.

The other topic not often thought about by the lay public is that these recipient patients typically have to be on anti-rejection drugs for the rest of their life, just like a kidney or heart transplant patient. This is not only very expensive, but there are several dangerous side-effects. This also does not even begin to examine the ethical questions of who pays for this surgery (patient or the insurance company), and is a candidate justified in his reasons for a transplant.

As a side note, a recent article in The Journal of Plastic and Reconstructive Surgery (February edition) by Curtis Cetrulo, et al from Harvard, circumvented the need for anti-rejection drugs using a novel gene therapy to convert the donated tissue, into tissue that the patient’s body recognizes as its own and will not reject. The study was done in lab rats, but laid the experimental basis for similar work in humans.

The day may not be far off when very large parts of one person are transferred to another without the lifelong drugs that are now routine and often overlooked by the public. I can guarantee you these things are not overlooked by the patients. #VeryExpensiveLifeChange

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