Rejuvenate You: Virginia Plastic Surgeon Michael J. Brown, M.D., P.L.L.C

In an earlier blog, I wrote about making sure patients searching for cosmetic plastic surgery take time to learn about the procedures they are interested in and to be sure to select a board certified plastic surgeon with experience. To illustrate these points and how important judgement is, here are some current news stories dealing with cosmetic surgery complications.

A family medicine physician was sentenced to 9 months in jail for performing facial cosmetic surgery procedures on women which resulted in complications. He has been under investigation with the board of medicine and had a restricted license preventing him from performing cosmetic surgery. Despite this, he continued to perform facial and breast surgeries on people. He was convicted of aggravated assault and assault causing bodily harm. He was performing these surgeries and telling people he was board certified, but not by whom.

In Beverly Hills, a radiologist opened a liposuction center and was performing liposuction on people without training. He has a civil suit against him for allegedly allowing his girlfriend and another person to perform the surgeries. He was also using the fat to try and fuel his car, (also against the law). He has fled the country and now is practicing in South America.

In Oregon, a woman sued and won lawsuits against a dermatologist she believed to be a plastic surgeon based on the dermatologist deceptive advertising. She also sued and won a larger suit ($1.32 million) against the magazine publisher who allowed the deceptive advertising practices and even promoted that type of advertising. The verdict was affirmed by the state Supreme Court.

The point of these examples, is take time to Verify credentials. Do not believe what someone tells you or see in a magazine. Educate yourself, and select properly trained plastic surgeons with extensive patient examples and referrals. If something sounds too good to be true, it usually is. Never compromise or barter when it comes to your health or your body. It is a very precious resource.

The interest in using a women’s fat to augment her breast is not a new one. Breast augmentation using fat origated more than 100 years ago. Only in the past decade has fat injection achieved a level of success that it could be a reliable option for breast enlargement. Several issues for fat injection breast augmentation will still persist for a while. Fat taken from the body needs to be put back into the body in a relative short time frame and needs to be handled well. This fragile tissue then needs be placed next to a blood supply to get oxygen. This is perhaps the most difficult aspect of fat injection anywhere in the body. Fat injection into the face is typically well tolerated because the face so vascular. The buttock has large muscle groups so the fat needs to be placed next to the muscle to get oxygen. Since there is so much muscle there can be large amounts of fat placed and it tends to do well. But there is still fat loss secondary to not being close enough to the muscle/oxygen.

The breast is different because the breast gland itself is not well vascularized and therefore large amounts of fat can not be placed and expected to survive. So only relatively small amounts of fat can be placed. Most women would not find the amount of enlargement would be worth the surgical time and expense to have this done. Another large concern is that of breast cancer surveillance. Some worry that the fat that does not survive may obscure a mamogram. Currently the best use of fat in breast enhancement is to refine a previous breast augmentation (using breast implants), refine a breast reconstruction or congenital deformity. We are currently doing research into determining if the breast cancer surveillance concerns will be significant. At present, the early research suggests that when fat injection into the breast is done conservatively and correctly, there in no significant change in mammograms.

A 43 year-old West Virginia woman suffered a dog bite injury that took off her nose. She was attempting to feed a friend’s dog when the dog (Rottweiler) jumped up and bit off the woman’s nose. She realized that the dog bite was severe and that the tip of her nose was gone. She looked for the nasal tip but could not find it. To learn more and see the photos of the injury and the plastic surgery reconstruction process click here.

Patients continue to be confused or misled from deceptive or less than forthright presentations of training and qualifications when it comes to cosmetic, plastic surgery and non surgical enhancements. The most common deception is the ‘board certified’ tag line in an advertisement. This appears to be the one line that patients look for when it comes to considering cosmetic enhancements, and the deception comes in the lack of ‘full disclosure’ of what the physician was actually trained in and/or what board exam they actually passed.

Physicians typically undergo additional training after 4 years of medical school. This additional training is called a residency. The residency period may be as short as one year or as long as six years. After a residency, some physicians, typically surgeons, may complete a second residency for additional training and certifications to further refine their areas of practice. After a residency or two, some physicians may spend an additional 6 months to 2 years in more training called fellowships. Fellowships may be acredited or non-acredited, meaning that they may be recognized by higher governing bodies as more valuable in educational experiences.

It is typically after a residency that a physician takes an examination (written and oral) to become board certified in what they have just been trained in. So being board certified means nothing if you do not know what they are board certified in.Every patient should ask what board the doctor is certified in and who is the regulatory body of the board. For example, the most credible boards (those used by hospitals to award priviledges) are governed by the American Board of Medical Specialties, ABMS. This is the premier board created to serve and protect patients. The American Board of Plastic Surgery is one of the 24 sub boards of the ABMS. This is the board that hospitals and lawyers check for when determing credentialing and expert status. The American Board of Plastic Surgery is the only board recognized as plastic surgeons, by the ABMS.

Unfortunately in the public’s eye, this is often overlooked or not understood. A doctor who completed a residency in OB/GYN, or Dermatology, Emergency Medicine can claim to be ‘board certified’, but they are board certified in those fields, not plastic surgery. Dentists, Oral surgeons, and any other doctor can also make these claims. They support their misleading advertising by joining a board that was created by others like them. They have created the American Board of Cosmetic Surgery, which is not recognized as a credible board by the ABMS or nearly all hospitals in every state in the US. In essence it is a board to support deception to the public. It is not against the law, and it is not their responsibility to inform a patient about its origins. The question to the public has to be, who do you really want performing procedures on you? It can be even more concerning because members of this American Board of Cosmetic Surgery, have created their own society to pad their credentials even further. The American Society of Cosmetic Surgery is this society.

Remember, ask what they are board certified in?, is it a member of the ABMS? and then think to yourself, is this what I am seeing this doctor for? You should not want a gynecologist to inject fillers into your face, or a dermatologist to do liposuction, or an ears, nose and throat surgeon to perform your breast augmentation or tummy tuck.

So when seeking to improve your looks be sure to look intelligently and ask the right questions to the right type of doctors and avoid complications before you get them. Do your homework, and compare to apples to apples and avoid the lemons.

I have had my primary office in Fairfax county, Virginia for 8 years. This Reston/Herndon area office served my patients well. It was a warm and caring place to meet my cosmetic surgery patients and educate them about the benefits of quality results oriented plastic surgery. My patients came from all over to meet with me there. Nearby Great Falls, McLean, Vienna, Ashburn and Leesburg and other Virginia suburb patients were frequent local visitors. My patients would travel from Maryland, and Washington, DC too. It is very humbling and I am honored to care for my patients. With my practice growth, it became time to seek out more space and opportunities. After searching for a space for nearly two years, I have found one in Loudoun County, Virginia near Dulles, Virginia. Although it will have an Ashburn address it is in very Eastern Loudoun county next to SR 28 and Leesburg Pike (SR 7). This location still allows my more Eastern geographically based patients easy access using major roads like SR 267, SR 50, and I-66. These main thoroughfares will actually make finding the Loudoun Center easier than my old Reston Herndon office. One of the exciting aspects of this move is that it allows my Western patients a more time efficient way to get my office for quality care in Loudoun. It will be accessible not only from the above roads but also Loudoun County Parkway. It is very close to the Washington Redskins Park in Ashburn, Virginia. My new furniture will be there a bit late so we will be improvising with the old furniture temporarily. I would like to invite you to come see the office at your convenience and watch it aesthetically change. I hope to see you there.