Rhinoplasty (Cosmetic Nose Surgery) and related Cosmetic Surgery Topics

How to Save Money on Plastic Surgery

Dr. Clavin has been performing cosmetic plastic surgery for over 35 years.  Even though he is a surgeon by trade, he has noted that there are many ways a patient can get a very desirable result by having an injectable, chemical peel, or laser treatment instead of actually having surgical intervention.  In today’s modern world, there is a whole variety of safe, proven materials that can help the facial appearance.  These include Botox, hyaluronic acids, for which two of the better known ones are Juvederm and Restylane, and fat grafting.  The latter procedure, fat grafting, has been used by Dr. Clavin for 30 years with exceptional results, which are permanent and help both in the nasal area as well as facial area and even in body areas.  Even though there are large numbers of doctors that are using a variety of injectables, Dr. Clavin feels that your best chance for success would be with a surgeon who actually operates and does cosmetic surgery.  The reason for this is that a physician who is performing plastic surgery and is well-trained has spent years honing his aesthetic eye and understands contouring.  With that particular aesthetic eye, the physician can better visualize the result achieved using an injectable, such as Juvederm, Restylane, or fat.  Dr. Clavin actually encourages many of his patients to have an injectable rather than surgery if they wish to have no downtime, wish to save a significant amount of money, and do not mind coming back once a year to have a touch-up.  Basically, it is a win-win situation and is a tremendous adjunct to the whole field of plastic surgery.  Therefore, a qualified plastic surgeon can save the patient a considerable amount of money if they wish to have one of the alternatives to actual surgical intervention, which include a variety of peels, laser skin treatment, Botox, and injectables.

Avoiding Nasal Surgery by Using Injectables

Dr. Clavin is finding that the trend toward nasal injectables is taking off and replacing in some cases the need for rhinoplasty or surgical intervention to correct a nasal deformity.  Fortunately, there have been some excellent injectables that have come onto the market, namely those being hyaluronic acid and Juvederm and also a patient’s own fat cells used to reimplant in locations on the nose and correct deformities that normally would require rhinoplasty or nasal surgery.  For patients not wanting to have surgery or not wanting to spend the money to have a surgical procedure, the modern injectables are proving very advantageous to help a variety of nasal conditions, including those that are caused by surgical intervention to the nose and/or congenital defects of the nose that the patient wishes to have corrected.

Even patients who have never had their noses done but wish to have  rhinoplasty can sometimes benefit by using an injectable to the nose, again, either fat, Juvederm, or others.  This would result in reshaping of the nose with beneficial results for at least one year or longer without surgery.

Stem Cell Research and Fat Grafting

Dr. Clavin has been performing fat grafting for almost 30 years and has noted that the skin tone on top of the areas where fat grafting has taken place appears to transform into more vibrant and less aged skin.  This observation was far in advance of the more recent excitement in stem cell research.  Companies are sprouting out throughout the world advocating that they have better ways of taking fat and using those cells to be reinjected into a body part to rejuvenate the area accepting the fat cells.  Dr. Clavin feels the public should be very much on guard and watch out for charlatans and/or unsubstantiated companies promoting stem cell research and procedures having to do with rejuvenating body parts with stem cells.

There is no doubt that there could be a significant future in stem cell research using fat cells.  With time, there will be more and more substantiated research by reputable companies and universities that will find good and safe use for stem cells.

In the meantime, Dr. Clavin continues to use fat cells taken from one part of the body and reimplanting them into other parts of the body, particularly in the facial area, the nose, the cheeks, the jaw line, and other locations.  He has always been very satisfied with these results and has noted that, after one to three sessions, the fat survives and is permanent.  It is also his observation that the skin on top of the area of fat grafting appears to be less atrophic and/or thin and seems to have a more youthful appearance compared to the areas where no fat grafting was placed.  This is his own personal observation, and more scientific data will have to come out through documented research to determine if, in fact, there is some effect in which the fat cells rejuvenate skin.  Dr. Clavin is looking forward to a very bright future of stem cell research to determine a truly beneficial and potentially helpful method of improving the whole field of plastic and cosmetic surgery.

Dr. Clavin’s Talk on Nasal Injectables is Well-Received

Dr. Clavin gave a talk at the quarterly meeting of the Los Angeles Society of Plastic Surgeons on nasal injectables on Wednesday, May 19, 2010.  He was well-received by the approximate 25 plastic surgeons that were in the audience.  He presented cases of both primary and secondary nasal surgeries that were benefited using a variety of injectable materials, including fat, Juvederm, and Restylane.  He gave examples in which surgical intervention was avoided by the simple use of injectables that can be permanent, such as fat, or temporary, such as Juvederm.  Much discussion was stimulated in the audience, and other plastic surgeons gave their feelings and experience using similar materials.  The overall sentiment in the audience was that the doctors are getting more encouraged by the results of using injectables to the nose and, therefore, avoiding surgical intervention.

Can Medical Schools or Residency Training Programs Teach a Surgeon to Have an Aesthetic Eye?

No.  No.  In order for a doctor to go through medical school and get into good residency programs, he or she has to have a certain degree of intelligence.  This allows them to gather the material, digest it, learn it, pass examinations, and become a qualified physician.  Then, they can move on and take residency programs to learn the art of plastic surgery, cosmetic surgery, and a variety of other types of specialties.  Certain types of specialties and particularly that involving plastic surgery and cosmetic surgery require a talent that, in my opinion, is not teachable, and that is the aesthetic eye.  Intelligence and training does not teach something that, in my opinion, is genetic, and that is looking at features, not just one feature but the whole feature, and be able to discern what is beautiful, what is natural, what fits that particular individual the best, and symmetry.  It’s a certain way of looking at a patient, it’s an art, it’s a talent, and it is not teachable.  Talent is not teachable.  You can teach a person with talent to be better at their talent, but a person with no talent cannot be taught.  Therefore, when it comes to cosmetic surgery and the talent of the plastic surgeon, it is a genetic event, and either a surgeon has that genetic propensity to see beauty, see symmetry, see the whole and not just the part, and combine them all in order to make his form of surgery aesthetically pleasing to the eye and not appear to be operated, artificial, or look weird.

Therefore, to summarize this little writing, I feel quite strongly that talent and the aesthetic eye cannot be taught, and it is a talent.  If that person has that talent, then it can be tweaked further by proper training by other surgeons that have the same genetic propensity.

Anesthesia Fear - Reason to Avoid Cosmetic Surgery?

One of the biggest fears that patients have to undergo any elective surgery, and particularly cosmetic surgery, is the fear of anesthesia and “going under.”  This fear, in modern day anesthesia, should be completely eliminated from the patient’s mindset.  The patient should be more concerned with the surgeon he or she goes to and the cleanliness of the facility and the surgicenter or hospital he or she actually attends rather than the anesthesia.  In competent hands, anesthesia is exceptionally safe.  It is a rare event when you hear about an anesthetic death following any type of surgery.  When this occurs, the vast majority of the time it is actually due to negligence and has nothing to do with some unusual drug reaction or something that just happens because of an unusual type of allergic reaction to a drug or a patient’s heart not working during the anesthesia.

New drugs and new ways of administering anesthesia are exceptionally safe.  I commonly tell patients that the risk of them driving to the office for a consultation is about 100 times or 10,000 times higher risk factor-wise than having anesthesia in a controlled environment.  Also, the new drugs and medication allow a patient to go under appropriate sedation so they are comfortable yet breathing on their own and in total control of all of their respiratory functions and yet have no pain or discomfort because of the use of local and regional anesthesia in conjunction with a qualified anesthesiologist and a qualified plastic surgeon, who work together as a team.  In fact, there are ways of doing anesthesia without the patient even requiring intubation, that is, tubes put down the patient’s throat to allow for proper airway.  Some procedures can quite safely be done without using intubation, or tubes down the throat, combined with a very qualified anesthesiologist, qualified plastic surgeon, and the proper use of certain medication.  Nausea postoperatively is a rare event and, in today’s modern anesthesia world, nausea postoperatively is exceptionally rare and, when it occurs, is usually avoidable had the anesthesiologist used a different drug or different medication.

Therefore, in summary, to avoid cosmetic surgery or any elective surgery for that matter because of the fear of anesthesia is a misguided thought.  There are a lot of reasons to avoid surgery, but certainly the risk of anesthesia is not one of them.