Richard L. Dolsky, MD (retired)

Why would you ask complete strangers who know nothing about your surgery? Your doctor should give you postop instructions. Do you have follow up visits with the doctor? Have you called the office and asked the doctor or his staff? 

Dr. Shafer obviously does not know the history of liposuction. I am board certified in Plastic Surgery, Cosmetic Surgery and Otolaryngology. In 1982, I was the first surgeon to teach liposuction in the USA at an educational meeting.

Modern liposuction was developed by a French gynecologist and an Italian otolaryngologist, not by plastic surgeons! The most important advance for safe liposuction was the development of the Tumescent technique. The Tumescent technique was invented by a dermatologist.

Any doctor, no matter what his speciality, who does not use the tumescent infiltration is using a 25 year old outdated method. Neither laser nor ultrasonic lipo can be performed without using Tumescent infiltration.

Richard L. Dolsky MD

 

I always give my breast  augmentation patients a prescription for Robson. Robaxin is a muscle relaxant. This medication is very helpful in treating the muscle spasms and pain that is associated with submuscular (subpectoral ) breast enhancement surgery.

Richard L. Dolsky MD

Cosmetic Surgery Of Philadelphia

Revision rhinoplasty is one of the most difficult cosmetic plastic surgery procedures. My professor of plastic surgery recommended that surgeons should not attempt revison of other surgeon's rhinoplasty for the first 10 years of their careers. 

The first problem is the anatomy of an operated nose is not normal. Rhinoplasty surgery alters and changes the nose's normal anatomy in order to create the new shape. Skin, cartilage, bone and mucosa ( the internal lining of the nose) are all altered. You never know what you will find and the revising surgeon must have the experience to correct whatever abnormalities he finds.

All wounds and incisions heal with scar tissue. As the nose heals, the original operation creates scar tissue through out the nose. This scar tissue is harder than normal tissue and acts like glue in holding the anatomical structures together. It is more difficult to dissect the the tissues in  a scarred nose in contrast to the easy separation  in an unoperated nose.

Scars contract and tighten as they heal and mature. The more scar tissue and the less strong normal structures in the nose, the less predictable  the healing . Over time , the contracted scar can twist and tun the nose in unexpected ways.

When choosing a surgeon for revision rhinoplasty, I would recommend a surgeon with many years experience in rhinoplasty and revision rhinoplasty surgery. You might look for a surgeon who is board certified in both Plastic Surgery and Otolaryngology (ENT) or has taken a fellowship in rhinoplasty surgery.

Richard L. Dolsky MD

Cosmetic Surgery of Philadelphia

When the FDA allowed silicone gel implants for cosmetic breast augmentation in 2006, the FDA recommended that women with silicone gel implants get periodic ( 2-3 years ) MRI's to look for "silent" ruptures. A "silent " rupture is an implant rupture that cannot be diagnosed by the appearance or feel of the breast.

The older silicone implants which are not used today were much more fluid and liquid- like. When they ruptured they could flow beyond the implant shell and scar capsule. There was often a change in shape or feel of the breast. Today's cohesive or Memory gel implants are more like a piece of firm Jello. They do no not flow like a liquid and maintain their shape. When they rupture, physical examination will not detect the rupture.

About 1% of the newer silicone implants fail each year. The result is a lot of negative MRI's or false positive MRI's.

The bottom line is the FDA will not "repossess" your implants or compel you to have the study. These guidelines will probably be modified as more data is collected on the aging of cohesive gel implants.

Richard L. Dolsky MD

Cosmetic Surgery of Philadelphia