Renaissance Plastic Surgery | Dr. Joseph Fata

#1 Wrinkles are mostly caused by aging.

False. While aging is a factor in the formation of wrinkles, it is the least important one up until about the age of 60. In younger patients, the main causes of wrinkles and other signs of aging are smoking, excess sun exposure and excess muscle activity around the eyes and forehead. Prevention, a prescription-based skin care regimen and selective use of Botox are all effective tools to delay this process.

#2 A sunscreen with a high SPF gives complete protection.

False. Sunscreens protect only against UVB (Ultraviolet B) rays but do not block UVA (Ultraviolet A) rays. Also, most sunscreens block less than 90% of the UVB light so limiting excessive sun exposure through avoidance or protective clothing is still beneficial.

#3 Over-the-counter skin care products are as effective as prescription-based products.

False. Over-the-counter skin care products sold at hair salons and high-end department stores contain most of the same ingredients but at a much lower strength. One example is hydroquinone, a bleaching agent used for sun and age spots. The concentration of hydroquinne in over-the-counter products is 2% but the concentration in our private label Lightener is 4%. The same is true for glycolic acids and alpha-hydroxy acids.

#4 Acne treatment can accelerate aging.

True. Cleansing agents that contain benzoyl peroxide or hydrogen peroxide can produce free radicals, which break down collagen and speed up aging. Sun exposure also increases the presence of free radicals and so an anti-oxident, such as Vitamin -C, should be part of a balanced skin care treatment regimen.

#5 Skin damage and aging cannot be reversed.

False. The typical signs of aging skin are a rough texture, enlarged pores, brown spots and wrinkles. A new laser technology, known as fractionated treatment (Fraxel is one trade name), can stimulate the deeper layers of the skin to remove the pigment in brown spots and create new collagen to tighten pores and fill out fine wrinkles. It also stimulates the outer layer of skin to shed so it is replaced with a new and fresh layer of cells.

Although it has been over two months since the tragic death of Donde West, mother of hip-hop star Kanye West, it remains fresh in the minds of the public and has raised many questions about the safety of plastic surgery. My own read on the media coverage thus far is that there has been as much rumor as fact, and I would like to set the story straight as best I can.

The facts we know are that Donde West underwent the procedures of breast reduction and abdominoplasty, also known as a tummy tuck, possibly with liposuction on a Friday by Dr. Jan Adams, a plastic surgeon. The following evening, a little over 24 hours after her surgery, she was at home and found unresponsive. Paramedics were called, she was brought to a nearby hospital and she died later that night. An autopsy was performed but the results were inclusive.

We also know that Dr. Jan Adams was a high profile Beverly Hills plastic surgeon who has appeared on Oprah and hosted a show on the Discovery Channel. According to the American Society of Plastic Surgeons, he is not listed as a board certified plastic surgeon. It has also been reported that he was being investigated by the California Medical Board for multiple DUI convictions.

What we don't know is even more important. We don't know if Ms. West had a general medical evaluation prior to surgery by a doctor specializing in Internal Medicine, a routine practice for a 58 year old woman, although reports have surface that this did not occur. We don't know if the surgery was performed in a hospital, a licensed outpatient surgery, or the the surgeon's office operating room. We also don't know whether Ms. West had her surgery as an outpatient or if she was kept overnight for observation, and if so, where this post-operative observation occurred. The issue of post-operative observation is especially important because patients who undergo this combination of procedures are at some risk for post-operative bleeding and dehydration, which is easily treated but if left untreated could lead to cardiac arrest.

This tragedy is a cautionary tale and although all of the facts are not yet available, there is a great deal to be learned from it. First, being a celebrity plastic surgeon has no correlation to either one's skills or credentials. One could easily be a good celebrity plastic surgeon or a bad celebrity plastic surgeon. It has only to do with how well someone plays to the camera.

Board certification does not guarentee that someone is a good plastic surgeon either, but it does provide an independent and fair assessment of a surgeon's knowledge and competence. Why, one might ask, would anyone choose a plastic surgeon who wasn't board certified? Statistics from the American Society of Plastic Surgeons state that there are over 6,000 board certified plastic surgeons in the United States. The problem isn't supply and demand; it's the education of the public about the importance of board certification.

Perhaps the most important point is that while plastic surgery is extremely safe, it is not completely risk-free. There is not enough information to know if the loss of Ms. West could have been prevented. However, a thorough pre-operative medical evaluation by an internal medicine or family practice doctor, and having both the surgery and at least 24 hours of post-operative observation completed in either a hospital or licensed, accredited surgery center, are all steps that normally would have been taken in this case. If all of these precautions are taken in similar situations, then patients and their families can have the peace of mind of knowing that they have taken all of the necessary steps to ensure that their surgery will be as safe as possible.