Joys of smoking

Many times, when looking at the list of the things patients must do before plastic surgery, some smokers are dismayed to find they must give up the habit at least three to four weeks before the procedure and continuing on through some weeks after the procedure.

Plastic surgeons are not being politically correct. Our concern is about the substances in tobacco that conflict with good medical practice and plastic surgery outcomes.

For starters, nicotine injures the blood vessels and makes them constrict. That means less blood can flow to points in the body where it’s needed.

And one instance when a free flow of blood is most needed is right after surgery that requires longer incisions. Blood is very necessary for proper healing because blood carries vital nutrients and oxygen to the wound site.

Why? If the blood flow is limited, healing can be so delayed the tissue on both sides of an incision can actually die – this leads to very poor scars. Smokers are also at a much higher risk under anesthesia.

Other undesirable side effects include:

• Increased risk of infection
• Longer-lasting bruises
• Raised, red scars

On the other hand, I realize how addicting smoking is and that you may be in some discomfort. You can’t use Nicorette because it also contains nicotine but you can get a prescription for Chantix or Wellbutrin.

That’s why I applaud efforts of plastic surgeons around the nation who actually use carrots, and fewer sticks, to provide additional motivation to giving up the habit, at least long enough to allow for a good outcome to your surgery.

For instance, one board-certified New England plastic surgeon offers fee discounts for patients who give up smoking permanently and lose weight. And it’s all on the record – patients there must submit urine samples before surgery!

A California plastic surgeon, Darshan Shaw, M.D. was featured in our local newspaper, The New York Times, when he started offering non-smoking prescriptions to patients who could only have their surgery after permanently giving up the habit for good.

That creates more healthy patients and a better-than-average-shot at an excellent outcome to rejuvenation surgery.

Remember our recent post about gynecomastia and shirts off and shirts on guys?

Julian, a handsome 24-year-old black dude, is very much a shirts-on guy AND a jackets on guy, to boot.

Even on a hot day at the beach, he wears some kind of a jacket to hide his huge, sagging breasts.

His man boobs are so large, the areola (the brown skin surrounding the nipples) have been stretched out.

Moreover, it is verboten for his lovely girlfriend to touch his chest. So Julian, tired of hiding part of his anatomy, saves his money until he can afford the attention of a board-certified Newport Beach (California) plastic surgeon.

While the story is told on a YouTube segment, it was actually filmed for the old Plastic Surgery: Before & After, a program that aired on the Discovery Channel before its host, Dr. Jan Adams, ran into extremely serious trouble over the death of Donda West and a subsequent D.W.I.

(Later on, we will post a blog about why Ms. West’s death could have been prevented by a physical before plastic surgery.)

Dr. Adams’ show depicted actual surgery which starts with liposuctioning of as much of Julian’s breast fat as possible.

The  surgeon makes a small incision on the bottom side of Julian’s areola and then removes the actual breast tissue – yes, like woman have – which doesn’t yield to liposuction.

Julian receives a bonus on healing when he discovers his areolas are smaller.

And he may go back to the surgeon in three to four months to remove some excess, sagging skin on his now flatter chest.

The final frames hold a lesson for many plastic surgery procedures.

Julian is thrilled to take his shirt off in public — for the first time ever! — but  his chest is still a little swollen.

The lesson? Final results often take more months than patients like.

Plus, the lady in his life is thrilled that his chest is no longer off limits!

Watch the gynecomastia video – which may also remind you how much Plastic Surgery: Before & After is missed!

More men in the United Kingdom (UK) are having their “moobs,” (short for man boobs) reduced through the procedure known as gynecomastia surgery.

The British Association of Aesthetic Surgeons (BAAPS) says the procedure to produce a more masculine, flat chest increased 44 percent in the UK during 2008 – despite the recession.

In the United States, 17,902 men had gynecomastia surgery in 2008, according the American Association of Plastic Surgeons (ASPS).

And it’s not a cheap procedure! In the UK, gynecomastia surgery costs an average $6,922.00. (Read more about the report that includes male breast surgical reduction.)

But why would more patients be showing up in surgeons’ offices with large male breasts in the first place?

It may literally be something in the water.

Back in 2005, British surgeons and others studied water supplies and found that, while the water was clean, it nonetheless contained an unusually high concentration of female hormones. The source?  Birth control pills for women. Also, hormones are given to many large farm animals. All that can leach into the water.

(Read more about hormones causing gynecomastia.)

Could a similar situation be happening in the United States? Possibly. Some scientists have found populations of fish in which the males are developing female characteristics.

Gynecomastia can also be caused by:

• Use of illicit street drugs
• Side effects of some medical treatments
• Having large amounts of the female hormone, estrogen
• True female breast tissue that is too sensitive to even small amounts of estrogen

With 1,450 gynecomastia treatments via surgery under my belt, I have noticed that true breast tissue in males looks under the microscope identical to that of females. But the tissue is very dense and hard and can not be liposuctioned. Instead, it is removed surgically.

Take a look at how some males and teens look, before and after, in their gynecomastia pictures.

T.V. comedian Seinfeld once touched on the issue in a show, telling a large chested male friend, he should not wear a bra for gynecomastia, but a “bro.”

However, in real life, male breast enlargement in a young lad or is anything but a laughing matter.

We’ll touch more on some actual cases, next post.