Thursday, June 25, 2009

CALIFORNIA LIPOSUCTION LEGAL STANDARDS

The law regarding liposuction standards in California is clear. I was involved in developing these standards. I testified several times before the California Medical Board and supplied them with materials and documentation to aid them in their decision-making process. I believe that these rules are important and necessary for safety. I want to make several points.
1) If you are seeing someone who does not start an intravenous line, they are violating the surgeon’s “standard of care” and also California law.
2) The other requirements include blood oxygen and blood pressure monitoring, which are simple, modern devices to see how well you are breathing and how well your heart is working.
3) Modern liposuction is a very, very safe procedure in experienced hands. However, there are risks and if you find someone who says that it is risk free, you should look elsewhere. Surgical complications such as infection are unlikely but possible.
4) If your surgeon uses no relaxation medicines at all, some sort of liposuction may be performed and the risks may be lower. However, like anything in life, there are trade-offs, in other words you have to accept possibly a lower standard of results—in particular less fat removal--in exchange for not going to sleep. Additionally, we have found that many of our patients find the option of having nothing but local anesthetic frightening and sometimes quite uncomfortable. This is not to say that I approve of general anesthesia for liposuction, I don’t. I think this compounds the risk.
5) For individuals who need significant amounts of fat removed, California law requires a certified surgical center, such as a hospital would have. Ask to see the certificate if this is the case.

Dr. Yoho has patients come from Glendale, Burbank,Pasadena, Los Angeles, Encino, Huntington Park, Studio City,Arcadia, Montrose, Hollywood, La Crescenta, La CanadaFlintridge, Valencia, Monrovia, Eagle Rock, Altadena, SanMarino, Sherman Oaks, Thousand Oaks, North Hollywood,Long Beach, Beverly Hills, Van Nuys, Santa Monica,Calabasas, Palmdale, Fresno, Visalia, Northridge, and WestlakeVillage, and Simi Valley to have their appearance improved with our special surgical technique.

Our Cosmetic Surgery center in Pasadena, California specializes primarily in Cosmetic Surgery including breast augmentation, liposuction, tummy tuck,cosmetic facelifts, forehead lift, Chin and jowl liposuction,Eyelid Surgery and other body contouring procedures.The center is lead by expert Los Angeles Cosmetic Surgeon Dr. Yoho, who has passed the Boards in Cosmetic Surgery and is dedicated to providing high quality yet affordable cosmetic surgery options for his patients and being the best cosmetic surgeon in Los Angeles, Glendale, Pasadena, and Beverly Hills. Our offices in Palmdale and Visialia offer cosmetic surgery in Fresno
Bakersfield and the Lancaster, Valencia California areas.

Wednesday, May 13, 2009

Traditional Breast Lifts/reduction versus the new “Vertical Mastopexy/Ice Cream Cone” Breast Lift (with or without implant or reduction)

This is the Sentinel in Yosemite National Park (nothing to do with Los Angeles Cosmetic Surgery).


When you are unhappy with your breasts, there may be three reasons:
1) volume
2) shape
3) positioning

Positioning really refers to how saggy the breasts are. If your only concern is volume, and you don’t have a problem with the shape or positioning or , breast liposuction or an implant may be the best choice. Most patients can achieve a one to two cup size reduction with liposuction, and a 1 to 2 inch nipple elevation with liposuction alone.

If you are concerned with the shape but you generally like the size of your breasts, then the “Ice Cream Cone/Vertical Mastopexy” may be the procedure of choice for you. This procedure can provide a volume reduction if necessary but it’s primary function is to shape the breast and re-position the nipple areolar area. If for some reason after this procedudre, you decide you want a bit more volume, it’s not a problem to place an implant 4 to 6 months later. About 50 per cent of patients choose to put an implant and 50 per cent are happy with the lift only without implant.

Note that the traditional “anchor” scar procedure is generally regarded as not as satisfactory as the vertical mastopexy. This older procedure needs a scar all around the bottom of your breasts plus a scar up the middle plus a scar around the areola as well. It does not hold up as well as the vertical mastopexy, and tends to sag sooner. Also, the newer procedure needs only a scar down the middle of the front of the breast and around the areolae.

Remember whatever choice you make, if you need an implant, it’s always better to do this procedure in two surgeries. This is because if you have the implant put in and reduce the breast as well, the forces on the breast tend to pull the scars apart. When you do the lift first, then put the implant in later, the breast tissues hold up better and there’s less risk of sag and other unsatisfactory results. .

Note: Dr. Yoho does not usually perform the anchor-type scar procedure, the traditional breast lift. However photographs of the other procedure both with and without implants are available at my Los Angeles cosmetic surgeon website dryoho.com