Cosmetic Surgery Center, Dallas | Dr. Rai

Have you been sticking to a diet and exercise regimen and being successful? You might be finding that although you lose a lot of weight you are not happy with some areas where the fatty tissue is stubbornly remaining.

Exercise helps in losing weight partly by speeding up the metabolism and partly by using up more calories. When we do a regular gym workout we can build up the muscle tissue to good effect in many areas, such as in the arms or on the male chest.

But some areas tend to retain fat and this becomes frustrating when you are trying to create a slim and shapely body profile. Some examples of those areas are:

• Under the chin in everyone
• The love handles in everyone
• Upper female arms
• Upper female thighs
• Lower abdomen if you have had babies

Ultrasound-Assisted Liposuction (UAL)
When you come to the Cosmetic Surgical Center in Dallas Texas, Dr. Rai can talk with you in a personal consultation about this issue. UAL is a way of doing liposuction that can help solve the problem. This procedure uses ultrasound to vibrate the cannula that removes fatty tissue. You cannot hear it vibrating as ultrasound is outside the human hearing range. But that subtle vibration helps to break up the fat cells, liquefying them for easier removal.

UAL can be done on smaller areas, like beneath the chin, and can give you a more sculpted look. Please see Liposuction Questions for more information.

If you would like to learn more about liposuction or any other cosmetic surgery procedures, please call or email our cosmetic surgery office for a free consultation with Dr. Rai.

On September 11, 2009, the FDA accepted a review application from Merz Pharmaceuticals, LLC for premarket approval of Belotero® Balance. This is the start of the approval process for marketing a product in the U.S.

Belotero® Balance
Merz Pharmaceuticals is a German company and Belotero® Balance has already been approved in the U.K., Switzerland, Austria, and Russia. It is a dermal filler and is based on hyaluronic acid. At the Cosmetic Surgical Center, we offer several other dermal fillers based on hyaluronic acid: Restylane, Captique, and Hylaform.

Hyaluronic acid is a substance found naturally in the body and its great asset as a basis for facial fillers is that it bonds very easily with water. It attracts water so that wherever the filler has been injected will plump up with the extra water in the skin. That creates a smooth and more youthful appearance.

Although some news reports are speculating that Belotero® Balance could be a new rival for BOTOX®, the two products work differently. BOTOX® is not a filler. It does create more smoothness in the skin and a more youthful look, but it does that by temporarily paralyzing the muscle where it is injected. When that muscle cannot contract, the skin does not crease.

Dysport™
On the other hand, another drug was recently approved by the FDA that is a rival to BOTOX®. It is called Dysport™. It works in the same way as BOTOX® and is based on the same botulinum toxin. It is given in different doses however, and is not directly exchangeable with BOTOX®.

Both BOTOX® and Dysport™ are used for smoothing out frown lines and horizontal forehead lines. Belotero® Balance may also be approved for that use, and perhaps, like Restylane and other hyaluronic acid-based fillers, for treating laugh lines, nasolabial folds, and thin lips

Meanwhile, if you would like to know more about the different ways of rejuvenating your facial appearance that are already FDA-approved and proven to be effective, please contact our cosmetic surgery office today for a personal consultation with Dr. Rai.

When we travel abroad and then return home to our own country, we assume that we’ll be allowed in. However, recently 23 women coming home to China were stopped by customs officials. On comparing the passport photos of these women with their live faces, the officials saw too much discrepancy.

The China Daily reported this incident, saying that the women had gone to South Korea for facial cosmetic surgery. They ranged in age between 36 and 54. Some of the surgeries they had had were:

• Rhinoplasty – to make their nose higher at the bridge
• Blepharoplasty – to make their eyes look larger
• Chin surgery – to have a slimmer chin. It is not clear from news reports what this surgery was; perhaps it was liposuction beneath the chin.

When the group of women arrived back in China they were wearing sunglasses and hats. When they removed them for identification purposes, their bandages and stitches were visible. Customs officers spent some time with each woman, comparing the photo and live face, and eventually admitted them to the country as being who they said they were. However, each woman was asked to get a new passport photo.

Cosmetic surgery has been increasing in popularity in China partly because the unemployment rate is ten percent. At first that might not seem like a good reason for the increase. But Chinese labor laws do not forbid discrimination based on an applicant’s appearance, and in fact, some jobs request certain physical characteristics such as round eyes. Increasing numbers of workers are resorting to cosmetic surgery to help in their job search.

To learn more about facial plastic surgery and how it could give you a more youthful or attractive appearance, please contact our Dallas, Texas office today for a free consultation.

In July of this year the American Society of Plastic Surgeons validated fat grafting as a way to do breast enlargement. It is a procedure where unwanted excess fat is taken from another body area and injected into the breasts to increase their size.

Some areas where the fat is typically harvested are:

• Abdomen
• Hips
• Buttocks
• Thighs

This is not a new procedure, as it was originally done in the late nineteenth century in Germany. It has also been used in the U.S. for adding fullness to facial areas such as the cheeks and lips.

It was first done for breast augmentation by a plastic surgeon here in Dallas, Texas. He wanted to satisfy women who had reservations about saline and silicone gel breast implants. The fact that there was no "foreign object" such as an implant, but only the woman's own fatty tissue, appealed to some women as being more natural. A favorite site for the fat harvesting has been the buttocks and some women feel that this is an exciting "twofer" - they lose unwanted fat from the buttocks and gain desired fat for the breasts all in one procedure.

Fat Can be Absorbed From the Breasts
At the Cosmetic Surgical Center, Dr. Rai prefers to offer silicone and saline implants because in many cases the body will absorb some of the transplanted fat. Up to 95 percent of that fat could be absorbed. Even if it is only about 20 percent absorbed, the reduction in breast size is very noticeable and unwanted.

Because of this uncertainty in each woman's individual case, we prefer the much greater predictability of implants.

To learn more about the many choices involved in breast enlargement, please call or email cosmetic surgeon Dr. Rai. Our office serves residents of Dallas Texas and we look forward to meeting with you.

Sometimes a pair of twins grow up trying to be as unlike each other as possible, and other times they try to be indistinguishable. In the U.K. recently two identical twins, Jo and Kerry Burton, have been living duplicate lives. After spending childhood duplicating each other's chickenpox, careers in the Brownies, and ballet lessons, they have spent 13 years of their adulthood having the same cosmetic surgeries. They are 34 years of age now.

Their goal is to continue to look indistinguishable from each other and to that end they have spent 60,000 U.K. pounds on operations done by the same cosmetic surgeons:

• Eyelid surgery
• Rhinoplasty
• Breast enlargement
• BOTOX® injections

They started when they were aged 21 with nose surgery to create the same curve in their noses. That was inspired by a photographer who was working with them as twin models. At age 26, they began the BOTOX® treatments and have kept them up to maintain the same smooth foreheads. They have each had one child, after which they had the breast implants to take them from size 34B to size 34DD.

In addition to these procedures, they have had facials, permanent eyeliner tattooed on to their eyelids, hair extensions, spray-on suntans, manicures and pedicures, not to mention two closetfuls of identical clothing.

So that their cosmetic surgeon could tell them apart when they had surgeries on the same day, they had their initials written on their bellies.

These twins co-own a beauty salon in Hertfordshire and have not ruled out more cosmetic surgeries in the future.

At the Cosmetic Surgical Center here in Dallas, Texas, we do not expect our clients to be twins. If you would like to have your individual consultation with Dr. Rai, please contact us today and we will be happy to schedule it for you.

BOTOX® is used by cosmetic surgeons to smooth out forehead wrinkles and frown lines. It is administered with an extremely thin needle directly into the muscle being treated. It prevents the brain from successfully sending messages to that muscle telling it to contract.

When you cannot contract the frown muscles, you cannot frown. That keeps the skin in that area more smooth, removing tension that would otherwise create the frown energy in your face. Repeated BOTOX® injections can prolong the smoothness and perhaps also retrain the muscle not to contract so often.

BOTOX® for Movement Disorders
BOTOX® works by blocking nerve impulses, in effect paralyzing that muscle. The medical profession has not been slow in seeing many other uses for a substance that safely paralyzes specific muscles. Physicians have been using BOTOX® to help with disorders that involve involuntary movements, such as cerebral palsy and multiple sclerosis. Cessation of that chronic, jerky movement is a great relief to these patients.

BOTOX® for Migraines
More recently BOTOX® has been used in treating migraine headaches which involve chronic muscular tension. This use of BOTOX® was discovered accidentally after patients who received the injections for frown lines reported headache relief. Physicians now inject BOTOX® into the sides or back of the head and have been changing the dosage to avoid unwanted side effects such as drooping eyelids.

BOTOX® for Bladder Problems
Another recent use has been for people with an overactive bladder. Urologists in two London hospitals recently did a double-blind trial with 34 patients, with half of them receiving BOTOX® and the others getting a placebo. Since BOTOX® works only on the specific muscle where it is injected, a long tube was used, with the injection needle inside it, to reach the bladder muscles targeted.

Twenty injections were given from different directions into the bladder, using a total of 200 ml of BOTOX®. Previous medications had been ineffective in reducing incontinence but the patients in this study who received BOTOX® all reported improvements in this and in their overall quality of life.

At the Cosmetic Surgical Center we use BOTOX® for facial enhancement only. If you would like to know more about how BOTOX® could smooth facial wrinkles and give you a more fresh and youthful appearance, please contact our cosmetic surgery office today.

In Framingham (about 20 miles from Boston, Massachusetts), there is a Brazilian community of about 14,000 immigrants. In late July of this year, the president of the Brazilian American Association in Framingham, Ilma Paixao, did a cable TV interview of a plastic surgeon who was visiting from Brazil.

It was part of her plan to raise awareness of health issues among the local residents and the doctor was one Luiz Carlos Ribeiro. He and his wife had been traveling back and forth between Brazil and Framingham for several years, performing plastic surgeries for low prices, between $1800 and $3,000. Paixao was pleased to get the interview because Ribeiro had an excellent reputation in Brazil.

Ribeiro gave a great interview, stressing the importance of always getting a second opinion and not accepting medical care from anyone unlicensed to perform it. He emphasized that the doctor should use only professional equipment in a professional clinic and never work outside of a medical facility.

Did He Practice What he Preached?
On August 1, an unconscious woman was brought to a local medical center, where she died. She had been a patient of Ribeiro, having liposuction done on a massage table in the basement of a local condo. Police examined the condo and found a great deal of blood protein on the floor. After more investigation they found that Ribeiro and his wife had been obtaining a series of 30-day work permits so they could perform plastic surgeries. His wife functioned as his surgical nurse.

Neither one of them is licensed to practice medicine in Massachusetts. However, neighbors of the deceased woman came forward to report to police that they also had had plastic surgery from Ribeiro. They had paid cash and it appears that the couple ran a cash-only business and kept no records. One of these neighbors was in hospital at the time for a severe infection after her liposuction.

Ribeiro performed other cosmetic surgeries besides liposuction, such as dermal fillers to plump up the lips and nose surgery. It is not known yet whether he is a qualified physician in Brazil.
An autopsy was planned for the deceased woman but no reports are available as to its results.

The results of your cosmetic surgery depend heavily on the quality of the surgeon you choose. Plastic surgery (including cosmetic surgery) is a specialty area in the U.S., with its own certification board. Before choosing any plastic surgeon, make sure he or she is board-certified to practice plastic surgery.

You can read about Dr. Rai’s extensive qualifications and professional memberships on his Training and Credentials page. If you would like to come in and see our clean and beautiful facilities, please call or send us an email. We can schedule a personal consultation for you with Dr. Rai.

If you would like to have breast augmentation, you currently have a choice between saline implants or silicone gel implants. Both are effective, safe, and popular. However some women prefer one over the other.

• Silicone gel implants are thought by many to look and feel more natural
• Saline implants are thought by some to be safer

The Best of Both Worlds

The IDEAL IMPLANT® was devised by a Dallas, Texas doctor to have the naturalness of silicone implants and the perceived safety of saline implants.

They are made with the same materials already used in breast implants. They are filled with saline and have saline implant shells and valves. But they have several shells nested inside each other.

• This design puts more control on the saline solution, restricting its movement to prevent sloshing and making it behave more like the thicker silicone gel
• The nested shells give more support to the outer shell, helping to prevent wrinkles and folds.
• The shells are designed to conform more comfortably to the convex shape of a chest wall.
• These implants can be inserted folded and empty like saline implants, which means the incisions can be smaller.
• IDEAL IMPLANTS® come in 14 sizes ranging from 184 cc to 600 cc.

FDA Trials

The plan is to conduct trials in several states and to have a ten-year follow-up period. Follow-up visits will be scheduled at pre-set intervals. Participants will pay the normal cost for the implants and procedure but will also have a Trust Fund set up in case Ideal Implants, Inc. ceases to operate and they need funds to remove or replace their implants. The follow-up visits are to research the long-term safety of these new implants.

Time will tell whether IDEAL IMPLANTS® turn out to be superior. Meanwhile, if you would like to learn more about the two types of breast implant currently available, please call or email our cosmetic surgery office for a personal consultation with Dr. Rai.

Cosmetic surgery has become popular worldwide, as the risky business of medical tourism can attest. You can read about one woman’s story of her international cosmetic surgery in our blog of August 28 this year. That woman’s procedures were probably quite safe, as she stayed in each country long enough to fully recover, whereas medical tourism does not necessarily provide for adequate recovery before the itinerary whisks you to the next country or back home.

Each country trains its own doctors and sets up its own laws to ensure medical safety. U.S. cosmetic surgeons are among the best-trained in the world and operate very safely.

A Chinese Story
In China, things are very different. Recently, a dissatisfied Chinese cosmetic surgery patient went back to the “shop” where she had had breast enlargement done three years previously. Her breasts were not the same size and she wanted compensation for that.

The shop had already refunded her entire surgery cost, but she wanted more so that she could have the problem corrected by another cosmetic surgeon who was apparently more expensive.

She entered the shop just as the staff were going off duty. In response to her plea, they locked her in the shop and left. She eventually called the police for help, but not until four hours later. News reports do not explain that delay. Perhaps she was expecting the staff to return and was determined to persuade them to pay her some more compensation. If so, she was certainly a patient woman.

The police had to break a window to get her out. News reports do not indicate whether this woman has any legal recourse.

Minimal Surgical Risks
All surgery brings some risk. A properly qualified cosmetic surgeon like Dr. Rai will always explain the possible risks of your procedure and U.S. law requires that every patient sign a Patient Consent Form indicating that they understand the risks. Dr. Rai will also give you printed post-operative instructions and will explain why you need to follow them for your safety and best recovery.

On our side, we will always do everything possible to correct a less-than-perfect surgical result. Dr. Rai can often do correctional surgeries, depending on what the procedure and problem are. If you had breast implant surgery and one breast were to end up larger than the other, we could correct that with new implants or by altering the saline content of one implant if you had saline filled implants. Better yet, we would avoid the problem by preparing carefully for your surgery and paying good attention throughout.

At Cosmetic Surgical Center you are in safe and experienced hands. Please call or email our cosmetic surgery office today for your personal consultation with Dr. Rai.