Cosmetic Surgery Center, Dallas | Dr. Rai

On Friday, January 1, 2010, California will have a new cosmetic surgery law called the Donda West Law. It has been working its way through the California House and Senate for about a year. It is named after Kanje West’s mother, who died after her cosmetic surgery in 2007.

Kanje West is a rapper and actor. His mother had pre-existing cardiac problems that were evidently not made known to her Beverly Hills cosmetic surgeon, who went ahead with a breast reduction, liposuction, and a tummy tuck in November 2007. Those procedures took eight hours and then she was sent home for recovery. However, the next day she was found in respiratory distress and was pronounced dead at a medical center that evening.

Pre-Existing Cardiac Condition

Those three procedures were major surgery, especially when done together for a woman aged 58. It appears from news reports that she was advised to recover at another facility where she would receive monitoring and proper care, but declined and instead went home. During the following day, she was in pain and having breathing difficulty but was walking around. She was left unattended near the end of the day and later found on her bed unresponsive.

After doing an autopsy, the coroner concluded that her breathing trouble “may have triggered the cardiac event” that caused her death and that she died from some pre-existing coronary artery disease and “multiple post-operative factors following surgery”.

Written Clearance Now Required Before Plastic Surgery

The new law will require that doctors do a physical exam within 30 days of any cosmetic surgery and sign off on a written clearance that the surgery will be safe. This law is designed to make sure that people do have a complete physical before any cosmetic surgery, because that could have prevented West’s death.

However, all reputable cosmetic surgeons already do a complete physical before they go forward with any cosmetic surgery. This law will make no difference to their surgery practice.

Dr. Rai offers a free consultation to all his new patients, where he listens to their goals and what they would like to have done, and evaluates whether it would be appropriate. A full physical is then done in a separate visit if he decides that cosmetic surgery is a possibility.

If you are interested in plastic surgery, whether major or minor, the first step would be to contact us for a consultation with Dr. Rai. We look forward to meeting with you and you can be very sure you will be in responsible and safe hands at our facility.

On December 15, 2009, this space reported on a planned cosmetic surgery tax of five percent. It was in a healthcare bill being considered by the U.S. Senate.

Now the Senate has replaced that tax with a ten percent tax on tanning salons. Apparently, cosmetic surgeons presented an effective opposition to that five percent tax, arguing that it would punish women unfairly, since most cosmetic patients are female. A very informative website was created to present the arguments against this tax.

Breast augmentation was the top cosmetic procedure in 2008 and Breast Lifts were close to the top at #6. Typically, men make up about ten percent of all cosmetic surgery patients, although that number has been rising.

Since the federal government is desperate to get more money somewhere, somehow, to cover their fantastical degree of spending over the past year, tanning salons are now targeted. They are fighting back, arguing that they already have heavily restricted access for teenagers and are already struggling in this poor economy. A new ten percent tax would put too much strain on their business.

Women Penalized Either Way

Salon owners are arguing that a tanning tax would punish women just as a cosmetic surgery tax would have, since most tanning customers are women. However, the tanning industry is not as large as the cosmetic surgery industry and they perhaps lack the lobbying power to fight effectively against this proposed tax. There are about 20,000 tanning salons nationwide, most being “Mom and Pop” businesses rather than large corporations.

One argument being presented in favor of a tanning tax is that it is linked to skin cancer and should be discouraged. This is a “sin tax” analogous to the cigarette tax, designed to discourage smoking but not to the point where no tax revenue would be collected.

However, if this is still a free country, it is the individual’s choice whether to smoke, get a suntan, or have liposuction, and not a government bureaucrat’s choice. Consumer education is the important thing so that when we make our choices, we know what risks we are taking, if any.

If you would like to learn more about the choices we offer at The Cosmetic Surgical Center, please call or email us today for a free consultation with Dr. Rai.

In July 2008 in Taipei, a woman with a last name of Hung and an unknown first name had breast augmentation done. The surgeon was one Lee Chin-liang, the son-in-law of a TV show host.

Lee advised Hung to come in for a second surgery in September of this year and he would adjust the implants. After that six-hour procedure, Hung woke up to find that both her breast implants were gone. She gave a press conference in October about this and stated:

• “I did not ask [him] to remove the implants, and the doctor refused to explain the situation to me until several days after the surgery.”

She also stated that Lee had refused to sign papers to transfer her to another hospital. She said she received dreadful treatment at his clinic and accused him of medical malpractice.

Lee scoffed at Hung’s statements, saying that he had removed the silicone gel implants because Hung had not massaged her breasts after the surgery and the implants had therefore contracted. He accused Hung of trying to extort NT$12 million (US$370,000) from him. Hung denied this and said that if Lee did not apologize she would take him to court.

City Government Stepping In

Also at the press conference was Taipei City Councilor Lee Wen-ying who said that Lee Chin-liang was in violation of the Physicians Law. Silicon gel breast implants had not been approved in Taiwan until October 2008 but the surgeon had implanted them in July. She said that Lee had failed to explain the breast implant surgery to Hung and suggested that the Taipei city government should look into this case to protect consumer rights.

In October 2009, Taipei’s Department of Health announced that they would look into this dispute. The surgeon is well-known in Taiwan. No doubt there will be more to this story.

Meanwhile, Dr. Rai also offers breast implants and always explains the procedure before he takes any action. Patient education is a high priority at The Cosmetic Surgical Center and we are all happy to answer questions at any time.

If you would like to know more about breast enhancement or any of our other cosmetic surgeries, please call or email us today to schedule a free consultation with Dr. Rai.

A couple in North Dakota is divorcing in Isaacson v. Isaacson and in dividing up the marital assets, the husband wants to count the money spent on his wife’s breast implants. He wants the cost of one implant repaid to him.

The Judge stated that this was “absolutely nonsense” and said:

• “I can't imagine people would actually waste time thinking that breast implants are marital assets. It just defies common sense. I don't know how you would expect me to award breast implants, if you want me to have them cut out and given to Mr. Isaacson."

Mr. Isaacson’s lawyer has argued that medical expenses should be considered marital assets when they paid for procedures that are "clearly cosmetic, elective, (and) non-necessary." Isaacson’s share would be $5,500. He is also asking for half of the cost of his wife’s LASIK surgery, another $1,000.

Where Might This End?

It seems to be human nature to push at every envelope. The North Dakota is considering whether they should include a breast implant as a marital asset and wondering how far this line of thinking might be taken by others. Justice Daniel Crothers asked last week, during the debate:

• “Do we have any lines to be drawn? Is dental work a marital asset? Is a hip replacement a marital asset?”

In another case in New York, a Long Island surgeon demanded that his estranged wife return the kidney he had donated to her; or else pay him $1.5 million for it. He had donated the kidney in 2001 and claims that only 18 months later she had an extramarital affair. At the end of three years she filed for a divorce. Divorce experts do not think he can succeed in having a kidney classified as a marital asset.

Mrs. Isaacson’s attorney is claiming that Mr. Isaacson is just trying to embarrass his wife. However, his wife has a lot of company in choosing to have breast implants. According to the American Society for Aesthetic Plastic Surgery (ASAPS), breast augmentation replaced liposuction in 2008 as the most popular surgery.

If you would like to talk with Dr. Rai about how cosmetic surgery could enhance your appearance, please contact our office today and we will be happy to schedule a free consultation for you.

The U.S. Senate is currently considering a bill for what the media call “health care reform”, meaning the imposition of government-run healthcare. It includes a five percent tax on all cosmetic surgery – procedures such as liposuction, BOTOX® Cosmetic, and breast implants that are done to enhance one’s appearance rather than to repair an abnormality or reconstruct after an injury.

These are the procedures that insurance companies currently do not pay for, for the same reason. For example, rhinoplasty can be done for either cosmetic enhancement of the nose or for correction of breathing problems such as a deviated septum – and it can be done for both reasons at the same time. In other words, a rhinoplasty can give you both cosmetic and health benefits. There is an ongoing battle between cosmetic surgeons and insurance companies as to whether each rhinoplasty should be covered or not, or whether it should be partially covered.

The Senate’s bill would apparently classify all rhinoplasties as cosmetic, although without reading the bill, we cannot know that for certain. In the current declining economy, cosmetic surgeons have been suffering from reduced business to some extent, and are mostly opposed to any tax on cosmetic surgery.

Are You Among “The Rich”?

According to the American Society of Plastic Surgeons (ASPS), about 40 percent of cosmetic surgery patients are in the income range of $30,000 to $60,000. So it is not only “the rich” who have cosmetic surgery. It is anyone and everyone who saves up enough money for it, or who takes out a loan.

Also opposing this proposed tax are the American Medical Association (AMA) and the National Organization for Women (NOW). Most cosmetic surgery patients are women and this tax would unfairly penalize them. NOW’s president recently stated to a New York Times reporter that “in a society that punishes women for getting older,” this tax would punish them further.

As mentioned in this space on December 8, 2009, New Jersey has a breast enlargement tax and is now moving towards repealing it. It failed to generate the expected income for the government because it reduced cosmetic surgery in New Jersey. People went out of state for their procedures.

On a national scale, the same thing could happen. If the federal government taxes cosmetic surgery, many people may go to another country for their procedures. Cosmetic surgery tourism is already a thriving trade worldwide. In any case, according to Vivian Ho, a health economist at Rice University, whatever income a federal cosmetic surgery tax generated for Washington would be “a drop in the bucket”, since the bill’s price tag is $850 Billion.

If you would like to learn more about cosmetic surgery procedures (all currently un-taxed), please contact our Dallas, Texas office today for a free consultation with Dr. Rai.

Before BOTOX® was used for cosmetic surgery purposes, it was used to treat spastic disorders (diseases that feature involuntary muscle movement; examples are Multiple Sclerosis and Cerebral Palsy). By injecting BOTOX® Cosmetic, those individual muscles are temporarily paralyzed, giving the patient relief from the recurrent, jerky movements. It is still used this way and was FDA-approved for that use in 1997.

In 2002, the FDA approved BOTOX® Cosmetic for treatment of glabellar (frown) lines. It is also used “off-label”, meaning for purposes not specifically approved by the FDA, such as horizontal forehead lines.

Off-label use is legal and frequent, as the FDA is far too busy to be able to test every new drug for every conceivable future use. Doctors make their own judgment calls in specific cases where they think use of a drug will benefit their patient in some way not specifically tested in FDA trials.

How BOTOX® Cosmetic Might Achieve a Breast Lift

At the annual meeting of the American Society of Plastic Surgeons (ASPS) in Seattle, physicians discussed using BOTOX® Cosmetic for a mild and temporary breast lift. The targeted muscle would be the pectoralis minor, a small muscle beneath the pectoralis major.

If this muscle is paralyzed, the back muscles would take over that loss by lifting the chest. Since the effects of a BOTOX® Cosmetic injection last just three or four months, and these treatments would cost between $1,000 and $2,000 for both breasts, this would be an expensive way to get any long-term breast lift.

But if you wanted a breast lift for a short time, such as a beach holiday or a cruise, it could be a good solution. There would be no scars and no downtime.

Some Professional Opinions

One plastic surgeon, Karol Gutowski in Evanston, Illinois, is skeptical.

• "You can probably get the same effect by altering your posture," he said. “It would be very difficult to target the smaller muscle that is covered by larger muscle … [and] … "other muscles of the shoulder, back, and chest play a role, so it is very hard to believe that just weakening the pectoralis minor would give any type of effect."

He would give it “two thumbs down”. One of the past presidents of the ASPS, Walter L. Erhardt Jr., from Albany Georgia, also expressed doubt:

• "I would go to the gym or take posture lessons before turning to BOTOX® Cosmetic for a breast lift," he said. "The results will be longer lasting and it will be a lot safer."

Other doctors do favor it though, and perhaps it will eventually become an accepted cosmetic surgery treatment.

Meanwhile, at the Cosmetic Surgical Center, Dr. Rai offers BOTOX® Cosmetic for smoothing out frown lines and horizontal forehead lines. This rejuvenates the face quite dramatically and repeat treatments can make it last indefinitely.

To schedule a free personal consultation with Dr. Rai, please call or email our Dallas, Texas office today.

In 2004, New Jersey implemented a six percent tax on breast enlargement that was proposed by Democrat Assemblyman Joseph Cryan. It has driven cosmetic surgery patients to other states for their procedures and has not generated anything like what New Jersey Democrats had expected.

In 2008 it generated about $9 million and cost an unknown amount to administer. It provoked intense controversy including the charge that it discriminates against middle-class women, who, according to the American Academy of Cosmetic Surgery, are the bulk of cosmetic surgery patients.

Cryan now wants his tax repealed.

• “It was a real education,” he stated. “We essentially discouraged the business from happening at all.”

That is a basic principle about taxes: whatever you tax, you discourage.

New Jersey cosmetic surgeon Susan Hughes reported that her practice suffered a ten percent drop in business when people began going to Pennsylvania for their surgery.

• “We became the tax collector,” she said in an interview. “Now you’re going to repeat that on a national level? You idiots!”

Many doctors felt similar anger agout it. The proposed national tax on cosmetic surgery does not specify procedures; it would apply to all cosmetic surgery.

According to the American Society of Plastic Surgeons, about 12 million people had plastic surgery in 2008, spending about $10.3 billion on procedures and products.

For now, there is no tax on cosmetic surgery and at The Cosmetic Surgical Center we offer a full array of procedures for both men and women. Breast implants are still the most popular female cosmetic procedure and for men, male liposuction is very popular.

If you would like to know more about a certain procedure, the best step to take would be scheduling a free personal consultation with Dr. Rai. Please contact our cosmetic surgery office today and we will be happy to set that up for you.

Media outlets are making a big deal out of the death of the former Miss Argentina, Solange Magnano, after complications from her cosmetic surgery. She had a buttock lift or perhaps buttock implants and reports say that she died from a pulmonary embolism – a blockage in the lungs.

Gluteoplasty is a low-risk procedure and apparently Magnano approached it as a non-event. News reports are not claiming that there was any surgical error. It is not known yet how her recovery period was progressing, other than the embolism.

All Surgery Brings Risk

Whenever the skin is cut or broken, the body is at risk. Protection is one of the skin’s most important functions. That is why surgeons and their assistants observe strict sterile technique – it is to prevent bacteria or other parasites from entering the body while the skin’s integrity is temporarily violated.

The best cosmetic surgeons screen their patients carefully to make sure that the procedure will be appropriate and safe for each person. Dr. Rai always talks to his patients to make sure they understand the procedure they are planning to have, its limitations, probable results, and possible complications. Patient education is a high priority at The Cosmetic Surgical Center.

Before your surgery, Dr. Rai will give you printed instructions for how to care for yourself during recovery. He will write any prescriptions necessary ahead of time so that you can fill them and have them ready when you arrive home after your surgery.

How to Maximize Your Cosmetic Surgery Results

1. Take time to prepare for your recovery with measures like arranging for someone to walk the dog, bring in the mail, pick up children, do a grocery run for you, etc. You can get the house cleaned, laundry done, and childcare arrangements made ahead of time. These measures will enable you to rest properly after your surgery, which is very important, especially if you had major surgery such as a tummy tuck or breast enlargement.
2. Follow Dr. Rai’s recovery instructions to the letter. For example, get up to walk a little only as he directs. Rest is important but so is a little exercise because using the leg muscles helps prevent blood clots from forming. This is how the lungs can be blocked, by a blood clot breaking free and traveling in the bloodstream to the lungs. Change any dressings only according to your instructions and do not take a shower or bath before that is advised.
3. Protect your treated area from any impact. The body needs time to heal incisions and a blow or premature exercise could re-open incisions, causing bleeding and potential infection.
4. Call Dr. Rai as soon as anything unexpected happens. If you start to bleed too much, or feel extra pain, Dr. Rai will address that so as to prevent any problem from developing.

Of course, the very first thing you should do to give yourself a good surgical outcome is to choose a fully-qualified and well-experienced cosmetic surgeon. Please read about Dr. Rai’s training and credentials and if you would like to have a free personal consultation with him, please call or email us today.