Download AAFPRS News 3 May 2005

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A New Face A New Life
May 3, 2005
For domestic violence victims, plastic surgery restores more than appearance
BY ELLEN MITCHELL
Two years ago the young woman lay on her kitchen floor bleeding profusely. Her throat
had been slashed repeatedly with a steak knife wielded by her husband. He'd hit her
before - this time he almost killed her.
Today this woman has relocated to Long Island, where she is raising her two small
children. Her husband is behind bars. She's just been promoted in her job, and she's
finally emerged from behind the scarf she always wore to hide her terrible scars.
Doctors in the state where the woman lived at the time of the attack saved her life; a
doctor here in New York, a member of a special volunteer program called Face to Face,
restored self-esteem and beauty to that life.
"There were nine deep cuts in my neck. The worst one started below my ear and went
down to my collarbone," she explained. "I'd always wear a scarf. People would tell me I
didn't need it, but I was extremely embarrassed."
"Life is a lot better now," she continued, in an understatement reflective of the fact that
she cannot fully believe the horrors of the past are behind her. It is for that reason that she
requests anonymity.
In the United States a woman is beaten every nine seconds by an intimate or former
partner, and 75 percent of these women receive battering to their face, head and neck.
It is because of such statistics that the American Academy of Facial Plastic and
Reconstructive Surgery has teamed with the National Coalition Against Domestic
Violence to develop Face to Face. The program provides free surgery, counseling and
support for victims of domestic abuse.
In the case of the young woman, her surgeon, Dr. Philip Miller of New York University
Medical Center, was "more excited than anybody when I stopped wearing the scarf. He
was like a father to me," she said.
Free local efforts
There are 17 facial plastic surgeons from the area currently donating their time and
expertise to the nationwide program, most of them in or near Manhattan. With the arrival
in Aquebogue of Dr. Paul E. Kelly, Face to Face has come to eastern Long Island.
Kelly, 38, who is board-certified in ear, nose, throat, head and neck surgery as well as in
facial plastic and reconstructive surgery, relocated to the Island recently from Houston,
where he first volunteered for Face to Face.
Although the coalition's major services are free to the victim, the program does not
provide transportation or housing.
"It was always difficult for victims to make tracks to big cities," said Kelly, "so we're
trying to infiltrate the smaller areas. They, too, certainly have their degree of abuse."
On the East End, Kelly expects that most of his program-related surgery will be done at
the Suffolk Surgery Center in Shirley. He is also working through Central Suffolk
Hospital in Riverhead, which has a domestic violence screening program. An
anesthesiologist, a scrub technician and a nurse have volunteered to assist him.
"I'm doing what I love, so I can't say it's a huge sacrifice, short of my time, from my
perspective," he added.
Repairing self-esteem
"We consider ourselves self-esteem doctors," said Kelly. "These women and men - and
sometimes the victim is a man - when they look in the mirror every morning are
reminded of bad choices. The things we do, whether it be scar removal, straightening the
broken nose or placing an implant in a cheek to restore symmetry, all provide an
incredible boost. These people have horribly low degrees of self-esteem, and that's why
they allowed these things to happen.
"I've seen some real disasters," he continued. "Some of these people also use cocaine, and
drugs wreak havoc with the inside of the nose."
He recalled a woman whose nose was so deviated from a beating that she could barely
breathe, and he also spoke of a man who couldn't bring himself to admit it but apparently
had gotten such a horrible laceration on his cheek from his wife that he "looked like a
chain gang member."
According to Kelly, most abusers "hit where it can be seen, usually the cheek or the nose,
because it keeps the victim in the house. It's a matter of control and dominance."
"We don't have any unfounded expectations about what we can do for these patients, but
in our own little way we know we can make things more physically acceptable for them,"
Kelly said.
Screening and counseling
Before victims can receive surgery, Face to Face requires strict screening to determine
that they are out of the abusive relationship. They are placed in a shelter if needed and
undergo extensive psychological counseling. Since the nationwide program began in
1994, more than 1,500 free surgeries have been performed for abuse victims.
Margaret M. Fox, a licensed clinical social worker from Laurel, will counsel victims both
before and after they are referred to Kelly for surgery.
"What I look for is their ability to see the problem. There is a lot of denial and a lot of
shame," said Fox. "They can no longer be saying, 'It won't happen again' or 'It was only
one time.'" Victims, she said, put up with the abuse over a long period of time, and "they
lose their sense of who they are. They feel like nothing. They define themselves by their
abuser.
"A split between the two is definitely needed, because the behavior is engrained and
dysfunctional on both parts. Abusers could at any time look at themselves and say, 'This
isn't right,' but they're not doing that. They'll probably go on to find another victim," said
Fox.
After the surgery, Fox said, counseling must continue. "Scars remain underneath the
restored face. A woman is very susceptible to going back to a similar relationship,
because it is familiar."
The young woman who has tossed out her scarves is not about to go back to anything
similar. She calls Face to Face "an absolute blessing."
"Sure, there are times when things get bad," she said, "but no matter how bad they seem,
my life now is a whole lot better than when I was with my husband. Wow, what a
difference."
Ellen Mitchell is a freelance writer.
WHERE TO TURN
The American Academy of Facial Plastic and Reconstructive Surgery and the National
Coalition Against Domestic Violence offer a 24-hour, toll-free number (800-842-4546)
for victims of domestic violence who have physical scars or injuries on the head, face and
neck. Callers are asked if their injuries are a result of domestic violence, if they are out of
the abusive relationship and to provide a brief description of their injuries.
The victim is given the name of a shelter in his or her local area and told to set up an
appointment with a counselor. Surgery is not usually performed until the victim has been
out of the violent situation for at least one year. - Ellen Mitchell
Profile Magazine
May 2005
Underneath the Mask: Plastic Surgery and You
by Hannah Claire Litman
Come on, admit it. There's something about your body that makes you unhappy — the
hook in your nose; the extra weight in your midriff; the crow's feet around your eyes.
These things that the rest of us think are your cosmetic traits can get you down, have you
wondering "what if I got rid of them?" and ultimately lead you into an (occasional or
frequent) plastic surgery fantasy. Because, in your current mindset, your lack of dates,
inability to get a promotion or stagnation in your marital sex-life are surely due to your
"flaw." No wonder then, that the two largest trends in plastic surgery today are couples
undergoing surgery together and singletons looking to give their online profile a cosmetic
boost. You think to yourself, if you fix the surface the cracks underneath — the literal
root of the problem — will certainly disappear.
Wendy Lewis, a private consultant for plastic surgery patients and co-author of America's
Cosmetic Doctors, sites television programs like Extreme Makeover and I Want a
Famous Face, as being the cause of this misconception, that surgery can "make the other
bad stuff go away."
"I wouldn't be surprised if the Extreme Makeover craze has spurred a lot of break ups as a
result from new strains on the relationship," says Lewis. "For a lot of couples there is a
co-dependency in your both not being too attractive to the opposite sex. Once you begin
to have things done and you gradually feel more desirous, the partner is bound to become
increasingly possessive. It's tricky."
However, most of us aren't in the Extreme Makeover league of looks. Instead, we are just
a little preoccupied with the cellulite on our thighs or the love handles developing with
each birthday. And, as such, Lewis admits that "for a lot of people, cosmetic surgery can
lead to increased confidence, loss of inhibitions and an increased desire for intimacy
which makes you feel better — and empowered — in your relationship. In general," she
concedes, "cosmetic surgery can be a very positive thing for both an individual and a
couple."
"I have seen a large increase in men coming in for cosmetic consultations for all numbers
of reasons," admits Lewis. "But for the most part, these men are dealing with a divorce,
returning to the dating-scene, and the desire to settle down although they haven't found
anyone yet. I may not even suggest all surgical routes — men hate anything too invasive
in the name of vanity — rather, it may be as simple as a new haircut and new glasses,
however the same result is achieved — a large confidence boost." Perhaps hence why, in
the instance of cosmetic procedures, porcelain veneers and hair transplants are very
popular with men; since what is more attractive than a warm, great-looking smile or a
thick head of hair to run your fingers through?
Dr. Alan Bauman, of Bauman Medical Group (www.baumanmedical.com), specializes in
hair transplants. "Hair is so tightly wrapped around the way in which we feel about
ourselves," he explains. "What's more, hair is something we all once had, unlike a DDbreast! And the loss of that hair is associated with aging, dying and unhealthiness, whilst
a full head of hair equates to youth, virility and beauty. Hair transplants," he says,
"therefore give men and women the opportunity to regain something they've lost."
"In the dating game," Bauman explains, "the smallest cosmetic procedure can help a man
or woman feel like they have increased their edge; makes them feel more marketable in
the bar on a Friday night. Ultimately," he says, "it's all about self-esteem being given a
boost."
One such patient of Bauman's sums it up this way, "I have given my whole relationship a
boost — it's like I turned the clock back 10 years and it's therefore like I have gained 10
years on my marriage. I'm back — and I didn't even need a sexual performance drug to
do it!"
Yet, Dr. Daniel Man, a board-certified plastic surgeon based in Boca Raton, thinks that
for a lot of his patients, unhappiness and anxiety are what eventually push them to take
action. "Typically," says Dr. Man, "my patients are stressed about their appearance and
feel that improving their look with improve their feelings about themselves, which will
lead to a better work and personal life. And often, they're right. A lot of times," he says,
"a millimeter in the body could be a mile in the brain. That's what drives people."
In the instance of a couple, it is crucial that neither one of your desires to "get something
fixed" cause a rift in your relationship. The longing to get work done is very personal and
a mate must tread a thin line between being supportive and gung-ho, the latter of which
leads to the partner hearing you too think s/he has flaws. As such, both Lewis and
Bauman suggest that a partner or spouse talk things over with their other half and explain
that you think s/he is beautiful just the way s/he is, but if it will make them happy then it
is ok with you. Yet women, says Dr. Man, are rarely supported by their husbands who
regard their wives as self-centered and narcissistic for even considering such a procedure.
Instead, says Man, the support often comes from a friend who has also had a procedure.
In such instances and despite initial difficulties in the marital relationship, postprocedure, Man says, the long-term the relationships are usually okay.
Dr. Pearlman, president of the American Academy of Facial Plastic and Reconstructive
Surgery (AAFPRS), agrees. "At the end of the day," he says, "if you are in a secure
relationship, then your increased self-confidence will enhance the relationship. On the
other hand, if your relationship is insecure, then it may make it worse because the outside
often also changes or alters the inside." What's clear is that if the rift is already there,
cosmetic procedures are more likely to affect a relationship negatively.
However, according to a national survey released by the AAFPRS in March this year, 59
percent of women and 54 percent of men would like to change at least one feature on
their significant other. What's more, despite women being known to be more savvy than
their partners when it comes to plastic surgery, more men than women are likely to
consider suggesting plastic surgery to their mate (16 percent men versus 11 percent
women, the survey showed.) Yet, as Lewis, Bauman and Pearlman all insinuated, if a
spouse or partner suggested plastic surgery and offered to pay for it, 58 percent of men
and 52 percent of women said they would feel insulted, according to the survey.
On the other hand, there is the increasing number of couples who enter the practitioner's
practice together. "In such instances," says Dr. Man, "you can see that they are good
friends who share a lot. More often than not, they're a little older and are going through
changes together — they see it in themselves and each other — and are bonding by doing
something about it together. On the other hand, a couple who is in the middle of a life
crisis should be told frankly that the psychological and physical burdens of the operation
may be too much for them and will not make everything better. They should adjust to the
existing crisis and be reasonably stable emotionally" before they consider going under the
knife.
In short, cosmetic surgery is becoming an increasingly popular bone of contention
amongst both couples and singles wanting to be part of the ever-elusive couple. But what
is clearer than ever is that communication — with both your surgeon, mate and friends —
is key in making the right choice.
May 4, 2005
Doctor Returns Home to Help
Local doctor travels to homeland to aid tsunami victims.
By Gary White
The Ledger
Thirty-two years ago, Raam Lakhani's Indian-American parents followed their cultural
custom and traveled to the home of his mother's parents so their son could be born there.
Lakhani took his first breaths in Sri Lanka, though his parents soon returned to their
home in Chicago.
The symbolic importance of that first pilgrimage partly inspired a trip Lakhani recently
made to Sri Lanka as an adult. Lakhani, now a specialist in facial plastic surgery at
Lakeland's Watson Clinic, visited the south Asian country to treat people still suffering
from the tsunami that struck last Dec. 26.
Lakhani used vacation time from the clinic and spent 16 days in Sri Lanka along with his
wife, Sonali, an internist at Orlando Regional Medical Center.
"Since I have some ties to the area, we decided to do whatever we could," Lakhani said.
"I was hearing all these stories of donating money and it was getting into the wrong
hands. . . . So we decided to do something where we would be able to go there and make
a difference rather than just sending a few thousand dollars."
Lakhani arranged the trip with a cousin who used to live in Sri Lanka. The husband-andwife doctors worked in tandem with a volunteer organization that had helped establish
refugee camps in the island nation, where the tsunami killed 31,000 people and left
900,000 homeless. During his time in Sri Lanka, Lakhani operated on three children,
repairing a cleft palate and a cleft lip and treating a burned hand. Though those conditions
did not result from the tsunami's waves, the disaster has worsened the already limited
access of Sri Lankans to surgical care.
The doctor had hoped to perform more surgeries, but a clinic could only give him a few
hours in its operating room. Lakhani hopes to return to Sri Lanka in a year or so, and he
says the contacts he made with local doctors will allow him to book surgical time in
advance.
Lakhani and his wife spent most of their time practicing basic medicine. They traveled to
makeshift clinics throughout the country, dispensing medications that had been donated
by other countries. Lakhani said the combination of standing water and crowded living
quarters spawned rashes and infections.
Some children were so dehydrated by stomach viruses that Lakhani ordered them to
hospitals. He estimates he and his wife treated 1,200 patients during the visit.
Though he had visited Sri Lanka a few times before, Lakhani discovered he was no
longer conversant in the official language of Sinhalese. He relied on a cousin and on
translaters provided by the relief organization. Lakhani's cousin also served as an
interpreter in the northeast region, where most residents speak Tamil, an Indian language.
Months after the tsunami, Lakhani saw countless effects of the natural disaster, including
beaches littered with toys and shattered boats lying half a mile inland, in addition to the
black tents that housed entire families. He got a sense of the tragedy's human dimensions
when the mayor of a village in the northeastern Trincomalee region gave him a tour.
"He'd show us, `These people lost a son,' " Lakhani says. " `These people lost an aunt.'
Every family had lost somebody."
Even so, Lakhani said he was impressed by the resiliency of the Sri Lankans. With help
from relief organizations, residents were replacing their lost homes -- in many cases,
using concrete rather than the inferior clay bricks of the destroyed houses.
Sri Lanka is a socially unstable nation plagued by anti-government groups that engage in
terrorism, and Lakhani worried before the trip about the dangers he and his wife might
face. But he says they never felt threatened, even in heavily Muslim areas.
"You keep hearing about how fanatical (Muslims) are, but they were the nicest people,"
Lakhani said. "They set up this clinic for me, and whatever I needed they had. . . . They
could have nothing, and literally they would split half of nothing with you."
CBS 2 Chicago WBBM-TV | cbs2chicago.com
Liquid Face Lift Shows Promise
May 2, 2005
Many people would like to get rid of wrinkles but are afraid of surgery. Now there's
another choice.
Medical Editor Mary Ann Childers reports on the liquid face lift.
Tammy Spinelli says under-eye bags add years to her face.
"I don't feel like I'm that old," she said.
Kelli Jordan doesn't want bags or wrinkles.
"Well, I felt like I needed to look less tired," she said.
But instead of surgery these women are choosing Sculptra. It's an injectable "volumizer"
made from a powdered form of standard surgical sutures. It stimulates skin to produce its
own collagen.
“We've used this material for years and years in cosmetic surgery to close wounds,"
Cosmetic Dermatologist Dr. Gregory Nikolaidis said.
After numbing the face, Sculptra is injected into carefully marked folds and sunken areas.
It takes minutes but can last up to two years. Other fillers, by comparison, last two to six
months.
“It's an in-office procedure,” facial plastic surgeon Dr. L. Mike Nayak said, “and is
almost a nice bridge to somewhere between doing nothing, and doing the ideal thing,
which is really doing the surgical procedure."
The results are noticeable in photos provided by Sculptra's maker, Sanofi-Aventis. You
can see the plumping effect not only on wrinkles, but also on folds, scars, and cheek
hollows. A total of two to four sessions are recommended, several weeks apart.
Right now Sculptra is approved only for facial fat loss in HIV patients, but some doctors
are permitted to use it for cosmetic purposes on an experimental basis.
Keep in mind, there can be some bruising and swelling and it can take days or even
weeks before results are apparent.
Contra Costa Times
Apr. 30, 2005
Costly results can stem from cheap surgery
By Nikki Waller
KNIGHT RIDDER
MIAMI - Many South Florida women travel to Latin America for discount plastic
surgeries, searching for tighter tummies and smoother faces. Some return mangled or
scarred.
Allyn Fader-Segura is one of them.
Six months after a botched tummy tuck in the Dominican Republic, the 40-year-old
mother of three from Miami has endured several operations, long hospital stays and
unimaginable pain.
"I was butchered," she said.
All she wanted was an end to chronic pain caused by multiple operations for hernias and
ovarian cancer. And maybe, she admitted shyly, a waistline. For the first time in her life.
Similar dreams of transformation lead many South Florida women to clinics in the
Dominican Republic, Colombia, Costa Rica, Brazil and other countries for cut-rate
cosmetic surgeries.
And although many doctors abroad provide high-quality care that rivals that of U.S.
surgeons, those who advertise cut-rate services often do not.
Of course, unlicensed, poorly trained surgeons are also a problem in the United States,
said Dr. Onelio Garcia, a Hialeah, Fla., surgeon and president of the Florida Society of
Plastic Surgeons. Tales of botched procedures, even deaths, are fairly common in Florida.
But patients can be at a great disadvantage if a problem develops and the person who
recently conducted the surgery is thousands of miles away.
Fader-Segura recounts the surgery and complications that left her with a gaping wound
and rotted her belly button.
Health insurance wouldn't cover the operation. She couldn't afford the $6,000 that local
cosmetic surgeons wanted for the job, so when she heard that doctors in the Dominican
Republic would operate for $3,000 or less, she began making plans.
No one collects official counts of U.S. residents who travel abroad for low-cost cosmetic
procedures, but surgeons locally and abroad estimate that they number in the low
thousands.
Some emerge from the recovery room to enjoy spectacular results. But a growing number
return with scarred bodies and infected wounds, rushing from the airport to the
emergency room.
Low prices should put would-be patients on alert.
Many surgeons in Latin America provide high-quality care on par with their U.S.
counterparts; their prices also match those of American physicians, Garcia said.
"Doctors who offer discount surgeries are not members of the accepted plastic surgery
community in their countries," Garcia said.
These discount doctors from other countries frequently come to South Florida to perform
consultations and book surgery appointments in hotel rooms, Garcia said.
Travelers seeking low-cost surgery can expect low-quality care, said Joao Sampaio Goes,
a Sao Paulo cosmetic surgeon and head of the International Society of Aesthetic Plastic
Surgery.
"If you just look for very low cost, you will go to bad places, to people who may not be
actual plastic surgeons," he said. "Good doctors don't have to advertise directly to the
public."
Local plastic surgeons and emergency room doctors say the problem is worsening as
South Florida's arms-race beauty culture and makeover-theme TV shows herald cosmetic
surgery as a shortcut to perfection.
"It's almost a health care crisis," said Dr. Seth Thaller, chief of the University of Miami's
Division of Plastic and Reconstructive Surgery.
In the past year, he has treated eight patients returning from botched surgeries in the
Dominican Republic, versus three from patients operated on in the United States. Garcia's
office gets calls about similar problems once a month.
Though small, these numbers mark a worrisome trend.
"We see them right off the plane," said Thaller, who oversees the plastic surgery division
at Jackson Memorial Hospital in Miami.
Cosmetic surgery patients should plan to visit their doctor for follow-up visits in the year
after surgery, Thaller said.
It's unlikely that a doctor can provide that kind of close observation from thousands of
miles away, he added.
His staff treats the immediate problems of infections and wounds -- often at public
expense -- then refers patients to private doctors for the costly removal of implants or
repeat tummy tucks.
Most doctors, unwilling to work on another surgeon's mess, avoid patients returning from
overseas surgery, said Foad Nahai, an Atlanta-based plastic surgeon and vice president of
the International Society of Aesthetic Plastic Surgery.
"It's not something they do willingly," he said.
At best, patients must live with deep scars and massive medical bills -- if they can afford
corrective surgeries. Others endure chronic pain and misshapen bodies.
Triple-D breasts on a petite frame caused Denise Suarez severe back pain. Her insurance
company wouldn't cover breast reduction, and the 25-year-old accounting student from
Tamarac, Fla., couldn't afford it on her own.
She booked a $4,000 surgery in Santo Domingo, Dominican Republic, in late 2003.
She loved the results at first. She felt beautiful, and the strain on her back disappeared.
Then the incision opened up, and an infection consumed part of one nipple.
In the end, surgery and treatment cost her as much as a breast reduction in South Florida
would have.
"You never stop to think. ... You just assume everything's OK," she said.
For their surgeries, Fader-Segura and a friend sought references from friends and on the
Internet.
They booked a six-week trip to the Dominican Republic last July to visit clinics,
interview doctors and undergo surgery. Plane fare was cheap, and the two saved money
by staying with Fader-Segura's family.
But the doctor they selected, Edgar Contreras, has been blamed in the deaths of several
young women who went to him for surgery.
He was barred from practicing medicine in the Dominican Republic in 1999 after he was
found guilty of involuntary manslaughter in the death of a patient.
But he returned to practice, attracting the attention of law enforcement only when another
woman died in his care last November, the Dominican press reported.
The Dominican Society of Plastic Surgeons has said in the news that it does not know
how Contreras managed to practice again, but it does not accept him as a member.
The Dominican press reported he and his brother left the country for Brazil late last year.
Silvia Torres would argue that Fader-Segura was lucky to escape with her life. Her sister,
America Chavez, a home health assistant in West Kendall, died after a procedure to
remove varicose veins and dark spots from her legs in Bogota in 2003.
Doctors allowed her to return to her hotel on the day of her surgery. She was far from the
clinic when a blood clot traveled to her lungs, killing her in 30 seconds.
Torres was shocked to hear many similar stories of complications and even death after
elective surgeries overseas.
"It happens more often than we think it happens," she said. "I never thought it was such a
high risk."