Plastic Surgery Gone Wrong

The importance of finding a board certified specialistBy Dr. Francisco Bucio
Nov 25, 2010 10:40 AM • Topic: History • Issue: 2010-11

Would you travel in a plane flown by a taxi driver? I don’t have anything against taxi drivers, it’s only that they have a different kind of skill; it has nothing to do with IQ. Certainly, with the adequate training they could surpass their counterparts that circle the skies.But what to think then of medical complications such as the one suffered by Mexican singer Alejandra Guzmán, who was intervened for an aesthetic procedure of buttocks augmentation, resulting in a serious complication because of the personal responsible for the procedure were not adequately trained and almost caused the death of the performer?
What if we mention that this was just a case of a celebrity and merely the “tip of the iceberg”, that cases like hers are counted by thousands? And if we also add the fact that a big portion of these cases have no solution and some are even fatal, then the issue is no longer a simple "medical trade" matter.
Malcolm Gladwell, in his book “Outliers. The story of success”, proposes that in order to succeed in any activity you require:
1.- OPORTUNITY
2.- LEGACY
In this specific subject of the correct practice of plastic surgery, the LEGACY is given by the accumulation of scientific and artistic knowledge provided by giants such as Tagliacozzi from Italy in the XVI century, Sushruta from India in the VI century and Buncke from USA in the XX century.The OPORTUNITY is given by being in the adequate place and ambiance to receive the training in PLASTIC SURGERY,THE MEDICAL RESIDENCY in a prestigious and certified program.
Furthermore, a basic element: THE PRACTICE.Gladwell proposes is not just a matter of having talent.Thousands of hours of practice are required.Mozart did not write his greatest masterpieces until he was 27 years old. The Beatles did not become The Beatles until
they played for several years 8 hours a day in a little Club in Berlin. Bill Gates programmed for years in one of his middle school computers before creating Microsoft. What all of
these legendary characters have in common is not just talent and opportunity but 10,000 hours of PRACTICE.
A Plastic Surgeon, when finishing the specialty, has already surpassed over 10,000 hours of accumulated practice, dedicated body and soul to give back the harmony of forms, proportions, beauty and function to the human body, treating genetically malformed patients like cleft lip and palate, trauma patients, hand and craniofacial malformations,
burned victims, post-mastectomy secuelae patients and of course aesthetic plastic surgery, all guided by the hand of their ancestors, heirs from the Gillies, Guerrero-Santos, Pintanguy and Ortiz-Monasterio tradition. It is not, let’s make it clear, practice without a foundation.
In the past years our specialty has been flooded by numerous advertisements especially over the internet by all type of offers from the miracle workers to the grotesque. The motive is monetary. The Panacea has been commercialized by charlatans throughout history without scruples and under no ethics to be ruled by.
A lot of these offers come from people that have received as minimal as two weeks training only and they call themselves specialists. It’s as if I were to take an electrocardiogram course and then consider myself a cardiologist!
When I was just starting medical school, I remember an Old doctor from my neighborhood that literally “did everything” and he did it well. Being his assistant I use to see him treat typhoid fever patients followed by an aplastic anemia, and to finish with a tuberculosis patient and then operating an ectopic pregnancy. Basically, medical specialties where somewhat recent. They were “Jack of all trades,masters of none”. There was no other option.
The year is 2010. Like the Darwinian evolution, doctors with a common medical path have differentiated into specialties. Like doctors, every organ of our bodies has a specific function, non-substitutable and SPECIALIZED that works collaborating with the rest of the systems. The heart is required to pump blood, but this could not happen without the nervous system and this one could not perform without the endocrine that also requires the digestive system etc.Without doubt the brain would not substitute the urinary system because of being more intelligent, but surely it needs it to purify the body they are sharing.
Shoemaker, to your shoes”.( “zapatero a tu zapato”) Anonimous.
In short, how to choose a Mexican Plastic Surgeon?
Verify that your surgeon is certified and re-certified by the CMCPER (Consejo Mexicano de Cirugía Plastica, Estética y Reconstructiva) at
http://www.cirugiaplastica.org.mx.

The Breast in Our Times

“You can only see through your heart, the essential is invisible to the eye” \"The little prince\"By By Dr. Francisco Bucio/Certified Plastic Surgeon
Oct 27, 2010 4:11 PM • Topic: Health • Issue: 2010-10

When we think about breasts in today's society, we immediately think of images such as Pamela Anderson, Victoria’s Secret models or the Sports illustrated calendar.
However, as incredible as it may appear, this breast "liberation" is as recent as the end of the 20th century, thanks to the social movements, especially the feminist one, during which women burned their bras as a symbol of freedom and ownership of their bodies.
According to Marilyn Yalon in her book "A history of the breast", women have finally taken possession of their breasts since the discussion of breast cancer, not just dealing with the suffering of the disease which apparently is growing every day, but taking part in the decision making as to the different treatment options offered. This includes chemo, mastectomy, therapy groups, family therapy etc.
Breast perception has suffered a radical transformation through out history. Nowadays, in the occidental society specially among men, it is a sexual symbol, a fetish, just like for Latin-Americans are the glutes, the neck for the Japanese or small feet for the Chinese.
It’s oldest symbolic representation is at least 23,000 years old, with the Venus of Grimaldi, and the goddess Iris breast feeding young Horus from the Egyptian culture, or the Greek Goddess Artemis adorned with 20 breasts in the II century, or Aphrodite in the year IV B.C. not to exclude the creation of our Milky Way through the milk that the Greek Goddess Hera spilled when refused to keep on breastfeeding Hercules.
And you may ask yourself : What are breasts? And who do them belong to?
To the baby that needs to be breast-fed? to men for sexual pleasure? to the adult movie director? to the lingerie designer? to the doctor for his diagnosis? to church for its censorship? to the psychoanalyst for his Freudian theories? or the artist for his own interpretation?
The response from my point of view is very simple: They Belong to women.
Truth be said, we are the product of society in which we live in. Women are constantly bombarded by television, magazines and publicity from us the plastic surgeons.
I think there should be a balance. We shouldn’t be carried away only by what the fashion tendency dictates, nor go back to the age where women needed to accept simply what “God gave them”.
For example in the field of plastic surgery, if a woman decides to modify her breasts (or other parts of her body), first there should be an auto evaluation as to the purpose of taking that decision; is it to satisfy your partner?, is it for keeping up with fashion? Is it to substitute an emotional deficiency? Or is it for the right reason, the way it should be; a very personal and well thought out decision that will improve their appearance and enhance self esteem; because a larger bust size will not prevent the husband from looking at other women, nor detain an imminent divorce or substitute a lost lover or attract a new one. What it will do is, that these woman will acquire a higher self esteem irradiating assurance and confidence and a general state of happiness within her and with others.
Modern Alternative procedures in plastic surgery are many, the equipment has improved, now implants are made from cohesive silicone gel which will not leak if they rupture, techniques also have improved. We are currently using a subfascial technique for breast augmentation. This technique consists in placing the implant under the muscle-fascia (the hard white part of the muscle) ; the benefits of this procedure are that they provide the same aesthetic result from those of the submuscular technique, with a soft edge, being anatomically correct, it is more precise and less painful and do not produce a “dynamic” post-surgery pectoral deformation.
Another technique that is winning a lot of acceptance is the breast augmentation through fat injections. Never the less this technique is reserved for special reconstructive cases such as implant rejection. This technique does not substitute implants.
The subject of Breasts will continuously change according to the evolution of our culture and civilization. For the time being we should take advantage of this window of opportunity opened for women and let them decide in terms of their bodies, reproductive health, mind and her own breasts.