11:58 In Your Face:
Welcome to “In Your Face CHAT.” I’m Colin Stewart of the cosmetic-medicine blog “In Your Face.” blog
11:58 In Your Face:
My guest today is plastic surgeon Dr. Michael Sundine of Newport Beach, the current president of the Orange County Society of Plastic Surgeons.
11:59 In Your Face:
We’re going to start the chat with a discussion of botched plastic surgeries, especially (but not exclusively) involving celebrities. Readers who are online are welcome to add their comments.
At the same time, I’m opening the chat to questions from readers who are online. I won’t ask Dr. Sundine to answer them until the second half of this chat, but don’t wait until then to submit them.
11:59 In Your Face:
Former supermodel Janice Dickinson is the first celebrity I’d like you to discuss. She’s one of many whose plastic surgery was botched, or at least fell short of what a patient would hope for. Here’s a photo:
11:59 In Your Face:
Tell me what you see there!!
12:00 In Your Face:
Readers’ comments are welcome too.
12:00 [Comment From michele]
bad boobs!
12:01 In Your Face:
Bad job of inserting breast implants, Michele?
12:01 [Comment From michele]
yes, too fake
12:01 [Comment From Dr. Sundine]
These breast inplants are way too large which appears to look like one breast and extremely high…too close to the mid-line.
12:02 [Comment From michele]
why didn’t the surgeon know better?
12:03 [Comment From Dr. Sundine]
Good question Michele…sometimes the surgeon might listen to the patient’s desires too much without looking at the limitations of the surgery. Bigger isn’t always better.
12:04 In Your Face:
And I’ve frequently heard from plastic surgeons that patients’ most frequent regret is getting implants that are too small.
12:04 In Your Face:
So I expect doctors have a difficult time knowing when to advise a patient to go smaller.
12:04 Dr. Sundine:
Sometimes this is true…but if you look at bad celebrity photos, the breast are almost always over done and this is the biggest problem.
12:05 In Your Face:
Would you recommend a second operation in this case, replacing these implants with smaller ones?
12:05 Dr. Sundine:
What we try to do is we size breast implants based on the patient’s chest wall dimensions and breast dimensions.
12:05 [Comment From michele]
I would
12:06 Dr. Sundine:
Second operation? Yes but she probably would need a breast lift at the same time.
12:06 [Comment From michele]
hmm. now it’s all getting too scary!
12:07 Dr. Sundine:
Frequently with oversized implants, patient’s don’t understand the soft tissue consequences and over time – the weight of the implants will pull the breast down.
12:08 In Your Face:
Michele, I’m reminded of Dr. Donald Altman’s comment about Michael Jackson’s problems. He said that fixing plastic surgery is like fixing a miscooked recipe — very difficult, much harder than getting it right the first time.
12:08 In Your Face:
Thanks. Let’s turn to Lara Flynn Boyle …
12:08 In Your Face:
And, thanks to FamousPlastic.com:
12:09 In Your Face:
What do you see going on there?
12:09 Dr. Sundine:
This is either a lip implant or overdone filler. Looks like she may have had cheek implants as well.
12:09 [Comment From michele]
over did the lips? too much? too frequently?
12:10 Dr. Sundine:
Yes to all your questions Michele.
12:10 In Your Face:
If the lips were plumped with a filler, that’s temporary, right? But an implant would have to be removed in a second operation.
12:10 [Comment From michele]
an addiction and can’t stop?
12:11 Dr. Sundine:
yes — fillers are temporary. Implants would need to be removed.
12:11 In Your Face:
Do you have a sense of what’s going on in the heads of so many actresses regarding lips?
12:12 In Your Face:
I guess they see Angelina Jolie and think they’d like to look like that, or bigger?
12:12 [Comment From michele]
They all want to look like Angelina Jolie!?
12:12 In Your Face:
Michele, you and I think alike!
12:12 Dr. Sundine:
I don’t know why Hollywood women need to overdo plastic surgery. Are they all trying to achieve an “Angelina Jolie” look?
12:12 In Your Face:
We all think alike!
12:13 In Your Face:
Lisa Rinna finally admitted that she overdid it.
12:13 [Comment From michele]
I hear once you get started, it’s hard to stop!
12:13 Dr. Sundine:
I don’t understand the psychology involved…but every procedure seems to be overdone.
12:14 In Your Face:
Every procedure that we’ve looked at, right? I assume you’re not talking about your own work — those must be exactly what’ appropriate?
12:14 [Comment From michele]
My friend’s daughter is on a roll and it is scaring my friend because her daughter try’s to keep her surgeries a secret but ultimately her mom can tell?
12:14 Dr. Sundine:
Yes – every procedure we have looked at.
12:15 Dr. Sundine:
Michele — you need to differentiate between maintaining appearance versus overdoing appearance.
12:16 [Comment From michele]
I agree
12:16 In Your Face:
FYI, readers, so far I haven’t received questions about plastic surgery. We’ll continue with this back and forth if none comes in.
12:16 In Your Face:
… this fascinating back-and-forth, that is.
12:16 Dr. Sundine:
Once you are 18 years of age, you don’t need parental consent so there is really nothing this particuliar mom can do.
12:16 In Your Face:
Our next celebrity is Tara Reid, who has discussed the problems she had with breast implants and with liposuction. In each case, she had a redo.
12:17 In Your Face:
Uneven implants. That sounds like something that would be incredibly easy to avoid. Is that not so?
12:18 Dr. Sundine:
This view could be deceiving since she is twisted.
12:18 In Your Face:
How about that — not twisted.
12:19 [Comment From michele]
bad doctor? or her choice which was bad?
12:20 Dr. Sundine:
Agreed. And the left breast is larger and looks like it is closer to the mid-line but she is asymmetical pre-operatively. Her left breast is bigger and more ptotic (sagging).
12:20 Dr. Sundine:
Breast asymmetry is a difficult thing to correct completely.
12:20 In Your Face:
She went to a new doctor, I believe, and had a new set of implants put it.
12:21 In Your Face:
I’ll hunt for an up-to-date photo which might show improvement.
12:22 Dr. Sundine:
Bad doctor? May be not just a difficult problem. But she is still too large for her soft tissue envelope.
12:23 In Your Face:
That’s a recent photo.
12:23 Dr. Sundine:
Looks better.
12:23 In Your Face:
Smaller implants. Less uneven.
12:23 [Comment From cat]
ewww aren’t we through w her yet?<
12:23 Dr. Sundine:
We can move on.
12:24 In Your Face:
One more issue re: Tara Reid, then we’ll move on.
12:24 In Your Face:
Liposuction problems.
12:24 [Comment From cat]
sad
12:25 Dr. Sundine:
Yes…it is sad.
12:26 In Your Face:
She is happier with her looks after a second procedure on her abdomen. That recent photo above illustrates her current looks.
12:26 [Comment From cat]
so nice before… and then after…….
12:26 In Your Face:
That’s the same photo again.
12:26 Dr. Sundine:
The important thing about liposuction is that it is not what you take out that is important but what you leave behind. She is over liposuctioned and had surgery created divots.
12:26 In Your Face:
I’m hoping you’ll also give us some quick comments on other celebrities’ cosmetic work. …
Of course, Michael Jackson
12:27 Dr. Sundine:
Oh my God!
12:28 In Your Face:
I’m not asking for a full analysis. After all, it took him a lifetime to get so messed up.
12:29 Dr. Sundine:
So much to say…horrific nose, malar implants, chin implants, lip implants versus fillers…not his face anymore.
12:29 In Your Face:
Melanie Griffith …
12:29 [Comment From Bob Jordan]
Is plastic surgery is covered under the new healthcare reform?
12:30 In Your Face:
That’s a question for later in the chat. I sent it through by mistake.
12:30 Dr. Sundine:
??? only if you are not on medicare.
12:30 [Comment From cat]
his real nose went bye-bye
12:30 In Your Face:
Back to Melanie Griffith?
12:31 Dr. Sundine:
Ok…she has had cheek implants, her lips are overdone and had at least one facelift and her nose is strangely deviated.
12:31 In Your Face:
Priscilla Presley
12:33 Dr. Sundine:
Almost the same thing…overdone browlift, cheek implants, lips over filled, at least one facelift and I heard she had silicone injected into her face which is problematic.
12:33 In Your Face:
Thanks. This is a “quick comment” portion of the chat, so we’re moving quickly.
12:33 In Your Face:
Joan Van Ark (courtesy of PlasticSergeant.com)
12:35 Dr. Sundine:
I don’t even recognize her. Again — she had a chin implant, overdone lips and unfortunately has too much sun-damage to her skin, which she is covering with a lot of makeup. We can’t forget the facelift.
12:35 Dr. Sundine:
Also huge amount of Botox in her forehead cause she has no expression.
12:36 In Your Face:
Kenny Rogers
12:37 [Comment From raicha]
Off the wall question, but isn’t it unethical for the former partner of one of MJ’s plastic surgeons to discuss MJ’s procedures?
12:37 Dr. Sundine:
We have to be very careful with patient’s private health information.
12:38 In Your Face:
When you and I were making plans for this chat, you made it clear that you wouldn’t comment on any of your celebrity patients, and I’m assuming that you’re sticking with that.
12:38 Dr. Sundine:
Correct.
12:38 In Your Face:
Back to Kenny Rogers.
12:39 Dr. Sundine:
In a male patient, it is really important not to raise the eyebrow. Men have low set eyes brows.
12:39 In Your Face:
By the way, dear readers, many of these celebrities’ before and after photos are contained in a new “In Your Face” slide show. Here’s the link for future reference:
12:39 In Your Face:
Botched plastic surgery slide show
12:40 [Comment From raicha]
I’m not referring to Dr. Sundine, but generally, don’t doctors need to respect privacy after death as well?
12:40 Dr. Sundine:
You see too much of Kenny’s upper eyelids.
12:40 Dr. Sundine:
Raicha — I would hope so.
12:41 In Your Face:
How about wrapping up this segment with Meg Ryan?
12:41 Dr. Sundine:
Meg – way too much lip filler, bad chin implant. She doesn’t have the softness of her youthful appearance anymore.
12:42 In Your Face:
Why is it that celebrities get such bad plastic surgery? After all, they could afford the best.
12:43 In Your Face:
Their expertise is in performance, not in medical-quality analysis, surely, but …
12:43 Dr. Sundine:
It seems be a culture that wants everything done over the top.
12:43 In Your Face:
… but they’re experts in making themselves look good, supposedly.
12:43 In Your Face:
… and they blow that so badly sometimes.
12:44 [Comment From raicha]
Do they tend to have “body dysmorphia” more than the rest of us?
12:44 Dr. Sundine:
True. But obviously their plastic surgeons are not setting limits on the procedures, they are not saying no. We should only do procedures where patients look better, not worse.
12:45 In Your Face:
I suppose a doctor confronted with a celebrity might have a tougher time saying “no” than with a non-celebrity patient.
12:45 Dr. Sundine:
Raicha — certainly celebrities are more focused on their appearance than others, but I don’t know of any study that shows there is more body dysmorphic disorder in this population.
12:46 Dr. Sundine:
That is the problem…they don’t say no, even harder with celebrities.
12:46 In Your Face:
A second topic we planned to discuss is this:
12:47 In Your Face:
The New Mommy: How to Redefine You into a Hot Mama
12:48 In Your Face:
That sounds like a marketing pitch, perhaps an appealing one, but a marketing pitch.
12:48 In Your Face:
Tell us about it.
12:48 Dr. Sundine:
The goal here is to restore moms into their pre-pregnancy status.
12:49 In Your Face:
A “mommy makeover”?
12:50 Dr. Sundine:
A mommy makeover includes typically lifting the breast, tightening up the stomach, perhaps some liposuction to remove collections of fat and a skin care regime.
12:50 In Your Face:
And your version of that is the restoration of the “hot mama”?
12:51 Dr. Sundine:
Some moms become depressed about their appearance after having children. For example, some moms still look pregnant after giving birth and they want be restored to a pre-pregnancy state.
12:52 In Your Face:
Some of that is just a matter of time, isn’t it? How long do you insist on waiting after childbirth before the mommy makeover?
12:52 Dr. Sundine:
Most of the breast enhancements that we do is women who loved their breast before pregnancy, while pregnant and now want to get back to that appearance.
12:53 Dr. Sundine:
I’d recommend waiting at least a year and have completed having all of their children.
12:54 In Your Face:
They discover they like the larger breasts that the body provides them temporarily for breast-feeding?
12:54 Dr. Sundine:
Yes – absolutely.
12:55 In Your Face:
What percentage of your business is in this category — mommy makeovers?
12:55 Dr. Sundine:
20%
12:55 In Your Face: Has that changed over the years?
12:56 Dr. Sundine:
Yes — more and more women are seeking this type of procedure. It is now more of a mainstream concept.
12:56 In Your Face:
It’s related to women and men wanting to look younger longer.
12:57 In Your Face:
Similarly, women don’t want to look like grandmothers even when they’re grandmothers.
12:57 Dr. Sundine:
Possibly…we live in a culture of youth and baby-boomers don’t want to look like their grandparents.
12:58 In Your Face:
I see that we’re out of time. Thanks, Dr. Sundine. I hope you’ll return to chat again in the future.
12:58 In Your Face:
Here’s the link to our schedule of upcoming guests.
12:58 In Your Face:
Schedule of upcoming ‘In Your Face CHATs’
12:58 Dr. Sundine:
Yes — thanks for having me on your online chat.
12:58 In Your Face:
Thanks for joining us.