All posts by Darshan Shah, MD

Providing exceptional face, breast, and body procedures to individuals across Central and Southern California, world-renowned surgeon Darshan Shah is an experienced professional who is dedicated to helping patients to look and feel beautiful. He has undergone extensive training at some of the most prestigious schools in the country. At Beautologie Cosmetic Surgery & Laser Center, Dr. Shah works together with Dr. Milan Shah and Dr. Brett Lehocky to incorporate the latest in cosmetic surgery technology into our practice so patients can benefit from the latest techniques and treatments available. His genuinely caring approach and attention to detail have enabled him to win the trust of patients from around the world. It is no wonder that patients from across the globe turn to Dr. Darshan Shah for all their plastic surgery needs. You can find more info at: Google+

Dr. Joseph Murray, Transplant Pioneer and Nobel Laureate, Dies at 93

One of the shining stars of plastic surgery is gone. Dr. Joseph E. Murray, who performed the world’s first successful kidney transplant and received a Nobel Prize for his work, died late last month at the age of 93. Dr. Murray died on November 26 after suffering a stroke at his Boston home on Thanksgiving.

Like many plastic surgeons of his time, Murray had a military background, and performed reconstructive surgeries on troops who had been injured on the front. Burn patients were often treated with skin grafts from other people, and the fact that skin grafts tended to be more successful when donors and recipients were closely related was a matter of great interest to Dr. Murray. As he wrote his autobiography for the Nobel Prize ceremony, “The slow rejection of the foreign skin grafts fascinated me. How could the host distinguish another person’s skin from his own?”

After the war, Dr. Murray went to work at the Peter Bent Brigham Hospital, which is now known as Brigham and Women’s Hospital. He and his colleagues developed a number of new surgical techniques through successful kidney transplant in dogs. In 1954, Dr. Murray and his team successfully transplanted kidney from 23-year-old Ronald Herrick to his twin brother Richard Herrick, who was suffering from end-stage kidney failure.

Dr. Murray continued to perform transplants on identical twins. As far as transplant operations go, identical twins present the least amount of risk – since the transplanted organs are genetically identical to the host body, there is no risk of foreign tissue rejection. Dr. Murray added to the growing body of knowledge on immunosuppression by performing kidney transplants on close relatives. With the development of immunosuppressive drugs, he was able to move beyond radiation therapy, and performed the first organ transfer from an unrelated donor in 1962.

Throughout the rest of his career, Dr. Murray continued to practice plastic surgery and the transplant surgeries that he had pioneered. In 1990, he shared the Nobel Prize in physiology or Medicine with E. Donnall Thomas, who had developed bone marrow transplantation as a treatment for leukemia.

Image credit: Harvard Medical School Archives

Pokertox: Less a Procedure, More a Punchline

Using Botox and dermal fillers to enhance a poker player’s ability to conceal their emotions? It sounds like the premise of an SNL sketch, but a doctor of aesthetic medicine in New York has been marketing the procedure, which he has dubbed “Pokertox.” But based on feedback from professional poker players interviewed by the Huffington Post, this might be one gamble that the doctor will come to regret.

In poker, the ability to hide facial emotions is extremely valuable, as other players are always on the lookout for clues about what type of hand you hold. These unconscious signals – known as “tells” – can change the course of a game. Dr. Jack Berdy is betting that many poker players might benefit from procedures that can minimize the appearance of such signals.

“Some people might get a card they like or don’t like and raise their eyebrows,” he told The Huffington Post. “If that’s the common reaction, we can put Botox in certain areas to minimize them… We can also put Botox in areas to make it look like the player has a ‘tell’ they really don’t have.”

So far, poker players and other surgeons haven’t been particularly impressed. “The game has moved on from bluffs, and is more analytical these days,” World Poker Tour competitor Josh Hale said in an interview. “Players might look at physical tells, but they are relying more on betting patterns and bet sizing.”

“Plastic surgery is expensive,” Jay Melancon, a long-time poker player, said. “You’d have to play in very high-stakes games to make it worth it, and if you have a ‘tell’ that is that obvious, you shouldn’t be playing in those games.”

But the real zinger goes to a cosmetic doctor from California: “My first thought is that it is sad an internist can’t earn enough that they have to resort to doing Botox and fillers with a gimmick.”

Image credit: Pokeravond, Wikimedia Commons

California Medical Board Investigating Fake Doctors

The Medical Board of California is stepping up investigations on people posing as doctors in order to reap profits from risky procedures, according to a recent report on ABC News 10. The investigative unit that targets these kinds of cases, called Operation Safe Medicine, has seen a near-doubling of cases over the past fiscal year – up to 61 from 31.

What types of cases has Operation Safe Medicine uncovered?

Fake medical professionals present many risks to their “patients,” and in many cases, people’s lives have been put at risk. In one case, a woman from Encinitas is accused of having posed as a doctor of naturopathy. After diagnosing patients with Lyme disease, she prescribed injections of bovine stem cells and dimethyl sulfoxide. After several infusions, one patient grew so ill that she was hospitalized for six weeks.

Another case involves a San Francisco man who is accused of performing liposuction while smoking a cigar. Prosecutors allege that the man operated with no assistant and had the client hold her own intravenous bag while he performed the procedure. There also been cases based on laser fungus removal, childbirth, facelifts, and hemorrhoid surgery.

What action is being taken against fake medical professionals?

The report released by the medical board calls for more staff to launch a unit in Northern California. The current Operation Safe Medicine is a six-person team based in Southern California. According to Jennifer Simoes, the medical board’s chief of legislation, “the Board believes that the OSM Unit is imperative in order to protect the public from the actions of unlicensed practitioners.”

How can Californians stay safe?

In the liposuction case, the accused had assumed the identity of the physician assistant with a similar name. Almost anyone can open a storefront and claim to be licensed or certified to perform medical procedures. Before seeking treatment with a medical professional, make sure that you check up on their qualifications, especially if you are not introduced to them through a professional referral. Above all, if the price seems too good to be true, it probably is.

FDA-Approved Silimed Breast Implants Are Safe According to Follow-up Study

A new follow-up study has reaffirmed the safety of Sientra’s Silimed brand silicone gel implants, which were approved in March by the FDA. Among the results of the study, which appears in the most recent issue of Plastic & Reconstructive Surgery, was a 99 percent rate of satisfaction among surgeons with the postoperative results.

The Sientra implants became the third FDA-approved silicone gel-filled breast implant in the United States when they were approved in March, joining implants manufactured by Allergan and Mentor. As one of the conditions of the approval, the FDA required Sientra to conduct post-approval studies. These would assess long-term safety and effectiveness outcomes, as well as the risks of rare complications.

The original approval for Sientra’s implants followed the largest silicone gel breast implant study to date. It made history for being the first approval for shaped silicone gel breast implants, which have been used worldwide, most notably in Brazil. This latest study presents the results of Sientra’s ongoing study through 5 years.

There are 1,788 women participating in the study, who were altogether implanted with 3,506 implants. These included:

  • 1116 primary augmentations
  • 363 revision-augmentations
  • 225 primary reconstructions
  • 84 revision-reconstruction subjects

During their follow-up appointments, the participants have physical evaluations, and complications are recorded at each visit. The effectiveness of the implants was measured by bra cup size, as well as ongoing assessments of subject satisfaction and quality of life.

What are the results after five years?

Overall, the risks involved with the Sientra implants are comparable to the implants already manufactured by Allergan and Mentor:

  • rupture: 1.8%
  • contracture: 9%
  • reoperation: 23.8%

The authors show that over 99 percent of surgeons reported satisfaction with the postoperative results. As well, subject satisfaction remained high, even five years after their surgeries. As a result, the authors argue, the five-year results “continue to provide a comprehensive safety and effectiveness profile.”

The Voice Lift: Is It Worth It?

Our voices naturally age as we get older – it’s an inevitable fact of life. Or is it? A recent post on RealSelf has highlighted an injectable procedure that can enhance vocal performance. The procedure, known popularly as the voice lift, is becoming more popular in the US and UK. However, many doctors argue that the procedure has too many risks and too few benefits.

What causes vocal aging? Our vocal cords thin over time, which makes the voice sound crackly and reedy. By plumping up certain points in the larynx, or voice box, plastic surgeons can restore the natural fullness of the voice.

Plastic surgeons have been using some of the same techniques that are often used to add volume and definition to the face. One of the most popular approaches is fat grafting. During a facial fat graft, unwanted fat is taken from elsewhere in the body, and used for the purposes of facial rejuvenation. During a voice lift, writes the Daily Mail, the fat is “grafted on to the vocal folds to plump them up and enhance voice performance.”

The alternative to fat grafting is injectable fillers, such as Juvederm and Restylane. Unlike fat grafting, injectable fillers do not require the removal of fat from elsewhere in the body. Injectable fillers tend not to last as long as fat grafts, and are naturally absorbed by the body after a few months.

But don’t imagine that fat grafting itself is a long-term solution. In fact, the body tends to reabsorb much of the injected fat over time as well. As a result, the voice lift is limited in its effectiveness, and only tends to improve the voice over the course of weeks or months.

Is there a surgical alternative to the voice lift? Not unless the larynx is seriously damaged or impaired. No responsible plastic surgeon would perform cosmetic voice enhancement, since the risk of complications is too great. Until minimally invasive techniques become more advanced, the voice lift is one procedure that most patients will want to decline.

Photo credit: Dinozauris, Wikimedia Commons