What are the advantages of IV sedation over general anesthesia? Dr. Todd Hobelmann is one of the Board Certified Anesthesiologists who works with Dr. Ricardo Rodriguez at CosmeticSurg.net in Baltimore.  Dr. Hobelmann administers the anesthesia to Dr. Rodriguez’s surgical patients. Dr. Rodriguez is a Board Ceritifed Plastic Surgeon who owns and operates a AAAASF accredited surgery center. Dr. Rodriguez prefers to perform  his cosmetic procedures under IV sedation.

Dr. Hobelmann is experienced with various types of anesthesia and explains why IV sedation is a better choice for most patients. According to Dr. Hobelmann there are two main differences between IV sedation and general anesthesia. With IV sedation: Read More »

Breast reconstruction after lumpectomy and irradiation poses a difficult choice for the patient who wants reconstruction. After treatment the breast can be noticeably different from the opposite breast, and sometimes can be indurated with hardened irradiated tissue. The alternatives usually offered are reconstruction with implant or a more extensive and complicated reconstruction with vascularized tissue.

Because irradiated tissue has impaired healing abilities, the use of implants has a high rate of complications, including fluid collections, infection, and a high rate of capsular contracture. The alternative is to use tissue from another part of the body which has not been irradiated and carries its own blood supply. These operations are lengthier, with a more prolonged recovery period, and carry their own risk. They can entail significant scarring in the donor tissue area. Because of this, patients who have had lumpectomy and irradiation are rarely encouraged to have reconstruction.

Recently investigators in Italy and Japan have perfected techniques for reconstructing breast lumpectomy and irradiation defects using fat grafts from the patients own body. The results are very encouraging, sometimes spectacular, and the techniques used are reliable and reproducible.

Fat grafting has existed for many years, but only recently have techniques that work consistently been developed and refined. Like all procedures, the success of fat grafting depends on the techniques used. Although many clinicians voice doubt over the reliability and longevity of fat grafting, Read More »

All breast implants used in the breast augmentation procedure have a risk of creating some amount of wrinkling. Wrinkling is the effect which can make the skin look like it has ripples. This occurs in a small percentage of cases, and the risk can be reduced if the surgery is planned well.

There are several factors which contribute to  visible breast implant rippling. The most common factors are:

1. Consistency of  the implant: saline, gel silicon, or gummy bear silicon
2. Your own soft tissue cover (skin, breast gland, fatty tissues)
3. how much of the implant is placed under the muscle

In terms of potential to wrinkle, saline implants are the most likely to show wrinkling, because they are the most flexible. Gummy bear implants are firm and are the least docile, so they are least likely to show wrinkling. Read More »

Plastic Surgery doesn’t have to be painful.  You can have a pain pump which will greatly reduce pain, reduce nausea, and result in a much quicker recovery. Watch my video blog about why pain pumps are awesome!

Think of the pain pump as having two main parts: 1) ball with the medication 2) long tubes. The ball holds a local anesthetic and the long thin tubes feed the anesthetic into the operative site.   The pain pump is placed into position Read More »

Patients nowadays are bombarded with infomercials for exercise apparatus to tighten your stomach. Does it work? Will exercise alone flatten your stomach? Or, do you really need a tummy tuck?

The answer is . . . Read More »

It is no secret that Michael Jackson experienced breathing problems throughout the last years of his life.  Was it a pulmonary condition, or was it something else?

I have strong reason to believe that Michael Jackson had internal valve collapse within his nasal passages. How did this happen? Multiple rhinoplasty cosmetic surgery procedures Read More »

Dr. Conrad Murray was the physician who administed CPR on Michael Jackson. According to the web site of the American Board of Internal Medicine, http://www.abim.org:

Dr. Conrad Robert Murray- not Board Certified (expired)

Certified 8/26/98

Expired 12/31/2008

The rhinoplasty procedure is a reshaping of the nose.  In your initial consultation with your plastic surgeon you should  describe the things you want to change about your nose in specific detail.  Plastic surgeons think about the nose using certain terms and you can paint a better picture of how you want your nose to look if you use these terms in your initial consultation.

video management, video solution, video streaming

In this video blog about rhinoplasty, I explain the following terms used to describe the nose: Read More »

I have previously written about the types of anesthesia used in cosmetic surgery. The various types of anesthesia include local anesthesia, various types of IV sedation where you breath on your own (twilight anesthesia) , and general anesthesia (assisted breathing with a tube).

I perform all of my major procedures, including multiple procedure makeovers with IV sedation.

The use of IV sedation offers several advantages over general anesthsia:
1- less nausea than general anesthesia
2- quicker recovery immediately following the surgery
3- eliminates the risk of pulmonary embolism which is a major concern with general anesthesia.

video management, video solution, video streaming

It is a myth that long multiple procedure cases can not be performed under IV anesthesia. I perform 8-9 hour multiple procedure cases every week. Read More »

In Episode #3 of my CosmeticSurg Video Blog I discuss the difference between two types of liposuction:
tumescent (suction) liposuction vs. laser/ ultrasonic assisted liposuction. If you are considering laser or ultrasonic liposuction you must watch this video to understand why these new technologies may not necessarily be as good as regular tumescent liposuction!

video management, video solution, video streaming

Traditional tumescent liposuction

Tumescent liposuction has been around well over a decade and allows the surgeon to have complete control of the amount of fat being taken out. Read More »

I filmed my second Video Journal when I brought my son up to Yale University in New Haven last weekend. Rico is a rising senior at Yale University and every time I visit the campus, it brings back great memories of my Plastic Surgery training at Yale. Rico was actually born at Yale New Haven Hospital during my residency program.

video management, video solution, video streaming

I have trained at a number of great institutions including Read More »

There is no doubt that the most exciting frontier in medicine now is the use of stem cells. Stem cells have the power to restore beauty, heal damaged tissues, and the potential to treat and cure some diseases.

Embryonic stem cells vs. fat stem cells

Up until recently the media has largely focused on the more controversial embryonic stem cells. These are stem cells derived from embryos. The potential uses of these cells to cure and treat diseases remain vast, but the controversial source of the cells poses ethical questions which have delayed medical progress.

During the past decade, researchers have discovered that stem cells can also be extracted from your own fat tissue. These adult stem cells have the same potential as embryonic stem cells, except for the ability to differentiate into sperm or ova. Unlike embryonal stem cells, stem cells extracted from your own fat are abundant, easily available, and pose no ethical or political controversy.

Cosmetic enhancements vs. therapies to treat diseases

Due to FDA regulations, stem cell therapies to treat diseases are not yet available in the U.S. unless Read More »

  video management, video solution, video streaming

This is my first attempt at a video journal.  Please send me ideas of plastic surgery topics you would like explained! What would you like to know or see? 

The topic of Episode 1 in my CosmeticSurg Video Journal is liposuction cannulas.  In the liposuction procedure, the cannula is the long slender rod which is used to extract  fat from unwanted area.  I will explore the evolution of the liposuction cannula and discuss why cannula size is important to get a good liposuction result. Read More »

A recent question to the blog:

“What is iv sedation and what is the difference between that and general sedation? Is the patient out completely and will not feel anything? I am interested in Breast augmentation but have a lot of questions.”

Some of you may have read my posts on why I like to do breast augmentation under IV sedation. I also do IV sedation for all major and combined procedures. Naturally, some patients are anxious because they don’t want to feel anything, but they are attracted to the idea of not undergoing general anesthesia. There is also some confusion as to what exactly is IV sedation. This is understandable because there are many levels of sedation. I will explain the different levels so you can make a more informed decision when discussing this with your surgeon or anesthesiologist.  

In cosmetic surgery, we often refer to the three distinct choices: local,  IV or General Anesthesia. However, Read More »

Cosmetic Surgery Virtual Consultations are a great way for patients to be introduced to a surgeon, gather  information and discuss surgical possiblities and goals. Patients get the opportunity to speak with the doctor either by teleconference or Ichat from the comfort of their own home.
video management, video solution, video streaming
 
Dr. Ricardo Rodriguez has been offering Virtual Consultations to his plastic surgery patients for several years. His patients are able to have their consultation in either English, Spanish, or French as Dr. Rodriguez is trilingual, speaking all three languages. Dr. Rodriguez is a Yale trained Board Certified Plastic Surgeon who has been in practice for 20 years.

Many of his of town patients use Virtual Consultations as a way to pre-screen for a certain procedure before making the trip to his plastic surgery practice  in Baltimore, Maryland. Patients travel from all over the world to have cosmetic surgery procedures with Dr. Rodriguez. He performs unique procedures such as the total body lift, brazilian butt lift, and specializes in fat grafting techniques used to rejuvenate the face, breast, buttocks, or hands. Read More »