Reddy Aesthetic Institute Blog
Reddy Blog No. 14 | July
BIA-ALCL — What is it and Should I be Concerned?
Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is a treatable and rare cancer of the immune system that develops in patients with breast implants. In the United States, an estimated 225 cases have been reported although the number of actual confirmed cases is approximately 25.
The first case of BIA-ALCL was reported in 1997. The FDA has studied the matter and issued two statements, in 2011 and 2016, affirming the safety of breast implants while noting a “possible association of ALCL and implants.”
The position of the American Society of Plastic Surgeons is that breast implants continue to be safe. The risk of a patient developing ALCL is rare and estimated at 2 cases per 1,000,000 patient-years. Furthermore, the ASPS does not recommend additional screening or health care monitoring for patients with breast implants and states that patients do not need to change their routine medical care and follow up.
The incidence of ALCL continues to be studies and we await the final results of the CARE Study although current estimates range from 1 in 30,000 to 1 in 4,000.
Patients who have undergone breast augmentation or reconstruction should be aware of swelling or fluid collections associated with breast implants which develop after the primary incisions, the original surgical site, have healed. Fluid that develops around a breast implant may be aspirated, a minimally invasive procedure, and the fluid submitted for analysis for CD30 marker.
Patients who are diagnosed with BIA ALCL generally have an excellent prognosis.
In my practice, and based on the case series of BAI ALCL, I recommend using smooth non-textured implants for all aesthetic breast augmentation. I do consider using textured implants in cases of reconstructive surgery as a strategy to minimize the chance of Capsular Contracture and maintaining implant position.
We adhere to the No-touch Technique of breast implant insertion after the pocket is created for a number of reasons. This is due to the idea that bacterial contamination of the implant during surgery contributes to capsular contracture and has been proposed as a cause of BIA ALCL.
If you note that you are developing fluid collections around your breast implant after healing from surgery is complete, you must consider the possibility of BIA ALCL as it remains a small but real possibility.
For more information on this important and treatable condition, please reference the ASPS web site at www.plasticsurgery.org.
Reddy Blog No. 13 | July
Breast Augmentation: How Big and How to Decide?
Breast Augmentation is clearly one of the most popular procedures women elect to undergo. It is a safe procedure associated with enduring results and extremely high patient satisfaction. Significant improvements in implant technology have improved the results.
When I ask clients why they are considering breast augmentation, the answers range from a desire to look better in certain clothing or to achieve an improved physique with idealized body proportions. For example, a client with fuller hips may feel larger breasts will achieve an improved balance of proportions.
Whatever the reason for electing to undergo breast augmentation, one of the most important decisions to be made in consultation with your physician is what size implant to choose.
I have observed that, compared to breast augmentation of the 1980s and 1990s, clients are opting for smaller implants. What appears to be driving this phenomenon is the desire for a more athletic physique. Many women complain that large implants interfere with their exercise routines – especially running. With the passage of time, larger implants are viewed as an inconvenience and impediment, and we frequently have requests to remove or downsize implants. Pop culture imagery and fashion have gravitated toward sleeker feminine physiques, as opposed to the more buxom look of a few decades past. For these reasons, clients nowadays are opting for relatively smaller implants.
Breast implants are sized based on of the volumetric unit of cubic centimeters – abbreviated as a cc. In non-metric terms, there are roughly 30 cc in an ounce. As a general rule, for a client with a 32-inch chest diameter, each 150-175 cc represents a cup size. Of course, this depends on the bra manufacturer as well. For example, I note there appears to be a degree of cup-size inflation by certain bra manufacturers – perhaps to instill a sense of fulfillment in the customer.
Armed with these rough metrics, one can begin to estimate how large of an implant to consider depending on one’s end goals. For example, a client who is naturally a B-cup and desires a final D-cup size would consider a 300-350 cc implant.
When considering breast augmentation, the aesthetic goals include creating cleavage, improving breast projection, and elevating the nipple-areolar position. In some instances, excess skin in the axillary fold, which is the skin in front of the armpit, may be addressed by recruiting into the newly augmented breast mound. I also ask clients to consider how the augmentation will fit with the rest of their body.
In the past, in order to help clients choose the size of breast implants, we would use the rice bag test. Using a kitchen scale to determine the amount of rice, clients would then add the rice to a sandwich bag which they would insert into a bra to approximate the augmentation. Thankfully, we have advanced beyond the rice bag test. We offer Anatomic Soft gel Sizers that the client uses to approximate the implant size. When presenting for consultation, I advise clients to bring two bras and a fitted T-shirt to get an idea of what their breast augmentation result will look like.
In a further advancement, we use the Crisalix virtual imaging system to refine implant size selection. The process is easy and involves generating 3D patient images, which is done at the time of consultation. The program contains all commercially available breast implants that can be selected and used to augment the virtual images. The client has the benefit of viewing themselves in an immersive 3D environment using a virtual reality head-mounted display (VR HMD).
I hope this perspective on breast augmentation provides some valuable insights as you consider plastic surgery.
Dr. P. Pravin Reddy is a Board Certified Plastic & Reconstructive Surgeon and a proud member of the American Society of Plastic Surgeons. Dr. Reddy of one of the few Plastic Surgeons with advanced training in Breast Surgery.
Reddy Blog No. 9 | July
After losing the weight — What next?
As many of you must be aware, obesity is a global epidemic with significant personal and societal impacts. The causes for the modern obesity epidemic are many and include dietary choices; genetic predisposition, industrialized food supplies; and social engineering.
Achieving and maintaining proper weight is one of the healthiest goals one can accomplish. While there are many commercial weight loss programs, surgical procedures designed to restrict capacity or cause malabsorption remain the most effective treatments for weight loss. In fact the National Health Trust in 2010 deemed surgical weight reduction the single most cost effective health care intervention in it’s entire system.
When patients are considering weight loss treatments, they want to know what happens to the excess skin after weight loss. Some patients are reluctant to proceed with weight loss, despite the uncontroversial benefits, simply because they do not want to be left with excess unattractive skin.
I have observed that in younger patients experiencing profound weight loss, there is a strong possibility that the skin will retract and redrape without the need of any further intervention. In those cases where excess skin remains, specialized body contouring techniques may be required.
When considering Post-Bariatric Body Contouring Surgery — the first step is to undergo a proper medical examination with special attention to nutrition. Many patients who elect to undergo surgical weight loss are chronically deficient in some nutrients and require supplements over their lifetime. Furthermore, patients undergoing surgical body contouring after massive weight loss have special considerations for undergoing surgery.
There are several techniques to restore the patient to an attractive physique. Many of these techniques are necessarily associated with long incisions that are strategically hidden. I frequently make the analogy that tailoring an oversized jacket requires the tailor to open more seams and this is the case when removing excess skin.
The most popular techniques for body contouring after weight loss are abdominoplasty; arm lifts; medial thigh lifts; breast lifting; and circumferential lower body lifts.
I find the circumferential lower body lift, or simply the lower body lift, to be one of the most effective techniques in cases of massive weight loss. This technique addresses excess skin of the trunk (the abdomen, hips, and flanks) as well as laxity of the outer thigh and the gluteal areas.
The incision is a single continuous line that can be camouflaged by undergarments or swimwear.
When properly planned and executed, body contouring after massive weight loss is one of the most transformational procedures I offer. I am always amazed at the improved confidence, self esteem, and functionality of the patient after successful body contouring. In my practice, I have noted many patients report suffering anxiety and depression due to their poor body image. However, once their excess weight and skin are addressed, they return to normal mental health.
The benefits of body contouring in the massive weight loss patient are many. In my experience, it is a procedure that returns a patient to ability and productivity from disability. It is for this reason that I encourage the massive weight loss patient to explore the benefits of body contouring surgery.
Dr. Reddy is a Board Certified Plastic & Reconstructive Surgeon practicing in Atlanta, GA. Dr. Reddy has performed hundreds of body contouring procedures in patients who have undergone successful weight loss after Bariatric Surgery.
Reddy Blog No. 8 | January
Breast Sensation Following Mastectomy and Reconstruction
In the past decade, many women at risk for breast cancer have increasingly elected to undergo a preventative treatment known as Prophylactic Mastectomy. This simply means removing a normal breast in an effort to prevent the possibility of future disease. Prophylactic mastectomy is most commonly offered in cases where the BRCA gene is identified and sometimes offered to women who have developed cancer in the opposite breast. Interestingly, studies from MD Anderson Cancer Center do not support a survival advantage in prophylactic mastectomies in the non-BRCA population.
The idea of prophylactic mastectomy became more acceptable as reconstructive techniques of the breast improved and it became possible to create a more natural appearing and feeling breast.
A recent article in the New York Times sheds light on an important deficiency in breast reconstruction – that is the profound loss of sensation in the reconstructed breast. More importantly, many women featured in the article reported that they did not feel properly informed as to the disadvantages of breast reconstruction. For example, when advised the breast would “feel” normal, many patients understood this to mean the breast would feel normal to them. Instead, what was meant was that the breast would feel normal to the examiner – an important distinction.
No one would argue the benefits of reconstructing an attractive and natural feeling breast in the case of breast cancer. In fact, the benefits to the patient are undeniable and supported by multiple journal reviews. However, it is important to have a full understanding of the breast reconstruction process and long-term outcomes.
The important take home message in the New York Times article is that we as physicians should be better educating our patients about breast reconstruction.
Education on breast reconstruction must include a discussion of alternative techniques in breast reconstruction; complication rates associated with implant based reconstruction; the effects of adjunct treatments (chemotherapy and radiation) on the reconstructed breast; quality of life considerations including sensation of the reconstructed breast; and finally – the maintenance of a reconstructed breast over a lifetime.
With regards to sensation of the breast mound, it appears that using one’s own tissue, or autologous breast reconstruction provides the best chance for regaining sensation in the breast. The return of erogenous sensation seems unlikely regardless of reconstructive techniques.
An exciting and emerging possibility is to re-establish sensation of the newly reconstructed breast using nerve grafts and microsurgical reconstructive techniques. Advances in nerve grafting have made this a viable option although long-term results remain to be seen.
When considering breast reconstruction after mastectomy, be prepared to ask your surgeon a list of questions in an effort to understand the process and outcomes. I find it is a better experience for both the surgeon and patient to enter into a partnership based on a complete understanding of available choices and the process toward healing. The first step is to identify a Board Certified Plastic and Reconstructive Surgeon facile in several techniques of breast reconstruction. In this manner, you can be assured that the best solution matching your unique situation and goals can be formulated after an informed discussion with an expert.
Dr. Reddy is a Board Certified Plastic & Reconstructive Surgeon with additional training in Microsurgery and Breast Reconstruction. His practice is located in Atlanta, GA.
Reddy Blog No. 7 | July
“Stockholm (don’t) Let Me Go Home…” Jason Isbell from Southeastern 2015
I recently had the privilege of attending the annual Beauty Through Science Aesthetic Conference held in Stockholm, Sweden. Stockholm, the capital of Sweden, is located on the Baltic Sea and the city is an archipelago of eleven separate islands. Stockholm is remarkable for it’s natural beauty, outstanding architecture, and the fact it boasts over 70 museums.
I attended the Stockholm meeting to broaden my perspectives on aesthetic surgery from our European colleagues. Our colleagues in Europe take very different approaches to the same aesthetic problems and it is important to appreciate these different techniques and approaches.
I was pleased to see many of my American colleagues take the podium to deliver outstanding lectures on topics such as face lifting and body contouring.
Some interesting concepts that emerged from the conference included the concept of Late Inflammatory Response Syndrome (LIRS) — the development of nodules after treatments with fillers. LIRS is believed to result from contamination by skin flora, or bacteria, due to inadequate skin preparation prior to administration of an injectable. At the Reddy Aesthetic Institute, we have always practiced meticulous skin preparation with alcohol-based agents prior to any injectable treatment. Incidentally, the latest version of the CDC guidelines for prevention of Surgical Site Infections (SSI) recommends alcohol-based skin preparations.
Yet another important concept that received attention was that of Biofilms in implantable materials including fillers. Yes – technically speaking, all fillers are implantable medical devices. Biofilms are represented by a community of co-operative bacteria inhabiting the surface of an implanted device with the potential to create a host of medical problems. Therefore, the correct handling of any implantable material as well as the recognition of Biofilms is extremely important.
The topic of Occlusions with the (mis)application of fillers was widely discussed by our non-surgical colleagues. An Occlusion Event is the interruption of blood flow to a region of facial skin resulting in necrosis (dead skin) and is a devastating complication. In extremely rare cases, blindness has been the reported outcome of an Occlusive Event. Although rare, the possibility of Occlusion with the application of fillers is one that clients should be well aware of when selecting an injectable treatment.
The topic of ALCL-BL associated with breast implants was presented and discussed in detail. This rare white blood cell cancer is associated with textured breast implants and completely curable when properly diagnosed. There continues to be debate as to the incidence of breast implant associated ALCL-BL with estimates ranging from 1 in 30,000 to 1 in 4,000. At the present time, the position of the FDA is that breast implants continue to be safe. If you are considering breast surgery, whether reconstructive or cosmetic, please be aware of ALCL-BL.
I hope readers find this brief summary of the 2017 Beauty Through Science Meeting to be informative. My attendance of this meeting reflects one of the many steps by which the Reddy Aesthetic Institute continues to offer our clients the highest standard of care in Plastic & Reconstructive Surgery.
P. Pravin Reddy, MD is a Board Certified Plastic & Reconstructive Surgeon and a member of the American Society of Plastic Surgeons.
Reddy Blog No. 6 | June
Over or Under. Which Comes out on Top?
Clients seeking to undergo breast augmentation are faced with the important decision whether to select placement of the breast implant under the pectoralis muscle (under) or on top of the muscle (over) or in the sub-glandular position.
When breast implants were first introduced in the 1970s, the over, or sub-glandular, plane was preferred. As experience with breast implants accrued, it became apparent that Capsular Contracture occurred in roughly 8% of patients. In an effort to reduce capsular contracture, the sub-muscular plane was adopted resulting in reduced capsular contracture.
During the Silicone Implant Moratorium in the United States from the years 1992-2006, only saline implants were available for general use in elective breast augmentation. Saline implants were associated with rippling and the sub-muscular plane proved to be an effective means of camouflaging the implant.
As the sub-muscular plane was adopted as the preferred plane of implant placement, several problems with this approach emerged. In many cases, the implant did not project as well and the implants demonstrated unsightly animation with activation of the pectoralis muscle – such as when executing a bench press motion.
These problems were improved upon by using a Dual Plane technique. In this approach the breast implant resides partially under the muscle in the upper pole of breast and under the breast tissue at the bottom of the breast. The pectoralis muscle is often detached from it’s origin in the breast bone in order to create the necessary pocket and reduce animation of the implant. The Dual Plane technique offered the advantage of a better camouflage and shape to the augmented breast while reducing capsular contracture and animation of the implant – in other words, the best of both approaches.
Although many of my colleagues maintain the sub-muscular, or under, technique does not weaken the pectoralis muscle, it has been my observation that patient’s note decreased exercise strength. In addition, one can directly observe attenuation of the pectoralis muscle and the simple fact of detaching the muscle necessarily weakens it.
Improvements in implant technology, such as texturing of the silastic shell, and cross-linked silicone gels – popularly known as gummy bear implants, have resulted in decreased capsular contracture and surface irregularities. Therefore, the sub-glandular plane has once again emerged as a viable option with a superior aesthetic outcome while not disturbing the pectoralis muscle. The prerequisite for an over implant is adequate tissue coverage determined by your surgeon using the Pinch Test.
One concern with the over technique is that it interferes with Screening Mammograms. When undergoing Screening Mammography, one should inform the mammographer of the presence of the implant and in what plane. The test can be accordingly adjusted to carefully examine the tissue adjacent to the implant to ensure no lesions are missed. There is no evidence that the presence of breast implants is associated with increased risk of breast cancer or delayed detection.
It is my practice to discuss all options with the client when considering Bilateral Breast Augmenation (BBA). When adequate soft tissue coverage is available, appropriate consideration to the over technique is given. Should the client prefer an under implant, the Dual Plane technique is offered.
It is important to consider life style when deciding between under and over implants. For example, clients who enjoy weight lifting or bodybuilding may prefer the result of an over implant due to the reduced animation and weakening of the muscle.
P. Pravin Reddy, MD
Dr. Reddy is a Board Certified Plastic & Reconstructive Surgeon with additional training in breast surgery.
Reddy Blog No. 5 | May
How much training is enough?
In 2015, the Georgia Governor signed into law HB 416 requiring health care professionals to disclose to consumers their proper credentials. Under this law, only Board Certifications issued by the ABMS (American Board of Medical Specialties) or the AOA can be advertised as legitimate credentials.
In light of the diverse array of practitioners offering elective cosmetic/aesthetic surgery, HB 416 was a boon to the public. Unscrupulous practitioners could no longer use white coat deception and false advertising to garner clients.
I have always been simultaneously appalled and fascinated by the fact that unqualified practitioners would take it upon themselves to attempt to execute technically demanding medical procedures without the requisite training or infrastructure. I wonder if myself and other Board Certified Plastic Surgeons are over trained or whether many aesthetic procedures are simply not that difficult.
The fact of the matter is that any surgical procedure is demanding and requires a certain degree of theoretical knowledge. I often inform my clients that the most important part of the operation is the consultation where the proper treatment is matched to the client’s goals and a surgical plan formulated.
The judgment and requisite technical skill set required to successfully perform surgery is the result of hours, days, and years of dedicated training. The economist and author Malcolm Gladwell has studied how many hours are required to achieve mastery in a cognitively demanding field. His conclusion of 10,000 hours was principalized in the 2008 bestseller Outliers. More importantly, Mr. Gladwell identifies the discipline required to put in 10,000 hours of effort, or trained ability, into an endeavor as the single factor that results in sublime expertise. Many of us may simply refer to the latter as grit.
All surgeons who have successfully completed training in a properly credentialed program comfortably surpass the 10,000-hour rule. Board Certification verifies the practitioner’s theoretical knowledge and technical competency. While it is true that Board Certification does not guarantee results, it does offer the highest probability of a successful outcome.
In my practice, I continue to advance my skill by seeking out additional training opportunities. In essence, I will never stop educating myself for the duration of my career. On the occasion that I am offered a compliment for an excellent surgical outcome, I am quick to humbly acknowledge that I am “simply well trained.”
If you are considering undergoing aesthetic/cosmetic surgery, please take the time to review the training and credentials of your surgeon in well in advance of the initial consultation.
P. Pravin Reddy, MD
Dr. Reddy is a Board Certified Plastic & Reconstructive Surgeon trained in all aspects of aesthetic face and body surgery.
Reddy Blog No. 4 | April
The Liquid Face Lift? Not really liquid and most likely not a lift.
Facial rejuvenation must necessarily address three separate components of the aging process in order to be effective. Textural skin changes — frequently the result of sun damage. Loss of volume occurring at multiple levels including bone and fat. Gravitational descent manifested as sagging skin.
It has often been quipped that the easiest way to rejuvenate the face is to simply have the patient stand on their head thus reversing the direction of gravity. While illustrative and humorous – far from a practical solution.
As more patients opt for non-surgical treatments, the idea of the “liquid face lift” has gained traction and carved itself into the conscience of the client. While it’s a catchy phrase, I do think it’s a far too ambitious idea for clients who demonstrate the multiple stigmata of aging.
Liquid facelifts are offered as a non-invasive alternate to traditional surgical face lifting but is it an effective and cost-efficient strategy to produce acceptable facial rejuvenation? The liquids referenced in the moniker “liquid face lift” are in fact semi-solid gels or fillers (Restylane, Radiesse, Juvaderm etc) that most of you are familiar with.
I use HA fillers extensively in my practice. In fact, they are an effective way to restore volume, correct lines and folds, and can even create a modest lift. However, from a practical standpoint, they achieve these results in a group of clients within a certain age range and present a recurring cost. I use HA fillers to create brow lifts, malar augmentation, correct tear troughs, unfolding lines, and restoring volume to deflated areas of the face. The best results are obtained when specific fillers are applied to correct specific deficiencies – for example applying a filler such as Radiesse to restore lost bone volume followed by a HA filler to reconstitute fat compartments is an effective strategy.
When correctly deployed, the results are highly satisfying and last up to a year. However, for clients beyond it a certain age, it is simply not feasible to achieve a facelift with injectable treatments alone. Often times, I observe clients have been over-filled to the point of changing their look – an example of iatrogenic dismorphism with no rejuvenating effect. In fact, the effect is akin to creating a caricature of the subject.
Fillers are undoubtedly effective for some aspects of facial rejuvenation and as part of a broader maintenance plan; however, they cannot rival a surgical facelift. If your goal is complete facial rejuvenation, it’s best to consult with a specialist who is expert in non-surgical and surgical techniques. In this manner, you can be advised of the full spectrum of options depending on your goals and expect to achieve an effective, natural, and durable result. It is my opinion that the liquid facelift, while an effective marketing term, fails to achieve the results of a properly performed surgical facelift.
P. Pravin Reddy, MD
Dr. Reddy is a Board Certified Plastic & Reconstructive Surgeon with an interest in craniofacial surgery, facial rejuvenation, and reconstruction.
Reddy Blog No. 3 | March
Gluteal Augmentation with Fat Transfer. Butt is it Brazilian?
In recent years there has been emerging fascination with gluteal augmentation often achieved by silicone implants; fat transfers; or a combination of both.
I frequently hear these procedures referred to as a “Brazilian Butt Lift” which is not quite accurate.
The creation of an enormous, exaggerated, and disproportionate bottom, often not in harmony with the rest of the client’s physique, is an example of iatrogenic dysmorphism. In fact, I’m often left to ponder where one shops for clothing to drape some of the enormous and obviously manufactured derrieres on display nowadays. Of course, it cannot be denied that beauty is often in the eye of the beholder and the deliberate creation of exaggerated curves and volume is considered both attractive and desirable by many clients.
The term Brazilian Butt Lift refers to a sculpted and elevated bottom which many women achieve simply by wearing high heeled shoes. High heels force the wearer to tilt the pelvis forward thus elevating the posterior and achieving an attractive lift. The high derrier is not new and was often a celebrated feature in Victorian fashion. It is no coincidence that the female derrier has attracted the attention of fashion designers over the centuries as has come to symbolize fertility which in turn is associated with health and youth.
At the Reddy Aesthetic Institute, we focus on creating an attractive gluteum, or bottom, that is in harmony with the client’s physique. One important ratio we attempt to optimize is the waist-to-hip ratio (WHR), which is ideally 0.70 based on studies of beauty pageant contestants. In addition, with careful study, it becomes apparent that many women are harboring an attractive gluteum but simply need some help to properly reveal it. This can be achieved with gluteal sculpting which focuses on selective removal of fat in the intra-gluteal areas; the superior gluteum; the gluteal fold; and the upper outer buttock. The zones of an attractive gluteum and upper thigh have been carefully studied and described by Dr. Constantino Mendietta and I subscribe to his approach in my own practice.
Treating the gluteum and upper thighs with lipo-sculpting results in an attractive and elevated bottom. As a final touch a selected amount of volume in the form of processed fat may be carefully grafted in the gluteus muscle to achieve improved projection, augmentation, and added lift. I rarely transfer more than 400 cc per side during a Brazilian augmentation.
As one can see, the Brazilian Butt is the result of sculpting as much as strategic augmentation with fat.
I hope this blog illustrates the difference between simply augmenting the bottom as opposed to properly sculpting the gluteal area. It is only the latter that must be considered a Brazilian augmentation or Brazilian Butt lift. I hope readers find this opinion useful when considering surgical augmentation of the bottom.
P. Pravin Reddy, MD
The Reddy Aesthetic Institute
Dr. Reddy is a Board Certified Plastic & Reconstructive Surgeon with an interest in a variety of body contouring procedures including surgery to restore an attractive physique after Massive Weight Loss (MWL).
Reddy Blog No. 1 | January
Welcome to the blog of the Reddy Aesthetic Institute.
The goal of our periodical correspondence is to address topics of current interest while educating, and hopefully entertaining, our clients.
The Aesthetics industry has undergone massive shifts in the last twenty years with the introduction of new technologies and the entry of an increasingly diverse array of practitioners. Philosophical shifts in the approach to rejuvenation and advances in the science of medicine have also contributed to our approach to rejuvenation and enhancements of the face and body.
With the dizzying area of treatments, practitioners, claims, and aggressive direct-consumer marketing what’s a client to do? It is all too common that I meet clients that are so thoroughly confused by the choices, that they are simply seeking a reliable and trusted source to guide them. I hope that this blog serves to cut through much of the static and bring clarity to many of the issues that concern our clients while providing an objective and scientific analysis of the treatment options.
I begin by addressing a curious phenomena of increasing prevalence which I term Iatrogenic Dysmorphism (īˌatrəˈjenic dis-mor´fizm). Yes – it’s a mouthful but what is it?
The term dysmorphism represents deviation in form that are so profound as to be easily recognizable. In most cases dysmorphisms are perceived to be unattractive and signal some thing to be avoided. It is hypothesized by anthropolgists that recognition of dysmorphisms is an important survival tool when early hominids were organized into tribal units of about 40-50 members. The infiltration of the tribe by an ill-intended outsider, usually with different feautures, would easily be recognized since the recognition of dysmorphisms was ingrained. The alarm could be sounded and a potential calamity prevented.
Dysmorphism offered a survival imperative as it’s recognition could signal a state of illness.
Iatrogenesis is a condition that results from medical treatments.
Therefore, iatrogenic dysmorphism is a profound and readily recognizable deviation in form resulting from a medical, for this discussion aesthetic, treatment. This is well illustrated when your pre-schooler remarks “that lady looks funny” referring to an overfilled and overtightened duck-lipped aesthetic client/victim.
Now that we have a name for the curious phenomena of voluntary dysmorphism, how is one to avoid it?
The recognition of dysmorphism occurs when natural ratios are exceeded. One useful guide for harmonious facial proprtions is the Golden Ratio — which you may recall from the DaVinci Code movies. In fact Dr. Arthur Swift has pioneered an entire philosophy of non-invasive facial treatment based on the Golden Ratio (represented by the Greek symbol Phi) dubbed Beauty-Phication.
When undergoing facial treatments, it is best to undergo a comprehensive analysis that considers a multi-modal approach. It is improbable that one can fill their way into rejuvenation and relying solely on the application of fillers is what leads to dysmorphism.
When considering facial rejuvenation or restorative procedures, be sure to select a practitioner facile in a number of different techniques. Don’t be a victim of Iatrogenic Dysmorphism. If you feel that you have been “overdone”, we may be able to restore you to a more harmonious and natural appearance.
P. Pravin Reddy, MD
Dr. Reddy is a Board Certified Plastic and Reconstructive Surgeon practicing in the Atlanta area. In addition to the full spectrum of Plastic Surgery, Dr. Reddy has an interest in corrective surgery.