Pain

Today would have been the 47th birthday of an old friend.  He was a remarkably bright presence, and his smile made the world a better place. I miss him.

I met him when he was starting college at Columbia University and I was starting Medical School there. He had a back issue he had been dealing with, and it seemed odd to me.  I sent him to a Neurologist who found a spinal cord tumor.

He underwent surgery and radiation therapy which stabilized the mass.  He went on to finish his degree, get married, and have children. The one thing he could not control was the pain.

Narcotics, Toradol, spinal stimulators, medical marijuana, and all other attempts were not met with success.  Still, he lived with a smile on his face and was there for all.

Finally, after 25 years of suffering, he ended his life.  He had a party to celebrate the 25 years, it turned out it was just to say goodbye. I was not there.

The point of the story is that pain cannot be ignored or disregarded, be it temporary or chronic.  Take it seriously, and save the medications for when you need them.


When the Hype Exceeds Reality in BBL

I have been a Board Certified Plastic Surgeon for quite some time, being in private practice for more than 20 years. I have been doing fat transfers to the buttocks since before it was called a Brazilian Butt Lift, and continue to perform this procedure more than 150 times a year. I think I get great results, yet I hear some disappointment from patients more than with all other surgeries. Am I just not good at the surgery, or is it something else?

When I compare my results to those seen in the Plastic Surgery journals, I feel they exceed nearly all in effectiveness and fat take. That makes me confident I am doing it well. So why are some people not thrilled? I blame social media.

People watch reality tv, look at photoshopped pictures and posts, and feel that it doesn’t matter what they start with, that a good plastic surgeon can do anything. This is unfortunately not true. The amount of fat you have, the bone and muscular structure, and metabolism are all factors beyond our control. I have miraculous changes walking around who are upset that with white lycra tights, there is a slight difference from side to side, even if they started out horribly asymmetrical.

My choices are to either stop offering the procedure, or to continue to try and educate each patient as to what is possible and what is not. I am not ready to stop. Be realistic and accept a great result. Perfection is sometimes the enemy of happiness.