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In Your Face ~ How celebrities and ordinary people use cosmetic medicine, in Orange County and elsewhere.

Heidi Montag surgeries hurt women, docs say

February 9th, 2010, 6:00 am by Colin Stewart

Photos: Below, “The Hills” star Heidi Montag in January, after her 10 recent plastic surgeries. (Photo courtesy of Pacific Coast News) Bottom, Montage before (left) and after (right) the 10 procedures. (Photos by Getty Images and courtesy of ABC).   Slide show: “Heidi Montag addicted to plastic surgery.

Related post: This is the first of two posts in which local doctors respond to Heidi Montag’s day-long plastic surgeries.

JUST SAY NO

heidi-montag-post-0110-paciThe news of Heidi Montag’s day-long plastic surgeries aggravates women’s self-image problems, local doctors say.

The doctors were responding to a statement by plastic surgeon Dr. Frank Ryan that women benefit from publicity about the surgeries because it teaches them the extent of Hollywood actresses’ reliance on plastic surgery. The reality-TV actress had 10 procedures ranging from Botox to browlift and from liposuction to chin reduction during an operation that lasted 7 1/2 hours.

As reported in the blog post “Heidi Montag surgeries help women, doc says,” Ryan told People magazine that the Hollywood myth that celebrities look good simply because of diet and exercise contributes to women’s low self-regard. Ryan is seeking to dispel that myth, which “perpetuates body dysmorphic disorder, a condition where a person’s perception of how they look is drastically off base,” American Health and Beauty reported.

Dermatologic surgeon Dr. David Sire of Fullerton challenged Ryan’s position. “Body dysmorphic disorder is a serious and under-diagnosed psychological disorder” that the Heidi Montag surgeries make worse, he said.

“The fact that this may be a prevalent idea in Hollywood merely reinforces the concept that it is OK to perform plastic surgery for perceived physical non-problems to satisfy a psychological problem caused by a distorted self image,” Sire said. “The individual goes through life looking for physical perfection to satisfy a psychological problem which cannot be helped by multiple surgeries. We as surgeons are not helping our patients by performing surgery on these people.”

Doctors should refuse to operate on such patients, said plastic surgeon Dr. Val Lambros of Newport Beach, although he admitted the effect of that refusal would be minimal. He said:

Sometimes giving a person what she wants isn’t the best thing for that person as very few people have an objective idea of how they look. Joan Rivers frequently goes on Larry King and says she looks great — a matter of opinion that many people would disagree with.

People who get multiple procedures done young frequently don’t know when to stop and wind up looking very strange by the time they get into their 40s. I see it all the time. The frightening thing is that they, like Joan Rivers, think they look great. Scary.

If a doctor tells them to stop, they just find someone else to do their surgery.

Plastic surgeon Dr. John Di Saia of San Clemente and Huntington Beach said Ryan’s statements to People magazine were self-promotion rather than charitable.

“I need to stop laughing,” he said. “Dr. Ryan, please. … The reason he did the People piece is that it was for People magazine. Being perceived as a ‘firebrand’ in a national magazine promotes his practice in a massive way. He is not doing a public service announcement or anything. ”

heidi-montag-pre-post-0110-getty-abc

Heidi Montag posts:

Recent slide shows:

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Get plastic surgery, forget Oscar?

February 8th, 2010, 8:00 am by Colin Stewart

penelope-cruz-ss-450w-02080
Photo:
Above, Penelope Cruz in 2007, a time when celebrity watchers speculated that her lips had been plumped up with injected filler. (Getty Images photo)
Below, Helen Mirren at age 62 in 2008. (Photo courtesy of DailyMail.com)
Slide show: “Any plastic surgery for Oscar nominees?”

UNFROZEN CHOSEN

Fans of plastic surgery got little comfort from last week’s lineup of 2010 Oscar nominees.

Of the 10 actresses nominated for their work in leading and supporting roles, none relies much on cosmetic medicine.

In fact, the lineup could be used as evidence that actresses who depend on plastic surgery disqualify themselves from winning an Oscar nomination.

That’s a position similar to statements by nominee Meryl Streep, who has spoken against Botox as an obstacle to expressive acting.

Botox “limits you,” she says. “You can’t play so many different great parts. … Parts of your face don’t move.”

Only a couple of this year’s nominees are even suspected of using injections to modify their appearance:

  • Sandra Bullock is sometimes zinged for what looks like excessive reliance on Botox injections.
  • Penelope Cruz’s occasionally pouting lips suggest that her dermatologist sometimes wields a syringe with too much gusto. She’s also suspected of having a nose job long ago, but that’s far from proven.

None of the nominees shows signs of overusing plastic surgery, though it’s never certain what procedures celebrities have undergone behind closed doors.

To be sure, the cosmetic medicine site MakeMeHeal.com, which see signs of plastic surgery almost everywhere, speculates that even Botox opponents Meryl Streep and Helen Mirren have had facelifts.

See the slide show “Any plastic surgery for Oscar nominees?” for a rundown on each of the 10 nominated actresses and their attitude toward plastic surgery.

Here are a few samples:

LEADING ACTRESS NOMINEES

helen-mirren-62Helen Mirren, 64 (pictured at right): “I don’t smoke and I don’t drink too much, exercise occasionally but not ferociously, and I’ve never had any work done.”

Meryl Streep, 60: “[Early in my career], I remember [wondering] if I should get my nose done, just a little. Just to turn it up. I remember sleeping on my face in the pillow … for maybe a year.”

Sandra Bullock, 45: She learned “how to achieve a more voluptuous figure without altering yourself surgically” while working on her “Miss Congeniality” films about beauty pageants, she says. “You can make it work. You can make it bigger or smaller. If you don’t like your hips, go exercise.”

Gabourey Sidibe, 26: On pressures to lose weight, she says, “I still hear it from people who don’t know that they’re pretty close to hurting my feelings, people who care about me, like this one friend. I was eating a light potato chip, and she eyeballed me like I was the most disgusting thing she’d ever seen. She says, ‘Every time you want to put something disgusting in your mouth, think of the designers who won’t make a dress for you because you’re fat.’ ”

Carey Mulligan, 24: She shows no signs having had plastic surgery or of being interested in it.

SUPPORTING ACTRESS NOMINEES

Mo’Nique, 42: When she lost weight two years ago, she denied that it was a result of bariatric surgery.

Vera Farmiga, 36: Two years ago, people suspected that she had had a nose job, but it turned out that what appeared to be nose-job bruises were caused by an accident on the set.

Penelope Cruz, 35: She’s suspected of getting a nose job early in her career, but no celebrity Web sites display before and after photos to prove it. Her lips sometimes look as if they were injected with filler.

Maggie Gyllenhaal, 32: She shows no interest in plastic surgery. She grew up in a Hollywood family “that valued education, intellect and liberal politics over plastic surgery.”

Anna Kendrick, 24: She’s young, with no signs of plastic surgery or speculations about it.

Recent celebrity posts:

Related slide shows:

Recent slide shows:

For other celebrity photos, see TOP CELEBRITY SLIDE SHOWS.

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Botox shortened child’s life, toxicologist claims

February 5th, 2010, 1:10 pm by Colin Stewart

michaelnicar-2008-tarrantco“Botox was a significant factor” in the death of 7-year-old Kristen Spears, a Texas toxicologist testified in a $20 million lawsuit brought by the girl’s family against Botox-maker Allergan.

Michael Nicar (pictured at right), technical director of the pathology department’s laboratory at Baylor University Medical Center in Dallas, was hired by attorneys for Kristen’s mother, Dee Spears, to analyze her daughter’s medical records. Kristen suffered from cerebral palsy and was receiving Botox injections to ease her leg spasms.

Irvine-based Allergan denies that Botox led to Kristen’s death.

“This trial relates to a very sad and unfortunate situation,” the company said in a public statement. “Our hearts go out to Kristen Spears’ family. However, Botox in no way caused or contributed to Kristen Spears’ death.

“The evidence will show Kristen Spears died due to the natural progression of her disease and that any symptoms or issues allegedly attributed to Botox were present before Kristen was first injected,” Allergan said.

The girl died Nov. 24, 2007, after receiving seven sets of Botox injections and being hospitalized seven times during a 16-month period.

Nicar, who has a Ph.D. in environmental science, said “I have no doubt that she would have lived beyond that date were it not for the Botox,” early in his two days of testimony.

kristen-spears-age-6“There were indications of spread of the toxin,” he said. “Breakthrough seizures indicate toxin was getting into the brain. Pneumonia shows it was getting into the lung area.”

Allergan attorney Vaughn Crawford challenged Nicar’s qualifications and conclusions during cross examination Friday.

Under questioning, Nicar acknowledged that he is not certified by the American Board of Toxicology. Nicar also agreed that a consensus of doctors recommends Botox as a treatment for cerebral palsy.

He stuck with his opinion that Botox was to blame for Kristen’s death even after Crawford questioned him about an array of other drugs she was taking. Some of them have potential side effects similar to Kristen’s symptoms.

Kristen (pictured above) was injected with therapeutic-strength Botox, which has more serious potential side effects than the weaker cosmetic-strength Botox Cosmetic.

Last year, the Food and Drug Administration required Allergan and the makers of rival forms of botulinum toxin to toughen the drugs’ warning labels.

The new Botox warning states that the effects of high doses can spread from the injection to other areas of the body, causing symptoms similar to those of botulism, including potentially fatal problems with swallowing and breathing.

The FDA has a different position on Botox Cosmetic, for which it has seen “no definitive serious adverse event reports of distant spread of toxin” after Botox is injected at recommended doses to smooth wrinkles between the eyebrows.

Recent coverage of Kristen Spears trial:


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Heidi Montag: Spiritual, superficial or smarter than we think?

February 5th, 2010, 6:00 am by Cindy McNatt
Heidi Montag before. Getty Images

Heidi Montag before. Getty Images

Heidi Montag might have achieved her goal of what physical perfection is in her opinion, but the wanna-be pop star has taken a serious hit from the press and public for her extensive plastic surgeries. Will she ever be mega famous?

For now, maybe. Montag has appeared on ABC’s Nightline, Good Morning America, Access Hollywood, made the cover of People magazine, and debuted her new look to her mother on a recent taping of The Hills reality show.

While being a star is her goal, each time she appears in public with her 10 surgeries in 10 hours, the outcry gets worse as Montag struggles to manage the negative publicity.

Montag might be her own worse enemy. Instead of focusing on her crafts, acting and singing, she believes as she tells GMA and Access Hollywood, that sex appeal is what sells. Montag did what she needed to do to take her career to the next level.

She told Billy Bush on Access Hollywood that she’d like to win a Grammy for her recent CD “Superficial”, that by the way sold 700 or so (reports vary) copies its first week.

How she reconciles her makeover with her Christian beliefs, though, has baffled almost everyone.

Heidi Montag after. Access Hollywood

Heidi Montag after. Access Hollywood

Bush asked her if she has rejected God’s creation. Her reply, “Or maybe God gave me extra because he knew what I would be doing and the career, and blessing me with such a great doctor. “

Adding that  “this has been as much or more of a spiritual transformation as a physical transformation” for her.

She finished the interview saying, “How incredible… we [are] blessed to even have this surgery that we have. “

Does Montag have a clue how to take her career to the next level, or is she waayyy smarter than we think? What’s God got to do with it?

Heidi Montag posts:

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Heidi Montag surgeries help women, doc says

February 4th, 2010, 9:32 am by Colin Stewart

heidi-montag-pre-post-0110-getty-abc

Photos: Above, “The Hills” star Heidi Montag before (left) and after (right) her 10 recent plastic surgical procedures. (Photos by Getty Images and courtesy of ABC). Below, Montag before and after her earlier nose job. (Photos courtesy of EntertainmentWise.com.)
Slide show: “Heidi Montag addicted to plastic surgery.”

DISPELLING HOLLYWOOD MYTH

Day-long plastic surgeries aren’t uncommon in Hollywood, says Dr. Frank Ryan, the plastic surgeon who recently performed 10 consecutive cosmetic procedures on reality-TV actress Heidi Montag.

In fact, he says, extensive plastic surgery is the basis of what makes women in Hollywood look as they do. It’s something every woman should know, which is the potential benefit for women from Montag’s surgeries and why he spoke out about them, he says.

He wants to dispel the myth that Hollywood celebrities make themselves look good through diet and exercise alone, he says. That myth contributes to women’s low self-regard. Ryan says it “perpetuates body dysmorphic disorder, a condition where a person’s perception of how they look is drastically off base,” American Health and Beauty reported.

Here’s that Web site’s account of its interview with Ryan:

Dr. Ryan said that the procedure took about seven and a half hours, and about 9-10 hours total under anesthesia. While that may sound like a long time, he maintains that it is not uncommon in plastic surgery, and especially in Hollywood, to have a procedure take that long. The reason it’s controversial, he said, is that the people having all this work done, simply don’t talk about it.

Dr. Ryan went on to say that a part of the reason he agreed to do the People magazine story, knowing that he would come under fire, is that plastic surgery is the reason women in Hollywood look the way they do. He feels that saying the reason women look that way is simply because of diet and exercise perpetuates body dysmorphic disorder, a condition where a person’s perception of how they look is drastically off base. Dr. Ryan believes that letting the world know the truth behind Hollywood’s beauty curtain will help dispel the myth.

heidi-montag-pre-post-nose-entertainmentwisedotcom

Montag underwent these procedures:

1. Mini Browlift
2. Botox for forehead and frown area
3. Nose job revision
4. Fat injections in cheeks, nasolabial fold, and lips
5. Chin reduction
6. Liposuction on neck
7. Ear surgery
8. Breast augmentation revision
9. Liposuction on waist, hips, inner & outer thighs
10. Buttock augmentation

In an interview with Radar Online, Ryan said scheduling 10 plastic surgeries in one day was appropriate. It’s just a surprise to the public because people don’t know the realities of modern plastic surgery in Hollywood, he said.

“In Heidi’s case – in a healthy 23-year-old girl – this was perfectly appropriate and the public is getting used to that or hearing about it for the first time,” Ryan said. “This is what young women and men are doing all the time – you know in terms of procedures together.”

Ryan told ABC News, “I disagree that it is that much plastic surgery. These are little tweaks and things we did. … These were all kind of small things.”

ABC also reported a different viewpoint:

Some hospitals, such as Manhattan Eye and Ear and some medical associations, have specific recommendations against allowing elective plastic surgeries to last more than six hours.

“You’re pushing the envelope there definitely, from a medical point of view, where you’re going to set up complications,” said Dr. Thomas Romo, a plastic surgeon at Lenox Hill Hospital. “And that’s irresponsible from a medical point of view. … My ethics would say that you don’t put your patient at that risk.”

Romo said that statistics show the risks of complications rise after a surgical patient has been under anesthetics for more than six hours. “After seven hours, you’re written up at our hospital,” he said.

Juliette Harris, a spokeswoman for Ryan, issued this statement in response:

“Dr. Frank Ryan adamantly refutes the idea that the decision to perform Ms. Montag’s procedures were in any way unethical or unsafe. Dr. Ryan is one of the most qualified plastic surgeons in the country. Although the media created controversy may make for an ‘interesting’ story, and viewers might disagree with Ms. Montag’s choices, the safety or propriety of the surgery are not and should not be in question.”

Heidi Montag posts:

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Botox maker seeks profit in numbness

February 3rd, 2010, 2:16 pm by Colin Stewart

filler2Injections of wrinkle-fighting filler could be a little less painful if Irvine-based Allergan succeeds in its latest marketing effort.

But doctors say the new Juvederm XC won’t eliminate the pains that injections cause.

The Food and Drug Administration approved the new formulation of Juvederm filler and pain killer last month. This week the Irvine-based company began selling the new product, which will cost about 10 percent more than the standard version of Juvederm.

Allergan sells $231 million of dermal filler per year, in addition to $1.3 billion worth of Botox.

Local cosmetic doctors disagree about how much pain their patients experience from filler injections and how helpful the addition of lidocaine anesthetic will be.

“It seems to decrease some of the discomfort of the injection,” said dermatologic surgeon Dr. David Sire, who already injects a mix of lidocaine and filler that he creates at his office in Fullerton.

But plastic surgeon Dr. Val Lambros of Newport Beach, who also creates his own filler-plus-lidocaine mix, said the anesthetic doesn’t help much. The problem is that it takes effect only after it’s injected, not before the pain of the injection occurs, he said.

“I don’t find that there is a big difference, especially in difficult areas like the lips. The trouble is you have to stick an area that’s not numb,” he said.

Some doctors apply a topical anesthetic before an injection, but that requires patients to sit around for 30 to 40 minutes waiting for the pain killer to take effect, he said.

“Paradoxically these fillers with local [anesthetic] will cause more pain in some patients because the impatient doctors will just jab away, thinking that after-the-fact local is as good as before-the-fact local,” he said.

In clinical trials, 93 percent of patients reported less pain when treated with Juvederm XC than with regular Juvederm, Allergan said.

Local cosmetic doctors reacted to the arrival of Juvederm XC with a mix of enthusiasm and skepticism.

Dermatologist Dr. Vince Afsahi of Tustin and Newport Beach said he welcomes the new availability of a mix of Juvederm hyaluronic acid gel filler and the lidocaine.

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