Hot Topics with Dr. Cherny

Some thoughts...

Plastic Surgery - the "Great Equalizer"

Plastic surgery has been called many things both good and bad.  Have you ever considered it as an instrument of democracy or of fairness? Life is in many ways unfair, and through genetics some of us are blessed, and some are not.  Some have desireable physical attributes, and the confidence it brings just through the lottery of life.  Some win, some lose. Everyone knows that good looking people are treated differently than others.  There are many studies that document greater opportunities, better treatment, better salaries and all the rest, for attractive people.

So plastic surgery can, to some degree, make up for this unfairness.  Plastic surgery can level the playing field and help people attain that which they otherwise could not have. This is one more reason that I really like being a plastic surgeon!

Is penile enlargement possible?

We actually get several calls a week on this subject.  The answer, generally, is no.  I repeat, there is no reputable method for penile enlargement.  Fat injections could make the girth larger but would leave the head the same size, resulting in a spongy shaft with a small appearing head.  Ligamentous release supposedly increases length, but as the ligament heals, it reshortens.  So the patient ends up back where they started from.  On the other hand, some men, especially those that are overweight and those that have lax skin, can have an increase in the apparent length with surgery. This is a condition called the "buried" penis.  In this situation, the penis is basically buried within the fat and skin.  The tummy tuck operation, which lifts the groin, pulls redundant tissue away, exposing the actual full length.  I've increased the apparent length by several inches as a positive side effect in tummy tucks on men.  Liposuction theorectically should help this also, but I've found it to be less effective.  Urology colleagues of mine tell me that the best method to enhance this area is diet and exercise.  As always, no pain, no gain.

So what happened to Kanye West's mom?

This was a truly tragic episode in plastic surgery.  It all boils down to one thing; the doctor was not board certified.  Board certification by the American Board of Plastic Surgery, which is under the American Board of Medical Specialties, is the gold standard.  As great at Oprah Winfrey may be, she promoted this surgeon on her show without investigating his background.  The board certification process of exams and reviews of your cases is the last best chance organized plastic surgery has to weed out its problem doctors.  In the process, your knowledge, judgement and morals are assessed.  Most hospitals will cancel your priviledges if you are not board certified by five years or so after graduating residency.  If a plastic surgeon is not board certified within a reasonable amount of time, this should raise a red flag.  There is one plastic surgeon in this situation in Des Moines, in fact.

What about Laser Lipo?

I've studied the machines and have attended lectures on this new technology.  It is agreed that laser lipo is not a replacement for regular liposuction at all.  It may work in very small areas, but anything more than that will need regular liposuction.  Also, the laser is very powerful.  Without great care there is a risk for severe burns.  This is probably just another fad that I don't think it will stand the test of time. 

Is there a cure for cellulite?

No. No.  Cellulite overlays areas of structural damage to subcutaneous fibrous tissue.  Cellulite is an acquired microscopic anatomical problem, that usually comes from childbearing or major weight gain/loss.  I'm currently treating a patient who went for some kind of laser treatment of cellulitis.   She has horrific burns all over her legs.  The best these treatments can do is swell the skin, which makes the cellulite temporarily better.  After the swelling goes down, your cellulite is back and your wallet lighter.  The same goes for stretch mark streatment.  If it sounds to good to be true, it is.  The only honest way to deal with cellulite and stretchmarks is to excise them in the context of a body shaping operation, as in a tummy tuck.