Because the world series is still on everybody’s mind, maybe we can go with the flow and explain it like this:

Strike one: You should only have cosmetic plastic surgery to please yourself.

Strike two: The only thing you should have injected for buttocks augmentation is your own fat.

Strike three: The only person augmenting your buttocks should be a board-certified plastic surgeon. The procedure is difficult enough, even in the best of hands!

In this particular scenario: Guzman was called “out!” not by an umpire, but by a real doctor who hospitalized and treated Guzman for infection and a very real pain in the…well, hey, you get the idea!

So, to create a home run in this story, let’s back up and see how to avoid those strikes.

1. You have an embarrassing facial or body feature you just can’t live with. Then, you should decide to see a qualified plastic surgeon. It doesn’t count if somebody else – even a parent or significant other — wants to “fix” you.
2. Learn about the procedure online. It’s easy. (Hey, you’re doing it now!) Just type into a search box the name of the procedure you want and the city where you would like to have it done.
3. Go to the website www.abms.org, register and type in the name of the plastic surgeon(s) you have found through your diligent online research.

Look for a board certification; it means the surgeon has many, many years of extra training (after medical school) and testing to make sure his or her knowledge is totally up to date.

The board-certification should show right up. Cosmetic surgeons who specialize in surgery of the head and neck will be board certified in Otolargyngology. Other plastic surgeons will be board certified in, well, plastic surgery.

But for a bases-loaded homer, don’t stop there!

Go the surgeon’s website and check for the doctor’s hospital privileges.

Then, take a gander at the surgeon’s before and after pictures of the procedure you want. There should be many.

After that, call for a consultation and see if you like the surgeon. If you don’t, see other surgeons until you are at ease.

• You want to use a top surgeon like a Beverly Hills board-certified plastic surgeon, but you live far away.
• Due to budget restraints, you don’t want to risk coming in for just a consultation visit and then for whatever reason, not using the surgeon.

Solution:   A virtual consultation

If you are a patient from out of town a virtual consultation with a California Surgical Institute surgeon may be just the thing for you. If you are interested, first speak to a physican’s consultant about the procedure. Then, he or she will send you patient registration and medical history forms. Be sure to fill these out and send them back over, along with detailed photographs for the doctor to review. From there you can schedule your virtual consultation with a plastic surgeon.

Given the Internet, the surgeon can point out, say, some breast augmentation before and after pictures that show results like you might expect.

If the surgeon sounds simpatico to you on the phone, you’ll have a good idea if you want to travel here for an in-person consultation before surgery.

The key to a good virtual consult lies in the photos of yourself. And holding a cell phone up to the bathroom mirror and taking a few shots won’t tell your surgeon what he needs to know.

To take the most informative pre-surgery shots:

• Choose a solid color background (a plain wall is good) and use good lighting with no shadows.
• Use a neutral expression with no smiling; forget about posing.
• Use a camera that can focus but does not have a wide angle lens. Those lenses distort too much of what you really look like.
• For facial procedures, make your head fill as much of the frame as possible.
• For body procedures, be sure and take full body pictures of your rear view, too.
• Take all pictures from the front, with a ¾ view and some in both left and right profile.
• For rhinoplasty, fill the frame from your eyebrows to your lips and include one close up from the front of yourself looking straight up so that the viewer can see into your nostrils.
• For upper or lower eyelift, take a front view of your face with your eyes both closed and open.
• For breast augmentation or tummy tuck, take the front, ¾ and side views of only the area to be treated without clothing. For instance, breast enhancement patients only need a picture showing their body from the collarbone to the belly button. Just relax your arms at your sides.
• Don’t suck in your stomach.

Ofcourse before you undergo surgery, you will need to meet with your surgeon for a comprehensive consultation. You will also need a pre-op exam and medical clearance to ensure that you are a candidate for the procedure.

Read more about traveling to Beverly Hills for plastic surgery.

Last December, the staff of Dorian, a Swedish gay magazine, devoted a whole issue to the superficial, including  plastic and cosmetic surgery. And the question of how to research the topic came up.

So the staff did the obvious thing – everybody had some rejuvenation surgery so they could take Hemingway’s advice to heart and write about what they know best.

While each staffer had an unspecified “mini-makeover”, the other procedures included:

• Facial liposuction
• Lip augmentation
• Rhinoplasty
• Face lift
• Muscle enhancement

News reports did not specify which muscle enhancements, but silicone implants — to suggest built up muscles — are available for mens’ chests, sides, biceps, buttocks and lower legs. (However, most guys develop bulging muscles between their ears all on their own!)

Dorian’s editor-in-chief Benjamin Falk wrote he would indeed recommend plastic surgery to others who want to “freshen up their looks a little” but don’t expect the surgery to bring life-altering circumstances. Bravo Benjamin!

Meanwhile, in England, Bucks Fizz, a rock band that had hits in the early to mid-1980s, made an appearance on an off-the-wall television program, (we are not making this up!) Pop Goes the Band.

The show brings back a once-famous band and puts the rockers through fitness training, makeovers and cosmetic surgery. Then the rockers show pictures from back in the day and compare those shots to the more current after plastic surgery pictures.

What could be next for plastic surgery and television?

With the trend in reality television, perhaps the handwriting is already on the wall.

One possible show could be named something like Plastic Surgery Survival Island.

Every month, a new group of plastic surgery patients crowd onto a lovely South Seas island and vie for the one most improved appearance prize worth bazillions of  the network’s dollars.

Week by week, as bandages come off, swelling and bruises go away and stitches are removed, contestants are voted off the island, until one glorious rejuvenated survivor remains to take it all.

What type of plastic surgery program would you like to see on television?

The denied cosmetic surgeries include:

• A professional gambler who was high on the radar screen – and cameras – of Las Vegas casinos; he wanted a whole new face to escape scrutiny.
• A terminal patient asked for a face lift so she would look great at her funeral.
• One 78-year-old patient asked for a nose job so she would look good in her coffin.
• A patient who used adhesive tape for a decade to hold up wrinkles, sagging and deep facial folds requested a face lift that would provide the same look.

Actually, there are a few other plastic surgery cases on record that should have been turned down – but, sadly, were not.

One involved a professional gambler from Canada who took a $100,000 wager that he could not have 38C breast implants inserted into his chest and keep them for a year.

He took the bet, had the breast enhancement surgery, made it through the year, collected on the bet and then made even more by writing a book about it all. (Read more about the $100K breast augmentation wager.)

 The International Society of Aesthetic Plastic Surgery (ISAEPS) yearly asks its surgeon members to report what patients want in the way of celebrity features. (Hopefully, most are turned down, but nobody counts the granted requests.)

 Some of the most popular requests worldwide are for:

• Angelina Jolie’s lips.
• Arnold Schwarzenegger’s chest
• Pamela Anderson’s breasts
• Brad Pitt’s eyes
• Jennifer Lopez’s buttock augmentation

It took ten years, but a Cypriot “performance” artist became obsessed with a having an ear – grown in a lab from his own body’s cells, no less – implanted on his forearm.

We assume it took a decade to get the operation because most plastic surgeons turned him down flat while quickly showing him the door.

So, yes, that’s purporedly a third ear on his left arm, implanted in the then 61-year-old’s arm in 2006.

We are not making this up, but the artist says once the ear matures, he wants to implant a microphone inside the transplanted ear. (Nonetheless, experts say it is not possible to clone a human ear!)

That gives the expression “lend me your ears” a whole, new meaning!

 
(Read more about the unusual ear-to-arm cosmetic surgery.)

• Dr. 90210
• Nip-Tuck
• Real Housewives of Orange County

and other programs about cosmetic plastic surgery.

They see how others improve their looks and gain self-confidence by getting rid of ungainly features like a big nose, ears that stick straight out or acne scars.

If ever there existed a group of people who want to look good, it’s teens!

Moreover, statistics show that more adolescents are having plastic surgery treatments. 

In 2007, The American Society of Plastic Surgeons (ASPS) reveals that 330,000 people 13 to 19 had plastic surgery, with the top procedures being:

• Rhinoplasty (38,886)
• Male breast reductions (16,400)
• Breast augmentation (10,505)
• Ear pinning (8,062)
• Liposuction (4,960)

The invasive surgeries on teens totaled 87,601.

But the real surprise: teens had more minimally invasive procedures like:

• Botox
• Laser hair removal
• Laser skin resurfacing,
• Leg vein treatment 
• Microdermabrasion

That total? 224,658!

So what are the guidelines for teens?

Technically, plastic surgery patients should be over 18. But plastic surgeons will make exceptions if the disliked feature – like jug ears, a flat chest or a big nose – causes misery in the teen’s social life.

The youngster must also be able to understand all the consequences of surgery, such as:

• A slight chance for complications
• A healing period is necessary
• You will still look like yourself

The young man or woman must also be mature enough to understand a nose job or ear pinning is not a ticket to better life or all-around problem solver.

The desire for surgery must also come from the teenager him or herself.

Teens likely to be quickly shown the door are the ones taken to a plastic surgeon by a parent who wants certain features changed.

If the surgeon sees a young person with a “whatever” attitude, and the parent does all the talking, the surgery is very likely not to take place.

One of the most quickly granted cosmetic plastic surgeries on young people is otoplasty, or ear pinning. Why?

The procedure can be done at five years of age.

 Many plastic surgeons understand a life-long self-esteem problem can be formed if a child starts school and is immediately hounded by teasing and harassment about the large ears.

Not until now! Cosmetic surgeons and researchers Dr. Mrinal Supriya, Neil McCluney and Dr. Muhammad Shakeel, all of Aberdeen Royal Infirmary in Aberdeen, Scotland, selected and tested 26 patients who had no other cosmetic surgery procedures besides upper and lower eyelid lifts.

Also known as a blepharoplasty, the procedure surgically removes drooping skin, fat and muscle from the eyelid, creating a more open and youthful eye.

Results? The patients showed top marks for all the quality of life questions on the test

The lower eyelid lift removes bags from under the eyes. Either one or both of the blepharoplasty procedures is commonly regarded as one of plastic surgery’s best buys that provides more bang for the buck.

With normal aging, eyelids stretch and droop, often falling over the eyeball itself and obscuring vision. Fat deposits are common, too, and may cause the bagging appearance under eyes.

Benefits of eyelid lift surgery include:

• A relatively low cost
• The procedure is done in-office in most cases
• Recovery is relatively quick

In the United States, the average cost for the upper and/or lower blepharoplasty procedures done in 2008 was $2963. (2008 is the most current year for which plastic surgery statistics are available.) 221,400 blepharoplasty procedures were done in ‘08.

The Aberdeen Royal Infirmary gave the 26 eyelid lift patients a standard test that measure quality of life before and after their surgeries. The test subjects had both upper and lower eyelid lift on both eyes.

Quality of Life” measures include:

• Financial and job status
• Sexual functioning
• Health status
• Local safety issues
• Divorce rate

The study was released at the 2009 American Academy of Otolaryngology (AAO) – Head and Neck Surgery Foundation Annual Meeting.

It’s noteworthy because the only two medical specialties qualified by the American Board of Medical Specialties to call themselves cosmetic plastic surgeons are those with board certification in:

• Plastic surgery
• Head and neck surgery

Surgeons who are otolaryngologists (Head and neck surgeons) usually specialize in cosmetic surgery of the face. (Learn more about board certification in plastic surgery.)

In addition to standard liposuction machines which remove fat by suction, an array of high-tech machines are put being forth to remove unsightly flab.

Nonetheless, most board-certified plastic surgeons agree that the gold standard in surgical fat removal is still the procedure known as “tumescent liposuction.”

But in case you were wondering, here are a few gizmos competing for your attention and fat removal dollar, including:

• SmartLipo

Also known as SlimLipo, LipoSculpt and Cool Lipo, these lasers melt, and not suck, fat. Some surgeons use suction to remove the fat while others let the body absorb the melted fat.

Plastic surgery is evidence-based medicine and so far, no reliable scientific evidence exists that that laser-assisted liposuction can:

• Tighten skin
• Work better than basic liposuction

Downside: The machines cost upwards of $150,000 and drive up patients’ cost for the procedures. Tumescent liposuction does virtually all of what laser liposuction does, making the extra high cost questionable.

• VASER (Vibration Amplification of Sound Energy at Resonance) liposuction. High energy sound waves emulsify fat which is then removed by suction.

Proponents say VASER spares blood vessels and other tissues, resulting in less swelling and bruising.

But not many plastic surgeons use it. If it’s so good, why do most cosmetic surgeons still use tumescent liposuction?

So what is real and what is just hyper marketing?

Our take: the most important choice you can make is the surgeon, him-or-herself!

Various plastic surgeons achieve all type of wonderful results using many types of surgical tools and equipment. Would you hire a carpenter who used an extra fancy hammer? So put your judgment to work studying surgeons’ results!

That’s why plastic surgery before and after pictures are so important and useful.

Also, check and make sure the plastic surgeon you want to use is board certified. (Learn more about plastic surgery board certification.)

Demographers say that group travels through the entire population like a gopher through a garden snake. In other words, there are a lot of them!

For instance, the current U.S. problems with social security and health care are largely fueled by Baby Boomers who soak up a lot of everything – plastic surgery included!

Boomers had 8.90 million cosmetic surgery procedures from a total of 12.1 million , according to the American Society of Plastic Surgeons (ASPS).

The most popular Boomer procedures include:

• Botox, hands down

In 2008, the most current year for which statistics are available, the age group 40 to 55 and over had 3,982,507 Botox injections figures the ASPS.*

That is 80 percent of all Botox given to 5.04 million patients.

• Eyelid surgery

The Baby Boomer age group had about 200,893 blepharoplasty procedures, or 90 percent of all 221,398 eyelid lift procedures says the ASPS.

• Liposuction

According to the American Society for Aesthetic Plastic Surgery (ASAPS) the age group 35 to 64 had 230,848 liposuction procedures in ‘08. That’s 69.5 percent of all 341,144 liposuction cases.

• Breast augmentation

ASAPS statisticians found 178,291 breast enhancements in the age ranges that include Boomers for half of the total 2008 355,671 boob jobs.

But the procedure falls off with age. Women 35 to 50 had 147,465 breast enlargement surgeries while women 51 to 64 only had 91,806.

• Rhinoplasty

ASAPS statics show 59,514 nose surgery patients in age range 35 to 64.

That accounts for 39.1 percent of all 153,434 nose jobs done during 2008.

• Tummy Tuck

Of a total 147,392 abdominoplasties in 2008, the ASAPS counted 114,003 done in the age range 35 to 64. That’s 77.3 percent of all tummy tuck operations.

(You could probably knock five percent off the totals to account for the procedures of people 40 to 45 and the 64 year olds.)

*Nobody keeps exact statistics on Baby Boomers. But the age range classifications at the two largest professional plastic surgery societies contain 95 percent Baby Boomers.

Dr. Eppley refers to these down-in-the-mouth patients as part of a plastic surgery psychological condition he calls “cosmetic accommodation.” (Learn more about less-than-thrilled cosmetic surgery patients in Dr. Eppley’s latest blog post.)

But his point is well made. What do you do if you are less than thrilled with the results of your cosmetic plastic surgery? Assuming, that is, the surgeon has done nothing wrong?

Ask during the initial consultation what happens if you don’t like your results. Some patients are happy with a minor touch-up. But you have to consider the costs of plastic surgery.

Many surgeons operate outside their offices and must book time at a surgical center. While the surgeon may include a touch-up in his fee, the surgery center must be paid for by the patient. (California Surgical Institute, however, operates its own fully staffed surgical centers.)

Most patients suffering “cosmetic accommodation” are women who feel their breast augmentation was not large enough. So spend extra time before surgery, making sure surgeon and patient are on the same page about the final size.

But before insisting on a touch up, there are a few things you can do first.

Call the surgeon to discuss your concerns. Any plastic surgeon will be happy to discuss this with you, because your new look is a walking advertisement for your surgeon’s skills. He or she wants you to look good and be enthusiastic with your surgery.

If you are completely healed — but unhappy — go back and look at your before pictures to see how much better you look now.

If you and your surgeon are still stuck, get a second opinion from another qualified plastic surgeon who does the same type of surgery. Let him see the before and after plastic surgery pictures while examining the patient.

It’s always possible that, medically speaking, a nose could not safely be made smaller during rhinoplasty or that eyes could not be made more open in an eyelid lift by removing more eyelid skin. (The ever present concern is that a patient won’t be able to close her eyelids!)

The completely wrong approach is:

• Anger
• Writing belligerent emails or letters
• Sulking

Here’s how it works in real life.

Say you are considering a face lift, breast augmentation, liposuction, nose surgery or some other cosmetic surgery.

Step 1: Go to your initial plastic surgery consultation.

Without Electronic Records:

• Fill out your medical history
• List the medications you take
• Jot down all operations and ailments you’ve had
• Note all doctors you’ve seen along with contact points
• Mention all health plans you have ever had

Step 1.5: Shake out writer’s cramp.

With Electronic Records: Do step one, adding your email address and filling in two pass words to allow you into your website based records.

Step 2: Arrange your pre surgery physical.

NO Electronic records: Repeat all of step 1 at examining doctor’s office.

WITH Electronic records: Make an email appointment. Later, let the reception see what she needs from your online history. Return to your waiting room magazine.

Step 3: Buy your compression garments.

NO Electronic records:

• Go back to surgeon’s office
• Make selection
• Pay

But, oh no, your paper records are at another doctor’s office across town! Repeat all of Step 1 and 1.5 if pain persists.

WITH Electronic records: go to your computer, bring up the compression garments site, make a selection, buy and CC your medical records page.

Step 4: Get your post-op meds.

NO Electronic records:

• Go to doctor’s for RX
• Take the prescription to the pharmacy
• Fill in Step 1 information
• Wait two hours, pay and leave only to discover you have somebody else’s medication
• Repeat all of steps 4 and 1 because your records were misfiled at pharmacy

WITH E records: Email your doctor who brings up the pharmacy website, checks the meds you need and CCs your medical page. The pharmacy then mails your medications to your home.

Step 5: Arrange for aftercare

NO E records: Fight through 37 square miles of stalled traffic, go to aftercare facility, and do all of Step 1. (Yes, again!)

Pay and leave, returning home via the same gridlock.

Fill gas tank. (Yes, again!)

WITH E records:

• Bring up the aftercare facility website
• Reserve the time and date
• Pay with credit card
• CC your records page