Dr. Lee's Blog

"Do you have privileges to do this surgery in a hospital?"

"In what specialty is your board certification?"

These are the 2 most important questions to ask your surgeon. Why? I'll explain.

An MD becomes eligible for licensure after completing medical school and 1 year of post grad training. This training is in a hospital and may involve work on all the different wards or be specialty specific such as in internal medicine or surgery. Then the MD takes and passes the National Medical Board Examination part 3 and may apply for a license to practice medicine. That license states "to practice medicine and surgery". An MD so licensed can legally do aesthetic surgery in an office O.R. Scary, right? In fact this rarely happens. What is more common is that surgeons do surgery for which they are not trained and board certified.

Most of us do more than 1 year of training after medical school. An MD certified by the American Board of Plastic Surgery has completed, 3-5 years of general surgery, or 5 years of ENT training and then 2 years of training in an accredited program for Plastic and Reconstructive surgery of the head and body. Board certification in plastic surgery also means that your MD has successfully passed a rigorous 2 part board examination in plastic surgery. An ENT surgeon with certification by the ENT board may do an additional year of training in aesthetic surgery of the head and be a great aesthetic surgeon for the face. But without having done a full 2 year plastic surgery training program, he or she has not trained in aesthetic surgery of the body. This may not be the best person to choose for your breast aug or tummy tuck.

Although an ENT surgeon may do surgery on the body using his or her own office O.R., a hospital will not allow him to do surgeries for which he has not received specific training. "Do you have hospital privileges to do this procedure?" lets you know your surgeon has the right training to care for you.

Posted previously on the Berkeley Parents Network in response to the paraphrased question above.

At one month postpartum, it is very early to be worrying that

the shape of your postpartum belly is permanent. It is really

true that your belly developed the big ripe shape of a term

pregnancy over 9 months, and you should wait at least that long

for nature to take its course and pull you back into shape

before deciding that your 'pot belly' will never go away.

That having been said, the separation of your muscles is called

rectus diastasis, and is often permanent. The muscles

themselves shorten over time from their stretched position

during pregnancy, but the connective tissue between them, called

fascia, does not have the same elasticity that muscles have, so

once stretched, it will never return to its pre pregnancy size.

However, if your skin is in good shape, your little 'pot belly'

will get better than it is now, and you have a good chance of

regaining that flatter shape that you miss. But you have had a

baby, and if you wore tight jeans before the pregnancy, you

might not get back into them, because your body has changed.

My advice as a plastic surgeon is just wait awhile. In 9

months, if you still don't like what you see, you can be

evaluated for a tummy tuck procedure which tightens up that

stretched fascia and removes extra skin in your lower abdomen.

Until then, enjoy your baby, do your aerobic exercise as you

have time, make sure you have at least one outfit that fits you

now that you feel good in so you are not always aware of your 'pot belly' and relax. Your body is likely to continue to get better on its own.

Well, I have been using Dysport® in the office and the patients are loving it. It does appear to have a quicker onset of action than Botox® Cosmetic, though this is very preliminary for me. So far so good though. Having competitive products to offer is always a good thing