Blog — Notes of a Plastic Surgeon

Welcome to my blog. I am a plastic surgeon in Seattle and have been in private practice since 1991. I've seen more than a few interesting faces and cases through my years spent in the exam room, the operating room and the emergency room. And I have an opinion on just about everything relating to plastic surgery (and a lot of unrelated stuff). If you like my blog, let me know. Thanks for reading! Lisa

Category: Non-invasive

Too good to be true??? Yes!!!

February 28th, 2011 — 9:21am

Seattle Plastic Surgeon Uncovers Some Really, Really Misleading Before and After Photos.

scan0043I am really on a roll here, or maybe it’s a rampage. It’s too soon to tell. Here is another “before and after” from yet another liposuction gizmo that is supposed to sculpt the fat layer and tighten the skin layer, all without surgery!

Take a close look at these photos. They are pretty impressive, don’t you think? But take a really close look. Mentally drop a straight line down from the point where her nose meets her upper lip. Then take a look at her chin. Her chin (AS IN CHIN BONE) has been moved forward. This ad thus implies that this non-surgical fat sculpting and skin tightening gizmo can actually move a chin and jaw bone. Maybe this lady’s chin and jaw were moved but if so, it was done using an orthognathic surgical procedure and it involved a bone saw and some metal screws and plates. Not exactly non-surgical or minimally invasive. Or maybe the ad folks just used Photoshop. Either way, this ad is more than highly misleading. It is fraudulent.

And again, the wretched thing is that these gizmos are heavily marketed to those without full training in Plastic Surgery. And those wannabe “plastic surgeons” who may be saying, “Wow, what a great result. I must have one of these!” don’t even know what orthognathic surgery is. I sure didn’t know it existed until I did my plastic surgery training.

Orthognatic surgery, by the way, is a field of plastic surgery and maxillofacial surgery which involves moving the bones of the face, usually the upper and/or lower jaw. And it’s not done with a “minimally invasive”, one bazillion dollar, fraudulently advertised gizmo with a “doesn’t know any better” doctor pushing the button.

Ineffective, New Technology, Non-invasive, Patient Beware

Look carefully, very carefully

February 23rd, 2011 — 6:17pm

Seattle Plastic Surgeon Reveals Some Very Shady             Before and After Photos.

I get buried in advertisements for the newest, latest, greatest, you gotta have it, gizmos that are supposed to make my practice and my results and my life in general even better that they already are. Of course, these gizmos average about $100,000 and – this is what really fries me – they are rarely available for demo prior to purchase. This is sort of like buying a fancy new car without a test drive.

Another thing that fries me is some of the very, very misleading advertisements that many of the manufacturers try to pass off as real results. Here is an example. This is from an ad for a non-invasive fat removal system that uses energy that passes through the skin and is directed at the fat layer. Wow, what a difference until you look carefully. (Plastic surgeons are trained to look carefully.) In the photo on the right, Mr. Sixpack is pinching a fat roll that starts above his bellybutton and in the photo on the right, he’s pinching a fat roll that starts below his bellybutton. So obviously the more fat pinched, the thicker the roll. I can do this myself – big fat roll and little fat roll. I bet you can do it too!

Okay, and just one more thing that fries me, and then I’ll stop, at least until my next blog entry: Most of these new technologies are marketed heavily to non-plastic surgeons. The family practice doc or gynecologist or even (I’m not making this us) ophthalmologist who may want a little piece of the cosmetic surgery action may see this ad and go, “Wow, I must have one of these!” These docs are not experienced with liposuction or other body contouring and may not look at these photos as carefully as a real plastic surgeon. So these non-plastic surgeons buy one, it doesn’t work very well but they have to keep promoting it and using it and in some cases, giving patients a really raw deal because they have already dropped $100,000 on it and they can’t sell it because after a while, everyone knows it doesn’t work very well. So beware of non-plastic surgeons using the “latest technology”. They likely just don’t know any better.

Ineffective, New Technology, Non-invasive, Plastic Surgery

Tattoo Regrets

December 27th, 2010 — 10:11am

womens-ladies-tattoosSeattle Plastic Surgeon Discusses Tattoo Removal. 

Recently a laser manufacturer surveyed some 65 tattooees in a Los Angeles shopping mall. They had two questions. 1. At what age did you get your first tattoo? 2. Do you regret getting your tattoo? Look at these results:18 or younger: 71% with regrets.  19-25: 14% with regrets.   26-35: 14% with regrets.   Over 36: 0% with regrets.

SOOOOO……..if you are 18 or younger, just wait a few years or you could be in for some big time regret and some big time $$$$$ for removal. And removal is never perfect. Even the most advanced lasers leave some textural changes in the skin.

I’ve told my three teenagers that I’ll give them $1000 on their 21st birthday if they are tattoo and piercing free (except for my daughter’s earlobes).

Something about the above photo and survery reminds me of something really smart George W. Bush said. “When I was young and stupid, I was young and stupid.” Wise words, W.

Thanks for reading!  Dr. Lisa Lynn Sowder

General Health, New Technology, Non-invasive, Plastic Surgery, Skin Care

Now For Something That Really Does Work

December 6th, 2010 — 10:20am

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Seattle Plastic Surgeon discusses the magic of  Retin A

I’ve spent the past few blogs presenting non-surgical procedures that are not very effective. So how about something that is totally non-invasive and really works like a charm?

Take a look here. This beautiful cheek belongs to a lady who is pushing 65. Look at the quality of that skin. Doesn’t it remind you a a baby’s bottom?

What is her secret? It’s no secret at all. It’s Rentin A. She started using it years ago for mild acne and noticed how smooth and healthy it made her skin, so she just kept it up. She’s been using it for 30 years! Every night.

I don’t know of any surgical procedure or any injectable or any laser that could deliver this type of result.

Thanks for reading,


Non-invasive, Plastic Surgery, Skin Care, sun damage


September 15th, 2010 — 3:54pm

Seattle Plastic Surgeon discusses possible hazards of removal of superficial fat. 

cc - rubenesque - CopyThe Wall Street Journal recently ran an article about non-surgical fat removal using two different devices. One freezes the fat under the skin and the other zaps the fat with a laser than is focused under the skin. These two procedures basically kill the fat cells, they leak out all their fat and then the body removes the fat droplets, metabolizes and excretes the fat. Over weeks to months, the treated areas slim down.

Does that sound sweet or what??? But stop and think about it…………

The fat treated this way and with other techniques like liposuction, tummy tucks and body lifts is subcutaneous fat. It’s just the fat that resides under the skin and is harmless as far as overall health is concerned. Yeah, it’s unsightly and can get in the way but it’s harmless.

Visceral fat, on the other hand is bad news. This is the fat that is internal and encases and infiltrates the internal organs. This is the fat that causes the “beer belly” in many men and in some women. This is the fat that makes one an “apple” as opposed to hip and thigh fat that makes one a “pear”. Visceral fat produces all sorts of bad substances that lead to metabolic and cardiovascular disease and cancer.

Stay with me here. If subcutaneous fat cells are removed using fat removal methods and the patient gains weight, those fat cells are not around to enlarge and store the excess fat. Soooo….the amount of visceral fat may increase instead. A person may have slimmer hips or thighs or their love handles may be smaller, but their “beer belly” and all the health issues that go with a “beer belly” may increase.

It always bears repeating what I have been telling prospective patients for years. Liposuction and body contouring such as tummy tuck and lower body lifts is for patients that are at a healthy and stable weight. These procedures are not to be used as a substitute for diet and exercise. They are only for the left over, stubborn bulges and/or lax skin. Using these procedures as a weight loss tool will leave many patients disappointed and, if patients gain weight after surgery, at increased risk for obesity related diseases.

Thanks for reading.  Dr. Lisa Lynn Sowder

Body Contouring, General Health, Laser Liposuction, New Technology, Non-invasive, Obesity, Patient Beware, Plastic Surgery, Tummy Tuck

Trust me, I’m a “cosmetic surgeon” and I have this nice operating room in my office.

August 20th, 2010 — 4:02pm

Seattle Plastic asps egoSurgeon discusses  fake cosmetic surgeons.

Just because she says says she’s a “cosmetic surgeon” and has an office operating room doesn’t mean that she is qualified to do cosmetic or any other type of surgery.

I want to thank O Magazine for the article “The OR Down the Hall” in September’s issue. You will have to buy the magazine to read the article but here are the main points.

1. Office operating rooms are less regulated than hospitals and free standing ambulatory surgery centers. In some states (Washington, for example), if patients do not have general anesthesia, office operating rooms are not regulated at all. YIKES!

2. Most states (Wahington, for example) issue a license to practice medicine but do not regulate scope of practice at all. A doctor who has not spent one day in an accredited surgical training program may perform surgery in their own office operating room as long as the patient does not have a general anesthetic. YIKES!!

3. “Board Certification” could mean a “board” other than the American Board of Plastic Surgery (ABPS). It can even mean a “self designated” board which exists only to give a facade of training or expertise to those who have not met the requirements for certification by the ABPS. The “cosmetic” surgeon who does liposuction may be “board certified” but that board is the American Board of Radiology. I’m not making this up. One of those “cosmetic surgeons” practices a stone’s throw from my office. YIKES!!! To check on a physician’s board certification, go to the American Board of Medical Specialties’ web site (

4. Your “cosmetic surgeon” may not even have hospital privleges. If you were to develop a problem after surgery, he could not even admit you to the hospital or treat you in an emergency room. I’m not making this up either. There’s one of those about 15 miles down the road from me. YIKES!!!! Always ask you surgeon, “Do you have privleges in a local hospital to do this procedure?” Check out this story.

5. Unless you are having just minimal sedation, you should have a board certified anesthesiologist or certified registered nurse anesthetist administer anesthesia. Some office operating rooms “fly under the radar” of state authorities by sticking with only sedation and/or local anesthesia. OUCH and YIKES!!!!!

6. “Only local anesthesia” does not imply “minor surgery”. Local anesthetic agents, like all drugs, can be toxic. This is often used as a selling point for some of these Yahoos. “It’s just a local anesthetic, so it’s not really surgery.” YIKES!!!!!! Check out this tragic story I was asked to comment on.

 Be careful out there. Do your homework and ask questions. A fully trained and ABPS certified plastic surgeon will not be offended but be very pleased that you are an informed patient. And if the issue of poor oversite of some office operating rooms and physician scope of practice is something you think our state authorities should address, let them know. Washington State DOH. It’s their job to keep you safe.

 Thanks for reading!  Lisa Lynn Sowder, M.D.

Body Contouring, New Technology, Non-invasive, Patient Beware, Plastic Surgery

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