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: Now That’s Cool


Will there be plastic surgery under your Christmas tree?

November 30th, 2018 — 3:11pm

Seattle plastic surgeon encourage the gift of plastic surgery.How to give the gift of plastic surgery.

Looking for the perfect gift this holiday season?  That perfect gift may just be a plastic surgical procedure.  Here are a few tips if you are considering this most thoughtful and personal of presents.

  • Only consider this if your loved one has confided in you that he/she is considering “doing something” or that he/she just wishes that he/she could just “get rid of this ______(fill in the blank)”.  Remember, it’s about him/her, not about you.
  • Make sure the lucky recipient is a good candidate for surgery.  Good candidates for surgery are in good heath (physically and mentally) and are in a socially stable place in their life.   If in doubt, shoot me an email and I can probably make an educated guess.  Do not, I repeat, do not give the gift of liposuction as a substitute for weight loss.  Need convincing that doing so is a bad idea?  Check out my blogs on obesity.
  • Make sure that you can afford the surgery!  You wouldn’t want to have to back out because of sticker shock.  I have a lot of ball park prices posted on my web site.  Or feel free to shoot me an email and I can give you a financial idea of how much this could set you back.
  • Make sure that lucky guy/gal will be able to take enough time off of work and/or household duties to recover.  It’s misery to try to get back to work too soon.  You want your gift to be a positive experience.  I have recovery times listed for most procedures on my web site.  Or shoot me an email.
  • Make sure you have nice package to present.   You can’t wrap up a tummy tuck or eyelid lift, but you can wrap up something they might love to wear or use after all the discomfort and bruising is gone.  Maybe something sassy from Hanky Panky for that mommy makeover patient or a pair of beautiful Firefly earrings for that eyelid lift patient.  Or for that dude of yours, how about a nice pair of Ethica boxer briefs You can include one of my practice brochures and a procedure brochure.  Oh, I can just hear the shrieks of joy now!

And just think, your gift of plastic surgery will last years, even decades.  You and your loved one will be enjoying the benefits much longer than a new car or television or laptop.  Do the math.  It could end up being a great value as well as a great gift!

HAPPY SHOPPING AND THANKS FOR READING!  Dr. Lisa Lynn Sowder

I would be honored if you followed me on Instagram @sowdermd and @breastimplantsanity.

Mommy Makeover, Now That's Cool, Plastic Surgery, Postoperative Care

Happy Thanksgiving

November 21st, 2018 — 10:17am

 

’tis the season of Thanksgiving. 

Here are a few things that this plastic surgeon is thankful for……….

  • Modern Anesthesia.  This makes for painless surgery.  And the surgeon can take her time to do a really, really nice job.  During the Pilgrims’ time, the main qualification for being a surgeon was to be really, really, really fast. Yikes!
  •  The Germ Theory and Antibiotics.  Surgery used to mean infection.  Now surgical infections are rare.  Not rare enough, but rare.
  • The Bovie.  This is the electrical gizmo that seals blood vessels as it cuts.  This is why you don’t need a blood transfusion when I do your Mommy Makeover.
  • Surgical Scrubs.  It’s like working all day in my pajamas.
  • My Dansko Clogs.  It’s like working all day in my slippers.
  • Surgical Loupes.  These are my silly looking magnifying glasses that allow me to see important teeny tiny things like nerves and blood vessels.  They also come in handy for reading the newspaper when I can’t find my reading glasses.
  • My Battery Powered LED Surgical Headlight.  Now I don’t have to be attached to the light source by a fiberoptic tube (which is how my dog must feel on her leash).
  • Power Assisted Liposuction a.k.a. PAL.  This PAL is a true friend.  It makes liposuction so much better for the patient and the surgeon. 
  • My Wonderful Staff and Colleagues.  They keep me on my toes.
  • My Wonderful Patients.  They are why I love coming to work!
  • My Wonderful Husband and Children and Dog and Cat.  They are why I love going home in the evening.
  • My Freakishly Good Health.  I’m 62 and still running, skiing, biking, and just starting with tennis lessons.  I’d like to take full credit for this but really I think I’m just lucky. 

Thanks for reading!  Dr. Lisa Lynn Sowder

Now That's Cool, Plastic Surgery

Maximizing Follow-Up in Cosmetic Surgery Clinical Trials – Money Helps

July 26th, 2018 — 9:05am

In a previous blog post bemoaning the difficulty of good follow-up in clinical research I sort of place most of the blame on patients who blow off the follow-up  once they have their desired implants.  This was my experience with the implant study I participated in many years ago.  I had an 80% follow-up at 5 years (which was really, really high)  mostly because I pestered patients relentlessly to come back for their follow-up exams.  I have taken a bit of flack (especially from the breast implant illness activists) for my blame-the-patient stance but now there is a recent study out that supports my politically incorrect opinion.  Check this out.  It seems if you pay the patient big bucks to show up they do!  This study has an astounding 94.9% and 96.7% follow-up compliance at 5 years.  The study has another 5 years to go and my guess is that given the size of the monetary award, those numbers will also be very high.

“Maybe I will show up for my follow-up.”

Novel Approach for Maximizing Follow-Up in Cosmetic Surgery Clinical Trials: The Ideal Implant Core Trial Experience

Mueller, Melissa A. M.D.; Nichter, Larry S. M.D.; Hamas, Robert S. M.D.

Plastic and Reconstructive Surgery: October 2017 – Volume 140 – Issue 4 – p 706–713
Cosmetic: Original Articles
Background: High follow-up rates are critical for robust research with minimal bias, and are particularly important for breast implant Core Studies seeking U.S. Food and Drug Administration approval. The Core Study for IDEAL IMPLANT, the most recently U.S. Food and Drug Administration–approved breast implant, used a novel incentive payment model to achieve higher follow-up rates than in previous breast implant trials.

Methods: At enrollment, $3500 was deposited into an independent, irrevocable trust for each of the 502 subjects and invested in a diversified portfolio. If a follow-up visit is missed, the subject is exited from the study and compensated for completed visits, but the remainder of her share of the funds stay in the trust. At the conclusion of the 10-year study, the trust will be divided among those subjects who completed all required follow-up visits. For primary and revision augmentation cohorts, the U.S. Food and Drug Administration published follow-up rates from Core Studies were compared for all currently available breast implants.

Results: Five-year follow-up rates for the IDEAL IMPLANT Core Study are higher for both primary augmentation and revision augmentation cohorts (94.9 percent and 96.7 percent, respectively) when compared to all other trials that have used U.S. Food and Drug Administration standardized follow-up reporting (MemoryShape, Allergan 410, and Sientra Core Studies).

Conclusions: This trial demonstrates the utility of a novel incentive strategy to maximize follow-up in cosmetic surgery patients. This strategy may benefit future cosmetic surgery trials and perhaps any prospective research trial by providing more complete data.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Hey, thanks for reading and I really thank Drs. Mueller, Nichter and Hamas for this awesome article.  And my hat is really off to Dr. Robert Hamas who not only thought up the idea of the Ideal implant but actually brought it to market.  And Ideal only sells its implants to surgeons certified by the American Board of Plastic Surgery.  That means if your surgeon is using an Ideal implant, he/she is actually a real honest to goodness plastic surgeon, not just poseur.

And I would be honored if you followed me on Instagram @sowdermd and @breastimplantsanity. Dr. Lisa Lynn Sowder

Breast Implant Illness, Breast Implants, New Technology, Now That's Cool

Happy Thanksgiving

November 15th, 2017 — 8:49am

 

’tis the season of Thanksgiving. 

Here are a few things that this plastic surgeon is thankful for……….

  • Modern Anesthesia.  This makes for painless surgery.  And the surgeon can take her time to do a really, really nice job.  During the Pilgrims’ time, the main qualification for being a surgeon was to be really, really, really fast. Yikes!
  •  The Germ Theory and Antibiotics.  Surgery used to mean infection.  Now surgical infections are rare.  Not rare enough, but rare.
  • The Bovie.  This is the electrical gizmo that seals blood vessles as it cuts.  This is why you don’t need a blood transfusion when I do your Mommy Makeover.
  • Surgical Scrubs.  It’s like working all day in my pajamas.
  • My Dansko Clogs.  It’s like working all day in my slippers.
  • Surgical Loupes.  These are my silly looking magnifying glasses that allow me to see important teeny tiny things like nerves and blood vessels.  They also come in handy for reading the newspaper when I can’t find my reading glasses.
  • My Battery Powered LED Surgical Headlight.  Now I don’t have to be attached to the light source by a fiberoptic tube (which is how my dog must feel on her leash).
  • Power Assisted Liposuction a.k.a. PAL.  This PAL is a true friend.  It makes liposuction so much better for the patient and the surgeon. 
  • My Wonderful Staff and Colleagues.  They keep me on my toes.
  • My Wonderful Patients.  They are why I love coming to work!
  • My Wonderful Husband and Children.  They are why I love going home in the evening.

Thanks for reading!  Dr. Lisa Lynn Sowder

Now That's Cool, Plastic Surgery

Is the ideal female breast of the future smallish? Yes, according to Blade Runner 2049.

October 10th, 2017 — 2:11pm

K (Ryan Gosling) and the very evil Luv (Sylvia Hoeks) stroll among the newly finished small breasted replicants.

My husband and I went to Blade Runner 2049 this past weekend at Seattle’s wonderful Majestic Bay Theater.  I am a big fan of the original Blade Runner thus the bar was very, very high for 2049.  IMHO, Blade Runner 2049 was too frenetic, too convoluted and the only characters I really cared much about was Rick Deckard (the still handsome and wiley Harrison Ford) and his big ass shaggy mongrel doggie.  I shed a tear when the doggie is shown peering out of a shattered building, wagging his tail just a bit, wondering where his human went.  I’m tearing up now just remembering that scene.

One thing I found interesting throughout the movie was the relatively smallish breasts of all of the female characters.  Hardly any cleavage at all – a real change for Hollywood.  K’s (played by a deliciously disheveled Ryan Gosling) made-to-order AI concubine Joi (Anade Armas) and her human side kick, Mariette (Mackenzie Davis) with whom she mind and body melds, were both small chested.  The LAPD’s Madame played by the ever wonderful Robin Wright was lean and mean and small chested.  The still-under-construction and just “born” female replicants would all measure into an A or B cup bra.    Even the gigantic virtual reality pleasure girl with the pastel hair was small breasted.  The only bouncing breasts seen in the movie was in the cocktail lounge hologram dancing girls of the distant past.  They contrasted nicely with Deckard and K beating the bejesus out of each other.

So maybe this return to a natural sized breast will be the next not-so-big thing for the ever scrutinized female figure?

Thanks for reading and if you haven’t seen the original Bland Runner, you are missing out on a great movie.  Follow me on Instagram @sowdermd and @breastimplantsanity.  Dr. Lisa Lynn Sowder

Breast Contouring, Now That's Cool, Stuff I love

Manual labor

June 8th, 2016 — 3:08pm

I recently returned from a 12 day stay in Vaison La Romaine, France where my husband taught his yearly Travel, Food and Wine Writing class.  Blog winery workerThis class combines some excellent sight seeing, lots and lots of eating and, of course, some winery tours.  On one of the tours, I skipped the usual sniffing, sipping and spitting routine and just wandered around the winery a little bit.  That is when I came across this photo on the wall which just delighted me.  You see, I have this thing about manual labor maybe because beneath all the fancy surgeon stuff, I am, like all surgeons, a manual laborer.  And I, like all surgeon, prefer it that way.  I cannot imagine spending most of my work week sitting at a desk.

I just love this image of this young winery worker hosing herself down after a long day of turning grape juice into wine.  Don’t think for one minute that I need to hose down after a long bloody case because the procedures I do are really very controlled, quite tidy and, thanks to the electric scalpel, not very bloody.  But there are days when I have labored all day, on my feet, in a warm O.R. under bright lights and I feel like need a good hosing down.  I just take a shower instead.

Thanks for reading!

Dr. Lisa Lynn Sowder

 

It's All About Me., My Plastic Surgery Philosophy, Now That's Cool

Halloween Owl is a Mother’s Friend

October 28th, 2015 — 9:49am

Happy Halloween!

blog halloween owl

“I’ve come for my candy.”

If you have young kids at home, you need to meet the Halloween Owl.  He is your best friend this time of year.

This is how he operates.   You help your  children set aside at least half of their sugary treasure to donate to the Halloween Owl.  They put their donation into a nice decorated paper bag with “Halloween Owl Only” written on it with big black letters.   After the children are in bed, their tummies aching from all of that crappy candy, the Halloween Owl taps on the window to claim his share of the bounty which he shares  with all of his woodland friends.    There is little pushback from the children as they imagine the owls and raccoons and possums enjoying their once a year treat.  And in Seattle, where I live, there are occasionally reports of coyotes in the city limits and once a report of a cougar in one of our city parks.   Those are big critters and they need lots of candy and the children may be even more generous with their donation.

My children are teenagers now and they are wise to the Halloween Owl but it worked great for years.  So if your kids are young, give it a try.  Just make sure that you put the candy at the very bottom of the garbage can.

Thanks for reading!  Dr. Lisa Lynn Sowder

Children, Now That's Cool

A really, really excellent scar.

October 22nd, 2014 — 12:51pm
The scar is between the two purple arrows.

The hairline scar is between the two purple arrows.

Any incision that goes all the way through the skin will leave a scar.  That the way higher organisms like you and me heal.  Scarless surgery is just not possible.

Patients are always concerned about scarring and so are plastic surgeons.  Plastic surgeons are good about hiding scars in wrinkles or skin creases or along natural structures.  It’s not that we don’t leave scars.  We just hide them.

The example on the left is one of the BEST scars I have seen.  This was a lady who came in for revision of a breast procedure done about 20 years ago and I had a hard time finding this scar.   This is what we call a hairline scar because it is not much thicker than a hair.  The fact that this lady healed so beautifully the first time around is a good indicator that the scar  I leave will also end up being hard to see.  Also, my scar may end up being even a little better because the patient is 20 years older and older patients scar less than younger patients.  Weird, huh?  But it’s true.

Thanks for reading!  Dr. Lisa Lynn Sowder

Now That's Cool, Plastic Surgery, Scar

The Non-surgical Breast Lift – All You Need Is Tape

August 19th, 2014 — 2:46pm

Seattle Plastic Surgeon performs a non-surgical breast lift in the exam room in 72 seconds!

blog breast lift

Non-surgical breast lift on the left. Nice, huh?

Recently I had a lady come in who really, really wanted to know what HER breasts would look like after a breast lift.  Showing her photos of ladies with similar breasts wasn’t quite enough.  She wanted to look in the mirror and see what a perky breast would like on HER chest.  So………………………………..I got out the tape.  Using the tape, I did what I do in surgery.  I raised the nipple, I tightened the breast and in her case I flattened the fatty area near her armpit.  Since the tape covered the nipple, I drew one on with a purple surgical marker.  She looked in the mirror and, except for the purple nipple, really liked what she saw.

Feel free to try this at home if you are thinking about a breast lift but just be aware that sooner or later you will need to remove that tape!  A surgical breast lift will last a whole lot longer!

Thanks for reading!  Dr. Lisa Lynn Sowder

Breast Contouring, Breast Lift, Non-invasive, Now That's Cool

A brow lift provides an anatomy lesson in the operating room.

May 22nd, 2014 — 9:13pm

Seattle Plastic Surgeon gives a little anatomy lesson during a brow lift. 

blog anatomy

Leonardo DaVinci loved anatomy as much as surgeons do.

I did an open brow lift yesterday on a lady who had just excellent anatomy.

An open brow lift is done with an incision that is made ear to ear across the scalp about and inch in back of the hair line.  The forehead is then separated from the frontal bone of the skull down to the top of the eye sockets.  (It’s not nearly as gruesome as it sounds.)  There are several important structures in harm’s way so great care must be taken with the dissection.  The rule of surgery is identify it before you cut it (or in this case, don’t cut it) which I think is pretty good advice for everyday living, don’t you?

This lady’s anatomy was right out of a text book.  Her supraorbital nerves that give sensation to the forehead and anterior scalp exited two little holes through the frontal bone  just about the rim of her eye socket.  And the little muscles that allow us to scowl (the corregators) were exactly where they should have been.  I made sure that everyone in the operating room got a good look at this anatomy not just because I find it fascinating no matter how many times I see it, but because it is clinically important.

For example, the entire forehead can be anesthetized with local anesthetic injections into the supraorbital nerves.  This is commonly done for excision of skin cancers on the forehead.  And another example is the corregator muscles.  These are the muscles that are injected with Botox to relax the area and eliminate the scowl.  They are very deep which is why the Botox injection in this area needs to go almost to the frontal bone.

Anyway, it’s a great day in the operating room when the anatomy is so clear.   And, yes, I am easily amused but believe me, the ability to be easily amused is a gift.

Thanks for reading!  Dr. Lisa Lynn Sowder

Now That's Cool, Plastic Surgery, Surgical Eductaion, Uncategorized

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