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


A few of my favorite things.

June 19th, 2013 — 2:30pm

Seattle Plastic Surgeon hits a triple on her morning walk.

Seattle Plastic Surgeon's all time favorite creature.

Seattle Plastic Surgeon’s all time favorite creature –       the kingfisher.

This morning I took a nice, brisk walk along Seattle’s Fremont Ship Canal.  It is wonderful place to start the day, especially in the summer.  Today I saw the usual early morning suspects:  dogs with their humans, middle aged rowers gliding across the water in their shells and skulls, the morning shift workers at Foss Maritime.

And I was treated to some of Seattle’s  urban wildlife.  First up was a Great Blue Heron, standing as still as a statue waiting patiently for it’s breakfast to swim by.  Next I saw the sleek brown head of a muskrat leaving a little wake behind it in the dark morning water.  She was likely headed home to little muskrat pups after a night of foraging.

Just when I thought my morning couldn’t get any better, I heard the distinctive rattle cry of a kingfisher.  I followed the sound with my eyes and spotted my all time favorite creature on a branch of a nearby poplar tree, just as he helicoptered down and then dove  into the smooth surface of the ship canal and emerged moments later with a small fish in his mouth.

This juxtaposition of the great outdoors with great city life is one of the many things I love about Seattle.  I just need to remind myself of this sometimes in the winter months when it’s so wet, I have moss growing on my north side.

Thanks for reading!  Dr. Lisa Lynn Sowder

I Love Seattle!, Now That's Cool

Downton Abbey – those corsets remind me of tummy tuck surgery

March 11th, 2013 — 11:16am

Seattle Plastic Surgeon riffs on how those Downton Abbey women stay so slim and what it all has to do with the modern day tummy tuck.

A tummy tuck is a little like having an internal corset.

A tummy tuck is a little like having an internal corset.

The ladies of Downton Abbey spend a lot of time having their corsets laced up by their maids – and it’s always right before they go down for dinner.  No wonder they all stay so slim.  Who can overeat when laced up tight?

And this brings me to a recent study about weight loss in ladies who have had a tummy tuck.  This is a common observation in my practice but I had never before seen it reported in the plastic surgery literature.  It seems that the internal corset that is part of most tummy tuck operations results in automatic portion control just like an old fashioned corset does.

Just another great thing about tummy tuck.  You get to wear your corset 24/7 and you don’t even need a maid!

Thanks for reading!  Dr. Lisa Lynn Sowder

Body Contouring, Now That's Cool, Obesity, Tummy Tuck, Wardrobe Observations

Fillers may reverse skin aging????? WOW.

December 27th, 2012 — 12:17pm

Seattle Plastic Surgeon shares some very interesting research on fillers and skin aging.  Check it out.

Fountain of youth

Could fillers be the Fountain of Youth?

I read with interest today an article from Dermatology Times e news.  To my knowledge, this is the first study looking at the anti-aging effects of off the shelf fillers.  Here it is:

Ann Arbor, Mich. — It may be possible to slow down the skin’s aging process by boosting support of the dermal extracellular matrix, a new study finds.

As the skin ages, the extracellular matrix, which acts as a scaffold for skin cells, becomes fragmented, according to researchers with University of Michigan Medical School, Ann Arbor. Fibroblasts shrink and less collagen is produced causing the support structure to decline, Newswise.com reports.

The researchers found that injecting the space between the skin cells with a filler enhances the structural support of the extracellular matrix.

Investigators injected a dermal filler into the facial skin of 21 volunteers over age 70 during a three month period. Data indicated that the filler stimulated fibroblasts to begin producing more collagen and boosted the support structure of the extracellular matrix. This increased support, the researchers noted, appeared to further stimulate the proliferation of fibroblasts and increase epidermal thickness, according to the abstract. The entire layer of skin grew thicker with more blood vessels, which nourished the cells, according to Newswise.com.

“By altering the matrix using an external filler and increasing the internal pressure, we’ve shown that we can essentially trigger a signal for cells to wake up,” a researcher said. “This shows that skin cells in elderly people have the capacity to respond robustly in a very positive way to alterations in the mechanical property of their environment. We still need to know more about how cells sense their environment, but in general it appears we have made a real difference in the structural integrity of skin.”

The findings were published in the October issue of the Journal of Investigative Dermatology.

Thanks for reading!  Dr. Lisa Lynn Sowder

Aging Issues, Facial Fillers, Now That's Cool, Skin Care

I have the coolest patients!

October 12th, 2012 — 3:50pm

Seattle Plastic Surgeon thinks her patients are the best.

Earlier this week one of my patients had bruises all over her body and I was a little worried about her until she told me that she and a bunch of friends had competed recently in a Muddy Buddy Race.  I knew what she was talking about because the Seattle Times had covered this race and after reading the article and seeing the photos, I thought,  “I bet that is a lot of fun!” 

But now after seeing those bruising and hearing a first person account of the obstacles (an ice water “hot tub”, being hoisted up many climbing walls, and electrical shocks) and a waiver that is called the DEATH WAIVER, I think I will leave that sort of fun for others.  But I am so proud that one of my patients was a finisher. 

Do my patients rock or what? 

Thanks for reading!  Dr. Lisa Lynn Sowder

I Love Seattle!, Now That's Cool

Improved posture – another benefit of tummy tuck.

September 6th, 2012 — 2:45pm

Seattle Plastic Surgeon observes that many of her tummy tuck patients have improved posture after surgery.

These waistline close up photos show marked improvement in this tummy tuck patient’s posture.

Tummy tuck is one of those great operations that improves both form and function.

Removing the excess skin and fat makes the torso look better but tightening the muscle layer makes the torso function better. 

This before and after photo shows this very clearly.   On the left, the patient had lordosis a.k.a. a sway back.  On the right, after surgery, her lordosis is almost gone.  The tightened abdominal muscles are now working better to support her back. 

Also, many patients who have low back pain prior to surgery find that they have much less pain after surgery. 

The abdominal muscles are important for back support.  Crunches may help but if the abdominal muscles have been separated by pregnancy, a tummy tuck may be necessary to get them back in the correct position. 

Thanks for reading!  Dr. Lisa Lynn Sowder

Body Contouring, Now That's Cool, Tummy Tuck

Prominent ears – a little tape is worth an operation.

August 30th, 2012 — 1:47pm

Seattle Plastic Surgeon discusses treating prominent ears.

Prominent earsThis week I operated on a young man with prominent ears.  He was starting college out of state in a month and decided to have his prominent ears fixed before heading off. 

His ear deformity was the most common one we plastic surgeons see.  His ears stuck out straight and he lacked a normal fold in his cartilage. 

Otoplasty refers to surgery that reshapes the ear.  In this patient’s case, an incision was made on the back of the ear, the cartilage exposed and stitches placed in the cartilatge to creat a fold.  This folds the ear back closer to the head.  He will be sore and swollen for a few days and in a head band for a week.  After his incisions heal, only his barber will see his scars. 

This young man may have been able to avoid surgery if his ears had been taped when he was a newborn.  Newborn ear cartilage is very flexible and can be molded in the first few weeks on life.  If a baby has ears that stick out and do not have the normal fold, taping them back is often very effective.  

Soooooo………………..if you know a little newborn Dumbo, you may want to consider a little tape.  It could save an operation down the road. 

Thanks for reading!  Dr. Lisa Lynn Sowder

 

Earlobes, General Health, Non-invasive, Now That's Cool

Time for a new bra. This one is 600 years old.

July 19th, 2012 — 5:26pm

Seattle Plastic Surgeon comments on recent discovery of ancient bra.

I came across a tiny mention about the discovery of ancient bras (and undies) in today’s Seattle Times.   This bra, discovered in an Austrian castle, is about 600 years old.  I think it looks pretty good for its age, don’t you?  Check out this article in the Huffington Post for the full story.

Also is today’s Seattle Times was an advertisement for Nordstrom’s Anniversary sale.   What a coincidence!  I think this sale is the very best time to shop for new bras.  There are a jillion styles on sale and even when it’s crazy busy, the sales staff is great with helping a gal find just the right fit. 

Sooooo……if your bra is looking a little like this 600 year old model, get thee to Nordstrom’s and get a nice little something for yourself. 

 Thanks for reading!  Dr. Lisa Lynn Sowder

Breast Contouring, Now That's Cool, Wardrobe Observations

Tatty – my favorite new word

July 10th, 2012 — 4:35pm

Seattle Plastic Surgeon shares a fun word – “tatty”.

I came upon a fun word last weekend while visiting my mother.  I was out for an early morning walk and stopped to check out the beautiful display gardens in Spokane’s wonderful Manito Park.   I was admiring a lovely stand of Cone Flowers and noted instructions on trimming them back if they become “tatty”.  What a great word!  And it’s a great word for surgery. 

Tatty means shabby or unruly and we surgeons sometimes take something from tatty to tidy by cleaning and trimming.   I had a tatty to tidy moment today when I stitched up a lovely lady who dumped her bike and suffered a cheek laceration.  Her wound was ragged and dirty and looked a mess.  After some local anesthetic, a little washing away and picking out the road dirt and trimming the ragged edged it was nice and tidy and ready for stitches. 

Surgeons speak of “tidy and untidy wounds” but I am going to replace “untidy” with “tatty”,  just for grins. 

Thanks for reading!  The very easily amused (it’s a gift) Dr. Lisa Lynn Sowder.

Emergency Room, Gardening, Now That's Cool, Trauma

Happy Birthday to BOTOX! It’s been 10 years since the FDA approved Botox for cosmetic use.

April 23rd, 2012 — 5:20pm

Seattle Plastic Surgeon shares a very quick history of Botox. 

My very first Botox patient. I injected her scowl lines and was met with great success.

I remember, years ago,  hearing about doctors injecting each other with Botox to reduce their scowl lines and thinking:  how crazy is that?????

But the anecdotal reports kept coming in and in 1992 a Canadian ophthalmologist, Dr. Jean Carruthers and her husband, Alastair, published their finding that Botox is effective in treating moderate of severe glabellar frown lines (those nasty vertical scowl creases right between the eyes).  Dr. Carruthers got the idea to try this because Botox had been used for years by ophthalmologists to treat involuntary squinting.    She and other astute opthalmologists noticed that the areas injected with Botox would loose their wrinkles. 

Botox quickly became one of the most widely researched pharaceuticals in the world with more than 2500 articles in scientific and medical  journals written about it.   Ten years after the paper by Drs. Carruthers and Carruthers, the FDA approved Botox for cosmetic use and well, the rest is history.  Botox is now approved for 25 unique indications in 85 countries.  In 2011, according to the American Society fo Plastic Surgeons’ procedural statistics, 5.6 million Americans opted for Botox treatment.  Some days when Botox is flying off my freezer shelf, I feel like I’m the one doing all those injections!

It is the scientific serendipity of the Botox story that I find so interesting.  It makes me wonder what other  discovery is just an astute observation away from being the NEXT BIG THING.

Thanks for reading!  Dr. Lisa Lynn Sowder

Botox, Now That's Cool

A Surgical Cure for Type 2 Diabetes?

April 13th, 2012 — 2:23pm

Seattle Plastic Surgeon shares some great news about Type 2 Diabetes.

For years it has been observed that obese patients with Type 2 diabetes have a dramatic improvement in their diabetes after gastric bypass surgery.   And this improvement is seen almost immediately after surgery, long before the patient loses significant weight.  Now there is something more that just anecdotal reports of this finding.

Recently the results of a randomized, prospective study of 150 obese, type 2 diabetic patients treated with  surgery or intensive medical therapy was released.  This study was carried out at the Cleaveland Clinic and took a look at the blood sugars of patients one year after surgery vs. one year after intensive medical treatment. 

The surgery patients blew the medical patients out of the water with their blood sugars going down, way down, despite stopping their diabetes medications. 

This study confirms the many anecdotal reports of the past decade or so.  Could it be that the first line of treatment for this devastating disease that afflicts so many obese patients will be major surgery?   It’s too soon to tell but as these types of surgical weight-loss procedures become safer and safer, that just may end up being the case. 

Now we just need a fix for obesity that triggers most cases of Type 2 diabetes.    Send me your ideas for this.  I’d love to be in on it. 

Thanks for reading!  Dr. Lisa Lynn Sowder

General Health, New Technology, Now That's Cool, Obesity

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