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BHP Blog

A March 28 article on Allure discusses new data from ASAPS (American Society for Aesthetic Plastic Surgery) showing that, despite the increasing popularity of injectables and other non-surgical treatments, actual plastic surgery still accounts for 77 percent of all aesthetic procedures. Among the facts mentioned, it appears that Botox has not diluted the popularity of traditional facelifts. In fact, United States procedures rose by nearly 22 percent in 2017. We agree with Allure that one very important reason for the ongoing popularity of plastic surgeries in the face of the newer alternatives is that their impacts typically last far longer. In some cases, such as rhinoplasty (nose jobs), a surgery’s impact can last as long as the patient.

Botox, for example, is a powerful temporary antidote to wrinkling – some believe it may even help prevent it – and facial fillers such as Juvederm can do a great deal to improve someone’s appearance. However, for the impact to last more than a matter of months, injectable treatments need to be repeated on a regular basis. That’s why a great many patients still opt for a face lift to deal with wrinkling and sagging. 


Moreover, there are other plastic surgeries that simply can’t be treated in any other way. ASAPS stated that eyelid lifts, known medically as blepharoplasty, can deal with sagging and dark circles far more powerfully than such currently available cosmetic fixes as make-up, cucumbers, and Preparation H. Of course, blepharoplasty can also be used to alter the shape of the eye. Of course, this type of surgery is not always strictly a cosmetic matter. Sagging eyelids can actually obstruct clear vision and blepharoplasty may, on occasion, be covered by medical insurance when that is the case.

For procedures impacting the body, of course, the only nonsurgical options are proper diet and exercise and special lingerie such as push-up bras and girdles. While both tactics are obviously tried and true, they are also limited. Lingerie, of course, only works while you’re wearing it; even diet and exercise has several limitations. Procedures such as breast lifts, liposuction, and tummy tucks can make a truly dramatic difference that will probably never be fixable with anything that comes out of a syringe. 

in Bariatric & Weight Loss Surgery 17 0

According to a February 7 article on the BBC News website, a major plastic surgeons’ organization is saying that UK women are substituting apps that allow users to improve selfies and other online images over facial plastic surgery. The startling claim comes alongside the continuing growth of procedures on the body, such as breast augmentation and tummy tucks. The belief seems to be that, since an app can improve your features online but can’t do much for your body, people are now focusing more on bodily alterations than on facial improvements.


We’re not at all sure this is actually true. If it is, however, it seems to us that it’s a classic case of an old warning from a wise Zen master: “Never mistake the finger pointing at the moon, for the moon.” What that actually refers to is the human tendency to mistakes symbols or representations of things for the actual thing. It’s a little bit like eating a picture of food or adjusting your scale to show you’ve lost weight instead of dieting.

Of course, there’s absolutely nothing wrong with using an app to apply a small boost to your online appearance. On the other hand, if the goal is genuine self-confidence, ask yourself this: whose perception of your appearance is more important – the people who see you online or the people you meet in IRL? After all, if only the online realm was important, you could just put someone else’s picture up instead of your own. If no one ever saw us in person, nobody would be the wiser and we could all look like supermodels.

Here at BHP, we think facial procedures from facelifts and Botox to eyelid lifts aren’t going anywhere. After all, we don’t actually live in a virtual world, at least not yet; non-virtual actual reality is still where it’s at. 

in Plastic Surgery, podiatrist 47 0

A recent article on Refinery 29 by cast member Tamra Judge of the Bravo network’s “The Real Housewives of Orange County” describes her motivations for getting a lower facelift shortly before turning 50, and how the procedure turned out successfully for her. Here at BHP, we think that her attitude towards the procedure indicates the growing reality that plastic surgery has become simply another weapon in a beauty-conscious person’s arsenal that can be used at any age.


Facelifts and other types of facial rejuvenation procedures are becoming increasingly common at all ages. Middle-aged and older people increasingly may suddenly find themselves in the dating pool or trying to stay relevant in their careers, so procedures that make them appear more rested and youthful can often improve a patient’s outlook significantly. At the other end of the spectrum, more and more people in their late 20s and early 30s are taking a proactive approach in terms of using such injectables as Botox to try and stop wrinkles before they become a problem. Still, the middle years remain the time when a great many women – and a rapidly increasing number of men – start looking into ways to maintain their appearance. 


Beverly Hills Physicians adds that, as with Tamra Judge, patients are often men and women who have taken superb care of themselves and who, even in middle age, may not seem to need any work. However, beauty savvy people know that the impacts of aging can be lessened by an approach that doesn’t wait for appearance issues to become obvious.

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A recent article on Live Science reports on a Norwegian study looking at 34 severely obese people with an average weight of 275 pounds. These individuals participated in an intense, medically supervised program of low calorie diet and exercise while a control group received a less vigorous weight loss program. On average, members of the more active group were able to lose an average of 24 pounds. Unusually, the study’s participants were successful in keeping the weight off for a two year period. Unfortunately, however, increased levels of hunger hormones persisted and so did a higher level of feelings of hunger. Moreover, after the weight loss, participants’ bodies actually slowed the speed at which they burned calories, making it even more challenging for them to remain at their present weight. Thus, while it was possible to lose a relatively modest number of pounds for an extensive period, the study’s participants will either have to struggle against their hungry feelings indefinitely or regain their lost weight. While the study concluded correctly that weight loss is a chronic problem requiring lifelong attention, it didn’t discuss the reality that a bariatric procedure can make defeating severe obesity much more achievable by getting at the root of the problem: hungry feelings that are out of proportion to the body’s actual need for food.


The most prevalent weight loss operation, a gastric sleeve procedure, works in two ways. First, it reduces the stomach’s size by at least three quarters. As you might expect, this makes overeating uncomfortable, creating an unpleasant association with overeating. In addition, the procedure removes the upper part of the stomach, called the fundus. This appears to be the seat of most of the body’s production of the hormone chiefly responsible for feelings of appetite. Beverly Hills Physicians notes that overweight people tend to produce more of the hormone and, to make matters worse, production of ghrelin actually appears to increase after individuals lose weight. Fortunately, removing the fundus largely removes the problem by drastically reducing the body’s production of the hormone. The result is that people are able to focus on changing their eating habits without being driven to distraction by constant pangs of appetite that are essentially indistinguishable from genuine feelings of hunger.

The participants in the Norwegian study, while severely overweight, will have to struggle indefinitely in order to maintain what appears to be a relatively modest, though certainly beneficial, weight loss. While bariatric patients also have to exert some effort, they are typically able to lose significantly more weight and keep it off, mostly because  their reduced feelings of appetite means that they are able to focus on developing a healthier lifestyle without being constantly distracted

If you’re interested in learning more about a weight loss surgery here at BHP, give us a call at the phone number above or request a consultation online.

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A February 1 article on Medical Express reports on the boom in plastic surgery and cosmetic procedures currently ongoing in Europe, the U.S., Brazil, Japan and numerous other nations. The article states that some 8.6 billion Euros were reportedly spent by European doctors and clinics in 2016, while the American Society for Aesthetic Plastic Surgery (ASAPS) reported that over $15 billion was spent by U.S. patients in 2016 on such treatments as buttock augmentation using transferred body fat. The article adds that Asia in general, and specifically China and India, are currently the worlds’ fastest growing markets for cosmetic treatments. We think that the increasing popularity of procedures is easy to explain – they consistently provide outcomes that make patients happy.


While some celebrity gossip writers might still refer to “accusations” of plastic surgery, mean-spirited criticism has mostly given way to a wide acceptance of procedures ranging from rhinoplasty and facelifts to Botox and other non-surgical forms of facial rejuvenation. Given that BHP is based in the entertainment industry‘s “company town” of LA, we naturally have many patients who are involved in the entertainment industry. However, a surprising number of those patients actually work behind the camera and are simply trying to stay relevant in a notoriously youth-obsessed business – like people many in other fields. Moreover, the word is out that these procedures are for women and men from all walks of life, and our clientele includes accountants, office assistants, teachers, construction workers and a great many others whose only involvement in the entertainment industry is watching Netflix.

While some procedures, such as Botox, are developments that arose in recent decades, the majority of plastic surgeries and cosmetic treatments have been widely available to patients since the mid-20th century and some are more than a hundred years old. With each procedure, leading plastic surgeons have been learning how to make treatments safer and more effective, to the point where recovery times have often been significantly reduced. Moreover, a growing number of “lunch time” cosmetic treatments require essentially no down time at all.

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Sometimes there’s a thin line between a mean-spirited dig and a bit of good-natured teasing, but celebrities and others increasingly being able to take a joke about plastic surgeries and cosmetic procedures is probably a pretty healthy trend. In this case, we’re thinking of a recent bit of repartee between living legends and stars of the Netflix hit, “Grace and Frankie,” Jane Fonda and Lily Tomlin.
Promoting the show, the new season of which appeared on Netflix on January 19th, Jane Fonda told Today Show host Hota Kotb that the two stars had known each for 50 years. “Before your first facelift,” quipped the acclaimed actress and stand-up comedy great. “Who are you, Megyn Kelly?,” responded Ms. Fonda, referring to a much discussed incident where she refused to answer a plastic surgery question from the former Fox News anchor turned Today Show regular.
Our team here at Beverly Hills Physicians believes strongly that plastic surgery and cosmetic procedures are simply another weapon in an individual’s arsenal to look his or her best and nothing to be embarrassed about. On the other hand, it’s also pretty obviously a very personal decision and not something that’s necessarily in the purview of journalists, random strangers, or even friends and family in some cases. There’s obviously a huge difference with a bit of ribbing from a very close friend and a question from a journalist when the subject of the interview is supposed to be an individual’s work. (In the Megyn Kelly incident, the question came during an interview promoting 2017’s “Our Souls at Night,” featuring Ms. Fonda’s equally mature male costar, Robert Redford. When he was interviewed by Kelly, he had no questions regarding measures to improve his appearance.)
Context is everything. In general, we’d say pretty much avoid the subject of someone’s work unless they decide to bring it up. Of course, that’s not what happened with Lily Tomlin’s quip. Then again, most of us aren’t comic geniuses.

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Ask anyone who works at a gym or a weight loss clinic or center, January is perpetually one of the busiest times. We all know why – people make New Year’s resolutions the day after eating and/or drinking themselves into a stupor on December 31st. Honestly, there’s nothing wrong with using a milestone like the start of a new year to make a positive change in one’s life, even if most people find themselves skipping days at the gym by early February and forgetting they even had a membership by mid-March. Enough people get enough benefit out of at least making an attempt at improving their fitness and health to make it a worthwhile shot, even if the gyms are often nearly empty by April.

Why Wait?

However, we’d like to propose an alternative. One of the many reasons people who want to make changes in their life face is a sort of all-or-nothing approach. People tend to feel like they either have to spend every day eating an ultra-light spa diet and working out for two hours at the gym, or they might as well take up a strictly meat-and-potatoes (and dessert!) routine and binge watch everything on  Netflix.  The way to go is to set realistic expectations for yourself and to find out how you can be healthier while also enjoying your life and not feeling constantly deprived. Going from one extreme to the other has never been the way to go.

Starting your new regime even as the holiday season is still underway is an outstanding way to figure out how you’re going to integrate a healthy lifestyle into your overall life. People who are healthy don’t skip holiday parties because they’re afraid of food and drink, they do their best to manage things – maybe exercising a little more and trying to only enjoy one of two of their absolute favorite treats instead of ransacking the buffet and feeling like a force-fed goose afterwards. The trick is to not set your expectations too high. It’s likely that you won’t lose a great deal of weight over the holidays but, once they’re over and everybody else starts trying to lose their holiday weight, you’ll have a healthy head start.

By the way, BHP offers support for people trying to get in shape in many ways. From liposuction for fit people to get rid of stubborn fat pockets, to weight loss coaches for men and women who are trying to lose some weight, to bariatric procedures for the obese and severely obese, we’re here to help

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Looking at weight loss related news articles can be confounding. The day we wrote this, we saw news stories from reputable journalistic outlets about how some believe that cinnamon can help us to lose weight (at least as long as we’re not getting it from a Cinnabon roll); how some of us may be genetically predisposed towards holding on to the excess fat; and how some people are using selfies and social media to help keep themselves motivated to stick to their weight loss regimens.

The problem is that all of these news stories are confusing, often not so scientific, and are of questionable value because, even when they are accurate they very rarely contain much information we can actually use. The upshot is that we might feel even more helpless than before as we try to control our weight with mixed results, or no results at all. After all, chemistry aside, the only way putting cinnamon on our food is going to help us lose an appreciable amount of weight is if we put it on just in our coffee but also on foods like spaghetti and meatballs. (Yuck.)

The good news is that losing a relatively small amount of weight is highly achievable with a little effort, if we can stay focused on the basics of eating less and exercising more, possibly with the help of a weight loss coach. For those of us with more significant amounts of weight to lose, however, bariatric medicine has been shown to make permanent weight loss a great deal easier to achieve by actually reducing our desire to eat, rather than through some kind of “weird trick.” Such procedures as the gastric sleeve and the Orbera weight loss balloon have proven to be very highly effective.

If you’d like to start next year off by facing your major or minor weight issues face to face, BHP has options available that can address your personal situation. Give us a call or visit our contact page.  

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Can Convenience Go Too Far?

Especially as we enter the holiday season, people here in Southern California are busier and more pressed for time than ever. And so we all try to carve more minutes and hours out of our schedules. We get take-out instead of cooking our own food and, when take-out takes too long, we hit a fast food joint; we adjust our schedules to save time on our commutes; we indefinitely put off reading the latest bestseller or binge watching the new season of our favorite TV show, and we find all sorts of short-cuts on everything from doing our hair to getting the dog washed. However, a news item from last month that we saw at NewBeauty takes things to another level.

The famously plastic surgery savvy nation of South Korea has taken convenience to a whole new level by offering a plastic surgery center inside Seoul’s bustling Incheon International Airport. It’s not clear whether it’s aimed at super-busy travelers who might want to work in a quick Botox treatment before or after a trip, or as a convenience for so-called medical tourists who want to get their procedures Gangnam style but who may not have time to actually visit Gangnam. Regardless, it brings up a serious question for those of us who perform and receive cosmetic procedures as we try to balance convenience with getting the most outstanding results possible.

While time is precious, it’s also true that all procedures need to take a certain amount of time. After all, both the patient’s health and appearance is on the line. Here at Beverly Hills Physicians, we do what we can to make getting a procedure as easy as possible. We also work hard to keep downtimes to a minimum so that patients can get back to their routines more quickly. We also offer locations throughout Southern California so that our clientele doesn’t have to deal with lengthy rides to or from their procedures.

At the same time, of course, cosmetic procedures – even ones as simple as Botox injections – should never be rushed, and they can’t be streamlined the way efficiency experts might redesign a supermarket. Here at BHP, we find ways to be respectful of our patients’ time largely by taking our own time to make sure we get things right the first time. It’s a formula that seems to work.

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Halloween is just about here – and especially parents and folks who live in child-heavy areas have the fear of a really frightening post-holiday weight gain.  The problem is that those of us fighting the battle of the bulge might ordinarily avoid having candy in the house but, as October 31 nears, we stock up on treats to give to neighborhood kids and, suddenly, there’s a lot of candy in the house for us to try and resist. Many of us are able to hold off until the big day, but once the trick or treaters have left, we’re faced with a bunch of left over candy. It’s even worse for parents. While we do our best to try and keep the kids’ candy consumption under control, we often find ourselves over-indulging right along with them.

Avoid a Scary Post-Halloween Weight Gain

Fortunately, there are a few common sense steps to avoid the dietary equivalent of a zombie apocalypse.

  1.     Don’t buy your favorites. If there’s some candy you love so much that you’re extra afraid you won’t be able to control yourself, get something else. You might even consider getting something you actually dislike. If, like some of us, you can’t stand coconut, Mounds Bars will be easy to resist and you won’t have to worry about your house being egged or TP’d for being a Hallo-Scrooge.
  2.  Don’t buy a whole lot. A lot of us have an almost irrational fear of running out on Halloween but, really, what’s the worst that can happen? You can always turn the lights out, watch a scary movie with your headphones on, and just pretend you’re not home.
  3. Spread the “pain” around. If you’re a parent there’s really no perfect answer as you try to keep everyone’s consumption under control without making your kids hate you forever. So, yes, let the kids take the candy to school (if there’s no rule against it, that is), and you always have the option to bring it into work or a social occasion. Your friends and coworkers might think it’s a mixed blessing, but at least you won’t be the only one tempted.


Even better, if there’s a local charity that can use the candy productively – your nearest Ronald McDonald House might be a good one – give it to them so they can to give it to kids who could really use a treat. Think of how much better that warm feeling of doing something good for people will feel compared to a bunch of extra pounds.

Of course, these kinds of helpful hints can only go so far. Remember that BHP plays host to an outstanding group of weight loss specialists, including weight loss coaches for people struggling with some extra pounds and bariatric surgery options for those with more serious weight problems. Whatever your situation, we’re here to help! 

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In conjunction with Breast Cancer Awareness Month, BHP is highlighting its bra collection drive. As always, We are requesting donations of both new and lightly used bras from anyone who has old or unwanted bras to donate. The bras will be recycled and then redistributed to women in need. Bra donors are invited to stop by during business hours at any of our nine Southern California locations, which are located in Beverly Hills, Encino, Lancaster, Oxnard, Pasadena, Rancho Cucamonga, Temecula, Thousand Oaks, and Valencia.

Our Bra Collection Drive for Breast Cancer Awareness

This year, the bra collection drive is also being held in cooperation with the breast reconstruction awareness campaign being sponsored by the American Society of Plastic Surgeons (ASPS) and The Plastic Surgery Foundation. BHP has a page devoted to the bra drive on the campaign’s web site and we enthusiastically support the campaign. Its goal is “to inform women of their breast reconstruction options following a mastectomy or lumpectomy.”

It’s worth noting that BHP offers post-breast cancer reconstruction surgery.  Of course, every woman is different and some may not want this type of procedure, while others may not be candidates for one or more health reasons. However, many women may feel a void following a procedure and breast prosthetics are often not sufficient to ensure they look and feel their very best. Therefore, post-surgical reconstructive procedures – which are legally required to be covered by health insurance -- are often the best way to address the situation.

If you are interested in participating in the bra drive, or in obtaining a reconstructive procedure, we’d love to hear from at 800-788-1416. If you’re interested in a procedure, you can also reach virtually and request a consultation.

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A recent article in Crain’s Detroit Business reports on complaints from plastic surgeons nationwide that they are performing an increasing number of revision procedures to fix botched surgeries performed by non-plastic surgeons. The article states that more and more practitioners from other specialties are trying to take advantage of the increasing popularity of cosmetic procedures. While most of the procedures in question are being performed by legitimate physicians, these individuals may simply lack sufficient experience to safely perform plastic surgeries, the article says. Even worse, some of the procedures are being performed by non-physicians such as nurses and medical technicians. This is just another reminder of something that really should be obvious: plastic surgeries should only be performed by highly qualified plastic surgeons.

The Increase in Revision Procedures and the Need for Caution

However attractive a lower cost might seem to a patient, working with someone less qualified is gambling in more ways than one and the odds are not in your favor. Plastic surgery has never been safer, but it is also a highly demanding type of surgery requiring a great deal of delicacy and highly specific medical knowledge. On the one hand, getting a cut-rate procedure is putting your health and, often, your life at risk. On the other hand, correcting a botched procedure can result in truly enormous costs as well as a great deal of heartache.

Beyond avoiding a disaster, there are a number of positive reasons to take advantage of the services of a skilled plastic surgeon over even a relatively qualified doctor from another discipline. The fact of the matter is that cosmetic procedures are not just a science, but are also something of an art. Skilled plastic surgeons benefit from a strong aesthetic sense that doctors from other disciplines might not have. Procedures that look natural and truly enhance a patient’s overall appearance require a discerning eye and a deft hand, and only a competent and sensitive plastic surgeon can be relied upon to provide that.

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When people think about getting a bariatric surgery, they often have two issues on their mind: finding a way out of the stigma and other social issues often associated with being severely obese in our culture, and defeating the many life-threatening health impacts related to obesity, such as increased risk of strokes, heart attacks, cancer, and many other life threatening events. While a lot of people are partly motivated by concern about dying prematurely, they don’t always think about lower quality of life often suffered by people who survive, but who have to live with multiple heath threats.



Here’s an excellent example of what we’re talking about. We’ve never heard of anyone dying from arthritis but it obviously can extremely painful and sometimes even disabling. Fortunately, a September 15 piece in U.S. News Health Care reports on a 2015 study which found very beneficial results for rheumatoid arthritis sufferers who had a weight loss procedure. In fact, the study found that only six percent of people who had obtained procedures between 1993 and 2013 were considered to be suffering “moderate to severe disease activity” starting from six months after the surgery. This compares with the 57 percent of patients who were classified that way prior to their operation.

Whether we’re talking about rheumatoid arthritis or more common, age related osteoarthritis, the more weight our joints are forced to bear, the greater our risk of developing the illness and the more likely we are to experience severe pain. While healthy people may rarely think about the implications of common maladies like arthritis, a sufferer can tell you that it can greatly reduce a person’s enjoyment of life. This becomes ever more important as modern medicine becomes better and better at extending life, without always improving our ability to enjoy being alive. For people with severe weight problems, weight loss surgery is one of the best ways we know to avoid the situation once succinctly described by baseball great Mickey Mantle. “If I knew I was going to live this long, I’d have taken better care of myself.”

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A recent article on NextShark discusses a reported dramatic increase in the number of South Korean men obtaining plastic surgery, largely influenced by the growing popularity of “pretty boys” in both K-Pop and television K-Drama. The truth is that standards of male appearance are changing not only in the Asian nation, where plastic surgery has been generally popular for many years, but all over the world. Even here in the United States, where men once favored a more rugged look, many males are now going for a combination of a softer, even somewhat androgynous, face, and a well-toned and muscular body. The good news is that plastic surgery and cosmetic offerings can help many men to achieve their desired appearance.


While there are definitely limits to what can be achieved, within reason procedures can help a great many men get closer to their ideal with numerous procedures. In terms of facial appearance, rhinoplasty (nose jobs) has long been one of the most popular procedures for American men, but now more of them are asking for somewhat more boyish appearance by making the nose less pronounced. Also, men wishing to stave off premature wrinkles and other skin issues often opt for Botox (aka “Brotox”).

The NextShark article discusses the increasing popularity of plastic surgeries that can create a more toned and muscular look. One procedure that is apparently growing in popularity in the South Korean market is breast reduction for men. Some young men in particular may have otherwise attractive physiques that may be somewhat marred by gynecomastia (enlarged male breasts). Other body contouring procedures often sought by men includes liposuction, to remove stubborn pockets of fat that seem immune to vigorous exercise and a healthy diet and abdominoplasty (tummy tuck) that is often chosen by men who have loose skin following a weight loss.

More and more men are learning what many women have long known: plastic surgery and cosmetic procedures are very often an outstanding solution, and there’s no shame in wanting to look your very best. 

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We at Beverly Hills Physicians are delighted to announce the addition of two plastic surgery fellows to our team for the academic year 2017-2018, Christina M. Busuito, M.D. and Lukasz Swistun, M.D. This one year fellowship is designed for candidates who have successfully completed residency in Plastic and Reconstructive Surgery.  The fellows will have the opportunity to work with leading experts in the field of aesthetic plastic surgery, gain hands-on experience, and have access to an unmatched volume of surgical cases, including breast augmentation (primary or revision), breast lift and reduction, liposuction, abdominoplasty, facial procedures, rhinoplasty (primary, revision and ethnic), fat transfer, post bariatric body contouring, and much more.  

Coming to Southern California from the state of Michigan, Dr. Busuito is bringing her friendly and approachable Midwestern bedside manner to the high-flying world of Los Angeles plastic surgery, where she is earning very positive responses from delighted patients. Dr. Busuito was trained in Plastic Surgery at Detroit’s Wayne State University, where she also performed her residency in General Surgery and attended medical school. The doctor is a member of the American College of Surgeons, the American Medical Association, and the Detroit Surgical Association.

Dr. Lukasz Swistun brings a fresh approach, a strong background in aesthetics, and a resume that underscores his ability to handle a wide variety of very challenging situations. Another former resident of the Midwest, Dr. Swistun graduated from the University of Chicago at Illinois, where he also completed his residency in general surgery. Moving further west, Dr. Swistun’s residency in Plastic and Reconstructive surgery was at the University of Utah in Salt Lake City, where he mastered craniofacial, reconstructive, and cosmetic surgery.  A Naval Medical Officer from 2004 to 2009, the doctor was twice deployed with the United States Marines in the Al Anbar province of Iraq. Dr. Swistun’s background also includes a B.A. in Visual Arts. While serving his country, Dr. Swistun took a sideline as a photographer working with the Associated Press and he continues to pursue his interest in the art of photography in his spare time.

Our team at BHP is proud to welcome both Dr. Busuito and Dr. Swistun. We look forward to introducing these two doctors to women and men from throughout Southern California.

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A slideshow we recently posted on Instagram, depicting a very graphic look at a tummy tuck (abdominoplasty) procedure, caused some concern from viewers about the issue of vertical scarring. (You can see the slideshow via this link, but be aware that it contains some extremely graphic images that are not for the squeamish.)

An explanation is in order. First of all, most tummy tuck procedures involve only a horizontal incision. The incision is typically placed on the lower abdominal area, below the bikini or panty line, with the added bonus that scars tend to fade and become less obvious over time.

The picture that appeared on Instagram, however, involved what is known as a fleur de lis abdominoplasty. A fleur de lis procedure adds a horizontal incision to the usual vertical incision to allow for the removal of significant loose skin; the resulting shape is somewhat similar to the fleur de lis (flower of the lily) symbol that many of us may associate with the Boy Scouts and Girl Scouts. This type of procedure is typically only performed when the patient has lost a very large amount of weight, usually with the help of a weight loss surgery or aggressive diet. When skin is overstretched beyond certain physiologic limits, it losses laxity and does not shrink back to its original shape. For example, a fleur de lis would likely be performed on a patient who had lost a very large percentage of his or her overall body weight – often as much as 100 pounds or more, and mostly from abdominal area. However, in a case where a patient had gained and lost a small amount of weight, such as the “baby weight” that often follows a pregnancy,  an ordinary abdominoplasty with a low laying horizontal incision would be sufficient.


Nevertheless, the fleur de lis procedure has been proven to provide outstanding results for patients who are left with a great deal of loose skin and other tissue following a major weight loss. To give you an example of what we’re talking about below is an example of a “before” and “after” results for fleur de lis adominoplasty. 

As you can see, the “after” picture above shows a fairly modest horizontal scar right along the bikini line. Keep in mind, the horizontal scar is low enough to be hidden by panties, bikinis, or low cut jeans or a skirt. There is an even harder to spot vertical scar visible in the picture. While most people would be able to spot the vertical scar after it had been pointed out to them, it’s entirely possible that many viewers who didn’t know about the procedure would miss the vertical scaring completely.

In any case, we think it’s pretty clear that the second picture is a dramatic improvement over the first picture. While we’re always working hard to minimize scarring, it’s a necessary part of almost any surgery.

The last point is that fleur de lis surgery is a highly technical and complex surgery and requires years of training and experience. Most plastic surgeons cannot offer this surgery due to technical challenges of the procedure.

We will be happy to address any questions regarding this case. 

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A recent article on Reuters Health News discusses a study which found that most successful weight loss surgery patients who had received a body contouring procedure reported experiencing a better quality of life, compared to other patients. Our doctors at BHP perform both of these procedures, and this report jibes with what we regularly hear from our patients who have received procedures ranging from liposuction to a tummy tuck (abdominoplasty) following a successful weight loss surgery.

The Realities of Defeating Obesity

We put a great deal of effort to making sure that weight loss surgery patients have a clear and realistic view of what to expect following their procedure. While every case is different, a great many patients who experience a truly significant weight loss can expect to eventually find themselves with folds of skin and pockets of fat that may not be vulnerable to standard diet and exercise. Moreover, these folds are not only a cosmetic issue, as many patients also find them to be uncomfortable.

BHP is able to provide complete care for loose skin after a weight loss, including the procedure popularly known as a tummy tuck (abdominoplasty). Our patients typically report that they feel as if the procedures complete the process that began with their initial weight loss procedure. Indeed, even with the very significant assistance of a bariatric surgery, patients must put some genuine effort into changing their eating habits and taking care of their health following a procedure. Many patients tell us that they feel that the results of their tummy tuck and/or liposuction procedures are a very significant reward for their efforts, and that they feel far more confident and at-home with themselves.

It gets better because we at BHP pride ourselves on using the most advanced techniques to perform all of our treatments, including abdominoplasty. An aspect of the procedure that nearly all patients find inconvenient at best are the drains that are routinely put onto patients following the surgical procedure. Fortunately, we are now able to offer many of our patients a drainless tummy tuck using TissuGlu, a surgical adhesive that allows the majority of patients to undergo a recovery without the need for any additional management of liquids during the healing process. 

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It’s entirely understandable that people trying to lose weight are often confused about how much they should focus on exercise, versus cutting the amount of calories they take in. Weight loss journeys can be extremely frustrating in that we feel like we’re eating a lot less and exercising a lot more, but the weight often seems to come off too slowly, or even not at all.

It’s Time to End the Diet vs. Exercise Debate (Do Both!)

In these circumstances, it can be tempting to try and focus more on one side of the equation than the other. Indeed, as a very good July 14 article in U.S. News and World Report points out, some (but not all) experts tend to say that diet is, in fact, the more important side of the equation when it comes to weight loss.

The confusion, however, is that while that may well be true on a strictly technical level, exercise is also absolutely crucial to people dealing with weight issues for at least two important reasons.

1.Muscle mass. Dieting without exercise can result in a dramatic weight loss, at least at first. However, without exercise, some of that weight will be muscle, which we absolutely need. This is important because, “weight loss” is arguably something of a misnomer. The term should really be “fat loss.” We want to get read of most of the fat but we also want to gain muscle…and we definitely want to keep as much of the muscle tissue we already have as possible. Importantly, muscle actually weighs more than fat, so it’s important to realize the battle against being overweight or obese is not just a numbers game.

2.Counteracting the effects of excess weight and obesity. Doctors sometimes note that, if the effects of exercise could be packaged as a drug, just about everyone would be taking it. Indeed, the beauty of exercise is that you’ll live longer and, just as important, be a lot happier, even if you don’t lose a single ounce. Exercise has proven effects on such key health matters as blood pressure and blood sugar – and it therefore helps to prevent innumerable serious medical problems associated with being overweight that can be devastating to the length and, more importantly, to the quality of our lives. From strokes and heart attacks, to joint pain/arthritis and depression, exercise is the closest thing there is to a miracle cure. Also, it just plain feels good.

So, the answer is pretty clear. Reduce your calorie intake to lose weight and exercise to reduce fat, gain/preserve muscle, and make sure you’re a healthy and happy as possible.  Even so, particularly for those of us with really persistent weight issues, there are many steps that can be taken with the help of our BHP medical team, including bariatric surgery for severely obese individuals (those with body mass indexes of 40 and over, or 35 and over with accompanying health problems). To find out more, contact us today!

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We at BHP are happy to announce that we are now offering eligible patients a tummy tuck (abdominoplasty) procedure without the need for drains during the post-operative recovery period, thanks to an outstanding new medical product. TissuGlu Surgical Adhesive binds tissues more closely together than a standard suture. The result is that, in a majority of cases, fluids do not collect excessively near the incision site and may exit the body without drains via the body’s natural processes.

TissuGlu Surgical

Tummy tucks, which remove the excess skin and fatty tissue that may appear around the midsection due to a weight loss or following a pregnancy, are one of our most popular plastic surgeries. Indeed, BHP patients regularly tell us that they are delighted with their tummy tuck results, but they also say that they are much less happy about the need to use small, plastic drains during a period following the surgery that may last as long as three weeks. Patients sometimes complain about the need to regularly measure and empty the drains, that they are hard to conceal underneath clothing, that they are somewhat uncomfortable, and that they can even make sleeping difficult.

Fortunately, patients who qualify for TissuGlu not only benefit in terms of avoiding inconvenience and discomfort, studies have also shown that drainless tummy tuck patients are able to resume their regular daily activities more quickly, including showering, driving, and working. While a minority of patients may need some assistance with fluid management following a procedure, roughly 75 percent of patients who receive the TissuGlu surgical adhesive need no additional help regarding fluids.

The good news is that the majority of patients who qualify for a tummy tuck are also candidates for TissuGlu. However, exceptions may include people with allergies to urethane-based products and those containing isocyanate, patients with body mass indexes over 28 or who are getting a tummy tuck following an extremely large weight loss, and patients who have used TissuGlu previously. (The product has not yet been tested for repeated usage.) If you are interested in a drainless tummy tuck with TissuGlu, the best way to find out whether or it’s appropriate in your case is to schedule a consultation with a BHP plastic surgeon. Contact us by phone or e-mail for a consultation.

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Stanley Paul Frileck M.D., F.A.C.S. of Beverly Hills Physicians has been closely following some of the media coverage of this issue in such publications as The New York Times. His thoughts on the matter are below.

I’m a rather experienced plastic surgeon and one of the operations I do is breast augmentation with silicone implants. Like many of my patients, I have read about BIA-ACLC non-Hodgkin’s lymphoma that seems to be associated with textured breast implants in some rare cases. Only a few of my patients have called to ask, but most folks understand we are talking about an extremely low likelihood. 

An FDA Executive Summary notes: “….Based on available information, it is not possible to confirm with statistical certainty that breast implants cause ALCL.”  It also says “….most women with ALCL have made a full recovery after surgery.” The associated implants were bacteria contaminated.

While it would be foolish to dismiss this finding out of hand, my guess is that not too many plastic surgeons will stop using silicone breast implants. Some people thinking about breast augmentation may decide not to go ahead, but if the need, want, desire, was there, I would not advise against the operation with textured silicone gel implants.

Doctors live with those kinds of decisions all the time. We look at the numbers like everyone else. The difference is in the responsibility for the recommendation. Most physicians practice at only one level, presumably the highest. 

As one of those doctors, my recommendations are the same for everyone: mother, lover, sister, stranger. Nor is this about selling breast surgery, which should not happen. It’s rather about informed consent.  The only reason I would mention the risk of ACLC cancer to a new patient, is because it is in the news. No material implanted anywhere in the human body is perfectly safe. Dental implants, for example, can foment squamous cell cancer; joint implants can cause hemopoietic cancer; all are rare.

There is enough to consider when thinking about a breast augmentation: capsule formation, infection, hematoma, and more. These all come at a greater risk than a silicone-related cancer, and even those risks are extremely low. The risk of ACLC is much lower again. (I am purposely tap dancing around the statistics, because while I know the danger of an ACLC is really tiny, I don’t want to get caught up in the numbers.)

Remember, two things occurring in relation to each other, is not the same as one thing causing the other. Women with implants should be aware of the possibility and check with the FDA sites below for further information.



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Disclaimer: Results vary, patients may achieve different cosmetic and weight loss results depending on body type, medical history, selected procedure and a variety of other factors. One patient’s success as shown by before and after pictures in no way guarantees similar results for other prospective patients.