Modesto Kybella coming soon – is here as of July 7th, 2015

Update: Kybella is available at Surgical Artistry as of July 7th, 2015.

Visit my Kybella FAQ page.

 

I’ve been getting a few buzzing questions about Kybella for the neck.  It’s a form of mesotherapy for the adipose tissue in the neck area.  I’ve told patients that I’m waiting for a few things which include getting excellent education and training on the product and waiting to see about complications.  There is much to learn from others when a new product comes out.  I frequently think of these new items as a watchful waiting type of process.

I’ll have updates on Kybella coming soon for our Modesto practice.  Stay tuned!

Here’s a website from the FDA regarding Kybella.

Calvin Lee, MD
Modesto Surgeon with needles and injections.

What is Plastic Surgery?

Plastic Surgery De-mystified

By Tammy Wu, MD

Plastic surgery is such a common term that when one hears it, one knows what someone is talking about. But more likely than not, people will equate the term “plastic surgery” with “cosmetic surgery”. Due to the recent popularity of media coverage as well as shows portraying lives of plastic surgeons and some plastic surgeries (ie. Nip Tuck, Dr. 90210, etc), and shows that “give away” plastic surgery, such as The Swan, plastic surgery is no longer “hush hush”, as it was in the past, but is in the very forefront of everyone’s television and/or internet.

But what IS Plastic Surgery? What does it entail? Who performs them? How is it different from Cosmetic Surgery, or is it?

These are the questions that I will address in this article.

The word “plastic” in plastic surgery came from the Greek word, “plastikos”, which means “to give form or to mold”. Hence the specialty of plastic surgery encompasses the field of Cosmetic Surgery, but also Reconstructive Surgery. As a plastic surgeon, I was trained on doing both reconstructive as well as cosmetic surgeries. In fact, if one were to read the history on cosmetic surgery, one will find that many cosmetic surgeries have their origins in reconstructive surgery. Many discoveries for either new ways or methods for cosmetic surgery came from the field of reconstructive surgery. Therefore, it makes sense then that a surgeon who is well versed in reconstructive surgery would also be well-trained in the field of cosmetic surgery.

What then is Reconstructive Surgery? How is it different from Cosmetic Surgery?

Reconstructive Surgery, in general, is surgery that is performed on abnormal structures to improve function or appearance. The abnormal structure may have been a structure that someone was born with, termed “congenital”, or due to acquired causes or external events, such as trauma, infection, tumor, or other disease processes.  Some examples of congenital structures that plastic surgeons perform to reconstruct, or correct the deformity, include cleft lip and palate, hemangioma formation or other blood vessel malformations, or limb abnormalities, such as absence of a thumb.

Some examples of trauma reconstruction would be soft tissue or bony injuries from car accidents or boating accidents, falls, dog bites, as well as burn care and burn reconstructions. Then there are also the reconstructive surgeries that are performed to restore a structure either deformed or taken away by cancer, such as breast reconstruction for breast cancer, facial reconstruction due to cancers of the head and neck, or limb reconstruction due to limb cancers such as sarcomas. Many of these reconstructive surgeries sometimes will involve microsurgery, which is the usage of a microscope, in order to perform very fine detailed work to optimize the outcome of the surgery.

As you can see, just the field of Reconstructive Surgery is quite extensive.

What is Cosmetic Surgery then?  Cosmetic surgery is surgery that is performed to reshape normal structures to improve appearance.  Therefore, most if not all cosmetic surgeries are elective in nature, meaning that one does not have to have the surgery, because the structure or body part that one does not like, is not necessarily abnormal or nonfunctional; but one wishes to improve upon its appearance. That is also why when a surgery is considered “cosmetic” in nature, insurance companies do not cover or pay for them. The range of cosmetic procedures is extensive as well. They include areas of non-invasive topical treatments to less invasive treatments such as Botox ®, fillers, medium-level chemical peels, to invasive procedures that require anesthesia in order for the procedure or surgery to be performed comfortably for the patient.  The cosmetic surgeries may involve any body part from head to toe. From the head (hair transplantation), to the face (eyelid lift and face/neck lifts), to the chest (breast augmentation /lift in women and gynecomastia treatment in men), to the abdomen (tummy tuck, liposuction), to the thighs (thigh lift, liposuction, etc.), and shaping of calves with contouring liposuction or other modalities of treatment. Thus, it does seem that the possibilities are almost endless.

So, is it true then, that when one starts down the road of plastic surgery, one can’t stop? This is an issue which shoulders the responsibility on both the patient and the surgeon, to ensure that  the patient does not become a cosmetic surgery “junkie”. However, there are certainly situations in which multiple surgeries are planned for the safety of the patient. For example, when one has lost a massive amount of weight (, ie, > 100 lbs), one may be left with a lot of loose skin all over. Due to the extensiveness of some of these body contouring procedures to remove the excess skin, it is necessary to divide up the surgeries and do them in multiple stages, so that we can minimize the perioperative risks and optimize the patient’s safety.

In the next article on Plastic Surgery, De-mystified, I will discuss in more detail some of these reconstructive and cosmetic surgeries.

Health Insurance Modesto Blue Cross

We don’t accept health insurance at our office, but for ourselves we could benefit from some health coverage.  What we selected was based on recommendations from a Direct Sales Agent of Blue Cross.

Below are some notes to myself about health insurance and perhaps they may be of help to you too.

1-855-383-7247 to make payment over the phone

Mirita Dorsey, direct phone number 1-844-470-6571.  Email Mirita.dorsey (at) wellpoint.com

http://www.anthemdirectca.com/mdorsey – to apply for California

Anthem Bronze 60 D Health Savings Account PPO

$465.10 per month for 2 people

Deductable $9,000 for family
Out of Pocket Max $12,500 for family (includes deductible)
Primary Care Visit to Treat an Injury or Illness You pay 40% after deductible
Specialist Visit You pay 40% after deductible
Tier 1 Drugs 30 day Retail: You Pay 40% after deductible 90 day Mail Order: You Pay 40% after deductible
Tier 2 Drugs 30 day Retail: You Pay 40% after deductible 90 day Mail Order: You pay 40% after deductible
Tier 3 Drugs 30 day Retail: You pay 40% after deductible 90 day Mail Order: You Pay 40% after deductible
Tier 4 Drugs 30 day Retail or Mail Order: You Pay 40% after deductible
Total Monthly Premium 465.10
Subsidized Premium 0.00
Total Member Responsibility 465.10

Dental

Total Monthly Premium
TOTAL $465.10
Disclaimers

 


 

Benefit Benefit details

Monthly Cost

$465.10 a month

Monthly Cost Breakdown
Total Plan Cost
$465.10
Subsidy Applied
$0.00

Total Member Responsibility$465.10

Issued By

Anthem Blue Cross

Deductible (s)

$9,000 for family

Primary Care Visit to Treat an Injury or Illness

You pay 40% after deductible

Out of Pocket Max

$12,500 for family (includes deductible)

Specialist Visit

You pay 40% after deductible

Most Generic Drugs (Tier 1)

30 day Retail: You Pay 40% after deductible 90 day Mail Order: You Pay 40% after deductible

Most Preferred Brand Drugs (Tier 2)

30 day Retail: You Pay 40% after deductible 90 day Mail Order: You pay 40% after deductible

Most Non-Preferred Brand Drugs (Tier 3)

30 day Retail: You pay 40% after deductible 90 day Mail Order: You Pay 40% after deductible

Most Specialty Drugs (Tier 4)

30 day Retail or Mail Order: You Pay 40% after deductible

Inpatient Hospital Services (e.g., Hospital Stay)

You pay 40% after deductible

Outpatient Surgery Physician/Surgical Services

You pay 40% after deductible

Emergency Room Services

You pay 40% after deductible

HSA Compatible

Yes

Live Health Online

You pay 40% after deductible

Pediatric Dental and vision

This product includes the required coverage for the Pediatric Essential Health Benefits which does not provide adult vision or dental benefits. Please review the Summary of Benefits for details

Mental/Behavioral Health Outpatient Services

You pay 40% after deductible

Urgent Care Centers or Facilities

You pay 40% after deductible

X-rays and Diagnostic Imaging

You pay 40% after deductible

Chiropractic Care

Benefit is not covered

Preventive Care/Screening/Immunization

You pay 0% – not subject to deductible

Prenatal and Postnatal Care

Prenatal Care: You pay 0% – not subject to deductible Postpartum Care: You pay 40% – not subject to deductible

Imaging (CT/PET Scans, MRIs)

You pay 40% after deductible

Laboratory Outpatient and Professional Services

You pay 40% after deductible

Mental/Behavioral Health Inpatient Services

You pay 40% after deductible

Delivery and All Inpatient Services for Maternity Care

You pay 40% after deductible

Inpatient Physician and Surgical Services

You pay 40% after deductible

Emergency Transportation/Ambulance

You pay 40% after deductible

Allergy Testing

You pay 40% after deductible

Durable Medical Equipment

You pay 40% after deductible

Outpatient Facility Fee (e.g., Ambulatory Surgery Center)

You pay 40% after deductible

Diabetes Care Management

You pay 40% after deductible

Other Practitioner Office Visit (Nurse, Physician Assistant)

You pay 40% after deductible

Outpatient Rehabilitation Services

Occupational Therapy: You pay 40% after deductible Physical Therapy: You pay 40% after deductible Speech Therapy: You pay 40% after deductible

 

calvinleeinsurance-t E21421087986843 Application Control Number

http://file.anthem.com/2015/OFF_HIX_CA_KIT6_2015.pdf

 


 

REQUIREMENT FOR BINDING ARBITRATION

 

YOU AND ANTHEM BLUE CROSS AGREE TO BINDING ARBITRATION TO SETTLE ALL DISPUTES INCLUDING BUT NOT LIMITED TO DISPUTES RELATING TO THE DELIVERY OF SERVICE UNDER THE PLAN/POLICY AND/OR ANY OTHER ISSUES RELATED TO THE PLAN /POLICY AND CLAIMS OF MEDICAL MALPRACTICE, IF THE AMOUNT IN DISPUTE EXCEEDS THE JURISDICTIONAL LIMIT OF SMALL CLAIMS COURT AND THE DISPUTE CAN BE SUBMITTED TO BINDING ARBITRATION UNDER APPLICABLE FEDERAL AND STATE LAW, INCLUDING BUT NOT LIMITED TO, THE PATIENT PROTECTION AND AFFORDABLE CARE ACT. IT IS UNDERSTOOD THAT ANY DISPUTE INCLUDING DISPUTES RELATING TO THE DELIVERY OF SERVICES UNDER THE PLAN/POLICY AND/OR ANY OTHER ISSUES RELATED TO THE PLAN/POLICY, INCLUDING ANY DISPUTE AS TO MEDICAL MALPRACTICE, THAT IS AS TO WHETHER ANY MEDICAL SERVICES RENDERED UNDER THIS CONTRACT WERE UNNECESSARY OR UNAUTHORIZED OR WERE IMPROPERLY, NEGLIGENTLY OR INCOMPETENTLY RENDERED, WILL BE DETERMINED BY SUBMISSION TO ARBITRATION AS PERMITTED AND PROVIDED BY FEDERAL AND CALIFORNIA LAW, INCLUDING BUT NOT LIMITED TO, THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND NOT BY A LAWSUIT OR RESORT TO COURT PROCESS EXCEPT AS CALIFORNIA LAW PROVIDES FOR JUDICIAL REVIEW OF ARBITRATION PROCEEDINGS. BOTH PARTIES TO THIS CONTRACT, BY ENTERING INTO IT, ARE GIVING UP THEIR CONSTITUTIONAL RIGHT TO HAVE ANY SUCH DISPUTE DECIDED IN A COURT OF
LAW BEFORE A JURY, AND INSTEAD ARE ACCEPTING THE USE OF ARBITRATION. YOU, ANTHEM BLUE CROSS AGREE THAT EACH MAY BRING CLAIMS AGAINST THE OTHER ONLY IN YOUR OR ITS INDIVIDUAL CAPACITY, AND NOT AS A PLAINTIFF OR CLASS MEMBER IN ANY PURPORTED CLASS OR REPRESENTATIVE PROCEEDING. THIS MEANS THAT YOU AND ANTHEM BLUE CROSS ARE WAIVING THE RIGHT TO A JURY TRIAL AND/OR TO PARTICIPATE IN A CLASS ACTION FOR BOTH MEDICAL MALPRACTICE CLAIMS, AND ANY OTHER
DISPUTES INCLUDING DISPUTES RELATING TO THE DELIVERY OF SERVICE UNDER THE PLAN/POLICY OR ANY OTHER ISSUES RELATED TO THE PLAN/POLICY.

Facebook for Plastic Surgery: Problem with Photos loading on Chrome

Photos won’t load on Google Chrome (Browser)

I had this problem for months and had a hard time solving it.  But I finally found a solution.

I tried the suggested solutions from FaceBook where they said to uninstall flash.  I even tried to reinstall Java.  That seemed to work a bit but the real solution was to uninstall Chrome all together.

Uninstalling Google Chrome was the best solution I found.

I went to control panel and selected the uninstall software option and selected to uninstall Google Chrome (listed under “G”).  Then I used internet explorer to reinstall Google Chrome by downloading it first from the website.  In the end, this worked for me and I was able to upload pictures with ease once again on FaceBook.  I thought I’d share this experience so that others who use FaceBook for their plastic surgery posts or any other posts would benefit.

Plastic surgery meetings outside of Modesto?

We sometimes take the Bart to the San Francisco Airport – driving from Modesto.

Disclaimer: we are not Bart.  I don’t have details about Bart, and most of the time I’m pretty clueless about the Bart because I live in Modesto, and most of the time I have my life buried in our Plastic Surgery practice.  They have a telephone number:

Customer Service: (415) 773-1200
Hours: 8AM-5PM, M-F
APLT (Airport/Long-Term)permits are not available for purchase at any of the BART stations and can only be purchased online prior to arriving at the station.
Customers who purchase an APLT (Airport/Long-Term) parking permit may park in the station’s permit/reserved or other areas that are non-restricted.
These permits offer you a space to park in the stations permit/reserved areas up until 10 am Monday through Friday. After 10:00 am these permit/reserved areas are open to the general public and space cannot be reserved.
By Telephone – You may make a credit card payment for your parking by telephone by calling the BART parking vendor at 1-877-700-7275

Airport Long Term Parking Online Bart Reservations.  Here’s the link (it was somewhat hard to find)

  • The long term airport parking page at Dublin/Pleasanton.  Sometimes called the APLT = airport long term.
  • on that page above, we pick the Dublin/Pleasanton link.  Then click next on the “select a spot page”
  • If there are no spots left at Dublin/Pleasanton, then I might consider the west Dublin Station.
  • Address is 6400 Golden Gate, Dublin, CA 94568
  • I think you just pick the nights which the car is going to stay over.  Thus the “end” date is probably the day before you pick up the car.
  • You will have to log in with email as user name.
  • Payment is visa or mastercard only.
  • A printout needs to be made and placed on the windshield.