Friday, February 26, 2010

Denied insurance claims- the bane of patients AND doctors

I started this post 2 weeks ago and got inspired by yesterday's goofy "health summit" between President Obama and Congress. Excuse the juxtaposition of the two subjects, but I think in the end they are related.

The issue of health insurance denying authorization for surgery or denying claims for procedures already performed is one of the most frustrating parts of being in practice. The New York Times featured a story on this entitiled , "Fighting Denied Claims Requires Perseverance" as it related to a patient fighting her insurer for coverage of an arthroscopic hip surgery.

To me the article is less about a hip operation, but rather represents the collisions of four forces


1. Insurers trying to control their cost and make money by limiting care
2. The people who pay for employee's health care trying to control their expenses by restricting unlimited utilization
3. Patients who want what they want, when they want it (but are removed from the actual costs of these procedures)
4. Physicians who are interested in advanced techniques and technology for procedures (who are slightly less, but still somewhat removed from the costs of these procedures)

As a society, America has not learned to reconcile our desire for expensive (and often futile) treatments with the fact that someone has to pay for all this. The congressional healthcare "summit" yesterday was a grotesque kabuki theater filled with political spin and lip service to the tough choices that have to be made to make the health care system sustainable. In summary: Democrats reflexively refuse to offend unions and ambulance chasers while afraid to limit or trim entitlement growth, while Republicans offer tepid (but useful) reform at the margins and refuse to budge on likely required tax increases.

The article about some advanced new orthopedic technique parallels the series the Times ran this week on an advanced melanoma treatment which described (what I presume) what was a very expensive palliative treatment which offered no cure and "worked" such that lifespan was extended for short periods of time. This kind of treatment is not sustainable for our health system, and focusing on it adds little value for considering "bending the curve" of costs. Ultimately, we'll have to decide whether we want society to pay for such exotic medical care, or expect patients to finance their own surgeries and treatments that go above and beyond approved evidence-based medicine (EBM) treatments.

Rob
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Thursday, February 25, 2010

Material Girl


Last night I had the pleasure of attending the filming of episode 4 for NBC’s new show The Marriage Ref. The show was absolutely hilarious! I highly recommend setting your DVRs to record Thursday nights after the Olympics. Last night’s episode was hosted by Tom Papa and his celebrity “experts” were Ricky Gervais, Larry David and Madonna.

Madonna has been all over the gossip websites with speculation that she had undergone a procedure known as the "Ribbon Lift". The "Ribbon Lift" is the marketing name for a trendy little neck lift that usually takes about 30 minutes to perform. The process uses a dissolvable "ribbon"-like suspension implant to lift neck tissues through a small incision around the earlobe. After about 2 months the ribbon is absorbed by the body and results are reported to last for about 3 years, although the jury is still out on that since we don't have the long term follow-up on the relatively new procedure.

Madonna is known to respond to any inquires about plastic surgery with her standard statement that she is “certainly not against plastic surgery; however, [she is] absolutely against having to discuss it." Her face looks as if she has had a successful lifting procedure and as if she may have undergone skin and injectable treatments. Regardless of what work she has had done, Madonna was looking as beautiful as ever, and I think the viewing audience will be pleasantly surprised to hear her witty contributions to the show.

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Wednesday, February 24, 2010

Ribbon Lift

Ribbon lift


Ribbon lift has caught the imagination of public thanks to certain celebrities like Angeline Jolie , who is rumored to have had ribbon lift done recently to restore her once chiseled jaw line. Celebrities and others who are constantly watched and captured on camera tend to start early with facelifts. They particularly seek surgery that is least invasive and gives subtle results with least downtime and scarring . Ribbon lift fits the bill perfectly.

Loss of jawline definition is one of the earliest signs of ageing and starts usually in early thirties. Overweight younger individuals in their twenties too can face this problem because of fat accumulation in lower face, upper neck and under chin. But with the onset of thirties even people with normal weight can lose the sharpness of their jawline because of the effect of gravity , loss of elasticity of skin and sagging of platysma muscle of the neck. Younger people tend to consider nonsurgical options like thermage or laser facial rejuvenation which claim to lift the face. None of the nonsurgical devices available can actually lift the sag of the muscles because muscles are too deep and outside the reach of nonsurgical methods. Plastic surgeons have constantly strived to find a solution that can actually lift the muscle with least amount of scarring or downtime, to suit the need of younger people with active lifestyle.

Ribbon lift involves placing a certain ribbon like device under the jawline between the skin and platysma mucle, to pull the skin and muscle in unison towards the ear. Ribbon , in this endotine devise is made up of absorbable material , is about one fourth of an inch wide and has hooks on the undersurface to grasp facial mucles . Ribbon is inserted through small incisions either behind earlobe or above the ear , within the hairline, where it will not be seen . Ribbon lift procedure is done under local anaesthesia . After engaging the hooks on the muscle, when ribbon is pulled towards the ear , the jawline stands out . If a lot of skin is seen bunched up , the excess skin may be removed through a short incision around the ear lobe. Procedure is quick and painless. Downtime usually is one week or less.

Ribbon lift is somewhat like older thread lift with “contour” or “happy” threads. Threadlift technique used absorbable or nonabsorbable thin barbed threads, which were inserted with needle under the skin of face and neck and pulled upwards similar to the ribbon. Multiple threads were required to hold the tissue. Since they were inserted blindly and the barbs were small and delicate results were short lasting and unpredictable. Endotine ribbon in contrast has broader and stronger grip and is placed more predictably and securely after surgical dissection. Therefore one can expect longer results with ribbon.

Who will benefit the most with Ribbon lift? Younger men and women who have minimum fat or excess skin on jawline are ideally suited to Ribbon lift. Typically people in late thirties and early forties, who shy away from conventional surgical facelift will benefit with Ribbon lift. Conventional facelift and even short scar versions involve an incision in front and behind the ear . This is a high price to pay for men and women with shorter or pulled up hairstyles and those who do not need extensive lift . Ribbon lift scars, in contrast , are smaller and well hidden. Facelift surgery involves more extensive dissection which leads to a downtime of 2-4 weeks. Ribbon lift has minimal downtime of less than one week. Of course less surgery also means lesser cost and lesser risk .

So can Ribbon replace the good old facelift completely? The answer is no. Conventional facelift and necklift is the only option when skin excess and sagging is significant. Facelift surgery results last longer 5-10 years whereas results of a ribbon lift may last much less . Ribbon is completely absorbed by body in about an years time. After that the fibrosis around the ribbon is supposed to be holding the sagging tissues for some more time. Since ribbon lift is a relatively newer technique long tem follow up is not available.
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Monday, February 22, 2010

The Little Bitty "Tibi" Committee

Fashion week in New York signifies certain times of year as much as Halloween makes one think October. Twice a year, as mid-February and mid-September approach, fashionistas across the land start to get that excited itch of the approaching fashion week. For most it's the unveiling of the hottest designers newest collection that brings out celebrities, editors, and photographers alike, but for me it's a candy store of plastic surgery both good and bad, and an endless playing of my favorite two games; 'who needs what' and 'who's had what'. This year I attended the Tibi show and was giddy like a kid on a snow day as the models started walking down the runway. I happen to love Tibi and even sported a dress by the designer to the show. I was really getting into it this year! So much so that instead of ignoring the runway and focusing on the audience to play the games mentioned above, I was extremely focused on the models. Of course they were all tall and skinny because that's just par for the course (and the only measurements that fit into those sample sizes!) but I couldn't help but feel that a little bosom would've made the collection look more feminine and wearable by the general public (translation: anyone bigger than a size 0). I realize that it is physically impossible to maintain a decent cup size with these models LOW body mass index, but I do think some of them would benefit from conservative breast implants. I think breast augmentation would make a lot of these models look and feel more womanly, without drawing any attention away from the clothes. I get that these shows are supposed to be solely about the collection, not the models, but until designers can figure out how to make actual hangers walk, they need to accept that the models are part of the show too. A B-cup will only make the clothes look better!!
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Engaged!



I know this is a side step out of the ordinary of our usual blog fare around here, but I saw a headline about Hilary Duff getting engaged and I was so genuinely happy for her. Hilary has always been extremely classy and just plain adorable. She made the transition from Disney's Lizzie McGuire to grown up Gossip Girl seamlessly. There were never any drunken photos of her dancing on tables or wardrobe malfunctions as she was exiting a vehicle. I think in Hollywood those activities have become the norm rather than the exception.

Last week Ms. Duff announced that she is engaged to hockey star Mike Comrie, who she has been dating for more than two years. Mike popped the question in Maui, but there is no date set to walk down the aisle as of yet.

In addition to her blooming love life, Hilary has always remained very natural looking. It is rumored that the star has had cosmetic rhinoplasty early in her career and possible liposuction. She obviously also has great genetics because her and her sister Hillary have glowing skin. I think she is probably too young to have delved into any type of botox at this point, but looks as if she possibly uses a dermal filler to plump up her lips. Whatever work she has or hasn't had done, I think she always carries and presents herself in a elegant put together way and is such a great example for up and coming stars of tomorrow.

Congrats Hilary!!
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Friday, February 19, 2010

What's New in Liposuction : VASER

Popularity of liposuction for unwanted fat removal has generated demand for better technology which can make liposuction safer, painless and quicker. Patients and plastic surgeons alike have constantly seeked solutions that can make liposuction a better and more satisfying procedure. VASER is the latest technological offering in this context.


VASER has been around since 2002, when it was approved by USFDA for fat removal. And no, VASER has nothing in common with similar sounding LASER, which also has been used for liposuction. VASER stands for Vibration Amplification of Sound Energy at Resonance. Simply put it adds the benefit of ultrasound technology to the standard liposuction procedure. Ultrasound waves are sound waves at specific frequency and one commonly comes across it during ultrasound cleaning of dental plaque and while looking at the growing baby in mother’s womb. Usage of ultrasound for liposuction itself is not new. Ultrasound assisted liposuction ( UAL)was very popular in eighties. Vaser has resurrected ultrasound in liposuction. Vaser is 4th generation ultrasound assisted liposuction technology which offers more safety than earlier ultrasound technologies. Speciality of Vaser is “ liposelection” – meaning it caused damage to fat cells only without damaging other tissues.

Vaser liposuction is a surgical procedure like the good old liposuction, only technology and results differ. VASER is performed in sterile operation theatre by qualified plastic surgeon. General or local anaesthesia is used . Tumescent solution which may contain local anaesthetic is injected into the fat to be liposuctioned. Injection of tumescent solution shrinks blood vessels, provides anaesthesia and also creates safe environment for VASER by completely soaking the fat tissue.Vaser probe , which is a solid titanium rod of 3-5mm diameter is then introduced into the fatty layer through small 3-5 mm cuts in the skin. The ultrasound energy is delivered at accurate dosage at the tip of the probe, while moving the probe through fat in all layers all over the area . Ultrasound energy selectively destroys fat cell membrane and liquefies fat. Since the blood vessels, nerves and skin are resistant to lower doses of ultrasound, they are safe. Liquified fat is then vaccumed out with hollow suction metal cannulas attached to vaccume suction machine.

Depending of how much fat was removed VASER liposuction can be a same day surgery or may require hospitalization. Antibiotics and painkiller tablets are prescribed and usage of compression garments is mandatory for 1 month or more after VASER liposuction.

Tissue swelling is natural after any surgical procedure. After VASER liposuction results are seen gradually over next one month onwards as gradually swelling comes down and skin retracts. This is facilitated by wearing compression garment.

So what is the special advantage of VASER liposuction? Vaser liposuction enables larger amounts of fat removal which was hitherto unsafe due to blood loss. So one can have more fat removal, without the need for blood transfusion. Recovery after large liposuction is faster with VASER. Vaser also allows for better sculpting in tougher and fibrous areas like back and male abdomen. High definition liposculpture with VASER is gaining popularity for creating six pack abdomen look. Vaser has been used in more than 100,000 procedures all over the world and has proven to be safe.
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Speidi Surgery Surplus


Every gossip magazine in the country is covering the Heidi Montag plastic surgery overkill story, and it looks like her hubby Spencer Pratt is wanting to cash in on the publicity Montag has generated with her previously reported 10 procedures.

Pratt has released statements to media outlets expressing his interest in chest implants, but sources close to the couple are also stating that he will also go under the knife for a rhinoplasty and liposuction.

Looks like the plastic surgery bug is contagious at their house, who’s next I wonder…. Stephanie Pratt or little Enzo?  

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Sunday, February 14, 2010

Related letter to the editor on Mayo Clinic model and Medicare

In January, I wrote about the Mayo Clinic's satellite in Arizona dropping Medicare patients claiming it was financially unsustainable. (see "The Mayo Clinic decision signals the health care bill is "One Big Ass Mistake, America"). Besides being embarrassing for the Obama administration as he'd held it up as his model health delivery vehicle, it produced a lot of teeth gnashing. For many people, they always assumed nearly all doctors accepted Medicare, and certainly an institution like the Mayo Clinic would accept Medicare rates (no questions asked).

Mayo exists as a really weird historical quick of American Medicine. It established a reputation for excellence generations ago and managed to make that name a "franchise" for medical care. While Mayo has some fine clinicians, it's kind of well known among most surgeons that a place like Mayo has had a hard time keeping the talent happy in terms of compensation and selling rural Minnesota as a destination to live. It takes a certain kind of personality to accept the trade-offs of that clinic system, but security of such a protected & salaried position is certainly going to become more common.

Exactly how Mayo operates as to your insurance has always been confusing to many people, and the Medicare announcement had a lot of people looking for answers. I found a great letter to the Editor in a Boston Globe article that is the most succinct summary to date

I am a surgeon practicing in Phoenix, Arizona. I also grew up in Rochester, MN where my father was a physician at Mayo for 35+ years. It's time to set the record straight on the misconceptions of the Mayo Clinic as a model for efficiency.

1)Mayo does not take Medicare, as outlined in the article.
2)Mayo does not take Medicare supplements for new patients.
3)Mayo has never emphasized primary care and in fact closed their family practice program here in Phoenix at a time of acute shortage in our state, citing costs. Primary care is labor intensive
4)Mayo refuses to provide care to citizens of Phoenix, the city in which they reside, in need of specialty care in situations where their specialists have availability and where there are acute shortages in the community. Their decisions for taking patients is made by administrators, not doctors, based solely on insurance. Doctor to doctor requests are frequently denied.

5)The Dartmouth Study, touted by many as the proof of efficiency of the Model compared Medicare expenditures county by county, throughout the country. Mayo Rochester resides in a rural farming community, where Medicare usage would be expected to be low. But since Mayo does cares for virtually none of these Medicare patients, extrapolating the cost efficiency of Mayo is simply wrong.
6) Mayo's model is very much a boutique model, catering to the wealthy, those willing to pay extra or out of pocket for their care or those with very good indemnity insurance coverage. Mayo is not in network for virtually every HMO and PPO plan, based simply on the high reimbursements demanded by Mayo. Mayo quotes 2-4 times the cost for surgical procedures that those in the community at large get paid.
7)Mayo relies heavily on the$ 200-300M/year in endowment money each year, to supplement their payrolls, build their buildings, fund research, and fund their pension plan. The cost structure of the Mayo Clinic is prohibitive without this additional funding. In this recession, Mayo is having considerable difficulty because it has been having appealing to those who used to come out of pocket for perceived more individualized care.
7) Community physicians in Jacksonville and Phoenix/Scottsdale assume virtually all the care for those in need, regardless of ability to pay.

I have always been of the belief that Mayo has the perfect right to practice Medicine the way in which they believe. Their doctors are dedicated to their mission and contribute each and everyday to the growth of medical knowledge.

Please, however be honest about what the Mayo model is: exclusive medical care for those with means and those willing to pay considerably more for their services.


Cheers!

Rob
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Friday, February 12, 2010

Plastic Surgery Channel iPhone App... At Your Service!

The iPhone has really made life easier by providing top-notch restaurants, shopping, travel, and navigation at your fingertips. The latest iPhone app even makes plastic surgery more accessible! Check out the Plastic Surgery Channel's iPhone app on the apple.com website.

Get answers to questions about plastic surgery directly from board certified plastic surgeons across the country! You can submit a question, view recent questions and surgeon responses, and even view video commentary posted by the doctors, all at the touch of a button.

Looking for a qualified plastic surgeon in your area? The app lets you search by zip code or your current location to access a list of board certified plastic surgeons within a 5 to 50 mile radius.  Click through to read surgeon profiles, get phone and email information, map their office location, or visit the surgeon’s website. You can even download the doctor’s contact information straight into your iPhone. The country’s leading experts in plastic surgery are in the palm of your hand!

Move over Urbanspoon!

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Thursday, February 11, 2010

Also, slightly unimportant since the previous post is obviously taking over everything, but this is what I wore today. 
(lol not showing my eyes: see last post)




Faux fur hat, beige lace dress, purple floral tights, grey knee highs all from H&M. Floral jumpsuit, Topshop. Floral cardigan, forest green skirt are vintage. White lace shirt, Urban Outfitters sale rack I think? Or maybe it's vintage. I forget.
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Lee Alexander McQueen.


My head and heart and body hurts so much right now. 

A man who’s work has had such a profound effect on me is just gone? I still can’t come to terms with this.

To apply the term "exceptional" to his work is demeaning and arbitrary. His work surpassed the exceptional, went beyond the contemporary vision. He formulated bodies of work (through his multiple collections) pieces that were heard of not only tangibly but conceptually. Of course an idea is one thing, but to execute it in an objective space and then excel above the concept is a rarity in the societal era of the tedious and indolent. His execution, his designs, his artistic demeanor, his heart and soul were the epitome of brilliance, not only within fashion but within modern art. He was fearless. He challenged himself each season and when doubts as if he could surpass his previous collection(s) were raised by viewers and critics alike he shot those uncertainties in the face with a sawed off shot gun. There was no climax of McQueen's career for each new collection was it's own climax. He was this climatic entity that never ceased to amaze. 

His work was one of the reasons I'm this passionate about clothes today. I feel like I lost a teacher, a friend who I could rely on to keep me inspired with every collection, and I would still maintain this inspiration for months and months until he released his next brilliant collection of clothing. The fact that I no longer have this is like someone ripped a piece from this passion and fed it to dogs.

I'm not reading this back because I'm incapable at the moment.

I'm just going to return to going through his archives and crying until my eyes are dry.

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Happy Doppelgänge Week!


When my mama told me I could be anyone I wanted to be in the world when I grew up, I thought she meant a princess or an astronaut, little did I know that I could be Jessica Alba.
Alba, who’s latest movie Valentine’s Day, has quite the fan base, myself included, but I’m pretty positive Xiaoging’s ex-boyfriend (from China) takes the cake as her number one fan!
Xiaoging, who is only 21, wants to undergo plastic surgery procedures to resemble Alba, her ex-boyfriend’s favorite actress.
Her ex-boyfriend reportedly is so obsessed that his whole apartment is covered with photos and posters of Alba, and although she broke up with him because of his obsession, she now wants to get back together with him.
The transformation wasn’t her idea. Xiaoqing recently revealed to Reuters, “When I broke up with my boyfriend, I was very sad. My friends… kept consoling me but it did not work, so they suggested I do plastic surgery to look like her (Jessica Alba).”
Alba has been made aware of the situation and released a statement reportedly saying, “If somebody loves you, they will love you no matter what.”
Xiaoging’s multiple surgery procedures will be complimentary by The Shanghai Time Plastic Surgery Hospital in order to obtain media attention. Ironically, on my Facebook account page I have had as a "favorite" quote for about 3 years now: "My theory is that if you look confident you can pull off anything, even if you don't know what you're doing."

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Tuesday, February 9, 2010

*This post has no relevant point or thesis to it. It's just a bunch of random closely related shit placed together.

So firstly let me acknowledge what I wore today. I left my camera back where I originally live and so I'm just resorting to Photobooth. I had a very limited choice of what to wear since all of my stuff was here, where I am now, but yeah, TEXTURES. Mad props to you.
Everything is vintage except for the striped skirt which is from H&M.

I got my nails manicured for the first time in ever at my mom's friend's nail salon and she was a bit thrown off when I asked her to omit two of them from being painted blue and to be done in white instead. I don't know why I have a sly grin on my face in the picture though, especially when all the notes in sharpie pen on my left hand are a series of errands I have to run. That involve spending money. AKA I should look genuinely upset in this picture.

This is a jacket I bought a couple of weeks ago from the Goodwill, when I saw it I immediately ran to a mirror and put it on my back and did the Blue Steel look which seemed to be an unconscious reaction. I suppose when you put on an article of clothing covered with MULTIPLE PICASSO PAINTINGS one inevitably tends to do this. In short it's a bad ass jacket and it's the best 5 bucks I've spent in a while.



This is from that book 'Radical Fashion' I was talking about previously (which I still have to finish, I just read three other books though so I'm leaving this one for the very end). It's only one of my favourite collections of EVER - Hussein Chalayan's "After Words" collection from the Autumn/Winter 2000 season. It's amazing in so so so many ways. I always admired Rei for her association with the design aspect of Comme des Garcons and how she perpetually played an integral role in coming up with the concept and execution of the architectural part of the house (i.e shop interiors, furniture, etc.) So when I first saw this collection and saw how Hussein literally integrated the two, essentially making the design his collection and his collection the design, I couldn't help but obsess over it. It also plays out like an installation (nearly all of his collections do), evoking a conceptual artistry as much as it does a series of clothing. 


Here is the video also, which I do recommend. It was definitely intended to be viewed in motion rather than in stills, and it leaves much more of an impact than the images do.


I'll end this post with an excerpt of something I wrote for a creative response assignment for my literary studies class. It has to do with Baudelaire's flaneur - basically someone with a child-like demeanor and sense of astonishment as they walk through a social place buzzing with life. In this paragraph this flaneur is watching individuals, couples, groups, deep in conversation and laughter as he walks by windows during a stroll through city streets.

Continuously in the bins they go, in between blood clots and stolen names, and I forget of this ridden debate as I glare through the shimmer of invisibility at spoken words my eyes don’t hear. But how glorious these conversations seem! A gap between each seat and life is translated through a different set of lens, and yet they all find joy in conjunctions tied together through seams. Different eateries I make my way past, with the silver of each spoon more dull than another, a chair less comforting than the next. But heads still bob back with gaping mouths escaping the echoes of satire still fresh on their breaths. I feel as though I can touch their hearts as they rise and pace, and the simultaneous lives shared through laughter makes my chest peak and suddenly I am unleashing waves in giggles to nothing, in particular, in the grey of the streets.

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Monday, February 8, 2010

Our Celebrity in Training!

Move over Paris Hilton, we have our own "Celebrity in Training" here at Dr. Walden's office. What am I talking about you ask, well here are the details. Her name is Allison, she is 15, she had a cosmetic rhinoplasty performed by Dr. Walden, and most importantly she is ADORABLE!!! What qualifies her as a "celeb in training"? Besides the fact that she is a beautiful young woman, Ms. Allison has been taking advantage of the world wide web to chronicle her journey throughout her pre and post-operative rhinoplasty procedure. She has a YouTube channel (which I will feature at the bottom of this blog post....oh, and don't forget to subscribe!) and she has a handful of video blogs where she discusses all the ins and outs of her procedure.

Now this is the part of the blog where I start to feel a little old....hehehehe.....I mean it is amazing all the things kids have access to today. They have so many amazing outlets to be expressive and creative....and this situation is no different. It is so refreshing to hear a well spoken young woman talk about issues of beauty and self esteem in such positive light....a great example to young and old women alike!! Of course my favorite video of the bunch is the "before and after". This post really shows the dramatic and beautiful results this young lady was given.

I also want to take a quick moment to applaud her parents. I know so many parents that would just brush off a 15 year olds request to get rhinoplasty, but the transformation is just amazing, and I can only imagine how positively this will effect this young lady's life. Elective plastic surgery is a very serious decision and I think it is great that this young woman's parents took the time to listen to her and weigh her options and come up with the best plan for her life. Really awesome. Anyway, check out Allison's story below!

Happy Monday!!


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Wednesday, February 3, 2010

Rah Rah Ohh La La

I have been searching the gossip magazines and apparently, with the exception of Heidi Montag, the celebrity world has been on a plastic surgery hiatus. Therefore, today's blog is going to be about someone who I think would greatly benefit from the results of a procedure. 

One thing you may not know about me is my personal obsession with everything Lady Gaga. Maybe its my recent transition from past work in the entertainment and fashion industries but there is just something about Lady Gaga that I cant get enough of. 

So CLEARLY I was sooooo excited to attend her concert at Radio City Music Hall. Gaga rocked it... the set was unreal, her voice was amazinnnnng and I'm sure I don't even need to begin to tell you how great her fashion pieces were. 

Needless to say, I'm a Fame Ball little monster.

After seeing this picture of Lady Gaga I think she would look great with a Breast Augmentation! I know rumors are flying about a possible nose job, and for me, the jury's still out. Her body is practically perfect, there is definitely no need for liposuction, but if Gaga got her goodies Rah Rah'd I think her outfits would really blow people's mind.

Just a thought, what are yours on the new Princess of Pop?

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Boob Man Bachelor

Well it wouldn't be a season of the Bachelor without the girl that every girl in America loves to hate and this season's villain makes her predecessors look like sweethearts. Vienna has successfully alienated all the other contestants while managing to convince Jake that the negative portrayal of her by the other girls stems from nothing more than jealousy. Jake might want to pick up a copy of US Weekly this week to shed some light on the real Vienna. According to the magazine, Vienna not only cheated on her husband while he was serving in Iraq, but she drained his bank account of $5,000 to fund her breast implants. Can you think of anything more disrespectful? While her breasts do look great, they're had to have been a better way to purchase them...has she not heard of CareCredit?!

Now coincidentally (or maybe not) Monday night's episode of The Bachelor had Vienna on a "two on one" date with the other rumored surgically enhanced contestant, Gia. Gia, unlike Vienna, is very well liked by both Jake and the other girls in the house. She is absolutely gorgeous and according to US Weekly has had not one, but two breast surgeries. She is a swimsuit model by profession and while she might lack some of the personality the other girls have, she can rock a bikini like it's nobody's business! It's a shame that Jake seem way more interested in Vienna's silly antics than Gia's sweet personality and beauty.

If Monday night's episode and the US Weekly reports leave me with any take home messages here they are... We as women will truly never understand what attracts guys to certain girls and men love breasts. Beautiful breasts are probably the only thing that Gia and Vienna have in common and Jake, like the rest of them, is a "boob guy". Enjoy the views Jake but just remember if you propose you're marrying more than what's behind the bra!!

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