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Category: Surgical Team

Plastic Surgeon and Surgery Facility

Beverly Hills plastic surgeon

As a Beverly Hills plastic surgeon and also a member of the American Society of Plastic Surgeons (ASPS), I must perform surgery in a facility that abides by the rigorous standards set for patient safety.

As I have stated in the past few blog articles, there are many key questions to ask when determining the right surgeon for your procedure. Along with doing your due diligence to decide on the right procedure, plastic surgeon, and anesthesia, I would encourage patients to ask not only where the surgery will be held but also what type of accreditations the facility meets.

As an ASPS member, I must meet the criteria of performing surgery in accredited, state-licensed, or Medicare-certified surgical facilities only. I am proud to state that I use Brighton Surgical Center, which is located in the same building as my office in Beverly Hills and carries two of the most stringent and distinguished certifications of accreditation for ambulatory facilities and hospitals within the state of California. The center has both Medicare certification as well as accreditation from the Joint Commission of Accreditation of Hospitals (JCOH).

For your safety, please ensure that your plastic surgeon is choosing an accredited ambulatory or hospital facility for your surgery. Please give us a call at 310-275-45413 or email us if you need more information about our surgery center.

 

Post Anesthesia Complications / Status Post Cosmetic Surgery

Beverly Hills Plastic Surgeon Dr. Linder

Dr. Linder has been filming today for Entertainment Tonight on February 3, 2014. The topic of discussion is Post Anesthesia Hallucinations and Psychosis. In general, after speaking to our Board Certified Anesthesiologist regarding the topic of Post Anesthesia Psychosis, this is not something that we believe truly exists. We should differentiate emergence delirium versus ICU psychosis. Emergence delirium may occur as seen in pediatrics when a child awakes with agitation.

In our practice we do see younger patients who have post anesthetics under general and may have emergence delirium due to Post traumatic Stress Disorder as well. These patients can be treated quickly verbally as well as protection of them from harming themselves and using small doses of Versed or short-acting Benzodiazepine, a valium-like drug. The situation will normally resolve in just a few minutes and the patient may re-emerge after being given the valium or Versed without agitation. ICU psychosis is multi-factorial and may be associated with disorientation associated with environment of pain, lights on for 24 hours, activity such as vital signs that are taken and the patient becomes completely disoriented and progresses to a state of psychosis. This can also be treated with medications and will resolve. The anesthetic ketamine is a dissociative anesthetic which can be associated with a psychotic event. We do not use this in our practice. It is notable that patients having surgery over 4-1/2 hours under general anesthesia do increase the risk of anesthetic-related complications. The most common anesthetic-related complications include cardiac, respiratory and neurological. Our patients are monitored both pre- and postoperatively and intraoperatively with the anesthesiologist. Preoperative evaluations must include full history, physical, and psychological evaluations prior to undergoing any surgical procedure, including plastic surgery.

Plastic Surgical Team Beverly Hills

For any successful surgical outcome, it requires teamwork from several multi-talented physicians, nurses, and techs.  As you would expect, your plastic surgeon must be Board Certified with the American Board of Plastic Surgery and Diplomate of the American Board of Plastic Surgery and should also be members of the American Society of Plastic Surgeons.  The anesthesiologist putting the patient to sleep should equally be Board Certified with the American Board of Anesthesia.  Here, they should be qualified in all forms of IV sedation and general anesthetics, including the use of laryngeal mask airways and endotracheal tube intubations as well as understanding all aspects of critical care medicine.  ACLS is required from both the Anesthesiologist and the Director of Nursing.  The Director of Nursing must be a Registered Nurse in all Medicare licensed ambulatory facilities such as ours at Brighton Surgical Center.  The Director of Nursing should have years of experience in both ICU Hospital as well as ambulatory outpatient surgery facility patient management.  The Recovery Room Nurse must be a Registered Nurse as well in all Medicare State Licensed facilities.  The circulating nurse in the operating room can be an RN or an LVN.  We use RNs.  They should be well-versed at all aspects of circulating, including helping to prepare each patient in the operating room, pulling supplies, filling out all paperwork and accountability for instrument needle sponge counts with the scrub tech as well as performing a timeout at the beginning of the surgery which includes patient’s name, allergies, surgery that will be performed and antibiotics that are given.

Finally, the Certified Scrub Tech should have years of experience in plastic surgical procedure understanding the instrumentations and how to expose tissue during the operation to allow for easier surgical manipulation by the plastic surgeon.  The Certified Scrub Tech is also responsible for the sterility of all instruments and autoclaving of all supplies.  Every aspect of the chain is essential in the loop of creating excellence for our final surgical outcome.

VIVA LAS VEGAS

Dr. Linder is now available in Las Vegas twice a month and is here to share the Hollywood-Beverly Hills style in Las Vegas, Nevada.

Women in Las Vegas may have somewhat different needs than those in Hollywood or Beverly Hills. The women in Las Vegas casinos, bars, strip clubs, etc., make a living on their appearance and their beauty. Therefore, the results of breast augmentation surgery may be different than those in other parts of the United States of America. Each woman must be recognized as a unique individual. Proportionality is usually the goal for plastic surgery; however, a somewhat slightly increased disproportion may be required for some of the women that we see in Las Vegas. Knowing this, women with very thin or ectomorphic figures may want to consider silicone gel high profile cohesive breast implants in Las Vegas. These implants have minimal rippling, more AP projection, great fullness and look absolutely fabulous. Women with thicker chest walls will do well with high profile saline implants, which should be placed subpectorally behind the muscle. They will get more definition than those with silicone gel due to the rounding shape of the saline implant which will lead to a more enhanced fuller result.

In general, high profile saline and silicone implants will be useful for all women of Las Vegas in that the HP implants have less width in diameter and more AP projection and fullness. This is something I believe all women want to have. They desire a fuller projection and less in diameter so they don’t look heavy, matronly and wide on the side. Each individual patient must be specifically reviewed in order to determine whether or not they are a good candidate for saline versus silicone implants.

Dr. Linder looks forward to working with women in Las Vegas throughout the year, as well as his Hollywood-Beverly Hills practice.

VIVA LAS VEGAS

Dr. Linder is now available in Las Vegas twice a month and is here to share the Hollywood-Beverly Hills style in Las Vegas, Nevada.

Women in Las Vegas may have somewhat different needs than those in Hollywood or Beverly Hills. The women in Las Vegas casinos, bars, strip clubs, etc., make a living on their appearance and their beauty. Therefore, the results of breast augmentation surgery may be different than those in other parts of the United States of America. Each woman must be recognized as a unique individual. Proportionality is usually the goal for plastic surgery; however, a somewhat slightly increased disproportion may be required for some of the women that we see in Las Vegas. Knowing this, women with very thin or ectomorphic figures may want to consider silicone gel high profile cohesive breast implants in Las Vegas. These implants have minimal rippling, more AP projection, great fullness and look absolutely fabulous. Women with thicker chest walls will do well with high profile saline implants, which should be placed subpectorally behind the muscle. They will get more definition than those with silicone gel due to the rounding shape of the saline implant which will lead to a more enhanced fuller result.

In general, high profile saline and silicone implants will be useful for all women of Las Vegas in that the HP implants have less width in diameter and more AP projection and fullness. This is something I believe all women want to have. They desire a fuller projection and less in diameter so they don’t look heavy, matronly and wide on the side. Each individual patient must be specifically reviewed in order to determine whether or not they are a good candidate for saline versus silicone implants.

Dr. Linder looks forward to working with women in Las Vegas throughout the year, as well as his Hollywood-Beverly Hills practice.

SPECIAL AWARDS FOR BEVERLY HILLS BREAST IMPLANTS FROM ALLERGAN AND MENTOR CORPORATION-2009

Dr. Linder is honored to receive the Allergan Partner Privileges Award which recognizes our ongoing commitment to Allergan’s Premier Portfolio in use of silicone and saline breast implants. This was awarded on September 14, 2009 by Allergan Pharmaceutical who has created Natrelle gel implants, saline implants aka McGhan Corporation.

BHAllerganMentor1

Mentor Corporation has also awarded Dr. Linder the Memory Gel Post-Approval Study Award for his commitment to research in the field of Plastic Surgery with the use of silicone gel Memory implants. Dr. Linder is always pleased to use the two FDA – approved silicone implants by both Allergan Pharmaceuticals and Mentor Corporation in his practice on a weekly basis.

BHAllerganMentor2

Becoming A Board Certified Plastic Surgeon

Dr. Linder is a Board Certified Beverly Hills Plastic Surgeon. To become a plastic surgeon in the United States of America requires several years of residency and fellowship after completion of accredited medical school training in the United States. After training at the UCLA Medical Center and receiving his medical degree at the University of California Los Angeles, he subsequently trained in general surgery at UCLA Medical Center and Harbor UCLA Medical Center. Dr. Linder also trained in Plastic and Reconstructive Surgery Fellowship in San Francisco, California at St. Francis Memorial Hospital.

After completing your residency and fellowship, you will take your written Boards and once passed, will then aggregate a substantial number of cases to be reviewed and then undergo your Oral Board Examination with the American Board of Plastic Surgery. Once passing the stringent Boards, your records will be reviewed and you will subsequently be awarded the status of Diplomate of American Board of Plastic Surgery. You may then become a member of the American Society of Plastic Surgeons. This is the most highly recognized society in plastic surgery in the world.

Every 10 years, we are required to recertify our Board status by taking once again written examinations as well as providing lists of surgical procedures performed. Our records are reviewed, including malpractice records, hospital privileges and specific categories of surgeries performed. Every year, we are to certify that we perform all surgical procedures either under licensed surgery centers and/or hospitals.

To become a Board Certified Plastic Surgeon is a long road and requires ethics, judgment and experience that we must maintain daily throughout our continuum of practice in plastic and reconstructive surgery.

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