Talking Shape

Spring 2017 Newsletter

The St. Charles Plastic Surgery Newsletter, Volume 13, Issue 1

The Perfect Imperfection

by Bahram Ghaderi, MD

Obviously, I have a specialty that deals with making perceived imperfections perfect. Patients we see have one thing or another that bothers them. Something which they don’t see as perfect. I am not immune to that either. You may have recently read that I had Botox injections for my crow’s feet. I didn’t like them and felt they made me look older (please don’t point out the bags under my eyes – I already know!). I have also had my varicose veins treated (What can I say, I got my mother’s thighs). So, we all have something that we wish was better. As for surgery, we all want our results to be perfect, and who wouldn’t want that? So, why is it that our specialty doesn’t say expect “perfect” results, but “expect improvement or better”? The answer to that became a little more apparent to me just recently when I received a gift from an excellent surgeon and colleague that just retired (many of you know who she is).

When she retired, she gave me a gift (picture is on this page) that looked odd. On closer exam, it appeared to look like a breast. I thought it was a joke since we both do breast surgery. But then she gave the gift a very valuable meaning by her explanation of how she had obtained it. She gave me the history of how it was created. Her friend was taking a glass blowing class, and her first attempt did not turn out so well. After the friend had looked at it some more, she realized that it very much looked like a breast and knew who would appreciate it. There was someone that would find her imperfect creation just perfect. So, she gave it to her. Now, I have it at my desk to remind me that even imperfections can be quite perfect.

Some of you may know that my sister has Downs Syndrome. She is only three years younger than me. My mom (yes, the one who gave me varicose veins) used to tell me that God gave her to us and it was our privilege to take care of her and see true perfection. Just another example of how mothers are always right. My sister has a pure heart and knows nothing else but to give you a genuine smile when you smile and return your love with nothing but love and free of expectations. She has forever brought our family something that we couldn’t have had otherwise – everyone feels pure love for her as soon as we see her. Having Downs Syndrome is considered an imperfection by some standards, but she is, without question, perfect.

As much as we can enjoy our appearance (don’t get me wrong, I love my Botox), I think it is only one part. Not every imperfection should be a source of disappointment or annoyance. I know, I know, easier said than done. There is a saying in surgery – “The enemy of good is perfection.” That is meant to teach young surgeons to not obsess to the point where they lose sight of the goal which is to make the patient better. You have most likely seen this in celebrities who have tried to make their faces or noses perfect only to have a worse result than they had with their original surgery. One of the greatest finds in medicine was discovered by accident. Penicillin was discovered after its creator had thrown away his petri dish for one of his experiments. Post-it notes are another example. They were invented by a man trying to make a strong adhesive and he became frustrated that it was too weak and could be easily peeled off. That less than perfect adhesive found a new use in the form of the post-it note. Just ask Dale how important a discovery like that was. She uses them constantly. In fact, I am thinking of limiting the amount she buys!


Contour Comments

Humming Through the Spring

Spring is when flowers start to bloom, the weather gets warmer, and birds start to chirp. One of Dale’s favorite birds does not chirp but hums, a hummingbird! Every spring Dale puts out her humming bird feeder in her back yard with a simple sugar water mixture.

All she does is boil 1 cup of water and mixes 1/4 cup unrefined white sugar into it and pours that mix in her feeder. Dale says she has the same humming birds return every year and enjoys the view of the birds gathering all season long.


Drainless Tummy Tucks

A flat, well-toned abdomen is something that most of us strive for at the gym. Sometimes regardless of appropriate diet and exercise, we cannot reach our goals. Even people that are close to their ideal body weight can develop a protruding abdomen with loose and sagging skin. The most common causes are heredity, pregnancy, prior surgery, significant weight fluctuations or even congenital spine abnormalities that affect posture.

There are many techniques available for abdominal contouring. Liposuction, for example, is used when localized fat is the cause. A tummy tuck, or abdominoplasty, may be the answer to a tighter, flatter abdomen when excess fat is combined with loose, sagging skin. Also, abdominal muscles that have weakened or separated, called diastasis, can also be corrected at the time of a tummy tuck. In addition, women who have undergone a c-section may often have their scar revised at the same time. This will give the abdomen a profile that is smoother and firmer, which can often enhance body image and confidence.

A tummy tuck is not a substitute for appropriate diet and exercise. A great outcome can be diminished by significant weight fluctuations. If you are planning substantial weight loss or considering pregnancy, it may be advisable to postpone your surgery. Abdominoplasty is ideal for adults of any age who are in good health, stable in their weight, moderately fit and have realistic expectations for the outcome.

The two most common concerns for patients are the scarring involved and the recovery. Part of the recovery that patients dislike are the drainage tubes used to help heal the surgical area and to prevent fluid formation called a seroma. Having no drains is something that every patient would love. Using what’s called progressive tension sutures or quilting sutures to prevent shearing forces from disrupting the healing between the skin/fat layer and the muscle fascia can reduce the risk of a seroma. Therefore, no drains needed! However, there is still a risk for a seroma and it is something to discuss on an individual basis. Please ask about the drain-less tummy tuck if you have any questions.



It’s that time of year when your daughter, niece, granddaughter, neighbor, or any other little girl gives you their sales pitch to sell delicious and tasty cookies. How can you say no to those cute faces? So, there you are buying 3 of each flavor and justifying your purchase because it’s going to a great cause. Now you are stuck with Thin Mints and Tagalongs until September.

Here is a creative way to use those extra cookies:

Tagalong Peanut Butter Parfaits

Peanut Butter Mousse
-4 oz soften cream cheese
-1/2 cup creamy peanut butter
-1/2 cup +1tbsp confectioners’ sugar
-1/4 tsp vanilla extract
-2 tbsp heavy cream

Trifle layers
-10 Tagalong cookies, chopped
-fudge sauce
-whipped cream

With a mixer, beat cream cheese, peanut butter, confectioners’ sugar, vanilla extract, and heavy cream in a large bowl until it’s fully combined and fluffy, about 3 minutes. Place 1 chopped Tagalong at the bottom of a small glass then spoon a layer of peanut butter mousse you just made, then fudge sauce. Repeat layers. Top with whipped cream and chopped Tagalong cookies.



Rabbit Food

With warmer weather coming you may spot a rabbit hopping around your yard. What would be the first food of choice a rabbit would want to eat? Most would say, “Carrots, duh”. Actually, that is not true. Rabbits in the wild barely eat root vegetables like carrots. They eat mainly grass or hay. So where did the carrot idea from? The website Mental Floss claims that Bugs Bunny is the reason. Bugs Bunny is always munching on a carrot. Hollywood actor, Clark Gable, was an inspiration for the character Bugs Bunny. In one of Clark’s films made in 1934 the actor leans against a fence and eats a carrot while explaining the rules of hitchhiking. Bugs Bunny was featured in a cartoon in 1940 doing the same thing. So, the next time you need to feed a rabbit skip, the carrot and opt for some grass!