Goodbye, Mountain View... Hello, Palo Alto!

The old Mountain View office, RIP 2008-2009.

Well, it's moving day for the Duet ladies. We're not going far, just up the Peninsula a little way.

Nearly everything else is staying the same - our phone number, our website - Dr. Weintraub and I are just relocating the physical space of our unique little plastic surgery practice to a rather convenient location in the heart of Silicon Valley, Palo Alto.

New office hours, though, and new neighbors. Although I'll certainly miss our old neighborhood in Mountain View, I'm definitely looking forward to showing everyone our lovely new office.

Forget Tupperware parties

Image courtesy of Allergan


Speaking of breast augmentation, Dr. Weintraub and I met with our local Allergan rep at the Duet office a little while ago. The rep showed us an interesting package the company just started promoting a few months ago.

At the risk of sounding like a corporate shill, I'll go on, but only because I genuinely think it's a neat idea.

Called their "pre-consultation kit", anyone interested in breast augmentation can send away for this package, which includes information about augmentation (both a booklet and a DVD), a bra, and best yet - "sample implants" to try out in said bra.

It's pretty brilliant because it allows women to toy around with "implants" in the privacy of their own homes. You can imagine inviting a couple girl friends over, opening a bottle of wine, and cracking up over the grown-up attempts at "we must, we must, we must increase our bust". . .

The "implants" in the kit aren't real surgical implants, of course - they're plastic, filled with mineral oil - which give just a general approximation of size and feel.

At the office, at our consultations and pre-op visits, we do a similar process with a range of real surgical implant samples. We often get asked by women (and sometimes, the men who accompany them) if they can take a few home for a sort of "test drive". The problem was, the silicone gel-filled samples are so irresistible to squeeze, that a lot of the samples never made it back to the office.

The kit from Allergan helps solve that problem - and provides a closer idea of what breast implants might look like in a bra and clothes than the old stand-bys, rolled up socks or sandwich baggies filled with rice.

Perhaps the most redeeming feature of this offer is the handful of rebates. You do have to purchase the kit, and pay for shipping; but if you really are interested, you do get a rebate on your future implant purchase, which evens out the expense.

And even if you're not actually interested in breast augmentation, the kit includes rebates that can be used for Botox and Juvederm, which are worth more than the cost of the kit. . .

My secret Sunday addiction

I remember first seeing this photo a few weeks ago on Postsecret. Visiting the site has become a nicely anticipated part of my weekend, sort of like the soul-satisfying thud of the Sunday Times, ready to be perused and lingered over with a steaming cup of coffee.

That postcard, that image, that secret have stuck with me, for some very obvious reasons.

But it makes me wonder again about what a charged topic breast augmentation truly is. As a plastic surgeon, for whom it literally becomes an everyday kind of thing, if you're not careful, you can quickly become inured to the whole idea: Woman wants larger, fuller breasts. Woman gets implants. Woman is thrilled.

It is, however, so much more complicated than that. As the confessor in the postcard implies, there is so much emotion and judgment and conflict and mystique wrapped up in breasts and the concept of augmenting them. And not just for the women who are thinking about it, the women who are planning to have it, and the women who have already done it; but also for their partners, friends, family, coworkers, and acquaintances.

In the end, it is a very personal decision. And it should be.

Keeping cool

I am in a calm, happy cool place, not worked up by maddening articles about Botox, not sweating in a very indelicate manner in this latest Bay Area heat wave.

I am back at Lassen National Park, overlooking one of the lovely Sifford Lakes which you see above, where the air between 7000 and 8000 feet was cool and clean and crisp last week.

Sigh.

Botox-To-Go. Really?

It's a little bit funny - I was just chatting with a patient this afternoon about how crazy it is that there are folks out there who will let anyone touch their faces. And we weren't talking about your monthly facial or whatnot; we were talking about injecting Botox.

As my patient put it, gesticulating wildly about her face, "There is an awful lot of stuff I like going on here!" We agreed - we wouldn't let just anyone even begin to approach our precious faces with a needle and neurotoxin in their hands.

Which is why I was amazed by this news article, which landed in my inbox this afternoon. A piece in the online version of the Tampa Tribune, it describes taking cosmetic enterprise to a whole new level, almost like Botox-To-Go. A company envisioning bustling storefronts in busy shopping malls is set to capitalize on shoppers who happen to wander by and decide to pop in for a little Botox on a whim. One location is already doing business, "tucked between a Chico's and, yes, a LensCrafters."

If that doesn't make you squeamish, maybe this will do it: "Licensed technicians" will be performing your medical procedure.

Seriously? Will they do my mani/pedi when they're done injecting my Botox?

It is absolutely serious. Botox Cosmetic (and its counterpart, Dysport) is a neurotoxin, a FDA regulated medication, and despite so many attempts to downplay it, injection is a medical procedure that is not suitable for everyone who walks through the door.

No offense to the many talented nail technicians out there, but I definitely want someone who knows what they're doing if they're putting a needle to my face. I want someone with solid medical training, like a nurse or a doctor. And when push comes to shove, I want someone who is intimately familiar with every intricacy of facial anatomy and what Botox can do to it - like a surgeon who has been inside the face and understands what's going on.

And so does my patient.

Last days in China: Changde to Changsha to Shanghai to Home

Alex, in the borrowed team office, with the local charge nurses.

Friday was the team's last day in Changde. A few people had already left earlier in the week, so our numbers were sadly dwindling as our memorable trip to China was quickly drawing to a close.

After morning rounds on the handful of our remaining patients, we took one last opportunity to thank the local staff for their kindness, patience, and fantastic care.


Alex and me, flanking the very capable Dr. Fu - the local doc who helped make things happen on the first floor ward.


Back at the hotel, a pensive-looking Johnny, displaying the framed and signed scrub shirt for our translator/guide/friend, Pan.

The giant custom frame was extraordinarily cheap, by U.S. standards - I think we paid less than twenty bucks, for a very nice job that would have fleeced us for hundreds of dollars here.

If you can zoom in on the scrub top, there are a lot of very sweet messages and meaningful sketches. Quite a few of us managed to scrawl our Chinese names beside our American ones, myself included.

On this, the last day of the trip, after I had been "signing my name" repeatedly with all the grace of a struggling kindergartner, a couple native speakers pointed out that I was writing my name wrong... Part of the character for my given name was backwards! Apparently, I've been doing this for the last twenty years... And there it is, on the shirt, behind glass, preserved for Pan and posterity.

Well, now I know.


Saying our goodbyes in the hotel lobby. Here's Faith, soaking it up like a regal princess.


Almost unbearably cute, Alfred and Rosa. Newlyweds (I think six months still qualifies). Rosa - who is a periodontist in Hong Kong - joined us for the second week of the trip.


The scene as we tried to board the bus. There were a lot of tearful goodbyes, and promises were made to see each other again at next year's trip. All of our translators were so sweet, kind, and helpful - not to mention quite good at helping us understand and communicate throughout our stay. I am sure each of them will go on to achieve great things.

And so another bus spirited us away, this time a nearly three hour journey to the city of Changsha, where most of us would fly to Shanghai, spend one night, then find our ways home.

This bus ride was a bit more subdued, from a combination of exhaustion and contemplation.

And the flight from Changsha to Shanghai, on China Eastern, was much less memorable than our first flight to Changde. In a good way.


But there was still more Pan to enjoy! Here he is, captured as he tries to figure out a logic puzzle.

The Shanghai crew finally settled in at the hotel late, around 9 pm, but we were determined to see at least a glimpse of the city - which was nearly an hour's taxi ride from the hotel. Ever patient, Pan - who was in Shanghai for some very important interviews - convinced this restaurant to stay open to serve us.
















One last feast, in Shanghai.

Left photo: center bowl, fish soup laced with Sichuan peppercorns. Clockwise, starting at 12, barbecued rabbit, deep fried whitefish, braised fungus, a dried rice and syrupy tropical fruit amalgam, spicy pork, another spicy dish, mashed potatoes!, and roast duck.

Right photo: my favorite dish of the night, silky tofu with the slightest touch of spice, in broth.


I had about 6 hours in Shanghai proper. But we made the most of it, before heading back to the airport and finally returning home.

Thank you to everyone who's been following this sordid tale.

This cleft trip to China was such a rewarding experience - not just seeing a tiny slice of this giant nation firsthand as an amazed tourist, but being able to give back a little something of myself too. Thanks to everyone behind the scenes (Jackie, Judy, all the foundations who helped us get to Changde) and the generous locals who helped us all the time, every day. It was a privilege to be part of the American team; every single one of whom rallied to make it happen for the children.