Dr. Kenneth Benjamin Hughes, MD
Harvard-educated, Harvard-trained Board Certified Plastic Surgeon in Los Angeles and Beverly Hills specializing in liposuction, Brazilian buttlift, and mommy makeover
Dr. Kenneth Hughes, Beverly Hills and Los Angeles Plastic Surgeon
Dr. Kenneth Hughes, Harvard-trained, board-certified plastic surgeon, specializes in complex plastic surgeries and revision plastic surgeries including liposuction and liposuction revision, mommy makeover, tummy tuck, Brazilian buttlift or BBL and Brazilian buttlift revision. In addition, Dr. Hughes performs all of the conventional surgeries like breast augmentation, breast lift, body lift, arm lift, and thigh lift, along with newer skin tightening technologies of Bodytite and Facetite.
Dr. Kenneth Benjamin Hughes, MD achieved the highest level of education and elite training prior to practicing in Los Angeles and Beverly Hills. He received his honors degree from Harvard University in 1999. Dr. Hughes graduated from medical school in the top 5% of his class and scored in the top 1% nationally on his licensing boards. Kenneth Hughes, MD was awarded entrance into one of the very selective integrated plastic surgery programs, in which he received extensive training for six years in the vast array of general and plastic surgery procedures. From residency, Dr. Kenneth Benjamin Hughes was selected as only the second plastic surgeon to pursue a year long aesthetic and cosmetic surgery fellowship at Harvard Medical School.
Dr. Kenneth Hughes Voted Top or Best Plastic Surgeon in Los Angeles by Many Sources in 2019, 2020, 2021, 2022, and 2023
Dr. Kenneth Hughes, Harvard-trained, board-certified plastic surgeon, has been selected as best plastic surgeon in Los Angeles for the past several years. Three Best Rated and Wimgo have continued to vote Dr. Kenneth Hughes the best plastic surgeon in Los Angeles. In addition, Kev's best, Caredash, Top 100 registry, Liposuction Doctors in Los Angeles, and several other websites and publications have made similar assertions. Each of these sites has no affiliation with Dr. Kenneth Hughes, and Dr. Hughes feels blessed to be honored in such a fashion by these review sites.
Dr. Kenneth Hughes has authored numerous papers and textbook chapters on cosmetic surgery topics including facial cosmetic surgery (facelifts, facial fat grafting, and rhinoplasty), breast surgery including breast augmentation, breast reconstruction, and fillers and facial fat grafting, among others. Dr. Hughes has been an invited speaker at regional, national, and international meetings, lecturing on such topics as the use of telemedicine in cosmetic and plastic surgery. In addition, Dr. Kenneth Benjamin Hughes is a consultant and lecturer for the Institute for Safety in Office Based Surgery (ISOBS), a nationally recognized, non-profit, patient safety organization at the forefront of protecting patients during outpatient procedures in plastic surgery.
On a personal level, Dr. Kenneth Hughes has been an athlete and natural bodybuilder for over 20 years, and he possesses a wealth of knowledge and experience in nutrition and exercise regimens. Utilizing his keen eye for details of the human form developed during his bodybuilding career, Dr. Kenneth Benjamin Hughes carefully evaluates his patients’ anatomy and goals and then tailors the results to an individual’s preference and specification. Dr. Kenneth Hughes brings a unique blend of technical skill, surgical acumen, and detail-oriented specificity to each of his patients in a caring and interactive atmosphere.
Dr. Kenneth Hughes - Cum Laude in Biology from Harvard University
Dr. Kenneth B. Hughes - Board Certification by the American Board of Plastic Surgery (ABPLS) in 2012
Dr. Kenneth Hughes Office and Surgery Center in Los Angeles
Dr. Kenneth Hughes's Office and Surgery Center in Los Angeles
Hughes Plastic Surgery in Los Angeles
Dr. Kenneth Hughes's Reception Area
Consultation Room at Hughes Plastic Surgery
Dr. Kenneth Benjamin Hughes Delivers Expert Plastic Surgery Results
Dr. Kenneth Hughes, Los Angeles plastic surgeon, is an expert at a vast array of cosmetic and reconstructive plastic surgery procedures. Dr. Hughes has spent countless hours creating and editing hundreds of cosmetic and reconstructive videos to display on youtube to help educate and inform patients. A sample video below highlights one of the many complicated plastic and reconstructive surgeries including silicone injection removal surgeries and reconstruction with Brazilian buttlift or BBL or butt implants.
Dr. Kenneth Hughes Video Explains Silicone Removal
Dr. Kenneth Hughes Explains Butt Implant Surgery
Why You Want a Board-Certified Plastic Surgeon Like Dr. Kenneth Hughes Not a Cosmetic Surgeon
Inside Dr. Kenneth Hughes's Fully Accredited Surgery Center in Los Angeles
Dr. Kenneth Hughes, a board certified plastic surgeon in Los Angeles, wants to help delineate the difference between a cosmetic surgeon and a plastic surgeon.
The American Society of Plastic Surgeons published a recent article on the how cosmetic surgeons are performing procedures beyond their scope of training. Doctors who advertise themselves as certified by the American Board of Cosmetic Surgery (ABCS) simply do not measure up to meet the criteria required for board-certified plastic surgeons according to the article published.
In a study published in the November issue of Plastic and Reconstructive Surgery reviewed online information to assess residency training history and advertised scope of practice for 342 ABCS-certified physicians. Nearly ten percent of ABCS members were not even trained in a surgical discipline.
According to the study, over half (62.6%) of ABCS diplomates advertised surgical operations beyond the scope of their ACGME or CODA residency training. Specialties with the highest prevalence of practicing beyond scope of training were internal medicine (n=2, 100%), general surgery (n=69, 95.8%), obstetrics and gynecology (n=17, 85%), otolaryngology (n=65, 59.1%), dermatology (n=16, 51.6%) and oral and maxillofacial surgery (n=30, 50%).
The most commonly offered out of training scope procedures were liposuction (59.6%), tummy tuck (50.0%), breast augmentation (49.7%) and butt augmentation including Brazilian buttlift and butt implant procedures (36.5%).
Misleading marketing and overtly false advertising are widespread in many large markets. One metric commonly used to select a qualified surgeon is board-certification; however, that distinction has become obfuscated, blurring the lines for patients.
A board-certified plastic surgeon must have at least six years of surgical training, including completion of an accredited plastic surgery training program. They must perform thousands of cosmetic and reconstructive surgery procedures of different types, pass rigorous written and oral examinations and commit to continuing education and assessment throughout their careers.
However, an ABCS-diplomat is asked to complete only one year of surgical training, experience 300 procedures and one written and oral examination completed during a single weekend, with no continuing medical education requirements.
These differences are so pronounced that in 2018 the Medical Board of California concluded ABCS certification is not equivalent to ABMS Board Certification, and that ABCS diplomates cannot advertise themselves as "board-certified."
Procedures considered "out of scope" by cosmetic surgeons not plastic surgeons
Otolaryngology
Aesthetic surgery below the neck
(e.g. arm lift, thigh lift, breast augmentation, abdominal liposuction, abdominoplasty, buttock augmentation, mommy makeover)
Ophthalmology
Aesthetic surgery outside of periorbital region
(e.g. rhinoplasty, full facelift, neck lift)
OB/GYN
Any aesthetic surgery
General Surgery
Any aesthetic surgery
Dermatology
Surgical procedures not including Mohs surgery or skin lesion
Oral Maxillofacial Surgery or OMFS
Any aesthetic surgery below the neck
Internal Medicine
Any surgical procedure
Air Purification System for Dr. Hughes's Surgery Center
Surgical Gas Storage and Dispersal System at Hughes Plastic Surgery
UV Microbe Destruction System at Hughes Plastic Surgery
Emergency Power System for Dr. Kenneth Hughes Surgery Center
State of the Art Operating Room at Dr. Kenneth Benjamin Hughes Surgery Center
For more information on Dr. Kenneth Hughes visit https://www.hughesplasticsurgery.com/los-angeles-kenneth-hughes/
Dr. Kenneth Hughes's Preparedness Initiative to Combat the Coronavirus
Dr. Kenneth Hughes's office staff takes many precautions to combat the coronavirus and assure that no patient contracts the coronavirus. At present in February 2021, the coronavirus has been responsible for 500,000 patient deaths, but patient deaths can be prevented. Dr. Kenneth Hughes has not encountered one transmission of COVID after almost a year of procedures and hundreds of plastic surgery procedures. Any patient seen in the office is seen in a particular exam room that has surfaces that can be readily cleansed with antiviral wipes. All surfaces, door handles, drawer handles, counters, and exam room tables and chairs are vigorously disinfected after each patient encounter. Secondly, the cleaning crew is on site every day to clean floors, bathrooms, fixtures, equipment, and even ceilings. All surgeries are scheduled apart from follow-ups or consultations so that the surgical patient is the only individual in the surgery center other than the 5 staff members. All staff members are instructed and follow these protocols as well. Masks and gloves are worn with follow-up patients. Any patients who have symptoms or coronavirus or who have been in contact with a person who had flulike symptoms are asked to stay at home. Any nonurgent patient follow-ups are conducted over the phone or through email to minimize the influx into the office. Finally, consultations can be performed through email or through Skype to minimize exposure as well.
There are many other aspects to this system of protection against coronavirus at Hughes Plastic Surgery. However, protection against the spread of coronavirus involves maintaining clean hands and body surfaces, contact surfaces on which the coronavirus can live, and air portals through which the virus can be transmitted. Finally, Dr. Kenneth Hughes's surgery center has an ultrafast air filtration system, which circulates the room volume 30 times an hour. As a last measure, this same filtration system has UV lighting apparatus which kills viral particles on contact. It is important to realize that all of these components protect not only against coronavirus, but other infections as well. If a patient is looking to have surgery, this surgery center of Dr. Kenneth Hughes in Los Angeles spares no expense.
Dr. Kenneth Hughes, Los Angeles plastic surgeon, has been interviewed about precautions that should be taken during the coronavirus (COVID-19) and has been featured on Marketwatch.
Dr. Kenneth Hughes Voted Best Plastic Surgeon in Los Angeles and Beverly Hills by Many Publications
Dr. Kenneth Hughes Has Been Selected to Best Plastic Surgeons in Los Angeles by Kevin's Best
Dr. Kenneth Benjamin Hughes Has Been Selected Best Plastic Surgeon in Los Angeles ins 2020 by Wimgo
Dr. Kenneth Benjamin Hughes Selected Again as Best Plastic Surgeon in Los Angeles by Three Best Rated for 2020
Dr. Kenneth Hughes Even Selected by Yelp as Top 10 Cosmetic Surgeons in Los Angeles in 2020
Dr. Kenneth Hughes Voted Among Best Plastic Surgeons in Los Angeles and Beverly Hills for Breast Surgery, Rhinoplasty, Eyelid Surgery, Ear Surgery and Many More
Dr. Kenneth Benjamin Hughes, Los Angeles Plastic Surgeon, Selected to Top 100 Doctors in US in 2020
Dr. Kenneth Hughes's Plastic Surgery Articles
Managing Negative Aspects of Cosmetic Plastic Surgery Businesses with Dr. Kenneth Benjamin Hughes - published on PRlog by Dr. Kenneth Hughes
So You Want to Become a Beverly Hills Plastic Surgeon? - published on PRlog by Dr. Kenneth Hughes
How to Become a Beverly Hills Plastic Surgeon - published on PRlog by Dr. Kenneth Hughes
Loose saggy thighs? Thighlifts Can Address These Issues - published on Top Doctor Website by Dr. Kenneth Hughes
Is Your Surgeon A Liposuction Expert? How do you know? - published on PRlog by Dr. Kenneth Hughes
How to Choose Your Plastic Surgeon - TV, Radio, Snapchat, or Instagram? Part 1 - published on PRlog by Dr. Kenneth Benjamin Hughes
How to Choose Your Plastic Surgeon - TV, Radio, Snapchat, or Instagram? Part 2 - published on PRlog by Dr. Kenneth Benjamin Hughes
The Rising Popularity of Plastic Surgery for a Larger Butt - published on Top Doctor website by Dr. Kenneth Benjamin Hughes
Bodytite Tightens Skin Without The Scars of Conventional Surgery - published on PRlog by Dr. Kenneth Hughes
Dr Kenneth Benjamin Hughes and the Removal of Dead Fat (Fat Necrosis) - published on PRlog by Dr. Kenneth Benjamin Hughes
Smoking's Effect on Plastic Surgery : Complications including Flap Death, Fat Necrosis, and Poor Wound Healing - published on PRlog by Dr. Kenneth Hughes
Postoperative Care Following Brazilian Buttlift Surgery - published on Top Doctor website by Dr. Kenneth B. Hughes
Doctors Are People Too - Doctor Deaths and Suicides on the Rise - published on PRlog by Kenneth Hughes, MD
Why Liposuction Cannot Remove Silicone and Other Foreign Materials Injected into the Buttocks - published on Linked-in website by Kenneth Hughes, MD
Dr. Kenneth Hughes and His Mommy Makeover Surgery - published on PRlog by Dr. Kenneth Benjamin Hughes
Evaluating Plastic Surgery Patients for Risk of Blood Clot with Dr. Kenneth Benjamin Hughes - published on drkennethbenjaminhughesmd.com by Dr. Kenneth Benjamin Hughes
Silicone and Biopolymer Injection and Patient Deaths by Plastic Surgeon, Dr. Kenneth Benjamin Hughes - published on Linked-in website by Dr. Kenneth Benjamin Hughes
Coming Back from Near Death Experience with Dr. Kenneth Hughes, Los Angeles Plastic Surgeon - published on Linked-in website by Dr. Kenneth Hughes
Dr. Kenneth Hughes Is a Renowned Scholar, Plastic Surgery Expert, National Presenter, and Author of Multiple Journal Articles and Textbook Chapters
Dr. Kenneth Hughes has spoken at regional, national, and international meetings abd gas made many presentations to medical staff related groups. Dr. Kenneth Hughes MD is also an expert at liposuction revision, fat necrosis removal, and silicone removal, which are by their very nature reconstructive. In addition, Dr. Hughes performs gynecomastia surgery or male breast reduction, calf implants and calf fat grafting, labiaplasty, and vaginoplasty.
Finally, Dr. Hughes performs all kinds of facial and facial revision surgeries including ear surgery or otoplasty, eyelid surgery, lip lift, chin liposuction, and chin implant surgery.
To learn more about Dr. Kenneth Hughes and plastic surgery advances, visit the site
https://www.drkennethhughes.com/
On this site, Dr. Kenneth Hughes keeps patients apprised of plastic surgery news and the latest in plastic surgery technology. Dr. Kenneth Hughes was one of the first plastic surgeons to bring Bodytite and Facetite to Los Angeles.
To See Before and After Photos of Dr. Kenneth Hughes please visit https://www.hughesplasticsurgery.com/los-angeles-before-after-photos/
What Makes for the Safest BBL or Safest Brazilian Buttlift in Los Angeles and Beverly Hills?
Up until 2018, most plastic surgeons in the US and worldwide injected fat into the gluteus musculature. The gluteal musculature had a better blood supply than the subcutaneous fat of the buttocks and provided for a higher fat graft take in these fat transfer procedures. Thus, it made sense to utilize this method to create the most satisfying results. In 2018, the standard for injection in BBL was changed to injection above the muscle in the subcutaneous plane to help avoid the fat embolus, which can occur in 1 to 600 or 700 buttlifts, with death occurring in 1 in 3000 or so. Up until that point dozens of board certified plastic surgeons had reported deaths with the BBL procedure. Death was not limited to a few plastic surgeons. In fact, the deaths usually occurred in the most expert of hands by those who had performed thousands of Brazilian buttlifts due to the statistical inevitability of such an outcome.
Dr. Hughes has altered his method to a subdermal injection method which will not allow for fat injection into a larger vessel. Dr. Kenneth Hughes has also utilized ultrasound to confirm placement. Some plastic surgeons will utilize ultrasound to try to confirm placement a cannula at a deeper level below the superficial fascial system. However, Dr. Hughes does not inject in the deeper fat. He only injects in the most superficial fat. Any cannula slippage in the deep fat can result in unwanted fat below the muscle fascia.
Ultrasonic Guidance for the Safest BBL or
Brazilian buttlift
An ultrasound probe can be placed at the area of any fat injection to provide an anatomic view of the underlying tissues. The ultrasound probe must be utilized appropriately and the images must be interpreted correctly to be useful. In addition, the surgeon must be able to inject fat within the visualized field in a steady fashion. Herky-jerky motions and nonvisualized maneuvers in the deeper fat plane place the patient at risk for fat injected into the muscle and a possible fat embolus.
Dr. Kenneth Hughes Restores Life to Patients with Complex Revision Plastic Surgery
Previous surgery compounds the risks for complications for expert revision plastic surgeons like Dr. Kenneth Hughes. It is important to understand that not every plastic surgeon's practice is the same. Statistically, the average plastic surgeon will perform about 4 plastic surgeons a week or fewer. Most perform less than 200 surgeries a year. Primary breast augmentation, primary tummy tuck, primary liposuction, primary mommy makeover, and rhinoplasty make up the majority of the procedures performed. Revision surgery is frequently less than 15% of a plastic surgeon's practice. What does this mean? Most plastic surgeons only perform a handful of reconstructive and revision surgeries each year. These complex revision surgeries are infinitely more difficult surgeries. The reality is that Dr. Kenneth Hughes performs at least 10 times as many complex revision surgeries as does the average plastic surgeon each year as borne out by the above statistics.
Because this analysis of plastic surgery procedures can be hyper technical it is better probably to give some examples of patients who may fall into certain categories so that people can understand what Dr. Kenneth Hughes make in front of the daily basis. Let us say that you are starting with a breast augmentation patient. This patient is relatively young and has no medical problems has never had breast surgery before has relatively symmetric anatomy and once a relatively small to moderate sized implant. This surgery almost 100% of the time will result in a nice outcome without any complications. This patient vignette is a totally different scenario than a patient who has had five breast augmentations with four capsular contracture outcomes despite anterior and posterior capsulectomies for treatment, the placement of the dermal matrix, as well as gummy bear implants to reduce the risk as much as possible.
This is in addition to the standard precautions of submuscular placement of breast implant with antibiotic irrigation use during the surgery and things of that nature. The real issue in the second surgery is that the patient is not at the same risk for complications as the first patient. The second patient has a much higher rate for recurrent capsular contracture. In addition, this patient frequently has visibility and rippling of implants with thinning of tissue and decreased or marginalized blood supply from multiple surgeries as well as the tissue expansion occurring naturally overtime from implants. In addition, the scar tissue and apparent deformities will be harder to fix in this patient due to the contraction of the skin envelope, the development of scar tissue, and all of the soft tissue and coverage concerns. How does one quantify the level of difficulty on the first patient versus the second patient? The first patient on a scale of 1 to 10 is probably 1 and the second patient on the scale of 1 to 10 is probably around 5.
If a complicated breast augmentation revision surgery only rates a 5, what would be considered a 10? The truth of the matter is is that very few breast surgeries are so complicated that they would be considered more difficult than any other surgery. The truth of the matter is that certain surgeries are much more difficult in their approach and the ability of the surgeon to manipulate the outcome in the most appropriate way. For instance, liposuction revision is notoriously difficult. Although the actual instrument and the movement of the instrument back-and-forth in liposuction appears easy, the curiously easy and seemingly monotonous back and forth movement of liposuction belies the inherent complexity.
The real talent of the liposuction practitioner involves the precise maintenance of the cannula track to optimize fat removal and uniformity of flap resection. Remember that liposuction is a blind procedure and liposuction relies upon an intact abdominal wall. Similarly, the same precision is imperative for prevention of dents, divots, uneven resection, abdominal wall perforation, skin death, etc. Let us delineate a third patient scenario as a potential liposuction candidate. This patient has probably 3 to 4 L of fat and has had two pregnancies and a C-section. Her skin is not as taught and tight like someone who has not had pregnancy or someone who genetically has good skin. However, the patient does not have extremely saggy skin. But, with the removal of 3 to 4 L of fat, that skin envelope will of course deflate the skin envelope further. Liposuction never improves the skin; it always makes the skin worse.
The genius of performing liposuction is removing fat at multiple depths to assure uniformity at multiple levels and across the entire surface area of the surgery. In addition, the surgeon has to be able to manipulate tissue as patients are inherently uneven in certain areas of fat thickness and skin laxity. The description or the understanding of this belies simple description and cannot be communicated except in the most simplistic of ways. So this patient with will call somewhat loose skin a large amount of subcutaneous fat a previous C-section which generates scar tissue in the plane of the surgery would probably be a three or four on the scale of liposuction patients.
Now let us go to patient 4 and give you an idea of who would be the difficulty of level 10. Dr. Kenneth Hughes gets many of these people because these patients have lost all hope and other surgeons simply tell them there is nothing that can be done. The problem with that is patient patients all over the world have been performed due to trauma a previous surgery or some type of birth defect or developmental abnormality and they do not want to live a life where they look in the mirror and are disgusted by what they see. The way they look in the mirror is absolutely integral to mental health and leading a productive life. To dismiss these types of surgeries as cosmetic is to be a true fool. Dr. Hughes may see patients that are more difficult than anyone else. With more difficult patients you can guarantee that there will be a higher risk for complications and there will be less certainty about results as well as less certainty about whether certain healing parameters can be met. Patient number four comes to the office after three previous liposuctions, a tummy tuck, tummy tuck revision with umbilical reconstruction, areas of previous burn from energy-based liposuction techniques and irregularity and deformity of the entire abdomen.
In addition, this patient has had previous hernia repair and is always at risk for hernia recurrence. What is the operative approach for this type of patient? First, this patient is queried about and examined for hernias. This patient could have a hernia anywhere. The patient could have an incisional or ventral hernia. In addition, the abdominal wall may have an overall weakness due to massive weight gain or pregnancy. Thus, all liposuction and liposuction revision patients must have an intact abdominal wall and intact fascia to perform safely.
Even if a person has had hernia repair and there are no hernias present on physical exam or even after CT or MRI, the patient should realize that there are many small hernias that cannot be picked up on CT or MRI but can still allow admittance of the cannula. So these patients who are revisions with multiple previous incisions and multiple previous poor liposuction results have a very very unfriendly internal environment where it is essentially a minefield that the plastic surgeon must navigate. Once again no matter how how gifted a surgeon is, a surgeon is not going to avoid every complication. This applies to liposuction related cases as well such as Brazilian buttlifts or BBLs and revisions of those surgeries.
Dr. Kenneth Hughes uses a technique in liposuction where he literally lifts the skin and fat off the abdominal wall to allow him to insert the cannula and perform liposuction well above the abdominal wall and rib cage. This is a critical component for avoiding lung puncture, liver puncture, intestinal puncture, and even kidney puncture on the back. Patients must understand that the risk for a complication in these very unfavorable revision liposuction cases is at least 10 times higher than in a primary liposuction patient with no previous surgeries or medical problems or hernias.
So then the question becomes why would you even do the surgeries if the risk is higher? The main issue in that is to determine the relative risk of patient harm versus the relative risk of patient harm should they continue their lives with these deformities. In an extremely deformed patient where Dr. Hughes feels that he can make a significant improvement and improve quality of life, he explains all of these potential eventualities with complications. Dr. Kenneth Hughes will do the best job of avoiding those complications but the risk is certainly not zero. Dr. Kenneth Hughes has performed thousands of these very difficult liposuction revision surgeries over the years and has given life back to thousands of people. So when you evaluate a surgeon, a surgeon who has performed thousands of difficult liposuction revisions should not confused with the average surgeon who has performed a few hundred primary liposuction cases. This one of the clearest examples of an apples to oranges comparison.
It is sometimes very difficult for patients to know what types of surgeries a surgeon is doing and the relative level of difficulty. However, looking at some of the YouTube videos can give some insight into how truly complicated the surgeries are. They are complicated from an evaluation standpoint, from an intellectual standpoint, from a technical standpoint, and from a recovery standpoint as well as a complication standpoint. All of these risks and benefits have to be weighed accordingly to determine if this patient is a suitable candidate for that plastic surgical procedure. There are no easy determinations to be made in these high stakes and complicated plastic surgery scenarios. The decision to move forward with the plastic surgical procedure results from the collaboration of both plastic surgeon and patient.
MOMMY MAKEOVER EXPERT IN LOS ANGELES DR. KENNETH HUGHES
In the world of plastic surgery, women comprise the overwhelming majority of surgical patients. Therefore, all aspects of women’s health are determinants in plastic surgery options and benefits. Breast augmentation, rhinoplasty, facelift, liposuction, and butt augmentation are some of the most common procedures performed in the United States each year. One of the most common combination procedures performed in the United States and in the Los Angeles and Beverly Hills areas is often referred to as a mommy makeover.
The mommy makeover usually refers to a combination of plastic surgery procedures that are used to improve the tummy and breast areas after pregnancy. This combination may constitute a tummy tuck in which skin and fat is removed and the muscles are tightened to restore abdominal contours following pregnancy. The breast surgery typically refers to a breast augmentation surgery with breast implants to improve the breast deflation and loss of volume following pregnancy and breast feeding.
However, the mommy makeover procedure certainly does not have to be limited to the tummy tuck and breast augmentation. Patients may have different anatomic concerns, different anatomic constraints, and different goals. Therefore, the mommy makeover has really exploded to include other procedures including liposuction, arm lift, thigh lift, breast lift, Brazilian buttlift or BBL, and butt implant procedures. In addition, Bodytite has ushered in a minimally invasive skin tightening for patients who may not have enough loose skin for the more invasive procedures.
Treating the Whole Patient with Dr. Kenneth Hughes
Dr. Kenneth Benjamin Hughes, MD started his odyssey of bodybuilding and weightlifting at the age of 12 years old. For over 30 years, Dr. Hughes developed himself through various athletic endeavors including soccer, swimming, shotput, discus, and weightlifting. Everyone will have a different idea of fitness, but Dr. Kenneth Hughes has experienced many of the ups and downs that accompany the development of any serious athlete.
Dr. Kenneth Hughes believes that his insights into nutrition, exercise, bodybuilding, health, aging and injury prevention, and his ongoing commitment to building a fund of knowledge in these areas will help patients reap additional rewards. Dr. Kenneth Benjamin Hughes has also developed a website that addresses these health, exercise, and nutrition topics. You may learn more about this at Dr. Kenneth Hughes's Bodybuilding and Fitness Website.
Before and After Photo Gallery of Dr. Kenneth Benjamin Hughes
Dr. Kenneth Hughes, Los Angeles plastic surgeon, has provided a few samples of the before and after pictures that are representative of the results of the cosmetic and reconstructive plastic surgery procedures that Dr. Hughes performs. Click on the individual photos for plastic surgery procedure descriptions.
To see more before and after pictures of Dr. Kenneth Benjamin Hughes, visit https://www.hughesplasticsurgery.com/los-angeles-before-after-photos/
The Negative Consequences of Tobacco and Cigarette Smoke With Regard to Plastic Surgery Postoperative Recovery, Healing, and Complications
by Dr. Kenneth Hughes
Dr. Kenneth Benjamin Hughes performs a great number of plastic surgical procedures in his surgical center in Los Angeles. Tobacco combustion and cigarette smoke increases the risk of complications following any type of surgery. Most surgeons typically recommend that smoking patients cease smoking for at least one month prior to elective surgery.
There are manifold reasons for this recommendation. Smoking contains several chemicals that are harmful to healing. Nicotine is a potent vasoconstrictor, which will decrease the blood supply to the healing tissue and result in greater complications including poor wound healing and poor scarring. In some cases, the vasoconstriction can lead to the death of tissue or death of a flap of tissue, known as tissue necrosis or flap necrosis. This dead tissue develops due to lack of blood supply to the tissue that is surgically manipulated. Smoking can have disastrous consequences that cannot be overstated in the surgical setting.
Additionally, cigarette smoke contains carbon monoxide, which decreases the ability of the blood to transport oxygen to the healing tissues. This chemical also results in poor wound healing. Finally, cigarette smoking contains hydrogen cyanide, which is essentially a cellular poison that increases complications through multiple processes. In addition to these chemicals, there are many other chemicals that are the combustion products of the tobacco that result in additional problems including the well-known correlation between smoking and various types of cancer.
Some of the chemical compounds in the tobacco smoke can be removed from the body in a few hours. Thus, smoking cessation just a few hours or days before surgery can result in significant reduction of complications. However, for the patient to return to more normal respiratory and immune system function, smoking cessation should occur at least a month prior to surgery. The cigarette smoke definitely reduces the ability of the immune cells to recognize and remove bacteria and other microbes that can lead to infection. The inability of the cells to perform the normal surveillance functions can obviously have grave repercussions. Cigarette smoke is also known to significantly reduce lung function, increasing the risk for lung-related complications including asthmatic attacks. We also know that smoking increases the rate of platelet aggregation and clot formation leading to the increased risk of heart attack and stroke.
In addition, there are some very specific complications related to plastic surgery. In addition to the wound healing complications that have already been delineated, these compounds can lead to poor scarring and higher scar revision rates. In addition, smokers have a 50% higher rate of fluid collections (seromas), which can distort and totally destroy a very nice cosmetic result after liposuction or similar body contouring procedures. Patients who have breast reconstruction and who are smokers have a much higher rate of breast implant complications, requiring removal of those implants. The most serious complication of cigarette smoke to the plastic surgery itself is the death of tissues, known as tissue necrosis or flap necrosis. A piece of skin dissected can literally die, yielding an open wound that can create a very long healing period and a horrible and possibly disfiguring result.
Although this has been a cursory review of smoking’s negative impact upon healing following surgery and specifically plastic surgery, it is very important to follow guidelines recommended by your surgeon. Most surgeons will recommend at least 2 to 3 days of cessation of smoking to reduce the short term negative repercussions of the cigarette smoke reflected by the nicotine and the carbon monoxide. For patients who have a higher smoking burden, it is probably much more appropriate to recommend at least a month prior to any elective surgery including cosmetic surgery. It is also important to recognize that you should not just quit before surgery but you should not be smoking throughout the postoperative period, which may be at least six weeks if not longer.
Dr. Kenneth Hughes and the Best Mommy Makeover Surgery in Los Angeles
Specialist mommy makeover surgeon Dr. Kenneth Hughes performs mommy makeover surgeries, which typically includes tummy tuck and breast surgery (breast augmentation and/or breast lift).
The tummy tuck can be helpful after pregnancy or after massive weight loss. The abdomen is stretched during pregnancy, both the abdominal wall (abdominal muscles and fascia) and the skin. A tummy tuck addresses both the loose skin and the lax abdominal wall as to give a nice, flat youthful contour to the abdomen. The tummy tuck also creates a more youthful belly button. Dr. Kenneth Hughes will also improve the waist to hip ratio with a tummy tuck.
While the tummy tuck is certainly effective in its removal of tissue and correcting issues of skin laxity and size, the scar produced is often objectionable to many patients. Dr. Kenneth Hughes in Los Angeles has extensive experience and amazing successes with the Bodytite technology to avoid the longer scars associated with tummy tucks. Bodytite can be used in conjunction with liposuction to tighten the tissues of the tummy by about 40%.
The breasts are frequently addressed at the same time as the abdomen in a mommy makeover. Some women as a result of pregnancy and pregnancy related weight gains as well as engorgement from lactation and/or breast feeding suffer a loss pf breast tissue and a deflated look. Breast augmentation adds fullness to the look of the breasts and improves the deflated appearance. .
For many patients, the skin of the breasts is stretched to the point that the droopiness of the breast can only be improved by tightening the skin envelope with what is known as a breast lift. A breast lift can be utilized if the areola and/or breast has fallen below the inframammary fold. Breast surgeon Dr. Hughes employs the breast lift that has the shortest scar necessary to affect the best appearing breasts. The breast lift is necessary in many mommy makeovers for the best overall look for the breasts.
Risks Associated with Mommy Makeover
• seroma (fluid collection)
• dehiscence (breakdown of the wound)
• skin necrosis (death of part of the skin)
• umbilical loss (death of the belly button)
• nerve injury
• hypertrophic scar or keloid
• slow healing (particularly with poor nutrition, diabetics, or in those taking corticosteroids)
Answer:
Definitely stop smoking! Smoking reduces circulation to the skin and impedes healing and can cause the death of tissue called tissue or flap necrosis. In fat transfer procedures such as BBL or Brazilian buttlift, the chemicals in cigarettes can cause a higher likelihood of fat death or fat necrosis. This means that the fat not only dies, but it can create very hard and unattractive lumps as it calcifies.
It is best to avoid smoking, including second hand smoke, and cigarette replacements, such as nicotine patches or gum, in the perioperative period. Stopping 1 month prior to surgery is usually recommended by most plastic surgeons prior to undergoing elective cosmetic or aesthetic surgery.
Answer:
If the waist was smaller at one time, the waist can likely be reduced through liposuction to those same measurements or smaller provided the muscular and fascial integrity has remained the same. Fat can be taken from many different areas of the body including abdomen, sides, back, bra rolls, thighs, arms, underarms, etc. The harvested fat can be transferred to the hips to make your waist look even smaller.
I’m currently 218.4 lbs and 5’4” tall. Do I qualify to get liposuction and a BBL?
Answer:
Your goal weight of 190 should be stable for at least 6 months prior to liposuction 360 and Brazilian buttlift or BBL. Reaching a BMI (body mass index) in the lower 30s would enhance results and decrease the risk of complications during and after surgery. Fat can be taken from many different areas of the body including abdomen, sides, bra rolls, thighs, arms, underarms, flanks, lower back, upper back, calves, ankles, buttocks, hips, and knees. You have to consider not only which areas will have perhaps the best fat, but also you have to consider which donor sites will have the fewest problems afterward with the liposuction. In general, the abdomen and thighs are preferred, but, if those sites are not available, other areas can be used. You may find that the laxity of the skin on your abdomen requires a tummy tuck at a later date.
Answer:
You appear to be a good candidate for liposuction and a BBL. Sometimes, individuals will have problem areas that are relatively exercise and diet resistant. These are the focus areas for your plastic surgeon to liposuction. You have to consider not only which areas will have perhaps the best fat, but also you have to consider which donor sites will have the fewest problems afterward with the liposuction. In general, the abdomen and thighs are preferred, but, if those sites are not available, other areas (bra rolls, back, and flanks) can be used. While liposuction will greatly improve those areas, it will not improve the skin on the abdomen, which will likely require a tummy tuck if you have finished having children. Consult with a board certified plastic surgeon who is an expert in liposuction and BBL. Price will depend upon your ultimate goal, number of areas liposuctioned, demand for the plastic surgeon, geographic location, etc.
Can the BBL process be used strictly to shape an already big buttocks?
Answer:
Without photos or an exam, it is impossible to provide specific feedback to your question. You may need an inferior buttock lift, posterior lower body lift, liposuction, fat transfer or a combination of listed techniques. Consult with a board certified plastic surgeon who is an expert in all of these body contouring procedures to allow for the best possible buttock result.
How many cc or ml could be transferred to get my desired outcome?
Answer:
Your plastic surgeon should be able to tell you if 800cc will be enough for you to reach your goals. Dr. Kenneth Hughes usually gets a minimum of 500 cc per buttock (1 liter of fat) in a small individual and 1000 cc or more per buttock (2 liters of fat) in larger patients. About 50 to 70% of the fat survives long term following a BBL. Dr. Hughes has seen patients after a year or two and the pictures reveal that the gain is permanent. Perhaps this is due to injection technique, harvest technique, and the amount of fat transferred. Dr. Kenneth Hughes does not tend to encounter fat necrosis, which is the death of fat and subsequent calcification. However, Dr. Hughes does perform a great number of fat necrosis or death removal reconstructive procedures. First the dead fat is removed by cutting it out. The dead fat cannot be liposuctioned as the density of the dead fat prevents vacuum suction removal. The defect from the removal can be reconstructed later if necessary.
Is a Brazilian Butt Lift or BBL a possibility for someone who is 5' 2" weighing 98 lbs?
Answer:
You should consult with an expert in butt implants to determine an appropriate size for your body dimensions. All of the patients for whom I perform butt implants are skinny or muscular with very low body fat. I place implants within the muscle to minimize being able to feel or see the implants. This creates a much more natural result. The intramuscular placement also reduces the risk for capsular contracture and sciatic nerve damage. This placement tends to reduce long term tissue death or tissue thinning. Dr. Kenneth Hughes is not only an expert butt implant surgeon, but also Dr. Kenneth Hughes is an expert at thin patient or skinny patient Brazilian buttlift or BBL.
Visit Dr. Kenneth Hughes's website dedicated to the Brazilian Buttlift or BBL
https://www.drkennethhughesbbl.com
Dr. Kenneth Benjamin Hughes Featured in TOP DOCTOR Article
Dr. Kenneth Benjamin Hughes, Harvard-trained, board-certified plastic surgeon in Los Angeles, is an expert plastic surgeon, author, and presenter in many plastic surgery procedures at the local, regional, national, and international levels.
Dr. Kenneth Hughes, board certified plastic surgeon, brings to Los Angeles and Southern California a level of expertise and sophistication few have ever achieved. Dr. Hughes performs surgery for 600 patients each year and approximately 1500 procedures for those patients in his Los Angeles surgery center. Doctor Hughes is an expert plastic surgeon and author and presenter in many plastic surgery procedures at the local, regional, national, and international levels.
Dr. Kenneth Hughes achieved the highest level of education and elite training prior to practicing in Los Angeles and Beverly Hills. Doctor Kenneth B. Hughes received his honors degree from Harvard University in 1999. He graduated from medical school in the top 5% of his class and scored in the top 1% nationally on his licensing boards. He was awarded entrance into one of the very selective integrated plastic surgery programs, in which he received extensive training for six years in the vast array of general and plastic surgery procedures. From residency, Dr. Kenneth Benjamin Hughes, MD was selected as only the second plastic surgeon to pursue a year long aesthetic and cosmetic surgery fellowship at Harvard Medical School.
Dr. Hughes has authored numerous papers and textbook chapters on cosmetic surgery topics including facial cosmetic surgery (face and neck lifts, rhinoplasty and nose surgery), breast surgery including breast augmentation, breast reconstruction, and fillers and facial fat grafting, among others. He has been an invited speaker at regional, national, and international meetings, lecturing on such topics as the use of telemedicine in cosmetic and plastic surgery. In addition, Dr. Kenneth Hughes is a consultant and lecturer for the Institute for Safety in Office Based Surgery (ISOBS), a nationally recognized, non-profit, patient safety organization at the forefront of protecting patients during outpatient procedures in plastic surgery.
On a personal level, Dr. Hughes has been an athlete and natural bodybuilder for over 20 years, and he possesses a wealth of knowledge and experience in nutrition and exercise regimens. Utilizing his keen eye for details of the human form developed during his bodybuilding career, Dr. Kenneth Hughes carefully evaluates his patients’ anatomy and goals and then tailors the results to an individual’s preference and specification. Dr. Hughes brings a unique blend of technical skill, surgical acumen, and detail-oriented specificity to each of his patients in a caring and interactive atmosphere.
Dr. Kenneth Hughes has developed his innate intellectual abilities and technical skill to their fullest potential, and he brings this talent to Los Angeles and Beverly Hills areas after being a clinical instructor in plastic and reconstructive surgery at Harvard Medical School. Dr. Kenneth Benjamin Hughes offers the full spectrum of plastic surgical procedures, and he tailors the operation for each and every patient.
As a next generation surgeon with the dual benefit of expertise in traditional approaches, training, and access to the latest advances and innovations in plastic surgery, Dr. Kenneth Benjamin Hughes meets the high expectations of today’s patient with ease. Recognizing that patients are demanding new approaches to postsurgical scarring, Dr. Kenneth Hughes’s techniques offer a range of options selected on a per procedure, per patient basis. Some of those options offer a virtually scarless approach, and in bigger cases, offer a significant reduction of scarring prominence.
Dr. Kenneth Benjamin Hughes specializes in virtually scarless, or minimal scarring, surgery for the face, nose, and breast, and offers the most advanced technologies available, including fat grafting with stem cell rejuvenation. Some of these techniques include short scar face lift, facial fat grafting (facelift technique without visible scars), closed rhinoplasty (no visible external scars), chin implants with no external scar, short scar tummy tuck, and TUBA (breast augmentation without scars on your breasts).
In addition, Dr. Kenneth Hughes is an expert at liposuction and fat transfer procedures including Brazilian buttlift and BBL. Dr. Hughes is also an expert at dead fat or necrotic fat removal as well as silicone and biopolymer injection removal and reconstruction. These are very complicated surgeries with a higher rate of infection, need for additional surgery, and a higher rate of complications including infection, sepsis, and death.
Best Plastic Surgeons in Los Angeles
Los Angeles’ Best Plastic Surgeons:
Hughes Plastic Surgery
Dr. Kenneth Benjamin Hughes – Hughes Plastic Surgery
Dr. Kenneth Benjamin Hughes, MD achieved the highest level of education and elite training prior to practicing in Los Angeles and Beverly Hills. Dr. Kenneth Benjamin Hughes, MD received his honors degree from Harvard University in 1999. He graduated from medical school in the top 5% of his class and scored in the top 1% nationally on his licensing boards. He was awarded entrance into one of the very selective integrated plastic surgery programs, in which he received extensive training for six years in the vast array of general and plastic surgery procedures. From residency, Dr. Kenneth Benjamin Hughes, MD was selected as only the second plastic surgeon to pursue a year long aesthetic and cosmetic surgery fellowship at Harvard Medical School.
Products/Services:
Face Procedures, Breast Procedures, Body Procedures, Male Procedures
LOCATION:
Address: 12732 Washington Blvd Suite B, Los Angeles, CA 90066
Phone: (310) 275-4170
Website: www.hughesplasticsurgery.com
Patient Reviews Of Dr. Kenneth Benjamin Hughes (Over 1000 Internet Reviews)
“Dr. Hughes is a gifted surgeon who has really honed his craft. He takes the time to listen to what it is that you want and delivers! He really is an artist and does what it takes to give you the aesthetically pleasing look you are hoping for. I am so pleased with my results! His staff is friendly and efficient, and I had an overall pleasant experience. I highly recommend Hughes Plastic Surgery.” -Shenil Walker
I had a great experience with Dr Hughes, i wish i would of done this a long time ago on my first breast implants surgery. I would have not gone anywhere else. I would have saved me a lot of money and stress. Love his professionalism, and his reassurance that everything is going to be ok. Highly recommend Dr. Hughes for any surgical procedure. i will recommend all my friends to him..... Thank you Doc!
L. R. – Oct 17, 2019
Honestly the best surgeon in the world.
Anonymous – Oct 16, 2019
Dr. Kenneth Hughes is my favorite. He told me what the problem was and did not give me high hopes. But I am very happy with the results. I had fat that had died in my butt from another BBL. Dr. Kenneth Hughes removed the dead fat from the buttocks and left a dent, which I knew it would. However, the pain was gone and I could live my life. Dr. Hughes then transferred fat a few months later to the dent and the butt looks great. I could not be happier. Thank you Dr. Hughes.
nd – Oct 13, 2019
This was my first serious surgery. I had gotten a Brazilian butt lift and breast lift with implants. I was nervous and apprehensive about it but Dr. Hughes gave me the comfort of his understanding and abundance of knowledge to ease my worries. Everything was amazing... besides the pain but it is all in the process.
K. F. – Sep 13, 2019
Great experience, friendly staff. Most of all my results are great! You can't go wrong with Dr. Hughes. Worth it!
D. S. – Sep 13, 2019
Love that he is HONEST! I had my implants redone, thigh lipo and fat transfer into my fave and I LOVE IT!!! 100%
S. S. – Sep 06, 2019
Friendly funny amazing on his toes with my healing process lm super pleased with my results
Angela S. – Sep 06, 2019
I had to redo my breast implants after 8 years and Dr. Hughes again did an amazing job. I asked for a natural look and that is exactly what I got. The pricing was also affordable. I highly recommend Dr. Hughes to anyone looking for a natural look for breast augmentation surgery.
Vanessa G. – Aug 27, 2019
I had a liposuction with fat transfer in the buttocks. Dr. Kenneth Hughes is a very nice guy. He really knows what your body needs. I am very happy with the results, and I will totally recommend this guy to all my friends. Thank you Dr. Hughes!!!!
Anonymous – Aug 24, 2019
Dr. Hughes is realistic and underpromises some time and over delivers all the time. His staff is warm and caring. You could not ask for more. He is a Harvard graduate and trained out the kazoo. In part I chose Dr. Hughes for his answers on realself. Patients should use board certified plastic surgeons. Also his pictures are miraculous. I came from out of state, because I felt that he was exceptional aesthetically and surgically.
Anonymous – Aug 24, 2019
Doctors Retiring Early Due to Coronavirus Pandemic
There have been many news articles covering the influence of coronavirus on doctors and trends in medicine. Some plastic surgeons have reported an increase in business during this time as patients apparently have more free time and can recover in private. However, other doctors are seeing much less business and are downsizing or retiring or just going out of business. Some of these doctors may have health-related issues and the risk of catching the coronavirus at the hospital is imply not worth the extra income that they could make during this time. Obviously, this consideration varies with the specialty, the location, and the patient population. An emergency medicine physician or an anesthesiologist, who may have to intubate those infected with COVID, may have the highest risk for contracting the disease.
Other doctors are simply encountering a reduced volume of patients. This reduced volume can simply not sustain a practice or the employees. Some practices cannot be maintained with virtual consults due to the nature of the specialty or the patient interest in setting up those appointments. So, despite the fact that many doctors are asked to cover the front lines with COVID and endure greater risks, many others find themselves in the same boat as many others in the US without a job and without prospects for the outlook to improve any time soon.
The Demise of the Small Business and Jobs Amid the Pandemic and The Need For Doctors
Former President Trump and President Biden have repeatedly said that he was going to protect small business owners and those employees associated with the small businesses. However, little has been done for the small business. The repeated shutdowns have forced huge unemployment numbers. The small stimulus checks to individuals are doing nothing to replenish the huge untold losses to the small business community and the economy as a whole. As a small business owner, a plastic surgeon certainly understands this. Many plastic surgeons have laid off their entire surgical workforce and even their executive workforce in the previous months. Some have returned to work, but some have retired or temporarily closed.
This is just a microcosm of what’s going on with doctors and small businesses across the country. In a time when doctors are needed for than ever, doctors take increased risk, less pay, and more stress. The simple truth is is that no one possesses the intellectual or technical knowledge of doctors to save us from ourselves. It is important to remember that the doctor is the only one preventing the patient from making the journey to the grave.
Many doctors are being asked to go even farther. Despite huge economic losses to the businesses they are being asked to give whatever supplies they can possibly get. In addition, they are being asked to donate equipment as well. So, in addition to losing businesses, they are being fleeced for everything else. Certainly no one else in society is being called upon in such a fashion as our doctors during these dire times. Perhaps society will learn a critical lesson to not disparage or be critical of doctors when and and if the world recovers from the coronavirus. It will be a costly lesson to learn as doctors are being required to help in an epidemic that is largely being kept alive by irresponsible people not practicing appropriate measures.
People have continued to the beaches, the house parties, traveling the world over, gathering for holidays and birthdays, not to mention the rioting and looting. The truth of the matter is that this global issue would run its course over the period of a few weeks if people stayed unto themselves. The virus cannot survive for long at all outside the host. The incubation time is short as well. It is unfortunate that people keeping the coronavirus alive are the same people who have been critical of doctors despite not having the knowledge or wherewithal to be in a position to critique.
Unfortunately, in the aftermath of the several hundred thousand deaths from the coronavirus, medical providers, doctors and surgeons, will be sued at record rates. Many medical malpractice carriers are publishing new programs to help protect doctors from the unfair lawsuits to follow. The truth is that there is no treatment for Covid-19 related illnesses and care is largely supportive. Some patients will recover from the virus no matter how poorly they are managed and some patients will die no matter how well they are managed.
Medical doctors during this time of national scourge were the heroes to everyone, literally sacrificing heir lives and the lives of their families due to the exposure faced each and every day all day. And the coronavirus is not done with us yet. The Good Samaritan laws should protect doctors in such cases as society would have been destroyed without the efforts made by these courageous doctors.
Yet patients and patients' rights groups will no doubt speak to the untold medical errors that could have saved thousands of lives in addition to the ones that were saved. And the lawsuits for medical negligence will roll in by the thousands in an attempt to try to extract as much money as possible from a profession and a calling at its breaking point.
The truth is that pretty much all doctors were the smartest, most capable individuals in their high schools, colleges, and grad schools and could have done anything in life at much less personal risk and exposure and without the degree of academic rigor required. They could have made more money doing something else as well. It is laughable and absurd to think that everyone else could meet those demands in their absence.
What if the doctors in the United States were to just step away from the battlefield and retire? What then? The plague that would follow would be epic and civilization as we know it would be no more.
This is already happening. Doctors are committing suicide at 4 times the national average and several have made front page news during the coronavirus pandemic. Doctors are retiring early or quitting and moving to a different career. The desperation seen by politicians and regulatory officials attempting to license medical students, foreign medical individuals, retirees, etc. should give the general public some insight into the apocalypse to come.
Physician Sense and Physician Burnout Amid Pandemic
In a recent issue of Physician Sense, they talked about physician burnout amid the coronavirus pandemic. Conditions are ripe for a shadow epidemic in medicine. How physician employers, and the doctors themselves, choose to respond will have major implications for the health of these vital healthcare providers, and the American healthcare system in general.
We’re talking about physician mental health, a topic doesn’t get the attention it deserves. Consider this: The most recent presidential debate, held at the Cleveland Clinic amid a pandemic. You might think the setting would bring healthcare workers to the forefront of either candidate’s thinking. Instead, they debated mask-wearing. We weren’t aware that the subject was still up for debate.
Unfortunately, many are taking the contributions of physicians and other healthcare workers for granted. Our healthcare system is far from perfect, and the pandemic certainly revealed room for improvement, but it did not break down. Doctors, nurses, and other frontline healthcare workers held and continue to hold the line. But at what cost?
The ongoing struggle with COVID-19 will likely keep us from knowing the full impact on physician mental health for years to come. However, we do know that physician burnout was a serious issue prior to the pandemic, and that early research has raised some alarms. Coronavirus may prove to be an accelerant.
The novel virus created massive amounts of fear and uncertainty among physicians, tasked with keeping others, and themselves, alive. A recent WHO report found that of all viral cases globally, healthcare providers represent 1 in 7. The figure hits 1 in 3 in some countries. Not only do doctors worry about falling ill, many must also grapple with the fear of infecting the people they love when they go home.
A UC San Francisco study of emergency medicine physicians during the early days of the pandemic. Among the surveyed physicians from 7 cities, male doctors reported stress levels at 5 on a scale of 1-7. Women put their stress levels at 6. Both said burnout increased from a pre-pandemic level of 3 to 4 out of 7 after the onset of the pandemic.
Researchers documented similar results in China among healthcare workers. A JAMA Network Open study found that among more than 1,200 healthcare workers in 34 hospitals, 50.4% reported symptoms of depression, 44.6% reported anxiety symptoms, 34% said they had insomnia, and 71.5% said they felt distressed.
The existential risk of being a physician during a pandemic is one thing. But exposing one’s loved ones is another. COVID-19 has added a new layer of complexity to the burnout crisis. Not only do physicians worry about harming their families, but they also don’t have access to their usual social outlets.
While protecting physician physical wellbeing is pretty straightforward, what should be done about the more amorphous recommendations?
Unfortunately, asking for help isn’t a part of physician training and conditioning, and many often worry about the career implications of mental illness. Doctors must have access to choose the approach that works best. That might include telemedicine, video chats, online forums, or in-person visits with psychologists and psychiatrists.
How Bad Is It to Be a Plastic Surgeon in Los Angeles?
Worse than you could ever imagine. Every day patients call in for consultations either through email or Skype, and many ask why there is a $100 email consultation fee or a $250 Skype consultation fee. Lawyers charge $300 to over $1000 an hour and have only 3 years after college. The minimum time to achieve the level of plastic surgeon is 10 years after college with much more intensive and rigorous training against much more competitive and intelligent colleagues. It is not uncommon to spend an hour with a patient on Skype followed by sometimes dozens of questions. $250 for several hours of time is a losing proposition for any plastic surgeon. The overhead alone in a plastic surgery office is at least $50,000 a month with payroll for all employees and independent contractors, rent, utilities, web and advertising fees, supplies and operating room fees etc. not to mention patient cancellations, fraud, and other issues. So $100 for an email consultation is a truly laughable amount. However, if consultations were free, Dr. Kenneth Hughes would be evaluating 50 people or more per day. There is also the argument that a person who spent 15 years after high school to develop expertise probably deserves to be compensated a tiny fraction for his or her time.
Dr. Kenneth Hughes probably receives 300 to 400 inquiries about plastic surgery each month. The office staff then follows up with all of those individuals to determine interest. Most of the patients when called or emailed never respond yet, just hours before, they expressed great interest in the procedure. What happened in the intervening period that they now are no longer reachable by any means?
This disappearing act would probably frustrate anyone and it frustrates Dr. Kenneth Hughes and his office staff to no end. Should you actually get a person by phone or email they will usually start with several questions before even considering paying the small consultation fee. They want to extract as much information as possible without any respect for anyone else’s time. On top of the endless questions, the office staff usually encounters quite a few unreasonable people who yell at them about why there is a consultation fee. Some will argue about why they know what must be done despite never having received a consultation with Dr. Kenneth Hughes.
Another common issue is arguing with the office staff about in person consultations during the coronavirus pandemic, when this done for their own protection. It is simply not worth it for the doctor, his office staff, and other patients to create a breeding ground for the coronavirus. Perhaps as the number of vaccinated patients approach the majority and the coronavirus number of cases goes down, in-person consultations will be appropriate. Dr. Kenneth Hughes believes that even one patient hospitalization or serious illness or death would be a really sad indictment on in person consultations for the masses during the coronavirus pandemic. Nonetheless there’s always complaining about in-person consultations. There are complaints about not being able to see the doctor multiple times prior to surgery. There are complaints about almost anything you could possibly imagine despite the fact that Dr. Hughes and his staff do everything they can to both take care of patients and keep patients out of trouble.
The virtual consultation typically begin with the patient sending a request for what they want done. Dr. Kenneth Hughes will usually respond by asking for to see pictures of those various areas so that he can evaluate. After that Dr. Hughes will usually get his office staff to provide an estimate. There will usually be questions about realistic expectations, goals and goal pictures, the procedure itself, time for the procedure, relative risks, and procedure downtime along with best ways to recover from procedure and advice during the recovery.
Remember that no one at Hughes Plastic Surgery is actively recruiting anyone and we never send emails or call patients to ask about those procedures. These patietns are sending inquiries through the website or calling the office directly. So it is sometimes hard to fathom why a patient could somehow get upset that we are responding to them or asking them if they’re interested in moving forward with a procedure or something of that nature. However, this happens all the time.
If a patient is not interested in a procedure, he or she can just simply tell us that. This certainly saves Dr. Hughes‘s office staff a lot of time with all of the misspent time on emails and phone calls that fall on deaf ears. Certainly, the goal is not to deal with people who do not want to have a procedure. There are plenty of people who do want to have a procedure. The doctor wants to focus on those patients. And, actually, all of these other patients who are asking unending questions who will never have the surgery only serve to disenfranchise the office staff and take away fromthe office's ability to help those patients who truly need the attention.
Nonetheless, there will be patients who will claim to call in and schedule a procedure only to find out later that they have not scheduled. They will say that they will schedule in the future only so that you can read their MRIs or write to their insurance companies or give doctors' excuses for work, or give doctor's excuses for travel, get help with visas to enter the United States. These are just examples and do not even scratch the surface. The number of disingenuous people is truly astonishing.
Dr. Hughes could probably list several thousand different ways patients try to manipulate doctor and staff in the plastic surgery realm. Once the patient schedules for surgery then all of the labs have to be done as well as medical clearance. This is where you ge further stratification of patients. Some of the patients, after scheduling the surgery, will want to back out of the surgery, because they have buyers remorse or want to spend the money for something else. So, at this point, they become impossible to reach by phone or email, despite calling the office dozens of times in the previous few weeks and asking Dr. Hughes hundreds of questions. In this manner, they can they think that they can avoid paying the fees for surgery for which they are obligated as these types of cancellations within the month of surgery lead to huge losses to any business.
Another method that is frequently employed is to find some type of illness. This has become particularly prevalent during the time of Covid as everyone just says they have Covid even though they supply no documentation of any positive test. Some have used the excuse that it is not safe to get surgery during COVID, as though they possess the knowledge necessary to make that determination.
Another very common excuse that people will cite is some type of family emergency. The number of family emergencies goes up exponentially anytime a surgery is scheduled for a patient who does not want to fulfill his or her financial obligations. An additional maneuver employed occurs when a patient says that he or she could not get the labs or that he or she does not have the lab results. The same thing is done for medical clearance. You can see how just getting a patient to surgery can be a very frustrating and time-consuming exercise for a lot of patients.
Assuming that a patient finally gets to have the surgical procedure, Dr. Kenneth Hughes routinely performs surgery at levels approaching perfection. Even in a perfectly executed surgery, at least 5% of the patients will have some kind of complaint following surgery. Despite 100% of the patients looking markedly better, this type of scrutiny will continue for months or years afterwards. There will be patients who will try to extort money by threatening to write reviews that are totally ludicrous and dishonest. There are patients who threaten to get a lawyer. There are patients who demand a copy of their records. All of these things are largely ignored by Dr. Hughes unless the patient is particularly nasty or malicious. Dr. Hughes has won many lawsuits, legal fees, and compensation due to defamation or malicious prosecution or legal misconduct. These amounts can be substantial amounts far exceeding what the patient or lawyer originally tried to extort. This approach serves to teach these really horrific individuals the dangers of trying to extort people as they have done throughout their lives.
If you are a reasonable person and do not talk in an insulting or condescending manner to Dr. Hughes, Dr. Kenneth Hughes will go above and beyond to try to help you. Dr. Hughes can help where someone else would not help or have the ability to help. He is willing to work with you and he will do it.
The Origins of the Coronavirus
Over a year after the coronavirus brought first unleashed devastation on the world, it appears that Donald Trump was right after all. Apparently, the US government and others around the world have known for over a year that the coronavirus was leaked from a Wuhan lab, not from a wet market in the area. How can something so important be buried for over a year?
Now mainstream media and media publications have embraced the origin story. But why?
And why now?
Everyone laughed at Donald Trump when he said it and said that he had seen evidence. However, Trump was viewed as a racist and all of his statements were dismissed as that of a crazy individual. How could something so monumentally important not be brought to light until Trump left the White House?
What could have been more important than knowing this at a time when vaccines needed to be made to help millions and billions of people worldwide?
Knowing the viral coding and the specifics of the virus from the beginning could have saved untold lives. It makes one wonder what else has been covered up.
If the most massive story of the world for the past 1.5 years and the greatest biological weapon developed in history can be kept a secret, what else has been fed to the masses as truth?
Brazilian Buttlift Questions Answered by Dr. Kenneth Benjamin Hughes
Plastic Surgery Videos of Dr Kenneth Benjamin Hughes, Los Angeles Plastic Surgeon
Dr. Kenneth Benjamin Hughes Before and After Plastic Surgery Gallery
UPDATE ON BREAST IMPLANT-ASSOCIATED CANCER
BIA-SCC is a rare but potentially aggressive epithelial-based tumor that appears to be associated with breast implants and emanates from the breast implant capsule. At this time, ASPS/PSF is aware of so few reported cases of BIA-SCC (in its update, the FDA notes it is aware of 19 cases of SCC in the capsule around the breast implant from published literature) that it is not possible to determine what factors increase patient risk.
All information provided by plasticsurgery.org.
Available information and recommendations are listed below, but the FDA did provide the following updated recommendations for healthcare providers in Wednesday’s communication:
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Include information about SCC and various lymphomas in the capsule around the breast implant in your discussions with people who have or are considering breast implants.
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For patients who have been diagnosed with SCC or various lymphomas in the capsule around the breast implant, develop an individualized treatment plan in coordination with a multidisciplinary team of experts including surgical oncology, plastic surgery, breast surgery, radiology, oncology, and pathology.
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Report all cases of SCC, lymphomas, and any other cancers in the capsule around the breast implant to the FDA. Prompt reporting of adverse events can help the FDA identify and better understand the risks associated with medical devices.
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Please include the following information in the report, if known:
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Clinical presentation and breast implant history
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Imaging studies performed
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Pathology of the capsule tissue
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Treatment therapy
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Outcomes
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Overview
The following overview is presented to help plastic surgeons recognize Breast Implant-Associated Squamous Cell Carcinoma (BIA-SCC) as a distinct disease entity and long-term complication of breast implants. In light of broad specialty-wide awareness concerning Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), information regarding BIA-SCC is presented in a comparative format below. A reference list of all available published case reports is included at the end of this statement, and The PSF is finalizing a manuscript summarizing the current state of knowledge for Plastic and Reconstructive Surgery.
BIA-SCCBIA-ALCL
What is it?
Breast implant-associated squamous cell carcinoma (BIA-SCC) is a very rare but potentially aggressive, epithelial-based tumor that appears to emanate from the breast implant capsule. Pathology shows sheets of squamous cells lining the capsule in nests and bundles. BIA-SCC can exhibit highly invasive properties including spread to lymph nodes, local tissues and distant sites, such as muscle and bone.
BIA-SCC is not a cancer of the breast tissue itself.Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon and treatable type of T-cell lymphoma that can develop around breast implants. BIA-ALCL can exhibit highly invasive properties, including spread to lymph nodes, local tissues and distant sites.
BIA-ALCL is not a cancer of the breast tissue itself.
Number of Known CasesTo the best of our knowledge, there are 19 cases reported in the literature.ASPS recognizes approximately 411 both suspected and confirmed cases in the United States and nearly 1,400 cases worldwide as of March 2023.
Lifetime RiskUnknownCurrent lifetime risk of BIA-ALCL varies widely (e.g., estimates of 1:2,207-1:86,029 based upon variable risk with different manufacturer types of textured implants. More recently, cumulative risk over 20 years in breast reconstruction patients implanted with Biocell devices was estimated at 1:100 (Cordeiro et al, 2020).
Age at presentation55.8 years (range 40-81)55.3 years (range 28-84)
Average length since initial implantation22.74 years (range 11-40 years)10.32 years (range 0.08-41 years)
Implant SurfaceIn case reports, BIA-SCC has been reported in patients who have had smooth and/or textured implants.No cases of BIA-ALCL have been confirmed in patients who have only had smooth implants in case series, case reports or registries. However, it is not possible to exclude the appearance of BIA-ALCL in association with smooth implants at this time. The FDA states that all confirmed cases worldwide either have a history of a textured device or an incomplete clinical history available for review.
Implant TypeBIA-SCC has been associated with both silicone and saline implants in aesthetic as well as reconstructive patients.BIA-ALCL has been associated with both silicone and saline implants in aesthetic as well as reconstructive patients.
Presentation
• Delayed seromaYesYes
• Unilateral swellingYesYes
• Pain, erythemaYesYes
• Capsular contractureOftenSometimes
Extracapsular spread at presentation80% at presentation28% at presentation
Typical PathologySquamous cells in sheets with varying degrees of atypia and metaplasia and at least one focus of SCC.Lymphoma with mass confined to single area on capsule.
Diagnostic AssessmentCK 5/6+; p63+; Flow cytometry + for squamous cells and keratinCD30+; ALK-; Flow cytometry + for T-cells
ImagingUltrasound to evaluate for peri-prosthetic fluid +/- aspiration; MRI with and without contrast to evaluate capsule to rule out mass; PET-CT for extent of disease, if present.Ultrasound to evaluate for peri-prosthetic fluid +/- aspiration; PET‐CT is performed following a positive diagnosis. Mammograms are not helpful for evaluating lymphoma but are important for the evaluation of breast cancer.
TreatmentOfficial treatment recommendations will need to be based on emerging data. At present, it appears that explantation with complete (en bloc) capsulectomy will provide the best outcomes.
Based on existing case reports, it appears that incomplete resection of BIA-SCC can result in early and/or aggressive recurrence.In the majority of cases, explantation with complete (en bloc) capsulectomy is curative. Incomplete capsular resection has been associated with both recurrence and significantly lower survival. Rare patients will present with more advanced disease and may require radiotherapy and chemotherapy. Treatment approach should follow international guidelines established by the National Comprehensive Cancer Network (NCCN) for BIA-ALCL. Current treatment recommendation is for bilateral complete capsulectomy and implant removal, as a small number of women have had contralateral disease found incidentally.
Chemotherapy / Radiation TherapyPatients treated within these cases did not appear to respond.Responds to Brentuximab plus CT.
Mortality43.8% at six months.2.8% at one year.
ReportingThe FDA recommends that any suspected or confirmed cases of SCC, lymphomas, or any other cancers around the breast implant be reported to the FDA's Manufacturer and User Facility Device Experience (MAUDE) database and the device manufacturer.
Patient Counseling and Informed ConsentBIA‐SCC should be discussed with any patient considering breast implants as part of the informed-consent process.BIA‐ALCL should continue to be discussed with any patient considering breast implants as part of the informed-consent process.
ASPS/PSF Recommendations
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Prior to implantation of any breast implant, plastic surgeons should provide patients with the manufacturer's patient labeling, the FDA-required patient decision checklist and any other educational material to best discuss the benefits and risks of breast implants.
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Preoperative workup is essential. All patients presenting with a late seroma should have fine needle aspiration (FNA) and cytology testing. Specimens should be sent for immunohistochemistry including CD30, ALK, CK 5/6, p63 and flow cytometry to look for T-cells, squamous cells and keratin.
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All patients presenting with a late seroma should undergo a breast ultrasound and MRI with and without contrast. If disease is confirmed, a PET-CT should be considered prior to surgical intervention. A thorough preoperative work-up allows for potentially the most appropriately planned, single-stage surgery with the greatest chance of success for cure.
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Consider the possibility of BIA-ALCL, BIA-SCC and other lymphomas when treating a patient with late onset, peri-implant changes. If you have a patient with suspected BIA-ALCL or BIA-SCC, refer them to experts familiar with the diagnosis and treatment of BIA-ALCL and BIA-SCC.
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At surgery, collect fresh seroma fluid, representative portions of the capsule, and specific pathology requests to rule out both BIA-ALCL and BIA-SCC.
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Diagnostic evaluation should include cytological evaluation of seroma fluid or mass with Wright Giemsa stained smears and cell block immunohistochemistry/flow cytometry testing for cluster of differentiation (CD30) and Anaplastic Lymphoma Kinase (ALK) markers, as well as Cytokeratin 5/6 (CK 5/6) and p63.
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Flow cytometry should include instructions to look for T cells, squamous cells, and keratin.
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All confirmed or suspected BIA-SCC data should be entered into the PROFILE Registry (Data entry mechanism forthcoming).
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Data for all patients with seroma should be entered into the National Breast Implant Registry (NBIR).
References
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