PSJOURNEYS.com has a forum dedicated to not only plastic surgery, but also dental and eye care abroad. Here is a good article on one person’s experience with eye in Mexico.

Crossing over to better vision
After a lifetime of misalignment, man’s eyes in focus

By Kristi L. Nelson (Contact)

Retired pharmacist Edd Bissell, 67, had crossed eyes all his life and wore bulky prism lenses, right, in order to be able to see. Last month, Bissell learned about a surgery that could “uncross” his eyes. Now, after surgery, Bissell is seeing things in a new way. “I can’t believe how light my glasses (at left) are,” he said.
WHAT IS STRABISMUS?

* Strabismus is a condition in which the eyes are not properly aligned with each other, usually because lack of coordination among muscles surrounding the eye prevents both eyes from focusing on the same point at the same time. It may prevent someone from seeing out of both eyes at the same time, affecting depth perception. Strabismus can be either a disorder of the brain coordinating the eyes or a disorder of one of more muscles and can affect just one eye, both eyes at the same time, or both eyes at different times. A person can be born with the condition, or it can result from trauma or some diseases.

For his whole life, Edd Bissell’s vision has depended on his ability to control a little set of muscles around his eyes.

The 67-year-old retired pharmacist has strabismus, or misalignment of his eyes. Born with it, Bissell - like many others with the condition - got used to controlling those muscles in his younger years by squinting. But as he aged, that grew harder and harder for him to do. Then Bissell’s eyes would appear crossed, and if he tried to use them both at the same time, he’d see double.

“You can look at the back of my car and tell by the bumper that I have no depth perception,” Bissell said. “I either looked out of my right eye or my left eye. … Throw me a pair of keys, and I don’t know where it is. I have no conception of where it’s coming to. I might reach here, and it might hit me there.”

For about 15 years, Bissell has worn “prism” lenses - big, thick curved lenses that draw his eyes together in the correct way, enabling them to focus. They’re a nonsurgical solution to milder cases of strabismus, said optometrist Gale Roberts of Tapp Optical Dispensary, who made Bissell’s prism glasses.

“He surprised me when I first put them on him; he immediately liked it,” said Roberts, who said most patients need an adjustment period, and some don’t really like the glasses at all.

“It was immediate,” Bissell said. “It was like snapping a finger.”

But last spring, Bissell returned to Knoxville from Mexico, where he spends part of the year, unable to uncross his left eye, even with the help of the prisms. At any rate, Bissell was already wearing such thick prism lenses that it was unlikely he could support a thicker lens on the bridge of his nose.

Not only was the crossed eye affecting his vision, but “it made me self-conscious,” he said. “Because somebody’s looking at you, and they don’t say anything, but you see them go … ‘His eye’s crossed.’ You know, it’s like being one-legged, or having a wart on the end of your nose. You know people are looking at you.”

He tried in vain to get an appointment with his regular ophthalmologist group but was told he would have to wait three months. Frustrated, he asked his internist for another recommendation.

“He said, ‘You know, your prescription’s as good as it’s going to get. You need to go to Gitschlag,’” said Bissell, who knew ophthalmologist Dr. Gary Gitschlag’s name from filling prescriptions for customers. “I said, ‘He’s a pediatric guy!’”

Like many older adults, Bissell had no idea there was a surgery available that could correct his strabismus - one that had been available for decades. In Knoxville, Gitschlag is the go-to guy for repairing strabismus.

About 80 percent of Gitschlag’s patients are children; his office is in the Koppel Plaza at East Tennessee Children’s Hospital. These days, most cases of strabismus that occur from birth are diagnosed during childhood. Strabismus can also occur as the result of some diseases, accident trauma, or stroke, Gitschlag said, and since he’s known among local ophthalmologists as someone who likes to do the surgery to correct it, and is experienced at it, he’s often referred adult patients as well. Gitschlag operates on adults one day a month.

Prism lenses are often a good solution when someone’s angle of misalignment is small, Gitschlag said, but larger angles would require lenses to be so heavy it would be difficult to support them. And for some, he said, it’s a question of lifestyle; they may not like wearing glasses at all. The surgery, common since the late 1960s, won’t fix existing near- or farsightedness, but someone whose only problem is misalignment wouldn’t need corrective lenses afterward just because of the strabismus.

“A lot of folks have the impression you can’t fix (strabismus),” Gitschlag said. “It’s actually very fixable, and has been for a long time.”

The $3,000-$8,000 surgery is also covered by Medicare and insurance companies; Gitschlag does not do cosmetic surgery, so all his surgeries are coded “medically necessary,” and his office will appeal if an insurance company denies it.

In the past, strabismus sometimes wasn’t caught until a child started school, Gitschlag said, but earlier screening through the state, day care centers and civic organizations like the Lion’s Club has meant strabismus is now usually caught before school age.

“That really makes our jobs not only easier, but a lot more pleasant, because you get good results,” he said.

There are six muscles - three sets of two - around the eye that control its movement. Surgery entails lengthening or shortening one or more sets of muscles to bring one eye into alignment with the other. The trick is to get the measurements exactly right, Gitschlag said.

“Some folks have greater or lesser elasticity,” he said. “It’s not like engineering, where you can cut and measure.”

Gitschlag does six to eight of the surgeries per week and has for years, so he has some experience in measuring. It’s rare that a patient needs more than one strabismus surgery, he said.

“The surgery has a pretty good success rate,” he said.

Bissell, who had plastic surgery six years ago in Mexico to correct the sagging skin around his eyes caused by a lifetime of squinting, couldn’t be happier with the results of the strabismus surgery he had last month.

“The first day, I was dizzy as Cooter Brown,” he said. “My brain could not figure out what was going on. But every day is a little bit better.”

He only wishes he’d known years ago that there was a surgical fix for strabismus.

“If it’s no better than what it is right now, it’s OK,” he said while still healing. “It’s 100 times better than it was before.”

“Hopefully, most people won’t end up thinking that they have to wait so long to get it fixed,” Gitschlag said. “He didn’t hurt his vision at all; it’s just that he could have gotten out of having those prism glasses.”

As plastic surgery goes mainstream, expressions of dismay more common

Mireya Navarro, New York Times

Sunday, January 6, 2008

(01-06) 04:00 PST Los Angeles –

Pity poor Ashley Tisdale. Riding high from her success as the scheming Sharpay in “High School Musical 2,” she seems to have come down with a minor case of Jennifer Grey syndrome.

After having surgery to fix what she said was a deviated septum on Nov. 30, she emerged two weeks later with what looked to many casual observers like a brand-new nose. Celebrity magazines and blogs piled on, questioning her for tinkering with the trait that many people say made her special.

Five-year-old fans said they no longer recognize her. She looks “plain,” “average,” even “Stepford,” according to some of the online comments.

“Any character her face once had is GONE!” says one of hundreds of opinions that poured into perezhilton.com after the first post-surgery pictures of the 22-year-old actress surfaced. “Bye Sharpay. Hello bland!”

As a celebrity, Tisdale might have expected scrutiny. (At least she still looks like herself, unlike Grey, the “Dirty Dancing” star whose rhinoplasty altered her face so much that her acting jobs dried up.) But anticipating and dealing with negative reaction to changed looks is not just for the boldface set.

Plastic surgery has become mainstream - almost 11 million procedures were performed in the United States in 2006, up 7 percent from the previous year. The vast majority were performed on women, with breast augmentation and nose reshaping leading in popularity.

Doctors say that anxiety about the response is common among patients and that they can expect comments that are not of the you-look-fabulous variety.

“As patients become more open about it, they should expect more open feedback, good or bad,” said Dr. Richard D’Amico, who is president of the American Society of Plastic Surgeons and practices in New York and Englewood, N.J. “There’s no question it adds some stress to the decision-making process.”

Plastic surgeons say rhinoplasty has the most potential to jolt the patient’s friends and loved ones. But any type of facial surgery can spark strong reactions, including silence, stares, gossip and confrontational remarks.

Sometimes people react as if mourning a loss.

“A couple of people said: ‘Where’s Pat? You don’t look like yourself,’ ” said Pat Casanova, 57, an asset manager in Los Angeles who had a face-lift two years ago. “They were just a little bit in shock.”

Lois Stern interviewed more than 100 women for “Sex, Lies and Cosmetic Surgery: Things You’ll Never Learn From Your Plastic Surgeon.” She said the women gave various reasons for less than ecstatic responses to their surgeries: Some said that looking better and feeling more confident unhinged boyfriends and husbands; a few had relatives who disapproved of the cost; and some said that friends became jealous and competitive.

Stern, who herself has had a face-lift, found that men became more attentive and complimentary, while women’s reactions ranged from thrilled to hostile. Her once-chatty hairdresser clammed up when she noticed the surgical scars on her scalp.

“I could feel something in the air, there was a different tone - and I left her because of that,” said Stern, who lives on Long Island, N.Y. “With some people, their value system says it’s a frivolous thing.”

Not all criticism is subtle, especially from those who believe surgery has robbed someone of an endearing feature or rendered him or her almost unrecognizable. Dr. R. Merrel Olesen, founder of La Jolla Cosmetic Surgery Center in La Jolla (San Diego County), recalled a case of buyer’s remorse in which a woman wanted her prominent nose back, after being shunned at a reunion for erasing a feature shared by many relatives. “The family almost made her suicidal,” he said.

Often, the harshest disapproval comes from children.

“My son was really sad,” said Jane Glenn Haas, the founder of WomanSage, a group for middle-aged women, and a columnist for the Orange County Register.

Haas said an inheritance from an uncle nine years ago allowed her to get rid of what she called her “walrus” look - a double chin and bags under her eyes. She went ahead with the surgery, though dreading the reaction.

“I thought people would make fun of me because I’m not a glamorous type of person,” she said. “I felt a need to justify it. I told everybody I used money that I had inherited.”

The face-lift was overwhelmingly embraced by everyone in her circle, she said, except her 31-year-old son. He told her she looked “like an Orange County woman,” which she said meant a woman with so much money she could buy herself a new face.

“I thought he was kind of kidding at first,” she said. “I felt very badly because I realized that there’s a ‘mother look.’ I didn’t look like that anymore.”

Haas told her son to get over it. “I was very pleased with the way I looked,” she said.

D’Amico said that what best equips patients to deal with the emotional consequences of cosmetic surgery is wanting to do it for themselves. If the motivation is something like needing to be liked by others or trying to fix something else that is wrong in their lives, “you refer them to a counselor,” he said.

Some patients, of course, hear nothing but compliments. Linda Rios, 50, a stay-at-home mother in San Diego who had a face-lift in July, said that if anyone made catty remarks, she is unaware of it.

“Everybody I’ve talked to is in awe,” she said. “Several of my friends have asked for my doctor’s card.”

And many patients say that after a while, the surgery is all but forgotten. Still, enough of a stigma lingers to make some people deny, fib or at least not advertise the reason they look different.

Sandra Miller, of Los Angeles, a 38-year-old writer, had surgery at 18 that included fixing a deviated septum and straightening the tip of her nose. Last year she again had a little work done on her nose.

She told no one about the first surgery and only a few close friends about the second one.

“You’re kind of embarrassed to say that there’s a problem with the way you look,” she said. “I wanted to look better but didn’t want people to know why.”

In Hollywood, where looks make or break careers, it is almost unheard of for an A-list star to own up to artificial enhancements. Tisdale told fans on her Web site that her nose surgery was for “health” reasons. But plastic surgeons say that fixing a deviated septum does not result in a changed nose.

Dr. Brent Moelleken, whose sees his share of celebrities at his practice in Beverly Hills, Calif., says some patients come at odd hours, wear disguises to throw off paparazzi, or pace their surgeries over several years “so you can’t put your finger on what’s happened to that person.”

Although he suggests that patients get a new hairstyle or admit to at least getting the eyes done as a way to explain away a new look, Moelleken said the best course is to come clean.

“The people who are the most open about their plastic surgery have the most positive experience,” he said. “If you’re open about it, you’re unembarrassable.”

Link: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2008/01/06/MNS3U6AGJ.DTL&feed=rss.news

These ladies met on our website, Plasticsurgeryjourneys.com
They were all plastic surgery patients in Costa Rica.
Watch the youtube video!

http://www.youtube.com/watch?v=fn9BfKSB19g

Another reason why research is sooooo importanat.

Breasts removed after botched surgery in Mexico

Updated Mon. Dec. 31 2007 9:47 AM ET

The Canadian Press

Updated: Mon. Dec. 31 2007 9:47 AM ET

GUADALAJARA, Mexico — Gabriela Sanchez always felt self-conscious about her small breasts, and at age 40 she decided to do something about it.

At 41, she has no breasts at all - they had to be surgically removed after implants inserted by an allegedly bogus plastic surgeon caused a severe infection.

The charges against Agustin Huerta, a sweet-talking, snappy dresser who zipped around town in a blue Jaguar, raise new questions about how easily untrained scam artists can pose as qualified doctors in Mexico.

At risk are not only the patients, but Mexico’s campaign to attract Americans with the promise of cheap and safe medical care.

Sanchez is one of 43 patients to file complaints since 2003 against Huerta, a medical doctor who allegedly branched into plastic surgery without a licence and botched dozens of facelifts, liposuctions, breast implants and other procedures.

“I can’t even look at myself in the mirror,” Sanchez said, fighting back tears. “I can’t be with my husband.”

Huerta, arrested Dec. 6, faces about eight years in prison if convicted on charges of fraud, medical irresponsibility, severe damages and professional usurpation, according to lead prosecutor Elsa Arias.

“He was operating left and right for easy money and didn’t perform the proper follow-up treatments,” she said. “He knew he didn’t have the seven years of training required for those surgeries. He was lying.”

Such cases are surprisingly common. That same month, authorities detained a man in the border state of Coahuila for working as a doctor for more than 30 years with nothing but an accountant’s degree. And Arias made her name prosecuting former stripper Miriam Yukie Gaona, dubbed the “Beautykiller,” for allegedly injecting industrial silicone and other substances into hundreds of women.

No one keeps records on how many U.S. citizens travel south for medical procedures, but anecdotal evidence suggests the number is growing.

In the border city of Tijuana, most patients in some hospitals are American. Most come from California for dental work and plastic surgery that isn’t covered by insurance. This month, Tijuana’s medical community announced an initiative to encourage even more patients to cross the border.

The U.S. Embassy warns that while elective surgery may be cheaper in Mexico, “facilities may lack access to sufficient emergency support.”

And when things go wrong, seeking redress can be next to impossible. Class-action lawsuits - a foundation of consumer protection in the United States - don’t exist in Mexico, and the judicial system remains plagued by corruption and bureaucratic inertia.

Huerta’s patients found an advocate in Arias because of her experience prosecuting Gaona, who still has cases pending against her five years after her arrest.

Arias said Huerta distributed business cards reading in English “Cosmetic and Aesthetic Surgeon.” Huerta, she said, would often pressure patients to undergo surgery immediately, boasting he could make them look like the Mexican pop star Thalia.

Many were left with severe infections, disfiguring facial scars, lopsided breasts or lumpy stomachs, she said.

Huerta declined to be interviewed, but his lawyer, Victor Varela, said he held a medical degree and had undergone postgraduate training in liposculpture in Europe. He said Huerta was well-qualified to perform “aesthetic procedures” but insisted none of them qualified as plastic surgery.

The doctor “only performed liposculpture, which encompasses breast and buttocks implants and liposuction,” Varela said. “It’s a question of aesthetics. It’s not plastic surgery.”

Dr. Alberto Smeke, who investigates medical misconduct for Mexico’s Health Department, called that rubbish. He said what Huerta did was clearly plastic surgery, and requires a licence.

Varela said the complaining patients are after money, and accused many of bringing on their own problems by failing to follow post-operation treatment and drinking or smoking after surgery.

But patients and their families denied that they were responsible for the outcome of the procedures, and said they simply want justice.

“I’ve given up,” said Montzerrat Ramirez, 21. “I’m not charging him with homicide - I just want my money back.”

Ramirez’s mother Lorena, 39, saw Huerta in July because her back was hurting. He recommended breast reduction, a tummy tuck and liposuction, even though she had diabetes and hypertension. Once she was under the knife, Huerta performed a full mastectomy, replacing her breasts with implants, the daughter said.

Following the surgery, Lorena Ramirez’s incisions repeatedly opened and became infected, and she spent 37 days in the hospital, racking up medical bills of more than US$23,800, her daughter said. She died of a heart attack in October.

Operating on a patient with diabetes and hypertension requires careful testing and monitoring, even when the most qualified plastic surgeons are involved, according to Dr. James Wells of Long Beach, Calif., former president of the American Society of Plastic Surgeons.

Gabriela Sanchez went to Huerta two days after the doctor inserted threads into the face of her mother Consuelo to lift her nose and help her breathe better, a procedure he performed in the hallway of his clinic.

Gabriela Sanchez woke up the morning after her breast surgery with a gaping wound in her abdomen. Huerta, she said, told her he had inserted the implants through her belly - and even given her “a bit of lipo” as a gift. Eventually, she had to have both breasts removed because of an infection, and scars now stretch across her abdomen.

Her mother’s nose, meanwhile, became so infected that doctors had to remove the entire bone, leaving her disfigured.