Plastic surgery, generally speaking, deals with the repair, reconstruction, or replacement of physical defects of form or function involving the skin, musculoskeletal system, cranio-maxillofacial structures, hand, extremities, breast and trunk, and external genitalia. It uses aesthetic surgical principles to improve undesirable physical attributes of otherwise normal structures as well as reconstructing defects in someone's appearance.

Special knowledge and skill in the design and surgery of grafts, flaps, free tissue transfer and replantation is necessary. Competence in the management of complex wounds, the use of implantable materials, and in tumor surgery is required. Plastic Surgery has been prominent in the development of innovative techniques such as microvascular and cranio-maxillofacial surgery, liposuction, and tissue transfer. The foundation of surgical anatomy, physiology, pathology, and other basic sciences is fundamental to this specialty.

Competency in plastic surgery implies a special combination of basic knowledge, surgical judgment, technical expertise, ethics, and interpersonal skills in order to achieve satisfactory patient relationships and problem resolution.

There are basically two parts to plastic surgery:

Cosmetic surgery is performed to reshape normal structures of the body in order to improve the patient's appearance.

Some of the most common cosmetic surgery procedures are:

• Breast enlargement
• Rhinoplasty (nose jobs)
• Face liftsEyelid lifts
• Liposuction

Reconstructive surgery is performed on abnormal structures of the body, caused by congenital defects, developmental abnormalities, trauma, infection, tumors or disease. It is generally performed to improve function, but may also be done to approximate a normal appearance.

Some of the most common reconstructive surgery procedures are:

• Breast reduction for hyperplasia
• Burn care
• Craniofacial surgery
• Correction of congenital anomalies such as cleft palate, cleft lip
• Excision of tumors

Sometimes there is overlap with certain procedures. For instance, there can be reconstructive rhinoplasty to correct a nasal deformity, but there can also be cosmetic rhinoplasty, simply altering the shape of a normal nose.

Please contact Dr. David Bray, Sr. and Dr. David Bray, Jr. to learn more about your cosmetic and reconstructive surgery options in the Los Angeles area.

Humans are social animals with a strong sense of hierarchy. We assess ourselves against those around us to determine where we belong in this hierarchy. Because we are also visual animals--the majority of our brain's devoted to sight--, it is natural that appearance should become an important part of our sense of worth.

This visual sense of worth is augmented by the high cultural premium placed on fashion, where the proper ornamentation represents an ostentatious sign of rank. Even those who opt out of mainstream fashion are rarely careless of their appearance, but have simply oriented themselves into a subcultural set where they feel more capable of competing, such as in urban, Goth, or grunge coutures.

Evolutionary psychologists have noted that many people feel highly anxious about their place in the visual hierarchy for the simple reason that our minds developed when human beings lived in small bands and each person only had to compete with a few other individuals, whereas modern humans have to compete with millions in the huge crowds of large cities, not to mention the virtual crowds present in TV, film, magazine, and street advertising. The sheer scope of the competition means that no one could place high on a visual hierarchy against all the people on the streets and on the screens and on the pages that they see every day.

We might call the stress caused by our failure to compete with the crowd Manhattan Anxiety, which combines the prototypical urban crowds of New York City with NYC's status as the fashion, advertising, and television capital of the New World.

Women are especially prone to Manhattan Anxiety, since they face competition from the ever-nubile virtual crowds of Madison Avenue, and nowhere do they face stiffer competition than in the area of their breasts.

The large breasts of actresses like Scarlett Johansson contribute to the anxiety of women with small or shrinking breasts. Women with sagging breasts have always been troubled by the memory of how pert their breasts used to be, but now they hold themselves against the ever-young starlet, replaced year after year: Jessica Alba one year, Megan Fox the next.

Fortunately, modern medicine has found a cure for this as so many anxieties. If you are anxious about the size of your breasts, you can have a breast augmentation, or, if your breasts are not as pert as they used to be, a breast lift can restore them to their former stature. For a Manhattan remedy for your Manhattan Anxiety, contact the New York Breast Expert, Dr. Bellin, today.

In case you were not aware, October is breast cancer awareness month, and, unfortunately this blog has been remiss in not calling attention to it, since it devotes a fair proportion of its time to breast augmentation, although, I would argue, not an undue amount, considering its subject matter. In fact, if anything, this blog has been actually neglectful of the number one cosmetic surgical operation in the United States.

In fact, apart from mentions in previous blog entries on The Consolations of Beauty, Gender Roles and Body Image, and Mommy Makeovers, I have not devoted any attention to breast augmentation.

Today, I will rectify that with a series of articles on breast augmentation surgery that will last through the end of the month. For example, one of the interesting things about the website of the Ariana Cosmetic Surgery & Laser Center in Las Vegas, Nevada, is how it represents itself through the use of a single model. This provides a certain consistency to the site and clues us into the personal aesthetic style of Drs. W. Tracy Hankins and Michael Belfiore.

Looking at the breast augmentation page of the Ariana Cosmetic Surgery & Laser Center website, we are presented with a very clear image that these Las Vegas cosmetic surgeons have what might be called the "lingerie model" image of female beauty. This is entirely appropriate to their venue, since Las Vegas is full of showgirls and waitresses who make their living or "augment" their living by presenting a conventional image of beauty to customers who have come to Vegas with a preconceived notion of what they were going to see. In other words, they try to become to the feminine ideal what New York, New York, is to the actual city of New York: all the big, flashy landmarks are there, packaged to be easily recognizable, but without the heart and soul of the city itself.

In similar fashion, looking at pictures of the doctors' work in breast augmentations, it becomes clear they are definitely working toward a particular image, a Las Vegas image, of feminine beauty which has a pleasing surface, but doesn't allude to anything beneath the surface. This is not to disparage their work: cosmetic surgery is, after all, about conveying a pleasing surface, which the doctors at the Ariana Cosmetic Surgery & Laser Center do quite well.

In his 1974 song "Chelsea Hotel #2," Leonard Cohen remembers an intensely personal moment between himself and his lover Janis Joplin. He describes the moment just before their parting:

You told me again you preferred handsome men

But for me you would make an exception.

And clenching your fists for the ones like us

Who are oppressed by the figures of beauty,

You fixed yourself, you said, "Well never mind.

We are ugly but we have the music."

The intensity of the feelings expressed conveys a truly desolate moment of parting for Cohen who was looking back on the moment several years after Joplin's death. The consolation of having music seems barely adequate for either Cohen, or Joplin who at first tries to foist the ugliness onto Cohen before admitting her own sense of being unattractive.

And, indeed, no matter how we feel about these singers, we have to admit that they're really not very attractive, especially not when compared to the megastars of today. They could both have used rhinoplasties to correct their overlarge noses. Cohen could have used a brow lift to correct his tired, brooding expression, as well as a facelift to smooth the deep frown lines around his mouth. By today's standards, Joplin's prematurely old face, bespeaking the depth of her emotion and the hardness of her lifestyle would certainly have been treated with laser skin resurfacing or injectable fillers. Her narrow, unfeminine eyes might have been addressed with blepharoplasty, and she would certainly have been encouraged to receive breast augmentation.

In contrast to these very natural, very earnest figures, today's most popular musicians regularly appear on magazine covers and lists of the world's sexiest people. Speculation constantly hovers around whether they have or have not had cosmetic surgery, and not just the women, but the men as well.

Now we wonder whether the music industry has, as Tom Petty suggests in his song "Joe" from the album The Last DJ, intentionally sacrificed the quality of music to get young men and women artists who are easily manipulable, and selling its customers a package rather than a product.

I think it is impossible to say whether a cause-and-effect relationship exists between increasing attractiveness and decreasing musicality, but I would definitely say that I would rather look at most of these musicians than listen to them.