Scar Tissue Flaps for the Correction of Postimplant Breast Rippling Massiha H (Louisiana State Univ, New Orleans) Ann Plast Surg 48:505-507, 2002

---

FIGURE 1.-A, A schematic view of the rippling skin over the implant (preoperatively). B, The flap o: capsular scar tissue with the lining of adipose and soft tissues is elevated from thicker areas, is hinged on it: base, and is sutured in place. C, Final stage before insertion of the implant. (Courtesy of Massiha H: Sca: tissue flaps for the correction of postimplant breast rippling. Ann Plast Surg 48:505-507, 2002.)

Background Palpanle implants under the skin, which are usually also visible as rippling and festoon-type deformities, are relatively common. The etiology of postimplant breast rippling includes an extremely thin individual, the type of dissection, and possibly the kind of implant and the total amount of fill. Outcome may also be influenced by the type of filling material used, whether saline or silicone. Rippling is more common in cases of implant exchanges, particularly with extensive capsulectomy. Two methods for the correction of postimplant breast rippling after breast reconstruction or in cases of primary or secondary breast augmentation are presented in this report. Methods The first method is an ideal approach and is both safe and effective. In this method, the thin area is covered with a flap or flaps of scar tissue from adjacent areas folded in on its base and doubled to thicken the affected areas. The flap could be brought in from the thickest parts under the mid breast and, whenever possible, from the chest wall (Fig 1). The second technique relies on transplanting fat into subcutaneous areas of the affected site. Results Complete correction of rippling is possible with the ideal technique described here. The author has used fat transplantation only in patients in whom the extent of the deformity covers such a large area that flap coverage is not feasible. The 1 patient in whom fat transplantation was used had significant deformities that were disrupting her social life. Results in this patient were excellent after 3 years. Conclusions Postimplant breast rippling can be corrected by rotating a flap of scar tissue from thicker parts of the breast to the thin, affected areas. The technique is simple to learn and provides excellent results. In addition, fat grafting was successful in a patient with severe rippling deformities in all areas of the breast. However, fat grafting is reserved only for the most extreme cases.

Sophisticated Woman September 2002

Massiha Plastic Surgery Center Surgical Masterpiece By Brenda Bell "I want to share my innovative techniques with my colleagues so they in turn can offer their patients more improved techniques that leave patients with a natural look." Before considering any surgical procedure, one should thoroughly research the doctor who will be performing the surgery. This is particularly important when considering plastic surgery, which is a most delicate, personal and sensitive procedure. What makes an exceptional plastic surgeon? There are some surgeons who are quite gifted intellectually but may lack one or more of the following qualifications to assure your best results. Knowledge gained through the proper education, as well as continuing to stay current on the newest advancements and technology in their field of medicine is critical when evaluating your surgeon. They must be able to comprehend what method of correction is necessary. Are they experienced in the procedure necessary and their success rate? Vision to exact the problem and see what the best and most effective way to approach each case in order to obtain an excellent result. Dexterity is essential to obtain the most effective results. Not all surgeons possess the manual flexibility, artistry and skillfulness necessary to perform the best plastic surgery. Dedication and Integrity of the surgeon lets a patient know that they are being evaluated on a personal basis and not as a dollar amount. There are approximately thirty plastic surgeons in the New Orleans metropolitan area. Only a handful of these are board certified Members of the Society of Plastic Surgery. This elite group is hand picked. To become a member, you must be a board certified plastic surgeon, spend 57% of your practice doing plastic surgery and be put up by two members of the Society of Plastic Surgery. Dr. Hamid Massiha is a member of this select group of surgeons. The most prestigious cosmetic organization has honored Dr. Massiha with The Award of Excellence. This award was given due to Massiha's discovery of innovative ways to approach plastic surgery as well as his dedication to his profession and his patients. The famous Annals of Plastic Surgery have published Dr. Massiha's techniques for breast augmentation and abdominoplasty. He is a member of the American Society of Plastic Surgeons, the American Society of Aesthetic Plastic Surgery, Diplomate of the American Board of Plastic Surgery and many other professional organizations. Since 1970, Dr. Massiha has been an annual recipient of the Physician's Recognition Award of the American Medical Association. He is the recipient in 1998 and 1999 of the plaque for Appreciation for Contributions in Aesthetic Surgery.

"My studies with the spiritual aspect of life help to make me a better person every day. I have never approached my work as just a way to make a living. I love what I do because I get to make the quality of life better for my patients and they are happier."

In addition to these honors, Massiha is a Clinical Associate Professor of Plastic Surgery at the LSU Medical Center. Since 1985, he has served three terms as Chief of the Plastic Surgery Department of East Jefferson General Hospital. Dr. Massiha has given over one hundred presentations to board certified plastic surgeons all over the world. He personally has taught many of these surgeons how to perform his innovative techniques. "I want to share my innovative techniques with my colleagues so they in turn can offer their patients more improved techniques that leave patients with a natural look." Thirty of these presentations have been published. Dr. Hamid Massiha has been recognized as one of the most renowned plastic surgeons in his field. He has been gifted with an artistic ability that has served him well as a surgeon. As a gifted sculptor, he has utilized this talent to not only perfect his dexterity but also to create innovative techniques in surgical procedures. This in turn has helped his patients suffer fewer traumas and have more effective, natural looking results. Dr. George Hoffman, who was Chief of Surgery at Louisiana State University Medical School when Massiha was an attending resident, spoke many times about the fact that of the sixty some odd residents that he had trained, Massiha was the best he had seen due to his manual dexterity and artistic eye. Your body is as unique and multifaceted as precious diamonds. You need to weigh the qualifications of a surgeon before going forward with any surgery. "I may spend over an hour with a patient helping him/her to comprehend the procedure so the patient can make an educated decision. I have never done two patients the same way in almost twenty-six years of practice. Every patient is different and nuances come into play with each patient," explains Massiha. Dr. Massiha has dramatically changed the lives of thousands of patients. It is important for a surgeon to have high moral and ethical character. "My studies with the spiritual aspect of life help to make me a better person every day. I have never approached my work as just a way to make a living. I love what I do because I get to make the quality of life better for my patients and they are happier," relates Massiha. I was fortunate to be able to interview one of Dr. Massiha's former patients. (I have omitted the name to respect confidentiality.) "When you go to Dr. Massiha he makes you feel beautiful. He tells you that you are beautiful the way you are. He makes sure that you are confident about yourself because Dr. Massiha tells you that the surgery will only change the way you look... not who your are. He wants to be sure you are a stable enough person before he considers the surgery. He is so nice and understanding and makes you feel so comfortable. It wasn't like some of those doctors who will tell you `I definitely think you should get your nose done' just to get the money. It doesn't make you a new person. You're the same person with cosmetic changes."

Before face lift	After face lift

She also commented, "The staff is very sensitive when you come in after surgery. They gently guide you to a private waiting area so you do not have to sit in the lobby with others." The Massiha Plastic Surgery Center is a fully accredited surgical facility with full-time registered nurses, certified surgical technicians and several other highly trained and experienced professionals including a full time aesthetician. The Massiha Plastic Surgery Center is located at 3939 Houma Boulevard, Suite 216, Metairie. Call (504) 455-9441 or visit the website at www.artplasticsurgery.com.

USA TODAY ARTICLE

FEBRUARY 23-25, 1990 MARDI GRAS WARMUP WET

NEW ORLEANS - Dr. Hamid Massiha had waited a year to be king, and refused to let rain interfere with his reign.

His parade - as king of the Krewe of Babylon - was washed this week.

But the krewe's dinner, ball and dawn breakfast went on as scheduled. "I wasn't going to let some rain ruin my turn on the throne," Massiha said.

In New Orleans Parish, five of 30 scheduled Mardi Gras season parades were canceled when papier mache-covered floats got too wet.

The parades-colorful caravans carrying revelers who toss doubloons to the crowds-are traditional during the 12-day season before Mardi Gras.

The revelry peaks with Fat Tuesday's 12 hours of parades. Forecast: sun in the morning, but evening showers.

The spirit will last even longer this year for Blaine Kern's Krewe of Alla. The club's rained-out parade was rescheduled for March 17.

"It will be St. Patrick's Day with a new twist," Kern said.

- Sharon Donovan

SUPPORTERS MAKE PARTY WAVES

The message was in the media, and waves were made on several social fronts. In a home decorated for fall and Halloween - the invitation said "Glas Residence" and people headed for the Octavia Street digs of John and Mary Glas - a pre-auction committee luncheon was the midday tune-in. At that point, almost all the committee programming for the WLAE-TV Auction was clicked into place, in preparation for the air dates of Nov. 6-10, and fun was to the fore. Christmas, too, since the Channel 32 auction is a nod to Noel. It's billed "Family Christmas Auction." But beyond the yuletide trimming, a "Trip to the East" - an Indian theme dinner party - will be one of the choice items, thanks to Har and Anila Keswani (and Taj Mahal Restaurant). Waiters in Indian costume, a belly dancer and Indian music are included in the culinary package. A little soul food is the offering of Irma Thomas, who will give a special tape to each player who cops her offering of a bowling party. Then, dream on .... A vacation to Caracas, Venezuela, is the stuff of travel fantasy. The Crescent City's Queen of Soul, Miss Thomas herself, was one of the midday mavens and matrons at the Glas house, who were welcomed by retired Archbishop Philip M, Hannan, the auction's honorary chairman. Additional notables were general chairwomen Camille (Mrs. Elmer H.) Eberts and Sandra (Mrs. Ronald L.) Karcher, who mingled with auction coordinator Karen Butler and art and antiques general chairwomen Margarita Bergen and Joann Abbott Thaxton. Also around and about (and lunching on the red-and-green theme victuals prepared by Royale Caterers) were Katherine Kammer, who did double time, and also stopped in at the Sybarites luncheon for new members at Commander's Palace Restaurant; last year's co-chairwomen Terrie Mancini and Ruby Smith; and Dessa Rutter, just back from a birthday trip to California. "It will be so nice to focus on the French Carre," said Margarita Bergen, about her arts and antiques committee. Billye Rivet Judlin was spreading news about the Nov. 11 annual fashion show and luncheon for Chateau de Notre Dame Guild, while Micki Ouzts entertained questions about a family wedding. Michael Deleadernier was about to wed - and has - Mary Zauner. The bridegroom's parents are Vinca Delesdemier and Mark Delesdemier Jr. Mark III is married to Micki's daughter, Melanie, and they have two children, Mark IV and Marshall. The third Delesdemier son answers to Merrick. And so go the M&M's.

Dr. Harnid Massiha was also with the lunching ladies, many of whom were still rapping up the benefit party held in his Park Island home on the eve of WLAE's "The Gospel Train to New Orleans." "His house now reflects a safari period," said Karen Butler, who made all non- party-attendees wish for an encore.

Begun just a few years ago, the "Blues for the Blind" benefit for WRBH Radio for the Blind and Print Handicapped, has now mushroomed into solid merriment. Flocking to the Robin Street Wharf were scores of supporters, who milled with Don Hem, president of the Greater New Orleans Council of the Blind; co-chairwomen Cathy Dennis, Kitty von Gohren and Sarah Sharp, special guest Cyril Neville (of the city's best-known Brothers); and Brown Sugar, the mistress of ceremonies. Also rubbing shoulders were Glade Bilby III, Bob Charlet, David Peltier, Lynn Robertson, David Smith, Paul Thomason, board chairman Glenn Hayes, vice president Craig Henry, Eileen Bagnetto, Don Banning, Suzanne Cliffe, Cathy and Tom Dennis, Patrick Gibbs, Bryan Lee and Tommie Vassel. Tim Green is WRBH station manager, and has as staff cohorts Erika Hamburg, Bill Grush, Randy Savoie and Trudy Stewart. The Praline Connection served melt-in-your-mouth cream cheese praline king cake and fudgelike pralines, while Bryan Lee and the Jump Street Five and others served up the sounds. Honorary chairman Don Hern got into the act in the best way: He thrilled the audience with an impromptu performance with Bryan Lee. The printed medium will have a lot of Orleanians perusing the November issue of Southern Accents magazine in which the St. Charles Avenue home of Dr. and Mrs. Walter Palmer Diaz is prominently featured. "Living in a Landmark" titles the article that has the Australian-born Jean Diaz, one of the principals of the recent "Royal Affair," smiling radiantly among her treasured possessions.

- Nell Nolan

Artist-Surgeon Hamid Massiha Builds Enviable Reputation in New Orleans Area There are many grateful "graduates" of the Magnolia Surgical Facility of Metairie, LA, who have undergone the surgical artistry of Dr. Hamid Massiha. Dr. Massiha has a distinguished record of academic positions (he is the current president of the Louisiana Society of Plastic and Reconstructive Surgeons), a Diplomat of American Board of Plastic Surgery and holds the Physician Recognition award from AMA and has maintained a prolific publication schedule on papers which have been read before various prestigious American Societies of Plastic Surgery. In off-hours, Dr. Massiha is not suprisingly, an artist. His particular forte is sculpture. Patients of the Magnolia Surgical Center have also benefited from its Free Standing basis. The total amount of time spent at the center, from anesthetic to wake up is usually less than half a day and the recovery rate from the operation, according to data supplied by the Department of Health and Human Resources, is actually less than that of those who choose in-patient hospital surgery. The Department of Health Attributes the speed of recovery, in great degree, to the lower risk of hospital-acquired infections and to the lower medication requirements of facilities such as the Magnolia. Yet another salient feature of the Magnolia Facility is cost. "We are definitely less expensive than hospitals" says Dr. Masshia, comparing his same-day operations to in-patient hospital surgery. "One minute of in-patient hospital surgery cost $10. Here we charge by the case. If an operation takes longer, we charge the same amount." The Health Department has reckoned these savings to be as much as thirty percent less than in-patient care in many instances, and points also to the patients shortened time off the job. To be licenced by the state, a free-standing center such as the Magnolia must be within 15 minutes from a hospital that will admit its patients in emergencies. The only patients discouraged by Dr. Massiha are those with no one to care for them at home; but other alternatives can be found. The Magnolia Surgical Facility specializes in a variety of ambulatory surgery procedures. These include general surgery, E.N.T., eye, plastic orthopedic, GYN, urology, podiatry and many more. The facilities provide general or local anesthesia, two fully equipped operating rooms, recovery rooms with additional space and R.N. on duty. Among Dr. Massiha's list of publications are such somber titles as "Dermal Ischemia in Thermal Injury; The Importance of Venous Occlusion," which was first presented to the American Burn Association in 1972. "Cosmetic Surgery of the Breast" followed in 1975. Eleven other titles follow these two, dealing with skin transplants, suction lipectomy, mammoplasty, facial rhytidectomy, cartilage grafts, all the solemn and challenging tasks of repairing damage from burns, accidents, and making restorations in the case of cancer patients. Dr. Massiha's work has a flip side, and this is one the public has come, fortunately, to understand better - surgery done for cosmetic purposes. Once this may have been regarded as the fluff of medical science because an unshapely nose is not life threatening, and bulbous thighs and sagging jaw lines are not contagious. Anyone who has ever lived behind an oversized nose (with the exception perhaps of commedians whose livelihood is enhanced by nose jokes); any woman who has gone through life behind padded bras and the resultant fear of ever being seen without them - all these people know that these imperfections pose no problem to physical health but they can produce havoc with mental health. The correction of these flaws by cosmetic surgery goes far beyond the skin-deep level. Their elimination by restructuring can be as supportive to the human psyche as bone structure is to the human frame. Dr. Massiha's list of successful operations is lengthy and growing, but the practice of plastic surgery will never be called "common." It is a most uncommon calling requiring the eye of the artist, the skill of the surgeon and the intellect of the scientist.

Dr. Hamid Massiha, Faye Cannon