A Plastic Surgeon on Michael Jackson, Dr. Conrad Murray, and Regulatory Reform

There is a very interesting article in the Huffington Post written by a board-certified plastic surgeon who shared a surgical suite with the late Michael Jackson's plastic surgeon. In it, he explains his thoughts on why Michael may have died (which appear to be refuted by the autopsy findings) and the responsibility that physicians and the lack of true health care reform share in contributing to his unfortunate death. While you may or may not agree with some of his opinions, it's definitely an interesting read. You can check it out here.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Michael Jackson, Dr. Murray, and IV Propofol

More details continue to emerge in the tragic death of Michael Jackson. This from TMZ:

Two days after Jackson's death, Dr. Murray told LAPD detectives he administered Propofol to the singer hours before he died ....We're told Dr. Murray gave Jackson an IV drip of the powerful anesthesia. Police believe Dr. Murray simply wasn't paying attention when the singer's heart stopped beating. Authorities believe Dr. Murray may have actually fallen asleep during the time the drug was administered and may have awakened to find Jackson already dead from heart failure... It is considered reckless in the medical community for a doctor to administer an IV drip of Propofol without the patient being monitored by an EKG, which sounds an alarm when the patient's pulse drops too low. No EKG was found in the house.

If the above claims are true, then the actions by Dr. Murray are horribly reckless. I've commented earlier that Propofol is an extremely powerful sedative, used mainly to induce anesthesia in controlled settings like operating rooms. In these settings it is a very safe drug. To use this medication in a person's house without respiratory and cardiac monitoring, however, blows my mind. Sadly, it is appearing that his death could have been prevented.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Michael Jackson and a Possible Prosthetic Nose

This is an interesting plastic surgery-related story regarding the sad tale of Michael Jackson. It appears that during the later years of his life he may have worn a prosthetic nose. From the New York Post:

Michael Jackson wore a prosthetic nose, according a report -- and it was missing from his surgically mangled face as he lay in an LA morgue.
Left behind was a small, dark hole surrounded by bits of cartilage, Rolling Stone magazine said, citing witnesses who saw the King of Pop's body on the autopsy table.
Jackson, who was notoriously shy about his appearance, wore the prosthetic to mask the effects of decades of plastic surgery, according to the magazine.

It seems that the more we learn, the sadder the story gets. Hopefully his children can grow up with some semblance of normalcy. As long as someone keeps that creepy Joe Jackson away from them, I suppose they have a chance.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Michael Jackson, Propofol, and HIPAA

Not surprising, the rumors are swirling regarding Michael Jackson's death. A couple thoughts:

1. The medication that TMZ reported was found in his home, Propofol, is extremely dangerous indeed. I have never heard of it being used recreationally, but see it used every day when I perform plastic surgery. This powerful drug is given intravenously to induce a rapid unconscious state. It's fast acting but also cleared very quickly from the bloodstream. If it is given in a large quantity then the unconscious state can be so deep as to create respiratory arrest. This can eventually lead to a cardiac arrest. I believe the only people who should administer this drug are anesthesiologists or nurse anesthetists.

2. I am surprised that the nurse who claims that Michael asked her to inject him with the medication is revealing this info to the press. I believe it's a violation of HIPAA privacy laws, similar to when a plastic surgeon in Beverly Hills revealed through his publicist that he turned down Donda West for surgery due to heart disease.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Michael Jackson and Farrah Fawcett - Rest in Peace

Shocking and sad news today: Both Michael Jackson and Farrah Fawcett have died. Both are icons in their respective fields of entertainment. Although Michael's life has undergone an incredible amount of scrutiny over the last several years, I think no one would doubt the tremendous impact he's had on the face of pop music. His voice will be missed. Farrah will always be considered one of the most beautiful women of her time. Both have undergone their share of speculation about their plastic surgery. I guess it doesn't matter now. It's a shame that both are now gone.

Rest in peace.

Photo credit: prphotos.com

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Michael Jackson - Does He Have Skin Cancer?

The newest Michael Jackson rumor circulating on the internet is that he may be getting treated for skin cancer. According to the Sun:

A source said: “Michael’s tests showed spots of skin cancer on his body, and cells which could turn to skin cancer on his face... He was at first very concerned, but says he has been assured by the doctors that they can treat this and he will recover... Michael is really looking forward to his concerts and is determined to wow his fans at each and every gig... He said he’s insisted that any treatment must fit around the concerts, and the show will go on.”

Jacko, who has been seen making regular visits to his Beverly Hills dermatologist wearing a mask and surgical cap, received the shock diagnosis last month.

The most common skin cancer is basal cell carcinoma, which almost never spreads to other organs or kills people. If left untreated, it just tends to get larger and larger. Pre-cancerous cells can often be treated without surgery.

For all you MJ fans, I bet that he'll be just fine.

Photo credit: prphotos.com

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Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Does Michael Jackson Have An MRSA Infection?

Several internet sources are reporting that Michael Jackson may be fighting a severe MRSA infection on the face. These sources state that he is on IV Antibiotics for treatment of this multiple drug-resistant bacteria, and that it may have originated from nasal surgery. Could this be true?

There doesn't appear to be any word from Michael's spokesperson yet, which may be a bad sign. MRSA is a type of Staph aureus bacteria which is often found inside the nose of "carriers." Although usually asymptomatic, in rare cases it can cause severe infections which can even destroy tissue. There are very few drugs which are effective against MRSA, although a handful do exist. The photos of Michael show a very limited amount of the skin of his face (since it is covered by a surgical mask), but the skin that is shown does appear red and possibly inflamed. For his sake, hopefully the rumors are false and he remains in good health. I have never seen a serious MRSA infection of the face (although I have seen it elsewhere), but I can imagine it can be pretty scary.

Source: The Sun

Photo credit: prphotos.com

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Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Reconstructing Michael Jackson

A long time ago I promised to explain how I would 'fix' Michael Jackson's nose. Well, if it has been operated on as many times as I think it has, his nose is now a scarred-up mess.
The best way to recontruct a nose like his would be to treat it like a cancer reconstruction. We can remake the soft tissue (skin and fat) of a nose by transferring the skin from the forehead down to the nose. This entails two surgeries. During the first surgery we lift up the skin of the forehead (into a shape to fit the nose) and swing it down to what's left of the nose. We temporarily keep the skin attached to the forehead, where the blood vessels continue to supply blood to the transferred skin. This connection is left for about 3 weeks, to allow new blood supply to develop from the nose to the new transferred forehead skin.
Yes, for three weeks the person walks around with the skin of the forehead attached via a 'bridge' to their nose. It's a pretty strange sight.
After these three weeks, the patient goes back to surgery, where the connection is divided at the forehead and the skin is 'inset' into the nose, giving him a new, softer, larger nose. Now, Michael may also need some nasal support if a good portion of his cartilage and/or bone has been removed. This would likely entail grafts of bone or cartilage from his ribs, a somewhat painful procedure I rarely perform.
The "Paramedian Forehead Flap" is probably the best way to take today's Michael back to the 80's Michael. During the time of his healing, he would be no PYT.



Photo credit: prphotos.com
For more information on the Paramedian Forehead Flap, click here.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.