Each week, nip/tuck starts with what’s known in Hollywood as a “cold open.” Also referred to as a “teaser,” a cold open is when a show’s plot begins prior to the show’s title sequence or running of the opening credits. This week, the cold opening involved Dr. Troy attempting to barter his services (in this case, plastic surgery on a salesman’s girlfriend) for a discount on a Lamborghini. Hey, it could’ve been worse; he might have offered another one of his many “services.” I guess you don’t know if you don’t ask.

Anyway, with my cold open out of the way, let’s get this show on the road with an episode I’m going to call…

Roll title…

You Be the Judge.

The American Society for Aesthetic Plastic Surgery (ASAPS) reports that in 2006, over 11 million surgical and non-surgical cosmetic procedures were performed in this country. If you’d like to see some patient stories regarding some of the more popular procedures, take a look at these videos of rhinoplasty and tummy tuck videos. Where was I? Oh, yeah… now, I’m fully aware that while chondrolaryngoplasty might not be as familiar to most as say rhinoplasty (nasal surgery), tummy tuck) or augmentation mammoplasty breast enlargement, but for some transgender individuals, the “tracheal shave” is an important step in becoming who they feel they were meant to be.

Sofia Lopez, a male-to-female transgender shows up at McNamara/Troy after unfortunately receiving a less than professional tracheal shave – or chondrolaryngoplasty – from an unscrupulous, probably alcoholic plastic surgeon operating illegally outside of the system. Not good, especially considering that a tracheal shave – as the name more than implies – involves the shaving away of the larynx’s largest cartilage (the thyroid cartilage) so as to reduce the size of the “Adam’s Apple.” The hope is to provide a more feminine appearance. Obviously, it’s a delicate procedure that when performed by an inexperienced – or drunk – surgeon can result in everything from difficulty breathing, and problems swallowing, to damage to the patient’s voice and scarring. Sofia’s problem of both significant physical and emotional scarring – was remedied by Dr. McNamara, which brings me to the really great thing about being in this industry…

The fact that plastic surgeons are capable of more than enhancing the body; they are able to enhance the spirit. A caring, qualified plastic surgeon can increase a person’s self-esteem; they can help a patient not only rebuild a life, but as was the case with Ms. Lopez, start a new, more fulfilling one; and, they never judge a person by who they were, are or who they want to be. Why? Because a plastic surgeons understands that it’s not his or her job to determine what’s “normal.” So, whether a patient’s looking for implants or injectable fillers to enhance the lips, breast reduction or an effective wrinkle treatment, a plastic surgeon is there to help, offer hope, and never ever judge. Sort of like your best friend… your really smart, highly skilled, board certified best friend.

So what else happened on nip/tuck? Oh, you know, the usual: Dr. Troy attended a porno party where he was immediately propositioned… by an old classmate and rival looking to hire him away. And, as usual, Dr. Troy uttered some outrageous line about plastic surgery: “The line that divides the porn industry and plastic surgery is a thin one – we’re both selling fantasy.”

Too bad no one’s buying it, Dr. Troy.

See you next time.

Charlie Sheridan

Medical Editor and Consultant