Dr. Ricardo Castrellon - Health Channel

Meet the Experts

Dr. Ricardo Castrellon

There are many things that patients are not aware of: the fee for an anesthesiologist, the fee for the products being utilized, fee for the
OR, sometimes the fee for insurances, the garments, the implants, the girdle and so on.

All of those things are included in a plastic surgery and that’s why It’s not possible to make it affordable for everybody, says Dr.Ricardo
Castrellon, Medical Director of the Burn Center at South Miami Hospital. For any procedure under anesthesia a oagulation test is important, affirms Dr. Ricardo Castrellon, Medical Director of the Burn Center at
South Miami Hospital.

Another analysis should include check blood levels, electrolytes, chest X-ray and, maybe, EKG (Electrocardiogram).

It’s important to see a certified plastic surgeon for any cosmetic procedures, he says. Dr. Ricardo Castrellon, Medical Director of the Burn Center at South
Miami Hospital, considers even before seeing a plastic surgeon,
everybody should be already emotionally prepared, because plastic
surgery is not going to cure depression.

The specialist talks about what DVT and PE are. He says, they refer to
blood clots in legs that can potentially go into lungs. Hematoma, nerve damage, infection, deep vein thrombosis and pulmonary embolism, scarring, general appearance dissatisfaction, organ damage, anesthesia complications, seroma and blood loss are the most common complications of plastic surgery.

However, beyond those complications, the false expectations that can be created about how the result of plastic surgery will be, it is the most frequent complication that Dr. Ricardo Castrellon, Medical Director of the Burn Center at South Miami Hospital, gets.

“Sometimes patients present dissatisfaction and you have a discussion with them about their real expectations,” he says. Skin infection is the most common infection after plastic surgery. Dr. Ricardo Castrellon, Medical Director of the Burn Center at South Miami Hospital, says these infections are related to the normal bacteria that people carry in their skin.

He also explains, in some cases, the infection can occur maybe two weeks later. The preoperative time is the best moment for preventing
infections. Doctors should control things like previous infections and
patients should be in a good condition, have an excellent personal
hygiene before surgery and check any chronic disease such as diabetes. Dr. Ricardo Castrellon, Medical Director of the Burn Center at South
Miami Hospital, says the most common illegal cosmetic procedure seen in South Florida is biopolymer injection, which is really silicon.

Most of the time, this procedure is performed in a barbershop or
similar and It’s not done by a doctor.

The doctor also explains there is something called “Body dysmorphic disorder”, where there are patients seeking from one plastic surgeon to another plastic surgeon. According to Ricardo Castrellon, Medical Director of the Burn Center at South Miami Hospital, skin has a capacity to regenerate. For example, a first degree burn does not need surgical treatment, because the body will regenerate the skin, but when we have third-degree burns, the skin is completely injured and that patient is going to need a skin graft.

Castrellon says a skin grafting is mostly needed for third-degree, maybe a second-degree burn and there will be other reconstructive options for deeper burns. Ricardo Castrellon, Medical Director of the Burn Center at South Miami Hospital, says it is important for the patient to feel that the doctor has the control of what happens; it takes a lot of their anxiety and depression away.

“It doesn’t matter really what I do in a patient, I’m 50% of it, he has to participate. If the patient is not mentally moving with their therapy and they don’t collaborate it’s not gonna move and it’s gonna be painful,” he highlights. Ricardo Castrellon, Medical Director of the Burn Center at South Miami Hospital, explains what is a severe burn, what are the risks associated with it and how hospitals treat a patient with this complicated type of trauma.

Every year thousands of people nationwide suffer severe burns due to accidents, fires, and other risk factors. Fortunately medical science has evolved to a point where many patients not only survive but are able to recover functionality. Ricardo Castrellon, Medical Director of the Burn Center at South Miami Hospital, explains the Rule of 9’s is about how badly burn you are and it refers to the surface area of your body and this will determine the treatment.

“In your upper extremities, if you have a circumferential burn of your arm, that refers to 9%, so 4.5% for the anterior surface and another 4.5% for the posterior surface, your torso will be 9 and the upper portion nine,” he says when explaining how with the palm you can have the percentage of your body is burnt. Thermal, radiation, chemical and electrical are the different types of burns. Ricardo Castrellon, Medical Director of the Burn Center at South Miami Hospital, explains thermal burn refers to when there is heat exchange, it is a transfer of energy or heat into the soft tissue.

According to him, radiation burn is the most common one and it refers to the transfer of ionizing energy and it could happen after being exposed to the sun for a long period of time. Chemical burns refer to the transfer of electricity and how electricity conducts to your body and an electrical burns is when you might have a superficial injury but you have a deep injury that goes through your body as the electricity path. Infections, low blood volume, dangerously low body temperature, breathing problems, scarring and bone and joint problems are some of the complications from burns that a persona can get if the injury is not treated properly.

Ricardo Castrellon, Medical Director of the Burn Center at South Miami Hospital, says the skin is one of the most important organs of the body, it is our first barrier against the environment. “Scarring is something we see in later stages, this will be a late complication, especially depending on how the burns are treated,” he points out. Medical tourism can be very risky, says Dr. Ricardo Castrellon, Medical Director of the Burn Center at South Miami Hospital, because although the surgery goes well, the patient needs follow-up. In most of cases, patients don’t realize that.

He affirms he sees very scared patients when they’re going to his office. “They have drains, they have concerns and they’re looking for someone who answers that”.

Patients try to do telemedicine with the physician in other country, but It’s not possible, he says. Ricardo Castrellon, Medical Director of the Burn Center at South Miami Hospital, says doctors most of the time have an idea of which patient can be at risk of suffering a shock, like the elderly, or the person who has some type of medical condition.

“A burn relates to loss of fluid, the skin is maintaining your fluid in your body and if your burn is open, you are going to lose fluid, plus the inflammation. So we treat this by giving IV fluids based on the dimension of the wound,” he explains. Ricardo Castrellon, Medical Director of the Burn Center at South Miami Hospital, explains there is a classification of degrees, because skin has a capacity of regenerating itself and depending on how deep the burns occur the skin will maintain this capacity.

According to him, first degree is a burn in the superficial layer of the skin, the dermis; second degree burn refers to a deeper layer of skin which will involve the epidermis; a third degree burn refers when all of your skin layers are burnt and it involves the epidermis, the dermis and the fat and fourth degree burn refers to having burns of everything, including the muscle. What is a patient looking for with a plastic surgery? Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, explains most of the patients want volume, projection, and says what are the other preferences. What are the most common plastic surgeries? Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, explains the most common plastic surgery procedures, such as those that have to deal with any deformity, non-invasive treatment for the skin, and hair replacement. There are some tips to help you choose a plastic surgeon. Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, gives some of them, such as considering your surgical goals, your medical conditions, and your drug allergies. Aging, sun damage, pregnancy, and genetics are some of the causes of sagging. Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, explains those, and how important it is to use sunblock all the time, among others. What is a plastic surgeon job description? Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, shares his experience as a plastic surgeon, and explains the reconstructive and the plastic parts of his job to help patients and improve their life. Every surgery has risks, including cosmetic and plastic surgery. Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, explains the risk factors of plastic surgery, and highlights the risk of having a heart condition and the complications that might be caused in the operating room. Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, explains as we are aging, the metabolic activity tends to decrease. He says with age, the body starts shutting down the systems that you are not using.

He also points out when you are morbidly obese, the fat is going to go to the central part of your body, and the skin and tissues are going to be damaged. With a digital imaging, Dr. Ricardo Castrellon, Medical Director of the Burn Center at South Miami Hospital, explains how he performs an elevation of eyebrows.

He states the procedure is a combination of skin resection and some type of implant or device that can cause a suture.

This procedure can help lifting in that area, he says. Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, says men are getting Botox because their muscles are more defined and sometimes they have an unhappy appearance, like a well-defined crease in the middle of their forehead and they use Botox to fix it.

Regarding laser hair removal, he explains people think it is permanent, but it is not, and you have to do it over several sessions. Nose reshaping, eyelid surgery, breast reduction, liposuction, and facelift are the five most common cosmetic surgeries for men.

Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, says men are demonstrating a more particular interest in looking more attractive to women, and with nose reshaping the goal is to enhance that male masculinity but correcting some deformities. Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, explains eyelid surgery is an option for excessive skin that makes you look older, and it is a simple procedure.

“We want to make sure the person does not have dry eyes, because if you take skin from around the eyes, you might end up with an exposed eye.” Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, explains dramatic weight loss refers to a significant weight loss that is more than 10 to 15% of your weight, but it is not a medical definition.

He points out you cannot have a dramatic weight loss in a healthy way unless it is monitored by a doctor. He says it is in preparation to have a bariatric surgery and it is a controlled weight lost program. He highlights patients that starve themselves or do fancy diets get their weight back again. Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, explains as people start gaining weight, they are going to get larger fat deposits into the abdominal area and the area of the breasts in a male. A female will also have fat deposits in the extremities, including in the arms, resulting in very large arms and stretching the skin.

He points out with weight loss, the patient’s excess skin in the abdomen will pass below the waist line and the genitals. Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, says patients that lose 100 to 150 pounds of weight have had a procedure. He points out it is not only about following a diet, but working out, physical exercise and well-managed nutrition.

He explains working out has to be something that you do gradually, you start walking and increasing your physical activity. He recommends having lifestyle modification in order to lose weight. Fractionated lasers will burn the surface almost like in a great stone pattern, explains Dr. Ricardo Castrellon, Medical Director of the Burn Center at South Miami Hospital.
Lasers also control how deep the burn is. This procedure should be done with sedation. However, fractionated lasers can be done in an office, he says.
Lasers will work on stimulating a pigment. The skin should be prepared before the patient undergoes this type of intervention as well, he advises. Using a model of a face, Dr. Ricardo Castrellon, Medical Director of the Burn Center at South Miami Hospital, affirms with age the soft tissue of the face, bone and skin are changing and they start to atrophy.
Eyebrow and eyelids are descending under the skin and accumulate, the doctor explains. He also says when the lines start descending, marionette’s line start to form around the mouth.
Around the eyes, bags also begin to appear. Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, explains plastic surgery for women is trying to accent their femininity (breasts, tummy tuck, and corrective changes after pregnancy or child delivery), but with men it is about maintaining masculinity by enhancing their masculine features, looking for muscular volume, enhancing the chin, and hair restoration.

He also says men are now also interested in skincare, and points out the most common procedure is liposuction. Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, says there are two types of injectables: one will be the fillers to enhance volume; and the other injectables are botox and muscular blockers that stop the movement of muscles in your face and that will help change the shape of your face or change the presence of wrinkles or lines.

He also explains you can change the shape of your brows depending on what muscles you block in the forehead and you can elevate the brows. At the beginning people are going to need procedures for smaller thing such as wrinkles in the forehead or other areas. Those things can be treated by easy procedures like botox, affirms Dr. Ricardo Castrellon, Medical Director of the Burn Center at South Miami Hospital.

He says when someone is younger, generally, he doesn’t need a surgical intervention for improving his face. Small things don’t need surgical intervention. They can be treated with a non-invasive intervention.

Fillers such as botox, injections, chemical peels and laser resurfacing are the most common facial rejuvenation treatments, the expert explains. Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, explains everyone carries a different genetic load. For example, Caucasian or Eastern European people were designed to be in cold weather and they tend to have a big tummy.

He also says the important thing is trying to achieve being healthy: “You want to decrease your cardio risk or diabetic risk, and find yourself in a situation with an appropriate weight.” Facial rejuvenation refers to non-surgical treatment and surgical treatments of the changes of the face, explains Dr. Ricardo Castrellon, Medical Director of the Burn Center at South Miami Hospital.
These changes include face bone during aging process, the texture of the skin, the discoloration of the skin as well as the volume of how the volume is distributed in people’s face, he describes.
The specialist says the most common thing physicians see is the rejuvenation of the eyelids. Wrinkles in the face are another common problem. Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, says there is radiofrequency and there are interventions with cooling devices for fat reduction in the waistline and the abdomen.

About the face, he explains they have the capacity of using kybella, which is a digestive enzyme that digests fat and the FDA has approved it for injections. Dr. Ricardo Castrellon, Medical Director of the Burn Center at South Miami Hospital says he sees a lot of younger people doing aesthetic procedures, especially in the area of the forehead, crow’s feet and eyes, especially in their 20s and mid-30s.
In cases of lip problems, the specialist affirms people start in the mid-20s.
Dr. Castrellon explains durability depending on the filler people are using. The absorber one, for example, will last from six months to a year. The American Society of Plastic Surgery has put out a warning about the risks of Brazilian butt lift due to a number of complications and deaths. Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, talks about the importance of having a board-certified surgeon. Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, says now with all the Marvel movies, men want to look muscular and like superheroes.

He points out men want to enhance the chest and make sure they have well-defined pectoral muscles, and about the expectations he highlights doctors can tell the patients there will be a lot of effort. Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, says if patients work out or do some exercise, sometimes they are able to get the lost volume replaced with increasing muscle.

He explains one of the most common things of weight loss that affects the patient’s functional status and lifestyle is the excess skin around the abdomen. With a surgery, all of the skin will be excised. Chemical peels are used through the patient’s face and depending on how thick, or how strong the acids are, they will go to different layers of the skin.
Dr. Ricardo Castrellon, Medical Director of the Burn Center at South Miami Hospital, explains there are several types of chemical skin peels: the lunchtime chemical peel, intermediate peels and deeper chemical peels which is phenol.
The experts says depending on what effect people want, they go deeper and they’ll be more of a typical chemical burn.
Chemical peels will rejuvenate the texture of the skin, he adds. Dr. Ricardo Castrellon, Director of South Miami Hospital’s Burn Center, explains the body will tend to have the preservation of the centripetal obesity and fat patterns into the belly and torso, which makes weight loss more difficult.

He also says centripetal obesity is associated with higher risk factors of cardiac arrest and diabetes. He points out obesity puts people at higher risks for other complications.

Videos

DISCLAIMER: The information and opinions expressed in the programs on this channel and website are intended to address specific questions asked or situations described in each particular program, are for educational purposes only, and are not designed to constitute advice or recommendations as to any disease, ailment, or physical condition. You should not act or rely upon any information contained in these programs without seeking the advice of your personal physician or a qualified medical provider. If you have any questions about the information or opinions expressed, please contact your doctor or other medical professional.