About Dr. Toots
Before Dr. Fernando P. Carlos decided to become a full-time cosmetic surgeon, he was a specialist of the ear, nose and throat (ENT). He has not regretted this shift in specialization since then, for he feels happy and satisfied seeing his patients equally exhilarated and pleased with the improvements in their looks.

Cosmetic surgery is very common today but it is sad that a lot of misunderstanding has been created about this profession. Much of the confusion could be traced to the mushrooming of the so-called “beauty-shops” all over Metro Manila which claim to provide all types of beauty enhancement services but whose personnel lack the necessary qualifications and training.

Cosmetic surgery, according to Dr. Carlos, covers aesthetic surgery, which includes noselift, eyebag removal, facelift, breast and butt augmentation, liposuction, and practically anything that has to deal with improving the looks of the human body. These surgeries can only be legally done by licensed and trained doctors, and never by anybody else.

“In cosmetic surgery and other operations, the surgical procedures are the same. The important thing about the cosmetic surgeon is the concern over the care of the skin and need for an aesthetic sense,” the doctor elaborates. “There are many cosmetic surgeons nowadays who know how to operate, but they still lack aesthetic sense.”

Cosmetic surgery is thus also an art. “It aims to beautify,” Dr. Carlos explains. “You have to look at the totality of the person. If you do a noselift, you must see that the nose conforms with the face. Thus, I would also recommend to the patient that, for her looks to be balanced, we may have to reduce or augment her chin, or whatever the case maybe.”

“The objective for any cosmetic surgery is that it should always look natural, not fake.  And they should be happy with the results,” he stresses.  “In cosmetic surgery, your advertisement is your patient.  If you operate successfully on one, three will come back.”

Dubbed as the Flying Doctor by his patients, Dr. Carlos goes around the Philippines to do his operations  -- Tacloban, Naga, General Santos, Cebu, Cavite and Laguna, aside from Manila. “My patients from the provinces usually call me up to inform me that they have relatives or friends who want to be operated on but cannot afford to travel to Manila for this,” he says. “So I tell them that I’ll be the one to go to them.”

Of the various services in cosmetic surgery, noselifts are the most in-demand. “You know Filipinos,” he adds. “But even in other Asian countries, the bread and butter in cosmetic surgery is noselift.”

After noselift, the removal of eyebags and the acquisition of deep-set eyes are popular. “Before, we have always patterned beauty based on Western models, with their aquiline nose and deep-set eyes.  We want to look westernized,” he reveals. “However, with the popularity of the F4, Chinese-looks suddenly became the in-thing and deep-set eyes are no longer in vogue.”

Among the older persons, other popular cosmetic procedures include facelifts, bust lifts or augmentation, and liposuction, Dr. Carlos says.  Most of his surgical operations are done at his clinic, while those requiring general anesthesia, such as liposuction and bust lifts, are done at the hospital.

Prudence must be exercised when using the various materials for implants.  For Dr. Carlos, the use of silicon gel has proven to be effective and safe.  Previously, silicon gel was suspected to cause cancer.  So much so that there was a shift to other products such as saline injection (salt and water), which proved to be ineffective in attaining the desired results.

By then, extensive research has subsequently proven that the use of silicon was not cancer causing and that it was suspected that the cases of breast cancer among those who had silicon implants were pre-existing. “When it was proven that the causes of cancer did not come from the implants, we started using it again.”, he says. “This is the only one that I use now.”

Other materials used in implants, which the doctor discourages, include the following:

Hydrogel implant, which was introduced in the mid-‘90s, is a plastic material that swells in water. Although no definite health risk has been identified and there is no information to indicate that there is any risk to women or their children with these implants, this was recalled in the year 2000 purely as a precautionary measure, until the manufacturers have addressed their biological safety assessments.

Soya oil breast implants, also introduced in the ‘90s, leak and cause reactions in scores of women. They were withdrawn from the market in 1999 amidst safety fears.  This breast augmentation technique was never approved in the U.S. because it was found to contain fillers that could become toxic in the body as it breaks down.

Saline-filled implants are sacs (implant shell) of silicone, a rubber-like susbstance, that is surgically implanted under chest tissue.  The sac is inflated with a saline (salt-water) solution through a valve.  The implants can break without immediate symptoms and should be removed or reoperated for pain or breakage.

Paraffin injection was the first surgical breast augmentation procedure introduced in 1890.  This breast augmentation can cause infections, hardening of the breasts and lump formations in the breast.  By 1920, this paraffin injection technique was totally abandoned.
In the late 1980’s, the gel was found to migrate out of the sac and into the body, raising safety concerns.

Dr. Carlos has had long years of training under Dr. Corazon Collantes-Jose.  He still assists Dr. Jose to learn more from self-invented techniques.