Use these informative and advice-filled articles to help you learn more about plastic surgery and to held you decide what procedures may be of interest to you.
[wpspoiler name=”Breast Implant Safety Website” ]
04/29/2005 – Breast Implant Safety Website
The American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery are pleased to announce the launch of a new objective, medically grounded web site www.breastimplantsafety.org – the most authoritative internet resource about breast implants.[/wpspoiler]
[wpspoiler name=”Plastic Surgery Societies Applaud FDA Panel Recommendation that Mentor’s Silicone Breast Implants be Approved with Conditions” ]
04/18/2005 – Plastic Surgery Societies Applaud FDA Panel Recommendation that Mentor’s Silicone Breast Implants be Approved with Conditions
The FDA advisory panel voted to recommend to the FDA that Mentor’s silicone breast implants be approved with conditions is applauded by the American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS), the two largest plastic surgery membership organizations. This recommendation comes 13 years after the FDA restricted access to the siliconeimplants because of safety concerns.
“We are pleased that the panel based its decision on scientific evidence, not on special interests, emotion or anecdotes,” said James Wells, M.D., ASPS past president. “The comments by Josh Levine, Mentor’s CEO, during his summationconfirm Mentor’s long-term commitment to safety. This should go a long way to assure the FDA and the public that the panel’s recommendation is prudent and sound.”
ASPS and ASAPS are optimistic that the FDA will follow the panel’s recommendation. “By doing so, Mentor can move forward to reintroduce silicone implants as an option for American women. Organized plastic surgery is enthusiastic about working with the manufacturer to ensure women’s health and safety,” said ASAPS President-Elect Mark Jewell, M.D. “Plastic surgeons are committed to help women make informed choices abouth their health care based on all the available and accurate information about these devices.”
Both societies are prepared to work with the FDA and Mentor to fulfill the conditions which include physician education, patient education, a registry, and a commitment from the manufacturers for continued data collection. Prior to the decision, ASPS and ASAPS have taken a leadership role in physician education, patient informed consent, and development of a registry.
The two societies believe continued data collection and study of the procedure and device are essential, and they are committed to being active participants in post-market monitoring of the implants.
An increasing number of women are choosing breast augmentation to ehance their appearance. According to ASAPS, nearly 335,000 women chose breast augmentation in 2004. More than 62,000 women had breast reconstruction in 2004, according to ASPS. Breast reconstruction has been proven in numerous studies to have many psychological and physical benefits for women who have undergone a mastectomy.[/wpspoiler]
[wpspoiler name=”Cosmetic Surgery Epidemic Not Found Amoung Young Adults” ]
03/07/2005 – Cosmetic Surgery Epidemic Not Found Amoung Young Adults
Many parents worry about the potential influence the media may have on their children’s self-esteem and body image. Stories about young women having excessive plastic surgery are enough to keep any parent up at night. However, according to a study published in the March issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS), only 5% of college-age women have actually had cosmetic surgery. Despite the low percentage of young women who cosmetic procedures, many of the students had a favorable attitude toward cosmetic surgery.
“There is a common belief amoung the public that a large percentage of young adults and teens are having cosmetic surgery,” said ASPS President Scott Spear, M.D. “This study shows that, while many college-age women see cosmetic surgery as an acceptable thing to do, many have not had a procedure.”
The study surveyed 559 college-age women – ages 17 to 24, at six universities. Amoung the 5% of females studied who had cosmetic surgery, chemical peel was the most common procedure, followed by breast augmentation, nasal reshaping and breast reduction.
“The study found the more a young woman cares abouth her physical appearance, the more likely she will view cosmetic surgery positively,” said David Sarwer, Ph.D., Associate Professor at the Center for Human Appearance, University of Pennsylvania, and lead author of study.
More than 60% of the study participants said they could envision having at least one procedure in their lifetime. More than two-thirds of the women reported knowing someone aho had cosmetic surgery and approximately one-third indicated that a family member had undergone surgery.
Despite concerns about young poeple’s motivations for having cosmetic surgery, the study revealed that only 2.5% of those studied screened positive for body dysmorphic disorder (BDD), or a preoccupation with a slight or imagined defect in appearance. This rate is consistent with the predicted rate of the disorder amoung the general population.[/wpspoiler]
[wpspoiler name=”Most Men View Cosmetic Surgery Positively” ]
03/07/2005 – Most Men View Cosmetic Surgery Positively
Almost three-quarters of men have a positive attitude toward cosmetic surgery, according to a recent American Society of Plastic Surgeon’s (ASPS) online survey. Of the 1,065 men polled, 74% said they approve of cosmetic surgery for themselves or others, while only 11% disapproved and 15% were undecided.
The cosmetic plastic surgery population has soarded since ASPS began tracking procedural statistics in 1992. More than 7.4 million procedures were performed in 2003, of which men made up 14%.
More than 311,000 men had cosmetic surgical procedures in 2003, up 14% from 2002, according to ASPS statistics. The total number of men having minimally-invasive cosmetic procedures in 2003 (including Botox injections, chemical peels, laser hair removal and micro-dermabrasion) was more than 922,000, up 51% from 2002.
“As the numbers suggest, most men consider plastic surgery as a reasonable option today,” said ASPS President Scott Spear, M.D. “Taking care of yourself and paying attention to physical appearance is increasingly important to men. Helped along by popular television shows and stories in the media , cosmetic surgery is definitely becoming more mainstream for men.”
In the ASPS survey, a quarter of respondents said that if they were to have a cosmetic surgical porcedure, they would choose liposuction. 22% named laser hair removal as the procedure that would interest them most, and nearly 12% opted for nasal reshaping.
When asked what would be their biggest obstacle to having cosmetic surgery, 57% of the respodents cited cost. Other responses included concern about what others would think (13%), fear of surgery (12%), and lack of knowledge about cosmetic surgery (10%).[/wpspoiler]
[wpspoiler name=”Winter Hibernation Could Sabotage Liposuction Results” ]
02/11/2005 – Winter Hibernation Could Sabotage Liposuction Results
Although liposuction is mistakenly viewed by some as a “quick fix” for weight loss, liposuction patients are 3 times more likely to gain weight without adhering to a proper diet and 4 times more likely to gain weight without regular exercise says a study published in the December issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASAP). Patients who do not follow a healthy lifestyle after liposuction may be considerably less happy with their results, the study also found.
“If patients want positive long-term results from liposuction, they have to be willing to eat a proper diet and exercise. Ultimately, it’s a lifestyle choice,” said Rod Rohrich, M.D., ASAP past president and author of the study. “This is especially important to remember as we approach the holiday season when poeple are invited to more parties and social activities where diet and exercise may be overlooked.”
According to the study, patients play a considerable role in the long-term success of their liposuction results. Not only are patients who have poor eating and exercise habits more likely to gain weight after liposuction, those who do gain weight have a 62 percent chance of an increase in clothing size, causing them to be 10 times more likely to be disatisfied with their results – compared to patients who eat a healthy diet and exercise.
In contrary, patients who adhere to a proper diet after liposuction are two times more likely to lose weight. These patients have a 96 percent chance of a decrease in clothing size, causing them to be 15 times more likely to be satisfied with their results and have improved long-term outcomes, the study concludes.
“Liposuciton should be used as an adjunct to living a healthy lifstyle rather than as a weight loss tool,” said Dr. Rohrich. “My practice turns away approximately one in five patients requesting liposuction because they are not appropriate candidates – many are 50 to 70 pounds overweighht. Patients need to understand that they are responsible for the long-term results of their liposuction by adopting and continuing a healthy lifestyle.”
In the study, which surveyed more than 200 patients, 43 percent gained weight after having liposuction, with the majority gaining weight after six months; 25 percent lost weight; while 32 percent experienced no change in weight.
Liposuction is the second most popular cosmetic plastic surgery procedure in the United States. More than 320,000 people had the procedure in 2003, up 13 percent since 2002, according tho the ASPS.[/wpspoiler]
[wpspoiler name=”Physician Credentials” ]
12/21/2004 – Physician Credentials
National attention to issues of patient safety will result, in some states, in more stringent requirements for physician credentials to perform cosmetic surgery. The American Society for Asethetic Plastic Surgery (ASAPS) will be among the leaders of this patient safety movement in 2005.[/wpspoiler]
[wpspoiler name=”Breast Contouring Using Short Scar Techniques” ]
01/26/2004 – Breast Contouring Using Short Scar Techniques
The vertical reduction mammoplasty is part of a growing trend to use shorter incisions in surgical techniques that to reduce, lift, or to correct asymmetry in the breasts.
The inverted T has been the standard procedure for the last 40 years. This procedure produces a periareolar scar with a vertical and a horizontal component, with the horizontal scar being primarily in the inframammary fold. The horizontal scar can extend quite far laterally and can even meet the opposite side in the midline.
Advantages of this procedure include its relative safety to the nipple and other breast tissue. The procedure can be performed with few complications, and is fairly easy to learn. The disadvantages primarily have been with regard to a long, sometimes quite visible scar. The scar has a tendency to be become either hypertrophic or keloid and has been a major source of patient dissatisfaction with the inverted T procedure.
Vertical Reduction Mammoplasty
The most widely used new technique for breast reduction called vertical reduction mammoplasty, which leaves a ‘lollipop’ shaped incision. The incision is made around the areola and includes a vertical incision that extends to the inframammary fold. Skin is removed around the areola and in the vertical segment, but there is no horizontal scar in the fold. The vertical reduction mammoplasty technique relies on the inherent ability of the skin to shrink down and reshape itself after the glands have been reduced or lifted.
The ideal candidates for the vertical technique are those without striae and with firm glandular tissue as opposed to fat. The patients need to be advised that it takes a little longer for the final breast shape to evolve and occasional revisions are necessary if there’s excess skin at the bottom of the vertical lift, but these are oftentimes able to be done in the office under local anesthesia. The revision rate should be less than ten percent.
Older patients who do not have a considerable number of striae of the skin can still be treated with the vertical technique. As surgeons have gained more experience with the vertical technique it’s being used for larger and larger reduction mammoplasty. Contraindications for using this short scar technique include patients with excessive ptosis and patients with very thin striated skin.
Plastic surgeons in the United States have been slower to adapt the shorter scar techniques, which in large part have been developed in Europe and Brazil. Part of that is due to the fact that surgeons in America have been very comfortable using the inverted T for so many years and perhaps the fact that American surgeons have a higher percentage of Caucasian patients who tend to form better scars.
In general, patients will accept scars if they have good breast shape, but what surgeons have found they can produce a similar or even better shape with the vertical technique for shorter scars. There are some clear advantages to try and reduce scars in aesthetic breast surgery and there is a major movement at the present time towards those techniques in selected patients.
Other Short Scar Procedures
Another procedure that produces minimal scaring is liposuction of the breast, with or without the use of ultrasound. This procedure produces a single quarter inch-incision scar. That would be for the patient who has good breast shape but just may want a relatively minor reduction in volume. The best candidates for this procedure are those with good skin that hasn’t been stretched out and patients with high fat content in their breasts.
The next shortest incision would be the periareolar incision. This procedure works well for small to moderate breast lifts, and generally reductions less than about 300 or 400 grams. Excess skin can be removed as well as the breast gland in the case of a reduction. In the case of a lift, the underlying glands would be reshaped, and all these techniques are designed to preserve sensation in the nipples. [/wpspoiler]
[wpspoiler name=”Sport a New Summer Look” ]
06/15/2003 – Sport a New Summer Look
Spring is the most popular time of year for many patients to consider body contouring. Diet and exercise can go a long way toward getting in shape. However, no amount of time in the gym can completely eliminate those unsightly bulges that result from hormones and genetics rather than too much wintertime feasting! And for women who want to look better in their clothing, especially swimsuits, breast augmentation can help improve overall body proportion.
Contrary to popular belief, current data on liposuction safety has shown that serious complications are extremely rare when a properly trained surgical specialist who adheres to accepted standards of clinical practice performs the procedure. The following guidelines can help you make a decision:
Be realistic about expectations. Liposuction is not a cure for obesity. It is best suited for the removal of localized fat deposits for individuals who are within 30 percent of their ideal body weight and have good skin tone.
Select a qualified plastic surgeon. Many state laws permit any licensed physician to be called a “plastic” or “cosmetic” surgeon-even if the doctor has had no surgical training. For this reason, it is important that you chose a plastic surgeon that is certified by the American Board of Plastic Surgery. Make sure the surgeon has hospital privileges to perform liposuction in an accredited acute care hospital like HealthSouth.
Discuss the procedure thoroughly with your surgeon. Make sure he has your accurate medical history. You will also want to know which technique he will be using (superwet, tumescent or ultrasonic). Some patients and surgeons prefer local anesthesia for more limited body contouring, however, many patients choose to remain asleep throughout the procedure. A board-certified anesthesiologist or certified registered nurse anesthetist should administer general anesthesia.
Today, advancements in breast augmentation have made it a safe choice for women who want to enhance their appearance. The Institute of Medicine has concluded that there is “no definitive evidence linking breast implants to cancer, immunological diseases, neurological problems, or other systemic diseases” (6-2-99). Interestingly, two major studies have also shown that women with breast implants have a lower-than-expected rate of breast cancer.
Breast augmentation using saline-filled breast implants has been associated with a very high rate of patient satisfaction. With this new option, the number of breast augmentations has risen each year since 1997. The procedure can be performed on an outpatient basis and involves a small incision, which can be made underneath the breast, around the areola or in the underarm area. All options can give excellent results.
The combination of liposuction and breast augmentation can result in a spectacular new look for the summer-and a lifetime.[/wpspoiler]
[wpspoiler name=”Body Contouring” ]
05/30/2003 – Body Contouring
Today’s advanced body contouring techniques enable plastic surgeons to safely and effectively help patients achieve more aesthetically pleasing figures. One of the primary techniques used today is liposuction. Basically, this technique involves inserting a cannula (a tube-like instrument) through small surgical holes or ports in the skin and removing fat by suction.
Liposuction is not a substitute for weight maintenance, a healthy diet, and regular exercise. It is merely a surgical procedure that can be used to remove troublesome fat deposits — such as “love handles” or “saddle bags” — that no amount of dieting or exercise can effectively eliminate. To enjoy the full benefits of liposuction, an ongoing healthy diet and regular exercise are essential.
Early liposuction was performed with what is called the dry technique. In the late 1980s two closely related techniques, tumescent and wet, were found to be safer and more effective in most cases. In both techniques, a diluted fluid containing epinephrine and lidocaine is pumped into the area where fat deposits will be removed. The diluted fluid expands the tissue and the epinephrine and lidocaine help minimize tissue trauma, blood loss, and fluid shifts. The primary difference between the two techniques is the amount of fluid used. These improved liposuction techniques are more effective, safer, and provide the patient a faster recovery.
Internal and external ultrasound also are being effectively used in liposuction procedures. With internal ultrasound, surgical ports are created, fluid is pumped into the area, the cannula is inserted and ultrasonic sound waves are emitted from its tip. With external ultrasound, surgical ports are created, fluid is infiltrated, and ultrasonic sound waves are emitted from the outside, prior to insertion of the cannula. Both internal and external techniques rely on ultrasonic sound to rupture the fats cells making it easier to remove the fat cells through suction.
If we look at the options with abdominal contouring, liposuction is at one end and at the other is abdominoplasty. Abdominoplasty is a surgical procedure that removes redundant skin and may include tightening the abdominal muscles which make up part of the strong part of the abdominal wall.
With age or after childbearing, a woman’s abdominal wall may become loose or lax. In a mini-abdominoplasty, an incision is made in the bikini line and redundant skin is removed — usually beneath the belly button. In a more formal abdominoplasty, the incision is longer, usually extending along the shape of a French-cut bikini. Redundant skin below the belly button is removed, the abdominal wall is tightened, and, because more skin has been removed, the belly button must be dissected and reintroduced to create a natural appearance.
[wpspoiler name=”Breast Lifts” ]
05/26/2003 – Breast Lifts
Pregnancy and breast-feeding can significantly affect the shape and overall appearance of a woman’s breasts. During pregnancy and breast-feeding, the breasts enlarge and the skin of the breasts stretches. After pregnancy, breasts that once were round and set high on the chest may appear tubular and elongated, with the nipples pointing down instead of out. This condition, which is called breast ptosis, is a natural part of the aging process but is accelerated by pregnancy. It can also occur developmentally. Some women because of genetic factors may experience breast ptosis as early as 18 or 20 years of age.
A saline-filled or gel filled-implant alone will not effectively correct breast ptosis. Effective treatment requires an aesthetic surgical procedure called a breast lift or mastopexy. Sometimes, depending on the amount of breast tissue atrophy, implants may be used in conjunction with a breast lift to give the breasts a more rounded, firmer, and youthful appearance.
In the past, the negative side of breast lifts has been the scars left from the incisions necessary to perform the procedure. Scars on the surface of the breast tend to fade and in some cases virtually disappear. Aesthetic surgeons also try to place the scars in locations that are easily concealed by a bra or swimsuit top. Still, visible scarring has always been the objectionable part of doing breast lift operations. Over the years, plastic surgeons have sought ways to create the lift effect and also minimize scarring. These efforts have been successful. Today some patients are candidates for what is called a minimal-scar breast lift procedure.
In a conventional breast lift, the plastic surgeon makes an incision at the bottom edge of the areola (the area of darker skin around the nipple) and continues that incision beneath the breast and across the fold located where the breast meets the chest wall. This procedure results in a scar shaped like an upside down T on the bottom of the breast. The minimal scarring technique eliminates the upside-down T-incision and thus the resulting scar.
With the minimal-scarring technique, an incision is made right at the edge of the nipple/areola complex, known as a “periareolar incision”. The resulting scar is extremely inconspicuous because it is located in the zone of transition between the darker pigmented areola and the lighter pigmented skin of the breast. If the scars are visible after approximately one year, the patient can choose to have them tattooed by the plastic surgeon to match the color of the areola, making them virtually undetectable.
There are two techniques for actually lifting the breast. Depending on the patient, the plastic surgeon may use either one or a combination of both techniques. One technique involves using special suspension sutures in the gland of the breast to lift and support it. The other technique, sometimes called the internal bra procedure, involves lifting the breast gland into a higher, tighter position with internal stitches and then placing an absorbable mesh-like material around the gland of the breast for support. The mesh material cannot be seen or felt beneath the skin surface, and it does not interfere with mammography. This mesh-like material holds the breast in the desired shape while it heals. As the mesh-like material is absorbed, the body replaces it with collagen and scar tissue that maintain the long-term shape of the breast.
Minimal-scar breast lifts can be performed as an outpatient procedure. The surgery requires approximately four hours. Most women can expect to need a about a week away from work. Recovery for all but sports activities is usually about three weeks. Within four to six weeks, most patients can return to full sports activities.[/wpspoiler]
[wpspoiler name=”Breast Reduction and Breast Augmentation” ]
04/26/2003 – Breast Reduction and Breast Augmentation
Most women seeking breast reduction are referred by their family doctor, gynecologist, or even their chiropractor. These women have had chronic back pain and general discomfort because of their exceptionally large breasts. Oftentimes they have been using medications in an effort to relieve their pain.
A breast reduction is usually a relatively safe outpatient or overnight procedure. It reduces the size of the breasts and lifts them up on the chest. Women in their childbearing years are often concerned that breast reduction will interfere with their ability to breast-feed. Breast reduction will not mechanically interfere if they already have the ability to breast-feed. In other words, not every woman naturally possesses the ability to breast-feed.
Recuperation from the surgery usually takes a couple of weeks. Many patients feel comfortable enough to return to work while they are still recuperating. If, however, the patient has a very physically demanding job, then the recuperation period is usually a little longer.
The procedure does leave the patient with visible scars. Some of the scars are hidden in the folds beneath the breast. The latest technology and techniques are used so as to minimize the length and breadth of all scars. There is also a possibility of some numbness, but only a small percentage of women experience it.
Because it relieves back pain, many insurance companies cover the expense of breast reduction surgery. For many women, breast reduction improves their quality of life. It relieves their back pain, relieves the need for pain medication, and enables them to dress in styles and fashions in which they never before felt comfortable or attractive.
Breast augmentation is the exact opposite of a breast reduction. With augmentation the physician lifts and enlarges the breast using either saline filled or silicone-gel filled implants. The procedure can be performed in a surgery center or hospital. Although considered a relatively safe and simple procedure, as with any surgical procedure there is a degree of risk involved with breast augmentation. Potential risks include deflation of the implant (10 percent chance over 10 years), hardening due to surrounding scar tissue, bleeding, or infection. All of these complications are uncommon.
Regarding implants, both saline-filled and silicone gel-filled are safe and effective ways of augmenting the breast. Saline-filled implants offer the advantage of being totally absorbable if the implant leaks. However, visible wrinkling or rippling is a little more common with saline-filled implants than with silicone gel-filled implants. Also, silicone gel-filled implants feel a little more like breast tissue than saline-filled implants. The American Society of Plastic Surgeons has invested over $5 million to find the answers regarding the safety and effectiveness of silicone implants, and the studies are ongoing. At this time, we can say that silicone-filled implants are not causing disease, that the silicone is not transmitted in breast milk, and that any effects of silicone breast implants are confined to the breasts.
Both saline-filled and silicone-filled implants are man-made objects and cannot be expected to last forever. Even though there are patients who have had the same implants for 29 years, as a patient you should be aware that the risk of deflation is 10 percent over a 10-year period. In time, you may need another procedure to replace your implants.[/wpspoiler]
[wpspoiler name=”Reconstructive Surgery After Breast Cancer” ]
03/26/2003 – Reconstructive Surgery After Breast Cancer
Cancer — any cancer — affects not only the patient but also the patient’s family and everyone who loves the patient. The diagnosis of breast cancer can be particularly devastating for most women.
Our society attaches so much to the female breast form. It is a source of love and nurturing, and certainly a source of sexuality in our culture. Breast reconstruction is one of the options that can enable a woman to live a satisfying, rich life after a breast removal.
A patient may choose to have her reconstruction done at the time of the mastectomy, or it can be delayed. The delay can be several months, a year, or even longer.
There can be some advantages to doing reconstruction immediately. The tissues are soft and pliable immediately following the mastectomy, so the surgeon does not have to recreate the natural droop of the breast because the original skin is there. There are also emotional advantages to performing reconstruction immediately. The patient does not have to go through the mourning of a lost breast.
There are also advantages to postponing reconstruction. The patient may want to simply concentrate on recuperating from her surgery and dealing with the possible chemotherapy and/or radiation treatment her medical treatment plan may include. By postponing her breast reconstruction, it may free her mind from having to deal with any other surgery and recuperation concerns. In short, she simply may not be mentally prepared for additional medical procedures.
Not every woman is a candidate for reconstructive surgery. For example, patients in poor health cannot tolerate the hours under anesthesia required for breast reconstruction. However, for suitable candidates there are three options for breast reconstruction. The physician can use muscles and tissues from the patient’s own body. These tissues may come from the abdomen, back, and sometimes in extreme cases the buttock area. The tissues are moved up onto the chest wall and molded to recreate the shape of a breast. Implants that are saline-filled or silicone-gel filled may be used to replace lost tissue. There can also be a combination of the muscle flap and a filler implant used to create the necessary volume. The physician will discuss all these options with the patient. Together they decide which option will be best for her both physiologically and emotionally. When doing reconstruction, the physician also looks at the other breast. On occasion we may alter it, make it larger or smaller, so as to create a more symmetrical match.
Recovery from reconstructive breast surgery is usually four to eight weeks. If a woman had a mastectomy even 15 or 20 years ago, reconstructive surgery is still possible, depending on her state of health.
Over the past several years, legislation has been passed, first state-by-state and now through a national bill, that requires insurance companies to cover the cost of reconstructive breast surgery.[/wpspoiler]