Coastal Empire Plastic Surgery Blog

Migraine Surgery Slow to Catch on Among Plastic Surgeons

February 29th, 2012

A simple plastic surgery procedure can help some patients with migraine headaches.

But so far, relatively few U.S. plastic surgeons are performing migraine surgery, reports a study in the March issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons.

Plastic surgeons are aware of studies showing the effectiveness of migraine surgery, and at least some are interested in performing the procedure. However, they still perceive “significant barriers” to the increased use of surgical treatment for migraine, according to the study by Dr. Theodore A. Kung and colleagues of University of Michigan, Ann Arbor.

Research About Migraine Surgery

The researchers surveyed nearly 3,500 ASPS members regarding their knowledge, attitudes and experience related to migraine surgery.

Recent studies have shown good results with a simple surgical procedure for migraine patients who don’t respond to initial treatments. The surgical techniques were developed by plastic surgeons who noticed that some migraine patients had fewer headaches after undergoing cosmetic forehead-lift procedures.

Questionnaire responses from nearly 200 plastic surgeons were analyzed. Of these, just 18 percent had performed surgery for the treatment of migraine. Of those who did, more than 80 percent said the surgery improved the patients’ migraine symptoms.

Most plastic surgeons were at least “somewhat familiar” with studies reporting on the effectiveness of migraine surgery. Sixty percent said they would be interested in offering migraine surgery if an appropriate patient were referred to them by a board certified neurologist.

Many of the surgeons surveyed felt they weren’t familiar enough with the technique of migraine surgery-or with migraine in general-to perform the procedure. Most were unaware that migraine surgery is covered by some major health insurers, including Medicare.

Barriers to Wider Acceptance of the Treatment

Migraine is a common problem that interferes with many aspects of daily life for millions of Americans. New surgical techniques have the potential to reduce or eliminate migraine attacks for many patients who do not respond to medications or other current treatments.

Previous studies have reported good results one to five years following migraine surgery. The study has some important limitations-especially the very low survey response rate (about five percent). However, the results suggest that at least some U.S. plastic surgeons are performing migraine surgery and achieving good results for their patients.

Many others are aware of research showing the effectiveness of migraine surgery, and would be willing to perform it if perceived obstacles to the procedure could be overcome.

“Increased referral of suitable patients by neurologists and improved familiarity with the concept and techniques of migraine surgery may motivate more plastic surgeons to perform migraine surgery,” Dr. Kung and coauthors write. They also call for “appropriately designed clinical trials” to confirm the benefits of migraine surgery.

New Breast Implant Monitoring Technology a Possibility

February 23rd, 2012

Ultrasound System Might Save Time and Money

Monitoring your breast implants can be costly and inconvenient, but that may all change with the advent of new monitoring procedures that could make the process far more efficient.

The Aesthetic Surgery Journal, partially funded by the American Society for Aesthetic Plastic Surgery (ASAPS), has released a study that explores the potential use of new portable, high-resolution ultrasound imaging technology to monitor the status of silicone breast implants. The report’s lead author, Bradley Bengston, MD, found that, “portable, surgeon-performed, high-resolution ultrasound is feasible for screening silicone gel breast implants, matching the capabilities of MRI in detecting shell failure.”

Keeping a close eye on the integrity of silicone gel breast implants is an important breast augmentation maintenance, because unlike saline-filled breast implants, silicone gel implant failure is not as noticeable, and the implant may even maintain its shape after springing a leak.

Currently, magnetic resonance imaging (MRI) is the primary method of assessing the integrity of silicone implants. However, MRIs are costly, impractical, and can take time to book an appointment for a scan. This new ultrasound technology would offer comparable results to the MRI, but would be less expensive to use, and could be done in a doctor’s office.

According to Felmon Eaves, Clinical Professor at the University of North Carolina at Chapel Hill and co-author of this study, the technology could be used for more than just implant screening.

“This office-based technology may also have broader applications, such as hand and facial fracture identification and treatment, vein surgery and ablation, visualization prior to shaped implant rotation, identification and management of seroma, and general breast evaluation,” said Eaves.

The study is still ongoing, and will focus on calibrating the sensitivity of the technology, as well as ways to improve breast implant designs.

Figures Looking Good for Plastic Surgery

February 23rd, 2012

13.8 Million Procedures in 2011

The economy is on a slow-but-steady rise, and consumer confidence starting to return. As a result, cosmetic procedures have enjoyed their second year of growth in a row.

According to a report issued by the American Plastic Surgery Society, surgeons across the country performed 13.8 million procedures in 2011. This is a 5 percent increase from 2010, which itself was a year of growth.

“Consumer confidence was up, auto sales rose 10 percent, so it is not surprising that we would also see increased demand for plastic surgery procedures,” said ASPS President Malcolm Z. Roth.

The report by the ASPS breaks down the numbers further, providing insight into prevalent trends in the industry.

“We are seeing notable increases in surgical procedures, such as facelifts, that reflect the demands of an aging boomer population,” said Dr. Roth. Chin augmentation, a popular procedure among men, nearly doubled, and lip augmentations went up by nearly 50 percent. However, the real action is in minimally-invasive procedures, such as laser hair removals (up 15 percent) and microdermabrasion (up 9 percent), with the number of procedures in the millions.

While consumer confidence goes a long way, Dr. Roth credits a lot of hard work from the industry in part for the promising trend.

“While insurance coverage for breast reconstruction is mandated by law, continued strides to provide coverage for other reconstructive procedures has contributed, in part, to the sizable gain that we are seeing with these procedures.”

For more information, read this year’s study, as well as the 2010 and 2009 studies.

New Jersey Works to Repeal Tax on Cosmetic Plastic Surgery

February 7th, 2012

Good news if you live in New Jersey and are looking to get a little work done - the hotly-debated tax on cosmetic procedures signed into law in 2004 is going to be repealed.

New Jersey Gov. Chris Christie signed a bill to phase out the six percent tax on cosmetic procedures in three stages.

The tax will be reduced to four percent this year, down to two percent next July, and finally eliminated altogether by July 2014.

Initially conceived as a way to generate additional revenue for the state, the legislation has come under fire by the New Jersey Society of Plastic Surgeons (NJSPS) and the American Society of Plastic Surgeons (ASPS) for being counterintuitive and costing more money than it brings in.

The tax adds a little over $10 million a year in revenue, but that number falls far short of the numbers legislators expected to rake in.

Furthermore, the tax loses money by encouraging what Allergan CEO David Pyott calls “surgical flight.” Potential patients chose to travel to neighboring states for surgery to avoid taxes, and some practitioners followed suit and relocated their practices out of state. Independent reports found that between 2005 and 2008, for every dollar made from taxes, three were lost.

Surgeons Pleased with the Decision

The bill was almost rescinded in 2006, but then-Governor Jon Corzine vetoed the legislation. The president of the NJSPS, Dr. Chris Godek, is pleased that the tax is finally being abolished. “We’re happy to finally have erased a tax that was unfair on several different levels – including bias against women – and which caused major unforeseen problems, such as the flight of residents across state borders for procedures,” says Dr. Godek.

According to Plastic Surgery Portal, a procedure like breast augmentation costs an average of US $4000. At the current rate of six percent, an extra US $240 is added to that cost in NJ. Under this new legislation, that number will drop to US$160, and then US $80, before it is finally waved entirely. The bill also applies to dermatological and ophthalmological procedures, in a time of financial difficulty for many Americans.

Can Rhinoplasty Make You Look Younger? Study Investigates

January 30th, 2012

Rhinoplasty is a popular operation to reshape and redefine the nose, creating a more balanced facial profile. It’s not considered an anti-aging procedure, like a face lift or neck lift would be.

But a new study finds that people often look younger after rhinoplasty. Researchers at the University of Toronto found that patients looked 1.5 years younger after a nose job.

How the Study Worked

During the study, 50 people guessed the ages of 53 rhinoplasty patients in before-and-after photos. The patients ranged in age from 15 to 61, and about three-quarters were women.

Patients who had a hump reduced or removed saw the greatest anti-aging effect. Among these patients, the reduction in perceived age was 1.6 years younger after surgery, compared to 1.1 years for patients who did not have a hump prior to surgery. Those with a droopy tip also saw more of the age reduction benefit.

Whether a patient was older or younger at the time of surgery was less of a factor, the researchers reported.

“Older patients tended to enjoy a greater degree of rejuvenation,” the authors write. But the differences between age reduction in older vs. younger patients was not statistically significant.

Why Undergo Rhinoplasty?

Although rhinoplasty could provide anti-aging benefits, this is not a common reason to choose it. Nose surgery is usually performed to improve the proportions of the nose or to improve nasal breathing.

A variety of nasal characteristics can be changed. Surgery can reduce the size of the nose, remove humps, improve the nasal angle and more. Looking younger may be an additional bonus.

“I wouldn’t say that in terms of the findings of this study, it adds a major reason to go forward with the procedure,” said Dr. Ali Sepehr to Reuters Health, “It’s just a nice added benefit when somebody’s already going to get the procedure for another purpose.”

Read More

ASPS Chooses Partner for Plastic Surgery EMR

January 15th, 2012

The American Society of Plastic Surgeons recently announced a partnership with an EMR company called eClinicalWorks. A 3-year initiative stemming from partnership will give ASPS members a chance to obtain customized electronic medical record systems.

The partnership brings together the world’s largest group of plastic surgeons with a leading provider of healthcare technology. Strengths of both organizations, they hope, will advance the specialty of plastic surgery practices around the nation.

The ASPS has been at the forefront when it comes to delivering practice management solutions, especially in the realm of information technology. For example, the society has a journal with a new iPad application, endorsed companies for website design, and now a collaboration with an EMR provider.

“ASPS has a long history of innovation in providing our members with practice management solutions,” said ASPS President Malcolm Roth MD, “including emerging information technology tools. Through collaborations like this, we can help transform the delivery of healthcare throughout the specialty of plastic surgery…”

About the Partnership

“eClinicalWorks and ASPS share the vision and the entrepreneurial spirit that evolution demands,” said Sameer Bhat, co-founder and vice-president of sales for eClinicalWorks. “This partnership further strengthens our leadership with specialties.

We are excited to collaborate with this leading medical specialty society and are confident our proven track record of product innovation will meet the needs of plastic surgeons.”

Plastic surgeons will get access to a variety of eClinicalWorks systems, helping to facilitate tasks like:

  • Management of patient flow
  • Accessing patient records (in house or remotely)
  • ePrescribing
  • Secure communication with referring physicians
  • Secure communication with patients
  • Clinical and financial analysis

ASPS chose eClinicalWorks after an 18-month evaluation led by a taskforce of ASPS members. 111 plastic surgeons responded to an ASPS survey regarding Health Information Technology and Electronic Health Records (HIT/EHR). The survey found that plastic surgeon’s use of the technology was “lighter than expected.” The ASPS task force has encouraged more plastic surgeons to embrace EMR and its associated technology.

Surgeons who responded to the survey listed their 5 most valuable EMR functions.

  • Computerized physician order entry (CPOE)
  • Web-based system (cloud computing)
  • Patient web portal
  • Ability to check or advise on evaluation and management coding levels based on fields entered
  • Ability to use a tablet in the office.

Through the survey, ASPS was able to understand practice profiles as well as different EMR/PM vendors to assess software features and functionality. By choosing eClinical Works, the society says it will help members find a cost effective entrance into an electronic medical record system.

Documentary Explores the World of Modeling and Plastic Surgery

January 5th, 2012

The new film About Face by portrait photographer Timothy Greenfield-Sanders takes a peek behind the modeling industry and the quest to continue looking young.

Through candid interviews, the film documents the experiences of models from the 70s and 80s.

“The divergent attitudes among the women about everything from the business of modeling, to aging and plastic surgery, are fascinating and priceless. ”


An excerpt from the film trailer asks Carmen Dell’Orifice: “What is it about plastic surgery and facelifts – what is your sense of that whole world?”

She says “Well, if you had the ceiling falling down in your living room,would you not go an have a repair?”

About Face has several screenings at the 2012 Sundance Film Festival, January 19 – 29 in Park City, Utah.

French Government Calls for Removal of Defective Implants

January 2nd, 2012

Two years ago, reports of defective silicone breast implants manufactured by PIP (Poly Implant Prothèse) prompted authorities to halt production of the devices.

The breast implants are said to have a very high failure rate and a non-medical type of silicone gel. France is now encouraging women with these implants to have them removed, and they’ll pay for the removal if the implants were originally used for breast reconstruction.

PIP silicone gel-filled implants have never been approved for use in the United States. The only way an American patient would have these implants is if she had undergone breast surgery in another country.

ASPS Monitoring the Situation

The American Society of Plastic Surgeons (ASPS), working with the French Society of Plastic Reconstructive and Aesthetic Surgery, is monitoring the recent developments on PIP silicone gel breast implants.

The ASPS issued a statement to its members practicing outside the United States:

“We believe that while the current focus of attention is in France, approximately 80 percent of PIP implants were exported to other countries including the United Kingdom, Spain, Brazil, Argentina, Chile, Colombia and Venezuela. There are also reports that implants under the brand name “M,” distributed by a Dutch company in Germany – and possibly elsewhere in Europe – may also be PIP implants that were rebranded as “M” implants.”

According to Reuters, Italy is working with cosmetic surgery clinics to compile a list of women who received the implants. Meanwhile, officials in Brazil and Britain are urging women to check in with their surgeons.

Allergan Inc, American Breast Implant Maker Assures Quality of Their Implants

In response to the French situation, Allergan issued a lengthy press release to reassure surgeons and patients about the quality of their breast implants. Allergan’s products are marketed under the names Natrelle, McGhan and CUI. None of these implants are included in the French investigation.

“The health authorities are specifically concerned about breast implants made by the company called Poly Implant Prosthese (PIP),” states the Allergan Press Release. The release also describes the extensive checks that are in place to ensure quality of their implants. “Allergan maintains rigorous clinical development processes, extensive manufacturing and quality assurance testing, as well as an industry-leading post-marketing surveillance program, to ensure the highest quality and safety of its breast implants that patients and surgeons can rely on.”

AP Video: France Calls for Breast Implant Removal

This one-minute video from the Associated Press briefly explains the situation in France.

Transaxillary Breast Augmentation

December 20th, 2011

The transaxillary technique in breast augmentation uses an incision in the axilla. The axilla is the space beneath the shoulder through which vessels and nerves enter and leave the upper arm. It’s commonly known as the armpit.

If you’re considering breast enhancement, this technique may be appealing to you, since the incision (and scar) is placed in a remote location, away from the breast. That’s why some have called it a “scarless technique.” If the scar is visible, is not associated with your breast augmentation.

Implant Choices

The surgical incision is small. Space is also limited when passing the implant from the armpit to the breast. Therefore, only a saline breast implant can be used.

Before it is filled with saline, the shell of the implant is passed through the axilla to the breast pocket. Through a port in the implant shell, your surgeon fills the implant to a specified volume, while it’s inside the breast pocket.

Challenges of the Technique

One known challenge of the transaxillary technique is difficulty seeing the breast pocket and muscle tissue. Lacking direct access to the breast (such as with the inframammary technique), it becomes more challenging to control implant placement.

Plastic surgeons have addressed this challenge by using endoscopy, a minimally invasive surgery technique. Using an endoscope, equipped with a tiny camera, your surgeon will have a clear view of the breast pocket and pectoral muscle.

The majority of breast augmentation procedures still use the inframammary technique, which involves an incision in the breast crease. However, transaxillary breast augmentation is an accepted technique with rigorous studies evaluating its safety and effectiveness.

Ask your plastic surgeon if this technique is suitable for you and read more about the breast augmentation techniques used here in Savannah, GA.

In Spain, Beauty Industry Thrives in Tough Economy

December 14th, 2011

A segment from PRI’s The World comes from Spain, where the European debt crisis has impacted a variety of industries. But not the beauty industry, which seems to be thriving.

Why would healthy and beauty be growing, while other industries remain flat in the country?

Inexpensive Ego Boosts Are Popular

It could be that people simply need a boost. When unemployment is nearly 23 percent, “inexpensive ego-boosts go a long way” reports PRI’s Marco Werman.

Salon manager Patricia Marquez explains, “a person needs to feel handsome to feel comfortable with themselves, she says. “If they don’t look good it doesn’t matter what they do; you have to feel comfortable in your own skin.”

“The well-groomed will be well positioned when opportunity knocks.”

The Salon Index as Spain’s Economic Indicator on PRI’s The World Listen Here

One theory says that during an uncertain economy, women take refuge in beauty products, especially lipstick, according to Leonard Lauder, chairman of Estee Lauder.

In 2001, Lauder claimed that sales of lipstick go up whenever the economy goes down. During times of distress, women skip the clothes and shoes, finding satisfaction in simpler beauty enhancements like lipstick.

Analda Santano, who works at the busy Cinema Nails salon, agrees with Lauder’s theory. She explains that people want to be prepared when the economic crisis finally ends and jobs become available. “The well-groomed will be well positioned when opportunity knocks,” she said.

In America, A Similar, But More Expensive, Story

reports this week on a similar trend back home. “We might be cutting back on basics, but we’re pouring money into our looks,” writes Rebecca Dana, who offers some peculiar statistics about the cosmetic surgery industry:

Between 2009 and 2010, Americans spent 3.8 percent less on food, 2 percent less on housing, 1.4 percent less on clothes, and 7 percent less on entertainment. At the same time, we spent 1.3 percent more on breast augmentation, 5.1 percent more on lipo, 8.1 percent more on eyelid surgery, and a whopping 24.4 percent more on butt lifts.

In a recession economy, looking good appears to be a high priority for Americans and Europeans alike. Perhaps it is important to remember the multitude of other ways you can reinvent yourself during uncertain times. You can get an “inexpensive ego boost” from a class, a book, or a new venture.

Honing your skills as well as your looks will keep you competitive in the job market.

Call us at or contact us online to schedule your consultation today.