Coastal Empire Plastic Surgery Blog

Study Reveals Age-Related Changes in Facial Bones

January 13th, 2011

facial-implant-researchAlthough changes in your skin are the obvious answer to the appearance of aging, there may be a deeper underlying issue that is to blame. A new study in the January 2011 Plastic and Reconstructive Surgery journal says that the appearance of aging is not only caused by changes in the skin, but also stems from aging of facial bones.

Authors of the study, Dr. Robert Shaw, Jr. and others at the University of Rochester Medical Center, analyzed computed tomographic scans of the facial bones for three age groups: young (age 20 to 40); middle-aged (41 to 64); and older (65 and up). The scans of 20 women and 20 men were analyzed in each group.

Measurements revealed differences in the facial bone structure between age groups. “The facial skeleton experiences morphologic change and an overall decrease in volume with increasing age,” the researchers wrote.

The study found that the eye socket area became wider and longer in both men and women as they aged. Aging also caused reductions in bones in several areas of the face, including the brow, nose, upper jaw and lower jaw

Changes were observed in both men and women, but many occurred earlier in women — between the young and middle age groups. On the other hand, in men most of the changes occurred between middle age and old age.

The researchers believe that by using materials and techniques for skeletal augmentation, plastic and cosmetic surgeons can improve the outcomes of facial rejuvenation. “Skeletal augmentation offers a permanent rejuvenation of the facial skeleton and may be performed in conjunction with soft-tissue redraping,” according to the researchers.

In some cases, a possible solution to changes in bone structure, or existing deficiencies in facial bones, is facial implant surgery.

The pictures displayed in the study are very interesting. You can see more in the journal Plastic and Reconstructive Surgery.

How Common is Breast Asymmetry?

January 12th, 2011

Size discrepancy between the breasts is actually quite common. Most women exhibit at least some minor asymmetry, while others have as much as a cup size difference or more. In severe cases, a woman may experience difficulty finding the right bra and may be very embarrassed by her condition.

A new study in the European Journal of Plastic Surgery explains the details of over 300 breast augmentation patients and the prevalence of breast and chest asymmetry among that group.

The author, Umar Daraz Khan, found that breasts were symmetrical in only 53.5% of the cases, and the left breast was more often larger than the right breast.  Because the asymmetry often stems from a chest wall deformity, the author measured for that as well, finding “thoracic deformities or asymmetries” in over 8% of the patients. Of the 312 breast augmentation patients treated, the doctor used different sized breast implants in 9% of them.

Read more about breast surgery at Coastal Empire Plastic Surgery

Read the study abstract via

Obese Patients Receive Equal Treatment in Breast Reconstruction

January 10th, 2011

A recent study presented at Plastic Surgery 2010 examined whether physician biases affected the treatment received by obese patients undergoing breast reconstruction.

In this video, Anita Kulkarni M.D. of the University of Michigan Department of Surgery, section of plastic surgery, explains the study, “Patterns of Use and Surgical Outcomes of Breast Reconstruction Among Obese Patients: Results from a Population Based Study.”

She explains that, for certain outcomes like “clothing fit and sexual attractiveness,” obese patients in the study were actually more satisfied with their treatment than normal weight patients. “ASPS (American Society of Plastic Surgeons) members are providing excellent care to this sometimes difficult patient population,” she says.

16th Century Book Describes Early Rhinoplasty Surgery

January 3rd, 2011

bookA rare book published in 1597 describes the rhinoplasty technique of Gaspare Tagliacozzi, a professor of surgery at the University of Bologna. According to the UK Telegraph, the book was recently purchased by a plastic surgeon at auction for 11,000 British pounds (about 17,000 U.S. dollars).

Inside the book, De Curtorum Chirurgia Per Insitionem, you can read about (in Latin) and view illustrations of the earliest rhinoplasty techniques. The doctor would reconstruct the nose by attaching a tissue flap from the patient’s arm. He also had methods for surgical reconstruction of the ears and lips. Tagliacozzi’s techniques were typically employed for treating war injuries.

A frequently cited quotation of Tagliacozzi:

“We bring back, refashion and restore to wholeness the features that nature gave but chance destroyed, not that they may be an advantage to the living soul, not as a mean artifice but as an alleviation of illness, not as becomes charlatans but as becomes good physicians and followers of the great Hippocrates. For though the original beauty is indeed restored . . . the end for which the physician is working is that the features should fulfill their offices according to nature’s decree.”

If you missed the auction or if you’re one of the losing bidders, here’s some consolation: there are 3 new translated versions of the book (Surgery of Defects by Implantations) available through the online bookseller .

How Breast Augmentation Patients Differ By Geography

December 23rd, 2010

breast-augment-georgiaDo women in different geographical areas have different needs or goals for breast augmentation? They might, according to a study in the Winter 2010 issue of the Canadian Journal of Plastic Surgery, which explores the “physical characteristics and implant details” of breast augmentation patients in different locations.

Breast augmentation cases from Texas, British Columbia and California were assessed. Among the different patient groups, the authors (Janae L Maher et. al) found significant differences in average weight, body mass index and breast implant volume. They also checked for differences in height, age and parity (breast symmetry).

According to results of the study, the average patient in British Columbia was 33 years old with a BMI of 20.8 and a 389ml implant. In California, she was 32 years old with a BMI of 21.6 and a 385ml implant.

Patients in Texas were, on average, slightly older at age 36 with an (slightly higher) average BMI of 22.6. The Texas group also seemed to show preference for a significantly smaller implant of 335 ml.

This article is currently available for free via the Canadian Journal of Plastic Surgery.

Study Evaluates Alloderm for Prevention of Breast Reconstruction Complications

December 21st, 2010

breast-recon-savannah-gaA recent study published in Plastic and Reconstructive Surgery examines the use of accellular cadaveric dermis (ACD) as an alternative to the total sub-muscular approach in breast reconstruction. During the breast reconstruction study, an Alloderm ACD – a bioengineered tissue substitute – created a “retaining envelope” for the breast implant, which was hypothesized to reduce the risk of capsular contracture.

Capsular contracture is a possible complication with some breast implant patients, occurring when scar tissue tightens around the implant. The cause of capsular contracture is unknown, but inflammatory reaction is thought to be a related problem. Doctors predicted that ACD could work by decreasing the typical inflammatory response that occurs around the breast implant.

Houston plastic surgeon Dr. Bob Basu, along with colleagues Dr. Mimi Leong and Dr. John Hicks, assessed the results of twenty breast cancer patients (average age 47) who underwent two-stage breast reconstruction.

During the two-stage breast reconstruction procedures, the ACD was attached in the breast crease as well as the pectoral muscle. The surgeons then created a space for the tissue expander, the lower part of which was covered by the ACD. After a few months, they removed the tissue expander and replaced it with a breast implant.

Between the procedure stages, Dr. Basu and his colleagues performed biopsies of the integrated ACD, along with histopathologic analysis. They found that, compared to the control group, the samples from the ACD showed significantly reduced levels of granulation tissue formation, among other positive differences.

The doctors concluded that ACD may impede capsule formation, thus possibly inhibiting capsular contracture. Although the findings of this study make a promising case for the continued use of bioengineered tissue in breast reconstruction, Dr. Basu stresses that it is only a snapshot of a process that takes place over several years, and further investigation is necessary to determine the effectiveness of ACD in eliminating capsular contracture.

Read the abstract in PRS Journal

Swiss Pharmaceutical Seeks to Acquire Restylane Manufacturer

December 14th, 2010

The latest news from say that Q-Med, the Swedish manufacturer of Restylane wrinkle filler, is likely to be acquired by the Swiss pharmaceutical company Galderma.

Galderma is known for making the popular Cetaphil products. The dermatology-focused pharmaceutical company was founded over 25 years ago, and is currently owned by L’Oreal and Nestle.

Q-Med makes the popular Restylane dermal filler, which was introduced in the mid 90s. Earlier this year, the company announced a new line of skincare products made with their patented NASHA gel, which is not currently available in the U.S.

In the United States, Medicis Pharmaceutical is licensed to distribute Restylane, along with Perlane, Dysport and other cosmetic products. According to the most recent updates from Bloomberg, Galderma’s offer to acquire Q-Med is conditional on approval from Medicis. On their corporate website, you can read about the and their partnership with Q-Med.

New Study Examines Psychological Results of Breast Augmentation

December 14th, 2010

It’s quite common for women considering breast augmentation to wonder about the physical changes in their appearance. “How will I look?” is a common question, and plastic surgeons have several ways of explaining or visually representing the results.

But how will you feel? Will the procedure change the way you think? Doctors in Berlin sought to find out. In a new study, they evaluate the psychological changes that occur after breast augmentation – specifically sub-muscular breast augmentation, a surgery that involves placement of the breast implant beneath the pectoral muscle.

The physicians outlined the following criteria to assess after surgery:

  • Attractiveness and self-confidence
  • Insecurity or anxiety
  • Emphasis placed on physical appearance
  • Sexual discomfort

Using a 100-point scale, they rated the responses of 58 patients who completed a body image questionnaire. The authors reported significant improvements in all areas except insecurity or anxiety, which they say exhibited “next to no change.”

How does sub-muscular breast augmentation work?

During breast augmentation, your plastic surgeon has the option to place the implant above or underneath the pectoral muscle. Either option is effective but in many cases, placement is determined by the patient’s body type.  For example, a petite woman and a muscular woman might be recommended different placement techniques.

New from Obagi Medical – ELASTILash

November 30th, 2010

Obagi recently announced the arrival of ELASTILash, an eyelash solution they say can help you achieve the appearance of thicker, fuller lashes without a prescription.

Known for their high quality medical grade skincare products, Obagi is obviously taking aim at the growing market for Latisse, the popular prescription eyelash solution by Allergan Inc.

Instead of the growth-inducing bimatoprost contained in Latisse, ELASTILash works with a peptide-based solution. The new product is hypoallergenic, physician tested and according to an official press release, 70 percent of patients in clinical trials reported the appearance of thicker, fuller lashes in 4-6 weeks.

ELASTILash is applied with “one generous brush stroke along the entire upper eyelash line every night.” The product is supposed to be available in physician’s offices soon at a price around $60 each.

Read more about skin care products

12-Hour Comedy Podcast Funds Reconstructive Surgery for Charity

November 30th, 2010

Last week, a 12-hour podcast by comedy host Jimmy Pardo raked in over $28,000 for the charity Smile Train, whose mission is helping children in third world countries with cleft lip and palate.

Last year’s Pardcast-a-thon all-nighter took 9 hours. Big names like Jon Hamm, Chris Hardwick, Greg Behrendt and Maria Bamford helped raise over $16,000. This year, on the day after Thanksgiving, comedians such as Sarah Silverman, Tom Dreesen, Rob Corddry, Andy Richter and others helped Mr. Pardo well exceed the goal of $20,000 in 12 hours.

For children in developing countries, cleft lip and palate can cause a variety of debilitating problems. More than just a cosmetic defect, these conditions can also interfere with speech development and breathing function. Fortunately, all it takes to repair cleft lip and palate is a 45-minute operation that costs just $250, according to Smile Train. Volunteer plastic surgeons routinely travel with Smile Train mission groups to perform the reconstructive surgery.

Cleft palate repair can be done when a child is around 9-18 months old, while cleft lip repair can be done earlier (at about 10 weeks). With the funds raised by this year’s pardcast-a-thon, over 100 children will be able to undergo reconstructive surgery.

Learn more about the cause through or

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