Archive for the ‘In the News’ Category

More Couples Getting Plastic Surgery Together

Monday, June 27th, 2011

With the increasing acceptance of cosmetic procedures among men, a new phenomenon among the plastic surgery clientele has been on the rise: more couples are appearing together in surgeons’ offices across the country.

According to in the Pittsburgh Tribune-Review, America’s recovery from the recession has seen a resurgence of plastic surgery procedures. Women account for roughly 80 percent of plastic surgery patients, but the number of men has skyrocketed 88 percent from 1997 to 2010. The most popular procedures among men include Botox, liposuction, and rhinoplasty.

The article tells the story of Marsha and Mike Gavula, a couple from Evans City, PA, who do just about everything together. Recently, the 50-year-olds both stepped into a plastic surgeon’s office. Marsha has undergone chemical peels, dermabrasion, and other minimally invasive procedures, while Mike opted for Botox and wrinkle-filling injections for the first time on his fiftieth birthday.

One medical spa with three offices in the Pittsburgh area reports that it offers cosmetic procedures for nearly 30 couples annually, compared with a half-dozen couples in the mid-2000s.

What are some of the factors driving this increase in couples’ procedures?

  • Plastic surgery no longer carries a stigma among men, particularly as the baby boomer generation ages.
  • More options are available for those who don’t want a surgical procedure, as products like Botox can produce results comparable to facelifts.
  • Many men wish to have a more youthful appearance in order to compete in a younger workplace. Injectable fillers such as Restylane and Artefill are fast, effective ways to rejuvenate your appearance.
  • Recovery times for many procedures have lessened, thanks to cutting-edge techniques like VASER LipoSelection that reduce tissue trauma.
  • Couples who have surgeries around the same time can “leapfrog” their procedures, alternating care and recovery.

Not All Elderly Patients Have Higher Risk for Facelift Complications

Monday, June 20th, 2011

How old is too old for plastic surgery? The answer may surprise you. A recent study has indicated that carefully selected patients who have facelifts after the age of 65 are not at a greater risk for facelift complications.

While no one is certain about the best age for a facelift, many doctors are uncertain about the risks of facelift complications among their elderly clients.

The prevailing wisdom is that facelift surgery in the elderly carries more post-operative risk, since this has often been the case in other areas of medicine. Slower healing times and latent medical issues often entail more complications among older patients than their younger counterparts.

However, a study by the Cleveland Clinic shows that the potential for facelift complications among the elderly can be significantly reduced through careful patient selection, so that a 65-year-old patient may be as safe entering surgery as someone 20 years their junior. The study, published in the journal Plastic and Reconstructive Surgery, examined consecutive facelifts in 216 women performed by a single surgeon from 2005 to 2008.

The women were divided into two groups, with 68 patients being 65 years or older, and 148 patients being under the age of 65. Elderly patients were carefully selected based on their medical history. After comparing various factors (such as co-morbidities, operative details, and overall health status) with statistical analysis, the study revealed that age was not an independent contributing factor to post-operative facelift complications.

The key to preventing facelift complications, according to the study authors, is to carefully screen patients and exclude those with significant co-morbidities (related medical conditions). While co-morbidity rates are higher among the elderly, this does not mean that all elderly patients should be excluded.

The Story of California’s First Hand Transplant Patient

Friday, May 13th, 2011

Luke Skywalker from the movie Star Wars recovered quickly after losing his hand, but in the real world, replacing a lost hand is a painful and long-term proposition. With the recent success of high-profile surgeries such as the , it seems that transplant surgery has come closer to the dreams of science fiction, but it’s worth bearing in mind that fiction rarely reveals the long road to recovery. In reality, the surgeries, physiotherapy, and risk of rejection demand true heroism.

Emily Fennell, who recently became California’s first hand transplant patient, lost her right hand in a car accident in 2006, when she was a passenger in a car that was sideswiped. The car rolled and Fennell’s hand was flung through the sunroof, crushed between the car and the road. The hand was mangled and had to be amputated.

The 26-year-old single mother didn’t give up, however, and after getting home from the hospital, she taught herself to use her left hand for everything. But Fennell didn’t want to live the rest of her life with only one hand. She learned about hand transplant surgeries and was accepted to Ronald Reagan UCLA Medical Center’s hand transplant program. She knew the risks of the surgery, which typically requires lifelong use of powerful immunosuppressant drugs and may result in outright rejection of the hand. The Center found a donor within a couple of weeks.

Fennell is now enrolled in eight-hour daily physical therapy, and waits for the day when her nerves will grow enough to connect with the nerves in the hand. The hand has no sensation, and Fennell still can’t fully accept the hand as hers. With time and effort, however, Fennell will soon get her wish: to hug her daughter “with both hands.”

Botox Helps Migraine and Cerebral Palsy Sufferers

Wednesday, April 20th, 2011

Botulinum toxin injections, commonly known as Botox, are by far the most popular non-surgical cosmetic procedure on the market today, with 5.4 million procedures performed in 2010. Botox restores a youthful appearance to the face by temporarily paralyzing certain facial nerves so that other muscles are able to pull the skin tighter than before.

However, there are alternative uses for Botox that may surprise you, as its unique ability to paralyze muscles with simple injections has improved the lives of spinal migraine and cerebral palsy sufferers.

The Mayo Clinic recently discovered that Botox helped a woman suffering from a rare type of migraine when little else had worked over the course of 25 years. Low cerebrospinal fluid headaches are caused by spinal fluid leaks that cause the brain to sag within the skull. The pain caused by low cerebrospinal fluid headaches can range from slight to overwhelming, and many people who suffer from these migraines find that existing therapies don’t help. Lying down is often the only way that they have to feel better.

Botox was administered to numb the nerve after the woman and doctors had exhausted all their options, and to everyone’s surprise, she made a strong improvement. While the pain is not completely gone, it has largely subsided, and the patient finds it easier to live a normal life.

On the other side of the globe, Australian children living with cerebral palsy have been engaging in a highly successful Botox treatment program. The injections relax the leg muscles of cerebral palsy sufferers, allowing them to walk with supports, leading to a huge improvement in their quality of life. The injections have also proven useful in alleviating leg pains and cramping that afflict the children.

Cosmetic Surgery Increasingly Popular Among American Men

Wednesday, April 13th, 2011

Recent statistics released by the American Society of Plastic Surgeons (ASPS) indicate that the number of American men who had cosmetic procedures in 2010 increased by 2 percent over the previous year. With over 1 million cosmetic procedures performed on men last year, this means an increase of more than 20,000 procedures. The numbers also reflect the changing priorities and perspectives of American men.

There was a decline in rhinoplasty, chemical peels, and microdermabrasion, although these procedures remain among the most popular. The most popular surgical procedure is rhinoplasty, and the most popular minimally invasive procedure is Botox.

Here are the top 10 surgical procedures that increased in popularity among men last year:

  1. Facelift (14% increase)
  2. Ear Surgery (Otoplasty) (11% increase)
  3. Soft Tissue Fillers (10% increase)
  4. Botulinum Toxin Type A (9% increase)
  5. Liposuction (7% increase)
  6. Breast Reduction (6% increase)
  7. Eyelid Surgery (4% increase)
  8. Dermabrasion (4% increase)
  9. Laser Hair Removal (4% increase)
  10. Laser Treatment of Leg Veins (4% increase)

The rising popularity of facelifts lies mostly among men in their 50s and 60s. As the baby boomer generation ages, men often find that even healthy lifestyles can’t prevent sagging neck skin. The increase of breast reduction surgery means that more men under 30 are no longer willing to be embarrassed by their large breasts.

But don’t think that the growing popularity of cosmetic surgery among men comes from celebrities and elites. Dr. Stephen Baker, an ASPS member from Washington, D.C. who is quoted in the report, says that the typical male cosmetic patient is “an average guy who wants to look as good as he feels…. Most of my patients are ‘men’s men,’ the kind of guy you might not think would have plastic surgery.”

Muscle-Derived Stem Cells Could Improve Fat Grafting

Wednesday, March 30th, 2011

Extracting and using muscle-derived stem cells may enhance the long-term prospects of fat grafting, say the authors of a recent article in Medical Hypotheses, a journal that encourages speculations about the future of medical practice and procedures.

Fat grafting is an essential part of numerous plastic surgeries, with uses in breast reconstruction as well as breast, lips, buttocks, and facial augmentation. Transferring fat from one part of the patient’s body to another can smooth wrinkles, fill out aged hands and faces, and improve the shape of breasts and buttocks.

“Autologous fat graft… gives a natural consistency, is easy and safe to harvest, exhibits no hypersensitivity or foreign body reactions, and is readily available,” the authors write. However, there may be some long-term shortcomings of fat grafting procedures, most notably the tendency for fat cells to not survive, failing to integrate with the body.

Researchers from Harbin Medical University in northeast China argue that these side effects are caused by insufficient blood flow. Without enough blood getting to the transplanted fat cells, they may wither and die. The authors explore a strategy for dealing with this problem, which involves the use of stem cells from the muscle tissue.

According to the researchers, previous studies show that best results for fat grafting occurred when fat tissue was transplanted inside muscle – because stem cells within the muscle tissue improve the formation of new blood passages in the grafted fat. Stem cells extracted from the patient’s body could be injected into the patient’s muscle tissue, along with the fat, at the site of the graft. At the same time, the plastic surgeon would cause minor damage to the muscle tissue, activating the body’s healing process. Over time, the healing muscle would interact with the stem cells to improve the formation of new blood vessels and integrate the fat tissue into the muscle.

While this is only one small study, it could be very exciting to see further research in this direction for fat grafting procedures. You can read more about this study on Pubmed.

Fruits and Vegetables Help Relieve Post-Operative Inflammation

Wednesday, March 23rd, 2011

According to a recent study by a team of Brazilian researchers, there may be another reason why it’s always a good idea to eat lots of fruits and vegetables: they help to alleviate inflammation after abdominal cosmetic surgery.

Low-grade inflammation is normal after abdominal surgeries such as tummy tucks and liposuction, but has a negative overall effect on the patient’s metabolism and cardiovascular prognosis. There’s a lot of evidence to suggest that a diet high in fruits and vegetables is associated with reduced levels of C-reactive protein (CRP), which is a plasma protein that rises in the blood when the body is suffering from inflammation disorders. Elevated CRP is a standard test in medicine that can measure the extent of inflammation in a person’s body.

For the study, which was published in the journal Nutrición Hospitalaria, sixty women between the ages of 25 and 60, and with body mass indices (BMI) of 30 or over, were selected. One group was asked to consume six servings each of fruits and vegetables during the first postoperative month, while a control group continued on their regular diets. To make sure that the women stayed on their diets, researchers gave them easy and convenient recipes, and checked up on them.

Almost all patients completed the study and kept to the diet. The study revealed that CRP decreased significantly in the treated group, and that increased fruit and vegetable intake was associated with lessened inflammation. The authors say that more research is necessary to learn more about longer-term effects and benefits.

For those who are anticipating or recovering from abdominal surgery, a diet high in fruits and vegetables may be one delicious lifestyle change that will reduce inflammation, improve heart health, and bolster their bodies with vitamins and antioxidants.

National Surgery Groups Form Patient Safety Coalition

Friday, February 25th, 2011

Four widely known and respected medical specialty groups recently announced the formation of the Physicians Aesthetic Coalition—a new, interdisciplinary organization designed to champion patient education and safety in aesthetic medicine.

Organizations involved in the Coalition include the:

  • American Society for Aesthetic Plastic Surgery (ASAPS)
  • American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS)
  • American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS)
  • American Society for Dermatologic Surgery (ASDS)

Each organization has a long history of promoting patient education and safety initiatives, however this is the first time these groups have worked cooperatively toward the goal of helping the public get better informed about cosmetic plastic and dermatologic surgery.

Dr. Felmont Eaves, III, president of the ASAPS, cites the increasing popularity of aesthetic surgery and non-surgical cosmetic treatments, as well as the rising number of unqualified practitioners and unproven technologies in the industry, as the motivating force behind the formation of the Physicians Aesthetic Coalition.

“This is a significant patient safety issue,” said Dr. Eaves. “Through the Coalition, we can address these issues on a stronger platform than we could individually, using credible medical evidence to help patients make informed decisions.”

ASDS President Dr. Jeffery Dover also added that one of the primary objectives of the Physicians Aesthetic Coalition will be to provide patients undergoing popular surgical procedures such as blepharoplasty, liposuction and breast augmentation or new, non-surgical cosmetic treatments with reliable, unbiased educational resources.
“One of the Coalition’s founding principles is to develop educational forums for the public and media, transparent and free of commercial bias,” said Dr. Dover. “Over the next several months we will be announcing new resources to help [patients] differentiate fact from fiction.”

According to Dr. Jonathan Sykes, president of the AAFPRS, the Coalition represents the unified voices of more than 8,000 board certified physicians specializing in plastic and reconstructive surgery of the face, body, eyes and skin. And at a time when the news seems dominated by awful plastic surgery stories and gimmicks galore, prospective patients can certainly rest easier knowing that there are physicians out there who really care about their well-being, not just making a buck.

“Nothing is more important to us, both as a medical society and as individual physicians, than keeping our patients safe,” says ASOPRS President Dr. Jeffrey A. Nerad. “We are hopeful that this new Coalition will help us in achieving this end.”

Study Reveals Age-Related Changes in Facial Bones

Thursday, 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.

16th Century Book Describes Early Rhinoplasty Surgery

Monday, 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 .

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