By: Carolynn Grimes
ThePlasticSurgeryChannel.com

Unapproved and potentially dangerous breast implants sold overseas stir debate over the safety and risks associated with aesthetic plastic surgery.

According to the author Alexander Edmonds, the recent scandal involving unapproved and potential dangerous breast implants sold by a French manufacturer should raise questions about the safety and risks surrounding all aesthetic surgery.  Edmonds received a PhD in anthropology from Princeton and has written on the social dimensions of plastic surgery.  He is the author of “Pretty Modern: Beauty, Sex and Plastic Surgery in Brazil,” and is assistant professor of anthropology at the University of Amsterdam. Edmonds says, “With most surgeries, the risks are weighed against expected health improvements. But aesthetic procedures, by definition, do not improve health.”

Dr. Jeffery Kenkel, President of the American Society of Aesthetic Plastic Surgery (ASAPS) disagrees. “What would be next? Will physicians be banned from performing procedures on cleft lip children because it doesn’t prevent or cure disease?”

According to reports, the recent breast implant scandal could affect up to 300 thousand women world wide.  The French manufacturer, Poly Implants Protheses (PIP) has admitted to authorities it was producing and distributing breast implants with a cheaper industrial grade silicone instead of a medical grade silicone which could be harmful according to officials. The implants have also shown to have a high rate of rupture. Edmonds says, “The fact that a surgeon is putting in implants sends a subtle message that they are safe.”

Edmonds points out that one response to the PIP scandal is a ban on doctors performing cosmetic breast augmentation altogether. He says, “It’s well known that breast implants of many types can cause burning pain, loss of sensation, hardening of breast tissue and serious infection.”     Breast implant expert, scientist and  Vice President of  The Aesthetic Society Education and Research Foundation (ASERF) ,  William P. Adams, Jr, MD says he  does not  agree with this conclusion,  “it  appears he is  quoting the  exceptions and not the rule, in fact the science and data says when implants are used with modern techniques that outcomes are optimized, patients have very few issues and have  an extremely high degree of satisfaction.”

The FDA says both saline and silicone breast implants in the U.S. are safe.

He quotes the FDA’s 2011 ‘Update on the safety of silicone gel-filled breast implants’, which states that: “Frequent complications include implant rupture, wrinkling, asymmetry, scarring, pain, and infection, among others.” But Kenkel says, “That’s not true.”  Last year the FDA (Food and Drug Administration) concluded that the silicone-gel implants are safe as long as women understand they come with complications.  According to Kenkel, “Breast implants are one of the most studied medical devices in the history of the FDA. Both saline and silicone implants that are manufactured in the U.S. are safe.”

However, Edmonds says the FDA made clear that local complications are not uncommon. He quotes the FDA’s 2011 ‘Update on the safety of silicone gel-filled breast implants’, which states that: “Frequent complications include implant rupture, wrinkling, asymmetry, scarring, pain, and infection, among others.”

Kenkel says Edmonds is confusing the issue of an unethical manufacturer using non-medical grade silicone and the legitimacy of plastic surgery. “When surgery involves a medical device that was fraudulently manufactured, it’s more logical to question the manufacturer than question the patient’s motivation for wanting the surgery.”

Dr. Leo McCafferty, President Elect for ASAPS says, “Cosmetic Surgery, if performed by a board certified plastic surgeon in a properly licensed and accredited facility has never been more safe.”   Dr.  Adams  agrees. He says, “If we look at the benefits of cosmetic and plastic surgery procedures to patients, it’s very well documented that patients have incredible elevation of their quality of life, and there’s data to support that.”

From 2009-2010, there was almost a 9% increase in the total number of cosmetic surgical procedures, with over 1.6 million surgical procedures this year, according to ASAPS. It is also reported that the number of breast augmentations alone have tripled during that same time frame with a 90% plus satisfaction rate.

Edmonds says his goal in the piece was to add to the already extensive debate about the risks of cosmetic procedures and whether consumers are adequately informed about them.  Drs. Kenkel and Adams , both Board Certified Plastic Surgeons in Dallas, Texas,  agree that patients need to be more educated on procedures and say patient education by qualified Board Certified Plastic Surgeons is a top priority in their practices.  In the end, they say,  an informed and educated plastic surgery patient results in a better outcome for the patient.

McCafferty states that anyone considering plastic surgery should “seek properly trained Plastic Surgeons certified by the American Board of Plastic Surgery and members of ASAPS and ASPS (American Society Plastic Surgeons). These surgeons operate in accredited, licensed facilities using safe effective FDA approved products, devices, implants and equipment.

Don’t gamble on your plastic surgery.  Finding the right doctor for your procedure should not be something that’s taken lightly. In view of recent headlines around the world where patients go to doctors who are not qualified or perform surgeries in questionable facilities, patients need to take the process of choosing a plastic surgeon seriously.

Researching a doctor’s credentials needs to be a top priority when considering any plastic surgery procedure, says Dr. John Gross, a contributing member for ThePlasticSurgeryChannel.com. Dr. Gross, a board certified plastic surgeon from Pasadena, California explains the steps to find the right surgeon and the credentials you should look for.

The first step in choosing a plastic surgeon is make sure your surgeon is board certified in plastic surgery.

Dr. Gross says, “In many states, surgeons and sometimes doctors without any plastic surgery training can perform plastic surgery procedures without ever having any formal training.”  He says, board certification in plastic surgery does the discriminating for you and makes sure your plastic surgeon has the appropriate background, training and credentials to do your procedure.

The second step is to ask where your procedure or surgery will be performed. Gross says it needs to be at an accredited surgical facility. These include accredited surgical outpatient facilities, or an accredited operating room in the office or hospital. Currently, only 21 states require accreditation of offices where doctors perform surgeries, making it even more critical for potential patients to do their homework. However, Gross says if you choose a doctor that is a member of the American Society of Aesthetic Plastic Surgery (ASAPS), they are required to only perform surgical procedures at accredited facilities.

What does it mean to be an accredited facility?

Accredited facilities are required to adhere to strict rules and regulations. They must have certain life saving equipment, strict safety procedures, and the right drugs and anesthesia on hand to treat patients.

Once you find a surgeon and a facility, Dr. Gross says step three is make sure you choose a surgeon you feel you can communicate with. “Someone who will ask what’s important to you, listen to you, and do a thorough examination,” says Gross.

ASAPS recommends patients communicate with their plastic surgeon by asking a few key questions: What experience does the doctor have performing this procedure? What are the possible risks? And, what is the expected time for recovery?

Gross says, “Many times your surgeon may present you with some options you have not thought of.” He says, “Communication is the final key to getting the best outcome for your plastic surgery procedure.”

What is  important to know for a patient who wants a facelift?

Dr. Bucky has extensively researched facial aging and has developed techniques that enhance natural appearances after cosmetic surgery. He says anyone considering a facelift needs to understand how your skin changes with age, and “the keys to an excellent facelift are understanding the [following] three components and treating them individually.”
The first change is a loss of elasticity to the skin. Elasticity problems need to be treated with things that improve elasticity; dermabrasion, peels or lasers.

Volume loss is a Key Problem a facelift needs to address

The second change is a loss of volume or deflation.  Bucky says, “Deflation problems need to be treated with things that improve volume, typically your own fat or sometimes other fillers.”

When deflation happens everything starts to drop and that leads to third change, gravitational descent.  According to Bucky, “Gravitational descent is the third component in aging and needs to be treated with a lifting procedure, some sort of anti-gravity approach.”

Dr. Bucky says, “When all three are performed appropriately, that usually ensures a good aesthetic result.” The final key is a quick and easy recovery.  “When all that is put together, you should come out with a result that looks refreshed, balanced, younger and not surgical.”

Plastic Surgery Channel facial expert Dr. Patrick  Sullivan commented,  “Facelifts when  performed properly can  result in some of the happiest patients;however, when patients are lured into procedures driven by marketing that  do not address all the facial aging components big issues are  often seen.”

As always, interested patients should ensure their surgeon is Board Certified by the American Board of Plastic Surgery when considering a facelift.

About The Plastic Surgery Channel

The Plastic Surgery Channel is a company devoted exclusively to educational programming about cosmetic and reconstructive surgery. Our goal is to provide credible, up-to-date information to people considering plastic surgery or a cosmetic procedure, as well as coverage of the latest news and hot topics from the field of plastic surgery.

Unlike shows you might see on network or cable television, the programming on The Plastic Surgery Channel does not strive to be sensationalist, focusing solely on extreme cases, nor is it solely devoted to a documentary-style overview of various medical procedures. Rather, we strive to inform — and in some cases entertain — viewers by providing relevant, engaging content that covers all facets of cosmetic and reconstructive surgery. We rely on experienced, board certified leaders in the field as content consultants, and conduct substantive research to verify the accuracy of the articles and videos that we present.

Of course, The Plastic Surgery Channel is not meant to replace the advice of medical professionals. Viewers are reminded to always consult a medical professional before making any decisions about plastic surgery or any other form of surgery.

For more information about our programming and our faculty, please email us at info@theplasticsurgerychannel.com

Plastic Surgery Scar Therapy Roundtable.   Every  patient who has  has  plastic surgery wants the best  scar as possible.  In an exclusive Plastic Surgery Channel roundtable Drs. Bruce Van Natta, Lou Bucky, Steve Antrobus and William P. Adams Jr. discuss what patients should know about scar therapy.

What is  Scar Therapy?

No matter how big or how small….scars can have a physical and emotional impact on a patient. Its something Plastic surgeons know all to well.
Dr Bruce Van Natta says ”when it comes to scars almost everyone has some concern about scars if they’re undergoing surgery, particularly cosmetic surgery.”  Board Certified Plastic Surgeon Dr. Bruce Van Natta from Indianapolis admits surgeons are responsible for a a lot of those scars.
Van Natta adds, “Part of the key there is we try to hide the scars. But clearly some of those are going to be visible. And when it comes to scars, I always try to tell patients the first big thing here is genetics.”
Some patients heal perfectly fine while others are prone to develop a thick or discolored scar. All of us don’t make scars the same way so if you had a history of not making good scars you need to realize that may not be something we can completely control.

How can scar therapy reduce scarring?

To reduce the appearance of scaring, Dr. Caroline Glicksman, a plastic surgeon in New Jersey, along with other surgeons are turning to a proven non invasive, low risk
treatment. “We know that silicone sheeting has worked for years from the science we have from our burn patients. We would like a product with a little silicone in it, a little
sunblock in it and particularly patient compliance. No scar therapy works unless the patient uses it.”

Plastic surgeon, Dr. Lee Thornton from Mississippi agrees and says silicone treatments
are effective.  ”Such things would be silicone sheathing to put over the scar, silicon gels
to put over the scar”
Thornton says silicon therapy can be used to prevent the formation of new scars and also helps to reduce the appearance of existing scars.
According to these plastic surgeons, the best way to dramatically improve scaring is with silicone gels or ointments that can be placed directly on a scar or rubbed into the
skin. That combined with a moisturizer and a daily sunblock seems to get the best results.