Comments for Plastic Surgery Channel http://www.theplasticsurgerychannel.com Just another WordPress site Thu, 16 Feb 2012 03:57:37 +0000 hourly 1 http://wordpress.org/?v=3.1.3 Comment on Is capsulectomy, along with strattice matrix best correct capsular contracture? by cglicksman http://www.theplasticsurgerychannel.com/is-capsulectomy-along-with-strattice-matrix-best-correct-capsular-contracture/#comment-9965 cglicksman Thu, 16 Feb 2012 03:57:37 +0000 http://www.theplasticsurgerychannel.com/?p=21912#comment-9965 Capsular contracture is the most common complication in breast implant surgery. It affects about 15% of first time breast augmentation patients and up to 20 % of revision augmentation patients, affecting almost 50,000 American women each year. The potential causes include infection, hematoma, seroma (fluid collection), gel rupture, the implant location, implant surface texture, and finally biologic factors such as smoking, age, and scarring. The most widely accepted theories involve bacteria and Biofilms as a cause for capsular contracture. Antibiotic used at the time of the procedure to wash out the pocket, and limiting potential implant contamination, have been shown to reduce capsular contracture rates. The use of Acellular Dermal Matrixes (ADM), such as Alloderm and Strattice has gained wide-spread popularity in breast reconstruction and breast revision surgery. The data suggests that there is less adherence of implants under the material, and it may possibly reduce capsular contracture. The addition of ADM however, is not a substitute for good surgical technique, nor does it come cheap (may run over $2500/breast). Drains are routinely recommended in revision breast augmentation and especially when using ADM. In addition a complete capsulectomy (removal of the old capsule) may reduce the risk of recurrent capsular contracture due to Biofilm. Finally, explant alone should be considered when multiple implant procedures have all resulted in the same outcome. Caroline Glicksman, MD FACS Capsular contracture is the most common complication in breast implant surgery. It affects about 15% of first time breast augmentation patients and up to 20 % of revision augmentation patients, affecting almost 50,000 American women each year.

The potential causes include infection, hematoma, seroma (fluid collection), gel rupture, the implant location, implant surface texture, and finally biologic factors such as smoking, age, and scarring. The most widely accepted theories involve bacteria and Biofilms as a cause for capsular contracture. Antibiotic used at the time of the procedure to wash out the pocket, and limiting potential implant contamination, have been shown to reduce capsular contracture rates.

The use of Acellular Dermal Matrixes (ADM), such as Alloderm and Strattice has gained wide-spread popularity in breast reconstruction and breast revision surgery. The data suggests that there is less adherence of implants under the material, and it may possibly reduce capsular contracture. The addition of ADM however, is not a substitute for good surgical technique, nor does it come cheap (may run over $2500/breast). Drains are routinely recommended in revision breast augmentation and especially when using ADM. In addition a complete capsulectomy (removal of the old capsule) may reduce the risk of recurrent capsular contracture due to Biofilm. Finally, explant alone should be considered when multiple implant procedures have all resulted in the same outcome.

Caroline Glicksman, MD FACS

]]> Comment on Is capsulectomy, along with strattice matrix best correct capsular contracture? by bvannatta http://www.theplasticsurgerychannel.com/is-capsulectomy-along-with-strattice-matrix-best-correct-capsular-contracture/#comment-9960 bvannatta Wed, 15 Feb 2012 15:40:48 +0000 http://www.theplasticsurgerychannel.com/?p=21912#comment-9960 It's always difficult to make suggestions without seeing the patient or at least photos. That being said, there is anecdotal evidence that the use of acellular dermal matrices such as Strattice, can significantly reduce the recurrence of capsular contracture. It sometimes may even make sense to take the implant out for a couple of months and then start over since many believe bacterial contamination is the culprit in recurrent capsular contracture. Another anecdotal idea is the use of fat grafting to reduce the incidence of contracture. Again, I want to emphasize that is not any good data yet to support the Strattice or fat grafting effect. Also, I believe strongly that if Strattice is used a drain is a must. You should definitely make sure that your surgeon is not only board certified by the American Board of Plastic Surgery, but also has significant experience at revisional breast surgery. Bruce Van Natta, MD It’s always difficult to make suggestions without seeing the patient or at least photos. That being said, there is anecdotal evidence that the use of acellular dermal matrices such as Strattice, can significantly reduce the recurrence of capsular contracture. It sometimes may even make sense to take the implant out for a couple of months and then start over since many believe bacterial contamination is the culprit in recurrent capsular contracture. Another anecdotal idea is the use of fat grafting to reduce the incidence of contracture. Again, I want to emphasize that is not any good data yet to support the Strattice or fat grafting effect. Also, I believe strongly that if Strattice is used a drain is a must. You should definitely make sure that your surgeon is not only board certified by the American Board of Plastic Surgery, but also has significant experience at revisional breast surgery.

Bruce Van Natta, MD

]]> Comment on Most Americans Look Online for Health Information by febeen http://www.theplasticsurgerychannel.com/mostamericans-look-online-for-health-information/#comment-9909 febeen Wed, 08 Feb 2012 01:04:32 +0000 http://www.theplasticsurgerychannel.com/?p=6080#comment-9909 survived the fighting and success always survived the fighting and success always

]]> Comment on The Secret to Long, Beautiful Natural Eyelashes by CMO http://www.theplasticsurgerychannel.com/the-secret-to-long-beautiful-natural-eyelashes-112/#comment-9857 CMO Thu, 02 Feb 2012 17:31:21 +0000 http://www.theplasticsurgerychannel.com/?p=20296#comment-9857 Thanks for your question. There are a couple really important points that you should know. 1. Stem cell fat transfer is not an FDA approved procedure and there are no FDA approved stem cell systems allowed in the US currently. 2. There is a lot of marketing that goes on about Stem Cells you should be very careful in reseraching this. Please see a PSC Mediawire piece we recently released: http://www.theplasticsurgerychannel.com/plastic-surgeons-say-do-not-believe-the-stem-cell-hype-108/ The doctor you mentioned is not a Board Certified Plastric Surgeon. I would direct you to the excellent Plastic Surgery group at <a href="http://Pvps.com" rel="nofollow">Ponte Vedra Plastic Surgery</a>to discuss this in more detail with you. you may be a candidate for a number of procedures including fat injection. The Ponte Vedra group has a great deal on expertise in this area and are all Board Certified Plastic Surgeons. Hope that helps. Best William P. Adams Jr. MD PSC Chief Medical Officer Thanks for your question. There are a couple really important points that you should know. 1. Stem cell fat transfer is not an FDA approved procedure and there are no FDA approved stem cell systems allowed in the US currently.
2. There is a lot of marketing that goes on about Stem Cells you should be very careful in reseraching this. Please see a PSC Mediawire piece we recently released:
http://www.theplasticsurgerychannel.com/plastic-surgeons-say-do-not-believe-the-stem-cell-hype-108/

The doctor you mentioned is not a Board Certified Plastric Surgeon. I would direct you to the excellent Plastic Surgery group at Ponte Vedra Plastic Surgeryto discuss this in more detail with you. you may be a candidate for a number of procedures including fat injection. The Ponte Vedra group has a great deal on expertise in this area and are all Board Certified Plastic Surgeons.

Hope that helps.
Best
William P. Adams Jr. MD
PSC Chief Medical Officer

]]> Comment on The Secret to Long, Beautiful Natural Eyelashes by Sherrill Phillips http://www.theplasticsurgerychannel.com/the-secret-to-long-beautiful-natural-eyelashes-112/#comment-9856 Sherrill Phillips Thu, 02 Feb 2012 16:55:20 +0000 http://www.theplasticsurgerychannel.com/?p=20296#comment-9856 I don't have a Board Certified Plastic Surgeon close to me in Jacksonville, Fl who is doing the adult stem cell fat transfer with the centrifuging using the FDA Cytori Pure Graft System or any other system. I really would like to have this done at some point in time as I'm tired of looking mad all the time and my jowls are the first thing you see. I saw Dr Bill Johnson, Dallas, Texas on one of the shows and his results were amazing. Do you know anything about him that you are able to share that would make it worth my while to make the trip. I want to do something that is going to last longer than a few months if I'm going to pay a high price. Also, what fillers out there now are really "more Bang for your buck" to lift and give volume to my face. There is so much out there now, I'm confused. What do you think of using Radielle on top of the cheekbone to lift my cheeks up from under my chin? Thanks for your help and your great website. Blessings S.P. /Jax., Fl. I don’t have a Board Certified Plastic Surgeon close to me in Jacksonville, Fl who is doing the adult stem cell fat transfer with the centrifuging using the FDA Cytori Pure Graft System or any other system. I really would like to have this done at some point in time as I’m tired of looking mad all the time and my jowls are the first thing you see. I saw Dr Bill Johnson, Dallas, Texas on one of the shows and his results were amazing.

Do you know anything about him that you are able to share that would make it worth my while to make the trip. I want to do something that is going to last longer than a few months if I’m going to pay a high price. Also, what fillers out there now are really “more Bang for your buck” to lift and give volume to my face. There is so much out there now, I’m confused. What do you think of using Radielle on top of the cheekbone to lift my cheeks up from under my chin?

Thanks for your help and your great website.

Blessings
S.P. /Jax., Fl.

]]> Comment on Should Cosmetic Surgery be Banned? Recent Headlines Stir Debate Over Plastic Surgery by Dominique http://www.theplasticsurgerychannel.com/should-cosmetic-surgery-be-banned-recent-headlines-stir-debate-over-plastic-surgery-119/#comment-9828 Dominique Tue, 31 Jan 2012 21:00:13 +0000 http://www.theplasticsurgerychannel.com/?p=21258#comment-9828 Why PIP scandal should not lead to Cosmetic Surgery Banned? PIP is a system failure, no more but this is already far too much! Some surgeons knew about the problem and authorities were informed via materio vigilance system. Why the system didn’t react this is the problem and this is what need to be investigated. Now using this scandal to ban cosmetic surgery is as ridiculous as banning advertising on aesthetic procedure; all this will serve others interests. This market (cosmetic surgery and cosmetic dermatology) is an anxious market. What is needed is the following: 1/ stringent efficacy proof and data when industry intend to register a new product / device 2/ make sure that these procedures are followed on a long term basis to monitor safety in a clinical setting (vs only in a trial setting) 3/ ensure that physicians are well trained 4/ promote ongoing discussion between consumers and the brands The above will be far better than a ban or any control which are not problem solvers. @ducrest Why PIP scandal should not lead to Cosmetic Surgery Banned?
PIP is a system failure, no more but this is already far too much! Some surgeons knew about the problem and authorities were informed via materio vigilance system. Why the system didn’t react this is the problem and this is what need to be investigated.
Now using this scandal to ban cosmetic surgery is as ridiculous as banning advertising on aesthetic procedure; all this will serve others interests. This market (cosmetic surgery and cosmetic dermatology) is an anxious market. What is needed is the following:
1/ stringent efficacy proof and data when industry intend to register a new product / device
2/ make sure that these procedures are followed on a long term basis to monitor safety in a clinical setting (vs only in a trial setting)
3/ ensure that physicians are well trained
4/ promote ongoing discussion between consumers and the brands
The above will be far better than a ban or any control which are not problem solvers.
@ducrest

]]> Comment on ‘The View’ Hostess Elisabeth Hasselbeck Shows Nipple In Photo by abubbleshooter http://www.theplasticsurgerychannel.com/%e2%80%98the-view%e2%80%99-hostess-elisabeth-hasselbeck-shows-nipple-in-photo/#comment-9824 abubbleshooter Tue, 31 Jan 2012 17:58:19 +0000 http://www.theplasticsurgerychannel.com/?p=1804#comment-9824 Heya, Thank you for this great post! I have to save this website. Thanks. Heya, Thank you for this great post! I have to save this website. Thanks.

]]> Comment on Neck Contouring by Lisa Parrillo http://www.theplasticsurgerychannel.com/how-is-it-done/#comment-9601 Lisa Parrillo Tue, 17 Jan 2012 15:55:42 +0000 http://www.theplasticsurgerychannel.com/?p=20602#comment-9601 Would like to find a Dr in my area to take a look at my neck and see what can be done with it. I watched one of the videos and the way the man was talking, is all me. Holding the head a certain way, being so very self conscious of my neck and I am only 45. I have tried everything under the sun, between creams and hand held devices. Still a crepey, crappy looking neck!!! Thanks for your help........Sincerely, Lisa Parrillo Ps. Would like to find a Dr as close to RI as possible. Would like to find a Dr in my area to take a look at my neck and see what can be done with it. I watched one of the videos and the way the man was talking, is all me. Holding the head a certain way, being so very self conscious of my neck and I am only 45. I have tried everything under the sun, between creams and hand held devices. Still a crepey, crappy looking neck!!! Thanks for your help……..Sincerely, Lisa Parrillo

Ps. Would like to find a Dr as close to RI as possible.

]]> Comment on Breast Implant Removal and Redo by anne golding http://www.theplasticsurgerychannel.com/breast-implant-removal-and-redo/#comment-9561 anne golding Thu, 12 Jan 2012 20:58:40 +0000 http://www.theplasticsurgerychannel.com/ask-a-doctor/breast-explantation-and-redo.html#comment-9561 Hi I live in the UK and had meme implants in 1988 when I was 40 years old. The procedure was performed by Mr Clive Orton at Bupa Hospital in Manchester. I have had routine mammograms and apart from a blocked mammary duct I have not experienced any problems with my breasts. My question is should I have the implants removed or leave them insitu. Kind regards Anne Golding Hi

I live in the UK and had meme implants in 1988 when I was 40 years old. The procedure was performed by Mr Clive Orton at Bupa Hospital in Manchester. I have had routine mammograms and apart from a blocked mammary duct I have not experienced any problems with my breasts. My question is should I have the implants removed or leave them insitu.

Kind regards

Anne Golding

]]> Comment on can my 8yr old use latisse? by cglicksman http://www.theplasticsurgerychannel.com/can-my-8yr-old-use-latisse/#comment-9498 cglicksman Sat, 07 Jan 2012 22:34:32 +0000 http://www.theplasticsurgerychannel.com/?p=21195#comment-9498 In the same way that you lose a certain amount of hair each day, we all shed some eyelashes on a regular basis. This minor shedding is normal and does not interfere with your sight or eye health. Traumatic eyelash loss may be more noticeable, but is usually temporary and the growth usually rebounds after about 6-12 months. It is important to determine why your daughter pulled out her lashes in the first place, and determine if this behavior has stopped. Any possible regrowth could be damaged if she continues to traumatize her lashes. If the eyelash damage is permanent from either inadequate eyelash regrowth or continued trauma, your child may be at higher risk for eye infections. The eyelashes act to filter out dust and dirt and protect the eye from damage. Although Latisse®, a prostaglandin analog, may be of some potential benefit, it is not presently indicated for children under the age of 16 due to the potential risks of hyperpigmentation of the eyelids and the iris with chronic use. I recommend that you and your daughter consult with a board certified pediatric ophthalmologist to determine the best and safest management of your daughter’s problem. Caroline Glicksman, MD In the same way that you lose a certain amount of hair each day, we all shed some eyelashes on a regular basis. This minor shedding is normal and does not interfere with your sight or eye health. Traumatic eyelash loss may be more noticeable, but is usually temporary and the growth usually rebounds after about 6-12 months. It is important to determine why your daughter pulled out her lashes in the first place, and determine if this behavior has stopped. Any possible regrowth could be damaged if she continues to traumatize her lashes.

If the eyelash damage is permanent from either inadequate eyelash regrowth or continued trauma, your child may be at higher risk for eye infections. The eyelashes act to filter out dust and dirt and protect the eye from damage. Although Latisse®, a prostaglandin analog, may be of some potential benefit, it is not presently indicated for children under the age of 16 due to the potential risks of hyperpigmentation of the eyelids and the iris with chronic use.

I recommend that you and your daughter consult with a board certified pediatric ophthalmologist to determine the best and safest management of your daughter’s problem.

Caroline Glicksman, MD

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