Types of Breast Lift - Mastopexy

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New plastic surgery statistics released 3/31/14 by the American Society of Plastic Surgeons (ASPS) show that breast lift procedures are growing at twice the rate of breast implant surgeries. Since 2000, breast lifts have grown by 70 percent, increasing from 53,000 in 2000 to 90,000 in 2013 vs only a 37% increase in breast augmentation surgery over the same time period. Breast implants are still by far the most performed cosmetic surgery in women, but lifts are steadily gaining. In 2013, 70% of these women were between the ages of 30 and 54.

At a young age the breast skin is taut and elastic and the ligaments holding the breast tissue to the chest wall are short and tight. With aging, exposure to gravity, weight changes and pregnancy the ligaments and skin are stretched and disrupted leading eventually to drooping sagging breasts, especially after breast involution following pregnancy and breast feeding. Surgery to correct this drooping is termed a mastopexy or breast lift and involves surgery on the breast skin and/or deeper breast tissue. The pencil test is a simple way for a woman to assess if breast lift surgery could be beneficial. A pencil is placed under her breast.  If the breast tissue holds the pencil in place against the chest that implies that there’s a hanging nature to the breast that may be improved with a lift. In assessing these patients the surgeon needs to know the history of breast sizes with changes in weight or pregnancy, breast measurements (breast volume, amount of breast skin envelope filling, nipple position on the chest, distribution of breast tissue, skin quality and amount, areola size, amount of skin show below the nipple on standing and asymmetry/symmetry).

Five Skin Care Tips for a Healthy Skin

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This is a guest post by Alyssa Furnell Content Writer/Proof Reader at Authority Specialists. Authority Specialists provides top-quality, value-filled content with the goal of building the authority of your website.

For busy individuals wanting to have their skin pampered, going for an intensive skin care is not easy. If you have a healthy lifestyle and practice good hygiene - especially in caring for your skin, then there is no need to go to a dermatology clinic. Unless of course your problem is getting rid of those hideous scars, then you really need the help of a professional, where they have a laser clinic.

Laser Hair Removal and Hidradenitis Suppuritiva

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Lasers and Laser Hair Removal

As described in my previous blog Hidradenitis of the Armpits Hidradenitis occurs when a plug of dead skin in the duct of a gland emptying into a hair follicle initiates an infectious process as bacteria multiply within the plugged gland. As the gland swells a boil becomes visible. The obstructed gland or boil ruptures into the deep layers of the skin; adjacent glands become involved; and abscesses form. Subsequently, multiple draining sinuses or holes appear on the skin surface and the whole hair bearing area may become inflamed. Such inflammation may result in star shaped skin scars and tunneling, causing ridging of the skin. The association of Hidradenitis with hair follicles has fed the notion that removal of this hair early in the process can cure or ameliorate Hidradenitis. Since the 1990s laser treatment to remove unwanted hair has become increasingly popular therefore such treatments should to some degree treat Hidradenitis.

A laser is basically a container of some medium (such as a liquid dye, gas, etc) into which an electrical charge  or flash of light is introduced. The charge or flash excites electrons in the material at the molecular level and the material gives off a narrow band width of light as the electrons come out of excitation. The exact wavelength of light created depends on the material itself and the characteristics of the charge or flash. Mirrors inside the container bounce the light around to create a chain reaction of molecular excitation and the emitted light is allowed to escape through a pinhole. This single wavelength coherent light is then focused down into a hand piece so it can be applied to tissue. The effect on the tissues depends on which tissue components absorb the specific wavelength of light, the depth into the the tissue that the laser can penetrate, the duration of exposure to the light (pulse width), the power of the light at the point of tissue contact, etc.

Laser penetration is a factor of light wavelength with usually greater penetration for lasers with higher wavelengths of light. The wavelength also governs which tissue component will absorb a specific wavelength.
 
 

Do It Yourself Plastic Surgery Devices and Gadgets

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As mentioned in my previous blog Plastic Surgery in South Korea South Koreans get more plastic surgery per capita than citizens of any other country in the world. In that country it is seen as a prerequisite for success in work and relationships. The patients are also getting younger so patients in their first or second year of high school are becoming common. With this high demand a number of citizens especially teens cannot afford to have the surgery so they are turning to cheaper devices and gadgets to mold their features into a desired shape or appearance. Most of these devices are designed to supposedly change facial appearance and are sold online. The sellers of these devices make claims that have no scientific basis and there are no studies proving the efficacy of any of these devices. In fact looking at some of these devices would make one think their application is more suited to a form of torture. The use or overuse of these devices could very well result in infections, permanent scars or other irreversible deformities especially in young people who are still growing.

Here is a list of available devices.

Double Fold Eyelid Glasses

Bandages and Dressings for #HidradenitisSuppuritiva

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As described in my previous blog post Hidradenitis of the Armpits - Boils Under the Armpits a plug of dead skin in the duct of a gland emptying into a hair follicle in areas of opposing skin surfaces like the armpits, under the breasts and in the groin initiates an infectious process as bacteria multiply within the plugged gland creating a skin boil. The obstructed gland or boil ruptures into the deep layers of the skin; adjacent glands become involved; and abscesses form. Subsequently, multiple draining sinuses or holes appear on the skin surface and the whole hair bearing area may become inflamed. We call this process #HidradenitisSuppuritiva (HS).

As I described my first choice of treatment for this process is surgical removal of the involved skin and closure of the resulting wound with a flap of adjacent normal skin. However, this aggressive surgery is not always the best near term option because of insurance, financial, work or personal reasons. For early stages of the disease temporizing the situation with topical treatments is appropriate and can provide significant relief.

10 Things to Consider Before Having Plastic Surgery

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1. What is my surgeons training background?

Traditionally, doctors from just four medical specialties — plastic surgery, dermatology, otolaryngology (ear, nose and throat), and ophthalmology — have handled the bulk of cosmetic offerings, including everything from minimally invasive aesthetic treatments like botulinum toxin (sold under the brand name Botox) to more involved procedures like face-lifts. And those specialists spend years honing their chops in residency training programs that teach skills unique to each specialty in addition to basic surgical skills. Now doctors in these and other specialties may take a weekend course as the only preparation for doing your surgery. “Unfortunately, this is an industry where the most creative, assertive, sexiest marketing often drives the business, but it may not be someone with the best experience,” said David B. Sarwer, a professor of psychology at the Perelman School of Medicine at the University of Pennsylvania.

Smoking Adversely Affects Facial Aging

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The link between smoking and premature facial aging was first made in 1971. Surveys of twins attending the annual Twin Days Festival, held in Twinsburg, Ohio between 2007 and 2010 conducted by Case Western Reserve University department of Plastic Surgery have corroborated this. In each pair of twins, either one twin smoked and the other did not, or one twin smoked at least five years longer. Pairs in which neither smoked or the difference in smoking was less than 5 years were excluded.Fifty-seven of the included 79 twin pairs studied were women, and the average age was 48. The twins completed questionnaires regarding their medical and lifestyle histories specifically sunscreen use, alcohol intake, work stress and smoking history. A professional photographer took standardized, close-up photographs of each twin's face. Without knowledge of the twins' smoking history, plastic surgeons then analyzed the twins' facial features in the photos, including grading of wrinkles and age-related facial features to identify "specific components of facial aging" that were affected by smoking.

The sister on the left smoked 17 years longer than the one on the right which accounts for larger jowls, lip wrinkles and lower eyelid bags not present in the sister on the right as well as the deeper frown and laugh lines in the sister on the left.

The conclusion of the study was that the effects of smoking on facial aging are most apparent in the lower two-thirds of the face specifically lower eyelid bags, malar bags, upper eyelid skin excess, the lips, laugh lines and jowls.  The forehead wrinkles, frown lines and crow's feet wrinkles were not statistically different.  Smokers had more sagging of the upper eyelids, as well as more bags of the lower eyelids and under the eyes. Twins who smoked also had higher scores for facial wrinkles, including more pronounced nasolabial folds, wrinkling of the upper and lower lips and sagging jowls. I had once had a patient who smoked only holding the cigarette on the right side of her mouth. She had aging wrinkles of the right upper lip but not of the left upper lip. In her case one side of her face aged more than the other.

The take home message is do not smoke to lessen the need for cosmetic surgery and do not smoke afterward to maintain the results of cosmetic surgery for a longer period of time.

Dr. Aaron Stone - Plastic Surgeon Los Angeles
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Heart - Coronary Artery Stents and Cosmetic Surgery

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Heart (coronary) artery blockage is a local blocking or narrowing in the arteries on the outer surface of the heart by accumulated deposits of plaque, which is mostly bad cholesterol. Every artery in the body is a blood pipeline. These pipelines get blocked with accumulation of bad cholesterol. When a cardiologist suspects blockage or narrowing of any of these heart arteries he/she will perform an angiography (threading a catheter up a thigh artery to the heart to inject a dye that is visible on X-ray) to view the inside of the arteries. When an area of artery narrowing or blockage is identified a catheter with a balloon is inserted along the same path and inflated at the problem area to open it up. This is called angioplasty. Increasingly stents are placed at these angioplasty sites to keep them open in the long term. In some cases multiple stents are sequentially placed in the same artery. If the area cannot be treated in such a fashion open heart surgery is required which involves opening the rib cage and bypassing the blocked area with a vein graft or connecting an artery from inside the rib cage to the downstream side of the blockage. These procedures have helped prolong the life of countless heart disease victims. This blog only addresses patients who have had stents placed. It does not address those who have had open heart surgery.

Blood Clots, Venous Thromboembolism, Pulmonary Embolus and Cosmetic Surgery

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In a previous blog I discussed Bleeding Disorders and Cosmetic Surgery focusing on bleeding tendencies and abnormally low blood clotting. This blog deals with the other side of the coin abnormally high blood clotting. These clots usually form in large veins of the leg or pelvis or in the chambers of diseased hearts.

Fat Injections to Reconstruct Breasts or Increase Breast Size

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As described in my previous blog Free Fat Grafting grafts of small pieces of fat removed from one area of the body and placed in another area was first attempted in the late 1800s and early 1900s. In 1893, German physician Franz Neuber grafted a piece of upper arm fat to a patient’s cheek. Two years later, in 1895, another German physician, Dr. Karl Czerny, performed the first documented breast augmentation when he grafted a fatty tumor from a patient’s lower back to repair a breast defect. With the introduction of liposuction in the 1980s the available donor source for fat injections rapidly increased. Although a minority of plastic surgeons currently inject fat into the breast to enlarge them for cosmetic reasons the tide is changing. In 1987 the American Society of Plastic Surgeons advised against fat injections into the breast due to concerns that it affected breast cancer detection and the survival rate of injected fat was unreliable. That opinion was reversed in 2008 in the face of increasing evidence that cancer detection and cancer rates themselves were not affected by the procedure. Now the flood gates have opened and everyone even non-plastic surgeons want to inject fat into the breasts.