Posts Tagged ‘plastic surgeon scottsdale’

One More Reason to Have Plastic Surgery in the United States

Tuesday, January 24th, 2012

My Phoenix plastic surgery patients sometimes ask me if it is a bad idea to go to other countries to have their procedure performed at a lower cost. In my opinion, surgery is serious business, and bargain hunting should not be one’s priority when it comes to issues of health, surgical quality and safety.

There are certainly some very talented surgeons in Mexico, South America and elsewhere, but the degree of oversight and regulations pales in comparison to the U.S. Surgery is not just about the plastic surgeon – for Scottsdale residents, it is also about the ancillary staff, as well as accreditation, medications and devices used during surgery. In the U.S., very stringent rules and regulations are in place to protect patient safety. The FDA provides important oversight to ensure that medications and products used during surgery have been studied and tested properly.

Recently in the news, there have been reports of concern with a particular type of implant manufactured in France by a now-defunct company called Poly Implants Prothèses (PIP). In 2006, I was involved in a study demonstrating the high deflation rate of saline implants produced by PIP, which was published in Plastic and Reconstructive Surgery, the most prestigious journal for plastic surgeons. In this article, we advised that the deflation rate with these implants was much higher than with saline implants produced by Mentor® and Allergan, the U.S. implant manufacturers.

More recently, it has come to light that the silicone implants produced by this company were made using industrial-grade rather than medical-grade silicone. Of course, this cut the cost on implants significantly, but it also cut major corners on safety. Now, many women are reporting concerns with their implants and tens of thousands of women all over the world may be advised to have these implants removed and exchanged.

Thankfully, because the FDA never approved these implants, the only American women who have to worry are those who travelled abroad for surgery and received PIP silicone implants. Unlike Mentor and Allergan silicone implants, which are considered the most studied medical devices in medical history, PIP implants did not have to undergo rigorous safety screening by the FDA. As a result, patients will have to endure extra surgery to deal with the failure of PIP to produce a quality medical product.

This situation should serve as a warning to patients: Cutting costs up front may end up costing more in the long run. Although surgery in the U.S. is generally more expensive than in other countries, this cost covers more than surgery alone. It covers additional safety and quality and, ultimately for patients, peace of mind.

Scars: What to Expect After Plastic Surgery [Part I: Controllable Factors]

Wednesday, January 11th, 2012

As a plastic surgeon in the Scottsdale area, one of the questions I often hear from patients is: “What will my scars look like?”

Obviously, scars will be a concern for patients having extensive surgery, such as a tummy tuck or a breast lift, but patients having less invasive surgery, such as liposuction or breast augmentation, still worry about their scars.

The truth about scars is that there are some aspects the surgeon can control, while other aspects cannot be controlled. Keeping that in mind, the first part of this two-part blog series will discuss the controllable factors, and the second part will discuss the uncontrollable ones.

Controllable factors mostly have to do with surgical technique and postoperative care. During surgery, it is important for the surgeon to be as gentle as possible with the tissues. Rough handling of the skin, overuse of cauterization and imprecise incisions can certainly cause extra scarring. In addition, poor suturing techniques, the types of sutures used and how carefully the sutures are placed can affect scar healing.

When I perform a procedure such as a tummy tuck in the Phoenix area, I am extremely meticulous about how I handle tissue in order to cause the least amount of trauma possible. I also take time during the closure to make sure the tissues and skin line up as cleanly and smoothly as possible. Finally, for all but the smallest surgeries, I do multiple layers of suturing with dissolving, under-the-skin sutures to avoid any stitch marks in the skin. I use longer-lasting deep sutures to take tension off the skin-surface sutures, which reduces the possibility of scar spread.

Controllable factors after surgery include minimizing the risk of infection, scar massage, using ointment in the early period and using silicone sheeting or steroid injections if necessary to flatten scars. For my patients’ follow-up visits after surgery, I always see them personally to evaluate the scars and advise them on what can be done to minimize the visibility of scars.

It’s important to understand that scars fade over time. As you heal, your scars will become less visible.

One final idea I would like to share is that patients can take part in their own healing process to minimize scars. It is very important to follow post-op instructions, including these recommendations:

  • Do not exercise too soon. This can put strain on the tissues.
  • Avoid smoking after surgery. Smoking impairs wound healing.
  • Avoid UV exposure or tanning of scar areas for a full year to minimize scar darkening.
  • Massage your scars for a few minutes each day to help them soften. Products such as Mederma®, which are marketed specifically for reducing scars and stretch marks, are fine, but studies have not shown a huge improvement in long-term scarring. If patients want to use these products, I do not discourage them as long as I know exactly what they are putting on their scars. Some products, such as topical vitamin E, have been shown to cause more harm than good.

In Part 2 of this blog series, I will discuss factors related to scarring that are outside our control.