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Latest Posts

Husband Disapproves Of Wife’s Decision To Get Breast Reduction Surgery

Jeanette’s story:

For as long as I can remember my nickname has been ‘Jen Big Boobs’. Friends joke that the first thing they see when I walk through the door is my chest. I know they mean no harm – just as ­­I know that my husband, Steve, adores them ­­– but it’s reached the point where they have ­­got to go. They simply dominate my life. Whether I’m trying to get comfy in bed or walking down the street I can’t forget them for a moment. They are always there, getting in the way of everything I do. In primary school I was the first in class to wear a bra. So when my pals changed in the classroom for PE, I’d change in the loos. Big boobs weren’t a huge surprise – they ­run in my family. But it was embarrassing and ­I didn’t like being different. They’ve singled me out for loads of attention. Buying bras has always been and still is a nightmare. I have to order specially-made ones that are ugly and cost up to £50. By the time I was 20 I’d already gone to see ­my GP about a reduction operation. He was ­sympathetic but said I was too young for ­surgery.

Steve’s story:

I love my wife’s big boobs and don’t want them reduced. I don’t mind admitting that Read more »

*This blog post was originally published at Truth in Cosmetic Surgery*

Can Major Scarring Be Avoided With Breast Lift Surgery?

Breast Lift surgery (Mastopexy) is obviously surgery to lift the breast. There are variations of this operation – quite a few variations. Breast lift operations are usually discussed relative to the “full breast lift” which has also been called the anchor lift. This operation leaves scars around the areola, under the breast and vertically between the two. The shape of the scar configuration resembles an anchor, hence the name. The potential for scars is one of the major concerns potential patients have with the surgery. This version of the operation also has the greatest potential to change the shape of the breast.

Reduced scar breast lifts came into creation to limit the potential for scarring. The important compromise, however, is that these modified breast lifts “lift” less. Reduced scar lifts can involve any portion of the full lift scar pattern. The modified lift with an incision above the areola only is called a “Crescent lift.” It provides only Read more »

*This blog post was originally published at Truth in Cosmetic Surgery*

When Instinct Trumps Expertise

A hard thing about being an ER doctor is that I know a little, sometimes very little, about a lot of things. When I am faced with a particular condition, I often need to call the specialist for that organ, who knows way way more about it than I ever will, and they all think I’m an idiot because I don’t know as much about their organ as they do. There’s a huge asymmetry of knowledge, and it can create some tension and conflict.

I’m OK with it, because I can ignore their condescension and I am secure with what I do know, and its limits. But sometimes I get perplexing instructions from the specialists. The emergency medicine dogma can be overbroad and a little hidebound and what the specialists will do in the real world often radically diverges from what the Emergency Medicine textbooks say to do. It’s often an interesting learning opportunity for me, especially when it’s a condition I don’t encounter that much.  But I also have to work to maintain a flexible and open-minded attitude when I call a consultant and my side of the conversation consists of “Really? I didn’t know you did that for this…” You need to know and trust your colleagues in other specialties, and know when to call BS on them and push to do something else, which is really hard to do when you are talking to someone who is so much more of an expert than you are.

So I saw this guy recently, an urban hipster who was perhaps a bit too old to be riding his longboard on the hilly streets of our fair town. He didn’t seem to be too good at it, judging by the collection of crusted abrasions and aging ecchymoses he was sporting. He had been falling a lot recently — we only get about a month of sun here, so I guess he was making the most of the summer weather practicing his new hobby.  He had a variety of complaints from Read more »

*This blog post was originally published at Movin' Meat*

Do Breast Implants Have An Expiration Date?

I read someone said she had to get her implants re-done 20 or so years later. I thought that getting breast implants was a one-time thing. How long do breast implants last?

Breast implant surgery is definitely not to be considered a “one time thing.” That is one good finding that came out of the breast implant craziness of the 1990′s in the US; the time at which the FDA banned silicone gel implants and demanded studies.

Interestingly, the implants themselves are not always the problem that leads to re-operation. It can be the body’s reaction to them. Silicone gel breast implants in particular can Read more »

*This blog post was originally published at Truth in Cosmetic Surgery*

Latest Interviews

Caring For Winter Olympians In Sochi: An Interview With Team USA’s Chief Medical Officer Dr. Gloria Beim

I am a huge fan of the winter Olympics partly because I grew up in Canada where most kids can ski and skate before they can run and partly because I used to participate in Downhill ski racing. Now that I m a rehab physician with a reconstructed knee I…

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How Do Hospital Executives Feel About Locum Tenens Agencies And Traveling Physicians?

I recently wrote about my experiences as a traveling physician and how to navigate locum tenens work. Today I want to talk about the client in this case hospital side of the equation. I ve had the chance to speak with several executives some were physicians themselves about the overall…

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Latest Book Reviews

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

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