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Latest Posts

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*

Required MRI Screenings Following Breast Implants: Unnecessary?

It’s amazing what you will find sorting through more than 20 years of stuff.  This picture of 3 implants includes:  top — an old McGhan double lumen (silicone gel implant surrounded by a saline implant); bottom left – Dow Corning textured silicone implant; and bottom right – Dow Corning smooth silicone implant.  Dow Corning has not made breast implants since approximately 1992.

Last week the FDA met to discuss and make recommendations on postmarketing issues related to silicone gel-filled breast implants.  As a condition of placing silicone implants back on the market in 2006, both Mentor and Allergan (McGhan) were supposed to enroll patients in 10-year-long follow up studies on side effects related to implants.  The aim was for 80,000 women.

I agree these studies are needed, but it is difficult to get women to return year after year.  This is evident in the data presented at the meeting: Read more »

*This blog post was originally published at Suture for a Living*

Medical Mythbuster: Mold in Saline Breast Implants

I read online a woman telling about how her saline breast implants got mold and she had terrible problems. Does this happen very often?

A few years ago I put up a YouTube video of my experience with silicone gel breast implants. Now every six months to a year somebody posts a comment about how saline implants are just as dangerous. A frequent portion of that response is a statement about a moldy saline implant. My response is and always has been, if saline implants are so often affected by mold, then why have I never seen it?

I have been implanting (and at times removing) breast implants for over 15 years. You would think if something was a dangerous and common phenomenon that I would be seeing it. I haven’t. Not even once.

A saline implant when left on a table outside of your body can develop mold, but this doesn’t seem to happen inside patients. The difference is probably that when implants are properly placed inside a woman’s breasts, her immune system helps protect them from such problems. Read more »

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

Hardened Breast Implants (Capsular Contracture): A Reader Question

I have had a capsulectomy due to capsular contraction, but now it has returned. I want an explant because they are uncomfortable and look unnatural. My doctor said that since the capsulectomy did not resolve the issue, he recommends having an explant and waiting about 6 months to a year. After my body has healed properly, he said that I can get implants again and will not get capsular contraction again. Is this accurate? Am I less likely to get capsular contraction or will I be free of capsular contraction? I’m also looking for a doctor experienced in explants.

The subject of hardened breast implants (Capsular Contracture) comes up frequently as it is the leading cause of long term dissatisfaction with breast implants. If your breasts tend to hurt or look unnatural, you likely have severe encapsulation (Baker Grade III or IV.) When contracture redevelops quickly after capsulectomy (assuming the operation was thorough,) this is worrisome as it may indicate a high tendency for recurrence. The main question when severe contracture is present is whether or not a cause can be identified. Bothersome contracture doesn’t happen to all patients. This kind of reaction is associated with cigarette smoking, bleeding, infection, silicone gel implants, poor soft tissue coverage and radiation exposure as well as a previous history of contracture. Some of these issues can be minimized in an attempt to reduce the tendency for encapsulation. Preventing the problem is the best solution. Read more »

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

Toner, Serum, Or Cream: Which First On Your Face?

Step-by-step skin care? It’s complicated. You have a cabinet full of toners, creams, and serums and you don’t know what goes on when. Using products in the wrong order could mean you’re not getting the most for your money. Here’s a guide to make it easier for you:

1. Toners

Toners are astringents, which means they contract tissue like pores, making your face feel tighter. They often contain alcohols and are used to remove oil from the skin as well as tightening. Therefore, you should use them first. If you have dry or sensitive skin, however, you might skip them completely because they can make dryness worse.

2. Serums

Serums are liquid cosmetics. They usually have antioxidants or peptides to minimize the day’s damage done to your skin and to give you a more youthful appearance. Serums are applied first so that there’s nothing between their expensive ingredients and your skin. The exceptions are serums that contain silicone or dimethicone. Silicone helps lock moisture in your skin, but it also acts as a barrier hindering anything above it from getting to your skin. Silicone serums should be applied last. Like expensive serums, any prescription medications should also be applied first to ensure that their active ingredients penetrate the skin unhindered. If you have both, then apply the prescription first and the serum second.

3. Eye cream and face cream

Face and eye creams can be simple moisturizers or complex anti-aging products. Eye creams usually have antioxidants to help restore this most delicate skin. If you have one, then apply it before your face cream. Otherwise, by applying your face cream first, you risk rubbing it into your eyes. Once your prescription medications (if any) serums, and eye creams have absorbed, then apply your face cream last. If your serum has silicone or dimethicone, then apply it last, so its protective ingredients are the outermost barrier.

*This blog post was originally published at The Dermatology Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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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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