January 27th, 2011 by John Di Saia, M.D. in News, Opinion
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From the Food and Drug Administration (FDA) safety alert yesterday:
ISSUE: The FDA announced a possible association between saline and silicone gel-filled breast implants and anaplastic large cell lymphoma (ALCL), a very rare type of cancer. Data reviewed by the FDA suggest that patients with breast implants may have a very small but significant risk of ALCL in the scar capsule adjacent to the implant.
BACKGROUND: In total, the agency is aware of about 60 cases of ALCL in women with breast implants worldwide. This number is difficult to verify because not all cases were published in the scientific literature and some may be duplicate reports. An estimated 5 million to 10 million women worldwide have breast implants. According to the National Cancer Institute, ALCL appears in different parts of the body including the lymph nodes and skin. Each year ALCL is diagnosed in about 1 out of 500,000 women in the United States. ALCL located in breast tissue is found in only about 3 out of every 100 million women nationwide without breast implants.
While the FDA’s new report is interesting, as it stands it’s of little consequence. A mere 60 cases of a unusual breast cancer worldwide is a tiny number compared to the huge number who develop the much more common ductal breast cancers (about one in seven women in the U.S.) Breast implants have not been found to affect this more common cancer incidence. I do expect this statistic to be misquoted by the anti-breast implant factions online.
As an aside, I do remember a case in a fellow plastic surgeon’s mother of a lymphoma near a breast implant capsule when I was a resident. This is the only breast cancer of this type I have ever seen, however, in 14 years of practice. While I don’t doubt the association, I do focus on the significance of this report to the average breast implant patient, which is very little at this point.
– John Di Saia, M.D.
*This blog post was originally published at Truth in Cosmetic Surgery*
January 5th, 2011 by John Di Saia, M.D. in News, Opinion
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From the Chicago Tribune:
A 35-year-old woman who wanted to resculpt herself for the new year with liposuction and a buttocks enhancement is dead from apparent complications of plastic surgery, her husband and lawyer said Thursday. Miami customer service representative Lidvian Zelaya died Monday, hours after the operation began at Strax Rejuvenation and Aesthetics Institute, a busy cosmetic surgery practice in Lauderhill. Zelaya went to Strax to have fat suctioned from her back and belly, and to have the material injected into her backside, family representatives said. She chose Strax because she got a good deal. Aronfeld said the operation was to be done by Dr. Roger L. Gordon. He was disciplined by the state in connection with two plastic surgery deaths in 2004.
This is getting ridiculous. Liposuction deaths have been frequent in the media as of late. And this surgeon, Roger L. Gordon, M.D., is a real, board-certified plastic surgeon as per the American Board of Medical Specialties (ABMS).
Then again, plastic surgery IS surgery and therefore has risk associated with it. Was this an unfortunate accident or something else? How can a potential patient choose well to limit the risk of cosmetic surgery? Read more »
*This blog post was originally published at Truth in Cosmetic Surgery*
December 27th, 2010 by John Di Saia, M.D. in Better Health Network, Health Tips, Opinion, Quackery Exposed
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I saw a Scarguard product on sale at a drugstore locally. The claims on the packaging were over the top as usual:
1. “Guards against new scars forming” – Difficult to prove.
2. “Flattens and shrinks old scars” – Not really.
3. “Scarguard is the #1 choice of plastic surgeons” – Really? Nobody asked me.
Scar treatment is pretty simple. Avoid wounding if you can. If you have plastic surgery, seek a skilled surgeon who will spend the time to do the best. After surgery avoid sunlight and smoking, and consider scar massage as directed by your surgeon. This “Scarguard” product is not going to make a bad scar much better unless it is applied early, and even then the results are debatable.
– John Di Saia, M.D.
*This blog post was originally published at Truth in Cosmetic Surgery*
December 18th, 2010 by John Di Saia, M.D. in News
3 Comments »
The Orange County Register blog posted on military plastic surgery and mentioned liposuction:
Army Times reports that soldiers are turning to liposuction to remove fat if extreme dieting, laxatives and other methods fail to get them under the Army’s weight limit for their height, age and gender.
“Liposuction saved my career. Laxatives and starvation before an [Army Physical Fitness Test] sustains my career,” a soldier told the periodical. “Soldiers are using liposuction, laxatives and starvation to meet height and weight standards. I did, do and still do.”
I am well aware of the military patient looking to stay within military parameters to stay in the service as my San Clemente office is quite close to Camp Pendleton, and I give military discounts. I have seen several of these patients in my decade in San Clemente. Surgery for wives still outnumbers surgery for soldiers, though.
As some of these clients have explained, the Marine administration requires active duty soldiers to have certain measurements at a certain weight. Those who do not fall within these expected norms are first warned and then penalized. Liposuction has worked at times to keep some of these soldiers in the service.
– John Di Saia, M.D.
*This blog post was originally published at Truth in Cosmetic Surgery*
December 10th, 2010 by John Di Saia, M.D. in Better Health Network, Health Tips, Opinion
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Reader question:
A surgeon I’m thinking about seeing said on his website that breast implants were able to be done under local + intravenous anesthetic (like twilight). Can this really be done? I always thought it was too invasive for just twilight, especially if it is under the muscle. Is there an advantage to using twilight? After looking it up, there are lots of differing opinions out there, but I think that this may just be a way for the surgeon to cut costs. What is the cosmetic surgery truth here, Dr. D?
I am not a fan of local anesthesia or twilight sleep for breast implant surgery except in rare cases (simple redos and such). The reasons are patient comfort and practicality. I place most of my breast implants under the pectoral muscles, and these muscles need to be relaxed for this to work out. That relaxation is suboptimal under less than a general anesthetic. Read more »
*This blog post was originally published at Truth in Cosmetic Surgery*
