July 19th, 2011 by John Di Saia, M.D. in Health Tips
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When I tell people I have a hybrid plastic surgery practice, I am not talking about a fuel efficient car. I am talking about the fact that I do both cosmetic surgery and medically-necessary surgery. Part of the medically-necessary surgery includes the repair of pressure wounds (also called decubitus ulcers.)
Not only is this type of surgery not cosmetic, it can be pretty ugly. It is surgery to assist often long standing wounds in healing in often significantly ill patients. If possible such a wound is repaired using tissue from adjoining areas of the body called fasciocutaneous and musculocutaneous flaps after scar and debris is cut away. This isn’t pretty, but Read more »
*This blog post was originally published at Truth in Cosmetic Surgery*
May 17th, 2011 by John Di Saia, M.D. in Opinion
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In a nation with 93 million obese people, a few ob-gyn doctors in South Florida now refuse to see otherwise healthy women solely because they are overweight. Fifteen obstetrics-gynecology practices out of 105 polled by the Sun Sentinel said they have set weight cut-offs for new patients starting at 200 pounds or based on measures of obesity — and turn down women who are heavier. Some of the doctors said the main reason was their exam tables or other equipment can’t handle people over a certain weight. But at least six said they were trying to avoid obese patients because they have a higher risk of complications.
Source: visiontoamerica.org/719/report-doctors-refusing-to-treat-overweight-patients/
While I have not specifically “refused to treat” obese patients, I have in a few cases recommended against surgery or recommended weight loss and re-evaluation later. Than again I am not in primary care and do understand what these OB/GYNs are saying. Obese patients do represent more risk when it comes to surgery and that would of course cover pregnancy and child bearing.
Take into account that Read more »
*This blog post was originally published at Truth in Cosmetic Surgery*
May 1st, 2011 by John Di Saia, M.D. in News, Opinion
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This MSN article states that doctor-owned hospitals are on the rise. In California, the opposite is the case. The hospital business is a lousy business in which to be. I would rather open a surgical facility. I had an opportunity to be a part of a group that bought a hospital a few years ago and passed.
In California, real medicine is going into the toilet as doctors realize that the work they have put in to get educated makes practicing fairly unrewarding. Niche markets and gimmicks are replacing the conventional medical landscape. That’s the reason we have so many non-plastic surgeons turning to cosmetic work. The bottom line is that you need to pay doctors enough so they can make a decent living or they will find something else to do.
Sad but true.
*This blog post was originally published at Truth in Cosmetic Surgery*
April 15th, 2011 by RamonaBatesMD in Opinion, Research
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I’ve spent some time thinking about this survey. I couldn’t find any better information on the survey than the press release from the University of the West of England (UWE). Perhaps in the future it will be published in a journal for better review.
The survey was apparently done by the new eating disorder charity The Succeed Foundation in partnership with the University of the West of England (UWE). The editor’s notes indicate 320 women (ages 18 – 65 years, average age 24.49) studying at 20 British universities completed The Succeed Foundation Body Image Survey in March 2011.
Notably, the survey found that 30% of women would trade at least one year of their life to achieve their ideal body weight and shape. Read more »
*This blog post was originally published at Suture for a Living*
January 28th, 2011 by Elaine Schattner, M.D. in News, Opinion
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The FDA [has] issued an alert about a possible link between breast implants — saline or silicone — and a rare form of lymphoma called anaplastic large cell lymphoma (ALCL). These lymphoma cases are exceedingly rare, but the association appears to be significant.
The FDA identified a total of approximately 60 ALCL cases in association with implants, worldwide. Of these, 34 were identified by review of published medical literature from 1997 to May, 2010; the others were reported by implant manufacturers and other sources. The agency estimates the number of women worldwide with breast implants is between five and 10 million. These numbers translate to between six and 12 ALCL cases in the breast, per million women with breast implants, assessed over 13 years or so.
In women who don’t have implants, ALCL is an infrequent tumor, affecting approximately one in 500,000 women is the U.S. per year. This form of lymphoma — a malignancy of lymphocytes, a kind of white blood cell — can arise almost anywhere in the body. But ALCL cases arising in the breast are unusual. The FDA reports that roughly three in 100,000,000 women are diagnosed with ALCL in the breast per year in the U.S.
These are very small numbers. Still, the finding of ALCL tumors by the implant capsules is highly suggestive. Almost all of the implant-associated ALCL cases were T-cell type, whereas most breast lymphomas are of B-cell type. The lymphomas arose in women with both silicone and saline-type implants, and in women with implants placed for purposes or augmentation and for reconstruction after mastectomy. Read more »
*This blog post was originally published at Medical Lessons*
