Wednesday, September 10th, 2014
It seems to be all the rage in New York these days. Saline injected directly into the breast tissue. Wow!
So, why on earth would a woman have something like that done? There are a few reasons. Some women who are considering breast augmentation want to have a good idea of what they'll look like with breast implants. Rather than trying on implants in their bras, they can have a doctor inject saline into their breasts. Seeing what 350 cc's of saline in the breast looks like may provide some indication of the look a 350 cc implant may create. Some women have no desire to actually get breast implants, they just want to have larger breasts for about 24 hours. The injections can certainly provide an amazing look for parties, weddings, and red carpet type events. The effect, however, only lasts about 18 to 24 hours. In New York City these procedures go for $2500 to $3500. That's quite a bit to pay for a 24 hour pick-me-up.
I understand the thoughts behind saline injection into the breasts. On some level it makes sense. On the other hand, in our office we use the Vectra XT three dimensional imaging system to help women understand about how they may look with specific breast implants. Rather than do multiple needle sticks (some of which invariably will pass through milk ducts, potentially introducing contaminants into the breast tissue), the Vectra system lets the computer do the work to help show potential results. A study published just last month found that this system has about a 90% accuracy rate. Saline that is injected directly into the breast will not give a reliable representation of what a breast implant will do. Saline that is injected into the breast is placed in the breast tissue itself; an implant is placed behind all of the breast tissue and in most cases partly behind the pectoral muscle. Saline injected into the breast tissue will expand the skin and breast tissue in all directions. An implant placed behind the tissue pushes the tissue forward. The look really is different.
There may be some risks to the saline injections. As mentioned above, they may push contaminants into the otherwise sterile breast tissue. This could lead to infection, even if the procedure is done as sterilely as possible. Also, if you've ever been given a shot, you know that some bruising may occur. Injecting saline deeply into breast tissue requires fairly large needles to pass through a lot of tissue, including some blood vessels. That's likely to create some bruising and soreness. Finally, if the procedure were to be done multiple times to the same woman, it's possible that her skin would stretch and become droopy. That's not likely to happen with one or two injections, but it's conceivable that it would happen after multiple procedures.
I have not yet had a woman come into my office asking for saline breast injections. If she wanted to do it for some special event and understood the effect would only last about 18-24 hours, I would probably consider it. On the other hand, if her thought is that she'd like to see how she would look with that volume implant, I would have her try three-dimensional imaging with the Vectra system. I think it's likely that the Vectra system will provide a more accurate representation of the potential outcome, and do it with no real risk.
Come by and see the Vectra XT three dimensional imaging system. We use it with almost every patient we see in the office. It's cool, it's powerful, and it makes the consultation process so much more meaningful.
Thursday, August 14th, 2014
We are proud to announce that Katie O'Keefe has joined the practice! We interviewed dozens of applicants, waiting patiently to find the person we think can provide outstanding results for her clients while maintaining the practice standards of customer service, client education, and desire for continued improvement. Katie is all that and more! From every-day skin care programs to chemical peels, dermaplaning, and microderm, Katie would love to personalize a treatment regimen to help your skin achieve optimal health and appearance. She went to TCU, is an avid hockey fan, and loves animals. Come visit with Katie and see why we're so excited she's here!
Tuesday, August 5th, 2014
With one son having graduated from high school this year and another who will graduate in 2015, we've become quite familiar with the college application process. What an ordeal! There's the common ap, of course, but then the individual college applications all want something a little different. And the essays! I particularly like the one where they ask the student to complete the essay in exactly 28 words, no more, no less. Having great letters of recommendation, well, that goes without saying. Great grades? Of course! AP test scores of 4 or 5? Better have it all. We saw the movie 'Admission' last year as our son started this process. Funny movie, but I can say it actually kind of mirrored the entire experience. This is a great time in my sons' lives, whether they realize it or not. And mine too. Watching them grow, mature, make meaningful decisions, and start down paths over which I have no control...fantastic stuff! It's scary, but I sure am enjoying it!
Thank you for reading this small digression from the usual plastic surgery information.
Thursday, June 26th, 2014
I just came back from a fantastic meeting in Las Vegas. This was a multidisciplinary meeting with plastic surgeons, dermatologists, ophthalmologists, and ENT facial surgeons from around the world. I was looking for an opportunity to see how physicians in other specialties address issues that I see as well. For instance, how do ophthalmologists who do cosmetic eyelid surgery treat patients with baggy eyelids? How do ENT facial surgeons do facelifts? I have been to many, many meetings in the past where plastic surgeons talk about how they do things; this was an opportunity to meet with many types of doctors. I spent time talking with a doctor from Dublin, Ireland who gives talks around the world about research showing that Botox may actually be medically helpful in patients with depression. Another interesting doctor I spent time with was an ophthalmologist from Beirut, Lebanon. We talked about fat grafting around the eyes, as well as life in Lebanon in general. The meeting exceeded my expectations. So much information! The only 'downside' is that now my office staff will have so many new things to integrate into the practice!
Tuesday, February 11th, 2014
This unusually cold North Texas winter will soon be a memory. Spring is just around the corner! Temperatures warm, heavy coats are put away, and warm weather clothing makes its way to the display racks. It's a perfect time for breast augmentation! Contrary to what a lot of people think, most women who come to see me for breast augmentation surgery don't want really big breasts; they just want to wear great tops. Most of these women have never felt comfortable in cute tops or bathing suits and they want to feel confident wearing sleeveless and strapless clothing.
One of the best things about breast augmentation is that there are so many shapes and sizes of breast implants available. We can help you choose an implant that enhances your figure without making you look disproportionate. In our office the Vectra 3-dimensional imaging system is used as part of the consultation to help you find the look you want. The Vectra system takes photographs of your torso with 6 cameras, and the computer blends these photographs into one three-dimensional image. We can choose any implants available in the US today, click a mouse, and like magic the software creates a simulated image of your breasts with those exact implants in place. Rather than seeing before-and-after pictures of other women who have undergone breast augmentation, this system lets you see what you may look like after an augmentation. The software even includes bikini tops and sleeveless tops that may be superimposed on the image to show you how you might look in those.
Spring is a fantastic time for breast augmentation. Be ready for the summer! Come visit with us and see what you might look like after an augmentation. The Vectra technology is way cool. Check it out!
Sunday, October 27th, 2013
I just returned from an educational event in Miami. About 200 plastic surgeons were invited by Allergan (a large company producing many aesthetics products including breast implants) to learn about a new product they will be launching in January 2014. The product is a sophisticated silk mesh that may be used for, among other things, revising certain types of reconstructive and cosmetic breast problems. We were taken to a lab, the Miami Anatomical Research Center, and provided with a "hands-on" learning experience in a very high-tech environment. The product, called SERI, looks like it may be very helpful for women whose breast implants have "bottomed out" or end up too far apart or too close together. This was a great experience and an opportunity to remain at the forefront of providing innovative products and services in breast surgery. All of us in the office are dedicated to providing our patients with current, comprehensive, and compassionate care. Come check us out!
Wednesday, September 11th, 2013
Board certification in plastic surgery is not easy. To become Board certified a surgeon initially has to pass a written examination. If he (she) passes the written examination he is then asked to take an oral exam. Each of these exams typically has a failure rate of about 20%. Put another way, for each 100 surgeons going through the process, only 64 are successful the first time around. This failure rate is the highest among all the surgical specialties' certification processes, indicating that certification in plastic surgery may be the most difficult of all Boards.
After becoming certified, the plastic surgeon then has to submit information to the American Board of Plastic Surgery every two or three years indicating what scientific meetings he (or she) has attended, what types of cases he has performed, and even examples of the advertising he does. This year (2013), for instance, I had to submit a list of every case I performed from January 1st through June 30th to the Board (names of patients were removed). The information included how long each case took to perform, what hospital or surgery center was used, what complications (if any) took place, and the number codes used for each diagnosis and each procedure. That's pretty detailed information that other Boards often do not require.
It's a lot of work to obtain all the information requested by our Board. I'm proud of our Board, however, because they really do have our patients' best interests in mind. The American Board of Plastic Surgery wants to make sure that its members are practicing safe surgery, obtaining excellent outcomes, and are doing this in an ethical way. I have been Board Certified since 1996 and have never failed a Board exam. Maintaining certification in plastic surgery indicates a high level of commitment to our specialty, and ultimately to our patients. Make sure you visit with a surgeon certified by the American Board of Plastic Surgery. Certification matters.
Thursday, September 5th, 2013
We are the first medical practice in Tarrant County offering the Vectra XT imaging system. This is truly a "Wow" device! Six cameras take pictures of you, then a computer takes those six pictures and reconstructs one 3-dimensional image. We can then do some amazing things with this 3-D image. The image can be rotated and twisted, allowing us to show you parts of you that are hard to see in a mirror. As part of the educational process, we can draw on the image to show you, for instance, where incisions may be required or to point out specific findings to make sure that we are talking about the things that are most important to you. For our breast augmentation patients it's even better. Information about every breast implant currently available in the US is stored on the computer. We can take the 3-dimensional image of the woman's chest and pick a specific size, shape, and volume implant. Click a button and voila! The computer creates an image of what the result of those specific implants might look like in that specific person. Want to see what a different set of implants might look like? Click, done. We have also found this to be very useful in our breast cancer patients. In those women it helps us tailor the final result to more closely match the size and look of the reconstructed breast to the breast without cancer. While this imaging system does not tell us exactly what someone's final result will be, we have found it to be a wonderful tool in helping our patients understand possibilities. Vectra has been, for our practice, an incredible enhancement to the entire educational process for our patients. Come see it for yourself! We're the first in the area to have it!
Saturday, February 4th, 2012
We are going to have another of our Girls' Night Out events this Wednesday, February 8th, from 6 to 8 pm at our 8th Avenue office. Each of our events, taking place three or four times a year, has a unique theme. The theme for this event is "Beauty with Friends". Our aesthetician, Lori Roby, will talk one-on-one with guests about some of the great products and services she offers. Our clinical nurse injector, Krista Barrington, will demonstrate Botox injections on one of our current clients. And of course, I will speak a little about surgical options over any number of topics, tailoring the discussion to the women present that evening.
These events also raise money for local organizations that provide special care and services that blend with the needs of many of our patients. Previously we have donated portions of the proceeds from these evenings to the Joan Katz Breast Center (link: http://www.wfaa.com/good-morning-texas/Celebrating-the-Opening-of-Joan-Katz-Breast-Center-92340909.html), and the local Komen Foundation ( link: http://ww5.komen.org/). For the February 2012 event, the recipient is Cuisine for Healing (link: http://www.cuisineforhealing.org/). We are excited to partner with these groups. Sue Austin from Cuisine for Healing will be present Wednesday evening and you can learn all about it from her.
Another terrific local organization that also offers special services to our breast cancer patients is Indigo Yoga (link: http://www.indigoyoga.net/). Brooke Hamblet Hinkle, Founder and Director, will also be present Wednesday. Come visit with her to learn about yoga may be of benefit to you or someone you know!
These are not just boring little wine-and-cheese events. The office staff kind of goes 'over the top' in putting these evenings together. Come join us and see for yourself. Bring a friend! Call the office and make a reservation because, darn the luck, the fire marshal only allows so many people in the building at one time!
Wednesday, September 28th, 2011
One of my passions is breast reconstruction surgery. In the Fort Worth area we have many talented surgeons performing mastectomies for breast cancer patients, and I have worked with 13 of those surgeons this year. Fort Worth surgeons are knowledgable about breast reconstruction and frequently present it as an option to their patients who are planning to undergo mastectomies. Nationwide, however, that is not always the case. Studies from the University of Michigan found that minorities had previously not been offered reconstruction in a disproporionately high percentage of cases. Because of this, the state of New York last year made it mandatory that women undergoing treatment for breast cancer be offered the option of breast reconstruction. This article is a nice summary of that: http://www.psnextra.org/articles/breast-recon-law.html .
I am involved with a team of physicians who treat breast cancer patients. We have conferences on Wednesdays where individual cases are presented. The team includes medical oncologists, radiation oncologists, surgical oncologists, pathologists, breast-imaging specialists, clinical breast nurse navigators, genetics specialists, and plastic surgeons. All aspects of the cases are discussed, from the specifics of the tumor cells to the living situation of the patient. This provides a balanced, well-thought-out plan of treatment uniquely suited to the patients. Because of my dedication to treat these cancer patients in a timely manner, we sometimes have to alter my clinic schedule so I can work with the mastectomy surgeon to eradicate the cancer and provide immediate breast reconstruction. My office staff does amazing work in managing all of this. We find that this team-oriented approach makes the entire process a little less scary, a bit more comforting, and a lot more thorough in providing optimal treatment for our breast cancer patients.