HOT TOPICS WITH DR. CHERNY

CAN BREAST IMPLANTS CAUSE CANCER?

A possible link of breast implants to breast cancer was reported in the papers 1/27/2011 and I don’t want my patients to be worried!

I first heard about this a year ago. A top scientist was lecturing at a national plastic surgery meeting. At that time only 12 patients, out of the millions who have had breast implants, developed a rare lymphatic cancer around their implants (ALCL).  The scientist reported that these 12 patients all had only one brand of implant, and only had the textured shell devices, which I never use anyway. In the latest news, the number reported is now sixty out of the five to ten million patients with breast implants.

The shells of saline and silicone are both are the same, so I don’t think switching back to saline is the answer.  Not using textured implants is the answer.  In the 1990’s I lived through the last scare like this, over polyurethane shelled implants.  That came to nothing. Polyurethane became a carcinogen if it was subjected to 1000 degrees of heat. We haven’t seen that happen to any of our breast implant patients lately! It was a great implant, but we dutifully stopped using them anyway. Though, these implants are coming back.

Large studies have shown that women with breast implants have an overall lower risk of breast cancer than the general public. We don’t use the implants in question.

If there was any evidence that breast implants cause harm to patients in any way, we would definitely stop doing them! So in the meanwhile, try not to worry.

What is the lifestyle lift and how is it different from the Heartland Mini Euro Facelift?

The lifestyle lift people just reached a settlement to pay $300,000 to the state of New York as a penalty for false advertising.

http://www.plasticsurgerypractice.com/eReport/2009-07-20_02.asp

Patients have told me about high pressure sales tactics.  I’ve looked at the pictures on their website and they look absolutely fabulous postop, but the patients appear to possibly had chin implants and possibly other procedures with the lift.  Looking at their panel of doctors, only a smaller percentage of the docs are Board Certified Plastic and Reconstructive surgeons. “Nuff said.  Whatever the medical situation, choose your doctors the old fashioned way; reputation, credentials, and recommendations of trusted friends and your personal physician.  Then meet the doctor and see if the chemistry is right. This way, you can’t go wrong.

What is the new “Bra Line Back Lift”?

We have always done lipo of the back to address those troublesome rolls beneath the bra line, but when the skin is loose, the rolls don’t always go away.  Dr. Hunstad in Charlotte, a fellow Aesthetic Society member, has designed a “bra line back lift that treats this area with the excision of the rolls with an acceptable scar that is hidden below the bra line.  In the procedure, Dr. Cherny marks the bra line (or the patient can tan before the surgery), so as to design the location of the scar.  The excessive skin is removed, with the skin ligaments removed that cause the roll.  The skin is pulled tight and sewn together so the scar lies below the bra line.  This method is a significant improvement over previous designs we have utilized.

Patients can shower the next day, and resume normal activities within 3 days of the operation.  The procedure is done under a local anesthesic and costs between $6,000 and $8,000.  To see if you are a candidate, schedule a consultation with Dr. Cherny.  The consultation fee is deducted from the surgical fee and all other preoperative visits and included in this charge.

 

Vaginal Rejuvenation:

There has been a lot of buzz lately about vaginal rejuvenation.  What is a lift of the mons pubis; does Dr. Cherny do this procedure?

The mons pubis is the full, cushioned area above the vagina that is typically covered by pubic hair.  Dr. Cherny has been doing lifting procedures in this area for a long time.  In the early days of post gastric bypass surgeries, many patients had this area descend just as the tummy did after major weight loss.  Aware plastic surgeons, who listen to their patients, quickly realized that the tummy tuck without the lift of the mons pubis was just not good enough.  Dr. Cherny offers this as an optional feature on all his tummy tucks; the feedback has been excellent.  So the lift of the mons pubis is an integral part of Dr. Cherny’s tummy tucks, and it prevents chafing and dramatically increases comfort and hygeine.  Some patients reported an enhanced sexual experience with the restoration of the original, youthful anatomy.

Labiaplasty:

Labiaplasty is a hot topic and more patients are asking for this procedure than ever before.  Women with labia minora that are large and protrude from the majora often experience discomfort or irritation. A short and simple procedure under topical and local anesthesia can correct this.

Does the method of dissection for breast implants make a difference?

I’ve had a few patients ask me about this lately, and am not sure where this technical question is arising from.  There is a plastic surgeon out of Texas, that is known for his Texas-sized ego and pronouncements, that is promoting the dissection of the implant pocket by the cautery device.  Blunt dissection, as it is called, is said to be bad.  This is actually a non-issue.  All plastic surgeons are taught that gentleness with human tissues is of supreme importance.  Anatomically, the most gentle method of dissection for the subglandular implant is with the cautery. To not do so invites bleeding and a more difficult operation.  Under the muscle, blunt dissection is the least traumatic in the upper part of the implant space, but the lower  part still needs cautery dissection for a better pocket.  I think its great for patients to be as educated as possible for any operation they may be considering.  I think actually that Wikipedia.com is an excellent source for scientific information on a variety of plastic surgical procedures and medicine in general.  I’ll discuss with you any operation to any level you might wish to go to.

Plastic Surgery – the “Great Equalizer”

Plastic surgery has been called many things both good and bad.  Have you ever considered it as an instrument of democracy or of fairness? Life is in many ways unfair, and through genetics some of us are blessed, and some are not.  Some have desireable physical attributes, and the confidence it brings just through the lottery of life.  Some win, some lose. Everyone knows that good looking people are treated differently than others.  There are many studies that document greater opportunities, better treatment, better salaries and all the rest, for attractive people.

So plastic surgery can, to some degree, make up for this unfairness.  Plastic surgery can level the playing field and help people attain that which they otherwise could not have. This is one more reason that I really like being a plastic surgeon!

Is penile enlargement possible?

We actually get several calls a week on this subject.  The answer, generally, is no.  I repeat, there is no reputable method for penile enlargement.  Fat injections could make the girth larger but would leave the head the same size, resulting in a spongy shaft with a small appearing head.  Ligamentous release supposedly increases length, but as the ligament heals, it reshortens.  So the patient ends up back where they started from.  On the other hand, some men, especially those that are overweight and those that have lax skin, can have an increase in the apparent length with surgery. This is a condition called the “buried” penis.  In this situation, the penis is basically buried within the fat and skin.  The tummy tuck operation, which lifts the groin, pulls redundant tissue away, exposing the actual full length.  I’ve increased the apparent length by several inches as a positive side effect in tummy tucks on men.  Liposuction theorectically should help this also, but I’ve found it to be less effective.  Urology colleagues of mine tell me that the best method to enhance this area is diet and exercise.  As always, no pain, no gain.

Is there a cure for cellulite?

Unfortunately, no.  Cellulite overlays areas of structural damage to subcutaneous fibrous tissue.  Cellulite is an acquired microscopic anatomical problem, that usually comes from childbearing or major weight gain/loss.  I’m currently treating a patient who went for some kind of laser treatment of cellulitis.   She has horrific burns all over her legs.  The best these treatments can do is swell the skin, which makes the cellulite temporarily better.  After the swelling goes down, your cellulite is back and your wallet lighter.  The same goes for stretch mark streatment.  If it sounds to good to be true, it is.  The only honest way to deal with cellulite and stretchmarks is to excise them in the context of a body shaping operation, as in a tummy tuck.