January 2009

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The Price of Beauty

 

Some Hidden Choices in Breast Reconstruction

 

By NATASHA SINGER

Published: December 22, 2008

 

For many cancer patients undergoing mastectomies, reconstructive breast surgery can seem like a first step to reclaiming their bodies.

 

But even as promising new operations are gaining traction at academic medical centers, plastic surgeons often fail to tell patients about them. One reason is that not all surgeons have trained to perform the latest procedures. Another reason is money: some complex surgeries are less profitable for doctors and hospitals, so they have less of an incentive to offer them, doctors say.

 

"It is clear that many reconstruction patients are not being given the full picture of their options," said Diana Zuckerman, the president of the National Research Center for Women and Families, a nonprofit group in Washington.

 

One patient, Felicia Hodges, a 41-year-old magazine publisher in Newburgh, N.Y., chose a double mastectomy after she was found to have cancer of the right breast in 2004. She consulted a plastic surgeon, who offered her only reconstruction with breast implants, she said.

 

Ms. Hodges chose implants filled with saline, a procedure for which more than a third of reconstruction patients underwent a follow-up operation, studies show.

Ms. Hodges developed wound-healing problems that required her surgeon to remove her right implant, and she was left with a concave chest with a quarter-size hole in it, she said; she described the experience as "worse than the mastectomy."

 

Then Ms. Hodges discovered a chat room on the patient-information Web site breastcancer.org, where women share detailed information about breast reconstruction beyond what they may have heard from their doctors.

 

Ms. Hodges learned of newer, more complex procedures that involve transplanting a wedge of fat and blood vessels from the abdomen or buttocks, which would be refashioned to form new breasts.

 

For complete article please go to: http://www.nytimes.com/2008/12/23/health/23beauty.html?_r=1&emc=eta1

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2009 Trends And Predictions From The Editors Of Consumer Guide To Plastic Surgery

 

 

28 Dec 2008

 

The editors of Consumer Guide to Plastic Surgery have gazed into their crystal balls to see what nips and tucks Americans will be seeking in 2009. From how the economy will affect cosmetic surgery to which new products will come to market, here's what we will see more - or less - of in the coming year:

Less is more in 2009. The economic recession will spur many consumers to re-evaluate their cosmetic surgery plans. More people may choose less invasive procedures such as injectables and fillers instead of major surgeries, to buy time until the economy rebounds. In fact, a recent poll of consumers and plastic surgeons released at the annual scientific meeting of the American Society of Plastic Surgeons (ASPS) in Chicago found that 27 percent of the survey participants were considering less expensive options, compared with 20 percent six months ago.

Will consumers be penny-wise but pound-foolish in 2009? As the recession continues, many doctors may cut prices on surgical procedures as well as injectables to help attract new patients. But buyer beware: The worst thing you can do is put price before professional training, warns the ASPS.

Freezing away fat in 2009. Fat freezing (or cryolipolysis) may give liposuction a run for its money in the coming years. This technology works by freezing fat cells and in turn breaking them down. It's in clinical trials now, and results look promising. Stay tuned.

The latest dream cream. There is much buzz about a topical version of the wrinkle relaxer Botox. Topical Botox may be potent enough to penetrate the skin and affect the muscles, without the pain of multiple injections. Sound too good to be true? Maybe, but so far the cosmetic surgery community is enthusiastic.

Eyelash lengthening. An FDA advisory panel has recommended approving Latisse, a drug that may promote longer, thicker, darker eyelashes. The drug is a spin-off of the glaucoma drug Lumigan, which has been shown to cause eyelash growth. Latisse will likely be the first eyelash-lengthening drug to gain FDA approval.

A new version of Botox. Reloxin is an injectable form of botulinum toxin Type A. Like Botox Cosmetic, small doses of the toxin are injected into targeted wrinkle-causing muscles, preventing the muscle from contracting and reducing the wrinkle's appearance. Reloxin has similar properties and lasts about as long as Botox Cosmetic, anywhere from four to six months. It should be available in 2009.

Fat injections for breast augmentation. In 1982, the ASPS condemned using fat injections for breast enhancement, but times are changing. In 2007, the same organization softened their stance a bit and called for studies. In 2008, a task force found that reshaping the breasts by injecting a woman's own fat works well for "touch-ups" after breast reconstruction, but is not yet proven effective for cosmetic breast enhancement. In 2009 surgeons will be refining this technique.

Cohesive gel breast implants. These so-called "gummy-bear implants" have been making their way down the pike for some time, and we may hear more about them in 2009. Filled with cohesive silicone gel, these leak-resistant implants are used in Europe and Brazil and are being studied in the United States. Gummy bear implants have the positive attributes of the silicone gel, but the gel doesn't migrate. This is a good thing, because if the shell should fail, the gel won't go into surrounding tissue.

Lipodissolve study. Lipodissolve, an experimental "fat-melting" technology, is being billed as a non-surgical alternative to liposuction. Also called mesotherapy, lipodissolve involves a series of medicated injections that may melt away unwanted small, localized areas of fat. To test these claims once and for all, the American Society for Aesthetic Plastic Surgery has begun a scientific study of mesotherapy using standardized ingredients, to examine its safety and effectiveness in a controlled setting. In this study, 20 people will have half of their lower abdomen injected with phosphatidylcholine/deoxycholate (PCDC) up to four times, with a minimum of two times. The treatments will be spaced eight weeks apart. Some results may be available in 2009.

Stronger warnings on dermal fillers. An advisory arm of the FDA has called for stronger, more specific warnings on dermal fillers. If the FDA follows the advice of this panel, expect some revisions to labels in 2009, including a timeline for potential side effects, as some adverse events can show up months after the injection.

For more information about these and other current issues in plastic surgery, please visit Consumer Guide to Plastic Surgery

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It Hurts, but Is It Worth It?

 

 

By CHRISTOPHER PERCY COLLIER

Published: December 17, 2008

 

WHEN Jessi Stensland, a professional triathlete, enters the Athletes' Performance training center in Tempe, Ariz., she usually goes through the door labeled "Work" and into the wing of the building filled with treadmills, elliptical trainers and free weights.

 

But once a week, Ms. Stensland, 22, carries her gym-worn body through a door labeled "Rest." As soothing music plays, she lies face down between two sheets atop a cushioned massage table to await her treatment.

 

But the session that usually follows is far from a coddling.

 

Ms. Stensland's muscles and tendons may be kneaded, pummeled, poked or scraped. Thumbs and elbows may be forcefully pushed into pressure points on her body. Clear plastic instruments, some the thickness of a pencil eraser, are used to deeply penetrate soft tissue that may be tender and tight.

 

Once the session is over, Jeremy Hassler, the on-site soft tissue specialist, often hears a similar quip as subjects rise from the table. "Thanks." And then, after a pause, "I think."

 

So-called sports massages have become a common facet of training for professional athletes of all kinds. And because of their increasing presence on spa menus (beside facial exfoliations, body wraps and hot stone treatments) and at health clubs (down the hall from Pilates, step aerobics and yoga classes), this sometimes painful procedure -- which can cost $45 to $150 an hour -- appears to be gaining in popularity among a growing segment of amateur athlete.

 

For complete article please go to: http://www.nytimes.com/2008/12/18/health/nutrition/18fitness.html?ref=fitnessandnutrition

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