The issues surrounding PIP implants keep growing. Even though the FDA warned French authorities about the substandard quality of PIP implants in 2000 they continued to allow their use. Recently it has become clear that the silicone used in PIP implants was not up to medical grade standards. This has caused a higher rupture rate and significant complications in women across the globe. As the PIP implant crisis grows more and more governments are coming forward to advise women in their country to have the implants removed. First were the French and Venezuelan governments. Now Italy and Czechoslovakia are following suit. Considering there are estimated 300,000 women with PIP implants around the world we will likely see more of this in the near future. The take home message remains the same – if you have PIP implants, you should have them removed. On my radio show, “New Reflections” we recently discussed PIP implants and other interesting breast implant topics with one of the doctors that helped develop the very first breast implants, Dr. Thomas Biggs from Houston, Texas. You can listen to the show here:
http://www.voiceamerica.com/episode/58776/from-the-beginning-to-the-end Many people believe that breast implants must be removed and replaced every ten years. This misconception has nearly become common knowledge and is simply not true. It is based upon one study that showed that breast implants grow weaker over time. As time passes they have an increased risk for rupture. Specifically, there is a cumulative 1% risk each year that breast implants will fail (break). That means that three years after breast augmentation there is a 3% chance of them breaking, and after ten years a 10% chance of them breaking. While the study implies that it might be a good idea to replace ten year old breast implants it does not suggest that doing so is a medical necessity. If you have breast implants that look good and feel good leave them alone. It doesn’t matter if they are brand new, ten years old or even 30 years old. Every patient is different and should be treated individually. You don’t need to treat your breast implants like your car – you don’t need to get ten year oil changes!
Just about everyone knows that smoking is bad for you. But it is easy to ignore just how bad it can be. Particularly for long term smokers who are planning a cosmetic procedure. The truth is, there are very few things that can increase your risk for complications more than smoking. Here’s why. Healing requires getting lots of oxygen to the healing tissues. Smoking affects your body’s ability to heal in three different ways. First, cigarette smoke has tar in it that gums up the surfaces of your lungs. This reduces the area that your lungs can use to work effectively. Basically it blocks the channels needed to get oxygen into your body and get carbon dioxide out. Second, while we are talking about the gases you breathe lets discuss carbon monoxide. You may have heard about people committing suicide by starting their car in a closed garage. How that works is the accumulation of carbon monoxide from the exhaust fumes. When you breathe carbon monoxide it gets into your lungs just like oxygen would. In fact it attaches to the same place on your red blood cells that oxygen does. The problem is that it never lets go. Typically every molecule of hemoglobin in your red blood cells is able to carry four molecules of oxygen. Once carbon monoxide attaches to hemoglobin it as there forever, until that red blood cell is replaced by a new healthy one. That can take many weeks. So people breathing in car fumes slowly reduce their ability to carry oxygen to their body until they can’t carry enough to survive. Smokers are doing this very, very slowly, one cigarette at a time. And last, the nicotine in cigarette smoke has a bad effect on the little arteries that carry oxygen to healing tissue. Nicotine causes them to shrink down in size. Imagine a normal sized artery being the size of rigatoni pasta. When nicotine is around that rigatoni shrinks down to the size of angel hair pasta. As you might imagine, the much smaller artery (capillary) can’t carry enough blood (carrying oxygen) to the healing tissue under the effects of nicotine. Continuing to smoke leads to lots of big problems including trouble healing, infections, wounds opening up, loss of skin, and lots more. It is particularly dangerous in the case of abdominoplasty (tummy tucks) or facelifts where the skin is really stressed by the procerure and needs lots of oxygen to heal. Patients that have those procedures and continue to smoke can lose big pieces of skin that can turn black and fall off. No matter what procedure you are planning, smoking is a very bad idea. In my practice I recommend that patients stop smoking two weeks before surgery and refrain from smoking for up to four weeks after surgery. At that point many patients have simply quit forever. If you are planning a cosmetic procedure and are a smoker you need to get the smoke out!
Recently there has been news of issues with breast implants in France. The French government has gotten involved by launching an investigation regarding problems with a particular type of silicone breast implant. These implants, manufactured by a company called Poly Implant Prothese (PIP), are now suspected of having higher than usual rupture rates. Most recently it has been learned that the silicone gel used to fill the implants was not medical grade. The former CEO of PIP has admitted that “non-standard” silicone was used in the manufacturing of PIP implants. In October the French equivalent of the FDA shut down PIP for producing substandard implants. Since then thousands of women in France have filed complaints against the now defunct company. It is estimated that over 300,000 women worldwide have undergone breast augmentation using PIP implants. French authorities have recommended that women with PIP implants have them removed as a precaution. This has sparked responses from countries around the world ranging from recommendations that women with PIP implants be checked regularly to government sponsored programs to remove the implants at no cost to the patients. It is important to remember that the FDA monitors breast implants very carefully in the United States. There is perhaps no other medical device in the world that is more carefully watched than breast implants. In fact, in the year 2000 the FDA warned French authorities that the manufacturing process of PIP implants failed to meet US standards in at least eleven different ways. The US report went as far as describing the PIP implants as “adulterated”. Breast implants used in the United States remain very safe and reliable. PIP implants have never been approved for use in the US. There should be no cause for concern about breast implants in general, though PIP implants definitely seem to be problematic. If you or someone you know has PIP implants you might want to consider having them exchanged for breast implants that are approved for use in the US. Both Allergan and Mentor brand implants are approved and are safe options. If you had breast augmentation performed in the United States you almost certainly have one of these two brands of implants and do not need to be concerned about the news coming from France. Here is a link to a recent article about this issue: http://www.reuters.com/article/2011/12/27/us-breast-implants-lawyer-idUSTRE7BQ0XN20111227
Breast augmentation can safely be performed with implants either on top of the muscle or beneath it. You should not have concerns about safety in choosing your implant position as they are equally safe. The choice of implant position is really more related to your being a bodybuilder. I have operated upon many bodybuilders, both competitive and amateur. Typically, bodybuilders do not want their muscles altered during surgery, so the best choice would be on top of the muscle. You can achieve a really nice and natural result without having the implant behind the muscle. That being said, most implants are placed behind the muscle because natural results can be achieved easier with implants in that position. I would recommend that you visit a few board certified plastic surgeons to get a sense for your options. With good information from qualified surgeons you can make the best choice to achieve great results. If you like you can visit my website where you can see some animations of the surgery being done and read more information about breast augmentation. If you’re interested in learning more about breast augmentation, whether you are a body builder or not, then
contact our office or call us at
305-792-7575. We’re located in Aventura, FL, near Miami, Ft. Lauderdale, Coral Gables, Boca Raton and Coconut Grove.
Patients these days often look for the best deal in town. But by searching for the cheapest price some get more than they bargained for. Making the price of your procedure the most important factor in choosing your doctor or facility is not the best way of thinking. In fact, it has cost some people the highest price of all. In most major cities there are clinics that offer very low prices for procedures that cost more when performed by board certified plastic surgeons in their own private practice. These clinics usually advertise a tremendous amount and make up for the lower profit with volume. One such clinic in south Florida is Strax Rejuvenation. This facility is known for very low prices, but also has a history of significant complications. Just last week a patient having a procedure at Strax Rejuvenation had to be taken to a nearby hospital due to a complication that occurred during surgery. She died three days later. This is the latest of four known deaths in the last two years. That is staggering number. In their defense Strax officials may claim that they perform a very high number of procedures and that the actual mortality rate is not so bad when you account for the number of procedures being done. Well, lets examine that for a moment. In a study published by the American Society for Aesthetic Plastic Surgery (ASAPS) in 1997, after looking at 400,000 cases the mortality rate was 1 in 51,459 cases. If you look at a two year period that would be an impossible number of cases to perform, even for Strax, to account for four deaths. Strax claims 14 doctors, not all plastic surgeons. Even if we give them the benefit of the doubt and assume all 14 are plastic surgeons, every doctor at Strax would have to perform more than 27 operations every day of the week (Mon-Fri) every week of the month for the entire year to match that mortality rate. In actuality, if we assume that all 14 surgeons perform 4 operations every day (Mon-Fri) every week of the year for the same two year period, the actual mortality rate at Strax would be approximately 1 in 7400 cases – more than
SEVEN TIMES the mortality rate published by ASAPS. So when you are thinking about having a procedure and looking to save money, you would probably be safer to stick with plastic surgeons that are certified by the American Board of Plastic Surgery and in their own private practice. You might have to pay a few dollars more, but if you look for the biggest bargain in town you might end up paying more than you ever thought possible. To learn more about patient safety, please check out my latest
radio show episode. Let’s say you had to get off an island onto the mainland. If you had a choice of taking a small sailboat with someone that didn’t have a captain’s license and had very little experience with sailing, or a more stable sailboat with a fully licensed captain with years of experience, I doubt you would take too long to decide. Now lets say that you could take the smaller boat for five dollars, but the larger boat would cost ten dollars. You probably would still choose the larger boat. This decision is being made everyday by people having cosmetic procedures and the choices that are being made are not always the obvious ones. If you change the details to fit cosmetic procedures you can see the choice that needs to be made. Patients can choose to have a doctor (and sometimes not even a doctor) who has little or no surgical training and is not board certified in plastic surgery, perform a consultation, injections, and even a surgical procedure. Alternatively, they can choose a fully board certified plastic surgeon with years of training and experience in the very same procedures that are being considered. If all things are otherwise equal the choice seems very clear. There are not too many people that would choose the less qualified, less experienced doctor. But when you add the element of cost people suddenly lose sight of that logic. If the unqualified doctor charges $400 and the board certified plastic surgeon charges $600 there are a lot of people that would choose the former based solely on price. Lets change the details a bit. What if you needed surgery on your brain. What would be more important, the cost or the skill and experience of the surgeon? Most people would not hesitate to pay $200 more for the greater experience and skill of the board certified surgeon. Why should your face and body be any different? There is a reason that board certification exists – the difference matters. Do you really want to place your face, body, or even your life at risk to save a few dollars? On my radio show, New Reflections we discussed this very issue on a special episode. I invite you to listen to that episode:
http://www.voiceamerica.com/episode/51157/be-safe-be-smart-a-patient-safety-special Don’t choose the small sailboat with the less qualified captain.
Patients choose to have plastic surgery and aesthetic procedures for lots of reasons. All of them very personal. Sometimes the significant other doesn’t “get it”. Every now and then I will see a patient in the office who comes in with her spouse who is against the idea of having a procedure. The patients feels strongly about wanting to improve something and her husband doesn’t think she needs it. It’s hard to understand why the person you love might want to change something about themselves when you look at them and love them just the way they are. Their reasons for wanting to make a change are usually deeply personal and may not make sense to anyone else. The most important reason for having a procedure is that it is very personally important to you, the patient. Once the procedure is done and you feel better about yourself, everyone else will understand how important this has been to you. On my radio show, New Reflections, we recently did an episode about plastic surgery procedures changing people’s lives. On that show I interviewed a husband and wife about just this type of experience. I invite you to listen to the show and hear their perspective.
http://www.voiceamerica.com/episode/52531/plastic-surgery-changed-my-life Why do you want to have plastic surgery? To make changes that are really important to you. People that care about you will see that and understand; sometimes it can take time.
The pageantry of young children has been controversial in the past, but never has the industry stooped to such a low. A mother injecting her child with Botox or any other injectable material used for aesthetic purposes is tantamount to abuse. When asked why she does it, the child’s reply is, “I don’t know…”. But when prompted by her mother she responds further, “I just, like, I don’t think, like, wrinkles are nice for little girls”. It is clear that she really has no concept of what the treatment does or even has a desire to have the injections. Regardless of the child’s (or parents’) desire to have this treatment performed, using aesthetic injectable treatments on a minor is abuse. Further, providing Botox or any other material for use in minors is a crime. In this case the mother gets her Botox from, “a trusted source” who is “behind the doctor scene” implying that it is taken from a doctor’s office without the doctor’s knowledge. The child’s mother is not a doctor, she is a part-time aesthetician. So now we can add theft to the illegal injections that she is admittedly committing on a regular basis. One would hope that we would have come a long way since the disaster of Jonbenet Ramsey. And in fact, it seems, we have. Only not in the right direction. You can learn more about the article source here:
http://abcnews.go.com/Health/mom-year-daughter-botox-young-young/story?id=13580804.
Contact Dr. Rubinstein today to learn more about Botox and if it is right for you, or call
305-792-7575.
The simple answer is yes. Silicone implants are approved by the United States Food and Drug Administration. When it comes to safety and risks of
breast augmentation, silicone implants and saline implants are basically the same. However, should a breast implant rupture occur, there are differences to consider. If a saline breast implant breaks, patients say it’s like “getting a flat tire.” You realize it very quickly. With the latest silicone gel breast implants, the breasts may not look any different if a rupture occurs. The best way to positively know is to get an MRI if you suspect that your implant is compromised. In my practice I recommend silicone breast implants in most cases because they produce results that look and feel very natural. To conclude, breast augmentation with silicone implants is just as safe as with saline implants. It comes down to your preferences and which implant type you are comfortable with. If you have any reservations at all about silicone gel, you should probably stick with saline.
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