The American Journal of Surgery recently published a study that found breast surgeries performed in Ambulatory Surgery Centers (ASC) take on average 69 fewer minutes than breast surgeries performed in hospitals. According to the study, breast surgery performed in an ASC is less time-consuming and more efficient than breast surgery performed in a hospital because the time needed to prepare for surgery is significantly decreased.
Unlike hospitals, ASC facilities are able to avoid unscheduled surgeries, such as add-on cases and emergency cases. ASC facilities are also physically smaller than hospitals, making it easier to move patients and equipment around more quickly, and ASC staff is usually smaller, more consistent and thus able to work more efficiently than hospital staff. Additionally, surgeons are assigned to a single room in an ASC and do not have to change rooms as they do in hospitals, which also saves times.
Study authors Drs. Terrence Trentman, Jeff Mueller, Richard Gray, Barbara Pockaj and Daniel Simula began their research in 2005 when their practice’s ASC facility was closed, which forced all outpatient breast surgeries to be performed alternatively in a hospital setting.
The study authors compared the surgical records of 92 patients who had breast surgery in the ASC facility between January 2004 and December 2005 with the surgical records of 92 patients who had breast surgery in a hospital facility starting January 2006. The cases reviewed for the study involved female patients of similar age, with similar recovery room times, and all of the breast surgeries were performed by the same two salaried surgeons who did not receive additional bonus pay for productivity.
Although the study concluded that ASC facilities offer significant preoperative time-savings, findings also suggested that breast surgery patients spend an almost identical amount of time in an ASC and a hospital once they reach the operating room. So, while study findings support the common perception that outpatient surgery can be far more efficiently performed in dedicated outpatient surgical centers outside of hospitals, such as ambulatory surgery centers, it identifies that the time-savings benefits of an ASC facility are only offered during the preoperative, or preparation, stage of a breast surgery procedure.
The type of anesthesia used during surgery can also affect recovery time immediately following surgery, however this did not significantly affect overall surgical time from the preparation stage to the patient discharge stage.
According to a study published by the Journal of the American Society of Plastic Surgeons, face lift patients are reporting high satisfaction rates both within the first year and 10-15 years after surgery.
Although many studies have been conducted to evaluate short-term face lift patient satisfaction, this study is the first to evaluate long-term satisfaction in face lift patients.
Study participants included 89 patients of study senior author Dr. John Owsley, who performed a superficial musculoaponeurotic system–platysma facelift, or SMAS facelift, on each patient between January 1, 1994 and January 1, 1999.
When patients were surveyed one year after surgery, 98 percent reported that their results were “very good or beyond expectations.” Each facelift patient was surveyed again 10-15 years after surgery, and 68 percent reported not only that their results continued to be “very good or beyond expectations,” but also that they looked 10 years younger.
Only 31 percent of patients who participated in the study indicated that they were disappointed by some aspect of their long-term face lift outcome, which suggests a majority of facelift patients experience a high degree of satisfaction with facelift results in the long term.
It is important to note that the results of a SMAS facelift are typically longer lasting than those of a subcutaneous, or skin-only, facelift, and improvement of sagging skin and jowls is an expected outcome. An extended SMAS facelift offers the same benefits as a SMAS facelift, plus correction of nasolabial folds.
Variations of the SMAS facelift technique exist, but all SMAS facelift techniques involve repositioning and tightening the SMAS, which is a sheet of muscle and connective tissue on the cheek that contributes to facial expression.
If you’re considering face lift surgery, don’t trust your face to just anyone. Avoid marketing hype and seek a highly experienced Owensboro facelift surgeon who can customize your facelift procedure to meet your unique facial rejuvenation goals.
Breast ptosis (pronounced “toe-sis”) is a condition characterized by drooping breasts with loose, stretched skin. The skin on a woman’s breasts is primarily responsible for maintaining their position. When the skin becomes stretched or loses its elastic properties, the breasts will gradually descend and sag.
What are the causes of breast ptosis?
In general, the cause of breast droop is a combination of factors including breast size, aging, and gravity. Large breasts are gradually pulled downward by gravity. As your skin becomes thinner and less elastic with age, it stretches and becomes less able to maintain a youthful breast position.
A recent study conducted at the University of Kentucky sheds some light on the factors that contribute to breast ptosis. Surgeons found that age, significant weight loss, higher BMI, larger bra cup size, number of pregnancies, and smoking were found to be significant risk factors for breast ptosis.
Interestingly, “breast-feeding, weight gain during pregnancy, and lack of participation in regular upper body exercise were not found to be significant risk factors.”
Evaluating Breast Ptosis
A common way to measure breast ptosis is the Regnault classification, which is as follows in simplified form:
1. Pseudoptosis – the nipple falls above the fold, but the breast is hypoplastic and hangs below the breast crease.
2. Glandular Ptosis – the nipple is above the fold, but the breast hangs below the crease.
3. Minor Ptosis – the nipple is level with the breast crease.
4. Moderate Ptosis – the nipple is below the breast crease, but above the lower breast contour.
5. Severe Ptosis: the nipple is below the breast crease and below the lower breast contour.
Correcting Breast Ptosis
Using the classification system above, a surgeon can recommend the right procedure to correct breast ptosis. Surgery to correct minor ptosis may be quite different from the procedure to correct a severe case of ptosis. The usual procedure of choice is breast lift surgery.
Otoplasty, commonly known as “ear pinning surgery” is a surgical procedure that corrects abnormal ear protrusion. Surgical techniques generally involve an incision behind the ear, reshaping of the ear cartilage, and placement of a suture to maintain the correction.
Surgeons in Lithuania recently studied the success rate of different suture types used in Otoplasty. A 3-year study was conducted with 100 patients. They were divided into these groups based on the suture materials chosen:
PDS
Monocryl
Mersilene
Patients (48 men and 52 women) had a median age of 20 years. After analyzing the data for each group, the doctors found that 3 patients in the PDS group and 3 patients in the Monocryl group had unsatisfactory aesthetic outcomes requiring revision surgery. Patients in the Mersilene suture group had the lowest rate of recurrence.
40 cosmetic surgeons from the United States, England, Canada, and Taiwan recently gathered for the 4th annual Breast Surgery Workshop at the Cincinnati cosmetic surgery practice of Dr. Mark Mandell-Brown.
Sponsored by the American Academy of Cosmetic Surgery, the nation’s largest medical society of cosmetic surgeons, the 3 day workshop focused on procedures such as breast augmentation, breast lift, and breast reduction surgery. “Our breast course has earned excellent recognition and is one of the most popular breast courses in the Academy,” said Dr Mandell-Brown.
The doctors discussed the latest development in cosmetic breast surgery. Through a combination of lectures, surgery, and anatomy labs, the visiting physicians can improve their skills. “Its a great way to showcase Cincinnati to our visiting doctors” observed Therese Holden, Nursing director. She added, “we really strive to make this an outstanding educational experience for the participants.”
CNN reports on the growing trend of cosmetic procedures being offered in the war-torn country of Iraq. As the violence subsides, doctors who treat war wounds are starting to see more patients for elective procedures.
The website of New You magazine went live this week, and it provides some great resources for consumers to learn about skin health, physical fitness, nutrition and cosmetic surgery. The articles this month are very well written, especially the piece by Dr. Mark Berman and the fitness article about posture by Maria Mercedes.
One section of the site titled Inspired features several patient profiles in which men and women of different ages discuss the impact a cosmetic surgery procedure made on their lives. Another section is about “Achieving the Look” with cosmetic procedures. Featured articles discuss arm lift surgery, laser treatments, vein treatment, the tummy tuck, and the Brazilian butt lift.
According to the media kit, the site should allow readers to upload a photo to the site and use special software to visualize results of a basic procedure. That feature must still be in the development stage.
Reading about abdominoplasty online, you might get the impression that only women benefit from the procedure. In fact, men who have experienced dramatic changes in body weight are often excellent candidates.
Unfortunately, some of those men may feel hesitant about investigating the tummy tuck and talking to cosmetic surgeons. One man who documented his experience online said he perceived a “stigma or shame associated with male tummy tucks,” saying he was “initially embarrassed” when he first made inquiries about the operation.
A good surgeon will have experience and advice to share about abdominoplasty for a male patient. On RealSelf.com, a man asks about the procedure:
I’m dealing with loose skin after a 50 lb weight loss in my teens. I’ve totally transformed and I’m very athletic with well-defined abs, but [skin] laxity mostly below the navel and around the lower back. The problem areas are very localized and I hide it under the belt line, and even under form fitting swimwear, with no one suspecting I was obese. But I feel “unfinished.” The front skin is very thin and hangs, the back is mostly smooth. Is there a tummy tuck technique that would excise the abdominal skin and provide modest tightening in the lower back?
Dr. Chris Hess, a plastic surgeon practicing near Washington DC, answers “even though we (men) tend to have better skin tone than women, we can still end up with excess skin due to skin memory. It sounds like you could undergo a mild excision of the excess tissue – less than a mini tummy tuck.”
However, in cases where the male patient has experienced a greater weight reduction, the full tummy tuck may be recommended. Dr. Angelo Cuzalina, an Oklahoma cosmetic surgeon writes “Do not hesitate to use a full abdominoplasty for a male patient with extreme skin laxity. Men tend to heal better than women after abdominoplasty.”
This comprehensive approach may be optimal in many cases to provide the results men expect. In Cosmetic Surgery Times, Dr. Alan Matarasso, scientific editor of Aesthetic Surgery Journal, says “you really need to treat [men] circumferentially, all the way around, because if you ask most men what bothers them, it’s the ‘love handles,’ and that goes all the way around to the back.”
Clearly, many plastic and cosmetic surgeons can offer specific advice for men considering abdominoplasty. If you think you might benefit from the procedure, don’t hesitate to ask a qualified surgeon for more details.
Since we wrote about the proposed cosmetic surgery tax last week, the media has been buzzing non-stop about the “Botax” and other new options that are supposed to help cover healthcare reform.
Plastic and cosmetic surgeons are opposing the tax for a variety of reasons. Others in support of the tax have suggested that, aside from generating revenue for healthcare, it could encourage talented medical professionals to work in areas of general medicine that need them.
The elective procedure tax we wrote about last July is now part of the latest healthcare reform bill and could be implemented as early as 2010. The tax is a 5 percent charge on any procedure, administered by a licensed medical professional, that isn’t necessary to ameliorate a disease, injury or congenital deformity.
Cosmetic and plastic surgeons have offered strong objections to the bill. One such objection is that women, the predominant consumers in this industry, will pay the projected 5 billion dollar revenue almost entirely. The tax is “discriminatory” and therefore, “the wrong way to raise money to pay for expanding health care.”
Others, such as the ASPS, are trying to draw attention to the fact that cosmetic surgery procedures are not a luxury for the rich and famous, but services primarily purchased by the middle class.
In a 2005 ASPS survey of people planning to have cosmetic surgery within the next two years, 60% of respondents reported an annual household income of $30,000-$90,000 a year. Most importantly, 40% of those reported a household income of only $30,000-$60,000. Only 10% of respondents reported a household income of over $90,000, which clearly refutes the suggestion that elective surgery taxes are “luxury” or “sin” taxes affecting a privileged few.
Follow the links below to learn more about the elective cosmetic medical tax.
women benefit from the procedure. In fact, men who have experienced dramatic changes in body weight are often excellent candidates.
