Monthly Archives: September 2011

Liposuction Benefits May Include Lowering Cholesterol

Liposuction benefitsLiposuction may have benefits beyond a smaller waistline, if new research stands up, according to the Los Angeles Times.

In addition to slimming your most troublesome body parts, liposuction benefits may include ridding your blood of some harmful fat elements, namely triglycerides. While your body needs some level of triglycerides, a high level of them can lead to heart disease and other cardiovascular ailments.

This new research found that while those with normal levels of triglyceride experienced no change following liposuction, those with high levels of triglycerides saw the additional liposuction benefits. In fact, three months after their liposuction procedure, patients with the highest levels of triglycerides saw a 43% reduction in triglycerides.

To compare, patients who take cholesterol-lowering medications can expect only about half that reduction in triglycerides.

Good news—the liposuction benefits may not stop there. White blood cells, which can lead to inflammation, were seen to drop 11% after liposuction.

While this may encourage you to contact your plastic surgeon immediately for liposuction, it should be noted that further research must be completed to understand the full additional liposuction benefits that may be achieved.

More details from the research were made available this weekend in Denver for the annual meeting of the ASPS.

To learn more about liposuction benefits, both cosmetic and health-related, we encourage you to join the mailing list of Philadelphia plastic surgeon Dr. Genter.

Plastic Surgeons Respond to USA TODAY Investigation

Surgeons Explain the Distinction Between Hospitals and Outpatient Cosmetic Surgery Facilities

Last week, USA TODAY ran a front-page story and series of articles that explored risks of cosmetic surgery performed at “low cost, high volume” clinics.

A quote from the article titled “Cosmetic Surgery Gets Cheaper, Faster, Scarier

“While these centers typically employ board-certified plastic surgeons, some don’t have privileges to treat patients at hospitals, leaving patients to fend for themselves at emergency rooms. Soto says she now wishes she had her procedure performed at a hospital rather than an outpatient surgical center “so that if anything happened I was already there.”

But is a hospital the answer to all safety concerns? We asked several respected plastic surgeons to respond to this question.

David Robinson M.D., an Indiana plastic surgeon, writes:

I do not feel that all cosmetic surgeries need to be performed in a hospital. The outpatient facility though, should be an accredited one staffed by board certified anesthesiologists. It should also have a contract with a hospital in the event an unstable patient should require transfer. I personally operate at an accredited surgery center that is adjacent to a hospital. The surgery center is also staffed by board certified anesthesiologists. This gives both myself and my patients peace of mind.

Detroit plastic surgeon Dr. Ellen Janetzke offered a similar argument:

To say that the only answer is to do surgery in a hospital is too extreme and generalized. Some surgeries should be done in a hospital. Most surgeries should be done in an accredited facility. Minor procedures such as touch ups or mole removal that can be done under local anesthesia would be excluded from this. However, even with these surgeries, access to the physician (or staff) is necessary. The key word here is accredited. If the facility is not accredited and/or the surgeon does not have hospital privileges, buyer-beware. You do “get what you pay for.”

Seattle plastic surgeon Richard Rand says that outpatient surgery centers are necessary for controlling the cost of cosmetic surgery. He writes:

It is not necessary to legislate that all cosmetic surgery needs to be done in a hospital setting.  However, it is necessary that ALL cosmetic surgery be performed in nationally accredited outpatient surgical facilities by surgeons properly trained and Board Certified in Plastic Surgery who have hospital privileges to perform the same surgery in the hospital setting if that were necessary.

In fact, if it were mandated that surgery would all be performed in the hospital, I would estimate that the costs would skyrocket and that the quality would go down dramatically.  The costs would be out of the surgeon’s control and the hospitals would set fees very high to make up for their losses from insurance based care.  The quality of the care would suffer because the surgeon would be forced to work with staff from the hospital who were not necessarily familiar with the exact details of the techniques the surgeon uses.  In the best accredited office surgical centers, the surgeon has the top staff, they know exactly what will be done for each patient and they do this surgery regularly with the doctor, and the costs and scheduling are completely under the control of the doctor to best serve the patients.

According to Philadelphia plastic surgeon Dr. Bruce Genter, patients should have a choice about where their surgery will be performed. He explains:

Limiting all cosmetic surgery to the hospital setting is not the answer, except for procedures longer than 4 hours, which should generally not be performed in an outpatient center.  Instead, the doctor performing the surgery at an outpatient center must also have hospital privileges to perform that procedure and should be able to give the patient a choice to have the procedure in the hospital or the center.  All centers should have proper credentialing and a nearby hospital to where patients can be transported in case of an emergency.  Standards of care at a reputable center should equal the standards at a hospital.

On his blog, Houston plastic surgeon Dr. Young Cho describes some advantages of choosing a plastic surgeon with hospital privileges.

Advantages of having a procedure in the hospital setting is that there are more resources at the doctor’s disposal to address any complications that may arise from surgery.  Surgeons that work exclusively in the outpatient setting require very strong filters in choosing the right candidate for that setting.  Many patients perceive themselves as healthy, but there are certain screening factors such as body mass index (BMI), age, medical co-morbidities, that make some patients higher risk.

As with any business, there will be pressures to manage costs and look for new sources of revenue.  Practices that are exclusively clinic or outpatient based may be tempted to ‘loosen’ the criteria for patient selection to drive revenue and expand their market.  This is particularly true of ‘cosmetic surgeons’ with no formal surgical training beyond a weekend or weeklong course.  They cannot obtain surgical privileges at hospitals to perform surgeries so they are forced to do it in an office setting.  Likewise, they may not be able to obtain accreditation for an outpatient surgery center.  This limits their ability to safely deal with complications and often send complications to other surgeons, or the emergency room.

Dr. Chris Hess, a plastic surgeon near Washington D.C. responded:

I don’t think surgery in a hospital is necessarily the answer to safety concerns.  The answer is knowing your surgeon and that he/she is Board Certified, has a good reputation, discusses ALL of the pros and cons of the procedure, is willing to meet with you as much as necessary before surgery so that the patient is clear on what will happen, and determines if an out-patient facility or hospital is the most appropriate place for surgery based on the procedure, length of surgery, patient’s medical history etc.  Nothing should be rushed and no sales people should be involved.

Surgical Adhesive to Seek FDA Approval by Year’s End

A new surgical adhesive may improve patient healing after plastic surgery, according to the Pittsburgh Post-Gazette.

Most often when patients who undergo a procedure like a body lift, in which excess fat and skin are removed circumferentially around the midsection, the incisions are closed with sutures. A side effect of a surgery like this is that fluid can build up in the areas around the sutures. As such, patients must often wear surgical drains for days and sometimes even weeks following treatment. This can leave the incision open for infection and the tubes themselves can be bothersome for patients.

TissuGlu, the surgical adhesive which was recently approved for use in Europe, is administered quickly and can greatly improve patient experience. The product, which does not require mixing or refrigerating, is applied by the plastic surgeon who places drops of it along the incision. The process takes just a couple of minutes and achieves a full bond in 30 to 45 minutes. In some cases, it may reduce a patient’s recovery time.

In testing of the surgical adhesive in 2009, none of the 40 patients tested at three different hospitals experienced complications. The ease of use and lack of complications in this testing of the surgical adhesive may be due in part to its components. While similar to other adhesives, TissuGlu is primarily made up of amino acids. These components are absorbed by the body as water, sugar and carbon dioxide.

Though European approval has already taken place, clinical testing is scheduled to take place in the US in early 2012 and the application for FDA approval is to be submitted by the end of this year.

To learn more about advances in plastic surgery, like this surgical adhesive or specials on non-surgical treatments in the meantime, please join the mailing list of Philadelphia plastic surgeon Dr. Genter.