Not just Suarez: Plastic surgeons handle as many as 200 bites every year !

The Irish Association of Plastic Surgeons has taken the opportunity of the publicity surrounding biting this week to warn of the consequences of serious biting.
AMID THE ONGOING controversy over Liverpool star striker Luis Suarez having a nibble at Chelsea defender Branislav Ivanovic’s arm last weekend, plastic surgeons have said there are a growing number of severe bites being treated in Ireland ever year.

Plastic surgeons are tending to on average 15 to 20 biting incidents a month according to the Irish Association of Plastic Surgeons (IAPS) with the vast majority of incidents linked to alcohol.

New Year’s Day has been dubbed ‘New Ears Day’ in some emergency wards due to the jump in malicious bites at that time of year.

“Bites and biting are no laughing matter,” IAPS president Dr Patricia Eadie warned.”The injuries we see are often truly horrific with entire ears bitten off, noses, finger tips and even lips.

“Whereas we can often reattach a severed fingertip if it has been cut with a clean instrument like a knife the nature of a bite means that it’s almost always impossible to reattach the bitten body parts, leaving a very ugly injury.”

Dr Eadie claimed that one injury can cost the public exchequer up to €10,000 to repair “as best as possible” with as many as four operations required in particularly vulnerable and visible areas, particularly the nose.

She said that the survey which found that up to 200 biting incidents are treated in a year means that it would cost a total of €2 million a year.

“Our members tell us that the vast majority of cases are directly related to alcohol where extremely inebriated people start fighting,” she said.

“At this point rational thinking has long been forgotten about but people should remember that human bites can be more dangerous than most animal bites.”

IAPS warned that germs in some human mouths can cause infections that make it harder to treat the injury.

Dr Eadie added: “Our advice to those affected is to get to hospital as quickly as possible with any body parts they can find, wrapped in a damp cloth. Surgeons will then determine the best reconstruction possible.”

Meanwhile Liverpool have until midday today to appeal the 10 game ban handed to Suarez by the English Football Association for last weekend’s biting incident.

Plastic surgery trends: where we put our money in 2012

You’re a fashion junkie but Anna Wintour and her skinny cohorts elbowed you out of front row at fashion week. Not to worry. There’s more to fashion than clothes. In fact, some fashion trends can be seen only when you’re in the buff. The 2012 National Totals for Cosmetic Procedures, hot off the press from the American Society for Aesthetic Plastic Surgery (ASAPS), tells you exactly which facial features and body parts Americans spent their hard-earned dollars on last year.

Where do the eyes go?

The winner and champion of all surgical procedures, breast augmentation, has regained its status in 2012 as the leading surgical procedure in the United States (after slipping back into second position in 2011). This is no surprise; with today’s low cut and scooped out tops, you put your best breasts forward along with your face. Also, this might reflect our delight at the return of silicone gel implants to the market in 2006, bigger and better than ever.

There were 330,631 breast augmentations performed in 2012 compared with 316,848 in 2011. Last year’s frontrunner, liposuction, had 313,011 procedures in 2012 compared with 325,332 procedures in 2011. Conclusion: American women realized that when eyes get stuck on magnificent cleavage, they don’t travel down. Further, in terms of the demise of liposuction, there are some new and cutting edge noninvasive body sculpting techniques that 76,612 people tried out in 2012 before they resorted to liposuction (including CoolSculpting, Vaser Shape, and Liposonix). Question: how many of these people will revert to liposuction next year?

Speaking of the face…

With the advent of Facebook, LinkedIn and the million and one dating sites that put your picture upfront and forward, nobody’s ignoring the face. The tried and true facelift went from 116,086 procedures in 2011 to 119,006 procedures in 2012. This is especially significant when you consider the other million and one facial noninvasive injectable, laser, and other skin tightening procedures women have been spending money on, including the reigning queen of injectables…….Botulinum Toxin Type A (otherwise known as Botox or Dysport), which, BTW, skyrocketed from 2,619,739 procedures in 2011 to 3,257,913 procedures in 2012.

The other facial development is the reemergence of the nose job. In spite of Barbra Streisand, who we love, rhinoplasty increased from 126,107 procedures in 2011 to 143,801 procedures in 2012. But it is interesting to note that otoplasty (ear surgery) also increased. Both rhinoplasty and otoplasty procedures made headlines in 2012 when some parents agreed to these procedures to avoid having their children bullied by peers.

Let’s not forget the stronger sex

Men are not only removing body hair, they are also tending to their overdeveloped breasts. Gynecomastia (male breast reduction), which oddly sounds like gynecology, has had a very healthy growth from 17,645 procedures in 2011 to 22,736 in 2012. The vagina is also gaining some surgical notoriety. Vaginal rejuvenation grew from 2,142 procedures in 2011 to 3,521 procedures in 2012.

Surgeries related to weight loss

With our focus on obesity, bariatric surgery and the extreme skin laxity that follows dramatic weight loss, plastic surgeons have had their hands full. Lower body lift rose from 9,175 to 10,119, abdominoplasty rose dramatically from 149,410 surgeries in 2011 to 156,508 surgeries in 2012, upper arm lift rose from 18,709 to 22,969 and thigh lift from 13,878 to 16,517.

The most frequently performed surgical procedure was breast augmentation. Cosmetic surgical procedures increased more than 3% in the past year, with almost 1.7 million procedures in 2012. Surgery accounted for 17% of all procedures performed representing 61% of total patient expenditures. The top five surgical procedures were:

•Breast Augmentation: 330,631

•Liposuction: 313,011

•Abdominoplasty: 156,508

•Eyelid surgery: 153,171

•Rhinoplasty: 143,801

“In 2012, breast augmentation replaced liposuction as the most popular surgical procedure. This might have something to do with the increased popularity in silicone gel implants since their return to the market in 2006,” said Leo R. McCafferty, MD, President of the American Society for Aesthetic Plastic Surgery. “According to the Society’s statistics in 2006, 383,886 breast augmentation procedures were performed and of those 81% were saline implants and 19% were silicone. In 2012, 330,631 breast augmentation procedures were performed and of those only 28% were saline implants and 72% were silicone.”

Women had more than 9.1 million cosmetic procedures, 90% of the total. The number of cosmetic procedures for women increased over 252% from 1997. The top five surgical procedures for women were: breast augmentation, liposuction, tummy tuck, eyelid surgery, and breast lift.

Men had almost 1 million cosmetic procedures, 10% of the total. The number of cosmetic procedures for men increased over 106% from 1997. The top five surgical procedures for men were: liposuction, rhinoplasty, eyelid surgery, breast reduction to treat enlarged male breast, and ear shaping.

Americans spent almost $11 billion on cosmetic procedures in 2012. Of that total $6.7 billion was spent on surgical procedures; $2 billion was spent on injectable procedures; $1.8 billion was spent on skin rejuvenation procedures; and over $483 million was spent on other nonsurgical procedures, including laser hair removal and laser treatment of leg veins.

The most popular nonsurgical procedure was injections of Botulinum Toxin Type A (including Botox and Dysport). Cosmetic minimally-invasive procedures increased over 10 percent in the past year, with almost 8.5 million procedures in 2012. Nonsurgical procedures accounted for 83% of the total number of procedures performed representing 39% of total expenditures. The top five minimally-invasive procedures were:

• Botulinum Toxin Type A: 3,257,913

•Hyaluronic Acid: 1,423,705

•Laser Hair Removal: 883,893

• Microdermabrasion: 498,821

•Chemical Peel: 443,824

This is the second year this survey asked the doctors for the total number of non-surgical procedures being performed in their practices by BOTH physicians and their physician assistants and nurse injectors. When procedures performed by physician assistants and nurse injectors are included, the total number of cosmetic surgical and nonsurgical procedures performed in the United States in 2012 increases to 12.7 million. Below is the TOTAL number of procedures performed in the practices surveyed:

• Botulinum Toxin Type A: 4,125,179

•Hyaluronic Acid: 1,806,806

•Laser Hair Removal: 1,224,920

•Chemical Peel: 718,465

• Microdermabrasion: 672,430

The Aesthetic Society, which has collected plastic surgery procedural statistics since 1997, says the overall number of cosmetic procedures has increased 250% since the tracking of the statistics first began. “We are confident that these statistics continue to accurately report cosmetic procedure trends as performed by the physicians who are most likely to perform them,” said Dr. McCafferty, MD. “For the past 16 years, the interest in and demand for cosmetic plastic surgery has risen exponentially, a 250% increase in surgical and nonsurgical procedures, and our comprehensive statistics continue to show that.”

The Aesthetic Society partnered with RealSelf, the most visited online community for learning about and sharing information and results for medical-beauty treatments, to get information on patients’ first-hand experience with procedures. The RealSelf ‘Worth It Rating’ printed in the statistics report reflects the combined opinions of thousands of RealSelf community members. Each member shares whether an elective surgery or treatment was “worth it”, all things considered.

New trends in breast augmentation

When you see a skinny lady of a certain age with large and perky breasts, you may wonder if they’re implants. “Real ‘C’ cups start sagging by the time you’re 30,” says a Beverly Hills plastic surgeon. So, rather than getting breast implants, some are now seeking a subtler way to increase breast size. The January 2013 issue of Marie Claire discusses the latest trends.

Fat Transfer or Injection

If you don’t want the stigma of implants, you can increase your breast size with fat. Assuming you’ve got extra fat to spare from love handles or saddle bags, it can be injected into your breasts. First you undergo liposuction and then your own fat is either injected into your breasts or processed. The advantages of this treatment are that you will have no scars, your breasts may feel more natural, and no one will know that you have had any work done. Further, if you gain weight, a Beverly Hills plastic surgeon says that the weight will go straight to your chest.

But there are disadvantages too. This process requires as much recovery time as implant surgery because of soreness from the liposuction. Further, it costs about $1,000 more for less volume. Only about 50 to 60 percent of the fat, which equals about a half to a full cup size, remains permanent after six months. The rest of the fat is metabolized by the body and the procedure can take up to six times as long as the standard 30-minute implant surgery.

Other innovations

Some doctors now have Vectra 3-D Imaging Devices, which can inflate your chest photographically, so you can see what you will look like. Or, if you wonder what will be the most flattering proportion for you, there is an app for a computerized program that uses chest dimensions and nipple spacing to calculate your perfect cup size and most perfect silhouette.

A graceful slope to the upper part of the breast looks natural compared with an upper bulge, which looks fake. You can look ahead to more anatomically-shaped teardrop implants with gummy-bear like silicone filling that help prevent that bulging look on top.

In Istanbul there are even plans for creating implants specific to the right or left side. And there is an implant that contains multiple smaller saline-filled sacks nested together.

For the most reliable information about what’s available to you for breast augmentation, contact a board-certified plastic surgeon.

3D printing may allow customized breast implants!

Texas company working on better breast implants from an inkjet printer!
April 11, 2013 10:35 am by Veronica Combs

Print-your-own breast implants could be one of the new products in the $8.4 billion market of 3D printer products projected for 2025.

TeVido BioDevices is working to commercialize technology that would allow doctors to use a patient’s own fat to print a customized breast implant. The initial focus is reconstructive surgery after breast cancer, but the technology could also make plastic surgery cheaper and more successful.

Co-founder Laura Bosworth-Bucher said that the printer is similar to an inkjet many students use to print school papers, but modified to shoot out proteins instead of ink. The protein mixture is a composite of gelatin and alginate and it is printed onto specialized gel. An aluminum plate added to the printer’s paper feeding sensor and two switches along the y-axis of the machine help to evenly distribute the gelatin into the form.

Co-founder Thomas Boland, Ph.D. is the inventor of the technology and CTO for TeVido. He is also the Director of Biomedical Engineering at the University of Texas at El Paso (UTEP).

The company just won a Phase I SBIR grant for $150,000 and plans to apply for a Phase II grant in the summer.

“We highlighted the idea that ours could be a platform and picked a target market,” Bosworth-Bucher said. “Once we get this working, it could be used in a large portfolio of applications. We’re focusing on filling a small tumor void as our first product.”

The problem with current breast implants is fat volume retention.

“Fat gets reabsorbed when we want it to stay in place and be predictable,” Bosworth-Bucher said.

She said that the team is working to prove that this new fat implant will connect with the host and keep it alive. The current focus is tiny implants in mice.

“Next the work will be to expand the size capability and prove that it works over larger sizes,” Bosworth-Bucher said.

The technology could also be used for nipple reconstruction, using skin created from a similar process. About 200,000 women are diagnosed with breast cancer every year. A study of more than 100,000 insured women with breast cancer who underwent mastectomy between 2000 and 2010 showed that 42% of women younger than 50 and 17% of women 50 and older had immediate reconstruction. The study also found that younger women with insurance were most likely to get reconstructive surgery.

For soft tissue reconstruction, a surgeon could use liposuction to extract autologous fat cells from the patient during a lumpectomy. The fat cells would be used to build the soft tissue replacement construct and replaced into the patient in a later surgery.

TeVido’s technology could reduce the cost of surgery, making it more accessible. The process for nipple reconstruction would require a biopsy performed in a clinic or doctor’s office and then used to build an autologous skin-equivalent graft. This could eliminate the need for surgery to obtain a skin graft, reducing the cost of the procedure and the risk and discomfort for the patient.

The plastic surgery market is another opportunity. There were 286,274 breast implant surgeries last year in the United States. Millennium Research Group estimated market in Europe and America for breast implants to be $1.1 billion by 2016.

Bosworth-Buchers is a former Fortune 50 executive and an engineer with a background in manufacturing and process design. When she retired and started donating her time to help new companies, she found that most volunteer work didn’t require her level of expertise.
“I started working with the university and helped them develop a strategy for innovation and entrepreneurship,” she said. “That’s when I got introduced to the professor.”

Then about a year ago she met Scott Collins, who had completed a PhD in biomedical engineering after a successful exit in another industry.

“He has been with us over a year now, and is our VP of product development and the lead PI on this grant,” Bosworth-Bucher said.

Bosworth-Bucher said the company is three to four years away from human studies, depending on how fast funding comes in. The company has pending patents on tissue engineering methods.

Additional reporting by Chris Seper

[Images of Thomas Boland and printer by Aurelio Hernandez from The University of Texas at El Paso News Service]

Cosmedica Journée Porte Ouverte / Open House

Real Questions, Real Answers From Dr.Benchetrit – Chemical Peels…how Often Should I Get Them

Hi, I am a 27 year old male with combination skin and a few old acne scars (not very visible). I am kind of going through a phase, I am beginning to see my skin a little more loose on my face and I am wondering if chemical peels could help “rejuvenate” my face a little, just to give it a little more glow. :)) I’ve heard that chemical peels are not very good because they age your skin faster, is that true? And if I get them, how often should I get them. What would be recommended at my age?

“Frequency of chemical peels

Chemical peels are a great way of maintaining a smooth and healthy skin. It helps accelerate the regeneration of skin cells, a process that slows with age. On a healthy skin with no particular concerns, I recommend doing a peel every 2 t 3 months. Using appropriate skin care at home will support what is accomplished in-clinic. This period of time is also when most patients are due to have their skin reanalyzed and skin care routines tweaked; needs change dramatically from season to season. The skin may look more wrinkled or dehydrated for up to 2 weeks post-peel because of the skin cells flaking or trying to detach themselves. A good exfoliation or “gommage” a few days after the peel will speed up the process and get your skin glowing faster.”

Real Questions, Real Answers From Dr.Benchetrit – Latisse-Eyelid Discoloration?

Myself and others have noticed my eyelids have colored they have turned a pinkish /tan color. I have been using latisse since March. But only once or twice a week nice August Is this a side effect of the product

“Tricks for Latisse application

Hyperpigmentation may occur to the skin where Latisse is applied. It is usually progressive and will dissappear as fast as it came once the use of Latisse is discontinued. This is a non-permanent side effect that happens quite often. Several of our patients have tried stopping the use of latisse until the hyperpigmentation went away and then resumed successfully. Ideally, the hyperpigmentation darkens only the skin at the root of the lashes and would look like fine eyeliner. Unfortunately, product leaks or is poorly applied and leaves undesirable stain patterns outside the lash line. Here are few tricks to try:

• With water, wet the applicator brush and squeeze the water out with your thumb and index. This will flatten the brush to insure precise application. You will also use less product as it absorbs less into the bristles of the brush.

• Apply latisse well after skin is dry from washing or showering.

• Let Latisse penetrate and dry well before applying creams around eyes and and shutting your eyes for the night.”

Real Questions, Real Answers From Dr.Benchetrit –What’s the Best Laser Hair Removal Machine?

The clinics near me offer a number of different laser machines. names like Light Sheer, IPL, Yag, Duet, Cool Glide.  What do the medical expert here think works.

“We obtained a new LightSheer Duet laser about 1 year ago, to replace our regular LightSheer Diode. The Duet is a huge leap forward for laser hair removal. Not only is it five times faster but the comfort level is significantly better. Not a single patient has complained of pain or discomfort with this laser. The results have been excellent on all skin types and many patients who were reluctant to treat large areas, such as the legs, chest and back, have gone ahead with this laser mainly because it is so tolerable and fast. Like other lasers, however, it does not work on blonde or white hair.

We have been doing laser hair removal in my practice for nearly 12 years. In that time, we have tested almost every type of laser there is, including the Alexandrite, NdYag, Coolglide, IPL etc. We and our patients agreed years ago that the LightSheer Diode was the best overall laser in terms of efficacy, comfort and speed. The new Duet sets the bar even higher and is the first laser I have obtained that has generated emails from patients thanking me for getting it.”

While no laser can guarantee the same results on every patient and skin type, most of the modern lasers do a very good job. The main difference between them is patient comfort and speed.”

Real Questions, Real Answers From Dr.Benchetrit – Sculptra for Sunken Cheeks

I am 70 years old and I’ve had two facelifts previously. My cheeks are sunken, as my skin is very thin. I am very healthy, but my cheeks look damaged. Is Sculptra for me? How many injections does it usually take, and how much does it cost?

“Sculptra was made for sunken cheeks!!

I have tried almost every filler on the market for sunken cheeks and none compare to Sculptra. Montreal, where my clinic is located, has many experienced injectors but only a few have a lot of experience with Sculptra as it is not as easy to use as other fillers. When properly injected in sunken cheeks, Sculptra will give a gradual, natural-looking filling that makes it look as though the patient has put on weight, but only on the facial areas that needed it. It also has the benefit of lasting two years or more, far longer than the HA fillers (Restylane, Juvederm etc.)

My usual protocol for sunken cheeks is to inject one vial per cheek at the first session and then half a vial per cheek at the second session, two months later. Some patients may need more than this or a third session, depending on how severe their case is. We charge $800.00 per vial. Every patient I have injected so far has been pleased with their result.”

Real Questions, Real Answers From Dr.Benchetrit – IPL and broken capillaries

Do IPL Treatments Cause Broken Capillaries on Face?

I did my first IPL treatment (full face) and noticed after a week, many broken capillaries around my cheek and chin area I didn’t have before the treatment! They are dark purplish in colour and much more visible than the brown spots that were treated! Will these go away or are these permanent?!! My skin looks far worse than before. My treatment was administered by a licensed esthetician in a plastic surgery clinic.

“IPL can treat a variety of skin conditions like hyperpigmentation, the appearance of redness and rosacea. An experienced medical esthetician or nurse will often times treat all existing conditions in a same visit. It is possible that the esthetician treated small telangiectasia that were already present in your skin but not very noticeable. These little veins can turn purple after treatment and then slowly disappear or shrink and turn pink again. Sometimes bruising can happen following a treatment, but this usually disappears within 7 to 14 days. This being said, downtime is usually predictable and should be discussed with patients before performing the treatment. I would recommend contacting your medical esthetician, and voicing your concerns. I am sure you will be satisfied with the results after downtime and completion of your 3 to 5 treatments. Hope this helps.”