Now that the holidays are over, the media is once again concentrating on the proposed congressional healthcare bill. One of the components of that bill is a federal surtax on cosmetic procedures—surgical and non-surgical. This is considered a “vanity tax” which allegedly will help to pay for insuring the uninsured. The perception is that only wealthy people go to plastic or cosmetic surgeons and thus it is their responsibility somehow to partially bear the burden of insuring the uninsured millions. However, information gathered by the American Society of Plastic Surgery has revealed that not only are 91% of cosmetic patients women, but that 60% of these women earn between $30,000-$90,000 yearly. The desire to look good and feel good about oneself is hardly limited to the wealthy upper classes. New procedures, especially non-surgical procedures such as Botox and fillers, fit the budgets of many individuals and cosmetic surgery patients no longer reflect only the rich and privileged in our country.

The Society is protesting this tax primarily on the basis that it singles out one demographic in our society and places an unfair tax burden on them. With much debate going on in Washington at the moment, we will not have to wait long to learn whether this “vanity tax” on cosmetic procedures will be included in the bill or not.

Many patients prefer a safe and and private facility in which to have their cosmetic surgery procedure performed. It is for this reason that many cosmetic surgery procedures are done at outpatient surgicenters or other private facilities. It is, however, important to research the facility and insist that it is certified by a national organization such as the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF). Such an organization (sometimes referred to as a “quad A” facility), establishes stringent guidelines and ensures that specific procedures and protocols are in place. This ensures that all cosmetic surgical procedures done in this setting are carried out in a safe and effective manner. In fact, plastic surgeons who are members of the American Society of Plastic Surgery will only perform surgery in an accredited hospital or an approved outpatient surgicenter. Patients should insist on these standards and be very cautious about having a surgical procedure done in a facility that does not meet these qualifications or criteria.

Melanoma is the deadliest form of skin cancer. According to the American Cancer Society, approximately 68,000 new cases are reported each year.

Recent studies have revealed a direct link between the ultraviolet light exposure in tanning beds and the increase in skin cancers in women 15-39 year of age. This has led to many states requiring written parental permission for a minor before they can use a tanning facility. The fact that these beds are “inside” does not make them any more safe than baking outside in the bright July sunlight! Besides, there are many self-tanning cosmetic products on the market that provide a safe alternative to direct sunlight and tanning beds–check them out!

A few facts of interest about melanoma:
1. occurs more often in older adults
2. occurs more often in Caucasians
3. occurs more often in people with lighter skin tones, light eyes, freckles, and/or red hair

Should you notice any unusual moles or lesions, you should monitor them for changes in color and/or shape, and watch for irregular borders. If any of these occur, call your doctor or your dermatologist right away.

Many patients complain about the extra flabby skin of their upper arms and wonder what can be done about it. Treatment often involves use of liposuction alone or liposuction with removal of the extra, stretched-out skin. The medical term for this surgical procedure is brachioplasty. If a small to medium amount of fat is present, liposuction alone may work to make the underarm look firm and contoured again–especially if skin tone is good. However, if the problem is mostly one of excess stretched-out skin–like what happens when a person loses a large amount of weight quickly–a brachioplasty may be the better answer. In fact, patients who have lost a good deal of weight either naturally or after a gastric bypass may be left with what can be called an “empty skin envelope” and as well as little skin tone. A common term for this is also “batwings” and it is in these patients that a brachioplasty may be most effective. When the problem is moderate to severe, It may be worth considering this surgical option because the significant improvement in upper arm contour may outweigh the considerable scarring involved with the procedure. It becomes a matter of priorities to the patient–possible visable scars weighed against the improvement in upper arm contour–and, as always, a consultation with an experienced and (equally important) a board-certified plastic surgeon for evaluation is invaluable.

Many patients ask in jest if they can use their own fat for breast augmentation–”Couldn’t you just take my belly fat and put it up a little higher?” Although presently not a reality, this may indeed be a possibility in the future. Research is presently being done to test the possibility of using a person’s own fat-derived stem cells to help tissue and fat regenerate in another part of the body. The research is focused at this time on the hope that when these cells are injected back into the same patient, the cells will regenerate. This would be a ground-breaking development in a variety of situations such as post-mastectomy breast reconstruction and cosmetic breast augmentation where the patient’s own fat cells could be used to regenerate and reconstruct the breast tissue. Of course, this is only in the research stage at present and much experimentation and testing must be done to insure the safety of using these types of cells in humans. But as is often the case, it is plastic surgeons who are leading the way in this exciting field, and while much more work needs to be done on this theory, the early studies are most encouraging. Stay tuned for further developments!!