A recent clinical study compared levels of patient satisfaction regarding the choice of silicone vs. saline breast implants after postmastectomy breast reconstruction. The results of this study revealed a higher level of satisfaction in those patients who chose silicone implants. In fact, the study statistically indicated a significantly higher overall satisfaction with their breast reconstructions. In addition, the patients who chose silicone implants indicated improved psychological well-being and a greater sense of physical and sexual self-esteem.

The choice, however, is not always an easy one for women. This may in part be due to the media’s past portrayal of alleged silicone-related complications and the resultant public perception. Yet, after thorough review of current medical literature on the subject and the fact that the F.D.A. has once again deemed the use of silicone in breast implants safe, many women do opt for silicone implants in their post-mastectomy reconstructive surgeries as well as for cosmetic breast augmentation. Considering the results in the previously mentioned study, these women are apparently very satisfied with their outcomes and the choice they made.

Stephen Delia, M.D.

It seems as though every week or two I see a patient in consultation who, having had a procedure done through some nationally franchised practice, presents to me with complaints of less then optimal results, problems and complications, or just plain bad experiences. These patients have unfortunately fallen victim to companies who generate business by making outlandish claims and promising unrealistic results regarding the cosmetic surgical procedures they offer. They lure their patients through slick marketing campaigns, high-pressure office staffing, “astroturf marketing” , and infomercials.

These practices are frowned upon by qualified, ethical, board-certified plastic surgeons. As members of the American Society of Plastic Surgeons (ASPS), board-certified plastic surgeons follow a specific code of conduct and adhere to prescribed ethical quidelines to ensure that patients receive quality care in a safe environment and effective manner. Indeed, costs may be slightly higher when procedures are done by board-certified surgeons in certified facilities–but with good reason. Using appropriate anesthesia for a given procedure administered by certified anesthesiologists in an appropriately certified facility will, of course, add to the overall cost of the procedure; however, by following these guidelines, quality care is maximized and complications and suboptimal results minimized.

Though tempting, it is unrealistic to believe that an effective cosmetic surgical procedure can be performed during one’s “lunchtime” break. With all surgery, there are risks as well as benefits and always some recovery period involved. Insisting on a plastic surgeon who is board certified through the American Board of Plastic Surgery (ABPS), a legitimate board recognized by the American Board of Medical Specialities, assures you that you are in the hands of a highly qualified practitioner with years of training and experience in performing safe and effective cosmetic procedures. Stephen Delia, MD

Mesotherapy (injection lipolysis) is a cosmetic procedure that was originally developed by Dr. Michael Pistor in Europe. This technique claims to reduce excess fat in localized areas of the body. Recently, here in the United States, this “therapy” has been widely advertised as a viable alternative to conventional liposuction. Conventional liposuction is a surgical procedure requiring anesthesia and the skill of a good surgeon. Injectable lipolysis, on the other hand, is the practice of injecting a chemical “cocktail” into an area of localized subcutaneous fatty deposits. The procedure must be repeated several times to attain any indication of reduced fatty deposits.

Currently there are no guidelines, benchmarks or standards by which to gauge the effectiveness of the technique and no standard regarding the chemical make-up of the mixure injected. The procedure for injecting the mixture is not standardized either. For this reason, the FDA has not approved this procedure for cosmetic use or any other purpose.

The American Society of Plastic Surgery maintains the position that there is not enough scientific evidence to support the use of mesotherapy/injectable lipolysis for fat reduction and therefore does not endorse its use. Plastic surgeons who are members of the A.S.P.S. respect the Society’s recommendations on such matters and adhere to their guidelines. Please click on the link below to learn more about the Society’s position on localized fat reduction techniques currently popular and often highlighted in the media.

Click here to read the guidelines.

A Botox mini-seminar was just completed several days ago at Spascape Dayspa in Scituate. The anti-aging effects of Botox were demonstrated on several patients. The injections were extremely well-tolerated and any discomfort was thought to be minimal in all patients.

With Vancouver and the Olympics on everyone’s mind right now, it is interesting to note that it was the Drs. Carruther, who still practice in Vancouver, that played a large part developing the cosmetic use of Botox. This cosmetic treatment continues to be very popular for men and women, helping to lessen wrinkles and soften features. Although the effects are not permanent, this nonsurgical treatment is a safe and effective anti-aging cosmetic treatment with almost no downtime. Botox is an extensively studied medication proven to be safe, and though originally approved as effective for use in the frown-line area, Botox is now used “off-label” and is appropriate for other facial areas as well such as the forehead, “smile lines”, the crow’s feet area around the eyes, and on wrinkles in the mid and lower face.

The use of Botox and wrinkle fillers continue to be among the most popular minimally invasive cosmetic procedures done today. As always, insist on an appropriately-trained medical professionals experienced in these treatments to administer them.

S. Delia, M.D.

Click here for recent Today Show segment on Botox

In 1998, the federal government passed the Women’s Health and Cancer Rights Act.

In essence, this Act required all health insurance carriers to provide the following benefits to women following mastectomies:

–Health insurance companies must pay for all stages of reconstruction on the post-mastectomy breast/breasts.

–Similarly, health insurance companies must pay for reconstruction of the unaffected breast if such reconstruction is needed to attain a symmetrical appearance.

–If complications were to arise post-mastectomy. any corrective surgery must be covered by the health insurer.

Click here to read this all-important Act in full.