Plastic Surgery Seattle Blog

Body Jet liposuction, the new technique that uses water to dislodge unwanted body fat, is featured on this CBS News video.

A Florida doctor’s medical license was recently suspended by the Florida Board of Medicine following an investigation that stemmed from a complaint made by a 2009 liposuction patient.  The doctor was also fined $50,000 and may be subjected to a three-year probationary period of supervised practice after the license suspension is up.

According to the medical board, the penalized physician, Dr. Yves N. Jean-Baptiste, allowed two unlicensed medical assistants to perform liposuction in an unregistered surgical facility.

The board also found that Jean-Baptiste failed to perform a proper pre-operative exam and did not appropriately document important surgical details, including the amount of anesthesia used and the amount of fat removed.

The serious penalties doled out by the Florida Board of Medicine in this case, such as increasing the physician’s fine from $10,000 to $50,000, highlight the board’s concerns regarding unqualified physicians performing cosmetic procedures.

Although Jean-Baptiste is “board certified,” the certification awarded is for family medicine specialization, not plastic surgery, and his liposuction training consisted of only a single three-day course.

“I think he’s in a lot of trouble because he doesn’t have a surgical background,” said Dr. Trina Espinola, a St. Petersburg surgeon and Florida medical board member.

The Florida Board of Medicine’s focus on consumer safety in cosmetic medicine and awareness of the inherent risk of unqualified practitioner participation in this cash-only industry is due in large part to the involvement of the state’s medical community.

Chris Nuland, a Jacksonville attorney representing Florida’s plastic surgeons and dermatologists, commented that in recent years, the state’s community of plastic surgery and dermatology specialists has grown concerned about the rise of untrained professionals, whose patients they end up treating when complications arise.

“This kind of case underscores how a weekend of coursework doesn’t prepare physicians to perform procedures such as liposuction,” said Nuland.

Be sure to seek a board certified Seattle plastic surgeon for liposuction, laser liposuction or any cosmetic surgery procedure, as surgeons certified by the American Board of Plastic Surgery are uniquely qualified and extensively trained to perform these procedures.

Cosmetic medicine is a “buyer beware” industry full of unqualified, unscrupulous practitioners promising cosmetic enhancement for a fraction of the usual cost.

All too often, cosmetic procedures offered at too-good-to-be-true prices prove to be at least twice as expensive as treatment performed by a qualified specialist in aesthetic medicine because of the poor aesthetic results they produce, which require additional revision surgery.

As highlighted in recent news featured by CBS Atlanta and the Orange County Register, sometimes discount cosmetic treatment can even cost far more than money.

See a board certified specialist for plastic surgery

Take for instance Kenyatta Brown, an Atlanta-area mother of four who nearly bled to death during a routine breast augmentation procedure performed by an ophthalmologist, or eye doctor, hoping to make a few quick bucks in the lucrative, cash-upfront business of cosmetic surgery by offering deep discounts.

Brown will likely spend thousands more on revision breast surgery than breast augmentation performed by a board certified plastic surgeon would have cost in the first place.

Brown’s story also illustrates the reality that medical authorities, such as state licensing boards, do not monitor or restrict medical practice based on specialty training or experience, so any licensed physician is legally allowed to practice plastic surgery or any other medical specialty regardless of his or her training or experience level.

Always seek cosmetic treatment at a licensed medical facility

Mayra Lissette Contreras, 22, of Pacoima, Calif. was duped into seeking treatment at an unlicensed back-alley cosmetics clinic run out of the San Fernando Valley home of sisters Guadalupe Viveros, 53, and Alejandra Viveros, 50.

After receiving silicone injections for buttocks enlargement, Contreras became ill and eventually died of respiratory problems.  The Viveros sisters are wanted by police but have fled to Mexico to avoid being prosecuted for Contreras’s death.

The cautionary stories of Kenyatta Brown and Mayra Contreras underscore the importance of researching your practitioner prior to undergoing cosmetic treatment and seeking an experienced Seattle plastic surgeon operating out of a licensed Seattle medical facility for breast augmentation, body sculpting or any other procedure.

Sci-Fi Skin, Algae Injectables & Fly Tape

Scientists are taking cues from nature in developing some of the latest innovations in cosmetic and reconstructive medicine.  Some of the most widely discussed new medical devices in research and production phases include hi-tech skin regeneration, soft tissue augmentation and surgical wound closure products with unlikely biological foundations.

Biochemists create sci-fi skin

New Zealand research and development company Mesynthes recently announced the release of its new Endoform Dermal Template, an FDA-approved skin tissue substitute used for wound care and dermal reconstruction.

This new hi-tech skin will be ideal for reconstructive surgery patients suffering from flesh wounds and tissue damage caused by severe burns and other accidents, and it will likely make skin grafting, the process of transplanting skin tissue, largely unnecessary.

The Endoform Dermal Template can effectively re-grow skin because it is composed of extracellular matrix material, which provides a unique mix of biological macromolecules that actively promote the cell regeneration and blood vessel formation to improve wound healing.

The Endoform Dermal Template is also purported to decrease healing time along with the length and expense of hospital stays after reconstructive surgery, as well as improve the quality of skin reconstruction results.

Due in large part to the FDA approval of the Endoform Dermal Template, Mesynthes recently received the NZ Trade and Enterprise’s “Focus on Health” award and is also on the fast track to receiving FDA approval for Endoform Infection Control, another Endoform product designed to prevent high risk post-operative infection.

Algae injectables

German pharmaceutical company Merz recently launched Novabel, a new injectable filler product available in Europe that is unlike any other.  While most other temporary injectable fillers are made of collagen or hyaluronic acid, Novabel is composed of spherical, flexible structures called Geleons, which are formed from marine brown algae extract.

This patented Geleon technology reportedly makes Novabel injections easy to administer and virtually pain-free.  Novabel is also purported to cause very little swelling and improve skin elasticity, so it will likely become popular for adding volume to facial areas with thin skin, such as the lower eyelids and tear troughs.

Caddisflies give new meaning to “Fly Tape”

Researchers from the University of Utah claim that the design and properties of silk spun underwater by caddisfly larvae could be mimicked to design a sort of wet Band-Aid that could close incisions much like a surgical suture.

The advantage of this caddisfly-inspired surgical tape would be dramatically increased adhesive bond strength, which would potentially lower incidence of suture failure in plastic surgery patients.

Scientific discovery and innovation is an important part of development in the field of plastic and reconstructive surgery, so staying up-to-date on all the latest research and technology is a top priority for Seattle plastic surgeon Dr. Jourdan Gottlieb.

According to a study published by the American Journal of Surgery, breast surgery procedures performed in Ambulatory Surgery Centers (ASC) are faster and more efficient than breast surgery procedures performed in hospitals.

The study found that performing breast surgery in an ASC rather than a hospital saved 69 minutes on average, and most of the time savings was attributable to decreased preoperative time, or time spent preparing for surgery.

Key time-saving advantages of the ASC include:

• Avoidance of unscheduled surgeries, such as add-on cases and emergency cases common in hospitals
• Better case flow as a result of having a surgeon assigned to a single room in the ASC
• Smaller, more consistent ASC staffing
• Smaller physical ASC facility that makes it easier to move patients and equipment

This study began in 2005 when the authors’ ASC was closed, which forced all breast surgeries to be performed alternatively in a hospital setting.  Study authors were then able to compare the amount of time breast surgery patients spent in the hospital facility versus the ASC facility.

In total, the records of 92 patients who had breast surgery performed in an ASC facility between January 2004 and December 2005 were compared with the records of 92 patients who had breast surgery performed in a hospital setting starting January 2006.

All patients were women 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 preoperative time-savings are significant in an ASC, the study also noted that breast surgery patients spend an almost identical amount of time in an ASC and a hospital once they reach the operating room.

The type of anesthesia used during surgery can also affect discharge time, or the time from when surgery is complete to when a patient leaves the hospital or surgical facility, however this did not significantly affect overall start to finish time of surgery from the preparation stage to the patient discharge stage.

So, while the study certainly supports the common perception that outpatient surgery can be far more efficiently performed in dedicated outpatient surgical centers outside of hospitals, it identifies that the time savings benefits of an ASC are only offered during the preoperative, or preparation, stage of a breast surgery procedure.

Dr. Jourdan Gottlieb performs all breast augmentation, breast lift and breast reduction surgeries in two state-of-the-art ASC facilities to ensure every procedure is performed as safely and efficiently as possible.

Swiss-based medical device developer, manufacturer and distributor Anteis S.A. launched an automated injection pen in 2010 called the Anteis Injection System.

The Anteis Injection System purportedly allows physicians to achieve more precise and consistent results with gel-based dermal filler injections because it is physically easier to use than standard syringes and electronically controls and regulates the volume of the filler and injection speed as it is introduced into the dermis.

The injection pen device is now being used in Europe with some apparent success.

Patients who have injectable filler treatments with the Anteis Injection System, as compared to conventional injection methods, report:

• Less pain during treatment
• Fewer and less severe side effects, such as post-injection bruising, swelling and redness
• Decreased social downtime

In addition to superior aesthetic outcomes, physicians using the Injection System are also reporting reduced muscle fatigue associated with administering manual injections with dermal filler.  The device is also purported to offer physicians improved handling, greater freedom of movement and increased opportunity to focus on ideal product placement rather than injection technique.

According to Anteis, the Injection System is effective for all types of cosmetic injectable treatments, including wrinkle treatments, facial volume restoration and augmentation and treatment of skin depressions, such as cellulite.

The Anteis Injection System was also awarded the 2010 red dot design award in the product design category, as well as the 2009 Gusi Peace Prize for its contribution to improving people’s well being through the application of innovative technology.

Although the Anteis Injection System is a promising innovation in cosmetic dermatology, it has not been appropriately tested or approved by the FDA and is not yet available in the U.S.  Additionally, the injection device was designed to work with Anteis-brand injectable fillers made of hyaluronic acid gel and has not reportedly been tested with fillers made of other substances, such as Radiesse, nor with wrinkle-relaxing products, such as Botox.

If you’re considering treatment with injectable fillers in Seattle, seek an experienced injector with superior injection technique who can ensure your experience with cosmetic injectables is painless, positive and precise.

In a guidance issued by the British Association of Aesthetic Plastic Surgeons, thousands of UK women with French-made Poly Implant Prostheses (PIP) breast implants were advised to undergo corrective breast surgery if their implants have ruptured.  The guidance was issued after an inquiry by the French Society of Plastic, Reconstructive and Aesthetic Plastic Surgeons revealed that PIP implants were faulty and prone to rupture, which could pose a potential health risk since the implants were filled with an unapproved silicone gel that had not undergone safety tests.   

Although the FDA-approved breast implants used in the U.S. are safe, and rupture is uncommon, it is important for breast augmentation patients to know how to detect a breast implant rupture, as well as their options for correction should implant malfunction or breast trauma occur.

Rupture in saline breast implants tends to be obvious, as deflation and noticeable volume loss will occur in the implants.  However, in silicone gel breast implants, ruptures are not as obvious and an MRI is required for detection.  When ruptured breast implants do not cause problems with breast appearance or health, occasionally women will choose to forego revision surgery, however most pursue corrective surgery. 

Options for corrective surgery include:

• Breast augmentation revision, or breast implant exchange
• Breast explant surgery, or breast implant removal
• Breast lift in combination with breast implant exchange or removal

Many women who experience a rupture in one or both breast implants choose to exchange their implants for new ones via breast augmentation revision surgery, while other women choose to simply undergo breast explant surgery, or implant removal, and do not have their implants replaced. 

A breast lift is often recommended to avoid sagging caused by excess skin when breast implants are removed and are not replaced.  A breast lift may also be recommended in combination with breast augmentation revision if breasts have begun to sag with time since the initial breast augmentation surgery. 

If your breast implants have ruptured, don’t panic, as there is no immediate health risk.  Consult an experienced board-certified plastic surgeon who can show you before and after pictures of satisfied breast revision surgery patients and help you decide which corrective breast surgery option is right for you.

If you’re considering breast augmentation, you’ve probably heard about the next generation “highly cohesive” silicone gel implants.  If not, you may want to read up on the Natrelle 410 or the Mentor CPG 300 series breast implants.

A recent study published in Aesthetic Surgery Journal compares the outcomes of both breast implants and studies the potential processes that may improve breast augmentation with the new prosthetics.

The authors evaluated data such as:

• Breast characteristics
• Patient’s quality of life
• Patient and surgeon satisfaction with outcome
• Adverse events

After breast augmentation with highly cohesive silicone gel implants, doctors followed up on patients 16 to 77 months later. “The outcome data indicate that these devices produce natural-appearing breasts with extremely low aggregate reoperation rate (4.2%), writes study author Mark Jewell M.D.  Between the two breast implant manufacturers, the study showed measurable differences in the incidence of visible implant rippling.

To learn more, read the abstract on PubMed.gov for  “A comparison of outcomes involving highly cohesive, form-stable breast implants from two manufacturers in patients undergoing primary breast augmentation”

Dr. Jourdan Gottlieb of Plastic Surgery Seattle is featured in the Summer/ Fall 2010 edition of NewBeauty magazine, which is due on newsstands the last week of June.

NewBeauty is the world’s most unique beauty magazine, and is fast becoming a powerhouse beauty brand spanning print, online and retail. NewBeauty magazine is the first publication devoted exclusively to “everything beauty,” converging the medical, spa and mainstream markets to serve as the ultimate aesthetic resource.

When launched in January 2005, NewBeauty instantly struck a chord with readers, marketers and medical professionals, becoming heralded as an archetypal, all-encompassing beauty publication, with an immediate national presence. Since then, NewBeauty has continued to revolutionize the way people learn about cosmetic enhancement, educating consumers about the latest advances, inside secrets, “must-have” products and expert advice.

With nearly 10.2 million surgical and nonsurgical cosmetic procedures performed in the United States during 2008, a 162 percent increase since 1997, NewBeauty fills the void for reliable information on all types of aesthetic procedures in light of the growing interest and surge in cosmetic-enhancing treatments. In doing so, it informs, enlightens and inspires its readers with new-age developments and tried-and-trusted beauty innovations.

With a distribution of approximately 500,000 copies per issue, NewBeauty is available for purchase at 40,000+ retailers in the United States, including major bookstores like Borders, Barnes & Noble, as well as airports, supermarkets and newsstands.