May/June 2010
Summer is just about here! Remember to use sunscreen/sunblock when you are going to be outside. The rates of skin cancer are always on the rise, plus prolonged sun damage can lead to poor skin tone and quality later in life. Besides stopping smoking, protection from the sun is the best way to prevent the signs of aging and wrinkles down the line. It is ok fo a mild amount of sun exposure, but you want to prevent any undo burning or intense UV exposure without protection.
Patient's always ask what I think the best skin care product line is, and I always answer the same way. I think LaRoche Posay makes the best moisturizers, etc. out there (www.laroche-posay.us). They make a great series of products and is worth a try.
Don't forget - if you are a Botox/Juvaderm/Latisse user, then make sure you are registered on www.botoxcosmetic.com. You are eligible for rebates from Allergan with each treatment you get. You earn points with each treatment, and the more points you acquire, the better the savings and free gifts.
With the passage of the new health care bill, many changes are going to occur between you the patient, your doctors, and the insurance companies. No one really knows how it is all going to play out, but the one thing that is clear is that the physician community as a whole did not support the legislation as crafted. The AMA may have supported it, but there is a reason only 20% of physicians are members - the AMA is more of a political tool than anything else.
Anyone else wonder why there was no malpractice lawsuit reform ( tort reform) in the health care bill? The answer is easy - the lawyer lobbying groups contribute tens of millions of dollars to make sure it doesn't happen, as well as the fact that many of our elected officials are lawyers themselves. My own representative, Melissa Bean, was bemoaning to a group of small business owners that her own father was put through a CT scan of the head when he probably didn't need it. She tried to use it as an example of how we could develop " best practice" models to prevent such things, but as long as the specter of a malpractice lawsuit for missing anything hangs in the air, physicians are always going to play it safe. I am sure she would have the lawsuit in hand had they not done a CT scan and there was something serious going on. Bring about tort reform, and you will safe an estimated $200 Billion a year in healthcare costs.
Dr. Chris was just awarded with the Patient's Choice Award for 2009 by Vitals.com. This is the second year in a row. Unlike other distinctions, like Chicago's Top Doctors or Whos Who where you actually pay and advertise to get your name associated with those titles ( ever wonder why the top doctors in Chicago Magazine every year are the same ones who advertise every month in the magazine?), this is voted on by actual patients, and reflects the setiment of our patients.
We are still waiting on the ultra-cohesive gel implant approval ( 4th generation silicone gel implants - 410 series by Allergan and CPG series by Mentor). They are being held hostage by the FDA for unknown reasons. They have had the data for over two years, and it is all very safe and positive, but the FDA wants to see the two companies there reporting on the 3rd generation cohesive silicone gel implants. These are the ones that are used currently. The 4th generation implants are really designed for breast reconstruction patients, and it is a shame that they are not on the market for those women.
Both Dr. Chris and Dr. Vince are part of IraqStar (www.IraqStar.org), a volunteer organization that helps perform surgery on our veterans from Iraq and Afghanistan who cannot get the care they need through our VA or military hospital system. They have been part of the organization for a year now. If you know any vets who could benefit from this, refer them to the website and they will guide them the entire way. This is a volunteer service with no cost to our veterans.
Because of the economic downturn, many people are putting off routine health care visits. Please continue to get your annual mammograms and gyn check-ups. We are not seeing the usual number of breast cancer patients being detected. The breast oncology surgeons report a big drop-off in new patients, which means women are not going for their screenings. It may be harder financially in these times, but the earlier you detect something, the easier it is to treat it.
Case of the Month
The patient is a 23 year old female who has undergone multiple breast surgeries by different physicians over the past 3 years. She originally had a transaxillary breast augmentation with saline implants, but felt that they were too large and felt the ripples more. She also bottomed out, with the implants pushing past her folds. She then underwent a change to silicone implants and repair of her bottoming-out. Unfortunately, her surgeon overdissected her and she developed symmastia ( the implants can touch each other under the tissues). She came for consultation and a comprehensive plan was developed to repair her symmastia, and also make her breasts narrower, but with the same projection.
The patient came to us and underwent change of her implants to narrower implants ( change from moderate profile to HP) so that there was not as much tension on the medial area of her breast, and repair of her bilateral symmastia with tissue capsule flaps and Strattice. Strattice is a dermal matrix that is used to reinforce the medial area, keeping the implant from pushing closer together, and hiding the folds/ rippling that she had in that area from the weakened tissues. The patient is 3 months out and doing very well.
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