Blog
Tighter Breast Implant Regulations in Brazil
While Brazilians are among the world’s most frequent plastic surgery patients, new regulations on breast implants may soon mean that some Brazilian citizens may travel to the US to receive breast augmentation, according to a recent article by the American Society for Aesthetic Plastic Surgery. This comes as the PIP breast implant scandal continues to reverberate throughout much of the world.
Last year, when the French breast implant manufacturer Poly Implant Prothese was found to have been using industrial-grade silicone in its breast implants, it created shockwaves throughout Europe. While the United States was unaffected by the scandal, since the FDA has some of the world’s most stringent regulations on breast implants, many other countries were forced to re-evaluate their own regulations. Now it seems that Brazil is among them.
Shortly after the scandal broke, Brazil’s National Health Surveillance Agency (ANVISA) temporarily stopped imports of foreign implants, but then developed new testing rules to ensure the quality of the products. Reuters reports that implants sold in Brazil will now have to undergo new testing procedures, which will guarantee their strength, durability, and lack of toxicity. This certification process could take up to two weeks.
“Manufacturers will be able to choose between certification through on-going pre-market tests on batches of their products, or on-site inspections of production processes that will come on top of existing factory inspections by Anvisa,” Reuters reports.
The ASAPS article suggests that many Brazilians may decide to simply fly to the United States in order to receive breast implants. To date, the FDA has only approved three silicone breast implants for use in the US, none of which were implicated in the PIP scandal. Breast implants, which may be filled with either saline or silicone, are also frequently used during breast reconstruction surgery.
Botox and Implants Continue Selling Strong in Europe
Cosmetic procedures continue to sell well in Europe despite the continent’s high unemployment and widespread austerity measures, according to the chief executive of Allergan. This report from the Financial Times reinforces recent statistics released by the International Society of Aesthetic Plastic Surgery, which indicated that Greeks and Italians remain major cosmetic consumers despite their countries’ ailing economies.
According to David Pyott, Allergan’s chief executive, the US pharmaceutical giant has managed to generate double-digit growth in its European sales of breast implants since 2011. Pyott says that much of this success can be attributed to the aftershocks of the Poly Implant Prothese (PIP) breast implant scandal. After it was revealed that PIP’s breast implants contained industrial silicone, many European plastic surgeons switched to Allergan’s breast implants.
Botox sales have also been performing strongly, especially since the drug is increasingly being used for non-cosmetic purposes. Its ability to cure chronic migraines has generated a great deal of excitement in the medical community.
The Times report comes after statistics released by the ISAPS that indicate that Greece and Italy occupy the second and third spots worldwide in terms of percentage of population receiving cosmetic procedures. This may come as a surprise to many Americans who watch the economic situation in the region with unease. However, says Pyott, this trend is nothing unusual.
“In southern Europe, people spend a higher proportion of their income on appearance and lifestyle,” Pyott says. “They are happy to live in a modest apartment and look good facially and body-wise when they go out.”
In Italy, Botox is the most popular non-surgical procedure, while liposuction tops the list of cosmetic surgeries. Breast augmentation surgery is the most popular cosmetic procedure in Greece. Based on the figures, only South Koreans pursue plastic surgery with greater frequency than Greeks or Italians.
Plastic Surgeons Learn Clay Sculpture for Better Surgeries
Plastic surgery is often described as an art, but can the development of traditional artistic techniques help plastic surgeons to produce better results? A group of plastic surgeons and medical students at the University of Lincoln in the UK are finding out in a course called the Art of Reconstruction. Now entering its second year, the course offers training in drawing and clay sculpture to promote better results during plastic and reconstructive surgeries.
According to BBC News, the course offers training in different approaches, including self-portraiture, life drawing, and clay modeling. The focus of the course centers on surgical applications of these techniques, so that drawings and models of the head, neck, and breast are featured.
This often involves some unusual tasks. For instance, some students use mirrors to draw self-portraits, but break their face into four quarters in order to create four separate drawings. They must combine and reposition these drawings in order to re-create their balanced face. In another task, students use clay to build a breast onto a cast of a female chest from which one breast is missing.
Emma Caroline Fernandez, a medical student from Debrecen, Hungary, says that the courses helped her to judge the proportion and size of the breast in a whole new way:
“Yesterday we did clay modelling and I thought I’d done a good job until I turned around, I went around the side, as mostly artists do, and then I noticed a huge gap. With the nose and the lips if you look from the front you can’t really judge the space between, until you look from another perspective.”
As a result of practicing these artistic techniques, many of the surgeons have adapted their surgical approaches. By adapting the light in the operating room, or looking at the breasts from different angles, they can get a new perspective on surgeries such as rhinoplasty and breast augmentation.
(Image source: Jastrow, Wikimedia Commons)
More Couples Are Having Plastic Surgery
While there are no statistics on the subject, anecdotal evidence suggests that there is a rise in the use of plastic surgery by couples, according to a recent article in the L.A. Times. The story highlights the growing popularity of plastic surgery among men and a new cultural shift that sees spouses simultaneously pursuing cosmetic enhancement.
The most important factor in rising couples’ plastic surgery is the overall increase of cosmetic procedures performed on men, who now comprise 9 percent of all cosmetic patients. There seems to be a greater openness among men to the benefits of plastic surgery. According to Dr. Richard Chaffoo, a plastic surgeon:
“When a wife comes in and has work done and is delighted with the outcome, the husband or partner feels more confident and secure and more likely to ask questions. Men are often initially introduced when they come in with their wives, who are looking at having this or that done. When the husband is in there, he sees some of the information, and then he sort of gets interested. Then, when the wife comes in for a postoperation appointment, we’ll talk about his eyes or neck.”
Plastic surgeries such as liposuction, eyelid surgery, and rhinoplasty are popular with both groups, although naturally there are different priorities for men and women. Men often pursue liposuction in certain areas, most notably the abdomen, chest, and chin, while women might have liposuction performed anywhere on their bodies.
The most obvious difference is in the chest area, where women often have augmentation surgery to enhance the appearance of their breasts, while men usually have male breast reduction surgery to achieve smaller chests. Of course, with female breast reduction surgery and pectoral implants, both sexes can augment or reduce their chests’ appearance.
Fat Transfer for Breast Augmentation in the Cards for Australia?
Fat grafting techniques that are already popular in the US and Europe may soon be recognized and covered in Australia by that country’s insurers, according to a recent article in the Australian daily newspaper Herald Sun.
Autologous fat grafting is an increasingly popular surgical procedure, with recent studies revealing that it is safe and effective for breast augmentation. The technique, which can also be used for facial and body procedures, involves which using the patient’s unwanted fat – extracted via liposuction from the buttocks, tummy, or another part of the body – to fill out other parts of the body. The fat is treated before being injected into the target site.
Fat grafting is not widely available in Australia, since most insurers refuse to cover the procedure, which leaves many surgeons in a difficult position. However, in the aftermath of the PIP silicone breast implants scandal – in which industrial-grade silicone was used in implants – many Australians are uncertain about placing foreign objects into their bodies. As a result, the Australian Society of Plastic Surgeons (ASPS) is in talks with insurers, hoping that they will cover the technique.
According to Dr. Graham Sellars, a leading Sydney plastic surgeon, fat grafting may soon become “one of the main techniques for both cosmetic and reconstructive breast surgeries… People will prefer to have their own tissue to something synthetic if it gives comparable results.
“You’re going to get a more predictable result with a silicone implant, but there’s now an alternative for people who don’t want implants…. A silicone implant will wear out. But it’s possible to have this kind of enlargement for life.”
While some Australian plastic surgeons remain skeptical, the results of recent studies have indicated that fat transfer techniques have improved greatly over the last decade, thanks to new methods and approaches. If the ASPS succeeds in its talks with medical insurers, the procedure may be covered in Australia within a year.
Selphyl Can Enhance Cosmetic Fat Grafting
Autologous fat grafting is one of the most promising – yet also perhaps the most challenging – developments in the field of plastic surgery in recent years. Research on more effective ways to transfer fat continues with a recent study that indicates improved results with Selphyl, a platelet-rich fibrin matrix, in a discovery that could improve the prospects of tissue survival after autologous fat grafting.
By using the patient’s own unwanted fat to enhance other bodily features, autologous fat grafting has provoked a great deal of excitement since it was initially introduced as a widespread alternative to injectable fillers. During a fat grafting procedure, liposuction can be used to extract fat from one part of the body. The fat is then specially treated before being injected into the target site.
Unfortunately, fat grafting has some disadvantages, the most significant of which is that due to insufficient blood supply, some fatty tissue will likely not survive the grafting process. There have been a number of different studies engaged in finding new ways of grafting fat that will minimize the chances of tissue necrosis. This latest study was published in the American Journal of Cosmetic Surgery.
Richard Goldfarb and Aaron Shapiro, the MDs who conducted the study, examined the surgical results for a 37-year-old woman who had fat from her outer thighs injected into her lower tummy. Two separate injections were used – one with fat and the other with a mixture of fat and Selphyl – so that the results could be compared side-by-side in the same patients.
An examination 8 weeks after the surgery revealed that the Selphyl had produced a greater number of blood vessels in the transplanted tissue. The authors concluded that Selphyl offered better results because of increased neovascularization, which enhances the chances of long-term results. “The result of this case study indicates that fat mixed with Selphyl may improve graft survival by increasing both neovascularization and total cell number.”
The Latest News on “Gummy Bear” Breast Implants
Although “gummy bear” breast implants have not yet been approved by the FDA, their worldwide popularity has many clamoring for the cohesive silicone implants. A recent poll on ImplantInfo revealed that 51 percent of 800 readers would be willing to wait for FDA approval before undergoing breast augmentation.
This newer type of implant, which has been approved for use in Europe and Canada, is popularly known as the “gummy” bear implant for its firm, sticky texture. According to plastic surgeon Dr. Steven Teitelbaum:
“Today’s silicone gel breast implants are far more cohesive, less likely to leak and less likely to spread than the more ‘liquid’ implants of the ‘70s and ‘80s – the type of silicone that gave breast implants a bad name.
What are the Benefits of Gummy Bear Implants?
These implants are stickier than older breast implant models. As a result, they are better at retaining their form and soft texture. Other advantages include:
- superior shape retention
- less frequent hardening of scar tissue (capsular contracture)
- less likely to cause folds
- lower chances of shell collapse
- less likely to leak
Of course, there are also some disadvantages with these implants, beginning with reduced flexibility and firmer feel. They’re more expensive than other implants and require longer surgical incisions. As well, with cohesive gel implants, there is a danger of distortion if the implant rotates within the breast. Nonetheless, as indicated by the ImplantInfo surgery, there seems to be significant interest in bringing gummy bear breast implants stateside.
Why Haven’t Gummy Bear Implants Been Approved Yet?
Dr. Teitelbaum says that the FDA is being cautious before approving a new medical device, but the implants may be available as early as this year.
“The FDA’s job is to be sure that medical devices sold to the public are safe for them. When fiascos like those with PIP happen, it delays the process because it worries everyone. But the data from (Gummy Bear) implants are better than for any other implant to date. It seems inevitable that they will get approved.”
Image source: Pumbaa80, Wikimedia Commons
Hand Rejuvenation 101
Wrinkles, brown spots, and veins are common signs of aging in the hands, but correcting these lines and blemishes presents significant challenges to plastic surgeons. Hands are marvellous structures with numerous bones, tendons, muscles, and joints, which all need to work together. However, as a recent article in the New York Times points out, it seems that new techniques for hand rejuvenation are being developed.
The Challenges of Hand Rejuvenation
“The hands are a hot new area. Now that we have the face so well treated, we’re looking at the hands, neck and décolleté.”
– Dr. Neil S. Sadick
There are several challenges that prevent hand rejuvenation surgery from being a viable option. According to New York dermatologist Dr. Neil S. Sadick, the removal of skin on the hands would result in significant scarring and poor healing. The hand, with its many moving parts, presents too many dangers of complications.
“You’d have to literally take a scissors and separate the tissue, and you might interfere with some of the tendons.”
– Dr. John F. Farella
Botox is another common method of resolving wrinkles in the face, but is poorly suited for use in the hands. Since it works by inhibiting targeted muscles and allowing other muscles to stretch, it is highly effective for facial wrinkles, but would limit the function of the hand.
Non-Surgical Hand Rejuvenation Methods
Other techniques have emerged as possible approaches to the problem of hand rejuvenation. Some surgeons use fat grafting and laser treatments to increase volume and remove blemishes. Other surgeons, such as Dr. Keith Marcus, have begun advertising a “hand lift.” By using dermal fillers, a plastic surgeon can rejuvenate the hands by adding volume and reducing the appearance of lines and wrinkles. The effects of this technique last about a year and can be renewed with further treatments.
Autologous Fat Transfer Safe, Effective for Breast Augmentation, Says Study
Silicone and saline breast implants have long dominated the field of breast augmentation surgery. However, recent advances in autologous fat grating indicate that this procedure may soon rival implants, with ongoing research into different methods of using a patient’s own tissues to provide larger breasts. According to a new study published in the journal Plastic and Reconstructive Surgery, the use of autologous fat grafting alongside a bra-like tissue expansion device has proven to be a safe and effective alternative to implants.
Autologous Fat Transfer: How Does It Work?
- uses the patient’s own tissues rather than an implant
- fat is extracted from the tummy, buttocks, or another part of the body where there may be unwanted fat
- the fat is injected into the patient’s breast, typically with about a dozen injection sites
- the patient’s body reintegrates the fat and the breast is left with a newly enlarged appearance
Pros and Cons of Autologous Fat Transfer
- fat deposits can be long-lasting and don’t require later removal for revision surgery
natural look and feel - body tends to absorb much of the fat
- risk that the transplanted tissue will not survive the procedure
This study examined 81 women who underwent autologous fat injections after several weeks of using a bra-like, vacuum-based, external tissue expander. This device works by stretching the breast tissues and preparing them to expand. The fat was injected into the breasts at 10–14 needle puncture sites. The results indicated that the tissue expansion device improved the surgical results with:
- larger breast augmentations
- more fat graft placement
- higher graft survival rates
- minimal graft necrosis or complications
- 16% incidence of fat necrosis after a year
While the researchers caution that more research into the technique is needed, they conclude that autologous fat grafting is a safe and highly effective alternative to implants for breast augmentation.
New Study Surveys Benefits of Breast Reduction
Reduction mammaplasty, more widely known as breast reduction surgery, is a popular cosmetic procedure that can offer a wealth of health benefits to women who pursue the surgery. A recent article in the journal Plastic and Reconstructive Surgery has highlighted these benefits by surveying past studies on the topic. Based on a literature review on studies from 1977 to 2010, the article shows how breast reduction can have benefits ranging from alleviated back problems to better sleep and breathing patterns.
Physical Benefits of Breast Reduction
- Reduced back and neck pain. Heavy breasts can weigh heavily on a woman’s back, causing soreness and chronic back issues, and many women can experience degenerative changes in the spine.
- Improvement in chronic headaches. Studies have shown that migraine symptoms can be alleviated by breast reduction surgery.
- Better breathing and improved sleep. A reduction in breast mass is associated with a greater flow of air while you breathe. This has a variety of benefits, including greater exercise tolerance, better outcomes for people with breathing problems, and reduced sleep disturbance.
- Other health benefits. Women who have undergone breast reduction surgery experience easier breast self-examinations, improved weight and exercise practices, and are less likely to have an eating disorder.
Psychological Benefits of Breast Reduction
- Improved self-esteem. Women with reduced breasts feel that their bodies now match their expectations and don’t feel that their breasts are attracting unwanted attention.
- Better sex life. According to the study authors, “women are more willing to engage in sexual activities and are more comfortable without their clothes on after reduction mammaplasty.”
- Superior quality of life. With less anxiety and depression, and the various physical and psychological benefits of surgery, breast reduction patients report an overall improvement in their lives.
