Breast Implants and ALCL

In the last few days I have received questions from several patients who heard about the U.S. Food & Drug Administration’s recent guidance regarding a possible connection between breast implants and anaplastic large cell lymphoma (ALCL). Both for women who have implants and those who are considering a breast augmentation procedure, I would like to provide more information about this guidance and suggest some next steps.

What the FDA Is Doing

An initial review by the FDA has identified 34 unique cases of ALCL in women with breast implants throughout the world. To put this in perspective, it is estimated that 5 to 10 million women worldwide have breast implants. The FDA believes that women with breast implants may have a very small but increased risk of developing this disease, and is asking health care professionals to report confirmed cases of ALCL in women with breast implants to the FDA.

What the FDA Is Not Doing

The FDA is not taking back its approval of saline and silicone gel breast implants. To quote the organization: “The FDA believes that the totality of evidence continues to support a reasonable assurance that FDA-approved breast implants are safe and effective when used as labeled.”

What You Need to Know

If you have had breast augmentation, I advise you to continue to follow your doctor’s regular implant care instructions. Because ALCL is not a breast cancer, there is no benefit to performing additional self exams, but it is worth talking with your surgeon in more detail if you are particularly concerned, if only for added peace of mind.

For women who are thinking about breast augmentation, it is important to get the latest facts. Additional fact finding on this issue will be ongoing and informed surgeons will be able to give you the most current information while providing additional context for the scientific findings so far.

Tags: alcl, Breast Augmentation, breast implants
Posted in Breast, Breast Augmentation, Breast Implant, General Plastic Surgery, Plastic Surgeon, Uncategorized | 2 Comments »

Is Post-Op Breast Asymmetry a Sign of a Bad Surgeon?

During consultations, I hear from some women that they are concerned about having asymmetry after breast surgery. Many of my breast augmentation patients felt anxious as they searched for a Los Angeles or Santa Monica plastic surgeon. They want to feel confident in their choice and, most of all, want to enjoy “perfect” results from their surgery.

A few years ago, a study of breast asymmetry found that after breast augmentation, 88% of patients had some degree of asymmetry and 65% of the women had more than one type of asymmetry. These numbers may seem very high, but before we start questioning the skills of plastic surgeons, we should consider the issue from every angle.

While a beautiful result is always the goal, some asymmetry is simply a result of each patient’s unique physiology. For instance, asymmetry following breast augmentation may be the result of slight pre-op asymmetry that has been magnified by the increase in breast size. However, skilled surgeons can minimize asymmetry by:

• Performing a thorough chest wall evaluation before surgery to determine your individual needs
• Carefully choosing your implant size, profile and placement based on your physiology
• Using an areolar (around the nipple) incision to ensure areolar symmetry (if necessary)
• Performing a breast lift in conjunction with augmentation
• Considering inframammary fold position before surgery to help prevent the implants settling in different positions.

Choosing a surgeon who is highly qualified can help prevent some of these issues, but keep in mind that asymmetry is a natural occurrence. Discussing your concerns with your surgeon is a great way to ease your anxiety and find out what he or she can do to help improve your symmetry after surgery.

Tags: breast augmentation in los angeles, santa monica plastic surgeon
Posted in Breast Augmentation, Plastic Surgeon | No Comments »

A Global Perspective

Recently the ISAPS (International Society of Aesthetic Plastic Surgery) released a “Biennial Global Survey” for plastic surgery procedures (learn more about it here). They compiled a list of the top procedures (both surgical and non-surgical) and the top 25 countries and regions where plastic surgery is most popular, which represented 75% of all cosmetic surgery procedures in 2009.

The United States leads the survey as the country with the most plastic surgery procedures, with China and Brazil rounding out the top 3. The survey may surprise people because of the inclusion of several countries that are not commonly associated with plastic surgery, such as India, Germany and Argentina. Another interesting result of this survey is that breast augmentation is no longer the most popular procedure worldwide; it is now replaced by liposuction.

As a board-certified Los Angeles plastic surgeon, I believe that this survey enables us to see plastic surgery from a different perspective. We are now able to look at this topic from a global standpoint and compare on a geographical level, by comparing trends by country or even region. Although this may not be the first time plastic surgery statistics for other countries have been released, reliable and credible statistics are few and far between, and I think some more detailed analysis of the data will reveal interesting trends in beauty across and inside different cultures.

If you’ve taken a moment to look at the stats, what is interesting or surprising to you? I welcome your thoughts.

Tags: los angeles plastic surgeon
Posted in Plastic Surgeon | No Comments »

Plastic Surgery 2009 Conference: What Did I Miss?

A few weeks back was Plastic Surgery 2009 in Seattle, WA. This is an important conference for many plastic surgeons and, as it turns out, for many patients. As a Beverly Hills area plastic surgeon, I always look forward to seeing what comes out of these conferences so that I can implement it in my practice. I thought I’d take a moment to share why the annual conference is so important.

What’s the Big Deal?

There’s a lot to be said for gathering together a large group of surgeons united by a common passion for cosmetic and reconstructive surgery. Inevitably, there are going to be some great ideas that come out of it. This was the goal behind Plastic Surgery 2009, and it was accomplished in several ways:

• Networking opportunities. For example, the Welcome Reception and Closing Session gave attendees the opportunity to mingle outside the structured environment of roundtable discussions or educational courses. Here, surgeons were able to share their experiences, learning from each other in the process.
• Continuing education courses. Topics this year ranged from skin rejuvenation with lasers, to breast reconstruction, to the prevention of surgical site infection, and much more.
• Lectures. Experts discussed topics such as breast shaping with hyaluronic acid injectables.
• Panel discussions. Panels were held about the cultural influences of breast implant selection, military plastic surgery, and other issues.
• Exhibits from companies such as Allergan (makers of BOTOX® Cosmetic and JUVÉDERM® Injectable Gel), Obagi Medical Products, and LifeCell.

What It Means for You

Events like this play a vital role in advancing the field of plastic surgery in California and the rest of the country. They provide an environment that fosters new ideas and technologies. They help plastic surgeons learn more about the latest developments in their field. They can also be a place where surgeons can build new or strengthen old relationships with one another, creating partnerships that reward patients with improved care.

So, to sum it all up – while it may be hard to trace, the conference this month could make your future surgery even better.

Tags: beverly hills plastic surgeon, plastic surgery california
Posted in General Plastic Surgery | No Comments »