Saturday, July 28, 2012


Loophole lets unqualified physicians offer plastic surgery

State medical boards do not restrict doctors from performing procedures in specialties for which they are not board-certified, and many doctors have taken advantage of the loophole to start offering financially lucrative cosmetic procedures. "Plastic surgery has become the Wild West of medicine, with an increasing number of doctors performing invasive cosmetic procedures without proper training or credentials," writes plastic surgeon Dr. Anthony Youn. After treating many patients for surgeries botched by unqualified doctors, Youn reminds potential patients to ensure their cosmetic or plastic surgeon is certified by the American Board of Plastic Surgery. CNN (7/25)

Thursday, July 26, 2012


Ban the Tan Movement Gains Momentum Across the Globe

More and more countries are placing restrictions on indoor tanning, according to a study published online in the Archives of Dermatology.
The number of countries with nationwide indoor tanning legislation restricting use by young people 18 years or younger increased from two countries (France and Brazil) in 2003 to 11 countries in 2011. The 11 countries were France, Spain, Portugal, Germany, Austria, Belgium, England, Wales, Northern Ireland, Scotland, and Brazil.
“Since 2003, youth access to indoor tanning has become increasingly restricted throughout the world as accumulating evidence demonstrated an association between melanoma and indoor tanning,” conclude researchers who were led by Mary T. Pawlak, MD, of the Colorado School of Public Health in Aurora. “Additional countries and states are developing indoor tanning restrictions or making their existing legislation more restrictive.”
In the US, New York state is the most recent to join the growing ban the tan movement. New York joined other states including California, Vermont, and Rhode Island in banning most indoor tanning by minors. The New York legislation follows the implementation of a 10% federal tax on tanning consumers, which is part of Affordable Care Act. The Act also calls for increases in licensing and inspection fees for tanning facilities.
Ban the tan legislation is pending in many states.

Saturday, July 21, 2012


Macromastia can bring teens mental and physical anguish, study finds
Teenage girls with macromastia have a higher risk than their peers for lower health-related quality of life and self-esteem, eating disorders and physical problems such as neck and shoulder pain, according to a study published in Pediatrics. Reduction surgery may be appropriate for some adolescents, plastic surgeon and lead author Brian Labow said. Moreover, keeping physically fit may be easier for overweight girls after the surgery, American Society of Plastic Surgeons President Malcolm Roth said. HealthDay News

Monday, July 9, 2012


So-called liquid, vampire and stem cell face-lifts may rejuvenate by restoring volume, but the results can be short-lived, plastic surgeons say. The acupuncture face-lift "is a marketing ploy, pure and simple," said plastic surgeon Jeffrey Darrow. He advises patients to "save yourself the disappointment and see a board-certified plastic surgeon for a solid surgical plan to rejuvenate your face."

Sunday, July 1, 2012


Chronic wounds are usually vascular, diabetic or pressure wounds.  Vascular wounds can be caused by venous stasis (incompetence of the valves within the veins leading to pooling of blood in tissues and breakdown of tissues) or peripheral vascular disease leading to decreased arterial blood flow and death of tissue. Diabetic ulcers are related to small vessel disease, decreased sensory input, hyperglycemia,  and poor skin quality.  Pressure ulcers are related to unrelieved pressure (for as little as 2 hours) on tissues leading to break-down, usually seen in paraplegics who have no sensation in the buttocks and thighs.

Normal wound healing is usually divided into four stages. An interruption of one or more stages causes a wound not to heal properly. The first stage is the coagulation stage in which platelets and the normal blood clotting cascade prevents excessive bleeding and provides the initial protection of the wound.  The inflammatory phase leads to mobilization of white blood cells and macrophases and the activation of  growth factors and dermal/epidermal cells. The third stage of wound healing is the proliferative phase
with the formation of granulation tissue.  The final stage is the remodeling phase with the formation of scar tissue that seals off the wound with a protective barrier.

Most chronic wounds that fail to heal are characterized by a prolonged inflammatory phase with associated infection.  Steroids, a compromised immune system, and smoking may contribute to poor wound healing.

Debridement of non-viable tissues, controlling infection (with topical antiseptics and topical antibacterials and systemic antibiotics) and maintaining a moist envirnoment are important managment tools.  Hyperbaric Oxygen Therapy is sometimes indicated to promote wound healing by adding supra-saturated oxygen concentrations into the arteries under increased pressure.

Despite our best efforts, even with improved medicated dressing technology and meticulous wound care, chronic wounds can be very difficult to heal.