BODY ART AS AN ALTERNATIVE TO BREAST RECONSTRUCTION

More women are choosing not to reconstruct after a mastectomy and tattoo over the scar tissue instead. Photograph: Guardian

Undergoing a mastectomy is a harrowing experience. Although a mastectomy is an undoubtedly life saving necessity, there is something primitive and brutal about the removal of a breast. Many women report feeling less feminine after the operation, or say that their sexuality is compromised. Mastectomy scars are rarely neat and can be perceived as disfiguring.
Reconstructive surgery is difficult, expensive and not always successful. A full reconstruction can take several surgeries to complete, and it is highly likely that the reconstructed breast will bear little resemblance to the original or its twin.
As a result, more women are actively choosing not to reconstruct. There is a small but growing trend in the US (slowly filtering though to the UK) to refuse reconstruction and tattoo over the scar tissue instead. For many women, the battle with breast cancer is the most intense fight of their lives and they are seeking a way to acknowledge this, rather than disguise it.
Pam Huntley from Fort Bragg in California says: "Getting my tattoo was the culmination of a three year dance with breast cancer. The tattoo changed my mastectomy scar into a shield." For many, the choice to tattoo is a liberating alternative to plastic surgery or hiding the loss of a breast.
There are a number of celebrated female tattooists specialising in mastectomy tattoos. Madam Chinchilla, based in California and author of Stewed, Screwed and Tattooed, talks about how mastectomy tattoos differ from other types of tattooing. "These tattoos represent vanity and survival simultaneously", she says. "We are creating a space where beauty can arise from sheer pain and terror".
Roni Falgout from Seattle is also fast becoming a famous name in the mastectomy tattoo business. She says, "Most women seeking this are feeling less like a woman, and either ashamed of the way they look, or just plain sick of people feeling sorry for them.
One client explained it best. She swam a lot at the public pool and when in the changing room she felt the eyes of pity on her. She hated it and wanted to shout, 'this is a victory, not a defeat. I'm alive. I won'. So she asked for the image of a phoenix to cover the scars, which is appropriate if you know the mythology. Now, when she goes to the pool, instead of the pity she sees and hears: "Wow! How beautiful!".
Women who have chosen tattoos over reconstruction cite the reclaiming of their bodies as the main reason for the choice. Some women refuse reconstruction because they feel it is a denial of the impact of cancer, both positive and negative, and that a tattoo (often very carefully designed to express the personal nature of the cancer journey) is the exact opposite.
Denise Levine was diagnosed with breast cancer in 2009 and was clear from the outset that a reconstruction wasn't for her. "I wanted to return to my old self as quickly as possible" she says, "I didn't see how that could happen if I let a plastic surgeon rearrange my muscles and tissue."
It was a year later (the minimum recommended time to let the scar fully heal) that she decided to visit a tattoo parlour for the first time. Although she was worried about it being the right decision, she made the right choice. "It is hard for me to describe how much I love my tattoo and how happy I am with it… I admire the beauty of the bird and the balance it has brought back to my appearance," Levine says.
Earlier this year an image of Inga Duncan Thornell's mastectomy tattoo was posted on Facebook. It quickly went viral, but was removed shortly afterwards under Facebook's obscenity policy. But it was the removal, rather than the original posting, that caused the most controversy. Facebook has now officially changed its guidelines on showing images of mastectomies and mastectomy tattoos, taking another long awaited step toward public acceptance.
Although Curly Moore, resident tattooist at the Tattoo Club of Great Britain and one of the UK's most respected tattoo artists, hasn't yet been asked to design for mastectomy. But if previous north American breast cancer trends are anything to go by (pink ribbons and Breast Cancer Awareness Month, for example), the UK will soon catch up. The mastectomy tattoo will become just another option for post cancer patients and a truly personal way of regaining control over post cancer bodies and proving once and for all that breast cancer is not just a pink ribbon.

MORE DOCTORS NOT TREATING MEDICARE PATIENTS

Posted August 13, 2013 -- A story by the Wall Street Journal reports numbers released by the Centers for Medicare & Medicaid (CMS) indicate that fewer physicians are treating patients enrolled in Medicare, largely due to issues related to payment rates and the increase of burdensome rules.
9,539 physicians who had previously accepted Medicare opted out in 2012 according to data released by CMS. While only a small percentage of the 685,000 physicians that do accept Medicare patients, the number of doctors leaving the program has tripled from 2009 when only 3,700 physicians opted out of the program. Many of those physicians that are still taking Medicare patients are reducing the number they treat. This is the first time that CMS has ever released opt out data related to the Medicare program

ACID ATTACKS

Acid attacks like the ones that targeted two British teenagers volunteering in Zanzibar are grimly effective – and difficult to treat, burn experts say.
The key to recovery is quick removal of acid-soaked clothing, immediate rinsing with copious amounts of water and fast treatment by doctors who can address issues like skin grafts, scarring and dealing with searing pain.
“It’s a terrible, terrible injury and it’s terrible to inflict it on someone else,” said Dr. Sidney F. Miller, founder and past director of the Burn Center at The Ohio State University.
Acid is cheap, widely available and invariably devastating when it is intentionally thrown with the goal of maiming, disfiguring or blinding the victims, according to the Acid Survivors Trust International, a nonprofit group that tracks acid attacks and works to help victims.
Teenagers Kirstie Trup and Katie Gee were due to arrive back in London Friday for treatment of burns suffered Wednesday, when two men riding a motorcycle poured acid on them. The 18-year-olds were in Zanzibar to volunteer as teachers on the majority Muslim island.
The young women reportedly suffered “horrendous” burns to their faces, hands, legs, backs and necks, Gee’s father, Jeremy, told the Telegraph newspaper.
But they are only the latest victims of acid violence, which occurs regularly in several countries, including India, Bangladesh, Colombia, Nepal, Cambodia and Afghanistan, the Acid Survivors group reports on its website.
About 1,500 cases are recorded every year, although that number is likely to be massively underreported, experts say. Between 75 percent to 80 percent of cases involve women, and about 30 percent of the women are younger than 18.
There aren’t many intentional cases of acid attacks in the U.S., said Dr. Tom Tallman, an emergency physician at the Cleveland Clinic. But the key here – or in other countries is to address the injury as quickly as possible.
Depending on its strength, acid can burn through the full thickness of the skin in seconds, even eating into tissue and muscle below. As the skin heals, it develops scar tissue, which creates much of the disfigurement often associated with acid burn victims.
Skin grafts and plastic surgery are often required, he added.
For the British girls, who have access to Western medical care, plastic surgery techniques can include both surgical and non-surgical options, said Dr. Howard Liu, director of cosmetic dermatology at Cedars-Sinai Medical Group in Los Angeles.
Fat grafts, bio-compatible dressings that encourage new skin growth and other innovative treatments could help them heal, even from the whole-body and splatter injuries that typically occur with acid burns, he said.
"For these two young ladies, hopefully they will get the resources they need to recover," Liu said.
But that’s not often the case for typical acid attack victims, said Miller, who is also associated with the American Burn Association. They are forced to contend with medical systems equipped only to provide basic wound care -- at best.
The burn association reaches out to doctors and hospitals in low-income countries to help train medical teams to respond quickly and effectively to the heinous intentional injuries.
“There are a lot of ways to hurt people,” Miller said. But this is one of the worst, he added.

THE HIDDEN DANGERS OF PLASTIC SURGERY

It is a frightening trend, and a fact that more plastic surgery procedures are being performed by doctors that may not be qualified.

 

I could even perform brain surgery in my office if a patient was foolish enough to agree to it, but I would not do so because I'm not properly trained to do it." Said Dr. Braun H. Graham of Sarasota Plastic Surgery Center in Sarasota.

 

"As long as you're a doctor you can perform any procedure that you want to do in the confines of your office." Said Dr. Scott J. Engel, also of Sarasota Plastic Surgery Center. Dr. Graham Added, "It's legal in the State of Florida to perform surgery in your office if the patient is willing to submit themselves to the procedure."
This information came too late for Julie Rubenzer, who died in 2003 following a breast augmentation performed in Sarasota
"The problem we have here in town is we have untrained people in the operating room helping the doctor" Said Dr. James W. Marsh, of James W. Marsh M.D.P.A., Plastic and Reconstructive Surgery, "And, they weren't trained well enough to take care of the problem when the problem came up."
More recently 44 year-old Christine Patterson of Sarasota is charged with practicing medicine without a license, accused of performing a post-operative procedure on a patient after a cosmetic surgery.
So what should you know to protect yourself?
"Make sure that it says the American Board of Plastic Surgery, "Said Dr. Engel, "and that they see that symbol, if that's not on there then they need to question whether or not that person is adequately trained to do these procedures."
Check that your surgeon is affiliated with a hospital. it could make a difference between life and death.
Dr. Engel said, "Hospital have the highest standards of any practice and so they need to make sure that you are qualified to do these procedures" and, Dr. Marsh added, "And they're going to require you to have training to pass boards and to be monitored before you start working in their hospital."
If your procedure is performed at a private center, make sure that its accredited. AHCA is one of the certifications you can look for. But, here's one of the top things you need to know.
"The biggest red flag would probably be saying that they are board certified but not saying what they're board certified in." Said Dr. Engel.
So, when choosing a plastic surgeon do your research and don't be scared to ask questions.

 

 

 

 

BREAST AND ABDOMINAL CONTOURING AFTER PREGNANCY

After the birth of a child, it takes several months for your body to return to its pre-pregnancy form. During pregnancy, the body makes hormones and changes to allow for the birth and growth of the new child. Not only does the abdomen have to stretch to accommodate the growing child, but breasts engorge to help provide milk for the baby. Once these changes are no longer necessary, the skin will contract to varying degrees in an effort to return the body to its pre-pregnancy state.
Following pregnancy, despite regular diet and exercise, some women may find that they have excess skin in the lower abdomen, and others may find that they have breasts that have lost volume and "sag," even after returning to their pre-baby weight. A mommy makeover describes the surgical procedures done to correct these changes and may include an abdominoplasty (also known as a "tummy tuck"), liposuction, and either a breast lift, breast reduction or breast augmentation.
These surgeries are body contouring procedures, not weight loss procedures. To ensure that you have a long-lasting result, you should be at your goal weight for at least six months and have stopped breast-feeding for 6 months. It's important to have stopped breast-feeding because your breasts need to return to their normal size and shape and stop producing milk. Additionally, I advise patients to have completed childbearing before proceeding with a "mommy makeover." You can have a successful pregnancy after a "mommy makeover," but you may require more procedures if you have more children or large weight fluctuations after your initial surgeries.

A GENEROUS GIFT

UM medical school creates plastic surgery professorship with $2.5 million gift

Face transplant doctor to be invested later this year

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July 23, 2013|By Andrea K. Walker

A Swiss businessman has given the The University of Maryland School of Medicine $2.5 million to create a professorship in plastic and reconstructive surgery with the first awarded to the doctor who recently performed a groundbreaking face transplant.
Dr. Eduardo D. Rodriguez will be invested at a ceremony later this year. He led a team last year in a 36-hour face transplant that included replacement of both jaws, teeth, tongue, skin and underlying nerve and muscle tissue from the scalp to the neck.

HERBAL SUPPLEMENTS

FRIDAY, July 26 (HealthDay News) -- About half of patients take herbal and other supplements before undergoing cosmetic facial plastic surgery, according to a new study.
Many of these supplements can put patients at risk during surgery and they should stop taking them at least two weeks before their procedure, Dr. Bahman Guyuron and colleagues at Case Western Reserve University advised.

The investigators examined the medication lists of 200 patients scheduled for cosmetic facial plastic surgery -- such as a facelift or nose job -- and found that 49 percent of the patients were taking at least one type of supplement.
Overall, the patients were taking 53 different types of supplements. The average number of supplements was nearly three per patient, but one patient was taking 28 different supplements, according to the study in the July issue of the journal Plastic and Reconstructive Surgery.
Older patients and women were most likely to be taking supplements, according to a journal news release.
One-quarter of the patients were taking vitamin and mineral supplements only, most commonly multivitamins, vitamin D, calcium and vitamin B. Twenty-two percent were taking animal- and plant-based supplements -- most often fish oil -- in addition to vitamins and minerals. Just 2.5 percent of patients were taking animal- and plant-based supplements only.
Thirty-five patients were taking supplements linked with an increased risk of bleeding, such as bilberry, bromelain, fish oil, flaxseed oil, garlic, methylsulfonylmethane (MSM), selenium and vitamin E.
In addition to the supplements linked to bleeding risk, other popular supplements with potential harmful effects include echinacea, ephedra (ma huang), ginkgo, ginseng, kava, St. John's wort, valerian, feverfew and ginger.
The patients in the study were told to stop taking supplements two to three weeks before surgery.
"These high-risk supplements . . . are quite commonly used and the surgeon must elicit a complete history in order to avoid the known adverse consequences of supplement use on surgical outcome," the researchers wrote.