Tuesday, October 30, 2012

Please Let Us Know Who You Are

As a successful blog, and we are, we get many comments from people who would like a response from us.

One problem: If you comment as "anonymous", we don't get an address to respond to.

Please comment with your Google ID so we can respond to you.


How much is a discount worth ?

The following article was supplied to my Fort Myers cosmetic surgery practice by the American Society for Aesthetic Plastic Surgery:

Dancing lessons, dinners, theatre tickets, massages, cruises and flat irons can be purchased on Groupon with variable results. But , the one area in which you should never seek discounts or shortcuts is your health. And some legal experts say that it is violation of state and federal laws for doctors to split fees with Groupon.
There was an article in UK’s Guardian about a Groupon ad for discounted cosmetic surgery, including breast enlargement. Britain’s Independent Healthcare Advisory Service banned the Groupon deal "because it encouraged recipients to hurry into a decision to purchase cosmetic surgery." But making an impulsive decision to lock in a price is just one of the things that can go wrong. A Redbook article about what not to buy on Groupon, August 2012, says “the quality of care – not how deep the discount – should always be your first consideration.” Redbook pinpoints three Groupon deals to avoid:
Lasik surgery. Since offers like Groupon are usually available for 24 hours or until they’re sold out, there’s no time for a consultation to determine if you’re a good candidate. For example, if you have chronic dry eyes, Lasik may not be for you. Further, there’s no time to evaluate the provider’s credentials, let alone check out his bedside manner.  The founding director of Boxer Wachler Vision Institute in Beverly Hills says, “If you have a bad Botox experience, it lasts three months. But if LASIK surgery goes wrong, you might have to live with the results for the rest of your life.”
Liposuction. A recent Groupon ad offered liposuction for $2,999, representing about a 60 percent discount from the usual price. However, taking a chance on liposuction means risking scarring, skin discoloration, nerve damage and – if too much fat is removed – uneven lumpy bits. A poorly-executed procedure can take two or three additional costly surgeries, upping your total expenditure and causing needless discomfort, anxiety and downtime. A prominent plastic surgeon warns, “Sometimes the results are impossible to correct.”
Laser upper eyelid lift. This Groupon offer for laser upper eyelid lift was potentially dangerous. In this procedure, droopy eyelid skin is removed. Groupon stated this was a “relatively minor” surgery that could be done in an hour, requiring only a “mild oral sedative and a little local numbing medicine.” Redbook interviewed the chairman of the department of plastic surgery at the University Of Texas Southwestern Medical Center who said most reputable plastic surgeons don’t even perform this technique because of the risk of burning the skin or eyes. Other complications include infection and temporary or permanent vision loss.
Answer these questions before undergoing any surgery: 

1) Are you an appropriate candidate? 

2) Is your doctor board-certified in the appropriate specialty? 

3) Does the doctor have a long track record of performing the procedure? 

3) Will the surgery be performed in a safe and licensed facility? 

4) Do you have realistic expectation for the results and are you aware of possible complications? 

The decision to undergo elective surgery should be a slow and measured process.

I might also add that almost every plastic surgeon may offer a special discount on a patient-by-patient basis, but that is always more specific than a first-come-first-serve coupon offer. Your health deserves better.

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Monday, October 29, 2012

Walk the makeup aisle of any store that sells cosmetics, and you'll probably see plenty of products touting anti-aging benefits. A wise shopper, however, will be cautious. Some of these companies use some extravagant wording to help sell their products. The Food and Drug Administration (FDA) keeps an eye out for false claims. Recently, it issued a warning to L'Oreal concerning phrases found on its website that made questionable statements about several of its products.
The letter singles out a number of beauty items. The warning also outlines some of the phrases in question. One claim said the Genetique Eye Youth Activating Eye Concentrate "boosts the activity of genes and stimulates the production of youth proteins." Two other products, the Absolute Precious Cells Advanced Regenerating and Reconstructing Cream SPF 15 Sunscreen, claimed that customers would "see significant deep wrinkle reductions in UV damaged skin, clinically proven."
The FDA warns that L'Oreal's products are not "generally recognized among qualified experts as safe and effective for the above referenced uses," and strongly urges the company to correct its website.
 L'Oreal isn't the first company to receive such a warning. Around the same time that the FDA warned the beauty company, it also wrote a letter to Greek Island Labs, which offered a product known as Athena 7 Minute Life. The company claimed this product was "a safe and effective alternative to Botox."
Fortunately, products like Botox and other injectable fillers have been given the stamp of approval by the FDA, which is part of the reason why they've become so popular over the past few years.
The background for this blog message was provided by the American Society for Aesthetic Plastic Surgery, of which I am a member. 

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Sunday, October 28, 2012

It's smart to stay smart.

I guess the more we use a part of our body the better it works.  

We’re told that playing cards or doing puzzles is a great way to maintain cognitive function as we age.  

Well, maybe we need to put down the cards and exercise for awhile. 

A recent study in the Journal of Neurology followed 700 people born in 1936 and found that those individuals who were physically active showed less shrinkage of the brain and less decline in cognitive functioning. 

So hop on that bike or treadmill.  I knew there was a reason I go to the gym at 3:00 AM!  Ugh!  Now I know it’s good for me – I think.

For more, interesting health news, visit my website at http://www.Beauty-by-Brueck.com

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Do it yourself plastic surgery

I guess we live in a do it yourself society - do it yourself home improvements and now do it yourself plastic surgery.  There are do it yourself peels, microdermabrasion or laser hair removal or even hair growth.  

I think the motivation is partly for convenience but driven also to save money.  

We are seeing more injuries as a result of these home remedies.  Reports surfacing of 2nd degree burns, for example, after a peel.  Home laser systems can likewise cause burns.  Some patients with home micro dermabrasion kits think if a little is good, a lot is better.  

So I just want to issue a word of caution. In the end, anyone who undertakes any of these activities without proper training, no matter how enticing the "user manual" or the cost savings, is taking a major risk with their health.

Better to consult with a board certified cosmetic surgeon before trying to do it yourself. At least then you will know the risks

Wednesday, October 24, 2012

Facial Fillers and Blindness

A recent study in South Korea showed that the “improper” use of facial fillers in the glabella or nasolabial fold areas can cause retinal artery occlusion and cause permanent blindness. 

Researchers reviewed the records of 12 patients.  Several people had autologous fat injections to these areas.  (Autologous fat is the patient's own fat.) Such injections may cause more potential problems due to variations in particular size of the injected matter. 

As a board certified cosmetic surgeon who works with facial fillers on a regular basis, I strongly recommend that anyone with eye pain following an injection should have an MRI and eye examination by an opthamologist.

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Breast reconstruction in irradiated patients

Many women following mastectomy will receive adjuvant radiation therapy. 

A recent study by Dr. Steve Kronowitz from MD Anderson in
Houston appeared in the October issue of “Plastic and Reconstructive Surgery”.  

Generally, it was found using a patient's own tissue (autologous) for reconstruction gave better results. 

Implants, however, may be the only choice available.  In one study, they found a complication rate of 45% for women receiving implants WITH radiation compared to 24% in women with NO radiation.  Complications were more common when the patient received radiation BEFORE rather than after reconstruction.  

Basically, radiation therapy affects the skin, which ultimately compromises the reconstruction.  It is also important for me to remember, as a cosmetic surgeon, disease control / eradication is ALWAYS my primary goal.

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Sunday, October 21, 2012

Botox (R) and OAB

OAB is not a new government agency. At least, not this OAB, which stands for "overactive bladder". (But who knows? There also may be a government agency with the initials OAB).  

Women who suffer from OAB, or "overactive bladde", also have episodic bladder incontinence.  In other words, the bladder muscle starts squeezing to push urine out before you’re ready to go — even if your bladder isn’t full. These contractions can create strong sudden urges to go, which can lead to leaks. Signs and symptoms of overactive bladder may mean

  • A strong, suddden urge to urinate.
  • Involuntary lossof urine immediately following an urgent need to urinate.
  • Frequent urination, usually eight or more times in a 24-hour period.
  • Awakened two or more times at night to urinate.

Although you may be able to get to the toilet in time when you sense an urge to urinate, frequent and nighttime urination, as well as the need to suddenly stop what you are doing can disrupt your life.
Now, a new study out of Duke University found that an injection of Botox in the bladder worked as well as pills daily and was more effective in completely resolving symptoms. It appears that women with OAB will have “another” choice.

I issue these little health bulletins based on my continuing research as a Fort Myers Florida cosmetic surgeon. But they are not and should not be considered medical advice. Always see your physician before considering treatment for any condition.

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Friday, October 19, 2012

What's the best breast implant?

Breast augmentation has remained one of the MOST popular operations cosmetic surgeons do.  The main complication that I see as a Fort Myers plastic surgeon is the development of a firm capsule post op.

I recently read a study comparing smooth silicone breast implants versus textured implants.  The study involved 168 women with smooth implants versus 181 women with textured implants.  

The results were pretty amazing - 19% of women with smooth implants developed capsular contracture versus only 1% for textured.  

A corollary study was done to compare incision sites.  The highest rate of hard capsular was with the transaxillary (underarm) followed by the peri-areolar (around the nipple where it meets breast tissue) and the best was inframammary (the fold where the breast tissue meets the chest wall).

The more we learn, the better informed you are as a patient.

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Thursday, October 18, 2012

Have your medical records been compromised?

This is frightening news.

reports on breaches of medical records security that may have compromised millions of individual health records.

For example, Health Net Inc of California reported on January 21,2011 that 1,900.00 records had been breached. In Florida, where I practice as a board certified cosmetic surgeon (Fort Myers)The Nemours Foundation reported that 1,055,489 records were compromised on August 10, 2011.

There are more here in Florida:

AvMed Inc reported 1,220,000 compromised on 12/10/2009.
University of Miami - 64,846 reported on 7/18/2012.
Blue Cross Blue Shield of Florida - 7,366 reported on 10/16/2010 and 3,463 reported on 4/11/2011
Ankle and Foot Center of Tampa Bay - reported 156,000 records compromised on 11/10/2010.
Florida Hospital - reported 12,784 records compromised on 8/10/2011 
At the University of Florida, 2,047 records were reported on  5/24/2010, after 12,580 had been reported at Shands at UF on 1/27/2010  

Even our local Lee Memorial  Health System in Southwest Florida reported 3,800 records at risk in 2010.

The causes of the breaches range from stolen laptops to hackers. 

Has one of your health care providers had a breach of security compromising your records?

All of this information and more concerning breaches affecting 500 or more individuals is available at the HHS website linked above.

The breaches are posted in an accessible, searchable format that includes brief summaries of the breach cases that OCR has investigated and closed, as well as the names of private practice providers who have reported breaches of unsecured protected health information to HHS. 

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Wednesday, October 17, 2012

Talking about Breast Cancer

As a Board Certified Cosmetic Surgeon in Fort Myers & Cape Coral, Florida, I am a subscriber to news from the ASAPS. From time to time they send helpful articles, one of which is reprinted (by permission) below.

Talking About Breast Cancer
Fighting cancer is a battle within itself. The shock of the diagnosis, treatment and the knowledge that it threatens your life, possibly affecting later generations can be overwhelming. A major step in starting the treatment and healing process is to get the support of your family and friends. Sharing the diagnosis with them can be traumatic for both those giving and receiving the hard news.

The American Cancer Society has some recommendations for  talking about cancer:
- If you are diagnosed, it’s important for you to discuss in detail with the doctor about the treatment, prognosis and what to expect in the months to come. Knowing all the details and course of treatment will be important so that you can become emotionally ready to share the news.
- It might be difficult to talk about cancer over and over again. So, you might feel the need to tell groups of people - via email, cards or people you designate to spread the news. Whatever way you choose to tell another or how much you are willing to share is personal. Those receiving the news  should be respectful of that personal nature.
- Having a support group of close family and friends is important and healthy during this time. You may want to reach out to a community group of other cancer survivors 
during this time, to share experiences.
- A common misconception is that the cancer patient or supporting friends and family should act happy and put up a false front. It’s more important to stay positive, but completely normal to have bad days.

An even harder task with an illness like breast cancer is talking to young children about the diagnosis. A recent Huffington Post article recommends being honest about cancer to let children know that they’re part of the family, that telling the truth is important and to quell any fears they might have. Here are some tips on talking to children about breast cancer:

- Let them know you are sick and you have breast cancer. Children are perceptive. It's important to tell them the real name to avoid mixed messages and confusion.
- Tell them in simple and straightforward terms about what to expect. For example: I will be going to the hospital for four nights to be taken care of by doctors and nurses. Then, I’m going to come home and rest here with you and Daddy.
- Encourage children to ask questions. Be sure to explain that cancer is not contagious, that no one caused the cancer (in case they think it’s linked to their bad behavior) and that someone will be there for them when you are undergoing treatment.

For family members and friends, the best thing to do is be available, supportive and act normally. Following a routine, enjoying hobbies and activities will help bring normalcy and a welcome distraction from possible treatments and surgery.


Sunday, October 14, 2012

Do you have "healthy" breath?

In a way, apparently we all have "healthy breath".  As a physician and cosmetic surgeon in Southwest Florida, I try to stay up with medical and health news. In that capacity, I read a truly interesting article recently that gave new meaning to “breathe”.

Usually, we think of breath tests or alcoholic breath when you are pulled over by the police and told to breathe, to check for evidence of alcohol in your system.

Doctors are now analyzing patients breath.  By examining a patient's exhaled breath they can monitor for kidney or liver disease. 

For example, 
elevated levels of hydrogen in your breath may be an indication of bacterial overgrowth in your small intestine signaling irritable bowl syndrome.  Acetone in the breath may mean diabetes.  Each person's breath is unique. It is sort of like a patient's fingerprint.  

Studies are now being conducted to standardize these tests.  Watch this blog for updates.

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Wednesday, October 10, 2012

Complications in men after body contouring

Cosmetic surgery is no longer associated only with women. I perform cosmetic surgery for men quite frequently. Eyelid lifts and chin lifts are common. Now, body contouring is seeing resurgence due to more and more patients losing massive amounts of weight.  

It is not uncommon to see people losing 100 or more pounds.  

I recently did a tummy tuck on a woman who lost 140 pounds through diet and exercise.  

I will soon be expanding weight loss programs in my office.  More will be available on my website and blogs.

A recent study shows men who undergo body contouring surgery, i.e. removing excess skin in abdomen, chest, back or arms- had a 4x greater risk of hematoma (collection of blood) than women.  

However men were NOT at higher risk of more serious complications such as infection.

We don't know why this is so.  

I do know that hematomas in men following facial cosmetic surgery is greater due to greater blood supply.

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Monday, October 8, 2012

Breast Size - Try before you buy.

Women get breast augmentation all of the time to restore a more youthful shape to their breasts following pregnancy or to enhance what they consider an under-developed breast. 

We now have a way to help women kind of see what size they may want to be.   

We have implant "sizers" of different sizes, ie.  275 cc, 300 cc, etc.  It's interesting that a recent study found women often had a cup size in mind but once they tried on the "sizers" – guess what: They they actually selected a larger breast size. 

For years I have told my patients, if anything, I will recommend on the side of a little “too big” rather than too small.  Women adjust up easier than they adjust down.  

But I am also quick to remind them at the end of the surgery, I have to be able to close the incision.

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Saturday, October 6, 2012

Have you noticed the Holiday ads?

Yes, stores are already advertising for holiday sales. That's a sure sign that holiday parties are not far behind.

Soon, it will be reunions with friends you haven't seen since they went up north.

It will be swimsuits at pool parties now that it is comfortable enough to be outside.

It will off-the-shoulder gowns at formal galas.

It will be all glamour and jewelry that calls attention to how beautiful you look.

What a smart time to set up an appointment with your favorite  
Southwest Florida cosmetic surgeon.  There have been so many advances in the field. Ask him how he can bring your beauty and shapeliness back to what it once was. 

If you do this now, you will have time for the procedure and recovery before the social swurl begins.

Have that body sculpting you have been promising yourself. Go for that QuickLift to bring the sparkle back to your being.

And consider this: If you are one of the millions of women who shun wearing a favorite party dress because of excessive sweating, talk to me about miraDry, a non-surgical way to stop heavy sweating that limits your wardrobe.

Excessive underarm sweating is a medical condition. It even has a medical name - hyperhidrosis. And it can be treated with miraDry
Patients I have treated have reported 95% reduction in underarm perspiration.

Call me at 239-939-5233 to arrange a consultation. It won't cost you anything to learn how your beauty wishes can be achieved in time to show off to your friends.

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Friday, October 5, 2012

Are these exercises a waste of time and effort

The next time you go to the gym, you may see some people working out their facial muscles

The Toronto Star, however, reports that there have been no scientific studies to back up the theory that facial muscle exercises translate to a more youthful appearance

Working out your arms, legs, back and torso makes sense, because when you don't use those muscles, you lose them. But facial muscles are different. You're likely using the muscles around your eyes, forehead and mouth throughout the day. So they run no risk of falling as a result of disuse.

The exercises aren't completely useless, however, according to Joanne Dorion, a physiotherapist at the Personal Best Independence and Wellness Center. She told the news source that while the exercises won't do much to reduce flabby or sagging skin on the face, they could "positively influence general appearance, however the changes to the muscle contours would be less obvious."

Some exercises for the neck may tone the skin under the chin. Dr. Catriona Steele of Toronto Rehab told the Star that an exercise which is basically a "chin sit up" could result in subtle improvements to the neck…if repeated three times a day.

If that doesn't appeal to you, there are other ways to help reduce sagging skin and wrinkles from aging. 

  • Injectable cosmetics like Botox and fillers are some of the most popular forms of cosmetic surgery non surgical procedures, and they can help lessen the appearance of crow's feet and laugh lines.

  • The American Society for Aesthetic Plastic Surgery (ASAPS) reports that facelifts are another way individuals can tighten the skin on the face and neck. According to 2011 Statistics on Cosmetic Surgery, facelifts were among the top five surgical procedures for men, with over 10,400 performed over the course of the year.

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Wednesday, October 3, 2012

MiraDry Patient Raves About Procedure

MiraDry is a non-intrusive treatment for hyperhidrosis, also referred to as excessive underarm sweating. People with this problem live in quiet desperation about it's impact on their appearance, professional image and wardrobe requirements. Below is a transcription of a hand-written note from a patient treated for the problem by Dr. Brueck MD and his staff, in his surgery center, using the miraDry technique.

"Dear Dr. Brueck and Linda:

I just want to take this opportunity to thank the both of you for introducing me to the MiraDry procedure. 

Words cannot express the amount of gratitude I have towards you both and I can't believe the amazing results I am seeing. 

You are both extremely talented healthcare professionals and it was a pleasure to see how much you thoroughly enjoy what you do for a living. The amount of care you put into my story and my recovery really made an impact on me and from that point on I knew I made the best decision when I chose to come to your office! 

My first treatment was May 30, 2012 and my second treatment was September 7, 2012 and I am more than satisfied with my results. I would say my sweating has decreased a good 95% thanks to both of you. 

I will forever be grateful for what you have done to help me, and I will never forget your generous and caring personalities. I will proudly wear my colored scrubs to nursing school, and each day I don't soak through because of excessive sweating, I will silently be thanking you both each and everyday. Thank you. Thank you. Thank you. Sincerely, KT"

MiraDry is available, at surprisingly low cost considering the benefit, in my free-standing surgery center in Fort Myers, FL. I welcome inquiries at 239-939-5233.

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