March 5, 2014

On February 10, a surgeon at Washington University performed surgery wearing a special pair of glasses that made cancer cells blue! This allowed the surgeon to distinguish the normal tissue from the cancerous tissue. Normally tissue needs to be removed and sent to pathology for a “frozen section.” But oftentimes healthy tissue is removed and sometimes bits of cancer remain behind. If this really works as touted, it may be one of the most important advances for oncologic surgery in decades. Wow!

March 5, 2014


Obesity kills, yet food is obviously essential.  Why do we forget that sun kills?  I talk about sun exposure and tanning booths with patients all of the time.  Highly intelligent men and women somehow live in denial that their ongoing sun exposure can lead them to get melanoma.  Unless they had a family member die of it, the subject seems abstract. 


But if I tell a woman in her thirties that putting on sunblock every morning will keep her skin gorgeous for decades to come, I feel like I am getting some traction.  It is simply interesting to me that patients are more apt to make this connection.


What motivates people to wear sunscreen doesn’t matter, so long as they do it to themselves and to their children (especially their children.)


Though we’ve known that excessive sun exposure can lead to melanoma, a recent study has shown that the rate of melanoma has been growing in women 40-50 years of age.  Perhaps they had gotten too much childhood sun before the danger of sun tanning was fully appreciated.  Or maybe they are still getting sun.


If melanoma doesn’t motivate you, just remember that sun exposure will make your skin crepey, wrinkled, thin, loose, and saggy well before its time.


March 5, 2014


A recent study published in plastic surgery’s leading journal demonstrated that “trained listeners” heard changes after surgery, but there was no change with speech function.


The study was done on individuals in Iran having “ethnic rhinoplasty.”  I wonder whether the change in size of those noses is representative of what the typical rhinoplasty patient experiences.


I’ve done rhinoplasty for over 17 years, and no patient or patient’s family member has ever commented that they noticed a change in their voice.  So I think this finding is interesting, but probably not applicable to the population of rhinoplasty patients whom I see in my practice.


March 5, 2014

The story of the young girl who died as a result of complications following a tonsillectomy is absolutely horrible.

But the way the flames were flamed by the media could be compared to, “Remember the Maine.”

The media kept referring to this, using some combination of, “…died following a botched routine tonsillectomy…”

But hemorrhage is a known complication of tonsillectomies; in fact I myself bled two days after mine and was rushed to the hospital. 

Was it “botched” because she bled in the hospital and wasn’t saved?  Getting an “airway” into a frightened and massively obese teenager bleeding from their mouth would be daunting for even the world’s best anesthesiologist.


Routine?  This girl had morbid obesity and had the surgery to correct sleep apnea.  That is a far cry from the typical tonsillectomy we all think of, an operation typically done on young healthy children suffering from chronic infections.


February 27, 2014


The word “Laser” has enticed patients since the technology was first associated with medicine. Anything “laser” meant better, less pain, better technology, which of course meant that it was the best.

Lasers are an amazing technology.  But just because something has a laser does not mean it is better.  For instance laser liposuction devices such as SmartLipo have been fairly well debunked as marketing gimmicks.  Yet that never kept patients from flocking to have that procedure done.

The newest term that is the darling of unscrupulous medical marketers is the term, “Stem Cell.” With little doubt stem cells will end up improving health and lives as much as any innovation in the history of medicine.

But at this point there is no evidence to justify the use of the term “Stem Cell Facelift.”  Fat is injected to fill the face, and along with it some stem cells.  But does any technique that minimally increases the amount of stem cells make a difference from just using fat alone?

At this time absolutely no evidence suggests that current stem cell purification technology makes a difference in the face, and to suggest that it does is unethical marketing hype.

In any case, adding fat or stem cells is not a lift; it is a filling.  Adding volume is important to reverse aging.  But calling what at best is “Stem Cell Filling” a “Stem Cell Lift” is an example of “bait and switch” at its very worst.

The American Society for Aesthetic Plastic Surgery released a position paper on this.  The chair of the task force was Peter Rubin, the world’s authority on stem cells.

For a very nice discussion of this topic, see a recent video from the Plastic Surgery Channel.  It is interesting and a well-balanced story.