Doing Our Part for Others: Charity Cleft Lip & Palate Surgery

The events In Japan (earthquake & tsunami) remind us how transient our happiness, security, and even health may actually be. Special efforts will be necessary to help those effected. However, Dr. Graham and the staff at Aesthetic Center regularly assist children and families in our region, impacted by cleft lip and palate congenital deformities.

Dr. Graham is one of the few plastic surgeons in our community that participate in the Facial Anomalies and Cleft Evaluation Team (FACET). This clinic offers a national-standard multi-disciplinary team approach. It includes pediatricians, geneticists, speech therapists, audiologists, social workers, orthodontists, and oral surgeons. It provides translators for non-English speakers. FACET cares for hundreds of children from Greenwood, Oconee, Pickens, Laurens, and Greenville Counties. Many families have health insurance, but Medicaid is available for those that qualify.

For indigent patients, we provide our plastic surgical services free of charge.

Rare ALCL Cancer Linked to Breast Implants

Scientists have been investigating a rare form of cancer occurring adjacent to breast implants (not well-known breast cancer) named Anaplastic Large Cell Lymphoma (ALCL). This entity gained attention recently when the FDA released a statement. Their information can be found at www.FDA.gov/breastimplants or www.FDA.gov/MedicalDevices/Safety/AlertsandNotices/ucm24000.htm

Here is some background information. Early reports date back 25 years and a JAMA article appeared in 2008. Following this the American Society of Plastic Surgeons contracted with the Rand Corporation to do independent evaluation and this information was used by the FDA for its 2011 announcement. The FDA did not change the regulatory status or availability of breast implants.

ALCL occurs in breasts without implants at a rate of 6 women per year in the US (3 in100 million). That makes it 18/millionth the rate of common breast cancer. It also occurs more commonly elsewhere in the body (1 in one-half million). There types appear to be more aggressive, with 30% five-year survival.

With implants 34-60 cases among 5-10 million women have been described worldwide. These types appear less aggressive. No deaths have been reported in published cases. It has been found near both silicone gel and saline breast implants. It has been found in both cosmetic and reconstructive patients.

The breast implant associated ALCL presents clinically as a late seroma (fluid collection) or mass in the capsule surrounding the implant. Recommended treatment is being researched, but removal of the capsule and any mass appears to cure the condition. Mastectomy did not appear to be necessary.

The American Society of Plastic Surgeons is working with the FDA to establish a registry at the FDA to collect new & existing data and allow careful scientific evaluation of the rare condition. This will guide scientists, regulators, surgeons and patients in making informed decisions.

Accreditation, Board Certification, State Regulation: Elements in Safe Office Based Surgery

Patient safety in surgery has long been important in the lengthy education and training of surgeons. Plastic surgeons typically have 4 years of medical school, 5 years of general surgical residency and additional years of plastic surgical residency or fellowship. The American Society of Plastic Surgeons is a national organization that emphasizes patient safety in many ways. One of them is the requirement for ongoing specific patient-safety education, another is the requirement that member surgeons only operate in accredited surgical facilities.

ACCREDITATION is the process which recognizes that the facility meets detailed standards. The process is similar to that for hospitals and out-patient surgical centers, but tailored to the size and scope of the office facilities. The process includes complying with standards (architectural, equipment, staffing training, reporting, etc.). Our center is accredited by the American Association for Accreditation of Ambulatory Surgery Facilities, Inc. (AAAASF.org). JCAHO, AOA and AAAHC are other similar organizations. As of 2007 South Carolina state law requires accreditation by one of these national organizations.

BOARD CERTIFICATION is a voluntary process of evaluating a physician's education and training. Members of the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery are required to maintain board certification. Dr. Graham achieved board certification in plastic surgery in 1992. He exceeds continuing medical education standards in his specialty. Patients treated in our office surgical facility have the additional benefit of a board certified MD anesthesiologist for their procedures.

STATE REGULATION has been encouraged by the American Society of Plastic Surgeons, as they believe patient safety will be enhanced. The South Carolina State Board of Medical Examiners put in place state regulations several years ago, but these were strengthened when full accreditation was required for all medical offices providing general anesthesia or deep sedation (level II & III facilities). Regulations are contained in statue Chapter 81-96. Additional regulations are produced by DHEC.

Special Savings from Restylane & Perlane

Medicis corporation the parent of Restylane & Perlane is making a special rebate offer between now & December 31st (New Year's Eve).

See myself or Janice for one syringe of Perlane and receive $75 dollar rebate from Medicis. If you benefit from 2 syringe, then the rebate is $150.

There are also rebates on Restylane. Schedule an appointment by calling 864-676-1707 or e-mail us at info@expertplasticsurgeon.com

Don't put too much emphasis on the technology. Evaluate the operator.

Dr. Graham makes periodic contributions to online patient information websites. RealSelf.com is one such site where many people write questions for panels of cosmetic physicians.

One of the most frequently misunderstood topics concerns patients choosing the right laser or other device for a skin condition such as wrinkles. "Should I chose Brand X or Brand Z for my laser treatments?"

Our humorous response to this question for a long time has been, "you need to consider more carefully the witch or the warlock, than which brand of wand they use." You will obtain the best results with the best diagnosis and proper treatment(s) regardless of the brand of laser your surgeon uses. It matters how the device is used and the selection of the appropriate devices. Of course, sometimes the answer from an experienced surgeon may be that lasers won't give you the results you expect, but that facelift or other surgery is your best answer.

Yellow Pages of Little Relevance for our Patients

We have changed our use of the Yellow Pages. Over our years in practice, fewer and fewer patients refer to the local Yellow Pages to find us, or to learn about plastic surgery in general. We know this because we ask! Learning this, we have reduced advertising in the phone book and increased emphasis on our website. Of course our phone numbers are still listed.

Our website remains the best source of information about what makes our practice special: Dr. Graham, our staff, our cosmetic medical and surgical procedures, our nationally accredited on-site surgical facility. And our website's most popular feature is hundreds of patient before & after photographs.

Out with the old - In with the new.

Additional Seminar Dates

See my prior post.

We have had so many responses - so many people wanted to attend our seminars and bring their friends - that we opened up additional dates.

We had another Breast & Body session last night, October 25th. We will have another Facial Seminar next week on November 2nd.

We are very happy to have so much interest and look forward to helping everyone!