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!

October Cosmetic Surgery Seminars

Come and join us! Find out about treatments that can give you the beautiful look you've always wanted. You will have the opportunity to meet our staff and Dr. Graham, see Before & After photos, and have plenty of time for questions.

Breast & Body Seminar: October 12th from 6:30 until 8:00pm

Facial Cosmetic Seminar: October 19th from 6:30 until 8:00pm

(Additional future dates are available)

You can register several ways:
Register by e-mail (info@expertplasticsurgeon.com)
Register through our website, www.ExpertPlasticSurgeon.com
Register by phone 864-676-1707

Contact us now!

Support Local Charities

We want our friends and patients to support area charities, which we do at Aesthetic Center for Breast & Cosmetic Surgery.

Our Patient Coordinator Betty Stapleton prepared a basket of complimentary services and quality products. It contains certificates for consultations with both Dr. Graham and our Skin Care Specialists, and UVA/UVB sun protectant, face & body wash, toner & make-up remover Magic Mitt.

Our Region is a Great Place to Live: High Rankings by Editors

The South Carolina Upstate is a wonderful place to live, play, sightsee, dine, and to practice cosmetic plastic surgery.

Most recently Fortune Magazine rated Greenville one of it's TOP FIVE places to retire. Fortune had this to say: "South Carolina has turned into the home of the halfbacks, folks from the Northeast who retire to Florida and then -- because of heat, high insurance premiums, hurricanes, or all of the above -- move halfway back up north. Greenville and its fellow South Carolina cities still give residents a change of seasons and a stable real estate market that never experienced sky-high prices during the bubble: Greenville has dropped a relatively modest 13% since its peak and has another 1% to fall. One of the biggest draws for Greenville residents is its downtown, which has undergone a 30-year revitalization plan. (Its Main Street has been recognized by the National Trust for Historic Preservation.) "It is so darn cute," says Lori Sperry, 50, who recently bought a retirement home in the Greenville area. A growing number of retirees are buying condos within walking distance of downtown's stores and nearly 100 restaurants. Those looking for a city culture can take advantage of Greenville's proximity to Charlotte and Atlanta." Fortune, June 2010.

Money Magazine also recognized Greenville in 2007 as one of the best places to live.

As you can imagine, we enjoy the recognition. We are happy to serve the cosmetic surgery, skin care & non-surgical / injectable cosmetic needs of many in the area.

Latisse Special Offer

Latisse 1st Anniversary Celebration. Allergan, the company that markets Latisse (eyelashes) is offering up to $100 savings on BotoxCosmetic and Juvederm XC when you purchase a kit of Latisse. Call our office for more details - 864-676-1707.

We received a state business reward (for recycling!): "Green" Plastic Surgery

The South Carolina Department of Health & Environmental Control (DHEC) has a program to recognize the efforts of businesses save energy, reduce pollution, conserve natural resources: The South Carolina Smart Business Recycling Program. The Aesthetic Center has received a certificate recognizing these exceptional efforts in 2010.

I don't think you should call us "green," but we're trying to help do our part.

We Love Cards & Notes From Patients: Testimonials

The following are two examples of messages sent from happy breast surgery patients. Obviously we are proud to share them with everyone.

First: "After arriving home form my post-op visit today, I gathered the courage to peek beneath the bandages. I am overjoyed by what I saw. Even with all the bruising and the sutures, there is great beauty to your work and I am so excited at what I see as the beginning of a wonderful change in my life. The entire process with you and your staff - especially Gail, Betty, Tina, Terri - has been unbelievably meticulous and handled with extraordinary kindness and professionalism.
I cannot begin to thank you and your staff for making this surgery a life changing event for me."

Second: "Wonderful. You did a great job and I am very pleased with the results. My daughter-in-law visited the office and she did some research and everything she heard about Dr. Graham was very positive. And after I talked with Dr. Graham, I knew I had the right doctor.
The doctor and staff were great. They treat you like you are family. They go out of their way to make sure you are comfortable. Could not have had a better group of people. Thanks for all the care that was given to me. Dr. Graham and staff are the best."

And finally there was simply, "I look fabulous in a bathing suit."

More News About Questionable Procedures or Practitioners

Now both National Public Radio (NPR) and the web company WebMD are alerting the public to concerns about a group of procedures called "injection lipolysis." Other names used in marketing are; lipodissolve, lipozap, mesotherapy, lipotherapy or fat melting. They use a variety of chemicals, but these lack FDA approval for that usage. Quality scientific studies have not been done to prove safety and effectiveness. Proponents have claimed liposuction-like results without surgery.

The FDA contacted several US companies promoting these treatments and warned them to cease. It also notified a Brazilian company about their web marketing.

You can get more information at:

http://www.npr.org/blogs/health/2010/04/lipodissolve_gets_fda_warning.html

http://www.webmd.com/skin-beauty/news/20100407/fda-cracks-down-lipodissolve-hype

Liposuction "Buyer" Beware: Lack of formal surgical training

Taken from the LA Times report on an article from the respected journal, Plastic & Reconstructive Surgery:

STUDY BLASTS LACK OF TRAINING IN COSMETIC SURGERY MARKETPLACE
April 2, 2010 | 11:38 am
Cosmetic procedures like Botox, facial fillers and liposuction are big money-makers for physicians. Not surprisingly, doctors other than plastic surgeons and dermatologists also offer cosmetic treatments. According to a new study, nearly 40% of doctors offering liposuction in Southern California had no specific surgical training.

The study, published in the April issue of the journal Plastic and Reconstructive Surgery, examined 1,876 cosmetic practitioners from San Diego to Los Angeles. Only 495 of them were trained in plastic surgery. Primary care physicians made up the fourth-largest group of liposuction providers following plastic surgeons, dermatologists and otolaryngologists.

There is no law to prevent doctors from offering these services, especially in a doctor's office (doctors need to apply for privileges to perform services in hospitals). Many non-surgeons take a course or participate in some form of limited training to perform liposuction or inject fillers. But such training is not required and is often inadequate, according to the American Society of Plastic Surgeons.

Though providing Botox or facial fillers is unlikely to be dangerous, liposuction can result in serious complications, the authors state. "We feel that the provision of such a potentially hazardous treatment by physicians with no training in surgery poses a genuine threat to the safety of patients."

Further, the authors state, aesthetic franchises have sprung up that have no association with one particular provider, making it more difficult for patients to know just who is responsible for their care.

"The practices are often named after a geographic location with a cachet of affluence,such as Rodeo Drive, Beverly Hills or La Jolla. In these practices, the practitioners are employees of the owner of the clinical facility, and are pushed to produce revenue. The divorce of the practice from the name of the responsible physician has the potential to have a profound impact on the doctor-patient relationship and how patients select a provider," the authors state.

Still, the authors say more legislation is not what's needed, calling government meddling "a guest who may never leave." They suggest more effort to educate the public on who is or isn't qualified to perform various cosmetic procedures.

I vote for whichever method -- education, legislation or perhaps both -- will protect consumer health and safety regardless of professional turf wars.

-- Shari Roan
http://latimesblogs.latimes.com/booster_shots/2010/04/cosmetic-surgery-liposuction.html

The American College of Surgeons has weighed-in on this subject with a public education program titled, "SURGERY BY SURGEONS." Their excerpt:

Surgery by Surgeons
A fully trained surgeon is a physician who, after medical school, has gone through years of training in an accredited residency program to learn the specialized skills of a surgeon. One good sign of a surgeon's competence is certification by a national surgical board approved by the American Board of Medical Specialties. All board-certified surgeons have satisfactorily completed an approved residency training program and have passed a rigorous specialty examination.

The letters F.A.C.S. (Fellow of the American College of Surgeons) after a surgeon's name are a further indication of a physician's qualifications. Surgeons who become Fellows of the College have passed a comprehensive evaluation of their surgical training and skills; they also have demonstrated their commitment to high standards of ethical conduct. This evaluation is conducted according to national standards that were established to ensure that patients receive the best possible surgical care.

Prepared as a public service by the American College of Surgeons.
http://www.facs.org/public_info/operation/consult.html

Finally, Dr. Graham is a fully trained, experienced, board-certified plastic surgeon. He is a fellow of the American College of Surgeons (FACS). We are happy to offer more information. Contact us at info@expertplasticsurgeon.com or 864-676-1707

Pillow to Prevent Wrinkles? Come By And See the "Save My Face! Pillow"

O.K., everyone knows that Dr. Graham and his staff offer a number of ways to treat facial wrinkles (professional skin care, Botox & Dysport, HA fillers, laser peels and facelifts).

But did you knoe there is a "pillowette" marketed to avoid the squeezing and compression of you facial skin while you sleep? It's called the "Save My Face! pillow. It is designed to cradle your face while sleeping on your back or sides in a way that reduces the pressure pushing your skin forward and down towards your mouth area.

Erin, one of our Skin Care Specailists, found this product and we're offering them to our clients and patients. Come by and see the "Save My Face!" pillow.

Learn more at www.SaveMyFace.com

Major Media Comments on Our Recent ASAPS Statistics

See the preceeding blog post. Since the ASASP statistics were released recently, several news organizations have commented on the effects of the economy on cosmetic surgical procedures (in 2009):

http://www.npr.org/blogs/health/2010/03/bad_economy_hurts_plastic_surg.html

http://online.wsj.com/article/SB10001424052748704869304575109752588876426.html?KEYWORDS=cosmetic+surgery+statistics

New Top Ten: Plastic Surgery Statistics From 2009

The word is out. The American Society of Aesthetic Plastic Surgery just published it's annual statistics for cosmetic surgery.

TOP FIVE FOR WOMEN (90%)
1. Breast Augmentation
2. Liposuction
3. Eyelid Surgery
4. Tummy Tuck
5. Breast Reduction

TOP FIVE FOR MEN
1. Liposuction
2. Rhinoplasty
3. Eyelid Surgery
4. Breast Reduction
5. Hair Transplantation

Our own experience with women is similar, although Facelift is also very common. For men in our practice the procedures differ from national trends. We do more facelifts and necklifts along with eyelid surgery. We do liposuction, male breast reduction (gynecomastia treatment), but not rhinoplasty or hair transplants (but we do plenty of laser hair removal).

In the non-surgical realm, wrinkle treatment with botulinum toxin (Botox or Dysport) remains the most common procedure.

TOP FIVE NON-SURGICAL TREATMENTS:
1. Botox (Dysport)
2. Filler (Hyaluronic, Restylane, Juvederm)
3. Laser Hair Removal
4. Microdermabrasion
5. Chemical Peel

In our practice, the trends are similar. Botulinum toxin & injectable fillers are most common. Laser & intense pulsed light treatments for hair, pigment, blood vessels, skin texture, etc. are common as well. We offer a wider range of options than just hair removal. We also offer more advanced non-surgical treatments than microdermabrasion.

Further details are available from ASAPS at: www.surgery.org/media/statistics

Dr. Graham has updated our photo gallery

We know patients and potential patients like to review a surgeon's sample results, so we regularly update the gallery of photographs. Again, we express our gratitude for the patients who graciously grant permission for use of their before & after pictures.

When you open the gallery link (click on the title line above), you will find a drop-down field in the upper left that will allow you to select the category from among several hundred images.

Increasing Interest in Breast Augmentation

Breast Augmentation in one of the most commonly requested plastic surgery procedures, nationally and in our experience at the Aesthetic Center for Breast & Cosmetic Surgery. (We are also known for facial & body cosmetic surgery)

We are noticing an increased level of interest among our new and established patients. More phone calls. More e-mails. More questions in person. We are happy to answer the full variety of questions; from price to discomfort, from size to recovery.

Almost everybody has something planned this Spring. Something they're looking forward to. To looking their best in Spring & Summer attire. We find these patients enjoyable, positive & very happy with their breast enhancement results. Call or e-mail us if we can help.

info@expertplasticsurgeon.com
864-676-1707

Dr. Graham is one of the areas most experienced breast enhancement surgeons. He has a strong reputation for his interested & caring manner, his emphasis on safety & comfort, and finally beautiful & natural-looking results for his patients.