Plastic Surgery Blog New Jersey - Dr. Larry Weinstein

New Jersey Plastic Surgery Blog

Silicone gel implants prefered over saline – the people speak

Patient Satisfaction and Health-Related Quality of Life Following Breast Reconstruction: A Comparison of Patient-Reported Outcomes Amongst Saline and Silicone Implant Recipients
Macadam, Sheina A. MS; Ho, Adelyn L. MD; Cook, E F. Jr SD; Lennox, Peter A. MD; Pusic, Andrea L. MHS
Published Ahead-of-Print

Abstract

Background: In recent years, there has been a growing acceptance of the value of breast reconstruction. The majority of women who choose to proceed will undergo alloplastic reconstruction. The primary objective of this study was to determine if the type of implant used in alloplastic breast reconstruction has an impact upon patient-reported satisfaction and quality of life.

Methods: Patients were deemed eligible if they had completed alloplastic reconstruction at least one year prior to study initiation. Patients were contacted by mail: two questionnaires (BREAST-Q(C) and EORTC QLQC30 (Br23)(C)), a contact letter, and an incentive gift-card were included. Scores were compared between silicone and saline implant recipients.

Results: 75 silicone implant recipients and 68 saline implant recipients responded for a response rate of 58%. BREAST-Q(C) responses showed silicone implant recipients to have higher scores on all 9 subscales. This difference reached statistical significance on 4 of 9 subscales: overall satisfaction (p=0.008), psychological well-being (p=0.032), sexual well-being (p=0.05), and satisfaction with surgeon (p=0.019). Regression analysis adjusted for follow-up time, timing of surgery, unilateral vs. bilateral surgery, radiation and age. Results from the EORTC QLQC30 (Br23)(C) showed a statistically significant difference on 2 of 22 subscales: silicone recipients had higher overall physical function and saline recipients had higher systemic side effects.

Conclusions: This study has shown higher satisfaction with breast reconstruction in silicone gel implant recipients compared to saline recipients using the BREAST-Q(C). There was no difference in overall global health status between the two patient groups as measured by the EORTC-QLQC30(C).

(C)2009American Society of Plastic Surgeons.


Flowers and Plastic Surgery with Spygrabber

My opinion is the British have it wrong, flowers should be managed in every patient room by the orderlies or nursing assistants. Life is better and patients do better with flowers. Of course there are exceptions, allergies and or immunocomprimised patients should not be subjected to flowers that may be harmful. In the BMJ-British Medical Journal an article appeared… Should flowers be banned in hospitals?Feature: Wards of the rosesDoes flower water harbour potentially deadly bacteria? Do bedside blooms compete with patients for oxygen? Do bouquets pose a health and safety risk around medical equipment? These are some of the reasons given by many hospital wards in the UK to ban, or at least discourage, bedside bouquets. But is this anxiety justified, and what do patients feel about flower policies? To find out more, Giskin Day and Naiome Carter of Imperial College London surveyed the literature and talked to patients and staff at the Royal Brompton Hospital and the Chelsea & Westminster Hospital about their attitudes towards flowers. Their findings are published on bmj.com today, as part of the Christmas issue. A 1973 study found that flower water contained high counts of bacteria. However, subsequent research found no evidence that flower water has ever caused hospital acquired infection. Yet hospitals continue to prohibit flowers on the ward in the absence of any official ruling from the Department of Health.Other negative effects have been ascribed to flowers. In the late 1900s it was common to remove flowers from bedsides at night as there was widespread belief that the blooms competed for patients’ oxygen. But this was dismissed as a myth when studies showed that the impact of flowers on air composition in wards was negligible and did not justify the labour involved in moving flowers to and fro. Southend University Hospital recently imposed a blanket ban on flowers on the grounds that they posed a health and safety risk around high tech medical equipment, but it could be argued that flower vases are no more risky than having crockery containing drinks or food around bedsides. There is some evidence that most nurses are not in favour of flowers, partly because of the amount of work generated. Interviews with staff in this study also suggest that they are more concerned about the practical implications of managing flowers than risks of infection. Other studies report that flowers have immediate and long term beneficial effects on emotional reactions, mood, social behaviours, and memory for men and women alike. One trial found that patients in hospital rooms with plants and flowers needed significantly fewer postoperative analgesics; had reduced systolic blood pressure and heart rate; lower ratings of pain, anxiety, and fatigue; and had more positive feelings than patients in the control group. Given that flowers and herbs have been used as remedies in the earliest hospitals, and as a means of cheering up the hospital environment for at least 200 years, it seems remarkable that flowers still tend to be treated in an ad hoc fashion in hospitals, say the authors. Although flowers undoubtedly can be a time consuming nuisance, the giving and receiving of flowers is a culturally important transaction, they conclude.In an accompanying editorial, Simon Cohn, a medical anthropologist at Cambridge University argues that flowers have fallen victim to new definitions of care. He suggests that the decision to ban flowers “seems to reflect a much broader shift towards a model of care that has little time or place for more messy and nebulous elements.”


Z-Lift Facelift vs Lifestyle lift

20 years of experience has given me an edge to get natural quick recovery face lifts with a technique I have developed. Lifting jowls, nasolabial folds or sagging necks can be restored to a more youthful natural look in 2 to 3 hours. There are some surgeons trying to brand techniques of facelift. I have seen several patients who have had 2 procedures on the same area to get a usual result of one procedure in competent hands. Barbara Walters, Sophia Loren and Joan Rivers all look younger then their age. They have had procedures which have made them look younger.

Although Joan Rivers may have over done it, she still looks younger then 70 years of age. I have many patients who look significantly less then their age after a Z – Lift Facelift. Most patients can be done with local standby anesthesia. That is some Valium and local injections. If a patient requests general anesthesia or is at increased risk, I prefer to perform the surgery at the hospital with a qualified Anesthesiologist. I still do it as an outpatient procedure, as my patients go home several hours after surgery. They usually return to work in 4 to 5 days, I have had physicians return to work the same day. Strenuous exercise should be avoided for 3 weeks.

Within a week 90% of patients are ready for a vacation on a 787 Boeing Dreamliner.

Celebrity Plastic Surgery

A cougar Theresa Rogers is having an affair with Tiger Woods alleged both before and after he was married to Elin Nordegren, making her a mistress with longevity.

She also is apparently the oldest of Tiger’s women, and is in her 40s. Woods is 33. Rogers traveled with Tiger “extensively” during the past five years. Thersa Rogers has obviously had multiple cosmetic and plastic surgery procedures including breast augmentation and lip enhancement. I am not her cosmetic surgeon nor have any direct knowledge of her life or surgery.

Theresa Rogers claims she met him in various cities for hookups, and while she has refused comment on her affair with Tiger, we give it a few hours.

Gotta make sure you find the right deal, after all. When you’re competing with 10 other women for attention, you gotta make your comments count and you have to look your best. In todays competitive world a little plastic surgery can go a long way.


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