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Dr. Adams' Newsletter: Spring '00

LOOK AND FEEL YOUR BEST
Responding to Trends in Plastic Surgery

Dr. William P. Adams, M. D. , F. A. C. S.
Director of The Adams-Seckel Center

There has been a considerable amount of attention focused on plastic surgery, the risks, the potential results, and the people, especially teenagers, who are opting for elective surgery. As you know, I don't believe that surgery is for everyone and teenagers are no exception. Each case must stand on its own merits.

Many major publications, including Boston Magazine, have run articles talking about the 153% increase in the number of cosmetic procedures performed by plastic surgeons since 1992. In these articles, they state that an alarming number of these procedures are being performed on patients 18 and younger. Quoting statistics such as 1,645 patients under 18 had liposuction while 1,840 had their breasts enlarged, they do not mention that these numbers represent only 3% of the total cosmetic surgeries done each year. Nor do these articles mention that this 3% number also includes the most common procedures performed on teens today, breast reduction and nose surgeries.

At The Adams-Seckel Center for Aesthetic Surgery, we are committed to providing honest and straightforward information about how people can look and feel their best by focusing on the overall health and well being of our patients. We believe that the overall health of an individual includes physical, mental, and emotional factors, regardless of age. Feeling beautiful comes from the inside as well as the outside, and that's a lesson that comes with maturity and not surgery.

Your Feedback is Important

Is there a particular topic or procedure you would like to see covered in an upcoming issue of Look and Feel Your Best? Let us know by calling 617.262.2208 or using our online contact form.

This Issue

Breast Reduction in Men and Women
Here's to Your Ears!
Options in Hair Replacement
Questions & Answers

Breast Reduction for Men and Women
REDUCTION MAMMOPLASTY, or breast reduction, isn't just for women. In addition to the physical implications, excessive breast development can cause significant self-esteem issues for both sexes.

Breast Reduction Can Provide Physical Relief
Many women with unusually large breasts suffer from medical problems that range from skin irritations to skeletal deformities and breathing problems. Breast reduction isn't usually done until a woman's breasts are fully developed; but if large breasts are causing serious physical discomfort, then it can be done earlier.

Overdeveloped Breasts in Men
An estimated 40%–60% of men are affected by gynecomastia, or enlarged male breasts. In the majority of cases, there is no known cause for gynecomastia, although certain drugs and medical problems have been linked with the condition. Surgery to correct gynecomastia can be performed on healthy, emotionally stable men of any age. The best candidates for this procedure have firm, elastic skin that will reshape to the body's new contours.

How Does Breast Reduction Work?
During your consultation, we discuss what type of results you can realistically expect based on your age, the size and shape of your breasts, and the condition of your skin. Depending on the type and amount of tissue that is going to be removed, liposuction may also be recommended.
Five Ways to Faster Recovery

1. Stop smoking for at least one to two weeks before surgery and during your recovery period.

2. Arrange to have someone drive you home after surgery and to help you out for a day or two if needed.

3. To help reduce swelling, you'll need to wear an elastic pressure garment or surgical bra until the swelling and bruising subside.

4. Limit exercises to stretching, bending and swimming until your energy level returns to normal.

5. Avoid exposing the area to sunlight for at least six months.

Excess glandular tissue, fat, and skin are normally removed by making an incision around the areola, then down and out beneath the breast. The nipple and areola are moved into their new position and the remaining breast is contoured around the areola. This type of procedure does leave permanent scars, although for women, they are easily concealed with a bra. For men, the incision is made in an inconspicuous location such as along the edge of the areola or in the under arm area. Major reductions that involve the removal of a significant amount of tissue and skin may require larger incisions that result in more conspicuous scars. If liposuction is used to remove excess fat, the instrument is usually inserted through the existing incisions.

Other Considerations
Risks include infection, skin injury, excessive bleeding, adverse reaction to anesthesia, and excessive fluid loss or accumulation. The procedure may also result in noticeable scars, permanent pigment changes in the breast area, or slightly mismatched breasts or nipples. If asymmetry is significant, a second procedure may be performed to remove additional tissue. Although it's unlikely, breast reduction surgery may reduce your ability to breast feed.

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Here's to Your Ears!
LASER TREATMENTS FOR WRINKLES

It is possible to achieve a more youthful appearance through laser resurfacing. Today's lasers are precise enough to treat areas near the eyes and around the mouth. Very fine, vertical creases around the upper lip, sometimes referred to as lipstick lines, is a good example of an area commonly treated with laser resurfacing. Areas that have undergone laser resurfacing tend to be noticeably smoother within about five weeks.

THE MOST COMMON GOAL of ear surgery, or otoplasty, is to reduce the appearance of protruding ears. The surgery can also help ears that are very small, when natural curve, folds, and rims are missing or tipped at an odd angle. Otoplasty is also done to improve the appearance of large, stretched or wrinkled earlobes. Keep in mind that we are seeking improvement of these elements, not perfection. Perfectly matched ears are both unlikely and unnatural.

This is one of those procedures that can be done on both children and adults. A lot of parents are concerned about how their children feel about large ears, especially if they are teased by their peers. Since ears are almost fully grown by age four, the operation is often performed on children between the ages of five and 14. The important thing to remember in this situation, however, is that the child must be the one who wants to change their appearance, not the parent.

The Surgery
Otoplasty is done through an incision in the back of the ear. The cartilage is then sculpted or folded to achieve the desired result. After surgery, the ears may throb or ache a little for a few days. This procedure can be done on adults under a local anesthesia in the office. Like all surgeries, there is the possibility of infection and the formation of scar tissue.

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Options for Hair Replacement
The goal of hair transplantation and scalp reduction surgery is to increase hair and decrease baldness. In men and women, a combination of aging, a change in hormones, and a family history of baldness usually cause hair loss.

In order to be a good candidate for hair replacement, you must have healthy hair growth at the back and sides of the head to serve as donor areas. Hair transplantation is achieved by moving small grafts from your donor site to the area being treated.

If you are trying to achieve coverage of bald areas at the top and back of the head, then scalp reduction may be the best option. In this procedure, sections of hair-bearing scalp are pulled forward or "advanced" to fill in a bald crown. It is not recommended, however, for coverage of the frontal hairline.

Depending on your personal condition, one or both of these techniques may be used. If you are interested in learning more about hair replacement or scalp reduction surgery, please call 617.262.2208 to arrange a consultation at your convenience.

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Questions & Answers

Q: Why do you always recommend that people stop smoking before surgery and during recovery?
A: In addition to the benefits to your cardiovascular health, there are other considerations. If you smoke, it inhibits blood flow to the skin, and can interfere with healing. Scars also tend to be much more noticeable in people who smoke.

Q: I've noticed that the area where I had surgery is dry and itchy. Is there anything I can do about it?
A: Dry skin is a common complaint among people who have undergone surgery. You should use a good moisturizer to relieve itchiness in surrounding areas. This will help to alleviate the itchiness associated with dry skin.

Q: When do I need to worry about fluid seeping from my incision?
A: A small amount of fluid draining from your surgical wound, or some crusting, is normal. If, however, you are bleeding or experience severe pain, then you should call us right away.

Q: Is the reduction in a breast reduction procedure relative to current weight, normal weight or proportional to weight and height?
A: Your goals and expectations for your post operative results are exactly what you should discuss with your doctor. Together, you can arrive at a mutual understanding of where you would like to be post operatively.

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