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Q: I'm looking for information on breast implants. Specifically, I'd like more information on silicone implants. How long do they last? What are the pros to these implants now, as opposed to years ago when there were questions about leakage and possible side effects?

A: The silicone implants of today are a totally different product than they were 10 - 15 years ago. The breast implant's shell is thicker, which makes them more durable, and the silicone gel used now is also made differently. There is a tremendous variety of styles and shapes available to suit all tastes.

Q: I started mesotherapy treatments a few months ago. I have had 4 so far but don't see any significant change. I opted for it instead of liposuction because it was non-surgical, and less expensive. I am a size 8, eat right, excercise and I'm in good health. Does mesotherapy usually work, or is liposuction the only thing that really will?

A: I do not recommend Mesotherapy. The drugs, vitamins, etc. put into the injections may vary, and some are not approved for the mesotherapy procedure. In general, 10 - 15 treatments are often recommended, and at $500 per treatment, the costs are substantial, especially for a treatment that often does not produce results.

I often get questions from breast reduction patients regarding whether or not their health insurance will cover the breast reduction. Typically, breast reduction surgery is only covered if the reduction is greater than 1,000 grams of tissue.

A recent study published in Plastic and Reconstructive Surgery showed that a breast reduction of even a modest amount could significantly help improve a patient's quality of life and ease some of the pain associated with very large breasts (a condition known as macromastia).

This study was particularly interesting in that one of its goals was to test whether the 1,000g benchmark had any basis in scientific fact, or was an arbitrary number.

The study included 59 patients, all of whom had breast reductions of less than 1,000g. All of these patients reported significant decreases in upper and lower back pain, shoulder pain, breast pain, and more. Also, patients reported an increased ability to play sports, an easier time in finding clothes that fit, and a better quality of life post-breast reduction.

I've seen several articles recently on people traveling to foreign countries for a "cosmetic surgery vacation."

Most of the people in these reports decided to go outside the U.S. to receive less expensive treatment, or treatments not yet approved by the FDA. Predictably, the majority of these "vacations" did not have happy endings.

While there are certainly good cosmetic surgeons throughout the world, there is often little regulation, and researching qualified surgeons can be difficult.

Here in the U.S., the medical field is highly regulated. But even here, any licensed physician can perform plastic surgery. A surgeon's qualifications can be easily obtained and evaluated. You should carefully review these before considering a particular surgeon, regardless of location.

Some things to look for include:

• Training
• Board certification
• What the certification is for (for instance, are you evaluating a facial surgeon to do a breast augmentation)
• Fellowships and surgical society memberships
• Where the surgery will be performed, and whether it is fully accredited
• The qualifications of nurses and the support staff
• The aftercare and recovery program and plan

There are other considerations, but in general, the risks outweigh the benefits when traveling outside the U.S. for cosmetic surgery. Contact me if you have any questions on this, or any topic you've read about in this newsletter.