To My Patients:
Once again this bias newsletter has been delayed a bit too long, but now I am ready to inform you of a few new things happening in this office and nationally in the plastic surgery field. Our last newsletter was generally well received except for the political comments on healthcare and the communist bastard insurance companies. Had a few calls and emails on these topics.
If you hate these newsletters or me, let us know and we will drop you from the list. However, any comments you have on my prejudice meanderings are welcome.
I. Thermage: As mentioned in the last letter, Thermage, a unique high radiofrequency technology that heats up deep layers in the skin, stimulating collagen and resulting in smoother, tighter and firmer skin in most patients, but not all patients, has recently improved. The technology and our Thermage machine has been upgraded, and we are actually excited about the improved results. Aesthetic facial rejuvenation is a commonly sought goal, and there has been a growing interest in pursuing nonsurgical options if clinically indicated. You can look up the Thermage treatment and more specific explanations at www.Thermage.com. I would like to give you my quick take on it.
Monopolar radiofrequency techniques, which Thermage implements, has been used to essentially tighten skin of the upper and lower face, eyelids, neck, arms, abdomen and even thighs in a noninvasive fashion. Our new machine can now deliver a higher energy with less pain and better results. Of course this technique is not for everyone nor does it work on 100% of the patients treated, but our statistics and our happy patient numbers are improving.
I evaluate all the patients to assess whether Thermage treatment is appropriate and/or surgical intervention is advised. Amy Boyd, our trusted aesthetician, completes the treatments as she is certified by the Thermage company and has treated hundreds of our patients.
She has treated my lower face and neck three times and actually this decaying surgeon has improved. I like the results.

We are also using Thermage on patients who have had suctioning of their neck fat followed by Thermage several months later to tighten up their skin. The treatment takes an hour or so, hurts a bit so you need some oral drugs and you are back at full throttle the next day. Amy has had no complications with our patients and is ready for the summer onslaught. The main disclaimer is that it does not work well for significant loose skin, fatty necks and abdomens nor in patients with poor skin contractility.
II. News from Amy: There are two new products that have arrived just in time to save your skin from unwanted sun damage this summer.
The first is from SkinCeuticals, sheer physical UV Defense SPF 50 is a wonderful sun screen that you won’t mind wearing every day. It is a transparent, mattifying fluid. It is the only zinc oxide formula that I have ever tried that I can honestly say does not feel heavy or greasy, and my make up goes on over it without any problem.
Next, is a new product from Nia 24, Rapid Exfoliating Serum. This product can be used daily because it is so gentle. It utilizes plant-based exfoliators to keep the skin smooth and bright. This is perfect for this time of year. Sun lovers should not use alpha hydroxyl exfoliators during the summer because they can increase sun sensitivity. This product also offers the added benefit of the Pro-Niacin molecule which repairs and prevents sun damage. This product is so new that it has not even shipped yet! Let me know if you are interested and I will hold one for you.

Please call or email me with any questions.
Amy Boyd, Aesthetician
816.616.7018 or Geraghtyskincare@yahoo.com Think Thermage.

III. Carcinogens and plastic surgery: If you are a smoker and like to lie around in the suntan booth, you are doing two things that will impair your general health. Both of these habits are carcinogenic (i.e. cause cancer) and not only have a harmful impact on your health, but will lead to crinkly, crusty skin that will make you look ancient. I know the puffers and the boother patients of mine are sick of hearing me harp at them.

Most techniques in plastic surgery rely on good blood supply to the tissues and tobacco compromises those outcomes, in addition to hastening your death and dying. Baking in a booth or under the sun leads to skin cancers and the old Miami Beach fried old hag look that you hate. Come on, stop these foolish habits.

IV. Health characteristics of women with breast implants: Since we are operating on several hundred patients a year for breast implant surgery, long-term health characteristics and quality of life in patients with breast implants are important issues in my practice. In a recent article from the Aesthetic Journal of Plastic Surgery, from the department of epidemiology at the University of Pittsburgh, 1257 women who had breast implant surgery and no prior breast cancer compared to 86,000 women in the study who did not have breast implant surgery and had no history of breast cancer was completed. The results of the women in the study that had breast implant surgery 20 or more years before being recruited into the study. Total mortality rates were substantially lower among women with breast implants as was the incidence of coronary heart disease. Women with breast implants in the study had a lower body mass index throughout their adult life and were more physically active than controlled subjects. The women with breast implants were overall healthier, more physically fit and less likely to be obese.

Results of a two year old study based in Sweden on over 6000 patients with silicone breast implants followed for over ten years were presented that revealed patients actually had a statistical lowering of breast cancer patients with breast implants. Of course, this may also be due to certain characteristics of the patients in the study from their age, their higher parity and lower body mass index. Basically, like the Pittsburgh study, I feel like women who have breast implant surgery have less breast tissue, are more apt to be in shape and follow a better diet which may lend to the fact that there is a slight decrease in breast cancer occurrence. We have known for years that the myth of an increased incidence of breast cancer with breast implants is false. Both of these studies were welcomed to ease patient’s worries.

V. Smart lipo, i.e. laser liposuction: For several years I thought I was too stupid to do smart lipo. Truthfully I felt like smart lipo or using lasers to enhance the treatment or skin shrinkage during liposuction was in fact a bit of a hoax. Using a laser concurrently with liposuction costs more, takes more time and there have been no good statistical studies to show that it works better. Of course, the men and women selling the machines and those surgeons who have purchased the expensive machines have other prejudices.

There is a welcomed letter from Dr. Mark Jewell, a former Kansas University medical school graduate and now a clinical professor of plastic surgery in Portland, Oregon. His commentary was published in the recent spring Aesthetic Journal.

The goal of lipoplasty or liposuction is both the reduction of volume of fat and potential tightening of the skin preserving good blood supply and lymphatic drainage to these structures. In the case with lasers, the use of frequencies that are designed to target vascular structures becomes a questionable benefit and has additional risks associated with this technology. There have been many other surgeons who have written about this topic of finding equivalent outcomes between conventional liposuction or lipoplasty and laser liposuction. Now it seems that commercialism and marketing to define the patients results As Dr. Jewell states “there seems to be a big rush to sell laser boxes and to promote the laser assisted lipoplasty, but the data that shows science, safety and improved outcomes over existing lipoplasty technologies and patient satisfaction are missing”.

I have improved my techniques since 1985 using smaller instruments with more gentle sculpting techniques. Having suctioned roomfuls of adipose tissue since 1985, I will continue to use the standard liposuction techniques until someone shows me convincing evidence that lasers indeed are better.

VI. Healthcare reform—oh, no—oh, yes: In my last correspondence I briefly brought up the need for healthcare reform for our burgeoning costs and the 50 million uninsured. I was all for it, but if I was in congress I would not have voted for the passage of this healthcare bill. It is going to be more expensive than represented and it is so complex, I do not think anyone understands it. We do need change, cost containment, tort reform and we need to penalize the communist bastard insurance companies. Now the health insurance companies are lobbying federal and state officials to ward off the strict regulations of premiums and profits under the new healthcare law. First they oppose the healthcare reform and now they are trying to influence how the new laws will be implemented. More than the fox guarding the hen house, it is more like the rat protecting the garbage.

My fellow physicians who rely on insurance reimbursement as well as Medicare and Medicaid payments are continuing to get screwed. For years overheads have increased, reimbursements decreased, making a profound effect on them. The fat has been cut out by the insurance company and many good surgeons and physicians are considering alternative careers.

We can only hope that some aisle crossing legitimate politicians who have the public good in mind will get together and come up with some simple and understandable solution. Today a simple legitimate plan for the public good does not exist.

Conclusion: Sorry, but had to get that healthcare stuff off of my mind temporarily as some of it enrages me. Before the summer ends, I am sending out a couple more of these newsletters. I hope you find this somewhat informative.

Next we will talk about fat injections in breasts, lipodissolve and Mesotherapy, mini lifts versus real face lifts and what types of doctors should be performing cosmetic surgery and other prejudiced thoughts. Please let us know if there is anything you would like to cover and/or if you wish to be off of this little email list. Exercise, eat right and put some sunscreen on for God’s sake.

Dear Patients:

We’re done with the summer- the quickest of my life- and time to move on.

This regular biased newsletter is long overdue as I’m bursting with information and in need of unloading my opinions on you. What’s happening in this office, changes in plastic surgical procedures and even ideas on the health care issues are poignant topics.

Our aesthetic practice simply involves making people feel better about themselves —whether it is a fresher look as you glance in the mirror or a more confident sense of well being when you are with or without your clothes. Our persistent goal is to make our patients happy; simple stuff.

In the next few months I’ll be dumping my gleaned biased thoughts on you again. Please, if you find this offensive or wish not to receive these newsletters let us know and we’ll delete you—but not from the face of the earth.

I. Cosmetic Breast Surgery

In 2008 cosmetic surgery nationally was down 9%; in our office aesthetic breast augmentation procedures were up 10%. We operate on several hundred patients a year for breast implants and it seems the economy has not affected our patients choosing implant surgery. I’m allegedly one of the breast implant experts in this region and my patients will attest to their happy results. Rather than brag about our results or discuss all the ins and outs of the operations, check us out on our website www.geraghtymd.com and the Mentor website at www.loveyourlook.com. We have thousands of satisfied patients who have had this aesthetic procedure. More on Breast Implants next newsletter.

II: Latisse for eyelashes: You’ve all seen commercials with Brooke Shields touting a new eyelash fertilizer using a topical ointment placed on the lashes to promote growth and thickness. Of course, I was skeptical of this not only because Brooke Shields promotes everything from Volkswagens to toilet paper and who can believe anything from Hollywood. Minoxidil for hair growth has been ineffective for eyelashes. Well, my old conservative thoughts were wrong and I am amazed by the results. Every woman in our office is using Latisse and they have rather remarkable looking lashes. My patients and office women make Brooke Shields look like a hairless Chihuahua. If you have any ocular problems such as glaucoma, a consultation with your ophthalmologist is appropriate. Check it out at www.latisse.com. It is available for purchase in our office.

III. Minimally Invasive Procedures: Into our second year of this wonderful economic crunch, sometimes all we have left is our pride. Minimally invasive procedures such as Botox and filler injections, lasers, skin care and even Thermage have been on the rise. This office has felt that movement towards less invasive procedures, especially on the face rather than choosing a surgical intervention. There are several websites, www.injectablessafety.org through my aesthetic surgical society that present all types of options. Rather than my belaboring these specifics, there are numerous pages, advisories, videos and informative sites that you can access. There is also www.thermage.com which describes the Thermage unique high radio frequency technology that heats the deeper layers of your skin, stimulating collagen and resulting in smoother, tighter and firmer skin in most, but not all patients. Plastic surgeons hold all of these injectable materials and devices to a very high standard of safety so there is no threat for any serious events.

IV. Words from Amy Boyd: Too much fun in the sun this summer?

The summer is unofficially over on Labor Day. Lounging at the pool and playing at the lake will only be memories soon. But, the telltale sign of sun damage are all too noticeable on your skin. Dryness, dull skin tone, brown spots and fine lines are just a few of the not so friendly reminders that summer can leave behind.

Make your appointment for a Summer Repair Facial today. For $80.00 you will get a personalized skincare plan to set you on the right track with your homecare products plus a medical grade mini-facial to remove thickened, dull skin, open clogged pores and soften lines. You will leave with a glowing complexion and a complimentary tube of Skin Ceuticals sunscreen.

Call or email to schedule. 816.616.7018 or geraghtyskincare @yahoo.com

V. Botox and Facial Fillers: We are currently using Botox and Juvederm. Look up www.juvederm.com for and www.botox.com for more information. Botox paralyzes the local muscle making those wrinkles between the brows less noticeable. It is also relaxes crows feet and horizontal forehead wrinkles. Juvederm is an injectable hyaluronic acid and filler for deep crevasses especially nasolabial folds and is effective for lip plumping. We have used gallons of these materials with great predictable results. Currently we do not use permanent fillers because of potential long term complications. We have no long term complications with Juvederm.

VI. Health Care changes

You are sick of listening to all the healthcare issues and the endless debate and public meeting rantings. The fact is that our nation’s economic stability short and long-term depends on some change in our healthcare system. The 40 million people uninsured are as important as the other 300 million insured with state or government funded subsidized healthcare. The private health insurance carriers remain communist bastards where their business profit motive is of more concern than your treatment or well being. Costs are rising; lobbyists, advertising and lack of tort reform pushes the cost of healthcare higher every year. We cannot maintain this status quo. We do have a bunch of smart people on both sides of the aisle that can get together, control the communist bastards health insurance companies rising costs and find some economically feasible system that will benefit all of us. Please be informed. Read about it and write your congressman. Please look up the facts on www.healthcarereform.com which eliminates the rumors and lies about what potentially would be beneficial for us all.

Conclusion:

In the next month, we are sending more jaundiced opinions. But you, my patients should maintain open minds. Please let us know if you hate this letter. Till next month.

Sincerely,

Thomas Geraghty

The longer I’ve been in practice, now over 25 years, the more I’ve encountered patients who are well informed and briefed on cosmetic surgical operations and nonsurgical treatments, i.e. Botox, facial fillers, Thermage, nonsurgical skin tightening, lasers and general skin care. Most patients know of the many options, but need our advice as to what is best for them as individuals. So we give our patients the most proper and safest course of treatment.

If you do not wish to receive these blog letters, please let us know and we will remove you from the list.

I. Non surgical facial procedures and skin care:

A. Skin care: Aside from avoiding sunburns, suntan booths and nasty cigarettes, most of us need to be on some daily skin care regimen to avoid the leathered, wrinkled, Miami retired facial look. It can be as simple as exfoliators and moisturizers to keep your skin youthful or using medical grade lotions and potions that are appropriate for your skin. There are several new products including Nia-24 and CE Ferulic serum, all of which have their benefits. Here are a few words from Amy.

MEDICAL SKIN MESSAGE: Amy Boyd, Aesthetician.
Summer and Fall are the perfect times to schedule your Thermage skin tightening treatment. Unlike other non-surgical treatments such as IPL and Thermage does not require that you stay out of the sun for an extended period of time. In fact, there is no downtime at all! Thermage targets the deep layers of skin where there is more collagen, so the surface of the skin is usually not even pink as soon as you walk out of the office. Please contact me at 816-616-7018 or geraghtyskincare@yahoo.com for more information.
Skin Ceuticals has launched a new antioxidant product! As many of you know, my favorite anti-aging product is the C E Ferulic serum. It repairs sun damage in the skin, resulting in fewer lines, smoother and brighter texture and more even pigment while at the same time protecting the skin from further UV damage. I love it!

Well, Skin Ceuticals has now introduced Phloretin CF serum. They tag it as a new generation of antioxidant. It has the same sun damage repairing properties as CE Ferulic but it is better for pigment problems and oily skin types. Phloretin CF was featured in the June 2008 issue of Oprah they said, “Phloretin, a natural extract that’s been studied as an anticancer agent, is the newest antioxidant available topically; research has shown it can penetrate the skin and provide significant UV protection”. Contact me at 816-616-7018 or geraghtyskincare@yahoo.com if you are interested.
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Amy has been with me for more than ten years and can give you advice for what is most beneficial for your skin. Not only do you need to maintain some semblance of youthful skin, but you can also improve your texture and wrinkles and smooth it up. Talk to us for advice.

B. For the last three years we have used Thermage as a part of our practice. There are now improved tips, i.e. the treatment end of the machine that can tighten facial and neck skin in appropriate patients. However, this treatment is not for everyone, for example, patients with significant redundant skin, very lax jowels and with significant wrinkling. Face lifts are more appropriate for more severe sagging.

The Thermage company has developed a few of these new tips, that we have been using with improved success. I have had several of these treatments by Amy (because I own the machine and hate personal decay). It has worked well and I am pleased. Along with the new tips, this treatment is more beneficial if done several times in a year—not just a one hit treatment.

II. Surgical Facial Procedure:
A. There have been some minor changes in lifting faces, foreheads, eyelids and cheeks such as suturing techniques in modified ways and manipulating the anatomy of a patient. Although face lifts and the adjunct procedures are more aggressive, time consuming, expensive and complicated, they are time honored procedures that give long lasting improvements to sagging facial tissue.

I have not been impressed with my peers use of string lifts and mini fact lifts, because I do not think they last very long and mini lifts give mini results. So I won’t be using these techniques unless someone shows me something miraculous.

B. Liposuction of the neck with Thermage. I have seen some promising results completing liposuction on the neck of patients with thick, fatty necks and only a moderate amount of skin laxity followed up by Thermage to tighten the remaining skin. These procedures are more appropriate for the fatty neck that does not have a good deal of skin redundancy or “waddle”. There is some down time but not as long as you get from face lifts.
The touted and advertised “lunch time liposuction” where you allegedly can return to the office that day refreshed and with no down time is pure BS. Don’t believe it. Don’t do it.

C. Botox and Hyaluronic acid fillers. In 2007 there were 3 million Botox injections in the United States and 1 ½ million injections of Hyaluronic acid (Juvederm and Restylane). That is comparable to several swimming pools filled with Botox and tractor trailers packed with facial fillers. I personally have used these products for years and do all of the injections myself. Granted, many medical practices have their nurse or aesthetician complete these but I’m just more comfortable in doing these procedures. The only real complications from Botox and Hyaluronic acid fillers are bruising and swelling which should quickly subside.
Botox blocks muscle motor function of fine facial muscles and creates less wrinkling in those areas. Hyaluronic acid i.e. Restylane and Juvederm fill deeper wrinkles around the lips and nasolabial folds (the lip/cheek junction) and even disguise jowling. Both of these products are excellent to use as lip fillers. I have been reluctant to use the more permanent fillers which may have delayed foreign body reactions and may cause pustules or granulomas (inflammatory tissue) months or years later. Juvederm which is a hyaluronic acid is our only new product and it allegedly lasts longer than Restylane allegedly. They do resorb after a year or so.

II. Thermage for the abdomen, thighs and buttocks.

A. Having used Thermage for several years on the face and some on the abdomen, we have been less impressed with skin tightening of the abdomen—until recently. In the past we have had good results but not on a regular, predictable basis. Now that the Thermage company has developed improved products, i.e. the deeper tip (one that penetrates and tightens deeper tissue) we are seeing good to excellent results in tightening loose skin of the abdomen. This is only good for mild to moderate skin looseness with a minimal amount of fat and not appropriate for an abdomen that needs liposuction or abdominoplasty treating thicker redundant skin and fat. There is minimal down time for this procedure, but does hurt and you need to take some drugs to take the edge off. We are also using thermage for post liposuction and abdominoplasty patients for that extra potential tightening. Using this combination of liposuction/abdominoplasty with thermage several months later is not appropriate for all patients.

In the future we may be treating cellulite and loose leg plus buttock areas but the results are not conclusive as yet – so we’re waiting. Review Body by Thermage results and treatment modalities at www.Thermage.com and look up the cellulite and body treatment plans and photos.

Conclusion: In the next several months I’d like to give you more advice on new liposuction and abdominoplasty procedures, breast implants and cosmetic breast procedures. I would also like to give you some thoughts on advertising in medicine (of course this is like an ad), charlatans in this town (no names) and my continued thoughts of communist bastard medical insurance companies and Medicare.
There is a bar in southern California that not only serves martinis, wine and whiskey but also Botox is injected by a physician while you are sipping new wines. Simply crazy.
So be cautious and conservative and I’ll inform you more next time.
Again if you do not wish to receive these blogs, let us know.
Thanks.
Sincerely,

Thomas E. Geraghty, M.D.

“Dr. Geraghty and his staff gave me answers to questions I had not even thought of! Dr. Geraghty is so cool. I just loved talking to him and his wonderful sense of humor put me at ease immediately.” – D.B.

“Dr. Geraghty has a good bedside manner and doesn’t do surgery when he knows that it is unnecessary. I feel that he does it to help people rather than line his pockets. Great Dr! Great staff!” – D.G.

“I felt like Dr. Geraghty really cared about the results of the procedure as well as me as a person”. – A.B.

“I consulted with Dr. Geraghty only because his name always came up when you ask anyone “who is the best?” I am a return/repeat patient – wouldn’t consider anyone but Dr. Geraghty. I consider him an exceptional person as well as an exceptional surgeon. I have the utmost trust in him.” – B.M.

“I like the help Dr. Geraghty gives to cleft palate people (in the Domincan Republic). Thank you again Dr. Geraghty for my smiles each day!!” – M.D.

“Great doctor! (cute too!!) (very tolerant!) Great staff! The end result is always great!!” – L.H.

“Once I met Lyn, his staff and Dr. Geraghty, there was no need to look elsewhere. I was in absolute comfort with this office and staff. Honestly, my experience could not have been made better. (The staff) was so organized and very simply put me at ease.” – K.M.

“I consulted with Dr. Geraghty only because I believe if a mammography tech recommends a certain doctor for breast surgery, she has probably seen the results of such surgery and talked to more people about it than most anyone else; therefore, she seems to be the best judge. We appreciate Dr. Geraghty’s interest and efforts in keeping timely appointments. I very much like the way I look and would have the surgery again in a heartbeat – should have done it 10 years ago.” A.L.

“I talked to about 3 other offices. No one else was as informative and friendly as his office. Dr. Geraghty came very highly recommended by several very close friends to me. I had researched surgeons for quite a few years before having this surgery done. Dr. Geraghty, I believe you have a wonderful reputation of treating the patients on a very personal basis. I was always treated very friendly each visit. This is now my 6 month check up and the time was flown! I will only see you again at my 1 year appointment. I will miss not having the patient/doctor/staff relationship that I experienced through my whole surgical experience. Thank you for making a VERY scary and stressful surgery into a relaxing and wonderful experience. I believe you have a highly qualified staff and should take great pride in that”. – G.G.

“Dr. Geraghty, to be honest, I had seen two others doctors before you and I had NO confidence in anyone. When I finally got in to see you, I left with an appointment date for surgery. You, by far, are one hell of an awesome doctor. You have great confidence in your work and it shows. To you, putting breasts on someone is probably like brushing your teeth, but to me it seemed as if it were brain surgery. You made the “brain surgery” so easy. Thank you very much!!!!” J.M.

As threatened in last month’s newsletter, plans are to present a new topic each month to keep you informed of the changing practice of plastic surgery as it affects you, my patients. Last month’s biased opinion on lipodissolve versus liposuction were well received with many positive responses. This can be reviewed per our website at www.geraghtymd.com.
January 2007 Subject: Silicon Gel Breast Implants
This month I would like to briefly inform you of the recent approval of silicone gel breast implants for general use in cosmetic breast enhancement. Since we do several hundred breast implant procedures a year, I would like to give you my take on this after several decades of experience.

Please if you do not wish these newsletter rantings, let us know and you’ll be eliminated—so to speak.

Subject: Silicone gel breast implants
In November, 2006 the FDA approved the return of silicone gel breast implants for general use in cosmetic breast surgery after a 15 year hiatus when the FDA restricted access due to safety concerns. Although I have been using silicone gel breast implants for only specific cases since then, i.e. congenital breast problems, patients with failure of saline implants, breast reconstruction patients and those patients needing an augmentation and a mastopexy or lift with very thin tissue. Now these implants can be used in most all cosmetic breast patients with certain conditions. Because I have completed nearly 3,000 operations with breast implants, a third using silicone implants, this is a timely topic.
Silicone gel breast implants have been studied and scrutinized more than any medical device in history. Now plastic surgeons will have a choice in offering silicone gel filled or saline filled implants and the patients will have an informed choice. Literally when shit hit the fan in 1991, the FDA pulled gel implants off the market for general use. At the time the trial lawyers were circling like buzzards allegedly seeking restitution for patients. At that time I was the local president of the Kansas City Plastic Surgical Society and we had to calm my patients and others to ease their feelings that they were sitting on some sort of a time bomb. Granted, the gel implants were not made as well as our new cohesive implants of today and had a very high leakage rate and a high incidence of capsular contraction or firmness. None of this was admitted by the implant manufacturers, most of whom went out of business. These companies went bankrupt and most of the trial lawyers dispersed because of the lack of deep pockets to pick. Subsequently the new implant companies, the FDA and our plastic surgical societies proceeded in a 15 year process of scientific reviews, clinical trials and extensive data collection to determine the benefits and risks of gel implants. Since most plastic surgeons are committed to our patients’ safety and education, these numerous studies have shown that silicone gel implants have a significant psychological and physical benefit for women choosing these procedures and science has won out. All patients need to know of the inherent risks before making a choice. Please refer to www.memorygel.com for more information from the implant company.
My experience still dictates to proceed with caution with my patients’ health and well-being of the utmost importance. So, yes, I’ll be using silicone gel breast implants in my patients, but still the vast majority of my patients will continue to undergo cosmetic breast surgery with saline implants. In my surgical practice in the last 15 years, augmentation with saline implants has reached a reasonable gold standard and are appropriate for most patients. The exceptions, those patients wishing silicone gel implants, will be patients who strongly desire these type of implants after extensive informed consent, patients with failure of saline implants, i.e. frequent ruptures, wrinkling and dislike for the feel, and patients with minimal breast tissue and muscle (very thin chest wall and tissue) and those patients with thin skin and tissue requiring lifts with augmentations.
With the plethora of reported complications from silicone, my personal studies have shown a high satisfaction in those above mentioned patient categories with some accepted drawbacks. Silicone gel breast implants require a longer incision, a higher incidence of capsular contraction or firmness, are more costly and need more follow-up including MRI studies at three and five years to detect rupture. The old silicone implants when ruptured would ooze a liquid gel but now the implants are cohesive and a cut in the implant will not leak throughout the tissue. Even with accepted complications, there is a greater than 95% satisfaction rate with silicone gel implants.
Recommendations to my personal patients who have saline implants would be don’t replace your saline implants if they function well, have no problems and they still look and feel good. If you’re having no problems, leave them alone.
However, if you have silicone gel or saline implants from the past that are too high, too firm, have wrinkling or you do not like their size and feel, then a change may be in order. Patients with silicone gel implants that are older than 15 years (implants, that is) have a high incidence of internal rupture rate and should be evaluated by exam, mammograms and even MRIs. Please look up the following web sites: www.memorygel.com and www.breastimplantsafety.org and even the New Beauty magazine (the Winter/Spring edition of ’07) as there are informative articles throughout regarding breast implants.
Since this office takes care of over 200 patients a year for breast implants, be assured that we will help our patients make informed and healthy decisions. Having the option of gel implants, we’re still proceeding conservatively informing our patients of the pluses and minuses and avoiding all of the media hype.
Sincerely,
Thomas E. Geraghty, M. D.
PS: In the next few months biased thoughts on new face lifts, abdominoplasty and liposuction techniques and overhyped television plastic surgery programs will be faithfully explained to you.
PSS: Remember all women should do monthly breast exams and after the age of 40, yearly mammograms are a must.