News & Features

Plastic Surgery News: World Roundup

Leeches Help Save Torn-off Eyelid
California: “Ban Cosmetic Surgery on Pets!”
Scotland: Proper Bank Loans for Plastic Surgery
Cosmetic Surgery on Brains?
Robot Does A Breast Lift

Leeches Help Plastic Surgeons Save Eyelid

Everyone knows about leeches. Most picture a fat, creepy crawler that attaches itself to the body and feasts on blood. Your body. Your blood. And when you think of hospitals, leeches usually are not the first things that rapidly spring to mind.

While the tiny vampires are associated with swamps and murky, dark waters, usually evoking fear and disgust, specially bred and raised leeches are helping plastic and reconstructive surgeons.

Plastic Surgery News: World Roundup In one case, leeches helped plastic surgeons save and reattach an eyelid. It happened when a dog attacked a Louisiana woman, got a really good grip on her face and ripped off an eyelid. But she had the presence of mind to put the skinned eyelid on ice – literally -- and call an ambulance. Then, surgeons, including Kamaran Khoobehi, M.D., a plastic surgeon and clinical associate professor at Louisiana State University, Charity, sewed the eyelid back, using threads smaller than human hairs.

Then, the leeches were called in to help.

They love their work because of a rich blood supply which is a big part why facial plastic surgery is feasible, experts say. The entire human head has such a fantastic blood supply that facial tissues are easily fed after being moved, nipped and tucked.

But when fingers or other small structures, like an eyelid, are reattached, the blood in the old section continues pumping and forms a pool. Meanwhile, the reattached item is screaming for the nutrients carried in blood that it can’t quite reach because the blood vessels and capillaries aren’t working yet.

When re-grafting amputated fingers or toes, especially, veins become so damaged, they lack the ability to send blood out of the area, causing clotting. If those veins are only taking blood in and not letting enough out, infection can set in and the patient may lose the digit altogether. But the leeches helped sped things up and the eyelid healed perfectly.

The Food and Drug Administration cleared the commercial marketing of leeches (Hirudo medicinals) for medical purposes in June, 2004, for the first time, according to an agency statement. After that, the little critters started to get notice once again for their many uses in reconstructive and plastic surgery.

“Leeches are helpful in certain situations,” said Jeffery Janis, M.D., an assistant professor in the Department of Plastic Surgery at the University of Texas Southwestern Medical Center. “Whenever you have a flap or some type of reconstruction, you must have blood flow into and out of that flap,” Dr. Janis said. “Imagine a bathtub: the object is to have the faucet on and the drain open and not collect any water.”

Moreover, the worm-like clingers emit a natural anesthetic that minimizes pain and releases hirudin, a powerful blood-thinner that breaks up pooled blood. They also have to be maintained during those times when there are neither eyelids nor severed fingers on which to feed.

“Leeches like a certain environment that has to be maintained,” Janis said. “You must keep them alive—obviously a dead leech doesn’t help with anything.”

Doctors, nurses, and the patients themselves must also be prepared for dealing with the tiny vampires. As if surgery isn’t bad enough, having a couple of leeches sucking on your blood as you lay helplessly in your hospital bed probably takes some getting used to. But if they succeed in helping to save a once severed finger or reattach an eyelid, you will probably be grateful in the long run.

So, here’s a “thumb’s up” to those fat creeper crawlers.

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California: “Ban Cosmetic Surgery on Pets!”

In the Golden State, if you live in West Hollywood or San Francisco, you may soon lose one of humankind’s most treasured freedoms – giving cosmetic surgery to your pet.

Regular subscribers to CosmeticSurgery.Com News will recall how cosmetic surgery on diary cows was outlawed in New Zealand. The procedures gave the heifers an unfair leg up in bovine beauty contests, charged some diary farmers.

Now, a similar anti-rejuvenation surgery trend has hit in West Hollywood where city fathers and mothers want to ban plastic surgery for cats and dogs. Of course, we’re not talking tummy tucks for fat cats or dermabrasion for dogs.

In the four-footed world, cosmetic surgery doesn’t come close to the type of makeovers pet owners have performed on themselves. With pets, cosmetic surgery means ear cropping, tail docking, debarking, defanging and other forms of surgical treatments, done for so-called “noncurative reasons.”

The actual law, when passed, may also add on some language preventing other, unspecified vanity procedures performed on pets.

Back in 2000, the San Francisco Commission of Animal Control and Welfare also tried to end cosmetic surgery on pets. Their reasoning? Humans may choose to have plastic surgery but animals cannot.

The measure was not approved but the city did pass rules about how we talk about pets (or, “animal companions” if you prefer.) Namely, the cruel phrase “pet owner” would be replaced in all city documents with the more animal-friendly phrase, “pet guardian.” Moreover, the same legislation decrees that strays no longer be housed in “dog pounds” or “shelters.” Instead, lost dogs and cats are supposed to dwell in “animal apartments.”

Whatever the preferred phrasing, it looks like the old saw about pets looking like their owners will no longer be true.

Because with so much cosmetic surgery being done on people, pet guardians are no longer letting their looks go to the dogs.

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Scotland: Proper Bank Loans for Plastic Surgery

Plastic Surgery News: World Roundup In Scotland, cosmetic and plastic surgery is joining home improvements, car shopping and other leading requests for loans. Lloyds TSB Bank’s personal lending division says plastic surgery is now such a common reason for applying for a loan, the bank intends to list plastic surgery as one of its loan categories for a loan.

In the past, loan requests for plastic surgery were listed under miscellaneous, according to Tony Gibbons, director of Lloyds TSB Personal Lending. But due to an increase of about 50 percent in requests for the rejuvenation surgery loans, the bank wants a separate box on its application for rejuvenation surgery.

A survey by the bank found 95 percent of the population in the U.K. would like to change something about they way they look with one in ten considering a bank loan to fund the nip and a tuck.

The same survey revealed eight percent of women and 15 percent of men would like their partner to have rejuvenation surgery.

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Cosmetic Surgery on Brains?

The ultimate makeover may soon include your brain. Cognitively speaking, of course. You won’t find anybody using a knife to give your brain a nip ‘n’ tuck or injecting Botox. Hey, when it comes to the human brain, those wrinkles are a good thing. The more, the better, in fact.

The study of “cosmetic neurology” involves the use of medicine and drugs to enhance normal abilities of our brains according to Dr. Anjan Chatterjee, M.D., a neurologist at the University of Pennsylvania.

“If we can improve cognitive systems in disease, can we also do so in health?” wrote the doc, explaining that physicians improve upon appearance every day, so why does the concept of a more beautiful brain seem outrageous? And while nobody is likely to see your actual gray matter, the idea is cosmetically stimulating your brain to be smarter, faster and more retentive. For, when it comes to beautiful brains, the beauty is in the doing, not the seeing.

And who would benefit from a more gorgeous mind?

Cosmetic enhancements to our minds would result in, say, better guitarists, pilots, or even snowboarders. Dr. Chatterjee dives into all this in a recent 2004 issue of Neurology, the scientific journal of the American Academy of Neurology. Improvement of motor systems, attention, learning and memory, mood and how we behave are the anticipated target areas for more beautiful brains. Thus, in the not-too-distant future, cosmetically enhancing your brain to help the synapses fire quicker – and not necessarily bodacious Ta-Ta’s or faces as smooth as a baby’s bottom – may be the next big thing. Then, maybe teens will forget about having a nose job and instead get a brain procedure which can result in higher SAT scores. Or maybe we just may find brainiacs like Bill Gates on the list of “Who’s Hot.”

“Some interventions are likely to be available over the next few years,” Chatterjee says, about the future possibility of patients’ access to enhanced brains and minds. “Neurologists and other clinicians are likely to encounter patients who see physicians as gatekeepers in their intellectual makeovers,” Chatterjee writes. How far will we take the idea of more beautiful brains? Maybe in the not-too-distant future, a television program called “America’s Most Radically Rejuvenated Brain” will give “Extreme Makeover” and “The Swan” serious runs for their primetime money.

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Robot Does a Breast Surgery

Plastic Surgery News: World Roundup Medical robots are nothing like the lovable automatons, R2D2 or 3P30 we’ve come to know and love from Star Wars. Especially medical robots which really don’t have much personality at all. They just sort of sit there, whirring and don’t even mutter “a-haa!” when they listen to your heart, lungs or consider your symptoms.

Nonetheless, a medical robot has made a worldwide first. Guided by the skilled hands of a plastic surgeon, a $1.4 million daVinci robotic surgical system performed a breast lift on 38-year-old San Francisco women in March, 2004, at Queen of the Valley Hospital in Napa, California. With about 200 daVinci robots worldwide, about half are in the U.S.

Undergoing surgery via the daVinci is often better because robot “hands” are so more steady and smaller. In the daVinci’s case, virtually all the operating is done under the skin and that means less scaring, pain and time in surgery and in recovery. All that can total big savings. The daVinci has three arms, two with various tools and a third for a light and camera -- about the size of a pencil – so the surgeon can see what he or she is doing.

In the breast lift, the robotic arms were inserted through three, one-inch incisions in the fold at the base of the patient’s breast. Working under the skin of the breast, the machinery uses a surgical threading device known as an endotine (normally used to lift brows) that attaches to the inside of a drooping breast on the chest muscles. Liposuction can also be done at the same time. The surgeon sits at a consul across the room from the patient and operates hand instruments that control the robotic arms.

“Basically, the robot does what the surgeon’s hands tell it to do,” says Mindy Graves, physician technical assistant at Napa Valley Plastic Surgical Associates. Ms. Graves assists plastic surgeon Rebecca Jackson, M.D. who studied the device for about eight months on the best way to do the breast lift. Since the first operation, Dr. Jackson has performed three more breast lifts (“mastopexy”) and is now doing a tummy tuck which tightens stomach muscles which have been stretched by pregnancy. A standard tummy tuck usually requires a hip to hip scar. But the daVinci does its work through three small holes below the bikini line.

“I think the daVinci is going to do more complicated procedures like a mastectomy and breast reconstruction,” Dr. Jackson told a local newspaper.

One other good thing about the daVincvi: it does not know how to send out a bill.

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