News & Features

Plastic Surgery News: World Roundup October 2005

Breast Cancer Updates from around the World

Pink Ribbon

The pink ribbon is the symbol for breast cancer awareness.

With October marked worldwide as National Breast Cancer Awareness Month, many health professionals around the world are studying and releasing new information about the malady, along with ways to cope after the diagnosis. A few of the more surprising studies:

In Other Cosmetic and Plastic Surgery News:

Breast Cancer Death Rates Continue to Decline

The message is starting to hit home. More women are taking to heart the words, “early detection and treatment." The payoff? Mortality rates from breast cancer have dropped by 2.3 percent yearly since 1990, according to the American Cancer Society (ACS.)

Advances in treatment and early detection are being credited for the drop.

The new ASC report reveals the decline has been most pronounced among women under 50.

The findings are part of a report, Breast Cancer Facts & Figures, 2005-2006. Published every two years, the report notes that breast cancer is still the most common cancer among U.S. women (other than skin carcinoma,) striking some 211,240 women yearly while taking the lives of about 40,000.

“The steady decrease in mortality rates since 1990 shows we are making progress," said Stephen F. Sener, M.D., national volunteer president of the ACS. “But there’s still more progress to be made."

However, for women 50 and older, the news was not so good because breast cancer is still increasing slightly among that group. Between 1987 and 2002, the rate went up by just 0.3 percent a year. Ahmmedin Jemal, program director for cancer occurrence at the ACS, said that’s probably because many of those women are taking hormones, getting mammograms or are obese.

Rates also differ according to race and ethnicity. Between 1992 and 2002, the report reveals that breast cancer rates went up among Asian Americans and Pacific Islanders. But the rates went down among American Indians and Alaska Natives. The rate did not change among Anglos, African Americans or Hispanics.

One other minority group – at least when it comes to breast cancer – showed an increased rate of the disease. Breast cancer in men has increased 1.1 percent a year from 1975 to 2002, for unknown reasons. Currently, some 1700 men develop invasive breast cancer yearly.

Stress Can Reduce Breast Cancer Risk

Stress Can stalled traffic, a nutso boss, stacks of unpaid bills and noisy neighbors ever actually be good for your health?

While it seemingly might run counter to what you think, women with fast paced lives and high levels of daily stress actually gain some protection again breast cancer, at least according to a study printed in the British Medical Journal. The study, done on Danish women concludes high levels of stress may actually reduce levels of the female hormone estrogen which is known to affect the development of breast cancer. Call it the silver lining stress and a bothered mind, but the researchers conclude a high level of daily stress may reduce the chances of developing the disease by 40 percent.

The study followed 6500 women in Copenhagen for 18 years. Stress factors rated included tension, nervousness, impatience, anxiety or sleeplessness. The findings show that for every increased level of stress on a six-point scale, there was an eight percent reduction in cancer risk. So those subjects with the highest stress levels had the lowest risk.

But don’t go out looking for traffic jams, bad bosses and other daily hassles, just to build up your own tension levels.

The researchers also say a stressful lifestyle might have other damaging effects on health, especially to the health of your heart.

So it’s O.K. after all, to use clear highways, have a smiling boss, good credit rating and cool neighbors.

Breast Reduction Operations may Reveal Cancer Risk

While breast augmentation is marked as the second most popular invasive cosmetic procedure in the U.S., an up-and-coming operation -- the breast reduction -- does the exact opposite. According to the American Society of Plastic Surgeons, 264,000 women in 2004 augmented their breasts. But during the same year, half as many -- 105,000 -- chose to lighten the heft of overly large breasts which usually brings on back and shoulder pain, along with other medical woes along with unwanted attention from boys and men.

 Breast Reduction Operations may Reveal Cancer Risk If the removed breast tissues are screened, the procedure can do double duty by screening women for any risk of developing breast cancer.

Because the testing in this study costs an average of $380.00, insurance companies insist only women over 40 be screened. But if, say, a 39-year-old woman is excluded and goes on to develop breast cancer; the medical and personal costs later on are huge. Unfortunately, for those patients, mastectomy, breast reconstruction and six months or so of chemotherapy are in the cards.

So Kristin Stueber, M.D., chief of Plastic Surgery at Baystate Medical Center in Springfield, Massachusetts, and colleagues organized a study on 300 breast reduction patients, aged 14 to 73. Results? 12 percent had abnormal pathologies indicating either a premalignant lesion or a lesion that could put the patient at an increased risk of developing breast cancer. Of those with an abnormal outcome, 28 percent were deemed moderate or high risk. However, two of the highest risk patients were younger than 40.

“Sure, savings could have been made by only testing subjects over 40," says Dr. Stueber. “But if only older patients were tested, our study indicates we would miss 20 percent of moderate to high risk pathologies, and that is not acceptable."

The costs for treating a cancer patient later on would be far more than any short term savings, she says.

“With 105,000 breast reductions in 2004, the medical community would have missed 633 cases of moderate to high risk breast cancer by only screening the older women," says Dr. Stueber.

Experts report that breast cancer is 90 percent curable when discovered early.

Everything You’ve Ever Wanted to Know about Breast Implants (But didn’t know whom to ask!)

The North America National Breast Implant Registry (Na.B.I.R.) takes reports yearly from participating surgeons who record all the particulars about breast augmentations they have performed. Not every breast augmentation operation is reported but the percentages obtained so far tell us something about trends in breast enhancement and reconstruction surgeries. It’s a little like the Nielson ratings of breast enhancements – by studying a small segment of a population, you can get a pretty good idea of the larger picture.

As of September, 2005, the Na.B.I.R. has reports on 39,094 implants inserted and 6430 removed. The “average" patient was 39 and had implants that added about 12 ounces to each breast. The women who asked for their implants to be removed had them an average of four years.

Cause for Implant

Reconstructive (because of cancer of congenital deformities:) 10 %
Cosmetic: 71%
Replacements: 12%
Cosmetic implant with breast lift: 6 %

Type of implant

Smooth: 87%
Textured: 11%
Expandable prosthesis: 2%


Implant only: 98%
Implant and a muscle/skin flap that covers the implant: 2%

Implant Shape

Round: 92%
Contour: 8%

Filler Type

Gel: 10%
Saline: 88%
Saline/gel: 1%
Other: 1%

Position in the Chest

On top of the chest muscle: 36%
Under the Pectoral muscles: 64%

Incision Type

In, or near, the armpit: 12%
In the fold where the breast meets the chest: 58%
In the area around the nipple: 22%
In a Mastectomy scar: 8%
Through the bellybutton: only 129 reported.

Reasons Why the 6430 Implants were Removed

Rupture: 32%
Capsular Contracture (a type of internal scarring) 35%
Infection: 3%
Implant shifted: 9%
To change the size of the implant: 32%
Patient request: 13%

Beauty: It’s Actually Bone Deep

It’s not only gravity and the passing years that can cause older faces to sag like a rope bridge being crossed by a Mac truck.

A new study on 60 subjects has revealed that shrinking facial bone has a lot to do with men and women looking older.

David Kahn, M.D., a board certified cosmetic surgeon at the Cosmetic and Laser Surgery center of San Francisco, ordered CAT scans (a special X-ray machine that takes more life-like pictures) of 30 men and 30 women ranging in age from 25 to 65 and over. Results?

“Many believe that gravity creates wrinkles," Dr. Kahn says. “Actually, we have discovered the loss of volume in the face and changes in bone structure contribute to making us look older."

The bugbear of aging, according to the study, is that facial bones actually change in shape, dissolve, shrink and leave empty spaces. Skin also loses elasticity as we age and can’t tighten around the spaces. Thus, we are left with drooping flesh and wrinkles.

The study also revealed that women tend to lose facial bone at a younger age than men. And that may explain why more women seek cosmetic surgical rejuvenation earlier than men.

In some cases, cosmetic enhancement can restore lost facial volume. By using fillers, and other techniques like forehead lifts and soft tissue repositioning, plastic surgeons can fill in the loss and lift the skin to created more refined, youthful appearances.

While people are fond of saying “Time Marches on," they rarely stop to think that march is all too often across our faces.

Botox and Facial Fillers – for your Voice

Botox and Facial Fillers – for your VoiceBotox really isn’t just for wrinkles, any more. In addition to an ever-growing list of ailments which Botox can combat, add the human voice. A common voice disorder (Spasmodic Dyspohonia) causes a voice to be hoarse, shake, break in pitch and suffer interruption in sound while speaking. Thomas Murray, M.D., Clinic Director of The Voice & Swallowing Center at Columbia-Presbyterian Eastside, found that Botox injected directly into the larynx, causes the vocal cord tightness to relax for up to six months.

Yet another voice disorder – vocal fold insufficiency – can be treated with the popular, new facial filler, Radiesse. Clark A. Rosen, M.D., a voice specialist and director of the University of Pittsburg Voice Center, studied 36 patients who had Radiesse injected into paralyzed vocal cords. Another 30 patients had a condition known as glottal incompetence, a medical woe brought on by muscle damage or loss associated with aging; the ailment usually results in a thin, weak voice. All the study subjects had Radiesse injected into the affected vocal cord; they were either under general anesthesia in a hospital or in a physician’s office under local anesthesia with their throats numbed.

When the patients were surveyed after six months, 94 percent showed improvement in their voice quality.

Until now, most patients just ignored both conditions because spasmodic dyspohonia required more invasive surgery while glottal incompetence was just written off as the result of normal aging.

Of course, other things might cause your vocal cords to tighten, freeze, squeak or otherwise fail – a gruff boss asking about a missed deadline, an interview with the IRS or a clergyman asking for an “I do."

Now, You can Have a Mouth & Lip Lift, Too

Now, You can Have a Mouth & Lip Lift, Too Time was, only dentists spent their days looking down in the mouth.

But, even after a full face lift, many makeover patients are left with mouths that do not look happy or younger. The reason: the marionette lines, those folds of skin that run down toward your chin from the corners of the mouth often aren’t taken out by a traditional facelift. Moreover, the nasolabial folds, the lines running from the corner of the nose to the corner of the mouth, are sometimes left showing after a full facial surgical rejuvenation.

“As we get older, the corners of the mouth naturally turn down, making us look unhappy and not as young looking as we feel inside," says George Weston, M.D., a co- founding plastic surgeon at the Austin-Weston Center for Cosmetic Surgery in Reston, Virginia, where, he says, the procedure was invented twenty years ago.

“Many patients report they are weary of people asking if something is wrong – due to the downturned mouth -- or if the patient is ‘tired,’" says Dr. Weston.

The mouth lift takes about half an hour and is usually done at the same time as a face lift," says Dr. Weston. “Scars are hidden in the red part of the lips and can not be seen from inches away."

The actual surgical technique involves removing excess skin through the lip incision, making the area around the mouth smoother, tighter and more happy looking.

A mouth lift can also include plumping up the lips which the passing years may have thinned. Fat injections usually work to pump the kissers up, along with laser or dermabrasion resurfacing. About one-quarter of the fat injections last indefinitely while about 75 percent eventually shrink back.

“A corner mouth lift not only makes the face look five years younger, but the face has a more natural and less-operated on ‘tight’ look," says Dr. Weston.

And all of that can make puckering up for a smooch from a special somebody way more appealing.

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