Weiler Plastic Surgery

2011-12-06T13:17:00.001-06:00

Breast Cancer Treatment

Many woman these days are opting for bilateral mastectomies when faced with breast cancer. Giuliana Rancic of E! Television has opted to proceed with bilateral mastectomies for her treatment of her breast cancer. Both my wife and I have enjoyed watching her show and watching her struggle with having children has shown a side of her not often seen with celebrities. I am happy that she has decided to also share withher audience her strggle with Breast Cancer. I believe that bilateral mastectomies with bilateral reconstruction is an excellent choice for women that do not want to deal with the risk of cancer in the other breast and are concerned with cosmetic appearances after, as bilateral reconstruction often gives a much better results. I have partnered with Dr. Ben Boudreaux to offer all types of Breast Cancer reconstruction to residents of Slidell, Mandeville, Covington, Hammond and Baton Rouge. We specialize in using your bodies own natural tissue and promarily use a Flap called the DIEP. This flap takes your excess skin and fat of your tummy and we use it to create your new breasts.
I beleive that all women that have been diagnsed should explore their options for treatment and for reconstruction, and should discuss all options with their cancer surgeon and with their plastic surgeon. Below is a copy of the article

Giuliana Rancic has announced she will undergo a double mastectomy, a surgical operation to remove both her breasts, in attempt to beat breast cancer.

"Well last time I was here, I told you that I was getting the double lumpectomy [a lump-removal surgery in both breasts] and radiation, but now instead of radiation, I'm going to go ahead and move forward with a double mastectomy," the Giuliana & Bill star told Ann Curry during a Monday morning appearance with husband Bill Rancic on NBC's Today show.

Bill, the original The Apprentice winner, told Curry the lumpectomy failed to remove the entire cancer mass in one breast, which left the couple with a big decision to make -- whether Giuliana should undergo an additional lumpectomy in an attempt to clean it out, or a more drastic medical procedure.

RELATED LINKS

Reality TV World: Giuliana & Bill

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Giuliana said she decided upon the double mastectomy after much thought, admitting the surgery would still allow her to try to have children sooner.

"That was actually a big part of it, not all of it, but a big part. If I had chosen to just do another lumpectomy and then do radiation and then do anti-estrogen therapy -- which means 2-5 years of medication -- that basically puts me into early menopause and I would have to put off having a baby for several years," Giuliana explained.

"So that was something we took into account. But to be honest, at the end, all it came down to was just choosing to live and not looking over my shoulder for the rest of my life. That's really what it came down to."

Bill told Curry he and Giuliana received numerous expert opinions and information when determining what would be the best form of surgery for Giuliana, but in the end, the couple said they believed removing both breasts would ultimately give Giuliana a better chance at defeating the cancer and having a more normal life.

"I think one of the other factors that came into play was quality of life. If she would have gone with the lumpectomy and the radiation, then you have to go in every six months for the rest of your life getting mammograms," Bill explained, adding that Giuliana would be constantly worried before the mammograms and after while waiting for the results.

"And it could have come back more aggressively next time. So for me, it was just very important to get the cancer out. That's what I wanted to do -- just get it out. With the double mastectomy, I have less than a 1% percent chance of getting it back. With another lumpectomy and radiation and medication, I could have seen a 20, 30 or 40 percent chance in my lifetime. And for me, it just wasn't worth it," Giuliana told Curry.

While Giuliana noted she could undergo reconstructive surgery almost immediately after the mastectomies, she said the posing changes in her physical appearance would be insignificant if it meant getting healthy again.

"In the end, Bill said to me -- I think this definitely got to me -- Bill said to me, 'I just need you around for the next 50 years, kid.' That's what he said. He said, 'I don't care what you look like. I don't care about the physical portion of this. I just need you around for the next 50 years, so let's just get you healthy,'" Giuliana explained.

"That certainly helped me come to the decision... I couldn't be more at peace with the decision, but it's hard. I still break down some nights when it's quiet in bed. It's easy to just start crying and be very sad, but I'm okay."

Giuliana revealed she had breast cancer in October. She learned of the bad news after she had received a mammogram when her in vitro fertilization doctor demanded -- over her objections -- she do so before beginning her third attempt at a fertility treatment.

"I sadly found out that I have the early stages of breast cancer," Giuliana told Curry on Today at the time. "It's been a shock because I recently found this out, and a lot of people have been asking, 'We saw in the season finale of your show that you went and got IVF, so what happened? Are you pregnant?' But sadly, we've had to put that off because of the news."

2011-12-06T12:49:00.001-06:00

Make Sure to research your Surgeon!!

A 30-year-old transgender woman with no apparent medical training was arrested in Miami Gardens, Fla., on Nov. 18 - after a year of eluding authorities - for practicing medicine without a license with serious bodily injury. In May 2010,

Oneal Ron Morris (pictured) allegedly injected substances including cement, glue and tire sealant into a woman as part of a buttocks enhancement "procedure" that landed the victim in Tampa General Hospital, according to the Nov. 22 online edition of USA Today.

The victim, who says she was referred to Morris by a friend, reportedly paid $700 for the series of injections. Additional medical bills are accumulating due to ongoing health issues that also prevent the victim from working. No other information on the victim was available.

Medical personnel in the Miami suburb alerted authorities after speaking with the victim about her experience. "The doctors knew no licensed physician in his right mind would ever do this," Miami Gardens Police Sgt. Bill Bamford told the newspaper.

Sgt. Bamford said Morris told the woman, "`Oh don't worry, you'll be fine. We just keep injecting you with the stuff and it all works itself out.'"

Morris regularly moved locations in south Florida to avoid arrest after an investigation by the Florida Department of Health, USA Today reported. An investigator with knowledge of Morris' addresses found his auto outside one of them during a routine drive-by and subsequently arrested the suspect.

Additional possible victims are beginning to come forward, the New York Daily News reported on Nov. 23.

Although this story is extreme and most patients realize to avoid these types of "practicioners" this illustrates the point that patients must know the credentials and training their plastic surgeon has! anotherwords make sure your surgeon is really a surgeon and skilled and trained in plastic surgery. There are lots of different injectables out there and I do specialize in a procedure to enhance the buttocks, called a Brazilian Butt Lift, but I use your bodies own fat to augment your buttocks and this will give you long lasting safe! results, please call either office if you are intereseted in buttock enhancement by a board certified plastic surgeon.

Plastic Surgery Obsession

2010-12-28T12:58:00.000-06:00

I recently came across a very interesting article related to obsession with Plastic surgery. I rarely come across individuals with this obsession but have in the past. the far majority of my patient's are men or woman that are looking for self improvement for there own benefit, not for an individual or society. This is an often discussed topic but plastic surgery obsession is rarely seen. I always ask patients why they are seeking a surgery to improve their appearance if there are not obvious reasons readible visible.
I also perform lots of reconstructive procedures and there is a striking similarity to patients that are going thru the reconstructive process and those that are seeking surgery to improve their appearnce, i.e. cosmetic surgery. Reconstructive patients have had there body changed by a disease process or trauma, cosmetic surgery patient's bodies have been altered by time or pregnancies or weight gains or multiple other causes and wish to restore their previous appearance. Very similar desires in my eyes.

The Fine Line Between Self-Improvement and Obsession

By Chelsea Mize

The term addiction has become applicable to numerous habits and vices these days. Sex addiction, Internet addiction, plastic surgery addiction. But how can you define addiction when applied to a behavior that in moderation is acceptable, even encouraged? As Marcel Daniels, MD, a Long Beach, Calif-based board-certified plastic surgeon, says, “Calling any repetitive behavior an ‘addiction’ has become fashionable. Notice how we suddenly have all these sexual addicts when previously it was merely felt to be an expression of Darwinian behavior.”

Sex, as opposed to, say, heroin, is a normal, healthy practice—in fact, if you’re not having sex, people tend to think there’s something amok. So, when is someone addicted to sex? The same goes for the Internet. The only people not spending many, many hours on the Internet in our society are considered backwards. How much is too much?

This question is particularly apropos when considering plastic surgery. Daniels says, “The subject of addiction in and of itself and with regards to plastic surgery is controversial.”

With celebrities like Heidi Montag, Joan Rivers, Cher, and Jocelyn Wildenstein making headlines by eliminating fine lines and wrinkles (and maybe getting a breast augmentation, some lipo…and some other nips and tucks), it’s easy to believe that Botox and boob jobs have some seriously addictive properties. After all, why else would an already attractive person like Montag go through so much to change herself into some kind of distorted Barbie? Then again, what if Heidi were totally happy with her new self? Would the media and her family be so quick to condemn her surgical alterations if she herself weren’t so clearly dissatisfied? Can you classify a habit as an addiction if it genuinely results in self-improvement?

Take, for instance, someone like Cher. She’s had some plastic surgery, which nobody can deny. But, she still looks pretty darn good for her age, and nobody’s really calling her an addict. Maybe part of what makes Montag "an addict" is that she’s young and she had so many procedures in such a short time. But why does age have an impact on addiction? And for that matter, why does someone who crams all their doses into one day have any more of a problem that somebody who has the same amount of surgery over a span of years?

Shervin Naderi, MD, a Washington, DC-area facial plastic surgeon, suggests, “There is no ‘number’ that signifies a threshold for becoming addicted to plastic surgery. A person who has never had a single procedure but constantly obsesses about his or her face and is constantly on chat rooms and spends an excessive amount of daily time thinking about his or her face is more concerning than the person who has had four successful cosmetic surgeries with nice and natural results.”

With this in mind, it would seem that the psychological concerns associated with plastic surgery are not so much its potential addictiveness, but rather insecurities with body image that go far below the surface. Excessive amounts of plastic surgery might just be a manifestation of a mental disease such as Body Dysmorphic Disorder. In this case, it seems that the procedures themselves have no addictive quality.

Botox Resistance

2010-11-17T22:34:00.000-06:00

Some patients claim a resistance to Botox and this is a recent article about how to overcome this resistance
Botox is an effective injection method for diminishing certain undesired facial expressions. For the vast majority of patients, it works very well and will continue to do so with endless repeat treatments. But there is a very small percent of patients who either don’t respond well or find that ongoing treatments become less effective. In many of these cases, the source of the problem is how the Botox was reconstituted, its age, and how it was injected. But this doesn’t apply to all of these ineffective patients; the problem likely lies in their receptiveness to the Botox molecule.

A new medication designed to treat these ineffective Botox patients is now available. Zytaze is a zinc and phytase prescription medication that is used prior to Botox treatment. It was studied in the medical condition of blepharospasm, which is uncontrolled eyelid twitching, and is one of the original FDA-approved uses of Botox from the early 1990s.

In a series of 44 blepharospasm patients who responded poorly to Botox injections, control of their blepharospasma was difficult to achieve. In these patients, Zytaze was given in oral tablet form 4 days prior to Botox injections. The study shows that 93% of the patients improved the effect of their Botox injections or how long they last.

No explanation was provided for the mechanism as to why this supplement would be effective or how it works. Furthermore, whether its effectiveness in blepharospasm would translate to the more widespread use for the treatment of undesired facial expressions is unclear. One would assume that it would since it is not only a facial muscle but an associated periocular muscle, as well.

For patients suffering from Botox "fatigue" or resistance, Zytaze oral medication may be worthwhile to try. But don’t think that taking it will make the Botox last longer—unless the patient exhibits less effectiveness than what you had shown previously.

DYSPORT VS BOTOX

2010-10-04T15:26:00.000-05:00

I use both Botox and Dysport in my practice for neuromodulators of problem areas. I have found that both Botox and Dysport have there pluses and minuses. I find dysport works beter for the crows feet area and Botox for the forehead. These are often the findings that are supported by my discussions with other plastic surgeons in the southern louisiana area. I recently cam across an article that supports these findings. Please read and decide for yourself. I invite all my patients to come in and see for themself!!

Dysport Better Than Botox for Crow's Feet

A new study released this week shows Dysport offers a significant efficacy advantage over the well-established Botox Cosmetic for treating crow's feet. The study was presented during a scientific session at the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) 2010 Annual Fall Meeting.

Investigators studied 90 subjects, assessing contraction at 30 days following treatment when compared with day zero. The internally controlled, double-blind study found a greater efficacy of action for Dysport over Botox. "Botox has long been considered the gold standard of injectables, so this data showing Dysport's stronger efficacy is compelling," says Corey D. Maas, MD, AAFPRS group vice president for public and regulatory affairs.

The study concluded that Dysport offers a quantifiable and demonstrable advantage in wrinkle shortening and hyperfunctional frown lines compared to Botox Cosmetic in the treatment of crow's feet. Study investigators recommend further studies in additional facial regions to confirm the data.

Downloadable photos, fact sheets, and other supporting materials are available here.

Can Fat Transfer be used to Reconstruct a Woman's Breast after cancer safely?

2010-09-27T21:32:00.000-05:00

Very interesting article that I recently came across. Fat transfers, taking fat from one area and placing it in another for augmentation or reconstruction, is becoming a very hot field. Lots of debate on both sides, those for and those against. I personally believe that fat transfers to the breast are a very safe and effective procedures and can have incredible results and I use them both cosmetically and for recosntruction. I believe the following research supports this

Fat Stem Cells: Safe for Breast Reconstruction?

Fat-derived stem cells can be safely used to aid reconstruction of breast tissue after mastectomy as long as there is no evidence of active cancer, according to researchers at the University of Pittsburgh School of Medicine. Their findings are available in Tissue Engineering Part A.

Plastic surgeons have long moved fat from one part of the body into the breasts for reconstruction, but with some complications and a varying success rate, explained senior author Vera S. Donnenberg, PhD, assistant professor of surgery, Pitt School of Medicine. More recently, they have considered adding stem cells derived from adipose, or fat, tissue (ADSC) or the bone marrow to the transferred fat with the aim of supporting graft integration by enhancing new blood vessel formation.

"But it has not been clear whether these stem cells are safe for breast cancer patients because they could send growth signals that promote tumor reactivation or provide new blood vessels for the tumor," Donnenberg says. "Our research suggests that this risk is real if the patient still has active tumor cells, but is safe when the cells are inactive or resting."

For the study, the researchers collected adipose tissue that would have been discarded during "tummy tuck" procedures performed by study co-author J. Peter Rubin, MD, associate professor of surgery, Pitt School of Medicine, whose team has several federally funded projects underway to develop fat grafting and stem cell therapies for reconstruction of a variety of tissues.

Plastic Surgery Worldwide

2010-09-08T09:09:00.000-05:00

Came across an interesting article. The United States is still the leader in cosmetic surgery and innovation when it comes to cosmetic surgical procedures. There are some suprising countries that are quickly becoming centers of cosmetic surgery innovation. China is one of them.
New York — The United States continues to dominate the plastic surgery field, but some countries not always associated with such procedures are emerging as leaders, according to a global survey released by the International Society of Aesthetic Plastic Surgery (ISAPS).

The “ISAPS Biennial Global Survey” of plastic surgeons and procedures is a first in terms of independent statisticians collecting and analyzing reliable international plastic surgery data, PRNewswire-USNewswire reports.

The society says the survey represents 75 percent of all cosmetic surgery procedures performed in 2009. Among many trends analyzed, the survey reveals what it calls “a new hierarchy of countries with the most surgical and nonsurgical cosmetic procedures.”

Among the top 25 countries are China (No. 2), India (No. 4), South Korea (No. 7), Turkey (No. 9), Colombia (No. 18), Thailand (No. 20) and Saudi Arabia (No. 23).

The survey also notes that liposuction is the leading aesthetic surgical procedure, comprising 18.8 percent of all such procedures worldwide. Breast augmentation follows, at 17 percent, along with blepharoplasty (13.5 percent), rhinoplasty (9.4 percent) and abdominoplasty (7.3 percent).

Nonsurgical procedures outnumbered surgeries, according to the survey. The top five were toxin or neuromodulator injections (32.7 percent), hyaluronic acid injections (20.1 percent), laser hair removal (13.1 percent), autologous fat injections (5.9 percent) and intense pulsed light laser treatment (4.4 percent).

The ISAPS Global Survey also estimates the total number of board-certified (or national equivalent) plastic surgeons practicing today to be 30,817, the total number of surgical procedures to be 8.54 million, and the number of nonsurgical procedures to be 8.76 million.

Full details of the ISAPS Biennial Global Survey are available at www.isaps.org.
A very interesting article. Reflects the globalization of cosmetic surgery.

Breast Cancer "Rights"

2010-08-23T21:51:00.000-05:00

One of the biggest issues facing all patients these days is access to treatment. I have found that most women are not aware that Breast Reconstruction after a cancer procedure is available to all women, in fact it is a law. Unfortunately many women are not given the opportunity to even consider reconstruction as they are not even made aware that reconstruction can be done at the same time as their Mastectomy or Breast Cancer Procedure. New York has gone one step further, the act of informing patients of what their options are concerning breast reconstruction must be discussed by law. I think that this is a wonderful idea and allows a woman to make the choice of whether or not to reconstruct their Breast. I offer all the latest Breast Reconstruction techniques here on the North Shore and I am always available to discuss reconstructive options no matter where a woman is in her treatment.

New Law Requires Hospitals to Inform Breast Cancer Patients of Reconstruction Options

While breast reconstruction after a mastectomy is covered by insurers in New York, many poor, minority, and less educated women do not seek out the procedure. Now, New York Governor David A. Paterson has signed into law a bill that is aimed at reversing this trend.

"A disproportionate number of women who are at a socioeconomic disadvantage do not get breast reconstruction surgery after a mastectomy for one of several reasons. Either they are unaware of it as an option, they do not know it is covered by Medicaid and Medicare insurance programs, they do not know where to gain access to the procedures, or it is never mentioned to them by their other doctors," said Evan Garfein, MD, the plastic and reconstructive surgeon at Montefiore Medical Center who authored the Bill.

He hopes that the new law (A10094B/S6993-B/Information and Access to Breast Reconstruction Surgery) will correct this disparity. It requires hospitals in New York to inform breast cancer patients about the availability of, and insurance coverage for, breast reconstruction before they undergo "mastectomy surgery, lymph node dissection or a lumpectomy."

While Congress passed the Women's Health and Cancer Rights Act in 1998, which guaranteed universal coverage for reconstruction after surgery, and New York soon passed comparable provisions into its laws, disparities in access remain.

"Breast reconstruction has been repeatedly shown to improve the quality of life and overall well-being of women who have been treated for breast cancer," Garfein says. "This new law will ensure that breast cancer patients from all socioeconomic groups are informed about their options regarding breast reconstruction and about where to get the procedure."

New "Botox" soon to be approved

2010-08-23T21:42:00.000-05:00

The world of cosmetic medicine is a ever changing landscape. I try my best to keep my patients informed of the newest and latest procedures that may interest them or help them. It is always important to research any and all new products and make sure that they can deliver what they promise. I hope to be one of the first practices in the Hammond,Covington and Mandeville area to carry the new Botox competitor, Xeomin. Please read the following article about Xeonmin and begin to educate yourself about this new product.

New Botox Competitor to Debut Next Month

Cosmetic use of Xeomin (Merz Pharmaceuticals] will be considered off-label use as of its initial US launch in September 2010. The drug was approved by the FDA in August 2010 only for treating neuromuscular conditions, such as cervical dystonia and blepharospasm, and is not yet approved to treat dynamic wrinkles between the brows and on the forehead.

Although Botox and Dysport are both approved for cosmetic use in addition to therapeutic use, Xeomin is expected to compete directly with the two botulinum toxin type A wrinkle-relaxing injectables.

Xeomin, Dysport, and Botox are each composed of similar, yet slightly different formulations of the botulinum toxin type A neurotoxin. The formulation in Xeomin (incobotulinumtoxinA) is particularly unique because it is free of complexing proteins, which may give Xeomin an advantage over Botox and Dysport in treating neuromuscular conditions, since the higher doses necessary can be given without resulting in antibody formation.

Xeomin’s lack of complexing proteins is not seen as a potential advantage over Dysport or Botox when it comes to cosmetic use. However, as the doses used to smooth forehead wrinkles and frown lines is so low, there is no noticeable difference. In fact, some physicians are concerned that it may be more difficult to control spreading or migration of Xeomin, which may lead to muscle relaxation that causes droopy eyebrows and other undesirable results.

Essentially, the effects of Xeomin injections for wrinkle reduction are anticipated to closely mirror the effects of Botox injections. The unit measurements of the two products are even expected to be about the same, although Botox is distributed in 100-unit vials, and Xeomin will be distributed in 50-unit and 100-unit vials.

The only other notable difference is that Xeomin will not require refrigeration prior to reconstitution as Botox and Dysport do, which is a convenience to physicians that likely will not affect consumers.

The lack of fluctuation in Botox prices after Dysport, its first competitor, was launched in April 2009 suggests that the introduction of Xeomin to the US market will not cause a decrease in the price of wrinkle-relaxing injections.

2010-08-19T11:19:00.000-05:00

...[A] new trend has sprung up in our youth-obsessed society: an increase in potentially dangerous cheap plastic surgery. Billboards advertising $2,999 bargain boob jobs from a "surgeon to the stars" have sprouted on the California 405 Freeway, a sign in the Midwest proclaims you can "buy one implant, get one free," while an advertisement near Clearwater, Florida brags $8 Botox injections. Still, as horror stories like the former Miss Argentina who died at age 38 following a butt augmentation prove, bargain-basement procedures have their price.
There is a disturbing trend occurring in the world of cosmetic surgery. Beauty at all costs and at the lowest bottom line. This leads to unqualified and unscrupulous doctors performing injections and procedures they are not qualified to do or handle the complications should they occur. This is an article from California that reinforces my position. I always offer free consultations for anyone that has any questions about something they heard in the media or questions about a procedure.
"To get the cost down, they could be cutting back on things like general anesthesia. They make you feel like the procedure must be easier and not so serious if you're just getting local sedation. Nothing could be further from the truth," says Long Beach, Calif., plastic surgeon Dr. Marcel Daniels.

The article is accompanied by snapshots of some hard sell-type highway billboards, which do look pretty tacky.

But because facial injections are less involved than full surgeries, they have become the most popular procedure that physicians like dentists and gynecologists are adding to their repertoire.

Experts cite concerns that untrained doctors can improperly inject the substances, which can be toxic and carry harmful side effects, like a droopy lid or lip. There is also the danger that an unethical doctor may use a blend of cheaper ingredients rather than the FDA-approved name brand, as in [Priscilla] Presley's case.