The Cosmetic & Reconstructive Surgery Center

FDA Issues Statement on Possible Link between Breast Implants and Rare Cancer

2011-01-28T12:20:00.000-08:00

The FDA issued a statement on the possible link between breast implants and a very rare form of lymphoma. This is not breast cancer. It is a rare form of non-Hodgkin lymphoma, a form that is so rare it was not discovered until 1985. It is known as anaplastic large cell lymphoma (ALCL), and it affects immune system cells, not breast tissue cells.

In its statement, the FDA says about 60 confirmed cases of ALCL in women with breast implants have been identified worldwide. The actual number is uncertain because case reports in scientific literature and by doctors sometimes lack identifying information, making it possible that cases were double-counted. In the US, where documentation is better, they have identified 34 unique cases of ALCL in women with breast implants and 17 cases in women without breast implants.

The FDA is not saying that breast implants cause these cases. The number of cases is so small that they cannot make a statement about a causal relationship between breast implants and ALCL. The condition is so rare that they admit they may never be able to identify a causal relationship.

One case study suggests that the relative risk of ALCL for women with breast implants may be up to 20 times greater than for women without breast implants. But the initial risk is so small to begin with (about 3 in 100 million women are diagnosed each year in the US), the absolute risk is still very small. You can read the FDA's analysis of the scientific data for a more detailed review of the studies.

Dr. John Kotis notes that the recommendations say routine care, such as normal follow-ups with your health care provider and breast self exams should be sufficient to identify the cancer in its early stages. The FDA recommends that as always you should pay attention to any changes in your breast implants, especially:

Pain
Lumps
Swelling
Asymmetry

Symptoms like those above have been associated with every diagnosed case to date. There is no evidence to support having your breast implants removed as a preventative measure.

If you have concerns about your breast implants, we will be happy to talk to you about your concerns and review follow-up care procedures. For more information, please call or email The Center for Cosmetic & Reconstructive Surgery in Chicago, Illinois.

Breast Reconstruction

2010-02-01T07:06:00.000-08:00

Breast reconstruction surgery is really a name for a series of procedures that allow a surgeon to cosmetically recreate breasts in women who have lost a breast to mastectomy, disease, or injury.

The breast reconstruction process can take many different forms, depending on how completely the patient wants to rebuild the breast and how much surgery she is willing to undergo to do so.

The procedure

The breast reconstruction process consists of steps to replace sufficient skin to cover the breast mound, construction of the mound, and finally, procedures such as nipple reconstruction and adaptive surgery to the natural breast, to create a symmetrical appearance.

Skin replacement

There are two options available for the skin replacement step: Skin expansion and flap reconstruction.

Skin expansion.

This is a procedure in which the cosmetic surgeon creates sufficient skin to accommodate the new breast mound. This is done by implanting an 'expander' in the chest area. This expander implant is filled incrementally, allowing the skin to regrow to accommodate it.
Flap reconstruction.

Flap reconstruction is an alternative skin replacement procedure to skin expansion. This involves repositioning skin from a donor area elsewhere on the patient's body, usually the buttocks, abdomen, or back.

Implantation

The implantation step is identical to breast augmentation procedures. During this step, the surgeon inserts a breast implant under the newly formed skin of the reconstructed breast.

Nipple reconstruction

The nipple reconstruction process involves recreating a nipple for the newly created breast mound. This is usually done by shaping a flap of skin from the breast into a nipple form, then tattooing the nipple and areola area a darker color to complete the effect.

Additional procedures to the existing breast

Following a breast reconstruction, the newly constructed breast may be a slightly different shape or size than the existing breast. In such cases, many women choose to have additional procedures to their natural breast to increase the symmetry between the breasts. These procedures may include breast augmentation, breast reduction, and/or a breast lift.

1.888.4.NIP.TUC

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Frequently Asked Breast Augmentation Questions

2010-01-25T13:16:00.000-08:00

Will I have scarring?

The location and extent of scarring will depend on individual physiological factors, as well as the type of incision you've had. Most procedures leave little or no visible scarring. TUBA and underarm incisions have the least potential for visible scarring, because they are located away from the breast itself, in the case of TUBA, in the navel; and in the case of underarm incisions, in the armpit. These types of incisions do limit your other options for placement and type of implant, however.

Current cosmetic surgery procedures, regardless of the type of incision, are designed to minimize visible scarring as much as possible.

How long will my recovery take?

This depends largely on individual factors including your healing abilities, age, whether you smoke or not, and your postsurgical care; as well as the type of incision, and location of the implant.

In most cases, however, you should be able to participate in all of your normal activities within about four to six weeks, and the full healing process, including any final scarring, will be complete in 6 months to a year.

What are the pros and cons of the different procedures?

Each specific procedure - incision type, implant placement, and implant type - has its unique benefits and drawbacks. For example, local incision types such as the inframammary fold incision and the periareolar incision allow the surgeon more direct access to the procedure site, but they may produce more visible scarring than remote incisions such as the TUBA and transaxillary incision sites.

To determine what type of procedure is right for you, familiarize yourself with each of the incision types, implant placements, and implant types available, and then discuss these options with a plastic surgeon who can help guide your decision making process.

Is breast enhancement right for me?

Breast enhancement may be right for you if you have a healthy self-image, but feel that breast enhancement would improve your confidence. It is important that you have a healthy attitude and realistic expectations about what the procedure can do for you.

What type of implant and procedure should I have?

There are so many types of procedures and implants available because there are so many types of women who seek them. The size, shape, and content of your implant will depend on factors such as your overall frame, your current and desired breast size and shape, your specific needs and interests. As such, this question can best be answered after a thorough consultation and examination with a qualified and experienced cosmetic surgeon.

Breast Augmentation

2010-01-25T13:14:00.000-08:00

The Center for Cosmetic & Reconstructive Surgery

Breast enlargement procedures, also called augmentation mammaplasty, are one of the most common body sculpting procedures performed today.

Enlargement of the breasts not only can make the breasts fuller and more youthful looking, but it has the additional benefit of bringing the rest of the body into more pleasing proportions, making the waist and hips appear smaller in comparison.

There are a number of different options available in modern breast augmentation procedures, including options for the type, size, and shape of implant, placement of the incision, and placement of the implant. Each procedure is unique, and is custom designed to meet the needs and goals of the patient.

Choosing an implant

Most implants in general use are constructed of a gel-like outer shell made of silicone, which is filled with a sterile saline solution, to replicate the look and feel of the natural breast. The outer shell portion of the implant is also called the lumen.

There are a number of options available for breast implants today, including:

Implants consisting of a single lumen, and double lumen implants.
Implants that are pre-filled with a measured quantity of saline, and those that are inserted, and then filled once the implantation is completed. Double lumen implants may have one pre-filled lumen, and a second lumen that is filled during the procedure.
Implants with a smooth outer surface, or those with a textured surface.
Round implants, or teardrop shaped implants.

Choosing an incision

There are a variety of different techniques available today for breast augmentation mammaplasty, each of which has its unique benefits and limitations. What type of incision you choose might depend on other factors, such as the type and placement of implant you've chosen.

Primary types of incision available include the following:

Periareolar incision.

A periareolar incision is an incision made around the areola, or the darkened area of skin surrounding the nipple. An areolar incision allows the surgeon to insert and position the implant directly. Any scarring following an areolar incision is obscured by the changes in color and texture of the skin in the area.
Inframammary incision.

An inframammary incision is made along the crease along the underside of the breast. The inframammary incision allows the surgeon to directly access the breast area, to place and adjust the implant with precision. Because the incision is located in the crease beneath the breast, any scarring should be obscured from view.
Transaxillary incision.

A transaxillary incision is an incision made under the arm, or in the armpit. A transaxillary incision can be used for either an open procedure-meaning a procedure in which the surgeon directly accesses the site-or as endoscopic surgery. Endoscopic surgery is performed through a thin, flexible metal scope, which allows the surgeon to work on remote areas. Scarring from a transaxillary incision will be located in the underarm area, where it is both obscured from view and remote from the implant site.
TUBA incision.

A TUBA incision, or Trans-umbilical Augmentation incision, is made inside the navel. The implants are then placed using an endoscope-a thin, flexible metal tube-allowing the surgeon to access the site remotely. Scarring from a TUBA incision is located entirely inside the navel, and should not be visible.

Choosing an implant placement

Breast augmentation mammaplasty procedures also provide several options for placement of the implant, each of which involves tradeoffs of convenience, recovery time, and aesthetic issues.

There are three general placements available for breast implants: Subglandular, submuscular, and subpectoral.

Subglandular placement.

Subglandular placement of breast implants means that the implant is placed beneath the mammary gland, but atop the muscle wall along the chest. This type of placement is the least invasive, and subsequently involves a somewhat shorter healing time. However, in some cases, particularly when there isn't sufficient breast tissue to cover the outline of the implant, it may result in more palpable implants.
Subpectoral placement.

Subpectoral placement of breast implants means that the implant is placed beneath both the mammary gland and the pectoralis major muscle, at the top of the implant.
Submuscular placement.

Submuscular placement of breast implants means that the implant is placed beneath the mammary gland, the pectoralis major muscle at the top of the implant, and beneath other minor chest muscles at the bottom of the implant. This placement completely covers the implant beneath both the soft tissue and the muscle of the chest.

Evaluating your augmentation options

As you can see, there are any number of interdependent factors involved in decisions about your augmentation procedure. Certain types of implants work with certain types of implant placements and incisions, and practical and aesthetic decisions must be carefully weighed on any of a number of issues.

These decisions can certainly appear overwhelming at first, so if you're considering an augmentation mammaplasty procedure, it is often easiest and most effective to do so in direct consultation with a qualified and experienced augmentation surgeon such as Dr. Kotis, who can guide you through the decision making process and help you determine what solution is right for your own needs and goals.

Frequently Asked Abdominoplasty Questions

2010-01-22T12:01:00.000-08:00

Is an abdominoplasty right for me?

An abdominoplasty can be an excellent solution for people who are generally physically fit, but have stubborn problems around in the belly area, including sagging skin, loose muscle, and pockets of fat that are resistant to diet and exercise.

However, abdominoplasty is not appropriate for patients who expect to gain or lose significant amounts of weight in the future, or for women who plan to have children.

Is abdominoplasty an effective weight loss technique?

No. Abdominoplasty is a very effective technique for sculpting, reproportioning, and rejuvenating your physique. It is not, however, an effective tool for weight loss.

How long will the results of an abdominoplasty last?

An abdominoplasty can turn back the clock on some of the effects of aging and childbirth. However, the natural aging process will continue at its normal rate following the procedure. This means that your abdomen will always appear more youthful, more taut, and more toned than it would have without the procedure. It will not, however, always look exactly the way it did right after the procedure.

Also note that the effects of an abdominoplasty will deteriorate much more quickly if you gain significant weight or become pregnant following the procedure.

When is the right time for an abdominoplasty?

Ideally, you should have an abdominoplasty after you're done with childbearing, and after any major planned weight loss. Any major weight gain or stretching of the abdominal skin following an abdominoplasty can reverse the effects, causing the skin and muscles of the stomach area to become loose again.

Can abdominoplasty get rid of my cellulite?

Cellulite is, simply, fat, and excess fat is removed during the abdominoplasty procedure. So to some extent, the abdominoplasty procedure may reduce cellulite. However, it is not guaranteed to remove all visible cellulite from the area.

Will abdominoplasty eliminate loose skin around my tummy?

Yes. One of the primary purposes of abdominoplasty is to tighten loose skin around the abdomen, creating a taut, more youthful looking abdominal area.

1.888.4.NIP.TUC

www.drkotis.com

2010-01-22T11:57:00.000-08:00

Abdominoplasty, also called a tummy tuck, is a procedure in which the loose skin and tissue around the tummy area are resculpted to eliminate the rolls, sagging, and excess skin that often develop due to aging, weight loss, and other factors.

The abdominoplasty procedure consists of procedures to eliminate excess fat, to tighten the underlying stomach muscles, and to tighten the skin, leaving patients with a slimmer, trimmer, more attractive waist.

There are two general types of abdominoplasty currently available: Complete abdominoplasty and partial abdominoplasty.

Complete Abdominoplasty

Complete abdominoplasty is a procedure in which the surgeon makes an incision from one hipbone to the next, detaches the navel, then lifts the skin up over the entire abdominal area. This allows the surgeon to separate and tighten the abdominal muscles from the bottom of the ribcage to the pelvic area, creating a trimmer waistline. Once this is completed, the surgeon will remove excess skin, pull the area tight, and cut a new navel to replace the original one displaced by the procedure.

Partial Abdominoplasty (mini-tummy tuck)

Partial abdominoplasty is a less extensive version of the abdominoplasty procedure, in which the surgeon makes a smaller incision near the pelvic line, and then lifts the skin over the lower abdominal area without detaching the navel. As with the complete procedure, the surgeon tightens the muscles in the area, and stretches the skin tightly over the newly sculpted area,
removing excess skin in the process

Call 1.888.4.NIP.TUC
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Frequently asked BOTOX questions

2010-01-20T13:50:00.000-08:00

Is BOTOX® Cosmetic right for me?

If you have moderate to severe frown lines or other furrows in your forehead, BOTOX® Cosmetic can eliminate or minimize those effects for up to four months at a time. BOTOX® Cosmetic is only indicated for the forehead area, however, so if you have deep wrinkling or other problems in other areas of your face, you may want to consider injectable collagen or other cosmetic treatments designed to fill out and smooth wrinkles and furrows, such as Restylane and Sculptra, or a surgical procedure such as a facelift, to correct your problems.

How long will the procedure take?

The procedure for administering BOTOX® Cosmetic consists of having a series of small injections in your forehead area. This usually takes no more than ten minutes.

How long will the results last?

Results of BOTOX® Cosmetic treatment can last up to four months, wearing off gradually over time.

Can I have additional treatments once the first one has worn off?

Yes. Many patients choose to continue BOTOX® treatments indefinitely, to maintain the smooth brow Botox Cosmetic provides them.

How does BOTOX® cosmetic work?

The BOTOX® cosmetic solution works by blocking the transmission of nerve impulses in the muscles, which relaxes the muscles of the forehead, smoothing out deep lines and furrows.

If you would like to learn more about BOTOX
Call 1.888.4.NIP.TUC
or visit www.drkotis.com

Botox Unit 10 Dollars !!!!!!!!!

2010-01-20T08:31:00.000-08:00

BOTOX® cosmetic is an injectable solution that can provide temporary correction of even deep frown lines on the forehead.It is a is a prescription injection, injected subcutaneously into the forehead, where it relaxes the muscles of the forehead, reducing the contractions that cause furrowing and deep lines, with results of a single treatment lasting for up to four months.

The effects of injections will take their full effect over the course of a few days following the treatment. As your muscles relax, your brow will appear smoother, and furrows and deep lines will recede.

A single BOTOX® Cosmetic treatment can last as long as four months, and many patients choose to have the treatment redone once the effects have begun to wear of

Our center offers BOTOX® for 10 Dollars a unit, with all the consultation needed.
get more information by calling

1.888.4.NIP.TUC
or visit www.drkotis.com

Fraxel Laser Treatments

2010-01-20T07:39:00.000-08:00

What is Fraxel?

Fraxel treatment is a safe, laser skin treatment that can remove years from your appearance.
Two main factors can be attributed to skin aging: 1) Genetics and 2) your Environment, such as sun exposure, smoking or pollution. Combined, these factors age our skin causing wrinkles, rough texture, sun spots and more. And this is where Fraxel can help.
Fraxel treatment affects two layers of the skin: the first is the epidermis or the outer layer of skin. The second is the dermis, containing a network of collagen and elastin, which are proteins that keep your skin youthful and tight. But as you age and get more sun exposure, those proteins break down faster than your body can rebuild them. As a result, your skin may start to show signs of aging.
Fraxel delivers microscopic laser columns deep into the dermis to create tiny columns, which trigger your bodyís natural healing process. The Fraxel laser only targets a fraction of the skin at a time allowing your body to heal the skin much faster. This natural healing process allows your body to remodel your collagen and elastin, which results in tighter, fresher and more youthful looking skin Fraxel re:pair treats mild to moderate skin damage and has multiple FDA clearances, including skin resurfacing, age spots and sun spots, wrinkles around the eyes and acne or surgical scars.

What it Treats
The Fraxel re:pair system is the industryís only fractional ablative device that has FDA clearance for photodamage and can be used to treat the following:
o Skin Tightening and Wrinkle Reduction
o Pigmented and vascular dyschromia
o Reduces crows feet and eyelid tightening
o Perioral rhytids ( reduces Wrinkling around the mouth)
o Pigmentation, Discoloration, Sun Damage and Skin laxity

ï Current clinical investigations using the Fraxel re:pair include:
o Acne scars
o Surgical scars and stretch marks
o Actinic keratoses (AKs)

Dr.John A.Kotis is one of only three other plastic surgeons in the state of Illinois who offer this kind of treatment, and Because Fraxel re:pair is a more concentrated treatment, most patients need only 1 treatment to achieve dramatic results. After treatment, there are immediate results that will continue to improve for up to 3 months. It is the most powerful Fraxel treatment available.

If you would like to learn more about Fraxel re:pair
Call 1.888.4.NIP.TUC
OR visit www.drkotis.com