The Poly Implant Prothese Debacle - PRS
/Plastic and Reconstructive Surgery
Re: Reply: The Poly Implant Prothese Debacle
Sir:
We welcome Maijer and Neissen drawing attention to the nonsurgical issues surrounding Poly Implant Prothese implants. Although initially unsettled in the United Kingdon, fortunately, last week's report from the Medicines and Healthcare Products Regulatory Agency has again failed to evidenced any harmful issues with constituent products. Although it is surprising that any breast-augmented women continues to decline follow-up given the global health scare, it is reassuring to have comparable figures using different tools of measurement from both Britain and Holland...
Ultrasonography in PIP scanning - JPRAS
/Journal of Plastic, Reconstructive & Aesthetic Surgery
Because further surgery is not entirely risk-free, initial advice reiterated recently recommended clinical examination and ultrasound scan (USS) on a six-monthly basis. USS is also being employed by some cosmetic companies as a screening test for qualification of implant exchange and because it is neither free from charge nor 100% accurate, we would like to bring the following cautionary case to wider attention.
HTR deformity in facelifting - JPRAS
/Journal of Plastic, Reconstructive & Aesthetic Surgery
Over the years, we have been increasingly aware of a new, unnatural and instantly recognisable feature of pure vertical vector lifts that we refer to as a ‘horizontal temporal ridge’
Platysma mastoid suture - JPRAS
/Journal of Plastic, Reconstructive & Aesthetic Surgery
Although modern lifting with short, concealed-scar techniques is both safe and reliable, in inexperienced hands there remain certain giveaway signs of surgery, that many would prefer to conceal, such as the ‘lateral sweep’. Others have noted ear lobule deformities.
Brachial Plexus Impingement - Springer science & business media
/Abstract
Breast augmentation is one of the most commonly performed aesthetic procedures, with many studies documenting the early and long-term complications that might be expected. This report describes the case of an active young woman who experienced severe pain, particularly with movement. Surgical exploration showed the cause of this pain to be impingement of the patient’s lower brachial plexus by the mammary prosthesis. Such a complication has not, to the authors’ knowledge, been reported previously.
Case Report
A 28-year-old woman sought a second opinion with the senior author (JJS) for severe pain in her right breast. The pain was present constantly, but was exacerbated significantly by movement of the ipsilateral arm. It had been present to varying degrees since her original surgery. The patient had initially undergone augmentation mastopexy via submuscular implants 3 years previously. Her case had been complicated by an acute hematoma in the right breast that required evacuation and hemostasis on the day of surgery. After 6 months, she returned to the original surgeon with bilateral capsular contraction and underwent an otherwise uncomplicated bilateral capsulotomy, implant exchange, and revision mastopexy. After 1 month, she experienced right breast pain. Oil of evening primrose was prescribed, which ameliorated her symptoms to some extent.
The patient presented when the pain worsened noticeably after her annual vacation, during which she was particularly active with swimming. At this time, the right breast was painful, and any movement radiated pain into the shoulder and right arm such that she was exhibiting protective reflexes. Furthermore, the symptoms had not been controlled by a combination of ibuprofen, tramadol, and amitriptyline.
On examination, both nipple–areolar complexes and implants were high producing a pseudoptosis (Fig.1), but there was minimal palpable capsule formation. An area of inferolateral nodularity was tender on palpation of the right breast, but ultrasonography had been unable to detect parenchymal abnormality. This and an additional magnetic resonance imaging scan, requested by the original surgeon, also confirmed the lack of implant rupture. Otherwise, the patient was in good health with an unremarkable medical history. Due to the severity of her symptoms, surgical exploration was planned.
At surgery, bilateral, large, very tight muscular pockets were found extending superiorly to the level of the clavicle. Notably, the patient’s well-developed pectoralis major muscles remained attached to the chest wall inferiorly at the sites of origin, and these were divided accordingly. Both capsules, as expected from preoperative assessment, were thin and left in situ after explantation and revision mastopexy.
The patient’s postoperative course was uneventful. At the time of writing, she remains both pain free and highly satisfied with her result, although the pseudoptosis has not been entirely satisfactorily corrected (Fig.2).
Botulinum neurotoxin A: A review - JPRAS
/Journal of Plastic, Reconstructive & Aesthetic Surgery
Summary
Despite its ubiquity in cosmetic circles and brand general awareness, a literature search on botulinum neurotoxin in JPRAS and BJPS yielded a mere 4 articles germane to cosmesis. A pair each detailing its application in masseteric hypertrophy and the use of cryoanalgesia. Given that botulinum neurotoxin A is the most commonly used cosmetic treatment, with American figures being most accurate, a review of the background, development and scientific evidence would be perhaps useful, if not overdue, as Plastic Surgeons increasingly incorporate non-surgical interventions into their practices as part of a comprehensive facial rejuvenation strategy.
Introduction & historical background
The use of botulinum neurotoxin A (BoNT-A) for medical and cosmetic applications has enjoyed a short, but remarkable, life so far despite considerable inherent toxicity. Based on its estimated inhalational lethal dose, a single gram is reportedly sufficient to kill one millions people. Therapeutic BoNT-A was born in the 1970s originally as a non-surgical alternative for strabismus and the list of medical used has mushroomed. Its cosmetic infancy arose from the serendipitous observation of diminished wrinkles during treatment for belpharpspasm. Now, many millions of injections later, safety and role have been clarified and sits in, relatively, comfortable adulthood as an increasingly routine part of the aesthetic regimen for many both in and out of the publis eye. New uses continue to emerge, many of which have arisen in a similarly fortuitous fashion.
The storey of BoNT-A starts with its description by a German, Justinus Kerner, sometime between 1817 and 1822. Perhaps combining his dual professions of poet and physician, he named it 'sausage poison', having observed that the toxin tended to thrive in poorly-prepared meat products, particularly those self-canned. Half a century later, his compatrios Muller Latinised sausage into "botulus" - the name the disease is produced i.e., botulism. The causative bacterium, Clastridium botulinum, was first culture by van Ermengern in 1897 and neuromuscular blockade as the mechanism of action was elucidated in 1949. The potential role of BoNT-A as a bio terrorism agent...
Further reading
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‘Selfie Surgery’: A Modern Phenomenon
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Wisconsin’s WEAU news site recently reported on the current trend of ‘selfie surgery’ in younger age groups prompted by the growth of social media. The hypothesis being that either posting photos by oneself or being tagged by others has made us ever more critical of how we look.
Read MoreOK! - EXCLUSIVE: Casey Batchelor opens up about plastic surgery and Celebrity Big Brother
/When asked if the cosmetic surgery, performed by Dr Jan Stanek, would affect her style, she said
"I’ll have to throw all my bras away but I’m hoping to give them to charity. I counted them the other day and I have 60 bras. Clothes wise I’ve always worn tight clothes so there won’t be a drastic change." — Casey Batchelor
Glamour model Casey Batchelor shows off the dramatic results of her breast reduction
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Glamour model Casey Batchelor shows off the dramatic results of her breast reduction in black jumper and skin-tight leggings.
Read MoreCelebrity 'Big Brother' contenstant Casey Batchelor set for breast reduction
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'I'm having a boob op' Casey Batchelor admits she's set for breast reduction
Read MoreI wiped FIVE YEARS off my face in EIGHT WEEKS (by eating and drinking collagen)
/There are numerous weapons in a woman's battle against ageing. But if any were to deserve the title 'elixir of youth', it's collagen. This precious protein is the basic building block of the skin, forming mesh-like bonds to hold it firm and stop it sagging.
Read MoreBotox: Sounding the Right Note
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Fleetwood Mac’s Stevie Nicks - currently wowing audiences on the supergroup’s triumphant world tour - claims Botox is ‘an ugly thing’ she will never have again. She says she will never turn to the wrinkle-defying injection again after a bad experience. “My eyebrows fell,” she confessed to an interviewer. “I looked like the sister of Satan.”
Read MoreTatler Beauty & Cosmetic Surgery Guide 2013
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Stanek is renowned for his use of glue to stick skin to muscle after eyelid surgery, cutting recovery time and reducing risk for slow healers. He uses barbed sutures for facelifts, allowing him to maintain the correct tension in muscles without the need for knots or a repeat procedure.
'People want a facelift every 10 to 15 years - not every three years,' — Jan Stanek
The skilled surgeon is also especially proud of the Dexter cattle he rears on his 350-acre farm in Oxfordshire.
The PIP Debate — Cosmetic News
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With the PIP controversy dominating the headlines we gauge the industry's opinion on the fallout from the scandal.
Read MoreFrom Russia with Botox: Has Putin had a facelift... or just plenty of sleep? Mystery as bags under eyes vanish
/Jan Stanek, one of the UK’s top cosmetic surgeons, said
‘I have no doubt at all that he has had quite a bit of surgery. ‘Unfortunately, it has made him look a little odd. ‘By lifting the brow so much it has a feminising effect, which is not what you want.’
Full article on the Mail Online
Leak rate of faulty implants is 1 in 3 in the UK
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The rupture rate of faulty PIP breast implants is as high as one in three, according to a new survey — at least 16 times higher than the rate previously claimed by the industry.
Read More
