Indiana Plastic Surgery Blog

A study published recently in the American Journal of Surgery confirmed the common perception that breast surgery can be more efficiently performed outside of hospitals in dedicated outpatient ambulatory surgery centers (ASC).

According to study results, performing breast surgery in an ASC rather than a hospital saved 69 minutes on average, and most of the time savings was attributable to decreased preoperative time, or time spent preparing for surgery.

Key time-saving advantages of the ASC include:

• Avoidance of unscheduled surgeries, such as add-on cases and emergency cases common in hospitals
• Better case flow as a result of having a surgeon assigned to a single room in the ASC
• Smaller, more consistent ASC staffing
• Smaller physical ASC facility that makes it easier to move patients and equipment

The study also concluded that while the type of anesthesia used during surgery can also affect recovery time immediately following surgery, this did not significantly affect overall surgical time from the preparation stage to the patient discharge stage.

Hospital vs. ASC study details

In 2005, the study authors’ ASC facility was closed, which forced all outpatient breast surgeries to be performed alternatively in a hospital setting.

Study authors Drs. Terrence Trentman, Jeff Mueller, Richard Gray, Barbara Pockaj and Daniel Simula compared the surgical records of 92 patients who had breast surgery in an ASC facility between January 2004 and December 2005 with the surgical records of 92 patients who had breast surgery in a hospital facility starting January 2006.

All study subjects were female patients of similar age, with similar recovery room times, and each breast surgery procedure was performed by the same two salaried surgeons who did not receive additional bonus pay for productivity.

ASC pre-op vs. post-op

In addition to concluding that ASC facilities offer significant preoperative time-savings, the results of the study also suggest that breast surgery patients spend an almost identical amount of time in an ASC as in a hospital once they reach the operating room.

Members of the American Society of Plastic Surgeons sent out a special bulletin today, urging other members to voice opposition to the 5 percent cosmetic procedures tax that was added to the healthcare reform bill Wednesday.

Due to the often-unclear distinction between cosmetic and reconstructive surgeries, and the fact that nearly 90 percent of cosmetic procedures are done on women, The ASPS has labeled the tax plan “discriminatory, arbitrary, and a potential auditing nightmare.”

According to the New York Times, “the tax would be paid by patients, but collected by doctors and clinics and forwarded to the government.”  Those patients – who are often middle class working females – would generate (a projected) $5 billion towards the $849 billion healthcare reform bill over the next ten years.

ASPS members are being asked to contact their representatives in congress or login at capitolconnect.com to take action.

CNN Health recently published a piece that cites several reasons why we could be “winning the war on breast cancer.“  Better breast reconstruction is one of the main reasons.

If breast reconstruction is performed immediately after mastectomy,  the traumatic psychological effects can be minimized significantly.  Also, if the mastectomy is performed in cooperation with a plastic surgeon, the results are far more likely to be  acceptable.

Health professionals have combined two disciplines to form a new specialty called oncoplastic surgery.  According to Dr. Gail Lebovic, president of the American Society of Breast Disease, this speciality allows surgeons to “look at a woman in a holistic way.”  Lebovic also comments, “When you’re able to offer reconstructive techniques at the same time, breast cancer surgery is not as horrible a thought.”

Here are 5 other reasons to be optimistic about breast cancer and reconstruction, provided by health writer Susan Brink:

1. More research and increased knowledge about breast cancer
2. Less traumatic surgery
3. Safer radiation
4. Fewer complications
5. Better breast reconstruction

Click here to read more about breast reconstruction in Indiana and see breast reconstruction before & after photos.

Forehead lines are a bothersome issue for many people, young and old, making them self-conscious of the appearance of their upper face.  Patients often ask us, what can I do about them, aside from brow lift surgery?

First of all, there are two types of forehead wrinkles a patient may need to address.
•    Dynamic wrinkles are caused by active movement of the facial muscles.
•    Static wrinkles are present without contraction of facial muscles, as if they are ‘etched’ into your face.

The neuromuscular blocking action of Botox (or Dysport) is perfectly suited to treat dynamic wrinkles.  That’s why Botox injection is regarded as the best and least invasive method of addressing forehead wrinkles.

Botox may help soften static wrinkles but will not cause them to completely go away. To go beyond what Botox can achieve and further erase these wrinkles, additional procedures such as laser therapy may be appropriate.

Soft tissue fillers, Juvederm and Restylane, may also be beneficial when used in conjunction with these procedures.