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Trends in Plastic Surgery

August 13th, 2007

Smaller Breast Implants
Today, breast augmentation is more popular than ever. According to the American Society of Plastic Surgeons  329,000 breast-augmentation surgeries were performed last year in the United States-an almost 30% increase from 2003. But the days of bigger is better may be diminishing.

 

Some plastic surgeons and their patients are rediscovering the aesthetic ideal for the female breast-one that is soft and supple, fuller in the lower than the upper pole, and in proportion to the rest of the patient’s figure.

 

Part of the change may be attributed to the changing demographics of breast implant patients. Today, women in their 30s and 40s-particularly moms-are the fastest-growing group of patients seeking breast augmentation. This patient population has lost breast volume following pregnancy and lactation, and simply want to restore a natural, more youthful breast contour to their chests.

 

Even women who have not had children are opting for smaller, more realistic-appearing breasts. Professional women do not want to look like they’ve had breast implants.

 

Potential breast augmentation patients should also give serious thought to the following consideration: one great advantage of a conservative breast enhancement is that small implants are much more likely to feel natural.  It is possible to provide an enhancement that is soft, supple, and even undetectable (by touching) with a small implant.

 

Implants of a moderate (and in my opinion, appropriate) volume, whether they be saline or the new FDA approved cohesive  silicone gel implants, can look and feel natural exceedingly natural.

 

 

Medical Tourism

August 13th, 2007

First, let’s look at the “real costs” of international plastic surgery for Americans.  Let’s say you travel to Rio, Brazil for your surgery.  Here are some additional prices to add to the surgeon’s fee:

 

-Airfare

-Hotel

-Transportation (taxi’s, etc)

-Meals

-Incidentals

-Insurance in case of emergency

 

Airfare: I chose 5 starting points from the US to Rio de Janiero: Chicago, Seattle, St Louis, NY and Miami, leaving July 26th and returning two weeks later, August 9th. I booked for 2 people (I assumed most people would take someone along for moral and physical support). The average airfare for two was $2,468, tourist class. NY was lowest at $1885, Seattle highest at $2900. The average flight time was 14 hours each way.

 

Hotel Costs: I chose a 2.5 star hotel, though you can imagine most plastic surgery patients would want 4-star. Still, to be fair, I priced all flights with the same 2 ½ star hotel. The average was $1800 when booked with the flight through Expedia. Keep in mind that the hotel average for the big cities was lower ($1574) but the Seattle patient would have paid $2613 for the identical hotel, when booked with airfare (how does that work?). This leads me to believe that if you live outside the largest US cities, you might pay more for a hotel if you book through an online service like Expedia.

 

Taxi and other transportation: Taxi from the Rio airport to either Copacabana or Ipanema averages $25 USD each way based on today’s Real to dollar conversion. Pretty cheap by American standards! Figure a total of $200 while you are there, for preop, day of surgery, postop, and shopping.

 

A person’s gotta eat, right? Like any big city, there are expensive places to eat and cheap places to eat. Figure $100 a day per person, which is actually pretty basic. That totals $2800 for 2 for 14 days.

 

And don’t forget the incidentals, like bottled water, a couple sodas per day, some fresh fruit from the street market to have around the hotel room, movie rentals, tips for the bellhops and the guy who gets you a cab, perhaps a laundry bill during that 14- day stay. Let’s add $25 a day for incidentals, which adds $350 to our tally.

 

Now, let’s consider the issue of health insurance to cover any unforeseen emergency created by plastic surgery outside the US. What if something goes wrong on the table? What if there’s a dehiscence? Or an infection?

 

Will US-based health insurance cover a complication created as a result of an elective procedure performed outside US borders? According to our sources at a NY agency, maybe they will and maybe they won’t. And even if the insurance company does cover it, coverage is generally limited to “life-threatening” emergencies (ie, they won’t let you die in Rio). The patient would pay out of pocket first, then negotiate with (more likely beg with) their US-based insurance company after returning to the States.

 

OK, so what about Travel Health Insurance? Travel health insurance, according to my inquiries to InsureMyTrip.com and Eisenberg Associates, does not cover any medical emergency arising as a result of an elective procedure. Both firms offer over a dozen plans, and they told me none of them would cover an illness or trauma caused by an elective procedure. Broken leg? Sure! Food poisoning? Without a doubt. But if it’s created by an elective plastic surgery procedure, fuggeddaboutit. This means that traveling outside the US for elective plastic surgery puts the patient at a definite risk for out-of- pocket costs if a complication occurs.

 

The grand total for this bargain overseas procedure?
Using my estimates, it would run around $9,643 for a breast aug with lift or a facelift in Rio. Cheaper than the US? Certainly not for a breast aug with a lift. Probably yes, for a facelift. And of course, assuming you feel up to it, you get a vacation thrown in. However, doing the tourist thing is a big assumption for a postop plastic surgery patient. I had a great face lift surgeon but I sure didn’t feel like running around the first 10 days afterwards. And I’m quite certain that a 14+ hour airplane trip wouldn’t have felt like a great plan either.

 

And remember, these are just Rio estimates. If you want a breast aug in Phuket it’s $3000 US. And the airfare will run around $3000 for two, plus hotel and all the above items.

 

Most importantly, of course, none of the above addresses the quality issue. The surgeons might be fabulous, but how can the prospective US patient judge this? How can one assess the surgical facility or the anesthesiologist from 5,000 miles away? How does one obtain stats on deaths or infections for foreign plastic surgery procedures? Jeepers, how does one go back for a 6-month postop check up? I’ve read nasty reports on some of the international plastic surgery forums written by patients who got themselves involved with a plastic surgery “mill” and had horrible experiences. Conversely, some people had great experiences. 

 

“The Body Beautiful”

July 31st, 2007

It’s an exciting time in Cosmetic Surgery.  There are new and advanced procedures that allow for more options in our quest for “The Body Beautiful.”

 

New  You can take the fat from “down there” and use it to sculpt and contour your face and eyes.  This procedure is for those who are not yet ready or wanting a full face lift procedure.

 

New  What some are calling “The Weekend FaceLift”…helps eliminate the apperance of a sagging face and neck with use of liposulpture, revision of the platysmal muscle (bands in the neck) and laser; as well as reshaping the jawline and chin.  All this is performed through a small incision in the natural fold under the chin.

 

New  Allergan, the maker of BOTOX® Cosmetic, announced approval by the U.S. Food and Drug Administration (FDA) of label extensions for JUVÉDERM" Ultra and JUVÉDERM" Ultra Plus based on new clinical data demonstrating that the effects of both products may last for up to one year, which is longer than reported in clinical studies that supported FDA approval of other hyaluronic acid (HA) dermal fillers.

“Patients are looking for longer-lasting, science-based products that fill in lines, such as the parentheses around the mouth, as part of their overall anti-aging skin care regimen,” said Robert Grant, President of Allergan Medical, a division of Allergan.  We are pleased to provide our patients with the only dermal filler product currently approved in the United States that lasts up to one year with a single treatment. 




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