Leesburg, VA (PRWEB) May 22, 2010 – Ten years ago, Dr. Chang introduced and taught his Transaxillary Breast Augmentation (underarm) technique to minimize breast augmentation scars. Last year, he was one of the first local plastic surgeons to offer the On-Q Pain Pump to his patients to minimize their postoperative pain. This year, Dr. Chang was one of the first local plastic surgeons to regularly use the Keller Funnel to minimize the length of scars in his breast surgery patients, as well as minimize the risk of trauma and bacterial infections that may cause implant ruptures and scarring around the implant, respectively. The Keller Funnel device was introduced at the Annual Conference of the American Society of Plastic Surgeons (ASPS) in 2009.

Dr. Phillip Chang, MD ( plastic surgeon in Loudoun and Fairfax Virginia )Breast Augmentation, also known as Breast Enlargement, is one of the most common surgical procedures performed by Dr. Chang. According to the American Society of Aesthetic Plastic Surgery (ASAPS), Breast Augmentation was the most popular cosmetic surgical procedure in the United States in 2008. Many patients decide to have a breast augmentation prior to having children. But the majority of patients decide to have a breast augmentation after having children as part of a Mommy Makeover Procedure to restore and rejuvenate their breasts. Due to pregnancy and breastfeeding, a woman’s breasts lose volume and roundness, the stretch on their skin leads to drooping, and the nipple-areola complex may become larger. Post-childbirth women often want to return their breasts to what they might have looked like before having children.

The Keller Funnel is a cone-shaped device designed to help surgeons place a pre-filled silicone breast implant into the breast pocket through an incision as small as three centimeters (cm). The cone is lined with a hydrophilic polymer coating, a special lubricant that — when moistened — makes the funnel so slippery that an implant can be placed without ever being touched by human hands. Dr. Chang cites at least three reasons do have a breast augmentation using a Keller Funnel Device:

1. Minimize the length of the scar;
2. Minimize the trauma of putting the implant into the surgical pocket;
3. Minimize the amount of bacterial contamination.

The benefit of minimizing the length of the scar is self-evident. To take a patient with an A-cup breast to a C-cup breast used to make a scar of at least seven- to-nine cm in length. The silicone breast implant can now be placed through a Keller Funnel with just a five cm incision. The benefit of decreasing the trauma of breast implant placement is also self-evident. Researchers have determined that the most common cause of implant rupture, even 10 years after the breast implant surgery, was trauma to the implant at the time of rupture. The effort of placing the implant with Keller Funnel is only a fraction of what is traditionally necessary. Finally, by delivering the breast implant through the Keller Funnel, the implant never touches the patient’s skin. Additionally, the implant is never touched by the surgeon or nurse — even wearing surgical gloves in a sterile environment — which reduces the risk of infection and capsular contracture.

Dr. Chang has performed the Keller Funnel procedure on dozens of patients. He states that his patients often compare surgical scars with their girlfriends who have also had Breast Augmentations, and universally, they say that they have the smaller incisions. Before and After Pictures of Breast Implant Procedures can be seen at Dr. Chang’s website at http://www.gotobeauty.com/breast-augmentation-before-after.php

More on the Keller Funnel can be seen on the Plastic Surgery Channel at http://www.theplasticsurgerychannel.com/breast-augmentation/breast-augmentation-risk-reduced-with-keller-funnel/

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Radiance Gift Card Bonus

Purchase $200 in Gift Cards during the month of May and receive a $20 bonus card* to be used towards any service at Radiance Salon&- Medi-Spa. Radiance will donate 10% of all May 2010’s gift card sales to The American Society’s Relay For Life.

*Bonus Card valid from June 1 – August 31, 2010

Come to our Open House to benefit Relay For Life

Saturday, May 22, 2010
10:00 am – 3:00 pm

Refreshments and door prizes.

www.relayforlife.org

Radiance Salon & Medi-Spa

Lansdowne – 571.333.3005 (near the dock)
Broadlands – 703.723.4600 (near Bonefish)

www.gotoradiance.com

Download the official flyer here

Overview of the Hair Transplantation Process (Follicur Unit Micro-transplantation)
There is no doubt that hair loss for men and women can be devastating to your self-esteem and self-image. Despite the advent of some medical treatments such as Rogaine and Propecia, more and more patients are turning to more permanent solutions such as hair transplantation. Hair Transplantation procedures have been revolutionized by the introduction of the Follicular Unit Micro-Hair Transplantation procedure. By using a surgical microscope to separate each hair follicle, hair transplantation is not only permanent but it no longer has the appearance of plugs that gave hair transplantation a bad name in the 70s and 80s. This procedure is based on the following principles.

1. Hair loss is the result of the abnormal sensitivity of hair follicles to the hormone dihydrotestosterone (DHT) after it is converted from testosterone
2. The hair follicles in the posterior scalp and the side of the head appear to be immune to the effects of DHT
3. Follicular unit hair transplantation uses this principle and the principle of Donor Site Dominance to move or transplant the hair from the back of the scalp to the areas of hair loss
4. About 2000 hair follicular units can be moved in each session. Depending on the degree of hair loss, some patients may benefit from 1 or more sessions.

Natural History of Hair Loss and Potential Treatments
Premature hair loss can be devastating to the self-image and self-confidence of both men and women. Most of us have experienced some temporary hair loss that we have worried about. There are many reasons for temporary hair loss. These can include

• Medical Illness ( hypothyroidism, cancer, viral syndromes )
• Medications
• Stress
• Poor diet ( Iron or vitamin deficiency )
• Direct Trauma
• Hormonal Imbalance ( pregnancy, perimenopause )

Temporary hair loss is fortunately… temporary. There is often a direct identifiable cause that we can find and treat. I often identify these problems during your initial consultation and the consultation often ends without having to proceed to a more involved hair restoration procedure.

More permanent causes of hair loss can also affect both men and women. Permanent hair loss in both men and women are most often due to hormonal influences initiated by a genetic predisposition. Specifically, hair loss is usually due to elevated levels of dihydrotestosterone (DHT). DHT is a male hormone that is also found in women in smaller amounts.  Because hair follicles are ultra-sensitive to DHT, an excess of the hormone often causes the hair to fall out.

Hair loss or baldness is a genetic trait—but unlike what you may have been told, it’s not necessarily passed down from your maternal grandfather. Medical science has come to learn that baldness genes are actually passed down from both sides of the family—and they affect hair loss in women as well as men. Baldness genes may also skip generations and are utterly random in terms of which siblings (male or female) they will affect. They may even have very different effects on siblings in the same family.

Hair Loss in Men

Baldness is a medical condition that affects some 25% of men in their 20’s and an astounding 2/3 of all men after the age of 60. Male-pattern hair loss and baldness does not have any intrinsic side effect aside from hair loss so many consider it a cosmetic medical condition, but for those who suffer from it, its effects it can be devastating with social and psychological consequences.

Androgenetic Alopecia, or “male pattern baldness,” occurs in me whose hair follicles are sensitive or over-exposed to the hormone dihydrotestosterone (DHT). In men, testosterone is converted to DHT. Over time, DHT-sensitive hair (usually found on the top and front of the head) becomes weaker, finer, and eventually stops growing. However, even men who experience advanced baldness have healthy hair follicles mostly around the sides and the back of the head that last a lifetime. Even though these healthy hairs are exposed to DHT, they are resistant to this hormone and survive for a lifetime. The usual life of a hair follicle is 5 years, 4 of those spent growing and the last year being stagnant, but follicles that are damaged fall out and are not replaced by new follicles. This is why male pattern baldness is gradual but irreversible in its later stages.

Hair Loss in Women

Hair loss in women can be particularly devastating. Women will often pay hundreds of dollars to stop by their local hair salon to receive a stylish cut and color. Her hair style often defines and frames her image. Now imagine the perceived affect on her self esteem when her hair prematurely and inexplicably begins to thin.

In most cases, hair loss in women is a normal condition dictated by heredity. Hair loss is relatively common in women, more common than one would imagine. Almost 30 million American women, or one in four, experience thinning hair due to androgenic alopecia – female-pattern-baldness. All women have both estrogen (female) and testosterone (male) hormones in their systems. The loss or depletion of the protective estrogen and/or the over-production of testosterone permits the invasive testosterone to exert its effect on the hair follicles, resulting in a thinning of the hair.

In women, hair loss usually begins at menopause. Before this time, DHT is counteracted by estrogen, but when estrogen levels drop, women’s hair follicles may also become prone to the effects of DHT. Unlike men, hair loss patterns in women are marked by thinning throughout the scalp; fully bald spots at the crown are rare.

The onset of hair loss in women can begin anytime after the teenage years, but most commonly occurs during perimenopause or menopause when a woman’s estrogen levels fluctuate at first and then gradually decrease to a new, much lower level – culminating in the loss of the protective effects of estrogen. Anything, from drugs to a traumatic event, that alters the protective levels of estrogen could lead to a premature development of female pattern hair loss.

Women may experience temporary hair loss following pregnancy.  The reason for this is because during the pregnancy term, the hormones of a woman’s body changes.  Because pregnant women have elevated levels of progesterone and reduced levels of estrogen, hair will begin to fall into its resting stage too early.  After childbirth, new hair will then begin to grow, causing the hair that is in its resting phase to shed.  This typically occurs between three and six months post childbirth, and women will attain normal hair growth patterns following this temporary situation.

Follicular Unit Transplantation is the scientific and permanent solution to hair loss, not only for men, but also for women.

Blog by Dr. Phillip Chang:  Board Certified Plastic Surgeon with Offices in Loudoun and Fairfax Virginia

The Following article is excerpted from The Aesthetic Surgery Journal:    http://www.aestheticsurgeryjournal.org/home

Primary Breast Augmentation Today: A Survey of Current Breast Augmentation Practice Patterns

by Edward M. Reece, MD, MS, Ashkan Ghavami, MD, Ronald E. Hoxworth, MD, Sergio A. Alvarez, MD, Daniel A. Hatef, MD, Spencer Brown, PhD, Rod J. Rohrich, MD

A study was undertaken to survey current practice patterns concerning primary breast augmentation. Members of the American Society for Aesthetic Plastic Surgery (ASAPS) were electronically surveyed concerning issues such as incision location, implant size and type, and complications, as well as information about the surgeons, their practices, and where procedures are performed. The survey response rate was 30%. Forty-six percent of respondents had more than 20 years of experience in practice. Forty-three percent of primary breast augmentations were performed in outpatient surgery centers. An anesthesiologist was in attendance in 60% of cases. The average operative time—indicated in 80% of responses—ranged from 45 to 90 minutes. Thirty-three percent of responding plastic surgeons used the base diameter to determine implant size and respondents most commonly used a smooth saline implant placed through an inframammary incision in a submuscular pocket. The most frequently reported complication was nipple sensation changes. Although the reintroduction of silicone gel implants was accompanied by expectations of a sharp increase in their use, this survey revealed that among ASAPS members, saline implants currently are used more often than silicone gel implants. However, both saline and silicone gel implants are used frequently, safely, and reliably. This survey represents a snapshot of current practice and future trends in primary breast augmentation will require additional assessment, although increased use of silicone gel breast prostheses over time is expected. (Aesthetic Surg J 2009;29:116–121.)In 1992, restrictions on the use of silicone gel breast implants limited plastic surgeons in the United States with respect to their choice of implants for primary breast augmentation. Fourteen years later, they regained the ability to decide how best to treat their patients when the US Food and Drug Administration (FDA) approved silicone gel implants for general clinical use in breast augmentation. In the interim, saline breast implants were shown to have a low risk of capsular contracture, low rupture rate, and only a small incision is required for implantation. When revision surgery was required, the procedure was relatively minor with a short recovery period and only moderate expense.

In my own practice in Loudoun and Reston Virginia, the the impact from the introduction of Silicone implants has been tremendous.  About half of my patients are now choosing Silicone breast implants.  Despite the previous problems with Silicone implants, most patients feel that the new generations of implants appear safer.  Moreover, they are attracted to the softer feel and the decreased ripple effect that silicone implants provide.  My personal survey of my patients shows that:

1. Despite the economy, the number of patients choosing to have breast implants is increasing.
2. About half of my patients are choosing to get silicone implants vs saline implants
3. About half of my patients who got  a saline breast implant before silicone was available are choosing to change their saline implants in for a silicone implant
4. My patients with silicone implants feel they are softer and have less rippling. 
5. About 70 percent of my patients choose to have the incision under the breast:  Reasons cited include the lowest complication rate and the visibility of the underarm and nipple incisions.
6. Nearly 100% of my patients have the muscle placed under the muscle
7. Nearly 100% of my patients have get a smooth round implant
8. I perform my breast augmentation procedures exclusively at an outpatient surgery center  owned by INOVA Hospital  in Loudoun to ensure your safety  ( I don’t believe in the safety of office anesthesia )
9. I perform my breast augmenation procedures in a center run and operated by anesthesiologists ( not nurse anesthetists ) to ensure your safety

Silicone Gel Implants:

Silicone gel breast prostheses have generated excitement in the plastic surgery community since their reintroduction, and new interest and questions concerning these implants can be expected from patients. The latest generations of silicone gel implants are stated to have improved durability and to herald a “new age” of silicone gel breast augmentation. Although the premarket approval data for silicone gel prosthetics are several years old, they are high-quality, objective, and solid data that testify to the safety and efficacy of these implants. The major drawback to these data is the limited follow-up period, which leaves unanswered the question of what impact the use of silicone gel implants may have on practice patterns. Comparisons of data concerning silicone gel and saline implants are difficult because of the paucity of follow-up for the newly introduced silicone gel implants.

A recent American Society of Plastic Surgeons (ASPS) survey revealed that most responding members believed that many primary augmentation patients would return to exchange saline for silicone gel implants.   In addition, members anticipated that more than 60% of future primary augmentation candidates would request silicone gel implants.  The current survey was conducted among a somewhat smaller population of plastic surgeons: those belonging to the The American Society for Aesthetic Plastic Surgery (ASAPS), who tend to perform a relatively large volume of cosmetic breast surgery. A primary purpose of the survey was to identify the impact of the reintroduction of silicone gel breast prostheses on ASAPS members’ practice patterns for primary breast augmentation. The study further represents other general trends in the practices of respondents to suggest current practice patterns in primary breast augmentation.

Methods

A survey containing 27 questions was created to assess current practices in primary breast augmentation (see Appendix). Questions were chosen that might elucidate the gestalt of practice pattern choices relevant to primary breast augmentation. The survey queried not only information such as incision location, implant size and type, and complications, but also details about the surgeons, their practices, and where procedures are performed. During a 3-month period beginning in June 2007, the survey was sent to 1746 ASAPS members. ASAPS members were chosen for the study population in an attempt to gather data from surgeons who most likely perform the highest volume of primary breast augmentation procedures. In addition to the questionnaire, a cover e-mail was sent asking for the participation of the ASAPS member in gathering information about current trends in breast augmentation. A total of 3 e-mails were sent to the entire group of potential respondents, with a total response of 508 digital surveys (30%). This response rate is comparable to that of a similar survey in the plastic surgery literature.  Forty-six percent of the plastic surgeons polled had more than 20 years of experience, with less than 14% having less than 10 years of practice (Figure 2).

When questioned about the number of primary breast augmentations performed per year, 51% of plastic surgeons surveyed stated that they perform more than 50 per year. Thirty-seven percent documented between 20 and 50 primary breast augmentations per year. Each surgeon was asked to rank the top three procedures performed in their practices. About 52% of respondents ranked breast augmentation as the most frequently performed procedure in their practices. Body contouring was ranked second by the largest number of respondents (about 25%). Lipoplasty and facial cosmetic procedures were reported equally as the third most common procedures.

Findings:

1. Forty-three percent of primary breast augmentation procedures took place in outpatient surgery centers. This was followed by offices with integrated operating rooms in another 33% of responses. Only 18% of breast augmentation procedures were performed in a hospital setting. 
2. Plastic surgeons performed primary breast augmentation with the help of fully-trained anesthesiologists in 60% of cases. Alternatively, certified registered nurse anesthetists were used in 33% of primary breast augmentation procedures. 
3. Operative time is a consideration in primary breast augmentation and has been scrutinized.  The average operative time in 80% of responses ranged between 45 and 90 minutes. Thirty-two percent of practicing surgeons reported operative times less than 60 minutes. Six percent of surgeons reported an operative time of less than 30 minutes.
4. Postoperative management, specifically patients’ return to regular activity, has also been carefully examined.  Four percent of plastic surgeons reported a same-day return to regular activity. Forty percent indicated resumption of regular activities within several days. Twenty-four percent reported resumption of normal activities within 1 week and 25% reported 1 month. Only 7% of plastic surgeons queried used pain pumps for their patients.

Implant Size

1. Sizing implants can be undertaken in many ways. Thirty-three percent of surgeons used base diameter as part of their preoperative evaluation for sizing. Within this group, 16% used base diameter as the main determinant of implant sizing.
2. The average size of breast implants reported by 81% of plastic surgeons was between 300 and 400 cc. Eleven percent of those queried stated an average size of 200 to 300 cc and 6% reported an average size between 400 and 500 cc.

Implant Type

1. Despite the reintroduction of silicone gel breast implants 60% of plastic surgeons reported using saline implants, and
2.  65% of those surgeons reported using saline implants in three-quarters of their primary breast augmentation cases.
3. Twenty-three percent of the total survey population reported using saline implants 100% of the time.
4. Eighty percent of respondents reported that their use of silicone gel implants is greater now than before the FDA’s approval of the devices for primary breast augmentation;
5. 18% reported no change in their use of silicone gel implants.
6. Overall, 55% of surgeons used silicone gel implants 50% to 100% more than before, supporting ASPS statistics.
7. Fifteen percent of plastic surgeons have converted to using silicone gel implants 100% of the time.
8. Most plastic surgeons (92%) used smooth implants most often. Eighty-two percent of these plastic surgeons said that they use smooth implants in every breast augmentation.
9. Seven percent of surgeons reported using textured implants in most cases. Of the few respondents using textured implants, 69% used round versus 31% using anatomically-shaped implants.
10. The reasons for the current trends were examined in other questions. Thirty-six percent of surgeons cited that “patient preference” was part of the reason for choosing a particular type of implant. Thirty percent of surgeons reported improved results with their chosen implant. Eight percent of surgeons made the choice of implant based on ease of use. Six percent said they choose implants based on decreased capsular contracture rates.
11. Frequent reasons given for choosing silicone gel versus saline implants were surgeon preference (16%), less wrinkling, overall better cosmetic result, and a more natural feel.
12. When asked whether shaped implants were preferred, 2.4% of surgeons responded that they used anatomically-shaped implants for primary breast augmentation.
13. Ninety-six percent of respondents preferred round implants, mostly because of improved results. Another reason for round implant use was ease of placement, cited by 22% of surgeons. Eleven percent noted other reasons for use of round implants, including less shifting, availability of implants, and the lack of any real difference between round and anatomically-shaped implants.

Incision Placement

1. Incision placement in primary breast augmentation was surveyed to determine the most popular approach. The majority of surgeons (64%) preferred an inframammary approach, while 25% preferred a periaerolar approach. The transaxillary incision was used by 8.7% of surgeons, while only 0.4% of surgeons used the transumbilical approach.
2. When questioned about how often they used their preferred approach, 38% reported using their indicated approach 100% of the time regardless of patient preference or anatomy. Fifty percent of plastic surgeons indicated using their preferred incision type 75% of the time and 10% of respondents indicated using the same approach 50% of the time.
3. The main determinant of incision selection was surgeon preference for best cosmetic result, cited by 56% of surgeons surveyed. Thirty-two percent reported that patient preference dictated incision approach. Another 8% stated that ptosis determined incision placement, followed by skin quality and skin color.

Implant Placement

1. When determining the most common position for implant placement, the overwhelming response was submuscular, reported by 62% of surgeons. This response was followed by 25% of surgeons who preferred dual-plane positioning. Only 11.5% of respondents reported implant placement in the subglandular position.
2. The most common reason for the above preferences regarding implant position was cosmetic result.  Forty-four percent of surgeons believe that their preferred position for implant placement produces the best cosmetic appearance.
3. Other reasons for selection of implant location included decreased capsular contracture rate (27%), patient preference (8.5%), and intraoperative decision (2.75%). Sixteen percent of respondents reported other reasons for implant position such as the use of silicone gel versus saline implants, anatomy of the patient, and mammography considerations.

Complications

1. The most common early complication reported was nipple sensation changes (50% of surgeons surveyed). The second most common complication, cited by 28% of surgeons, was hematoma. These complications were followed by seroma, wound infection, and thrombophlebitis.
2. More than 50% of surgeons reported capsular contracture as the most common delayed complication of primary breast augmentation. This was followed by implant rupture/deflation and bottoming out.

Discussion

Several points are worth repeating. ASAPS members are still using saline implants more frequently than silicone gel implants. Saline is used 60% of the time; the implants are usually smooth and round. This choice reflects the surgeons’ positive experience and data collected over the past 15 years concerning saline implants.2, 3

The greatest percentage of responding ASAPS members was from the South and Southwest, followed by the Northeast. The largest percentage of respondents had more than 20 years’ experience and the majority performed more than 50 breast augmentations per year. ASAPS member surgeons typically require an hour to perform primary breast augmentation and most commonly choose saline implants placed through an inframammary incision into a submuscular pocket. Submuscular placement is preferred by surgeons, who believe it provides the optimal cosmetic result. Patient preference was the most common factor driving the choice of silicone gel implants. The most common implant size selected by respondents was 300 to 400 cc; this size was reportedly used in 80% of cases. Base diameter and preoperative implants placed in the patient’s bra are the most commonly used tools for size selection. Finally, the most common procedure performed by ASAPS members is breast augmentation, followed by excisional body contouring, liposuction, and facial cosmetic surgery.

Conclusions

FDA regulations regarding silicone gel breast implants have had a significant impact on the current trends in primary breast augmentation. In order to ensure patient satisfaction, plastic surgeons must be familiar with current data and have command of the skills necessary to effectively use those techniques and devices that have been shown to be most effective. Although this study represents data from only a limited cross-section of plastic surgeons across a small interval of time, it supports the assertion that surgeons find both saline and silicone gel breast implants to be safe and effective for their patients. The practicing plastic surgeon can assure patients that satisfaction is high with both types of implants.  My personal statistics for my patients in Loudoun and Fairfax Virginia are very much in line with the ASAPS data.

ASAPS members have successfully embraced new technology in primary breast augmentation. Future trends are expected to reflect an increase in the use of silicone gel breast prostheses and further data collection will be necessary in order to definitively track these trends.

Blog by Dr. Phillip Chang MD:  Plastic and Reconstructive Surgeon at Aesthetica with Offices in Loudoun and Fairfax Virginia

The snow is falling outside.  Over the last week there has been over 40 inches and in the last month there has been over 50 inches.  Every spring and summer, I have the unfortunate job of treating dozens of patients who are injured in lawn mower accident.  Every winter, I have the unfortunate job of treating dozens of patients who are inured in snow blower accidents.  The U.S. Consumer Product Safety Commission reports up to 200,000 people – 16,000 of them children – are injured in snow blower and lawn mower-related accidents each year.   As a plastic and reconstructive surgeon, I am often called upon to reconstruct and make presentable and functional, mangle fingers and limbs.   As many of my patients know, we are in the midst of potentially the highest snowfall in Washington history.  The record is 54 inches and we have so-far had 52 inches… and it is still snowing outside.  This week alone, I have had to treat 5 patients with mangled fingers from putting their hand in the snow blower.  For the most part, these are smart men and women, some are even professional landscapers.  They simply aren’t thinking when they stick their hands into a snowblower or lawnmore to unclog the snow or grass.  Most people don’t realize that a snowblower may seem to be off because it is clogged; they then reach their hands in the machine and its spring loaded blades spring back when it is unclogged.  And the fact that many of my patients turn out to be children makes this an issue I am expecially concerned about.  

 Understandably, most injuries such as severed fingers and toes, amputations, broken bones, burns and eye injries are caused by caredless use and can be prevented by following a few simple safety.

The American Society for Reconstructive Microsurgery (ASRM), American Society of Plastic Surgeons (ASPS), American Society of Maxillofacial Surgeons (ASMS), American Academy of Pediatrics (AAP), and American Academy of Orthopaedic Surgeons (AAOS) have teamed up to prevent injuries and educate adults, parents, and children about the importance of lawn mower safety during National Safety Month, June 2009.  They should have a similar conference on snow blower accidents.  Their conclusions were as follows.

1. Children should be at least 12-years-old before they operate any lawn mower, and at least 16 years old for a ride-on mower.
2. Children should never be passengers on ride-on mowers.
3. Always wear sturdy shoes while mowing – not sandals.
4. Young children should be at a safe distance from the area you are mowing.
5. Pick up stones, toys and debris from the lawn to prevent injuries from flying objects.
6. Always wear eye and hearing protection.
7. Use a mower with a control that stops it from moving forward if the handle is released.
8. Never pull backward or mow in reverse unless absolutely necessary – carefully look for others behind you when you do.
9. Start and refuel mowers outdoors – not in a garage. Refuel with the motor turned off and cool.
10. Blade settings should be set by an adult only.
11. Wait for blades to stop completely before removing the grass catcher, unclogging the discharge chute, or crossing gravel roads. (As a safety feature, some newer models have a blade/brake clutch that stops the blade each time the operator releases the handle.)

 Have to go now.  The children are building an igloo.  I’m hoping that they are also shoveling the driveway.  We don’t own a snowblower although during this winter season, I almost wish I owned one.

About ASPS
The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. Representing more than 7,000 physician members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.

About ASRM
The American Society for Reconstructive Microsurgery is an organization of more than 600 surgeons that perform microsurgery and other complex reconstructive surgeries. The ASRM is dedicated to promoting, encouraging and advancing the art and science of microsurgery and other complex reconstructions through education and research. For more information, please visit www.microsurg.org.

About ASMS
The American Society of Maxillofacial Surgeons is the oldest organization representing maxillofacial plastic surgeons. The Society accomplishes its mission to advance the science and practice of surgery of the facial region and the craniofacial skeleton through excellence in education and research, and advocacy on behalf of patients and practitioners. www.maxface.org

About AAP
The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well being of infants, children, adolescents and young adults. (www.aap.org)

About AAOS
With more than 35,000 members, the American Academy of Orthopaedic Surgeons (www.aaos.org) or (www.orthoinfo.org) is the premier not-for-profit organization that provides education programs for orthopaedic surgeons and allied health professionals, champions the interests of patients and advances the highest quality musculoskeletal health. An orthopaedic surgeon is a physician who treats the musculoskeletal system, including bones, joints, ligaments, tendons, muscles and nerves.

Contact ASPS
Media Relations | 847-228-9900 | media@plasticsurgery.org

How To Find a Plastic Surgeon: 

1.  Make sure he is a Board Certified Plastic Surgeon ( not just a Board Certified… doctor; or not just a Cosmetic Surgeon )

2.  Make sure that he has surgical privileges at area hospitals ( hospitals do your homework in terms of credentialling for you )

3.  Never have breast or body surgery by an Oral Surgeon, Dermatologist, Gynecologist, or ENT Otolaryngologist.

4.  Review before and after pictures particularly since we tend to post are average to better results.

How Does the American Board of Medical Specialties ( ABMS ) help you

The American Board of Medical Specialties is a professional not for profit organization which is recognized as the gold standard in ensuring the qualifications and certification of physicians.  It oversees 24 approved medical specialty boards in the development and use of standards in the ongoing evaluation and certification of physicians.  It believes that higer standards for physicians means better care for patients.  Importantly, hospitals approve physicians to work at their facilities based on whether the physician is certified by one of the specialties represented by the ABMS.  This means that in order for a physican to work at a given hospital, that physician is required to have completed a residency in a given field represented by the ABMS and that physician must have passed an “Board” exam which proves the physicians aptitude in that field.  How is this relavent to cosmetic surgery patients?  It is relavent because patients should know that hospitals is done some of the homework for them.  If the prospective doctor does not have privileges at an area hospital for the procedure he wants to do for you, this generally means that a hospital would let him do it because they were not qualified to do so.  This includes Dermatologists doing liposuctions and facelifts, Oral Surgeon Dentists and Otolaryngologists doing breast augmentations and tummy tucks.  Believe me when I say that this happens.  There are some doing this in Leesburg and Lansdowne.

*** Note that the Amercian Board of Cosmetic Surgery is NOT recognized the The ABMS.  And hospitals will in general not grant privileges based on this pseudo-credential.  It is a Board used by the unqualified for purposes of advertising.

Blog by Dr. Phillip Chang MD:  Plastic and Reconstructive Surgeon at Aesthetica with Offices in Loudoun and Fairfax Virginia

As a Plastic and Reconstructive Surgeon, my patients need informed choices no matter what procedures they might be interestedin.  In an informal survey of my patients  in Loudoun Virginia who have had breast reconstruction procedures from other surgeons, I have found that most patients were not informed of all the methods of breast reconstructions available.  Most patients were only given the options of breast reconstruction with breast implants or a breast reconstruction with their own tissue through a pedicled flap.  More sophisticated techniques such as reconstruction through a microvascular flapwere not offered.   Many patients are not offered the option of a microvascular DIEP or TRAM Flap reconstruction because it takes the most sophisticated techniques and the most technical experience.  And it is this last technique, that most insurance companies are decreasing their financial compensations for.

“Women need to understand all of their options to make an informed decision,” said ASPS President John Canady, MD. “Those who are diagnosed should be immediately referred to a full team of physicians that can provide breast care, and plastic surgeons need to be included as part of that treatment team.”  This team should include their primary care physician, an oncologist, general surgeon, pathologist, radiologist, as well as a plastic surgeon.

The ASPS is launching an ongoing effort to bring public awareness to breast reconstruction issues, including education, access, and a team approach. Because early involvement by plastic surgeons and other physicians can allow development of an optimum treatment plan for each individual patient, collaboration amongst specialties is essential.  This team approach allows for the patient to not only have the best chance at a cure from their breast cancer but the optimum opportunity to have an excellent cosmetic result.  It is also important that patients actively participate in their treatment. Though a common misconception, eligible patients should not assume that anyone other than a board-certified plastic surgeon affiliated with an accredited facility is qualified to perform breast reconstruction. While technology has made breast cancer diagnosis, treatment, and reconstruction better than ever, it does not negate the need for medical expertise within each specific area of care.

Blog by Dr. Phillip Chang, M.D. :  Offices in Leesburg in Loudoun, Reston in Fairfax, and Winchester.

Adapted from a Story by the American Society of Plastic Surgeons.

About ASPS
The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. Representing more than 7,000 physician members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada