Dr. Bosshardt's Blog

Your Hands & Plastic Surgery

It may surprise many people that many plastic surgeons perform a lot of hand surgery. Both orthopedic and plastic surgeons receive extensive training in hand surgery during their residency programs, and hand surgery is an integral part of plastic surgery. Some surgeons go on to do additional training to specialize in hand surgery.

hand surgeon floridaYou may be referred to plastic surgery for a broad range of hand problems. We do lots of trauma care involving hand injuries. These include such things as tendon repair, repair of hand fractures, and repair of complex soft tissue injuries of the hands and fingers. In the area of elective surgery, you may be sent to a plastic surgeon for removal of tumors or skin cancers of the hands; for problems related to Dupuytren's contracture, an unusual condition in which fibrous bands in the palms gradually cause the fingers to bend and remain bent; for carpal tunnel surgery to relieve pressure on nerves in the wrist than can affect hand function and sensation, for trigger fingers; and for ganglions of the fingers and wrist.

Some plastic surgeons that specialize in hand surgery can offer highly technical and complex care such as microsurgery, joint replacement, major hand reconstruction, tendon transfers, nerve and blood vessel repairs, and more.


Does liposuction help with weight loss?

liposuction weight lossThe short answer is no. The more comprehensive answer is, it depends. It depends on what type of liposuction you are discussing. There are two general categories of liposuction: large volume and small volume. 

Large volume liposuction is performed in patients who are overweight or obese and seeking removal of a large amount of fat. Most plastic surgeons agree that this would be 5 liters of fat or more at one time, about one and a quarter gallons for the non-metric types. Large volume liposuction is not a cosmetic procedure although it may produce cosmetic benefits. It is major surgery and should be done in a hospital setting with overnight monitoring because of the potential for major effects on such things as blood pressure and heart, kidney, and lung function. Deaths from liposuction have been primarily in patients undergoing large volume liposuction. In some patients who are obese and have diabetes, large volume liposuction has been shown to provide some improve in blood sugar control. 

Most liposuction done today removes much less than 5 liters and is done for body contouring. In many cases, the benefit may be seen more in how your clothes fit and how you look, than what you scales show. If you are stable in your weight and have specific areas of concern, then liposuction can help you work towards your goal. 


How long is recovery time after cosmetic surgery?

plastic surgery lake countyMany patients ask what typical recovery times are after our most popular plastic surgery procedures. This depends on many things of which the type of surgery is only one. First, what is meant by “recovery time”? Is this when you will look presentable, when you will be able to resume normal day to day activity, or when you can resume all activities, with no restrictions? Is it when you can return to work? This can be very different for a secretary who works at a desk versus, say, someone who does heavy manual labor. Each of this may have a different time frame, from days to weeks. Is it when you will feel back to totally normal in every way? This could be months. Scars can take six months to over a year to fully mature. It is important always to remember that each individual will recover in their own, unique way and so we have to allow some leeway for this in our estimations.

Facial surgery is more difficult to hide than surgery in areas covered by clothes, and this must be taken into account as well.

Most patients can return to full, unrestricted activity after any surgery within 4-6 weeks. Most can look presentable, even after facial surgery (makeup can hide a myriad of things like bruising and redness) within 7-10 days. With the above factors in mind, the following is a list of average recovery times -- when you will look OK and be able to function in normal day to day activities after our most common and popular procedures:


What are the latest information on breast implants and lymphoma?

After the blockbuster success of the movie, Jaws, in driving moviegoers out of the ocean in droves, the tagline for Jaws 2, simply said, “Just when you thought it was safe to go back into the water…..”. This could serve equally well for any number of situations in medicine. One of these is the issue of breast implant safety.

Recent media stories about the possible connection between breast implants and a rare lymphoma of the breast have made it important that women be updated on this issue.

After a decade of some of the most intense media scrutiny, claims and counter claims, and arguably the most concentrated research in the history of any medical device extending over a decade, from 1990 into the new millennium, it seemed that the question of whether or not implants could make women sick or cause cancer had been put to rest. Like a phoenix rising from the ashes, however, the issue won’t stay dead. Concerns have been raised by women’s groups and some medical professionals about possible systemic illnesses, immune disorders, and a slew of ill-defined symptom complexes blamed on implants. Scientifically proven, reproducible proof of causality has been hard to come by. Then it was discovered that there did, indeed, appear to be a true association of breast implants with a rare form of lymphoma, anaplastic large cell lymphoma, in the breast. The association is such that this has now been officially labeled breast implant associated anaplastic large cell lymphoma (BIA-ALCL) to distinguish it from ALCL not associated with implants.


Endoscopic breast surgery - cutting through the hype

One of the most frequently asked questions about cosmetic surgery concerns scarring. The ideal is to have a successful cosmetic procedure and have no scars at all. Unfortunately, we are surgeons, not magicians, and scars are a fact of life. Many techniques have been tried to reduce or eliminate scars. Some have come and gone. Others have stayed. One of these is endoscopic surgery. It has been applied to many procedures, including breast augmentation. On the surface endoscopic breast augmentation through the armpit sounds like a winner. You get breast implants, no scar on your bresats, and only a tiny scar in the armpit. What's not to like? Well, there is more to it than that. There always is.  


Endoscopy, surgery via small incisions using a lighted device called an endoscope, is the proverbial hammer in search of a nail. As with lasers, it has been over-hyped and some practitioners have tried to promote it for procedures where it provides no real advantage and actually creates problems. While it has revolutionized many areas of surgery, it has had limited application for plastic surgery. Much of what plastic surgeons do involves the need for larger incisions and this effectively negates one of the biggest advantages of endoscopic surgery. 


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Tavares, FL
West of Waterman Hospital, just off US 441

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Wednesday, July 5, 2017

Your Hands & Plastic Surgery


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