Dr. Bosshardt's Blog

Doing implant surgery does not mean never having to say you are sorry

Some women claim their implants harmed them. The term 'breast implant illness' has been coined to describe a small group of women who feel that their implants made them sick. The number, and this is only a rough estimate, is small, perhaps 1-2% of women with implants, but with over 5 million women with implants in the U.S. alone, it is still a large number. Estimates are around 35,000 but that could be way off, either way. The problem is that anyone can react to anything put into their body and such reactions are often unpredictable both in how and when they present. I am very sorry for anyone who feels that her implants harmed her. I am trying very hard to learn more and to figure out how best to deal with this. Explantation (removal of implants) is always an option but it is not one without possible harm either. Women need to be fully informed and that has always been a primary principle in how I practice. For more, go to the link below. 

http://www.hypeorlando.com/house-calls/2018/03/20/mea-culpa-to-those-who-believe-they-have-breast-implant-illness/

 

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Breast implant illness and the strange case of Dr. Susan Kolb

 

Is there such a thing as ‘Breast Implant Illness”, a unique condition found in women with breast implants? With over 5 million women with implants in the U.S.A. alone, this would seem to be an important question to answer. Are there women who have breast implants and experience a dizzing array of medical symptoms? Of course. As of 2010, over five million women in the U.S. have had breast implants inserted. In any group so large, you are going to have women with all sorts of complaints or disorders. The question then becomes, are these caused by their implants, all or in part, or not?  

 

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Radiation for non-melanoma skin cancer- look before you leap

I recently saw an 80 year old man. Ten years ago, he had a squamous cell skin cancer on his scalp. His dermatologist recommended radiation therapy. Eight years later, the treated area broke down spontaneously and for two years he has had an ulcer on top of his head that has resisted all efforts to get it healed. On his examination now, he has a 2. 5 cm (1 inch) round ulcer on top of his head. The base of this ulcer is bare bone. The surrounding scalp is fibrous with no elasticity and clearly poor blood circulation. Getting this ulcer healed will require major surgery, if can be done at all.

 

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The verdict is still out on Cool Sculpting

Ironically, It is the holy grail of plastic surgery. I say ironic because it is not really surgery at all. What is it? It is the removal of unwanted fat and tightening loose skin without having to go through an operation with its attendant costs, risks, postoperative pain, and scars. Surgery, of course, can remove large quantities of fat and tighten skin as nothing else can but has all of the aforementioned issues, making it an unattractive option for many people.

 

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What should I do to prepare for surgery?

plastic surgery Florida Patients often ask me what they can do to prepare themselves for an upcoming surgical procedure. I love this. It means the patient is invested in the surgery and actively working with me to get the best result. 

I believe the single most significant factor under a patients control is to avoid tobacco in all its forms. Smoking is, I feel, the single biggest lifestyle factor that can adversely affect surgery. In addition to being one of the worst habits anyone can engage in- I semi-seriously tell patients they would be better off shooting heroin than smoking- smoking puts patients at greater risk of surgical complications. Nicotine containing products, such as patches or gum should also be stopped. Nicotine is a potent vasoconstrictor; it causes blood vessels to clamp down for up to 24 hours. This reduces blood flow to areas, especially skin, and, combined with surgical manipulation, can reduce blood flow below a critical level where skin and other soft tissues will die. Smoking's ill effects are so serious that I will not perform certain elective operations unless the patient stops for a minimum of four weeks before surgery and does not resume for three to four weeks afterward. These include facelifts, breast lifts and reductions, tummy tucks, and any operation where the skin will be lifted and tightened. The risks just aren't worth it. 

Patients often ask about drinking alcohol before surgery. I have no problem with patients having a glass of wine, beer, or a single mixed drink on the evening before surgery. I don't feel this has any clinically significant effect on bleeding. I don't want patients inebriated the night before surgery or drinking heavily in the weeks leading up to surgery. Excessive alcohol intake creates enough problems of its own without adding this to the lead to surgery. Alcohol, like other sedatives, can affect a patient’s ability to metabolize and respond appropriately to many drugs used for anesthesia. Alcohol in excess damages the liver and this organ is crucial to the metabolism of a large spectrum of drugs as well as producing factors necessary for blood clotting. 

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1879 Nightingale Lane, Suite A-2
Tavares, FL
West of Waterman Hospital, just off US 441

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