Category Archives: Cosmetic Surgery

Relative Contraindications for 410 Natrelle Breast Implants

Dr. Tammy Wu had a discussion over lunch time with our Modesto plastic surgery staff about the Natrelle Style 410 Breast Implants sometimes known as the Gummy Bear Breast Implant.  The topic of discussion was when is the Natrelle 410 Breast Implant an appropriate medical device for breast augmentation?  The discussion first turned to when it is not an appropriate choice.

The Natrelle 410 Shaped Gel Breast Implant may NOT be appropriate for

  • Patients who desire an overly exaggerated upper pole for their breast augmentation
  • Patients who have very loose skin envelope
  • Wants to be very large breasted
  • has pectus excavatum
  • has pectus carinatum (these are deformities of the sternum)
  • Has significant ptosis (gravity effects), where a mastopexy / Breast Lift is indicated
  • Has severe asymmetries
  • May not be appropriate for a revision patient due to the possibility that the previous pocket size may be too big.

So you want to switch from your previous implants to the new Natrelle 410 shaped implants

As with the above relative contraindication, this may not be the easiest thing to do due to the possibility that the previous breast implant pocket size may be too big and thus the Natrelle 410 shaped breast implants may rotate.  For more information, consider seeing Dr. Tammy Wu for a Breast Augmentation Consultation.

Additional Notes regarding the Natrelle Style 410 Breast Implants

From listening to Dr. Tammy Wu’s discussion today:

The 410 Natrelle implants, which are textured, shaped, highly cohesive silicone gel implants, made by Allergan, were recently approved by the FDA for use in breast augmentation as well as in breast reconstruction.

Many people may wonder, wow, is this finally the right one for me? I want the latest and greatest and the best (and happens also to be the most expensive – costs about twice as much as the regular cohesive gel round silicone gel implants)!  The 410 Natrelle Breast implant isn’t for everyone – in fact it isn’t for many of the cosmetic breast patients.  It is more popular it seems in the reconstructive breast cancer surgery patients.

After reviewing some literature on the 410 Natrelle implants, it appears that the implants were designed and manufactured with some specific indications in mind.

The 410 Natrelle implant is textured to prevent rotation.

The round silicone gel implants, which were approved in November of 2006, have been very popular since its approval for usage in breast augmentation.

Above bullet list helps to decide who is possibly NOT appropriate for the Natrelle 410 shaped Gel Breast Implant.

How does this Educational on Breast Implants (Natrelle 410) Help me?

  • It helps me work better in our Surgical Artistry Modesto Plastic Surgery Office.  The more I know, the more I understand what goes on around me.  I also get questions during some of my Botox, Fillers, Veins, or Acupuncture sessions.
  • To be clear, I (Dr. Calvin Lee) do not do breast augmentation surgeries – they are done by Board Certified Plastic Surgeon, Dr. Tammy Wu.

2013 samm mile marker - 22 full - surgical artistry2 - Cropped2

 

2012 Plastic Surgery Statistics Report by ASPS: Top procedures & Top age groups

Growth and statistics of Plastic Surgery and it’s relation to our practice in Modesto, CA

ASPS (American Society of Plastic Surgeons) Released its 2012 Plastic Surgery Statistics Report.

Here are the key highlights of the report as it relates to our Plastic Surgery Practice in Modesto: Surgical Artistry led by Dr. Tammy Wu, MD Board Certified Plastic Surgeon and member of the ASPS.

At the bottom of this post, I compare my own minimally invasive cosmetic procedure (ie. Botox, Veins, Fillers, chemical peels, microdermabrasion) data from Modesto, CA to the national ASPS data.  I am not an ASPS member.  Only Dr. Tammy Wu is an ASPS member.

All statistics here is 2012 vs 2011 data from the ASPS.

Cosmetic Procedures For 2012:

  • Cosmetic Procedures:  Cosmetic Surgeries vs. Minimally Invasive Procedures:
  • Cosmetic Surgeries were down 2%
  • Minimally invasive cosmetic procedures were up 6%
  • But both considered procedures, there’s an overall increase of 5%

Plastic Surgery is growing equally for men and women

  • Cosmetic procedures performed on men and women are up a total of 5%
  • Men make up 9% of all cosmetic procedures

Minimally Invasive Cosmetic Procedures Statistics

Breast Augmentation

  • Continues to be the top cosmetic surgical procedure and has been since 2006.
  • Silicone implants were used 62% of the time (saline used 38%) in all breast augmentation in 2012

2012 Top 5 cosmetic Surgical Procedures

  • Breast augmentation down 7%
  • Nose reshaping no change
  • Eyelid surgery up 4%
  • Liposuction up 1%
  • Facelift up 6%

2012 Top 5 cosmetic Minimally Invasive Procedures

  • Botox (Botulinum toxin type A) up 8% (6.1 million injections)
  • Soft tissue fillers up 5%
  • Chemical Peel up 2%
  • Laser Hair removal up 4%
  • Microdermabrasion up 8%

Other Minimally Invasive Cosmetic Procedures

  • Laser vein therapy is down -2%
  • Sclerotherapy is up 1%
  • Fat injections is down 8%
  • Cellulite treatment is down 13%

Age Demographics: 40-54 years old

  • 40-54 year olds is the group that makes the majority of all cosmetic procedures
  • 48% of the total

 

My own thoughts

FaceBook targeted demographic ads for plastic surgeons

  • It aids in marketing efforts.  Perhaps we could concentrate more around the age of 40-54 years olds in the marketing.  In FaceBook for example, ages could be targeted.  Thus selecting 40-54 as an age selection in FaceBook might be beneficial for plastic surgeons.

How does our Minimally Invasive Cosmetic Practice compare?

Chart of Dr. Lee's practice

Growth of my minimally invasive Cosmetic practice in Modesto, CA from 2009-2012

  • Bar 1 represents 2009, Bar 2 is 2010, Bar 3 is 2011, and Bar 4 is 2012 (last year) for my minimally invasive cosmetic surgery practice.
  • Our Minimally invasive practice increased 29% last year compared to the national increase 6%.  We have not yet compiled our data for surgeries.  Dr. Wu has access to that data.  I have access to my data and this is my blog.
  • The growth between bars (1-4) respectively: 42%, 23%, 29%
  • I just did our own analysis of Surgical Artistry Cosmetic popularity based on zip codes

 

Sunscreen UVA vs UVB Protection Chart

Obagi Sunshield 50. 10.5% zinc oxideSummer time – that also means SunScreen time!  I consider sunscreens even more important than Botox for anti-aging.  And of course there’s no reason why Sunscreen and Botox can’t be used at the same time.

Sunscreen vs. Sunblock: Sunscreen is the modern term.

The term Sunblock seems to be going out.  It’s considered to be somewhat misleading because the term “block” implies total protection.  Sunscreen is used in place of sunblock these days.  A while ago, sunscreen was used to talk about chemical sunscreens and Sunblock was used to describe the ingredients titanium and zinc.

UVA vs UVB

Both are ultraviolet light spectrums – which are really part of a singular continuum.  But for the sake of categorization, UVA is longer wavelengths than UVB.  UVA has more penetration ability.  Both aren’t entire good for your skin in regards to aging and cancers.  So you want to shield from both.  SPF unfortunately only reflects UVB blocking ability.

Mineral vs. Chemical

I like the idea of mineral sunscreens where it doesn’t form a chemical compound with your skin and that it works more like a mirror.  But if you really dislike ultraviolet light damaging your skin, consider both.  My favorite is Zinc Oxide.

Here’s the Chart for Sunscreen active ingredient and it’s action against UVA and UVB.

zinc chart and other sunscreen ingredients against uv-a and uv-b

 

I found this wonderful chart on the internet.  I’m not sure of the source and I’ve seen it repeated in several different places.  I had to write this blog just so that I could have a copy of this picture somewhere so that I could refer to it when talking about Sunscreen.  As you can see from the chart, it is easy to have Zinc Oxide as your favorite because of its broad spectrum.

What about Vitamin D from the sun?

The Academy of Dermatology current position updated in 2011 recommendation on Vitamin D:

There is no scientifically validated, safe threshold level of UV exposure from the sun
or indoor tanning devices that allows for maximal vitamin D synthesis without
increasing skin cancer risk.

They basically recommend oral supplementation of vitamin D.

After Microdermabrasion and other skin procedures

After a Microdermabrasion or a chemical peel, we recommend that patients protect their skin with a zinc oxide sunscreens.  We also reinforce that with sunscreens, thicker is better – in other words – the strength of a sunscreen is dose dependent.

More Sunscreen Resources:

Thank you for reading my little review of my knowledge of Sunscreens.

dr-wu-and-dr-lee

BREAST & ABDOMEN
Augmentation Options
Augmentation FAQ
Augmentation Consultation
Cost of Augmentation
Gummy Bear Implants
Running and Implants
Breast Reduction FAQTummy Tuck FAQ
SURGICAL ARTISTRY
Services | Prices | SiteMap		 TAMMY WU, MD
About Dr. Wu
What’s Special?
REVIEWS
Review Screenshots
Thank You Notes
FUN
Gluten Free Vegan Recipes
Modesto is Great
What is Plastic Surgery
“Cosmetic” vs “Plastic”		 CALVIN LEE, MD
About Dr. Lee
Botox | Acupuncture | Veins
Anatomy for Botox
Intro to Acupuncture
Medical Education BlogMicrodermabrasion
Chemical Peel – medium
Obagi Blue Peel – deep
Compression Socks
Sunscreen
$LOW Latisse | Latisse FAQ

Senate Resolution Award for Surgical Artistry from Senator Tom Berryhill

a three of us IMG_4506 - Copy

Senator Tom Berryhill made a surprise visit in person to our office in April 2013 and we took this picture holding up the Senate Resolution signed by him, commending Surgical Artistry! Because we were totally surprised by the award, I was given this very nice explanation of the award: “This award was given because of what you and Dr. Wu have done for the people of Modesto! These awards are not given lightly. There is a process that must be gone through and certain criteria that must be met before an award of this type is even considered. You both earned this through all of the selfless, tireless hard work you do every day of the year. The Senator Tom Berryhill’s Sacramento staff did their research and felt you deserved this Senate Resolution.”

Bob Phelan gave me the award

while I was pigging out at the pasta carbo loading feast the night before the Surgical Artistry Modesto Marathon.  Bob is the District Director at the California State Senate and a great friend of ours.  We sat at the same table during the carbo loading dinner but he seemed a little too well dress and had a name tag on.  Well, I figured he was there to make a political appearance and I figured he had to work that night.  When he was called up to make a speech, I started chowing down at full speed.  I might not run fast, but I can eat fast. Then before you knew it he called my name to come up to receive an award.  Boy was I in for a surprise!   Thank you Bob for working that night.  What he didn’t know was that I was stifling some hiccups while up there on the stage while getting these picture taken:

882852_10151548539587419_2080322429_o

883330_10151548539597419_280328997_o - Copy

Bob and his wife Alta also participated in the Surgical Artistry Modesto Marathon.  It was certainly a pleasant surprise.  Alta recounts the funny look on my face when I had to suddenly stop eating to go up on stage.  She thought it was worthwhile, but there was no picture of that – thank goodness.

Dr. Wu couldn’t be there because she had to rush off to a meeting in Sacramento, and then she was coming home later that night to get ready for the event the next day (The Surgical Artistry Modesto Marathon).  But while she was driving home from Sacramento, I updated her on the exciting news of the award, and she was very impressed with the wording on the framed Senate Resolution Award.

A few days later: Dr. Wu and Senator Tom Berryhill

got a chance to meet and the above (on top of the blog) photo was taken.  And several of these other photos were taken.  It was very considerate and we were very honored to have Senator Tom Berryhill visit our office (yet another great surprise!) along with Bob Phelan too.

IMG_4517 - Copy

This is a picture of Bob Phelan, District Director, who came with Senator Tom Berryhill to our office. And the mailman got into the picture too!

a pic with tammy and tom IMG_4522 - Copy - Copy

Dr. Tammy Wu with Senator Tom Berryhill

a pic with calvin and tom IMG_4518 - Copy - Copy

This is just the beginning

We are proud founders of the Gallo Center for the Arts, founding title sponsors for the Surgical Artistry Modesto Symphony Pops Series / Surgical Artistry Modesto Symphony Fat Cat Classics 2006-2009, and founding title sponsors for the Surgical Artistry Modesto Marathon.

The award hangs up proudly at our office near the entrance and it serves as a reminder to us that this is just the beginning of what we set out to do.  We want to do great things for our community here in Modesto, California.  Thank you for the recognition and we hope to continue with our efforts which include performing surgery at a very high level.  And of course that includes a continued effort on continuing our life long learning in medicine.

senate resolution

Lemon Water and Vitamin C

Recently my good friend Dana posted an informative blog about drinking some warm lemon infused water every morning.  Included in her blog was other recipes regarding real-fruit flavored water – some of which are found at upscale resorts.

My strange mind decided to think about the benefits of Vitamin C.

First of all, I wondered which citrus fruit had more vitamin C: Orange or Lemon?

As it turns out, an orange has more vitamin C than a Lemon.  And the grapefruit fell in between the two.  Source of info:  Livestrong.com

One of the benefits of Vitamin C is better skin

  • At our Modesto, CA office, Surgical Artistry Plastic Surgery, we carry various vitamin C serums.  Including those from Obagi.  We have a page about Obagi Peels which uses certain acids.  (Vitamin C is an acid too).  Vitamin C serum works well together with those using Botox to prevent wrinkles.
Vitamin C Serum by Obagi - comes in varying strengths

Vitamin C Serum by Obagi – comes in varying strengths

 

Vitamin C denatures with heat

denatured protein

  • There are many sources that say that 70 degrees Celsius is the temperature at which Vitamin C is denatured. 
  • Thus as a modification of what I do with warm lemon water, is I keep the temperature down a bit – I’d like to get the benefits of vitamin C.

Lemon Juice and Teeth

  • Acids have been known to erode away enamel of the teeth
  • perhaps drinking through a straw might help – but this leads to some lines around the mouth which I can Botox – the name of this muscle is the obicularis oris face muscle.
  • My own adaptation:  I just swish a bit with regular water after drinking lemon water – that goes for lemon aid, orange juice, and grapefruit juice.

Please visit my friend Dana’s Blog

Visit our Plastic Surgery Home Page