New Address For Dr. Gallego’s Plastic Surgery Blog
March 15, 2011
For a variety of reasons, a decision has been made to move this blog to a different site. In the future all blog entries will be found here at Dr. Gallego’s website. We are still working on updating all of the links so that future traffic will end up at the new location. Sorry for any inconvenience. See you soon at www.drgallego.com/blog.
Online Breast Reconstruction Resources from the ASPS
January 23, 2011
Roughly 86,000 breast reconstruction procedures were performed in 2009 according to statistics from the American Society of Plastic Surgeons (ASPS). The individual decision to undergo breast reconstruction can be complex for many patients. A variety of reconstructive options exist including implants alone, tissue expanders followed by implants, and flap procedures which use tissue from the back, abdomen or other anatomic sites. Further complicating the decision process are these options: immediate vs. delayed reconstruction, saline vs. silicone gel filled implants, and whether or not to undergo nipple and areola reconstruction.
Patients tend to benefit greatly from discussing their options with a board certified plastic surgeon prior to mastectomy. Unfortunately, many patients complain that they never knew they were a candidate for breast reconstruction, or they did not know that breast reconstruction is covered by insurance. Just this last year a law was passed in the state of New York requiring that women have their breast reconstruction options explained to them prior to their breast cancer surgery.
The ASPS website has a section of their website with a number of helpful resources for patients interested in learning more about breast reconstruction. There is this video which discusses some of the useful stats. There is this section which allows patients to review before and after photos of patients who have undergone breast reconstruction. Lastly, there is this link to PSnet, an extremely useful site which contains a forum for patients to ask questions of other women who are considering or have already had breast reconstruction.
For more information on breast reconstruction, please contact our office at 888-799-8677.
Radiesse®: An Effective Treatment Option for Wrinkles
January 12, 2011
Sooner or later it happens to each one of us. We look at our face in the mirror, and start to see lines that did not used to be there. Obviously, no one is fan of wrinkles. Luckily, for those who are concerned or even discouraged with facial wrinkles, fine lines, and deep folds, there are good treatment options. Some of the more common treatments are non-invasive, and require minimal downtime.
An example of a patient with fine lines as well as deep facial folds
Currently, one of the more effective and most popular treatments is that of dermal fillers. Dermal fillers are substances injected into or under the skin to correct wrinkles and deep folds, and to add volume. In recent years, the use of dermal fillers has become increasingly more popular. The American Society of Plastic Surgeons estimates that dermal filler treatments were performed roughly 1.7 million times in 2009. That was a 7% increase from 2008 and a 164% increase from 2000. Dermal fillers are less expensive and less invasive than surgery, require minimal down time, and can be quite effective.
As a board certified plastic surgeon, I administer dermal fillers in my office quite frequently. Patients undergo a thorough assessment of their facial lines, wrinkles and folds. Most patients receive local anesthesia prior to the treatment. The total treatment time is roughly 30 minutes. After treatment patients should avoid strenuous exercise, alcohol, and heat exposure for the first 24 hours. Patients are instructed to apply ice during the first day or so to help decrease the swelling. Patients can expect their results to last anywhere from six to 18 months depending on the type of filler used and the location treated. Adverse reactions are typically rare and short lived. They include redness, pain, swelling, firmness, bruising, bumpiness, and itching.
One particular dermal filler used in my practice is Radiesse®. Radiesse® is long lasting, and is composed of synthetically produced smooth microspheres of calcium hydroxylapatite (CaHA), a mineral found in bone. Radiesse® is FDA approved for the treatment of prominent nasolabial folds and marionette lines. In many patients it has been shown to last up to 18 months. 
More information about Radiesse® can be found at www.radiesse.com. To find out if you are a good candidate for treatment with a dermal filler, please contact our office to set up your complimentary cosmetic consultation. Our office number is 888-799-8677.
Here are a few examples of patients who were treated with Radiesse®:
Before treatment with Radiesse
After treatment with 1cc of Radiesse
Before treatment with Radiesse
After treatment with 1cc of Radiesse
An Exceptional Offer From The Makers of Latisse®
January 4, 2011
Latisse® is a relatively new treatment which greatly enhances the appearance of eyelashes. It has been shown to make eyelashes longer, darker, and thicker. I have previously written about Lattisse® here and here.
Before treatment with Latisse
After 3 months of treatment
Currently, there is an exciting offer available where patients can receive a free bottle of Latisse when they purchase a bottle at the normal price. The offer was sent out to all Brilliant Distinctions members, and is also available by clicking at www.latisseoffer.com. Patients simply sign up for the Latisse® Lashperks program, and a buy one get one free coupon will be sent to them.
More information about Latisse® can be found at www.latisse.com. If you are not sure if Latisse® is right for you, call our office today at 888.799.8677 to schedule your complimentary consultation.
Breast Cancer Awareness Month
October 1, 2010
In case you have not heard, October is Breast Cancer Awareness month. 
Breast cancer is the second most common cancer affecting women. Roughly 190,000 women were diagnosed with invasive breast cancer in 2009, and approximately 40,000 succumb to the disease every year. Still there is much to be hopeful about, and currently there are 2.5 million breast cancer survivors alive today in the United States.
There are numerous way for you to show your support to the many women who are currently being treated, or have been treated for breast cancer. The Siouxland Susan G. Komen For The Cure website lists many of these events. There really is something for everybody whether you enjoy eating out, are a big hockey fan, or just enjoy a good afternoon of shopping.
October is also a great time to talk about breast reconstruction options. Roughly 80,000 women undergo breast reconstruction every year. Still, this number is only about 30% of the women who are candidates for reconstruction after a mastectomy.
Deciding to undergo breast reconstruction after a mastectomy is a very individual decision. Some helpful online resources for patients considering breast reconstruction include this section of my practice website, the American Society of Plastic Surgeons site, the American Cancer Society website, BreastCancer.org, and www.breastreconstructionmatters.com.
Of course your best source for professional information on breast reconstruction will be a local board certified plastic surgeon. For more information on my plastic surgery practice check out www.drgallego.com.
The Tri-State Specialists Team Poses Before The Race
The second annual Komen Siouxland Race for the Cure took place Sunday, May 9 in Sioux City, Iowa. The 5k race coursed through the downtown area, beginning and finishing at the Tyson Center. More than 3000 participants took part in this year’s event. The Komen Race For The Cure website describes the goals of the annual race:
The Susan G. Komen Race for the Cure® Series, the largest series of 5K runs/fitness walks in the world, raises significant funds and awareness for the fight against breast cancer, celebrates breast cancer survivorship and honors those who have lost their battle with the disease.
As a board certified plastic surgeon, breast reconstruction after breast cancer treatment is a large part of my practice. This year Tri-State Specialists, LLP-Plastic Surgery decided to sponsor a team for the first time. A total of 21 staff and family members took part in the event.
The team was able to raise nearly $2700 for the cause. As the team captain, I was extremely encouraged by the level of generosity shown by our colleagues, business associates, friends and family. Among the numerous thoughtful donations, was a donation from Pierce Street Same Day Surgery for $1000.
Team Members Showing Off Their Form
Team members really enjoyed being a part of this extremely important event. “I felt participating in the Race For The Cure was very rewarding. The community support along the route was inspiring, and I’d do it again in a heartbeat,” says Tri-State employee Julie Hofmeyer.
Breast cancer is quite common in the United States affecting 1 in 8 women during their lifetimes. The American Cancer Society (ACS) estimates that 192,370 women were diagnosed with invasive breast cancer in the United States in 2009, and there were roughly 40,170 deaths from breast cancer. A number of women choose to undergo mastectomy as part of their breast cancer treatment. Other surgical treatments include lumpectomy or partial mastectomy with sentinel node biopsy, commonly known as breast conservation therapy (BCT).
With Dr. Larry Volz, A Local Breast Cancer Surgeon
Most women who undergo mastectomy are candidates for breast reconstruction. Breast reconstruction can begin at the same time as the mastectomy, or in a delayed fashion, a minimum of six months later. According to statistics from the American Society of Plastic Surgeons (ASPS), a total of 86,424 breast reconstruction procedures were performed in 2009.
Amidst the alarming news of the prevalence of breast cancer, there is hope: over 2.5 million breast cancer survivors live in the United States today.
Posing With My Family
Acne Scarring
May 12, 2010
Acne Scarring of the Cheeks
Acne is a very common problem. It affects up to 80% of teens, and roughly 5% of adults. Although most people who experience acne do not experience severe scarring, some patients can find their scarring to be quite disturbing. One study, by Layton and associates, showed that as many as 95% of some patients may be affected to some extent by acne scarring.
The best way to prevent acne scarring is to treat acne early and aggressively. Treatment regimens typically include topical and oral medications. In some cases laser treatment can also be helpful. Other preventative measures include not picking scabs, using Retin-A, and avoiding direct sunlight on the face.
In contrast to hypertrophic scarring, most acne scarring is atrophic in nature related to destruction and loss of supporting tissues. Jacobs and colleagues categorized acne scars into three groups: ice pick, boxcar, and rolling.
A wide range of procedures have been used to treat acne scarring including dermal fillers, punch excision, punch excision with skin grafting, punch elevation, subcision, laser resurfacing, and dermabrasion.
Last night Christy Batien, of News Channel 4, discussed the problem of acne scarring during her Healthbeat segment. She included clips from a conversation we had last week discussing this troubling problem. Click here to watch the video.
Teens and Plastic Surgery News Segment
May 10, 2010
What’s The Deal With Lipodissolve?
April 21, 2010
An example of the lipodissolve delivery instrument offered at www.mesoone.com
Lipodissolve, also known as mesotherapy or injection lipolysis, is a procedure where a mixture of medications are injected into certain areas of the body with the purpose of dissolving unwanted fat. The mixture often contains chemicals such as phosphatidylcholine and sodium dioxycholate. Many proponents claim it is a safe and a less expensive alternative to liposuction. Unfortunately, there really is a distinct lack of credible evidence to back up their claims. As this ASPS Technology Brief states, ”Neither the injection mixture nor the method of treatment is standardized, and the procedures are not approved by the FDA for any purpose.”
Somewhat complicating the issue, many med spas are now offering lipodissolve treatments. Their websites often make claims that liposuction is excessively painful, and that it can be avoided by instead opting for simple fat dissolving treatments with minimal or no down time. Fortunately, the FDA has begun to crack down on med spas who are making these unsubstantiated claims. MSNBC has an excellent article on this issue. Click here for the story.
As a board certified plastic surgeon, I have been performing body contouring procedures such as liposuction and abdominoplasty for nearly seven years. To be completely honest, I have never attempted lipodissolve. However, I have taken care of numerous frustrated patients who were led to believe they could avoid surgery, and found the treatment to be extremely disappointing. Currently, liposuction is the only treatment which has been shown to be a safe and effective means of removing undesirable areas of fat.
For additional information on lipodissolve, here is an excellent video from the ASPS website on the topic, as well as a clip from ABC News.
Who Is Doing Your Cosmetic Surgery?
April 13, 2010
A couple of years ago, I wrote a blog post entitled, “Who is doing your Botox® injections?” It raised the issue of training and qualifications as they relate to cosmetic procedures. As a board certified plastic surgeon, I have always been somewhat puzzled as to why a patient would choose to have a cosmetic procedure performed by someone other than a plastic surgeon. Of course there seem to be a number of reasons including price, convenience, and referred by a friend.
Here is a link to a recent blog post from the L.A. Times discussing an article published in this month’s publication of Plastic and Reconstructive Surgery. The title of the article is ”Who Is Providing Aesthetic Surgery? A Detailed Examination of the Geographic Distribution and Training Backgrounds of Cosmetic Practitioners in Southern California.” The authors looked into the specialty, training, and board certification of doctors performing cosmetic procedures in Southern California.
Not surprisingly, the authors found that plastic surgeons were the most common providers of cosmetic procedures. They also found a high concentration of physicians offering cosmetic procedures in areas such as Beverly Hills, Orange County, and La Jolla. A trend of providers having multiple office locations was also seen.
Interestingly, the authors found that a large number of non-invasive, and invasive cosmetic procedures are being offered by physicians who were not formally trained in plastic surgery. Roughly 73% of providers offering dermal fillers, and 38% of physicians performing liposuction were not plastic surgeons. Surprisingly, primary care providers were the third largest group offering the non-invasive dermal fillers Restylane® and Juvederm®, and the fourth largest group offering liposuction.
Every cosmetic procedure comes with its own set of risks. It is widely understood that appropriate training can decrease the risks of a particular treatment. According to a recently published study of fatalities caused by liposuction, “The lack of surgical experience was a notorious contributing factor, particularly regarding the timely identification of developing complications.”
Now more than ever, it is vital for patients to verify the credentials and training of their prospective providers. Numerous resources exist to assist in determining qualifications and board certification. The American Society of Plastic Surgery has a page to help you determine the location of a board certified plastic surgeon in your area.
For more information regarding Dr. Gallego’s practice, please visit www.drgallego.com.
