Recent Segment on Channel 9 Eyewitness News
February 8, 2010
This last week I discussed some of my views on breast reconstruction with Jenna Rehnstrom of Channel 9 Eyewitness News. A portion of the interview aired last night during the Focus For The Cure segment. Click on the photo to the right for the link to the video.
The Situation in Haiti and the LEAP Foundation
January 26, 2010
It’s no secret that many people have really been affected by the horrible images coming out of Haiti. The many news reports continue to detail the utter devastation. Current estimates are putting the death toll at 150,000 to 200,000. Last week there was a major telethon, hosted by George Clooney, televised on a number of networks and watched by more than 24 million people. Numerous charities are going the extra mile to raise money for the effort.
I’ve recently become acquainted with an organization called the LEAP Foundation. Briefly, they are a group which strives to help people in the developing world by providing specialized medical services. The organization was started in 1991 by plastic surgeon, Dr. Craig Hobar. Currently, they are organizing surgical teams to travel to Haiti. Currently, they have a number of teams working in Haiti, and plan to send many more in the next few months, as well as in the years to come. The teams will consist of plastic surgeons, anesthesiologists, nurses, and other surgical specialists.
The group’s website is quite informative, and has a number of videos detailing their recent activities in Haiti, as well as other countries around the world. There is also a special section devoted entirely to their recent work in Haiti. Here you will find a “wish list” of items, and volunteer opportunities. In addition, they have an often updated blog which provides information about the current situation in Haiti.
If you would like to help the people of Haiti, but just aren’t sure how, I recommend you visit the LEAP Foundation’s website and consider making a donation. I am hoping to join one of the surgical teams traveling to Haiti later this spring or early summer.
Dr. Kelly Gallego is a board certified plastic surgeon practicing in the Sioux City area. For more information regarding his practice, please visit his website at www.drgallego.com.
Latisse™: Is it right for you?
January 13, 2010
Last year an exciting new treatment for eyelashes became available. I wrote a post about Latisse™ last April, so I figured it was time for an update. Treatment with Latisse™ has shown itself to be a highly effective means to make one’s eyelashes darker, longer and thicker.
Complaints regarding the application of the medication have been non-existent. Each night patients merely need to remove makeup and contact lenses, wash their face, and apply the medication to each eyelid. The application consists of placing a single drop of Latisse™ near the tip of the disposable applicator brush, and then immediately applying the medication to the skin of the upper eyelid near the base of the eyelash. The medication does not need to be separately applied to the lower eyelids.
Most patients have seen some results within the first few weeks of Latisse™ use, with significant changes seen after 8-12 weeks.
As I wrote before, side effects tend to be rare and mild in nature. The two most common are itching and redness of the eye. Other possible complications include darkening of the upper eyelid skin where most women apply eyeliner and darkening of the colored part of the eye. Patients who stop using Latisse™ can expect their eyelashes to return to their normal appearance within a few months.
Its important to remember that patients with a history of an allergic reaction to any of the ingredients in Latisse™, should not use the medication. Also, patient’s with a history of glaucoma or who have risk factors for this condition should consult with their ophthalmologist before starting Latisse™.
The best way to know for sure if Latisse™ is right for you is to call us at 888-799-8677 and set up a free cosmetic consultation. Also, much more information can be obtained at www.latisse.com.
Dr. Kelly Gallego is a board certified plastic surgeon practicing in the Sioux City area. For more information in regards to his practice, please visit his website at www.drgallego.com.
ASPS List of Common Plastic Surgery Myths
January 8, 2010
There is great list of ten common plastic surgery myths on the American Society of Plastic Surgeons website. Here is the link.
Breast Reconstruction Discussion on Channel 4 Evening News
January 6, 2010
Recently, I had the opportunity to discuss the topic of breast reconstruction with KTIV’s Christy Batien during her HealthBeat segment of the evening news on channel 4. Here is a link to an article discussing our conversation.
Article in Siouxland Life Magazine
December 16, 2009
Here is a link to a recent article in Siouxland Life Magazine where I discuss treatment with Botox Cosmetic.
My recent move
December 16, 2009
Recently, I decided to relocate my practice to Sioux City in northwestern Iowa. For a wide variety of reasons, I think it is going to be a great move. The area really needed another full time board certified plastic surgeon. Although, things were slow at first, the practice is really starting to pick up.
Apart from cosmetic plastic surgery and breast reconstruction, I am also doing a lot more general reconstructive surgery including facial trauma, hand surgery, treating complicated wounds, and skin cancer reconstruction.
My new office address is 2800 Pierce Street Avenue, Suite 101, Sioux City, IA 51104. The office telephone number is 888-799-8677.
Finally, the address for our new and improved practice website is www.drgallego.com.
Latisse™: A revolutionary new treatment for eyelashes
April 27, 2009
Recently, an exciting new treatment for eyelashes has become available. Latisse™ is a new prescription strength medication that was recently approved by the FDA.
The treatment has been shown to be a safe and remarkably effective way to grow longer, darker and thicker eyelashes.
Latisse™ is quite easy to use. Each night patients merely need to remove makeup and contact lenses, wash their face, and apply the medication. The application consists of placing a single drop of Latisse™ near the tip of the disposable applicator brush, and then immediately applying the medication to the skin of the upper eyelid near the base of the eyelash. The medication does not need to be separately applied to the lower eyelids.
Although gradual changes can be seen within the first few weeks of starting Latisse™, the majority of patients should see significant improvement within 8 weeks.
Side effects tend to be rare and mild in nature. The two most common are itching and redness of the eye. Other possible complications include darkening of the upper eyelid skin where most women apply eyeliner and darkening of the colored part of the eye. Patients who stop using Latisse™ can expect their eyelashes to return to their normal appearance within a few months.
Patients with a history of an allergic reaction to any of the ingredients in Latisse™, should not use the medication. Also, patient’s with a history of glaucoma or who have risk factors for this condition should consult with their ophthalmologist before starting Latisse™.
Please call our office at 877-389-0368 to set up an appointment to see if this new treatment is an option for you. Also, more information can be obtained at www.latisse.com.
Dr. Kelly Gallego is a board certified plastic surgeon with offices in Newport Beach and Corona, CA. Please visit his website at www.GallegoPlasticSurgery.com
UPDATE: Dr. Gallego’s office is now located in Sioux City, IA. The current website is www.drgallego.com.
My recent trip to India
January 19, 2009
Recently, I embarked on an adventure to India. The trip was part of an exchange program sponsored by The Smile Train (smiletrain.org), a charitable organization primarily dedicated to helping patients with cleft deformities in the developing world. I left roughly a week after the terrorist attacks in Mumbai, so as you can imagine my mom, sister and girlfriend were more than just a little nervous about me going.
Passing time at the airport in London
The trip lasted 11 days, although because of the distances traveled, I was only in India for a week. The town I visited is called Hisar. It is in the state of Haryana in northwest India about a three hour drive from Delhi. Because of a paucity of tourist sites, the town itself is infrequently visited by Americans. Thus, many of the inhabitants viewed me as quite a novelty.
This was my first trip with The Smile Train, so I was a little uncertain of exactly what to expect. Instead of going with a team, the Smile Train exchange program allows individual plastic surgeons to plan their own trips to credentialed sites in the developing world. While in Hisar, my time was spent almost exclusively with Dr. Sunil Soni, an incredibly well trained Indian plastic surgeon. Dr. Soni’s practice is full of variety with the majority of his time spent treating patients with clefts, burns, hand problems, trauma, hypospadias, and occasionally cosmetic concerns.
Dr. Sunil Soni, myself, and the scrub nurse a.k.a. "half ticket"
The medical building we worked in is set up a bit differently than the ones here in America. The building itself has four levels. In the basement was the laboratory, pharmacy and physical therapy room. The first floor had the operating room, and doctors’ offices. Dr. Soni shares the building with his brother Monish, an orthopedic surgeon. The second floor had the patient rooms with roughly 20 beds. The top floor was the apartment where Dr. Soni lived with his family. Larger, standard hospitals also exist in India, but this privately owned set up is much more common.
Dr. Soni's Hospital
During the week that I was there, we did quite a few procedures. As you can imagine, I tried to take as many pictures as possible.
A 16 year old boy with an unrepaired cleft lip
A young boy with a hand deformity
A young girl who was thrown from a car
We operated on patients with cleft lips, cleft palates, other cleft deformities, burns, serious infections, trauma, hand deformities, lower extremity wounds, and we even did a breast reduction (one of my more common procedures in the U.S.). A handful of procedures I did myself, but the majority of cases were done by Dr. Soni with me either assisting or just observing. The staff was very well trained and treated me like royalty.
Dr. Soni's Staff
Dr. Soni’s wife, Archna, was a tremendous hostess and did her best to make me feel welcome. Everyday, we had lunch and dinner in Dr. Soni’s home. I was able to sample a wide variety of classic Indian foods. Much of the cuisine is vegetarian and a lot of it was quite spicy. In addition, we also had a few meals at the family home where Dr. Soni’s parents live with Monish and his wife and daughter. Dr. Soni’s father is also a plastic surgeon as is his youngest brother.
Dr. Soni with his father, Dr. S.K. Soni
Much of my time was spent discussing American and Indian cultures. Apart from the differences, I learned that many similarities also exist. The Indian people I met were all very hard workers. They typically work everyday, and only occasionally work a half day on Sunday. I told Dr. Soni a number of times that in the U.S. we call those people “workaholics.” In addition to work, I was also able to attend a wedding feast, have drinks with the guys one night, and spent an afternoon touring the city including a local Hindu temple.
Celebrating at a wedding feast with my new friends
There were a number of experiences that really made an impression on me. One of the more interesting sights is the massive numbers of cows that wander the streets.
Cows wandering the streets
As most people know, cows are sacred in India and they are pretty much allowed to do as they please. Routinely, cars have to swerve around a cow walking down the middle of the highway. Another fascinating thing was the driving habits of the Indians. No offense to any of my Indian friends, but they drive like maniacs over there. For Indians, the horn is as important as the steering wheel or the brakes, if not more so. The roads are crowded with big trucks, cars, three wheeled taxis (sometimes with ten people crammed inside), motorcycles (sometimes with four passengers), and carts pulled by a variety of animals including bullocks and camels.
Cart being pulled by a camel
A standard taxi
It would be difficult for me to overstate just how much tea i drank while in India. Anytime we sat down for more than a couple of minutes, someone brought us tea which they call “chai.” They weren’t real big on coffee in India. I ordered it a couple of times, but it mostly tasted like tea.
Of course, one of the most difficult thing to see in India is the poverty. Although, the Indian economy has been growing rapidly, a large portion of the population remains exceedingly poor. The city streets were often lined with men from rural areas who had travelled to Hisar in search of work. Many of these men perform manual labor and are paid the equivalent of $3 a day. We saw a number of patients who had been injured on the job. Some of the electrical burns are especially challenging. In particular, we took care of a 16 year old guy who had suffered a severe electrical burn. For mostly financial reasons, he didn’t present to the clinic for about three weeks. He had been treated by a local “healer” with what appeared to be ink. It’s a wonder he didn’t lose his hand.
A severe electrical burn apparently treated with ink
Overall, it was a tremendous, life changing trip. Although, it turned out a little different than I expected, it was quite rewarding and extremely educational. Before embarking on the trip I was very excited about all the people I was going to help, and the huge difference I was going to make (sometimes, surgeons get these “delusions of grandeur”). However, while in India I was reminded that often the greatest value of trips like this one is how they help me. These experiences improve my understand of the world outside of my comfortable surroundings. Exposures of this nature assist me in reviving those portions of my heart that can become numb over the years. I would strongly encourage anyone reading this to consider a similar adventure.
The Soni brothers with their families
Hyperhydrosis is a condition that involves excessive sweating from the underarms, the palms, the soles of the feet or the face and head. Patients frequently complain that the appearance of soaked underarms is a major source of embarrassment. Many patients also lament how sweaty palms also can give the appearance of extreme anxiety. It is not uncommon for patients to complain that their professional and social lives have been disrupted by this condition. The majority of patients have suffered for years prior to seeking help for their condition.
The primary function of sweat secretion is to assist in regulating body temperature. Sweat glands are distributed throughout the body, but are more concentrated in the underarms, palms and soles of the feet. Most cases of hyperhidrosis have no detectable cause and can affect up to 1% of the population. Affected individuals appear to have an elevated baseline level of sweat secretion and an exaggerated response to other normal stimuli.
The overall goal of treatment is to reduce the volume of sweat secreted to a level that does not cause anxiety and embarrassment. The ideal treatment should be safe, effective and relatively inexpensive. Conservative treatments include prescription antiperspirants, oral medications, and iontophoresis. Prescription strength antiperspirants are effective for many patients, but drawbacks include the short duration of effect, skin irritation, and some agents can stain the skin. Anticholinergic medications have many side effects including dry mouth, blurred vision, urinary retention, and constipation. Both antianxiety and antidepressant medications have been useful in helping patients deal with hyperhidrosis. However, they are only useful for short periods, can cause dependency, and are associated with lethargy and drowsiness. Iontophoresis uses a battery powered device to provide direct current to the hands and feet while they are submerged in water. The treatments only block secretion temporarily, can be uncomfortable, sometimes cause skin irritation, and require maintenance therapy.
For many physicians Botox® injections have become the treatment of choice. Botulinum toxin is a protein produced by the bacteria clostridium botulinum. Currently it is used to treat a variey of functional and aesthetic conditions. It is most useful in focal areas of hyperhidrosis, such as the underarms. The treatment requires multiple small injections to the affected area. Injections are appropriately spaced 1-2cm apart and typically 50 units is adequate for one axilla or one palm. Some studies have shown patients can expect a 70 to 80 percent reduction of sweat excretion in the axillae and 26 to 31 percent in the palms. The duration of effect varies from 3-8 months depending on the patient and the dose used. Complications are minor for the most part and include: bleeding, numbness, and inadequate reduction in sweat secretion. In addition, decreased grip strength can occur with injections to the palms. The only real major drawback of this treatment is the discomfort experienced when treating the palms and soles of the feet. Generally, treatments of the axillae tend to be well tolerated.
Surgical treatment is reserved for the more aggressive forms of hyperhidrosis that remain unresponsive to conservative therapy. In the past, underarm skin and fat was directly excised to remove overactive sweat glands. Another surgical technique that has been advocated is liposuction of the underarm region. This method appears to disrupt the nerve supply to the sweat glands, but because it has not been widely used, its efficacy is unknown. Currently, the surgical procedure of choice in these most severe presentations of hyperhidrosis is thoracoscopic sympathectomy which directly disrupts the nerves supplying the sweat glands of the palm and the underarms. This minimally invasive procedure utilizes small incisions on the chest wall and an endoscope to gain access to the portion of the chest cavity where the nerves are located. General anesthesia and an overnight stay in the hospital are necessary. Patients can typically return to their normal behavior within a few days. Success rates are high for palmar hyperhidrosis, but tend to much lower for hyperhidrosis involving the underarms. Complications, although rare, can be quite serious and even life threatening. Side effects include compensatory sweating in up to 50 percent of patients, gustatory sweating in up to 1/3 of patients and permanent changes to the palmer skin.
In conclusion, hyperhidrosis can be very distressing, but fortunately there are a number of safe and effective treatments from many which most patients can benefit.
Dr. Kelly Gallego is a Board Certified plastic surgeon with offices in Irvine and Corona, CA. He specializes in all types of cosmetic plastic surgery including breast enhancement, rhinoplasty, and body contouring. For more information on visit his website at www.GallegoPlasticSurgery.com.
UPDATE: Dr. Gallego’s office is now located in Sioux City, IA. The new web address is www.drgallego.com.
