Category Archives: Plastic Surgery

Not All Board Certifications Carry the Same Merit

by Jane Namkung, MD

Recently, in a landmark vote, the Medical Board of California voted unanimously to deny the American Board of Cosmetic Surgeons’ (ABCS) request to advertise as “board-certified” cosmetic surgeons.

By doing so, the Medical Board of California is declaring that the certification provided by the ABCS and its training provided by the American Academy of Cosmetic Surgeons (AACS) is NOT equivalent to the certification and training provided by the American Board of Medical Specialties (ABMS) and its member boards, which includes the American Board of Plastic Surgery.

The investigation by the Medical Board of California found that the ABCS and the AACS programs did not consistently provide adequate training or education in all aspects of cosmetic surgery. 

Now, why does this matter? 

The American Academy of Cosmetic Surgeons (AACS) offers a one-year program designed to train physicians from ANY specialty in cosmetic surgery. This means your cosmetic surgeon may be an emergency room doctor, an OB-GYN, an internal medicine doctor, or even a pathologist who decided to train for one year under another cosmetic surgeon to perform various procedures.

Plastic surgeons, on the other hand, train for three to five years in general surgery and then three years of plastic surgery. They often go on to subspecialize even further with additional fellowships. Facial plastic surgeons are typically ear, nose and throat (ENT) or plastic surgeons who then go on to do an additional one year training in facial plastic surgery. Oculoplastic surgeons are ophthalmologists who train for an additional two years in eye and face surgery. 

Most patients know these days to make sure their surgeon is board-certified. The danger comes when it is unclear in what specialty your doctor is board certified.

Hopefully, other state medical boards will follow California’s example and not allow the ABCS to advertise as board certified surgeons. Until then, do your research. Ask your doctor about their board certification. If it is not in plastic surgery or facial plastic surgery, look elsewhere.

Please Note Changes in the Brilliant Distinctions® Program

Brilliant Distinctions ®  is a consumer loyalty program that rewards its members with savings for purchasing qualifying Allergan treatments and products. Our clinic is affiliated with this program which honors and redeems the coupons/rewards.  We also issue points for services you receive that are a part of the Brilliant Distinctions® program. You may register for the reward program by logging into their website and then activate your rewards.  You can also download their app on your smartphone, which is the easiest way for you to activate rewards/coupons prior to your appointment.

To our existing patients:  We are no longer able to manage your Brilliant Distinctions® account due to security updates that Allergan has implemented so you will now need to activate your coupons prior to your appointments. Your membership login is your email address and you will need to change/update your password. You can call Brilliant Distinctions® customer service with any questions, to change your password, or to update any information at (888) 324-2745 or call Angela at (360) 823-0860 if you need assistance.

Medical Tourism Offers Greater Risk and Difficult Follow-ups

Medical tourism has been in the news quite a bit over the last few years, but what is it?  Medical tourism is when patients, who are often looking for the best “deal,” go outside of the United States for their surgical procedures. While there is no doubt that high quality plastic surgery exists outside of the U.S., it does come with increased risks.

Training and Credentials

The American Society of Plastic Surgeons (ASPS) cautions patients that it may be exceedingly difficult to assess the training and credentials of surgeons outside of the US, and that patients are at risk of choosing unqualified physicians and having procedures performed at non-accredited surgical facilities.

The U.S. healthcare system has an extensive and exhaustive system of checks and balances in place to ensure patient safety, whereas many of these other countries have far fewer safeguards.

Sterilization

Another concern should be about sterility and how medical equipment and supplies are handled or reused. Reusing supplies and improperly sterilizing equipment is one method of reducing costs but increases the patient’s risk for infections and other complications. In addition, the cosmetic surgery products and devices used in other countries may not have been tested, proven safe or effective, or been approved for use by the FDA.  “Cosmetic” surgery is still real surgery which comes with the very real risks of infection, bleeding, poor cosmetic outcomes, pulmonary embolisms, and blood clots.

Follow-up Care

Follow-up care and monitoring is critical after any surgery. Patients who choose to have their surgeries performed outside of the U.S. have little to no follow-up care and may find it quite difficult to find a plastic surgeon in the U.S. to treat the problem or provide revision surgeries.  Revision surgeries can be quite complicated with suboptimal aesthetic results and the costs are often not covered by insurance.

The Long View

Medical tourism and bargain surgery can be quite costly in the long run.  Patients have to bear the brunt of the additional cost for revision surgeries and complications that may overall be more than the cost of the initial operation if it had been originally performed in the US.  Additionally, if a patient suffers a medical emergency overseas, they may find that their health insurance may not provide coverage in a foreign country.

Do your research.  Although it is tempting to go overseas to find the “best deal,” surgery performed by an unqualified surgeon or in a setting that is not safe can risk your health and result in poor outcomes and end up costing you more in the long run.

At Salmon Creek Plastic Surgery, we strive to provide the best care in the safest way possible and are here for you in case sometime goes wrong. Call us at (360) 823-0860 or contact us for a consultation.

Meet Our New Surgeon: Dr. Jane Namkung

Dr. Jane Namkung is the newest board certified surgeon to join the team at Salmon Creek Plastic Surgery. She is a Washington native who has now come home to help provide caring and compassionate plastic surgery to patients in Vancouver and in the surrounding areas.

Dr. Namkung grew up in Tacoma and graduated from the University of Washington with a B.S. in Biochemistry in 2001. She then attended New York Medical College, in Valhalla, NY, where she graduated in 2006.

Dr. Namkung has completed two competitive residencies in both general surgery and plastic surgery from two well-known universities, UC Davis and Indiana University respectively. While at Indiana University, she had extensive training in aesthetic, reconstructive, microsurgery, and hand surgery. After completing her training at IU, Dr. Namkung took her skills to the Bay Area, where she was an associate at a successful private practice.

Dr. Namkung is committed to providing a warm and personalized consultation, where she will listen to your desires and your concerns, and offer advice and education with an experienced and gentle touch.

Dr. Namkung is happily married and has three young children. When she’s not working or just busy being a mother, she enjoys hiking, going to the coast, and reading.

Preventative Maintenance Key to Healthy Looking Skin

Patients regularly ask us what they can do to keep their skin looking healthy and youthful. Many patients will choose to have procedures such as laser or injections, but many forget about preventive maintenance.

The best (and frankly, the simplest) things you can do to improve your skin are quitting smoking and regularly applying sunscreen. Mark Twain once said, “Quitting smoking is easy, I’ve done it hundreds of times.” It is never too late to quit, and if you do, within six months your facial skin will look at least five years younger.

Sunscreen is even more important. Before the age of 40, significantly more woman develop melanoma than men. After age 40, significantly more men develop melanoma than women. Caucasian men over age 50 are diagnosed with the most melanoma cancers. Overall, one in 35 men and one in 54 women will develop melanoma in their lifetimes.

Everyone should wear sunscreen every day, regardless of the season of the year. Many people say that their makeup has sunscreen in it, but that may not be enough. You should use a sunscreen with an SPF (Sun Protection Factor) of at least 30. Reapply the sunscreen if you are exercising or swimming and have been outside for more than two hours. Finally, don’t forget about putting sunscreen on other parts of your body. Women especially tend to show a lot of skin aging in their décolleté area and on the back of their hands. Be sure to protect that skin as well!

Healing, Teaching, and Learning During a Trip to Peru

Carolyn and Rick

In March, my daughter, Carolyn, and I had the magnificent privilege of traveling to Peru to participate in a surgical mission trip organized by the Peruvian-American Medical Society.  We joined several doctors from the Chicago area, one of whom, Dr. Juan Angelats, was my main teacher and mentor in surgery. Two residents from my plastic surgery training program at Loyola University were part of the team as well.

I returned to Arequipa, Peru’s second largest city, and a place I had visited for a similar mission 22 years ago as a senior resident in plastic surgery. It is a beautiful but economically challenged city located at the base of a nearly 20,000 foot volcano named El Misti.  From the operating room, we also had spectacular views of other mountains in the Andes on clear days.

Our task on this trip was to work with patients with significant scarring secondary to old burns, usually as the result of some sort of accident.  Adequate burn care is not available in much of the country, and several of the patients had taken bus rides of between six and 12 hours to come see our group. We operated in the burn unit at a large government hospital where patients appeared to wait all day long for their appointment.

One of our favorite patients was a small three-year-old boy named Santiago. His mother, Flor, had brought him in for correction of scarring on the palm side of his index and middle fingers, which he developed after grabbing exposed electrical wires. We were able to remove the heavy scars and repair the area with skin taken from his hip area, thereby allowing him to fully extend his fingers again once healed.

I had the chance to teach the two residents a few of the tricks I have learned in the 21 years I have been practicing surgery.  I also learned a few more tricks from my recently retired mentor, Dr. Angelats, who still seems most at home in an operating room.  The best picture of the entire trip was this “Three Generation” photo showing my teacher on one side of me  and the young surgeons in training on the other.

This mission was also the first time I had ever taken my daughter to “work” with me. Burn reconstruction can be a bit bloody, and she did great, not even coming close to passing out or throwing up!  She posed under the picture that seems to hang in every South American operating room I have ever visited.  Jesus appears to have forgotten to put on his surgical mask.

After the completion of our time in Arequipa, Carolyn and I traveled to Cusco City, high up in the Andes mountains, and then to Machu Picchu, the center of the Inca Empire 800 years ago.

People in Cusco find many different ways to eke out a living, from weaving beautiful textiles on a hand-held loom, to renting out their baby alpaca for pictures. We spent two days in Machu Picchu itself, a stone city carved into an extraordinarily steep mountainside. Travelers from the Pacific Northwest and the local llamas did not mind the rain and fog on our first day there, as it made for some nice photos.  Neither did we complain about the bright sun on our second day when we hiked 1000 feet vertically up Waynapicchu, an adjacent mountain which afforded spectacular, if not somewhat frightening views of Machu Picchu. Given my fear of high open places, the picture makes me look a great deal more comfortable than I actually felt.

Journeying to a foreign land, especially a developing country such as Peru, makes me appreciate just how fortunate we are in the United States of America, at least from the standpoint of material wealth. My daughter and I did see very clearly though that mothers love their children just as much in Peru as they do here in the United States, and it really doesn’t take much “stuff” to be happy. We are grateful to have had this wonderful opportunity.

  • Hand loom near Machu Picchu
    Hand loom near Machu Picchu
  • Carolyn and operating room picture
    Carolyn and operating room picture
  • Three generations of surgeons
    Three generations of surgeons
  • Treating burn scarring on Santiago's hand
    Treating burn scarring on Santiago's hand
  • Santiago's mother, Flor
    Santiago's mother, Flor
  • Santiago
    Santiago
  • Patients waiting for treatment
    Patients waiting for treatment
  • View of the Andes from the operating room
    View of the Andes from the operating room
  • El Misti
    El Misti
  • Arequipa, Peru
    Arequipa, Peru