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Patients Are Happy with This Type of Surgery

Regular readers of this newsletter may have become accustomed to learning about the non-surgical aspects of our practice.  We are surgeons though, and I thought it might be nice to discuss some of those procedures over the next few months.

Richard Green, MD, FACS
Richard Green, MD, FACS

I am often asked what operations are the most enjoyable to perform.  I usually answer any operation that makes the patient happy.

Some of our happiest patients are those who have undergone breast reduction.  
Not only do they feel better about their appearance, but they also no longer have back, neck and shoulder pain. Their clothes fit better and they no longer feel so fatigued by the end of the day. Plus, the procedure might possibly be covered by insurance.  

We generally do these outpatient operations in our surgery center which makes for a nice experience overall.

At Salmon Creek Plastic Surgery, we are happy to answer any questions you may have regarding procedures. Please call us at (360) 823-0860 or contact us

Dr. Green Visits Australia for Cutera Conference on Lasers

Dr. Green and his wife, Nancy, enjoyed a trip to one of the friendliest places in the world at the end of March.

He was honored to serve as moderator for the Cutera Clinical Forum in Sydney, Australia, a conference which brought together physicians from all over Australia, New Zealand and Asia to learn about new ways to get the most out of their medical lasers.

While there, he also took advantage of an opportunity to attend a meeting of the Rotary Club of Sydney Cove, a breakfast gathering that took place on a boat in Sydney Harbour. As immediate past president of the Vancouver Rotary Club, he was eager to meet Rotarians and their guests from the other side of the world. It turns out that they talk as much about American politics as we do!

Australia has a Medicare for All system (similar to what is being proposed here by various presidential candidates), but most Australians who can afford it still buy private health insurance so that they can access health care services in a more timely fashion.

In Sydney, sunrises tend to be more spectacular than sunsets. Dr. Green took an early walk over the Sydney Harbour Bridge to catch the Sunday morning sun coming up over the iconic Sydney Opera House.

Pearl Fractional vs. Secret™ RF

Comparing Treatments for Fine Lines, Wrinkles, Large Pores and Scarring

Fine lines, wrinkles, enlarged skin pores, scarring.  The approach we use to treat these conditions continues to evolve and improve.

Pearl Fractional Laser 

In 2008, we began to use the Pearl Fractional laser to resurface facial skin, thereby improving the surface texture of the skin in a single treatment. 

This laser treatment does have downtime, however, and I usually tell patients that they will look as though they have a bad sunburn for about four days.  Makeup cannot be applied to camouflage the redness until day five. Patients may expect a 40-50% improvement in scarring and skin texture. 

Secret™ RF Microneedling

Last year we added a new option for treating facial texture and scarring for those patients (and there are many) who simply don’t have four to five days of downtime availability. 

Secret™ RF is a radiofrequency microneedling device that inserts 64 tiny needles at a time into varying depths of the skin. Energy is then released from the tips of the needles to simulate a more aggressive wound.

Patients will appear flushed for a couple of hours after the procedure, but there is no significant downtime. Patients require four treatments, four weeks apart, to achieve the same 40-50% improvement in skin texture or scarring as with the Pearl laser.

Which Is Better for You?

So which laser is better? Essentially the results are equivalent, although for deeper acne scarring, the Pearl laser resurfacing may have a slight advantage. For patients with lines on the neck, or stretchmarks on the body, Secret microneedling would be a better choice. Otherwise, is simply depends upon whether someone would prefer one treatment with four days of significant redness or four treatments with no days of downtime. Always good to have options!

If you want to improve the appearance of your skin, call us at (360) 823-0860 for a consultation and details.

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.