Transplant Patient Meets Transplant Patient

AP Wire

Apparently the French partial face transplant patient (a woman) has met with the French double hand transplant (a man). I don't know if it is the media or the French medical system runs like a circus. The "human interest" angle is played but only small bits of real information are given.

The piece does mention that the woman has realized some facial movement and seems to be happy with her situation. The medical questions of what exactly was transplanted in the hand operation and other details like his pre-operative condition and the improvements realized in his case were not disclosed.

Hopefully this information will hit the medical literature so we can find out the "bottom line" on these procedures.


Best Regards and Happy New Year,

John Di Saia MD



Tags
face transplant
hand transplant

Facial Bone Loss Contributes to Aging

MSNBC.Com Story

Clarification 12/30/05

I always like cases in which authors try to refute logic. It is possible that bone volume loss might contribute to the appearance of aging, but to say that from the results of a volume-measuring bone study alone is a bit much.

Like everything else in life, the appearance of aging is more likely than not due to a number of things, not just one thing. How we take this information and use it to determine what (if anything) should be done...like injecting volume into the face is a much bigger question. My point (perhaps phrased poorly before) is that the conclusion that age-related changes and bone volume are causally-linked is not necessarily a solid one from the study as quoted.


Best Regards,

John Di Saia MD


Tags

aging
looking old

Health Courts Bill in Congress

Common Good Article

Now this is interesting. Hopefully, the idea will catch on. If we reduce litigation risk expenses, the cost for health care might actually come down.

Best Regards,

John Di Saia MD

Facelifts for X-Mas? - CNN Video

CNN Video

Cosmetic surgery for the holidays.

The concept is a bit funny to me, but others seem to disagree. Cosmetic surgery is a personal choice. My hopes are that the patients receiving this actually want it.

Best Regards,

John Di Saia MD



Tags
cosmetic surgery present

Does Anyone Ever "Need" A Boobjob?

This young lady is petitioning for donations for breast enhancement surgery. I do not know her and she is not my patient. This one brings to focus the subject of whether or not anyone ever "needs" a boobjob. I believe not.

A woman may feel better with a larger or lifted bust line, but if it is between surgery and food or a roof over your head, it seems an easy choice to me. I do them for a living, but consider the procedure elective in all cases. Do not tap yourself out for this ladies. If you want surgery, save for it and get it when you can afford it.


Best Regards,

John Di Saia MD



Tags

need boobjob

Cosmetic Surgery Tax Response

News Max

The American Society of Plastic Surgeons is against comsetic surgery taxes. This press release further discusses the states involved. New Jersey has passed such a tax. Washington and Illinois are considering them.

Not mentioned is the fact that in California (at least) breast implants are now taxed. Seeing as the State cannot determine which are used for cosmetic purposes and which are used for reconstruction, this indirectly increases costs to cancer patients. If a doctor's office buys implants, they are taxed. Patients pay those taxes.

I'll bet cosmetic surgery in New Jersey has decreased in popularity and surgery in adjoinng states has increased.


Until Later,

John Di Saia MD



Tags

cosmetic surgery tax

Tookie Williams Case - An Opinion- Again

I picked up this image of Tookie Williams from another blog. As I am a physician (if you consider plastic surgeons real doctors), I have been asked today how I feel about this execution:

"I feel it is a shame that the organs aren't considered for organ transplants."

I have been an advocate for utilizing these organs for years. Now that's a real payback to the society that you have wronged. This of course assumes that these people have organs in good medical condition for transplantation.

Looking at this image of Tookie, here's the man as he was when the crime's occurred. Here is the man that still won't admit that he did that for which he was accused, convicted and condemned. I feel far more for the victims of his crimes and their family members. Maybe they can obtain closure, if they are still alive to do so. I am not a judge or a jury member. My job is not to work in our legal system (at least not anymore than I can avoid).


Best Regards,

John Di Saia MD

Boston Woman Gets Holiday Cosmetic Surgery Present

Boston Herald

Cosmetic surgery given as a present is a bit of a sticky subject. The question becomes whether or not the recipient really would want the surgery under other circumstances. In this case, the patient, a 49 year old woman, seems happy. Her husband of 28 years gave her the present. Hopefully, she asked for it.

I wrote an article for a local newspaper a year or so ago about teenagers getting breast implants for graduation. I was against that. The patients being younger seems the "catch point." This case in Boston is that of an adult woman. In trying to give appropriate informed consent for an operation, the age of the patient matters. The surgeon's comfort level probably matters more.


Until Later,

John Di Saia MD



Tags

plastic surgery gift

Partial Face Transplant Slide Show

Yahoo News Slide Show


This image (from Yahoo News) is a diagram of the tissues transplanted in the French partial face transplant last week. Check out the slide show. This was very cool.


What would be even more cool would be to see video of the patient speaking at 3 months post-op. We will see.


Best Regards,

John Di Saia MD



Tags
face transplant

face transplant video

"Failed Facelift at 35" - Forum Question

Another one from the forum:


The Question:

Dear Dr. Di Saia
I am 35 and have had fullness or jowling at my jawline since my late 20's. One year ago I had a Lower F/L (SMAS included) which the plastic surgeon said was the only thing that would address the jowling. The clean jawline only lasted for one month and then the jowling returned. In addition to that I developed hypertrophic scaring around the ears. Some doctors have said that I'm way to young to have had a Lower F/L and that due to my thick skin it is bound to fail. While others have stated that the doctor was not aggressive enough. Is this procedure never appropriate for someone my age?


An Answer:

I have not to date performed a facelift on such a young patient. Unless the problem was large enough in magnitude, I would not have operated. To date, I have not seen such a young patient appropriate for facelift. I have offered peels, botox, soft tissue fillers and an occasional blepharoplasty in this age group, but not a facelift.

As you have discovered, surgery involves risk. There needs to be enough potential benefit to make those risks reasonable. I would need to know alot more before I tried to guess what might improve your current situation.


Best Regards,

John Di Saia MD

Hospitals risk losing specialists in ERs

Dayton Business Journal

"Many hospitals, including a few in the Dayton area, are finding it difficult to get specialist doctors to respond to emergency room calls."

People don't realize that emergency departments of hospitals don't have many plastic surgeons at times to come care for the patients. It is pretty simple: money and liability.

If you want plastic surgeons to take an interest, your insurance company needs to pay a specialist enough to allow him to make a profit without exposing him to undue liability. Well, emergencies pay poorly and expose surgeons to much more liability than better paying cosmetic work. And this assumes that the patient is insured. Many emergency patients are "freebies."

Just try to get a plumber to come to your house at 3 AM and tell him he is doing it free half the time.

I have limited my emergency room exposure in response and dropped Provider status for most insurance plans. You might see me in the ER, but you might end up paying in addition to your insurance company to do so.


Until Later,

John Di Saia MD



Tags

emergency plastic surgery

Update on the Face Transplant (France)

Star Tribune


This was a full thickness transplant down to muscles (from the article linked). This will potentially offer a great functional result, but may be harder to keep from rejection by the patient's body. This story should be interesting as it matures folks.


Best Regards,

John Di Saia MD



Tags
face transplant

First Face Transplant in France

BBC News Story

This seems technically kinda cool, but the big question is how will the transplanted tissue do over time and how will the patient do with immunosuppression. To suffer the negative effects of immunosuppression (susceptibility to infections, development of cancers, etc) for a soft tissue repair is new. To do so for the sake of a life-saving organ like a heart or kidney is pretty standard. A free tissue transfer could have reconstructed the same area, but maybe not as well functionally. The aesthetic and functional outcome of this transplant will be interesting. I hope it is reported upon.


Best Regards,

John Di Saia MD



Tags
face transplant