Strax Rejuvenation Deaths: The Death of Strax Rejuvenation?

May 21st, 2013

It seems that news of a death related to Strax Rejuvenation in south Florida is not surprising news. The most recent happenings, though, are quite surprising. Even for someone very familiar with the very sketchy track record of Strax Rejuvenation when it comes to patient safety and patient deaths. Diana Gonzalez, health reporter for NBC6 in south Florida, reported one of the most recent deaths of a patient related to Strax Rejuvenation. Here is a link to the story:

http://www.nbcmiami.com/news/local/Woman-Dies-After-Cosmetic-Procedure-Family-Wants-Answers-144991735.html

Given the history of the last few years, another death of this nature is not altogether surprising. What is surprising, even shocking, is that this death is only one out of three that have occurred in the last few weeks. That’s three deaths of patients associated with Strax Rejuvenation in the last few weeks. Almost as shocking is that only the story of Idell Frazer made the news. The tragic loss of Ms. Frazer was well covered by Diana Gonzalez, however, nothing has been reported on the other two deaths. How is it that the two other souls were not worthy of coverage? And how many more Strax related deaths have there been over the years that were never made known to the public.

One answer is that not all Strax related deaths happen on their premises. It is probably easier to keep such a tragic event quiet and out of the news if they don’t have to call an ambulance to the center itself. If a patient dies in the immediate post-operative period (the first few weeks after surgery) it is considered a complication of surgery. When calculating mortality rates these deaths would be included, even if they never made the news. And even if they didn’t actually happen during surgery or inside the walls of Strax Rejuvenation.

If you are a regular reader of my blog you will be familiar with my two previous articles about Strax Rejuvenation and their death rates. Here are the links to those stories:

http://www.dr-rubinstein.com/blog/russian-roulette-strax-rejuvenation/

http://www.dr-rubinstein.com/blog/bargain-price/

As you can see, giving Strax Rejuvenation tremendous benefit of doubt still arrives at a shocking mortality rate. If we re-examine the death rates including the most recent additions the numbers get even more alarming. Another year has passed so the total number of procedures will be higher. If we use Strax Rejuvenation’s own numbers, 29,000 procedures performed over eight years, that would add up to exactly 14,500 procedures performed over four years. I am aware of eight patient deaths related to Strax Rejuvenation in the last four years. That adds up to a death rate of 1 in 1813 cases. That’s shockingly TWENTY EIGHT TIMES the published mortality rate of  1 in 51,459 cases (American Society for Aesthetic Plastic Surgery, ASAPS). That means that in the time it would take to have a single death in a surgery center with the numbers published by ASAPS, twenty eight people would have died at Strax Rejuevantion.

If you have a friend that has been involved in eight car accidents in the last four years, how would you feel about letting that person drive your children around? Probably not too comfortable. Now imagine that all of those accidents included a fatality. You would probably sooner have your kids walk than ride in that car. The risk of a day to day car ride is much lower than having surgery. How many more deaths will it take to make everyone think twice about having surgery at Strax Rejuvenation? I would hope the answer is zero. Maybe the next death won’t be a patient, maybe it will be the death of Strax Rejuvenation.

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Dr. Adam Rubinstein being interviewed at the 2013 iGuide Luminaries Conference in Beverly Hills, CA

April 8th, 2013

Check out Dr. Adam Rubinstein being interviewed at the 2013 iGuide Luminaries Conference in Beverly Hills, CA. He discusses the latest in non-invasive neck lift treatments from iGuide. This procedure is great for younger patients who are not quite ready for a full neck lift. People who don’t have a lot of skin hanging from their neck, but still a little something.

The consultation is very important because that’s where we learn what our patients are looking for, where they’re starting from, and what they hope to achieve. They key is education. Once patients know what their options are, many of them opt for the non-invasive solution.

Check out the interview below to see Dr. Rubinstein speak about the procedure.

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Are Gummy Bears Always a Sweet Deal?

December 24th, 2012

Breast implants that is…

If you have heard any news at all about breast implants in the last few years the term “gummy bear” has probably been associated with them. These gummy bear implants are all the rage. They promise to revolutionize breast augmentation with safer breast implants that won’t leak if they break. But what exactly IS a gummy bear breast implant? It can be confusing. Lets take a look at the history of breast implants and the latest trends.

When breast augmentation started a wide variety of materials were used while doctors were searching for the best choice. Solid silicone, soft sponges, and other materials were tried with limited success. In fact, the very first breast augmentation ever done used a fatty tumor that had been removed from another area on the same patient. Then Dr. Cronin and Dr. Gerow in Houston, TX came up with the idea of liquid silicone in a plastic silicone bag. And the rest is history. Hundreds of thousands of women have had breast augmentation performed with silicone filled implants since that fateful day. But the implants have been updated over time.

In total there have been five generations of breast implants. The first implants used a very thin shell and thin liquid silicone. As the newer generations have been introduced the shell has gotten thicker and the silicone gel has gotten thicker as well. Today’s silicone gel implants have the thickest silicone gel ever used in breast implants. The gel is so thick that if you cut the implants completely in half they retain their shape. The silicone gel will very, very slowly run out of the shell. The newest implants available would hold their shape nearly forever. So, they are kind of like a gummy bear in that when you cut a gummy bear in half the two pieces keep their shape; and the gummy bear when whole is kind of spongy to feel like a breast implamt. So when the newest generation of implants were being introduced someone described them like gummy bears. And the name stuck.

Here’s the thing, while an implant that doesn’t leak if it breaks sounds like a good idea (and it is to some extent), it’s not the best idea for every patient. The newest breast implants that have the thickest gel do not flow as naturally as the softer implants. The do hold their shape better, which is good for some patients, but not for all patients. Sometimes the gummy bear implants are a little too firm and don’t give as natural an appearance and/or as natural a feel. The moral of the story is to be sure you discuss your options with your board certified plastic surgeon. He/she can help you learn about the choices available and help you pick the best breast implant to achieve your goals while taking into account your body and breast type. Remember, the gummy bear implants might be the best choice for you, but sometimes they’re not such a sweet deal.

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Lifestyle Lift, One Size Never Fits All

December 19th, 2012

You’ve probably heard the  radio ads or seen the TV commercials for the Lifestyle Lift. I’ve seen them myself – ads promising a revolutionary one hour procedure that is done under local anesthesia and gets you back to work as soon as the next day. You know the old adage, “if it sounds too good to be true, it probably is”. Well, from the ads I’ve seen it sounds really good, but some of the claims are simply not true. In fact, a lot of things surrounding what you may have heard about the lifestyle lift are not what they seem.

Let’s begin with the name itself. To my knowledge there has never been a paper describing the Lifestyle Lift published in any plastic surgery journal. I am not aware of any technique that is called a Lifestyle Lift. As best as I can tell, a Lifestyle Lift is some kind of variation on a mini-facelift. In fact, one of the medical directors for Lifestyle Lift recently explained in a trade magazine that the technique used by Lifestyle Lift is largely left to the surgeon operating that day. So, it seems to me that there really isn’t a special or “revolutionary” procedure called a Lifestyle Lift. If you sign up for a Lifestyle Lift it doesn’t seem like there is a procedure or technique called a Lifestyle Lift to have. And if that’s the case, what are they selling when you go for a consultation at Lifestyle Lift?

What they are selling is some kind of facial rejuvenation procedure that is likely to include a variation of a mini-facelift. Figuratively, what they are selling is what every patient wants to hear: short operative time, local anesthesia, quick return to work, and a cheap price. The advertising is very catchy and draws a lot of interest and attention. But the reality is often not as nice as the advertising might make it sound. The procedure takes longer than an hour. Actually, that’s just fine because if I’m the patient I want my doctor doing the best job possible and not trying to meet a promised one hour deadline. And the procedure in nearly all cases requires some amount of sedation along with local anesthesia. In most cases patients take sedation pills and pain pills before the procedure begins. The problem with that (other than not really being completely under local anesthesia) is when the sedation and pain medicine wears off, you’re stuck with only local anesthesia if the procedure is still ongoing. And if the pills you took to start the procedure are not enough, you’re out of luck as well. If you had an anesthesiologist keeping you comfortable (which is generally NOT the case with Lifestyle Lift) everything could be adjusted all the time to keep you completely comfortable and safe.

I always talk about looking out for bargains that end up being more that you bargained for. This one appears to end up that way all too often. The web is riddled with bad reviews from patients that have had surgery by Lifestyle Lift doctors. Of course, not all reviews have been bad, but when there are so many less than happy reviews (and many that are shockingly angry) you should take notice. You wouldn’t buy a one size fits all wardrobe of clothing, especially if there were a lot of bad reviews out there, no matter how cheap the price might be. Give your face, and your health, the same consideration. Because the truth is, one size never fits all.

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Can Chin Ups Really Lift Your Chin?

November 6th, 2012

You spare no expense in buying the latest anti-aging creams and undergoing a variety of treatments.  You love staying up-to-date on the latest anti-aging innovations, and there’s nothing you wouldn’t do to shave five or even ten years off your look.

But will facial muscle exercises really make you look younger? Facial muscle exercises were really popular in the late eighties; and there seems to be a trend towards bringing them back in a big way.  Face and neck exercises are becoming popular with trendy gyms, and you only need to stop at your local exercise store to find facial exercise DVDs.

But are facial exercises actually working to reduce the appearance of wrinkles, fine lines, and other tell-tale signs of aging? To put it simply, no. Don’t get lured in to the idea that making some funny faces and tensing your neck on a regular basis will rejuvenate your face and neck. In fact, the truth is that these exercises show little benefits in terms of eliminating wrinkles and getting rid of fine lines.

So what makes facial muscles so different from other muscles within the body, which end up looking sleeker and stronger when you work them out? You use your facial muscles constantly, all day long. That means that you’re not in danger of suffering from sagging or weakening muscles.  While your body muscles often become weaker with lack of use, facial muscles are used to help you smile, laugh, talk, and even blink.  Therefore, your facial muscles don’t need additional exercise to stay healthy.  Actually, repeating some kinds of muscle movements can even cause wrinkles and fine lines to get worse – and that’s exactly the opposite of what you want!

If you have some loose or hanging skin in your face or neck don’t count on a trendy facial exercise regimen to make things better. You may want to consider some of the many options we offer in the office that can help turn the clock back. There are lots of non-surgical techniques to keep you looking young. And if you’re looking for a little more oomph you can consider some more advanced options. Either way, discuss your goals with a board certified plastic surgeon and don’t rely upon making funny faces to turn the clock back.

 

 

 

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Jewel Plants a Flower for Breast Cancer Awareness

October 29th, 2012

In a couple days I will be attending the national meeting of the American Society for Plastic Surgeons (ASPS). While there a special fundraising event will be held featuring the recording artist, Jewel. You may know that October is breast cancer awareness month. The idea is to raise awareness of the seriousness of the problem that breast cancer poses and make women aware that there is great hope for a good recovery. Part of that recovery can include breast reconstruction. Jewel has recorded a song entitled, “Flower”, that she will perform live at the meeting to benefit breast cancer awareness.

One in eight American women will suffer breast cancer in their lifetime. That is a shockingly high number. Every woman should be aware of that possibility and take steps to help themselves stay healthy. Regular mammograms and self exams play a big part. Women requiring treatment for breast cancer should be aware that there are many options for reconstruction of their breasts that can often be started right away, the same day as any cancer procedure they may need. Jewel will perform “Flower” at the ASPS meeting on Breast Reconstruction Awareness day to help women know that they have options when going through cancer surgery that may change their breasts. Attached is a clip that tells more of that story:

I hope you never need to consider breast reconstruction and stay cancer free throughout your life. If you do find that you need treatment for breast cancer always remember that you have options for recreating your breasts after cancer treatment. Seek out the opinion of board certified plastic surgeons and together develop a plan that is right for you.

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Fade to Brown: Hyperpigmentation

October 24th, 2012

Here in Miami the sun is one of our best assets. Warm weather, bright sunny days, year round tans… But it’s also one of the biggest threats to skin health. Besides causing sun burns, those golden rays are responsible for unwanted dark spots and patches

Brown spots, or hyperpigmentation, are becoming the latest skin woe. In Elle’s September 2012 issue, beauty experts commented that the purchase of treatments to fade color in the skin is steadily rising.  With more and more spas and plastic surgeons offering diverse options for fading stubborn brown spots, it’s becoming increasingly clear that people are determined to achieve perfect skin by tackling their hyperpigmentation head on.

So what exactly is hyperpigmentation – and what can you expect from your treatment?

Hyperpigemntation in simple terms just means too much pigment. It can be small spots or broad patches of skin. While most hyperpigmentation is related to sun exposure there are other causes.

Trauma to the skin can create areas with too much pigmentation.  In this case, inflamed and damaged skin takes on a scar-like appearance, which changes the pigmentation of the injured area, usually darkening it.  This is called post-inflammatory hyperpigmentation. This is sometimes seen after some treatments, such as laser resurfacing. Another common cause is the influence of hormones. In fact, some hyperpigmentation can be caused by pregnancy, which is commonly referred to as melasma. Melasma can be found in people that have never been pregnant but patchy brown discoloration can be common as a result of hormones during pregnancy. Whatever the cause, hyperpigmentation is no fun.

The good news is that there are a host of options for treating hyperpigmentation. From a daily skin care regimen, to medications designed to decreas the color, to light and laser treatments, you have many choices to help blend your skin tone. If you have pigmentation that you want to fade, with the right regimen you too could say (in the words of Shakespeare), “out dammed spot”!

Visit Dr. Rubinstein and get ready to kiss those brown spots good-bye! To schedule your consultation simply leave us a note here or call 305-792-7575.

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Russian Roulette? Strax Rejuvenation

March 27th, 2012

Patients seeking bargain pricing for their plastic surgery have been going to Strax Rejuvenation for years as the cheapest option in town. Strax commonly advertises very low prices to lure patients for their procedures. Recently, patients are learning that the lowest price is often not the best value. There has been another death at Strax Rejuvenation. That makes 5 known deaths in less than three years.

Last Thursday I received information about a patient that died while undergoing a procedure at Strax Rejuvenation. The patient went to Strax for fat transfer to the buttocks. During the procedure her blood oxygen levels began to drop and she could not be resuscitated. She died in the operating room at Strax Rejuvenation.

I have written about the deaths at Strax Rejuvenation in the past:

http://www.dr-rubinstein.com/blog/bargain-price/

In that post I analyzed recent deaths at Strax and calculated their mortality rate. Based upon my review, giving Strax Rejuvenation a huge benefit of the doubt, their mortality rate is alarmingly high. In fact, it was seven times higher than a published acceptable rate from the American Society for Aesthetic Plastic Surgery. When last Thursday’s tragedy is added to the analysis the numbers get much worse.

My original review of the Strax Rejuvenation death rate was based upon 4 deaths in two years time. That was less than one year ago. Let’s look at an analysis that includes this most recent death. Strax Rejuvenation currently has 12 doctors on staff. Only 10 perform aesthetic procedures. We could assume that every one of them operates every day of the week, never takes a vacation, and never sees patients for consultations nor follow up visits. Clearly that is not the case, but let’s give them the benefit of the doubt. Also assume that each doctor performs 4 procedures everyday. That would calculate to  31,200 procedures in a three year period. If that were true the death rate at Strax Rejuvenation would be 1 in 6240 cases. But it’s actually worse than that.

Strax Rejuvenation has six operating rooms. It would not be possible for all 10 surgeons to perform procedures all day, everyday. Only six cases can go on at the same time. So now let’s assume that each of the six operating rooms are fully occupied 12 hours a day, 5 days a week, 52 weeks a year, for three years. That would add up to a total of about 19,000 cases which would make the death rate at Strax Rejuvenation 1 in 3800 cases. That’s more than THIRTEEN TIMES the mortality rate published by the American Society for Aesthetic Plastic Surgery (ASAPS).

If we use Strax Rejuvenation’s own numbers it is even more grave. They boast having performed 29,000 procedures. Strax was founded in 2004 which gives it an eight year history. If the cases are evenly distributed over the eight years that would come out to just under 11,000 cases in three years. That means the death rate at Strax Rejuvenation over the last three years using their own numbers is 1 in 2175 cases. That is shockingly over TWENTY THREE TIMES  the published mortality rate. When compared to having your procedure performed by a board certified plastic surgeon in their own private practice, having surgery at Strax Rejuvenation sure does seem like making a riskier choice to me. Maybe not quite like Russian roulette, but definitely not the bargain most patients think they are getting.

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Mini-facelift or full Facelift: Make the right choice!

February 15th, 2012

Mini-facelifts have grown popular due to a lot of advertising by some of the franchise facelift businesses. There are lots of different types of these operations, but they’re all variations of the same basic principle. The most well known example is the Lifestyle Lift. The goal is to improve the area between your lower eyelids to the jaw line. The most improvement is usually seen along the nasolabial folds which are the lines from the corner of your nose to the corner of your mouth. If you have the right set of concerns/problems a mini-facelift could be a great operation for you.

Too many people, however, choose to have a mini-facelift for the wrong reasons. Some for cheaper cost, others for the idea of a shorter scar or shorter operation time. Mini-facelifts are not one size fits all. If you have any issues in your neck (for example) the mini-facelift will not improve them at all. A lot of people get enamored with the idea of a mini-facelift and end up choosing the wrong operation for their anatomy and concerns. If you have a mini problem, the mini-facelift can be great. If you have a bigger issue, you probably need the full facelift.

Be very careful when choosing a procedure to improve the appearance of your face. There is a lot of hype and many promises made that may not be delivered. I encourage you to listen to a two part radio show that highlights some shocking details surrounding the Lifestyle Lift (links below).

http://www.voiceamerica.com/episode/57040/special-encore-presentation-lifestyle-lift-a-real-lift-or-a-letdown-part-1

http://www.voiceamerica.com/episode/57210/special-encore-presentation-lifestyle-lift-a-real-lift-or-a-letdown-part-2

I recommend that you visit with a few plastic surgeons certified by the American Board of Plastic Surgery. get a few opinions and a lot of information. Then choose your procedure together. That’s a good way to get a great result!

I hope this info helps!

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Help for PIP Implant Victims

February 13th, 2012

The scandal surrounding PIP implants has become a top story worldwide. Since the news broke about substandard industrial silicone being used in PIP implants there has been a cascade of reactions from governments around the world. Some countries are providing free procedures to remove the tainted implants. Others are offering some form of support falling short of free procedures to remove PIP implants. While free surgery is very helpful for the estimated 300,000 women around the world with PIP implants in place, it is not the best solution for many PIP victims.

There is no question that PIP implants should be removed. The question then, is what to do once the implants are removed. Some patients may choose to simply remove the PIP implants and remain without any implants moving forward. Most patients will likely prefer to have safe, American made implants inserted to replace the PIP implants being removed. The catch is that while the surgery to remove the implants is free in many places, having new implants placed is not covered. This will leave thousands of women left to pay the associated fees to keep the look they desire.

Mentor, one of the only two FDA approved American implant companies, has announced a program to assist in the replacement of PIP implants. The program provides for a $250 American Express gift card for all patients having PIP implants replaced with Mentor implants. While it hardly covers the cost of surgery to replace PIP implants, it is a very nice gesture. Receiving $250 dollars is better than nothing. I expect Allergan, the other FDA approved American implant company, to follow suit and announce a similar program soon.

In an effort to help patients with PIP implants that wish to have them removed I am offering my services at greatly reduced fees. The total cost to have PIP implants removed is $2500 including all costs. For patients choosing to have PIP implants replaced the total cost is $3750. Though the American government does not offer any benefits for PIP implant victims (PIP implants were never approved in the USA) I feel a personal commitment to help those patients in need. If you or someone you know has PIP implants simply make an appointment for a free consultation and mention this blog. There is no expiration date for this offer. It will always be honored as my commitment to aid in this PIP implant tragedy.

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