Adam J. Rubinstein, MD, FACS
Adam J. Rubinstein, MD, FACS
Adam J. Rubinstein, MD, FACS
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Breast Implants Still Safe

Just a couple days ago the FDA issued a notice explaining that there may be an association between breast implants and a very rare condition call ALCL. This condition, anaplastic large cell lymphoma, is extremely rare. In looking at the population of women with breast implants the FDA feels there may be a slightly higher risk of the occurrence of this problem. Lets look at the numbers. The FDA has identified between 34 (in the USA) and 60 (worldwide) cases of ALCL in patients with breast implants. There are as many as 10 million women with breast implants worldwide. That means at worst there ALCL is currently reported in approximately one out of every 165,000 women with breast implants. To illustrate how rare that really is here are some stats that I found: Source: http://www.pittsburghlive.com/x/pittsburghtrib/s_385745.html
  • Odds of fatally slipping in the bath or shower: 1 in 2,232
  • Odds of dying from a car accident: 1 in 18,585
  • Odds of injury from fireworks: 1 in 19,556
  • Odds of injury from shaving: 1 in 6,585
  • Odds of dying from any kind of fall: 1 in 20,666
  • All of these far more likely than having breast implants and getting diagnosed with ALCL.
It is important to note that this disease is NOT breast cancer. In the cases identified by the FDA ALCL seems to have been found in the fluid and tissue that surround the implants, not in the breast tissue itself. This finding includes all types of breast implants, both saline and silicone filled. The FDA has partnered with the American Society of Plastic Surgeons to create a breast implant registry. The registry will be used to track cases of ALCL in women with breast implants. Currently the FDA still finds breast implants safe to use. No restrictions nor cautions have been issued regarding the use of breast implants. Breast implants are still considered safe to use by the FDA.

Plastic Surgery Disaster – Stay Safe, Do Your Homework

Recently in South Florida there has been a tragedy. Hoping to improve the appearance of her buttocks Lidvian Zelaya, a 35 year old woman from Miami, went to Strax Rejuvenation and Aesthetics Institute for liposuction and fat transfer to the buttocks. She chose the center based upon price, she thought she was getting a bargain. She ended up paying the ultimate price. On December 27th, 2010 Mrs. Zelaya suffered complications during surgery and was transferred to a hospital where she was pronounced dead. She went to a large center where lots of procedures are done everyday. Her surgeon was board certified in plastic surgery. One would think she had made good choices. Had she done a little homework she might be with us today. She was quoted a price of $4500 for liposuction and fat transfer. While this is a very good price, one has to be suspicious of pricing that is WAY less than other qualified surgeons are charging. And then there is the surgeon. Strax did not release the name of the surgeon, though the lawyer for Mrs. Zalaya’s husband claims the surgeon was Dr. Roger L. Gordon. While he is, in fact, board certified, a quick perusal of the Florida Board of Medicine might have changed her mind about her choices. Dr. Gordon has multiple complaints and disciplinary charges filed against him. Looking at county records there have also been legal actions involving Dr. Gordon. A little homework may have helped avert this terrible tragedy. If you are considering have a procedure soon, take time and investigate your options well. Search the American Board of Plastic Surgery website to confirm the doctor is properly certified. Check the state board of medicine website to see if his/her license is clear and if there are any disciplinary actions on record. You can also look up the doctor in your county records website to see if the doctor has been named in legal actions in the past. A little diligence may go a long way in keeping you safe!

Tummy Tuck Without Anesthesia

I recently had a patient that was scheduled for a couple of procedures. When her day of surgery arrived everything was moving along as usual until she was being placed under anesthesia. The anesthesiologist could not easily place her breathing tube. After some very careful attempts without success the procedure was cancelled. We later discovered that this patient had a rare problem in her trachea (windpipe) which made it very difficult to fit the breathing tube for surgery. Posed with this problem we had to come up with a solution. After considering all the options we chose to do perform a tummy tuck (abdominoplasty) without general anesthesia. Instead, we used spinal/epidural anesthesia. This is same kind of anesthesia used for delivering babies. It allows for the patient to be fully awake but not feel anything in the area of surgery. The operation went very well and the patient was completely comfortable throughout the process. Spinal/epidural anesthesia has some advantages over general anesthesia. Many patients fear “going to sleep” which is not necessary with spinal/epidural anesthesia. Since you don’t “go to sleep” there is no waking up so the immediate recovery part is a little easier. Also, the types of medications used are very different. Unlike general anesthesia, spinal/epidural anesthesia has very little chance of causing nausea. However, some patients may have a headache with spinal/epidural anesthesia which is less common with general anesthesia. All things considered, my patient had a great experience. And so did I. I am always looking for new ways to help my patients have a comfortable experience with surgery. I am definitely adding spinal/epidural anesthesia as a choice for my patients having a tummy tuck (abdominoplasty). If you are considering this procedure you might want to consider this option yourself.

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