WHAT'S NEW

Finally, a photo of Wigod Plastic Surgery's Komen Race for the Cure Team.

Despite a rain filled Spring, we have nearly made it to Summer and the Sun is out. Sure the Sun feels great beating down on us and many love the tanned look, but the results of Sun damage are no longer a secret. Minimize your risk of skin cancer (including potentially deadly melanoma) and maximize your chances of youthful skin later in life by applying Sun Screen before you go outside. Ask our staff about PCA products, or use your favorite brand.  The following is a primer by PCA on sunscreens

Two types of Sun Protection:

There are two types of sun protection available: chemical and physical sunscreens.  A chemical sunscreen works by absorbing, reflecting or scattering the sun’s rays (UV radiation) before they affect the skin.  A physical sunscreen sits on the skin’s surface and reflects or scatters UV radiation before it is able to damage the skin, buy does not have the capacity to absorb.  These two forms of protection have different methods of achieving a similar goal.

The FDA requires that all sun protection products display a Sun Protection Factor or SPF label, although many consumers are unaware of the fact that this label only indicates the relative amount of protection from UVB rays a product can provide when used correctly. Certain ingredients must be included in a product to receive adequate UVA protection. In order for a sun protection product to provide broad-spectrum UVA/UVB protection zinc oxide, titanium dioxide, avobenzone or ecampsule (MexorylTM) must be included. Sunscreens with an SPF of at least 30 are recommended. High SPF numbers can be misleading, as an SPF of 30 is not twice as protective as an SPF of 15. When used properly, an SPF of 15 protects the skin from 93% of UVB radiation, an SPF 30 97% and an SPF 65 98% protection.

Two types of UV Radiation:

The two types of UV radiation that can affect the skin, UVA and UVB, have both been linked to skin cancer and a weakening of the immune system. They also both cause skin color changes and contribute to premature aging. UVA rays are not absorbed by the ozone layer and penetrate deep into the skin. UVB rays mostly impact the surface of the skin and are the primary cause of sunburn. Up to 90% of the visible skin changes commonly attributed to aging are caused by sun exposure.

About PCA SKIN Sun Protection Products:

SPF products from PCA SKIN are formulated with a sophisticated blend of zinc oxide and several proven chemical sunscreen ingredients that protect the skin from UVA and UVB rays. The suite of highly effective and cosmetically elegant sun protection products from PCA SKIN provide:

• Protection for every skin type, condition and tone. This ensures that most people can wear our products comfortably on a daily basis. Daily broad-spectrum UVA and UVB protection is important for everyone of every color.
• PCA SKIN sun protection products also provide important antioxidant protection with silybin (milk thistle) and caffeine to prevent and correct free radical damage. Topically applied caffeine has also been shown to cause damaged skin cells into apoptosis (cell death) minimizing the chances of skin cancer.

The May 7, 2011 Komen for the Cure Race Day was a great effort in the fight against breast cancer.  Our team was 52 members strong and we won for the largest team in our category for the second year in a row.  More importantly,  several of our breast cancer reconstruction patients were outstanding fund raisers.  Their hard work contributed to a total of $2,645 raised by the team thus far.  That places us at 8th amongst all teams and 2nd in our category.

We were happy to see staff, patients, family, and friends get together for a good time and a great cause.  We had walkers, runners, and even a few kids.  We are grateful to all of those who joined or contributed to our team effort to raise money to fight breast cancer.  We look forward to a great effort next year.  Be sure to look for our team photo in an upcoming blog (it was, unfortunately, unavailable at this time).

Bogus View - Black and White Conversion

The Susan G. Komen for the Cure annual 5k (3 mile) walk / run is coming up soon on Saturday, May 7th.  The office has formed a team again this year and we already have 24 members.  We made it to 50 members last year. We hope that you will join our team and walk or run the race with us.  Most team members are office staff or patient friends and family, but all are welcome.  This year, we will be giving out pink bandannas instead of ball caps.  We will also offer esthetician services such as facials and microdermabrasion to our top fundraisers.  Follow the link to see who is on the team and to sign up.  As May 7th draws closer, we will send an e-mail to the team with details on shirt pick up and our race day meeting point.

http://boise.info-komen.org/site/TR/RacefortheCure/BOI_BoiseAffiliate/1142176426?pg=team&fr_id=2030&team_id=154775

I went to Wikipedia and found some information to share with you on the Komen phenomenon.  The foundation was formed in 1982, is the largest and best funded breast cancer organization in the U.S., and has invested approximately $2 billion for the campaign against breast cancer.  Susan G. Komen was diagnosed with breast cancer at the age of 33 and died in 1980 at the age of 36.  Her younger sister, Nancy Goodman Brinker, founded the Komen organization 2 years later.  The rest, as they say, is history.

Bogus Basin Backcountry

I am happy to report that our new web site,  breastaugmentationboise.com has been launched.  At last check,  our main web site,  www.wigod.com actually occupies the first organic spot on a Google search for “breast augmentation boise.”  I like to think that our current site is frequently visited due to its helpful information and photographs.  Depending on the time of year, breast augmentation is often my most commonly performed operation.  Many patients come in for consultations with lots of misinformation that they have gleaned from the web.  To better educate potential patients, I thought it would be worth the time and effort to develop a whole site dedicated to this one operation.  The site presents some of the same basic information found on our main site, but a section on the augmentation process - start to finish -  is presented in greater detail.  I have also presented 12 new cases (one is the case of the month) with my own classification system.  Finally, I have introduced a frequently asked questions page.  One particularly nice feature of the new web site is that I can add more material myself (like faq’s and photos) as time and need allows.  I will announce any significant additions in the monthly blog.  Please visit http://www.breastaugmentationboise.com and forward it on to any friends who are looking for more information on the procedure.

Also, do not forget about the upcoming 2011 Komen Race for the Cure on May 7.  Our team is forming and we would love to have you, your friends, and your family join us for the effort.  We are currently designing a new bandana for team to wear on race day.  I should have a photo of it for the next blog.  Go to http://boise.info-komen.org/site/TR/RacefortheCure/BOI_BoiseAffiliate/1142176426?pg=team&fr_id=2030&team_id=154775 and join.

Bogus Basin View

Plastic Surgery, like many disciplines, has operations which wax and wane in their popularity.  One of those is the nipple sparing mastectomy.

In the 1980’s, the operation was more commonly known as a subcutaneous mastectomy.  It was mainly offered to women who did not have cancer, but who did have severely fibrocystic breasts which were difficult to examine for potential cancers or who had intolerable breast pain (mastodynia).  As there was no cancer, there was no reason that the nipple had to be removed as well.  The nipple has elements of breast tissue, ducts, to direct milk out of the breast gland and into a baby’s hungry mouth.  It was therefore thought to be unsafe to leave the nipple because of the small amounts of breast tissue left behind.

While the subcutaneous mastectomy sounds like a great idea, I can tell you from first hand experience that the operation can have plenty of problems.  I have seen dozens of patients operated on in the 80’s and 90’s who had poor results.  I am also sure there are many women out there who had good results and have had no reason to see the plastic surgeon again.  The question is, why would some women have poor results while others had good results?  The answer is another common theme in plastic surgery: patient selection.

The subcutaneous mastectomy is back in recent years and has been much discussed in the recent literature and at our recent meeting.  I have seen that it is a good operation in the right setting.  What is different this time?  Now, it is being offered to patients with breast cancer.  Studies have found that patients with relatively small tumors far away from the nipple can have the nipple spared and still have an acceptably similar cure rate to a mastectomy including nipple removal.  This operation can only be offered by an experienced breast cancer surgeon who knows how to evaluate his or her patient.  The breast cancer surgeon must also be able to perform this more difficult operation well, or the remaining skin may contribute to post operative healing problems.

Once it has been determined that nipple sparing mastectomy would be a safe operation for a patient, she should then be evaluated by a plastic surgeon to assess if she would be likely to have an aesthetic result.  What I have found examining patients with poor results is reflected in the most recent literature.  Women with larger and more ptotic (droopy) breasts tend to have worse outcomes.  If you think of the breast as a bag, and the mastectomy empties the bag, a large and ptotic breast will have a further distance for blood flow to go to feed the nipple and the bag volume will be difficult to fill effectively.  Therefore, if women with smaller and less ptotic breasts are selected for the operation, they will be more likely to have a good result. The use of acellular dermis (see previous blogs) has also contributed to better recent outcomes.

The operation, of course, still has its problems.  There may be healing difficulties, infection, poor shape, implant visibility, and contracture.  The most common source of dissatisfaction in a recent survey, however, was decreased or absent nipple sensation.   In many ways, the operation has more risks than a mastectomy in which the nipple is removed, but the results of a successful nipple sparing mastectomy can be excellent and difficult to replicate with other techniques.

Don’t forget… The Boise Komen Race for the Cure is coming up on May 7th.  We have formed team Wigod Plastic Surgery again.  You can sign up to raise money for the cause to cure breast cancer and take part in the fun with us at:

http://boise.info-komen.org/site/TR/RacefortheCure/BOI_BoiseAffiliate?team_id=154775&pg=team&fr_id=2030