Board Certification Protects Patients

The case of Peter Normann is a great example of why patients must be educated and carefully check into the qualifications of a surgeon they are considering for cosmetic surgery.  These events can occur with Birmingham plastic surgery, as the state of Alabama is rather lax in the regulation of cosmetic surgery. Those calling themselves “board certified cosmetic surgeons” can readily perform cosmetic surgery, in their Birmingham offices, with minimal oversight. This, as seen in the Dr. Normann case, can make for unsafe surgery and poor outcomes. Many of these surgeons have no formal residency training or certification by the American Board of Medical Specialties (ABMS). It is the patient’s responsibility to determine if a surgeon has the right certifications and qualifications. Complications can arise with any surgery, but they should be minimized in the hands of the appropriately trained, experienced, and certified cosmetic surgeons. Birmingham plastic surgeon Michael S. Beckenstein, M.D. offers advice about choosing a safe plastic surgeon and questions to ask a prospective cosmetic surgeon.?

Posted in Body Contouring, fat transfer, fat transfer breast enlargement, fat transfer breast reconstruction, General Plastic Surgery, Liposuction, Midsection Makeover, Patient Education, Surgeon Education, Tummy Tuck, Uncategorized | Tagged , , , , | 1 Comment

Advantages of Neograft Over Traditional Hair Replacement Methods

In Birmingham, Neograft was just recently introduced by plastic surgeon Michael S. Beckenstein, M.D. This revolutionary technology changes how hair replacement is performed. The usual strip method is not used to obtain the hair to be transplanted, instead the Neograft technology harvests the individual follicles without any incision. This has many advantages over the currently used techniques:

  • no incision, stitches and no scar 
  • faster healing and return to normal activity
  • more hair transplanted in single session than other methods
  • saves money!

Men and women considering hair replacement in Birmingham should contact Dr. Beckenstein about Neograft.

Posted in General Plastic Surgery, hair replacement, hair transplantation, Patient Education, Surgeon Education, Uncategorized | Tagged , , | Leave a comment

Do Cosmetic Surgeons Learn More Cosmetic Surgery Than Plastic Surgeons?

Some surgeons who declare themselves as cosmetic surgeons state that they learn more cosmetic surgery than plastic surgeons. This is a ridiculous argument and demonstrates a dangerous lack of fundamental knowlege and judgement. It is the training that lays the strong foundation for a surgeon.

 Let’s start with basic training for a surgeon; the residency. this is where a surgeon builds the strong foundation of knowlege and experience in his/her field. A true residency has a board examination process that must be satisfied to obtain certification. This board should be recognized by the American Board of Medical Specialties (ABMS). This is where the basic fundamentals of surgery are learned. This includes not only learning how to operate, but how to manage patients before during and after their surgery. Essenetial to a successful residency is learning how to stay out of trouble and how to manage complications and challenges that might arise. Wounds, scarring, and other issues arise in plastic surgery patients as with other specialties, often the plastic surgeon is the last specialist brought in to finally solve and coreect a complex surgical situation. this is where the plastic surgery residency is invaluable to the plastic surgeon and those who depend on him/her. No other residency teaches and provides the vast experience with these complex issues. 

Plastic surgeons are trained in plastic surgery which includes cosmetic and reconstructive surgery of the face and entire body. Often the reconstructive training is called upon to manage difficult and challenging situations, especially pertaining to cosmetic surgeries. These surgeons must become certified by the American Board of Plastic Surgery (ABPS) to demonstrate competence in performing plastic surgery, including cosmetic surgery.

Cosmetic surgeons are ENT, gynecologists, general surgeons, and other non surgical specialties who also perform cosmetic proecdures, after completing some sort of cosmetic surgery fellowship, which is not a residency. Some participate in weekend type courses to learn cosmetic surgery! They do not possess the strong foundation that plastic surgeons have. Plastic surgeons, after completing their residency requirements, can compete a cosmetic surgery fellowship to augment the training in cosmetic surgery they already received in their plastic surgery residency. They are building an even stronger foundation of knowlege and experience that those deemed cosmetic surgeons.

Fellowships are designed to enhance training so a surgeon can specialize and further hone knowlege and skill of what was learned during residency. It is NOT to learn new techniques on parts of the body that are “foreign” to them where there is no “comfort zone” when operating in those areas. Cosmetic surgery is very challenging and demanding with little margin of error. Many fellowships are not “hands on” as patients only desire the teaching surgeon to perform the procedure. So the fellow usually takes on an assisting or observational role. With an appreciation of performing these procedures already, a plastic surgeon can effectively learn in this environment where others can not. So again, here an ENT surgeon, with no real training in breast surgery, could not have the same appreciation for mastering procedures on the breast and body when compared to the plastic surgeon, in this circumstance. They are focusing on the how to perform the basics of the procedure where the plastic surgeon is learning the nuances of how to do it better. So cosmetic surgeons stating they learn more cosmetic surgery than plastic surgeons is a ridiculous one as they do not have the foundation, nor the hands on experience compared to plastic surgeons. You can’t even compare a cosmetic surgeon to a plastic surgeon who completed a cosmetic surgery fellowship.

Cosmetic surgeons often take weekend courses on cosmetic procedures, perform a few under some sort of “supervision” and then feel they are ready and adequately trained to go out and operate. They use the argument that plastic surgeons often take weekend courses and learn a new procedure, why can’t they? Well, the reason is plastic surgeons have the foundation to stand on to appreciate, learn, and more readily perform the new techniques. Again, there is no merit to this flimsy argument used by cosmetic surgeons!  

 Imagine an ENT surgeon performing a breast reduction or enhancement, after a weekend course or “fellowship”. Plastic surgeons have much more experience here as they completed at least 2 to 3 years of general surgery where breast surgery is learned and another 3 years learning plastic surgery of the breast. Who would you want to operate on your breast, abdomen, or perform liposuction on your thighs? This is the question you must ask when you are choosing a cosmetic surgeon. Make sure he/she is certified to perform cosmetic surgery by an ABMS specialty, has adequate experience, and has a good, safe reputation! This responsibility is yours and the consequences can be dire if you make a poor, uniformed decision.

Posted in General Plastic Surgery, Patient Education, Surgeon Education, Uncategorized | Tagged | Leave a comment

Does a Tummy Tuck with Gynecologic Procedures Makes Sense!

Women often ponder having cosmetic procedures but are hesistant to actually undergo surgery. What many don’t think about is if the situation arises where a medically necessary procedure is needed, they can inquire about having a cosmetic procedure at the same time. If the procedures are gynecologic, in my opinion, it makes perfect sense to entertain indergoing aprofedure like a tummy tuck in Birmingham. It is an excellent opportunity  to combine these procedures as we are” right in the same neighborhood.” There are many advantages to combining these surgeries:

  • obtain a cosmetic improvement with a medically necessary surgery
  • save an additional surgery, anesthesia, and recovery
  • saves money
  • post operative discomfort and recovery time is the same
  • no additional hospital stay

These procedures can be safely combined using a well coordinated team of gynecologic surgeons and skilled plastic surgeon in Birmingham cosmetic surgeon As a plastic surgeon with over 12 years experience working with some of the largest gynecologic practices in the area, I see the value in working together efficiently to asure a safe surgical experience, with total operative times of less than three hours. If you are having to undergo a hysterectomy, bladder suspension, or other gynecologic procedure and desire a tummy tuck, consider contacting me to find out if you are a good candidate for this.

Posted in Body Contouring, General Plastic Surgery, gynecology, Midsection Makeover, Patient Education, Surgeon Education, Tummy Tuck, Uncategorized | Tagged , , | Leave a comment

Fat Transfer in Breast Reconstruction

The use of performing liposuction and transferring the fat into the breast is becoming more commonplace. While still in it’s infancy, the use of fat for breast enhancement can be performed safely and yield nice results  and is being used frequently in Birmingham breast reconstruction. As a Birmingham plastic surgeon I sometimes use this technique to augment breast reconstruction patients. The addition of fat to the periphery of a breast implant or flap significantly improves the cosmetic result. Eventually with more experience and studies, it MIGHT be possible to reconstruct an entire breast with the use of fat transfer. This would require multiple surgeries and the patient would have to have enough fatty tissue to donate for building the breast.

While it is not currently being used in breast enlargement , surgeons are watching carefully the trials being conducted in other countries and universities to determine how safe and effective it is for breast augmentation. Again, this would require more than one surgery and there would have to be enough fatty tissue to transfer to each breast to reach the desired size. Many women seeking breast enlargement often do not have excess fat to accomplish this.

Right now this  methodology is new, yet it is progessing. It does show promise right now to enhance breast reconstruction and may be of benefit for breast augmentation.

Posted in Breast Cancer, Breast Enhancement, Breast Enlargement, Breast Oncology, Breast Reconstruction, fat transfer, fat transfer breast enlargement, fat transfer breast reconstruction, General Plastic Surgery | Tagged , | Leave a comment

Your Options after Mastectomy

Women who have had a mastectomy typically experience positive emotions when they learn about breast reconstruction options. At my Alabama Breast Cancer Institute, we offer a comprehensive consultation to provide you with all the information you need to make an informed decision regarding breast reconstruction in Alabama.

I offer two different techniques for reconstructive surgery: autologous and prosthetic reconstruction.

  • Autologous Tissue Reconstruction

This type of surgery uses your own existing tissue to rebuild the breast. I transfer fat and skin from one area of the body (such as the abdomen, buttock, or thighs) to the chest. I often perform a complementary procedure during this procedure, such as a tummy tuck, based on the patient’s desires. Autologous breast reconstruction is a more complex, intricate surgery than reconstruction using breast implants in Birmingham, and it often involves a longer recovery with more downtime. However, the results can be more natural than implant reconstruction.

  • Prosthetic/Implant Reconstruction

Breast implant reconstruction uses silicone or saline implants in place of natural breast tissue. The type of implant chosen depends on an individual’s personal preferences and existing anatomy. My patients often opt for saline implants due to their proven safety record, while others prefer silicone implants because of their natural appearance and feel. This procedure is usually less intensive than autologous reconstruction because there is no donor site. As a result, my patients usually recover more quickly.

At my Institute, we can perform breast reconstruction during or after a mastectomy. Choosing the best option for you requires a thorough consultation with your surgeon to discuss the benefits of each method, including any possible consequences. We take the time needed to fully discuss your options before we perform this highly individualized treatment.

Posted in Breast Cancer, Breast Enhancement, Breast Enlargement, Breast Implants, Breast Oncology, Breast Reconstruction, General Plastic Surgery, Lumpectomy, Oncoplastic Surgery, Patient Education, Uncategorized | Tagged | Leave a comment

New Law, New Hope

A new law in New York that took effect January 1 requires that hospitals provide breast cancer patients undergoing mastectomies with reconstructive surgery information. As a Birmingham breast augmentation and reconstruction specialist, I am extremely pleased with this initiative.

I have always been a strong believer in patient education. The best way to empower women to make informed medical decisions is to provide them with details about their treatment options. This belief played a key role in my decision to devote the past decade to developing the Alabama Breast Cancer Institute – the new, cancer-focused treatment branch of my Breast Surgery Center. My highly specialized team of oncologists, radiologist, surgeons, and physicians now perform breast cancer screening, diagnosis, treatment, and post-operative care all under the same roof. With this system, I provide women with consultations, diagnostic exams, and testing results in the same day. When it comes to early breast cancer detection, time matters.

Unfortunately, some surgeons do not adequately attend to a patient’s post-operative care. I see women daily at my Breast Surgery Center who had mastectomies at another facility and are now experiencing body image concerns, as well as feelings of loss and self-consciousness. They cannot cope with their post-surgery emotions because they never received the medical support they deserved. At the Alabama Breast Cancer Institute, we offer women physical therapy and counseling to address the physical and psychological effects of breast cancer surgery. Our clinicians are sensitive to the needs of women and fully understand the complex emotional impacts of mastectomy.

Recovering from breast cancer surgery requires a strong support system. At my Alabama Breast Cancer Institute, we offer women just that: complete comprehensive care for a healthy, cancer-free life.

Posted in Breast Cancer, Breast Enhancement, Breast Implants, Breast Oncology, Breast Reconstruction, General Plastic Surgery, Lumpectomy, Oncoplastic Surgery, Patient Education, Uncategorized | Leave a comment

Who is Best Qualified to Perform Your Lumpectomy?

The most important aspect of a lumpectomy is to make sure the tumor is adequately resected and to minimize recurrence of the cancer. It is also important to have a nice aesthetic result as well. Both of these can be achieved with good pre-operative planning, technique, and surgeon experience. General surgeons have plenty of experience with tumor removal, but many do not appreciate the aesthetic component of the surgery. They are not trained in this aspect. The training and practice of general surgery is focused on tumor removal and it is not focused on the cosmetic aspects, whereas the plastic surgery is all about cosmetic results! I trained as both a general surgeon and plastic surgeon and can attest to this fact.

Breast aesthetics is complex and requires years of training and years of practice to achieve good surgical results. A surgeon who is board certified in general surgery AND plastic surgery would have the best of both worlds when it comes to lumpectomies. This is especially true of a surgeon who specializes in breast reconstruction, breast reduction, and breast lift in Alabama. All of these techniques are useful when planning a lumpectomy and reconstructing the resulting defect, a specialty known as oncoplastic surgery (explained well in this Wall Street Journal article). General surgeons, even those who have taken a weekend courses in oncoplastic surgery, do not have the true knowledge and expertise it requires to reconstruct these deformities. A dual boarded surgeon would be better in these situations.

If you cannot find a dual boarded surgeon to perform your lumpectomy, ask your surgeon to refer you to a plastic surgeon, specializing in breast surgery, BEFORE you undergo your procedure. Plastic and general surgeons often work closely in these situations to plan a good procedure that will ensure a safe oncologic result while preserving nice breast aesthetics.

Posted in Breast Cancer, Breast Enhancement, Breast Lift, Breast Oncology, Breast Reconstruction, Breast Reduction, General Plastic Surgery, Lumpectomy, Oncoplastic Surgery, Patient Education, Surgeon Education | Tagged , , , | Leave a comment

DISPELLING THREE COMMON FEARS OF SILICONE GEL BREAST IMPLANTS

Several patients, during their intial consultations with me, in Birmingham, are fearful of silicone breast implants. They share, with me, many false impressions about these devices that create a tendency for them to choose saline implants. I offer them explanations, direct them to my website www.msbmd.com, and provide them with other sources of information to help educate them about these implants. It is important to allow patients to make rational, eductaed decisions about what implants they choose. Below are three common fears patients present about silicone gel implants.

  1. If the devices fail (break) the gel will “leak” into the body: The new cohesive gel, in implants, is more “firm” in consistency and does not leave the shell. The gel is more like “jello” than a liquid. The capsule surrounding the implant also serves as a barrier, protecting the surrounding tissues from contact with any gel.
  2. Implants break in 10 years and need to be replaced every 10 years: Studies conducted by the implant manufacturers state that the failure rate is less than 1% per year. This means that in 10 years, there is less than a 10% chance of them failing. An MRI and possibly a new ultrasound can be used to detect implant failure determining if replacement is recommended.
  3. Silicone gel causes illnesses such as arthritis, fibromyalgia, and other disorders: There are many studies that have extensively reviewed this and there is NO association of gel implants with any systemic illnesses. If this was the case, the FDA would not approve these implants for use!

Silicone gel implants are safe for use in breast augmentation and breast reconstruction. Patients should not fear them and should calmly consider them for their procedures.

Posted in Breast Enlargement, Breast Implants, Breast Reconstruction, General Plastic Surgery, Patient Education, Surgeon Education | Leave a comment

Preventive Breast Surgery and Reconstruction

A recent study published in the Journal of the American Medical Association from researchers at the University of Pennsylvania School of Medicine (read the article here) has shown that prophylactic breast removal, or removing the breast before a patient develops breast cancer, can drastically reduce the chances of that patient developing breast cancer in the future.

Having both of your breasts removed, or having a healthy breast removed when the other breast is affected, may seem like a scary thought, but for many women carrying the breast cancer gene, early breast removal can be a wise and prudent choice. And with the advancements in breast reconstruction, these women can have normal-looking and healthy breasts even after a mastectomy.

Women should know that choosing prophylactic breast removal does not mean they have to live without breasts or with a prosthesis for the rest of their lives. I’ve helped many of my Alabama breast surgery patients reclaim their bodies after cancer through breast reconstruction. Here are 2 methods of breast reconstruction I offer my patients. Both can produce healthy and attractive breasts after mastectomy.

  • Autologous tissue reconstruction: Skin and fat are taken from a donor site on the patient’s body and used to rebuild the breast. Often the skin and fat are taken from the abdomen, called a TRAM Flap.
  • Prosthetic/implant reconstruction: Instead of using tissue from the patient’s body, I will use an implant to restore the breast. Once the breast skin is prepared during surgery, the procedure is similar to how I perform breast augmentation.

Breast reconstruction, either using a patient’s own tissue or an implant, can help repair the emotional and physical damage associated with mastectomy, even for women who choose to have a preventative mastectomy. They too can struggle emotionally with mastectomies even though they have not yet experienced cancer. Fortunately, women who choose prophylactic breast removal and undergo breast reconstruction can still have beautiful breasts in addition to greater peace of mind.

Posted in Breast Enhancement, Breast Implants, Breast Reconstruction | Tagged , | 6 Comments