Tuesday, August 9, 2011

Cosmetic Surgery: Are the Payoffs Worth the Price?

Cosmetic Surgery: Are the Payoffs Worth the Price?
Kim Gregson's moment of doubt came two weeks into her recovery. In pain, swollen, and aching with a sensation like a bad sunburn around her liposuction sites, she sat in her doctor's office bawling "What was I thinking? This is awful."

After shedding 70 pounds through weight loss, Kim spent $8,500 on a tummy tuck to remove excess skin. She also wanted to remove the negative self-image that lingered with her. In the end, the 5-foot-1 human resources manager went from a size 16 to a 4 petite.

Despite the pain and the cost -- her husband sold his Harley Davidson to help pay for the procedure -- Gregson, 47, says it has been worth it. Today, she calls herself a "new person" and "emotionally better" and has had significant health benefits from her weight loss, including lower blood pressure and cholesterol.

Reclaiming Selves Through Cosmetic Surgery
Those sentiments are echoed time and again with other women who have had similar procedures.

Sabrina Blasingame, a 26-year-old mother of two who lives in Twentynine Palms, Calif., says her $18,000 breast augmentation and tummy tuck were "worth every penny." Samantha Alvarado of New York City, also a 26-year-old mother of two, was so pleased with her $13,000-plus breast augmentation and lift, and tummy tuck -- aka a "mommy makeover" -- that she returned to school to become a plastic surgery nurse. Alicia Hunter, 43, of Miami, bartered her services as an aesthetician for a pair of silicone implants to add volume to her breasts, after she breast-fed her two children. "I feel like a whole woman now," she says about her 32-D bra size.

More women who have lost significant weight or had several pregnancies are turning to cosmetic surgery to reclaim a positive feeling about their bodies. They join others who seek to turn back or stop the clock, or enhance what they already have, through surgery and/or injections. These various motivations, largely emotional in nature, have driven spending on cosmetic procedures to more than $10 billion in the last year alone. Women made up 91% of those customers for a total of 11.5 million procedures, up by 5% from 2009, according to theAmerican Society of Plastic Surgeons.

Injectables Fuel Growing Business

'stem-cell' facelift courtesy Amy KleinDespite the recession and its aftermath, the cosmetic procedure industry has continued to grow, and every demographic tracked by the ASPS registered an increase last year. Over the last decade, there has been a shift from surgical operations like full surgical facelifts, to injection-based treatments or injectables, like Botox and Restylane.

Cosmetic surgeons, physicians and even dentists giving injectables like Botox would have consumers gloss over the costs. Botox costs between $400 and $600 per session, and needs to be redone every four months. It doesn't take an advanced accounting degree to see the repetitious nature of such therapies adds up to a lot of money.

"I counter by asking a woman how much they spend on cosmetics every year," says Dr. Phil Haeck, president of the American Society of Plastic Surgeons.

Cristina Hadzi, 54, who owns her own interior design firm in New York City, has been getting Botox for almost 10 years with Dr. Adam Kolker, aPark Avenue plastic surgeonand an associate clinical professor of surgery at Mount Sinai Hospital. Christina says she budgets for the injections in the same category she budgets for hair and other beauty treatments. Last year, when her business slowed, she stopped treatments. But with her income back up this year, she is back to doing injectables regularly.

Another procedure growing in popularity is a "stem-cell facelift", which also done entirely with injections of a person's own body fat, which can cost between an estimated $5,000 and $10,000. Amy Klein, 41, says the results were worth it for her.

Amy, who is a freelance writer, had the procedure done two years ago on the eve of moving to New York City from Los Angeles, where she had lived for the previous decade. She says the procedure knocked five to 10 years off her age, which made her feel confident returning to her home city of New York.

"When I was coming back to [New York City], it was like returning to a 'den of thieves,'" she says. "But I was looking pretty good next to the women who were five years younger than me on the Upper West Side." A romance that was budding before the procedure, bloomed after her facelift and she's now engaged to get married.

When Does Beauty Pay Off?

Determining whether a cosmetic procedure, surgical or injectable, is worth it is a deeply personal question, and the answer tends to depend on whether one is asking the question in terms of economic outcomes (not really), happiness (yes, perhaps) or health (depends).

Despite marketing campaigns and personal anecdotes that suggest otherwise, there's very little academic data to show cosmetic surgery has any direct economic benefits for those who have it done.

Daniel Hamermesh, aneconomist at the University of Texas at Austin, has studied the economics of beauty for more than 20 years. There's little concrete economic analysis on the benefits of cosmetic surgery, he says, because those who get it are a self-selecting group. Hamermesh did find, in a study he co-authored which looked at beauty and income, that for every extra dollar spent on appearance, thereturn on investment was about 15%.


But as so many women attest, it's not money they are after but happiness. And that return on investment equation does have compelling data to back it up. Hamermesh has found that beauty and happiness are correlated: Better-looking people tend to be happier and experience both direct and indirect economic rewards.

"Any kind of market where you interact with a seller and the seller has some discretion [over the price], a better-looking person might do better," says Hamermesh.

Dr. Haeck reports that he is increasingly seeing men getting nips and tucks with the purpose of specifically boosting economic outcomes. "They are competing for a scarcity of jobs," he says. "A man might say 'I am the the oldest guy in my division and the competition is younger.' Before, the motivations were to look more attractive, like it was buying new clothes, but this year, we really heard the job issue."

Cosmetic SurgeryKim Gregson has become a real advocate for women wanting to undergo cosmetic surgery. She emails with hundreds of women in various stages of their own plastic surgery journeys onRealSelf.com, a popular online reviewand discussion site for cosmetic pro.

"Women are judged because it is vain or it's a lot of money," she says. "But a lot of people spend money on a car, so why can't you spend $15,000 on yourself?"

Still, a number of recent studies have pointed to the downside to cosmetic surgery and procedures. In July, research by scientists at the University of Colorado showed thatfatty deposits removedfrom the belly, hips, and thighs returned within a year of the procedure -- but in new areas, mainly the upper abs, shoulders and upper arms. Another recent study from Duke University on those with Botox showed it maylimit their ability to empathizewith others because facial mimicry is a key component to perception and relating to people.

Yoga and Almonds: Nature's 'Cosmetic' Procedures?
Mitch McCabe is a documentary filmmaker who lives in Los Angeles. Her 2009 film,Youth Knows No Pain (watch it on Hulu), was part memoir about her experience growing up as the daughter of a plastic surgeon, and part investigation into why people seek out age-defying surgery.

Along the way, she dabbled briefly the world of injectables, getting Radiesse during the film and another injection later which left a lump near her eye. McCabe says her experience made her confront the double-edged allure: She enjoyed the results of the first filler she received, but was less impressed with her second treatment. Ultimately, she had reservations about putting foreign substances into her body, and getting sucked into the ongoing costs of treatments. "Getting my hair colored is insane enough," she says. "You have to pick your battles."

She admits that in the appearance-worshiping culture of Hollywood, where people "have much nicer cars than houses," it's hard to commit to "never again" for cosmetic procedures. Meanwhile, Mitch swears by raw almonds and downward dogs as the antidote to getting older.

"I took up yoga just as I was finishing the film and I have never gotten so many compliments," Mitch says. "Just like exercise is to anti-depressants, so is yoga to anti-aging."

Monday, August 8, 2011

Heather Locklear Photos Spark Plastic Surgery Rumors

Heather Locklear Photos Spark Plastic Surgery Rumors
by Sheila Ring

Heather Locklear has sparked a storm of speculation over whether she has had breast augmentation surgery following photos taken of the actress Thursday night at a charity dinner in London.

For 49-year-old Locklear, hitting the half-century mark seems to be a breeze, judging by her stylish little black dress, reports CBS News.

The sun-kissed stunner, who turns 50 in September, stepped out in stilettos for Samuel L. Jackson's charity dinner, rocking the figure-hugging ensemble.

She stepped out for the third annual Shooting Stars Benefit ball with a black clutch and shoes to match.

The “Melrose Place” alum attended the event with her longtime boyfriend, actor Jack Wagner, 51, who is a firm advocate of a healthy lifestyle for them both, CBS News reports.

"He has been a great influence on Heather," a friend of the actress told PEOPLE in 2008. "He's really committed to a healthy life."

In an interview on the Regis & Kelly show in March, Locklear denied having ever had cosmetic surgery.

However, she did admit she might think about having something done "in the future,” reports AOL Lifestyle UK.

The former “Spin City” actress added: 'I think [plastic surgery] is great. Especially since I'm at an age now where all my friends talk about it."

"No one's done it yet, but it's all they talk about....Sometimes I look at this [gestures to her chin]... I think it would be scary, but hey, I'm not against it at all. At all,” Locklear said.

She was named one of People Magazine's 50 Most Beautiful People twice, first in 1994, and again in 2001.

Friday, August 5, 2011

Are you an exhibitionist?

Are you an exhibitionist?
Ian Kerner, a sexuality counselor and New York Times best-selling author, blogs about sex on Thursdays on The Chart. Read more from him at his website,GoodInBed.
Are you an exhibitionist? Maybe even a little bit of one? Have you ever fooled around in the backseat of a taxi, or gotten it on at your parents’ house, or made out in an elevator or stairwell, or enjoyed some great sex amidst the great outdoors?
In my experience as a sexuality counselor, exhibitionism tops the list of frequent fantasies for both men and women and is also the inner desire that couples are most likely to translate into action. So what is it about being potentially caught in the act that’s such a turn-on?

On a simple level, the thrill of possibly being seen or heard while otherwise sexually engaged increases the brain’s transmission of dopamine, a neurotransmitter that’s a close cousin to adrenaline and plays a big role in sexual excitement.
As psychologist Elaine Hatfield says, “Adrenaline makes the heart grow fonder.” And for those couples whose hearts are already deep in the throes of infatuation, exhibitionist behavior may simply be a byproduct of that all-consuming, can’t-keep-your-hands-off-each-other feeling, in which love is not only blind to the opinions of others, but also to their gaze.
And of course, for some, exhibitionism is more a matter of practicality (like when you’re living at home or with roommates) than a function of actual desire.
But still, a propensity for exhibitionism runs far and deep and many psychologists theorize that its broad appeal may be strongly related to our first youthful experiences with the intense pleasure of orgasm, which most of us experienced (whether on our own or with someone else) when the possibility of getting caught was close by - say, in our parents’ house.
And, not unlike the development of a fetish, these formative experiences may establish a powerful link between the particular risk of getting caught and the singular pleasure of sexual gratification.
As a result, even years later, the possibility of getting caught as manifest in our exhibitionistic urges elicits powerful feelings of sexual desire. We may be far from our teenage years (and even have kids of our own), but that doesn’t mean we’re not above acting like horny, hormone-addled teenagers when home for the holidays.
With exhibitionism, there is also an underlying sense of power that comes from being observed - a power in knowing that we may be arousing the watcher(s).
In their recent book on the Internet and sexual desire, authors Ogi Ogas, Ph.D., and Sai Gaddam, Ph.D., note that “one in four webcams on the free webcam network ChatRoulette are aimed at a penis.”
This strong compulsion to experience power through the premise of arousing others would explain why guys like Anthony Weiner “sext” photos to women they’ve never even met. It’s not about specific sexual gratification, but more about a general feeling of power.
While most women probably don’t get turned on by random photos of guys’ genitals, that’s not to say that women don’t also experience a power and pleasure in being desired, hence the female propensity to engage in other acts of exhibitionism just as much as men.
Classical paintings of nudes often featured women who were more interested in soliciting the sexual gaze of the disembodied spectator than anyone else with whom they happened to be depicted, and today much amateur porn features women who are often making love as much - even more - to the person on the other side of the camera as the person they’re actually with.
Exhibitionism is not just about the thrill of getting caught, it’s about being seen, admired, loved and appreciated. Not long ago there was a spate of Hollywood starlets — Britney Spears, Paris Hilton, Lindsay Lohan — who were exposing themselves “accidentally” while wearing short skirts with nothing on underneath.
Clearly, this could have just been their desperate ploy for press, but it also felt like their desperate attempt to be wanted and sexually craved by one and all.
In the end, a little playful exhibitionism can be fun and exhilarating and may well be part of our innate sexual psychology—but remember, it can also get you arrested. While you may enjoy drinking a fruity cocktail like Sex on the Beach, don’t take that as a suggestion to actually have sex on the beach, as one young couple recently did. You could end up in jail.
It’s one thing not to be able to keep your hands off each other in public; it’s quite another when you can’t keep your genitals off each other. In that case, go get a room. Odds are you can find one with a view.

Thursday, August 4, 2011

Fergie has A LOT to say about those cosmetic surgery rumors

Fergie has A LOT to say about those cosmetic surgery rumors

Black Eyed Peas' Fergie opens up about those nagging cosmetic surgery rumours


FERGIE has been the target of more cosmetic surgery rumours than we've had roast dinners.And while Black Eyed Peas' Fergie has laughed off reports she's spent £20,000 on having cosmetic surgery, we still don't feel satisfied that she's ruled it out altogether.

Anyways, the beauty has spoken out about the ongoing rumours in a brand-spangling new interview - saying it's "ridiculous" to claim she's spent that much going under the knife.

Speaking about the reports, Fergie explained that she's had to learn to laugh off all the craziness over the years.

The songstress said in the business she's in, you can't focus too much on everything that's written about you - as you'd drive yourself crazy.

Fergie, who showed off her sizzling curves in a stripey mini-skirt and bright yellow top on the shoot, also spoke to Cosmpolitan about her struggle to be disciplined with that she eats.

She said healthy eating and exercising is something she's always working on, but sometimes late at night so she tends to have fast-food meals - which is where she gets into trouble.

The beauty claimed that she's not in the best shape she could be, but she's a curvy woman and just wants to be comfortable with that.

Meanwhile Fergie, who married actor Josh Duhamel in 2009, said family plans are definitely on the agenda for the couple.

The Black Eyed Peas' star said they're looking forward to starting a family and they talk about it, but added that's a whole other chapter for them that's going to be a lot of fun.

Read the FULL interview with Fergie in the September issue of Cosmopolitan UK, on sale August 8.


Wednesday, August 3, 2011

Can you undo plastic surgery?

Can you undo plastic surgery?
Reality star Heidi Montag says she regrets the cosmetic procedures she's had. Can she do anything about it?
By Melissa Dahl

Remember Spencer Pratt and Heidi Montag? The villainous duo of MTV's "The Hills" who were so very famous, at least for a time, for simply being famous, recently gave an interview to The Daily Beast, in which they discuss their regrets. They have a few: Among them, Montag says she wishes she hadn't had so many cosmetic procedures.

“Obviously I wish I didn’t do it,” Montag tells the online magazine. If you'll recall: The now-25-year-old has had breast implants, rhinoplasty, liposuction, collagen injections in the lips, a chin reduction, a brow lift and a buttock augmentation, among other procedures .

We wondered: How often are regrettable cosmetic surgeries redone — or even "undone"?

"Redos are very, very common," explains Dr. Tony Youn, a Michigan-based, board-certified plastic surgeon and contributor to msnbc.com. In fact, Youn says up to 20 percent of the patients he sees are people seeking some kind of "redo" — usually, it's a correction or improvement to rhinoplasty or breast augmentation.

There aren't many statistics to come by in terms of cosmetic surgery "redos." But the American Society of Plastic Surgeons has this to offer: In 2010, there were 21,714 breast implant removals among augmentation patients. No figures exist that describe the number of "undos" — but that's likely because, in terms of cosmetic surgery, what is done usually can't be "undone."

With breast augmentations, in particular, "typically, the changes that happen to a breast, they are permanent. So if you take the implant out, the skin ends up being stretched out," Youn explains. "If Heidi ends up taking them out, her 700 CC implants — almost the biggest size that we make — if they take them out of her breasts, she's going to have two basically empty sacs."

Youn says the most common procedure his patients want redone are nose jobs. Judging from his own patients, he estimates that up to 25 percent of patients who have rhinoplasty surgeries eventually want something corrected — either they feel their nose has changed too much and they no longer look like themselves, or it hasn't changed quite enough.

Of course, things like Botox or Montag's collagen injections are temporary, lasting about four to six months, so her lips have likely depuffed by now. But it gets sketchier when we get into some of the other cosmetic surgeries Montag's had: If she regrets her chin reduction, for example, the only way to fix that would be to put an implant in. And the only way to "undo" a liposuction procedure is to gain weight — or have fat injectedback in, Youn explains.

The lesson here: With plastic surgery, as with life, there really is no CTRL+Z.

Tuesday, August 2, 2011

Anti-aging tool kit

Anti-aging tool kit
Patients are often confused about what different techniques can actually accomplish. Here are the basics.By Claudia Pinto

Women come to Dr. Dawn Vincent all the time, anxious to get rid of their “11s” (what they call the lines between their eyebrows) or their “parentheses” (the lines around their mouths).

Vincent, a dermatologist with Belle Meade Dermatology, says people typically have no problem identifying what they want fixed. However, the explosion of non-invasive cosmetic procedures in recent years has resulted in confusion over what treatments will best address their issues.

Dr. Brian Biesman, executive director of the Nashville Centre for Laser and Facial Surgery, says a lot of times patients have heard about a new treatment and they’ll ask if it works. He says the answer frequently depends on what you’re using it for — a product meant to erase wrinkles is not going to cure sagging skin.

“Does a hammer
work? Well, if you are trying to hammer a nail it works perfectly. If you are trying to saw something, not so much,” Biesman says.
HOW THEY WORK

We turned to doctors Brian Biesman and Dawn Vincent for a crash course on non-invasive cosmetic procedures, an anti-aging 101 if you will. Read on for an overview of how to effectively treat some common aging problems.

Sagging skin
Treatments: Thermage, Ultherapy
How they work: Both treatments heat tissue under the skin, causing it to shrink and stimulate collagen, which makes the skin on the face become tighter and younger looking. Ultherapy uses ultrasound energy. Thermage uses radiofrequency energy.
Staying power: It takes a few months to see the full effects. Results are expected to last about a year for Thermage and one to two years for Ultherapy.
Possible side effects: Temporary bruising, numbness, skin tenderness and swelling.
Cost: $3,000 to $4,000. Thermage is about $3,000 to treat the entire face. Ultherapy is about $4,000.

Upper face wrinkles
(Lines between the eyebrows, on the forehead and around the eyes)
Products: Botox, Dysport (injected)
How they work: Wrinkles on the upper part of the face are typically caused by muscle movement. Botox and Dysport work by temporarily weakening the muscle, reducing activity that causes lines to form.
Staying power: Results can be seen within a few days and last for about four months.
Possible side effects: Temporary swelling, bruising and drooping eyelids or eyebrows.
Cost: $300 to $400 per site, depending on severity.

Lower face wrinkles
(Wrinkles around the mouth and chin)
Products: Juvederm, Restylane and Perlane (injected). Why not Botox or Dysport? “You don’t want to limit muscle movement around the mouth,” Vincent says.
How they work: Juvederm, Restylane and Perlane are products known as fillers. They are gels that are injected into the skin to fill in wrinkles.
Staying power: Results can be seen immediately and last several months.
Possible side effects: Temporary swelling and bruising.
Cost: $600 and up depending on severity.

Dark sunspots
Treatment: Q-switched lasers
How it works: The laser’s light beam is absorbed by excess pigment cells and destroys them.
Staying power: Permanent
Possible side effects: Temporary swelling, a little bit of crusting that can last a few days.
Cost: $100 to $350 per treatment. It typically takes one to three treatments for desired results.

Volume loss
(hollow cheeks and sunken eyes)
Products: Sculptra, Radiesse, Juvederm, Restylane, Perlane (injected)
How it works: Sculptra is a poly-L-lactic acid that stimulates collagen growth. The rest are gels that are used to fill in areas of the face that have lost volume due to aging.
Staying power: Sculptra and Radiesse can last two years or more. The other products last several months.
Possible side effects: Temporary bruising and swelling. Sculptra and Radiesse may also cause small bumps deep in the skin.
Cost: $600 to $1,000 and up. Treating an area with sculptra or Radiesse can cost $1,000 and up, depending on severity. The other products run about $600 and up.

Monday, August 1, 2011

Plastic surgeons reveal reality of global hot topics in cosmetic surgery

Plastic surgeons reveal reality of global hot topics in cosmetic surgery
By: Lisette Hilton

Boston — Stem cell therapy advancements continues to be an issue of great interest among the cosmetic surgery field, but the lack of scientific evidence leaves many surgeons concerned, according to experts speaking at the Aesthetic Meeting 2011 in Boston.
Stem cell facelifts and biofilms were among the topics that a panel of plastic surgeons discussed during the Global Hot Topics forum at the American Society for Aesthetic Plastic Surgery’s annual meeting, aimed at vetting new and emerging technologies in plastic surgery, according to moderator William P. Adams Jr., M.D., associate clinical professor, plastic surgery, University of Texas Southwestern Medical Center, Dallas.
“Often, new devices, techniques or technologies are released and marketed … way ahead of the science. That’s what Hot Topics is really about: basically, to sort out what’s real science versus hype and marketing,” Dr. Adams said.

Top picks: Stem cells in plastic surgery
The use of stem cells in plastic surgery is a classic example of technology that has no currently proven scientific foundation, according to Dr. Adams.

Peter B. Fodor, M.D., who presented on stem cells, said the miraculous results from stem cell therapy in any specialty are, at this point, isolated and anecdotal cases.
“If one were to Google ‘stem cell facelifts,’ for example, some 200,000 or so results come up. But, do a literature review of bona fide and peer-reviewed journal articles on the topic and only about 20 relevant articles on stem cell supplemented fat grafting and almost no articles on stem cell facelifts are found.

“So, there is a major disconnect, here, between reality and hype,” said Dr. Fodor, past president of the American Society for Aesthetic Plastic Surgery and associate clinical professor of plastic surgery at University of California, Los Angeles.

A history of stem cell research helps to put reality into perspective, according to Dr. Fodor, who was part of the stem cell research at UCLA as early as 2002. He notes that it is important to realize that there are stark differences between embryonic stem cells, usually collected from umbilical cord blood, and stem cells harvested from adult subjects.

Basically, allogenic embryonic stem cells are associated with rejection issues, as well as ethical, political and religious concerns, he said.

“The same concerns do not apply to … stem cells procured from adults and used autologously, for therapies in the same person. In either case, however, there are serious concerns and questions that still remain about the use of stem cells in plastic surgery and other specialties,” Dr. Fodor said.

Cosmetic surgery applications
Researchers have uncovered information that could someday be applied to cosmetic surgery procedures. For example, about 10 years ago, a number of centers, including the University of Pittsburg and UCLA, found that subcutaneous fat is abundantly rich in adult stem cells. While there are only about 75 cc of bone marrow available in an average adult for stem cell isolation, there are thousands of cc of subcutaneous fat present in most adults.

Furthermore, the stem cell yield per cc of fat is 100 to 1,000 times more than in the same volume of bone marrow. And bone marrow harvesting is more cumbersome and uncomfortable for the donor than liposuction, according to Dr. Fodor.

UCLA researchers have also proven that, with appropriate induction factors, subcutaneous fat-derived stem cells have the ability to be grown in the laboratory into other tissues, such as bone, cartilage, muscle, nerve or fat.

“But just because we can make cartilage, at this point in time, it does not mean that we can engineer a joint. This is the direction in which the research could eventually take us,” he said.
Researchers also found stem cell potency is related to patient age: the younger the patient, the more potent the stem cells.
“The feeling is that the stem cells will retain the age at which they were collected, even though the person continues to age,” Dr. Fodor said. “It all sounds very exciting. The problem, however, is that there are a lot of snake oil salesmen prematurely touting stem cell therapies.”

Renewed interest 
While much of the research focus for stem cells has been on cardiac applications, such as post myocardial infarction, according to Dr. Fodor, there is a renewed interest in researching applications in plastic surgery.

There is evidence that stem cells injected in the margins of a pressure wound have an uncanny ability to speed healing. And fat enriched with stem cells seems to work well when injected to refine residual deformities in connection with breast reconstruction, he said.

There is, however, no solid peer-reviewed evidence in the medical literature that stem cells can be applied successfully to facelifts.

“Actually, it has not even been defined what a stem cell facelift is. Is it to take fat, isolate the stem cells and inject them into the face blindly? Is it using fat and adding stem cells and injecting that? Or while doing a facelift, you’re also injecting stem cells?” he said. “Theoretically, by injecting fat into faces, you’re injecting stem cells (as well), because fat is inherently rich in stem cells. These are only some of the many questions surrounding the concept of stem cell facelifts.
”
There are also questions about serious health issues. Dr. Fodor says stem cells can accelerate the growth of active cancer cells, but not necessarily those in a dormant stage.
For now, the safest stem-cell application in cosmetic surgery is to store patients’ fat-derived stem cells for future use, he said. Dr. Fodor has been doing this in his practice, upon patient request, since 2002.

Biofilm update 
New evidence helps to confirm that biofilms have been shown to cause health issues in plastic surgery procedures; mainly, breast implant related capsular contracture. Biofilms could also be linked to latent post soft tissue filler infections and granulomas.

Contracture around breast implants is the most common medium- to long-term complication following breast augmentation, said Anand Deva, B.Sc., M.B.B.S., M.S., F.R.A.C.S., associate professor, Macquarie Cosmetic and Plastic Surgery and head of the Surgical Infection Research Group, Macquarie University, Sydney.

“There is now clear evidence that bacteria can attach to the surface of breast implants at the time of surgery to form a biological coating (biofilm), which can go on to cause inflammation and contracture,” Professor Deva said. “We are now working on strategies to prevent bacterial access to implants at the time of surgery and early results are very promising.”

Professor Deva and his group have been looking at the issue of biofilm and prosthetics for more than a decade.

“We have used basic scientific investigation, field studies of patients with failed prosthetics and laboratory models to show conclusively that biofilm is the single most important cause of prosthetic failure in medicine,” he said. “The range of prosthetics is vast — from orthopaedic pins, artificial heart valves, replacement knees and hips and even contact lenses. For cosmetic surgery, our focus has been on breast implants. More recently we have also turned our attention to the problem of biofilm in injectable fillers.”

In a study funded by the Aesthetic Surgery Education and Research Foundation, Professor Deva and colleagues looked at currently unapproved antibiotic impregnated bioabsorbable polymer, which could help prevent biofilm formation, Dr. Adams said.

This product essentially is an absorbable piece of mesh, impregnated with antibiotics and implanted with the breast implant to sterilize the pocket, Dr. Adams said. In a pig model, the researchers showed all of 14 of the animals that had the implants without the product developed capsular contracture, while none of the 14 that had the product developed the contracture.
“I think it has become mainstream thinking that bacteria and biofilms are the leading cause of capsular contracture. This is important research because we’re going to need to develop strategies to prevent the formation of biofilms to reduce morbidity,” Dr. Adams said.