American Academy Of Cosmetic Surgery Opposes Cosmetic Surgery Tax

Chicago, IL – As negotiators on Capitol Hill try to find ways to fund a health care overhaul, a 5% tax on cosmetic surgery has been introduced on Nov. 18 as part of the Senate’s proposed health reform bill, introduced by US Senator Harry Reid (D-NV). The American Academy of Cosmetic Surgery strongly opposes such taxes and urges legislators to consider the following points:

• A tax on elective cosmetic procedures is an unreliable, risky revenue source that has no proven record of raising projected revenues.
• The difficulty of defining elective vs. medically-necessary cosmetic surgery. There is a blurry line between what procedures are considered medically-necessary and those that are elective.
• Retention of highly-skilled physicians is at risk. Physicians face many challenges in operating their practices on a day-to-day basis. Turning them into tax-collectors is an additional burden on these doctors.
• Cosmetic surgery is not a specialty for only the wealthy or the vain. In fact, the median income for those electing to have cosmetic surgery is dropping.
• Despite the fact that more men are seeking cosmetic procedures than ever, the largest portion of patients are still working women, who would be unfairly targeted by such taxes.
• A large portion of those being taxed would be the baby-boomer generation. And as this age group continues to age, the more interest will be generated in cosmetic procedures. It is important to note that the age bracket are most likely to vote in elections is the same as those who are electing to have cosmetic procedures.

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Nuevos Conceptos en Cirugía Plástica

La belleza y la juventud, cualidades alabadas por poetas, filósofos y artistas desde el principio de la humanidad, no son sino una armonía de formas, energías y actitudes, desarrolladas sobre un cuerpo sano, resultado de una vida ordenada y en equilibrio espiritual. Pero muchas veces esta armonía se quiebra por diferentes circunstancias,  ya sea producto de un rasgo poco equilibrado, del inevitable paso del tiempo, de accidentes, de exceso de peso o secuela de enfermedades que comprometen lo que llamamos “formas”.

También es una realidad que la evolución de la sociedad y los cánones de belleza que  esta impone, acompañados de una mayor expectativa y calidad de vida, exigen el verse bien y en equilibrio psicofísico. Por eso, la Cirugía Estética busca restablecer la belleza perdida, aumentarla o crearla donde no existió, modificándola o adecuándola. Siempre teniendo en cuenta la salud integral de la persona, tanto en el plano físico como en su equilibrio psicológico, la personalidad tiene que corresponder con el resultado obtenido.

La decisión de una Cirugía Plástica no es tan simple como comprarse un cosmético y no es solo cosa de mujeres. Actualmente, los hombres requieren cada vez más este tipo de procedimientos y representan un 20 % de las consultas. Además, no existe un tiempo ni una edad ideal para la Cirugía Plástica. Igualmente, una serie de factores condicionan el estado estético, como son: la exposición solar, la herencia, la nutrición, el tabaco, el alcohol, el estrés, los embarazos, los cambios de peso, etc. La necesidad aparece cuando una persona no está conforme con alguna parte de su cuerpo y se plantea cambiarla o mejorarla. Esto es algo muy personal. Entonces el cirujano plástico, con criterio médico, evaluará al paciente, hará un correcto diagnóstico del problema y seleccionará el procedimiento adecuado para cada caso en particular, que  no siempre implica un procedimiento quirúrgico.

¿Existen  riesgos? Son cirugías programadas y esto permite un adecuado chequeo  clínico, cardiovascular y de  laboratorio. El paciente no se opera por una enfermedad, el organismo está sano y responde cien por ciento. Lo cual hace que estos procedimientos sean muy seguros, con riesgos mínimos. Obviamente deben ser realizadas en un correcto ambiente de quirófano y por profesionales idóneos.

Por otra parte, la Cirugía Plástica es una especialidad médica que como tal es dinámica y está en constante evolución acompañada de avances tecnológicos que  permiten tratar diferentes partes del cuerpo con técnicas innovadoras, menores cicatrices y un mayor confort postoperatorio.

No dude en contactarnos para tener una consulta con el Doctor Roberto Martínez Rinaldi.

Cirugías Comunes con Incisiones Mínimas

Menos dolor y mejor recuperación

El desarrollo vertiginoso de la ciencia en las últimas décadas ha generado un fenómeno que supera a veces nuestra capacidad de asombro.  La medicina en sus distintas especialidades no ha sido ajena a este suceso, y en el caso de la cirugía ha incorporado nuevos conceptos que cambian radicalmente el enfoque de la cirugía tradicional.

Todos sabemos que al momento de realizar una operación, el cirujano necesita realizar una incisión para poder alcanzar el problema y resolverlo.  El espacio necesario para trabajar “con la mayor seguridad posible” trajo aparejada la idea de que “a grandes cirujanos, grandes incisiones”. Esto significaba que era necesario “exponer lo suficiente” el área de trabajo para asegurar buenos resultados en la operación.   Alcanzado el éxito de la cirugía, los problemas se centraban ahora en la recuperación, ya que una incisión grande implica mucho más dolor, más tiempo de recuperación y una demora considerable en el retorno a la actividad laboral.

Basados en la idea de generar el menor daño posible en el paciente, surgió el concepto de la Cirugía Mínimamente Invasiva, que implica el cambio de rumbo desde la cirugía tradicional “abierta” hacia la cirugía actual “cerrada”.

Esto ha sido posible gracias al desarrollo de la tecnología digital en imágenes. A través de incisiones pequeñas se introduce una cámara que ofrece al cirujano una visión amplificada y real de la cirugía, que le permite resolver con gran detalle  el problema. Es por esto que, comparada con la cirugía convencional, esta técnica mejora notablemente los resultados a largo plazo.  Además, el desarrollo de instrumental cada vez más pequeño nos permite realizar incisiones de dos a tres milímetros, con un resultado estético excelente.

Las ventajas de esta técnica se resumen en menor dolor,  menores complicaciones en la herida, mayor confort para el paciente y corta estadía en el centro asistencial.

Las condiciones para que estos modernos procedimientos puedan realizarse en forma segura tienen que ver con la calidad profesional, determinada en la mayoría de los casos por la experiencia del cirujano en prestigiosos centros de formación del extranjero, y una infraestructura, equipamiento e instrumental adecuados para cada caso.

Es así como asistimos hoy a la posibilidad de resolver en forma segura a través de incisiones muy pequeñas, problemas habituales de distintas especialidades. A modo de ejemplo, afecciones de vesícula, hernias inguinales, quistes de ovario, varicocele, y hasta algunos casos de nódulos tiroideos pueden ser operados de este modo.

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Survey Shows Majority of Respondents Openly Discuss Use of BOTOX® Cosmetic and Hyaluronic Acid Dermal Fillers

“In a similar survey issued four years ago, we dispelled the myth that Hollywood and corporate wives were the typical BOTOX® Cosmetic patient,” says ASERF President Laurie Casas, MD, a plastic surgeon practicing in suburban Chicago. “Now, demographic and perception data trends show us that aesthetic injectable treatments have continued to evolve into mainstream and accepted options for the everyday woman.”

Survey results found that the typical aesthetic injectable patient is a married, working mother between 41-55 years of age with a household income of under $100,000. The survey also found that women receiving aesthetic injectable treatments are health-conscious and philanthropy minded, with the majority incorporating exercise (95 percent) and healthy eating habits (78 percent) into their lives, and many volunteering with charitable organizations that matter to them (32 percent). In addition, nearly seven out of 10 respondents believe that BOTOX® Cosmetic (72 percent) and hyaluronic acid dermal fillers (65 percent) are important parts of their aesthetic routine.

“Interestingly, among BOTOX® Cosmetic patients, nearly seven out of 10 respondents also received treatment with hyaluronic acid fillers,” says Dr. Casas. “Most people have great success with BOTOX® Cosmetic and dermal fillers; however, we need to make patients aware that even though injectables are not ‘surgery,’ their administration is a medical procedure with risks that depend on the training and experience of the clinician, the clinical setting and the technique used.”

Additional findings of the survey found that 72 percent of respondents received BOTOX® Cosmetic injections to treat their glabellar lines – also referred to the “11” – the frown lines in between the brows, while 63 percent of those surveyed received hyaluronic acid dermal filler injections to treat their nasolabial folds – also known as the “parentheses” – the lines around the nose and mouth. A few of the most frequently cited reasons to receive treatment with BOTOX® Cosmetic was “to look more relaxed, less stressed” while patients reported choosing treatment with hyaluronic acid dermal fillers to “look more rejuvenated.”

Based on its annual survey of U.S. physicians performing cosmetic procedures, ASAPS recently reported that BOTOX® Cosmetic injections have remained the most frequently performed procedure since FDA approval of the product in 2002. Hyaluronic acid dermal fillers ranked as the third most popular procedure performed last year. ASERF conducted this follow-up survey to quantify the characteristics and opinions of the patients who receive the treatment to help its members and the public obtain a better understanding of these important modalities.

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Infertilidad sin causa aparente

Definición y diagnóstico

La infertilidad o subfertilidad sin causa aparente es un diagnóstico de exclusión que suele determinarse en un10 a 15% de las parejas con infertilidad o subfertilidad.

El profesional así lo denomina cuando la etapa de diagnóstico de la pareja descartó otras causas posibles. No significa que no hay razón para la infertilidad, sino que la causa no se ha podido identificar aún.

La evaluación convencional de la infertilidad en la mujer puede incluir: historia médica, examen físico, niveles de hormonas en sangre, función ovulatoria e histerosalpingografía (HSG) (radiografía del útero y trompas de Falopio). Laparoscopía, lo que comprende la inserción de un instrumento delgado, como un telescopio iluminado dentro del abdomen para ver el útero, ovarios, y trompas de Falopio; puede ser necesario excluir factores como la endometriosis y adherencias que pueden no ser vistas por HSG.

La evaluación convencional en el hombre puede incluir: historia médica, examen físico, análisis de semen y exámenes de hormonas. Tests para determinar la capacidad fertilizante del esperma del esposo, o pruebas de penetración de ovocitos de hamster pueden ser realizados pero no son completamente con?ables. Este problema, sin embargo, puede ser descubierto durante la Fertilización in Vitro (FIV).

La FIV es una técnica de reproducción asistida que une en el laboratorio el ovocito (huevo) con el esperma. Si el ovocito fertiliza y comienza su división celular, el embrión resultante es luego transferido al útero de la paciente.

Otros factores

Los factores más relevantes para ser considerados en la evaluación y manejo de la infertilidad sin causa aparente son la duración de la infertilidad y la edad de la mujer.

Una pareja joven sin problemas de infertilidad cuenta con un 20% de probabilidad de embarazo por mes. Por el contrario, parejas con infertilidad sin causa aparente que no han logrado el embarazo durante tres años, tienen una chance de embarazo espontáneo de 1 a 2% por mes solamente.

El proceso de envejecimiento en la mujer, particularmente luego de los 35 años, trae aparejado una reducción en la capacidad reproductiva e incremento en los abortos espontáneos. Las pruebas de capacidad reproductiva (reserva ovárica) que pueden incluir niveles de FSH y estradiol en el día 3 del ciclo menstrual para evaluar la función ovárica. Parejas infértiles o subfértiles, donde la mujer es mayor de 35 años, deberían consultar sin demoras al especialista luego de 6 meses sin lograr embarazo. Especialmente cuando se haya identificado un factor de infertilidad como endometriosis, historia de ciclos menstruales irregulares, etc.

Tratamiento

No hay acuerdo sobre el procedimiento óptimo para tratar la infertilidad sin causa aparente, dado que muchas parejas con uno a tres años en esta situación, finalmente lograrán concebir espontáneamente.

En la mujer, el tratamiento empírico (tratamientos de infertilidad cuando no hay una causa definida) con drogas inductoras de la ovulación por 3 a 4 ciclos combinados con inseminación intrauterina (IIU) (insertando el semen procesado directamente dentro del útero), seguido de FIV es un proceso frecuentemente utilizado.

Investigaciones recientes indican que las tasas de embarazo con estos tratamientos son iguales o más altas que las tasas de embarazo de parejas con otros diagnósticos de infertilidad.

En el futuro, un conocimiento mejor de la fisiología reproductiva humana permitirá tratamientos aún más efectivos para pacientes con infertilidad sin causa aparente.

Contáctenos para tener una consulta con el  Doctor Andrés Juárez Villanueva o el Doctor Gustavo Gallardo.

Nearly 15-Million U.S. Working Women Considering Cosmetic Procedures

Faced with news of increasing layoffs, straining economic times, and a belief that hiring is based on looks, millions of American women are looking at cosmetic medical procedures to give them a competitive edge in the workplace. In a new telephone survey* compiled by the American Society of Plastic Surgeons (ASPS) of 756 women between the ages of 18 and 64, many reveal cosmetic plastic surgery procedures now appear to be an important rung on the success ladder.

* 13 percent (more than 1 out of 10 of the 115-million working-age women) say they would consider having a cosmetic medical procedure specifically to make them more confident and more competitive in the job market.

* An astounding 3 percent (nearly 3.5-million working women) say they’ve already had a cosmetic procedure to increase their perceived value in the workplace.

* 73 percent (almost three out of four or, 84-million working women) believe, particularly in these challenging economic times, appearance and youthful looks play a part in getting hired, getting a promotion, or getting new clients.

* 80 percent (four out of five or 92-million working women) think having cosmetic medical procedures can boost a person’s confidence.

An Insurance Broker recently had a chemical peel and fat transfers from her abdomen to her face. “Time has given me the professional knowledge. But time can take away the youthful sparkle of my appearance if I let it. When you look good, you feel confident. That gives me a competitive edge and something my clients have come to expect from me,”.

ASPS Member Surgeon, MD performed Axelrod’s cosmetic procedures at Advocate Lutheran General Hospital in Park Ridge, Illinois. He says “Not only do the women believe youthful looks help in the workplace…they’re acting on that belief.”

“Consumers need to remember that while cosmetic procedures might help them in the job market, they’re still medical procedures.”

Feel free to contact us for a free quotation with Doctor Roberto Martinez Rinaldi.

Source: ASPS

Divorce, Antidepressants, or Weight Gain/Loss Can Add Years to Your Face

Your mother’s wrinkles or lack there of, may not be the best predictor of how you’ll age. In fact, a new study claims just the opposite. The study, involving identical twins, suggests that despite genetic make-up, certain environmental factors can add years to a person’s perceived age. Results just published on the web-based version of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS), reveal that factors like divorce or the use of antidepressants are the real culprits that can wreak havoc on one’s face.

“A person’s heritage may initially dictate how they age – but if you introduce certain factors into your life, you will certainly age faster. Likewise, if you avoid those factors you can slow down the hands of time,” “In this study, we looked at identical twins because they are genetically programmed to age exactly the same, and in doing so we essentially discovered that, when it comes to your face, it is possible to cheat your biological clock.”

During the study, Dr. Guyuron and his colleagues obtained comprehensive questionnaires and digital images from 186 pairs of identical twins. The images were reviewed by an independent panel, which then recorded the perceived age difference between the siblings.

Results showed that twins who had been divorced appeared nearly 2 years older than their siblings who were married, single or even widowed. Antidepressant use was associated with a significantly older appearance and researchers also found that weight played a major factor too. In those sets of twins who were less than 40 years old, the heavier twin was perceived as being older, while in those groups over 40 years old, the heavier twin appeared younger.

“The presence of stress could be one of the common denominators in those twins who appeared older.” Additionally, researchers suspect that continued relaxation of the facial muscles due to antidepressant use, could account for sagging. And though they do not advocate gaining weight to look younger, researchers note that losing abnormal amounts of weight not only have harmful effects on a person’s health, but on their appearance, too.

“This research is important for two reasons,”. “First, we have discovered a number of new factors that contribute to aging and second, our findings put science behind the idea that volume replacement rejuvenates the face.”

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What Influences Women’s Opinions On Their Breast Surgery?

The six major factors that affect how happy a woman feels with the outcome of her breast surgery have been uncovered. Researchers writing in the open access journal BMC Women’s Health have determined that, as well as final breast appearance, there are five other major concerns that influence surgical satisfaction.

“Patient satisfaction with breast appearance was without doubt the key theme and is a salient factor in determining the success of breast surgery. However, other themes were also identified that related to the broadened notion of quality of life, including concepts such as physical, psychological and sexual well-being”.

The authors found that breast conditions and breast surgery impact women in the following six main areas: satisfaction with breasts; satisfaction with overall outcome; psychosocial well-being; sexual well-being; physical well-being; and satisfaction with the process of care. Although these six themes were common to women in all three groups, the importance ascribed to each was seen to vary by surgical group. According to Pusic, “While physical well-being was of only limited importance to breast augmentation patients (only a few reported pain and discomfort post-operatively), it was often the main motivation behind breast reduction surgery (patients reported substantial pain and activity limitations pre-operatively), and was often an issue for women following breast reconstruction”.

Pusic and her colleagues have used their framework to develop a new patient-reported outcome measure called the BREAST-Q©, which consists of three procedure-specific modules (Augmentation, Reconstruction and Reduction). The authors hope that their findings may be used to guide the development of patient education materials and facilitate shared medical decision-making. They conclude, “The combination of extensive detailed qualitative research and modern psychometric methods make it possible to measure constructs, such as patient satisfaction, in a more clinically meaningful and scientifically robust way than has ever been done in this patient group”.

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Source: BioMed Central Limited