silicone breast implants- 2 steps forward and ? back

The FDA, in its infinite wisdom has ruled to allow all silicone breast implants for all patients. In the past 15 or so years the silicone implants have been limited to study patients who already had silicone implants or who had cancer surgery and elected to have them placed for reconstruction. The advantage of silicone is the improved texture for both appearance and feel compared with saline implants.
The entire controversy should have been avoided since there was never conclusive evidence that liquid silicone caused disease. However it was a bonanza for trial lawyers who made a lot of money and for a few patients who got away with the lie- albeit unwittingly. The controversy bankrupted the manufacturer, I believe Dow Corning, and caused great emotional consternation among doctors. And the know-it-alls in the medical community and the lay public had a field day celebrating their sky is falling mentality. The killer in the controversy was the revelation that Dow Corning knew the implants leaked and hid the information. The lie angered the juries and the retribution was the demolition of the company.
Now, to the best of my knowledge we have irrefutable proof that recipients of the silicone implants under very close monitoring have shown no evidence of disease. At the same time it is my understanding that all implants leak. So, knowing that the silicone is "safe" and knowing that it will leak into my body after implantation, and knowing that I could have saline implants which leak harmless salt-water, I wonder which I would choose were I to make such a decision for myself.
Once again, buyer beware!

What to Do When You Lose Hair

There are so many reasons for losing hair that hyped over the counter remedies sometimes "work" for the wrong reasons. By far the most common reason is genetics and for that you may look to your parents and to their parents. There are shocks to the system which affect the most rapidly dividing cells first- namely scalp hair. These include pregnancy, drugs including chemotherapy, anesthesia, and even the shock of surgery. We must also consider diseases of the scalp and diseases of the body such as cancer. In fact, to approach all hair loss with one brush usually leads to frustration and disappointment from not achieving expected results.
There are few doctors trained to diagnose hair loss and most of us are dermatologists. First a thorough history must be taken and then a thorough physical exam of the affected areas of the skin. Then, depending on what is found a physical exam of other body organs may be needed perhaps with the assistance of your primary physician. Hairs need to be examined and so does the scalp. For a minority of patients blood tests and scalp biopsies are essential in making a diagnosis.
We have several break-throughs in knowledge in the past few years. First, FEMALE PATTERN BALDNESS IS NOT USUALLY THE SAME AS MALE PATTERN BALDNESS. I put this in caps because while so much homage is paid to testosterone (and I am a big fan of testosterone) this is not the cause of most cases of what we mistakenly call androgenetic baldness of women or more accurately called non-patterned diffuse alopecia of women.
The second is that MOST MEN UNDER 30 SHOULD NOT HAVE A HAIR TRANSPLANT. There are medications to preserve hair and due to physical and emotional immaturity hair transplants in young men are inadviseable (what if you do the transplant and then lose it or all the hair between the transplanted hairs).
The third is that a lot of diseases can be treated such as alopecia areata, alopecia totalis, fungal diseases, mechanical causes of hair loss, poor hair care, and some cases of inherited hair loss to name a few.
The fourth is that there are medical breakthroughs like minoxidil foam and propecia that can preserve existing hairs or even grow dormant hairs.
The fifth is that hair transplants look very natural when well performed and can add self-confidence with a normally framed face.
Edward Lack MD

Marketing hype works: What is smart lipo?

I received an e-mail lst night asking if "smart lipo" is a new improvement in liposuction. Once again an entrepeneurial physician, or clinic, or industry leader, or non-physician is coining a new term to market a medical procedure. When I did a search on the internet I found a site purporting to be the info site for liposuction. Several doctors were listed, several from Mexico, and none that I clicked on mentioned smart lipo on their website. I am guessing this is a marketing company that charges doctors to be on their website.
This is advertising hype at its best. I previously talked about a company of ?physicians and non-physicians who are threatening to sue doctors who use the term lipodissolve. For that reason I am trademarking the name liporesolve to have should I need it. In our litiginous environment there is always an attorney searching for a nonesense lucrative deal to match a physician who also wants to cash in on a lucrative nonesense deal. This is no different than the abuse our politicians heap on us to self promote, or the abuse the religious right and left heap on us to promote their self-interests. P.T. Barnum must have been right: there is a sucker born every hour. I should probably stop being offended.

Lipolysis = Lipodissolve = LiporesolveTM

As Western civilization becomes ever more rotund and as the obsession of magazines and television programming concerns body proportions with low body fat, physicians continue to look for ways to remove body fat without surgery. Each innovation sells for at least a while. Nothing has ever been as effective as liposculpture for achieving harmonious proportions. Yet even then attention must be paid to nutrition and exercise because proportionate shape does not equal low body fat.
Many years ago innovative and often unscrupulous physicians developed mesotherapy to treat any ill that might beset you. The concept was to inject a myriad of substances including vitamins, minerals, enzymes, and perhaps even dishwater into the dermis, the lower 80% of the skin, and when these substances were absorbed you would be cured. Each doctor had his own potion and his own technique and the entire field was clouded in disrepute.
More than 15 years ago European physicians began injecting phosphatidyl-choline into body fat and noted that fat was reduced in volume. The technique was confused with mesotherapy because it involved an injection. However, as the technique evolved it was nothing like mesotherapy. The solution concentrations and formulations were standardized and the injections were delivered into the fat and not into the skin. The Europeans formed a society to study this phenomenon and gradually it became accepted around the world. In the United States this technique is variously called lipolysis and lipodissolve and I will soon be introducing the term liporesolveTM. Regardless of its name this is an off-label use of an approved drug and as such it is legal in the United States. I have been using this technique for approximately 6 months and so far all patients have noted improvement in fat protrusions. These are much more subtle changes than liposculpture. However, the lowered cost and absence of surgery appeals to many and since people can return to work the next day it does not interfere with normal activities. Having said that, the area is sore for several weeks, it takes multiple treatments to achieve acceptable results in a given area, and it is infinitely slower than liposculture in achieving improved contours.