Beauty by Brueck

Why do we brag.

2012-05-26T11:26:00.001-07:00

I guess we all have universal needs and wants. We all want to feel loved and needed.

Researchers recently revealed that when we brag about ourselves it triggers the same pleasure center in our brain like food and money. Self disclosure or bragging was extra rewarding.

I guess that explains why we all need a little self-indulgent kick once in a while.

That may also explain some of he popularity of Facebook, almost a million members. You can find me on Facebook at http://www.facebook.com/DrBrueckMDFortMyersPlastic Surgeon or at my Fort Myers plastic surgery website, Beauty-by-Brueck

STEM CELLS – PRP – AND THEIR FUTURE IN PLASTIC SURGERY

2012-05-23T13:49:00.000-07:00

Innovation is the cornerstone of progress in most human endeavors and plastic surgery is no exception. Some of the advances I have seen in 30 years as a Fort Myers and Cape coral plastic surgeon are truly remarkable – I sometimes have to pause and catch my breath.

One area of new research and innovation has to do with the field of stem cells, autologous fat and PRP or platelet rich plasma. There are recent trends that have received much hype and notoriety but I think it is important to not oversell something before we enough about it.

As we speak, studies and research are being conducted to unlock new avenues of clinical application of stem cells and platelet rich plasma. The possibilities are only limited by the collective geniuses of hundreds of scientists world wide working to unlock the hidden secrets of stem cells and PRP.

For years, stem cells were a hot political issue and to some extent that persists today but to a lesser degree because of new discoveries in stem cell research. We were led to believe the only stem cells available for research were embryonic, but we know now that the “pooch” around our stomachs – mine included – contain millions of stem cells. It really is not necessary to go out and harvest embryos or fetuses.

Basically a stem cell is a pluri potent cell, ie. a cell looking for a neighborhood to hang out in or grow up in. If you put a cell in say an ankle joint – the stem cell looks around and hopefully will differentiate say into a bone or cartilage cell. I have had stem cells injected into my arthritic left ankle three times with what I consider good results. Is my ankle like it was before my injury – no! Is it less painful – yes. So, many questions remain to be answered. One of these newer trends in cosmetic surgery is to augment the face with a patient's own fat stem cells and PRP.

I would say about 30% of the time or more, I recommend patients get autologous fat to build up their facial structures. As we age we loose volume – our skin thins – it sags – we lose collagen and elastic fibers. Finally one day we wake up – look in the mirror and decide the time has come to do something – time to go see Dr. Brueck about some cosmetic surgery in Fort Myers, Florida.

The fat/stem cells are usually harvested from the patients abdomen. We recommend combining the fat/stem cells with the patients own PRP. This combination of fat/stem cells – alone or with PRP is then injected into a patient's face to build it up and replenish what was lost due to aging.

What is PRP?

2012-05-20T17:11:00.000-07:00

We hear so much about PRP – What is PRP?

This three-letter name stands for "Platelet Rich Plasma."

How do we get PRP?

The process is very simple. We draw off about 60-70 cc’s of the patients’ own blood. We then spin it down for several minutes. This gives us the red cells in the bottom of the centrifuge tube and the top half containing plasma, platelets, ie. the platelet rich plasma.

We recently had a new development which allows us to get super concentrated platelet rich plasma. After the initial spinning down – we draw off the plasma – minus the red cells. We then spin it down a second time for several minutes giving us pure or more concentrated PRP which we then mix with the patients own fat and stem cells. It is this combination that we inject into the patients face to augment it. This would be in lieu of say Juvederm, Restylane or Sculptra. The best part is it is cheaper – lasts longer and it is your own tissue.

What makes platelets so special?

Platelets are very special and have a very prominent role in healing wounds. Part of their magic centers around them containing x-granules. These are small packets contained within the platelets that have several growth factors, ie. protein with growth factors that are released when the platelets are activated. These factors increase in growth of blood vessels, new collagen and a whole host of other cellular functions to heal and rejuvenate our skin. The proteins contained in these granules influence many aspects of wound healing.

What’s on the horizon?

More and more people want simple – easy – no downtime procedures to enhance their facial appearance. That helps to explain the explosive growth in Botox and fillers. Millions of these procedures are done every year and their popularity is growing. People want something easy – quick with no downtime.

This may be the "miracle" they are hoping for.

Why Starbucks makes "bucks"

2012-05-20T09:53:00.000-07:00

Several months ago, I posted my thoughts and some findings about coffee consumption and health. Now, the New England Journal of Medicine chimes in with the findings of a massive (400,000 subjects) study of coffee drinkers. The article is excerpted below.

"Association of Coffee Drinking with Total and Cause-Specific Mortality

Neal D. Freedman, Ph.D., Yikyung Park, Sc.D., Christian C. Abnet, Ph.D., Albert R. Hollenbeck, Ph.D., and Rashmi Sinha, Ph.D.

N Engl J Med 2012; 366:1891-1904 May 17, 2012

BACKGROUND

Coffee is one of the most widely consumed beverages, but the association between coffee consumption and the risk of death remains unclear.

METHODS

We examined the association of coffee drinking with subsequent total and cause-specific mortality among 229,119 men and 173,141 women in the National Institutes of Health–AARP Diet and Health Study who were 50 to 71 years of age at baseline. Participants with cancer, heart disease, and stroke were excluded..."

"Inverse associations were observed for deaths due to heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections, but not for deaths due to cancer. Results were similar in subgroups, including persons who had never smoked and persons who reported very good to excellent health at baseline.

CONCLUSIONS

In this large prospective study, coffee consumption was inversely associated with total and cause-specific mortality. Whether this was a causal or associational finding cannot be determined from our data. (Funded by the Intramural Research Program of the National Institutes of Health, National Cancer Institute, Division of Cancer Epidemiology and Genetics.)

Supported by the Intramural Research Program of the National Institutes of Health, National Cancer Institute, Division of Cancer Epidemiology and Genetics.

So, if you love coffee and have been worried about it's affect on your health, this should be reassuring. Perhaps we should offer a cup of coffee when you come to visit my Fort Myers plastic surgery center.

Do you sweat too much? Read this.

2012-05-17T21:45:00.000-07:00

EXCESSIVE SWEATING OR HYPERHIDROSIS

Several million people suffer from hyperhidrosis, or excessive sweating. It is estimated that 2-3% of population has hyperhidrosis. People with hyperhidrosis often sweat even when it’s cool outside. It runs in families and many people choose to live with it since, no permanent effective treatment existed until now. There are several conditions that can cause excessive sweating such as menopause, hyperthyroidism. This is termed secondary hyperhidrosis.

Symptoms

The main symptoms are excessive underarm perspiration. It can effect the palms and soles of the feet. Most people with excessive sweating have had to alter their lifestyles, and their clothing because it causes many embarrassing moments not to mention permanent stains to blouses, shirts and other articles of clothing.

Available Treatments:

Antiperspirants
This is the front line of therapy for most people. Usually the deodorant consists of 10-20% aluminum chloride hexahydrate. This can be irritating to your skin and expensive. It can also cause damage to your clothing.

Medication-
Some people have tried anti-cholinergics such as robinul but these are not very popular due to side effects such as dry mouth, dizziness and difficulty urinating.

Iontophoresis-
This is an FDA approved procedure that utilizes electric current to temporarily shut down sweat glands. This is effective for hands and feet. It takes 10-20 minutes per session and several sessions are needed.

Botox-
The FDA has approved Botox for underarm sweating. About 70-100 units are divided equally between the patient’s armpits and injected. At a cost of $10-$12.00 per unit the expense is considerable. The Botox may last 3-6, months but again is only temporary.

Endoscopic Thoracic Sympathectomy (ETS)-
This transects the nerve that is responsible for stimulating your sweat glands. This is usually not too effective for excessive armpit sweating. It’s good if someone has excessive palms, sole or facial sweating.

Other surgical rx’s-
Sometimes one can use special suction cannula to remove the sweat glands or use a special surgical shaver which will “shave” away the glands. These are surgical procedures; often require anesthesia and a more prolonged recovery.

This can be a very disabling and devastating condition. It causes extreme embarrassment. Many people alter their types of clothing- the colors they wear. They limit their arms or shoulder movement so as to not reveal their wet armpits. It can affect careers where people need to manipulate equipment with their hands, like a surgeon. Then there is a risk of dehydration. I had one patient who would drive to work with her armpit hanging out the car window to “keep them dry.”

THE NEW, FDA APPROVED, REVOLUTIONARY MIRA-DRY

Late last year, miraDry was approved by the FDA to correct permanently excessive axillary or armpit sweating. It is NOT used to treat excessive hand or foot sweating.

The procedure is done under local anesthesia as an out-patient. In Fort Myers, FL, this will be either in the licensed surgery center of Dr. Robert J. Brueck MD, who is the only Southwest Florida surgeon licensed to perform the procedure, or at Fort Myers' All-Inclusive Medi-Spa, by staff trained to perform the procedure. The area of skin with excessive sweating is determined and infiltrated with local anesthetic, similar to the way Novacaine is administered when having a tooth filled. The miraDry procedure is then performed. The treatment of both armpits takes around 40 to 45 minutes. The miraDry machine delivers electro-magnetic energy to the armpit area to eliminate the eccrine or sweat glands. Once eliminated, these glands DO NOT regenerate.

What will it feel like? There are no incisions. Once the local is injected, we wait 5-10 minutes for it to take effect. This totally eliminates any pain or discomfort.

What do I do after the treatment? It’s simple, we usually put some ice packs under the patient’s arms and they are discharged home. The most important thing the first day or two is ice to minimize the swelling. Usually a simple Motrin or Advil is all that is needed for controlling minimal pain. You can shower the next day and go to work.

What are the results? Most patients will experience an immediate reduction in their underarm sweating. In one clinical trial patients experienced an 86% reduction.

How many treatments do I need? You will need 2 treatments separated by about 3 months to maximize your results. On rare occasions a person may need a 3^rd treatment.

How long does it last? The decrease in sweating is permanent. Once the eccrine sweat glands are destroyed by the electromagnetic waves, they do NOT regenerate.

Is it harmful to de-activate under arm sweat glands? The sweat glands in the under arm area represent only 2% of the total number so there are NO more bad side effects.

Who can have mira-dry? Patients should be 18 years or older. If you have excessive sweating, this is made to order.

Dr. Brueck, a Board Certified Fort Myers plastic surgeon, advises that this article is for informational purposes only and should not regarded as medical advice.

(c) 2012 Dr. Robert J. Brueck MD

PRP FACIAL REJUVENATION.

2012-05-02T09:00:00.000-07:00

What is this? Once again we are utilizing the patients own tissues.

We draw off 60-70 cc’s of a patients blood and spin it down twice to get super concentrated PRP with all of those growth enhancing proteins.

We apply an anesthetic cream to the patients face - sometimes use a little ice which is numbing as well. While the cream is working we draw the blood and get our concentrated PRP. After working and prepping the face, we spray the activated PRP onto a small area of the patients face, say the forehead. We have a micro-dermal roller with very tiny needle points 1 mm in depth and make literally thousands of small openings in the patients skin to allow all of these goodies, ie. growth factors, to sink in. We roll – massage – roll – massage.

We then move to another area, say the left cheek, and repeat this process until the entire face is done. Once completed we cover the patients face with a collagen mask for 15-25 minutes. It’s removed and the patient goes home – they don’t shower or wash their face that night. Up in the morning – shower – and back to normal routine with a new healthy glow to their face.

As a plastic surgeon in Fort Myers-Naples, I do not want to oversell this procedure, but UNDERSELL it. This is NOT a facelift, but it is a good way to restore your skin to a more normal healthy appearance.

I recommend a patient receives 2-4 of these treatments separated by 4-8 weeks. It is also helpful if a patient is on a good skin care program such as Nia-24 or Obagi. Some patients may need a peel to soften wrinkles – fat to fill in hollows or depressions - but the key is that the combination of all of the above can go along to help rejuvenate a patients facial appearance. Again, it is NOT a facelift. Also remember whenever a non-surgical procedure is done on someone – there may be a tremendous variation in one patient's response compared to another. It’s another alternative – another choice – outpatient – non surgical – minimal downtime. It is not a panacea, but surely a step in the right direction.

NEW RX FOR AK!

2012-04-28T05:00:00.000-07:00

What are AK’s? They are actinic keratosis which many people get over the year and they can be a precursor for skin cancer.

There is a new medicine that may be quicker and more effective than other treatments. This new medicine is called Pecato – kind of sounds like an Italian Veal dish.

This cream is applied once a day for only 2-3 days versus other creams that require several weeks of therapy. This shorter duration of treatment leads to a much higher rate of patient compliance.

As a plastic surgeon in an area with a lot of sun exposure, I'm eager to learn more.

NOVEL BREAST IMPLANT ON THE HORIZON

2012-04-27T10:04:00.000-07:00

Researchers at the University of Akron, led by Dr. Judit Puskas have developed a breast implant made from an impermeable polymer material.

This material may be embedded with medicines to even fight breast cancer.

Further studies are being done to define the drug delivery technology. They hope to have a prototype implant ready for clinical trials in 1-2 years.

Plastic surgeons in Fort Myers, Florida will be looking forward to their future announcements.

HOW HAPPY ARE YOU?

2012-04-25T06:58:00.000-07:00

There was a recent study in our “Plastic and Reconstructive” plastic surgery journal gauging patients response to liposuction and abdominoplasty.

These combined procedures produced a remarkable increase in a patients self esteem and quality of life.

The two performed together produced a satisfaction rate of greater than 99% - that’s impressive!

86% of the patients reported higher levels of self esteem and 70% of patients reported an enhanced quality of life.

A whopping 98% of the patients said they would undergo the procedure again.

Actually, that corresponds to the results I see as plastic surgeon in Cape Coral Florida

FREE PLASTIC SURGERY

2012-04-24T06:00:00.000-07:00

I knew that would get your attention.

But it's not plastic surgery in Florida. You have to go to Brazil. And be poor.

Many plastic surgeons in Brazil are offering free plastic surgery or significantly discounted plastic surgery free to the poor.

Brazil is the second largest market for cosmetic surgery. Who do you think is number 1?

Many Brazilian plastic surgeons do this to boost people's self-esteem. We know how great that can be.

POPCORN – NEW HEALTH FOOD

2012-04-22T12:30:00.000-07:00

As a Southwest Florida cosmetic surgeon, I don't get a lot of time to go to movies.

When I do, I need my popcorn.

Somehow eating a bag of popcorn after a big meal created guilt feelings inside of me, but maybe not anymore.

A new study shows that popcorn may be more nutritious than some fruits and vegetables (remember that mantra – 7-8 servings daily).

Researchers at the University of Scranton in Pennsylvania found that popcorn husks contained high levels of antioxidents called polyphenols. These polyphenols can reduce the risk of cancer and heart disease.

So maybe a bag of popcorn without the salt and/or oil isn’t a bad choice after all. Let's all go to the lobby...

NEW TEST FOR ALZHEIMER’S

2012-04-21T09:22:00.000-07:00

Here's a new blog message from Dr. Robert Brueck, Fort Myers and Bonita Springs plastic surgeon

Pharmaceutical giant, Eli Lilly Company, recently got approval from the FDA for a new Alzheimer’s test.

The test relies on a chemical called florbetapir which is injected into the patients body. This radioactive substance also known as Amyvid will stick to the characteristic amyloid plaques found in Alzheimer’s patients. The chemical is injected followed by a PET (positron emission tomography) scan.

The cost of the chemical is about $1,600.00. A lot of money. But what isn't when it comes life-saving developments?

OBESITY – WHAT REALLY WORKS?

2012-04-09T13:21:00.000-07:00

Here's another heads-up from Dr. Robert Brueck MD, Fort Myers plastic surgeon who works with patients seeking weight loss.

New studies/reports show that bariatric surgery or weight loss surgery is more effective than medicine in controlling blood sugar in obese patients. The study appeared in the New England Journal of Medicine recently.

EAT CHOCOLATE FOR A THINNER YOU!

2012-04-08T19:17:00.001-07:00

More good news from Dr. Robert Brueck MD.

We all know friends who are chocoholics.

A new study of people living in Southern California reveals that people who eat more chocolate tend to be thinner. The chocolate eaters actually consumed MORE calories that those that didn’t eat chocolate.

The study, however, may link the frequency of eating chocolate to weight loss. People who ate a small amount of chocolate 5 days a week had a lower BMI or body mass index.

MIRACLE DRUG!

2012-04-03T13:15:00.002-07:00

Dr. Robert Brueck MD, who practices plastic surgery in Fort Myers, Florida, likes to share good news with his blog readers.

This is good news. A drug many of us take everyday may be a key drug to prevent cancer and keep it in check.

A series of new studies shows that common everyday aspirin just may be the key to ward off cancer. Oxford University studies done to test aspirin’s effects on the heart, showed that not only were these people less likely to have a heart attack but also 23% less likely to develop cancer over a 3 year period versus those who took NO aspirin.

Over a 5 year period they had a 37% lower risk of dying from cancer.

They also conducted a study in people with cancer and found that those who took an aspirin a day had a lower rate of metastasis. Study author Peter Rothwell said “no drug has been shown before to prevent distant metastasis.”

XEOMIN OR BOTOX

2012-03-31T10:54:00.000-07:00

Dr. Robert Brueck MD, Fort Myers Florida plastic surgeon reports:

It is sort of like a heavy weight bout between two heavy weight fighters.

They take their gloves off and now it’s serious.

Botox maker Allergan has won a court injunction blocking Merz from selling their competing brand Xeomin. Apparently some Allergan employee’s came to work for Merz. So in the meantime while they “duke” it out, the roll-out of Xeomin will be blocked.

Round two to follow.

AN APPLE A DAY MAY BE GOOD AFTER ALL

2012-03-30T08:49:00.000-07:00

As a Fort Myers MD and plastic surgeon, I try to keep up with news related to skin care.

Now there's this:

Maybe we should put those potato chips and chocolate cookies aside (even though they taste good), and start munching on apple slices and carrot sticks.

A new study revealed if you only eat ONE – that’s right – not two – extra servings of a fruit or vegetable, it can enhance the appearance of your skin. The study involved 35 college students and after 6 weeks, independent observers noticed an increase in the redness and yellowness of individuals who ate extra fruit/vegetables. They feel the carotenoids in the fruits/vegetables was the causative culprit.

Sounds good.

CAN WE EAT OUR WAY TO MENTAL HEALTH

2012-03-29T10:43:00.000-07:00

Have you heard about the “Mediterranean” diet and how healthy it is?

It is a diet centered on fresh fruits, vegetables, fish, grains, nuts and olive oil, not to mention a moderate amount of alcohol.

A recent study found that people who followed this diet had better blood vessels in their brains.

Maybe it's the other way around. Maybe being smart directs you to a healthier diet.

That causal relationship is the kind the kind I constantly question as a plastic surgeon in Fort Myers, Florida

The total number of surgical cosmetic procedures...

2012-03-28T10:31:00.003-07:00

...performed in 2011 showed women having 1,493,615 total which was 91.2% of all procedures while men had 144,909 total surgical procedures which was 8.8% of the total numbers. As a Fort Myers plastic surgeon, I find these stats instructive.

Cosmetic procedures by age groups – male/female:

18 and under 34,663

19-34 456,400

35-50 665,381

51-64 382,378

65+ 99,701

Top 5 cosmetic procedures:

Breast augmentation 316,848

Liposuction 283,669

Tummy tuck 142,657

Blepharoplasty 124,635

Breast lift 122,054

Top 5 cosmetic procedures for men:

Liposuction 41,663

Rhinoplasty 24,553

Blepharoplasty 22,905

Gynecomastia 17,645

Facelift 10,400

Some year to year comparisons:

1997 2011

Tummy tuck 34,002 149,410

Breast augmentation 101,176 316,848

Breast lift 19,882 127,054

Liposuction 176,863 305,332

Facelift 99,196 116,086

Browlift 55,090 28,200

Interesting stuff, eh?

MERCURY IN SKIN CARE PRODUCTS

2012-03-21T12:48:00.000-07:00

As a Fort Myers plastic surgeon, I am an avid reader of the FDA alerts.

The FDA recently published a warning about mercury contained in certain skin care products ie. lotions, soaps, and/or cream. They have been marketed as anti-aging treatments.

The products are manufactured abroad and have been imported illegally.

Exposure to mercury can have serious health consequences. It targets kidneys and the nervous system.

My suggestion would be to go to the website at http://www.fda.gov/ Once there, look for updates.

HOW TALL YOU ARE MAY MAKE A DIFFERENCE

2012-03-21T06:40:00.001-07:00

We all have been inundated about America’s obesity epidemic and it’s real. As a Fort Myers plastic surgeon, I am regularly exposed to people who are threatening their health by not reducing their body mass.

Now, a newly released study shows men taller than 6 ft. have a significantly lower risk of developing heart failure than men who are 4 inches shorter.

Other studies have shown that taller men have a lower risk of heart attacks.

The current study involved over 22,000 doctors who were studied for 22 years!

There were 4 height categories. So I wonder when the word leaks out if platform shoes will be a hot seller! Hmmm.

NEW WAY TO LOWER MELANOMA RISK

2012-03-18T18:43:00.000-07:00

This is a new and novel way to lower melanoma mortality rates.

Recruit and hire more dermatologists to your community.

A recent study out of Case Western Reserve found the greater density of dermatologists per patient population, the lower the mortality rates for melanoma.

Simple. Easily executed and one I heartily endorse as a Fort Myers plastic surgeon.

LYMPHEDEMA FOLLOWING BREAST SURGERY

2012-03-17T09:44:00.000-07:00

Lymphedema can occur after almost any kind of breast surgery.

It usually occurs after a modified radical mastectomy. It can occur after a lumpectomy or simple mastectomy. There have been reported cases after breast reduction or rarely breast augmentation, neither one of which I have seen in 33 years of practice as a Fort Myers Plastic Surgeon.

Lymphedema can occur almost immediately after surgery or years later. Usually it manifests as non-painful swelling of hands, fingers or arms. The patient may complain of tightness – or heaviness.

Lymphedema can NOT be cured so we treat it symptomatically. The normal course of therapy is a technique of complete decongestive therapy (CDT) provided by a certified lymphedema therapist. There are things a patient can do to help control lymphedema – good nutrition, good skin care, exercise, maintain a stable weight. If there is a lot of swelling keeping the extremity elevated – wearing compression garments – avoid repetitive exercises of the involved extremity. Several sites to go to for help include:

1. National Lymphedema Network www.lymphnet.org

2. Lymphology Association of North America www.ch-lana.org

HOW YOUNG WILL I LOOK?

2012-03-16T18:44:00.000-07:00

One question I’m always asked as a Fort Myers plastic surgeon is how much younger will I look? Wow – that’s a tough one to answer – it’s so subjective. I read about a recent study in the “Archives of Facial Plastic Surgery.” It was done by a group of researchers at the University of Toronto.

Patients were ages 45-72 and placed in 3 groups.

Group 1: face/neck lift

Group 2: face/neck lift, upper and lower blepharoplasty (eyelid)

Group 3: face/neck lift, upper and lower blepharoplasty, coronal lift (forehead)

They then asked medical students to be the judges. They asked the students about there chronological age before and after surgery.

Group 1: patients looked 5.7 years younger

Group 2: patients looked 7.5 years younger

Group 3: patients looked 8.4 years younger

So I guess we can conclude the more facial plastic surgery you have, the younger you’ll look!

SLEEPING PILLS – LURKING DANGER?

2012-03-15T18:15:00.001-07:00

Several people I know as a Fort Myers plastic surgeon, many of whom are my patients, take sleeping pills either occasionally or on a regular basis.

In a recent study, 10,000 people who took sleeping pills was compared to a group – similar in age and health history – who did not take sleeping pills.

The shocking news – people who used sleeping pills were more than 5 times likely to die of ANY cause over the study period. Even light users ie: 1-10 pills per year had a 3.6% greater risk of dying.

A word of caution – these statistics do NOT necessarily mean that the sleeping pills were the cause of the increased death rates because it may mean people who take sleeping pills have other health issues as well.

But,it makes you wonder!