City hosting conference on plastic surgery

October 27, 2007|By Dennis O'Brien | Dennis O'Brien,Sun reporter

Roxanne Guy and Stephen M. Milner are the two faces of plastic surgery.

In Melbourne, Fla., Guy performs tummy tucks, face-lifts, Botox and breast augmentations. Miller, who heads the burn unit at Johns Hopkins Bayview Medical Center, honed his skills as a plastic surgeon with the British army in the first Persian Gulf war.

They will meet with colleagues from around the country in Baltimore this weekend as the American Society of Plastic Surgeons begins its five-day annual convention here. The conference, which formally opens today at the Convention Center, is expected to attract 6,000 physicians, technical experts and exhibitors.

Few specialists probe the extremes of medicine as plastic surgeons do. Their patients range from the disfigured victims of accidents, fires and war -- who are surviving in increasing numbers -- to a generation of baby boomers searching for lost youth as they near retirement.

So lectures and panel discussions will focus on subjects as diverse as laser face-lifts, liposuction, caring for wounded veterans and new carpal tunnel surgery that can be performed while patients are awake.

"It's an opportunity to hear from experts from all over the world about the latest in any number of areas," said Dr. Michele Shermak, a plastic surgeon at Bayview who practices cosmetic and reconstructive surgery.

This year's attendees have plenty to talk about. Modern trauma surgery has created new demands on plastic surgeons, whose patients might have been seriously injured in car crashes, fires or military combat. "Over the last 20 years or so, massive strides have been made on survival rates, but that's presenting new challenges," said Milner, who was a lieutenant colonel in the British army before he came to Hopkins in 2004.

Doctors, for example, have been saving more burn victims since the 1970s, when they began performing immediate skin grafts, rather than waiting for burned skin to separate by itself. Better antibiotics also have prevented deaths from infections, he said.

These days, research is focused on improving those grafting techniques. "If we can get someone to where they look reasonable and they can function, that can be a big step," Milner said.

But most topics at this year's conference focus on a generation of baby boomers worried about aging faces and other body parts that sag, wrinkle and can even begin to flap. Hence topics such as "Silicon Implants: Where Do We Go From Here?"

"You have boomers who as they are gearing up for retirement and what's ahead for them, they're looking at themselves and trying to decide what to do," says Guy, who is ASPS president.

Some of the cosmetic services being offered might seem frivolous to some people, but that view isn't shared by thousands of patients who come to plastic surgeons each year, Guy said: "A lot of people think that way, until they start reaching a certain age."

And they're paying for it. A nose job can cost up to $10,000, a face-lift up to $20,000 and breast implants up to $7,000, Guy said.

The $11.5 billion billed for cosmetic procedures last year compares to just $7.4 billion in 2000, according to the ASPS. Most of it is paid directly by patients because such elective procedures are not generally covered by insurance, Guy said.

About 85 percent of the patients are women, she said. Of 11 million cosmetic procedures performed last year, 329,000 breast augmentations topped the list of surgeries, while 4.1 million Botox injections led minimally invasive procedures, according to ASPS.

Although any licensed physician can practice plastic surgery, Guy recommends that patients seek out a doctor certified by the ASPS board, a process that requires six years of training beyond medical school.

"If a patient comes in for an injection of Botox, a plastic surgeon can evaluate whether another procedure would be better," Guy said. "Some people think Botox is a face-lift in a bottle and when they find out it isn't, they're disappointed."

The profession got a boost last November, when the FDA lifted a 14-year ban on silicone gel implants for cosmetic breast enhancement in women 22 and older -- and for any woman who needs reconstructive surgery. The restriction was meant to stop teenage girls from getting them until their bodies are developed.

In rescinding the ban, FDA regulators cautioned that the implants can break down and that the surgery can cause complications, including pain in the breasts and shrinkage of scar tissue around the implanted shells.

So why do some many women opt for them?

"Society tends to favor, in a lot of ways, the look of larger breasts in women," said Shermak, who does about 100 breast augmentations a year. "It's safe, and the patient base is pretty broad. You have women in a lot of different age groups interested in having it done."

Baltimore Sun Articles
Please note the green-lined linked article text has been applied commercially without any involvement from our newsroom editors, reporters or any other editorial staff.