Q&A: Breast Cancer Reconstruction

It’s a paralyzing diagnosis that no one ever wants or expects to hear from their doctor; “I’m sorry, but the biopsy came back as breast cancer.” Right away an explosion of emotions and a feeling of impending doom engulfs the unprepared patient. Her entire world will now be consumed with various doctor appointments, an overload of information, and many choices that have to be made rather quickly. I’ve seen more families dealing with this medical crisis than I want to remember. However, I sleep well at night knowing that our involvement as surgeons, and the instant family bonds we create during this difficult time, really helps people understand what options they have in restoring their health and rebuilding their appearance as we navigate this road together. The typical consultation with a family going through this may take an hour or more, so I would never be able to sum it up concisely here, but hopefully this will help answer some initial questions:

Q1: What should I do right now?

A1: One in Eight female patients (12%) will be diagnosed with breast cancer at some point in their lives. Yes, although shocking to hear, this is not a rare cancer. However, like many forms of cancer (cervical, colon, skin, etc.), breast cancer can be caught early, prevented, and cured with early diagnosis. So the two most important things you can do is: know your family history and make sure your doctor knows it too; and get mammograms at age 40 if you don’t have a family history or earlier than that if you do. The rule of thumb is to have a mammogram five years before your youngest immediate family member was diagnosed.

 

Q2: Why does my family history matter?

A2: There are familial or genetic forms of breast cancer. In these families, the incidence of breast cancer can be as high as 86%! Therefore, for patients with close family members with breast cancer, it may be possible to test your genes (BRCA1 and 2 for example) and determine your risk before you ever get diagnosed with cancer. For gene positive patients, or patients categorized as very high risk, performing prophylactic mastectomy can decrease your chances of getting breast cancer to less than one percent.

 

Q3: If I have been diagnosed with breast cancer, where do I start?

A3: If you have not already met with an oncologic (cancer) surgeon, this is where you need to start first. Your GYN or Primary physician could likely refer you to a good one locally. This surgeon is an expert at dealing with breast cancer, and based on the characteristics of the tumor (type, location, size, grade, stage) and your overall health, will be able to recommend your best options in treating this tumor. There is much to factor in to this decision, but he/she will help facilitate your decision. If the choice is mastectomy, then this surgeon will be able to refer you to a plastic surgeon that will help with the reconstruction options.

 

Q4: What will the reconstruction cost me? I want to look and feel normal again.

A4: Breast reconstruction is medically necessary and therefore an insurance covered procedure by law. Reconstruction has come a long way in recent times, and now there are several good options to help restore a women’s body and self-confidence. Depending on the type of cancer operation chosen, plastic surgeons have many tools available to aid in rebuilding the affected breast, as well as, improving the unaffected breast to match. All of these procedure are covered by medical insurance. Medical studies performed to evaluate female patients with breast cancer have shown much higher quality of life scores for those who chose to have breast reconstruction after mastectomy.

 

Q5: What are the most common ways to reconstruct a female breast?

A5: After mastectomy, most women opt for a silicone implant to restore the fullness of the breast. Sometimes, a temporary spacer, called an expander, will be placed first, and other times women with small tumors may go straight to a silicone implant. Your own fat can also be used as a secondary option to help soften and improve the look of the breast. If implants are not desired, or radiation has caused damage to the skin of the chest, then free fat and muscle grafts can be taken from the abdomen to rebuild the breast mound. The opposite breast can be improved to match by any option available to the patient, ie. Lift, implant, reduction, fat grafting, etc. The reconstruction plan and recovery will be discussed in detail with your plastic surgeon.

Erez Sternberg, MD
Ponte Vedra Plastic Surgery

Go See The Brow Expert…

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I have always been plagued my entire life with not so “on fleek brows.” I plucked at them so much as a teenager, having no clue what I was doing. This resulted in uneven brows, as far as shape, length and fullness. I also had light colored and very thin hairs in some areas.  I would attempt to fill them in on my own, plagued that each day they looked different which also drove me insane. When microblading became a trend, I did some research and was thrilled when PVPS decided to bring it on board. Alison Kuzoian the Aesthetician at our Nocatee location has had 7 years experience in permanent makeup and 2 years in the microblading technique. I saw her before and after pictures and felt extremely confident in her ability to do a phenomenal job!

I met with Alison and she explained to me how the procedure would go and asked what I would like my brows to look like. I showed her some pictures of eyebrows that I liked, and explained to her what I did not like about my own brows. Alison then used an eyebrow pencil to draw the “new eyebrows” to show me an example of how it would look. I definitely approved of the pre-drawn shape and fullness! I laid back while numbing cream was applied and Alison found the correct color that matched my natural brow hair color. The color match was perfect and I was so thrilled! The overall time and procedure spent with Alison was about 2 hours, so please plan for that time. The hair strokes are manually done and take precision and perfection…don’t ever rush perfection! The pain is minimal and with my amazing results, I would definitely do it again!

I left the office with beautiful brows, minimal swelling and no discomfort. I was given post procedure instructions to follow for the next seven days. I am due to go back in 4 weeks for a touch up and then will be good to go! My confidence level has boosted and it is so comforting to know I don’t have to stress about filling in my eyebrows and can now get away with just mascara on the days I want to be laid back. I can now say I have beautiful brows. I have Alison and PVPS to thank for that!

The below pictures were taken directly before and after the procedure.

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Written by: Audra Kelley

Call 904-273-6200 to schedule your appointment with Alison Kuzoian

www.pvps.com

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“Don’t Sweat it, SCULP(t) it…”

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SculpSure and it’s innovative laser technology offers several advantages over Coolsculpting in regards to performance, time, and a reduction in risk of complications. The drastic differences between the two have been listed below.

Sculpsure 

VS

CoolSculpting

SculpSure can treat multiple areas at the same time (up to 4 areas) in 25 minutes VS  Coolsculpting can only target one area per treatment in 60 minutes.
SculpSure ensures comfort by utilizing flat applicators that do not use a suction method. Also, is able to treat even the smallest amount of stubborn fat. VS The applicators used in Coolsculpting require enough “pinchable” fat that is able to be pulled and sucked up into the applicator for treatment. If the problem area is not large enough to fit in the suction, it can not be treated.
 You can repeat SculpSure treatments on the same area after 6 weeks, SculpSure also has the ability to reach your optimal results in just one treatment. VS Coolsculpting patients are required two or more treatments to achieve their desired result.
 SculpSure patients have not reported pain or discomfort following treatment. VS Those who had Coolsculpting have reported numbness, pain and bruising that can last for weeks post treatment. Also, research is now revealing that Coolsculpting can cause more severe complications such as delayed onset pain and even nerve damage. 
SculpSure utilizes laser technology to heat the fat cells to release them from the tissue to be naturally eliminated by the body. Treatment is described as a warm soothing sensation and does not pose any threats to the nerves or the treated tissues. VS  Coolsculpting uses a process called Cryolipolysis to freeze fat cells. This method can cause nerve damage and pain. 

After seeing the vast differences between the two, its easy to admit SculpSure is the best choice!

Call us today for your consultation at 904-273-6200.

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“I Spy With My Little Eye…”

You look in the mirror and begin to notice dark spots that may not have been there before, or maybe you have had them for awhile and you finally are deciding to research ways to rid them of your skin. These dark spots you see are called sun spots, the ultimate reminder that the summer was hot and long!

The summer heat brings summer sun spots and at PVPS we offer many different treatments to help eliminate them.  Some of our most popular treatments are the BBL and the HALO. BBL has been used traditionally to treat brown and red pigmentation on the face and body and HALO resurfacing treats pigmentation, pores, fine lines, acne scars, and overall skin texture. In addition to our very popular Broadband Light Laser (BBL) and HALO resurfacing treatments, we’ve also added the NanoPeel and MicroPeel.

 The NanoPeel is best described as a ‘polishing’ of the skin in addition to treating pigmentation and is a great compliment to BBL treatments.  The NanoPeel consists of little downtime and is a great ‘over the weekend’ treatment, as far as peeling goes. The face and body (including hands, feet, etc) can be treated with the Nanopeel, but require multiple treatments for best results. The MicroPeel is a deeper laser treatment which requires more downtime and recovery, but less treatments.

To learn more or to reserve your appointment with one of our Nurse Practitioners call us today at 904-273-6200.

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Claudette Walker Written by: Claudette Walker, ARNP

LED Therapy & your skin…

Anti-aging has never been easier! PVPS now offers LED light therapy

LED therapy (officially known as Light-Emitting Diode) can work wonders for our skin. This technology was originally used for household gadgets such as alarm clocks in the 1960s. Several years later NASA started using LED therapy to speed wound healing in no-gravity situations, which then led to LED being used in skin cancer treatments. The skin care industry now uses this technology to improve skin health and appearance in many ways.

LED light waves travel deeply into the skin triggering live cells to react. Red light LED actually strengthens and builds collagen! We love collagen, which is abundant in young skin and decreases as we age, so incorporating treatments that increase collagen production is extremely anti-aging. LED therapy is also anti-inflammatory, promotes increased circulation, speeds healing, reduces redness, constricts pores, and can suppress oil and acne.

This treatment is completely painless and takes about 20 minutes. It does not heat the skin, so burning is not a risk. All of the work is done below skin’s surface, so there is no damage and no down time whatsoever. It is also a perfect addition to our HydraFacial treatment.

PVPS now offers HydraFacial Elite (includes the LED therapy), and is a perfect multi-tasking skin treatment! This treatment deep cleanses, exfoliates, extracts pores, deeply infuses several nutrients, builds collagen, and renews your complexion. Your skin will glow for days! Our experienced Aestheticians offer this treatment at Ponte Vedra Beach, Southside, Amelia Island, and our Nocatee location.

We have a special going on now until 8/31/16 for the HydraFacial. Call us today to schedule your treatment at 904-273-6200.

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 Andrea Written by Aesthetician, Andrea Bailey

Tired of being told your symptoms are normal?

How ThermiVa has helped me after child birth:

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I am a 32 year old full time working mom of a beautiful three year old little boy.  Pregnancy and child birth changed a lot about my body.  Some of the things are easy fixes and other I had come to accept as the new normal, like being nervous if I felt a big sneeze coming on. All of which is a small price to pay for the joys of being a mom.  One of my favorite things about my job is hearing about all the new up and coming treatments available and being in the know before the general public.  Our staff at Ponte Vedra Plastic Surgery started receiving education on a new treatment called ThermiVa…vaginal rejuvenation.  I remember when I heard vaginal rejuvenation I thought to myself “Wow  I never thought that would need rejuvenating.”  I went through the training and while intrigued I was hesitant because  let’s be honest that might be a little bit of an awkward experience.  So I put it in the back of my mind and didn’t really start seriously considering it until my coworker, Beth, shared her experience with me after her treatments.  She was literally singing its praises and gave me all the details.  So I decided to give it a try.  I figured if I had one treatment and it was just too awkward that I didn’t have to have another one.  So I made my appointment and saw Suzanne, our nurse practitioner at the Nocatee office.  It was anything but awkward.  She made me feel extremely comfortable throughout the whole experience and I saw an improvement after my first treatment.  I had two other treatments after that each 4 weeks apart, and will have yearly touch up treatments.  I no longer get nervous before a sneeze, and my husband even commented he noticed a difference.  This amazing new treatment has allowed me to no longer have to accept the changes pregnancy and child birth caused.

Written by Meagan Heineman

 

Call Ponte vedra Plastic Surgery today to schedule your appointment (904) 273-6200

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Sealed With A Kiss……

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For several years I got Juvederm injections to plump my thinning lips.  I loved the look but unfortunately, it only lasted 3-4 months for me, so the expense mounted with the frequency of the fillers.  When Dr. Sternberg told me about lip implants I jumped at the chance to have them inserted!  No more injections and every morning I look in the mirror and think, “oh, it looks like I just had my lips injected.”  It is a very natural look and no one knows I have the implants until I mention it.

It can be done under local anesthesia, like you get when you go to the dentist.  Mine were done during a surgical procedure I had planned.  I knew someone who had it done weeks before under local anesthesia, so I got to see her lips and knew what to expect.  She said she could not drink through a straw, as she was told to do (per post procedure guidelines), but could only eat with a baby spoon for several days.  I found I could not use a spoon, but could better use a straw for the first several days. I also applied ice to the lips which felt good and helped with the slight swelling.  I returned to the office a week later with very little swelling noticeable and had 2 small stitches removed from the corner of my mouth.

I have had my lip implants for 4 years now and still love them.  I don’t think about the fact that they are implanted, as they’ve become a part of me.  I can feel the implants if I press my lips together, otherwise, it’s life as usual.  I encourage anyone who has routine lip injections for restore volume to consider having implants placed and make an appointment to meet with one of our Board Certified Plastic Surgeons at Ponte Vedra Plastic Surgery. You will love them!!

Call Ponte Vedra Plastic Surgery today to schedule your consultation (904) 273-6200.

Written by Robin McBride       Robin

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Reclaim, Restore and Revive with ThermiVa

 

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What is ThermiVa?

When I first heard about ThermiVa and what it did I giggled to myself and thought “No way”, but after some research about the treatment and all the benefits I then decided to speak with our Nurse Practioner Suzanne Reibling  to hear more about it. I was amazed how simple the process was, and how long the results lasts.  In the beginning I was interested in the treatment because it helped with urinary incontinence, but when I found out the other advantages, such as vaginal laxity, lubrication and the overall physical appearance I was sold.

I was a little intimidated walking in for my first treatment but Suzanne’s professionalism and calm demeanor immediately put my nerves at ease.  After Suzanne thoroughly explained the process she made me feel so comfortable, and she even shared her personal experience and told me about her amazing results. To be honest, it was easier than visiting the OBGYN and the treatment only took thirty minutes! Suzanne uses a small diameter wand that uses radio-frequency energy to heat the vaginal tissue which rejuvenates collagen. There was no discomfort or downtime. Suzanne and I chatted through the treatment, and before I knew it we were finished. When I saw results, after just one treatment, I was enthralled by how cosmetically appealing it was. It had a youthful appearance and I noticed an immediate improvement with my urinary incontinence.  Other than Botox, this was one of the best things I have done for myself. I am extremely happy with the results and I am proud to share my experience.  Trust me ladies ….it is worth it.

Call Ponte Vedra Plastic Surgery today to schedule you appointment (904) 273-6200

Beth Griffin Written by Beth Griffin – Patient Care Coordinator

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Brown patches, age spots and Hydroquinone

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Why do I have brown patches and spots on my face?

This is caused by overstimulated and irregular pigment production, known as hyper-pigmentation. Some contributing factors are sun exposure, heat, injury, hormone fluctuations and pregnancy.

How can I improve this condition?

There are medical grade skin care products and treatments effective in improving and controlling this chronic condition.

What are effective products?

Hydroquinone (HQ) is a result oriented product to help suppress the pigment production. This pigment begins deep in the basal layer of your skin. It is recommended to use HQ for no more than 5 months.

What are the concerns of using HQ for more than 5 months?

Long term use of HQ alone can become non-effective in treating hyper-pigmentation.

Some studies have shown that there is a rare condition called exogenous ochronosis that was linked with prolonged hydroquinone use longer than 6 months. This can cause the skin to present with brown-grey or blue-black hyper-pigmentation and is very difficult to treat.

Should you immediately stop HQ if you’re using it for more than 5 months?

It is NOT recommended to abruptly stop HQ use, but to gradually wean off of it as you replace it with a medical grade NON HQ product such as Zein Obagi MD’s (ZO) Brightenex, Brightalive, or for a more mild condition, C-Bright maybe the best choice for you.

The danger in discontinuing HQ without weaning off and replacing it with an alternative pigment regulator could result in rebound hyper-pigmentation which means you may develop more unwanted pigment as the suppression of HQ has been removed.

Where can I go to have someone help me get on the right skin care regimen for my specific concerns?

You will find 6 very caring and qualified Medical Aestheticians at Ponte Vedra Plastic Surgery (pvps.com) able to improve skin conditions such as aging, hyper-pigmentation and acne by using medical grade products and treatments. You can also utilize our Nurse Practitioners for laser treatments such as the Halo and BBL, that can also help to fight hyper-pigmentation. Here at Ponte Vedra Plastic Surgery you have a team of experts at your fingertips!

Call today to schedule your complimentary consultation (904) 273-6200.

Kim Lindsey – Aestheticiankim

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Perfect Summer Skincare Treatments

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During summer months we typically spend more time outdoors. Activities such as cookouts, picnics, sporting events, pool and beach time means more UV exposure. We all know how very critical daily sunscreen application and reapplication are, but what are the best skin care treatments to promote skin health and radiance during this time without down time?  The aestheticians at Ponte Vedra Plastic Surgery recommend the DF Facial, Hydrafacial MD, and Hydrafacial Elite.

The DF Facial is a very relaxing treatment that combines spa-like pampering with clinical benefits to the skin. During this treatment, sound waves (sonophoresis) are used to deliver vitamin A deep within the skin to build collagen. Another unique feature of this treatment is microcurrent (iontophoresis) which gently and effectively tones facial muscles; almost like pilates for the face! This entire treatment is completely painless and extremely relaxing. Your skin will be noticeably nourished, hydrated, and have a gorgeous glow after receiving the DF Facial. There is no down time with this treatment, which takes 90 minutes and the cost is $200.

Hydrafacial MD is a true clinical treatment like no other. Our aesthetician uses a machine to deep cleanse, gently exfoliate with mild suction and mild exfoliants, extract pores painlessly, all while simultaneously infusing numerous antioxidants and plumping hyaluronic acid into the deep tissues of your skin. The result is extremely clean, noticeably plumper, hydrated skin. You will possess a glow to your complexion that will last for about a week. This painless, clinical treatment takes 30 minutes and the cost is $175 but we have an amazing summer special going on please call our office to get the details.

Our aesthetician can also step up this already fabulous treatment to the Hydrafacial Elite, which also includes a specialty serum vial and LED light therapy . Infusing a specialized concoction of Dermal Repair serum or Growth Factor serum will result in increased collagen production. LED light therapy specifically chosen for your skin concerns will build collagen, reduce inflammation, reduce bacteria, and improve overall complexion appearance. The Hydrafacial Elite is a painless, one hour treatment and the cost is $250.00

Andrea Written By: Aesthetician Andrea Bailey

Please call Ponte Vedra Plastic Surgery to book your facial today (904) 273-6200.

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