Dr. Pacella releases the definitive textbook on treatment of skin cancer: AESTHETIC RECONSTRUCTION AFTER MOHS SURGERY
After years of caring for patients diagnosed with skin cancer, I have heard this story too many times:
A patient sits in my exam room with a large bandage over their nose. What started as a small spot biopsied by their dermatologist has progressed into a large open defect requiring major plastic surgery. The patient sits anxiously, waiting for the final procedure to make them whole again. The patient’s emotions fluctuate rapidly: they may experience guilt about spending too much time in the sun, disbelief in the deformity that they have suffered, and fear of the possibility of permanent scarring. They are in shock…How I can possibly restore their cosmetic appearance to a time before they were diagnosed with skin cancer?
This past weekend, I was invited to speak at the 8th Annual Oculoplastic and 31st Annual Breast Symposia in Atlanta, GA. The dual symposium is a special event hosted by the The Southeastern Society of Plastic and Reconstructive Surgeons (SESPRS
). Founded in 1958, the SESPRS is composed of many talented board-certified plastic surgeons from around the Southeastern United States. Their annual scientific meetings create an unparalleled opportunity for intellectual exchange of ideas and are a model for professional surgical education across the country. Their motto of “Beauty and Function” was exemplified during a fantastic four day program!
Practicing medicine in 2014 is an interesting endeavor. Many times the patient-doctor relationship is obscured by insurance companies, electronic medical records and pre-authorization requests. Every once-in-a-while, I am reminded why plastic surgery is such a fantastic vocation. As a member of the Board of Directors and a Volunteer Surgeon, I am lucky (and humbled) to be part of Fresh Start Surgical Gifts
Fresh Start Surgical Gifts was founded in the 1980s as a non-profit to treat children who suffered from traumatic injuries or birth defects. Its mission is to provide children with a “fresh start” in life. Our model is much different than the average plastic surgery charity. Instead of traveling abroad to offer our services, where sometimes patients may not have access to appropriate follow-up, Fresh Start welcomes both domestic and international children to San Diego. As they arrive in San Diego, every aspect of their care is donor-funded. From transportation, meals, evaluation, surgery and post-operative recovery. They stay until they are ready to head home safely…it’s that simple. In addition, Fresh Start is one of the only organizations where U. S. children who are “under-insured” can receive cosmetic surgery secondary to deformities of traumatic injuries if their primary insurance denies service or if it is too costly for their families.
As we round out the summer, those barbeques and beach beers can really bombard our busting bellies. We devote this month’s blog to the unsung heroes of economic vitality: The Suburban Dad.
Most of us live fairly busy lives: education, chiseling away at our career and devoting the needed time for wives and families. But somehow between the trips to soccer practice and the scattered dinner or Monday Night Football game, we (myself included) have missed a few opportunities to keep in shape and try to hold on to the youthful physique that we once had.
Here in San Diego, a common question I get as a Plastic Surgeon is: “What do I do about these wrinkles around my eyes?” The first thing I say is: “Those aren’t wrinkles. They are called ‘smile lines'”. The lesson I learned here is that the word “wrinkle” evokes quite an emotional response and is usually synonymous with “are you saying I look old?!!”. But its important to understand that those wrinkles are not just about aging… they are about expression! We wouldn’t be human if we could not express ourselves. For this reason, many performers or actresses that I have encountered over the years in my practice shun the idea of any treatment or injection that will impede their ability to express themselves.
But fear not! There is a way to reap the benefits of neuromodulator injections (i.e. Botox Cosmetic or Dysport) without looking like a porcelain doll or appearing “paralyzed”. The key lies in having your plastic surgeon inject strategically!
I am a dog lover. In fact, it’s difficult to imagine my life and my family without our dear adopted labrador retriever. Turning 11 this month from the date of her rescue when she was just 6 months old, little Montana (pictured above) has never hurt a fly. But having two young kids in the house, most parents like me worry about protecting our loved ones from getting mixed up with other doggies in the neighborhood.
As a plastic surgeon here in San Diego, I often see a complete other side to what can happen when doggies are not so nice. There are an estimated 70 million dogs living in U.S. households. Sad to say, millions of people (most of them children) every year visit the ER bitten or injuried by dogs. According to the American Society of Plastic Surgeons, in 2013 over 26,000 reconstructive procedures were performed to repair injuries caused by dog bites. Most of these injuries occur in the head and neck and can lead to unsightly scarring.
As we approach the heat of summer, its important to teach our children strategies for avoiding injury and respecting man’s best friend.
I have a soft spot for the 1980’s. This decade defined my childhood. Tunes such as this Billy Idol song really take me back to a great place. Let’s face it, which other time in history could mix peg-leg pants, neon pink tee-shirts and super-mullet haircuts? Ahh…those were the days.
Over the last several years, I have seen many patients who share my same age. A common request they have is rejuvenation of the eyes and face. Many patients have said: “I look so tired all of the time…and I can’t stand these bags under my eyes.” As a plastic surgeon in San Diego (and a guy in his 40s), I share similar concerns. I woke up the other day (after a not so restful night with my infant daughter) and looked in the mirror. I didn’t quite recognize the guy staring back at me: puffy lower eyelids, dark circles and a scruffy beard (ok…maybe the beard isn’t so bad?)
It has long been a question that many patients ask during consultation: “It’s too bad you can’t just take this fat from my hips or tummy and bring it up to my breast?”. Ten years ago, I may have answered this question with a whimsical laugh and an “I wish we could!” Today, that answer is a resounding “Yes!”
Fat transfer or fat grafting is one of the fastest growing procedures in cosmetic and plastic surgery. A recent survey by the American Society of Plastic Surgeons*show that over 70% of plastic surgeons are performing this procedure in their practices. While fat transfer has been around for many years, recent advances in surgical technique and technological advances in industry are making the procedure more efficient, more reliable and longer lasting. The procedure is one of the fastest growing procedures that I perform here in San Diego.