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Archive for November, 2011

Cosmetic surgeons combine knowledge, surgical skill, technical expertise and ethics to achieve their goal of providing aesthetic enhancement for their patients. When choosing a cosmetic surgeon it is important to select a cosmetic surgeon who is board certified. In most states it is legal for any physician who holds a valid medical license, with or without surgical training, to practice cosmetic surgery. Board certification is important because it makes certain that your cosmetic surgeon has the training, qualifications and experience needed to perform your cosmetic surgical procedure safely and skillfully. A board certified cosmetic surgeon has greater insight into your needs, has knowledge of state-of-the-art techniques and the surgical skill and judgment to recommend and perform the cosmetic surgical procedure that will enhance your appearance effectively and safely.

Having said that, board certification does not equal quality care or quality outcomes. Having a Tennessee driver’s license does not make one a good driver—it only verifies that they have successfully completed the examination and have been issued a license to drive.

Becoming Board Certified in Cosmetic Surgery

In order for a surgeon to become board certified in any medical specialty, they must go through a long demanding process that takes years to complete. The American Board of Cosmetic Surgery [ABCS] is the only certifying board that exclusively tests a surgeon’s knowledge and experience in cosmetic surgery. Surgeons develop their cosmetic surgical skills through post residency training and experience. The point is that a cosmetic surgeon’s skill and ability will depend on the surgeon’s cosmetic surgery training and experience, not on core board-certification.

The number of people seeking cosmetic surgery has grown rapidly over the past several years. As part of a greater focus on appearance, people are turning to cosmetic surgery as one means of enhancing their appearance. At the same time, more and more doctors are practicing cosmetic surgery.

Given the growing number of cosmetic surgery patients and the highly competitive pool of doctors performing cosmetic surgery, it is vital that you obtain accurate information regarding cosmetic surgery and the doctors who perform it. Before you undergo cosmetic surgery, it is important you become informed about the doctor’s education, training, experience and proven competence with respect to the specific procedure you seek.

Cosmetic surgery may be performed in various facilities such as hospitals, surgical centers and office settings. An accredited surgical facility must meet certain minimum standards to obtain and maintain its accreditation.

Research Before Undergoing Cosmetic Surgery

Before the surgery, your doctor should explain to you the risks and possible complications, and potential side effects, including the pros and cons of the procedure. In addition, ask about the surgeon’s privileges in an accredited surgery center or a hospital to perform cosmetic surgery.

As for how you should choose a cosmetic surgeon or cosmetic surgical center— You should do the research locally and online. You can perform a standard internet search with the name of the doctor or the procedure about which you would like to receive more information. What do you see online? Negative or positive feedback or reviews.

Make sure that your surgeon has a good reputation, a strong background in the surgical field, and above ALL … that he or she produces good results. Training is important; board certification is important; but skill, judgment and artistic detail are evidenced by experience and outcomes — not board examinations.

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office based cosmetic surgery in Chattanooga, TennesseeSurgeons are doing more than just checkups in their offices these days. Advances in medical technology have made it possible for physicians to perform more advanced and more complex surgical procedures in their offices. Whether it is vein surgery, skin cancer excisions, tummy-tuck, breast augmentation, facelift or a complex biopsy, these procedures can be completed in an office-based surgery suite. Since most patients want to avoid an overnight hospital stay after surgery, ambulatory surgical procedures have become very popular. That’s why almost one-half of all surgeries are now being done in an outpatient facility, either connected to a hospital or in a separate surgical center.

More recently, though, there has been a growing trend for surgery to be done right in a doctor’s office. Office-based surgery can offer the convenience of having a procedure done in a more comfortable setting with a quick return home. Charges associated with ambulatory surgery are less than fees charged at a large hospital. Charges associated with ambulatory surgery completed in an office setting are substantially lower.

Anesthetic Techniques in Office-based Surgery

The same anesthetic techniques used in hospitals and ambulatory surgical centers are used in office-based surgery. They include:

Local anesthesia, which provides numbness to a small area of the body, such as a dermatologist might use to numb the skin around a mole before removing it.

Monitored anesthesia (sedation/analgesia), during which a patient receives medications that relieve pain and make the patient drowsy. During surgery, the patient’s vital signs, including heart rate, blood pressure and oxygen level, will be watched closely in order to avoid sudden changes or complications.

Regional anesthesia, which can include spinal blocks, epidural blocks or extremity blocks. Spinal and epidural blocks involve interrupting sensation from the legs or abdomen by injecting local anesthetic medication in or near the spinal canal. Other blocks can be performed for surgery on your extremities, or limbs, blocking sensations from the arm or leg.

General anesthesia, which involves the total loss of consciousness, pain sensation and protective airway responses.

From the simple removal of a mole to breast augmentation/reduction, liposuction, hernia repairs or knee arthroscopies, a rapidly growing number of surgeries are being performed in doctors’ offices rather than in hospitals or ambulatory surgical centers. More complex procedures are likely to become common in the near future.

At last review in 2005, an estimated 10 million procedures were performed annually in doctors’ offices – twice the number of office-based surgeries performed in 1995. Today, about one out of 10 surgeries is performed in a doctor’s office.

In considering your options when surgery is advised, here are some items that you should consider before undergoing surgery in a doctor’s office. Ideally, anesthesia during larger surgical cases should be delivered or supervised by a person extensively trained in anesthesia techniques, like a Certified Nurse Anesthetist or Anesthesiologist.

Anesthesia needs are determined by your medical condition as well as by the type of operation you will have completed. A doctor’s office should have the necessary emergency drugs, equipment and procedures in place to care for you in the rare event of a life-threatening complication. Many states require licensing or accreditation by a recognized agency. These agencies regularly inspect such offices to ensure that minimum standards of patient care and safety are met. Ask your doctor if their surgical office suites have been accredited.

Advanced Surgical Concepts is a fully accredited AAAHC facility.

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Liposuction in Chattanooga Before and AfterLiposuction is the most commonly performed cosmetic procedure in the United States. Liposuction or liposculpture is defined as the removal of fat from deposits beneath the skin using a hollow stainless steel tube (called a cannula) with the assistance of a powerful vacuum. Liposuction can be accomplished either with the use of general anesthesia in a hospital/ outpatient surgery center, or with heavy IV sedation, or totally by local anesthesia in a surgery office setting.

Tumescent Liposuction

Tumescent liposuction refers to a technique of liposuction that uses larger volumes of very dilute local anesthesia fluid which is injected into the fat, causing the targeted areas to become tumescent, or swollen and firm. Along with the tumescent effect, the area and covering are anesthetized or totally numb. If used in safe doses, large areas of fat can be removed using local anesthesia alone in a surgery office setting without the need for general anesthesia.

The ideal candidate for tumescent liposuction is physically fit and eats well-balanced meals, but is unable to reduce a fatty deposit that is well localized and often seems to involve a genetic susceptibility. In the past, surgeons completed liposuction under general anesthesia removing large volumes of fat at one mega surgical session; the surgery required blood transfusions because blood loss in the aspirate was significant. Dr. Jeffery Klein, a dermatologic surgeon, is credited as the originator of the tumescent technique in the 1980s. This technique has allowed liposuction to be performed with the patient under local anesthesia while minimizing blood loss and the risks of general anesthesia. Since its inception, liposuction performed with the tumescent technique has had an excellent safety profile.

Tumescent Liposuction vs. “Old-School” Lipo

Traditional liposuction cannulas (stainless steel tubes) have a relatively large diameter and remove large volumes of fat rather quickly. However, with the use of large cannulas (diameter greater than three millimeters), there is an increased risk of irregularities and depressions in the skin post procedure. The tumescent technique permits the use of small microcunnulas which in turn yield smoother cosmetic results. Microcannulas with a diameter less than three millimeters allow fat to be removed in a smoother and more uniform fashion. Some surgeons prefer larger cannulas under general anesthesia because it allows liposuction to be performed more quickly. But with any artistic media, quick is not necessarily better.

With general anesthesia, pain is apparent the moment that the patient awakes from anesthesia; these patients usually require narcotic medications for pain control. Patients who undergo tumescent liposuction generally do not require narcotic medications post procedure as the tumescent anesthetic effect may last as long as 24 hours after completion of the liposculpture. The tumescent technique for liposuction is unquestionably the safest form of liposuction when performed correctly (not excessively). As opposed to general anesthesia techniques for liposuction, there have been no reported deaths associated with tumescent liposuction totally by local anesthesia techniques.

Liposuction Candidates & Treatment Areas

Tumescent liposuction patients must have realistic expectations. The ideal candidate is only 20-30 lb. overweight with focal adipose accumulations unresponsive to diet and exercise. Common anatomic areas for liposuction include the upper and lower abdomen, the flanks (love handles), breast, outer and inner thighs, inner knees, arms and back, the neck, ankles and calves.

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