What You Should Know About Plastic Surgery Videos on YouTube

Everyday people watch more than a billion hours of YouTube. Increasingly, those hours include some time searching for health information and watching plastic surgery related videos in particular. Unfortunately, many of these videos are low quality and should be watched with caution, says new research published in the journal Plastic and Reconstructive Surgery.

Researchers graded over 500 videos on subjects like breast augmentation, breast lift, breast reduction, eyelid surgery, face lift, and tummy tuck. The videos analyzed came from a variety of sources, mainly physicians, patients, and product companies.

The videos were rated using the EQIP (Ensuring Quality Information for Patients) scale, scoring on a wide variety of criteria including:

  • Quality and accuracy of information presented
  • Clarity of video sponsorship or funding
  • Disclosure of risks, potential complications, and alternative treatments

With the average video scoring 13 out of 27 on the EQIP, the results of the study were not encouraging.

“Patients should be aware that the information contained in aesthetic surgery videos could be of low-quality and has the potential to be inaccurate,” said Ash Patel, MBChB, senior author of the study in this press release. “It involves a little research from the viewer, but they should check if the video is produced by a board-certified plastic surgeon.”

YouTube is a social media and entertainment platform, never intended as a gatekeeper for high quality medical information. Nonetheless it is a place where people seek this kind of information, and what they find often influences their health care making decisions.

That is why we urge all our patients to use a critical eye whenever viewing plastic surgery information on social media platforms like YouTube. Here are some questions to ask yourself the next time you view one of these kinds of videos:

Who produced the video?

Anyone can upload a video to YouTube and say nearly anything they want, but, according to the study, videos created by physicians tended to be of higher quality. Make sure the video you are watching is produced by a legitimate medical center, government entity, plastic surgery society, or board certified plastic surgeon. Look for logos and links to websites for verification.

Is the language general or product specific?

No one product, medication, or surgical procedure is perfect for everyone. Watch out for videos that appear biased toward one brand, as they are likely sponsored and created primarily to sell you a specific product. Language should be clear with limited use of jargon, and products should be presented using generic names. Not all sponsored videos are bad, but this information should be clearly disclosed.

Are risks, complications, or alternative treatments mentioned?

A well trained board-certified plastic surgeon is trained to put the patient first, and sometimes this means saying no to certain procedures. A careful balance of risks versus benefits should be part of every treatment decision. Pre-existing medical conditions and lifestyle choices are among the many considerations that come into play. A high quality video will address issues like risks, complications, and treatment alternatives to some degree.

Here, at North Texas Plastic and Reconstructive Surgery, we encourage you to do your homework when it comes to medical procedures and choosing a plastic surgeon. The internet, YouTube, and other social media can be terrific sources of information, as long as you use a critical eye. Always back up any information you learn there by talking to an actual board-certified plastic surgeon who knows you specifically, like Dr. Slack. And be on the look out for Dr. Slack’s new YouTube channel coming soon.

If you have questions about something you’ve seen on the internet, contact our Allen, TX office. You can make an appointment for a consultation today

After Tummy Tuck with Muscle Repair

Not all tummy tucks are alike. Some involve more extensive surgery than others, and for this reason, what to expect during recovery can vary from person to person. The aim of the tummy tuck is to slim and tighten the waist for a more shapely and youthful appearance, but the surgical route to get you there (and into some cute new clothes) can vary quite a bit.

Depending on the amount of excess skin and fat to be removed, incisions can be shorter or more extensive, including the repositioning of the belly button. But one of the biggest factors to impact recovery from a tummy tuck, also called an abdominoplasty, is whether or not a muscle repair is included.

Why the muscle sometimes needs a repair

If you have seen the abs on even one superhero you will know the muscle we are talking about. It is called the rectus abdominis and it runs vertically from your sternum to your pubic bone. It has a left and right side separated down the middle by a band of tissue called the linea alba.

The linea alba can become over stretched, usually during pregnancy but also due to extreme weight gain or a lifting injury. When this happens the two sides of the muscle move further apart, resulting in an outward bulging of the belly that doesn’t go away, even when weight (baby or otherwise) is gone. This condition is called diastasis recti.

Besides being a cosmetic issue for some people, this condition can affect posture and trunk strength. It can cause pain in the abdomen, hips, and back, as well as bowel and bladder issues, all of which can have a huge impact on quality of life.

Why the muscle sometimes doesn’t need a repair

Not all tummy tucks include a muscle repair because not all bellies that can benefit from a tummy tuck have a diastasis recti. Even when the linea alba is stretched out, it can sometimes return to its normal size on its own. Furthermore, if a woman has had a cesarean section, a repair will likely have already been completed at that time.

How the muscle is repaired

Diastasis recti can be corrected by a general surgeon, but plastic surgeons routinely do this as part of their tummy tuck procedure. The surgery involves folding over the stretched tissue of the linea alba and suturing the two sides of the rectus abdominis muscle together. Though you can’t see it from the outside of the body, this involves suturing up and down the whole length of the abdomen.

Why a muscle repair impacts tummy tuck recovery

The difference in recovery between a tummy tuck with muscle repair versus one without has to do with the fact that muscles contract. Unlike the skin and fatty tissue that cover the abdomen, the muscles underneath (and the rectus abdominis is a big one) are prime movers and stabilizers of the whole trunk. This means that they contract nearly any time you move your body. Even simple movements like lifting your arms when sitting upright or rolling over in bed can engage these muscles — and then there’s coughing and sneezing.

When the muscle is repaired it needs time to rest so that it can heal up. Over exerting yourself too early can compromise your results and will certainly be painful.

How a muscle repair impacts recovery

When a muscle repair is included with your tummy tuck, you will be required to be more careful and your recovery will take a bit longer — from three to four weeks longer.

After a muscle repair patients often experience feeling more full quickly when eating and the sensation of not being able to take as deep a breath as they used to. This is due to a decrease in the amount of room inside the abdominal cavity caused by tightening the muscles. The stomach has less room to expand and the diaphragm meets more resistance as it moves down to allow you to take a breath. Both of these issues, if they occur, typically resolve within four to six weeks.

Abdominal Binder
Shortly after surgery you will be given an abdominal binder to help support the repaired muscle and to reduce overall swelling. You will be given instructions on how to put it on and will be told to wear it regularly. You will probably need help putting it on and taking it off in the first few days.

Lifting restrictions
After surgery, your doctor will restrict you to lifting no more than about 10-15 pounds. You will be prohibited from lifting anything heavier for a full six to eight weeks after surgery. You will also not be allowed to do any core strengthening exercises, such as sit-ups, to avoid stressing and potentially tearing the repair.

It is typical of all patients after a tummy tuck to have slightly hunched over posture. This is normal and it is important not to force an upright position and put undue strain while your incision heals. This becomes even more important after a muscle repair. You may even be given a walker to get around the first week after surgery.

You still have to get out of bed
Even with a muscle repair, your surgeon will require that you begin moving about within a day of your surgery. This includes getting up to go to the bathroom and with some restrictions, taking a shower. This is important for your overall health and healing and the prevention of blood clots. Many patients opt to sleep in a recliner to make these movements easier. Have someone at home to help you, especially during the first couple of weeks.

Though the muscle repair does add some challenges to your recovery, the long term benefits can far outweigh them. A study published last fall (2019), showed postpartum women who underwent a rectus abdominis repair had significant improvements in trunk function, urinary incontinence, and overall quality of life.

If you are considering a tummy tuck and want to know more about muscle repair, Dr. Slack would be pleased to offer a consultation in his office near McKinney, TX. Please contact us now to schedule your appointment.

Why Drinking Alcohol and Plastic Surgery Don’t Mix

Woman drinking during the holidays. Remember Alcohol and plastic surgery simply don't mix.

‘Tis the season to be jolly, and often that means drinking more than usual. In the month between Thanksgiving and the New Year holiday, Americans spend more than $12 billion on distilled spirits – that is one-quarter of the industry’s yearly profit. If this season, you are giving yourself the gift of plastic surgery, however, we recommend you skip the spike in your eggnog. Alcohol and surgery (before or after) can be a bad mix.

We’re not just talking about excessive drinking, either. Research has shown that even drinking moderate amounts of alcohol before surgery can impair the immune system and increase the risk of respiratory complications. Heavy drinkers are also more likely to suffer from complications of wound healing and infections. They are 30 percent more likely than non-drinkers to be admitted into the intensive care unit after surgery.

Alcohol affects a number of different body systems already taxed by surgery. Here are five of the most common types of complications:


Alcohol in your system can make it more difficult to get the dosing of anesthesia to an optimal level during surgery. This can result in pain and increased awareness during surgery. Alcohol consumption also decreases pain tolerance in general, making for a more difficult recovery.


Swelling is a natural part of any kind of surgery. Alcohol has the effect of dilating blood vessels and can make your tissues even more prone to swelling. This is not only uncomfortable, it can result in poor fluid balance after surgery as well as poor wound closure.


Alcohol is a natural blood thinner. Its use can lead to increased bleeding during surgery as well as in the days and weeks following a procedure. Excessive bruising and increased swelling are also possible, both of which can cause more pain and delayed healing time.


Surgery can result in dehydration. Add alcohol, a diuretic, to that and the effect can be dangerous. Dehydration can affect wound healing and it can make your recovery far more uncomfortable than it has to be.

Wound Healing

Excessive Alcohol consumption is linked to poor wound healing. This is especially important when it comes to plastic surgery. While your surgeon will do all he can to minimize the appearance of scars, they are nonetheless a natural outcome of surgery. Infection or excessive swelling can result in larger more misshapen scars, greatly diminishing the beneficial effects of having plastic surgery in the first place.

Dr. Slack takes the medical risks associated with drinking alcohol very seriously. He, like many other surgeons, requires patients to quit or significantly limit alcohol in the weeks before and after surgery.

Quitting alcohol may be no problem for you, but if you are a heavy drinker you need to consider the risks of withdrawal if you quit suddenly. Withdrawal from alcohol can be dangerous and can further complicate surgery and recovery. That is why it is important to take a hard look at your drinking and take steps to quit in a safe manner, well before any planned procedures. Sometimes this means quitting under the supervision of a physician.

The holidays can be an especially difficult time to quit drinking. But remember that being healthy and safe is the best gift you can give yourself. So if you have plastic surgery coming up, let that thought help you resist the champagne and hot buttered rum.

Will Breast Density Limit My Plastic Surgery Options?

Getting good news about breast density and plastic surgery options

The last time you got your mammogram results, did you notice a little note about your breast density? If you are like 40 percent of women, it might have said something like, “Your breasts are heterogeneously dense, which may obscure small masses and may put you at greater risk of developing breast cancer in the future.” Though this may sound a bit scary, it’s actually a normal reading.

Normal breast density exists on a spectrum from not dense at all to extremely dense. Knowing this information is important; it helps women and their doctors decide which breast screening methods are best, and how often they should get them. According to the American Cancer Society, whether a woman has dense breasts or not, regular screenings (mammograms in particular) are still the best way to find cancer early.

Because of the relationship between breast density and cancer risk, it is now the law in many states that breast density information be conveyed to each woman who has a mammogram. You may have seen talk of this newer legislation on the news.

What this means is that more women than ever before know that breast density matters, and many can tell you just how dense their own breasts are. Knowing this has also left some women wondering if their breast density will affect their options when it comes to cosmetic breast surgery.

To help answer this question, it will help if we first explain what doctors mean when they talk about breast density.

Breast density is a radiologic (mammogram) finding that has nothing to do with how breasts look or feel from the outside. The classification of density has to do with the ratio of fat (not a dense tissue) to everything else that makes up the breast, including glandular and fibrous tissue. On a mammogram, the fat shows up dark and the other stuff shows up white. The more white seen on a mammogram, the more dense the breast classification. The breast density classifications that may be assigned are – from least dense to most dense – the following:

  1. Fatty
  2. Scattered Fibroglandular
  3. Heterogeneously Dense
  4. Extremely Dense

Only about 10 percent of women are categorized as having extremely dense breast tissue. You can learn more about these breast density types, and see images too, at the American Cancer Society.

Here at North Texas Plastic and Reconstructive Surgery, Dr. Slack performs a wide range of cosmetic breast procedures including breast implants, liposuction, breast lifts, and breast reductions. In some cases, he may perform a combination of one or more of these procedures, depending on the goals of the patient. Here is how breast density may come into play with each of these procedures:


Breast implants are placed underneath the breast tissue not within in. This means that the breast tissue itself, no matter how dense, sits on top of the implant and therefore has little bearing on whether a breast implant is possible.


Liposuction alone is sometimes an option for women who are looking for a mild reduction in breast size. It is possible that a woman with extremely dense breasts, which means they have a lower ratio of fat to other tissue, may have a limit as to how much fat can be successfully removed using this method.

Breast Reduction or Lift

A breast reduction or lift sometimes includes liposuction, and the limitation just mentioned may come in to play to some degree. However, because these procedures also include an open surgical component, the goal of the reduction usually isn’t limited by breast density.

Here is the big takeaway: None of these procedures are off limits to a woman simply because she has higher breast density.

There are many factors that will limit a person’s plastic surgery options, including poor health, weight instability, and a bad smoking habit, but breast density usually isn’t one of them. That said, every person who walks into our clinic has their own unique anatomical identity, and that includes breast density. Dr. Slack takes all of this (and more) into consideration when advising each patient and planning their surgery.

If you have more questions about breast density and which breast procedures might be right for you, call our office today and schedule a consultation with Dr. Slack.

How Breasts Change With Age

“Women across generations agree that age does not define beauty,” AARP Survey of Women’s Reflections on Beauty, Age, and Media.

Thanks to the passage of time, hormonal changes—and gravity—most women begin to see a change in their breasts around age 40. It is normal at this point for breasts to appear smaller, less firm, more droopy, and further apart. Exactly when and how quickly changes like these occur depends a lot on genetics, body type, breast density and things like diet, exercise, and being a smoker.

For these reasons, no two women (and no two breasts) will age in the same way. That said, nature tends to follow certain patterns when it comes to aging tissues in and around the breast. Understanding how age affects bone, muscle, and other breast tissue can help explain the changes that each woman sees in the mirror, and what, if anything she might want to do about it.


No, breasts are not made up of bone, however, aging of the bones in the rib cage can have a visual impact on the breasts. With age, bone tends to shrink and lose density, providing less support and forward projection of the overlying breasts. This together with changes in posture can decrease the appearance of breast fullness.


Between the rib cage and breast tissue lies a layer of muscle that can greatly affect the appearance of the breasts. The tone and thickness of this muscle tends to diminish with age, resulting in flatter and lower placed breast. Some of this can be mitigated by exercise to keep these muscles toned.

Fat/Glandular Tissue

Breasts are mostly made up of a combination of fat and glandular tissue, including the milk ducts. With age and hormonal changes, breast tissue becomes less glandular and the ratio of fat becomes higher. Though the ratio of may be higher, the total amount of fat overall may still be reduced. The remaining fat is also usually less well distributed or smooth. This can result in less volume, especially in the upper part of the breast, and more sagging.

Some women, of course, gain weight with age (particularly after menopause) and for them fatty tissue increases, and their breasts do get bigger. “I have seen many women over the years who in their early 20’s underwent breast augmentation. Now in their late 50’s or early 60’s their breasts have increased in size due to this, and they feel too big and heavy,” says Dr. Slack. “Often they will choose to have their implants removed, which can be done without a significant increase in droopiness. This gets them back down to a size that they are happier with.”


The skin that covers the breast acts like a container for the rest of the breast tissue. Connective tissues like collagen, elastin and glycosaminoglycans (GAGs) keep the skin tight, elastic, and hydrated. With age, the body produces fewer GAGs, giving skin a dryer, less plump, and saggier appearance.


Technically speaking, what we call the nipple is the nipple-areolar complex (NAC). The center most raised part of the NAC is the actual nipple and it is where the milk ducts exit the breast. The circle of pigmented skin surrounding the nipple is the areola and it contains small bumps called Montgomery glands. With age, the areola can shrink and in some cases disappear. The nipple can sometimes become more inverted.

Among women there is huge variability in the way all these components come together to form a pair of breasts. There is even more variability on how these breasts then change with age. This means that for those women (and men) considering plastic surgery, a nuanced and highly individualized approach is necessary. It’s important to have a surgeon who can help you achieve the best results possible, even though not all the components can (or should) be changed surgically.

Dr. Slack, who has specialized training in plastic surgery of the breast, operates with one simple guiding principle – the patient comes first. With him, each patient gets the time, attention, and information they need to make the decision that is best for them. Make an appointment for a consultation today.

Breast Implant Associated Cancer (BIA-ALCL) in the News Again

woman thinking about BIA-ALCL

Most of our life choices carry a certain amount of risk. Each time we get behind the wheel of the car or sign a form allowing our child to participate in sports, we accept a basic level of risk.  We do this because we feel the reward outweighs the potential downside. When choosing to have a plastic surgery procedure, we do the same thing. All surgeries carry the risk of complications, but we choose the path that makes the most sense based on our goals, lifestyle, and comfort with risk.

Most of the more common complications associated with cosmetic procedures are relatively mild and can be avoided with proper preparation before surgery and care after surgery. But occasionally a rare complication arises that has more serious repercussions. In the case of breast implants, Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is one of those rare complications.

BIA-ALCL has predominantly occurred in patients who have, or at one time had, textured breast implants. Reports of the disease developing in patients who have only had smooth implants lack adequate patient history for confirmation, but even so, the unconfirmed reports make up a tiny fraction of the cases.

This unusual cancer is a cancer of the immune system (called a lymphoma) not a cancer of breast tissue itself. It occurs in people without implants but is exceedingly rare. Why it can develop around a breast implant not clear, but it is thought to be related to how a person’s immune system reacts to the implant surface, specifically a textured-surface implant. It typically occurs within the natural scar tissue (capsule) that forms around the implant but can develop as a mass within the breast.

According to the FDA, BIA-ALCL has been reported 457 times in association with breast implants since 2010, but it appears that some of these reports are duplicates. Either way it is quite a rare complication. In fact, the risk of developing the disease for women with textured implants is somewhere from 1 in 3,817 to 1 in 30,000. For perspective, the overall risk of developing breast cancer due to all causes is one in nine. Even though the numbers are small, the association with breast implants is clear. Most cases are caught early and cured with the removal of the implant and the scar tissue surrounding it. Three-year disease survival is reported to be 93 percent. More advanced cases with cancer spread have been reported, and these cases do require chemotherapy. The nine reported deaths in the US from the disease occurred in patents who did not receive these recommended treatments.

We first updated you on BIA-ALCL in 2017, when the FDA announced the association between breast implants and the cancer had been identified. More recently, the FDA has addressed primary care physicians about the issue. As most women don’t see a plastic surgeon for routine health care, it is more likely to be a primary care physician (PCP) who will detect a lump or other change in the breast. This means PCPs must be aware of the special attention a woman with breast implants requires when providing her ongoing care.

As a patient, it pays to be proactive as you think about potential complications of breast implants. Below you will find concrete actions you can take that will give peace of mind about choosing a procedure and living with the results for years to come.

  1. Prior to surgery, discuss all possible complications with your plastic surgeon, including the possibility of BIA-ALCL. Compare the risks and benefits of different types of surgeries and implants to make the decision that is right for you. If your surgeon isn’t up front about potential risks, he or she is not the right surgeon for you.
  2. Do everything your surgeon recommends to prepare for a successful surgery – quit smoking, exercise, eat a well-balanced diet, and limit your alcohol intake.
  3. After surgery, strictly follow the post-operative instructions your surgeon provides for you.
  4. Have a frank discussion with your PCP about your breast implants and ask them to brush up on the latest research on BIA-ALCL. You might even share the FDA letter with them to be sure you are on the same page. Follow-up with them as recommended so they are able to detect any changes over time.
  5. The most common symptoms of BIA-ALCL are the development of fluid (seroma) around the implant several years after surgery, lumps, swelling or pain within the breasts. If you have any concerns at all about your breast implants, always contact your surgeon. He or she is in the best position to evaluate any symptoms that are bothering you.

If you are thinking about getting breast implants or have concerns about the implants you already have, Dr. Slack is your best local resource. Not only is he a member of the American Society of Plastic Surgeons, he completed a fellowship in breast surgery at Georgetown University Hospital in Washington D.C. He would like to discuss your questions with you and help provide a clear view of the risks and benefits of any procedure you choose. Contact our Collin County office to schedule a consultation.

The Three Things You Need to Know About Plastic Surgery After Weight Loss

The new year is right around the corner, which for many of us means it’s the time we start thinking about New Year’s resolutions. Perhaps you want to lose weight, stop smoking, or save money. Whatever it is, the new year offers a kind of reset button on life. For some, plastic surgery also offers this opportunity for a reset. Though it can’t fix everything, it can give you the confidence boost to start making other changes.

In this post we will be talking about plastic surgery after weight loss, which is an especially good example of this kind of reset. But, unlike many other changes you might choose to make in the new year, plastic surgery requires an especially large amount of thought, research, and preparation. It’s surgery, after all.

Plastic surgery after weight loss can feel like a huge reset because, for many, it is the last step in a long journey to remake their lives. Losing a large amount of weight (say, 50 to 100 pounds or more) takes time, effort, and in some cases weight-loss surgery. It is arduous, no matter how you get there. Weight loss alone changes lives in a big way, giving people more energy, improved health and self-esteem, and greater mobility. But, like most things in life, it isn’t always a perfect solution.

After significant weight loss, some people are left with excess loose skin. This affects people differently; for some it is a minor cosmetic issue and for others the loose skin itself diminishes mobility, causes rashes and infections, and impacts their sense of wellbeing. This 2018 study of nearly 1200 people (80% were women) who underwent gastric bypass surgery, found a link between excessive skin and poorer psychosocial functioning.

Unfortunately, the loose skin that follows a large loss of weight won’t go away no matter how many sit ups you do or expensive creams you buy. For this reason some people turn to plastic surgery for a permanent solution.

This kind of surgery is generally referred to as body contouring, and it can include a whole host of different procedures including the following:

While these procedures can restore a more youthful and toned appearance to the body, they come with some risk, especially when more procedures are performed at once. For this reason there are three things you need to consider if you are thinking about plastic surgery after massive weight loss.

It’s not an option for everyone

Obesity is a well known health risk and the medical conditions (called co-morbidities) that can go along with it include diabetes, heart disease, stroke, high blood pressure, sleep apnea and other breathing problems. These are serious health issues and they are often the reason someone undertakes an extreme weight loss effort. Sometimes those co-morbidities don’t completely go away, even after a large weight loss, making it too risky to undergo cosmetic surgery.

Plastic surgery for weight loss also won’t be an option for you if you are unwilling to change unhealthy habits. For example, you have to be willing to quit smoking, as it can get in the way of healing.

You have to wait a while after weight loss

Most plastic surgeons will require you to wait at least six months after reaching your goal weight before considering plastic surgery. This gives your body time to stabilize. Many of the health conditions associated with obesity will improve or go away during this time, and good long term eating and exercise habits will get established. This waiting period also gives some of the extra loose skin time to shrink down on its own.

It isn’t a panacea

Plastic surgery is the only permanent way to remove the large amount of loose skin that follows significant weight loss. It can improve your appearance and mobility and even your health. But it will not turn back the clock to a time before you had any weight to lose, to the body you had, say, at 16. Your body will also continue to be subject to the effects of aging after the surgery.

Though there are ways to minimize the appearance of scars, scarring is inevitable as well. (Learn how Dr. Slack keeps scar visibility to a minimum). Take a look at our before and after gallery so you know what to expect, at least in the first months after surgery as scars will continue to fade.

Also, it is important to know that no plastic surgery is a panacea for all of life’s problems; it won’t save your marriage, make you smarter, or get you that promotion. Being realistic and specific about the problems you want to solve will take you a long way toward a more satisfying result.

If you are considering plastic surgery after weight loss, it is important to take your time thinking about it, do your research and find the right surgeon for you. It has taken you a while to get where you are so a little more won’t hurt. Call our office today and make an appointment with Dr. Slack to get that process underway.

Yes, You Need to Stop Vaping Before Plastic Surgery

In nearly every blog post we write, we tell you that one of the best things you can do to prepare for plastic surgery is to quit smoking. Smoking is known to slow healing and increase the risk of infection and blood clots, all of which can get in the way of achieving the look you want. Smoking is clearly linked to heart and lung disease and cancer so it’s a good idea to quit anyway — you probably already knew that last part. What you might not know is that you should also quit vaping before and while you are healing from plastic surgery.

Vaping, or smoking e-cigarettes, was introduced in 2004, with some experts claiming it to be a healthier alternative to smoking regular tobacco cigarettes. According to this study published last month (Oct 2018) in the Annals of Internal Medicine, more than ten million U.S. adults had picked up the habit by the year 2016. And that growth seems to be continuing.

But is vaping a healthy alternative? The answer is that no one knows for sure yet, but the evidence is beginning to suggest it is not.

The problem with regular tobacco cigarettes, say many experts, is that they contain so many harmful chemicals like carbon monoxide, hydrogen cyanide, and nitric oxide, in addition to nicotine. E-cigarettes contain nicotine but supposedly none of that other stuff, leading some to suggest that they can be used as a form of nicotine replacement therapy (NRT).

The problem is that e-cigarettes do have some additives in them. They don’t just deliver nicotine and vapor, as once thought. A study that came out of Johns Hopkins earlier this year (2018) showed high levels of lead and other toxic metals including chromium, manganese, and nickel in the inhaled vapor. Further, this 2018 study suggested that vaping can damage DNA and increase the risk of developing cancer and heart disease.

Nicotine, the chief ingredient in e-cigarettes, tobacco products, and NRT is also not a healthy compound. It is addictive and has been linked to gastrointestinal, cardiovascular, and respiratory ailments, as well as lowered immunity and cell damage. It also can cause poor wound healing and other complications following surgery.

Surgery of any kind challenges the systems of your body and plastic surgery in particular requires good wound healing. To get the best results possible it is important to be as healthy as you can be. Dr. Slack recommends that you quit smoking (and that includes vaping) at least four weeks before surgery and during your recovery.

If you are considering any kind of plastic surgery in the coming months, the time to quit is now. And you’re in luck because this month (November) also happens to be the time of year that the American Cancer Society offers all kinds of resources during The Great American Smokeout.

If you want to learn more about how your smoking/vaping history may affect plastic surgery outcomes for you, schedule a consultation with Dr. Slack today.

Heads up on the Brazilian Butt Lift: Urgent Warnings Issued

Perhaps you are proud that you have your great grandma Sylvie’s slender ankles or your dad’s jet black hair. But maybe you also inherited … something you aren’t so fond of. For a lot of women, that something is a flat butt. There are lots of reasons (like celebrity trends) that make people want to change a part of their body, and a flat bottom has women turning to plastic surgery more and more for a procedure called the Brazilian Butt Lift. In 2017, about 20,000 were performed, a number that has doubled in the last five years, with some deadly consequences.

Experts estimate that the death rate after a Brazilian butt lift is as high as one in 3,000. No other cosmetic surgery procedure is associated with such a high death rate. Few surgeries of any kind have such a high death rate. These startling statistics have prompted the world’s prominent plastic surgery societies to come together to form a task force and to issue warnings to plastic surgeons and patients alike. The American Society of Plastic Surgeons issued a press release about the task force just last month (August 2018).

The Brazilian Butt Lift (BBL), also called gluteal fat grafting, isn’t actually a lift procedure at all; rather it involves taking fat, via liposuction, from one part of the body and injecting that fat back into the buttocks. While this may sound simple enough, it is actually a technically difficult procedure, requiring special training.

The fat that is removed has to be processed carefully before it is re-injected, and the method of injection is critically important. The amount of fat, the exact location, and the depth of the injection are all factors that can affect whether blood vessels are damaged in this area. If this happens, even the tiniest piece of injected fat can enter the bloodstream and cause a life threatening clot, called a fat embolism.

In a study published in the Aesthetic Surgery Journal, of nearly 200,000 Brazilian Butt Lifts performed, this kind of fat embolism formed and was fatal in 32 cases and non-fatal in another 103. Experts believe these numbers are likely much higher in reality because of under-reporting. Further, because of the increase in popularity of this procedure, many more unqualified practitioners are offering to perform the procedure in poorly equipped settings.

For these reasons, if you are considering this procedure it is more important than ever that you do your homework: understand the risks and verify that whomever you choose to do the procedure is properly trained and licensed. One of the best ways to do that is to make sure your plastic surgeon is board certified and has legitimate hospital privileges. Learn more about how to do that in our post How to Choose a Plastic Surgeon.

It is also a good idea to make sure the surgeon you choose is a member of the American Society of Plastic Surgeons (ASPS). This ensures that he or she is board certified and will be kept up to date on this critical issue. The ASPS is a member group on the newly formed Multi-Society Task Force for Safety in Gluteal Fat Grafting that is focused on studying the Brazilian Butt Lift and making it safer.

“The Task Force continues to review and share additional information on this topic to ensure that ABPS board-certified plastic surgeons and patients are up-to-date on the latest statistics and practices and can make informed decisions with patient safety as the goal.” — American Society of Plastic Surgeons Press Release

Choosing any kind of plastic surgery is a very personal decision. Doing your homework and going in with your eyes open is the best way to get the best possible outcome. If you live in Allen, Texas and have questions about the safety of any procedure you are considering, please contact our office and make an appointment with our board certified plastic surgeon, Dr. Charles T. Slack.