BOTOX AND BREAST RECONSTRUCTION

I would say the lion’s share of Breast Reconstruction today involves the placement of tissue expanders, followed by their removal and the replacement of permanent prosthesis.  Since these expanders are placed under the muscle the amount of expansion can be limited due the tension and pain experienced by patients undergoing expansion.

A recent study of 30 patients was done with 15 patients receiving 40 units of Botox in 4 injection sites and 15 patients receiving saline injections.  Those patients receiving Botox had less pain associated with their injections and also they had greater volumes injected at each sitting. Also after 7 days the rise of narcotics was less in the group receiving Botox.

BOTOX - A NEW ANGLE

It seems like every time I turn around there is a new indication for Botox. A recent study showed injections of botox could lessen the production of sebum. The study was conducted by Italian and Chinese researchers and involved 42 female subjects. 

The sebum production returned to normal after 16 weeks. So it may be that Botox may be a new treatment modality for acne. This may be a new role in the therapy of patients who have acne that is refractive to normal therapy. However, at this point more questions remain and more studies are needed.

ANTIAFING AND FACIAL SKIN

When we look at anti-aging for the face we need to look at the skin, it’s texture, sun spots, wrinkles and loss of soft tissue. If there is mark redundancy of the skin, then some type of lift is in order. One of the nuances in face lifting procedures today is the addition of fat grafting with stem cells and PRP or protein rich plasma. I recently read a study by a well known Plastic Surgeon in Italy by the name of Dr. Gino Rigotti.

He studied 6 consecutive patients and placed them in 2 groups. One group received injections of fat and stromal vascular fraction while the second group received expanded mesenchymal stem cells to set which subset would effect anti-aging. The results showed BOTH categories showed increased regeneration of their skin that is an increase in collagen and a decrease in elastin fibers (elastosis or loose skin).