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The difference between BIA-ALCL and Breast Implant Illness

Tuesday, August 6th, 2019

There can be some confusion between Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) and ‘Breast Implant Illness’ and whether they are the same thing.

BIA-ALCL and Breast Implant Illness are not the same. BIA-ALCL is not Breast Implant Illness.

BIA-ALCL is a rare form of lymphoma which has been associated with breast implants.

Breast Implant Illness is a term used to describe symptoms which women attribute to breast implants. There is no examination, imaging or laboratory testing for Breast Implant Illness and scientific studies have not found it to be a consistent or measurable condition. The symptoms of patients with implants are being studied further.

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Dog bite injuries a serious problem in New Zealand

Thursday, October 15th, 2015

Another dog attack on a young child has prompted the New Zealand Association of Plastic Surgeons president Dr Sally Langley to call for tougher dog-control laws. Read the full story at http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11528640

A recent study showed that there had been over 99,000 dog bites in New Zealand in the past 10 years

The study was presented at the NZ Association of Plastic Surgeons annual scientific meeting held in Queenstown in August 2015. The national study quantifies the huge burden that dog bites are exacting on our communities. The members of the New Zealand Association of Plastic Surgeons, whose members are generally the doctors who deal with dog bites, are concerned about the increasing incidence of admissions to hospitals for dog bite injuries.

Dog bites are a serious problem with an average of 2 hospital admissions per day. Data shows that over the last 10 years, over a third of these were children, mostly with facial injuries. The Association recognizes this as a significant problem and wishes to highlight this public health issue for dog owners, parents and policy makers. The Association is asking for us, as a society to have a wider debate about how to sensibly deal with this issue.

The findings of the study are below.

The Burden of Dog bite Injuries in New Zealand: 2004-2014.

Authors: Jonny Mair – Medical Student; Zachary Moaveni – Plastic and Reconstructive Surgeon, Middlemore Hospital

Key Study Findings

This study describes the pattern of serious dogbite injuries treated across the New Zealand public hospital services for the ten-year period 1st July 2004 to 30th June 2014. There were 99,003 dogbites recorded during this period, with 5,842 cases requiring hospitalization and surgical management.

The incident rate rose steadily from 10.5 / 100,000 population per annum in 2004, to a peak of 14.3 / 100,000 in 2014. This rate is significantly higher than previously reported incidence rates for the New Zealand population and is amongst the highest reported in comparison with studies from Australia, UK, and USA.

The highest risk subgroups were identified as children under the age of 9 years, Maori and those resident in low socioeconomic areas. In cases where the scene of injury was recorded, 69.8% occurred at a private residence or property.

The pattern of injury analysis showed head/neck bites in 79% of 0-4 year olds and 63% of 5-9 year olds. This compared with 8% and 5% head/neck bites respectively in 20-59 year olds and 60+ years age groups.

Conclusions

The incidence of dogbite injuries continues to rise over this 10-year study period and in comparison with previously published rates in New Zealand. Additionally, more vulnerable population subgroups have been identified who are most likely to require hospitalization with serious dogbite injuries. Current national legislation and policy around dog control and education in NZ appears to be inadequate in addressing these trends and is failing in particular the most vulnerable population subgroups.

More links:

TVNZ Sunday episode, 2nd August 2015

NZ Herald article, 3rd August 2015

NZ Herald article, 6th May 2015

NZ Herald opinion piece – Brian Rudman 5th August 2015

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Medical Surgery Tourism and Cosmetic Cowboys

Sunday, August 2nd, 2015

Caution is necessary for those considering travelling overseas for cosmetic or plastic surgery procedures or seeking surgery from surgeons without specialist surgical training.

“Cosmetic Cowboys”

60 Minutes Australia documentary about cosmetic surgeons operating without specialist surgical training. Most dangerous of all, these operations are being carried out using potentially toxic anaesthetic methods. Watch the full item at http://www.9jumpin.com.au/show/60minutes/stories/2015/september/cosmetic-versus-plastic/

Medical Surgery Tourism

Patients often say that cost is the main reason for choosing to travel overseas for cosmetic surgery. However, if there are complications with the surgery and revisions are needed, that initial cost can increase significantly. It is therefore important that patients assess all the risks involved before making an informed decision.

Cut- price Breast Implant Surgery dangers

Speaking at the New Zealand Association of Plastic Surgeons annual scientific meeting, New Zealand Institute of Plastic and Cosmetic Surgery founding co-director Janek Januszkiewicz  warned of the dangers of medical tourism trips to places like Thailand for cosmetic surgery. In some cases the resulting hospital bill is then picked up by the New Zealand taxpayer through ACC.

“We’re striving to get the best results through having highly trained surgeons, really good nursing staff and reputable implant manufacturers,” Mr Januszkiewicz said. “You can save yourself money but you don’t know what you’re getting, how long they are going to last and what they’re going to do to your body.”

Mr Januszkiewicz said women returning with infections, misshapen breasts and other issues led to the need for further surgeries. “One of our concerns now is managing the increasing number of problems we’re seeing from patients coming back from overseas with devastating circumstances.” (reported in the Otago Daily Times, 3rd August 2015).

Some of the questions patients should ask before making a decision are:

  • Is my surgeon a member of the International Society of Aesthetic Plastic Surgery (ISAPS)? This means they have some form of internationally recognised qualification
  • Have I got the right information and had enough time to give informed consent?
  • Has there been at least a week between appointments so that I have had adequate time to consider surgery and make an informed decision?
  • Are the medical standards of care and quality control requirements at least as good as those in Australia and New Zealand?
  • Have I been assured that the devices and products used in overseas hospitals meet Australian and New Zealand standards?
  • Have I got a plan for what I will do in the case of post-operative problems?
  • Did I actually see the surgeon, or was the initial ‘free’ visit with a nurse or administration person?
  • Did I get full, written financial details, including all out of pocket expenses for not only the surgeon, but also the anaesthetist, assistant and hospital theatre or facility costs?
  • Were the risks and complications explained to me?
  • What will happen if things go wrong? Will by surgeon accept liability?
  • Where will I be financially if things go wrong, what other costs do I need to consider?
  • Have I been told about post-operative care and what to do if complications arise after the surgery?

Post-operative care is vital to your recovery from surgery and should not be combined with a holiday. A qualified and accredited surgeon should offer their patients a high level of post-operative care.

The article Paradise Botched from NEXT magazine, July 2015, looks at the issue and talks to some women who have travelled overseas for surgery Paradise Botched – Cosmetic tourism – Next magazine July 2015.

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Melanoma

Friday, June 12th, 2015

Careful monitoring and an accurate diagnosis is key to identifying which moles could develop into serious issues like melanoma and skin cancer.

Melanoma is a skin cancer that develops from the pigment producing cells in the skin. Identified early there is the potential for full cure but unfortunately melanoma can spread and be life threatening. New Zealand has the highest rate of Melanoma in the world with 1800 new cases diagnosed per year. It is the third most common cancer diagnosis in New Zealand (excluding non-melanoma skin cancer). Fortunately, due to the ability to recognise and treat melanoma in its early stages, it is only the tenth most common cause of cancer death.

Your Plastic Surgeon is trained to help with both the initial diagnosis of melanoma as well as its subsequent management. The best way to manage melanoma is to prevent it developing. One of the most significant risk factors for subsequent development of melanoma is sun burn in childhood or adolescence therefore the use of sun protection from an early age is essential. Once Melanoma has developed it always requires surgical removal.

If a melanoma does develop we worry about it for four main reasons. Firstly there is a risk that it may regrow where it originally appeared. To decrease that risk your Plastic Surgeon will remove a margin of normal skin from the site of the melanoma – the amount of skin removed depends on the severity of the melanoma. The second risk is that it may spread to the lymph glands near where the melanoma was. Your surgeon will recommend if further assessment of the glands is necessary. This may involve scans or removal of a single indicator node called the sentinel lymph node. Thirdly there is a risk that melanoma can spread throughout your body. Your Plastic Surgeon can investigate and advise you on further care if that is the case. Finally there is always the risk of developing a further new melanoma if you have already had one. Your Plastic Surgeon can offer you ongoing surveillance or advice on alternative appropriate review.

Further information is available from the Cancer Society, Melanoma Foundation and the Online Cancer Guide – A comprehensive resource providing complete information on various types of cancers such as prostate cancer, breast cancer, lung cancer, skin cancer, throat, blood cancer, brain cancer, bone cancer, etc. Also know about the causes of these cancers, symptoms, various treatment methods.

Our plastic surgeons are fully trained to identify and treat your worrying moles. See our Find a Surgeon page for a list of plastic and reconstructive surgeons who specialise in treating Melanoma.

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