Say hello to Exparel. It’s a new form of a local anesthetic that’s been recently approved by the U.S. FDA. Here’s the neat part: a single dose can provide relief for up to 72 hours, which is a big improvement over what we have now.

The product combines the long-acting anesthetic bupivacaine with Pacira’s patented DepoFoam, which allows a slow release of the drug. If the price is right, you can expect to see this used a lot in anesthesia pain blocks, as well as outpatient surgery, such as breast augmentations and tummy tucks.
Exparel has been evaluated in 21 clinical studies, with more than 1,300 participants, and has an excellent safety profile. It should add significantly to post-op comfort, and reduce the need for nausea-causing opiate medications.
Having a top-quality office surgery center like we do means that, every third year, there is a detailed and thorough inspection process that must be passed to retain our certification.  An independent inspector, typically another plastic surgeon, is assigned to check our facility with a long checklist of safety and quality standards.  It’s a big deal, and one we take very seriously.We had this inspection yesterday.  A great deal of time and effort on our part went into preparing for it…and believe me, we were ready.

So, I’m very pleased to report that we achieved a score of 100% in each of the 10 separate categories evaluated.  A big “Thank you” to my staff for a job well done!!

This brings me to my second point of this blog entry.  As a patient, it’s important to choose a facility that has gone through and passed this rigorous process, and maintains an up-to-date certificate.  Then you will know that they have the safety equipment, training, facility standards and protocols in place to protect you during your surgery, and in case of the unexpected.

There are only 3 organizations that are accepted nationally – and all have long acronym names.


We’re certified by AAAASF.  Check for the certificate – it should be proudly on display at the hospital, surgery center or office OR.  If it’s not there…then you shouldn’t be, either!

Two weeks ago, the 5k walk/run fundraiser for the Susan G. Komen foundation was held here in Orlando, at the UCF stadium.  I thought you’d be interested in the results of this breast cancer fundraiser:

  • Money raised:  $303,198.21
  • Number of Participants: 7,701
  • Number of Teams: 362

More of the official race photos can be seen here.
Great job, everyone!  I’d also like to thank our sponsors again who donated to our own office effort.  Support these very community-minded merchants when you need their products.

Wekiva Music
ASi Automotive Solutions
Supera-Tec Promotional Products

Next year, Team Captain Denise says we’re going to have pink costumes.  I’m getting a little worried!

A new tax on cosmetic surgery has been passed in the U.K. Government estimates hope that it will raise up to £500 million a year. The tax, mockingly called the “boob tax”, will raised the price of cosmetic surgery by 20%, or about $1500 U.S. for an average breast augmentation.Reconstructive patients will not be charged the tax.

Needless to say, British cosmetic surgeons are none too pleased. A spokesperson for the British Association of Aesthetic Plastic Surgeons was unhappy with the lack of discussion about the proposal.

I suspect that this additional cost will simply encourage potential plastic surgery patients to take a quick trip to another EU country, to get their surgery there. I think Paris is only about 2 hours away from London by the high-speed Eurostar train.

Mentor, the breast implant manufacturer, has announced a few minor changes to its line of moderate (low-profile) silicone gel implants.

Effective immediately, the “Moderate” profile line will now be called “Moderate classic”.  They’ve also added a few more in-between sizes, to allow women greater choices.  The shapes have also been slightly updated – they are now slightly more rounded and a little more narrow than before – making them pretty comparable to the Allergan Style 10 implant, in my estimation.

The older “moderate” implant family will be phased out.  No rationale was given for this change.

There have been no changes in the design of the Mentor “Moderate Plus” implant (the most popular one at our Altamonte Springs office), or their high profile implant.

Editor’s note:  This minor change should not significantly affect people who are considering the Mentor moderate implant for their breast augmentation – the differences between the old and the new are very subtle.

OK, guys – listen up.

Among middle-aged and older men, prostate issues are common.  Many men try a plant extract, known as Saw Palmetto, for these symptoms – it’s one of the most commonly used herbal non-prescription products in the U.S.

Unfortunately, a recent study in JAMA shows that it’s no better than placebo, at standard doses.  The study, a double-blind, multicenter, placebo-controlled randomized trial at 11 sites in North America, looked at symptoms in men aged 45 and up.  They tried several different dosing strengths for the Saw Palmetto tablets.

While there were few side effects, there was also no significant benefit seen for prostate-related symptoms in the Saw Palmetto group, using up to 3 x the standard dose, when symptoms were compared before and after treatment.

Conclusion:  Another myth – busted.  If you are having prostate issues – see your doctor.  Don’t waste your money on Saw palmetto.


Dressing stylishly, when you are extra-curvy up top, can be a challenge. Here are some suggestions from fashion pros that may be helpful, whether you are naturally well- endowed, or recently had an augmentation.Consider trying: 
–  scoop or V-neck designs
–  wrap dresses
–  keep detailing on top to a minimum – keep it simple
–  shirts and jackets should be fitted to show off waistline
–  solid colors typically work better than patterns
–  good fit is a must;  if necessary, buy a slightly larger size and have it tailored.Avoid:
–  crew-necks & turtle-necks
–  frills and ruffles
–  bows in the front
–  formless tunics
–  poor fit or poor support of bust

It can also be a challenge to find clothes that fit well at the local mall, as “off the rack” doesn’t fit.  That’s where on-line retailing can be helpful.  Here are some links that patients have alerted me to – I have no commercial connection with any of them.

Dress shirts, tops, dresses:
Rebecca & Drew – dress shirts are sized based on the woman’s bra size and height; seen on Oprah.
Bravissimo / Pepperberry – sized based on “curvy”, “really curvy”, “super curvy”.  UK-based, so sizing is slightly different than USA.
CarissaRose – seen on Oprah; shirts & dresses
Campbell & Kate
Biubiu – 3 curviness levels; more “vintage” look.  Website is in both Polish and English.

Swimwear specialists:
Zena swimwear – custom fitted swimsuits and bikinis
Freya swimwear – available here or here
Bikini Beach – sizes D-F
Miss Fit UK
Bras & more
Linda’s – the famous NYC bra-lady, featured on several TV shows
Bra Smyth (NYC)
Jenette bras (LA) – for the “overdeveloped and underserved”
Bravissimo (UK)Sizing note:  many of these stores have their own sizing methods.  You may not wear your “usual size” at these stores….so ask for fitting advice, and be prepared with your exact measurements.Some of these stores use “traditional” bra sizing, in which 4-5 inches is added to your ribcage measurement to determine the band size.  But some stores use a newer “alternative” sizing method, in which your actual ribcage measurement is the same as your band size – this results in a much larger sounding cup size and smaller band size than what you may be used to.  Please ask.

Beginning January 1, 2012, teens under age 18 in California will no longer be permitted to use tanning beds.

This makes California the first state to prohibit minors from using commercial indoor tanning devices, regardless of parental consent.

The measure was sponsored by the California Society of Dermatology and Dermatological Surgery and the AIM at Melanoma Foundation. A spokesman for the Indoor Tanning Association said the ban will hurt businesses, since 5-10% of ITA members’ customers are under 18.

If teens want a tan, they’ll have to do it the old-fashioned way: outside!

Bad news for the vitamin industry.

A study published in Archives of Internal Medicine examining the use of vitamin and mineral supplements among 38,772 postmenopausal women over a 19 year period found that copper supplements and high-dose iron supplements actually caused a statistically significant increase in mortality. Daily multi-vitamins, vitamin B6, folic acid, magnesium, and zinc were also found to cause a slight increase in the mortality rate.

Use of a daily calcium supplement, on the other hand, was associated with a lower risk of death.

Absolute increases in risk were low, and ranged from 2.4% with multivitamins to 18% with copper. Use of calcium supplementation was associated with a 3.8% lower risk of death.

The mortality risk associated with iron supplementation increased in a dose-dependent manner, rising with doses more than 200 mg/day, and highest for doses more than 400 mg/day.

“Based on existing evidence, we see little justification for the general and widespread use of dietary supplements,” the authors wrote. “We recommend that they be used with strong medically based cause, such as symptomatic nutrient deficiency disease.”

Taking dietary supplements to hopefully improve health and prevent diseases is widespread in the U.S., with about half of American adults using supplements, according to the study authors. Annual sales of supplements exceed $20 billion.

Editor’s note: Eat a healthy diet. Save your money. Older women should take calcium.


For those of you who haven’t been paying attention: it’s October, which means breast cancer awareness month, in addition to Fall weather (= still hot in Orlando) and Halloween.

The Susan G. Komen foundation is holding their annual Race for the Cure this sunday, at UCF. You can run or walk the 5K distance. Our office team – of lovely ladies and a few guys – will be out there, helping out. You will see us in our snazzy team t-shirts!

You still have time to sign up, if you’d like to join us – just call Denise at our office. If you prefer to participate with your credit card, rather than your feet – that’s OK too. Denise can help with any contributions for this excellent cause.

Thanks for supporting breast cancer research and treatment.

Plastic Surgery In Florida