Lung cancer treatment revamped

Lung cancer treatment revamped

By ASSOCIATED PRESS

Thousands more lung cancer patients each year could be offered surgery or other aggressive therapy under a new system that classifies many tumors as more treatable than in the past.

It is the first big overhaul of a decades-old method used to predict survival and help determine whether a lung cancer patient will have surgery, chemotherapy or be treated at all.

The new guidance is to be presented at a conference of lung cancer specialists in Seoul, South Korea, that starts today. It is expected to be adopted by policy-making groups in the next year.

Lung cancer is the world's top cancer killer, claiming 1.3 million lives each year. In the United States, 213,380 new cases and 160,390 deaths from the disease are expected this year.

Nearly 60 percent of people die within one year of diagnosis, and nearly 75 percent die within two years, American Cancer Society statistics show.

Treatment

In treating it, doctors use a formula called tumor staging. It is based on a tumor's size, how far it has spread and other factors to predict a patient's survival odds and to guide treatment.

The current system was developed from about 5,000 tumor samples from University of Texas M.D. Anderson Cancer Center in Houston decades ago — before improved scanning technology was available to evaluate a cancer's spread.

The new plan is based on 100,000 tumor samples from around the world including Asia, where lung cancer rates are projected to climb because of trends in smoking, unhealthy lifestyles and aging populations.
It keeps four broad groupings but sorts people more precisely based on refined understanding of tumor characteristics.

The result: "There will clearly be shifting of patients from categories not operable to operable" — as many as 10,000 a year in the United States, said Dr. David Johnson, a lung cancer specialist at Vanderbilt University in Nashville, Tenn. He reviewed the plan, which was partly published in a medical journal recently.

Tumor stages

The stage of the tumor at diagnosis is the best predictor of survival. Only 20 percent of cases are diagnosed in Stages 1 or 2, when tumors are small and confined to a lung, Johnson said. About 30 percent to 40 percent are found in Stage 4, after they have widely spread. The rest are in the middle.

Five-year survival rates are 47 percent for Stage 1 and 26 percent for Stage 2, but only 8 percent for Stage 3, and 2 percent for Stage 4, according to the American College of Surgeons.

Most lung cancers are the type called "non-small cell," which is covered by the new staging system. The system was developed by the International Association for the Study of Lung Cancer, a group of lung cancer specialists from around the world.

Dr. Peter Goldstraw, a surgeon at the Royal Brompton Hospital in London, led the project, and Canadian scientists independently validated the recommended changes by comparing survival across geographic regions.

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One Surgery Often Enough for Peritonitis

One Surgery Often Enough for Peritonitis

Study questions usefulness of secondary procedures
By Randy Dotinga HealthDay Reporter

TUESDAY, Aug. 21 (HealthDay News) -- Patients with a serious gastrointestinal infection known as peritonitis may not automatically need to undergo more operations beyond the first one, new research suggests.

In the United States, most surgeons choose to wait and see if they think patients need the extra surgery, said Dr. David Flum, a gastrointestinal surgeon at the University of Washington, who wrote a commentary about the study.
Until now, however, "there hasn't been a lot of evidence to guide that decision," he said.

The findings are published in the Aug. 22/29 issue of the Journal of the American Medical Association.

Peritonitis occurs when a hole develops in the intestines -- such as when the appendix bursts -- and allows bacteria to spill into the abdominal cavity, Flum said. Severe infection can result.

There's a high risk of death even after surgeons plug up the hole, he said, because bacteria remains and creates problems.
One approach has been to operate and then "keep taking them back to the operating room and washing out the abdominal cavity until they improve," Flum said. "Another strategy is to re-operate when the patient's body is giving you signs that it needs an operation."

In the new study, Dutch researchers at the Academic Medical Center, Amsterdam, examined the impact of each strategy on 225 patients. Only 42 percent of those in the "non-automatic-surgery" group actually went on to have a secondary operation, compared to 94 percent in the automatic-surgery group.
About a third of the patients in both groups died, and the researchers said there was no "significant difference" between their mortality rates.

However, patients who only underwent a second surgery when their doctors thought it necessary spent an average of seven days in intensive care versus 11 days for the other group. They also spent an average of 27 days in the hospital versus 35 days in the automatic-surgery cohort.

Meanwhile, "direct medical costs" were 23 percent less among those who didn't automatically have a subsequent surgery.
"It doesn't like look there's a huge difference in survival," Flum said. "But the approach with fewer operations and less cost would be the preferred one."

Dr. E. Patchen Dellinger, chief of the division of general surgery at the University of Washington, Seattle, said he hopes that questions about the validity of automatic re-operation are now settled.
"An area that could use study is how long antibiotics should be continued in the treatment of peritonitis," said Dellinger, who also wrote a journal commentary on the Dutch study. "Currently, I believe that many [peritonitis] patients get antibiotics for far longer than needed."

More information
There's more on peritonitis at the University of Maryland.
SOURCES: David R. Flum, M.D., associate professor, surgery and surgical outcomes and gastrointestinal surgeon, University of Washington, Seattle; E. Patchen Dellinger, M.D., professor and vice chairman, department of surgery, and chief, division of general surgery, University of Washington, Seattle; Aug. 22/29, 2007, Journal of the American Medical Association

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Indiana Plastic Surgeon Offers Silicone and Saline Breast Implants for Breast Enlargement in Indiana

Indiana Plastic Surgeon Offers Silicone and Saline Breast Implants for Breast Enlargement in Indiana

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“Almost all my patients want a naturally enhanced look. I can provide a more tailored breast augmentation now that there are more implant choices on the table.”

Women can now customize their breast enhancement in Indiana by choosing between saline breast implants and a new generation of silicone gel implants at the Valparaiso or Schererville offices of Indiana plastic surgeon Gustavo E. Galante, MD.

Only 10 months ago, most women considering breast enlargement in Indiana and across the United States had to choose saline implants, the only implant material widely available. But now, following U.S. Food and Drug Administration (FDA) approval of a new generation of silicone gel implants, the choices for breast augmentation in Indiana have grown. Plastic surgeon Dr. Gustavo Galante, after seeing for himself the strong safety record of the new silicone gel implants, has expanded his implant options to include both saline and silicone gel. "Women are excited about having more choices, and there really has been no better time to consider breast enhancement," says Indiana plastic surgeon Dr. Galante. "Almost all my patients want a naturally enhanced look. I can provide a more tailored breast augmentation now that there are more implant choices on the table."Choosing an implant material is only one of the many decisions every woman needs to make when considering breast enlargement.

Indiana women also have a wide array of choices regarding shape, size, and profile. There are literally hundreds of variations possible, allowing Dr. Galante to provide each of his patients with a custom result."The latest silicone gel implants have a consistency remarkably like real breast tissue," adds Dr. Galante. "This is preferable for many patients, particularly those with very little breast tissue of their own.

In these patients, silicone gel implants tend to look more like a natural breast, with a gentle slope away from the collarbone when they stand up, rather than a fixed or overly round appearance that might occur with saline."Various generations of silicone implants have been available in other parts of the world for several decades, but since 1992 they had not been used for most breast surgeries in the United States. Initial safety concerns did not pan out after over a decade of research and technological improvements have increased the durability of this implant type. Modern silicone implants use silicone with a more gel-like consistency, allowing them to hold together better than earlier versions. As a result, silicone migration is much less likely if rupture occurs. "In my experience silicone implants can provide a more attractive breast augmentation result for selected patients, but saline can be an excellent choice for some women, particularly those very worried about safety or implant rupture. Silicone implants have a slightly higher rate of capsular contracture, the hardening of the scar tissue that surrounds the implant.

Also, I can use a slightly smaller incision when placing saline implants, so this may be the right choice if scarring is a big concern."Dr. Galante has the training and experience to provide a pleasing, shapely breast appearance regardless of whether a patient chooses saline or silicone gel. He encourages women interested in breast enhancement to schedule a consultation and learn more about which implant type is right for them. "Ultimately," he says, "it's a personal decision, but I do everything I can to make sure each patient has the facts so she can make the best choice for her breast augmentation goals."

The cosmetic surgery practice of Dr. Gustavo Galante serves Northwest Indiana, with offices in Schererville and Valparaiso. Dr. Galante offers a variety of cosmetic surgery options, including breast augmentation, tummy tucks, liposuction, and face lifts. He is board certified by the American Board of Plastic Surgery, a member of the American Society of Plastic Surgeons, and a fellow of the American College of Surgeons and the American Society of Laser Medicine and Surgery. His practice is committed to creating an environment where each patient can feel comfortable with every step of their surgical experience.

Many in they UK still regard cosmetic surgery as a largely American indulgence

Many in they UK still regard cosmetic surgery as a largely American indulgence. But with more operations than ever taking place, what's the chance of the person next to you having had some "work" done?

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Joely Richardson is facing quite a dilemma - her marriage is on the rocks, so would breast enhancement make her happy? The beautiful blonde ponders this poser on billboards, all to advertise her new TV series about plastic surgeons.

With its unflinching depiction of invasive procedures such as liposuction and butt implants, Nip/Tuck, which begins in the UK on Tuesday, has been described by one critic as "Six Feet Under six hours earlier". The show's catchphrase, "tell me what you don't like about yourself", has special resonance on both sides of the Atlantic.

For cosmetic enhancement is a thriving industry in the UK, and it is not just glamour models, aging starlets and Dale Winton who keep plastic surgeons in Ferraris and speedboats.

WHAT UK WOMEN WANT

Breast augmentation
Blepharoplasty, or eyelid lifts
Face and neck lifts
Liposuction
Rhinoplasty, or nose jobs
Source: British Association of Aesthetic Plastic Surgeons The number of Britons trying to improve on nature has increased six-fold in the past six years, with an estimated 25,000 surgical procedures performed in 2002. Add non-surgical procedures such as Botox injections and laser treatment, and that figure climbs to 75,000 a year, according to Bupa.

Compared to the United States, where patients attend "Flaunt It" parties to show off their new breasts, bums, pecs and noses, it seems Britons prefer to be discreet about the "work" they have had done.

Dr Patrick Bowler, the chairman of the British Association of Cosmetic Doctors, says few of his patients - who include 20-somethings and men - admit to the treatments they've had.

"British women want to look better, they want to be told they look better, but they don't want to say they've had a face peel. Few of my patients would tell their husbands - they might tell their closest friend, but most keep it secret. I doubt we'll become like America, where 'who did your facelift?' is taken as a compliment."

WHAT UK MEN WANT

Otoplasty, or ear-pinning
Rhinoplasty
Blepharoplasty
Face and neck lifts
LiposuctionRumours constantly circulate about which home-grown stars may have felt the touch of knife or needle, yet often it's those who have had treatments too obvious to ignore who will talk openly about it.

Adam Searle, a consultant plastic surgeon and the honorary secretary of the British Association of Aesthetic Plastic Surgeons, says Britons' attitude towards cosmetic surgery is shifting - and not in a good way.

"It's become far more acceptable to do this, and if thoughtfully done, it can alter the lives of those who need it. But I fear that we may be slipping into a gratuitous cosmetic surgery trap, where people tumble into having multiple procedures as if it's a hairdo. Yet it carries very real risks, which have to be taken into account."

Leslie Ash suffered a reaction to lip plumping, and newspaper odiumNor are the risks properly explained to patients, says the consumer watchdog Which?
In an undercover investigation into cosmetic treatments such as Botox and chemical peels, only five of 16 consultations were considered good. Others failed to take a medical history and didn't fully explain the risks. The researchers also found a doctor under investigation for serious professional misconduct.
Women's lib

If this is, however, another trend which will spread inexorably across the Atlantic, what might be in store for Britons?

One part of the body where cosmetic surgery is still in its infancy is the feet, but not for long perhaps. Dr Suzanne Levine has made a name for herself among the style conscious women of Manhattan, who turn to her when they can't fit into designer high heels.

"It's up to patients to be able to enjoy their lifestyle," says Dr Levine, who performs a range of operations such as toe-shortening at her Institute Beauté clinic.

It has echoes of the ancient Chinese practice of foot binding, yet her patients are anything but enslaved. Many are "baby-boomer" career women in their 50s, whose feet have weathered a lifetime of discomfort in what the doctor calls "limousine shoes" - precipitously high with virtually no structure.
'FOOT FACELIFTS'

So-called claw toes (see above) stick out beyond the big toe
They are incompatible with pointy shoes and can be shortened with bone removal

Other foot options include narrowing and collagen injectionsDr Levine resets the bones in the foot, and, with lasers, returns a healthy glow to the skin.
Dr Magdi Greiss, a leading foot surgeon in the UK, frowns on such procedures.
"Last week a 16-year-old girl asked me to remove the inherited bunions on her foot because her boyfriend didn't like them," says Dr Greiss. "Do they hurt, I asked. No, she replied. So I told her to get a new boyfriend."

Yet he concedes that cosmetic foot surgery is creeping to these shores - already some clinics give collagen injections in the feet for high-heel wearers.
"Removing a bunion is a serious piece of surgery that involves slicing through the bone. There's a lot of pain. So I say, if it's not painful to start with, don't create more pain."

WHAT'S BEING DONE?

No longer is plastic surgery limited to facelifts and tummy tucks. Today's procedures can remodel those with cash to burn from head to toe:

Breast implants now come coated in biocompatible titanium - to reduce the risk of the body rejecting foreign matter. There's no word on the risk of setting off airport metal detectors.

Surplus fat can be sucked from the upper arms and injected into thinning, aging hands.

Butt implants fill out a flat rear - these are placed just above the sitting area so weight isn't placed on them.

Don't like that sticky-out belly button? Umbilicoplasty turns that "outy" inwards.

Men can have their "man breasts" reduced - and those who dream of a gym-fit bod can opt for silicone pectoral implants.
Stiletto-wearers can have their feet padded and toes shortened to make those Manolos more comfortable.

For improvements of a particularly intimate nature, surgery can offer practically any kind of increase or decrease in size or alteration to shape.

Follicular Unit Extraction vs Older Methods of Hair Transplantation

Follicular Unit Extraction vs Older Methods of Hair Transplantation

In the past, as the names of these earlier procedures indicate, undergoing a hair transplant was a painfully unpleasant process. Men with receding hairlines and balding scalps often resorted to the unnatural-looking, and often ridiculed, toupee to avoid the pain, slow healing, and scarring of a transplant.

Because of this, the hair transplant business was staggering in the late twentieth century. Surgeons knew that hair restoration techniques needed to evolve.Fast forward into the beginning of the twenty-first century…Thousands of bad comb-overs and strip incision scars later, the new technique that hair restoration surgeons were waiting for was finally perfected.

The hair transplant community eventually embraced follicular unit extraction (FUE). Surgeons praised the method and potential patients were curious about it. But what exactly is follicular unit extraction? And is it really more effective and beneficial than older methods of hair transplantation?Follicular unit extraction involves the removal of small groups of hair follicles (usually between one and four) from the donor site and their reinsertion into the receptor site. These small grafts allow for equal distribution of hair in the balding area of the scalp and produce more natural-looking results.

In fact, once the receptor site has completely healed, it is virtually impossible to detect that any sort of hair transplant procedure has taken place.The differences between FUE and the older methods of transplantation are noteworthy.Firstly, the FUE procedure is quicker and less painful than any other hair restoration technique. FUE is performed with a punch-like scalpel that cuts the skin around the follicle.

This facilitates the removal of about one to four follicles from the donor area at the same time. Also, the advanced method of follicular perforation™ allows the surgeon to make a shallow punch on the surrounding tissue, ensuring that the graft be released from the tissue with minimum traction and with better ease. The extracted follicles (called grafts) are then inserted into small slits that have been cut in the recipient area. These slits do not need suturing, heal quickly, and are completely undetectable once the new hair begins to grow in about seven to ten days.Secondly, FUE is beneficial because the recovery process is much faster and less painful.

In most patients, the grafts become fully secure in about eight days after surgery and the surgical wound in the donor area usually heals within one to two weeks. Some discomfort may be present, but usually analgesics like Tylenol or codeine will help. Generally, normal activity may be resumed one to two weeks after the procedure. In older methods of hair restoration, bleeding, suturing, and bandaging were parts of the long and painful recovery process. Thirdly, 100% of hair loss sufferers are candidates for FUE.

In the past, hair restoration was not as widely available to every hair loss sufferer as it is today. There were various criteria that each candidate had to meet to be eligible for a hair transplant. Such criteria included the patient’s age, color and texture of hair, skin complexion, amount of donor hair available, and future hair loss projections.

However, because the methods involved with follicular unit extraction are so advanced, such criteria are not much of a concern. For example, the amount of donor hair on the head is not an issue when determining candidacy because the procedure allows for the extraction of hair from other parts of the body.Fourthly, the incidence of complication during the FUE procedure is lower than with other transplantation methods.

In a study, published by Dr. Masumi Inaba, of over 150 patients treated with FUE, researchers found that patients suffered only from mild discomfort from sitting still for several hours at a time. Furthermore, only four out of the 150 patients experienced donor area shock, while two more patients experienced a more limited variety of patchy circular alopecia (hair loss). Nevertheless, all patients made full recoveries within five weeks. Lastly, FUE patients recover without visible scars in the donor or recipient area.

Unlike previous methods, like strip incision, where an unattractive linear scar was exposed in the donor area, FUE does not leave ugly, unbearable scars on the head. Instead, the tiny slits that are cut in the recipient area are conveniently hidden by new hair. The final result of FUE in all patients is that of a seamless, natural, healthy-looking head of hair.For all those who are suffering from hair loss and are searching for the best method of restoring their youth, follicular unit extraction should be considered.

It is a hair restoration method that discards the use of the painful linear donor incision and regards 100% of hair loss patients as proper candidates for the procedure. It is widely predicted that within the coming years, follicular unit extraction will make further advancements and become the method of choice for every hair restoration surgeon and patient.

About the AuthorDr. Robert Jones has been practicing medicine since 1979. He is active in the field of hair restoration. An advocate of providing his patients with the best quality, Dr. Jones is among the first doctors in North America to use follicular unit extraction—a procedure he praises for its great value and efficiency.

Dr. Jones is a member of the International Alliance of Hair Restoration Surgeons, the International Society of Hair Restoration Surgery, the International Society of Cosmetic Laser Surgery, and the American Society for Laser Medicine and Surgery. He is also the president of the International Society of Follicular Unit Surgeons. For more information on Dr. Jones or follicular unit extraction visit:

http://www.torontohairdoctor.com

http://surgerynews.net/200501.html

The Top 10 Cosmetic Surgery Trends

THE TOP 10 COSMETIC SURGERY TRENDS

Over the last decade, plastic surgery has become a mainstay in our society.Not only have celebrities such as Joan Rivers, comedienne Kathy Griffith andCarnie Wilson become self-professed plastic surgery advocates, but averagemen and women jumped on the cosmetic surgery bandwagon as aestheticenhancements have become a regular fixture in our culture.

Programs aboutcosmetic surgery such as ABC's "Extreme Makeover" and MTV's "I Want A FamousFace" have perpetuated the trend making that used to be a dirty littlesecret, something that people now regularly boast about having done.

The American Society for Aesthetic Plastic Surgery (ASAPS), the leadingnational organization of board-certified plastic surgeons who specialize incosmetic surgery has announced their plastic surgery trend predictions for2005. Below is a summation of those predictions. Dr. Dennis Hurwitz, a topplastic surgeon located in Pittsburgh, Pennsylvania is available to commenton these trends, how celebrities have helped raise the profile of particularsurgeries and the consequential effects of plastic surgery on society as awhole.

* HELLO RESTALYNE, GOODBYE COLLAGEN:
New, long lasting soft tissuefillers for facial wrinkles and creases will challenge collagen for thenumber one spot among injectable cosmetic treatments.

* FACIAL REJUVENATION:
Endoscopic (arthroscopic) facial rejuvenationprocedures will increase in popularity. Suture suspension techniques thatpromise facial rejuvenation with minimal downtime will also be a populartrend. There will be many patients who will still opt for traditionalfacelifts or endoscopic procedures with more predictable and lastingresults.

* TOTAL BODY SURGERY: The number of total body lifts, includingtorso, breasts and for some patients, face and neck will increase, as postbariatric surgery patients seek plastic surgery to rid themselves of excessskin left hanging after massive weight loss.

* BIGGEST BUZZ: A new generation of breast implant fillers andcoatings, advanced lasers that rejuvenate the skin from the inside out, newproducts for scar management and keloid prevention.* LIFESTYLE ASSESSMENT REFERRALS: After receiving plastic surgery,doctors will refer their patients to other health and beauty professionalsincluding specialists in nutrition, weight management and cosmeticdentistry.

* EMPHASIS ON NOSTALGIA & ELEGANCE: More cosmetic surgery patientswill express a preference for classical facial features embodied bycelebrities like Nicole Kidman and icons like Grace Kelly.* ETHNIC MINORITIES: Cosmetic surgery for racial and ethnicminorities in the United States will increase.

* PATIENT SAFETY: National attention will result in more stringentrequirements for physician credentials to perform cosmetic surgery.

* NON-INVASIVE FAT REMOVAL: Experimental techniques that will offera non-invasive alternative to liposuction will be tested in clinical trials.

* "REALITY" TV: The long term psychological effect of undergoing adramatic change in appearance from simultaneous multiple-procedures, as iscommon for participants of reality shows, may surface in 2005.

About Dr. Dennis Hurwitz: Since 1977, Dennis J. Hurwitz, M.D., F.A.C.S. hastreated thousands of patients with cosmetic concerns, structural defects,and congenital deformities. At the University of Pittsburgh, Dr. Hurwitz isClinical Professor of Surgery and former director of the Aesthetic PlasticSurgery Center. He is a skilled practitioner, teacher, and innovator and wasrecently recognized as one of America's Top Doctors for specialist referrals-- the only plastic surgeon in Western Pennsylvania in the 2000-2004 editionof the <" target=_blank>http://www.castleconnolly.com/index.cfm?dws=ey>; Castle ConnollyGuide. A diplomat of the American Board of Plastic Surgery, a member of theAmerican Society of Plastic Surgeons and the prestigious AmericanAssociation of Plastic Surgeons, Dr. Hurwitz has been president of city,state and regional plastic surgery organizations, as well as the AlleghenyCounty Medical Society.

http://www.castleconnolly.com/index.cfm?dws=ey ;
For additional information on Dr. Dennis Hurwitz, please visit his websiteat www.hurwitzcenterforplasticsurgery.com
http://www.hurwitzcenterforplasticsurgery.com ; or his national website at
http://www.usalipo.com
http://www.usalipo.com

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New Instant Recovery Facelift

Prominent Long Island plastic surgeon Dr. Zachary Gerut develops revolutionary new surgical procedure.

i-Newswire, patients desiring a younger look have been forced to choose between a small improvement from a “mini” procedure or thread lift allowing a quick recovery or a substantial face lift procedure with a lengthy recovery of one, two or even three weeks.

The Gerut Lift is a complete and long-lasting face lift procedure! Not a mini lift, not a thread or feather lift and not any other small procedure. Dr. Gerut’s procedure has a reliable record of providing excellent facial rejuvenation and lasting many years. Dr. Gerut has combined many innovations and established techniques including a very striking departure from the usual: the facelift is done with the patient totally awake yet totally comfortable.

Dr. Gerut states “Anesthetic drugs cause major physiologic changes that increase bruising and swelling. Without anesthesia and with Gerut’s innovations, the recovery is significantly and even amazingly faster- so much less swelling and bruising that most patients are exceptionally well healed in as quickly as one, two or three days.”

For his new procedure Dr. Gerut uses techniques that have been proven effective for other cosmetic procedures- special techniques, special instruments and Dr. Gerut uses Novocain to numb the face with several totally painless injections using a tiny, imperceptible needle and a special apparatus that spreads the Novocain slowly to avoid even the slightest discomfort. Distributing the Novocain throughout the face can take approximately ½ hour or more. For patients who are squeamish about needles, small amounts of Valium are given orally or even by I.V. to keep them comfortable.

How can Dr. Gerut be sure that a patient is numb? Dr. Gerut explains that the entire face is full of the diluted lidocaine, saline and adrenaline (which is commonly used in tumescent liposuction), which turns the tissues completely white so that he can see the affect the adrenaline is having on the numbing process.

What about the patient ‘fear factor’ in terms of being completely awake during surgery? As Dr. Gerut explains, “the patient is lying back and listening to any type of music they wish. If the patient feels he or she wants a break, Dr. Gerut can pause during the surgical procedure. The patient can speak with Dr. Gerut but if he needs them to remain especially still or silent, he will let them know. As Dr. Gerut points out, “even when a patient is sedated by traditional means, they can still make involuntary movements such as scratching or hand movements so there is no more risk in terms of patient movement using this Novocain method. If a patient feels the need to scratch or shift positions they simply let Dr. Gerut know so that that he can pause.”

In addition to eliminating the potential dangers of anesthesia, there is no post operative nausea, grogginess, or anesthesia ‘hangover.’ The Novocain wears off an hour or two after the surgery is over and patients do not feel pain. There is perhaps some tightness, which is quite normal. Dr. Gerut uses a very long acting Novocain called Marcaine that lasts up to six hours.

Because tumescent liposuction is so successful in minimizing bruising and swelling, Dr. Gerut has been tumescing the face for many years, and is adept in his surgical technique to accommodate for the facial changes that occur when the patient’s face is full of saline and Novocain. At this point, Dr. Gerut has successfully performed over 25 facelift procedures using this anesthesia-free method. He has had no complications and only positive aesthetic outcomes.

Just as surgeons have readily accepted the tumescent technique for liposuction, Dr. Gerut feels that once this facelift technique has been taught to other plastic surgeons that it will be widely embraced. Although Dr. Gerut is not suggesting that the use of anesthesia is a uniformly dangerous method of performing plastic surgery, the fact remains that its use does pose potential risks even in healthy patients.

For those patients wishing to minimize that risk and recover much faster post operatively, this is perhaps the most exciting news to emerge from cosmetic surgery in a long time.

*** Dr. Gerut will be submitting a paper on this technique to The American Society for Aesthetic Plastic Surgery.
Dr. Gerut is a diplomate of The American Board of Plastic Surgery, a member of the American Society of Plastic Surgeons and a member of the American Society for Aesthetic Plastic Surgery.

****An understanding of tumescent liposuction helps to better comprehend the principles of Dr. Gerut’s no-anesthesia technique
One of the most significant improvements in liposuction in recent years has been the use of tumescent anesthesia, introduced by Dr. Jeffrey Klein a few years ago. Tumescent liposuction (Tumescent Technique) refers to the performance of liposuction using large volumes of a dilute solution of lidocaine, a local anesthetic, in combination with the drug epinephrine that temporarily shrinks capillaries. This is comfortably performed with minimal or no sedation required. The Tumescent Technique minimizes post-operative swelling, bruising and discomfort.

With the Tumescent Technique there is no post-surgical nausea, nor the unpleasant feeling of "hang-over" usually associated with general anesthesia. The Tumescent Technique dramatically reduces both the bleeding during surgery, and the post-operative bruising and swelling as compared to liposuction done purely by general anesthesia. Minimal bleeding reduces post-operative recovery time. Most patients can return to work within three to four days after surgery.

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