Skin Cancer Prevention - No Time For Malignant Melanoma

Three weeks ago I blogged about early diagnosis of malignant melanoma and what you can do to protect yourself. I received some feedback from patients that my recommendations were confusing and I confess that my writing tried to tie 2 different subjects into one. Because it is so important I will try to do better today.
Let's go over the facts. Malignant melanoma is the 8th most common cancer in the U.S. and causes 1-2% of all cancer deaths. It has increased in incidence more than any other cancer in the U.S. In the U.S. alone in 1999 there were up to 90,000 cases of melanoma and 7300 deaths. It is most often found on the trunk in men and on the lower limbs of women. By far the most alarming sign is that of a changing mole. A mole can change colors (blue, black, red, white), size, or shape and this gives the best chance of catching the disease early and obtaining a cure. In order to provide the greatest accuracy the entire mole must be removed for biopsy and not just a part of it. Therefore, if you see a changing mole on your body or if you have many moles on your body - see a dermatologist for advice and when necessary a biopsy.
That is point number one. See a dermatologist for changing moles and if you are unsure get a total body skin exam. At MetropolitanMD we have a dermatologist, a facial plastic surgeon, and a plastic surgeon to provide efficient and accurate diagnosis and surgical treatment.
My second point is more difficult to deal with. The average person develops 40 moles up to the age of 40 or so and then moles tend to regress over a lifetime. Therefore moles are always changing. So an industry has grown up around the fear of melanoma, and that is the industry of taking off normal moles. If you remove every mole on your body your risk of melanoma will decrease by less than 50%. That is because more than half of melanomas do not arise in moles! What a dilemma. Doctors are afraid of getting sued and patients are afraid of dying and this results in a lot of needless surgery and a lot of disfiguring scars. The solution - know your doctor. If your doctor keeps taking off moles and the reports are benign, you probably need another physician with more diagnostic acumen. If you are in doubt get several opinions before proceeding. If you are frustrated and want to get it over with and don't want many unsightly scars see a dermatologist with experience in minimizing scars after surgery. Remember, you bear half the responsibility. The location on the trunk or limbs is not conducive to nice scars and you need to do your homework.
Lastly, after you have been given a clean bill of health, there are numerous treatments to minimize scars including botox, lasers, dermabrasion, and silicone that can improve outcome if performed within the first 6-9 months of surgery.
Conclusion: When in doubt see your dermatologist and do your homework so you don't have needless surgery.
Edward Lack, http://www.metropolitanmds.com/

Disappointment Follows Poorly Planned Cosmetic Surgery

During the past week my associate, Dr. Rachel, was scanning the "info boards" online regarding cosmetic surgery. Most of the comments are negative and relate to disappointment over not achieving expected results. Many of these patients went to high powered clinics with large advertising budgets who promise results that are often not achieved with procedures that are questionable for the patient's needs. Non-invasive procedures such as Botox, and minimally invasive procedures such as "the weekend face lift" do work - if they are performed by skilled cosmetic surgeons on the right patient. It is the job of the cosmetic surgeon to evaluate the wishes of each patient, determine the cause of the perceived problem, consider with the patient what the options are, and together with the patient decide on a course of action. Very often a wish for minimal or no surgery and a wish for low cost determine a patient's decision rather than what is best for that patient.
Dr. Rachel has written an epilogue about this increasingly prevalent problem.
Dr Rahel:
Our society’s interest in cosmetic procedures that provide quick and effective results with minimal downtime continues to fuel the search for a better operation. There are many advertisements in the print and television media and a seemingly endless number of online claims regarding the opportunity for a return to youth. The ads commonly promise outstanding results with little to no risk and everyone is a candidate. The product may be a topical cream, an injectable or a surgery. Occasionally the information about the product is so limited, we have no idea what is involved. Frequently, our patients will consult with our physicians about the latest available miracle that was seen in a weekly magazine or a morning TV news show. We agree when we listen to patients expressing concerns and skepticism regarding potentially unrealistic claims. Occasionally it is astonishing to hear a patient’s enthusiasm for a product whose effects may either only be placebo or actually do harm. With the availability and exchange of information from reliable sources in this day and age, it is always important to make informed decisions on the medical care that is recommended for you. Common sense will dictate that if something seems too good to be true, it probably isn’t true. Any product or procedure carries a risk and there are limitations to every surgery. The advances in the field of cosmetic surgery are very exciting. When properly used and delivered, patients can benefit from these advances more than ever before. At MetropolitanMD, we are committed to providing personalized and expert care with the experience to give you the results you deserve using the latest reliable and tested techniques.
You may visit our website at http://www.metropolitanmds.com/.

Sweaty Armpits Are Controlled with Variation of Liposculpture

Sweaty armpits are a significant source of discomfort in American culture. From stains on clothing to malodor, people are aware of their appearance and very self-conscious about the impression they make on others, including an impression of smell.
In the past 20 years three solutions have been offered. Antiperspirants and anti deodorants will minimize the problem for the majority of people and these cosmetics account for many millions of dollars of sale per year.
Botox is more effective. A series of injections usually over 2-3 weeks time will significantly reduce sweat production and in most cases alleviate the need for deodorant. While some people object to the perception of needle pain, the reality is that these needles are so small the sensation is irritating and not much more. Cost has been a factor until recently when many insurance companies have begun to cover the procedure. When not covered by insurance the costs average about $1200.00 per application (covering 2-3 visits) and treatments are administered every 6-12 months depending on the patient's needs and response.
Lastly, curettage has been practiced for several decades with fairly good results. This involves inserting a sharp instrument under the skin and then scraping away sweat glands from the under-surface of the skin. The chief risk was scarring of the armpits and while this was rare it could be uncomfortable. In the past several years the much more gentle procedure of liposculpture has been substituted for curettage and the comfort of the procedure and the greatly reduced incidence of scarring makes the procedure much more appealing. The term "liposculpture" is a euphemism since fat is not removed. Instead the same tiny instruments as are used in liposculpture are turned against the skin so the sucking and rasping motion of the instrument gently removes sweat glands. Healing occurs within days and there is no downtime to the procedure. This is another in series of newly introduced minimally invasive procedures which are easy to perform and easy to tolerate.
Armpit sweat is a luxury our culture does not tolerate well and with a single procedure liposculpture techniques can eliminate one more nuisance from our consciousness.