PaulEBanwell

Mr Banwell notes a recent article on Skin Cancer in the UK

janine — Fri, 11 May 2012 16:17:14 +0000

Once a week, Alison Doughty makes a 60-mile round trip from her home in Hove, Sussex, to a reconstructive surgery clinic in East Grinstead. There a doctor injects saline into two inflatable bags that sit under the skin on either side of her right calf. Her leg looks as if a small dumbbell has been implanted in it.
In fact Alison, 52, a divorcee with two teenage children, is undergoing a procedure called tissue expansion, where her skin is being slowly stretched to produce enough skin to fill in a deep crater — five centimetres in diameter, two centimetres deep — that has disfigured her calf.
Alison has not been in a car crash or fire. Her leg was scarred by surgery to remove a cancerous mole — which doctors say developed due to Alison’s love of sunbathing.
‘I come from the age group who, when we were in our teens in the Seventies, had never heard of the dangers of too much sunbathing,’ says Alison. ‘I loved to lie out in the sun with tanning oil on and I took regular holidays to hot places such as Spain where I delighted in getting a tan.
‘And like many women, I thought my legs looked better brown. I occasionally even used a sunbed and if I did think about skin damage I consoled myself with the thoughts that I was relatively dark-skinned anyway.
‘I don’t remember a particular incident when I was badly burnt. But I certainly remember times when I felt a bit sore after sunbathing, which was probably a burn.’
As she got older, the messages about the dangers of the sun began to filter through and Alison began to be more careful.
‘As a professional make-up artist I often come into contact with people who have skin damage, and for the past ten years I have used factor 25 when sunbathing and covered up in strong sunlight. Sadly, by then the damage was probably already done.’
She first noticed that the mole on her calf had changed colour when she was in Portugal in August 2009, ironically while applying sun screen.
‘I had been born with this particular mole,’ she explains. ‘It was about the size of a one pence piece and had always been dark and flat, but now I could see lighter spots of pigment were coming through. As it wasn’t itchy or raised or bleeding — the classic signs — I wasn’t too worried.
‘It wasn’t until I went away for a weekend in October to Portugal again that I noticed the mole was by now two different colours, one half dark brown, the other quite pale.
‘It was a heart-stopping moment. As soon as I got back to the UK, I went to see my GP.’
Her GP referred her immediately to dermatologist Dr Bav Shergill, who she saw privately for more tests. ‘Just a few days later I was listening in horror as he told me he could see what he thought could be a cancerous speck in my mole,’ recalls Alison.
‘He removed the mole under local anaesthetic and told me to come back in a week for the results.
‘That week was the longest of my life. I told the children as little as possible, just that I’d had a mole removed and it was being looked at.
‘When I went back I could see straight away from Dr Shergill’s face that he had bad news. The mole was malignant. I had cancer.
‘To have it confirmed was just awful and I broke down. I was so shocked that it had happened to me.’
Rates of malignant melanoma in women have almost tripled from 1979 to 2008, with around 6,138 women diagnosed each year (5,584 men were diagnosed, a five-fold increase in the same period).
Alison Doughty’s skin was stretched by two inflatable bags before it was used to cover the scar
More than 2,000 people die of the disease each year. Although the most common age for diagnosis is over 65, more than a quarter of cases are diagnosed in the under-50s. ‘Skin cancer is almost always caused by too much exposure to ultraviolet (UV) light,’ explains Dr Shergill of the Brighton and Sussex Universities Hospitals NHS Trust and the Hove Skin Clinic.
‘And you don’t have to be sunburned to get it, although that of course does increase the risk.’
UV light disrupts the genetic code of the cells that make up the pigment of the skin. The cells try to repair themselves but over time this process can go wrong; and a skin cell can malfunction and turn cancerous.
‘Like most cancers, if a melanoma is caught early, the outlook is good. But melanomas can grow very rapidly, sometimes over just a few weeks, and once they reach the lymph system the prognosis is very poor,’ says Dr Shergill.
At stage 1 — where the cancer is contained within the mole and the mole surface is unbroken, about 80 per cent of patients are alive ten years later. However, at stage 4 — where the cancer has spread to other parts of the body, only between 7 and 19 per cent of patients are alive five years later.
Once Alison was diagnosed, she underwent a barrage of tests to see if her cancer had spread. Luckily, these came back clear and the cancer was classed as grade 1 — but she still needed a large amount of the skin around it removed. ‘After the surgery, when I first saw the size of the scar I was devastated,’ she says. ‘It looked as if a shark had taken a bite out of it. It seemed a high price to pay for sunbathing all those years ago.’
Statistics show the majority of melanomas — 40 per cent — contracted by women are on their legs, while men are more likely to get them on their torsos.
A recent survey by the British Association of Dermatologists found 92 per cent of people say they have been sunburnt at least once and almost a third recall burning on more than ten occasions. But even those who have never been burnt are at risk.
‘Many people delay getting a mole or suspicious pigment checked because they think they are not the type to get skin cancer,’ explains Dr Shergill. ‘But I have patients who have never sunbathed in their life — yet they are perhaps keen cyclists, or walk their dogs every day. Skin cancer can occur in a young person who spent their gap year in Africa, or an old person who has never left the UK.
‘We don’t really know why some get skin cancer and not others, although there can be a genetic susceptibility. ‘What we do know is that rates are soaring and are set to double by 2024. Even if your cancer is caught early it is still a very unpleasant and frightening disease to treat, as Alison will testify.’
Shortly after surgery, Alison’s doctors mentioned skin stretching. ‘Skin stretching, or tissue expansion, has been around for decades and has been used very successfully for facial wounds, large ulcerations, breast reconstruction — in fact in any situation where a large piece of flesh has been removed,’ explains Dr Shergill.
‘I don’t think I will ever be completely free of the fear that it may recur’‘You can cover a deep wound with a skin graft, taking the top layer of skin from another part of the body and grafting it over the wound, but all you get is the outer layer, the thin epidermis. The other layers of the skin, including the thick dermis which contains the sweat glands and the hair follicles, are missing.
‘However with skin expansion, you produce fully functioning skin with all the layers right down to the subcutaneous tissue — the fat. As the bag is slowly inflated over the weeks and months, a larger amount of skin is created and when we judge that enough of it has been created we bring the patient back in for an operation.
‘Under a general or local anaesthetic, we squeeze those newly produced layers of skin back down, so that the surface is flat again. The patient just ends up with a neat scar rather than the large contour that was there before.
‘It is not just a cosmetic procedure. You are also providing protection for the muscles which have been exposed by the surgery.’
The procedure is usually only available privately, although sometimes it can be considered on the NHS if the wound is particularly disfiguring and causing the patient physical or emotional distress, he adds.
Alison has been undergoing tissue expansion since January and it will continue into the summer when she will have the final surgery.
She will then be monitored for five years in case the cancer returns; every three months she has a check up of all her moles.
‘I know that I have been very lucky, but even so I have had cancer,’ she says. ‘I don’t think I will ever be completely free of the fear that it may recur.
‘I just hope my story makes other people think twice before they head out unprotected into the sun. If I could go back again and not sunbathe as I did in my teens and 20s, of course I would.’
The British Association of Dermatologists have launched an app to show what sun protection you need in any country in the world: bad.org.uk/sunawareness.
- Daily Mail 7 May 2012

Macrolane Withdrawn in UK

janine — Tue, 24 Apr 2012 15:45:28 +0000

Mr Banwell notes BAPRAS’ Vice President Graeme Perks commments on Macrolane.

“BAPRAS believes it is critical that every patient in the UK – whether being treated on the NHS or privately – is protected before, during and after their surgery. If there is any doubt about the safety and efficacy of a product it should not be used. We therefore support the withdrawal of the dermal filler Macrolane for breast augmentation.

“The recent examples of PIP breast implants and now Macrolane reiterate how important it is for cosmetic interventions to be properly regulated within the UK. We continue to work closely with the Department of Health to review current regulation and make recommendations for the future. We would to see a mandatory register for breast augmentation as part of this, with all types of ‘implant’ included.”

23 April 2012

Does Plastic Surgery Benefit the Poor?

janine — Thu, 19 Apr 2012 16:03:22 +0000

Mr Banwell notes a recent article published by ASAPS below.

Plastic surgery considered a health benefit in Brazil – ASAPS 17 April 2012

While plastic surgery is considered a luxury in America, in Brazil it’s considered a right.
A recent Associated Press report in the Daily News revealed that thousands of the country’s poor have undergone plastic surgery procedures such as Botox injections, laser hair removal, chemical peels and laser treatments free of charge.
According to the AP, more than 220 clinics throughout the country offer free or discounted plastic surgery to those who wouldn’t otherwise be able to afford it. The reason – these procedures help boost self-esteem and enable patients to feel more confident about themselves.
“What’s a wrinkle? Something minor, right? Something with precious little importance,” a Rio de Janeiro-based plastic surgeon, told the AP. “But when we treat the wrinkle, that unimportant little thing, we’re actually treating something very important: The patient’s self esteem.”
Dr. Ivo Pitanguy, the “philosopher of plastic surgery” in Brazil founded the first surgical center to treat the poor, mainly focusing on burn victims and those with deformities, but also offered discounted cosmetic surgery. Now, the growing numbers of hospitals and clinics that offer these services have long lines and waiting lists. Once a surgery is approved by a physician, patients might wait years to undergo their desired procedure.
And while the cosmetic procedures are beneficial to those undergoing them, it can also be argued that there’s a benefit for the providers as well, as they allow young doctors to gain experience.
Brazil, a common destination for medical tourists seeking discounted plastic surgery procedures, is the world’s top plastic surgery provider, with the United States coming in second place.
According to the American Society for Aesthetic Plastic Surgery (ASAPS), more than 9.1 million plastic surgery procedures were performed in the US in 2011. The most common cosmetic surgeries included liposuction, breast augmentation, tummy tucks, cosmetic eyelid surgery and breast lifts. The most common nonsurgical procedures included botulinum toxin type A injections, hyaluronic acid injections, laser hair removal, microdermabrasion and laser treatments.

PIP REPLACEMENT STATISTICS TO DATE…

janine — Wed, 11 Apr 2012 11:50:03 +0000

Mr Banwell notes this recent post by Safter Cosmetic Surgery.

As concerned women with PIP implants come forward for reassurance and treatment the Department of Health (DH) continue to investigate the scandal.

Recent statistics from the Department of Health have revealed to date 4,872 referrals have been received by the NHS from patients who had their initial surgery at a private clinic. 280 of these referrals were received last week by 120 trusts.

So far 2,393 scans have been undertaken, leading to 252 decisions for explants to take place.

It was confirmed earlier in the year; patients who received PIP implants on the NHS will be contacted and offered removal and replacement procedures. The NHS has also agreed to help women who have been rejected by their initial private clinic by removing the faulty implants; but they are unable to replace them.

The DoH announced today the NHS will replace PIP breast implants for private patients if their reason for having implants was part of a reconstruction following breast cancer.

The ‘NHS offer’ to private patients with PIP implants varies depending on the circumstances of each patient, not all women will be advised to have their implants removed at this time, some women will simply want reassurance. 1,303 women have completed their NHS offer, 119 of these were completed last week.

The latest estimate of the number of women with NHS PIP implants in place is 748. So far 743 women have been contacted by the NHS and 112 decisions have been made to replace the implants. 37 scans have been recorded and 30 women have completed their NHS offer.

SaferCosmeticSurgery would like to reiterate the advice from the Department of Health and the British Association of Aesthetic Plastic Surgeons (BAAPS):

All patients are advised that they should be aware of the make of their implants. Those patients unsure of these details are advised to contact their surgeon/provider. Patients are advised that BAAPS agree with the DoH expectation that patients should not be charged to access their notes. All NHS patients who have a PIP implant will be contacted by their hospital.

Signs and symptoms of rupture/leak/inflammation in one or both breasts may include:

- Lumpiness of the breast
- Lumpiness/ swelling of the regional lymph nodes in the underarms and rarely in the neck
- Change in shape and size of the breast
- Redness of the skin
- Tenderness of the breast and or the lymph glands in the underarms
- Swelling of the breast
- Firmness of the breast
- Pain
- Hyper sensitivity

The advice to patients is that those who experience signs or symptoms of rupture or irritation should seek advice earlier. Those who do not have complaints but have concerns and wish to discuss the risks and benefits of implant exchange should also seek advice at some stage.

Sunscreen for the Olympics

janine — Mon, 02 Apr 2012 16:36:44 +0000

Mr Banwell notes this recent article in an Australian newspaper. Whether wearing a one piece or two piece swimsuit, you need to protect yourself. Mr Banwell recommends Heliocare SPF 50 which is available in neutral, light and dark tint.

Canberra Times, March 29 2012

”A new swimsuit war has broken out four months from the Olympics.

It pits Australian swim team sponsor Speedo against other brands including Adidas, the uniform sponsor for the overall Games team.

The new row is not about exotic materials, but it does carry some echoes of swimming’s dark ”super suit” era, when 255 world records were smashed in two years until world body FINA banned the controversial polyurethane outfits in 2010.

Advertisement: Story continues below Swimmers must now wear textile suits, shorts for men and knee-to-shoulder for women, but the new hot question for elite competitors is: which textile suit to wear?

The Australian Olympic Committee has allowed swimmers at this year’s London Games to apply for permission to use suits other than Speedo, and many are taking up the chance. They include adidas-sponsored sprinters Cate and Bronte Campbell, the first siblings in 40 years to represent Australia in swimming.

”We have found the adidas suit is by far the best suit out there, and swimming in Speedo will impair our performances,” said Cate Campbell, the 19-year-old who won two bronze medals in Beijing. ”We believe 100 per cent adidas provides the best suit possible, so it’s another stress we don’t have to worry about.”

Cate Campbell described the situation as a repeat of the dilemma facing Australian swimmers at the 2009 world championships in Rome, where 43 world records fell.

”Speedo didn’t have the super suits and they were sponsoring the Australian swim team, so all the Speedo-sponsored athletes were having to worry about what suit to wear,” she said. ”It’s just that all over again.”

PIP Bullying is NOT Acceptable

janine — Mon, 02 Apr 2012 14:37:08 +0000

Mr Banwell notes the BBC article on patients who are being coerced in to additional surgery. Mr Banwell will be happy to see you for a no-pressure and honest consultation in London, East Sussex, West Sussex or Kent for PIP removal.

Consulting Rooms

janine — Fri, 23 Mar 2012 16:29:28 +0000

Mr Banwell is happy to be attending the Haywards Heath Nuffield Hospital once per month. This is our most recent addition to Mr Banwell’s consulting space where he will be available to see new patients for Breast Enlargement, Breast Reduction, Labiaplasty and Liposuction.

Plastic Surgery Procedures Increase in 2011

janine — Tue, 20 Mar 2012 16:23:49 +0000

The American Society of Plastic Surgeons reports an increase in cosmetic surgery from 2010. Breast Augmentation has increased 4% and Liposuction has increased to 207,000 procedures in 2011. Mr Banwell consults in Tunbridge Wells and Haywards Heath, specialising in breast surgery and body contouring.

Mr Banwell notes study on facial surgery

janine — Mon, 05 Mar 2012 17:29:42 +0000

STUDY CONFIRMS PLASTIC SURGERY TAKES ON AVERAGE 7 YEARS OFF LOOKS

A study by the Archives of Facial Plastic Surgery has found surgery turns back the clock on average 7 years of ageing.

The aim was to help patients considering surgery to have clearer expectations of what can be achieved before going under the knife. The study was lead by Dr Nitin Chauhan a plastic surgeon at the University of Toronto.

Before and after photos of 53 women and 7 men all aged 60 were shown to 40 first year medical students. They were asked to estimate the ages of the patients before their surgery and then afterwards.

The patients had undergone a variety of facial cosmetic surgery, ranging from one to three procedures; 22 had a face and neck lift, 17 had a face and neck lift as well as an eyelid lift and a further 22 had a face and neck lift, eyelid lift and brow lift.

According to the study, patients’ ages were reduced on average by 5 to 7 years following one procedure such as a face lift or neck lift. Patients who went under the knife for two facial procedures were estimated 7.5 years younger, in comparison; patients who had three procedures were thought to be 8.4 years younger.

Other experts in the field including Dr Garry Brody, professor of plastic surgery at the University of Southern California, warned patients to remain realistic about what surgery can achieve for them personally.

American Plastic Surgeon Operates on Daughters

janine — Thu, 01 Mar 2012 17:15:47 +0000

Mr Banwell notes how celebrity plastic surgeon performed breast implant surgery on his own teenage daughter

A plastic surgeon has told how he gave his own daughter a breast augmentation when she was just a teenager.

In an upcoming television special, Dr Michael Niccole, from Newport Beach, California, reveals how he gave Brittani, now 23, breast implants at 18.

In addition to increasing her chest size from an A-cup to a C-cup, he also gave her a rhinoplasty, just weeks before her 21st birthday.

From Dad, with love: Dr Michael Niccole, from Newport Beach, California, gave Brittani (pictured here), now 23, breast implants at 18.

He says he has done surgical procedures on other family members too, including Brittani’s sister Charm, now 22, who had surgery on her belly button at the age of ten, to turn her ‘outie’ into an ‘innie’.

Unsurprisingly, Dr Niccole, whose patients count the Real Housewives of Orange County’s Alexis Bellino, has come under severe criticism for his actions.

Many consider it unethical to operate on his own family, and also question his decision to allow the girls to change their appearances at such a young age.

But as far as Dr Niccole is concerned, he is only acting in the best interests of his family.

Confidence boost: Dr Niccole, right, with his daughter Brittani, left, counts the Real Housewives of Orange County’s Alexis Bellino as one of his patients

On a 20/20 special, due to air on Friday, he said: ‘Who would give them the time – that extra little look during surgery more than I would?’

He added that he feels at ease operating on his daughters, both of whom are adopted.

‘I’m not changing their looks in any means. They want maintenance,’ he explained. ‘They don’t want to get old. They want to stay young.’

Four years on, Brittani herself remains thrilled with her breasts.

The make-up artist and model said she initially elected to have the surgery to build her self esteem.

Sister act: Brittani (left) and Charm Niccole (right) would both rather their father did their cosmetic surgery than any other doctor

Surgically-enhanced: Brittani, who is a make-up artist and model, also admits to having Botox injections, as well as other cosmetic procedures

‘I didn’t have large breasts when I was younger, and all my friends did,’ she said. ‘I felt very self conscious about it.’

She admitted in another interview, with Anderson Cooper late last year, that going to another plastic surgeon ‘never crossed my mind’.

‘I consider the day I got my breasts done one of the best days of my life so far,’ she added.

Both girls also admit to having Botox injections, as well as other cosmetic procedures.

Daily Mail, 1 March 2012