A Board Certified Plastic Surgeon in Scottsdale
Plastic Surgery History
Maintenance of Certification in Plastic Surgery.
012 months ago
Scottsdale – I have participated in the Maintenance of Certification process from the American Board of Plastic Surgery since the inception of the program. What exactly is maintenance of certification?
Well, according to the American board of Medical Specialties, the measure of physician specialists is not merely that they are certified, but how well they keep current in their specialty. It turns out that in the past a physician would become certified once in their lifetime. What about all the new technologies and discoveries in medicine since then? I think you get the point, that most medical specialties are changing quickly and incorporating new techniques and ideas in the every day practice faster than ever before. Therefore, as the specialty evolves, then the certification process has evolved to keep up with the changes!
In 2000, the 24 Member Boards of ABMS agreed to evolve the re-certification programs to one of continuous professional development program. This is what we now know as Maintenance of Certification Program! Just about all specialties are requiring maintenance from their diplomats.
For plastic surgery re-certification there is a fairly rigorous process required each year. All plastic surgeons re required to re-certify at 10 years, unless they are “grandfathered” by having certified way in the past. I am due to re-certify in 2013, but have decided to take the examinations a year earlier, as the plastic surgery specialty is evolving a quicker pace than most other specialties.
A Brief History of Tummy Tuck.
11 year ago
History of Tummy Tuck (model used).
Scottsdale- Tummy tuck is a commonly performed plastic surgery operation. Over the years, this popular cosmetic surgery procedure has undergone significant evolution. How did it all get started?
Well, here is a brief time line for tummy tuck:
in 1899 – Kelly reported an attempt to correct excess abdominal skin and fat. He excised the excess using a transverse incision.
in 1924 – Thorek was the first to devise a procedure that preserved the belly button.
in 1967- Pitanguy (Brazil Plastic Surgeon) reported on 300 abdominal lipectomies.
in 1967 – Callia described a low incision that extended below the inguinal crease and was the first report of muscle wall repair.
in 1972 – Regnault (France) published the W technique for abdominoplasty.
in 1973 – Grazer (USA) was one of the first to describe the so-called bikini line incision.
in 1977 – Grazer and Goldwyn reported the complications of tummy tuck techniques.
in 1978 – Psillakis suggested suture plication of the external oblique muscles after raising it in a beltlike fashion.
in 1988 – Matarasso expanded the use of abdominal contour surgery by combining tummy tuck and liposuction.
in 1995 – Lockwood described the high lateral tension abdominoplasty with repair of the superficial fascial system repair.
in 2000 – Pollock described the progressive tension or quilting suture, a technique for “no drain” tummy tuck.
in 2001 – Saldanha described lipoabdominoplasty with selective undermining and “no drain” technique.
For more information about tummy tuck and plastic surgery history please look at tummytuckmds.com
Great Plastic Surgeons: McIndoe.
01 year ago
Scottsdale – Let’s learn about some great plastic surgeons from the past.
We are going to start with telling you about: Sir Archibald McIndoe (1900-1960) was born on the 4th of May, 1900 in Dunedin, New Zealand. He was the second of the four children of John McIndoe, a printer, and his wife, Mabel Hill. Dr. McIndoe was educated at Otago High School. He studied Medicine at Otago University. He qualified for the medical board in 1924, winning medals in medicine and surgery. After qualifying, he was appointed house surgeon at Waikato Hospital.
When World War II started, plastic surgery was largely divided on service lines. McIndoe moved to the recently rebuilt Queen Victoria Hospital in East Grinstead, Sussex. There he helped found a Center for Plastic and Jaw Surgery. He treated very deep burns and serious facial disfigurement like loss of eyelids. McIndoe was a brilliant and quick plastic surgeon.
He not only developed new techniques for treating badly burned faces and hands, but he also recognized the importance of the rehabilitation of casualties and particularly of social re-integration of severely injured patients back into normal life. With the help of two friends, Neville and Elaine Blond, he also convinced the locals to support the patients and invite them to their homes. One part of this legacy was the formation of the Blond-McIndoe Research Foundation.
AB Guerra, MD, FACS. Surgery Training, 1997.
01 year ago
Scottsdale – An unbelievable photograph taken at Harbor-UCLA Medical Center. This is during the my general surgery training years, before I was thinking about pursuing a career in plastic surgery. I was way too busy back then to care about photos, but I am glad an old friend had a camera handy! After so many years, I have learned to appreciate the value of old pics.
Antibiotic Use in Plastic Surgery.
11 year ago
Use of Antibiotics in Plastic Surgery
Scottsdale – Evidence-based medical practices for the appropriate use of intravenous antibiotic prophylaxis in plastic surgery are important to reduce the risk of infection. The information below is based on multiple resources including the standards developed via the Centers for Disease Control and Prevention, the Medicare National Surgical Infection Prevention Project, and various professional medical societies. These recommendations are used to reduce the risks of infection at the surgical site while reducing the risks of developing pathogens with drug resistance. In our practice, some patients may be transitioned to oral antibiotics.
Recommendation for the Use of Antibiotics at Phoenix Plastic Surgery:
Antibiotics used for prophylaxis should be carefully selected, consistent with current recommendations in the literature, and taking into account the issues of antibiotics resistance and cosmetic surgery patient allergies. Cefazolin is the most commonly recommended antimicrobial agent for plastic surgery operations. Clindamycin or vancomycin may be used for patients with a confirmed ß-lactam allergy. Vancomycin may be used in patients with known colonization with methicillin resistant Staphylococcus aureus (MRSA) or in facilities with recent MRSA outbreaks. Exposure to vancomycin is a risk factor in the development of vancomycin-resistant enterococcus (VRE) colonization and infection. Therefore, vancomycin should be reserved for the treatment of serious infection with ß-lactam-resistant organisms or for treatment of infection in patients with life-threatening allergy to ß-lactam (i.e. Penicillin) antimicrobials.
Recommendation on the Timing of Antibiotics during Arizona Plastic Surgery:
Timing and dosage of antibiotic administration should optimize the efficacy of the therapy. Prophylactic antibiotics should be administered within one hour prior to skin incision. Due to an extended infusion time, vancomycin should be started within two hours prior to incision. Dose amount should be proportional to plastic surgery patient’s weight. In patients with weight greater than 80 kg the doses of Cefazolin should be doubled.
Additional intraoperative doses (during cosmetic surgery) of antibiotic are advised when:
- The duration of the procedure exceeds one to two times the half-life of the antibiotic used.
- There is significant blood loss during the procedure.
General guidelines for frequency of intraoperative antibiotics are as follows:
| Antibiotic | Frequency of Administration |
| Cefazolin | Every 2-5 hours |
| Clindamycin | Every 3-6 hours |
| Vancomycin | Every 6-12 hours |
Recommendations on Stopping antibiotics after surgery:
Duration of prophylactic antibiotic administration should not exceed the 24-hour post-operative period. Prophylactic antibiotics should be discontinued within 24 hours of the end of surgery. The medical literature does not support the continuation of antibiotics until all drains or catheters are removed and provides no evidence of benefit when they are continued past 24 hours.
