Hugh Jackman: When Sunscreen Alone Will Not Keep The Skin Cancer Away

Hugh Jackman as of May of this year has had three skin cancers treated. He is realistic that he will have more.

Jackman, who plays Logan and Wolverine, wore a bandage on his nose after having a basal cell carcinoma removed last week. Basal cell carcinoma is a slow-growing form of skin cancer and Jackman was treated for the same disease last year.

He told The Associated Press: “I’m realistic about the future and it’s more than likely that I’ll have at least one more but probably many more, which is not uncommon for an Aussie particularly from English stock growing up in Australia where I don’t remember ever being told to put sunscreen on.”

Source: http://www.foxnews.com/entertainment/2014/05/13/hugh-jackman-expects-skin-cancer-will-return/

Don’t take it personally Hugh, my kids don’t listen much when I encourage their use of sunscreen. I am known to embarrass at baseball games, etc. :)

Jackman correctly attributes the skin cancer to sun exposure and his heritage. What is not mentioned in the Fox piece is that there are other preventative therapies for skin cancer useful in people who have had them already. When you have already had three skin cancers just wearing sunscreen is probably not enough to keep them from returning. Hopefully he is looking into some of the alternatives now.

Best Regards,

John Di Saia MD

Related:
Wanna See a Nodular Basal Cell Cancer?

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Chinese Man Kills His Plastic Surgeon Over A Nose

When I was a resident we were taught how to screen patients to avoid problems. In Orange County these days we all see people who we might believe would have been better off without some plastic surgery. Specifically as a resident nasal surgery (the rhinoplasty or nose job) was frequently the operation that drove some male patients to harming their surgeons. Well in China this had just happened:

A Chinese man has been sentenced to death after he attacked and killed a doctor who had carried out plastic surgery on his nose that he was not happy about.

Zhejiang’s provincial Higher People’s Court heard that Lian Enqing, 33, had been unhappy about his nose and had requested that the doctors carry out plastic surgery to improve the shape.

But afterwards he did not like the way it looked, and also claimed that it no longer worked properly and that he could not breathe easily with his nose.

Source: dailymail.co.uk/news/article-2596099/Chinese-man-sentenced-death-killing-doctor-carried-plastic-surgery
-nose-did-not-like.html

There are people who would be better off without plastic surgery due to an inability to appreciate improvement or often a desire for unobtainable results. A simple test for this during the patient interview is to inquire to assess the capacity to be happy about anything….a haircut for example. People who are “difficult to please” often report being unhappy with many things and often unreasonably so.

Yes, occasionally Dr D finds people for whom he does not recommend plastic surgery. Then again I do not do nose jobs. :)

Best Regards,

John Di Saia MD

Related:

Does A Plastic Surgeon Ever Say “No?”

Originally posted 2014-04-28 07:30:13.

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Good Liposuction Results – Booty Refinement for You?

Good Liposuction Results can mean your future booty might be “refined.” 

Liposuction is a popular procedure and when performed judiciously it can have good long lasting results. As we have discussed before it is not immune to large weight fluctuations. For patients in a reasonable weight range (plus or minus a few pounds,) it performs well in the right hands. Despite that which you see featured elsewhere good butt liposuction is not a matter of removing more, but rather removing the right amount in the right patient the right way.

Here is a case I did about ten years ago on a woman with a bit of extra (her words) “junk in her trunk.” She was later to call this “good butt liposuction” herself . :) No laser or other high tech gizmo was used. She did have a short anesthetic in a surgery center and there were no complications.

 

Good Liposuction Results

Good Liposuction Results Orange County California

Realistic Thigh Liposuction Orange County California

The operation made things quite a bit better. She was pleased. It did not however make her into a “thin woman.” It made her into a “thinner woman.” That is “good liposuction results.” :) 

 

Best Regards,

John Di Saia MD

Originally posted 2013-02-22 07:30:52.

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Sclerotherapy – The Truth

Small procedures are on the rise with the economy being depressed. Sclerotherapy (injections to improve spider veins) are pretty common.

The concept is pretty simple: inject a fluid into the vein causing it to clot and scar (and eventually go away.)

This works pretty well for small veins but frequently can leave a bruised vein for several weeks. You really should keep the treated area out of the sun while this bruise resolves or it can be permanent.

The veins can come back. They usually do to some extent so this is a maintenance therapy.

Best Regards,

John Di Saia MD

Related:

Originally posted 2009-12-25 07:30:27.

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Tummy Tuck Technique, Liposuction and Seromas

Prospective tummy tuck patients are often surprised by my advice that liposuction in the sides at the time of the tummy tuck surgery is more trouble than it is worth. That is probably because most of my local competition sells the liposuction as a good thing.

The bottom line is that tummy tuck surgery is a big deal and healing afterward as well as swelling (the accursed “Swell Hell”) can be limited. Technique to a large extent determines the outcome. Seroma refers to fluid collections that can be persistent at times after large scale operations. It has been my opinion that liposuction plus tummy tuck equals an unacceptable risk of seroma. Now a study has affirmed my position:

Conclusions: Patients should be counseled regarding an increased risk of seroma formation following abdominoplasty when combined with liposuction of the flanks. In addition, patients who are overweight are at increased risk for developing a postoperative seroma compared with patients with normal body mass indices.
Source: journals.lww.com/plasreconsurg/Abstract/2011/01000
/Comparison_of_Seroma_Formation_following.57.aspx

The actual incidence of seroma in the study was very high compared to what I see, but they did see fewer seromas with tummy tuck sans flank liposuction.

Best Regards,

John Di Saia MD

Originally posted 2012-10-02 07:30:58.

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Lingerie Choices for the Tummy Tuck / Lower Body Lift Patient

Sorry all…the source of the images went offline. :(

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Over the years my tummy tuck patients have asked about a surgeon’s perspective on lingerie recommendations. To answer this at least in part, I went through the catalog of one of my blog advertisers and picked a few for your consideration. Comments follow each. Your incision type and personal taste will of course rule supreme here:

A Dr D Post TT Fav – Great raised sides to cover most of my tummy tuck and lower body lift incisions and inexpensive too.

Best Regards,

John Di Saia MD

Originally posted 2010-12-03 07:30:52.

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Dr D’s “Trout Pout – Celebrity Fish Lip Fillers?”

Dr D’s Trout Pout Comedy Bit Mp3

Dr D pokes fun at the current practice of Lip Fillers and the tendencies of some celebrities to end up resembling fish after their placement.

Best Regards,

John Di Saia MD

Originally posted 2010-07-14 07:30:38.

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Boob Job Redo Video

Boob job redo surgery is certainly more difficult than first time cases. Looking over some of my older YouTube videos, there was a desire to fix some up a bit. I had this boob job redo video with a patient testimonial. This video is now new and improved with reduction of annoying music and re-arrangement of the elements. It tells the story better now.

The story in short was this very nice young woman had been operated by a local surgeon who reported himself as the “best of the best.” Sound familiar? He nevertheless ran into a complication and after three operations left her pretty deformed. He reported to her that “this was as good as it was going to get.” Then she found Dr D through a friend. This was not an easy case and her result is just as much due to my work as her persistence, faith and patience.

Best Regards,

John Di Saia MD

Originally posted 2012-09-20 07:30:14.

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Tanning Salon Owners Mislead Clients

Many tanning salons are downplaying the health risks associated with indoor tanning while claiming that time in a tanning bed offers an array of health benefits, according to an investigative report from Democrats on the House Energy and Commerce Committee. Committee investigators, posing as fair-skinned teenage girls, called 300 tanning salons across the country, and found that 90% said that the use of tanning beds did not pose a health risk. When pressed about skin cancer risks, some salon employees said the link to indoor tanning was “hype” or “a big myth.”
Source: skinandallergynews.com/newsletter/the-skinny/singleview40946
/tanning-salons-mislead-teens-congressional-probe-
finds/4aaea3a6b8.html

Studies showing tanning bed use is associated with increased risk of skin cancer and even melanoma skin cancer are now plentiful. It is funny though to expect businesses outside of medicine to discuss risk much. Does it really surprise anyone that tanning salon management downplays the risk of the services they provide?

As far as I am concerned tanning salons are cancer traps. They should have warnings similar to those on cigarette packages proclaiming the absolute foolishness their patrons have in using their services. I will even donate to the hypothetical copy of such a statement:

“To our Clients,
While we appreciate your patronage please be advised that tanning beds have been associated with increased risk of skin cancer and premature aging. The money you are pouring into our pockets might be better spent on sunscreens and sun avoidance clothing. By using these facilities you have decided to go against your better interest and as such the ownership takes no responsibility for the cavernous wrinkles, cancer and even death you might receive in the bargain.
Thank you.”

Best Regards,

John Di Saia MD

Originally posted 2012-02-09 07:30:06.

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Nasal Mohs Patient & The Politics of Doing The Right Thing

Recently I saw a patient with a small superficial basal cell cancer on the rim of her nose (the Nasal Ala.) She was referred by a dermatologist who had scheduled her for Mohs Surgery and wanted my help with reconstruction of the wound that would result from the Mohs surgery. I saw her before her Mohs surgery.

It is true that reconstruction in this area frequently leaves less than attractive results and that there are alternatives that might obviate her need for surgery namely topical chemotherapeutic creams. They only work for superficial disease which her biopsy indicated she had. I have used them before and they have worked pretty well but they do require a lot of follow-up visits.

At the risk of angering the local dermatologist I suggested that the patient speak with her about this possibility before her scheduled Mohs operation. It is true that that a surgeon working with his mind as opposed to with his hands makes less less money, but it is the right thing to do. The patient actually decided to have the Mohs surgery anyway.

I always wonder when I do these things if I am annoying the referring doctors and I may do so on occasion. The focus should be on what’s best for the patient, but business can distort that in some cases.

Best Regards,

John Di Saia MD

Originally posted 2010-08-23 08:00:27.

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