Breast Cancer And The United States - 2010

by Dr. Robert A. Gardner, General Surgeon and Breast Surgeon

One in every two women in the United States today will consult someone in the medical system for a breast condition or problem in her lifetime.  Most of those will be benign, some will be malignant.
This year, 192,000 women in our country will develop invasive cancer of the breast, 62,000 will develop in situ carcinoma of the breast, and 60,000 to 70,000 will develop lobular carcinoma in situ, not really a malignancy of the breast but a marker lesion that doubles the risk of breast cancer.  This year, 40,300 women are expected to die from metastatic or locally recurrent breast cancer.  WE CAN DO BETTER.  We must do better.  Allow me to show you how.

One out of every seven women in our country will develop breast cancer in her lifetime.  While the mortality from breast cancer is decreasing, the number of breast cancer cases is increasing in part due to the aging population of women in their 50’s, 60’s, 70’s and 80’s where the incidence is high and gets higher until the late 80’s.

The best insurance against death from breast cancer is early detection and diagnosis.  That leads to cure most of the time.

A woman’s awareness of her own breast is of critical importance.  About four out of every ten women who develop breast cancer have some change in the breast that they noted which will often bring them in for consultation, mammography, ultrasound or other.  Awareness is crucial.  Competent breast self-examination is still important.

The best tool for early detection, diagnosis and treatment is mammography.  Most mammograms in south Florida today are done with digital technology.  Analog films are still being done and are useful but we can see the evidence of pathology more clearly with digital films.  A woman coming for a mammogram should know if her facility has a CAD (computer aided detection) unit available to her interpreting radiologist who will be looking at her mammogram.

Screening mammograms are for women who have no signs, symptoms, preexisting disease in the breast, prior breast surgical procedures, etc.  More and more mammograms are done as diagnostic mammograms because it gives us the freedom to do the extra views we think we might need, even while the woman is still at the facility.  By looking at a woman’s films early in our breast center, we are able to note dense breasts, a risk factor for breast cancer by itself, which also leads us to request a surveillance breast ultrasound be carried out.  These two tools—mammography and ultrasonography—are invaluable in the detection of very early breast cancer.  It is this writer’s opinion that each woman over the age of 40 should have a dedicated clinical breast examination at least once a year done by the clinician of her choice.  At that breast examination, it is appropriate to make sure there are no symptoms such as nipple discharge, redness, swelling, unusual breast pain, scaling of the nipple, etc., and to spend a few minutes between the woman and her examining clinician to make sure her mammogram is up-to-date, determine if she needs ultrasound or MRI, and schedule her next dedicated breast visit based on her level of risk and related issues.

READ FULL ARTICLE; Breast Cancer and the United States -2010, by Dr. Robert A. Gardner, General Surgeon and Breast Surgeon

What Is New In Reconstructive Breast Surgery?

New options give patients increased self-esteem
By Dr. Harold Bafitis

It is important and significant for breast cancer survivors to know their reconstructive options. It is also important for them to comprehend and be responsible for creating their team of medical professionals, a team that consists usually of a general surgeon, a plastic surgeon well-versed in reconstruction, and of course, an oncologist who will improve and monitor the immune function of the patient. The intricate dance among these three medical professionals is essential for optimal outcomes. Furthermore, the mindset of the patient is equally important for healing no matter what stage of the disease.

Recently technology has brought us a literal biologic scaffold for our own tissue to grow into. These acellular tissue matrices have expanded in use and are now an important part of breast reconstruction. They literally allow the patient’s own tissue to grow into them, and by six months, they degenerate and are absorbed by the body, leaving behind new, viable, strong tissue that gives a much more natural look to the reconstruction.

We have also seen the use of a patient’s own fat to fill in contour defects in breast reconstruction. Furthermore, I have personally used a patient’s fat to permanently improve some of the changes seen in the skin after radiation. A thick, leathery, often painful appearance of the skin has been improved dramatically, and this has been documented not only photographically but also histologically (at the cellular level) at one year.

Other surgeons are doing this all over the world. The advantages of fat may lie in the fact that one gram of the patient’s own fat has more than 5,000 stem cells versus one milliliter of bone marrow having only 100 to 1,000 stem cells. These stem cells are literally building blocks of new tissue. The use of stem cell technology will definitely bring us a new age in bioengineered medicine and will significantly improve breast reconstruction.

The use of nipple-sparing mastectomy (NSM) has also gained acceptance as a viable option in breast cancer management and obvious breast reconstruction. The patient satisfaction rate is comparable to traditional reconstructive techniques, although revision rates seem to be slightly higher. Nipple sensation is diminished, but the patient’s own nipple areolar complexes are present. This is certainly something to be discussed with your reconstructive surgeon.

Finally, patients do not have to settle for less-than-acceptable breast reconstruction. Reconstruction in 2010 and beyond, for the most part, should be done at the same time as mastectomy. There are few real indications for waiting and creating another surgery, another anesthetic, and even more anxiety for patients. The use of some of the new concepts in reconstruction have allowed plastic surgeons to redo poor results and significantly influence the patient’s self-esteem and improve the patient’s emotional outlook and even spiritual wellbeing, all contributing to a longer survival.

Dr. Harold Bafitis is a double board-certified plastic surgeon with more than 20 years of experience. He has led teaching conferences at national cosmetic plastic surgery meetings, and has performed live surgery on closed-circuit TV with literally hundreds of cosmetic surgeons and resident plastic surgeons in attendance. Dr. Bafitis practices at Bafitis Plastic Surgery, Inc. located in Jupiter and Wellington and can be reached at 561.795.3787.

2010 Annual Clinical Assembly of Osteopathic Surgeons (ACA)

Dr. Bafitis will be speaking to Plastic and Reconstructive Surgery Discipline at the 2010 Annual Clinical Assembly of Osteopathic Surgeons (ACA).

The presentation will be "Water Assisted Liposuction and Gluteal Fat Grafting and Fractional Laser Resurfacing Using the C02 Dot Laser"

Sunday October 24, 2010
The Hyatt Regency San Francisco
San Francisco, California.

Plastic and Reconstructive Surgery

BIOGRAPHY

HAROLD BAFITIS, D.O., MPH, FACOS, FAACS

Dr. Harold Bafitis graduated with Honors from the University of Maryland, College Park. He obtained a Masters degree in Public Health from the University of Texas School of Public Health, Houston Health Science Center, Houston, Texas. Dr. Bafitis earned his medical degree Cum Laude from the University of North Texas, Texas College of Osteopathic Medicine.

Dr. Bafitis completed a full 5 year general surgery residency at Grandview Medical Center, Dayton, Ohio, affiliated with Ohio University’s Medical School. He then completed his 2 year training in plastic and reconstructive surgery at the Plastic Surgery Institute and affiliated hospitals in Des Moines, Iowa. Dr. Bafitis also took an additional full year fellowship in cosmetic surgery, breast surgery, and breast reconstruction with the Cincinnati Plastic Surgery Associates and affiliated hospitals in Cincinnati, Ohio. Dr. Bafitis is DOUBLE BOARD CERTIFIED IN GENERAL SURGERY AND PLASTIC AND RECONSTRUCTIVE SURGERY.

Dr. Bafitis is board certified in plastic surgery and has achieved the coveted title of FELLOW (FACOS) in the College of Surgeons. In 1994, Dr. Bafitis was honored by being selected to be a plastic surgery board member to the American Osteopathic Board of Surgery. He was responsible for maintaining the high standards in testing and certifying other plastic surgeons in the United States. Subsequent to that, he was elected as one of the youngest CHAIRMAN for the entire American Osteopathic Board of Surgery. He presently sits on the Residency Evaluation and Standards Committee of the American College of Osteopathic Surgeons in Washington, D.C. This group sets the standards for residency training in plastic surgery for university programs in the United States. Dr. Bafitis is also a clinical associate professor of surgery at Nova Southeastern University College of Osteopathic Medicine.

Dr. Bafitis has trained medical students, residents, and other physicians for more than 20 years. He has contributed to many medical publications and has lectured nationally and internationally to medical and lay groups about all aspects of plastic surgery. He has hosted numerous scientific programs in West Palm Beach, conducting live surgery at his state-of-the-art certified surgery center, where physicians have an opportunity to learn and get continuing medical education credits by taking his courses. Most recently, Dr. Bafitis has hosted scientific programs dealing with state-of-the-art technology with fractional dot laser resurfacing and jet lavage liposculpture. He has recently developed and refined a technique of integrated liposculpture and abdominoplasty that can be done with minimal anesthesia as well as minimal downtime. He has also developed instruments to be used in this procedure and will be presenting the clinical research on this surgery at a national meeting in November 2010.

Dr. Bafitis has taken part in national and international mission trips for most of his 21 years in practice. He has donated his time and skills toward educating other surgeons as well as taking care of the indigent in countries from Bolivia, Peru, and most recently in Cambodia. Dr. Bafitis has recently come back from working in the Cambodia Children’s Hospital in Phnom Penh. Dr. Bafitis is proud of his family and his extended family, which includes his highly-trained office staff.

BAFITIS PLASTIC SURGERY
Plastic Surgery Institute of the Palm Beaches

Wellington Center
9116 Forest Hill Boulevard
Wellington, FL 33411
561-422-1117

Palm Beach Gardens/Jupiter
4601 Military Trail, Suite 208
Jupiter, FL 33458
561-795-3787

CO2 Fractional Laser or DOT Laser Therapy

HISTORY OF CO2 LASER -- The Old Gold Standard

The definitive gold standard of laser resurfacing of the face and neck has been the CO2 laser. It produced amazing results that were permanent. In fact, our CO2 patients of 15 years ago still have a softness and glow to their facial skin. No other laser treatment has been able to duplicate these remarkable results.

Unfortunately, with the CO2 laser came a prolonged healing time, sometimes up to several months of redness as well as crusting/weeping of the facial skin. Often times, a temporary lightening of the skin was not only disheartening to the patient but to the physician as well. Physicians would often tell patients to avoid the sun for up to a year after the CO2 laser. The more significant issue was that usually the patient was subjected to general anesthesia for this procedure.

EVOLUTION TO THE NEW CO2 FRACTIONAL LASER -- The New Gold Standard

The medical community swung the pendulum to less effective lasers in “hope” of obtaining the same result with less problems. “Nonablative” laser surfaced: The Intense Pulse Light (IPL) laser was excellent for hair removal and minimal lightening of some age spots but did nothing for the facial skin lines compared to the amazing results with the CO2 laser. Erbium and Fraxel™ provide a less invasive penetrating laser beam to the face -- but again, long-term results were not significant, and the Fraxel™ required many treatments that were expensive and painful (when they are awake).

THE PRESENT FRACTIONAL CO2 THERAPY -- The New Gold Standard

So, the pendulum has shifted again back to the gold standard CO2 laser therapy -- now with a system that leaves some normal tissue unlasered (microscopically), so healing time is only a day to 5 to 7 days (at the most), depending on the depth of penetration and the intensity of the treatments. For example, acne scarring would need a deeper treatment with a more intense laser light. After a DOT Therapy procedure, thousands of microscopic perforations stimulate new collagen growth to improve skin’s texture and tone, significantly improving lines and wrinkles and, of course, even acne scarring. DOT Laser Therapy leaves the skin around each of the perforations intact, allowing the epidermis to heal from the edge of the tiny microscopic laser ablative holes, dramatically improving the overall complexion. Even with a “deep” (penetrating) treatment, most people can return to activities in 24-48 hours. They look like they had a sunburn, full peeling with “new” beautiful skin ensues within 36-48 hours and can last up to 7 days. Again, the patient looks like they had a sunburn.

Advantages of fractional CO2 laser therapy

1. No general anesthesia -- done awake.
   Usually use local blocks like in a dental office or an anesthetic cream as used before a bikini wax.
2. Less healing time -- rapid healing post laser.
   Patient up and ready to work with cream on face/neck within 24-48 hours; looks like a sunburn.
3. Facial skin appears to look improved after first few days -- but when the body starts producing its new collagen by week 3, the patients note that lines start to disappear, and by 6 months with more collagen remodeling, the facial skin appears even more improved. Therefore, this is a biphasic treatment. Initial result by 3 weeks and even more significant improvement by 6-9 months.
4. Safe and can be used on all skin types.
   Darker skin may need to have up to 3 to 4 weeks of pretreatment with a medical skin program. Excellent results seen with Asian, Latin, and even African American skin.
5. Patients can resume sunbathing.
   Sun activities are fine with a sunblock after 1 month post laser treatment if desired.
6. Procedure can also lighten and improve sun-damaged skin on neck, décolletage, and lighten age spots on hands, feet, and legs.
7. Fractional laser can be used for facial scarring, deep acne pits, warts, discolorations of face, i.e. melasma after pregnancy.
8. It can be used effectively even if you are a smoker.
9. It can be combined with surgical procedures, i.e. cheek/neck lifts and foreheadplasty.
10. It can do segmental areas about face. It can laser around the mouth, the perioral area. It can be used for dark areas under the eyes, which is a highly effective treatment for this condition.

The CO2 fractional laser is probably the biggest advance in laser resurfacing in the last 30 years. It combines all the Gold Standard pluses that we see with total CO2 laser resurfacing, now with none of the downside.

But remember, fractional means that you are leaving a percentage of the skin “untouched” by the laser. It is, therefore, recommended that at least 2 sessions be planned. This is a challenge with our patients because the majority is so satisfied with just one session that we call them “prematurely happy!”

Dr. Bafitis does use a medical skin care protocol that not only creates the basis for these “prematurely happy” patients but actually improves the results of the laser therapy. He often states that a “medical skin program” is like brushing your teeth. You would not go to bed without brushing your teeth. So, why not take care of the largest organ of your body -- your skin. The way it should be taken care of literally involves 5 minutes in the morning and 5 minutes at night.

The Truth About Bafitis Plastic Surgery And Fractional Co2 Therapy (DOT Laser Therapy)
Dr. Bafitis has been selected to train other physicians in this delicate and artistic laser modality. He has held medical workshops at his state-of-the-art certified facility. He performs live surgery and instructs physicians from around the country, South America, and Europe on the fractional CO2 system. Dr. Bafitis was also a national instructor in the past with the fully ablative (nonfractional) CO2 laser system.

Dr. Bafitis has 20 years of experience with CO2 therapy. Bafitis has made it his mission to embrace this new technology from Florence, Italy, with the DOT laser. It changed the scope of his facial rejuvenation, and the before and after photos prove it.

Ask the staff to arrange a consultation and if you desire to speak with previous patients. Explore your options with Dr. Bafitis and the Plastic Surgery Institute of the Palm Beaches, Inc.

BAFITIS PLASTIC SURGERY
The Plastic Surgery Institute of The Palm Beach, Inc., with Dr. Harold Bafitis, Medical Director
Palm Beach Gardens/Jupiter Office: (561) 795-3787, 4601 Military Trail, Suite 208, Jupiter, Fl 33458
Wellington Office: (561) 422-1117, 9116 Forest Hill Blvd., Wellington, Fl 33414

A Bafitis NIGHT OF BEAUTY - February 22, 2010

Monday, February 22, 2010 at 6PM
A NIGHT OF BEAUTY at Michael Angelo Salon & Spa
4095 State Road 7, Suite M, Wellington, FL 33449

It's free but seating is limited.
Please call and reserve a seat today.
561-795-3787

Dr. Bafitis will discuss the newest techniques in laser skin rejuvenation including Smart Xide DOT™ Laser (Fractional CO2 laser) and the new Body Jet Water Assisted Smart Liposculpture. He will also be speaking and demonstrating Juvederm™, plus new applications of Botox™.

Listen to testimonials from patients who had Smart Xide DOT™ Laser and Jet Lavage Smart Liposulpture.

• Hear Client Testimonials - Watch Demonstration of New Facial Fillters -
• Learn about the Latest Techniques in Plastic Surgery
• Free Give-Aways
• Fillers, Botox, plus consultations on assoicated procedures
• Gourmet food and cocktails served
• Discounted price for all Botox and filler patients attending this event.
• Discount on all procedures for event participants

We look forward to seeing you!

If you are interested in attending this event - please call 561-795-3787 or reply online.
Seating is limited, sign up today.