Dr. Susan Downey | Pasadena
Weight Loss Surgery | Pasadena
Facelift | Eyelid Surgery | Pasadena
Breast Augmentation | Breast Reconstruction | Pasadena
Liposuction | Tummy Tuck | Pasadena
Botox | Restylane | Pasadena
Ear Pinning Surgery | Scar Revision | Pasadena
ON-Q System | Dr. Downey | Pasadena
Cosmetic Surgery | Pasadena
Dr. Susan Downey: 1301 Twentieth Street | Suite 470 | Santa Monica, CA | Tel: 310.401.2929
Female Plastic Surgeon | Pasadena

Rare Condition associated with Breast Implants

February 9th, 2011

A new national registry has been established by the American Society of Plastic Surgeons and the FDA to document reported cases of a rare condition  , Anaplastic Large Cell Lyphoma (ALCL) which is possibly associated with breast implants.  Thirty four cases of ALCL  in patients with breast implants have been reported in the world and that is in the 5-10 million women who have implants world wide.  Most of the patients presented with late onset seromas ( swelling) around their breast implants .  The condition appears to arise in the capsule surrounding the implants and is not breast cancer.  Currently the recommendation for women who are found to have this condition is to remove the capsule ( scar tissue) which surrounds the implant as well as the implant.  Safety is always of first concern and I  concur with the the American Society of Plastic Surgeons , the Aesthetic Society as well as both implant companies (Mentor and Allergan) in supporting efforts to research this rare condition .

My Christmas Present

December 17th, 2010

Dr Jorge Palacios just gave me the most wonderful Christmas present.  I was with Dr Palacios in Ecuador on a visiting educator trip where we were training young surgeons to do cleft lip and palate surgery.  One of the patients was a 45 year old woman with an unrepaired cleft lip.  Dr Palacios assigned her care to me.  in 45 minutes I was able to repair her lip-  a 45 minute operation for which she had waited 45 years !!  I am so grateful that I was able to do this for her.   She will be able to smile at her children and her husband for the first time .  To be given a chance to help another person like this is priceless.

Plastic surgery in Ecuador

December 17th, 2010

I just got back from spending ten days in Ecuador.  I was a visiting Educator with Resurge( formerly known as Interplast).   This was my fifth trip to Ecuador and my third as a visiting educator.  Most medical missions that I have been on   we are just trying to get as much surgery done as well and safely as we can in our limited time. A visiting educator trip is different -  on these trips we are trying to teach local doctors to improve their techniques and help improve through our training the outcomes of many surgeries after we leave.  It is exactly like the old adage -  give a man a fish and your feed him for a day,   teach a man to fish and you feed him for a lifetime!    I always get so much more out of these trips than I give -  we are so lucky in this country with all that we have .   I am very gratefull that I have the opportunity to give back in even a small way.

Breast Reconstruction immediately after Mastectomy Linked to Increased Survival

November 4th, 2010

A very interesting study was presented recently at Plastic Surgery 2010 : Joint Annual Scientific Meeting of the  American Society of Plastic Surgery (ASPS)  and the Canadian Society of Aesthetic Plastic Surgery (CSAPS)meeting in Toronto Canada.  The  study looked at cases of breast cancer between 1998 and 2003 and analyzed  data in the US National Cancer Institute  Surveillance, Epidemiology, and End Results (SEER) registry database.  The SEER analysis looked at more than 46,000 women who had undergone mastectomy alone and 8500 who had undergone a first stage of reconstruction at the time of their mastectomy. The analysis showed an amazing result that immediate breast reconstruction was associated with a 26% reduction in breast-cancer- specific mortality!  No one thinks that breast reconstruction is saving lives but the hypothesis is that patients who undergo immediate breast reconstruction  are usually in higher income brackets and are better educated.  This has been widely supported in the literature.  In addition patients with better access to good cancer centers are more likely to be referred to a reconstructive plastic surgeon by their breast surgeons than patients being treated outside a cancer center and they might be getting better overall care. This study certainly is interesting and more research needs to be done to sort out the reasons behind this increased survivial .  It certainly is interesting though!

Breast reconstruction in Los Angeles

September 24th, 2010

A recent survey  of  women with breast cancer found that 43% of the patients who were eligible for reconstruction did not receive information about their reconstructive options when making decisions at diagnosis.    This is an alarmingly low number!  Many patients are not aware that  a federal law signed into effect by President Bill Clinton mandates that breast reconstruction be covered by insurance companies.  this means that even if a women does not opt for reconstruction at the time of her mastectomy she has the option at any time later-  even years later.  This law also covers the opposite breast -  this means that the breast not involved with cancer can be reduced, lifted and even augmented to achieve symmetry between the two breasts.  God built women with two breasts and we need to get the word out that even if a woman suffers through cancer treatment she can again have the opportunity to have two breasts !

Form Stable Breast Implants

June 21st, 2010

Recently I went to Sweden to observe the practice of Dr Charles Randquist.  Dr Randquist has extensive experience with form stable breast  implants -  Mentor’s CPG implants and Allergans 410 implants -  which are not currently available in the USA except under study conditions.  These implants are shaped -  with a sloping upper pole .  We used to have shaped implants in the United States but the FDA did not include them in the approval process along with round implants so they were taken off the market in the States five years ago.    I am hopeful that soon we will have shaped implants as I think especially for the reconstruction patient they are a valuable tool.

Breast reconstruction - Immediate or delayed?

April 20th, 2010

When a woman is diagnosed with breast cancer she is faced with a multitude of decisions -  lumpectomy or mastectomy, decisions about chemotherapy and radiation therapy - it can sometimes seem like too much to have to decide about breast reconstruction (implant reconstruction, flap reconstruction, silicone vs saline implants) at the same time.  Our goal as plastic surgeons is to try and make sure each patient has all the information she needs to make the best choice for her.  For some patients this might be to undergo the breast cancer treatment and not even worry about the reconstruction until later.  For others it might be to undergo breast  reconstruction at the same time as the mastectomy.  Recent data suggests that 70% of breast cancer patients are not informed of the various reconstructive options available to them.  This is not acceptable.  We need to work harder to make sure that women are given all the information they need at the time of their cancer diagnosis so they can make the best , informed decsions for themselves.

Cosmetic versus reconstructive surgery

February 16th, 2010

Plastic surgery as a specialty encompasses both cosmetic as well as reconstructive surgery.  The definition of cosmetic surgery is surgery  ”to improve on the normal”  whereas reconstructive surgery is surgery  ” to restore to normal form and function”.  In some cases it is clear -   repair of a cleft lip is clearly reconstructive surgery and liposuction of small amounts of fat that one just does not like is cosmetic surgery.  In other situations it is more difficult.  An upper eyelid lift to improve one’s appearance is cosmetic while an upper eye lift to remove excessive skin which is blocking one’s vision is reconstructive.   Breast reconstruction after cancer treatment is unusual in that there is a Federal Law signed into effect by Bill Clinton mandating that breast reconstruction and surgical treatment of the opposite breast (if needed) is covered by insurance.  Thank you Mr. Clinton!

New barbed sutures save time in the operating room.

February 16th, 2010

Surgery on patients who have lost a lot of weight can take a lot of time.  This is a problem for many reasons .  The risk of complications can go up with a patient on the operating room table for an extended period of time  -  risks of wound infection, healing issues, risk of DVT or even pulmonary embolism can increase.   New sutures are now available which can lessen the time on the operating room table.  These sutures are an exciting  advance  especially  for plastic surgeons working with  Massive weight loss patients .  The sutures are barbed which work to close the wound without  knots.  This decreases the time to close the wound and reduces the incidence of knot related issues such as stitch abscesses.     I have been really pleased with the barbed suture -  and especially the combination of the barbed suture and surgical glue to seal the wound.  This combination is great for my patients -  less time on the OR table, less tape and bandages and patients can shower right away !  A win for all!

Choices in breast reconstruction

September 23rd, 2009

A few years ago I surveyed a group of female plastic surgeons as to what they would choose for reconstruction if they were faced with the diagnosis of breast cancer.,  My thinking was that this group of doctors had an unique perspective on breast reconstruction options -  they were very well informed as to  not only the options available but also to the risks and outcomes of each reconstructive option .  The results were interesting.,  A total of 54 female plastic surgeons were surveyed.  Ninety one percent stated that they would opt for mastectomy over breast conservation .  Most   (87%) choosing a mastectomy would opt for reconstruction.  For their reconstructive procedure 54% would choose tissue expansion with implant reconstruction and, 28% would choose a Tram flap and only 5% would choose a latissimus flap.  For the women choosing implant reconstruction 79% would choose a silicone implant , 24% would choose a saline implant and one respondent felt that either choice would be acceptable.  The most frequently chosen reconstruction then was tissue expansion followed by a silicone implant (43%).  Interesting  and food for thought!