James L. Baker, Jr., M.D., FACS
How long after using Accutane (acne medication) is it safe to have a breast augmentation? My dermatologist said I should wait 6 months to a year due to Accutane prolonging the surgical healing process. Please advise with your opinion.
I agree with him. If you were having skin resurfacing, I wait 2 years for safety. Accutane severely inhibits wound healing and skin regeneration.
I am considering getting my breasts enlarged, and I have some concerns. I know that they are using saline now, but I have seen pictures of saline implants that have molded and caused severe illness. I saw a surgeon on a talk show that was discussing soybean oil filled implants. I would like to know if those are available or if it is even an option.
Soybean oil-filled breast implants were removed from the market some years ago. These were only implanted as part of clinical trials, and only a very small number of women in the U.S. participated in the studies. It was found with a much larger number who received the implants in Europe that the oil became rancid and the implants had to be removed. There are no plans, in the future, to bring this implant back to the market.
Saline-filled implants remain safe and effective, FDA-approved devices for breast augmentation. Although some years ago, there were a few reports of mold forming inside saline implants, researchers have concluded that this was due to contamination that occurred at the time of filling the implants. Today we know that implants should be filled directly from an IV bottle containing sterile saline solution. This is done in the operating room at the time of implantation. Utilizing this "closed system," there have been no reported cases of contamination of the saline.
Silicone gel-filled implants are also available on a restricted basis, and through research protocols, for those patients who qualify. The patient must be followed for five years, with reports filled out at one, three and five years and submitted to the implant manufacturer who, in turn, submits them to the FDA. It is possible that silicone gel-filled implants may become more widely available in the future.
I have very wrinkled skin under my eyes. I believe this condition was exacerbated by cortisone usage for severe eczema. I am in my early 40s. What can be done on this very thin, sensitive area? My eczema is now gone. I also have very, very dark areas between my eyes and the bridge of my nose. Can anything be done for this?
After discontinuing cortisone ointment, the skin should return to normal thickness after time. However, this can take months. Taking Vitamin C, 500 mg. twice a day will help. Depending on the amount of pigment in your other skin, or your general skin coloring, a chemical peel may be useful (after skin thickness is normal) as well as laser treatment. Eyelid surgery can improve bags or excess skin but does not help dark circles. Botox injections are best for fine line wrinkles.
I had rhinoplasty 25 years ago and was never really happy with the result. I would like to have a second rhinoplasty, but now have deep puffy bags under eyes. If I were to get a lower blepharoplasty and then have rhinoplasty six months to a year later, would the rhinoplasty stretch out the skin below my eyes?
The best secondary rhinoplasty plastic surgeon I know is Dr. Jack Gunter in Dallas, TX. Rhinoplasty after eyelid surgery does not negate the eyelid surgery. There is no relationship.