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Plastic Surgery Plastic Surgery

Plastic Surgery - PowerPoint Presentation

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Plastic Surgery - PPT Presentation

What a Primary Care Physician Should Know William A Wallace MD FACS April 30 2015 Disclosures Lattice Biologics Scottsdale AZ Scientific Advisory Board Member Key Points Plastic Surgeon misconceptions ID: 568713

plastic surgery skin board surgery plastic board skin reconstruction cosmetic surgeon hand breast aesthetic scars reconstructive treatment congenital burn

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Slide1

Plastic Surgery: What a Primary Care Physician Should Know

William

A. Wallace, MD FACS

April 30, 2015Slide2

DisclosuresLattice BiologicsScottsdale, AZScientific Advisory Board MemberSlide3

Key PointsPlastic Surgeon misconceptionsPlastic Surgery Scope of PracticeCommon patient complaints warranting a Plastic Surgery evaluationSlide4

Plastic SurgeonsSlide5

MisconceptionsA Cosmetic Surgeon is a Plastic SurgeonBoard Certifications/Memberships are all the sameSlide6
Slide7

Plastic SurgeonAmerican Board of Medical Specialties recognized Certification BoardAmerican Board of Plastic SurgeryOnly ABMS specialty recognized to perform cosmetic proceduresMaintenance of Certification requiredRequires minimum of 3 years of General Surgery TrainingAdditional 2-3 years of Plastic Surgery TrainingAmerican Society of Plastic SurgeonsMembership requires Plastic Surgery Board CertificationFocuses on all aspects of Plastic Surgery

American Society of Aesthetic Plastic SurgeonsMembership requires Plastic Surgery Board CertificationFocuses on Aesthetic Plastic SurgerySlide8

“Cosmetic” Surgeon American Board of Cosmetic SurgeryNot Recognized by ABMSRequire only one year of “surgical training”Limited Apprenticeships observing other Cosmetic SurgeonsLimited examinationGenerous application feeDue to pressure are increasing requirements for new membersAmerican Academy of Cosmetic SurgeonsRequire Board Certification by any board deemed appropriate

by AACS TrusteesSlide9
Slide10
Slide11

Scope of Practice(It’s quite a lot actually)http://www.plasticsurgery.org/for-medical-professionals/legislation-and-advocacy/health-policy-resources/plastic-surgery-clinical-privileges.htmlSlide12

Misconceptions 2009 Poll of residents in Internal Medicine, Pediatrics, Family Practice1117 respondantsAsked to pick which specialist(s) performed which surgeryEyelid: (1st Plastic Surgery, 2nd Ophthalmologist)Cleft Lip/Palate (1

st OMFS, 2nd Plastic Surgery)Facial Fracture (1

st OMFS, 2nd Plastic Surgery)Hand Surgery (1st Orthopedic Surgery, 2nd Plastic Surgery)

Rhinoplasty (1

st Plastic Surgery, 2nd ENT)

Skin cancers of the face (1

st

Derm

, 2

nd

Plastic Surgery)

Plastic Surgeons perform all these procedures and moreSlide13

Skin Neoplasms, Diseases, and TraumaBenign and malignant lesions of the skin and soft tissueReconstructive grafts and flapsLaser therapy for vascular lesionsHemangiomas et. al.Scar revisionKeloids

Hypertrophic scarsUnsightly scarsSkin Resurfacing for acne, rhytids

, traumatic scarringChemical peelLaser skin resurfacingMechanical dermabrasionSlide14

Surgery of the BreastBreast reconstructionBreast reductionBreast biopsyCongenital anomalies (Poland’s disease, et. al.)Mastectomy (subcutaneous and simple)Breast augmentationSlide15

Treatment of Facial Diseases and InjuriesMaxillofacial fractures including the mandibleAcquired or congenital deformities of nose, ear, jaw, eyelid, lips, palateEyelid/Eyebrow PtosisProminent EarsCleft Lip/PalateCraniofacial surgerySkull

base surgeryFacial deformity and wound treatmentTumors of the head and neckSlide16

Surgery of the Hand and ExtremitiesSoft-tissue wounds and congenital abnormalities of the hand and upper extremity fracturesCongenital abnormalities of the bones of the hand, wrist and distal forearm. Carpal tunnel syndrome (endoscopic and open)Dupuytren's contractureSurgery for rheumatoid arthritis

Tumors of the bones and soft tissuesSlide17

Reconstructive MicrosurgeryMicrovascular flaps and grafts Replantation/revascularization of upper & lower extremities & digitsReconstruction of peripheral nerve injuriesHand/arm transplantsFace transplantsSlide18

Reconstruction of Congenital and Acquired Defects of the Trunk and GenitaliaChest and abdominal wall reconstructionSternal necrosis s/p CABGComponent separation for loss of abdominal domainSurgical closure of pressure ulcersVaginal reconstructionRepair of penis deformitiesGender reassignmentSlide19

Complex Wound Healing and Burn TreatmentInitial burn managementIncluding Emergency Room Assessment and Critical Care managementAcute and reconstructive burn treatmentEarly debridement and graftingReconstructive scar revisionSlide20

Aesthetic SurgeryBody contouringIncluding Post BariatricFacial contouringBreast augmentationBreast lift (mastopexy)Aesthetic rhytidectomyAesthetic

rhinoplastyAesthetic blepharoplasty

Subcutaneous injections/Botox/filler materialSkin peeling and dermabrasionVein injection sclerotherapy

Liposuction

Endoscopic cosmetic surgeryLaser therapy for vascular and cutaneous lesionsSlide21

Common Conditions/Complaints Warranting Plastic Surgery ReferralSlide22

SkinScar ConditionsKeloidsHypertrophic ScarsBurn ScarsNeoplasmsLipomas/Sebaceous CystsSkin CancersSuspicious MolesSlide23

BreastsReduction of Macromastia/GigantomastiaBack Pain, Neck Pain, Shoulder PainHeadachesShoulder grooves from bra strapsImprovement in 90% of symptomatic patientsReconstruction after mastectomy or lumpectomyImmediateDelayedSlide24

Post Bariatric Body ContouringIncreasing criteria by insurances