Tuesday, September 29, 2009

This could save your life - Advice from Dr. Robert Brueck, Fort Myers Plastic Surgeon

This blog message is brought to you by Dr. Robert J. Brueck, Board Certified plastic surgeon in Fort Myers, Florida, who also has a web site at http://www.BeautybyBrueck.com .


Now that I have your attention let me give all of you, my wonderful friends and patients, a few words of warning that conceivably could save your life.

Realize that supplements are not as closely scrutinized as drugs in America. A senate judiciary committee recently sat down to plan a hearing this month focusing on dietary supplements and their safety.

There are countless stories of individuals taking dietary supplements and developing liver problems, bleeding problems, mood changes or alterations and the like.

I remember a short time ago I did a face lift on a lady who was taking Omega-3 fish oils. She bled profusely and developed a hematoma which is a collection of blood under the skin. This had to be drained. In the end she was fine. What was surprising to me was that nearly 67% of adults take dietary supplements. That’s a lot of people. It’s important to understand the concerns that may exist concerning certain supplements.

In a 2007 survey of weight loss and athletic supplements the British labs analyzing these substances found trace amounts of steroids in 25% of the samples that they tested.

Since December, 2008 the FDA has issued warnings about more than 70 weight loss supplements. Now we all know why so many athletes are banned for steroid use or is this really the case? I know I have all of my surgical patients get off ALL dietary supplements two weeks before surgery.

Some helpful websites include the National Libraries of Medicines Medlineplus.gov under the heading drugs and supplements.

Also try NCCAM.NIH.gov and dietarysupplements.info.nih.gov.

You can also go to www.FDA.gov to see if supplements that you are currently taking are included under the warnings label. I guess it’s true that sometimes simple is better.

All the very best and I hope this proves beneficial to you.

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Sunday, September 20, 2009

Can you trust Plastic Surgery directories? Here's what Dr. Brueck thinks.

Thank you for visiting my blog. I try regularly to offer news and opinions about beauty and cosmetic surgery that I find interesting and helpful.

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This issue's subject is plastic surgery directories and thoughts on how they, and some probing questions, can help you find the right cosmetic surgeon for you.

Used to be there were two, maybe three directories in our lives. The White Pages, the Yellow Pages and, at one time, City Directories.

With the onslaught of the Internet and the Web, there are now more directories than weeds in an untended lawn. All manner of entrepreneurs have discovered they can create a directory and sell companies a place in it.

Some of these directories have no subject discipline. If you have a few bucks, you can have your web site listed in a directory. Others, have requirements that a company or individual be in a certain business.

Plastic surgery directories are like that. You must be a qualified plastic surgeon to be included in the directory. There are a few of them and they all require medical/surgical qualification at some level.

The general idea is that someone looking for a plastic surgeon will enter an appropriate search term, such as breast augmentation, in one of the Web Search Engines. Among the results they receive will be a few Directories of Plastic Surgeons.

The directory can be sorted by geographic location or other criteria. If you are looking for a plastic surgeon in "Anyplace Town", the directory will deliver a list of plastic surgeons in or around "Anyplace Town".

It will also include a profile of the doctor, an email address, a telephone number and, occasionally a web site address, for each doctor. There is nothing wrong with this. In fact, for someone seeking information and access to a local plastic surgeon, a directory can be very helpful, just as the Yellow Pages can be. (Of course, the internet is usually more responsive, more comprehensive and more current than a printed directory.)

The Yellow Pages can be an instructive analogy, though. Doctors run paid advertisements in the Yellow Pages. Similarly, doctors are required to pay to be included in online directories. This doesn’t make any doctor who pays to be included a bad doctor. He or she would not be listed without meeting what are quite demanding qualifications.

The problem is that an extremely well qualified plastic surgeon may not be willing to pay the directory publisher to be included. That doctor could be the finest surgeon in town, board certified in his or her practice, recognized by his or her peers as the best. If, however, he or she chose not to pay to be in the directory, you as a searcher wouldn’t know it, and you wouldn't learn about that doctor in this otherwise very helpful list. It’s not that you get false information. It’s just that you don’t get all the information.

What can you do about it? Use the directories, by all means. Look in more than one. A surgeon may have paid to be in one directory but not another. When you have zeroed in on the surgeon or surgeons that you want to advise you, go to the consultation with a list of questions.

1. Are you, doctor, board certified in the procedure I am interested in? May I see your certification?

2. How many other patients you performed this procedure for? Can you give me a short list that would be willing to comment on your work?

3. Can you show me before and after photographs of your work?

4. Am I a good candidate for this procedure? What are the chances of complications?

5. What can I expect after the procedure has been completed? What will recovery be like?

6. If you were unavailable to perform this surgery, who would you recommend in your place?

7. Can you give me the name of a patient who was not happy with your performance?

Question #7 is a real test. No surgeon is perfect. Each of them has had at least one patient that he or she did not completely satisfy. If the surgeon can’t answer that question, it should set off an alarm in your head.

Does it mean the surgeon thinks he or she is “perfect”?

Does it mean the surgeon has not paid enough attention to patients to know when one is not 100% satisfied?

Does it mean the surgeon has something to hide?

Incidentally, whether you contact the person the surgeon names or not is less important than asking the question and paying attention to he answer.

So, can you trust plastic surgery directories? More so than not.

In the words of a past President of the United States, however, “Trust but verify.

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Sunday, September 13, 2009

Now they want to tax how you look.

Thoughts from Dr. Brueck, Fort Myers plastic surgeon, on the latest government threats to tax cosmetic surgery and non-surgical procedures.

When will it ever end?

It seems every time I pick up the newspaper I read about healthcare. The amount of material is staggering.

It seems that the opinions of the party in control change like the wind. The cost of government healthcare is projected to cost 1 to 1.6 trillion dollars over the next 10 years. But, alas, it will be budget neutral.

Sure, we can all believe that - we only need to look at Medicare with its $30 to $60 trillion in unfunded liabilities; Medicaid which is bankrupting many states (look up Tenncare) and last, but not least, Veterans Care. We all have read about the horrible conditions at Walter Reed Hospital and the care that our war heroes get.

To my count, that is three strikes and in America, three strikes and you are out. To maintain “budget neutrality” the powers-that-be are proposing a 10% tax on ALL cosmetic procedures.

When will this never-ending litany of new taxes end? This administration is already spending our country into the brink of bankruptcy. If they spent as much time on our deficit and decreasing it as they do on dreaming up new taxes our country would certainly be far better off.

I recently resigned from the AMA, the FMA and the American College of Surgeons. It was done with much thought. It was a very difficult decision to make. But these organizations “support government health care” and all of this with no tort reform.

I recently wrote to the chairman of the AMA and a similar letter was sent to the head of the American College of Surgeons. I think it says it all. Something to ponder in a spare moment.

July 29, 2009
James Rohack, M.D.
American Medical Association
515 North State StreetChicago, IL 60654

Dear Dr. Rohack:

Recently I resigned from the AMA and recent events have solidified the purpose of my decision. I am utterly shocked, appalled, and disheartened by the AMA elite endorsement of Obama Care. The AMA “elite” have sold our patients, our physicians and the greatest healthcare system in the world down the river.

There is no question our system has flaws but remains the preeminent healthcare system in the world. Why do so many presidents and foreign dignitaries come to America to receive lifesaving medical care? The free medical marketplace breeds innovation and new technology, life saving pharmaceuticals, etc. There isn’t one socialized system that can compete with ours.

We hear about the “great Canadian system” yet thousands of Canadians cross the border every year to receive their care here in America. In 2005 the Canadian Supreme Court opened the doors to private medicine and healthcare in their country. Why, because the socialized system was broken and was not serving the Canadian people.

Over 15,000 people died in France in 2003 because of a heat wave. When was the last time that happened in America?

Look at the list of Nobel Prize winners in medicine over the last 20 or 30 years and the case is quite clear and obvious. 8 out of 10 of the last major medical advances such as MRI’s and CT scans were developed here in America. If you suffered from an MI in the 80’s and made it to the ER the survival rate was about 60%, today it’s over 90%. Stroke survival rates today are twice as great as they were 25 to 30 years ago.

Look at the longevity table today versus 20 or 30 years ago. Yet we still have that bastion of healthcare that is so vital, so precious to doctor patient relationship and now you want the government to intrude and destroy and destroy they will.

Mark my word. They are like an insidious cancer growing and advancing not to be stopped. We need less government control in medicine and in our lives in general. Healthcare is 20% of our gross developmental products. I do not want the government to control anymore of lives than they already do.

Look at the government medicine we now have, Medicare is going broke, Medicaid is breaking every state budget in the union and then let’s not forget the great government controlled Veteran’s healthcare system which is a shamble and a disgrace to our proud men and women serving in our Armed Forces.

To put 20% of our gross developmental product in the hands of our totally irresponsible government is abhorrent. A short time ago the house passed a cap and trade bill and in large NO ONE ever read the bill and now they are trying to rush through and ramrod a healthcare bill down our throats that NO ONE once again has read. I wonder what they want to hide!

Of course they want to rush it through for the sake of not having it read, discussed and digested so that they can have more control of our lives. Just like the takeover of the banks, the insurance companies and the car companies. When and where will government control of our lives and our country end.

The government’s reasoning is that we have 50 million uninsured. It’s interesting how that number has grown from 35 to 50 million. If we look at that numbers it’s really not all that significant. Of that number 10 to 12 million are illegal aliens and should not be entitled to healthcare. It’s also estimated that 14 million of these uninsured qualify right now for SCHIPS/Medicaid. Several million of these uninsured can afford insurance but elect not to have it.

The census figures also show that 18.3 million of the uninsured were under 34-years-old. Many have elected not to have coverage because they feel healthy and secure in their present situation. Many millions are uninsured for short periods because they are between jobs.

When all is said and done a Blue Cross Blue Shield study in 2003 found that there were approximately 8.2 million Americans without coverage for long periods of time. We also hear of the tremendous costs of uncompensated care and the shifting of expense from the non-payer to the payers.

A Kaiser Family Foundation study in 2008 said that the TOTAL uncompensated care was 56 billion dollars. So we are going to turn our healthcare system over to the government with a projected cost of 1 to 1.5 trillion dollars over 10 years.

We all know about government efficiency. I am sure their numbers are accurate. Look at the VA healthcare system. This has been in place for decades and it’s government run and look how it’s in shambles. We all recently saw pictures flashed across the screen about the poor conditions of our Veteran’s healthcare facilities.

We are also told that we need a government option to create competition. With over 1500 healthcare plans in America today this is nothing more than a ploy to get the government’s foot in the door and gain total control of our lives. Even if the government plan loses money don’t worry we have the taxpayers to fall back on.

Look at the postal system which now is projecting a deficit of 10 billion dollars and of course who is going to pay for it, the taxpayers. We will just throw another 10 or 15 billion here to subsidize another losing government proposition. Maybe we will give the government’s plan some free government subsidies.

What government program over the last 10, 20 or 30 years has run efficiently and under budget? The answer is none. Do we subsidize Amtrak, the postal system, you name it. The list goes on and on and to think that this is going to be budget neutral is foolhardy.

We also always read about Medicaid fraud, Medicare fraud, durable medical good mills and so forth. When was the last time that we read about a Blue Cross Blue Shield or Human fraud? It doesn’t exist because the private sector is far more efficient in delivering healthcare. It is also possible that the private sector might be better keepers and stewards of our hard earned dollars.

To pay for this we are told that we can “squeeze” $500 billion in savings from Medicare. Yet the enrollees in Medicare is set to grow by over 30% as the baby boomers are set to retire over the next several years. Now you tell me how you cannot take away from the quality of healthcare for our senior citizens by squeezing a half a trillion dollars from their budget and yet have their enrollment increase 30 to 40%.

They must have some Houdini pulling the levers at the Medicare center. Past history has always shown us that we can’t trust the wisdom and brilliance of bureaucrats in Washington.

Our president talks about the out of control spiraling healthcare costs but recent trends seem to refute his claim. Here are some facts:

1970 – 10.5%
1980 – 13.0%
1990 – 10.9%
2000 – 6.6%|
2003 – 8.6%
2004 – 6.9%
2005 – 6.5%
2006 – 6.7%
2007 – 6.1%

This really is a promising trend.

As a loyal American I want free market capitalism to be given a chance ahead of a huge government bureaucracy filled with corruption and waste. Free market capitalism is what has made our country the richest, the strongest, most prosperous nation in the world.

Repeat Webster’s definition of tyranny “repressive government control”. I question what direction our country is going. I am certainly appalled at your decision to support Obama Care and I certainly have no plans in the future to ever again become a member of the AMA and will actively campaign to have other friends of mine who are active members to renounce their membership as well.

With Warmest Regards,

Robert J. Brueck, M.D.

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Saturday, September 5, 2009

A New Filler - Fort Myers plastic surgeon Dr. Brueck comments



It seems every time I get up from bed there is a new filler/a new toy to tempt us to answer the needs of our patients.

The newest kid on the block is Hydrell/recently approved by the FDA.

It’s the newest Hyaluronic acid filler with anesthesia already in it.

The drug is manufactured by Anika Therapeutics and will be distributed in the U.S. by Coapt Systems. It is designed to fill in mid to deep dermis facial wrinkles and folds. It requires about 50% of the typical injection volume, meaning fewer injections to fill in those ugly, nasty facial wrinkles.

So far no word about when it will be released but I am sure there will soon be a new “knock on my door”.

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