Thursday, June 30, 2011

Is a diabetes cure on the horizon? Dr. Brueck comments.

Thanks for joining us for another blog about health and medicine by Fort Myers plastic surgeon, Dr. Robert J. Brueck MD FACS

It’s early Sunday morning and I’m beginning my 3
rd cup of coffee.

As I am thumbing through the News Press I see an article, “Study finds 347 million diabetics worldwide.” It goes on to state that the numbers of diabetics has doubled in the last three decades. The numbers are astonishing and I’m sure you and I all know someone who has diabetes and is affected by it.

There are two types, Type 1 comes on early in childhood and is considered an autoimmune disease. The cells in the pancreas that secrete life-saving insulin are called “islets of longerhans”

One area of diabetic research is centered on how to turn off the body's immune response to prevent the destruction of the insulin producing cells. Well, an answer may be on the horizon. The study involves a “cheap” (I question, "Is anything cheap in medicine today?") generic vaccine that has been used in fighting TB. This soon hoped-to-be miracle drug is called BCG or more technically bacillus-Calmette-Guerin. Now that’s a mouthful.

A team of researchers led by Dr. Denise Fauntman found that injection of BCG in type 1 diabetics seemed to halt the immune response against the insulin producing cells. What was even more remarkable - 4 of 6 patients who had been living with the disease an average of over 15 years, saw their bodies' insulin secreting cells awakened from a long slumber. It was thought these patients' pancreases were dead.

These are only some preliminary studies on a small group of patients. Larger clinical trials will be needed and are underway. Perhaps the future will be a bit brighter for the millions suffering from diabetes.

To think this is coming from America where, according to Michael Moore, we’re only 17 or 18th in the world ranking in health care. I believe Cuba led the list. By the way, that’s where Hugo Chavez goes to get his health care. I’m sure Michael Moore has his gas-guzzling jet on the runway ready to go at a moment's notice.

Monday, June 27, 2011

Buyer Beware - A cautionary tale from Dr. Brueck

This is the blog of Dr. Robert J. Brueck, MD, Board Certified plastic surgeon. Dr. Brueck practices in his licensed plastic surgery center in Fort Myers Florida. Here he comments on the folly of seeking "cheap" surgery and going ahead with it despite having no knowledge of the surgeon, his training or his credentials. For a complete statement of Dr. Brueck's medical education and training, including his Board Certification, visit his website at

There are many axioms in the English language. One that comes to mind is the proverbial, "if it’s too good to be true, it probably isn't true". As we ride through this terrible economy, another prudent saying is, “buyer beware.” This has been proven to never be now than ever.

People are always looking for “the deal.” But in your search for the perfect deal you may come up short or even dead.

In South Carolina, a boutique owner was arrested following the near death of one of her clients from a botched buttock lift/implant. The patient was a woman from New Jersey who sought out the procedure. Michelle Rosa apparently flies doctor’s in from outside the country to perform their procedures in her salon or boutique.

So the "he said, she said" continues and the finger pointing and blame continues on.

But a simple question – why would ANYONE (looking for a deal) have a major cosmetic procedure performed in a boutique by a doctor they don’t even know?

Yes, a boutique. Not a licensed surgery center. It is simply a recipe for disaster. Truly, buyer beware.

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Friday, June 24, 2011

FDA- On the Breast Implant Warpath Again

The FDA just released - who knows why - a report on implant safety. I guess they just want to beat an old horse. As a Board Certified Plastic Surgeon practicing in Fort Myers, FL, I feel compelled to comment on this report.

There is absolutely NOTHING to be concerned about in this latest released memo.

Of course the media tries to spin it in a way that is “alarming”. For example, the Boston Globe headline read, “FDA urges caution for silicone breast implant recipients.” The Wall Street Journal blogged, ” A.M. Vitals Silicone Breast implants carry risks but will stay on the Market.”

I am totally bewildered by this sudden press release/announcement, whatever you want to call it.

I have been doing implants for over 32 years and feel very strongly silicone implants are safe and represent a cosmetic surgery procedure that has one of the highest satisfaction rates.

This may have been prompted by a news release earlier in the year concerning a very rare from of lymphoma that may have a very slight increased risk with implants. This is ALCL or anaplatic large cell lymphoma. The risks are ever so slight.

One set of data cited by the FDA was the high rate of re-operation in the first 10 years after augmentation. A study done in 2006 showed a rate of 20-40%. First and foremost I tell all of my patients that their implants will NOT last forever. They are no different than a car or a lawn mower. They are devices that have a limited life time.

Secondly you have to look at the 20-40% re-operation rate and ask yourself WHY it is so high.

The casual, uninformed observers might think the complication rate is extremely high but you have to remember many of these re-operations are due to a patient's personal desire. For example, a patient who is a 32A comes in for a breast aug, has an aug that is now a nice C cup, but comes back in 4 to 5 years and wants to be fuller.

Another patient may have had an augmentation gets married, has two children and now her breasts are sagging and she needs fuller implants as well as a breast lift. Another patient may come back because after pregnancy, the ligaments that support her inframammary fold (this is where the breast meets the chest wall) may have weakened and caused the implant to be lowered (or we say it has bottomed out) so the fold may need to be re-enforced.

Many of these re-operations, i.e. 20-40%, are elective and requested by the patient and not necessarily due to a complication of the implants.

The FDA release also talks about capsular contracture. What is a capsule? First know that EVERYONE gets a capsule after the placement of an implant. This is a NORMAL body’s response to the presence of a foreign body. A capsule is nothing more than scar tissue that forms around the implant or foreign body. If you got a sliver from a piece of wood and did not remove it your body would form a capsule or scar tissue around it. This is perfectly normal.

The key thing following a breast augmentation is to keep the capsule soft-don’t let it get hard.

I instruct all of my patients post-op to do breast exercises at least twice a day forevermore. Patients who do this regularly have far fewer problems with hardness then women who do not.

I also think it is important to discuss the changing technology. Many of these studies reported by the FDA were including implant verities from 10-15 or 20 years ago. The newer implants have a cohesive gel that doesn’t migrate like the old gel implants of 20 years ago.

So, yes, implants don’t last forever and, yes, there are risks just as there are when we drive a car. But in the end analysis, they are safe and effective. It’s no wonder it is the number one cosmetic procedure. So we need to analyze this latest FDA release from a slightly different perspective.

Sleep tight all is well.

Wednesday, June 22, 2011


Dr. Robert J. Brueck MD is a Board Certified plastic surgeon in Fort Myers and Cape Coral, Florida. He periodically comments on subjects related to cosmetic and aesthetic surgery that interest him. You can read more about Dr. Brueck at his web site,

Remember seeing in the T.V. news about the mother in California who let her 8 year old daughter get Botox to help her in a beauty contest?

Now, in the State of New Jersey, a bill is moving through the State of Legislature that would make Botox for minors illegal accept in cases authorized by a licensed physician.

According to statistic compiled by the American Society for Aesthetic Plastic Surgery (of which I am a member) teenagers received more than 12,000 injections of Botox in 2009.

The shocking part of all of this to me is that we somehow feel the need to pass a bill to legislate responsible parenting. How sad. How pathetic. Where have our morals, our values, our sense of family gone.

It is a sad commentary on society today and I PRAY America wakes up before it is too late.

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Monday, June 13, 2011

China? The New South Beach?

Another blog message from Dr. Robert Brueck MD, who writes here about aspects of health and plastic surgery. He practices as a Board Certified cosmetic surgeon in Fort Myers, FL

It seems we can hardly pick up the paper and not read about China - the new emerging economic and military power. As they have embraced free market initiatives, their middle class has really blossomed.

According to China’s Health Ministry, cosmetic-plastic surgery now ranks as the 4th, that’s right, 4th, most popular way to spend discretionary income.

The first three are home buying, cars and travel, in that order. The “big three” in cosmetic surgery are the United States., Brazil and now, China. Not only are they third but according to their health minister their numbers are doubling every year.

So what are the three most popular procedures?

1. Eyelid surgery to westernize their eyes.

2. Nasal surgery to elevate their nasal bridge

3. Procedures to narrow and elongate their jaws.

These patients are not elderly. Maybe 40% are in their 20’s. Medical tourism may soon flourish to the far East, if not already.

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Please Vote for Dr. Brueck as the Best of Southwest Florida

In this special blog message by Fort Myers Plastic Surgeon, Dr. Robert J. Brueck MD, we ask for your vote in the current Best of Southwest Florida ballot.

If you are a subscriber to the Fort Myers News-Press, you should have received an insert in Sunday's edition, including a ballot to vote for your choice of the “Best” of Southwest Florida.

Among the categories of particular interest to me are those for Best Cosmetic Surgeon, Best Eyelid Surgeon and Best Facial Cosmetic Surgeon. I encourage you to write in my name and check your vote for me, Dr. Robert Brueck MD, in one or all three of those categories.

(You also can vote online at

You can vote anytime until noon, Monday, June 20, but only once and only one vote per category.

You will find one candidate's name pre-printed in each of these categories. Each is a qualified surgeon. They have been listed because they purchased an ad in the special “Best of” section in the newspaper.

Of course, I only want you to write in my name if you honestly believe my 30-plus years of practice as a plaastic surgeon, and my Board Certification by the American Board of Plastic Surgery, qualify me for this distinction.

In any case, I thank you for your consideration.

By the way, you also can rate me at the following physician rating web sites., and If you are so inclined to recommend my practice, I will greatly appreciate it.

PS: You also can "like" my fan page on Facebook. Just enter my name in the FaceBook search window.

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Bariatric Surgery Nutritonal Side Effedts

This is the place where Dr. Robert Brueck MD blogs about issues of health from his perspective as a plastic surgeon in Fort Myers, FL

I think everyone can agree we have a “Big” - no pun intended - weight problem in our country today.

In my practice, I am seeing more and more patients who have lost 100-150 pounds or more. I congratulate them all for taking control of their liver and losing all that weight.

A recent study done at Emory University at their School of Public Health found that 12% of 155 patients they were following post-bypass had severe copper deficiency. Copper is an essential trace mineral necessary for normal body functioning. Severe deficiencies, if uncorrected, can lead to irreversible paralysis.

An important lesson to be learned is that after massive weight loss one must be diligent at all times.

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Friday, June 10, 2011


Another blog message from Dr. R. J. Brueck MD, Board Certified Fort Myers Plastic Surgeon, who comments here on matters of health and aging.

In his never ending quest to find the fountain of youth, his goal, his failure, his journey has caused us to continue to this day. Through modern science, however, we are now closer than ever to understanding the aging process. It probably won’t be reversed or changed by jumping in to some magical pool, but it may be as simple as taking a pill or an injection.

Recently, a group of scientist at the Dina Farber Cancer institute at Howard were studying how to slow the aging process. Their work was being conducted with mice. Much of the aging process centers around damage to our DNA molecules. They are the building blocks of our body. DNA is a long complicated molecule or substance and damage to the ends of the DNA molecules causes aging. The ends of these DNA molecules are called telomeres. When shortened they all either die or become old. Oh, there’s that word “old” or maybe we should say the cell has matured.

These scientists studied the effects of an enzyme – telomere which can affect functioning of the telomere. The mice in this experiment were genetically manipulated so they LACKED telomere and the result was they simply aged – their bodies broke down. These genetically altered mice were then injected with telomere and you guessed it they began to heal and regenerate.

In humans it is a little different because we have a “switch” in our bodies that turns this enzyme off so cells don’t grow out of control.

The results are interesting and encouraging; someday we may have telomerase in a bottle. Never aging? Over populated? It may raise more questions than answers.

Wednesday, June 1, 2011


Dr. Robert Brueck, who is a board certified Fort Myers plastic surgeon, blogs here periodically on subjects of skin health, plastic surgery and related health matters.

In my 65 years, I think I have pretty much seen it all. Then, along comes something to shatter that myth.

It seems we live in an age where people of all ages - teens, adolescents, young adults, seniors, you name it, have tried a variety of drugs, agents and substances to get high, look better, feel more energy. The list is limitless.

But now, to add to this list, is a disturbing report out of the Philippines where people are injecting themselves to have whiter skin. What will they think of next?

People in the Philippines are injecting themselves intravenously with glutathione. This substance is produced in our liver and helps in antioxidant defense and metabolism. If large quantities are injected people can develop the deadly Stevens Johnson syndrome, Thyroid malfunction, skin necrosis and even kidney failure all because they want to lighten their skin.

I can only pause and wonder in my solitary moment of bewilderment….why?

So foolish, so unnecessary.