6418 Normandy Lane Suite 210 Madison, WI 53719
PHONE (608) 271-0500 Fax (608) 271-0502
HOURS: 9:00am - 4:00pm Mon - Thurs
9:00am - 11:30am Friday
After moving from New York to Los Angeles in 2010 to take a job with a financial services firm, Joan, now 59, believed she needed to freshen her look. So she got a face-lift and tummy tuck from a board-certified doctor in Beverly Hills.
What she did not realize was that his certification was in otolaryngology — ear, nose and throat — not plastic surgery. The outcome was less than ideal: thick scars on her temples and a wavy abdomen.
“I had to use all my savings to get a real plastic surgeon to fix what he did to me,” said Joan, who asked that her last name be withheld to protect her privacy. “I have an M.B.A. I’m not stupid. But when the doctor has a nice clinic and all those diplomas and certifications on the wall, you think he knows what he’s doing.”
With declining insurance reimbursements, more doctors, regardless of specialty, are expanding their practices to include lucrative cosmetic procedures paid for out of pocket by patients. It’s now common to find gynecologists offering breast augmentation, ophthalmologists doing liposuction, even family practice physicians giving Botox injections.
The result, according to certified plastic surgeons, is an increasing number of dissatisfied, even disfigured, patients.
“The public needs to be protected from doctors who are not upfront about what board certifications they have,” said Dr. Malcolm Z. Roth, chief of plastic surgery at the Albany Medical Center in Albany and president of the American Society of Plastic Surgeons.
Members of the society claim there has been a surge in patients requesting revisionary surgery — operations to undo damage caused by botched procedures. “I’m seeing cases like this on a weekly basis now, when a few years ago I hardly saw any,” said Dr. Patti Flint, a plastic surgeon in Mesa, Ariz.
But many of these new alternate practitioners say that traditional plastic surgeons are simply trying to protect their lucrative trade. “For a certain group to wage a turf battle and say for financial reasons that they are the only ones who can safely perform cosmetic procedures is hypocritical and grossly untrue,” said Dr. Angelo Cuzalina, the president of the rival American Academy of Cosmetic Surgery, composed primarily of doctors who are not board-certified plastic surgeons.
About 80 percent of licensed doctors get a specialty certification by one of 24 boards approved by the American Board of Medical Specialties. This requires a minimum three-year residency in the chosen area of concentration, plus extensive oral and written exams.
There are no laws in the United States that require doctors to practice only within the specialty fields in which they were trained. Dr. Cuzalina, for example, was first board-certified as an oral and maxillofacial surgeon and then completed a yearlong fellowship at a cosmetic surgery clinic.
“With my experience, I don’t think of myself as an oral surgeon anymore,” he said.
Only Texas, California, Louisiana and Florida mandate that doctors be specific in their advertising about which specialty board certifications they have. Elsewhere they may say just that they are “board-certified.”
No one knows how many doctors are practicing outside their specialty; they don’t have to report to any oversight authority that they are doing so. And doctors performing cosmetic procedures are not required to report complications.
Still, the unregulated nature of cosmetic surgery is raising concern. Michael Freedland, a medical malpractice lawyer in Weston, Fla., said that since 2008 he had seen a steady rise in the number of patients incapacitated or even fatally injured by cosmetic surgery performed by unqualified doctors.
“Not only are the doctors not properly trained in plastic surgery, but they are also operating in facilities, like tanning salons and med spas, that are not equipped to handle a medical emergency,” he said. “The best they can do for you if things go wrong is call 911, and sometimes they don’t even do that.”
State medical authorities don’t tally deaths or injuries by the type of doctor involved. In any event, many plastic surgery patients are, like Joan, too embarrassed to file formal complaints.
“A doctor may be good and well trained in his or her specialty, but it takes more than a weekend seminar to achieve mastery in plastic surgery,” said Dr. Joel Aronowitz, a plastic surgeon in Los Angeles who is also a clinical assistant professor at the University of Southern California.
He noted that aspiring cosmetic surgeons may attend weekend continuing medical education courses, some held aboard cruise ships, in which they are taught to perform Botox and filler injections, liposuction and breast augmentation. The courses are often taught by physicians who themselves are not certified by the American Board of Plastic Surgery, he said.
Many such physicians claim certification by boards that have names similar to the American Board of Plastic Surgery but are not endorsed by the American Board of Medical Specialties. “They have lower requirements and are not as rigorous,” Dr. Aronowitz said. “There’s a reason they are not recognized boards.”
Dr. Cuzalina said that lobbying by plastic surgeons prevented groups like his from joining the medical specialties board.
Dr. John Santa, an internist and director of Consumer Reports’ Health Ratings Center, which rates hospitals and gives advice on choosing doctors, advised that prospective patients check state medical boards for any disciplinary actions, and also to see whether a doctor has full operating, privileges at a given hospital.
“Above all, I think common sense is in order,” he said. “I would be suspicious of anyone who is operating way outside his or her specialty area, and always get a second opinion.
“When there’s no insurance involved,” he added, “it’s really the Wild West and there’s no sheriff in town.”
nytimes.com
(Madison, Wis.) — For Rachel*, it began when she turned 40. Almost overnight, she noticed small but distinct changes in her body. A few more wrinkles, a little sagging, a slight neck crease. The progression was slow but sure. Though not entirely welcome, she was comfortable at first. It wasn’t until her 50th birthday that she looked in the mirror and suddenly felt as if she was seeing a stranger.
"I felt so young and vibrant, it was literally the best time of my life thus far, and yet when I passed a mirror and saw myself it was deflating," she shared. "I’m not a vain person and quite honestly I always said I wouldn't have any surgical procedures. But that was naïve. It wasn’t about vanity for me, but about feeling good about myself. I wanted the outside to match the inside."
Rachel sought out Madison-based board-certified plastic and reconstructive surgeon Dr. Thomas Bartell to discuss her options. Together they carefully evaluated the possibilities. For Dr. Bartell, the consultation phase is critical. During consultation, he educates patients about various procedures and the type of results that can be expected. For women in their 50s and 60s, common procedures include abdominoplasty, breast lifts, and arm lifts. In the end, Rachel chose an abdominoplasty and breast lift.
The process is different for everyone, says Dr. Bartell. "Everyone ages differently and everyone feels differently about the process. My job is to help our patients find the best solution for their lives. It's really about restoring or improving confidence levels."
Rachel is a perfect example. Her experience mirrors that of many of Dr. Bartell's patients. While cosmetic procedures and surgical interventions are not necessary or even optimal for every individual, for some it is transforming. "This experience has truly impacted my life and the way I see myself. I feel like the old me. I feel free. I am ready to face anything."
For more information about cosmetic surgery and how to find a qualified surgeon, visit the American Society of Plastic Surgeons (ASPS) web site at www.plasticsurgery.org.
Thomas Bartell, MD, is a board certified plastic and reconstructive surgeon practicing in Madison, Wis. To schedule a consultation or learn more about Dr. Bartell, visit www.drbartell.com or phone (608) 271-0500.
* Composite experience. Names have been changed to protect patient confidentiality.
(Madison, Wis.) — Welcoming a new baby into the family is often one of the happiest times of a woman’s life. Whether the firstborn or a welcome addition to a growing family, motherhood promises a lifetime of new experiences and much joy.
What many moms do not expect, however, are the associated post-pregnancy body changes. Even with preparation, it may come as a surprise. Breasts commonly lose some of their elasticity during pregnancy and can appear "deflated" following breastfeeding. Tummies are not as tight as they used to be. And sleepless nights can accelerate the natural aging process, perhaps leading to uneven weight gain.
Given these dramatic changes, it's no surprise that some women begin to wonder what happened to the body they knew and loved. "Post-pregnancy, many women report feeling they don’t recognize their bodies," says Dr. Thomas Bartell, a board-certified plastic and reconstructive surgeon practicing in Madison, Wis. "The good news is that there are so many options to recapture that pre-pregnancy body. Today's procedures as less invasive and more effective than ever before."
A specialist in below-the-neck cosmetic procedures, Dr. Bartell says the most common post-pregnancy procedures include breast lifts and augmentations, tummy tucks and liposuction.
A breast lift, or mastopexy, removes excess skin and tightens tissues to raise and firm the breasts. To complement the lift, some new moms opt for a simultaneous breast augmentation to restore volume that has been lost following breastfeeding. Dr. Bartell specializes in scarless augmentations, an option no more complex than a traditional augmentation but often vastly preferred to traditional surgical methods.
"The primary difference between scarless and traditional breast augmentation is the incision site. With scarless breast augmentation, we make a tiny incision in the armpit rather than a larger incision underneath the breasts or in the nipple or naval areas. The procedure and recovery periods are similar, but this technique avoids any scarring on the breasts themselves, which is a big plus for many patients."
For more information about post-pregnancy cosmetic surgery and how to find a qualified surgeon, visit the American Society of Plastic Surgeons (ASPS) web site at www.plasticsurgery.org.
Thomas Bartell, MD, is a board certified plastic and reconstructive surgeon practicing in Madison, Wis. To learn more about Dr. Bartell or schedule a personal consultation, visit www.drbartell.com or phone (608) 271-0500.
Though labiplasty is growing in popularity, many women are unaware of this routine plastic surgery
(Madison, Wis.)—A generation ago, it was unusual for a woman to be able to compare her genital area with other women. Unlike many men, the majority of women simply don't walk around the locker room naked. Today, however, thanks to the proliferation of websites showcasing various anatomical images and the increasing popularity of Brazilian waxes, the variety of shapes and sizes that make up a woman's genital area have been exposed. This has caused some women to become self-conscience about their appearance.
The majority of women desiring a change in the appearance of their genitalia object to the size and projection of their labia. The labia minora are the small inner flaps of tissue that cover the clitoris and vagina, and these may be elongated or enlarged as a result of sexual activity, childbirth, genetics, or the aging process. The labia majora may also be enlarged. The labia majora are the larger fleshy parts on the outside of the body.
Thomas Bartell, MD, a board certified plastic and reconstructive surgeon practicing in Madison, Wis., is one of only a handful of surgeons in the area performing this procedure. "I've had patients come to me in tears, fearful of undressing in front of anyone and sometimes unsure of how to talk about the issue,” said Dr. Bartell. “I reassure them that there’s nothing at all to be embarrassed about. As with any procedure, our goal is to improve confidence and quality of life. Whether it be a breast augmentation or reduction, a tummy tuck or a labiaplasty, the end goal is the same."
Having enlargement of the labia can cause more than mental discomfort as well, explained Dr. Bartell. "Enlargement of the labia may cause pain during intercourse, exercise, or even while wearing tight clothing," he said. Prominent labia may also be visible in some bathing suits.
Labiaplasty is a minor surgical procedure that can reduce the size and projection of the labia by trimming and reshaping the vaginal inner lips (labia minora), outer lips (labia majora), or both. The surgery is not designed to enhance sexual pleasure or satisfaction, but rather to alleviate any painful symptoms, boost confidence, and help improve quality of life.
Because labiaplasty is relatively new, selecting an experienced plastic surgeon is critical. Be certain to see out a "board certified" professional to ensure the best outcome and maximum safety.
For more information about labiplasty surgery and how to find a qualified surgeon, visit the ASPS web site at www.plasticsurgery.org.
(Madison, Wis.) — At some point in their lives, many women are unhappy with the size and appearance of their breasts. In fact, breast augmentation is the most popular cosmetic plastic surgery in the United States—nearly 290,000 procedures were performed in 2009 according to the American Society of Plastic Surgeons (ASPS).
Even though it's a common procedure, it's important for women to research the available surgical options and interview plastic surgeons to achieve the results they desire, said Thomas Bartell, MD, a board-certified plastic and reconstructive surgeon practicing in Madison. Dr. Bartell specializes in below-the-neck cosmetic body surgery.
"Unfortunately, many women don’t know about the option of scarless breast augmentation,” Dr. Bartell said. “Surgically, it’s no more complicated than other procedures and the recovery period is the same. But the difference in how women feel about the results of their surgery can be significant."
Dr. Bartell performs breast augmentations through a tiny incision in the armpit. The technique is called a transaxillary incision. Most area surgeons perform augmentations through incisions under the breast, nipple or in the naval area, which leave scarring on the chest wall.
"I’m the only surgeon in the area who performs a breast augmentation without leaving any scars on the breasts themselves," he said. "I do the procedure through a small incision in the armpits and the scar literally vanishes within six months. I’ve been doing this procedure for nearly 20 years now and my patients are thrilled with the results."
In addition, Dr. Bartell uses saline implants, which require a smaller incision than silicone implants while achieving the same effect. Typically, the surgery enlarges the breast by one or more cup sizes while preserving a very natural look.
For more information about breast augmentation surgery and how to find a qualified surgeon, visit the ASPS web site at www.plasticsurgery.org.