What’s Your Wrinkle®, the plastic surgery show with Dr. Arthur Perry

How gummy bear implants and galaflex make complex breast augmentations simpler

August 11, 2018 Arthur Perry MD Season 13
What’s Your Wrinkle®, the plastic surgery show with Dr. Arthur Perry
How gummy bear implants and galaflex make complex breast augmentations simpler
Show Notes Transcript
Breast augmentations are the most common cosmetic surgical procedure. The new gummy bear (form stable) implants have revolutionized these operations. But sometimes implants droop below the breast crease and sometimes they drift over to the side of the chest wall. These reoperative cases can be very difficult. But with the textured form stable implant and the new galaflex mesh, these can be readily handled. Tonight we discussed this, as well as the choice of implant and why MRIs are important after surgery.
Speaker 1:

You know what we need, we need a radio show on the air like maybe on Saturday nights to talks about this kind of thing. Dr Hoffman here, want to let listeners know, but a brilliant renaissance man named Dr Arthur Perry art, their very best plastic surgery. He's a distinguished award winning cosmetic surgeon, traded Harvard and Cornell with a practice in New York City on Fifth Avenue. Are you there? And numerous other activity. He's written numerous medical journal articles and case contributed to textbooks on plastic surgery knowledge, but also you're great at delivering content, which is why it's been a blessing to have you on my show. It's clear that when it comes to skin and aging, this doctor knows what he's talking about. John, the public wants to know I can give it to a surgeon, which is what people come to you. They don't come for an opinion and that's why I trust you with my friends and relatives. When I was a resident at the University of Chicago, we had. I didn't realize we were going to get the Michael Jordan of plastic surgeon nine. Oh, two one. Oh, bows to this guy and welcomed

Speaker 2:

is Dr Arthur Perry. This is. What's your wrinkle right here on WABC? I hope you're all having a great weekend. I am, and it's kind of a muggy summer, isn't it? It's probably the most humid summer I remember, but that's okay. At least it's not cold and it's not snowing, so, uh, I appreciate that. All right. This is the show about you, the show about what you look like about what you look like in the mirror and to you and to other people. This is the show about wrinkles and about, about splotchy pigmentation and about gels and about large noses and protruding ears and small breasts and droopy breasts and things like that. This is the plastic surgery show. This is the skincare show. This is the sort of the dermatology show, although not quite, but this is the show about you. So give us a call. Eight hundred, eight, four, eight, nine, two, two, two, 800, eight, four, eight, wabc. Now, I do have to tell you that at the end of last show, literally the last 15 minutes, the board was flooded with phone calls. We were a little light in the beginning of the show and then it was just flooded. Everybody wanted to get their questions in and we could not get to most of those questions, so please call me early in the show. Don't wait till the end. It's an hour show. I wish it were two hours, but no, it's only an hour, so give me a call. Eight hundred, eight, four, eight, nine, two, two, two. And we're going to send you a bottle of nighttime. If you do come up with a question you can't call in. I get these every now and then. People call in and they'd just say, I don't have a question, but I'd like my nighttime. It doesn't work that way. You have to work for your nightthyme. You have to give me a good question. And a nighttime, what is it you say? Well, it's the one stop shopping for skincare. It's everything you need in a skincare program and nothing you don't need, so I don't have plant stem cells in there. Isn't that a ridiculous concept? Plant stem cells. I'll tell you why later in the show. I don't have hexapeptides in there. Another ridiculous concept. I don't have the things

Speaker 3:

that people put in their skincare that can't possibly do anything. I just have vitamin C, vitamin A, fruit acids and things like licorice extract. That's a good one. That's a skin brightener and milk thistle and Niacin. That's what's in my products- good things. I try and eliminate anything that looks, sounds or seems toxic and a lot of you may have seen the paraben story was in the news again this week because parabens are a carcinogen and there's a lot of rumblings that the FDA should get these off the market. Well, I don't have parabens. They're preservatives. I don't have parabens in my skincare. I never did. I never would. And I really try very hard to make my skincare as safe as possible. So a bottle of the nighttime is yours. If you give me a call this evening, and by the way, we do have a special this week. I know a lot of you asked for specials. All right, it's a buy one bottle of nighttime. Get One free. Buy One bottle, get one free. You have to use the good night code. freenight code. that's night, not you Millennials spelling it, nite. So good night. And you get one bottle of nighttime free. If you buy one bottle. And again, a lot of you have been asking, well, why? Why are you giving away nighttime? Why are they all these specials in just a few weeks? We've got a new packaging coming. I've been mentioning this for a couple months now, but you know, we, we ordered by the tens of thousands of these bottles and and we have to make room in our, not so enormous warehouse. It's reasonably big, but we have to make room for the new nightthyme. So, uh, the old stuff is perfectly good. It is absolutely pristine, but it's in our old packaging with the flowers. We've gotten rid of the flowers. Some of you didn't like the flowers. Some did, but you know, what can I say about half of you like it and half of you don't. All right. I'm Dr Arthur Perry. This is the show about you. So let's start talking about you tonight. We're going to talk about breast augmentations but a little bit different topic than we usually talk. We talk about kind of the standard augmentations. I did a very difficult one this weekend and you say, well, what's the difference between a difficult breast augmentation and an average breast augmentation? Well, we'll talk about that and why this particular augmentation was a little more difficult than usual. And and I used a very special substance with the breast augmentation this week and we'll talk about that. So if you have breast implants or if you want breast implants, this is the show for you. Or if your daughter is thinking of getting breast implants and you're wondering, are those things safe? Well, let's talk about that during the show. So you can give me a call, 808, four, eight, nine two, two, two. We're also going to talk a little bit more about eyelid surgery and and what is ptosis? PTOSIS is. I bet you don't know how to spell it. It's p, t o s i s the P is silent ptosis. So we'll talk about ptosis and I'll talk about eyelid surgery and brow surgery this week also. So we've got a lot to talk about during the show today. And, we'll talk a little bit about plexaderm.. A lot of you have been, have been asking me about Plexiderm. Well, I'm going to tell you about it. So during the show, give me a call. Eight hundred eight, four, eight, nine two, two, two. And did I tell you, we're also going to be talking about hand rejuvenation with the laser. Now this is something new, relatively new. I mean it's a few years old. It's not brand new, but it is really catching on now. And I've been doing the, uh, the lasers. I did my own hand with the laser and I'll talk to you about that. Uh, you know, I always joke with my nurse about, uh, operating on myself, you know, some Monday morning she'll come in and find me on the floor after I lasered myself and passed out, but hopefully not it, it's actually not bad. It did not hurt when I did it to myself and not to the patients at last week. All right. I'm Dr Arthur Perry. This is, what's your wrinkle? One? Eight hundred eight, four, eight wapc 808, four, eight, nine, two, two, two. So breast augmentations are one of the most popular procedures in all of plastic surgery and every year it's either breast augmentation or liposuction vying for that number one position in terms of the most popular surgical cosmetic procedure. Now of course, Botox and wrinkle fillers dwarf the surgical procedures literally maybe 10 times as many of those. Let's see. Let's do the math. There were six and a half million botox injections last year in the United States and a couple hundred thousand, I think it was around 300,000 breast augmentation, something like that. So it's a lot more. But those are the nonsurgical things. As far as surgical procedures go. It's breast augmentation and liposuction number one and two. Some years it's one, some years, it's the other one. Uh, but I've been doing breast augmentations since way back. Nineteen 85. I did my first one as a resident at the University of Chicago and the implants in 1985 were made of silicone otherwise known as Silicon- Silicone Gel. And we used implant that. Some of them were, were just a very loose silicone gel. Some were made of sailing but they weren't that popular in the 19 eighties. And what suddenly we'll of course there's silicone in it. It's like a water balloon. So there's saline is just salt water and the outside of the, uh, the balloon was made of silicone. So some people said, I don't want silicone in my body. They still got it because the outside was made of silicone. And then there were the polyurethane implants, some of you might remember those. And I hope not too many people have those in them. I never liked the polyurethane implants. Polyurethane is a type of a plastic and it degraded very rapidly. I remember re operating on someone six months after I put polyurethane implants in and almost all the polyurethane was gone already. Where does it go? Ah, I don't know. In your liver, who knows? Well, we don't use those in the United States anymore. Uh, so we just use the silicone implants. That's all. There is a different types of silicone implants. So 1962, I believe that was at first year that silicone breast implants were placed in women and I believe it was in Texas, where they were done. And boy, it really caught on, in the 19 fifties there were some very daring and not so bright plastic surgeons that actually injected silicone into breast. That was a real bad thing. And we're going to talk about that also later in the show. If we have time injection of silicone, not so good. So in breast augmentations that was done. But that went out in the late 1950s, early 19 sixties, and then those bags of silicone where we're placed, there were a lot of issues with the implants. we went through a lot of phases. There was a moratorium and the 19 nineties, for breast implants, some of you may remember that that era, we didn't have silicone gel at the time, we just had sailing implants, but the gel implants were placed back on the market several years ago and we've been placing silicone gel implants in. And the big thing, the big change was a few years ago when the gummy bear implants were FDA approved. So those gummy bear implants, they're also called form stable implants. They were a giant step forward in the safety and the effectiveness of silicone breast implants. So we're going to talk all about those gummy bear implants and some new things with the implants. But let's, let's go ahead and take your call John. What can I do for you? What is your wrinkle?

Speaker 4:

Yeah. Hi. Uh, my girlfriend wants to get breast implants and she's really thinking about, you know, going big. And she wants to know like what's the safest breast implants?

Speaker 2:

Okay, John. So you know, there are right now three, actually four different types of breast implants. So there are the saline implants which are a saltwater implants. They kind of feel like a water balloon. They don't feel too natural, very commonly you feel and see ripples and the implants. I'm not wild about the saline implants anymore. I put them in women who are afraid of having silicone in there, a silicone gel in their body. And there are some women that just don't want to be bothered with it. the small chance of a rupture of an implant scare some people. So we use a silicon gel now. There's still silly. They're still silicone. The Gel that's been around since 1962, it's very similar in the implants. I don't put those in anymore because now we have those gummy bear implants and the gummy bear implants are in my opinion much better. So John, hang on the line. We're going to take a short break. We'll be back in a few minutes and we'll talk a little bit more about breast implants. I'm Dr Arthur Perry.

Speaker 5:

Listen carefully if you're interested in beautiful skin. I'm plastic surgeon, Dr Arthur Perry. Good skincare really can improve your appearance. I know you've used many products over the years and haven't seen a difference. So you say, why should I try your products? Dr Perry. Here's why I combined scientifically proven ingredients into just a few products and that keeps skincare. Very simple. A study showed my products reduce the appearance of wrinkles over 20 percent by 12 weeks. Protect your skin in the morning with daytime, nourish your skin in the evening with nighttime and wash your face and even removed most makeup. With my nontoxic, clean time soap wibc listeners. For one month only, I'm offering my basic skincare kit at half price. You'll get all three products for$55 plus shipping. Go to Dr[inaudible] Dot Com. That's D, R, p e r r y s.com. Or give us a call at eight, four, four. Dr Perry. Use the WBC 50 code for the discount to learn more or less in every Saturday evening. Six PM right here on w ABC. Ladies, are you seeing an older person in the mirror? You love your mother, but you might not want to look like her. She was older and you're not. I'm plastic surgeon, Dr Arthur Perry and I've spent three decades perfecting techniques to help you look younger. If you have sagging eyelids, wrinkles, jazz bands in the neck or splotchy skin, I can help some people just need a change in their skincare, but for others, Botox, wrinkle fillers, all therapy or the new insta lift might be just what you need and for the most dramatic rejuvenation I performed, short scar face lifts. Let's spend an hour together and my Fifth Avenue or Somerset New Jersey offices. I'll examined you and will alter your photographs to show you what you could look like after surgery. Schedule a consultation by calling two. One, two seven, five three slash 18 slash 20. That's two. One, two, seven, five, three slash 18 slash 20 on the web. It's Perry plastic surgery.com. That's Perry plastic surgery.com. And don't forget to listen to me. Dr Arthur Perry every

Speaker 2:

Saturday at 6:00 PM right here on Wabc,

Speaker 7:

77. You're listening to Dr. Arthur Perry

Speaker 2:

and what is your wrinkle? I'm Dr Mary, the board certified plastic surgeon. Host of What's your wrinkle right here on wapc? Eight hundred eight, four, eight, nine, two, two. Two is our phone number. We're talking with John and John asked the question, what's the best type of implant for his girlfriend threatened best type of breast implants. So there are different types of breast implants. We talked about the saline implants, which are good, you know, but they tend to show ripples tend to be a more palpable. That means we can kind of feel the ripples and realize that if someone has as very small breasts, then you know, you really feel that there's a, almost like a water balloon in there. So if someone has larger breasts and they want to go up maybe one or two cup sizes, then the saline implant is a more reasonable, reasonable idea because there's more breast tissue to hide the implant. But the most natural feeling implants are those new gummy bear implants. And, and the reason I really, really liked these implants, and I didn't think I would, I'll be honest with you, but the reason I do is because now they come in all different shapes. The old ones were just round implants and whatever the shape of your breast was, it was just a magnification. We just made your breast larger with implants, but now with these new implants we can shape your breast with the implants and what that means is if you have kind of a funny shaped breast, then you're more likely to get a good result with these new implants without having to make incisions on the breasts that are visible, like incisions around the areola, which is the pigmented area around the nipple, things like that. So the shaped implants, they come in different widths and different heights and different projections and really there's hundreds and hundreds of different sizes now as opposed to just a few sizes for the old implants. So the gummy bear implants are, in my opinion better if they do rupture. The silicon does not spread the same way. The old silicone spread, the old silicone, you know, it was a kind of an issue. I in many cases, if there was a rupture, I had to remove silicone from around the chest in the armpit and sometimes even down onto the belly, believe it or not, for ruptures that with these, these gummy bear implants, that doesn't happen because the material doesn't go. It doesn't travel. And the reason they call them gummy bear, by the way, if you've ever eaten those gummy bears, you cut into them or you try and chew them. And the gel material doesn't spread like a Goo, like the old stuff. So. So I really do like the gummy bear implants. There are some new implants out there. there's a new one with these, I talked about it a few months ago on the show. I haven't used it yet. They have these cells have saline inside the. Not sure about

Speaker 3:

that implant yet. I'm not sure whether I'm going to use it. but John, it's your girlfriend also talked about the size and I do want to caution people, the larger you go with breast implants, the more problems you are going to have. She's going to have over time. And I know that a lot of people think, well, you know what, let's get our money's worth, let's just go huge, you know, and it just doesn't work that way because you might look good in the beginning. but the larger her breasts are, the faster they are going to droop. That's one. The more stretch marks you can get, the more misshapen they can get over time. So, so I do caution women and I like people to be kind of an average size. And what is an average size? It's a big beast. Small C, I do get concerned when people go too large. If, you know, if a woman really wants to be a D Cup, I will advise them that that might not be the best thing, but of course I will do that within reason. But if you want to be enormous, enormous model, you have to find a different plastic surgeon. I will not make women enormous. Like you hear about these, these celebrities and these people that think it's a contest, how big they can make their breasts. You know, it's not about that really, breast implants are, are a wonderful tool to make women feel normal, just normal, flat chested woman who lacks self esteem can fit in proper clothing and feel better about herself with, with implants. So John, that's my recommendation for you and for her. I'm very happy to help you. Thank you for calling. I'm Dr Arthur Perry. This is what's wrinkle right here on wABC. So, well we'll get to your question in just a minute. Albert, I want to talk a little bit more about these breast implants. So that gummy bear implants are really a very, very nice implant. I didn't mention that there are smooth implants and there are textured implants and that's the surface now most implants placed in the United States are smooth or about 75 to 80 percent of implants are smooth, but the problem with smooth implants is that they do have the potential to move in the pocket and what's the pocket? That's where I placed the implants. We lift up the skin and we lift up the breast tissue and in most cases now we placed the implant beneath the muscle and that's the pectoralis muscle. So there's a pocket and just like a pocket in your clothing. If the, uh, if uh, there's a smooth, let's say a water balloon in your pocket, it could kind of move around in your pocket, but if that water balloon has velcro on the surface, it's going to stay exactly where you put it in your pocket. Right? I mean, it's the same sort of thing with these new implants that are textured. They're just like velcro. When I put those in the pocket, it's really very difficult to move them around even in the operating room. So why don't we just do that and everybody. Well, you know, for many, many years we do. We did a, there are now some cases, and I'm sorry to say this, of Lymphomas, which are a type of cancer. There's about 75 now reported in the world and we're talking about millions and millions and millions of women that have breast implants. But almost all of those are associated with textured implants and then they occur about a decade after implantation. Now they're very, very rare. the FDA not advising plastic surgeons and oncologists are not advising women to have their implants taken out if they have textured implants. Yes, we're still putting textured implants in a, but it's just something that has to be discussed., so, a benign form of lymphoma and, you know, what does that mean? What's a benign form? Well, it's the type that's treatable just by removing the implant and the capsule, which is the scar tissue around the implant. So it's got to come up in the discussion when we talk to you about, about breast implants and it's one of the things that we talk about as well as what type of implant, what the location that we put it in, what's the incision, all sorts of things. A breast augmentation consult is one of the longest consultations that I do. It really takes over an hour to do a consultation properly because there are so many issues with these implants. And, uh, uh, after our next call I'm going to talk to you about placement of the implant and how they can move. But let's, let's go ahead and call out what can I do for you? What is your wrinkle

Speaker 8:

are?

Speaker 3:

Thank you sir. What can I do for you?

Speaker 8:

I'm 42 years old. The past 10 years I've been noticing more and more my mouth lines or laugh lines. They've been getting more and more noticeable.

Speaker 3:

Okay. Now let me ask you something. Are these the lines around your lips or are they the folds that connect between the corner of the nose and the corner of the mouth? Right? So those are called nasal labial folds. We've got a name for everything in plastic surgery and that's a lot more common. The reason I asked is in a man that's much more common than to get those, uh, those lines of like spokes around the wheel, the lines that occur around women's mouths, even in smokers, in men, they tend to not get too many of those wrinkle lines, but those folds that you're talking about are very common in men and women. So what do we do? the most common thing, Al is we call it wrinkle filler, but it's a, it's just a filling material and there are different types when we fill those folds, the way to look at the full, by the way out, it's sort of like the Grand Canyon. Have you, have you been to the Grand Canyon?

Speaker 8:

I've never been there.

Speaker 3:

Uh, it's, it's one of the most beautiful places on earth. But when you go to the Grand Canyon, you looked down and way down in the bottom is the Colorado river. Now the way I look at the nose, the nasal labial fold, you have the Colorado River way on bottom, and that's the fine wrinkle and most men don't get that. But you get the, you get the, uh, the Grand Canyon, and that's the nasal labial fold. So we treat the fine rankl and the deep fold differently. Now we treat the, the deep fold with a wrinkle filler called either radius, radius r I, D, I e, s, s e, that's made of calcium hydroxylapatite, big words. But that's the building block of bone. It's a such a great job filling the nasal labial fold as does something like restylane lyft or wrestling defined. There are different types of materials, but, but the one thing that we really need for that fold is something that is fairly thick, so we can't use the fine fillers that we use for the little lines around the lips and women or, the under eye or in the lips. We can't use those for the nasal labial fold, but that's the preferred treatment. Now there's two other things, uh, that possibly can be done for the nasal labial fold. That's always the first step out. But if you have really deep folds, then one of the things we do is called an incisionless wire release. That's a lot of words, but, and that's a very uncommon procedure, but it's a good procedure for people who have really deep nasal labial folds. And what it is, is we take, some of you may get a little squeamish when I described this procedure, but we take a wire with needle, a needle on the end of it and I put it underneath the skin. And then out of the skin and back in encircling the nasal labial folds set that the wire is now completely under the skin. A little hard to envision. But if you go to my website, I talk about this, it's Perry plastic surgery.com. We go underneath and then we saw through, Oh wow, boy, now everybody's getting squeamish. We saw through the, uh, underlying tissue from the nasal labial fold and we free it up and we destroy the connections between the nasal labial fold and the tissue underneath. And then we fill it with one of those pillars that is a very aggressive way to treat the fault, usually not necessary, not necessary. And I, I've done it probably a dozen times in my career, uh, as opposed to thousands and thousands of times that I've filled the folds, with a wrinkle filler. There's also one other thing that is very occasionally done and that's actually exercising the folds, cutting them out. And, and the only reason I mentioned this is some men, particularly men in their forties who have really deep faults. That might be the answer. So there's a few different approaches, but always the first one is to get some filler because that is the simplest. You go in, get numbed up, have filler placed in less than an hour. You go out and you're at work the next day. All right. Okay. Thanks so much for calling. What's your wrinkle on Dr Arthur Perry? This is the only show in the United States that talks about things. The incisionless wire

Speaker 5:

release. I promise you. All right, we're going to have another half hour of the show. Stay tuned. Eight hundred eight, four, eight, nine, two, two, two. We'll be back after these words. Listen carefully if you're interested in beautiful skin. I'm plastic surgeon, Dr Arthur Perry. Good skincare really can improve your appearance. I know you've used many products over the years and haven't seen a difference. So you say, why should I try your products? Dr Perry. Here's why I combined scientifically proven ingredients into just a few products and that keeps skincare. Very simple. Study showed my products reduce the appearance of wrinkles over 20 percent by 12 weeks. Protect your skin in the morning with daytime, nourish your skin in the evening with nighttime and wash your face and even removed most makeup. With my nontoxic, clean time soap webc listeners. For one month only, I'm offering my basic skincare kid at half price. You'll get all three products for$55 plus shipping. Go to DrPerrys.com. That's D, R, p e R, r y s.com. Or give us a call at eight four, four. Dr Perry. Use the WABC50 code for the discount to learn more or less. Listen every Saturday evening, 6:00 PM right here on wABC

Speaker 2:

And what is your wrinkle? I'm Dr Arthur board certified plastic surgeon. Host of this show for 13 years on Saturday evenings. If you've got nothing to do, this is even if you do have something to do, you really have to make room for the show. If you're interested in what you look like, if you're interested in cosmetic surgery, if you're interested in improvement of yourself in many ways. We talk about all sorts of things on this show and tonight we're going to mention plexiderm. A lot of you have seen the commercials on TV. They're really incredible. There's some of the best commercials I've ever seen. My good friend John Greenhut and we did nightskin together. Remember that great product that I did. Now we have nighttime, but and that John is not part of that one, but he's got plexiderm. This is a great product and I'm very happy that I'm able to talk about it on the radio. Now here's the story with Plexiderm serum. It's not skincare, so it's not going to. If you put it on every single night for a year, it's not going to make a difference. It's not vitamin A. Vitamin C, things that I have in my skincare, it's more like a cosmetic, but it is really a space. Age, cosmetic. This is something that you put on your skin. You can put it on under your eyes. You can put it on your cheeks, on your forehead, and in minutes your wrinkles disappear. And how does it do? It's real. How does it do it? Well, because there's these. He calls it a clay, like substance chemically, I believe it's a silicone, you know, kind of like those breast implants, but it goes on, not really goes on your skin and as it cures, as it dries,

Speaker 3:

your wrinkles go away. It is so cool. You've seen the commercials. It's real, you know, when it first came out, I said, John sent me some for my wife. I've got to look at this stuff and I put it on my wife and sure enough, just like the commercials, it really does work. Plexiderm really cool, but what happens is if you wash it off your wrinkles that come back right away, you know, I call those the Cinderella products. Remember what happened to cinderella. You know the middle of the night, you know, but that's what happens. But that's okay because if you're going to an important meeting or if you're going on television, if you want to look good for a date, something like that, you want to cover those wrinkles. Plexiderm is the product for you. And you might say, well, Dr Perry did I hear you talking about about these wrinkle products, these instant wrinkle products that are dangerous, not this one. There are two different classes of these wrinkle products. Plexiderm is one and that is safe. That's fine. The other ones are the sweaters that caused your lips to swell. They've got these caustic chemicals like capsaicin and other things, and they caused you to swell just like those little Katharine Hepburn movies. Rapper, she would, you know, slap her face too to get rid of the wrinkles that was the inflammation, the swelling that got rid of wrinkles, that's not good for you. In fact, that can actually cause a condition called a blepharochalasia which is a repeated swelling of the eyelids. It goes up and down and up and down. You wind up getting more skin, not so with Plexiderm is a temporary approach for wrinkles. And it is really very interesting. John likes my show, so thank you John. He listens and he's given me an 800 number for you to call and get 50 percent off.

:

Eight hundred. You ready for this? Write this down. Eight hundred, nine, two, five, nine, nine, six, three. So that's 800, nine, two, five, nine, nine, six, three. You get up to 50 percent off the normal retail price. Tell them you heard me, you know you heard about it on the doctor Perry, what's your wrinkles show? That's 800, nine, two, five, nine, nine, six, three, four, plex derm. You will love it and give me a call when you use your flex at Durham and we'll talk about it on the radio. All right. I'm Dr Arthur Perry. This is. What's your wrinkle right here on wipc. How He, what can I do for you? What's your wrinkle? Did I lose you, Howie?

Speaker 4:

Hello? Hello? Hi. Can you hear me? I'm in. Howie, go ahead. What can I do for you? Um, my question to you is, what do you recommend for spider veins at them? Pretty bad on my thigh. And uh, any doctor I've spoken to says it's purely an aesthetic issue with not really a medical problem. I don't know if you agree with that or not. But what, what do you have to say about it?

Speaker 3:

Well, certainly I advise getting it looked at by a vascular surgeon if they protrude from the legs. So if they don't protrude from the legs and if they don't then

Speaker 2:

they're not varicose vein. So you have to make that distinction, whether they're Varicoceles varicose veins, which are medical issue as opposed to spider veins, which are a cosmetic issue. Once we establish that their cosmetic, then the treatment is one of two things. It is either injection with a and, and that takes a lot of skill on the doctor's part. Injecting with a, I prefer the 23 percent salt water solution. So your body's made a point nine percent salt water. So if we go 23, 25 times as high, what we actually do is fry the inside of those blood vessels and uh, and it works. We get rid of a lot of those, depends on the size of the blood vessel, a butt injection, it's called Sclerotherapy. Works fine on the legs. And another way to do it is with the laser. And there are lasers. I use a Yag laser. The laser can be used. There's advantages to both techniques. I think that the sclerotherapy is more effective if you have a lot of these things. Uh, but the laser also does work if you have just a few, or if you have just kind of a blush appearance of the skin where there aren't a discreet blood vessels, then the laser works very well. Now on the face, by the way, I know you're talking about your legs, but if we do the face, we always use the laser. We never inject the, the capital areas, that's what they're called in the face or the[inaudible], the little tiny veins of the face. We always use the laser and it's called a Yag laser y a g. and it works very well. Again, it'll get rid of about two thirds of the, uh, of the capillaries of the spider veins. And in fact, both techniques, it's about two thirds a gone. We'd like it to be 100 percent, but it doesn't work that way because your body just thinks I've injured you. It doesn't know we're doing this for fun. And it tries to channel through and reestablish those little capillaries again. So your body's going to fixing itself. And it kind of defeats some of the cosmetic benefit that we do. So usually when you have a treatment, whether it's sclerotherapy with injection or whether it's the laser, it takes a number of sessions to achieve your goal and that really depends on how meticulous you are. Some people say, you know what, you got rid of the, uh, the big ones. That's it. We're good enough with one session and some people do three sessions, some for some five, something like that. Okay. How are you?

Speaker 4:

Well, yeah, these techniques they did on the area that you do then, do they, do they last, you know, permanently or quite a while? There's one technique last tend to last longer than the other, or how does that work?

Speaker 2:

Well, it depends. It depends on what's causing the spider veins. So if you're someone that stands all day and your legs, yeah, you know what I personally recommend the best thing that, that you can do. And, and I'll tell you, women who are pregnant or if your daughters are pregnant, I can't understand why obstetricians don't tell women to use the compression stockings. And there's a new generation of compression stockings. There's a company, Brooklyn now, they're not sponsors of mind. They should be, they're called Mojo Moj. Oh, they make the best and least expensive compression stockings. And you feel so good when you were. I've been wearing compression stockings since I was a medical student. I've actually had a couple of vein strippings, you know, for varicose veins in my legs. So I wear these things all the time. Uh, and this new generation with this one company, there are about a third, the price of the big companies out there. So they should really, don't you think they should advertise that much? I think so, but anyway, they got their free ads. So, you know, that's a good thing to do because that will prevent, prevents a bad word that will stall the development, the redevelopment of the capillaries of the spider veins and varicose veins and whether you use them up to the knee or up to the thighs or in women, they have pantyhose, ones that go all the way up, uh, that's what you should use in pregnancy. Um, you know, they're, they're very good. So, uh, the causes of these spider veins, they're, they're less likely in men than women. They are somewhat hormonally mediated. and certainly during pregnancy, uh, they're, they're very, very likely a because of the, you're not you, but the fetus sitting on on those big veins inside the pelvis, they tend to cause swelling of the legs and spider veins. And that's why women who are pregnant should be wearing these, uh, these compression stockings. They're also good at decreasing the swelling that you get if you fly a lot, uh, because, you know, in the aeronautical medicine, it's well known that a lot of people get swollen legs when they fly and if you use compression is, and you need at least 20 millimeters of mercury by the way. So you look at these things, if you go to the drugstore, you might see ones that are just these little white stockings, they don't do anything. You have to get up and you can get them without, without a prescription. Now, uh, and they're called compression stockings and you start at 20 millimeters of mercury and work your way up. Alright. So, so that's, that's what I would suggest, and if you do that, if you wear the stockings, then they're less likely to recur. But the other thing that I mentioned right from the beginning was you have to make sure that you don't have a component of varicose veins because if the varicose vein is not fixed or the faulty valve by a vascular surgeon like my good friend Neale cane over at Nyu, uh, if you, uh, if you let him fix that, then they shouldn't recur the same way. If the valve is bad or if you have varicose veins that you don't even know, they could be deep, a little deep and you might not realize that. Then if you, uh, if you treat the spider veins, uh, and you don't treat the varicosity, they're going to return. So you have to be careful. All right, great. Thanks for the information, Dr. you're very welcome. Thanks for calling. I'm Dr Arthur Perry. This is what's your wrinkle right here on wABC and we got more calls on the board, but we're going to have to take a short break and just a few seconds. So, I got an email during the break during that last while I was talking and said, give the number for Plexiderm. DRAMATICA must've been John Green hot asking me to do that. 800, nine, two, five, nine, nine, six, three, 800. Nine, two, five, nine, nine, six. Three. That's the 50 percent offer for a arm. Okay. So actually that was a lane that sent that email. I had Dr. Arthur Perry. We'll be back after these words. Eight hundred eight, four, eight, nine years

Speaker 12:

too, too, too late.

Speaker 5:

Are you seeing an older person in the mirror? You love your mother, but you might not want to look like her. She was older and you're not. I'm plastic surgeon, Dr Arthur Perry, and I've spent three decades perfecting techniques to help you look younger. If you have sagging eyelids, wrinkles, jazz bands in the neck or splotchy skin, I can help. Some people just need a change in their skincare, but for others, Botox, wrinkle fillers, all thera or the new insta lift might be just what you need and for the most dramatic rejuvenation I performed, short scar face lifts. Let's spend an hour together and my fifth avenue or Somerset, New Jersey offices. I'll examine you and will alter your photographs to show you what you could look like after surgery. Schedule a consultation by calling two. One, two, seven, five, three slash 18 slash 20. That's two. One, two, seven, five, three, 18, 20. On the web it's Perry plastic surgery.com. That's Perry plastic surgery.com. And don't forget to listen to me. Dr. Arthur Perry every Saturday at 6:00 PM right here on w B, c,

Speaker 6:

do you remember me? Sure. You and your husband were moving to another home. You told me to wave my arm like I was scattering seed. I remember everything disappeared. Yes, it did. Just like that. Just like that. This is where we moved to. It's beautiful. Please look at all the junk they left behind or what you would like to disappear. Ma'Am, you don't want me to wave my arm again? Only if you want everything to disappear. All I have to do is point. All you have to do is point. Well, let's start with that broken bird baths. That'll swing set and that nasty. All Yard furniture, we work until midnight, seven days a week. All you have to do is point and broken trailer call. One 800 got junk or visit one 800. Got Junk Dot com.

Speaker 12:

ABC. Listening

Speaker 5:

carefully. If you're interested in beautiful skin. I'm plastic surgeon, Dr Arthur Perry. Good skincare really can improve your appearance. I know you've used many products over the years and haven't seen a difference, so you say, why should I try your products? Dr Perry. Here's why I combined scientifically proven ingredients into just a few products and that keeps skincare. Very simple. Study showed my products reduce the appearance of wrinkles over 20 percent by 12 weeks. Protect your skin in the morning with daytime, nourish your skin in the evening with nighttime and wash your face and even removed most makeup. With my nontoxic, clean time webc

Speaker 2:

listeners, for one month only, I'm offering my basic skincare kid at half price. You'll get all three products for$55 plus shipping. Go to Dr[inaudible] Dot Com. That's D, r p e r r y s.com. Or give us a call at eight, four, four. Dr Perry. Use the WBC 50 code for the discount to learn more. Listen, every Saturday evening, 6:00 PM right here on w ABC

Speaker 7:

77.

Speaker 2:

And we're back. This is Dr Barry. This is. What's your wrinkle right here on web. And the phone number here at ABC is 808 four eight, nine two, two, two. And you know, you get all these emails during the show. I really, I suppose I shouldn't be looking at my email during the show, but I do. And uh, Lisa said she went on the website to get the discount and the good night code isn't working. Well Lisa, that's because I gave you the wrong code. It's free night. Sorry. Isn't that terrible? I gave the wrong code for the buy one get one free night time at the beginning of the show. It's free night F r e e n I g h t free night is the code. That's what gets you the free bottle of nighttime. Not good night. That was a few weeks ago. So it's free nights. Sorry about that. So those of you who did that well, you'll have to go back to the website and if you did put your auto order through and uh, and didn't get the free the free product, just give our office a call on Monday morning. And uh, Pam, my nurse will be happy to honor that code. The free night code. All right. So, uh, we were talking about breast implants tonight. Oh, well before we get back to that, I do need to tell you there was a, uh, a very interesting study about crime in America that was released just a few days ago. And do you know what the number 77 town in the entire United States, out of fat, tens of thousands of towns for crime rate was the lowest crime rate. That is highland falls. I'm like an ambassador for highland falls. Now you know, that's the town, uh, that uh, bobby fallon has the property. Remember I've been talking about this for for a few weeks. Highland falls has one of the, it's in the top 100 safest towns in the United States. Surprise me. I mean, I, I grew up there. There was no crime to speak of, but when they compare it to every single town in every state in the United States and it comes out number 77, that's pretty good. So Bobby Fallon, kerasal homes. She is the realtor. She's got that property is still one slash 73 main street. She tells me she's got to sell that. She wants to sell this by the end of the summer one 73 main street. I think it's like 379,000, something like that. And there's two bedrooms. There's a one bedroom, there's two different apartments. There's an office, it's point eight acres. It's less than a mile from westpoint. It's incredible. What a, if you look at at studios in Manhattan, while you look in the upper west side, you can't even get a studio for under 6,000, 600,000,$700,000. Here. You can have your whole, your own property and your business escape from New York. You know, I love New York City, but I do have to say that the garbage is building up in the streets. It's changed in the last few years. You know, we've gotta we've got to clean up in New York, but in the meantime, check out highland falls, the 77th safest city town in America. Give bobby a call. Eight, four, five, four, four, six, two, two, three, eight, eight, four, five, four, four, six, two, two, three, eight. That's Bobby Fallon asked her about one 73 main street. Marsha, what can I do for you? What's your wrinkle?

Speaker 1:

Hi, Dr Perry. I got a solo sailing implants in 1998 and I go every year for my mammography. And last time I went they had me sign a form releasing them of any responsibility if the implants should rupture during the process of mammography. And it made me a little concerned. So I was wondering what, what are the chances of that could happen with mammography?

Speaker 2:

Okay Marsha, you've got 20 year old saline implants and now and the statistics are at about, there's about a one percent failure rate for these implants up to year 10. So by the time you get to 10 years you have about a 10 percent chance of the implant rupturing. But then it goes up exponentially after that. So you know, a lot of women ask me and we're getting off topic and I'll get back on your mammo mammogram topic in a second. But a lot of women ask me should I take out my saline implants and replace them prophylactically? And the answer is absolutely no because you never know the, the new implants could rupture in six months. So you don't want to do that. If you've got saline implants, it's a different story if you have silicone gel implants because there we have the same issue of rupture as those implants get old and I do think it's a reasonable thing to change implants, a gel implants at 20 years and maybe even a little earlier than that. But as far as your mammograms are concerned, I have never heard of one rupturing with a, with a mammogram. In fact, I like to show women how durable these implants are and I kind of stomp on them either on the floor, on my desk when I show women these implants. However, I do have to tell you that about three or four years ago, one of those did rupture when it was a great demonstration that. And I was surprised because I didn't think it would happen because I've been doing it to these implants for years and years. But when did rupture. So that was a gel. Implants. So coming back to your question of mammograms, you know, they're covering themselves medical legally because there they are, uh, they are pushing on the implants but you don't have a choice. And if one ruptures, it ruptures a, I don't think it's particularly likely in a Mammogram, but let me tell you about something a little more important than that. If you have not been getting Mris, you should be. Have you ever gotten one of your breasts? No. Okay. So let me tell you a little bit about that. Marsha was probably the worst thing about breast implants that people don't like to talk about is that they hide the breast tissue when you're having a mammogram. And the studies have shown anywhere from three percent of the breast tissue to 60 percent of the breast. Breast tissue is blocked by the implant when you have a mammogram. So considering the fact that if you have a breast cancer in your breast, it is a. You will see that with a mammogram one to two years before you can feel it, and that's the great utility of a mammogram and you lose that if you have implants that block your breast tissue. So what do you do? You need to get Mris. And in fact, the FDA tells women now that if you have implants in, you should get Mris and their schedule is something like you get one three years after you have the implants in and then every two years after, I don't think that's proper. I think what they're looking for is rupture of the implant, silent rupture of the implants. But what I'm looking for is much more important and that is a breast cancer. And I do think that you should have Mris at least every other year. If you have breast implants in. The bad news is that your insurance company will not cover these unfortunately. And they do cost between one and$2,000. But the way I look at the breast augmentations and breast implants, Marsha is a very similar to a. If you drive a car, do you drive a car? Yes. Okay. So you have to buy auto insurance, right? Yes. You have to. And it's going to cost you a couple thousand dollars a year. Otherwise you can't drive. It's Sorta the same way with breast implants. If you put breast implants in, you have to say to yourself, I'm going to have the Mris and if insurance doesn't cover it, I'm going to have to pay for those myself because the Mri cs 100 percent of the breast tissue it sees right through the breast implant unlike the mammogram. So as that, for a really long answer to a very simple question.

Speaker 1:

Well, I appreciate the information. I do have one other question though. So usually recommend I get a sonogram at the same time because I tend to have cystic breasts. Is there a benefit to that or the Mri is going to show me things at the Sonogram is not.

Speaker 2:

Well they are, they're different and there are cases where the MRI is inconclusive and they get more information from an ultrasound or sonogram. They're synonyms by the way. Uh, so, so, and also there are some calcifications that are seen by a mammogram that can't be seen on an MRI. So usually we leave it to a good radiologist to decide whether or not, uh, you know, my advice is you get Mris and whether or not they think you should have sonograms and mammograms. In addition, we leave it to the radiologist and also, uh, your surgeon who has a place, the implants should be chiming in and your, because they all have knowledge of this particular knowledge about you, your breasts, and your history, your family history, it all comes into play. All right, Marsha, thank you very much. Okay, great. I'm Dr Arthur Perry. This is, what's your ankle right here on Webc star. What can I do for you? I'm sorry to keep you waiting. What's your wrinkle?

Speaker 6:

Hello? Did we lose star? Okay.

Speaker 2:

Okay. All right. Well, let's, uh, let's continue our topic. So I wanted to talk a. we're running out of time. I only have a few minutes left and I wanted to talk about this new thing called Galflex. So a lot of women have breast implants and what happens is over time breast implants tend to droop and you know, so that's not the best thing if you get drooping. Uh, last week I saw a woman whose breast implant drifted way over to the side, so instead of it being a, you know, on the side of your breast, it was almost underneath her arm. So what do you do in that situation? There's something new and uh, it's called Galflex, which was really very interesting. It's a mesh that we so in to contain the implant and keep the implants up along the, uh, if they droop long decrease and it can reduce or even eliminate the need in some cases for a mastopexy, which is a breast lift. Or in this case I was able to move the implant over so that a, it made a very complex operation into a much simpler opera, simpler operation with this new substance. It's Kinda like a material. It's almost, it almost looks like cotton material and it's called Galflex. There's a bunch of these different materials now. A plastic surgeons have been using these materials like stratos and uh, a cellular Jervis and things like that, Allah germ, but the new one is called Galflex and uh, it's a really nice way to handle a, a previously pretty complicated problem. And those of you who have had breast implants drift either down or to the side or sometimes even to the middle. This is a, uh, a nice approach, uh, in my ear. They tell me that stars back, but we only have, we've got like 30 seconds of star. I'm so sorry. I know we kept you waiting, but maybe you could call the beginning of the show next week. I apologize. Uh, we're here for a full hour call at the beginning of the show. Uh, but we are out of time. They're going to play the music and pull me right out of the studio. I want to thank Bruce for great engineering and Jennifer for all her hard work with a show. I'm Dr Arthur[inaudible] by the way, if you do wanna, learn more about me and about the plastic surgery, you can go to Perry plastic surgery.com. That's the website if you want to learn about the products, it's Dr[inaudible] dot com and of course the facebook page, facebook.com/Dr Arthur Perry. Thank you so much and don't forget

Speaker 13:

we have that free night is the coupon code. Buy One get one free for the nighttime. Thanks so much. We'll see everybody. Six o'clock next week. Bye Bye.