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Archive for October, 2009

Ask Our Expert: Brown Spots: Are they sun damage or just age spots?

Friday, October 23rd, 2009

Ask Our Expert: Brown Spots:

 Q: Roxanne, I have brown spots on my face, arms and chest.  How do I know if they are caused from sun damage or if they are just age spots?

A: Lentigos, or lentigines are commonly referred to as brown spots, sun spots, liver spots or age spots.  They appear as flat, brown blotchiness (in various shades of brown) that appear on skin that has been over exposed to the sun. These spots can appear on the face, arms, shoulders, neck, chest, hands; anywhere the skin has been over-exposed. Typically, the lighter the skin and the more sun exposure one has, the greater accumulation or chance of accumulation of these spots you have.

Melanocytes, which are cells that produce pigment in the skin are activated to produce more pigment (melanin) when you are exposed to ultraviolet rays. Because the symptoms of excessive sun damage are cumulative, these spots increase with age, hense the term “age spots.” They are more common in lighter skin types (Fitzpatrick 1-3), such as those who freckle and who burn easily. If you have had enough lifetime sun exposure to develop brown spots, this may place you at a higher risk for skin cancers.

Sun spots are not themselves cancerous.  However, you may be at a higher risk for skin cancer if you have them.

I recommend applying a physical sunblock (such as TiSilc 60) 365 days per year to all skin that will be exposed.  Not only is this your best defense for future sun damage but over time you may find that the brown spots that you have appear lighter. There are also other treatments that will help to rid your skin of brown spots. CO 2 Micro-fractional Laser Resurfacing is typically an excellent option.  A series of Intense Pulse Light (IPL) treatments can also deliver very good  results.  https://www.cosmeticplasticsurgery.com/cosmetic-surgery/laser-skin-rejuvenation.cfm  Some chemical peels https://www.cosmeticplasticsurgery.com/cosmetic-surgery/skin-resurfacing.cfm can improve spots to some degree as well as prescription skin bleaching nano medications such as Epi Quinn Micro.

Roxanne, Cosmetic Plastic Surgery Clinic

Roxanne Hammond, RMA
Skincare and Laser Specialist
G. D. Castillo, M.D.
COSMETIC PLASTIC SURGERY
Become a Facebook Fan of CPS @  http://www.facebook.com/pages/Cosmetic-Plastic-Surgery/65943304419
https://www.cosmeticplasticsurgery.com
800-252-7123 (within IL)
217-359-7508 Savoy (Champaign-Urbana)
309-662-0436 Bloomington

Insurance Coverage – Is It A Possibility?

Wednesday, October 14th, 2009

Q:  Will my insurance cover this procedure?

A: While many procedures performed by G.D. Castillo, M.D. at Cosmetic Plastic Surgery Clinnic are solely cosmetic in nature, there are a number of procedures that may qualify for insurance coverage. For example, rhinoplasty or a “crooked nose deformity” may qualify for insurance coverage if it is performed to repair a deviated septum that is causing a blockage in the nasal passage for the patient.  Another procedure that may qualify is breast reduction if the patient is experiencing symptoms caused by the weight of the breasts, like back, neck or breast pain, difficulty with exercise, or interference with work duties. Upper blepharoplasty (eyelid surgery) may qualify for benefits if drooping skin is obscuring a patient’s vision.

The most important question for insurance companies is medical necessity – is there a medical reason for having this procedure, or is it solely being performed for aesthetic reasons?

Regardless of policy terminology, the insurance company Utilization Review Department’s determination of benefits will both begin and end on this basic question as defined by their own criteria.

Medical necessity often begins with proof that conservative medical treatment has been tried prior to a surgical recommendation and has not alleviated the problem.  With so many over-the-counter options available to the consumer today, many people are not reporting their symptoms and the frequency of their symptoms to their physician.  This lack of documentation can delay insurance eligibility since the background information as to conservative treatment is not documented within the patient record.  This is just one reason why it is important that patients communicate with their physician as to frequency of symptoms and response to the recommended treatment, including any over-the-counter remedies that the patient may be using.

As one example, a woman with large pendulous breasts may ask for a prescription or referral from her physician to have a bra constructed to help support the weight of her breasts to help alleviate her discomfort.  She should report any rashes or break down of her skin that may be caused by the size of her breasts as well as reporting the results of remedies she is utilizing, regardless if she is using a prescription medication or an over-the-counter product.  She should report any back or neck discomfort and be checked for postural difficulties and shoulder strapping (grooves or indentations in the shoulders caused by the weight of the breasts supported by bra straps).

If you believe that you have a condition that would be helped by a procedure that may qualify as medically necessary, you can call your insurance company’s benefit department and ask them to inform you of the coverage available in your specific policy, and further, to send you, in writing, their exact criteria for determining medical necessity for that procedure.  I’ve seen cases over the last 14 years where a few months of well-documented, failed conservative treatment has made the difference in obtaining insurance benefits for permanent surgical relief.

A consultation with Dr. Castillo at Cosmetic Plastic Surgery may be all that’s necessary to determine if insurance reimbursement is a possibility.  These consultations are available in both our Savoy and Bloomington, Illinois offices.

It’s well worth the effort!

Gynecomastia – Large Breasts in Males

Friday, October 2nd, 2009

When males of any age develop large breasts, it can be very damaging to their self-esteem. Though large male breasts are actually quite common, often the result is social isolation. This creates a distressing and debilitating body image that most males try to camouflage with tight upper garments and very loose clothing.

Many of our male patients who suffer from excessive breast tissue, express their inability to really enjoy life. They are embarrassed to take their shirt off.  It constricts their willingness to be social and participate in sports. They are unable to enjoy vacations at the beach and most summer related activities.  Most importantly, it changes their ability to interact within key relationships in their lives.  Many males find it difficult to feel masculine during intimate moments with their partner. They find that it even inhibits the way they interact or play with their children.

Male breasts are the result of increased volume of both fat and glandular breast tissue.  At Cosmetic Plastic Surgery, our patients learn that male breast tissue is indeed an occurrence in 100% of males. However, this tissue is vestigial, that is, it is present in very small amounts in most males  For reasons associated with genetics, diet, and environmental factors, the amount of both fat and breast tissue can increase in the breast area of males of all ages (aging men, young men, children alike…).

At Cosmetic Plastic Surgery, the treatment for this problem is both effective and simple.  Very often patients ask me, “Dr. Castillo, can this problem be solved with liposuction?”  The answer is a definitive no. The treatment is two-fold.  It involves the removal of fatty tissue from the pectoral area through liposuction with very small cannulas. We do this using traditional tumescent liposuction techniques and ultrasonic-assisted liposuction.

Then we create a small, invisible incision in the nipple- areolar region. This incision is utilized as a window. With special, delicate instruments, we use this window to remove a significant portion of breast tissue which in most individuals is not accessible for removal through liposuction, because it is very thick, fibrous, glandular tissue.  It is removed by dissection with special instruments that create no injury to the surrounding tissues.  The entire procedure takes two hours, and cleanly and effectively removes all of the offending breast and fatty tissue from the area.

A fitted garment is used and worn underneath normal clothing for the first week after surgery. Very small sutures are removed within six days after the procedure.The patient is allowed to do routine light physical activities within three days after the procedure.  This procedure, known as excision of male Gynecomastia will help to resolve the lack of self-confidence that can occur after years of teasing and scrutiny. It will reveal a more masculine male contour of the chest. It has been universally successful and there is a remarkable lack of problems associated with it. The changes in self-esteem and positive personality reinforcement are seen immediately.  It has been a most satisfying way of correcting a rather disturbing problem for our patients.

If you would like further information on this subject, call our office to schedule a consultation. During consultation, we can discuss your desires and concerns. You will be able to view before and after photos of other patients who have undergone this procedure.  We will answers any questions you may have and give you the information needed to help you decide if this procedure is right for you.

Click on this link to view male breast reduction photos : https://www.cosmeticplasticsurgery.com/photo-gallery/details.cfm?ID=29&StartRow=1

Click this link to learn more about Dr. Castillo and liposuction :  https://www.cosmeticplasticsurgery.com/cosmetic-surgery/liposuction.cfm

Dr. G.D. Castillo, Triple-Board Certified Cosmetic Surgeon

G. D. Castillo, M.D., FASC
Director of COSMETIC PLASTIC SURGERY
Become a Facebook Fan of CPS @  http://www.facebook.com/pages/Cosmetic-Plastic-Surgery/65943304419
https://www.cosmeticplasticsurgery.com
800-252-7123 (within IL)
217-359-7508 Savoy (Champaign-Urbana)
309-662-0436 Bloomington