Siemionow and CNN chief medical correspondent Sanjay Gupta talked with CNN’s Larry King about the reconstructive procedure and the prognosis for the patient. The following is an edited transcript of the interview.

Larry King: Dr. Siemionow, what caused the patient to need a new face?

Dr. Maria Siemionow: The patient has a severe deformity of the face after trauma and was missing a nose and missing cheekbones and a large part of the skin and the front of the face, upper lip, lower eyelids. There was a large part of the skin and bone components which were missing, and practically the patient was missing the front of the face.

King: Did you have to find the perfect donor?

Siemionow: No. That’s not what were looking for. We were looking for a possibility of reconstructing this patient’s face in a way that it would replace the missing components and that we would be able, also, to give back this patient’s function, which is probably the most important idea behind this procedure.

Siemionow: Well, the transplant was the transfer of the transplanted face, which included (a) large amount — about 80 percent of the entire face of the patient. It included skin components, bone components, the entire nose, cheekbones, a palette and upper lip and also included the eyelids — the lower eyelids.

King: From another doctor’s standpoint, Dr. Gupta — and I know that you’re not a plastic surgeon, but a brain surgeon — what was the most amazing thing about this to you?

Sanjay Gupta: The face is one of the most complicated areas of the body. I mean, it’s responsible for your facial expression, your ability to eat, your ability to breathe, your ability to speak, obviously. Being able to take all those really, really functional areas that are made up of so many nerves, so many blood vessels — not to mention the cosmetic aspects of it — and making it all come together and work in some sort of functional form is pretty remarkable.

King: Doctor, has the patient seen her new face?

Siemionow: No, the patient has not seen her face, but she touched her face, and she was very happy. She, for the first time a few days ago, just went with her fingers over her face. She felt that she has a nose. She was feeling her lip, and she was very happy.

King: How long did it take (to do the surgery)?

Siemionow: It took 22 hours — 22 hours of many team members of different subspecialties working together, from one afternoon one day into the late afternoon the second day.

Gupta: It strikes me that you found the perfect recipient, someone who’s a good candidate for this operation. Four years, though, it took, Dr. Siemionow. Is that how rare this type of procedure will be?

Siemionow: Yes. Well, you know, we discussed it very extensively, that you want to be sure that in our approach we were looking only at potential candidates who would be a patient who had already exhausted all conventional means of reconstruction. I think it’s very important because you would like to be sure that the patient is not undergoing such a serious procedure without being helped in conventional means before.

However, it is very difficult to reconstruct certain parts of the face, including, for example, lips or including eyelids. Even reconstruction of the entire nose is difficult.

There are plastic surgeons who are doing wonderful reconstructive procedures, but they are also done in several attempts. This takes time and patients suffering and the results not always are presentable.

CNN.com

Citing published studies, the group said a red or itchy rash, known as “mobile phone dermatitis,” affects people who develop an allergic reaction to the nickel surface on mobile phones after spending long periods of time on the devices.

“It is worth doctors bearing this condition in mind if they see a patient with a rash on the cheek or ear that cannot otherwise be explained,” it said.

The British group said many doctors were unaware mobile phones could cause the condition.

Safety concerns over mobile phones have grown as more people rely on them for everyday communication, although the evidence to date has given the technology a clean bill of health when it comes to serious conditions like brain cancer.

“In mobile phone dermatitis, the rash would typically occur on the cheek or ear, depending on where the metal part of the phone comes into contact with the skin,” the group said in a statement.

“In theory it could even occur on the fingers if you spend a lot of time texting on metal menu buttons.”

Nickel is a metal found in products, ranging from mobile phones to jewelry to belt buckles and is one of the most common causes of allergic contact dermatitis, according to the Mayo Clinic in the United States.

Earlier this year Lionel Bercovitch of Brown University in Providence, Rhode Island and colleagues tested 22 popular handsets from eight different manufacturers and found nickel in 10 of the devices.

Doctors warn of skin rash from cell phones – Skin and beauty- msnbc.com

“I felt like I had another pair of breasts under my arms,” says Wilkinson, who’s 67 and lives in Covington, Va. “It made me feel not-human. I didn’t feel attractive with all that loose skin.”

Enter the bra-line back lift, a new procedure designed to eliminate those bumps and bulges caused by loose skin — sort of like a facelift for your back. Wilkinson was treated by Dr. Joseph Hunstad, a Charlotte, N.C., plastic surgeon who created the procedure and penned the small study that appears in the October issue of Plastic and Reconstructive Surgery.

“It completely eliminates the rolls and folds on the outside of the chest and the back,” says Hunstad. “Even women who are really fit can have a lot of skin laxity; they have a bulge above or below the bra. And that’s what this procedure corrects: It takes all that laxity and eliminates it.”

Not to be confused with lipo
This surgery doesn’t remove back fat; that’s still best eliminated by liposuction. The bra-line back lift is designed for patients with saggy skin caused by aging, sun exposure or massive weight loss, like in Wilkinson’s case.

“You know, you just think, ‘Oh if I can just lose the weight’ — well, that brings a lot more things to the surface, because there you are with all that stuff hanging off you,” Wilkinson says.

Hunstad so far has only treated women — 20 total, including the seven in the study. Aging and sun exposure doesn’t cause as much skin looseness in men as it does in women, so Hunstad expects the only reason a man would need this surgery is after losing a significant amount of weight.

But men wouldn’t benefit from one of Hunstad’s favorite parts of the procedure: The scar can be hidden under a bra or bathing suit. Before surgery, Hunstad instructs patients to wear the skimpiest swimsuit or bra they’d ever dare to wear, and he marks an outline to guide his incision.

During the one-hour surgery, he cuts across the woman’s back and removes her extra folds of skin — he’s taken as much as 10 inches of skin from a patient — and sutures the remaining tissue back together.

A trend in the making?
Since he started performing the procedure seven years ago, Hunstad has seen a slow but steady increase in women professing their disgust over back rolls.

“It’s funny — more and more women are starting to be bothered by this area,” Hunstad says, “and I think it’s ‘cause our clothing is more and more revealing — and all of a sudden they’re like, ‘Ew.’”

But at $7,500 to $10,000 a pop —  none of which is usually covered by insurance — and a scar that stretches across the back, this surgery isn’t for everyone, says Dr. Richard D’Amico, president of the American Society of Plastic Surgeons.

“There are lots of people who have back bra-line rolls of fat and a little bit of extra skin that can be very satisfactorily treated with just liposuction, with a scar that’s hidden in the armpit. So we want to be careful for who we prescribe this for,” says D’Amico, whose cosmetic surgery practice is based in Englewood, N.J. “The population that’s most likely to benefit from this is massive weight-loss patients.”

D’Amico sees the new technique as a “completion” procedure: After a tummy tuck, breast lift, thigh lift and arm tuck, then a patient might consider the bra-line back lift. “This is a piece in a bigger puzzle, and it’ll likely be the last procedure done,” D’Amico says.

After her tummy tuck and back lift, Wilkinson, for one, says she doesn’t plan to undergo any future plastic surgeries.

“I look like a normal person now, and feel that way,” Wilkinson says. “That was the motivation for getting this done — to feel like a normal person and not feel ashamed.”

Plastic surgeons are now reporting an increase in the number of male clients that are seeking a slimmer waist or stronger jaw line. The numbers have gone up by 16 percent from the year 2002 to 2007, according to the American Society of Plastic Surgery. You won’t find many men discussing this issue, but cosmetic surgeons are now reporting that their services are becoming more popular by the opposite sex in what has typically been a female-dominated market.

A weblog for Intactinfo stated, “Not just for women anymore, Beverly Hills Plastic Surgery is popular with self-conscious men as well! Many cosmetic surgeons are now performing surgery on both women and men. Of the most popular, Beverly Hills VASER liposuction is commonly performed on couples who come in together, seemingly for moral support. Men alone, usually get liposuction on their waist, abdomen, neck and chest, which is especially successful in getting rid of he ever-popular ‘man boobs.’” The website indicates that other common procedures among men are otoplasty (ear surgery), used to correct oversized or protruding ears; rhinoplasty, blepharoplasty (eyelid tuck and lift) and the Beverly Hills facelift or short scar facelift. The short scar facelift provides a younger, fresher face without the more severe and lengthy scarring and recovery time of the typical facelift.

The American Society of Plastic Surgeons reported that procedures involving plastic surgery maintained a steady climb in 2007, and cosmetic plastic surgery spending has increased from 9 percent to $12.4 billion dollars a year. Despite concerns such as inflation and the home lending/credit crisis, the average American continues to spend more money on plastic surgery. The latest procedural statistics report from the American Society of Plastic Surgeons (ASPS), approximately 12 million procedures involving cosmetic plastic surgery were performed in the year 2007. This was a 7 percent increase from the year 2006 and a 59 percent increase from the year 2000. There were also 5.1 million procedures that were performed last year that involved reconstructive plastic surgery.

The ASPS president, Richard A. D’Amico, said that report tells him that Americans are devoted to feeling and wanting to look their best. There is still a high demand that continues for less invasive and less expensive procedures, but here were also promising rebounds for some surgical procedures.

The top five surgical procedures that are being performed are nose reshaping (285,000), breast augmentation (348,000), liposuction (302,000), tummy tucks (148,000), and eyelid surgery (241,000). Cosmetic procedures that are minimally invasive climbed by 9 percent, to nearly 10 million procedures. Hyaluronic acid fillers such as Restaylane, Hylaform Plus, Hylaform, and JuvedermTM jumped with a hefty increase and demand from fifth most popular in the year 2006 to second most popular in the year 2007. The top five minimally invasive procedures were as follows: Hyaluronic acid filler (1.1 million), laser hair removal (906,000), Botox (4.6 million), chemical peel (1 million), and microdermabrasion (897,000).