What are the new "Gummy Bear" breast implants?

Gummy Bear Breast Implants are made of "cohesive gel". This semi-solid gel implant feels softer and more natural than saline breast implants and, unlike saline implants, they will not wrinkle. The Cohesive Gel Gummy Bear Implants also differ from saline or standard silicone implants, which leak when the implant shell is ruptured. Cutting into a Cohesive Gel Implant is a little like cutting into a Gummy Bear.

Silimed is the third largest implant producer in the world and their implants are used in over fifty countries. The Cohesive Gel Gummy Bear Implant has been used widely in Europe since 1995 and throughout Canada since 2000.

Fifteen surgeons have been approved to place these implants in patients throughout the United States. The Gummy Bear Implants feel like a natural breast. They do not have the water balloon feel of saline breast implants. For more information on these implants, you can call 310-827-2653 or log onto www.gummybearimplants.com.

W. Grant Stevens, M.D.
Diplomate, American Board of Plastic Surgery
Member, South Bay Independent Physicians Medical Group, Inc.

Is there any other non-surgical alternatives to heel surgery?

I have been suffering with a painful heel spur on my foot for the last year and a half. I have been to several doctors and they have given me several cortisone injections, night braces to wear to stretch my tendons, custom foot orthotics, and a lot of physical therapy with stretching, however, I still have pain. My last doctor recommended heel surgery, but I am afraid. Are there any other non-surgical alternatives available?

Heel pain is a very common complaint seen in our office. It is most commonly caused by an inflammation of the larger ligament that attaches to the heel bone on the sole of the foot called the plantar fascia. Whether or not there is a "bone spur" or "heel spur" seen on an x-ray is usually not a large factor in the resolution of this common condition. Over 90 % of patients respond to treatments that have been tried.

In the past, patients with persistent cases of plantar heel pain or plantar fascitis that did not respond to the usual conservative treatments were taken to surgery. Several different surgeries have been available, but all are not without potential complications such as infection, nerve damage, and prolonged recovery.

Now there is an alternative method of treating the painful heel condition; it is called "Extracorporal Shock Wave Therapy (ESWT)." This is similar to the lithotripsy procedures done by urologists to break up kidney stones. It is a non-invasive treatment (no incisions or cutting of any kind) and can even be done in the office. The treatment uses high-energy sound waves to break up the inflammation of the plantar fascia at its attachment to the heel bone. This treatment was approved by the FDA in the last three years, and is very effective in treating these resistant causes of plantar fascitis. The success rate with this treatment is very high. Most patients can return to work the very next day and resume all their pre-treatment activities within a few short weeks. There is no lengthy recovery like with conventional surgery

Marc G. Mittleman, D.P.M.
Diplomate, American Board of Podiatric Surgery
Fellow, American College of Foot and Ankle Surgery
Member, South Bay Independent Physicians Medical Group, Inc.

Each area of the world has different infectious diseases that are common. Some of these diseases are preventable by vaccination or by taking medication. Vaccination may take two to three weeks to be effective, sometimes requiring repeat vaccination.
Medications also need be taken prior to leaving for the area to get an effective level in your blood. Therefore, see your doctor 2-3 months prior to travel if possible.
He will need a detailed itinerary including exact parts of the country that you are visiting. One should make sure that you have enough of your usual medications to last through your travel and return to your doctor.
Some of the advice and vaccination needs can be obtained from the visa office of the country of travel or your travel agent. On the web, you can look up travel at CDC. ORG.

Aqdas Kuraishi, MD

Who is a good candidate for cosmetic eyelid surgery?

As people age, excess fat and wrinkles can accumulate in the upper eyelids that can make them look constantly tired or sad. Ageing lower eyelids can acquire bags and loose skin as well. Eyelid surgery removes the puffy bags under the eyes and the wrinkled folds of skin overlapping the eyelashes on the upper lids. The incisions follow the natural contour lines in the upper and lower lids.

Some patients may have lower eyelid fat removed without any external incisions by placing the incision inside the lower eyelid. The resulting incisions are closed with stitches and the lines fade and blend into natural skin creases. Patients can expect some swelling that may persist for a week or longer. The overall result is that the patient's appearance is brighter, more alert and rested.

Ronald F. Rosso, M.D.
Member, South Bay Independent Physicians Medical Group, Inc.

The single most reliable screening test to assess for either overactive or underactive thyroid function is a blood test called TSH (thyroid stimulating hormone). It measures the regulation of the thyroid hormone production by the pituitary gland. There are also other additional blood tests used. It is very important to have the appropriate tests correctly interpreted by the physician. Measuring body temperature is a very inadequate way to diagnose an underactive thyroid condition.

John M. Tsao, M.D.
Diplomate, American Board of Endocrinology and Metabolism
Member, South Bay Independent Physicians Medical Group, Inc.
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