Thursday, September 29, 2016

Restoring Facial Volume: Fat Grafting vs. Fillers


For many years, facial rejuvenation was limited to skin resurfacing with lasers and peels, 
and various surgical soft tissue repositioning procedures. However, our options have 
expanded with the understanding of muscle relaxation via neurotoxins such as Botox,
 and the evolution of our knowledge of how fat atrophy in the face leads to stereotypical 
architectural changes with aging. Plastic surgeons can now add volume to refresh the face. 

In order to achieve a youthful but natural appearance for my patients, I use a combination 
of muscle balancing, skin resurfacing and tightening, as well as volume restoration.

 Ultimately, when the battle of gravity versus skin plays out over time, 
surgical repositioning is required.



Restoring Facial Volume: Fat Grafting vs. Fillers

Wednesday, September 28, 2016

Misinformation fuels opposition to health-care reform in Canada

The reality is that for-profit provision of health-care services is commonplace among industrialized countries with universal health care


By Bacchus Barua
and Jason Clemens
The Fraser Institute
VANCOUVER, B.C. / Troy Media/ - For almost two decades, fear of a U.S.-style system has fuelled opposition to genuine reform of Canadian health care. Many of those same opposition voices are now protesting the constitutional challenge to Canada's health regulations by the former head of the Canadian Medical Association, Dr. Brian Day.
In reality, our health-care system is expensive, delivers poor-to-modest results, and fails to achieve many of its laudable aspirations. The solution to fixing and maintaining our universal health-care system is to recognize the successful approaches used in other universal-health care countries, such as the use of for-profit companies to deliver health-care services.
The Dr. Day case, which will likely end up in the Supreme Court of Canada, focuses on two aspects of British Columbia's health regulations: (1) prohibition against doctors working in both the public and private health-care systems, and (2) the disallowance of purchasing private insurance for core medical services.
Legal arguments aside, the context of the case is worth noting. Canada is one of the highest spenders, on both a per person basis and as a share of the economy, on health care among industrialized countries that provide universal health coverage. Yet Canadians endure some of the longest wait times for medically necessary procedures. For example, in 2015 Canadians waited 18.3 weeks between referral by a GP and actual treatment. Canadian patients also suffer from comparatively poor access to doctors and medical technologies such as MRIs.
But if the voices of opposition at the Dr. Day trial are to be believed, there's an incompatibility between medical care delivered by private, for-profit companies and universal health care.
The reality, however, doesn't match this rhetoric. A recent study looked at for-profit insurers and hospitals in six industrialized countries (Australia, France, Germany, the Netherlands, Sweden and Switzerland) that all maintain universal health care.
For-profit hospitals are found in all six countries. In Germany, France and Switzerland, for instance, universally accessible hospital care is delivered by both non-profit and for-profit hospitals. In Australia and Sweden, governments contract with for-profit hospitals for universally accessible services.
For-profit health insurers are also found in all six countries. Notably, for-profit companies compete to offer the primary health-care insurance in the Netherlands, offer a private substitute for public health-care insurance in Germany, and offer a private option alongside the public system for patients in Australia and Sweden.
Remember, all six of these countries maintain universal health care.
But Canadians need not look beyond our own borders to see the benefits of private, for-profit provision of health services. Saskatchewan's Surgical Initiative (SSI) was introduced in 2010 with the express goal of reducing what were the country's longest wait times for medical treatment.
Under the SSI, select day surgeries were contracted out to private, for-profit clinics. A recent study by the former NDP finance minister of Saskatchewan, Prof. Janice MacKinnon, provided evidence that on average, private clinics delivered procedures at 26 per cent lower costs than public-sector equivalents. For example, in 2012, Regina Surgical Centres Inc. provided cataract surgeries at $618 per procedure compared to $1,273 in public hospitals in the Regina Qu'Appelle regional health authority.
The results in Saskatchewan have been stunning. The province has gone from having some of the longest wait times, on average, for medical treatment to having the shortest. The government's own wait time data indicates a decline of 75 per cent in the number of patients waiting three months or longer for surgery.
The reality is that for-profit provision of health-care services is commonplace among industrialized countries with universal health care. Canada is actually the oddity in limiting - and in some cases, actually prohibiting - such activities. Hopefully the Dr. Day case, if nothing else, will bring these important reform lessons to light for Canadians.
Bacchus Barua and Jason Clemens are economists at the Fraser Institute.
© 2016 Distributed by Troy Media

HEALTH

Monday, September 12, 2016

Parabens Are Worse Than Previously Thought

A study from the National Food Institute at the Technical University of Denmark discovered that butylparaben, commonly used in cosmetics and skincare products to stop bacterial growth, has more adverse effects on the reproductive system than previously believed. Researchers observed endocrine disrupting effects on the development of the reproductive system in rats that were exposed to butylparaben prenatally. They observed reduced sperm quality as well as changes in the prostate, testicles, ovaries, and breast development. "Overall, our results suggest that butylparaben has more negative effects on reproductive health than previously thought," says Julie Boberg, senior researcher from the National Food Institute.
In male rats, researchers observed changes in the prostate as well as the testicle’s ability to produce hormones. Sperm count was significantly reduced in all doses of the substance male rats were exposed to. In female rats, they observed a decrease in ovary weight and an increase in mammary gland outgrowth. The study shows, however, that some effects were only observed at high doses of the substance. It is also important to note that humans are not exposed to paraben doses as high as the rats were in the study. "We need more knowledge about what it means for humans to be exposed to parabens from skin lotions and cosmetics for example,” says Boberg. “It is especially important to take account of cocktail effects because people are exposed to many types of endocrine disruptors at the same time over the course of a normal day.”—Isabela Palmieri