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ASPS Releases List of “Five Things Physicians and Patients Should Question”

Ava Lawson | June 30, 2014 | Posted in Breast Augmentation

Best Plastic Surgeons in NYCSince 2012, the American Society of Plastic Surgeons (ASPS) has supported the Choosing Wisely Campaign — a program that encourages healthy doctor-patient discussions on the perceived advantages of common procedures and diagnostic tests.  Earlier this month, the ASPS released a list of “Five Things Physicians and Patients Should Question” to help facilitate these conversations and help patients elect healthcare treatments that are actually necessary, free of harm, supported by evidence-based guidelines, and aren’t repetitive of other tests or procedures.

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The Choosing Wisely initiative has garnered the support of 60 specialty societies, including the ASPS, the American Academy of Dermatology, the American Academy of Nursing, and others to help U.S. patients make better-informed decisions about suitable medical care given their specific health needs and situation.

Assembled by the ASPS’s Health Policy, Patient Safety, and Quality and Performance Measurement Committees, the following five guidelines may help patients ensure that their medical goals are met.

5 things doctors and their patients should question

  1. Routine mammograms before cosmetic surgery on the breasts

The ASPS recommends that: “Mammograms should be ordered based on existing clinical practice guideline recommendations, for patients undergoing breast surgery, including non-complicated breast augmentation, mastopexy, and breast reduction.” Women are encouraged to have their first mammogram at age 40 and regular tests thereafter depending on family history and other risk factors. The ASPS concludes that there are no indications for patients who are opting for elective breast augmentation or reduction to have additional screening unless there are known risk factors.

  1. Avoid using drains in breast reduction surgery

Studies have revealed that the placement of drains following breast reduction mammaplasty is unnecessary as it has little effect on post-op complications and may only add to patient discomfort. “Although wound drains can minimize the amount of fluid at the surgical site, there is no evidence to support the use of drains… In patients that have liposuction as an adjunctive technique to the breast reduction, the decision to use drains is left to the surgeon’s discretion.”

  1. Mammograms following a mastectomy

The ASPS advises: “Evidence indicates that clinical examination is sufficient to detect local cancer recurrence in patients undergoing breast reconstruction after complete mastectomy. Current clinical practice guidelines recommend regular clinical exams for detection of breast cancer, and imaging studies are not recommended as a part of routine surveillance.”  However, patients who have only had mastectomy on one breast, or have undergone a lumpectomy or partial breast reconstruction are still encouraged to have regular mammography.

  1. X-Rays following facial trauma

Plain X-rays may expose patients to excessive amounts of radiation and are not as sensitive as maxillofacial Computed Tomography (CT), which is typically available in most trauma clinics. The ASPS recommends that CT scans are the preferable method for diagnosing fractures in cases of suspected facial trauma.

  1. Prophylactic antibiotics more than 24 hours after surgery

The prevalence of antibiotic-resistant bacteria has shown the dangers of prolonged ingestion of prescription antibiotics. To prevent surgical site infection, antibiotic prophylaxis within 24 hours or less is generally sufficient, says the ASPS – as research indicates there are few benefits of extended use, which may also lead to other adverse side effects like Clostridium difficile colitis.

Choosing among the best plastic surgeons in NYC

These suggestions may prove invaluable for patients who are contemplating plastic surgery in New York, as they may hopefully provoke more open communication between patients and their physicians.

For more information about specific cosmetic surgery procedures, we invite you to contact the offices of Dr. Thomas Loeb – widely considered among the best plastic surgeons in NYC. Call 347-706-1073 to arrange a private consultation today.

+ Resources
- Resources
  1. Medscape, 5 Things Plastic Surgeons Shouldn’t Do 
  2. ASPS, ASPS Participates in the ABIM Foundation’s Choosing Wisely Campaign,
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