Meet Dr. Robert J. Brueck MD FACS
3700 Central Ave. Fort MMyers, FL 33901
14 N. Del Prado Blvd. Cape Coral, FL 33909
23097 W. Olympia, Suite 301, Punta Gorda
Board Certified in Plastic Surgery
Caring & Understanding
30+ Years of Cosmetic Surgery Excellence I am intensely interested in all things relating to health, skin, weight management and beauty. From time to time, I discover news or facts about these subjects that don't necessarily fit anywhere else on this web site. I will post them here for you to read.
News and views about cosmetic plastic surgery and related subjects for the average person.
~~~~~~~~~~~~~~ Have you heard about "snail therapy"? Seems some Asian spas have determined that snail mucous is good for skin. So they place live snails on the patient's face and let the snails creep around leaving mucous behind on the skin. I don't think I will be doing that any time soon.
Big News For Punta Gorda:
I have opened a new consulting office in Punta Gorda. The address is Suite 301, 23097 W. Olympia.
For starters, I will be there for free patient consultations each Monday morning. As demand increases, I will expand hours into Monday afternoon. I am hopeful that I can make a diference in this area that has been underserved for plastic surgery until now.
NEW FILLERS JULY 4, 2013 - It seems every week brings a new laser or filler to market. The newest fillers are developed with the G prime factor in mind, which has to do with the hardness or firmness of the gel. The higher the G prime the more firm the gel. To augment cheeks or chin, you want a higher G prime filler. To fill in superficial wrinkles. you would want a filler with a lower G prime factor. Belotero Balance is a filler with a low G prime and is good for superficial injections. A new Juvederm filler called Juvederm Voluma is awaiting FDA approval and will be used to fill and volumize cheeks. A new line of fillers currently being studied is Emervel, which is a range of 5 fillers that are designed based on Optimal Balance Technology. The 5 products have variable degrees of cross linking and can be used for superficial or deep implantation.
~~~~~~~~~~~~~~~ I am excited and gratified to have been named a "most compassionate" doctor for 2012 by patients reviewing me on Patients' Choice. You are everything my practice is about and being included in the 3% of US doctors recognized makes me very happy. Thank you.
What's the diiference between Botox and facial fillers?
Troubled by deeplines on your face?
Do you wish you cold geta quick fixfor the signs of aging around your
mouth and eyes?
You may think Botox TM is your only option, but other injectable cosmetic s that plastic surgeons use can treat some lines on the face.
That's why it is important for individuals to understand the difference between injectables like Botox and facial fillers like Juvederm TM
According to the American Sociaety of Aesthetic Plastic Surgeons (ASAPS), Botox is a neuromuscular toxin, most widely recognized by this brand name. There are, however, other variations that have FDA approval such as Dysport (TM) and Xeomin (TM). The injectable medicine is used to treatactive "facial lines", meaningtnhose that have only recently formed. A board-certified plastic surgeon will inject the cosmetic into facial areas thare associated withthe formation of wrinkles. For example, the muscles you use to frown may be responsible for around the mouth, so a plastic surgeon can use Botox to artistically alter facial espressions. This won't result in a loss of the ability to show emotions on the face - the intension is to make subtle changes that will stop lines from forming while promoting a natural appearance.
What fillers do
Dermal fillers are used to trreat "firmly established wrinkles," reports ASAPS. There are many variaitons of soft tissue fillers available. Ask yoiu rboard-certified cosmetic surgeon for a recommendation. In addition, to treating deep wrinkles, these cosmetics can alter the appearance of soft tissue - for example, they may be injected into the lips to make one's pout appear fuller.
Making the choice
A plastic surgeon is the best person to help you decide between these two types of skin treatments. Often patients think of Botox as a "fix-all." A lot of them don't know. "This is a a problem. Can you put some Botox there?" But that's not an area where Botox works. A thorough consultation with a board-certified plastic surgeon can help you make thr right choices.
This infographic from ASAPS has some interesting facts - in easily digestible format.
WHERE DID YOUR SMART PHONE GET ITS "MD"?
I was reading the Wall Street Journal this morning and came across an article evaluating mobile phone apps for diagnosing skin cancer, specifically melanoma. The best app had 98.1% success and the worst one was 6.8% and the other 2 studied were in the middle at about 70%. This is quite disturbing and could cost someone their life since melanoma is the one form of skin cancer that can be fatal. I am sure there will be people relying on these apps to be their doctor. They do so at their own peril. These apps will NOT replace the well-trained eye of a plastic surgeon or dermatologist. If the doctor has doubts, he can do a biopsy. Beware – these apps are not doctors!
NEW VITAMIN STUDY
I recently saw a pretty neat study about the effects of multi-vitamins. If you read the label on the bottle it has everything but the kitchen sink. Pfizer studied 15,000 men who took either Pfizers Centrum Silver or a placebo daily. They followed them for 11.2 years and found that the men taking Centrum Silver had an 8% less chance of developing cancer. So maybe multi-vitamins are a good idea.
DID YOU KNOW?
We hear about how “belly fat” is so bad. Research has now shown that this belly fat that surrounds our organs is not sitting by idly, but it is producing molecules known as cytokines. These cytokines set up inflammation that can lead to all types of medical problems such as heart disease. One of the markers in our bodies to measure inflammation is C-reactive protein. Losing weight can lower our levels of C-reactive proteins. We like to see our level of C reactive protein be less than 1 mg/c.
It's NOT The Cat's Meow!
Far from it. We have millions of dog and cat lovers out there but now cat lovers have to be on alert. Women infected with Toxoplasma gondii – a parasite found in cat liter – had a 1/12 times greater risk of suicide. The larger the amount of T. gondii in their bodies, the greater the risk was. The parasite has been linked to schizophrenia in humans.
Medical Tourism - A Warning. Please be careful.
Cosmetic surgery is booming around the world. Vietnam is an example. Many people are traveling to Ho Chi Minh City, the capitol of Vietnam, seeking beautifying cosmetic surgery procedures. The attraction? Seems to be the combination of cheap prices and an exotic location. TuoitreNews.com, the Vietnamese news service, reports that women there go to "beauty salons". But only "authentic beauty salons", as defined by local authorities, include a cosmetic surgeon. Hundreds of other "beauty salons" do not have cosmetic surgery licenses.
If you go to Vietnam or anywhere else in the world for cosmetic surgery, be forewarned. A complicated treatment by an unlicensed practitioner may prove far more costly in the long run than any savings from cheap prices.
If you’re a Floridian whose bikini-clad body needs a little tweaking, you will now have a much better chance of undergoing a safe liposuction procedure. The April 27 Sun-Sentinel reports that Governor Rick Scott of Florida has signed legislation mandating that, as of January 3, 2013, doctors can no longer perform most liposuction procedures in unregulated offices.
This could drive up prices of some Florida liposuction procedures. I know, however, that the law is warranted and intended to assure patients of safe procedures. Lower fees are a bad trade-off for the risk of death.
In recent years, some doctors and unregulated beauty businesses performed liposuction without administering appropriate anesthesia. Instead, they used sedative pills or creams. After 14 Floridians died as a result of medical distress during liposuction in the last decade, the legislation was filed.
The new law states that when a liposuction procedure removes more than about two pounds of fat it must be performed in a regulated office, staffed with a doctor that has lifesaving training and equipped with lifesaving equipment and procedures. The facility will be required to be inspected by the state or become accredited.
The American Society for Aesthetic Plastic Surgery (ASAPS) requires its members to operate in accredited, state-licensed or Medicare-certified facilities. To ensure your safety, if you undergo surgery, make sure your surgery occurs in such a facility.
Maybe size - when it comes to your head - does matter.
A study in the Journal of Neurobiology found that people with big heads had a reduced risk of developing Alzheimers disease.
Seems that CT studies of human brains revealed that people with small intracranial volume had an increased risk of Alzheimers.
So, while we often describe people with big egos as having "big heads", we may be giving them the promise of a longer life.
NSAID Use May Lower Skin Cancer Risk
Non steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, may help reduce risk of developing squamous cell carcinoma and malignant melanoma, according to a new study published online in Cancer.
Sigrún Alba Jóhannesdóttir, BSc, of Aarhus University Hospital in Denmark, and colleagues analyzed medical records from northern Denmark from 1991 through 2009 and identified 1,974 diagnoses of squamous cell carcinoma, 13,316 diagnoses of basal cell carcinoma, and 3,242 diagnoses of malignant melanoma. They compared information, including NSAID prescription data, from these patients with that of 178,655 individuals without skin cancer.
Those individuals who filled more than two prescriptions for NSAIDs had a 15% decreased risk for developing squamous cell carcinoma, and a 13% decreased risk for developing malignant melanoma than those who filled two or fewer NSAID prescriptions, the study showed. The longer participants took the NSAIDS, the lower their risk for these skin cancers.
Exactly how, or even if, NSAIDS affect skin cancer risk is not fully understood, but these drugs target the cyclooxygenase-2 (Cox-2) enzyme, which is also expressed by certain cancers. “We hope that the potential cancer-protective effect of NSAIDs will inspire more research on skin-cancer prevention,” says Jóhannesdóttir, in a press release. “Also, this potential cancer-protective effect should be taken into account when discussing benefits and harms of NSAID use.”
LET'S HAVE ANOTHER CUP OF JOE - May18,2012
A while ago I posted information on my blog about coffee drinking and health. Now, a new study has been released that says not only is coffee not bad for you, it appears to contribute a longer life.
"One of life’s simple pleasures just got a little sweeter. After years of waffling research on coffee and health, even some fear that java might raise the risk of heart disease, a big study finds the opposite: Coffee drinkers are a little more likely to live longer. Regular or decaf doesn’t matter. "
400,000 people were e included in the largest study ever done on the question. The study results are comforting for coffee lovers. Apparently starting your day with coffe will not end your life prematurely.
Several million people suffer from hyperhidrosis or excessive sweating. It is estimated that 2-3% of population has hyperhidrosis. People with hyperhidrosis often sweat even when it’s cool outside. It runs in families and many people choose to live with it since, no permanent effective treatment existed until now. There are several conditions that can cause excessive sweating such as menopause, hyperthyroidism. This is termed secondary hyperhidrosis.
We hear so much about PRP –
What is PRP? May 1, 2012
PRP stands for "Platelet Rich Plasma."
Getting PRP a simple process. About 60-70 cc’s of the patients’ own blood are drawn. It then is spun down for several minutes. This yields the red cells in the bottom of the centrifuge tube and the top half containing plasma, platelets, ie. the platelet rich plasma.
Recently, there was a new development which allows us to get super concentrated platelet rich plasma. After the initial spinning down – we draw off the plasma – minus the red cells. It then is spun down a second time for several minutes yeilding more concentrated PRP, which then is mixed with the patients own fat and stem cells. It is this combination that is injected into the patients face to augment it. This would be in lieu of say Juvederm, Restylane or Sculptra. The best part is it is cheaper – lasts longer and it is your own tissue.
What makes platelets so special?
Platelets have a prominent role in healing wounds. Part of the reason is because they containg x-granules; small packets contained within the platelets that have several growth factors, ie. protein with growth factors that are released when the platelets are activated. This increases the growth of blood vessels, new collagen and a whole host of other cellular functions to rejuvenate our skin. The proteins contained in these granules influence many aspects of wound healing.
What’s on the horizon?
People want simple – easy – procedures to enhance their facial appearance, with no downtime. That helps to explain the growth in Botox and fillers. Millions of these procedures are done year and year out. Their popularity is growing. People want something easy – quick with no downtime.
This may be the "miracle" they are hoping for.
April 7, 2012
A drug many of us use each day may be a key drug in preventing cancer and keeping it in check.
New studies shows that common aspirin may be the key to warding off cancer. Studies done at Oxford University to test aspirin’s effects on the heart, showed that not only were these people less likely to have heart attacks but also 23% less likely to develop cancer over a 3 year period versus those who took NO aspirin.
Over a five year period they had a 37% lower risk of dying from cancer.
A study of people with cancer found that those who took an aspirin a day had a lower rate of metastasis. Study author, Peter Rothwell said “no drug has been shown before to prevent distant metastasis.”
FINANCING PLASTIC SURGERY - No one expects you to pay "cash" for everthing. Somethings qualify for financing with low monthly payments. CareCredit makes the possible for plastic surgery. If you are interested in how much financing you qualify for, use the confidential form from CareCredit to find out.
FLORIDA LIPOSUCTION BAN FACTS -A bill to outlaw liposuction from being performed in licensed surgery centers died in the house. The Senate passed a bill to limit where liposuction can be performed. There have been 14 deaths from medical distress post liposuction here in Florida over the last 10 years. Where or when it will come up again is anyone’s guess but again, BUYER beware. Make sure your doctor is a board certified plastic surgeon and performs it in a fully accredited surgery center.
A & MELANOMA - A
recent study in the Journal of Investigative Dermatology showed that
vitamin A derivatives may stave off melanoma. The study was done at
Kaiser Permanente in Oakland and consisted of 69,635 study patients.
Of these, 566 developed melanoma and those individuals who took vitamin
A supplements were 40% less likely to develop melanoma. There are no
magic wands. But a small step here and a small step there can make a
WHERE DO YOU GET YOUR INFORMATION
ABOUT PLASTIC SURGERY? -
The way patients get information
on plastic surgery is undergoing evolution. Years ago, it was by word of mouth or by a referral from your family doctor. Then advertising hit the air. Now we have the internet.
In a recent survey, the American Academy of Facial Plastic Surgeons showed 42% of prospective patients get their information from social media sites such as Facebook.
It is amazing to me, as a Fort Myers Plastic Surgeon, the power and popularity that social media are experiencing. I have patients who spend 1 to 2 hours per day on sites like Facebook.
My suggestion? Don’t rely of this ALONE to make your decision on who to go to for your cosmetic surgery.
That said, if Facebook is your thing, you'll find me at ttp://www.facebook.com/DrBrueckMDFortMyersplasticsurgeon. You can "like" me there and receive my informative, and occasionally amusing message on your newsfeed.
NEW INDICATION FOR BOTOX What will they think of next. I guess the only limitations of finding uses for Botox is your own imagination. Now they are injecting Botox in a patients stomach. These injections are NOT in the patients skin on the outside but are actually injected with a needle to the mucosa or lining of your stomach. I was watching a doctors show – it seems there are as many as 7-11 stores – and a gastroenterologist was injecting Botox into a patients stomach. The idea is that by injecting Botox into someone’s stomach it slows down the emptying of the stomach – hence – the patient feels “full” and does not eat as much. At last, a new weight loss program. The GI doctors (gastroenterologist) who spoke about this has had her stomach injected and has lost 7 pounds over several weeks. Who knows a “Botox” cocktail may be just around the corner.
SHOULD WE BAN COSMETIC SURGERY ADS? Apparently the British are getting ready to ban or recommend a ban on advertising by cosmetic surgeons. This is the recommendation by the British Society of Aesthetic Plastic Surgeons. They are proposing a 6 point plan.
- Ban all ads for cosmetic surgery.
- Re-establish an implant register
- Re-clarify dermal fillers as medicine
(this would restrict who could inject ie. must be a doctor)
- Register all aesthetic surgeons
- Mandate a safety audit
- Revalidation or recertification
This has been prompted in part by the recent PIP implant controversy. For years physicians in our country were not allowed to advertise. Your advertisement was your reputation. If it was good, patients would come and if not,.... well, you know the rest of the story. Maybe, for the sake of patient safety we need to long for the old days.
Here's Press Release that went out a few days ago. Thought you might enjoy it:
Innovative QuickLift® Mini Facelift Procedure Now Available in Fort Myers/Naples, FL
Board-certified Plastic Surgeon
Robert J. Brueck, MD Now Offering
the QuickLift Mini Facelift Procedure.
Fort Myers, FL (PRWEB) January 26, 2012
Women and men in Fort Myers and Naples now have access to the QuickLift®, a revolutionary
mini facelift procedure that tightens sagging skin along the jaw line and chin, offering immediate, natural-looking results without the lengthy recovery and costs associated with traditional facelift surgeries.
Board-certified plastic surgeon Robert J. Brueck, MD, FACS, is the only surgeon in the Naples/
Fort Myers area to offer the QuickLift procedure.
Unlike procedures with similar names that tighten only skin, the QuickLift Mini Facelift permanently suspends the underlying structures of the lower face (SMAS), jaw line and neck, offering men and women the benefit of a more youthful appearance for years to come. The QuickLift is performed under local anesthesia or with twilight sedation, and takes one to two hours to complete. Small incisions and shorter surgical time result in less swelling and bruising, and a shorter recovery period, with most individuals able to return to their normal routines within a few days.
“The QuickLift is a minimally invasive procedure that produces outstanding results,” says Dr. Brueck. “This is a great option for those who want to stay ahead of the aging process, but do not want to go the route of a full facelift. Lax skin along and under the chin, jaw line and neck can add years to a person’s appearance and contribute to a tired, worn facial expression. The QuickLift addresses this area, producing an overall firming of the lower facial area and noticeable jaw line definition for a more elegant, youthful appearance.”
Before and after photos and video testimonials from patients who have chosen the QuickLift Mini Facelift procedure can be viewed at http://www.quickliftmd.com.
SUPERBUGS - We all know what they are. They could be flesh-eating bacteria, leading the way in an epidemic of antibiotic, hospital-acquired infections. Now, a new weapon against these invaders may be on the horizon. Israeli researchers have found a process to restore a bacteria’s sensitivity to antibiotics. It's called lysogenization.
Scientists use a bacteriophager (virus that attack bacteria) to invade resistant bacteria which can then restore their antibiotic sensitivity. So far these new “phases” have not been tested on superbugs, but we hope they soon will be.
GLAUCOMA AND GEOGRAPHY - What could this vision problem have in common with geography? As a plastic surgeon concerned with physical beauty, I am intrigued by news about vision problems. Well, they both begin wiht G (just kidding). It appears however, that people who live south of 41dwgrees north latitdue (the line passing through hicago) have a significantly lower risk of developing exfoliaition glaucoma, which causes protein deposits in the eye, which can lead to vision loss. And here, we thought people were moving south to Florida for the weather.
ANTI-AGING PROCEDURES BY AGE OF PATIENT - Common sense would tell us the “older” generation or baby boomers would be undergoing the most procedures to head off aging. But surprisingly, a study by the American Society of Aesthetic Plastic Surgery, of which I am a member, found that people aged 31-45 actually led the way with 43% of the 10+ billion spent on cosmetic procedures in 2010. The baby boomers, of which I’m also a "member" accounted for 28% of the total spent. There were a total of 13.1 million cosmetic procedures done and of this total 11.6 million were non-surgical.
YOU EAT WHAT YOU ARE? - It seems we are always finding connections between two entities; cause and effect. When you eat too much of a food you are more likely to get or suffer from something related to that food.
Now, research links personality to body weight.
A growing body (no pun intended) of research suggests that the part of our brain that controls our emotions and stress also controls our appetite or hunger center.
People who were “impulsive” were more apt to be overweight. People who were not overly agreeable tended to put on more weight over the years.
It's a connection between emotions and weight that begins early in life.
Kids who had low emotional relationships with their mothers tended to be more obese by the age of 15.
“Food for thought” is not far from the truth.
Fish Oils? - Fish oil is important in our diet. I take fish oil everyday. Unfortunately, fish oil and face-lifting don’t go hand in hand.
I tell all my patients to avoid fish oil a couple of weeks before surgery.
That aside, there is good reason to eat fish: a recent study of people in their 70’s found that a diet of fish once a week for over 10 years their brains were bigger. The brain's area linked to memory and learning seemed to be the most affected. Some people think Omega 3 acids reduce inflammation and increase blood flow to the brain.
But if you eat fish, bake it or broil it. - NO fish frys.
Implants are safe - Recently the French government announced it would pay to have all Gel implants in French women removed. This gnerated considerable concern. Why? What's the problem? Are you at risk here in the US?
You should know that only implants manufactured by a French company, PIP (Poly Implant Prosthesis) were to be removed. From what research I have done, it appears that the gel used in PIP implants was INDUSTRIAL grade NOT MEDICAL grade.
I guess it’s like buying a steak. You can order choice or you can order prime. There appear to be many European women with PIP implants. Unfortunately, PIP used industrial grade silicone because it simply was CHEAPER.
Several years ago, I took care of several patients who had “industrial” grade silicone actually injected into their breasts. No implants. Just industrial grade material placed into syringes and then injected into their breasts.
The results were terrible. These women developed severe inflammations and multiple nodules. Mammograms became more difficult to perform. Many of these women required simple mastectomies and reconstruction.
The European company, PIP, went bankrupt in 2010 and shut its doors. Their president/founder, M. Jean-Claude Mas, is 72 and in poor health. As all this will be resolved in the courtroom…many years later. Till then, rest assured, unless you received a PIP implant, most likely in Europe, all is well.
Testimonials - Most doctors receive "thank you " notes. Trust me, they are greatly appreciated. I maintain a page dedicated to such notes from happy patients. In a way they are 'testimonials'. Since I feel it is helpful for prospective patients to know about experiences of women who have undergone cosmetic procedures, I like to share what tyhey have to say. Most recently, I received one referring to a breast augmentation. Interestingly, this patient entered into the process with her fiance sitting in on the consultation. After the surgery and recovery, she was married and commented on how good she looked in her wedding dress. Notes like these are very gratifying.
Hand Sanitizers - It seems, no matter where we go, we bath our hands in “hand sanitizer”. Several years ago they were non-existent, and now they’re everywhere – gyms, restaurants, stores. You name it, they have it.
There are some risks, however:
1. They cut down on the exposure of our immune system. Our immune system pours out antibodies (like antibiotics) in response to contact with germs; no germs – no exercise
2. They are NO replacement for the time-honored use of good ole' soap and water.
3. They have high concentrations of alcohol which removes skin oils from our skin.
4. They can give you a false sense of security.
I can tell you, after three decades as a practicing plastic surgeon, your best protection is a vigorous hand washing with soap and water.
A Whole Lot of Beauty - According to the American Society of Plastic Surgeons there were 13,100,000 cosmetic surgery procedures performed in the United States last year (2010). It will be interesting to see what this year brings as we close it out. More or less? Feel free to comment.
Why Do Drugs Cost So Much? How many times have I heard – “that’s outrageous!” - when talking about the price of a particular medicine?
My brother, Bill. takes a pill every day that costs upwards of $25.00. That’s pricey. But in the end, it all comes down to the cost to develop the drug, the cost to manufacture and the size of the potential market.
Drug research is $100 billion a year endeavor. Two years ago, some researchers in Boston showed how they could kill cancer cells by targeting a protein in the cells called STK33 – don’t ask me what it stands for.
Amgen, the well known biotech pharmaceutical company, jumped all over it. They put together a team of scientists/researchers totaling 24 to see if they could duplicate this. If they could, this could prove to be a pathway to create new drugs to fight cancer. After 6 intensive (and expensive) months – all their efforts had failed.
One of the cornerstones of original research is reproduceability. In other words, if one lab does research, say, in Chicago, can that research AND results be duplicated in a lab in Miami or Paris? That is crucial. These Phase 2 trials involve reproducing results from other labs.
The bottom line is that those FAILED attempts cost money – cost real dollars. This helps explain in part the rising cost of prescription drugs.
Obviously, we all wish that drugs could be developed at lower cost. But researchers must be paid, facilities must be maintained and gambles are taken that the research will produce a life-saving or life-enhancing drug. When it doesn't, that cost drops to the bottom line of the drug companies.
Dr. Brueck is associated with professional medical societies, including:
Florida Medical Association
Lee County Medical Society
Southern Medical Association
American Society of Plastic & Reconstructive Surgeons
American Association of Laser Medicine & Surgery
Aesthetic Surgery Association
American Society for Aesthetic Plastic Surgery
Contact Dr. Brueck at 239-939-5233, through email
or through his Aesthetic
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Dr. Robert Brueck MD, Board Certified plastic surgeon