The Sentinel: Beauty

How to ensure your cosmetic surgery is safe and successful

Plastic surgery should always be performed by board certified plastic and reconstructive surgeons. You should also check to see that the surgical facility is accredited, too.

Photo: Pixabay

StatePoint Media - In the pursuit of beauty and self-enhancement, an increasing number of individuals are turning to plastic surgery.

However, beneath the promise of transformation lies a darker reality: the alarming rise of botched plastic surgeries due to an influx of undertrained, completely untrained, or reckless surgeries, most commonly undertaken by non-plastic surgeons.

“The consequences of choosing the wrong provider can be catastrophic,” says Dr. Alan Durkin, double board-certified plastic and reconstructive surgeon, Ocean Drive Plastic Surgery. “The risks associated with botched plastic surgeries are not just physical; they extend to emotional and financial repercussions.”

According to Dr. Durkin, patients who undergo procedures under the care of inexperienced practitioners face the following risks:

Physical Harm: Complications such as infections, scarring, nerve damage, and anesthesia-related issues can result from poorly executed surgeries.
Emotional Toll: Dealing with unexpected outcomes can lead to depression, anxiety, and a loss of self-esteem, reversing the procedure’s intended benefits.
Financial Burden: Correcting botched surgeries often requires additional procedures and expenses that may not be covered by insurance, leading to significant financial strain.

Choosing a Safe Practitioner

Amidst the risks, there are crucial steps you can take to mitigate them and ensure a safe cosmetic surgery experience. Dr. Durkin provides these factors to consider when selecting a practitioner:

1. Credentials and Accreditation

Plastic surgery should be undertaken by board certified plastic and reconstructive surgeons. Verify that your surgeon is board-certified by accredited organizations such as the American Board of Plastic Surgery or the American Society of Plastic Surgeons. Certification ensures that the surgeon has undergone at least six years of rigorous training and meets high standards of competency and ethics. Dual board certification offers an even greater degree of safety, but those practitioners are not in every market.

2. Experience and Expertise

Research the surgeon's experience performing the procedure you're considering. Experienced surgeons possess technical skill and a track record of successful outcomes and patient satisfaction. Ask about their specialization within plastic surgery and inquire about their frequency of performing the procedure. Further, ensure that your physician has hospital privileges for backup resources and that they carry malpractice insurance. It’s a big red flag to provide aesthetic procedures without malpractice insurance.

3. Facility Accreditation

Ensure your surgical facility is accredited by recognized organizations like the AAAASF, State Certification, Accreditation Association for Ambulatory Health Care or the Joint Commission. Accredited facilities adhere to strict safety standards and protocols, reducing complication risk during and after surgery. Most higher-end facilities, similar to hospitals, offer dual facility certification.

4. Patient Reviews and Testimonials

Read reviews. Websites like Google, US News and World Report and Healthgrades provide valuable insights into patient feedback, outcomes, and overall satisfaction with the surgeon and their practice.

5. Consultation and Communication

Schedule a consultation to discuss your goals, expectations and concerns. A reputable surgeon will take the time to thoroughly assess your candidacy for surgery, explain the procedure in detail, and address all your questions regarding risks, recovery and expected outcomes. Also interview the staff. Make sure you are comfortable with the process and personnel at your facility of choice.

6. Transparency and Red Flags

Red flags include discounted prices that seem too good to be true, pressure to undergo multiple procedures simultaneously, and promises of unrealistic results. A trustworthy surgeon prioritizes safety and provides transparent information about potential risks and limitations. Beware of clinics that do not provide adequate information about your procedure.

Legislative and Regulatory Measures

In response to the rise in botched plastic surgeries, legislative efforts are underway to enhance patient protections and regulate the industry more effectively. Initiatives like Senate Bill 1188 aim to strengthen oversight and ensure that only qualified professionals perform cosmetic procedures, protecting patients from harm and exploitation.

“Choosing to undergo plastic surgery is a personal decision that should be approached with careful consideration and thorough research. By educating yourself about the risks, selecting a qualified practitioner, and advocating for stronger regulations, you can achieve safer, more satisfying outcomes,” says Dr. Durkin.

African-American women who use chemical relaxers suffer from hormone-related cancer more frequently

by Ronnie Cohen
Kaiser Health News

Social and economic pressures have long compelled Black girls and women to straighten their hair to conform to Eurocentric beauty standards.

Deanna Denham Hughes was stunned when she was diagnosed with ovarian cancer last year. She was only 32. She had no family history of cancer, and tests found no genetic link. Hughes wondered why she, an otherwise healthy Black mother of two, would develop a malignancy known as a “silent killer.”

After emergency surgery to remove the mass, along with her ovaries, uterus, fallopian tubes, and appendix, Hughes said, she saw an Instagram post in which a woman with uterine cancer linked her condition to chemical hair straighteners.

“I almost fell over,” she said from her home in Smyrna, Georgia.

When Hughes was about 4, her mother began applying a chemical straightener, or relaxer, to her hair every six to eight weeks. “It burned, and it smelled awful,” Hughes recalled. “But it was just part of our routine to ‘deal with my hair.’”

The routine continued until she went to college and met other Black women who wore their hair naturally. Soon, Hughes quit relaxers.

Social and economic pressures have long compelled Black girls and women to straighten their hair to conform to Eurocentric beauty standards. But chemical straighteners are stinky and costly and sometimes cause painful scalp burns. Mounting evidence now shows they could be a health hazard.

Relaxers can contain carcinogens, like formaldehyde-releasing agents, phthalates, and other endocrine-disrupting compounds, according to National Institutes of Health studies. The compounds can mimic the body’s hormones and have been linked to breast, uterine, and ovarian cancers, studies show.

African American women’s often frequent and lifelong application of chemical relaxers to their hair and scalp might explain why hormone-related cancers kill disproportionately more Black than white women, say researchers and cancer doctors.

“What’s in these products is harmful,” said Tamarra James-Todd, an epidemiology professor at the Harvard T.H. Chan School of Public Health, who has studied straightening products for the past 20 years.

She believes manufacturers, policymakers, and physicians should warn consumers that relaxers might cause cancer and other health problems.

In conversations with patients, Gore sometimes also talks about how African American women once wove messages into their braids about the route to take on the Underground Railroad as they sought freedom from slavery.

But regulators have been slow to act, physicians have been reluctant to take up the cause, and racism continues to dictate fashion standards that make it tough for women to quit relaxers, products so addictive they’re known as “creamy crack.”

Michelle Obama straightened her hair when Barack served as president because she believed Americans were “not ready” to see her in braids, the former first lady said after leaving the White House. The U.S. military still prohibited popular Black hairstyles like dreadlocks and twists while the nation’s first Black president was in office.

California in 2019 became the first of nearly two dozen states to ban race-based hair discrimination. Last year, the U.S. House of Representatives passed similar legislation, known as the CROWN Act, for Creating a Respectful and Open World for Natural Hair. But the bill failed in the Senate.

The need for legislation underscores the challenges Black girls and women face at school and in the workplace.

“You have to pick your struggles,” said Atlanta-based surgical oncologist Ryland Gore. She informs her breast cancer patients about the increased cancer risk from relaxers. Despite her knowledge, however, Gore continues to use chemical straighteners on her own hair, as she has since she was about 7 years old.

“Your hair tells a story,” she said.

“It’s just a deep discussion,” one that touches on culture, history, and research into current hairstyling practices, she said. “The data is out there. So patients should be warned, and then they can make a decision.”

The first hint of a connection between hair products and health issues surfaced in the 1990s. Doctors began seeing signs of sexual maturation in Black babies and young girls who developed breasts and pubic hair after using shampoo containing estrogen or placental extract. When the girls stopped using the shampoo, the hair and breast development receded, according to a study published in the journal Clinical Pediatrics in 1998.

A 2017 study found white women who used chemical relaxers were nearly twice as likely to develop breast cancer as those who did not use them.

Since then, James-Todd and other researchers have linked chemicals in hair products to a variety of health issues more prevalent among Black women — from early puberty to preterm birth, obesity, and diabetes.

In recent years, researchers have focused on a possible connection between ingredients in chemical relaxers and hormone-related cancers, like the one Hughes developed, which tend to be more aggressive and deadly in Black women.

A 2017 study found white women who used chemical relaxers were nearly twice as likely to develop breast cancer as those who did not use them. Because the vast majority of the Black study participants used relaxers, researchers could not effectively test the association in Black women, said lead author Adana Llanos, an associate professor of epidemiology at Columbia University’s Mailman School of Public Health.

Researchers did test it in 2020.

The so-called Sister Study, a landmark National Institute of Environmental Health Sciences investigation into the causes of breast cancer and related diseases, followed 50,000 U.S. women whose sisters had been diagnosed with breast cancer and who were cancer-free when they enrolled. Regardless of race, women who reported using relaxers in the prior year were 18% more likely to be diagnosed with breast cancer. Those who used relaxers at least every five to eight weeks had a 31% higher breast cancer risk.

Nearly 75% of the Black sisters used relaxers in the prior year, compared with only 3% of the non-Hispanic white sisters. Three-quarters of Black women also self-reported using the straighteners as adolescents, and frequent use of chemical straighteners during adolescence raised the risk of pre-menopausal breast cancer, a 2021 NIH-funded study in the International Journal of Cancer found.

Another 2021 analysis of the Sister Study data showed sisters who self-reported that they frequently used relaxers or pressing products doubled their ovarian cancer risk. In 2022, another study found frequent use more than doubled uterine cancer risk.

After researchers discovered the link with uterine cancer, some called for policy changes and other measures to reduce exposure to chemical relaxers.

“It is time to intervene,” Llanos and her colleagues wrote in a Journal of the National Cancer Institute editorial accompanying the uterine cancer analysis. While acknowledging the need for more research, they issued a “call for action.”

No one can say that using permanent hair straighteners will give you cancer, Llanos said in an interview. “That’s not how cancer works,” she said, noting that some smokers never develop lung cancer, despite tobacco use being a known risk factor.

The body of research linking hair straighteners and cancer is more limited, said Llanos, who quit using chemical relaxers 15 years ago. But, she asked rhetorically, “Do we need to do the research for 50 more years to know that chemical relaxers are harmful?”

Charlotte Gamble, a gynecological oncologist whose Washington, D.C., practice includes Black women with uterine and ovarian cancer, said she and her colleagues see the uterine cancer study findings as worthy of further exploration — but not yet worthy of discussion with patients.

“The jury’s out for me personally,” she said. “There’s so much more data that’s needed.”

Not long ago, she considered chemically straightening her hair for an academic job interview because she didn’t want her hair to “be a hindrance” when she appeared before white professors.

Meanwhile, James-Todd and other researchers believe they have built a solid body of evidence.

“There are enough things we do know to begin taking action, developing interventions, providing useful information to clinicians and patients and the general public,” said Traci Bethea, an assistant professor in the Office of Minority Health and Health Disparities Research at Georgetown University.

Responsibility for regulating personal-care products, including chemical hair straighteners and hair dyes — which also have been linked to hormone-related cancers — lies with the Food and Drug Administration. But the FDA does not subject personal-care products to the same approval process it uses for food and drugs. The FDA restricts only 11 categories of chemicals used in cosmetics, while concerns about health effects have prompted the European Union to restrict the use of at least 2,400 substances.

In March, Reps. Ayanna Pressley (D-Mass.) and Shontel Brown (D-Ohio) asked the FDA to investigate the potential health threat posed by chemical relaxers. An FDA representative said the agency would look into it.

Natural hairstyles are enjoying a resurgence among Black girls and women, but many continue to rely on the creamy crack, said Dede Teteh, an assistant professor of public health at Chapman University.

She had her first straightening perm at 8 and has struggled to withdraw from relaxers as an adult, said Teteh, who now wears locs. Not long ago, she considered chemically straightening her hair for an academic job interview because she didn’t want her hair to “be a hindrance” when she appeared before white professors.

Teteh led “The Cost of Beauty,” a hair-health research project published in 2017. She and her team interviewed 91 Black women in Southern California. Some became “combative” at the idea of quitting relaxers and claimed “everything can cause cancer.”

Their reactions speak to the challenges Black women face in America, Teteh said.

“It’s not that people do not want to hear the information related to their health,” she said. “But they want people to share the information in a way that it’s really empathetic to the plight of being Black here in the United States.”

Kara Nelson of KFF Health News contributed to this report.

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

Remember to protect your skin this spring and summer

Photo:Jeff Denlea/Pexels

(StatePoint Media) Whether you are getting outside to start planting flowers for this spring and summer or heading out to enjoy watching kids play their spring sports, don't forget that sunscreen. Like most people we tend to prioritize skin protection when spending time outdoors, but skin damage from UV rays and free radicals can occur inside too.

Consider these tips and insights this summer:

Indoor and Outdoor Hazards
If you’re already taking measures to protect skin while outdoors, that’s great. The sun is responsible for up to 90% of visible skin changes commonly attributed to aging, according to the Environmental Protection Agency. But you don’t have to be at the pool or beach to be susceptible to sun damage.

Whether you’re driving your car or you’re inside your home, it’s important to keep in mind that your skin can be exposed to free radicals from the sun’s rays through windows. What’s more, blue light from digital screens -- ubiquitous these days -- can also be harmful to skin. Additionally, damaging free radicals can be generated by pollution, certain foods, like those with a high glycemic index and red meat, exercise, alcohol and more.

Topical Care
Be sure to apply a topical SPF daily to your face and body. Keep in mind that some fabrics don’t offer complete protection, so wearing sunscreen even on areas of skin that are not directly exposed to sunlight is a good idea. You can offer additional protection to sensitive areas like your scalp by wearing a hat. And of course, take good care of your eyes with sunglasses featuring UV blocking.

Double Up
Ultimate skin health comes from a combination of defensive layers. Double down on your skin’s health from the inside out with a daily supplement, such as Heliocare Daily Use Antioxidant Formula.

Eighty-seven percent of U.S. dermatologists recommend taking Heliocare to help protect skin from free radicals, like those produced by the sun’s UV rays. Dermatologist-recommended, this natural, dietary supplement contains 240 milligrams of a powerful antioxidant formula derived from the extract of Polypodium leucotomos (PLE), a tropical fern native to Central and South America that’s been used for centuries as a remedy for skin-related conditions.

Unlike other skincare supplements that contain PLE, Heliocare has a clinically-established, proprietary antioxidant formula, Fernblock PLE Technology, which aids in eliminating free radicals in the body.

"Ultimately, no one is immune to skin damage. Taking a supplement like Heliocare each day is an excellent precaution to help your body protect itself from the damaging effects of free radicals," says New York-based dermatologist, Rachel Nazarian, MD. "By neutralizing the outcome of these harmful atoms, it can help to promote a healthy appearance of skin."

To help keep skin healthy and radiant, avoid free radical damage in the first place and prioritize a comprehensive skin care routine, even when indoors.

To learn more and to access additional skin care information, visit heliocare.com.