Dr. Landon McLain has recently been named as a board examiner for the prestigious American Board of Cosmetic Surgery (ABCS) starting October 2012. This honor recognizes Dr. McLain as one of the leading cosmetic surgeons in the nation and serves as an endorsement by his peers and other cosmetic surgeons throughout the United States for his commitment to the field of cosmetic surgery and the education of surgeons striving to challenge the Board for the distinction of diplomate status.
“ I am deeply honored to be asked to become a board examiner for the American Board of Cosmetic Surgery. It has taken a great deal of time and hard work to become a diplomate myself and I look forward to giving back to a wonderful organization that strives to maintain the highest level of professional standards in the specialty of cosmetic surgery.”
Becoming a diplomate of the American Board of Cosmetic Surgery is a significant professional achievement and honor. Diplomates must strive to represent the high ethical and moral standards of the ABCS and to support the Board activities for the advancement of the specialty of cosmetic surgery. Diplomates agree to adhere to the ABCS and AMA guidelines regarding the ethical practice of cosmetic surgery, including advertising and representations to the public, and to practice the highest standard of patient care and safety at all times. The American Board of Cosmetic Surgery (“ABCS”) is the only certifying board that evaluates and certifies doctors exclusively in cosmetic surgery. In order to be board certified by the ABCS, a doctor must do the following:
1. Satisfactorily complete specialty residency training and be board certified in one of the following surgical specialties: Dermatology; General Surgery; Obstetrics and Gynecology; Opthamology/Oculoplastic Surgery; Oral & Maxillofacial Surgery (with MD degree); Otolaryngology; or Plastic Surgery.
2. Complete a one or two year fellowship program concentrated solely in cosmetic surgery (the fellowship route), or alternatively, demonstrate vast experience in the field of cosmetic surgery through the performance as primary surgeon of 1,000 documented cosmetic surgical cases in the 6 year period preceding certification (the experience route).
3. Perform at least 100 documented cosmetic procedures following the completion of a one-year cosmetic surgery fellowship program (50 documented cosmetic procedures following the completion of a two-year cosmetic surgery fellowship program) in the 12 month period preceding certification.
4. Pass a stringent 2-day oral and written examination.
5. Be of good moral character.
For more information on the American Board of Cosmetic Surgery please visit http://www.americanboardcosmeticsurgery.org.
I am often surprised at what my patients tell me they read, hear or have been told about some of the procedures I offer. Breast augmentation is one of the more often ones cited as misleading by some of my patients, especially regarding the different incision types. Occasionally, patients report that some of the misinformation comes from other surgeons, even ones that I know are very experienced. This is often regarding one of the newer techniques used for breast augmentation… the transaxillary or armpit incision.
The truth about incisions to place breast implants is
fairly simple. In most patients, if the surgeon is experienced in all types of incisions, the results should be similar regardless of the approach used. There are 6 different approaches possible to place breast implants commonly used today. They are…
Trans-umbilical (limited to saline implants only)
Trans-abdominoplasty (through the tummy tuck incision)
Trans-mastopexy (through mastopexy or breast lift incisions)
In my practice, the transaxillary, inframammary and trans-mastopexy incisions are by far the most common approaches requested. However, the transaxillary incision seems to be a source of some confusion for patients and surprisingly some surgeons. I have been told by more than a few clients that they were informed that they could only get saline or very small silicone implants if they chose the armpit incision… or that there is a higher risk of asymmetry using the transaxillary technique. That is entirely untrue. I have personally placed 800cc (the largest silicone implant made) gel implants via the armpit approach and have had wonderful results with a very high rate of symmetry and patient satisfaction using this technique. For this reason this has become my most requested approach to breast augmentation. So why is it that this “myth” continues to be espoused. Here are a few of my theories as to why…
1) Lack of any actual experience with this technique by some surgeons offering breast augmentation
2) Increased cost of materials required for the transaxillary technique (i.e. different retractors, and endoscopic instruments),
3) Lack of training in this particular technique in many residency programs, and
4) Overall, a higher degree of technical demand placed on the surgeon (the inframmamary and periareolar incisions are typically easiest to learn)
So what are the advantages of the transaxillary/armpit approach to breast augmentation? Primarily, it is that this format keeps an incision off the breast as long as possible. Of course, breast implants do not last a lifetime in most cases, so any replacement, adjustment or removal MAY require a different incision type. There are also several studies that suggests this incision has a lower degree of complications versus others, specifically related to the ability to nurse after augmentation, lower risk of infection and lower rates of capsular contracture.
To summarize, the armpit or transaxillary incision for breast augmentation is a wonderful option for most patients seeking breast enhancement and can be used to place both types of implants (saline or silicone), all sizes and in either plane (above or below the muscle). Thanks for reading and call if you would like to set up a complimentary consultation to answer any questions you may have about this or any other blog entries.
“Do not hire a man who does your work for money, but him who does it for love of it. “
I have always been creative. In my formative years I was continually drawing, building, designing and imagining. I was fortunate enough to have an artistic eye and steady hand at an early age. I won a few small art fairs in elementary school and was convinced I would become some sort of artist as an adult. However, I also had a profound interest in science… particularly biology, human anatomy and physiology. Initially this seemed to be at odds with my more artistic, right brained side. So in my adolescent years, there was an escalating internal struggle for how best to handle these differing parts of my persona. Although I did well in school and was a good athlete, I always felt a bit off or at least a bit different than many of my peers. I occasionally split time between the “artistic” crowd, who were not always the most popular kids and the the “jocks” who were. Don’t get me wrong, I was well adjusted and stayed out of trouble, I just felt a little bit like a fence straddler so to speak. This internal divide continued a bit through college. I was fortunate enough to play college baseball, which payed for most of my school, and although a wonderful experience, I knew my athletic ability wasn’t going to pay for anything else. I majored in chemistry (it was one less 3-hour lab than biology and was a bit of a rarity for an athlete) and minored in art (I considered it as a major but there were about 10 more 3+ hour studio sessions versus 3-hour chemistry labs) all the while knowing I would pursue a career in something completely different. That was when I did a one month rotation with 2 very prominent plastic/cosmetic surgeons as part of our January mini-term. While many college kids went to build homes in Africa, sail a ship in the Caribbean, track wolves in Minnesota, or critique pubs and plays in London… I decided to spend several weeks with Dr. James Grotting and Dr. Gaylon McCollough at their expansive downtown office.
The seed must have been planted at that time. I remember the artistry in the orchestrated dance of instruments, suture and skilled hands. I had seen 2 of the most accomplished surgeons of their time. I suspected then I would be a surgeon myself. Truthfully, I fought it a bit. The proposition of school and training into my thirties was not particularly exciting, especially for someone who never really liked school. Again do not mistake me… I always excelled in school and tested very high at all levels, but to say I always enjoyed it would be to tell a lie. Then again, I have always been a glutton for punishment. The first surgery I ever saw was a jaw repositioning surgery done by an oral and maxillofacial surgeon. I remember being fascinated that he had both a dental and a medical degree. I didn’t know that was even possible at the time. He had a wide array of knowledge that seemed impossible to accomplish, but I wanted to see if I was up to the task. Part 2 next time.