For Dr. DeWeese, reconstructive plastic surgery is among his most rewarding work. The opportunity to make patients feel whole again is especially satisfying, and the challenge of performing under the pressure of urgent and tragic circumstances improves his ability to meet the needs of all his patients. Throughout his career, Dr. DeWeese has performed successful surgical procedures in a variety of different reconstructive areas.
Breast reconstruction surgery is most often performed to replace breast tissue that has been removed due to cancer or other disease. New medical techniques and devices have made it possible for surgeons to create a breast close in form and appearance to a natural breast. This includes flap reconstruction, in which a patient's own muscle, fat and skin may be repositioned (from the abdomen or back) to create or cover the breast mound.
Frequently, reconstruction is possible immediately following breast removal (mastectomy), so that the patient wakes up with a new breast mound already in place, having been spared the experience of seeing herself with no breast at all.
Breast reconstruction typically involves more than one operation. The first stage, whether done at the same time as the mastectomy or later, is usually performed in a hospital.
Follow-up procedures may also be done in the hospital or, depending on the extent of surgery required, your surgeon may prefer an outpatient facility.
While making preparations, be sure to arrange for someone to drive you home after your surgery and to help take care of you for a few days, if needed.
You are likely to feel tired and sore for a week or two after reconstruction. Most of your discomfort can be controlled by medication prescribed by your doctor.
Depending on the extent of your surgery, you'll most likely be released from the hospital within two to five days. Many reconstruction operations require a surgical drain to remove excess fluids from surgical sites immediately following the operation, but these are removed within the first week or two after surgery. Most stitches are removed in a week to ten days.
It may take up to six weeks to recover from a combined mastectomy and reconstruction or from a flap reconstruction alone. If implants are used without flaps and reconstruction is done apart from the mastectomy, recovery time will be less.
Post-op patients should refrain from any overhead lifting, strenuous sports, and sexual activity for three to six weeks following reconstruction.
Burn reconstruction is the term for reconstructive surgery performed on abnormal anatomy of the body caused by trauma or injury. This surgery can improve physical function and restore normal appearance. The reconstruction process often requires several operations, depending on the severity of the burns and the health of the patient.
Dr. DeWeese treats burn patients at Saint Francis Memorial Bothin Burn Unit in San Francisco. The Bothin Burn Unit is the only verified burn unit in the Bay Area.
For more information about the amazing reconstructive work performed Dr. DeWeese, please take a look at the following article: Dr. DeWeese Saves War Torn Child (San Francisco Chronicle - Saturday, June 26, 1999)
Once a devastating disease whose diagnosis meant certain swift death, HIV infection has become more of a chronic, albeit debilitating, disease.
Dr. DeWeese has had extensive experience performing surgery on HIV and AIDS patients, dating back to a time before these terms were even part of the medical vocabulary. He is on the forefront of developing procedures aimed at ameliorating the ravages of this disease and the side-effects of the life-saving drugs used to treat HIV/AIDS all without jeopardizing the life expectancy of the individual affected patients.
One of the more prominent tangibles effect on the body of HIV/AIDS (and its associated drug treatments) is called lipodystrophy. Lipodystrophy describes both “visible" changes in body shape, and “hidden" changes in metabolism, i.e., the way your body turns fat and sugars into energy. Lipoatrophy, or fat loss, may occur in the face, legs, arms and buttocks. Lipoaccumulation, or fat build-up, may occur behind the neck insensitively dubbed "buffalo hump" in front of the neck, deep within the belly, and in the breasts.
The exact cause(s) of lipodystrophy are not known. Some risk factors include: low CD4 count, HIV infection itself, prolonged duration of HIV infection, various HIV medications, age, race, gender, weight, and diabetes mellitus. The accumulation of fat in the region behind the neck and back of the upper torso was initially thought to be a side-effect of steroid medication. But, recently, it has come to be associated with the use of anti-HIV medications. Not only is it unsightly, but the accumulation of fat can also cause restriction of motion of the head and neck, as well as discomfort or debilitating pain.
The most stigmatizing location for lipoatrophy to occur is in the mid-face. While no one procedure can completely correct this wasting deformity once it develops, cheek augmentation with Silastic implants is the most popular and expedient treatment to date.
Fat transfer from another site on the patient's body, when available, is also an option. Injectable and implantable fillers are under development but to date there is no FDA-approved permanent injectable filler available.
The most common visible form of lipoaccumulation in those with HIV/AIDS occurs behind the neck. Ultrasound assisted lipectomy (UAL) is one way to improve the dramatic contour irregularities affecting these patients. Dr. DeWeese has performed this procedure on more than forty patients with excellent initial results. Unfortunately nearly one-third of the patients complain of some degree of recurrence of the lipoaccumulation. Newer medications are being developed with the hope of fewer side effects.
This patient is a 48-year-old shown just before and two years after UAL of the dorsocervical region (back of the neck and upper torso).
In collaboration with other plastic surgeons and physicians whose practices focus on HIV/AIDS, Dr. DeWeese has advanced the field by presenting his experience treating the condition commonly called "buffalo hump" in both International and National Scientific Forums.
The manner in which scars form on an individual can be as unique and unpredictable as the individual him- or herself. Many factors contribute to the way a wound heals, only some of which are under our control. Thankfully, through our bodies natural functioning, scars continue to improve for at least two years following an initial injury or revision.
Innovative new methods have been developed to minimize the visibility of scars. These include changing the direction of the scar to run parallel to the lines of relaxed skin tension, shortening the scar in one direction and or lengthening it in the other, or shifting the scar's location and shape in relation to other anatomical structures to make it less obvious. Often, scar revision can be performed with local anesthesia and a recovery period of only a week to ten days.
Face-to-face consultation with Dr. DeWeese is necessary in order to determine if you would benefit from a scar revision. The cost depends a great deal on whether the procedure may be performed in the office versus the hospital, and will be outlined in detail during your consultation with the doctor.
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