Virtual Consultations Available
An Interview with
Dr Michael C. Edwards, MD, FACS
Dr Michael Edwards practices as a board-certified plastic surgeon and is a partner of Plastic Surgery Vegas in Las Vegas, NV. His skill and experience enable him to combine aesthetic vision with technical expertise, to make your vision a reality. With a strong belief in the ethical and safe care of his patients, he also serves on the State Medical Board and has had many leadership roles in national plastic surgery societies, including ethics committees.
Plastic Surgery Vegas is a plastic surgery practice that embodies excellence in cosmetic plastic surgery, providing comprehensive and state of the art care in a comfortable environment. In addition to Mike’s Dr Edwards’ impeccable credentials, he has earned the respect of his peers through years of experience in the full range of surgical and non-surgical procedures. Dr Edwards’ practice now focuses on all aspects of primary and revisional breast surgery. During your consultation, which will last an hour or more, your medical history will be reviewed and your motivations and expectations discussed.
You will be educated about your specific anatomy, the procedure(s) Mike Dr Edwards would recommend to reach your stated goals and why he is recommending them. Through the use of a wonderful system called TouchMD, patient’s photos are stored to include drawings. You will be able to access all of your information and additional educational materials on a HIPPA compliant site from your own home and are encouraged to ask any additional questions. From your first visit in consultation through your post-operative appointments, your recovery will be guided by Dr Edwards and his team with our goal being a great aesthetic result in the safest manner we can, to ensure a complete recovery and the best possible outcome from your chosen procedure.
http://www.plasticsurgeryvegas.com/
Would you introduce yourself and advise what your areas of interest are?
I am Michael C. Edwards, MD, FACS and I currently practice in a group practice with 3 partners, a dermatologist and a staff of 30 in the greater Las Vegas area. I have been in clinical practice now for 23 years and I have been trained in and performed all facets of plastic and reconstructive surgery. My current focus is primary and revision breast surgery which keeps me quite busy.
Are you board-certified and what are your qualifications?
I am currently board-certified in Plastic Surgery by the American Board of Plastic Surgery. I have a strong belief in the ethical and safe care of our patients and I am honoured to serve on the State Medical Board and on our national societies ethics committees.
Are you affiliated or a member of any professional bodies?
I am a member of The American Society for Aesthetic Plastic Surgery (asaps). I have served in many roles in this society up to being honoured to have served as president 2014-2015. I am also a member of the American Association of Plastic Surgeons and the Clark County Medical Society which I also served as president of. I have been a member of numerous professional societies and served 19 years in the US Air Force as an officer and physician.
If yes, why have you chosen to join that professional body and what do they do?
ASAPS is the preeminent plastic surgery society representing national and international plastic surgeons that focus their practice on the safe and state of the art aesthetic plastic surgery. It was my honour to serve as president because I share the societies passion for education and patient safety. ASAPS provides education to all level of plastic surgeons starting with residents through our annual large meeting, smaller focused meetings, webinars and publications to include the Aesthetic Surgery Journal (ASJ) which is the number one global monthly journal on aesthetic plastic surgery.
Do you charge a consultation fee and is it a set amount regardless of the procedure the patient is inquiring about?
I do charge a consultation fee of $50 for new consultations. The promise I make to my patients is that they are there for an hour or more and that when they are done, they will have been educated about their specific anatomy, the procedure(s) I would recommend reaching their stated goals and why I recommend them. I use a wonderful system called TouchMD where the patient’s photos are stored to include drawings I make for their education. The patients are able to pull up these and other educational materials on a HIPPA compliant site from home and are encouraged to return to me with any additional questions. I don’t like patients have surgery without making them as informed as I possibly can.
Do you ever perform breast augmentation under local anaesthetic and why, or if not, then why not?
I do not. My preference is to place breast implants partially under the muscle (dual plane technique) and, although it is possible, I feel I can personally perform a more precise surgery with the patient carefully and safely relaxed under a general anaesthetic.
Do you perform reconstructive breast surgery?
I no longer work with health care plans as a provider so I do not do primary breast cancer reconstruction. I do see women who have had breast reconstruction and are unhappy with their result. I am happy to be able to help them with revision breast surgery.
Do you perform Flap reconstruction?
I do not for the same reason as the previous question.
Do you have a preferred manufacturer of breast implants and if so why?
I prefer Allergan implants and have used them since I began training when they were known as McGhan, then Inamed and now Allergan. In full disclosure, I serve as a consultant for Allergan and I frequently lecture for them on revision breast surgery and safe techniques. Although I am compensated for these educational events, I receive no more discount or incentive to use their products than any other plastic surgeon. I enjoy working with Allergan as an educator and as a plastic surgeon because I believe in their products and I like their philosophy and dedication to education.
Do you have a preference between silicone or saline-filled implants and if so, why?
I have preferred smooth round silicone gel implants for the past 15 or more years. On rare occasions I will use a smooth saline implant but only if the patient requests. I believe current generation Allergan silicone implants provide my patients of all body shapes and sizes with the best aesthetic result. There are 2 other implant manufacturers in the US, Mentor and Sientra, which are FDA-approved as well.
Do you have a preferred incision and placement for breast implants?
I prefer to place breast implants through an infra-mammary fold incision for a variety of reasons. For me, this allows me the best visualization to develop a sub-muscular pocket in a controlled and precise way to fit the implant I am placing. I also believe this incision has the lowest rate of capsular contracture, in my hands because of decreased bacterial contact. I have performed the other incisional approaches and there are plenty of board-certified plastic surgeons who use them very effectively. I will virtually always place the implants under the muscle for better coverage, decreased risk of capsular contracture and I believe a better aesthetic result.
What alternative incisions do you offer?
If I am performing a breast lift, I will use a mastopexy (breast lift) approach.
Do you offer T.U.B.A and if not, why not?
I do not. In my revision breast surgery practice, 80%+ what I do, I see implant malposition or improperly developed pockets from patients who have had this technique. You can only use a saline-filled implant with this technique as well and I prefer to not perform a blind technique where I cannot see in the pocket.
What is the largest cc volume, silicone breast implant and the largest cc volume saline implant, you have ever used and was it for reconstruction, revision surgery as patient desired larger implants or for a standard breast augmentation.
The largest silicone implant currently available is 800cc and I have used the on occasion. Patients come in all shapes and sizes and an 800cc implant may yield a proportionate breast in some patients. Patients will sometimes present with a stated desire of a larger implant than I believe is appropriate because a friend had this implant. It is my obligation to lead a patient to the proper implant, size/style/shape, that fits their breast dimensions.
Do you use permanent expandable implants and what is the largest cc volume you have filled up to and was it for reconstruction, revision surgery as patient desired larger implants or for a standard breast augmentation.
I do not use these implants. Clear and simple, the more you stretch breast tissue and skin, the worse it will look and perform into the future. It is then, that I or other revision breast surgeons, will see them for the redo surgery.
If you don’t use permanent expandable implants, why not?
See the answer above.
Do you think there should be a limit on the maximum cc volume that can be used?
It depends on the patient’s anatomy and proportion for sure. I would not be truthful if I did not say that I have not used larger implants in women. Living and practising in Las Vegas, the average implant volume I place is larger than in other parts of the country. I do try with each consultation to guide a patient to the best implant for them to reach appropriate goals.
Do you ever use mesh or internal sutures to support larger implants?
I most certainly do. I prefer Strattice ADM for revision surgery where there is a need for improved coverage or in the case of recurrent capsular contracture. I have had very good success in over 250 patients with minimal complications and good longevity of results. I have also used a dissolvable mesh called Galaflex for fold support.
The FDA and GMC have advised that non-symptomatic patients with Textured Allergen implants that have now been withdrawn from the worldwide market due to the link with BIA-ALCL, should not have their implants removed, what is your opinion?
I have this conversation perhaps 1-2 times a day in my clinic. I listen to my patient’s concerns and try my best to educate them with the best current science I know. BIA-ALCL is a rare but real and so far poorly understood process. To date, it has only been seen in patients with a history of having had a textured breast implant. In general, the cure is surgery to remove the implants and associated capsules. If a woman is made aware that her risk is quite low of developing BIA-ALCL and still would like her implants removed, I will care for them. For those who like their breasts, I ask them to return at least annually for a follow-up exam and ultrasound. As I stated above, I have not used textured implants for the great majority of my plastic surgery career.
Have you had any patients diagnosed with ALCL-BIA?
No.
What is your opinion on fat transfer as an alternative to implants?
In the right patient, I think autologous fat grafting is a very nice alternative for patients who do not wish to have a breast implant. The patient must be properly screened and consented that they know there is a limit to how much of a change they can expect and that there are times when multiple procedures may be required. I would heartily encourage potential patients to carefully choose who they decide to perform their surgery. There are more and more non-plastic surgeons advertising this and other “cosmetic” procedures. I have seen complications in my revision practice.
In your opinion what is the most important information you need to ascertain when you are speaking to a patient, in order to achieve high levels of patient satisfaction.
I start every patient encounter as though I will be performing their surgery. By this, I mean I try to educate them through the visit as I gather information about their overall health, previous surgeries (aesthetic or not). After this need to know what their motivations are and if they have realistic expectations. I believe I am a very good plastic surgeon but I have to make the patient aware of our starting point and what changes and improvements I can provide. On rare occasion will simply say to a patient with unrealistic expectations that I do not feel I am the right plastic surgeon for them. I am blessed to have had many very happy and satisfied patients.
Michael C. Edwards, MD, FACS
Past President-American Society for Aesthetic Plastic Surgery
Plastic Surgery Vegas
8530 W Sunset, Suite 130
Las Vegas, Nevada 89113
(702) 822-2100
http://www.plasticsurgeryvegas.com/
Worried about BIA-ALCL?
I have Allergen implants that have now been withdrawn from the worldwide market due to a link with this type of cancer and I am keeping them to find our why and for more information:-