normal  medium  large

  • FAQs about Arm Lift Surgery — What Patients Need to Know

    Posted by Stony Brook Surgery on May 21, 2013

    Dr. Tara L. Huston | Stony Brook Plastic Surgeon
    Dr. Tara L. Huston

    In 2012, there were over 15,000 brachioplasties performed in the United States, according to new statistics just released by the American Society of Plastic Surgeons (ASPS) . This is an increase from only 300 procedures done in 2000.

    The dramatic rise in procedures performed — an increase of 4,378% in just over the last decade! — is likely related to the rise of bariatric surgery during the same time frame.

    In addition, new technologies and surgical techniques have made it more reasonable to treat upper arms. Plastic surgeons can now offer more patients better results with less downtime.

    Here, Tara L. Huston, MD, assistant professor of surgery and a member of our Plastic and Reconstructive Surgery Division, answers frequently asked questions about arm lift surgery.

    Q: What is brachioplasty?

    A: It is the medical term for an arm lift. It means arm (brachio) reshaping (plasty).

    Q: What is done in arm lift surgery?

    A: The excess upper arm tissue, sometimes referred to as a "bat wing," is removed during brachioplasty. This is done using direct excision (removal by cutting) or a combination of liposuction followed by direct excision.

    Q: Is liposuction always done as well?

    A: Depending on the level of correction needed, liposuction may be required to achieve the final desired contour.

    Q: Is arm lift surgery painful?

    A: There is discomfort associated with all body contouring procedures. Most patients report that the pain is very tolerable. The great majority of patients are off of prescription pain medicine by a few days after surgery.

    Q: What type of anesthesia is used for arm lift surgery?

    A: Arm lifts are usually performed in the operating room under general anesthesia. Additionally, many surgeons inject additional local numbing medicine in the surgical area while you are asleep to provide additional postoperative pain control.

    Q: Where is the incision made?

    A: The incision will depend upon how much tissue needs to be removed and whether the tissue is near the armpit or lower down on the arm. The traditional vertical incision goes from the armpit to the elbow. If the excess tissue is limited to the top of the upper arm, you may be a candidate for a short-scar arm lift with a crescent-shaped incision in the armpit area.

    Before/After Arm Lift Surgery
    Before and after arm lift surgery (American Society of Plastic Surgeons;
    click on photos to see more in ASPS gallery)

    Q: Is there any scarring with arm lift surgery?

    A: Yes, there is scarring associated with all body contouring procedures. Many physicians and patients believe this is the biggest downside to an arm lift.

    Q: Where is the scar?

    A: In a standard arm lift, the scar is a straight line from the armpit to the elbow. It is placed along the inside of the arm. However, it can still be visible in short sleeve shirts and tank tops. In the short-scar arm lift, the scar is a curved line that can be hidden in the armpit.

    Q: How long does it take for the scar to heal?

    A: Initial scar healing takes approximately two weeks. After that time, your surgeon will work with you on scar management including massage and topical therapies to minimize its appearance.

    Q: Who is a good candidate for an arm lift?

    A: A patient in overall good health, who has been weight stable for at least one year and desires to improve the contour of their upper arms.

    Together, you and your surgeon will devise a treatment plan that
    addresses your concerns and is surgically feasible.

    Q: What can I expect in my initial consultation?

    A: Your plastic surgeon will ask about your general medical history and examine your areas of concern. This is the opportunity for you to discuss what bothers you. Together, you will devise a treatment plan that addresses your concerns and is surgically feasible.

    Q: How long does the surgery take?

    A: To contour both upper arms, the total length of surgery is approximately three hours.

    Q: What will prepare me for surgery?

    A: The best way to prepare for an operation is to understand why you are having the operation, what exactly will be performed, and what your results are likely to be. If there are medical issues such as high blood pressure or diabetes, these should be well controlled prior to surgery.

    Smokers must stop smoking in order to decrease the risk of wound healing issues. All patients should be nicotine-free for at least six weeks prior to and after surgery.

    Q: What are the risks of arm lift surgery?

    A: The risks are similar to most major operations. They include wound healing issues, poor scarring, bleeding, infection, and seroma (fluid collection) formation. In order to prevent fluid accumulation, your surgeon may leave a small drain in place for a few days. In addition, he or she may place your arms in compression garments (similar to ACE wrap sleeves) right in the operating room, which you will wear during your initial recovery.

    Q: When can one return to normal activities? Exercising?

    A: Most patients are able to resume their daily routines within two weeks. It takes about four to six weeks to return to your exercise regimen.

    Q: Can other procedures be done at the same time?

    A: Yes, short procedures can be combined with an arm lift. In order to maintain the highest level of patient safety, we limit the number of body contouring procedures that can done at once, in order to limit time under anesthesia.

    Q: How much does arm lift surgery cost?

    A: Cost varies by location and consists of three components: professional fee for the surgeon, professional fee for anesthesia, and the cost of the operating room. Insurance companies generally do not cover the costs associated with these operations. They are considered cosmetic procedures. Most plastic surgeons have financing plans available.

    Click here for more information about the plastic surgeons and the plastic surgery services at Stony Brook Medicine.

  • Our Vascular Surgeons Perform Long Island's First "Fenestrated" Endovascular Aortic Aneurysm Repairs

    Posted by Stony Brook Surgery on May 16, 2013

    New FDA-Approved Stent Device Allows for Minimally Invasive Treatment of Complex, Life-Threatening Aneurysms

    Drs. Shang A. Loh and Apostolos K. Tassiopoulos
    Drs. Shang A. Loh (left) and Apostolos K. Tassiopoulos

    Two members of the Vascular Surgery Division have become the first physicians on Long Island to successfully implant fenestrated endografts in patients with complex abdominal aortic aneurysms (AAAs). The first procedures took place in February, and more have followed.

    Both vascular surgeons who performed these procedures, Apostolos K. Tassiopoulos, MD, professor of surgery and chief of vascular surgery, and Shang A. Loh, MD, assistant professor of surgery, have the advanced technical skills required for doing fenestrated endovascular aortic aneurysm repair (FEVAR).

    Fenestrated aortic endografts are custom made to suit each individual patient’s anatomy, based on reconstructions of the patient's vascular anatomy derived from computed tomography (CT) scans.

    These tube-like stent devices have precisely placed openings in them — full-circular holes and/or semi-circular scallops, called fenestrations — that allow extension of the "seal zone" above the kidney arteries, thus permitting normal blood flow to the kidneys and bowel.

    FEVAR represents the latest advance in the treatment of abdominal aortic aneurysm, and
    offers more patients the benefits of minimally invasive surgery for this life-threatening condition.

    Fenestrated endografts make possible the minimally invasive endovascular repair of AAAs that are located very close to the arteries supplying the kidneys and, hence, are not suitable for the standard aortic endografts. The purpose of aortic endografts, in general, is to seal off the AAAs in order to prevent blood from flowing into them.

    Fenestrated endografts recently received approval from the Food and Drug Administration (FDA) and require particular technical expertise for insertion. Only select centers in the nation with appropriately trained vascular surgeons are offering this new treatment option.

    Dubbed the "silent killer," AAA is fatal in most cases if the aneurysm ruptures before being repaired. Therefore, early detection and repair are crucial.

    "Abdominal aortic aneurysms seldom give warning signs. The condition occurs when a weak spot on the wall of the abdominal aorta balloons out — something like a bulge on an overinflated tire," explains Dr. Tassiopoulos.

    An estimated one million Americans live with an undiagnosed AAA — including 20,000 in Suffolk County alone. According to the Centers for Disease Control and Prevention, AAA is more common in men and in individuals aged 65 years and older.

    About FEVAR

    Fenestrated Endovascular Aortic Aneurysm Repair
    Fenestrated endograft placed within
    abdominal aortic aneurysm, showing
    arteries that feed kidneys through cus-
    tom-tailored openings (fenestrations) in
    top of graft (click on photo to enlarge).

    Minimally invasive endovascular aortic aneurysm repair (EVAR) has revolutionized treatment of AAAs in recent years. The technique involves insertion of a self-expanding, fabric-covered stent inside the aneurysm, using two small groin incisions for access to arteries, to effectively exclude the aneurysm in the aorta from circulating blood.

    The EVAR technique has significantly reduced the mortality and complication rate associated with traditional open repair of AAAs, and has become the preferred treatment method for most patients, including a significant number of patients who would have been turned down for a traditional open repair because of other health issues.

    Unfortunately, not all patients with AAA are candidates for EVAR. One of the most common limitations with standard endografts is an inadequate seal zone — also called a short neck — indicating little or no distance between the top of the aneurysm and the take-off of the arteries feeding the kidneys (renal arteries).

    When a short neck is present, the standard stent graft is unable to create a tight seal with the aortic wall, thus allowing continuous blood flow into the aneurysm.

    An estimated 10% of all patients with AAA have the short neck condition, and thus are not candidates for standard EVAR repair. Until recently, their choices for treatment were limited, and most had to undergo a traditional open AAA repair.

    Custom-made fenestrated endografts, which are designed based on each individual patient’s vascular anatomy using CT scans, incorporate tailored openings in the top section of the graft that allow extension of the seal zone above the kidney arteries without compromising blood flow to the kidneys and intestine.

    During the FEVAR procedure, stents are put through the graft fenestrations into the renal arteries to ensure that placement of the aortic endograft is accurate and secure, blood flow to the kidneys is preserved, and the aneurysm is successfully sealed off.

    FEVAR represents the latest advance in AAA treatment. The custom-made endograft is the most state-of-the-art device today for AAA treatment. This new device enables experienced vascular surgeons to treat patients with very complex aortic anatomy in a minimally invasive way.

    Drs. Tassiopoulos and Loh are members of Stony Brook Medicine’s multidisciplinary team of aortic disease experts that provides the most advanced treatments of aortic conditions on Long Island.

    Free screening for AAA is provided by the Vascular Surgery Division to qualified adults with risk factors. Individuals who wish to be screened are invited to use the Division’s interactive online appointment request form; or, to call 631-638-2100 to arrange for a screening.

  • FAQs about Skin Cancer and the Dark Side of the Sun

    Posted by Stony Brook Surgery on May 14, 2013

    Dr. Colette R.J. Pameijer | Surgical Oncologist
    Dr. Colette R.J. Pameijer

    According to the American Cancer Society, skin cancer is the most common of all cancer types in the United States, with over one million new cases diagnosed each year.

    Here, our melanoma surgical expert Colette R.J. Pameijer, MD, head of our melanoma and sarcoma surgery service, discusses what can be done to help prevent skin cancer and how to detect early signs of the disease.

    Q: What should people know about protecting themselves against skin cancer?

    A: Typically, skin cancer is the result of sun exposure and blistering sunburns that occur before the age of 18. So, in some ways the most important thing we can do is to protect our children from early sun exposure, although it's never too late to reduce your risk for skin cancer. And obviously eliminating ongoing sun damage is very important.

    The good news is that most people with skin cancer are going to be fine, because most skin cancers are either basal cell or squamous cell carcinomas. Only 4% of all skin cancers are melanoma, the most serious type of skin cancer. While it's not the most common, melanoma is the most common cause of death from skin cancer.

    May is National Skin Cancer and Melanoma Awareness Month.

    Q: Besides early sun exposure, what are some other risk factors for skin cancer, especially melanoma?

    A: Skin type has a lot to do with it. The vast majority of people who get melanoma are those with fair skin and light hair, and people with a lot of moles on their upper back; but sun exposure is by far the most common risk factor. The use of tanning salons also adds to the risk.

    Q: What are the symptoms of skin cancer, and what should people look for?

    A: We use the ABCDE memory guide to spot changes in moles: A is for asymmetry in the mole; B is for irregular borders; C is for color variation; D is for a diameter greater than 6 millimeters (about the size of a pencil eraser); and E is for evolution, or any change in a mole, including itching.

    Q: How often should people do self-body checks for changing moles, and how often should they get clinical checkups?

    A: If people don't have any history of skin cancer, they should have a complete skin examination annually. Those with a history of skin cancer, especially melanoma, should be evaluated twice a year by a dermatologist and do skin self-checks monthly. It's a lifetime of follow-up evaluations with your doctor, not just because of possible melanoma recurrence, but because of the possibility of other skin cancers as well.

    When in the sun, seek shade, cover up, get a hat, wear sunglasses, and use sunscreen.

    Q: How can people protect themselves against the UVA and UVB rays of the sun?

    A: Plan your outdoor activities before 10:00 am and after 4:00 pm. Sunbathing is not recommended at any time. Use a broad-spectrum sunscreen with SPF of 30 or higher, and apply over all exposed skin about ten minutes before going out, and reapply every two hours.

    There is also clothing that now has UV protection in them, including bathing suits for kids. And be sure to wear a hat to protect the scalp and ears. We don't want people to feel that they can't go outside. Just reduce your exposure to the sun.

    Q: How is skin cancer treated?

    A: If you have a lesion that you're worried about, the first step is to see your dermatologist, who will remove it if it looks suspicious. Most of the basal and squamous cell cancers are handled with local removal by the dermatologist and that's all the treatment needed.

    Melanoma
    Click on image to learn more.

    If there is a diagnosis of melanoma, a surgical oncologist will become involved, and the treatment depends on the depth of the melanoma. If it's what we call a thin melanoma, which is less than one millimeter deep, the treatment is removal of some normal skin around the melanoma.

    Once the melanoma is more than one millimeter deep, in addition to removing normal skin around the melanoma, we also sample the lymph node, because the deeper the melanoma, the greater the chance of lymph node involvement.

    Q: What distinguishes Stony Brook from other centers in treating skin cancer?

    A: Stony Brook provides comprehensive, multidiscplinary care to patients with melanoma. We offer screening, surgery, and the option to participate in local and national clinical trials. In addition, we conduct basic science and translational research, and also provide community education.

    While clinical trials are not for everyone and participation in them is strictly voluntary, the availability of these trials serves as a hallmark of our ability to offer leading-edge treatment. For many patients, this is the only opportunity available in Suffolk County to benefit from such studies.

    Several trials are currently underway at Stony Brook, studying new chemotherapy agents. The Multicenter Selective Lymphadenectomy Trial (MSLT 2) is evaluating the role of lymph node surgery in melanoma, in order to determine the optimum care for patients.

    Our dedicated team of pathologists, dermatologists, and medical and surgical oncologists meets once a month to review each melanoma case, and thus ensures that our patients receive the benefits of multidisciplinary care.

    Submit your questions about skin cancer to Dr. Pameijer via the comments feature below. For more information about skin cancer and its prevention, please visit the Centers for Disease Control and Prevention; also, follow Dr. Pameijer on Facebook.

  • Talking about Weight Loss Surgery Alternatives, ABC News Features Dr. Aurora Pryor

    Posted by Stony Brook Surgery on May 10, 2013

    Dr. Aurora D. Pryor
    Dr. Aurora D. Pryor

    The recent revelation that New Jersey Governor Chris Christie secretly had weight loss surgery in February has put bariatrics in the spotlight once again.

    Yesterday, ABC News published on its website an article titled, "Lap Band Alternatives Await FDA Approval," that features Aurora D. Pryor, MD, professor of surgery and director of the Stony Brook Bariatric and Metabolic Weight Loss Center.

    Dr. Pryor is the chairwoman of the Emerging Technologies Committee for the American Society for Metabolic and Bariatric Surgery (ASMBS), which tracks alternative weight loss procedures that may one day provide a viable alternative to going under the knife.

    The need to make weight loss interventions more patient-friendly continues to motivate the pursuit of alternative procedures and devices that offer other options to those currently used.

    In the ABC News article, Dr. Pryor says, "It's unlikely any one procedure will work for everyone and that any and all of these devices may eventually find their place in the arsenal in the fight against obesity."

    Obesity has become a national epidemic. During the past 20 years, there has been a dramatic increase in obesity in the United States and rates remain high, according to the Centers for Disease Control and Prevention. More than one-third of U.S. adults (35.7%) and approximately 17% (or 12.5 million) of children and adolescents aged 2-19 years are obese.

    "Our current bariatric operations are not right for everyone … Emerging technology might fill that gap."

    "We are limited because our current bariatric operations are not right for everyone," Dr. Pryor explains. "Emerging technology might fill that gap. People who don't want to be cut may be willing to have a device implanted."

    Dr. Pryor is also quoted as saying that "some [surgery alternatives], like stunning the stomach and intestinal lining with the cosmetic drug Botox to reduce hunger pangs or chemically scarring the intestine to slow digestion, haven't quite panned out."

    Some of the proposed weight loss surgery alternatives are controversial.

    Dr. Pryor points out: "One of the more controversial devices on the ASMBS emerging technology list is the AspireAssist pump, which works by sucking the food right out of the stomach so that only about a third of the calories are absorbed by the body. Patients wait 20 minutes after eating, then empty 30% of their stomach contents into the toilet through a small, handheld device that connects to a skin-port discretely embedded on the outside of the abdomen."

    The principle behind the AspireAssist pump is that calories not digested are calories not absorbed, and use of this pump should thus lead to weight loss. In a one-year trial of the pump, the 24 obese patients who were studied, on average, lost 49% of excess weight, the equivalent of about 45 pounds.

    Several weight loss surgery alternatives are available in many parts of the world but the Food and Drug Administration has not yet approved them for use in the United States, where the approval process involving clinical trials can take years.

    Commenting on the FDA in a blog of ours posted a year ago, Dr. Pryor stresses that many new procedures with good success in other countries never make it to the United States because of tight FDA regulations, and that the system here needs to be reworked to avoid stifling innovation.

    Read Dr. Pryor's blog from last May, "My Testimony before the FDA: Advocating for Innovation in Weight Loss Surgery." Follow Dr. Pryor on Twitter!

  • May Is National Trauma Awareness Month — Time to Think about Avoiding Distractions

    Posted by Stony Brook Surgery on May 3, 2013

    Road safety means avoiding distractions!
    May is National Trauma Awareness Month that features the annual campaign to promote safety on our roads, in our work, and at our homes. The campaign slogan of this year's National Trauma Awareness Month is, "If You're Distracted, We're Impacted," and the focus of the month is on Distraction.

    In observance of this year's National Trauma Awareness Month, our trauma team wants the public to know the issue of distracted driving and other activities where individuals are distracted is a critical issue for public safety and demands action immediately.

    The American Trauma Society (ATS) was instrumental in having May of each year designated as National Trauma Awareness Month by Congress in 1988. Since then, ATS has worked with other trauma organizations to develop injury prevention and trauma awareness materials for use by our members in their communities.

    Each year, a new focus is designated that relates to injury prevention and raising trauma awareness. For this year's campaign, ATS has put together the following set of facts about the dangers of distraction:

    • In 2009, 5,474 people were killed in crashes involving driver distraction, and an estimated 448,000 were injured.
    • 16% of fatal crashes in 2009 involved reports of distracted driving.
    • Distracted driving contributes to up to 8,000 crashes every single day.
    • Drivers who use hand-held devices are 4 times more likely to get into crashes serious enough to injure themselves.
    • Text messaging creates a crash risk 23 times worse than driving while not distracted.
    • Using a cell phone while driving — whether it's hand-held or hands-free delays a driver's reactions as much as having a blood alcohol concentration at the legal limit of .08 percent.
    • Sending or receiving a text takes a driver's eyes from the road for an average of 4.6 seconds, the equivalent — at 55 mph — of driving the length of an entire football field, blind.
    • 40% of all American teens say they have been in a car when the driver used a cell phone in a way that put people in danger.

    Program your phone voicemail to say, "If I don't answer I may be driving, and it would be unsafe
    for me to answer" — do this now in the spirit of Trauma Awareness Month!

    According to the AAA Foundation for Traffic Safety, passengers like hand-held devices are one of the most frequently reported causes of distraction that result in traffic-related trauma.

    Passengers need to train themselves to be considerate of everyone’s safety. They must avoid distracting the driver’s attention from the task of driving. Adult passengers can see to the needs of younger passengers so the driver is not distracted.

    Every effort the passenger can make to remove sources of distraction is a positive favor for road safety. To help drivers avoid potential distractions, passengers can assist drivers with:

    • Reading a map or give directions.
    • Answering cell phone and text messages.
    • Controlling temperature and ventilation.
    • Adjusting the stereo volume or channel.
    • Paying close attention to signs and landmarks.
    • Managing needs of other passengers, like infants and children.

    For information about trauma awareness and injury prevention programs in Suffolk County, please email our trauma nurse coordinator Jane E. McCormack.

  • Conducting Clinical Trials of Non-Surgical Treatment of Cellulite

    Posted by Stony Brook Surgery on April 23, 2013

    Drug Developed by Stony Brook Researchers Shows Potential as Therapy

    Drs. Alexander B. Dagum and Marie A. Badalamente
    Drs. Alexander B. Dagum and
    Marie A. Badalamente

    No effective treatment currently exists for cellulite; that is, the condition associated with the dimpled appearance of skin, commonly on the thighs and buttocks. According to the American Society for Aesthetic Plastic Surgery, up to 90% of women and 10% of men have cellulite.

    An effective, long-lasting treatment remains the goal of both researchers and countless patients.

    Alexander B. Dagum, MD, professor and interim chairman of surgery, and also chief of plastic and reconstructive surgery, and Marie A. Badalamente, PhD, professor of orthopaedics, have collaborated on the development of a collagenase (enzyme) injection method specifically for treating cellulite.

    This collagenase injection would break down the collagen that anchors fat tissue beneath the skin and, thereby, even out skin irregularities caused by cellulite. Drs. Dagum and Badalamente hope their research will result in the first effective treatment of cellulite.

    At present, a phase 2 clinical trial of the collagenase treatment is planned to start in the fall of 2013. It will follow the successful phase 1 pilot study that yielded promising results.

    "While cellulite isn’t harmful, it is a serious cosmetic concern for many people who want to feel better about their appearance and reduce cellulite as much as possible," says Dr. Dagum. "The methods to remove cellulite are many, but none yet have been supported in medical literature to be effective or potentially usable as a standard practice."

    The pilot study of the new drug found that, after six months, patients had on average a
    76% reduction of cellulite in the treated area, which is a promising demonstration of effectiveness.

    "We are looking for a standard and safe method of treating cellulite, one that can be effective for a long period of time," says Dr. Badalamente. She explains that current approaches to reduce cellulite, such as laser therapy, massage treatments, or topical creams show little evidence of significantly reducing cellulite.

    In 2006, Drs. Badalamente and Dagum obtained an investigational new drug number from the U.S. Food and Drug Administration (FDA) for collagenase in the treatment of cellulite.

    They completed their pilot study in which 10 women were treated with the collagenase treatmant here at Stony Brook. The study was presented at the 2006 American Society of Plastic Surgeons’ Annual Meeting held in San Francisco, CA.

    Participants in this trial had a collagenase injection based on the assessment of cellulite on the back of their thighs. The area of cellulite was quantified in centimeters with photo documentation. On average, a 77% reduction of cellulite occurred one day after the injection.

    After six months, patients had on average a 76% reduction of cellulite in the injected area. Only minimal side effects occurred, such as black-and-blue areas, soreness, and mild edema, shortly after the injection. After six months, the patients reported an average satisfaction score of 1.75 (1 = completely satisfied, 4 = not satisfied).

    "To have a significant reduction of cellulite after six months from an injection that is shown to be safe is promising for patients and warrants continued testing within the FDA regulatory process," says Dr. Badalamente, summarizing the pilot study.

    She emphasizes the overall study results were proof of concept for collagenase efficacy and safety in treating cellulite.

    Expanding Drug’s Indications

    Before and After Collagenase Treatment of Cellulite
    Patient's upper thigh before collagenase treat-
    ment and at six months after treatment, showing
    reduced cellulite (click on image to enlarge).
    The collagenase drug, under the trade name Xiaflex, is currently marketed and distributed by Auxilium Pharmaceuticals, which has been licensed to sell the drug for the treatment of Dupuytren’s contracture, a debilitating hand disorder.

    The results of the pilot study for cellulite and additional evaluation of collagenase by Auxilium prompted the company to expand the field of its license for the drug in January 2013 to include the potential treatment of adults with cellulite.

    Auxilium is responsible for the research, development, and new potential use of the drug for the treatment of cellulite. This includes clinical trials. Should the drug be FDA-approved for this new indication, the company will also be responsible for its marketing and distribution.

    In February 2010, the FDA approved the drug as the first non-surgical treatment of Dupuytren’s contracture, which is caused by progressive accumulation of collagen that deforms fingers and limits motion of the hand.

    The drug was originally developed for the use in Dupuytren’s contracture by Dr. Badalamente and her colleague Lawrence C. Hurst, MD, professor and chairman of orthopaedics, and their research has been reported in several journals, including the New England Journal of Medicine.

    Cellulite is formed of normal fat, anchored by collagen strands, beneath the skin. The irregular anchoring of this fat creates the dimpled appearance of the skin. There is no clear cause of cellulite, though factors may include genetics, hormone changes, lack of physical activity, slow metabolism, and poor diet.

    Phase 2a placebo-controlled clinical trials using the experimental drug treatment of cellulite are projected to start at Stony Brook Medicine in the second half of 2013. For more information, please call Dr. Dagum's office at 631-444-9265.

  • Grateful Patient Who Had AAA Repair Organizes Vascular Screening That Saves Lives

    Posted by Stony Brook Surgery on March 21, 2013

    Firefighters and Their Team Benefit from Fellow Firefighter's Experience with Vascular Disease

    Dr. Apostolos Tassiopoulos with East Meadow Firefighters
    Firefighters Michael Signorelli (left) and Thomas
    Etter (right) with Dr. Apostolos K. Tassiopoulos.

    Our upcoming free public vascular screening on Saturday, April 6, reminds us of the happy stories about our screening program — the ones where screening helped to save the lives of people who didn't even know their lives were in danger. We recently blogged Robert Rouge's amazing story.

    Another story involves a firefighter, who survived a potentially life-threatening vascular disease, and who, out of gratitude for the care he received at Stony Brook Medicine, collaborated with us to provide vascular screening to his fellow members of the East Meadow Fire Department in Nassau County.

    Sponsored by the East Meadow Fire Department's Benevolent Association, of which Michael Signorelli is president, the screening took place in October at the firehouse on Newbridge Road in East Meadow, NY.

    Five of 29 people screened were found to have vascular disease known as silent killers because they often have no symptoms, until it is too late:

    • Abdominal aortic aneurysm (AAA) that can be fatal if the aneurysm — bulge in the aorta just below the heart — ruptures; and
    • Carotid artery disease — clogged arteries in the neck — that can lead to a fatal stroke (brain attack).

    Our screening identified one person with an AAA, and four with carotid disease in which there was more than 50% blockage of one or both arteries. Two with carotid disease also had peripheral artery disease (PAD), and another two had PAD alone. PAD is often a sign of heart disease.

    The good news for those people who have vascular problems detected at our screenings
    is that they can get the medical attention they need to stay alive and keep living.

    This story actually began with what happened to Thomas Etter, 60, of Farmingville, NY. For years he used to live in East Meadow. That's where he served as a volunteer firefighter in the East Meadow Fire Department. Now retired from active service, he serves on the board of trustees of the East Meadow Fire Department's Benevolent Association.

    Thanks to Screening

    Abdominal Aortic Aneurysm
    Last spring, Mr. Etter had a routine stress test for his cardiac health that led to his having a CAT scan of his chest. This CAT scan found he had a large aneurysm that needed to be treated with surgery.

    "I am no stranger to any of this, as I know all too well the dangers of having such disease," says Mr. Etter. "Years ago, employed as a forensic pathology assistant with a county medical examiner's office, I saw firsthand what the end result was of having an abdominal aortic aneurysm.

    "Later in life, I became an advanced emergency medical technician with a municipal police agency, and I again witnessed aneurysmal disease. I was trained to recognize the symptomology of a dissecting abdominal aneurysm and the poor prognosis one faced, if not treated immediately. I knew that I was staring trouble in the face."

    On learning he had an aneurysm, Mr. Etter did extensive research to consider his options for the best possible care. His research led him to Stony Brook Medicine and Apostolos K. Tassiopoulos, MD, professor of surgery and chief of vascular surgery.

    In May, Dr. Tassiopoulos treated Mr. Etter's AAA with endovascular stent graft repair, an effective minimally invasive procedure that generally reduces hospital stay and recovery time.

    "I will always remember awakening, post anesthesia, and seeing Dr. Tassiopoulos sitting next
    to my bed. He was there to assess and reassure me of the procedure's success."

    Mr. Etter recalls, "In my follow-up visits I found comfort in knowing I made the right choice in my doctor and his staff. They always kept my wife and family well informed about my care and progress. Everyone was included in the loop. That made the diagnosis, surgery, and post-surgical care better for me."

    His personal experience has turned Mr. Etter into an advocate of aneurysm screening. For him the screening he organized that took place last fall is just the beginning. He plans to organize more to help his community. It's his way of giving back for the good care he himself received after his own "positive" screening.

    Mr. Etter's new health mission complements ours: we strive to save lives and educate our community through free vascular screenings.

    Our next vascular screening will take place at the Stony Brook University Heart Institute on Saturday, April 6, from 8 am to 4 pm: click here for details. The screening consists of three non-invasive tests for AAA, carotid disease, and PAD.

  • Providing "In Office" Balloon Sinuplasty for Chronic Sinusitis — It's Almost the Season

    Posted by Stony Brook Surgery on February 26, 2013

    Treating Chronic Sinusitis in Both Adults and Children with Minimally-Invasive Procedure; Now Also Performed as Outpatient, Same-Day Procedure in Doctor's Office


    Watch this video (1:57 min) to see how the procedure works.
    Sinusitis affects 37 million people each year, making it one of the most common health problems in the United States. It significantly impacts an individual’s physical, functional, and emotional quality of life.

    Patients suffer from headache, facial discomfort, nasal congestion, nasal drainage, loss of the sense of smell, and malaise.

    Until recently, sinusitis patients were limited to two treatment options: medical therapy such as antibiotics and topical nasal steroids or conventional sinus surgery including functional endoscopic sinus surgery (FESS).

    Medical therapy can help alleviate symptoms for some patients. However, for 20-25% of sufferers, this form of treatment alone is not adequate. For these patients, sinus surgery is their next hope in finding relief.

    Balloon catheter dilation of paranasal sinus ostia, or balloon sinuplasty, is an effective minimally invasive technique for treating chronic sinusitis, and a leading-edge procedure of our minimally invasive ENT program at Stony Brook.

    FESS is a conventional operation that requires bone and tissue removal in order to open up blocked sinus passageways. With no desirable treatment, more than 600,000 people nationwide are left living with their sinus condition.

    The current revolution in minimally invasive procedures for endoscopic sinus surgery has led to the development of the new technology called balloon sinuplasty, which provides an effective alternative to FESS.

    Our ENT specialists — Mark F. Marzouk, MD; Elliot Regenbogen, MD; Ghassan J. Samara, MD; and Wasyl Szeremeta, MD — are experienced in using the sinuplasty technology to treat both adults and children with chronic sinusitis.

    In 2007, we became the first in Suffolk County to offer balloon sinuplasty. In 2012, we became the first to treat children with it. We proudly continue to use leading-edge technology to lead the way in patient care.

    Now, with the latest sinuplasty technology, our physicians can perform the procedure in our ENT office in East Setauket on an outpatient, same-day basis, offering patients state-of-the-art treatment that fits on-the-go lifestyles.

    For consultations/appointments with our ENT specialists who provide balloon sinuplasty, please call 631-444-4121.

  • Stony Brook Lung Cancer Support Group Nurses Receive National Recognition

    Posted by Stony Brook Surgery on January 29, 2013

    Lung Cancer Alliance Honors Two Stony Brook Nurses for Their Dedication

    Recipients of the 4th Annual Lung Cancer Support Group Award, with Flowers
    (l to r) Thomas Bilfinger, MD, co-director of the
    LCEC; Rose Cardin, RN, MSN, associate director
    of nursing, oncology, and administrator, Cancer
    Services; Yusuf Hannun, MD, director of the Can-
    cer Center; honoree April Plank, DNP; Sajive
    Aleyas, MD, co-director of the LCEC; honoree
    Kathleen Shurpin, PhD, RN,     ; and Amy Copeland,
    MPH, of LCA, who presented the award.

    We are very pleased to announce that April Plank, DNP, and Kathleen Shurpin, PhD, RN, of our Lung Cancer Evaluation Center (LCEC) team, received the 4th Annual Lung Cancer Support Group Award from Lung Cancer Alliance (LCA) in a ceremony held last week at the Stony Brook Cancer Center.

    The award was presented by Amy Copeland, MPH, associate director of support services for LCA.

    Dr. Plank is a member of the thoracic surgery service of our Cardiothoracic Surgery Division, and Dr. Shurpin is a member of the faculty in the School of Nursing.

    Together, these two nurses serve as co-facilitators of the LCEC's Lung Cancer Support Group, which meets once a month at the Cancer Center. The support group is free and open to the public, and is not restricted to patients treated at Stony Brook Medicine.

    Based in Washington, DC, LCA created the award to recognize excellent support group facilitators, and to inspire and encourage the creation of more lung cancer support groups throughout the United States. Award winners have shown great dedication to those affected by lung cancer in spite of the challenges that often come with sustaining these support groups.

    "There are few words to express the sheer joy one receives in observing the process that often takes place
    in those who become regular group attendees of our Lung Cancer Support Group at Stony Brook."

    "Anyone fighting this disease needs their family members and loved ones to rally around them," says Yusuf Hannun, MD, director of the Cancer Center and vice dean of Cancer Medicine. "We are extremely proud of April and Kathy for their outstanding contribution to the Cancer Center and this wonderful recognition from Lung Cancer Alliance."

    Nurses April Plank, DNP, and Kathleen Shurpin, PhD, RN
    Nurses April Plank (l) and Kathleen Shurpin.

    "April and Kathy are truly committed to making their group a safe and supportive place," Ms. Copeland told the audience at the award ceremony. "They are warm, compassionate, and enthusiastic about the group, and think creatively about how to provide support even when someone is not well enough to attend."

    At Stony Brook, the Lung Cancer Support Group provides a place for patients to gather each month to share information and provide mutual support to others who are on the same journey. The group is one of dozens of support services provided to patients and community members at the Cancer Center. In keeping with the Cancer Center's mission, these programs offer a wide variety of respite, advocacy, and hope — not only to the patient, but to family members and caregivers as well.

    "It is truly an honor for Stony Brook Cancer Center to be given this award from such a prestigious organization," Dr. Plank says. "There are few words to express the sheer joy one receives in observing the process that often takes place in those who become regular group attendees. Co-facilitating this group of patients and their loved ones along their journey with lung cancer has been one of my greatest career rewards."

    "It is a privilege to have the opportunity to serve patients and families experiencing lung cancer in this support group," Dr. Shurpin says. "These patients and their family members provide not only support for each other but insights into the cancer experience that inform my teaching, research, and practice."

                      Lung Cancer Alliance is the only national non-profit organization dedicated solely to patient support and advocacy for people living with lung cancer and those at risk for the disease. Established in 1995, Lung Cancer Alliance is the largest lung cancer advocacy organization in the United States and world.

    Lung Cancer Alliance offers real-time patient support through a team of professional staff. The free information referral services include a 1-800 information line staffed by professionals, an online support community, a peer-to-peer telephone support program, and clinical trial matching service.

    For more information about the Lung Cancer Support Group of the Stony Brook Lung Cancer Evaluation Center, and also for registration to attend if desired, please call April Plank, nurse practitioner, at 631-444-8236.