Showing posts with label women. Show all posts
Showing posts with label women. Show all posts

Nipple-Sparing Mastectomy: The Ultimate Aesthetic in Breast Reconstruction

Posted by admin on Friday, November 26, 2010

Over the last 10 years, there has been an increasing awareness among General/Breast Surgeons that in many cases, it is not necessary to remove the breast skin along the breast tissue. This is called NIPPLE-SPARING MASTECTOMY (NSM):

Advantages of the NSM and immediate reconstruction technique:
  1. It is a single-stage technique with only one general anesthetic in the majority of cases
  2. There are no visible scars on the breast, unless later mastopexy ("breast lift") is desired or needed
  3. It is performed using an adjustable permanent implant, not a tissue expander, OR a flap reconstruction
  4. The implant or flap is placed over the muscle to avoid animation ("motion") deformities when the pectoralis major muscle flexes
  5. The recovery is shorter and involves significantly less pain than traditional two-stage expander-implant breast reconstruction
  6. This is an oncologically safe, unique mastectomy technique which cores out the nipple on the involved side for additional Pathological tissue analysis
  7. In some cases, it is possible to perform a nipple lift (mastopexy) at the same time as the mastectomy and reconstruction
  8. This technique is the simplest, quickest, most aesthetically pleasing technique for women who are considering prophylactic mastectomy for genetic risk.
  9. There is no delay of radiation or chemotherapy due to a speedy recovery and extremely few wound healing problems


The NSM technique has taken years to refine, but we believe it is the simplest and most aesthetic single-stage implant reconstruction. It is also being used in our practice with the DIEP flap and other microsurgical flaps such as the inner thigh (TUG) flap.
 
NSM is ideal for women who are carriers of the BRCA-1 or BRCA-2 gene and other women with a strong family history of breast cancer who are seeking prophylactic mastectomy and breast reconstruction. It is also appropriate for women with DCIS and invasive cancer that is at least 2 cm away from the nipple.

For those women who have tumors which are very large, very aggressive, or involving the nipple, single stage reconstruction removing the nipple is still available. This is also done over the muscle in our practice.
 
NSM is performed through an incision hidden under the breast, in the breast fold ("inframammary fold"), limiting the scar.  Following mastectomy, in the same operation, reconstruction is performed using either an implant or a flap. 

Read about my patient Desdemonia's experience with this procedure!

If an implant is placed, it is located in the exact same space that the breast was, on top of the pectoralis major muscle.  A permanent, adjustable implant is used.  It is inflated approximately 60%-80% of the way at the time of surgery; only one or two additional inflations are required in the office in the 1-2 week period following surgery.  No "expansion" of the breast skin is needed, as the implant is not used to stretch the skin but is used to "fill out the space".  The great thing about these types of implant is that the woman undergoing the procedure is empowered to make the final decision about her desired implant size, not the surgeon!

A flap placed for reconstruction provides the ultimate soft, warm, living tissue reconstruction that has none of the risks and potential complications of implants.  


Please visit our website for more information.
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What are drains? Why are they used?

Posted by admin on Tuesday, March 2, 2010


A suction drain is a thin, soft, silicone tube that is inserted into an area of the body where surgery has been performed - examples are following a breast augmentation, tummy tuck or breast reconstruction procedure.  

The drain tubing exits through the skin and its purpose is to remove wound fluid during healing.  It is attached to a small suction bulb, often in the shape of a grenade (known as a JP, or Jackson-Pratt bulb), that when compressed, applies very gentle suction to the drain tube, and slowly removes fluid from the area of surgery.  



Initially, the drain wound fluid appears thick and red, as there is minor bleeding with any surgical procedure.  With time (over days to a week), there are less red blood cells in the wound fluid and the fluid becomes more clear and less red.  The color changes from dark to light red, pink, orange and finally clear light yellow (known as serous fluid).  It is at this point that the drains are ready to be removed.  

You will be asked to record the fluid your body is producing on a drain log (see the link for a downloadable form).

Just as when you scrape your knee and it initially bleeds and then weeps fluid for a time, wounds inside the body also make wound fluid.  This is a normal part of healing.  However, wounds outside the body that are exposed to air eventually dry out and form a scab.  

Wounds that are inside the body, such as around a breast implant, or in the area of a tummy tuck, continue to create wound fluid until the body is healed.  Bacteria love to grow in wound fluid - this is why Plastic Surgeons usually use drains to remove this fluid as it forms - to decrease the risk of infection and capsular contracture (contraction of scar tissue around a breast implant). 

Drains are not painful, and do not hurt when they are removed in the office, usually 3-10 days after surgery.  They are held in place by a small drain stitch (suture) that is cut, and the drain is easily pulled out.  

After breast implant or reconstructive surgery, I usually recommend that my patients avoid showering while their drains are in place, also to decrease the risk of infection of their breast implants.  You may sponge-bathe, shower only the lower half of their body, and either wash their hair in the sink or go to the salon for a wash and blow-dry (and splurge on a mani-pedi while they're there!).

Remember, "drains are your friends!".  They are there to help you heal without complications and will be removed when they are ready. 

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Breast implant massage video - Instruction on how to keep your breast implants soft after breast augmentation

Posted by admin on Monday, March 1, 2010

Following a breast augmentation, is is imperative that women massage their breasts to keep the implant inside mobile and to ensure a soft, natural result!



To watch the Women's Plastic Surgery video on breast implant massage technique, click here.


POSTOPERATIVE MASSAGE INSTRUCTIONS FOR BREAST IMPLANT SURGERY

MORE INFORMATION:
Video: Post Reconstruction Surgery, Implant Massage Techniques 

Video: Post Breast Augmentation Surgery, Implant Massage Techniques 

Capsular Contracture Prevention Program

Breast Implant Antibiotic Prophylactic Recommendations

We cannot over-emphasize how important your post-op massaging is in order to preserve your excellent results of breast augmentation surgery.


Massaging begins general at a week or two after breast augmentation surgery.  You will be taught by Dr. Horton and her staff how to massage directly only your own breast.

DO NOT WORRY, YOU CANNOT BREAK THE IMPLANT. It takes more than 50 times the force of a mammogram to rupture an implant!

You should be able to make your fingers meet through the implant in both the vertical and horizontal directions. You should also move the implant around in its pocket to keep the pocket open. The best time to massage is in the shower or when you are warm and relaxed. You should massage once or twice a day for five minutes.


If you have any questions about the massage technique or whether your implant is hardening, do not hesitate to contact us.

GOOD LUCK AND HAPPY MASSAGING!  See the video here:  http://womensplasticsurgery.com/video_massage-aug.html.
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Online Article with Dr. Karen Horton of Women's Plastic Surgery - Neko Cheri and NC Mag Online

Posted by admin on Thursday, February 25, 2010

I was recently interviewed by Neko Cheri about my experience being a woman Plastic Surgery and in starting my practice and business in San Francisco.  



  

  

Neko Cheri is the creator of NC Mag, "The intelligent woman's guide to sophisticated living", an online publication for women, by women.

She also hosts a live online talk radio show, Neko Cheri LIVE on Blog Talk Radio.  Check her out!




  
The full article including links to my website and additional information can be read here:


INTERVIEW QUESTIONS DR. KAREN HORTON:
Q:        WHAT PROMPTED YOU TO START YOUR OWN PRACTICE, AND HOW LONG HAVE YOU BEEN IN BUSINESS?
            I completed a long, but very rewarding 16 year road of University study to become a Plastic Surgeon, and started my private practice in Plastic Surgery in 2006.  I am one member of a unique, all-woman Plastic Surgery practice, "Women's Plastic Surgery".  See our website www.womensplasticsurgery.com for more information. 
            Starting your first job at the age of 35 was quite different from many of my friends from college and peers in the community; however I wouldn't have done it any other way!  I am exciting to get out of bed each day and to go to work, something that many others can't relate to! 
            When considering the options for employment, I considered different types of practice, including academic University life, an HMO setting (like Kaiser Permanente), a large group practice, or private practice. 
            For me, private practice was the best fit, in that it enabled me to develop a specialized practice, focusing on the areas of Plastic Surgery I am most passionate about, and to deliver the best patient care, in a personal setting. 
             

Q.        WHAT IS YOUR AREA OF EXPERTISE?
            I am a Board-Certified Plastic Surgeon and Reconstructive Microsurgeon, practicing in the Pacific Heights area of San Francisco.  I specialize in both reconstructive surgery and cosmetic surgery for women.  Visit my bio for additional info about my background and training. 
            At least half of my practice focuses on breast cancer reconstruction, using new techniques that are not yet widely performed in the United States.  One technique for reconstruction of the breast involves a single-stage procedure using an implant, giving women a natural result without the need for multiple surgeries.  Another novel technique involves Microsurgery to reconstruct the breast using the body's own tissue, usually from the lower abdomen or inner thigh area.  This option avoids the use of implants, and provides a permanent, soft and living tissue reconstruction, while adding the benefit of a tummy tuck or a thigh lift! 
            The other part of my practice focuses also on women, many of them Moms!  The "mommy makeover" spectrum of procedures rejuvenates a woman's body after she has completed childbearing.  This type of surgery usually focuses on the breasts and body.  There are permanent changes after pregnancy such as breast deflation or drooping, loss of abdominal muscle tone, and/or excess skin and fat in the middle section or thighs.  Many of my patients are personal trainers, who also need a little help once they are mothers!
            A mommy makeover can include a breast lift, breast augmentation or breast reduction, depending on the changes of pregnancy and your specific aesthetic goals.  Because the muscles of the abdominal wall are permanently separated after pregnancies (particular after multiple children or twin pregnancies), a million sit-ups will not help!  A tummy tuck ("abdominoplasty") and/or liposuction is often recommended to bring the abdominal muscles back together in the midline, and to recreate a flat belly.
            Lastly, I see patients for general Plastic Surgery concerns: moles, skin cancers, and other body concerns.  Labiaplasty is one procedure I particularly enjoy!  Redundant labia minora tissue (inner lips of the female external genitalia) that hangs lower than the labia majora (outer lips) is trimmed for both cosmetic concerns and sometimes for pain during intercourse. 

Q:        WHAT WOULD YOU SAY IS THE MOST SIGINIFICANT ADJUSTMENT THAT WOMEN HAVE AFTER SURGERY?
            Any body-modifying surgery can have a major impact on body image and self-esteem.  Hopefully, the change is a positive one!  However, just like a drastic haircut, there can be a "body image adjustment" period or temporary feeling of remorse after surgery.  I counsel my patients at their initial consultation that this adjustment period of potential feelings of uneasiness, anxiety or "what have I done?" is completely normal and common after surgery.  It can take some time to adjust to your body after any surgery, and the most healthy approach is to acknowledge how you are feeling and to communicate this to your loved ones who are assisting you after surgery. 

Q:        IT SEEMS THAT PLASTIC SURGERY IS A MALE DOMINATED INDUSTRY HOW HAVE YOU BECOME SO SUCCESSFUL?
            Many women come to see me after doing an internet search because I am a woman Surgeon.  I think many women feel most comfortable discussing their bodies, their body image and self-esteem, and their personal goals for surgery with another woman - with the same anatomy, and who can relate to them as a peer as well as their doctor. 
            I give every single patient who walks through the door or my practice my full attention and absolute care.  I get to know my patients intimately, and strive to understand them as a whole person.  I explore how their desire to modify a part of their body will affect their life, health, wellness and spirit, and I encourage realistic goals and objectives for surgery. 
            Each of my patients is given my personal cell phone number, and my patients are encouraged to contact me directly with any questions or concerns, no matter how big or small. 

Q.        WHAT HAS BEEN THE MOST CHALLENGING PART OF STARTING YOUR PLASTIC SUGERY BUSINESS?
            In Medical School and Residency, we are given NO business teaching or training!  Subsequently, it is a crash course in self-employment for most Physicians.  I am still learning about running a business, managing employees, hiring and firing, overseeing the books, etc!  Sometimes I wish I could just wake up with an MBA degree and naturally understand it all.  My business aptitude is a work in progress, but I'm enjoying the journey. 

Q:        WHAT ARE SOME OF THE MILESTONES YOU HAVE ACHIEVED IN THE PAST YEAR?
            In the past year, I have helped literally hundreds of women become whole again after breast cancer, feel sexy and youthful again after pregnancy or aging, and to be more comfortable and confident in their own skin.  This provides such gratification to me; it's almost a bonus that I get to make a living doing this!
            Within five months of starting my practice in July 2006, I was covering my overhead and starting to make a profit, which is a feat in itself!  Since then, I have maxed out my practice schedule, and am fully booked in the operating room and in the office.  I now officially need to focus on "working smarter, not harder". 

Q.        WHAT IS THE MOST COMMON MISCONCEPTION ABOUT PLASTIC SURGERY?
            Any Plastic Surgery operation is a major deal.  Each procedure involves cutting and sewing, bruising, downtime, discomfort, and healing time.  Reality shows and celebrity gossip magazines often portray Plastic Surgery in an unrealistic light, minimizing the downtime and sensationalizing the results.
            In addition, many Hollywood celebrities who have had more than their share of cosmetic procedures (no names needed!), look abnormal and have lost their natural beauty.  The best Plastic Surgery does not make you look different, does not distort your facial features, and is not overtly obvious to any passer-by.  Most women seeking surgery in my office want a natural result, without looking "fake" or "done". 

Q.        WHAT ADVICE WOULD YOU GIVE TO A YOUNG WOMAN LOOKING TO WORK IN YOUR FIELD?
            I had very few female Mentors during my training.  My father is a General Surgeon and was a breast cancer specialist, who undoubtedly influenced me, although he was a workaholic and hardly ever around!  My mother held a Ph.D. in Biochemistry, and instilled in my sisters and me the conviction that "you can be anything you want in life, except a Daddy!"
            I was raised to believe that I could achieve just about any career goals I wished, as long as I received good grades in school and worked hard.  My parents encouraged me to investigate other career fields, based on my interests of art and drawing, such as architecture and fine arts.  However, medicine and surgery was the best fit for me, based on my fascination with the human body, science and figuring out the way things work!
            A career in Plastic Surgery is difficult to enter and is fiercely competitive.  In Canada, my birthplace and location of training, only ten training spots are available each year, and the competition is intense.  Four years of undergraduate University, four years of Medical School, five to six years of Plastic Surgery Residency, and often a final year of Fellowship training are necessary before you can start your own practice. 
            I encourage students who are interested in learning more about Plastic Surgery to shadow me in the office and the operating room, and I regularly mentor young females who are considering a career in Medicine. 

Q.        WHAT IS THE REWARDING PART OF YOUR OCCUPATION?
            The most rewarding aspect of my career is helping people in an intimate and emotional way, every single day!  Plastic Surgery enables me to use my brain, my hands, my creativity and artistic talents, and my compassion and caring nature in the best possible way.  Helping others truly is my calling, and Plastic Surgery is the venue!

Q.        WHAT TRENDS TO SEE HAPPENING IN YOUR INDUSTRY?           
            Many non-surgical aesthetic treatments are increasingly being offered as an alternative to, or as an adjunct to surgery. 
            Examples are Botox, Dysport and other injectable agents that decrease muscle contraction and eliminate wrinkles, injectable fillers that help to fill lines in the face, that decrease the effects of aging around the eyes, and plump the lips or cheeks, and "laser"-type treatments that can help to tighten skin without surgery and to improve abnormal pigmentation of the skin.
            Nonsurgical treatments such as these can be a little less expensive than surgery, and can be a great option for women who are not ready for a facelift or eyelid lift surgery.  However, the effects are usually temporary, and over time, the expenses can add up!   Surgery sometimes is the correct answer; your Plastic Surgeon can help to determine which options will best achieve your goals!

Q.        HOW DO YOU SEE YOUR PRACTICE EXPANDING IN THE NEXT 5 YEARS?
            I will always be committed to breast cancer patients, and I intend to continue to perform breast reconstruction for women facing cancer throughout my career.  At this point in my practice, I am already extremely busy, I'm tired, but I'm thrilled about this! 
            I would like to expand my "mommy makeover" cosmetic practice and help many more Moms achieve their body image and self-esteem goals via surgery (once they have achieved their maximal results with a health diet and regular exercise).
            I am now ready to train a "Fellow" (fully trained Plastic Surgery graduate) and teach them all I know, and to eventually take on a Junior Associate in my practice!  I also plan to hire a Physician Assistant to enable me to be as efficient as possible and to share my responsibility with inpatient hospital rounds, office preoperative visits, phone calls, and weekend call. 
            I hope to start my own family soon, and having someone I have personally trained and trust to care for my patients in the same manner and degree as I do, will enable me to best juggle work and a family life.  I look forward to that challenge!

Q.        HOW HAS SOCIAL NETWORKING AFFECTED YOUR FIELD?
            There is a great deal of inaccurate information and gossip on the internet, particularly regarding Plastic Surgery.        
            I am active on Twitter and Facebook, and I use these resources as a way to reach out to other and to educate, inform and empower women (and men!) about what Plastic Surgery is and isn't, to discuss some of the latest controversies in Plastic Surgery, and to get the word out there about new surgical techniques that are the latest and greatest!
            I think social networking is great, as long as it is used with respect and professionalism.  Many of my patients "follow" me online, and it's important to remember that once an opinion or message is posted, it is out in cyberspace forever! 




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The SAFETY and science of breast implants and SILICONE!

Posted by admin on Thursday, February 18, 2010

Most women who come to see me in consultation for breast augmentation have one major question:  "Is silicone safe???" 

I spend a great deal of time and effort in my practice educating women about their options for surgery, and when discussing breast augmentation, I emphasize that all implants, both saline- and silicone-filled, are SAFE.



In fact, silicone breast implants are the most extensively studied implantable medical device in the history of medical devices! 

All breast implants have a silicone shell; the fill material is what differs.  For most of my patients, I recommend silicone specifically, because it can have a more natural look and feel. 



The website breastimplantanswers.com is an excellent resource for women to learn all about breast implants.  I send each woman I see in consultation to this site to do some "homework" and to learn more about this medical device.



Here are some excerpts from the site (I encourage you to also visit the website for additional information):

The History and Uses of Silicone

Silicone is a highly versatile substance that has many medical uses. Different types of silicone have been used for decades in a variety of medical devices, such as pacemakers and artificial joints.

The Safety of Silicone and Silicone Gel-Filled Breast Implants

Silicone gel-filled breast implants are among the most extensively studied FDA-approved medical devices in existence. In the United States alone, Allergan has examined the safety of silicone gel-filled breast implants in more than 80,000 women.

Silicone and Silicone Gel-Filled Breast Implants: The FDA's Evaluation

The United States Food and Drug Administration (FDA) approved silicone gel-filled breast implants after reviewing a vast amount of scientific data. These data consisted of results from extensive preclinical testing, four years of data on 715 women from Allergan's Core Clinical Study, and a European study that evaluated implant rupture prevalence rates beyond 10 years1. In addition, countless published, peer-reviewed studies and research support the safety of silicone and silicone gel-filled breast implants. The FDA also considered in their decision the opinions of advisory panels made up of outside experts.
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Power Women Magazine's Blogtalk Radio - Dr. Karen Horton as featured guest!

Posted by admin on Thursday, January 28, 2010

I was recently interviewed by Power Women Magazine for a full live hour, discussing the latest in Plastic Surgery for women, both cosmetic and reconstructive.

Click this link to listen to the interview!

Power Women Magazine
Where Power Women can network
Dr. Karen H...
Dr. Karen Horton has invited you to the event 'Dr Karen Horton' on Power Women Magazine!
Log in to listen to my online radio interview tomorrow (Tuesday) - 9 a.m. PST, PowerWomenMagazine.com!

I will be discussing the latest in Plastic Surgery for women.

Karen Horton, MD, MSc, FRCSC

Dr Karen Horton Time: October 27, 2009 from 11am to 12pm
Location: www.blogtalkradio.com/powerwomenmag
Organized By: Dee Jones

Event Description:
Dr Karen Horton will be speaking on women and plastic surgery


See more details and RSVP on Power Women Magazine:
http://powerwomenmagazine.ning.com/events/event/show?id=2871844%3AEvent%3A6521&xgi=0kl7ziWtD2JBXK
About Power Women Magazine
Power Women Magazine is an online publication about women by women for women and issues important to women worldwide.
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Template for a Letter Regarding Cosmetic Surgery Tax ("BoTax")

Posted by admin on Monday, December 7, 2009

The Aesthetic Society and all of organized Plastic Surgery present a united front to fight the unfair Cosmetic Surgery Tax!

The Society leadership strongly disagrees with this discriminatory tax and is very concerned with the role of the surgeon as tax collector. Additionally, we see potentially devastating consequences to patient safety, as some may choose to have surgery abroad, seeing physicians who may not have comparable training certification or surgical site standards up to those of ABMS Board-certified Plastic Surgeons.

The following is the template for a letter that patients can use to express their opinion and dissent toward the proposed cosmetic surgery tax:



You can find your elected representative by clicking here: http://www.senate.gov/general/contact_information/senators_cfm.cfm





Dear Senator ______,



HEALTHCARE PLAN IN THE SENATE WILL UNFAIRLY DISCRIMATE AGAINST US!



I am writing you today about an issue that affects everyone who utilizes plastic surgery services for anything from Botox to Tummy Tucks.



The healthcare bill approved by the US Senate this weekend, Page 2045 Sec. 9017, Excise Tax on Elective Cosmetic Medical Procedures included in the “Patient Protection and Affordable Care Act.



This dense legalese translates to a tax on all cosmetic procedures as partial payment for the healthcare overhaul our current administration is attempting to implement.



The problem is that we would be paying this tax, the FIRST time this country has levied a tax on patients for medical procedures. This Bill is objectionable in many ways, including:

· This is a discriminatory tax. According to the Aesthetic Society Annual Statistics, 91% of all cosmetic procedures are requested by women

· This will not have considerable consequences on the wealthiest patients but, as usual, affects the middle class. We working women, soccer moms, and scores of others who carefully save and budget to improve our appearance and self esteem will be penalized for doing so.

· Procedures such as breast reduction that have been cited in the literature for improving self esteem and quality of life would be taxed as well.

· Our doctor as tax collector: This provision places physicians in the role of tax collector and holds physicians liable should an individual fail or refuse to pay the tax. That is not the relationship we want with our medical provider!

Please, do not allow this portion of the tax bill to pass!



Sincerely,



______________________

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Local Heroes in Medicine: Women Pioneers that Shaped Medicine in San Francisco

Posted by admin on Saturday, November 7, 2009

The following is an article from the September 2009 San Francisco Medicine publication:

www.sfms.org


Local Heroes in Medicine


Pioneers that Shaped Medicine in San Francisco
by Nancy Thomson, MD

“Women should not be expected to write or fight or build or compose scores. She does all by inspiring men to do all.” —Ralph Waldo Emerson (1802–1882)

In 1948, when I started college at Stanford University, my physician father discouraged me from preparing for medical school, saying that I would take a man’s place, then marry and never practice. Lois Scully, MD, a San Francisco internist, Stanford graduate, and 1979 president of the American Women’s Medical Association, ran into the same bias at about the same time when the
Stanford physician who interviewed her told her to go home, marry, and have five children.

In the early 19th century, Lucy Stone (1818–1893) wanted a good education, but the only college in the world that accepted women at that time was in Brazil. Luckily, Oberlin University was founded in 1835 in Ohio, the first U.S. college to accept both women and African-American students. Stone enrolled and graduated in 1847. However, when it came time to seek a profession, the only field open to women was teaching. In 1849 (the year Elizabeth Blackwell graduated from Geneva Medical College in New York), Lucy Stone wrote, “We believe that if the system of educating females for physicians be generally adopted, a great amount of suffering and death will be saved.”

In fact, the number of female medical school graduates rose steadily from 1849 to 1900. By 1900 in Boston, women represented 18 percent of practicing physicians. However, by 1903 women’s participation in medicine began to decline, as most of the women’s medical schools established in the previous 50 years were closed or merged with male dominated schools, which continued to reject women applicants. This situation generally prevailed until the 1970s, when the feminist movement and antibias legislation brought about an increase in women attending medical schools.

In 1970, female admissions to medical schools were at 9.2 percent; in 1980 they had risen to 27.9 percent, and they are at almost 50 percent today. The decline in economic potential for physicians (which was historically one of the foremost motivations for male medical students) is given comparatively little importance by female students, who cite longtime interest in medicine and science, the desire to help others, and dissatisfaction with other types of work among
their reasons for choosing medicine.

The following time line highlights women’s place in the medical history of San Francisco.

Historical Time Line

From the time of landing at Plymouth Rock, women as well as men practice medicine in New England, often after an apprenticeship with a practicing physician. However, when American medical schools are established, they follow the European pattern of barring women from
seeking medical degrees.

1863
Elizabeth Pfeifer Stone, the first woman to practice medicine in California, settles in San Francisco. Probably German-born and -trained, she previously practiced in New York.

1873
University of California acquires Toland Medical School in San Francisco, and since U.C. is already coeducational, Lucy Maria Field Wanzer, a thirty-three year-old teacher, is accepted as its first female medical student. However, the dean suggests to her fellow students that they “make it so uncomfortable for her that she cannot stay.”

1874
Charlotte Blake Brown applies to the San Francisco Medical Society for admission. Some members of the membership committee feel strongly that females are mentally, physically, and morally unfit to study medicine, let alone practice the profession. On advice of mentors, Brown
withdraws her application.

1875
Following the model of Elizabeth Blackwell’s New York Infirmary for Indigent Women, Pacific Dispensary for Women and Children is founded by three women, all educated on the East Coast: Charlotte Blake Brown, Martha Bucknall, and Sarah E. Browne. This outpatient clinic, initially located at 510 Taylor Street, is intended to provide opportunities for women physicians to obtain internship experience.

1876
San Francisco Medical College of the Pacific accepts its first female student, Alice Boyle Higgins, who graduates in 1877.

1877
Having been admitted to the California Medical Society along with four other women in 1876, Lucy Wanzer becomes the first female member of the San Francisco Medical Society.

1880
Founders of Pacific Dispensary create the first nursing school west of the Rockies. Its one-year course becomes a two-year curriculum in 1882.

1887
The Pacific Dispensary moves to a new two-story building at California and Maple Streets and becomes Children’s Hospital. Interns and residents can be either male or female, but there are no men allowed on the medical staff.

1895
Citizens of San Francisco raise money to build the Little Jim Building for pediatrics at Children’s Hospital.

1896
One year after X-rays are discovered, Elizabeth Fleischman-Aschheim, an engineer, opens the first X-ray laboratory in California, at 611 Sutter Street.

1896
William Randolph Hearst leads the campaign for the Eye and Ear Pavilion at Children’s Hospital.

1904
Dr. Charlotte Blake Brown dies at age fifty-eight. Her daughter, Adelaide Brown, MD (1868–1933), carries on her mother’s work at Children’s Hospital but also serves on the Stanford faculty at Lane Hospital. She fights locally and nationally for clean milk, sanitary garbage disposal, maternal and child welfare, visiting nurse services, and clinics offering cardiac care and birth control.

1906
The San Francisco earthquake forces the demolition of the 1887 Children’s Hospital building.

1911
A new, four-story brick Children’s Hospital building opens at California and Cherry Streets.

1912
The Contagious Disease Pavilion opens at Children’s Hospital, with money donated by William Randolph Hearst, to care for diphtheria, scarlet fever, measles, TB, and, later, polio.

1915
Children’s Hospital affiliates with the University of California for the teaching of medical students.

1915
The American Medical Association admits its first female member.

1916
Henries Hagar Duggan, MD, becomes a pioneering medical anesthesiologist. She works at various hospitals but settles at Children’s for twenty-five years, retiring after the end of World War II.

1938
UCSF pediatricians Mary Olney and Ellen Simpson found summer camps for children with diabetes.

1946
Marian Yueh Mei Li arrives in San Francisco, having completed medical school in Shanghai. She eventually opens a private practice and becomes the first Chinese female ophthalmologist to practice in Chinatown.

1952
Pediatrician Hulda Thelander establishes the Child Development Center at Children’s Hospital for children with cerebral palsy, developmental delays, and congenital defects.

1960
Internist Roberta Fenlon, MD, becomes the first female president of the San Francisco Medical Society.

1971
Dr. Roberta Fenlon becomes the first female president of the California Medical Association.

1977
Linda Hawes Clever, MD, MPH, founds (and chairs) the Department of Occupational Health at California Pacific Medical Center. She is also the first female editor of the Western Journal of
Medicine and is the founder of RENEW, an organization to help fight professional exhaustion and dissatisfaction.

1980
Children’s Hospital acquires St. Joseph’s Hospital.

1988
Marshall Hale Hospital, formerly Hahnemann Homeopathic Hospital, merges with Children’s Hospital.

1991
Children’s Hospital and Pacific-Presbyterian Medical Center merge to create California Pacific Medical Center (CPMC). CPMC joins the Sutter Health chain.

1995
Judith M. Mates, MD (ob-gyn), becomes the second female president of the San Francisco Medical Society.

1996
Toni J. Brayer, MD (internist), becomes third female president of SFMS and, in 1990, the first female chief of staff at California Pacific Medical Center.

2003
Rita Melkonian, MD, FACOG (obgyn), becomes the fourth female president of the San Francisco Medical Society, with E. Ann Myers, MD (endocrinology), as the president-elect.

In closing, it’s interesting to note that in 1868, while debating the admission of women, the American Medical Association recorded this statement by Dr. Alfred Stille, prominent teacher of pathology:

“Another disease has become epidemic. The woman question in relation to medicine is only one of the forms in which the pestis mulieribus vexes the world. In other shapes it attacks the bar, wriggles in the jury box, and clearly means to mount upon the bench; it strives thus far in vain to serve at the altar and thunder from the pulpit; it raves at political meetings, harangues in the lecture room, infects the masses with its poison, and even pierces the triple brass that surrounds the politician.”

If only Dr. Stille could see us today. We’ve sure come a long way.

Nancy Thomson, MD, was a practicing anesthesiologist at Children’s Hospital from 1963 to 1985. In 1988 she received her master’s in public health from the University of California at Berkeley. From 1991 to 2000 she worked as the infectious disease officer and staff physician at San Quentin State Prison. Dr. Thomson currently serves on the editorial board for San Francisco Medicine and is the magazine’s obituarist.
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Women's Plastic Surgery featured in the CRAVE San Francisco publication!

Posted by admin on Friday, October 2, 2009




See the CRAVE SF website for additional information!


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Welcome to Women's Plastic Surgery Blog!

Posted by admin on Saturday, February 21, 2009


Welcome to the new blog, Women's Plastic Surgery!

I will be entering weekly updates on all plastic surgery topics, relevant to my patients, women and to the public in general.

I am one member of a unique all-women Plastic Surgeon group, Women's Plastic Surgery.

See our website, http://womensplasticsurgery.com for information on our practice and as a more detailed reference for content posted in this blog.

I will be posting topics including details of common cosmetic surgery procedures, including breast augmentation, breast lift/reduction, liposuction, tummy tucks, and the "mommy makeover" spectrum of procedures.

Special attention will be paid to the latest breast cancer reconstruction techniques, as this is a major focus of my practice. You will learn about microsurgical reconstruction including the DIEP flap, SIEA flap, TUG (inner thigh) flap, and immediate single-stage implant reconstruction following mastectomy.

Keep in tune also for information about the latest facial rejuvenation techniques, including facelifts/browlifts, eyelid surgery (blepharoplasty), and non-invasive strategies such as Botox, fillers, lasers, and more!

I welcome your comments and look forward to hearing from you.

Karen M. Horton, M.D., M.Sc., F.R.C.S.C.
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