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Congratulations to Christine Kelley, MD chosen by her peers as a 2024 Indianapolis Top Doctor in the Plastic & Reconstructive Surgery category.
The Top Doctors 2024 listing was compiled by "Professional Research Services Company" of Troy, Michigan. Top Doctors are voted on by asking physicians to recommend someone they would see themselves or recommend to a family member.
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I am excited to announce that registration information is now available for the first "Breast Implant Illness Summit: Navigating Your Healing Journey!" This patient-focused virtual summit is FREE and open to anyone interested in learning more about breast implant illness. Breast implant risks, empowering stories of recovery, and effective healing strategies will be presented by 65 speakers over five days, August 18-22.
The summit is co-hosted by Danielle Valoras and Sarah Phillipe, two well-respected medical practitioners with personal and professional experience managing Breast Implant Illness (BII). Danielle has become a trusted resource and good friend. I know Sarah to be a highly motivated and effective colleague as well.
Most of us are familiar with professional race car driver, Danica Patrick, who will be sharing her story on Day 1. I encourage you to watch as much of the summit as you can. I emphasize that the summit is FREE while it is airing live. Paid lifetime access is also available starting at $67.
Please share the information and registration link to promote awareness of this first of its kind, information-packed program! Register here: https://breastimplantillnesssummit.com
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If you're interested in learning more about Breast Implant Illness, listen to this very informative and detailed podcast. Lexi Yoo, FNP-BC/CPNP and CEO of Yoo Direct Health, interviews Christine Kelley, MD of Meridian Plastic Surgeons.
Dr. Kelley is a Board Certified plastic surgeon and an expert on Breast Implant Removal procedures and Breast Implant Illness (BII). And, she has done groundbreaking work on BII.
Together, she and Lexi have a lively discussion about the intersection of functional medicine and aesthetics, the cautiousness needed when considering implants for patients with autoimmune conditions and much more.
I am immensely pleased and gratified to share news of success and recognition regarding my research collaboration with Dr. Mithun Sinha and his diligent and talented team at the Indiana School of Medicine.
I am grateful and honored to be part of this team and recognize and appreciate the support received from the IU system, the NIH and the Plastic Surgery Foundation. As you know, I have been working with Dr. Sinha to investigate possible cellular and molecular mechanisms to validate and explain the symptom complex currently referred to as Breast Implant Illness (BII). To be clear, I am not the scientist responsible for this thoughtful work, but I have served as the clinician bridge between those of you suffering from this illness and the researchers who have the knowledge and skills to help shine light on what might be happening in the body.
After extensive peer review, the manuscript that represents the foundation of Dr. Sinha’s exploration has been published! Furthermore, Dr. Katherine Gallagher, a highly respected scientist at the University of Michigan, has offered an eloquent commentary in which she summarizes the findings and recognizes the work for its ground-breaking implications. We are grateful for her review.
I also offer thanks to all of you who have agreed to provide symptom inventories and tissue samples for this work, including our non-BII and normal tissue volunteers. Without your gracious willingness, we would not have this knowledge. I am happy to share a pivotal outcome of your participation. As a team, we hope to continue to contribute significantly to this emerging field of inquiry into host responses to implants and biofilms.
Bold copy: Please share these links!
For Dr. Gallagher’s commentary, please see the commentary button under “Related Article” on the second manuscript link above.
Congratulations to Dr. Christine Kelley named by her peers as a 2023 Indianapolis Top Doctor in the Plastic & Reconstructive Surgery category.
The Top Doctors 2023 listing was compiled by “Professional Research Services Company” of Troy, Michigan. Top Doctors are voted on by asking physicians to recommend someone they would see themselves or recommend to a family member.
Our practice offers a wide range of fillers and neurotoxins. And our plastic surgeons have extensive training and experience administering these injections to ensure patient safety and optimal, natural-looking results.
Restylane is a group of hyaluronic acid fillers that can be used on multiple areas of the face, lips and under eye area. Included are Contour, Defyne, Kysse, Refyne, Restylane Eyelight, Restylane, Restylane Lyft.
Dysport if a fast-acting, long-lasting clinically proven treatment for patients who want to smooth frown lines between brows.
Call Meridian Plastic Surgeons to schedule your appointment with Dr. Kelley: 317-575-0330
During the month of February, we are promoting a Designs for Health product we all LOVE! Whole Body Collagen is clearly our most favorite product in the DFH line. I grin every time one of my staff comes up to me clutching their jar and telling me how much they like this product. It happens a lot!
To help you try this product for yourself, we are offering a one-time 15% discount at my online dispensary through February 28, 2023. Use code LOVE15 when you place your order.
Order using this link: https://tinyurl.com/2pujs76j
Here at the office, we are fortunate enough to have access to high-quality, medical grade topical skin care and high-tech rejuvenating treatments. Nothing, however, has won such consistent praise as this collagen supplement. Staff talk about more radiant, firmer appearing and more hydrated skin. Most of them have received compliments about their skin within a few weeks of starting the product.
Collagen supplements vary in quality and can contain unwanted additives. DFH Whole Body Collagen consists of three patented collagen peptides supported by clinical research to not only improve skin quality but bone strength, joint integrity and muscle mass. I recommend it for anyone who is interested in an effective adjunct to an anti-aging strategy, to patients undergoing various biostimulatory treatments and to my recovering surgery patients.
Congratulations to Dr. Christine Kelley! She was named by her peers as an Indianapolis Monthly Magazine Top Doctor for 2022. Dr. Kelley’s partners at Meridian Plastic Surgeons also made this year’s list: Dr. Stephen Perkins, Dr. Bruce Van Natta and Dr. Michael Sadove.
The Top Doctors listing was compiled by Healthcare research and information company, Castle Connolly Medical. They asked physicians in central Indiana to recommend someone they would see themselves or suggest to a family member.
Hello, everyone! Today I would like to bring your attention to an upcoming virtual meeting programmed to inform and educate healthcare practitioners regarding the potential adverse effects of breast implants on the body. BIHS, or the Breast Implant Health Summit, is hosted by Danielle Valoras and Terri Diaz. Both women are dedicated to using their professional and personal skills to increase awareness of Breast Implant Illness (BII) symptoms, diagnosis and management, and they also promote further research on the subject.
They are members of a group that successfully lobbied the FDA for the black box warning on breast implants. Danielle is a Certified Physician Assistant and founder of NavWell Rx, an integrative health practice with a focus on treating implanted device related-illnesses such as Breast Implant Illness. Terri experienced ten years of debilitation from an implanted device in 2006 and is now tirelessly dedicated to patient safety advocacy. She is a founding member of GPAC-Global Patient Advocacy Coalition and also the Breast Implant Illness Florida Support Group. She also serves on PEAC-Patient Engagement Advisory Committee as a Special Government Employee for the FDA.
This is the second summit hosted by Danielle and Terri. The first summit was held in 2020 and included presentations from many experienced physicians and researchers including early pioneers. This year’s Summit promises to be just as informative with timely updates emerging from clinical and scientific research studies.
Dr. Mithun Sinha, lead scientist for our research team at Indiana University, is a featured CME speaker on Saturday morning. He will be presenting our research on implant-associated biofilms.
Check out the Facebook page for the Summit: Breast Implant Health Summit. This page introduces the presenters and their topics and contains interesting information. https://www.facebook.com/BIHS2022
I have registered for the event so I can be as current in this emerging field as possible. If any of you have an interest, patients are invited to attend as well. Registration does require a fee but a discount is available for women with BII or breast implants. Here is the website for registration. It has details about the Summit as well as information about the hosts and presenters: https://www.breastimplanthealthsummit.com/
I am excited to announce the formation of a local Breast Implant Illness support group, “BII Healing and Support Indianapolis”. I was invited to cofound this group, and I feel honored to participate. I am grateful to the two primary drivers of this group, Dr. Melanie McLaren and Erin Kassner.
I have been looking for local resources to support women as they navigate the challenging physical, mental and emotional journey that is explant. I feel fortunate to have encountered Erin and Melanie. They bring a wealth of knowledge and experience to the conversation. They are passionate and compassionate advocates for the health and well-being of all, but they have particular insight into the issues that women experience. They are committed to helping explanted patients regain the vitality they knew before BII.
Dr. McLaren is a naturopathic physician who works with individuals to address chronic health concerns in a natural way. She believes this approach empowers patients to manage their own wellness. She founded Dragonfly 360 Yoga and Wellness to educate patients on the benefits of holistic and naturopathic approaches to good health. She does have experience treating BII and the related issues of chronic fatigue, gut issues and allergies. You can view her story at the link here.
Erin Kassner is an explant patient and a functional medicine consultant for Designs for Health, a company that offers an extensive portfolio of nutritional supplement products in the healthcare practitioner channel. DFH is widely used by functional, integrative and naturopathic practices. On that basis, Erin has significant knowledge regarding environmental toxins and chronic immune sensitization that appear to underlie chronic disease states and simply feeling poorly. She plans to support the group in many ways, including guiding women through gentle detox protocols.
The goal of the group is to augment the resources that are already available to women considering explant. Some of the other groups have become quite large and can be difficult to navigate. We hope to establish a smaller, more personally interactive group that is supportive and educational. We also hope to increase awareness of the issues that motivate women to pursue explant, and promote networking opportunities in support of research and advocacy.
This is a private Facebook group; only members are able to see who is in the group and the information that is posted. I encourage you to join to see the helpful information that is already collated on the site. Also, Erin plans to host a guided detoxification session to members in the Fall! Dr. McLaren will open the session with an overview of detoxification processes and principles. For all of you who have asked me about how to detox, this is for you!
For almost three years, I’ve collaborated with a research team at Indiana University School of Medicine looking into the possible role of bacterial biofilms as an underlying cause of Breast Implant Illness (BII). The initial results were presented in poster form at the American Society of Plastic Surgeons 90th Annual Meeting last year and won the Top Poster Award in the “Breast” track.
Our team recently published an extensive peer-review article on BII in the Journal of Immunology Research titled “Breast Implant-Associated Immunological Disorders”. It is the first publication resulting from our efforts on this subject, hopefully with many more impactful manuscripts to follow.
This is a remarkable accomplishment for the team, and also represents a growing acceptance of the plausibility of implant-associated illnesses. You can view the full article here.
For over two years, I have collaborated with a research team at Indiana University School of Medicine looking into the possible role of bacterial biofilms as an underlying cause of Breast Implant Illness (BII). The research is progressing well. The initial results were presented in poster form at the recent American Society of Plastic Surgeons 90th Annual Meeting in Atlanta, and won the Top Poster Award in the “Breast” track. This is a remarkable accomplishment for the team, and also represents a growing acceptance of the plausibility of implant-associated illnesses.
The Poster was titled “Host Biofilm Interaction in Implant Associated Immune Response”. I would like to thank my research colleagues for their tireless and enthusiastic work on this project, especially primary author Imran Khan Mohammed, PhD (pictured here), and team leader Mithun Sinha, PhD. Through their knowledge, experience, and intensity, they are making impressive progress in a short amount of time. I would also like to thank my partner and fellow research team member, Dr. Bruce Van Natta, for initiating and supporting our collaboration.
We still have a long way to go to unravel the complex pathophysiology of BII. But, this recognition at ASPS represents a very important step towards validation of the condition, and is a hopeful sign that someday we will have better understanding and management to assist women currently suffering from unexplained symptoms, and future prevention strategies as well.
Congratulations to Dr. Christine Kelley! She was named by her peers as an Indianapolis Monthly Magazine Top Doctor for 2021. Dr. Kelley’s partners at Meridian Plastic Surgeons also made this year’s list: Dr. Stephen Perkins, Dr. Bruce Van Natta and Dr. Michael Sadove.
The Top Doctors listing was compiled by Healthcare research and information company, Castle Connolly Medical. They asked physicians in central Indiana to recommend someone they would see themselves or suggest to a family member.
If you’re considering a plastic surgery procedure and looking for attentive, informative and compassionate care, call for a consultation with Dr. Christine Kelley at Meridian Plastic Surgeons.
She’ll help to bring about a more confident, healthy and renewed you.
Listen here for a personal message from Dr. Kelley. Meridian Plastic Surgeons: 317-575-0330.
As you know, I have been involved in a research project in conjunction with the Indiana University School of Medicine looking into the possible role of bacterial biofilms as an underlying cause of Breast Implant Illness (BII). Our findings (shared here previously) have had promising results. Data collection for that research continues.
As part of our investigation, we would also like to identify the frequency of BII and autoimmune diagnoses associated with breast implants. We are working to develop a validated survey that should enable us to define a percent number for the incidence of Breast Implant Illness in a defined population of women who agree to complete the survey annually.
These research efforts are funded in a variety of ways, including donations from the public. You can view more information about the study as well as donate to the cause by visiting the link here.
This Dr. Christine Kelley patient underwent explant surgery 4 months ago for severe Breast Implant Illness symptoms involving multiple body systems. All of her symptoms have resolved. She is also delighted to see a marked difference in her appearance, as her facial inflammation is gone. She feels so much better.
Please read our abstract here regarding Staph epidermidis bacterial biofilm and the potential link to Breast Implant Illness.
Dr. Christine Kelley was named by her peers as an Indianapolis Monthly Magazine Top Doctor for 2020. Dr. Kelley and her partners at Meridian Plastic Surgeons also made this year’s list: Dr. Stephen Perkins, Dr. Bruce Van Natta and Dr. Michael Sadove.
This year’s Top Docs Indianapolis listing was compiled by Castle Connolly Medical, a healthcare research and information company. As part of the nomination process, they asked physicians to recommend someone they would see themselves or recommend to a family member in Central Indiana.
I have been involved in a research project looking into the possible role of bacterial biofilms as an underlying cause of Breast Implant Illness (BII). I am excited to have reached a point where I can share initial but significant results. The manuscript has been posted to medRxiv and can be viewed through the hot link below. The study was able to show that compared to non-BII patients, BII patients are more likely to have a bacteria, Staphylococcus epidermis, in the capsules surrounding their implants. This is relevant because the study design went on to show that Staph epi is capable of oxidizing breast fats to produce a chemical that stimulates the immune system in ways that are often seen in autoimmune conditions.
This study is valuable, as it identifies a possible mechanism underlying BII, and in doing so, supports the existence of this controversial condition. I am grateful for all of you who have agreed to participate in this research with me so far. I am also thankful for my hardworking staff who have helped with the data collection. I am privileged to assist Dr. Mithun Sinha and his talented research team at Indiana University. We still have a long way to go to get to the bottom of BII, but this is an important contribution to our understanding of this complex problem.
https://www.medrxiv.org/content/10.1101/2020.11.18.20233510v1
If you got too much sun exposure this summer, Halo fractional laser may be a great way to head into Fall. Halo is a fractional laser that restores your skin’s youthful glow. There is minimal downtime, and it works on the damage you can and cannot see.
During September & October 2020, schedule Halo of the face and neck, and receive Halo to the chest FREE at Spa 170 West. And, receive 20% off SkinMedica TNS Advanced+ Serum with the purchase of a Halo Treatment (Sept/Oct 2020 while supplies last).
Call Spa 170 West for more information about Halo and to book your appointment: 317-558-1541
We love THERMI Smooth EYE treatments! They are a great way to smooth and tighten the delicate eye area without having downtime. If you’re busy getting back into a routine for Fall, this is a great procedure because there’s no anesthesia required, and it’s non-invasive.
Available at Spa 170 West – our medical skincare spa.
When you purchase a package of 4 THERMI EYE treatments during the month of August 2020, you’ll receive an eye cream of your choice at 50% off. Call Spa 170 West for more information and to book your appointment: 317.558.1541
While supplies last. Discount only available with package purchase.
Our highest priority is the safety and health of our patients, physicians and staff members. In order to accomplish this, we have put new measures in place.
We appreciate your patience and understanding as we all navigate through this new way of providing care to our patients. We look forward to seeing you.
If you would like to schedule a consultation with Dr. Christine Kelley or have questions, please call our office at 317.575.0330.
Meridian Plastic Surgeons looks forward to reopening our office on Friday, May 1st.
Our highest priority will be the safety and health of our patients, physicians and staff members. In order to accomplish this, we have put new measures in place.
We appreciate your patience and understanding as we all navigate through this new way of providing care to our patients. We look forward to seeing you.
If you would like to schedule a consultation with Dr. Christine Kelley or have questions, please call our office at 317.575.0330.
Join Dr. Christine Kelley on Tuesday, April 28th at 12:00 noon for a Facebook “Live” event. Tune in for great info.
She will discuss questions related to plastic surgery that patients ask most often, including the topic of breast implant illness and BIA-ALCL. She will also explain how she conducts her “Virtual Consultations” and how to be comfortable with them.
Visit her Facebook page for the event: https://www.facebook.com/drchristinekelley/
I am performing Virtual Plastic Surgery Consultations! This is a great way for us to connect during the COVID-19 Isolation. All you need is a laptop or desktop computer with a camera and reliable Internet connection.
Virtual consults enable us to talk and see each other in real time on camera to discuss your goals for plastic surgery. It's very easy. I realize that some of you might be intimidated by the idea of a video consult. I use a HIPAA compliant portal, and no information is stored by the hosting service. Although I felt a little uncomfortable with my appearance on video at first, I actually acclimated to the process pretty quickly! Since the nature of my procedures nearly always requires an in-person physical examination to confirm our thoughts and plans, I do not require a visual examination during the virtual consult. The idea is for us to become acquainted in preparation for the full direct evaluation. With this process, I anticipate that we will be able to arrange your surgery more efficiently in the upcoming months.
Our current hope and goal is to reopen the practice for in-person activity on Friday morning, May 1st. Unfortunately, none of us should expect the easing of restrictions to look or feel “normal”. Your safety and the safety of my staff and the community will remain priorities. Regulatory and professional societies are currently developing new policies and procedures for medical practice, but I do anticipate appointments will be spaced father apart than usual. Telehealth, including virtual consults, will remain useful even after we reopen.
I hope all of you have been able to remain secure and healthy during the early crisis period of this pandemic. I have missed taking care of all of my recent and potential new patients, and I am looking forward to the easing of restrictions that will allow us to meet in person soon.
In the meantime, call us to schedule a Virtual Consultation: 317.575.0330
Dr. Kelley
Covid-19 continues to devastate our country and our local community. As you likely realize, executive orders mandating closure of non-essential business and services, suspension of elective surgery and social distancing have been extended to April 30, 2020.
As a result, Meridian Plastic Surgeons will remain closed until at least May 1, 2020. This remains an uncertain situation, and further extensions may be required. I plan to offer “Virtual Consultations” and will provide an update once I have that in place. This will enable me to see patients utilizing a video app whereby patients connect using a tablet, laptop or desktop computer.
We will continue to address your questions and concerns during this unprecedented moratorium on elective medical services. Please reach out to us by phone at 317-575-0330 from 9:00 to 4:30 Monday through Thursday and 9:00 to 4:00 on Friday. That same number will allow you to reach me in the evening, and the physician on call will be contacted on weekends.
I hope that all of you are staying safe and well. I know that these circumstances are frustrating and challenging. I look forward to the day when we can meet in person again, and I can perform procedures to enhance your quality of life. Until then, we must prioritize to the safety and well-being not only of ourselves, but our local and national population.
Dr. Kelley
In compliance with Governor Eric Holcomb’s “Stay-At-Home” order, Meridian Plastic Surgeons will be closed through Monday, April 6th.
We plan to reopen Tuesday morning, April 7th.
Thank you for your understanding.
This is an important message for my valued patients, past, present and future:
We are all experiencing unprecedented and extraordinary impacts from the novel coronavirus. The disruptions to our daily routines have been unimaginable.
At this uncertain time, I would like to provide broad notice of my decision to cancel all surgeries and non-essential office appointments until at least March 31. Those of you impacted by this decision have already been notified. If you have not been notified or you are still uncertain, please check your email and voicemail or contact us to clarify.
Office appointments will be reserved for very recent surgical patients who require in-person evaluation of their recovery process, and for unanticipated emergencies. My staff and I will be available by phone and email to address questions and concerns from 9:00 to 4:30 Monday through Friday. We may ask you to send us a photo of your surgical site to potentially avoid an in-office evaluation. This approach actually works well in many instances. The office phone number will allow you to reach the physician on call during non-routine hours. For your reference, I will be posting my usual guidelines for postoperative care to my website soon.
My approach to the care of my patients has always prioritized safety and optimal outcomes. I am concerned about the consequences of operating on patients who are asymptomatic on the day of surgery, and then are either exposed to the virus or develop illness during their early recovery. These patients would be at higher risk of developing more severe illness due to the fact that our immune systems are challenged after surgery. Healing complications would be more likely to occur in the face of an overlapping viral illness as well. Although uncommon, I also worry about the ability to access timely hospital care if complications such as serious wound infections develop.
I am also committed to my employees, my community and my nation. I am motivated to be a good steward of medical resources at a time when the guaranteed availability of those materials is in jeopardy.
I have closely observed rapidly unfolding events regarding the coronavirus outbreak, and I have read guidance from multiple sources including WHO, CDC, the American College of Surgeons, and the International Society of Aesthetic Plastic Surgery. I have informed myself regarding the behavior and risks associated with novel viral illnesses such as Covid-19. I am also aware of requests from our federal, state, and local governments, which can be interpreted as orders, to practice and enforce social distancing by cancelling all non-essential in-person medical interactions including elective surgery. Although these considerations and recommendations are highly disruptive and inconvenient to all of us, I have made the decision to comply.
My current hope is to resume operations, likely on a limited basis, April 1. This expectation is contingent, however, on the status of the outbreak at that time. We are being told to expect severe disruptions and restrictions that may extend into mid or late April, and perhaps longer. Local or national circumstances, expert guidance, and governmental mandates may necessitate extending this cancellation policy further. If an extension is required, affected patients will be advised in a timely manner. We will strive to maintain open communication with you.
Thank you for your cooperation and understanding. This is a challenging and anxious time for all of us. We can manage this adversity, however, with composure, compliance, and compassion. Please take care to be healthy, for yourself and others.
Dr. Christine Kelley
In order to protect the safety of our staff and patients, Spa 170 West will be
closed from March 19th through March 27th. We will reopen on Monday, March
30th at 9:00 am.
If you have an appointment scheduled during our closure, one of our Spa staff members will call you to reschedule.
Worldwide, more than 10 million women live with breast implants. More than 3.3 million breast cancer survivors in the United States have undergone a breast implant augmentation surgery. Without access to breast implant augmentation, many cancer survivors would not feel they have returned to a full, complete life when they return to health.
In recent years, many complications have been attributed to these implants including chronic fatigue and other symptoms associated with autoimmune diseases, called Breast Implant Illness (BII). Some women have even developed a rare type of T-cell non-Hodgkin’s lymphoma around their breast implants, called BIA-ALCL. Hundreds of women have been affected by BII/BIA-ALCL, and many have lost their lives to BIA-ALCL. This is why more research is needed to understand other factors contributing to breast implant complications.
Indiana University School of Medicine researchers, along with physician partners throughout the community (including those at Meridian Plastic Surgeons), are working to investigate the role of bacterial infection (biofilm) as an underlying cause of problems associated with breast implants.
The goal of the research is to make existing silicone-based implants safer and improve the health of women with breast implants.
Scientific research of breast implant associated complications is incredibly limited despite the urgent need for more research. If the complications are not addressed, they could lead to nationwide restrictions on implant surgeries, preventing breast cancer survivors from returning to a full, complete life after regaining their health.
Making a gift to the Breast Implant Associated Complications Fund will help researchers at Indiana University to conduct studies to reduce breast implant complications and improve the quality of life for breast cancer survivors and all women with breast implants.
Donate Online Here. All donation dollar amounts matter! Thank you for helping women with breast implants to live healthier lives.
By Check:
IU Foundation - School of Medicine PO Box
7072
Indianapolis, IN 46207-7072
Write in Memo/Note
Account#
380014948/Breast Implant Research
For information write to:
Dr. Mithun Sinha –
mitsinha@iu.edu
Every dollar donated to research matters and enables IU School of Medicine investigators work to make implants safer in the future.
The Dean’s Council celebrates donors who make annual leadership gifts of $1,000 or more to Indiana University School of Medicine. All Dean’s Council participants are acknowledged in a specific giving circle, each with its own unique opportunities to engage with the school. Inclusion in a giving circle is based on all gifts, pledge payments and matching gifts received in a calendar year. Couples are recognized jointly for their total household giving.
Cornerstone Circle: $1,000-$2,499
Loyalty Circle: $2,500-$4,999
Ambassador Circle: $5,000-$9,999
Leadership Circle: $10,000-$24,999
Visionary Circle: $25,000-$99,999
Legacy Circle: $100,000 or more
Dr. Christine Kelley was named by her peers as an Indianapolis Monthly Magazine Top Doctor for 2019. Dr. Kelley and all of her partners at Meridian Plastic Surgeons made this year’s list: Dr. Stephen Perkins, Dr. Bruce Van Natta and Dr. Michael Sadove.
This year’s Top Docs Indianapolis listing was compiled by Castle Connolly Medical, a healthcare research and information company. As part of the nomination process, they asked physicians to recommend someone they would see themselves or recommend to a family member in Central Indiana.
On Wednesday, Allergan announced that they are voluntarily recalling all of
their Biocell textured breast implants and tissue expanders at the request of
the FDA.
The FDA subsequently explained the rationale for this request in the
communication linked here.
The FDA has been closely monitoring reports regarding Breast Implant Associated Large Cell Lymphoma (BIA-ALCL). They note that ongoing analysis of the most recent Medical Device Reports (MDR) data indicate an increase in the number of unique cases of BIA-ALCL reported worldwide to a total of 573, and an increase in deaths due to the condition to a total number of 33. Further analysis indicates that nearly 85% of the cases have involved the Biocell textured surface, and this correlates to a six-fold higher risk with that surface compared to other manufacturers. The FDA indicates that this analysis reached a threshold that caused concern regarding the safety of the Biocell surface. Although the risk of developing BIA-ALCL remains low at 573 confirmed cases worldwide, the diagnosis is serious, requiring surgery to manage. The disease is also rarely but potentially fatal. The increase in the number of deaths from a previously known nine cases to 33 particularly required attention.
The FDA indicates that their decision is intended to protect women from further exposure to the Biocell surface by preventing new implantations. They specifically note that they continue to advise against removal of these implants in existing asymptomatic patients, but instead advocate for patient and provider awareness and early evaluation of potential symptoms.
This decision is a reversal of the FDA’s conclusion earlier this year regarding textured device availability, and now aligns the U.S. with the position of other regulatory agencies around the world, as I discussed in an earlier post. Our understanding of the disease itself has not changed significantly. The risk appears to remain relatively low. The specific cause of the condition remains unclear, but research suggests the lymph cell cancer develops through a combination of factors. The Biocell surface may be an irritant in itself, or may create an environment favorable to the growth of certain bacteria that cause ongoing activation of T lymphocytes.
Genetic susceptibility also appears to be required. Diagnosis commonly occurs when patients develop persistent swelling from fluid around the implant. Masses or hardening can also be signs. Pain around breast implants can occur for many reasons but is also a symptom warranting evaluation. No specific screening tests exist for asymptomatic patients. Tests are directed to the presenting symptoms. Prognosis is excellent with the majority of patients responding well to surgical removal of the implant and total capsulectomy.
BIA-ALCL was first reported in 1997, and a few scattered reports followed. The FDA began monitoring reports in 2011. An increasing number of cases have been identified in recent years, possibly through greater awareness and the development of specific reporting portals. Understanding of the disease is rapidly evolving, leading to what may appear to be sudden policy changes similar to this week’s announcement. Stay tuned for further discussions as more information on this and other breast implant related issues becomes known and available.
Here is a link to a timely news report from Tampa, FL. The reporter provides a good summary of an increasing trend toward breast
implant removal surgery, both in her local area and nationally. She interviews
Dr. Dave Rankin, a plastic surgeon practicing in Jupiter. He performed
approximately 400 explant surgeries last year alone, and now has more requests
for explant than implant. His experience mirrors my own, both in terms of the
number of women requesting implant removal and the consistent observation of
symptom resolution following implant removal.
In my practice, fatigue, brain fog, chronic joint and muscle pain, headaches, bowel issues, rashes and unusual neurologic symptoms are common. Explant surgery has become the primary procedure in my practice. This is very gratifying because I love helping women regain their ability to feel well and function normally in their busy lives. I encourage women affected by this condition to report their experiences to the FDA through the link provided in the article.
Increasing awareness is necessary to promote acceptance. This will hopefully lead to research to help us understand why these symptoms are developing, and which women are most at risk of being affected. Evaluating physicians also need to recognize that this symptom complex is poorly understood but real, not fabricated – so affected women can be more quickly referred for appropriate management.
Dr. Christine Kelley
I would like to share a shortened synopsis of a special announcement that was recently published by the International Society of Aesthetic Plastic Surgery. The news release reviews the conclusions of the FDA following the March 2019 hearings on breast implant safety.
On May 2nd, Commissioner Dr. Amy Abernethy, PhD, and Director of the FDA’s Center for Devices and Radiological Health, Dr. Jeff Shuren, JD, issued a statement regarding the March 2019 public advisory hearing on breast implants. This hearing reviewed topics including Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), use of mesh in implant surgery, and evaluating the symptom complex referred to a Breast Implant Illness.
Following the hearing, the FDA stated that regulatory action needed to be based on scientific data. Based on all the data and information available at this time, the FDA does not believe there is enough evidence to meet the banning standard set forth in the Federal Food, Drug and Cosmetic Act.
Much of the statement involved discussion of BIA-ALCL, as this is a recognized risk of breast implant procedures. The disease is highly associated with the use of textured devices, particularly those with more aggressive or “macro-textured” surfaces. Earlier this year, regulators in France, the Netherlands, and Canada banned the use of macro-textured breast implants and polyurethane implants out of utmost precaution regarding the risk of BIA-ALCL. The FDA decision contradicts the conclusion of these agencies, but is in line with the conclusion reached in Australia. In its statement, the FDA provided the rationale that although the majority of women who developed BIA-ALCL had textured implants, there might be cases in women with smooth-surface breast implants as well. Additionally, many reports do not include the surface texture of the implant at the time of diagnosis. Therefore, there is not sufficient evidence or significant enough risk to meet the banning standard at this time.
Conclusion
The conclusion is that women and providers must be adequately informed of the potential risks of breast implants, and that with BIA-ALCL, the risk is higher with the use of textured implants. The known risks, however, are not currently understood to be common enough to ban breast implants in general or textured in particular. The FDA would like to evaluate the question of breast implant safety further and looked favorably at partnering with registries, like the Patient Registry and Outcomes for Breast Implants and Anaplastic Large Cell Lymphoma (ALCL) Etiology and Epidemiology (PROFILE), which collects real world data on patients with BIA-ALCL diagnoses, and the new National Breast Implant Registry (NBIR), which collects data on the safety and performance of breast implants.
What Does This Mean For Patients?
I have managed a patient with BIA-ALCL and I am seeing many women with BII (Breast Implant Illness). I am very interested in the topic of breast implant safety. I will remain actively interested in this subject and will be abreast of new developments that address known and potential safety questions.
I do not consider the recent FDA ruling a pass for breast implants. I do agree that we do not have a clear understanding of the true risk profile for BIA-ALCL, and I also agree that textured implants do still have a role to play in the management of patients with both cosmetic and reconstructive concerns. I have generally avoided the use of textured implants in my patients for the last two years, however, unless I perceive a significant benefit to that textured surface in a specific individual’s case. That decision is preceded by a thorough review of the estimated risk/benefit profile based on the knowledge we currently have about BIA-ALCL and breast implants in general. Similarly, I am careful to educate patients who are considering breast implants about my experiences and thoughts regarding BII. Unfortunately, we know even less about that symptom complex than we know about BIA-ALCL, so that discussion contains even more uncertainty.
However, I would like my patients to be aware of the potential for autoimmune, allergic, neurotoxic, hormonal and chronic pain reactions to breast implants as part of their overall decision-making process.
Dr. Christine Kelley was named by her peers as an Indianapolis Monthly Magazine Top Doctor for 2018. Dr. Kelley and all of her partners at Meridian Plastic Surgeons made this year’s list: Dr. Stephen Perkins, Dr. Bruce Van Natta and Dr. Michael Sadove.
This year’s Top Docs Indianapolis listing was compiled by Castle Connolly Medical, a healthcare research and information company. As part of the nomination process, they asked physicians to recommend someone they would see themselves or recommend to a family member in Central Indiana.
Dr. Christine Kelley recently was named as a Top Doctor in Indianapolis Monthly Magazine in the category of Plastic Surgery.
Healthcare research and information company Castle Connolly Medical, LTD., compiled this year's Top Docs list of honorees by asking physicians in Central Indiana to recommend physicians they would see themselves or suggest to a family member.
I often have patients ask me if their fat will return after having a
liposuction procedure performed. Liposuction is the surgical procedure that
removes unwanted body fat. The answer is that liposuction does permanently
remove fat cells. It is, however, very important for patients to maintain
their post-operative body weight. If they gain a moderate amount of weight,
fat cells in other areas of the body will become larger.
And, if there is significant weight gain, new fat cells can develop in all areas of the body – including the treated areas. Here is a good article on this topic from the American Society of Plastic Surgeons with a few tips on maintaining your liposuction results.
Restore the youthful beauty of your lips with the newest injectable
enhancement product, Juvederm Volbella XC. Volbella is formulated to provide
soft, smooth fullness with less swelling than previous fillers. The result is
a very natural, attractive appearance. If you have been hesitant to try lip
fillers or to continue them because of concerns about the heavy, overfilled,
“fish-lip” look, know that this product addresses those problems.
Your lips will also look more hydrated with a nice sheen. Volbella is an
excellent product to fill vertical lip lines and fine lines around the mouth.
We’ve included Botox at no extra charge during the month of February
2017 (15 units) which can be used to soften crow’s feet and frown lines.
Call my office today for more information or to make an appointment.
317-575-0330.
Are you looking for the perfect stocking stuffer or idea for a gift exchange?
Give the gift of Clearly Beautiful serum, mist or hand lotion.
All Clearly Beautiful products contain a blend of natural ingredients including: collagen, hyaluronic acid, growth factors, plant DNA and algae.
20% Off Holiday Offer!
Stop by and visit us for your holiday shopping, and check those names off your list! Receive 20% off your order through December 20, 2016.
I am excited to announce that I am performing a new non-surgical facial rejuvenation procedure that lifts sagging facial skin without the need for surgery, scars or general anesthesia. It’s called InstaLift, and it’s an in-office procedure that restores youthful cheek and jawline contours by gently lifting the deeper layers of skin with absorbable sutures. The sutures provide an “instant lift” of the mid face and neck. Although the sutures naturally and gradually resorb over time, the absorption process stimulates collagen production over time as well. This aspect of the technique contributes to skin renewal and helps to maintain the results even after the sutures have fully resolved.
InstaLift can provide effects similar to injectable fillers. However, the techniques do differ in underlying concept, and the selection of an approach will be dependent on the specific nature of your aging process. Some of you may be candidates for both. Fillers are primarily utilized to restore the volume loss that occurs with aging. They are used to “fill in” folds, hollows, and lines. And some types of filler can also appear to lift sagging facial tissues when injected along the cheekbone to correct volume loss there. InstaLift differs from fillers in that it actually moves sagging tissue back into place. The subsequent collagen production then contributes to natural skin tightening and soft tissue augmentation.
InstaLift is comfortably performed under local anesthesia in the office and typically takes about 45 minutes. A visible lift is apparent immediately. Recovery is relatively modest. Expect some mild bruising and swelling. Certain facial movements such as strong chewing are avoided for about a week. The procedure is ideal for patients with mild to moderate laxity of the cheeks and jowl area. This technique can be used to delay more aggressive procedures such as facelift. It is also an excellent tool to refine and enhance the results of prior facelift procedures. If you are interested in more information, please call my office at 317-575-0330.
Dr. Christine Kelley recently named as a Top Doctor in Indianapolis Monthly
Magazine for Plastic Surgery.
Healthcare research and information company Castle Connolly Medical, LTD., compiled this year's Top Docs list of honorees by asking physicians in Central Indiana to recommend doctors they would see themselves or suggest to a family member.
I have many women who come to me because their breasts are starting to sag. There are several factors that can contribute to this problem including, pregnancy and nursing, weight gain, menopause and gravity taking its natural course as we age. Breast lift surgery is a big commitment, and while I use various techniques to perform this procedure, they do result in visible scars. I am excited to let you know that I am one of the first plastic surgeons to be performing a “non-invasive” breast lift called ThermiBreast. This is a great alternative that I am happy I can offer my patients!
This treatment is not for everyone. It’s appropriate for women who have moderately sagging breasts, are in good health and don’t wish to undergo a traditional breast lift surgical procedure. ThermiBreast is performed using “local” anesthesia and takes only about an hour. I use a ThermiRF device that produces radio frequency energy (thermal energy) to stimulate collagen production and improve overall skin tightening. I am able to target specific areas of the breast using very small entry points with the Thermi probe. Results are immediately noticeable and continue to improve over the course of 12 months, when final results are visible. There are no visible scars, and patients are back to their normal activities right away.
Call my office for more information or to schedule a consultation with me. 317-575-0330.
I had a request from a Facebook follower to write about breast
reconstruction, and in particular, how reconstruction is a
“process” as opposed to a procedure. I think that this point is
well-taken, and the potential length of the process often surprises women at
first consultation. Although some patients are candidates for single-stage
reconstruction, and the application of this technique is increasing, most
reconstructions are still performed as a series of stages over the course of a
year or more. Typically, reconstruction will begin at the time of the
mastectomy, utilizing techniques to recreate the breast mound. Most commonly,
this consists of insertion of a temporary stretching device called a tissue
expander. The expander is then replaced with a softer, more long-lasting
implant at a second surgery. Sometimes it is possible to perform nipple
reconstruction at that time, but this may be delayed to a third stage.
Pigmentation of the nipple areolar area requires medical tattoo, representing
yet another stage in the process. Even when the breast is reconstructed in a
single stage, for example with a flap of tissue from the abdomen, it is common
to return to surgery to refine and fine-tune the result within the first year.
Improving the breast contours and soft tissue thickness with fat grafting is a
powerful tool for these revisions regardless of initial reconstruction type.
However, the nature of fat grafting is such that several sessions may be
required to achieve the desired results.
In the years after initial successful reconstruction, issues can occur that lead to more surgery to maintain or revise the result. This is especially common in women who have had mastectomy and reconstruction on one side as opposed to both sides. The non-cancer breast and the reconstructed breast often behave differently with aging and weight changes. Implant related issues can also occur. Breast implants will eventually wear out and will need to be replaced in many patients, usually around ten to twenty years after insertion.
Breast reconstruction decision-making is highly complex. Numerous techniques are available, and many factors need to be considered when selecting a reconstructive approach. These factors include tumor characteristics, the use and timing of adjunctive techniques such as chemotherapy and radiation, individual patient characteristics such as breast form and size, health status, lifestyle goals, and personal preferences. The use of radiation in particular has profound effects on the breast tissues, and is a common reason for a more drawn out reconstructive process.
Breast reconstruction requires time and patience. Nevertheless, for many patients, the process is an integral part of their journey to a new life as a cancer survivor. Although I wish that reconstruction could be a one-time event, I really enjoy watching my patients recover physically, mentally, and spiritually over the course of their treatment, and I relish catching up with them when they return years later to address the changes that can occur with their breasts over time.
Here is an
interesting video/article from the Plastic Surgery Channel about “The BIG Breast Debate”. A new study shows that American Women
have the largest breasts in the world, yet breast augmentation is still the most
popular cosmetic surgery. Interestingly, implant sizes selected in warmer climates
tend to be larger than those in cooler areas such as the Midwest or East Coast.
I tell my patients there are multiple considerations when we discuss implant size.
Unfortunately, sizing is not a simple matter of the patient saying “I want
this size bra or this volume of implant.” The standards for bra cup sizing
are imprecise and variable, and patient preferences for bra fit and coverage vary
as well. The final breast size consists of a complex relationship of the natural
tissue plus the implant volume and characteristics. These factors can be predicted
roughly, but not precisely.
Most importantly, the goal should be to improve breast size and proportion while respecting the limits of what the breast tissues can handle. Sometimes the tissues present a limit to the size that can be safely achieved. By that I mean that we now know that over time, excessively large implants can stretch breast tissues into ugly positions and shapes. I believe it is most appropriate to respect the tissue limits to reduce the chance of these problems occurring, because they almost always require expensive surgery to fix. I use a method referred to as tissue-based planning to determine safe breast sizing, and I use before and after imaging to help my patients see what their potential results may look like. This is a great tool that enables us to communicate more clearly about the size question.
In addition to choosing a board certified plastic surgeon, I advise my
patients that it’s equally as important to choose a fully accredited
facility. Following is a good article from the American Society of Plastic
Surgeons (ASPS, of which I am a member) that discusses why. It lists 10
reasons that accreditation matters and provides commentary regarding how to
know if the center you are considering is accredited.
Meridian Plastic Surgery Center, where I perform many of my procedures, is accredited by the Accreditation Association for Ambulatory Health Care, Inc. (AAAHC).
Medical Tourism is a topic that has been covered in the news quite a
bit lately. For plastic surgery, it can be very dangerous. Here’s how it
works: Patients don’t want to pay the U.S. prices for plastic surgery,
so they take a vacation in another country and have a “nip here and a
tuck there” during their trip.
My partner, Dr. Bruce Van Natta, did a great video 2 years ago on the Plastic Surgery Channel on this very topic. The outcome can be dangerous, and it may end up costing patients thousands of dollars to try to fix things. One of the issues is that you may not know who is actually performing your procedure. And, while they may claim that the surgical environment is “safe”, it may not be safe compared to U.S. standards. Here is a recent article published in Time Magazine that outlines the dangers of medical tourism in plastic surgery, including serious bacterial infections.