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You don’t need Doc Holliday to pull your trigger finger

Stenosing tenosynovitis is more common than you might think even though few of us can pronounce it. Even its common name, “trigger finger,” sounds like something that might affect gunslingers. Regardless of what you call it, trigger finger is pretty easy to recognize. One or more fingers get stuck in a bent position as if to pull a trigger. People over the age of 40 with a history of diabetes or rheumatoid arthritis are especially at risk but it can occur in people of all ages.

Manish R. Gupta, MD, is a board certified plastic surgeon with significant experience dealing with trigger finger. “The exact cause of trigger finger is unknown,” he says, “but the treatment, for me, is pretty straightforward. Continue reading

Written by Artisan Cosmetic Surgery June 1, 2015

Getting A Handle On Hand Injuries

Most people probably associate plastic surgery with cosmetic procedures—reshaping the nose, removing the bags under the eyes, or changing the breast size. Dr. Manish Gupta reminds us, however, that plastic surgery also plays an important role in reconstructing tissues injured by trauma or burns. Often these procedures are technically complex and deal with the patient’s ability to function as well as with his appearance.

“Plastic surgeons have intensive training in hand surgery, for example,” says Dr. Gupta. “Along with orthopedic surgeons and general surgeons, we treat a wide range of hand problems from carpal tunnel to trigger finger to trauma repair.” Continue reading

Written by Artisan Cosmetic Surgery May 29, 2015

Here’s an eye opener! Look better and see better with surgery for ptosis.

You may remember to old cartoon character Droopy Dog. In the first scene of the 1943 debut, Droopy saunters in, looks at the audience and says “Hello all you happy people. You know what? I’m the hero.” Droopy’s meek, deadpan personality and appearance made him an improbable looking hero. Still, he managed to consistently foil his adversaries. There are a lot of people, especially Baby Boomers, who feel that their appearance does not adequately reflect how youthful, vigorous, and “heroic” they really feel despite the fact that, like Droopy, they have rather sad, drooping basset hound eyes.

Those droopy eyes might be natural for a basset but in humans the comparable condition is called ptosis Continue reading

Written by Artisan Cosmetic Surgery February 26, 2015

Board Certification – Does that wallpaper mean anything?

The nurse escorts you from the examining room to the doctor’s office. “He’ll be with you shortly,” she says, “to review the test results.” So, you sit there wondering just how bad the results can be. There is some consolation. At least you are in good hands. The doctor’s office walls are papered with certificates from important-sounding organizations. He must be pretty good.

But what do all those certificates mean? What is the significance of board certification?

Manish Gupta, MD, is a Diplomate of the American Board of Surgery who specializes in plastic surgery, cosmetic surgery, and hand surgery. “Certifying boards are not educational institutions and do not confer degrees the way universities and medical schools do,” says Dr. Gupta. “Certification doesn’t establish your legal qualification to practice. It is not medical licensure or the right to prescribe medicine nor is board certification required for the practice of a medical specialty. Certification comes after all of these rather than before. Plastic surgeons certified by the American Board of Plastic Surgery have already undergone years of extensive education and training to gain the necessary skill level  to provide the most competent and comprehensive patient care.”

Dr. Gupta explains that not all surgeons offering cosmetic procedures are board certified by the American Board of Plastic Surgery (ABPS). Board certified plastic surgeons have proven their ability by meeting stringent qualifications. They have graduated from an accredited medical school, Completed at least five years of additional residency, usually three years of general surgery and two years of plastic surgery. After that, they must actively practice plastic surgery for two years and then pass comprehensive written and oral examinations. There are ethical, professional, and practical requirements for board certification but the requirements don’t end when a physician passes the board examination. To maintain certification, the physician must have staff privileges and actively practice in his specialty. He is also required to attend seminars and conferences to keep up with the latest developments and periodically sit for re-examination.

Lifetime board certification was once granted but, in the last ten years, most boards have established more stringent requirements. Physicians who were already board certified for life retained this right but newly certified physicians are granted certificates that expire after a specified period, generally ten years. To be re-certified in a specialty, physicians now must take another examination. Board certification does not guarantee good results but it is a good indicator of training, competence, and experience. “Being board certified means so much because the standards are so rigorous,” says Dr. Gupta.

The American Board of Medical Specialties supports improved care of patients by regulating the quality of medical education. The ABMS is the umbrella organization that oversees the certification process of its member specializations. For example, although the American Board of Plastic Surgery does not determine who may perform plastic surgery procedures, it does initiate the qualifying requirements for applicants requesting certification, regulate comprehensive examinations and award certification to those who meet the established criteria. ABPS is one of the 24 specialty boards recognized by the ABMS and is the only ABMS Board that certifies in the full spectrum of the entire specialty of plastic surgery. This board’s accreditation is held in high regard and once a surgeon satisfies its requirements, he or she is referred to as a diplomate of the American Board of Plastic Surgery. Diplomates are recognized professionally for their extensive skills in reconstructive and cosmetic surgery.

“Many people associate plastic surgery with Hollywood,” says Dr. Gupta, “and the obsession with looking beautiful. They may not be aware, however, that plastic surgeons also repair congenital defects, such as cleft palates, deal with the effects of accident and trauma, as well as with burns. Quality of life as well as quality of appearance is within the scope of the plastic surgeon. It is not all just liposuction and breast augmentation.”

Awareness of certification is one of the steps patients can take to become informed consumers. In Sept. 2004, a Gallup poll asked respondents to choose between a board certified physician and one not certified but recommended by a trusted friend or family member. Seventy-five percent said they would prefer to be treated by the board certified physician.

Written by Artisan Cosmetic Surgery December 1, 2014