Choosing Wisely: 5 Things to Avoid in Plastic Surgery


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TCW 1he American Society of Plastic Surgeons (ASPS) recently released their contribution to the American Board of Internal Medicine Foundation’s Choosing Wisely campaign to educate patients on procedures that have little or no value. Dr. Gutowski was closely involved in the selection of the “Five Things Physicians and Patients Should Question” in plastic surgery based on a comprehensive review of medical studies on each topic. These include:

  • Avoid performing routine mammograms before breast surgery
  • Avoid using drains in breast reduction mammaplasty
  • Avoid performing routine and follow-up mammograms of reconstructed breasts after mastectomies
  • Avoid performing plain X-rays in instances of facial trauma
  • Avoid continuing prophylactic antibiotics for greater than 24 hours after a surgical procedure

For more information, read the Medscape report or click on the image above.


  • Copyright: Karol A. Gutowski, M.D., Chicago, IL, 2014


Cosmetic Procedures Continue to Increase

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The latest statistics from the American Society of Plastic Surgeons confirm that Americans are still seeking out both surgical and nonsurgical treatments to improve their appearance. 

If you are considering these options, please make sure you see a Board Certified plastic surgeon for a consultation. 


Botox, Dysport and Xeomin to Improve Wrinkles: Dr. Gutowski Explains the Difference


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Botox Cosmetic LogoXeomin LogoDysport Logo

By now, everyone knows about how Botox can make frowns disappear. But most people don’t know that there are two other products, Dysport and Xeomin, which are approved in the United States to do the same thing.

Last month, Dr. Gutowski was invited to present his thoughts on all three options now used to stop active facial wrinkles, at the American Society of Plastic Surgeons annual meeting in San Diego. For a summary of Dr. Gutowski’s presentation, and to learn more about how each of these medications work, go to the Botox, Dysport, and Xeomin page.

ASPS 2013 (2)

“It was an honor to educate other plastic surgeons on the use of Botox, Dysport and Xeomin in treating facial wrinkles at our annual educational meeting. I look forward to providing more innovative educational topics to my fellow physicians.”

Karol A. Gutowski, M.D.

  • Copyright: Karol A. Gutowski, M.D., Chicago, IL, 2013

Dr. Gutowski Awarded Best Paper in Plastic & Reconstructive Surgery for 2012


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Best Paper PRS

With more recent emphasis on patient safety, particularly during the time of surgery, Dr. Gutowski and his colleagues at the University of Wisconsin compiled a guide for plastic surgeons to use in their practices. As seen in the video below, Dr. Rohrich award this paper as one of the best papers in Plastic & Reconstructive Surgery as determined by the number of people reading and downloading it.

“I believe that we have a duty to provide the best possible care for our patients. This includes providing a safe environment during surgery when a patient may be most vulnerable. These two papers, along with the patient safety courses I teach at national meetings, are intended to reduce complications and improve outcomes in plastic surgery.”

Karol A. Gutowski, M.D.

Click on the link below each image to access and download a pdf file of each paper.

Pt Safety 1


Pt Safety 2Patient_Safety_in_the_Operating_Room___II_.13

Dr. Gutowski Discusses “Stem Cell” Face Lifts in the New York Times


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One of the most promising new innovations in medicine is the application of stem cells to repair and regenerate the body. Stem cells have the potential to grow (differentiate) into specific cell types and influence the other cells around them. While stem cells may revolutionize both aesthetic and reconstructive plastic surgery, there is little evidence at this time to recommend their use in clinical situations. Research studies are underway to determine in which situations stem cells may be useful to restore normal form, function and appearance and to improve healing.

Since stem cells are found in fat tissue, liposuction can be used to remove fat and stem cells together. The combination of cells can then be injected into areas of the body where fat and stem cells are needed. While this sounds good in theory, actual successful clinical examples of stem cells improving outcomes using this technique are rare. 

Unfortunately, some doctors are promoting the use of stem cells to enhance plastic surgery procedures such as face lifts and breast augmentation. Despite the 2011 position statement on stem cell treatments by the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery, there are still those who promote stem cell use without educating patients about the lack of proof that stem cell treatments offer any benefit over regular treatments.

At this time, there is no evidence that “stem cell” face lifts offer any advantage compared to other standard treatments to improve facial aging. Most of the doctors promoting this treatment are not training in stem cell applications and many are not even plastic surgeons (or even surgeons). So until properly done studies show that stem cells can improve face lifts, or any other aesthetic procedure, consider such claims to be untested and without any value. 

To learn more, read the New York Times article on Stem Cell Face Lifts



Dr. Gutowski Answers Questions on Aesthetic Plastic


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AskimoEvery wonder wish you could listen to an interview with a plastic surgeon? Thanks to Askimo TV, you can now listen to Dr. Gutowski discuss common and cutting edge plastic surgery procedures. For more information, click on the images below.


Askimo Aesthetic Plastic Surgery

Dr Gutowski discusses aesthetic plastic surgery


Askimo Breast Augmentation

Dr Gutowski discusses breast augmentation


Copyright: Karol A. Gutowski, M.D., Chicago, IL, 2013

Indoor Tanning: Adds to Skin Cancer Cases & Risks not Disclosed by Tanning Salons


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This time of year, many of us in the cooler climates miss the sun, and tan skin, that comes with summer. However, turning to indoor tanning is not a good idea. Although the risks for artificial tanning have been known for years, the indoor tanning industry does not seem to fully disclose the potential harm to users.

Last year, an investigative report conducted by the U.S. House Energy and Commerce Committee raised concerns about indoor tanning salons not providing factual and sufficient information on the health risks associated with the practice.

ABC News reported that “Committee investigators posed as fair-skinned 16-year-old girls, and contacted 300 indoor tanning salons throughout the country. Of the salons contacted, 90 percent told the ‘girls’ that indoor tanning did not pose health risks, and more than half the salons denied that the fake sun increased risk of cancer. Many described such statements as ‘rumor’ and ‘hype,’ according to the report, and more than three-quarters of salons said indoor tanning is actually beneficial to the health of a teen girl. Salons told the ‘teens’ that the intense UV rays treat depression, induce vitamin D production, prevent and treat arthritis and help with weight loss, cellulite, depression and self-esteem. Employees also often referred to industry-sponsored websites that downplay or disregard the copious research that has found indoor tanning causes melanoma, the deadliest type of skin cancer.”

The truth however, is much different. Medical research shows that indoor tanning is a cause of skin cancer, including melanoma, the deadliest form of the disease, while the World Health Organization grades indoor tanning beds as a “Group 1″ carcinogen (along with tobacco smoke and arsenic).

Adding more evidence to the risks of indoor tanning, a 2012 study published in the journal BMJ, combined the results of 12 prior studies on over 80,000 people. The researchers estimated more than 170,000 cases of non-melanoma skin cancers may be due to indoor tanning in the United States each year. Those with exposure to indoor tanning before the age of 25 were linked to an increased risk for basal cell carcinoma, according to the study.

So while a tan may look good, beware of the skin damage and cancer that may result from indoor tanning.

  • Source: ABC News and ABC News
  • Image Source: (Unless otherwise noted, all images are models and not actual patients.)
  • Copyright: Karol A. Gutowski, M.D., Chicago, IL, 2013

Latest Operating Room Patient Safety Recommendations Published by Dr. Gutowski


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Dr. Gutowski and colleagues composed recommendations for surgeons on ways to improve patient safety during surgery. This work was just published in the medical journal, Plastic & Reconstructive SurgeryWhile the vast majority of patients experience a safe surgical experience when treated by Board Certified Plastic Surgeons, there is always room for improvement. So when considering a cosmetic or reconstructive plastic surgery procedure, be sure to seek out a Board Certified Plastic Surgeon who is also a member of the American Society of Plastic Surgeons (which requires its members to earn at least 10 credits of patient safety education every year).

Breast Reconstruction Awareness (BRA) Day October 17th


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The American Society of Plastic Surgeons (ASPS)and The Plastic Surgery Foundation ( PSF) are supporting the first national Breast Reconstruction Awareness (BRA) Day USA on October 17, 2012. With a goal of raising awareness of breast reconstruction options following mastectomy, plastic surgeons throughout the United States will work with patient groups and other organizations to educate their communities and patients. Surprisingly, as many as 7 out of 10 women treated for breast cancer are never told about their reconstruction options.

For more information, go to Bra Day USA.

Dr. Karol Gutowski Contributes to Latest Patient Safety Recommendation for Plastic Surgery Patients


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The American Society of Plastic Surgeons (ASPS) released their latest recommendations to make plastic surgery procedures safer for patients. Although rare, blood clots in the legs, also called deep venous thrombosis (DVT) can happen after any surgery and cause serious complications. In an effort to provide the highest level of care for patients undergoing plastic surgery, ASPS formed a task force to study the issue and make recommendations for surgeons.  These latest guidelines include the use of the Caprini Risk Assessment Module which lets surgeons calculate a risk level for DVT and then provide proper interventions to decrease the risk. 

For any patient considering a major surgery, be sure you follow your surgeon’s recommendations for decreasing the risk of DVT and read the ASPS information material on DVT.

Belotero, A New Wrinkle Filler now Available at MAE Plastic Surgery


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The newest addition to the group of fillers used to improve wrinkles is Belotero Balance and it is now available for patients in the USA. Belotero is similar to Restylane and Juvederm (two of the most popular wrinkle fillers) and works by replacing hyaluronic acid, a naturally occuring substance in our bodies, that is lost in our skin over time. 

While not permanent, Belotero Balance will last about 6 months and is FDA approved for improving the nasolabial folds (the folds in the skin that run from the nostril to the corner of the lips). Touch-up treatments may be useful 2 weeks after the first treatment.  

For “Before & After” pictures of Belotero patient, click here: Belotero Gallery.

“Our patients have been very happy with the results of Belotero when used for fine lines and wrinkles, particularly those around the lips. The injections are easy and the improvements are seen immediately. Belotero will be a great addition to our options to improve facial aging.”

Karol A. Gutowski, M.D. 

Sculptra is an Excellent Option for Restoring a Youthful Face


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Sculptra is now available at MAE Plastic Surgery for patients seeking a nonsurgical option to restore volume in their face. After a simple injection of Sculptra under the skin, the body is stimulated to make new collagen which results in less skin wrinkles and more volume. The result is a more youthful appearance that can last up to 2 years. 

“I’ve been using Sculptra to improve facial appearance since 2005 and have seen wonderful results that last for 2 years or more. Unlike most other injectable products, Sculptra actually causes the body to create new collagen and can be easily used to fill out the cheeks and temples. Patients have been impressed with the results!”

Karol A. Gutowski, M.D.

Read Dr. Gutowski’s comments about Sculptra in the  New York Times 

Dr. Karol Gutowski Talks About Scar Treatment


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Scars after surgery or skin injuries can be hard to improve, particularly in younger people. While there is no way to prevent scarring after surgery, there are a few things that can help minimize scars and improve their appearance. In the this video, Dr. Gutowski discusses the advantages of using NewGel silicone gel products to improve skin scars after surgery. 

  • Image Source: Ambro / (Unless otherwise noted, all images are models and not actual patients.)
  • Copyright: Karol A. Gutowski, M.D., Chicago, IL, 2012

3D Imaging for Breast Enhancement now Available by Dr. Michael Epstein and Dr. Karol Gutowski


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Dr. Gutowski & Dr. Epstein of MAE Plastic Surgery are excited to announce the availability of 3D imaging technology to allow patients to see how their breasts would look before and after breast implant enhancement. 

A special opportunity to try this new technology is being offered on April 23rd and 24th. Please call 847-205-1680 for a complimentary appointment.

  • Image Source: Unless otherwise noted, all images are models and not actual patients.
  • Copyright: Karol A. Gutowski, M.D., Chicago, IL, 2012

Are Drains Needed after Breast Augmentation?


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One of the most common questions patients have when considering breast enlargement is “are drains are going to be used?” Drains are thin rubber tubes that are placed during a procedure and exit through a small hole in the skin. The drain tube connects to a soft plastic container, about the size of an apple, and the container catches any fluid that normally builds up under the skin after surgery. The container can be emptied by a patient at home and the amount of fluid is recorded. After the fluid drainage amount is less than about 25 cc to 30 cc (about one ounce) during a 24 hour period, the drain can be removed in the surgeons office with a gentle pull.

While drains are commonly used in some plastic surgery procedures in an attempt to prevent fluid from building up under the skin at the site of surgery, they do have some disadvantages such as pain, discomfort, leaking, difficulty with normal activity, and possibly infection.

In breast augmentation, there is no evidence that drains offer any benefit or result in a better outcome. There are very few situations where a surgeon may want to place a drain when placing a breast implant:

  • Excessive oozing during surgery
  • Revision of a prior breast surgery
  • Removal of a capsular contrature
  • In some cases of breast reconstruction
  • To treat a seroma (fluid collection) that developed after surgery
  • When treating bleeding or a hematoma (blood collection) after surgery

So if your surgeon is planning on using drains in an uncomplicated breast augmentation, ask if it is really necessary in your case. It is one of those questions that is worth discussing before your procedure.

“In my experience with hundreds of breast augmentations, I’ve only used drains twice, both times in patients with more oozing at the time of surgery than expected. In both cases, the drains were removed the next day. Not using drains routinely allows my patients to have less discomfort and be more active right after their breast procedure.”

Karol A. Gutowski, M.D.

  • Copyright: Karol A. Gutowski, M.D., Chicago, IL, 2012

Sientra Silicone Gel Breast Implant Approved in U.S.


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The U.S. Food and Drug Administration (FDA) approved a new silicone gel–filled breast implant made by Sientra, offering a third option in breast implant options for women in the United States. As with the other two breast implant products, women who choose to have these new implants should be monitored for any possible problems.

Despite the need for monitoring, the FDA deemed the new Sientra implant and those from Allergan and Mentor as safe. “Data on these and other approved silicone gel–filled breast implants continue to demonstrate a reasonable assurance of safety and effectiveness,” said William Maisel, MD, deputy director for science in the FDA’s Center for Devices and Radiological Health, in a press release.“It’s important to remember that breast implants are not lifetime devices,” said Dr. Maisel. “Women should fully understand risks associated with breast implants before considering augmentation or reconstruction surgery and recognize that long-term monitoring is essential.”

Sientra’s new implants can be used for breast reconstruction for women at any age and to increase a women’s breast size in women aged 22 years and older.

For more information on breast implants go to:

More information on the FDA decision is available on the agency’s Web site.

Dr. Karol Gutowski Publishes Recommendations on Treating Breast Implant Infections


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For most women who have breast implants, an infection around the implant is a rare event. However, in some cases, particularly after placing an implant for breast reconstruction, an infection may result. Since the human body has a hard time fighting an infection around an implant, both patients and surgeons face challenges when these unfortunate events happen.

A publication this month by Dr. Gutowski and Dr Washer, an infection specialist, offers advice and guidelines for physicians who are faced with different treatments for breast implant infections. 

Dr. Karol Gutowski Comments in the Washington Post on Suzanne Somers’ Stem Cell Breast Reconstruction


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For the many women who are affected by breast cancer, the loss of a breast is a serious concern. Thanks to advances by plastic surgeons, current reconstructive procedures can result in a natural looking breast for most women. But even when the breast is not removed, but only the cancer is excised (as in a lumpectomy), a breast deformity can result, particularly if there is radiation treatment involved. 

For actress Suzanne Somers, breast cancer treatment resulted in one breast being a D-cup, and the other breast being a B-cup. Typically, her options to achieve similar sized breasts would have included:

  • Making the larger breast smaller with a breast reduction
  • Making the smaller breast bigger by using a breast implant
  • Reconstructing the smaller breast with a piece of her own living tissue (called a flap)

However, a new option is using a patients own fat cells taken from one part of the body and injecting them in to the breast that needs to be larger. While this may be a good option for many patients, it is not for everyone. Furthermore, some surgeons are promoting a “stem cell” breast reconstruction which takes advantage of the normal stem cells found in fat. As in the case of Suzanne Somers, there is little scientific data to support this stem cell procedure and no evidence that the result will be any better than just fat injections alone.

For more details, click here to read the full article, including Dr. Gutowski’s comments, in the Washington Post.

“Despite the recent position statement on stem cell treatments by the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery, there are still those who promote stem cell use without educating patients about the lack of proof that stem cell treatments offer any benefit over regular treatments. Although stem cell treatments offer great potential in plastic surgery, the advantages have yet to be proven and risks are not known. To learn more about the current state of stem cell treatments in plastic surgery, click on the link below.”

ASPS & ASAPS Stem Cell Position Statement

Karol A. Gutowski, M.D.

  • Source: Washington Post
  • Copyright: Karol A. Gutowski, M.D., Chicago, IL, 2012

Exercise Maintains Fat Loss After Liposuction



Liposuction is one of the most common plastic surgery procedures and is ideal for removing fat from stubborn to lose areas. For men and women who’ve tried changing their diet and increasing their activity but still can’t achieve their desired shape, liposuction can result in a better appearance of the arms, thighs, waist and other areas. It now appears that the weight lost following liposuction may be maintained with regular exercise.

A new study of women who had liposuction to remove fat from the abdomen showed that compared to women who did not exercise, those who did regular exercise had less fat return around their abdominal organs.

The 4-month exercise program involving aerobic and resistance training three times per a week. Both women who exercised, and those who didn’t, had much less fat in the area treated with liposuction after 4 months. However, those who did not exercise had some increase in fat deposits around their organs in the abdomen. An additional benefit of exercise was that physical capacity also improved only in the exercise group after 6 months of training.

It seems that exercise has a protective effect on metabolism and body composition after liposuction. 

“In my practice, liposuction procedures are very common and result in extremely satisfied patients. It is common for patients to return 4 to 6 months later, proud of their continued weight loss. While I don’t attribute it to their liposuction procedure, I suspect it is due to their lifestyle changes that often follow body contouring surgery. For most patients, an exercise program can start 2 to 3 weeks after liposuction so as to help maintain the improved appearance.”

Karol A. Gutowski, M.D.

Dr. Gutowski Announces Educational Meeting for Plastic Surgeons


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As President of the Midwestern Association of Plastic Surgeons, Dr. Gutowski is pleased to announce the Association’s 51st Annual Educational Meeting to be held in Chicago this April. 

This two day course is being organized by Dr. Gutowski and the Association’s Program Committee to offer plastic surgeons new and cutting-edge information on topics including:

  • Patient Safety
  • Breast Augmentation
  • Hand Surgery
  • Breast Reconstruction
  • Cleft Lip & Palate Treatment
  • Face & Body Contouring
  • General Reconstruction

Dr. Gutowski will also moderate an expert panel on how to help patients in selecting the right implant for breast augmentation. 

“Being elected as President of the Midwestern Association of Plastic Surgeons has not only been an honor, but also a wonderful opportunity to serve my fellow plastic surgeons. By working with my fellow association members, we are able to offer an excellent educational program for plastic surgeons. This learning opportunity will result in better results for our patients.”

Karol A. Gutowski, M.D.


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