Q: What is the difference between facial plastic surgery and a “liquid facelift?”
A: Facial plastic surgery includes more invasive procedures such as rhinoplasty, brow lift or facelift, which are performed under anesthesia and have a more permanent alteration of your physical appearance. Surgery is recommended for patients whose goal is to straighten the nose, eliminate drooping brows or eyelids, or reduce jowling and/or a double chin. “Liquid facelift” is a term to describe the more affordable injections performed that either relax muscles or increase volume in the face. Neurotoxins such as Botox® cause the wrinkles on the forehead to relax and can also create the appearance of a temporary “brow lift.” Dermal fillers last six to 18 months and work by injecting a natural substance underneath the skin to increase fullness in deep lines and wrinkles, hollow areas, cheeks and lips. Injections are not used to change features, but are for patients whose main concerns are wrinkles or loss of fullness. “Liquid facelift” is an excellent option for those whose goal is to “refresh” their appearance with almost immediate results.
Alan H. Brill, MD
Alan Brill Cosmetic Surgery (803) 744-7770
Q: What happens when I get a sinus infection and how can it be treated?
A: Sinusitis is simply inflammation of the lining of the sinuses, which produces mucous and results in symptoms like nasal drainage, facial pressure, headaches and nasal congestion. Comprehensive treatment of sinus problems usually involves consideration of allergies and often includes allergy testing. Most episodes of sinusitis can be treated with medicine and symptoms will go away after treatment. CT scans either before or after treatment are helpful in determining the type and extent of the sinus infection you may have. In most cases, surgery is reserved for patients who do not respond to medicines. Modern sinus surgery is done using telescopes through the nose, using little to no packing. There are new minimally invasive techniques including a small balloon that is placed into the natural opening of the sinus and then inflated to enlarge the natural opening and restore normal drainage of the sinus. Most of the time this can be done in the office with only local anesthesia.
Neal W. Burkhalter, MD
CENTA Medical Group (803) 256-2483
Q: What are the effects of being too sedentary?
A: Sedentary behavior is an epidemic in our modern society and is likely to continue to be a problem with improved access to personal computers and television, as well as automated household chores and jobs that chain us to a desk. The Women’s Health Initiative Observational Study examined a person’s sitting time with a risk of cardiovascular disease. They followed 71,000 women aged 50 to 79 years for up to 15 years, comparing those who sat more than 10 hours per day with those who sat for less than five hours per day. They found that the women who sat for the longer period of time were at a 63 percent greater risk for cardiovascular disease than the highly active women. Given the projected population growth of U.S. women aged 65 and over, plus the relatively high prevalence of physical inactivity, the study’s findings have important public health implications. If older women who are less active simply reduce their sitting time, they could potentially reduce their risk of coronary heart disease and stroke.
Meghan L. Businaro, DO
Cardiologist, Palmetto Heart, Palmetto Health (803) 434-3800
Q: What makes total joint replacement in a surgery center possible?
A: A three-pronged approach of minimally-invasive surgical technique, improved pain management and immediate rehabilitation promote rapid recovery from total joint replacement, making the outpatient surgery center setting a viable option for many patients. We experience pain as tissue injury during surgery leads to inflammation that triggers nerve stimulation through peripheral nerves to the spinal cord and on to the brain. Many opportunities exist to minimize pain throughout this process, but we have historically relied on narcotics alone to manage pain. More progressive techniques reduce the tissue injury at the outset thereby decreasing inflammation, which reduces nerve stimulation. Reducing tissue injury also reduces physical limitations, making rehabilitation easier and immediately possible. Additionally, adjustments to anesthesia and other medications reduce pain more effectively while also minimizing side effects like nausea that delay recovery. This comprehensive approach enables patients to experience only mild discomfort as they return home with a new joint the same day of surgery.
Robert M. DaSilva, MD
Midlands Orthopaedics, P.A. (803) 256-4107
Q: As an adult patient in need of orthodontic treatment, I dread time spent in braces. How can I get this done right in the shortest amount of time, and what are my options so that my braces won’t be so conspicuous?
A: Seek an orthodontic team that will provide you with the treatment you need for optimum results in the timeliest manner possible. Acceledent is a device available to patients that when used during treatment can shorten a patient’s time in orthodontia by 30 to 50 percent. Some adults may not feel comfortable with a mouth full of metal, for those patients, a qualified orthodontic team will offer translucent ceramic brackets that blend in nicely with your teeth, and depending on the severity of your needs, some patients are eligible for treatment using clear aligners that fit right over the teeth and are virtually invisible.
Edward Davis, DMD
Davis Orthodontics (803) 739-1600
Q: What is an MRI and how is it different from an x-ray?
A: MRI, Magnetic Resonance Imaging, is a very valuable diagnostic tool. An MRI utilizes a strong magnetic field and radio waves instead of radiation to produce extraordinary detailed images. This examination is the method of choice for the diagnosis of many injuries and other complaints. Due to the magnetic field, a thorough “screening” must be completed and reviewed with each patient before entering the procedure room. No one is allowed to enter the MRI room with metal, zippers or implanted devices such as a pacemaker, vascular stents or aneurysm clips. An MRI causes no pain to patients, and most examinations can be performed within 30 minutes; some examinations require 60 minutes. The machine produces some “thumping” noises as images are produced. Earplugs or headphones are usually provided to help patients relax. A 1.5, an open style MRI, has a large opening and accommodates most patients up to 550 lbs., depending on body habit. As with all examinations, MRI procedures are interpreted by a certified radiologist.
Martin P. Dommers, MD
ImageCare, LLC (803) 462-3680
Q: Are there non-surgery options for severe knee pain caused by osteoarthritis?
A: Yes; Osteoarthritis (degenerative joint disease) is caused by deterioration of cartilage in a joint. This cartilage acts as a “cushion” between the knee bones. When it breaks down, the knee functions bone-on-bone, causing pain, swelling and stiffness. Viscosupplementation can dramatically help this painful scenario. The method involves injecting a thick fluid into the knee, which bonds with natural joint fluid to create that all-important cushion between the bones again, reducing pain, swelling and inflammation and allowing you to return to normal activities. The procedure is done in office, not a hospital. Pain from the procedure is minimal if any. There is no recovery time requiring assistive devices like walkers. The risk of infection is very low. The procedure is covered by many insurance plans and has a 90 percent success rate.
Thomas Gibbons, MD
Doctors Care, P.A. (803) 738-9522
Q: What is the biggest medical problem facing older adults?
A: Overmedication. Half of all older adults, 65 and older, have more than three chronic medical conditions. Many seniors end up on 12 or more medications. As the number of medications increase, the side effects and drug interactions surge. Physicians need to select medications that will have the biggest impact on health rather than adding medications to comply with guidelines. Physicians should not prescribe a pill for every complaint. For every pill administered, you should ask the following: Why am I taking this? Is it effective? Is this medication causing side effects? Or treating the side effect of another medication? Never stop a medication without talking to your doctor first, but ask to review and taper medications to see which you really need.
David Greenhouse, MD
Laurel Crest Continuing Care Retirement Community (803) 796-0370
Q: Why wasn’t my child given an antibiotic?
A: There are two main types of infections in the pediatric population: viral and bacterial. Viral infections are responsible for most colds, vomiting, diarrhea and sore throats. There are no cures for most viral infections. They must run their course, which lasts five to 10 days. Since antibiotics are not effective against viral infections, treatment is aimed at comfort and symptomatic relief. Antibiotics are the mainstay of treatment for bacterial infections and are among the most prescribed pediatric drugs. As antibiotic use has increased over the years, so has the resistance of pathogens. This makes it more difficult to treat true infections. Antibiotics come with potential for side effects varying from mild to severe reactions. Your pediatrician should take a conservative approach to treating illness, using antibiotics only when appropriate, looking out for the best interest of your child.
Kay Moore, MD
Palmetto Pediatric and Adolescent Clinic (803) 732-0140
Q: Can allergies affect work performance in adults and school performance in children?
A: Yes; studies have shown that uncontrolled allergies can adversely affect the work performance of adults. Likewise, allergic rhinitis in children can negatively affect their school performance. One study found that children with uncontrolled allergic rhinitis had lower test scores on standardized tests and decreased ability to recall information. In some studies, there was improvement in test scores in children when they were treated with non-sedating antihistamines. Up to 40 percent of children have allergic rhinitis. According to recent studies, many of these cases are not diagnosed and treated. Children with attention deficit hyperactivity disorder should be evaluated for uncontrolled nasal allergies if they have chronic nasal symptoms, as these can further impair their school performance. Additionally, some of the older sedating antihistamines used to treat children can further impair cognitive function due to crossing the blood brain barrier into the central nervous system and causing sedation. Specialty care from an allergist can correctly diagnose and successfully treat these conditions.
Lisa S. Hutto, MD
Palmetto Allergy and Asthma (803) 765-9435
Q: Why is the LenSx femtosecond my best option for cataract surgery?
A: The femtosecond laser has been used for nearly a decade to perform LASIK, and was approved by the Food and Drug Administration in 2011 for cataract surgery. This technology allows the surgeon to perform certain key steps within cataract surgery with a laser rather than a blade. This allows the surgeon to take advantage of the precision and accuracy that a laser affords and apply it to cataract surgery to help patients obtain their optimal result. Additionally, the laser provides an extremely detailed image of the eye. Since each eye is different, the surgeon can use this information to customize the surgery for your eye.
Edward G. Mintz, MD
Columbia Eye Clinic (803) 779-3070
Q: What are the symptoms of menopause and are there treatment options?
A: Menopause is defined as the cessation of menstrual periods and usually occurs around the age of 51. The symptoms of menopause, often called the perimenopause, usually begin four to five years prior to the last menstrual period. There is a wide variation in the severity and duration of symptoms between women. Some women may have symptoms for more than 10 years, while others may never have a perimenopausal symptom. The most common symptoms include hot flashes, night sweats, mood changes such as irritability or depression, sleep disturbances, irregular periods and changes in sexual function. Other medical conditions such as thyroid disorders, fibroids or endometrial cancer also can cause symptoms similar to those of perimenopause. If symptoms become severe, it is important to consult with your physician to rule out these other conditions. There are many treatment options for relief of symptoms, ranging from lifestyle changes to medication therapy. There are also treatment options that may help prevent long-term effects of menopause such as osteoporosis. Not all women need treatment for the symptoms of menopause, but if symptoms are severe or affect quality of life, you should discuss these treatment options with your doctor.
Mark Wild, MD, Parkridge OB/GYN
Palmetto Health (803) 907-7300
Q: What are signs that my parents may be ready for assisted living?
A: Do they remember to take their medications correctly? An assisted living community will administer medications to ensure they are being taken properly. Does your loved one wear the same clothes over and over or wear soiled clothing? They may be forgetting to change clothes. If they have an odor, they may also be forgetting to bathe. Have you noticed bruises or other signs that your loved one may be having falls? People can fall anywhere but a pattern of falling may mean it’s time to consider a move to a safer environment. Have they cut back on social activities? Maybe they used to enjoy reading or sewing, but are no longer able to perform these activities. If they are withdrawing from friends and family, they may be experiencing depression and would benefit from being around other people their own age.
Oakleaf Village of Lexington (803) 808-3477
Q: How do I choose the right retirement community?
A: Make sure you choose a Continuing Care Retirement Community (CCRC), which gives you the added benefit of comprehensive wellness programs and a lifetime of care that enables you to age in the same place. Should your health care needs change along the way, a CCRC assures you have access to various levels of care, including in-home assistance, skilled nursing and memory care, without ever having to leave your community. Choosing the right CCRC allows you to maintain your independence, expand your horizons and make your own decisions, while giving you the benefits of a dynamic lifestyle, supportive social involvement and good nutrition. After you have done some research and made some visits, high quality, faith-based CCRCs governed by a strong, committed board of directors should make up your short list. The CCRC you then choose should fit your desires and expectations.
Still Hopes Episcopal Retirement Community (803) 739-5040