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Northwestern Medical Education Series

By: Kent Spencer

Regarded as one of the top plastic surgeons in Chicago, assistant professor of surgery at Northwestern, Dr. Robert D. Galiano gave an hour-long lecture in the Dorothy Menker Theater on the evening of February 8.

In front of a crowd of over 100 people, Galiano shared information about scarring and gave new insights of the breakthroughs in the field of plastic surgery.

Galiano also shared what was new in the field of plastic surgery and cosmetic surgery. Through his years as a doctor, his favorite procedure to preform is breast reduction, which relieves woman of back and neck strain. With this, he explained that there are over 25 techniques of breast reduction.

“Keloids have been a major branching of the unwanted result of scarring,” explained Galiano. A keloid grows beyond the boundary of scars and has many different treatments such as excisions, steroids, radiation, and the usage of chemotherapeutic agent’s 5-FU and Bleomyein. There are surprising factors within who gets scars. Race and age are factors people often don’t know about. African Americans and Asians are at a higher risk among all races to get keloids. Ages between 10-30 are also at highest risk for developing keloids. Doctors have found that properly closing incisions helps reduce this occurrence.

Big or small, scars rank at the top of people’s personal list for undesirable features. People spend hundreds of dollars on creams and procedures to help remove childhood scars. Making sure the scar is moisturized is a major step in decreasing its visibility. Using moisturizers such as baby oil can have a great effect. Galiano explained that silicon gel sheets are becoming popular in the plastic surgery world for reducing scars.

Galiano also highlighted some tips for skin care. He said to get sleep, to not smoke, and to not stay under the sun too much. He pointed out cosmetology is thriving with great treatments to help wrinkles using Botox and Dysport. Galiano included there are currently great options for looking younger. The deep plane facelift is becoming a very usable option to be a great feature for a great natural facial look.

Galiano did a great job explaining what’s new in the medical field. Even with no plans of any of these procedures, it’s important to know what’s available and progress of health improvement.

Northwestern prof’s innovation heals facial burns, teams with Army

By Daniel Schlessinger

The first face transplant in Spain shocked the world in 2010, advancing facial reconstruction techniques that hadn’t changed in more than 15 years. Now, Northwestern , University of Texas at Arlington and U.S. Army researchers are giving the field a new face with an invention called the Biomask.

The Biomask, which is currently undergoing testing at the microscopic level, would work by allowing a doctor to essentially build a face out of individual cells. A doctor would take a 3-dimensional mold of a burn victim’s face and determine with a computer which parts of the face need to be thicker or thinner.

The project started when NU plastic surgery Prof. Robert Galiano began tissue engineering research in 2006. His project, focusing on growing tissue inside mice using advanced methods, went on hiatus shortly thereafter due to lack of funding.

His team received a second chance on the project when Colonel Robert Hale, commander of the U.S. Army Dental and Trauma Research Detachment in San Antonio, and Army researcher Kai Leung rediscovered Galiano’s research. Galiano and NU colleagues doctors Thomas Mustoe and Claudia Chavez-Munoz started collaborating with the Army and University of Texas Arlington engineer Eileen Moss after receiving an Army grant.

“Colonel Hale had a vision, since there aren’t great options for soldiers who have their faces burned almost completely in the Iraq and Afghanistan wars,” Galiano said. “We started talking, and through discussing with them and other collaborators, we launched the Biomask project.”

Current methods of facial reconstruction for burn victims include face transplantation or skin grafting. Transplantation is both costly and extremely difficult, and grafting is not ideal either, Galiano said.

“On a face, where the skin has color variations, sweat glands, oil glands and hair follicles, grafting looks like a quilt,” Galiano said. “These patients are not satisfied with the current techniques, but that’s all they’ve got.”

In the past, when scientists have attempted to grow tissue components in vitro, the tissue cannot integrate and survive. What makes the Biomask so unique, Chavez-Munoz said, is the tissue grows on top of its host, with a preexisting vasculature system that can transport essential substances, such as blood, nutrients and oxygen.

The mask includes sensors that monitor pH, temperature, flow of nutrients and bacteria beneath the mask. The mask is also transparent, which allows doctors to visually examine the patient at all times without disturbing the healing process. Finally, vacuum suction applied over the whole mask can promote tissue growth.

The team is currently perfecting the tissue growth rates and optimization of the technology. Chavez-Munoz said the NU doctors provide a clinical perspective so that the UT Arlington researchers will know how to reengineer each component. Within two years, it will test the mask on large animals such as pigs.

“It’s a work in progress,” Galiano said. “My guess is that within the next four to five years we’ll be doing clinical trials on patients.”

The team’s work may result in patents, Galiano said, but right now he is focused on perfecting the product at the cellular level. He predicts it will pique the interest of top officials in the Army and hopefully receive more funding.

“We have the ideas and we have the hope,” Galiano said. “If we could achieve even a simplistic gain, then over time we could grow more sophisticated types of tissue.”

Moraine Valley to host medical presentation on plastic surgery

By Moraine Valley Community College

Moraine Valley Community College will host a Medical Education Series presentation on “Scars and Plastic Surgery: What is New?” from 7 to 8 p.m. on Wednesday, Feb. 8, in the college’s Dorothy Menker Theater in the Fine and Performing Arts Center, 9000 W. College Pkwy., Palos Hills. The event is co-sponsored by Northwestern Memorial Hospital and is free and open to the public.

Dr. Robert D. Galiano will lead this presentation. Dr. Galiano is an assistant professor of surgery at Northwestern University Feinberg School of Medicine. He graduated from Washington University with a Bachelor of Arts in Biology and English Literature before receiving a Doctor of Medicine degree from Northwestern University. Dr. Galiano completed his plastic surgery residency at the Institute of Reconstructive Plastic Surgery of New York University Medical Center. He performs aesthetic surgery on the face and body in addition to reconstructive surgery with an interest in facial surgery, complex wound care, microsurgery, breast reconstruction, and limb salvage. He has won several awards for his scientific and clinical research, authored a number of journal articles and book chapters, and is an editor of the textbook “Current Therapy in Plastic Surgery.”

For several years, Moraine Valley’s Career/Health Sciences Programs and Northwestern Memorial Hospital have collaborated to host this Medical Education Series on a variety of health topics, including concussions, mind-body pain management, cardiology, tobacco cessation, diabetes, urology, pelvic health, chronic obstructive pulmonary disease, and cochlear implants.

More than meets the eye: Northwestern doctor hoping to change stigma of plastic surgery

Plastic surgery might just be the most controversial field in the health care industry. Tabloid pages are plastered with pictures of past vixens who have undergone certain enhancement procedures. Some gossip websites have made it their sole purpose to show botched jobs.

But is this really the light that should be shone onto this profession? Even the most narcissistic person has at least one cosmetic item on his or her wish list, so why condemn those who go for it? Furthermore, should plastic surgery be backed into this one corner? There’s more to it than just looking pretty.

That’s a stigma that Dr. Robert Galiano is trying to change. Galiano is a board certified plastic surgeon and is an assistant professor of Surgery at Northwestern. The doctor got his degree from Washington University and went on to complete his plastic surgery training at the Institute of Reconstructive Plastic Surgery at New York University Medical Center. He now finds himself at Northwestern Plastic Surgery, which is affiliated with Northwestern University. And he finds himself wearing a couple of hats at work.

“I am, first of all, a surgeon,” says Galiano.

Aesthetic, cosmetic surgery procedures range from breast enhancements and liposuction to laser surgery and eyelid procedures. Reconstructive practices range from complex wound care and limb salvage to cancer defects and microsurgery. All of these procedures take up a majority of Galiano’s time. But the surgeon also gets to wear another hat during the workweek.

“I’m also a scientist,” says Galiano.

Research required

The practice where the doctor works, since it is directly related to a higher learning establishment, is rooted in academia.

“I’m very fortunate to have a job that allows me to do basic science research,” says Galiano. “Twenty percent of my is spent leading the lab.”

Even though most of Galiano’s time is spent, one-on-one, with patients, he cherishes the times that he gets to put on that lab coat and learn something new. The work of the surgeon and his colleagues tries to push forward the field of plastic surgery. By looking at and understanding different issues, such as human scarring and stem cells, Galiano can be better suited when it comes to keeping patients happy.

“That’s my motivation,” says Galiano. “To make people happy.”

The doctor thinks that the field of plastic surgery will keep getting grins if the focus shifts to the understanding the needs of patients scientifically.

“I want to make plastic surgery as scientifically based as something like cancer,” says Galiano.

The media, through tabloids and terrible television series, has created hype around plastic surgery that needs to be gone. Once it has hit the road, out comes more subjective, helpful research. Galiano has seen, with the aid of his research, that stem cells are very promising and have a lot of potential. But if it is hyped up too much, there is a danger of overselling the procedure and possibly doing more harm than good.

The doctor hopes his vision of plastic surgery with more emphasis in scientific research will soon be realized.

“I want to do more,” says Galiano. “I want to be part of that.”

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