Arkansas is the perfect place to try out this new health trend. Read all about the what, why, where and how here.
Kris Shewmake was named the best plastic surgeon in Arkansas by his colleagues in 1999. Ten years later, he's been named again as the top doctor in his field, an honor he shares with James Yuen of the University of Arkansas for Medical Sciences.
Shewmake, 54, a Pine Bluff native, is a cosmetic surgeon most of the year. But for around 20 days a year, he's both surgeon and teacher, correcting severe craniofacial malformations and doing other reconstructive surgeries in Tegucigalpa, Honduras, with the medical mission Operation New Life.
Shewmake has made medical mission trips for years, but his first trips left something to be desired. “I'd go to [somewhere in the Third World] and fix as much as I could and never go back.”
Seven years ago, after the orthopedic team that was to have accompanied him had to cancel at the last minute, Shewmake and another doctor decided to visit the Hospital Escuala in Tegucigalpa and meet the surgeons there. The hospital has 1,600 beds and is the only hospital to serve the indigent population of that very poor country, one where poor diet has created a higher-than-normal incidence of malformed skulls and faces. “We hit it off with those guys,” Shewmake said, and Operation New Life was born. Teams of orthopedic, general and plastic surgeons since then have trained dozens of Honduran surgeons at the hospital, using a camera donated by Baptist Health that broadcasts live from the operating theater to a large-screen television set up outside. Doctors fluent in both Spanish and English translate questions from the watching surgeons for the operating team and the team's responses.
It's a tough place to work. Sometimes the lights go off. Sometimes the water goes off. There's only one autoclave to sterilize instruments, and it is 50 years old. But Shewmake sees God's hand in the circumstances that brought Operation New Life into being.
Back home, Shewmake, who says his colleagues sometimes place cosmetic surgery in the 90210 zip code of specialties, finds his work fulfilling. Cosmetic surgery is “incredibly satisfying,” he said, “and life-changing” for his patients. The 10 years since the Times last interviewed Shewmake has seen a number of innovations in cosmetic care. The biggest thing in the past five years is the use of fillers to restore youthful plumpness to older faces. Injections of hyaluronic acid, a natural product of the body — “the slippery stuff in joints,” he explained — can smooth out wrinkled areas, fill in sunken places under the eyes. The effect of the fillers, which cost around $1,000 for a couple of syringes, can last from six to 18 months and “delay the need for a [face] lift,” which costs 10 times as much (though it lasts for eight to 10 years).
Disport, an alternative to Botox, is now on the market; its advantage is that it works to smooth the face (by temporarily hindering muscle contraction) within 24 to 48 hours rather than the 10 days to two weeks that Botox takes. It's cheaper as well — $200 an injection (an introductory price) — and may last longer than the four months that Botox makes that forehead flat.
Shewmake tested the new Fraxal laser treatment on himself. It's a “kinder, gentler” technique that removes pigmentation, acne scars or lines with a grid of tiny pinpricks rather than burning off whole areas of skin. With traditional laser surgery, the patient may want to stay out of the public eye for three weeks; Shewmake said he went out to the movies after his Fraxal treatment.
He also does breast implants, both with silicone (back on the market since our 1999 interview, now that it comes in a form he likens to “gummy bears” to prevent leakage into the body) and saline. The latter can be adjusted post-op with a tiny tube and port that are later removed. That's an advantage, Shewmake said, since as much as 85 percent of women who get implants wish they had gotten a bigger size.
Shewmake was trained in craniomaxillofacial surgery at the University of California at Los Angeles and in plastic and reconstructive surgery at the University of Texas-Southwestern Surgery Medical Center in Dallas. At one time, he worked at UAMS and Arkansas Children's Hospital to create a plastic surgery residency program, but UAMS eventually decided it could not support the program. Shewmake hopes that will change, since UAMS is one of the few medical universities, he said, that don't offer a plastic surgery residency. “I'm hoping and praying some light will come on at the med center,” he said, “and they'll support plastic surgery.”
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