Practice News

The Reconstructive Plastic Surgeon at The Institute for Advanced Reconstruction in Shrewsbury, NJ Provides Expertise and Compassionate Care

A small but growing society of women and those who love them have firsthand experience with the decision and outcome revealed today by actress Angelina Jolie. In a lengthy and revelatory editorial in the New York Times* she tells the story of her family history (her mother died of breast cancer) and her own subsequent discovery that she carries the ‘faulty’ BRCA1 gene, predisposing her to an estimated 87 percent risk of breast cancer.
Ms. Jolie said she told the story of her decision to undergo a double mastectomy in order to help other women. What is remarkable is her positive attitude, and her desire to speak to the many women “who do not know that they might be living under the shadow of cancer.”

Ms. Jolie is particularly positive about her final surgery, which was breast reconstruction with implants. As a caring and experienced doctor, this is an area of expertise for Dr. Michael Rose of The Institute for Advanced Reconstruction at The Plastic Surgery Center in New Jersey. He has performed hundreds of breast reconstruction procedures, from the types using the patient’s own tissues (autologous), to using implants, such as in Angelina Jolie’s case. In addition, he has been a board member of The Cancer Support Community of the Northern Jersey Shore since 2008.

Here is Dr. Rose’s analysis:

“Angelina Jolie’s stunning announcement today that she had a double mastectomy with reconstruction as a measure to prevent an almost certain chance for future breast cancer deserves some discussion. While all women should be vigilant and do monthly self exams, yearly doctor visits and annual mammograms, very few women require the expensive gene test that Ms. Jolie got. That is because familial breast cancer accounts for less than 5% of all breast cancers. If you have a strong family history of breast cancer, earlier screenings (age 35 instead of 40) and possibly a gene test would then be appropriate. Ms. Jolie is certainly known for her curvaceous figure and public life, and as it is for any woman, her decision must have been very difficult for her. However, as she has discovered, an appropriate and well-executed breast reconstruction procedure can restore a sense of wholeness even after the loss of both breasts. In many cases, the results can be equal or even better than what the woman originally had. Hopefully, Ms. Jolie’s excellent experience with breast reconstruction will show women everywhere that a mastectomy is not necessarily the end of being able to feel like a woman.”

“I perform all types of breast reconstruction, including the type performed on Ms. Jolie. Each case must be individualized based upon the particular woman’s needs and desires. I work closely with the patient’s breast surgeon and oncologists to ensure an optimal chance for a cure, as well as a beautiful esthetic result.”

The role of a good surgeon also includes the emotional component. Explains Dr. Rose, “I provide support throughout the process, and help project the patient’s psyche into the future. There is always a period during the process in which she feels not whole. But without exception, with a properly constructed breast, every patient is thrilled with the end result and feels that everything she went through was worth it to preserve her wholeness as well as her wellness.”

Anyone who has ever been treated by Dr. Rose has experienced not only his skill, but the type of care and compassion that leads women like Angelina Jolie to negotiate this life-altering experience and decision-making with the utmost of confidence.

With an expert surgeon and medical care, coupled with sensitivity and compassion, other women may come to feel as Ms. Jolie does when she concludes in her editorial, “Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of.”

Source:
*My Medical Choice, NY Times, May 14, 2013

Police Officer Len Guida had 30 years’ experience on the job, but like almost everyone in New Jersey, he had never experienced anything quite like Hurricane Sandy.

The 53-year-old Bradley Beach Chief of Police and native, who is also part of the Office of Emergency Management (OEM), put in 80-hour workweeks during the storm,  lifting cement benches and heavy sand bags, among other duties,.

Shortly thereafter, Guida said, “My right knee started locking up.” He couldn’t do much about his knee injury during the many weeks of storm-related work, he said. “It got progressively worse; I put it off for weeks.”

Finally, it got so bad he contacted Workers’ Compensation, which referred him to a doctor. From there he went to an orthopedist, who thought Guida might have suffered nerve damage. That’s when Guida was further referred to an expert, this time to Dr. Andrew Elkwood of The Institute for Advanced Reconstruction. Dr. Elkwood, an expert in the diagnosis and treatment of peripheral nerve damage, is also the founder and Director of the Center for Treatment of Paralysis and Reconstructive Nerve Surgery at Jersey Shore University Medical Center.

Following a number of tests to verify the diagnosis of nerve damage, Guida underwent surgery in January 2013 at Jersey Shore University Medical Center. Three months later, he reports that he is feeling much better. He praises the medical help he received from both his orthopedist and Dr. Elkwood.

“I am extremely pleased with the care and attention I received from Dr. Elkwood and his staff,” he said.

As Dr. Elkwood elaborates, “Len had surgery to the nerves around the knee. We interrupted the ‘sensory nerves’ to his knee. The result is that he has no feeling to the knee joint. No feeling means no pain. This surgery is a very useful, but an under-utilized technique when other options, such as orthopedic means, have not been able to control chronic knee pain. This technique can also be used for other joints (i.e. wrist, shoulder, elbow, and ankle.)”

After two to three months of rehabilitation following his surgery, Guida is off of restricted duty and back to full-time work.

Guida, who faced a similar problem 10 to 15 years ago with his left knee, which at that time included a torn lateral meniscus, may also have nerve damage in that knee. As a result, he explained, he plans on surgery for his left knee “as soon as possible. And I’m absolutely going to use Dr. Elkwood.”

Dr. Matthew Kaufman of The Institute for Advanced Reconstruction, Only Known Expert, Performs the Surgery

Kurt Matthewson went out for his typical run one morning, and quite suddenly, had trouble breathing. “I couldn’t take a deep breath,” was how he felt. When the problem persisted, he went to his family physician, and then to a specialist, who determined the 48-year-old Madrid, Iowa resident was working on only 50 percent lung capacity.

Tests revealed the left side of his diaphragm was not functioning. The diaphragm muscle is the primary muscle involved in breathing. Contraction of the diaphragm muscle permits expansion of the chest cavity and inhalation of air into the lungs. The cause of phrenic nerve damage is sometimes very easy to pinpoint, such as surgery to the neck or chest, or an accident; however sometimes, as in Matthewson’s case, it can be difficult to discern.

Over the next several years, Matthewson twice traveled to a very famous major medical center. After the first time, he waited for two years, hoping the problem would abate. When he returned to the same center for testing, they found no change in his diaphragm function, and suggested plication, a surgical procedure that pulls the diaphragm down. Matthewson was not inclined to do that surgery, and when he asked the specialist at this renowned institution about nerve grafting, the doctor answered back, “There is no such thing.”

Four years removed from the problem, Matthewson found Dr. Matthew Kaufman on the Internet, for whom phrenic nerve surgery is, in fact, a reality. Among his nerve surgery expertise which he performs at the Institute for Advanced Reconstruction in Shrewsbury, NJ, Dr. Kaufman is the only known surgeon to perform specialized phrenic nerve surgery. He has performed the surgery over 75 times, on patients from age 11 to over 70 and from all over the USA and one from Australia.

In addition to a career as a commercial lender in the banking industry, Kurt Matthewson is a lifelong athlete whose resume includes a career as a collegiate golfer and a period of time in his 40s as an amateur competitive natural body builder.

He traveled to New Jersey in 2012 to undergo surgery with Dr. Kaufman, who as part of his usual procedure, did a nerve transplant with a graft taken from Matthewson’s ankle.

According to Dr. Kaufman, “We are optimistic that Mr. Matthewson will regain substantial diaphragm function after undergoing phrenic nerve surgery and that he will see progressive improvements over the next two to three years as the regenerated nerve leads to gradual muscle recovery.”

Kurt Matthewson’s surgery was six months ago. Reports Matthewson, “Today I’m feeling better. I feel my breathing is improved. I’m going to fight the good fight.” To that end, Matthewson, who is now regularly running, has set himself a goal. Since he believes long distance running is the ultimate test of breathing, his goal is to run a marathon (26.2 miles) on the one year anniversary of his surgery, July 20, 2013. “Hopefully, I’ll be able to celebrate my improvement.”

Dr. Michael Rose with patient David Milazzo

On Monday, April 15th, 2013, Dr. Michael Rose of The Institute for Advanced Reconstruction at The Plastic Surgery Center had the opportunity to explain his craft as a reconstructive and cosmetic plastic surgeon when he was featured on NEW JERSEY TODAY! hosted by Bert Baron on WCTC Radio. Dr. Rose appeared with patient David Milazzo, whom he reconstructed after a debilitating car accident. In the one-hour segment, both doctor and patient recounted their experience, now with the perspective of one year’s time since the accident and subsequent 5-hour surgery and one later follow-up procedure done at The Plastic Surgery Center’s Center for Outpatient Surgery. Dr. Rose also elaborated on the various roles and procedures he performs as a plastic surgeon, including nerve surgery. Information on finding a qualified plastic surgeon helped consumers understand the importance of doing their homework on both reconstructive and cosmetic procedures.

Dr. Michael Rose with patient David Milazzo and radio host Bert Baron

Listen to a podcast of the show. Click Here!

Read more about David Milazzo and his miraculous surgery.

Local doctor offers treatment option for painful neuropathy

Written by
Susan Bloom
For the Asbury Park Press

[original article]

For Gale Krywinski, 65, contracting diabetes 12 years ago was bad enough, but the subsequent tingling sensation she felt in her legs was more than she could bear.

“I could never get my legs comfortable and it was hard to sit in one place for a while,” she said of the throbbing pain that “made it difficult to go to a show or sit in a car or on an airplane” and which would often wake her at night.

Though the Brick resident and retired healthcare worker tried treating it with medication for a while, “I didn’t like the side effects and didn’t want to live on medication for the rest of my life,” she said. “Most doctors told me they really didn’t have much to offer for my neuropathy and that I would just have to live with it.”

Happily for Krywinski, another option was in store.

“In simple terms, neuropathy occurs when a nerve isn’t working properly, a condition which can result in numbness and tingling in the hands and feet,” said Dr. Michael Rose, cosmetic, plastic and reconstructive surgeon at The Plastic Surgery Center in Shrewsbury.

Typically associated with diabetes or of “idiopathic” origin with no known cause, neuropathy also can be triggered by alcoholism, lead poisoning, certain medications and chemotherapy “and can cause crippling pain that makes it difficult for patients to walk, sleep, hold things or work,” Rose said.

“Patients with severe cases often have to go on long-term disability,” Rose added. “It definitely impairs their lives.”

Nerves travel through tunnels, and can swell and choke within their housing if the nerves are not healthy, almost like someone’s neck when it’s restricted by a tight shirt collar, Rose said.

“This compression of the nerves causes a tingling or throbbing sensation in the extremities,” he said. “Many doctors consider neuropathy progressive and irreversible, but the truth is that a subset of patients will respond positively to a special technique that releases pressure on the nerves.”

About half of the patients who have the 45-minute, minimally-invasive outpatient procedure show improvement, Rose said.

To determine a patient’s potential for the procedure, Rose conducts an evaluation to assess their overall health and status of circulation to their limbs, and will then perform a test to determine if the nerve is alive enough to respond.

If the results are promising, he will proceed with the technique.

Krywinski took the chance in July 2012 when she elected to have the procedure performed on her left leg.

“It’s much better than it was before,” she said. “My toes can bend much more easily and I can put my leg up on the couch and cross my legs for longer.”

She is about halfway through the expected 18-month recovery period for her leg.

“I continue to get more and more sensation back as time goes by,” she said, adding that she returned to have the technique performed on her right leg in January. “My legs aren’t tingling or throbbing anything like what they were before and I’m so happy for this bit of relief.”

The Institute for Advanced Reconstruction (www.advancedreconstruction.com) at The Plastic Surgery Center is at 535 Sycamore Ave. in Shrewsbury and can be reached at 732-741-0970 or by visiting www.looknatural.com.