SD Union Tribune article – Dr. Bucko

By Erin Hutkin, Special to U-T San Diego   6:00pm   Dec. 2, 2014

“On Oct. 19, Dr. Dennis Bucko – a plastic surgeon affiliated with Scripps – left for Mexico with a team of 35 medical professionals.

The group, the Mercy Outreach Surgical Team, spent a week in the country treating an estimated 300 to 350 children and adults with limited access to health care.

During the trip, Bucko helped some of those children who were born with a cleft palate, one of the world’s most common birth defects.

It’s a condition in which the tissue that makes up the roof of the mouth, the palate – which is formed between the sixth and ninth weeks of pregnancy – doesn’t join completely together during development. In some babies, both the front and back parts of the palate remain open, while for others, only part of the palate is open.

Bucko said the defect occurs in roughly one of every 750 births, and while it’s normal for the condition to be surgically fixed in the U.S. starting in infancy, those in less-developed countries such as Mexico may not always have access to the medical care needed.

For instance, he said, he repaired a cleft lip of an 80-year-old woman during a surgical team trip to Mexico. She told her medical team she was going to die soon, and when she goes to heaven, she wanted to look good.

Yet, while the problem is treated in the U.S. at a young age, correcting a cleft palate is a process that can take several surgeries and span most of a person’s childhood and teen years. It also requires a team of professionals — everyone from social workers and plastic surgeons to speech therapists and dentists.

While the cause of a cleft palate is unknown, Dr. Michael Nelson, a general pediatrician and medical director of Kaiser Permanente’s cleft and craniofacial clinic, said when a baby is born with a cleft palate, a genetic counselor is often consulted to determine whether the issue is an isolated defect or part of a larger genetic syndrome.

In addition, he said lactation consultants help parents with feeding methods because babies with cleft palates can’t generate the pressure needed to suck milk from a bottle or breast. Because babies born with the defect are more likely to have middle-ear problems, he said an ear, nose and throat doctor will be consulted and tubes might be placed in the ears when surgery is done to repair the palate. This can improve hearing and prevent fluid buildup in the middle ear.

If a baby is also born with a cleft lip — a physical split of the two sides of the upper lip – he said, this is repaired when the infant is 3 to 5 months old.

However, he said, “The lip is just the tip of the iceberg.”

Nelson said lip surgery is followed by an operation to repair the palate when the baby is 8 to 12 months old. From there, he said the child’s speech is evaluated at roughly 18 months, as those born with cleft palates often need to retrain the muscles for effective speech.

In addition, he said, when the child is between 6 and 10 years old, he or she may need to have a hole in the gums repaired. He said this is often done by grafting a piece of bone from the hip to patch the hole in the gum. This sometimes involves pulling or moving teeth, and if so, an orthodontist or oral surgeon is involved.

As the child grows, he said, doctors also watch the growth of the jaw, and if the person’s bite is not what it should be, surgery might be needed in the late teen years to bring the jaw forward. In some cases, a rhinoplasty may be needed to adjust the structure and appearance of the nose.

“They’re major surgeries,” Nelson said. “The care of a cleft child is complex and long-term.”

On the plus side, he said those who receive the right surgical care can go on to look like they were born without a defect and live healthy lives.

“In experienced hands,” he said, “(treatment) is usually very successful.” ”

 

San Diego’s BEST Cosmetic Surgeon

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Dr. Dennis Bucko, director of the Belladerma Cosmetic Surgery & Skin Care Center, would like to thank everyone who voted him San Diego’s BEST Cosmetic Surgeon, and also included his Skin Care Center as a finalist for BEST Medical Spa in this year’s San Diego UT Readers Poll. Read more

Dow Corning Settlement

“Why is Dow Corning giving money to women who have silicone breast implants?”

Dow Corning agreed to set up a multibillion dollar Trust Fund in 1992 to provide cash settlements for women implanted with Dow Corning breast implants in the mistaken belief that silicone implants might cause certain autoimmune diseases.

In response to multiple class action suits and 410,000 baseless claims that blamed silicone implants for triggering autoimmune diseases, the settlement was agreed to as a business decision by Dow Corning in bankruptcy proceedings. We now know that these claims were not substantiated by any of the credible scientific evidence that has been studied over the past 35 years.

Contrary to popular belief, the U. S. Food and Drug Administration never actually concluded that these implants were harmful and they even continued to allow use of the implants for cancer reconstruction while they were being studied. Recently, after their review of over 30 years of scientific studies showing no relationship between breast implants and autoimmune diseases and the assurance of safety by numerous unbiased prestigious scientific organizations, the FDA fully approved the sale and use of silicone breast implants for cosmetic and reconstructive purposes, formally, in 2006. Most other countries had already approved silicone breast implants years ago.

Initially, the Trust Fund awarded $2000 (“Expedited Settlement”) to women simply because they had Dow Corning Silicone breast implants. This offer expired in 2009. At this point, however, there still remains millions of dollars in the Dow Corning Trust Fund that was set up for women who have registered with the trust fund before 8/30/04 and can prove they have Dow Corning implants and now want them removed for any reason, even though we know the implants have not been shown to cause autoimmune diseases!

If you now wish to have your implants removed or replaced with saline implants, you must do so before June 1, 2014 to be eligible for a $5000 cash settlement when your implants are removed or replaced with saline implants. To be eligible you must 1) already be registered with the Dow Corning Settlement Trust, 2) have previously proven that you have Dow Corning implants or be able to prove that you had Dow Corning implants after they are removed, 3) have not accepted the $2000 Expedited Settlement offer before 6/1/09, and 4) and have not previously made a claim for explantation or replacement of your implants.

If you did not register with the Trust previously and wish to receive $5000 to have your implants removed, you are not eligible. You must have registered by 8/30/04 and offered proof that you have Dow Corning implants and then had them removed before 6/1/14. The criteria of “proof” is documented by the Dow Corning Trust Agreement and further clarification can be obtained by calling 1-866-875-6099 or by consulting the settlement website www.sfdct.com.

Surprisingly, patients do not need to offer any medical proof that her implants are actually causing any problems with disease to be eligible for this settlement.

Some patients who coincidentally have Dow Corning silicone implants and also at least one of the nine conditions or autoimmune diseases listed (see list at the settlement website or by calling 1-866-875-6099 may be eligible for a higher cash settlement and have until 2019 to offer proof and file claims.

Patient should keep in mind that none of these settlements and payments indicates that silicone implants caused any medical diseases and, furthermore, patients are not required to prove that they have been harmed by the implants to be eligible for the cash settlements.

The FDA has fully approved the sale and use of silicone breast implants for cosmetic and reconstructive purposes. There are well over two million satisfied patients in the USA who have had silicone breast implants for many years and silicone breast implants remain the most popular and trusted breast implants used throughout the world.

In general, silicone implants do not need to be removed or replaced unless they are causing some physical deformation of the breast such as scar contracture and firmness, or malposition.

If you feel your breast implants are causing a problem, you should consult with a knowledgeable physician.

Cosmetic Surgery in Tula, Mexico, with the Mercy Outreach Surgical Team

Over 200 hopeful patients greeted the arrival of the Mercy Outreach Surgical Team with applause on Monday morning, March 18, 2013, at the local hospital in Tula…definitely a first and very heartwarming.

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Six hours later, the three plastic surgeons had filled their surgical schedules for the next 3 1/2 days with over 100 patients, and the mood was high as we all eagerly anticipated the week ahead.

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Surgery began at 7AM and when the last case finished around 5PM the number of patients treated was 37. Definitely a good day!

 

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We celebrated the completion of our third day in Tula with a barbecue hosted by the doctors in honor of the MOST team. Conversation centered around the day’s patients and everyone had a special story or favorite patient.

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They are all such a trusting and hopeful group of children!

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M.O.S.T. Trip to Aguascalientes, Mexico

By Sally Bucko

In October, 2012, the Mercy Outreach Surgical Team (M.O.S.T.) went back to Aguascalientes, Mexico. Although we had planned to post an on-going commentary of the trip on Facebook, the Internet connection in Aguascalientes was a challenge and we managed only one post during the week.

On the first day we were greeted by 600 patients as we arrived at the clinic, all hoping to be treated by the team doctors in the short time that we are here.

The team of four surgeons, seven anesthesiologists and approximately 30 ancillary staff members performed 250 surgeries in 3 1/2 days, made many new friends and saw some old friends who drove several hours for follow-up surgery with the organization they knew and trusted.

Dr. Bucko operated on a mother and her son who both suffered from a congenital eye problem called Ptosis, that prevented them from raising their eyelids. He also performed several cleft lip and palate surgeries and revised some burn scars.

El Día de los Muertos celebrations were just beginning and in evidence throughout the city.

These M.O.S.T. trips are always so rewarding for the team, which is probably why so many members use their vacation time to participate.

Be sure to check out our Facebook page for more photos.