Blog — Notes of a Plastic Surgeon

Welcome to my blog. I am a plastic surgeon in Seattle and have been in private practice since 1991. I've seen more than a few interesting faces and cases through my years spent in the exam room, the operating room and the emergency room. And I have an opinion on just about everything relating to plastic surgery (and a lot of unrelated stuff). If you like my blog, let me know. Thanks for reading! Lisa

Category: sun damage


Got Sunscreen?

June 12th, 2018 — 9:47am

Seattle Plastic Surgeon comments on the results of a long running sunscreen use study from Austrailia. 

90% of this ladies skin aging is due to the sun. I hope her grandson uses sunscreen.

90% of this women’s skin aging is due to the sun. I hope her grandson uses sunscreen.

It’s that time of year when I must nag about tanning.  In rainy Seattle it is so tempting to soak up the sun once summer arrives (that is usually about July 5th).  But please, think before you rip off your clothes, don your thong and grab your beach towel.

A good study published by the Annals of Internal Medicine and reported in the Wall Street Journal  has shown that regular use of sunscreen reduces skin aging by 24%.  It had already been shown many times that sun protection prevents most types of skin cancer but now what seemed to be obvious has also got some scientific cred.   Now my nagging has some scientific backing!

I’m certain we are hardwired to love the feel of photons bombarding our skin but way back when we were being hardwired and learning to walk upright, we would die from an abscessed tooth or a ruptured appendix or (if we were lucky) a quick take down by a leopard long before we developed skin cancer or even a bad case of the wrinkles.

Fortunately, sun protection has finally caught up with our longer life spans.  We have really good sun screens and sun block, protective and comfortable clothing and don’t forget about umbrellas, cabanas and the most lovely shade of all, trees.   And lets hear it for staying indoors when the sun is at it’s strongest.  How about a nice glass of ice tea with some fresh mint leaves and a good book.  May I recommend The Storms of Denali by Nicholas O’Connell, or A Visit from the Goon Squad by Jennifer Egan, or I Remember Nothing by the late and great Norah Ephron?

And just to remind you, I nag because I care.  Thanks for reading.  Dr. Lisa Lynn Sowder

I would be honored if you followed me on Instagram @sowdermd and @breastimplantsanity.

Aging Issues, General Health, Skin Cancer, Skin Care, sun damage

Driver’s side skin damage. Check this out!

June 8th, 2017 — 8:12am

Got sunscreen in your glove box?  You should!

 This is an ABC news report written by Serena Marsh and edited for length by me.  This was originally posted in 2012.

Sunny Side Old: Pic Reveals Sun’s Aging Effects

William (Bill) Edward McElligott is two different ages, 66 and 86 yeaars old. 

If you look at McElligott from the right, he looks like any 66-year-old would expect to, but from the left, wrinkles and sagging skin place him far beyond his years. He is a living demonstration of the importance of protecting your skin from the sun.

“It would take me an hour to drive to work and an hour to come home,” McElligott said. “It was a semi route, I’d have six to eight stops. … 6 a.m. to 3 p.m. on the road.”

For almost 30 years, McElligott drove a truck during prime sun hours throughout the city of Chicago delivering milk to stores and gas stations.

“My left arm was always more tan than my right, because a lot of the time I had the window open (since) we didn’t have A.C.,” McElligott said.

The 66-year-old truck driver suffers from unilateral dermatoheliosis or photo-aging, which was caused by repeated, long-term exposure to UVA rays of the sun.

It was 15 years before he noticed any difference between the two sides of his face, but McElligott ignored it, that is until his grandchildren’s questions got the best of him.

Dr. Jennifer Gordon a dermatology resident at UT Southwestern saw McElligott while on a rotation at Northwestern in Chicago and submitted his case study, which was featured in the April edition of the New England Journal of Medicine.

“It was very stark,” Gordon said. “We are used to seeing photo damage, photo aging every day, (but) for it to be so one sided? We were taken aback.”

Gordon explained that since McElligott spent so much time in his car, his left side was exposed to UVA rays that can penetrate glass and cause the majority of photo-aging, unlike UVB rays, which cause sunburns.

“We think its because it (UVA) can penetrate more deeply into the skin than UVB and affect your collagen and elasticity,” she said. “When you destroy those that’s what gives you the aging appearance that we see.”

Dr. Mitchell Chasin, a dermatologist who did not treat McElligott, says it is extremely common to see patients that come in with more damage to their left side than their right.

“Most people are completely unaware and most people who come in to have sun damage treated, they often times will point to their left side saying they see more spots, more wrinkles, more aging, but never put two and two together,” said Chasin.

Chasin says that whenever people are outdoors, even when covered from the sun directly or on a cloudy day, they should be aware they are not safe from the reflected rays of the sun and should wear sunscreen.

“Sun block is the answer, really, for someone 365 days a year, whether it’s cloudy whether it’s sunny, whether someone is outdoors, in the car, or at the beach,” Chasin said. “If someone wants to age as best they can, sun protection is a daily regimen no matter what you are doing. Put sun block on before you leave the house.”

With summer approaching and vacations and road trips, it’s important to make sure your sunblock has protection against both UVA and UVB rays.

Last year the FDA demanded sunscreen manufacturers update their labels to offer protection for both UVA and UVB, as well as to stop the use of misleading claims such as waterproof. The agency recently extended the deadline to December for manufacturers to comply.

For McElligott sunscreen with UVA and UVB protection has become a daily fixture.

“When I’m out in the sun, when I’m going to be driving, I have sunscreen on,” he said. “I always carry it with me.”

Thanks for reading.  And do you have a favorite sunscreen?  Send me an email and let me know. lsowder@madisonplasticsurgery.net

Dr. Lisa Lynn Sowder

Follow me on Instagram: @sowdermd and @breastimplantsanity

 

Aging Issues, General Health, Now That's a Little Weird, Skin Care, sun damage

Chemical peels can help undo sun damage. But first you have to be a pepperoni pizza.

June 21st, 2016 — 12:44pm
Chemical peel

Top: Before deep chemical peel. Bottom: 9 month after the deep chemical peel.

It’s summer and time for me to start ragging and nagging about sun protection.  Well, today it’s gonna be a little different.  I am going to talk about what can be done after the sun damage is done.

Many years ago, I spent 6 weeks training with Tom Baker, Howard Gordon and Jim Stuzin in Miami.  This trio wrote the book on facial rejuvenation and I think the location of their practice has something to do with the depth of their understanding of facial aging.  Some of the patients in their practice had skin that was so sun damaged it resembled leather.  It’s almost impossible to get a great face lift result on that type of skin.  Baker, Gordon and Stuzin were very quick to nix the idea of a lift and instead turn to an aggressive chemical peel.  A chemical peel can do things for sun damage that a face lift cannot.

Take a look at this lady.  Her skin is pristine compared to some of the faces I saw in Miami but she does have a lot of sun damage.  She and her husband run a ranch in Northern Idaho and she spends a lot of time outside on her horse.  She has a lot of fine wrinkles and she has a big area of hyperpigmentation, sort of like a gigantic freckle.  It may even be a very early and non invasive melanoma (so called lentigo maligna).   I did a deep chemical peel on her about 9 months ago.  I used a variation of the peel that was developed by Baker and Gordon many years ago.  She looked like a pepperoni pizza for about 10 days.  She’s tough as nails and it didn’t bother her much although she did get tired of her husband saying “But I ordered a cheese pizza, Honey.”  As you can see from her post peel photo on the bottom, she has a lot of smoothing out of her wrinkles and even some tightening along her jaw line and, look, the gigantic freckle is GONE!

I don’t do as many chemical peels as I would like to do.  The recovery is very challenging and it takes a tough cookie like this lady to sign up for it.  But really, when the problem is sun damage, I think a deep peel is the way to go.

Thanks for reading and thanks to my awesome and beautiful patient and her handsome husband for letting me share their experience.  Dr. Lisa Lynn Sowder

Skin Care, sun damage

Fifty Shades of Sun Damage

February 24th, 2015 — 8:50pm

Seattle Plastic Surgeon spends a week in Hawaii and returns with no tan lines!

sun-damage

Last week I attended the annual meeting of the Northwest Society of Plastic Surgeons on the Big Island of Hawaii.  And contrary to popular belief, I actually sat in a conference room for about 5 hours a day and actually learned how to be a better surgeon.  The other 7 or 8 hours of daylight presented a bit of a challenge to a sun shunning person of pallor such as my Germanic self.  But it can be done.  Here are my rules:

  1. Slather with sun block first thing after that morning shower.  The spray on stuff by Neutrogena works great.
  2. Wear a hat and sunglasses.
  3. Lounge in the shade.  Walk on the shady side of the street.  (Duh)
  4. Wear a rash guard while snorkeling after respraying yourself with sun block.
  5. Spend the few hours of the really nasty mid-day sun in the bar.  (Duh)  Drink cocktails with umbrellas.  (Duh)
  6. And most of all, embrace your pallor.  I hear that the Hawaiians and Southern Californians refer to us as “Chalk People.”  Bring it on.  I won’t be spending my golden years tending to my skin cancer.
  7. Oh, and look for my new book, “Fifty Shades of Sun Damage” soon to be a major motion picture staring this dude with the bad skin.

Thanks for reading!  Dr. Lisa Lynn Sowder

Skin Cancer, Skin Care, sun damage

Add a Rash Guard to your summer wardrobe. Your skin will thank you for it.

June 9th, 2014 — 12:06pm

Seattle Plastic Surgeon loves her rash guard.  She also hopes you also have one to love.

cc rash guardI love this time of year in Seattle because the outdoor public swimming pools are open and the lakes are warm enough, barely, for a really quick dip.  And I loooove to swim, especially outdoors.  And I loooove my rash guard which not only protects me from the strong summer sun, it keeps me warm in the chilly waters of Lake Washington and Green Lake and when I am really, really brave, the frigid waters of Puget Sound.

I was a real water dog growing up, spending most of my summer days in Northern Idaho’s Lake Coeur d’Alene or Spokane’s Comstock Pool.  My mother made me wear a t-shirt into to the water in the mid day sun.  As much as I used to gripe about it, I now appreciate her wisdom.  I do have sun damage on my chest and back but it would be much worse without my mom’s nagging.

I have my kids trained so they almost feel a little underdressed without their rash guards.  There’s no need for a baggy, soggy t-shirt to ruin your beach or pool style.  Rash guards come in colors and designs for just about any taste.

Oh, and the lady here is not actually me but I do own this rash guard!

Thanks for reading and happy, happy, happy summer!  Dr. Lisa Lynn Sowder

General Health, Skin Care, sun damage, Wardrobe Observations

F.D.A. Announces Stricter Rules on Tanning Beds

June 3rd, 2014 — 4:19pm

Seattle Plastic Surgeon is delighted with the new rules regarding the use of tanning beds.  

She just wonders what took so long????????

 

blog sun damage

Check out this article in the New York Times.  

Thanks for reading and don’t forget your sunscreen this summer.  Dr. Lisa Lynn Sowder

 

Aging Issues, General Health, Government and Politics, Skin Cancer, sun damage

Do you or someone you love rock the Kojak look? Don’t forget a hat!

May 13th, 2014 — 9:09am

Seattle Plastic surgeon beseeches all young Kojaks to wear a hat this summer.

blog telly savalasWe all owe a lot to Telly Savalas, a.k.a. Kojack.  He was man enough to embrace his male pattern baldness and opt for the clean shave rather than a nasty comb-over or a nastier toupee.  And that was way back in the 1970’s when the earth was cooling, I was in high school and the rock opera Hair was all the rage.  Telly was soooooooooo  fashion forward.

So I love it when guys who are challenged in the coiffure department rock the Kojak look but………………………….these guys need to protect their pate.  A nice shiny bronze dome may look great on the beach (especially if attached to a six pack) but fast forward a couple of decades and that scalp will be sprouting skin cancers like crocus in my garden in February.

I have seen all three types of skin cancer on bald heads.  There’s basal cell cancer which usually grows slowly and is usually caught and treated before it causes too much trouble.  And then there is squamous cell cancer which spreads wider and faster and is not as easy to diagnose visually.  And then there is malignant melanoma that can lead to a much too early grave.    These cancers are all related to sun damage that occurred decades earlier.

So all you testosterone oozing Kojaks out there and all you ladies who have one of these in your life, don’t forget a hat and take a good look at that gorgeous scalp at least twice a year.  If you find something funny, get thee to a dermatologist.

Thanks for reading and you can leave your hat on.  Dr. Lisa Lynn Sowder

Skin Cancer, Skin Care, sun damage

Got Sunscreen?

June 7th, 2013 — 11:00am

Seattle Plastic Surgeon comments on the results of a long running sunscreen use study from Austrailia. 

90% of this ladies skin aging is due to the sun. I hope her grandson uses sunscreen.

90% of this women’s skin aging is due to the sun. I hope her grandson uses sunscreen.

It’s that time of year when I must nag about tanning.  In rainy Seattle it is so tempting to soak up the sun once summer arrives (that is usually about July 5th).  But please, think before you rip off your clothes, don your thong and grab your beach towel.

A good study published by the Annals of Internal Medicine and reported in the Wall Street Journal  has shown that regular use of sunscreen reduces skin aging by 24%.  It had already been shown many times that sun protection prevents most types of skin cancer but now what seemed to be obvious has also got some scientific cred.   Now my nagging has some scientific backing!

I’m certain we are hardwired to love the feel of photons bombarding our skin but way back when we were being hardwired and learning to walk upright, we would die from an abscessed tooth or a ruptured appendix or (if we were lucky) a quick take down by a leopard long before we developed skin cancer or even a bad case of the wrinkles.

Fortunately, sun protection has finally caught up with our longer life spans.  We have really good sun screens and sun block, protective and comfortable clothing and don’t forget about umbrellas, cabanas and the most lovely shade of all, trees.   And lets hear it for staying indoors when the sun is at it’s strongest.  How about a nice glass of ice tea with some fresh mint leaves and a good book.  May I recommend The Storms of Denali by Nicholas O’Connell, or A Visit from the Goon Squad by Jennifer Egan, or I Remember Nothing by the late and great Norah Ephron?

And just to remind you, I nag because I care.  Thanks for reading.  Dr. Lisa Lynn Sowder

Aging Issues, General Health, Skin Cancer, Skin Care, sun damage

Keep those fresh scars out of the sun!

September 5th, 2012 — 11:30am

Seattle Plastic Surgeon discusses the importance of keeping fresh scars out of the sun.

This ankle scar would have turned out much better had it been protected from the sun.

Seattle is enjoying a beautiful late summer with warm, sunny days and crisp and cool nights.  There’s lots of skin showing out on Seattle streets and I am compelled to nag a little (again, for the bazillionth time) about sun protection.

Fresh scars are very susceptible to the sun and can turn permanently dark unless protected.  A “fresh” scar is defined as any scar that is still pink.  A “mature” scar is defined as any scar that is soft, flat and normal skin color or a little lighter.  Most adults have a “mature” scar by about a year.  Childrens’ scars may take longer to “mature”. 

 The best way, in my opinion, to keep a “fresh” scar protected is to cover it with clothing or with a piece of flesh colored tape or, if you prefer, a Hello Kitty band aid.  Really good sunblock will also likely do the trick if you remember to reapply it several times during the day.   Keep that scar protected until it fades to normal skin color or lighter and then sun exposure is unlikely to cause it to hyperpigment.

 A dark scar may be helped with hydroquinone cream or laser or surgical scar revision.  But, as per usual, an ounce of prevention is worth a pound (and $$$) of cure.

 Thanks for reading!  Dr. Lisa Lynn Sowder

Plastic Surgery, Postoperative Care, Scar, Skin Care, sun damage

Ban the Tan?

July 23rd, 2012 — 11:57am
 

Pasty white Seattle Plastic Surgeon shares her view on tanning bed restrictions.

What’s wrong with this picture???

My daughter is a competative Irish step dancer and if you don’t what that involves, you must rent the documentary “Jig”.  The Irish dancing subculture is an interesting mix of athletic, artisitic and beauty competition.   I have attended many a competition and have seen that part of the “look”, for some of the girls, includes deeply  tanned legs. 

Some of the girls have spray on tanned legs but some of them have obviously been spending time in an indoor tanning salon and, as a physician, it drives me nuts. 

 The incidence of Malignant Melanoma has been going up, up, up in the past couple of decades and it’s rising the fastest in the same group that spends the most time in indoor tanning salons – young women. 

 Many countries and some states have placed age restrictions on indoor tanning.  Brazil has an outright ban on indoor tanning.  I’m not one to advocate a nanny state, but I do think that we need to protect children from their own bad choices when the stakes are very, very high.  Isn’t that why we don’t sell children cigarettes and alcohol? 

 What do you think?  Should a 12 year old be able to waltz into a tanning salon to spend her allowance on a tanning session?  Should I say something to the parents of these tanned girls?   Should I spray paint my daughter’s legs?????

 Thanks for reading!  Dr. Lisa Lynn Sowder

 

 

 

 

General Health, Government and Politics, Irish Step Dancing, Skin Cancer, Skin Care, sun damage

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