Summer is Here: Making Educated and Informed Choices to Stay Sun-Safe




Dermatologist Dr. Allison Britt Kimmins, MD, MPH with Advanced Dermatology PC with Tips on Reducing the Risks of Skin Cancer While Enjoying Summer.

As never before, the chance to get outside under sunny skies is a relief. “It’s been especially welcoming as a result of the COVID-19 Pandemic”, observes Dr. Allison Britt Kimmins, a dermatologist with Advanced Dermatology PC. After weeks spent inside to limit the spread of coronavirus, it is no surprise that we are all anxious to get outside and enjoy the sun. “However” emphasizes Dr. Britt Kimmins, “we want to make sure that we also protect ourselves from the damaging and potentially deadly ultraviolet light”.

Skin cancer is the most common cancer in the world. In the United States, cases outnumber all other cancers combined, according to the non-profit Skin Cancer Foundation.

In spite of all we know, rates of skin cancer continue to rise. In this country, 20% of the population will get skin cancer by the time we’re seventy. Last year, it was estimated that 192,310 people in the U.S. would be diagnosed with melanoma – the deadliest cancer of all.

Dr. Allison Britt Kimmins

The threat of the sun’s ultraviolet rays is so great that the World Health Organization lists them as Group 1 carcinogens, alongside plutonium and cigarettes. The U.S. Department of Health and Human Services also has labeled the sun’s radiation as a known carcinogen. “Ninety percent or more of cases of skin cancer are linked to sun exposure”, states Dr. Britt Kimmins. According to the Skin Cancer Foundation, “having 5 or more sunburns doubles your risk of developing melanoma”. In 2020, it is estimated that the number of melanoma cases is expected to rise.

Protecting children and helping young people develop healthy sun habits are keys to reducing skin cancer rates. Just one blistering sunburn during childhood almost doubles the risk of melanoma. Most of the damage occurs before the age of eighteen.

Dr. Allison Britt Kimmins

“Every one of us – regardless of skin tone or age – will benefit from practicing ‘safe sun precautions”, advises Dr. Britt Kimmins, who makes the following suggestions to enjoy the outdoors safely.

5 Tips to Stay Sun-Safe This Summer – and Year-Round

  1. Stick to your skin-checkup schedule: “Early intervention is essential to stay safe from skin cancer. “When detected and treated early, the 5 year survival rate for melanoma is over 98%. Dr. Britt Kimmins recommends that patients see a dermatologist to establish their baseline level of skin health and identify their level of risk. Scheduling regular annual skin examinations will help to monitor the skin for changes and encourage self-examination. This supports early intervention and effective treatment”.
  2. Make sure that your sunscreen protects you: “People may think they’re protected when they are not”, warns Dr. Britt Kimmins. “We need to apply enough sunscreen at least 15 minutes before going outdoors and reapply every 2 hours while outside. If swimming or sweating, more frequent reapplication may be necessary. It is important to apply enough sunscreen to all exposed areas including hands, feet, neck, scalp and ears. A one ounce shot glass is the amount needed to cover exposed areas of skin”.
  3. Remember: You need more than sunscreen: “Even if we follow the American Academy of Dermatology’s guidelines”, notes Dr. Britt Kimmins, “and use a water-resistant product that is SPF 30 or higher with full-spectrum UVA/UVB protection, we cannot completely avoid the sun’s rays. Between 10 a.m. and 2 p.m., when the sun is most direct, we need to be careful: Seek shade and wear protective clothing, including a hat and sunglasses”.
  4. Indoor ‘sun’ is just as risky: “Just one indoor tanning session”, Dr. Britt Kimmins emphasizes, “can increase the risk of cancer by almost 70%. Additionally, tanning beds primarily emit UVA rays which penetrate our skin more deeply, further accelerating changes associated with aging”.
  5. Pass safe sun habits on to the next generation: “Protecting children and helping young people develop healthy sun habits are keys to reducing skin cancer rates”, states Dr. Britt Kimmins. Just one blistering sunburn during childhood almost doubles the risk of melanoma. Most of the damage occurs before the age of eighteen. Young people are influenced by the behaviors of their caregivers. We see this, for example, with tanning bed use, which often begins during teen years, in the company of a family member”.

“As we all spend time outdoors this summer, let’s remember our sun-safety suggestions so we can stay healthy now – and skin-cancer-free for years to come”.

About: Allison Britt Kimmins, MD, MPH, is board-certified in dermatology.

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York, New Jersey & PA) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies. Come into the beautiful world of Advanced Dermatology P.C..





Breast Reconstruction Specialist Dr. Constance M. Chen Offers Tips for Patients

Among women who opt for reconstruction after losing a breast to mastectomy, 80% undergo reconstruction with implants. “Many women see implants as the quickest, simplest reconstructive option”, says plastic surgeon and breast specialist Dr. Constance M. Chen. “Their other choice – natural-tissue reconstruction – requires a more complex surgery and longer recovery time”. However, studies have shown that the risk of cosmetic and health problems with implants in the first few years is significant and the risks increase over time. Implants aren’t expected to last forever. Most have a ten-year warranty although many will have to be removed before that.

Studies have shown that the risk of cosmetic and health problems with implants in the first few years is significant and the risks increase over time. Implants aren’t expected to last forever.

Dr. Constance M. Chen

Implants fail for many reasons. Different types have different characteristics that women must weigh against their individual requirements and preferences but all implants are foreign bodies and pose the risk of comfort and cosmetic problems. Dr. Chen describes some of the common complications and unsatisfactory results of implant reconstruction and provides tips on corrective measures and on options if implants have to be removed.

Infection can develop in the tissue around an implant, often in the days or weeks following surgery. That said, infection has been seen 20 years after implant surgery. Women with breast implants should take antibiotics if they undergo teeth cleaning or colonoscopy. Signs of infection are redness and swelling. Treatment with an antibiotic may be sufficient; if it isn’t, the implant may have to be removed.

Capsular contracture is a tightening – or contracting – of the scar tissue that forms around the implant as a natural reaction to the presence of the implant. The capsule is usually soft and barely noticeable but it may become hard and painful, like a calcified shell that develops around the implant. Symptoms of contracture usually develop gradually and may be noticed first as a feeling of mild tightening.

As contracture increases, the breast may appear misshapen and become very firm and painful, especially when lying on it. Treatment is to remove the implant and capsule surgically, but the capsule will reform and usually become harder more quickly. In some cases, the implant may be replaced with a new one wrapped in acellular dermal matrix to try to reduce capsular contracture; in others, natural-tissue reconstruction may be the best option.

Rupture becomes more likely as an implant ages. Saline implants may appear deflated or misshapen. Silicone implant ruptures are either silent, or they present as unusual pain due to the irritation to the surrounding tissues. Since silicone implant ruptures are silent, the FDA recommends breast MRIs for surveillance every 2-3 years for women with silicone implants. Ruptured implants are generally removed as long as the patient is healthy enough to tolerate surgery.

Displacement of the implant can occur for several reasons, one of which results from the placement of the implant under the chest muscle (sub-pectoral placement). Placement of a breast implant under the chest muscle can cause the breast to feel tight and painful, and flexing the chest muscle can also cause the implant to shift visibly under the skin and distort the breast.

The problem can be corrected by removing the sub-pectoral implant and placing a new implant above the muscle (pre-pectoral). A prepectoral breast implant is closer to the natural anatomy of the breast, because the natural breast is also above the chest muscle. The new implant may be wrapped in acellular dermal matrix to provide some additional soft tissue protection under the skin.

Many women who have had unfortunate experiences with implants prefer not to try again, even with a different type of implant or modified surgical procedure. They turn to natural tissue breast reconstruction, also known as autologous reconstruction, which is the ‘gold standard’ of breast reconstruction. Natural tissue breast reconstruction uses a woman’s own tissue to create a breast that is soft and warm and that lasts a lifetime.

Feeling cold occurs because there is no blood supply to the implant and because the skin that remains after the removal of breast tissue can be quite thin. Fat-grafting can help by adding additional ‘padding’ over the implant, but it is often of limited utility. A better solution is natural-tissue reconstruction, which recreates a soft, warm living breast.

About Dr. Constance M. Chen

Constance M. Chen, MD, is a board-certified plastic surgeon in New York City with special expertise in the use of innovative natural techniques to optimize medical and cosmetic outcomes for women undergoing breast reconstruction. She is Clinical Assistant Professor of Surgery (Plastic Surgery) at Weill Cornell Medical College and Clinical Assistant Professor of Surgery (Plastic Surgery) at Tulane University School of Medicine.

Dr. Chen is frequently invited to lecture nationally and internationally on new advancements in breast reconstruction and the surgical treatment of lymphedema. She is the author of three books, five book chapters, and fifty journal articles. She has also won numerous awards for her work in plastic and reconstructive surgery at the local, regional, and national levels.

Dr. Chen has developed a reputation in the community for the personalized attention that she devotes to her patients. She is committed to aesthetic restoration of the breast and body, and enjoys helping her patients achieve overall well-being. At the end of the day, there is nothing more important to her than the joy she hopes to bring to her patients’ lives. Come into the beautiful world of Dr. Constance M. Chen.

Seeing Spots: Understanding the Skin Cancer Risks of Moles


For some, they are ‘beauty marks’. But dermatologist Dr. Richard Torbeck, a skin cancer specialist with Advanced Dermatology P.C., says moles demand our attention for health reasons, too: “Monitoring our body’s moles is important to stay alert for melanoma – the most dangerous form of skin cancer”.

Skin cancer outpaces all other cancers combined, according to the nonprofit Skin Cancer Foundation. And melanomas are the most deadly forecast to cause more than 7,000 deaths this year in the United States, according to the American Academy of Dermatology. “

If melanoma is not treated early, it can spread to other organs, becoming difficult to treat.

Dr. Richard Torbeck

Dr. Torbeck also adds that there is an increase in thin melanomas which may be the result of importance placed on physician and self/partner skin exams on annual basis at a minimum. Melanoma begins in the skin’s melanocytes, the cells responsible for producing pigment. Moles – medically called ‘nevi’ – are clusters of melanocytes. ‘Moles are normal’, emphasizes Dr. Torbeck. “Almost all of us have them, and most do not become cancerous. But checking for changes is important so that we can act rapidly if a problem develops”.

Having moles is not a cause for alarm. But we need to monitor our moles so that we can take action if needed.

Dr. Richard Torbeck

Most of us have between ten and forty ‘common’ moles, which typically develop from childhood until age 40. Common moles share a range of traits: they’re round and small, no larger than a pencil eraser; they have an even color, usually pink, tan, or brown; and they’re smooth, with a distinct border. A smaller percentage of people also develop atypical – or dysplastic – moles, which are larger and may have an irregular color, surface, or border.

ncreasing melanoma awareness remains important: The CDC reports that rates more than doubled between 1982 and 2011. “Early intervention is key”, emphasizes Dr. Torbeck, noting that the five-year survival rate is 99 percent when cases are treated before they spread to the body’s lymph nodes. “If we add in the fact that about half of melanomas are self-detected, the case for self-checks becomes even more compelling”.

With that in mind, he offers the following advice: 5 Tips to Protect Ourselves from Melanoma.
1. Know your risk level: “Genes and environment contribute to risk”, explains Dr. Torbeck. “Factors include fair skin, childhood sunburns, the presence of atypical moles, more than 50 common moles, and any personal or family history of skin cancer. For those with elevated risk, it’s important to develop an appropriate check-up schedule with your dermatologist. That might be once a year or as frequently as every three months, if there is a combination of factors”.

2. Map your moles: “Early intervention starts with skin awareness”, notes Dr. Torbeck. “The American Academy of Dermatology website has a Body Mole Map that people can print out and use to map their body marks. This is a great first step to establish a baseline reference to check for changes. Photos are also helpful”.

3. Practice the alphabet check: “Do regular self-exams, and think ‘A, B, C, D, E’ to remember the five key factors when inspecting moles”, states Dr. Torbeck. “Asymmetry: an irregular shape. Border: an uneven edge. Color: uneven color. Diameter: changes in size. Evolving: changing over a period of weeks or months. If any of these occurs, we need to see a doctor immediately”.

4. See other changes? Take action!: “It’s not only moles we need to be aware of”, says Dr. Torbeck. “Research shows that seventy percent of melanomas can develop in other areas of our skin, so if we notice changes in skin color or texture or experience itching, oozing or bleeding, it’s vital to see a doctor”.

5. Protect the next generation: “Ninety-five percent of melanomas are linked to UV exposure”, emphasizes Dr. Torbeck. “Early skin exposure is especially damaging. Today’s adults may have grown up before this understanding. But we can make sure the next generation is protected by using sunscreen, covering up, and staying away from indoor tanning devices”.


About Dr. Richard Torbeck

Richard Torbeck, MD, is a board-certified and fellowship-trained dermatologist specializing in Mohs micrographic surgery for skin cancer and cosmetic dermatology at Advanced Dermatology P.C.

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies. Come into the beautiful world of Advanced Dermatology P.C.





Remember the time

It’s June, which means we are officially into summer, it’s the wedding season, and when everything goes well, lots of sunshine, and many happy faces! I love summer, I love Sunshine, and I am a happy person, who likes to smile. But today, for 15 years now, this month brings also some sadness. The month of losing some loved ones. My mother and ‘grandma’ Begum Om Habibeh Aga Khan.


Old vintage photo of my mom (1936 – 2000), in old vintage silk Cartier picture frame, vase Wedgewood, flowers by Bloom studio (click photo to enlarge).

It’s now exactly 15 years ago that my mother died of cancer. Time flies, and sometimes it still feels like yesterday.

Hearing the bad news (again) she didn’t wanted any treatment. And then, one day, she was on. Although I remained at home, to take care of her, I didn’t see how sick she really was. Actually, the realization came when she no longer came out of bed. Almost six weeks my mother needed to die. It were horrible weeks, to swallow, was getting more and more difficult. Quite apart from all the pain she must have had of the falls. Lying upstairs in her own bed was the only thing she wanted. So we could have our ‘normal’ life.

Candle GIF

My mother had a few very good friends, who helped us through: Dora van Ee, Ann Voets and Riek Vroegop (I will never forget!), we called them ‘the Golden Girls’ after the famous tv-show. All 4 represent one of the types from the show. Upstairs, in her bedroom, it looked many times if we were on the set of ‘the Golden Girls’. We laughed (out loud) and we cried. I let her drink when she wanted, I offered her small tasty snacks, which she sometimes took, but fast enough that they where no longer wanted. Not all nurses who suported us when we needed understood what was going on (“she must sleep in a hospital bed!”). We continued day and night with her to let her know that she should go. It was alright.
When my mother ‘finally’ passed away, we saw the face as we knew coming back a bit: the face of a dear mother, who had tried to live her life as best she could, who had peace with her death, children and her friends. Then the disease, and taking care of her children was over.

Cartier Limoges La Maison Vase Mother Tiffany & Co Sterling frame

Cartier Limoges Art Deco La Maison vase and vintage Tiffany & Co sterling frame (all privat collection) (Click photo to enlarge)

Yes, I remember the time. The time that she (and my dad) took care of me, after countless hospital stays. Our fantastic holidays. All the things they teached us….

Time flies, sometimes it (still) feels like yesterday! I will always remember the time! Thanx always!

gr.Jean Amr

What You Don’t Know About Sunscreen Can Hurt You; Dermatologist Drs. Joshua L. Fox Provide Tips for Summer Skin Safety


Skin cancer is the most common form of cancer in the United States. Yet despite the well-documented and well-publicized association between sun exposure and skin cancer, only 30% of adults report that they apply sunscreen when exposed to the sun. Among teenagers who are outside for more than an hour on a sunny day, only 14% of girls and 7% of boys regularly use sunscreen.

This data is extremely disappointing. The vast majority of skin cancers are caused by exposure to the sun. And despite the widespread promotion of best practices for prevention, the incidence of melanoma, the most dangerous form of skin cancer, has been increasing for thirty years. We can’t prevent all sun exposure but there are simple steps we can take to minimize the risk.

Drs. Joshua L. Fox, Medical Director of Advanced Dermatology P.C.

Everyone knows the basics of skin protection – stay out of the sun between 10:00am and 4:00pm, wear a hat and other protective clothing, and use sunscreen. But there are hundreds of brands and varieties of sunscreens, not to mention the confusion caused by SPF ratings and advertising claims. Dr. Fox sorts through the issues and answers your questions about sunscreen:

Why is sunscreen so important? Does everyone need it? All the time?
Ultraviolet radiation from the sun is a known cause of skin cancer. Two types of rays, UVA and UVB, damage DNA in ways that cause cells to grow out of control and become cancerous. Sunscreen serves an important protective function by blocking or absorbing ultraviolet rays. It should be used by everyone – dark-skinned as well as fair-skinned people – all year round, even on overcast days, when as much as 80% of the sun’s rays pass through the clouds.

What about SPF ratings? What do I need?
The sun protection factor (SPF) rating is a measure of how long it will take for protected skin to burn compared to unprotected skin. The Skin Cancer Foundation recommends sunscreen of SPF 15 or higher for everyday activity and SPF 30 or higher for intense or prolonged exposure. Individuals with higher-than-average risk – those with a personal or family history of skin cancer and those with particularly fair skin and hair – can get some additional protection from SPF factors up to 50. According to the Food and Drug Administration, there is no evidence of additional protection above SPF 50.

Children are even more vulnerable to sun damage than adults. A blistering sunburn in childhood or adolescence more than doubles the risk of developing melanoma later in life.

Drs. JosHua L. Fox

Is there anything else I should look for on the sunscreen label?
SPF is a measure of protection from UVB rays. To be protected from UVA as well, it’s important to choose a sunscreen labeled ‘broad spectrum’, which offers protection from both types of radiation.

How – and how often – should sunscreen be applied?
Apply sunscreen 30 minutes before going outside to give the skin a chance to absorb it. Reapply at least every two hours and immediately after swimming or sweating. Use about an ounce – the amount in a shot glass – to cover all exposed skin and pay particular attention to the more delicate skin on the face. Every time you apply sunscreen, also apply lip balm with SPF of 30 or above. And don’t depend on cosmetics or facial moisturizer for protection from prolonged exposure.

Is last year’s sunscreen still effective?
Sunscreen is generally effective for two to three years. Check the expiration date on the container. Store it in a cool place.

Sunscreen is a key element of a sun protection program, but it isn’t enough. You should stay out of the sun when rays are strongest, cover up with clothing and a wide-brimmed hat, and wear UV-blocking sunglasses. With some common sense precautions, you can enjoy all the pleasures of the great outdoors.

Drs. Joshua L. Fox

What about babies?
Children are even more vulnerable to sun damage than adults. A blistering sunburn in childhood or adolescence more than doubles the risk of developing melanoma later in life. Infants under six months old should be kept out of the sun entirely and well protected with a hat and clothing anytime they are outdoors. For babies older than six months, use sunscreen with SPF of 15 or higher, 30 or higher if they spend a lot of time outdoors or are fair-skinned.

Are sunscreen sticks effective? The new drinkable sunscreen?
Sticks are fine and particularly convenient for children. They offer another choice along with lotions, creams, gels and sprays. Drinkable sunscreen, on the other hand, should be avoided! It purports to have ingredients that ward off UV rays and prevent them from penetrating the skin. There is no research or evidence to support the claims and dermatologists recommend against using it.


About Joshua L. Fox, M.D., F.A.A.D.

Joshua L. Fox, M.D., F.A.A.D., is the founder and medical director at Advanced Dermatology P.C. He is a leading authority in the field of dermatology with expertise in skin cancer, cosmetic surgery and laser procedures and is program director of a fellowship in laser and cosmetic surgery. Come int the beautiful world of  Drs Joshua L. Fox

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies. Come into the beautiful world of Advanced Dermatology P.C.