Category Archives: Women’s Health

Should You Get a Genetic Test for Breast Cancer?

Should You Get a Genetic Test for Breast Cancer?

A talk with Dr. James Lasker about when, why and who should get this potentially insightful test.


“This test affects a very specific percentage of women. It’s a small percent, but it’s important,” says James Lasker, MD, a board certified oncologist with Birmingham Hematology Oncology Associates.


What test? The genetic test for the BRCA 1 and BRCA 2 mutation (pronounced like “bracka”). A lab looks for the mutations in your DNA using a blood sample taken by your oncologist or physician.


Who should get one? Dr. Lasker says that if you fall into any one of these three categories, get the test:

  • If your sister or your mom tested positive for the BRCA 1 and BRCA 2 mutations,
  • If you have at least two relatives who were under 50 and had any breast or ovarian cancer, or
  • If you were under 45 years old and diagnosed with any breast cancer.


What about men? “This includes males in the family too,” says Dr. Lasker. “Though only 1% of men get breast cancer, if your brother has it, go get the genetic test and see if you’re carrying these genes.”


How do you get the test? “You go to the breast cancer center of your choice or your oncologist and meet with a genetic counselor,” says Dr. Lasker. “Bring documents showing positive test results for your relatives in order to prove you might need the test.” The counselor will take your medical history, and if needed, schedule you for the blood test.


Why bother? “Women with BRCA 1 and 2 mutations have a markedly elevated risk of getting breast cancer – 50% to 85% greater than people without those mutations,” says Dr. Lasker. “And also a 15% to 40% increased risk for ovarian cancer.”


It doesn’t just spot breast cancer risk. “If you’re a carrier, you’re also at a higher risk for pancreatic cancer,” says Dr. Lasker. “So knowing that your family has multiple higher incidences of glandular malignancies means you can screen early to pick up on these things, and that makes a difference with possible outcomes.”


What it means if you test positive. “If you have the BRCA 1 and BRCA 2 mutation, then you need to get a mammogram and MRI every 6 months, instead of yearly, and have your ovaries screened too,” says Dr. Lasker. Early detection of breast cancer means a high chance of curing it. And knowing about the heightened risk of ovarian cancer can also help you decide to have your ovaries removed once you’re done having children.


A good source. “If you want to know more, visit the National Comprehensive Cancer Network website at,” says Dr. Lasker. You’ll find in-depth and recent information about the genetic test and various cancers.


by Jane Ehrhardt


To read more about Dr. James Lasker, click here.

For more on Birmingham Hematology Oncology Associates, click here.

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Facial Fat Grafting Offers a Natural Alternative to Temporary Fillers

Facial Fat Grafting Offers a Natural Alternative to Temporary Fillers


Fat can be your friend when it comes to fighting certain signs of aging, like sagging cheeks and deepening lines.


You may never have thought of fat as being your friend. But when it comes to fighting aging, fat becomes your natural ally when used as a facial fat graft to restore that youthful lift and plumpness to your face.


“Most people are surprised to hear about this procedure, because they’ve only heard of temporary fillers, like Juvederm or Restylane,” says Al Cohn, MD, a plastic surgeon with Grotting & Cohn Plastic Surgery in Birmingham. ”But with facial fat grafting, you can have all that a temporary filler can give you and then some, often for less cost.”


What is it? “It’s a cosmetic surgical technique where fat is moved from one part of your body, like your tummy, and placed where we’re using temporary fillers now to fill hollows in the cheeks and under eyelids or smooth out lines that become more prominent with aging,” says Dr. Cohn.


Better than fillers. “Unlike temporary fillers, facial fat grafting is relatively permanent,” says Dr. Cohn. “And once the living fat is in place, you don’t traditionally have it repeated, unlike with fillers that dissipate in six months to a year.”


Back on your feet. Facial fat grafts do require more recovery time than fillers, though. “When fat is injected, the instrumentation is larger than with fillers, so there’s generally bruising that lasts a couple of days following this out-patient procedure,” says Dr. Cohn.


Costs less. “Two to three syringes of a temporary filler equals the entire cost of facial fat grafting, and it’s permanent,” says Dr. Cohn. With this cosmetic surgery, you’re just paying for the procedure, because everyone has enough body fat to achieve their relevant facial goals.


Choose wisely. “Get your facial fat grafting done by someone who has done a lot of them,” advises Dr. Cohn. “Performing liposuction is not the same. Just because you have removed fat from some part of your body doesn’t necessarily make it usable for a graft. Ensuring that your plastic surgeon is board certified by the American Board of Plastic Surgery is a good starting point.”


by Jane Ehrhardt


To read more about Dr. Al Cohn, click here.

For more on Grotting & Cohn Plastic Surgery in Birmingham, click here.

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Robotic Surgery and Women’s Health

How has the da Vinci surgical robot changed gynecology options for women?

“The biggest changes in gynecology in the last few years have been because of robotic surgery,” says Christy Heath, MD, a gynecologist with Birmingham OB/GYN in Alabama.

Three cheers for minimally invasive surgery. Open surgeries used to be the most often utilized option for most gynecological procedures, like hysterectomies, which meant one long incision in the abdomen that took several months to heal.

Then came minimally invasive surgeries using straight-stick laparoscopy. Healing time dropped to four weeks or less, because it meant only three or four tiny incisions in the abdomen for a camera and special instruments.

With the da Vinci surgical robot, the minimally invasive options door for women has swung wide open. The robot’s instruments have “wrists” that allow surgeons to angle and turn them within the abdomen for far more reach and better visualization than straight-stick laparoscopy could ever attain.

Less pain. “Recovery time with any minimally invasive procedure means the risks are lower and recovery’s quicker. With the robot, the results are even better,” says Dr. Heath. “After robotic surgeries, women are up and mobile that afternoon. And many don’t require narcotics to manage their pain after they leave the hospital. It’s amazing.”

Fewer obstacles to better procedures.
“Women with certain medical problems, like scar tissue, obesity or an enlarged uterus, used to be exempt from minimally invasive options,” says Dr. Heath. “But that’s not true anymore because of the flexibility of the da Vinci robot within the abdomen.”

More and more options. Besides hysterectomies, robotic surgery now lets women choose the minimally invasive approach for numerous gynecological surgeries, including treating endometriosis, performing pelvic organ prolapse procedures, repairing bladder hernias and rectal hernias, and offering alternatives to vaginal mesh procedures.

“This procedure is technically difficult, so very few gynecologists are using straight stick laparoscopy for it. But the robot now makes it possible,” says Dr. Heath. “Women can return to normal activity within two weeks instead of six to eight weeks.”

Myomectomies. The same holds true with myomectomies, a gynecology surgery for removing uterine fibroids (benign smooth muscle tumors). “If symptoms were bad enough to warrant surgery, the majority of women weren’t eligible for straight-stick laparoscopy. But the robot allows us to address larger and multiple fibroids where we used to have to do open surgeries,” says Dr. Heath.

Dr. Heath says the list of gynecology surgeries now open to women as minimally invasive grows longer as surgeons and the robot become more experienced and advanced. “It’s almost like having a mini human hand inside the abdomen. It allows surgeons so much more mobility.”

by Jane Ehrhardt

To read more about Dr. Christy Heath, click here.
For more on Birmingham OB/GYN, click here.

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Moles: Beauty Marks or Time Bombs?

Moles are unpredictable. Some lay like glorified exclamation points on the creamy skin of models and others grow into grotesque mini-mounds of tissue better suited to an ogre. But do you know which ones are dangerous?

Yes, Cindy Crawford and Marilyn Monroe made moles into beauty marks. But looks can be deceiving. Since most all moles grow, can you tell which ones just look like they’re trying to kill you and which ones mean you’re facing a real health danger?

What is that thing? Moles are pigment cells, called melanocytes, that grew in a cluster instead of spreading out. “These types of cells continue to grow,” says Retna Billano, MD, a dermatologist at Montclair Dermatology & Aesthetic Center in Birmingham. Most moles appear by the time you hit 20, with the average person having 10 to 40 moles by adulthood. Some grow slowly, some fast, some change color, many get lighter, and some may even disappear.

It all means something. And those changes can tell you, or more importantly, a dermatologist, if or when to do something about them. “The growing mole is not a concern unless it changes in character, like shape or texture or darkens in color,” says Dr. Billano. “Growing larger, but the same, is fine.” Otherwise, go see your dermatologist.

The sun, it burns!
“Nothing can inhibit the growth of a mole, but changes can be triggered by sunlight or some hormones, such as during pregnancy,” says Dr. Billano.

You can even get moles there. “The scalp and the bottom of the feet are places people don’t think to look for moles,” says Dr. Billano. Moles on the sole of your foot are most likely melanoma (skin cancer), so head right to your dermatologist.

Get it off me! If your dermatologist suspects the mole is cancerous, they will likely numb the area and cut the whole thing out, leaving you with some stitches. If they think it’s precancerous or it’s a mole that’s simply irritating to you, such as rubbing against your clothing, they will use a scalpel to “shave” it down to skin depth or freeze it off.

Young women are the worst. Because moles are so unpredictable, get a full body check of your moles every year. Start as early as 20 years old, because melanoma is the most common cancer in women ages 25-29. “Catch it early,” emphasizes Dr. Billano. “It’s curable if you catch it early.”

Remember that if you’re looking for certainty, look to your dermatologist. They can always tell whether that mole you’ve got is a burgeoning beauty mark or a little time bomb that needs defusing.

by Jane Ehrhardt

To read more about Dr. Billano, click here.
For more on Montclair Dermatology & Aesthetic Center, click here.

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A Talk with Dr. Mia Cowan

A Talk with Dr. Mia Cowan

“I like to fix problems,” says Mia Cowan, MD, FACOG, MA, MBA. “I loved surgery, but I also love educating people on their health and disease prevention.”

By her third year at the Medical College of Wisconsin, she knew she had found how she could best serve patients with her trifecta of healing skills — gynecology.

Her mother, a nurse, first implanted the idea of Mia becoming a doctor by taking her along on home visits. “I remember in the seventh grade telling my mom that I wanted to be a doctor,” she says.

After her gynecological residency in Wisconsin — where she also met and married her husband — Dr. Mia Cowan returned to Birmingham and spent four years serving the indigent in Jefferson County.

Then in the fall of 2010, she stepped out on her own to open her dream practice. It revolves around making women feel both healthy and beautiful. “I want my patients to look good and feel good about themselves,” she says.

MiBella Wellness Center now includes not only her thriving gynecological practice, but a weight loss program. For this component, Dr. Cowan completed extensive training at the Center for Medical Weight Loss, which is the largest network of physicians focused on bariatric medicine in the country.

“Weight loss can be a very emotional thing, so we have a very encouraging staff,” she says. Weight problems, she says, contribute to so many chronic health conditions, like osteoarthritis, back pain, hypertension and diabetes, that it deserves special attention from physicians. “It’s something I’ve struggled with myself,” she adds.

To further fulfill MiBella Wellness’ mission of “a beautiful approach to health,” Dr. Cowan recently began offering cosmetic procedures. The first one, called Smartlipo, uses a laser to melt and destroy fat cells, which are then easily removed.

In every aspect of her practice, Dr. Cowan has instilled the call of service. “We do almost a concierge kind of service here. I even give my patients my cell phone number. But we educate them so well on any health issues that I rarely get a call,” she says. “I’ve been able to build my practice on referral alone because of our strong belief in service.”

Having attended both University of Alabama for her undergraduate and master’s degrees and Auburn University for her MBA, her allegiance to Birmingham couldn’t be stronger. She and her husband Joseph live in Hoover with their daughter Marley (named after Bob Marley). Not surprisingly, she loves Jamaica and hopes to travel more frequently soon.

by Jane Ehrhardt

To read more about Dr. Mia Cowan, click here.
For more on MiBella Wellness Center, click here.

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