Best Docs 2007: The Specialists

Orthopedics

Dr. Lyle Micheli

Vital Stats: Director of sports medicine, Children’s Hospital Boston; 35 years in practice.
Clinical Notes: Having suited up for football, rugby, lacrosse, and boxing during his years at Harvard, Micheli is going strong into his 60s (though he hasn’t played rugby for a while, the good doctor still bikes to work daily). That gives him a lot in common with the folks flocking to orthopedists today. As other in-demand specialists face a wave of obese or sedentary patients, Micheli and his colleagues are seeing a countertrend: older Bostonians who are demanding a lot of their joints as they turn to exercise to feel young. “You know that picturesque little French village scene with the old people walking around with their canes?” he says. “People don’t want to be that picture anymore. People want to ski when they’re 71.”
What’s Hot, What’s Not: Thanks to advances in arthroscopy (a minimally invasive, camera-aided operation), orthopedic outpatient surgery has boomed. Of the two dozen or so operations Micheli performs weekly, only two or three require hospital admittance. Well on the way out: fusing joints, a once common procedure to protect arthritic hips and the like.
What’s Next: Instead of using metal or plastic to shore up joint injuries, orthopedists may one day be able to implant cartilage grown from a patient’s own cells.
Doctor’s Orders: Consider taking a chondroitin sulfate–glucosamine supplement, and dig into those (complex) carbs. Exercise, but don’t overdo it—if you’ve been relatively slothful, try increasing your physical activity by just 10 percent a week, and go for something that’s easy on the joints. (Micheli’s delighted Mayor Thomas Menino has joined him as a cycling devotee. “I mean, can you imagine the mayor of Boston a generation ago riding around the city on a bicycle?”)

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Plastic Surgery

Dr. Brooke Seckel

Vital Stats: Private practice, Concord; 26 years in practice.
Clinical Notes: As baby boomers put the squeeze on the healthcare market as a whole, Seckel—who founded the Lahey Clinic’s Center for Cosmetic and Laser Surgery before striking out on his own—says he’s been surprised to find a different group filling his waiting room lately: 30-to-45-year-old women who’ve had their kids and are busy getting back into shape. He’s also noticing more and more men looking for tighter tummies and smoother skin. “I love it—seeing these tough guys, even construction guys, coming in and having their faces done, and they don’t blink an eye.”
What’s Hot, What’s Not: New laser therapies have made a big dent in harsher traditional procedures like chemical peels and dermabrasion, and Botox has made the brow-lift operation virtually obsolete. Meanwhile, partly due to the recent re-introduction of the silicone gel implant, the popularity of breast enhancement is holding steady.
What’s Next: Technology that allows doctors to remove fat without making an incision, eliminating the need for liposuction (currently one of plastic surgery’s most common procedures). Researchers are experimenting with using infrared, radio frequency, and ultrasound to dissolve fat under the skin; Seckel, who’s consulted on tests using potbellied pigs, predicts we’ll see this become reality in the next two years.
Doctor’s Orders: Well-kept skin will delay the need for a facelift, so steer clear of the sun and smoking. Keep a lid on your stress level, too, as high amounts of cortisol, a.k.a. the “stress hormone,” have been shown to damage collagen—not to mention clog arteries, which sets the scene for heart attacks, strokes, and high blood pressure. So get yourself to a yoga class, already!

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