How to reduce your chances of being taken for a ride

Recently we had a new patient who was interested in improving the fine lines on her eyelids. This is not necessarily an easy task, but it can be accomplished. As the conversation developed, it became clear that she had been previously treated for this. She had gone to one of the nationally syndicated laser chains with the same request, and was told that they could help her. However, as the treatment was starting, the nurse placed eye shields that covered the lines that she most wanted treated. When the woman pointed this out to the nurse she was told "Oh, we can't treat there."

Eyelid Surgery Declines II

In a previous post the decline in eyelid surgery was discussed, focusing on upper eyelid surgery. However, it is likely that the decline in lower eyelid surgery has been much greater than the decline in upper eyelid surgery. The aging changes of the lower lid have, until recently, been poorly understood and have been the subject of a considerable amount of misdirected surgery.

Happy Patient: Fraxel Re:pair (CO2) Laser Follow Up

One of our patients is a man in his 50s who has a very young son. He doesn't want his son to grow up with people questioning him whether the man accompanying him is his father or his grandfather. The patient had the Fraxel re:pair treatment on his full face and neck one month ago. He came in today for a follow up visit and was ecstatic. His comments are below:

Eyelid Surgery Declines

The number of eyelid surgeries performed in the last 10 years has declined by 50%, according to statements made at the Jules Stein Eye Institute's course on cosmetic eyelid surgery. The decline is not due to the fact that too few procedures are currently being performed. Rather it is that there have, in the past, been many "overoperated eyes", according to the speakers.

What's New in Fillers

There are a great number of fillers available, many of which are not currently approved in the US. The next major new filler scheduled to be approved is Evolence, a porcine derived collagen which was developed in Israel. The advantage of the original bovine collagen filler was its very smooth flow. Disadvantages were its short duration of effect and the need for a skin test. Evolence is said to persist  for a year but, unfortunately it appears to lack the smooth flow of the  earlier collagens. It does not require a skin test.  The company has  introduced a second generation product, Evolence Breeze, which may overcome some of the shortcomings of the original product. Until it is released, it remains an unknown.      

Bad Celebrity Cosmetic Surgery

One would think that with their high incomes, Hollywood celebrities would be able to afford the best in cosmetic surgery. While they may be able to afford it, many clearly lack the judgment to make wise choices. When you undertake a cosmetic procedure you should have a good idea of the results you can expect. What you want may not be completely possible, but your surgeon should make very clear the range of outcomes to be expected from the proposed procedure.

My Beautiful Mommy: Solution or Problem?

"My Beautiful Mommy" is a book written for kids to help explain mom's cosmetic surgery to them. It is written by Micharl Salzhauer MD, a Florida plastic surgeon who claims that over half his cosmetic patients bring their children to the office with them. This must be a Florida phenomenon since we almost never have children brought in to a cosmetic consultation. children usually are not interested and often are distractions during this type of visit.

Hyperhidrosis: Sweating Your Life Away

Increased sweating, especially of the palms, is one of the most debilitating conditions seen by dermatologists. For people who have this condition, it can become the focal point of their lives. They are in continual dread of being placed in a position where they will be forced to shake hands with someone while their own hand is hot and dripping with sweat.

Efficient Surgery

At a recent conference on rejuvenation of the aging skin, the physicians in the audience were able to respond electronically to questions posed by the conference organizers. When polled about the type of anesthesia used in facelift surgery, 2/3 of the audience responded that they used general anesthesia. Another significant percentage responded that they used conscious sedation. A relatively small percentage indicated that they used conscious sedation. When the pannelists were asked, most responded that they use  general anesthesia, commenting that it was  "more efficient"

What's New in Botulinum Toxin and Botox

Botulinum toxin A (BTA) safety concerns have been making headlines The news media has played up the reports of a small number of deaths linked to BTA, without making it clear that none of these has been associated with the cosmetic use of Botox. The FDA, apparently spooked by their failure to catch problems with Vioxx and Celebrex, has begun an investigation into BTA safety.