Zeltiq on In Your Face Blog

One technology that we're extremely excited about here at Sanctuary is Zeltiq. Stemming from research in the 1970s about how the cold from popsicles created fat depressions in the cheeks of children, this non-invasive procedure has really been fascinating to research and use (including on myself!)

Check back soon for "after" pictures from our first round of patients in September.

One thing to remember is that in our experience, this procedure really takes 90 days to see the full results, not 2-6 weeks.

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Watch Dr. Oscar Ramirez operate on Facebook

No, the title of this post is not misleading. Many plastic surgery and cosmetic dermatology practices are "on" Facebook, but very few are doing anything to grab people's attention. Well, we've got something!

Dr. Oscar Ramirez, here at Sanctuary Plastic Surgery, is very well known for his work in pioneering the mandibular matrix facial implant system. It is performed on any adult who has concerns about a weak jawline.

For more info on it, check out our web page on it here.

A patient has graciously decided to share his entire surgical and recovery process with us on Facebook! On our Facebook fan page (join here), anyone will be able to see his Vectra 3d imaging "preview" of how his results will look, view a pre-surgery interview with him and Dr. Ramirez, view photos and video from the surgery as it happens, and then get updates on his results during the roughly two week recovery period.

Although some practices have done Facebook procedures with minimally invasive surgery, this is the first that will document the process of a transformation like this:


The patient for Wednesday will also be having an endoscopic neck lift. If you want to hear more about it, join our Facebook page or watch WPLG on Wednesday morning!

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Sarah Jessica Parker on "Molegate"

We don't write about celebrities and plastic surgery too much, but this story has a good message.

Sarah Jessica Parker recently had her "signature mole" removed. Although she has faced a lot of backlash from people who thought it was a form of giving in, Parker explained:

"I was like, 'My mole was my signature? Isn't my brain my signature?'" I didn't have strong feelings," she said. "I didn't object to it. I just didn't care for it."

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

It should be news: Environmental Pollution Increases Incidence of Renal Failure

A good study from 1996 that I wanted to bring to everyone's attention was titled "Environmental Pollution is Increasing the Incidence of Chronic Renal Failure."

It comes from a study in Egypt by Mohamed A. Sobh, of the University of Mansoura's Nephrology Department. Renal failure, by the way, is the failure of the kidneys to function adequately.

Pretty scary stuff just from the abstract:

"These risk factors could be physical (radiation, heat, electric or altitude), chemical (for example heavy metals and hydrocarbons) or biological (bacterial, parasitic, viral or fungal) in nature, which can reach the human through air, food, water, drugs or cosmetics. These risk factors could be present at home, in the workplace, or in the environment at large.

Airborne environmental toxins could be gaseous (for example carbon monoxide, vinyl chloride, radon), vapour (for example lead, mercury, arsenic, nickel), dusts (asbestos, silica, cotton fibres, coal), airborn allergens or radiation. Waterborne could be microbial pollution of drinking water, or chemical contamination (metals, toxic, wastes, pesticides or agricultural chemicals). Food could be a risk factor for instance rhubarb causing oxaloses and liquorice causing salt and water retention with hypokalaemia."

We are going to have an increased emphasis on addressing toxins with the age management and wellness aspect of Sanctuary. Stay tuned!

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Cosmetic Bootcamp in Boca Review

Dr. Pozner and I just returned from Cosmetic Bootcamp at the Boca Hotel and Resort. This was a meeting run by renowned dermatologists Ken Beer of Palm Beach, Mary Lupo of New Orleans and Vic Narukar of San Francisco.

They run a few cosmetic bootcamps per year and this one was targeted towards practice management. Dr. P gave 3 lectures - lasers and lights for a cosmetic practice - speaking about the usual devices we use such as Sciton fractional and TRL resurfacing, and newer devices such as Ulthera, Zeltiq, Liposonix and Ultrashape.

He gave another lecture on the role of the internet in cosmetic practices - using web sites, blogs, Facebook etc. my last lecture was on laser safety - pretty dull subject but there were some laser complications thrown in to keep everyone awake for that 8 a.m. talk on Sunday (ouch - considering we were out with Dr. Pozner and family until late on Saturday eve!!!)

There were some excellent lectures at this meeting. Mark Nestor spoke about the Botox and Dysport black box warnings - we covered this in a previous blog post. There was a discussion about new toxins such as Xeomin and Puretox. Doris Day did her usual excellent job.

This meeting was unique in that its emphasis was not so much on cosmetic doctors as attendees. They were there, but in addition, their administrative staff members were in also attendance . A variety of issues were discussed that looked at keeping patients happy. These included an emphasis on both receptionists and clinical staff understanding the needs on each patient in the office.

I personally lectured on a variety of legal issues that relate to running a cosmetic practice. I also discussed Latisse, the FDA approved eyelash enhancer from Allergan. One of the most fascinating talks was one given by Atesh Chendra, Vice President of Administration at the Breakers Hotel in Palm Beach, FL. He discussed his 25 year experience in creating the ideal environment for hotel goers and applied these concepts to the cosmetic medical office. Overall, the meeting was fascinating.

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

In the OR for stitches? Wait for a plastic surgeon.

Momlogic's Vivian Manning-Schaffel had an interesting blog post last week relating a story from a friend.

"While waiting for an ambulance to arrive, she made a few calls to family members in the medical profession, who tipped her off about requesting a plastic surgeon so Lucie wouldn't have a scar on her face...

"We opted to wait," Erin explains. "And if a plastic surgeon wasn't an option, I know for sure I would've fought for it. I heard the guy had a great reputation, so that made me feel good. And I felt that, even if Lucie ended up with a scar, I did everything I could to keep that from happening."

Three years later, there is barely a visible scar. We add that laser skin resurfacing is really good for treating scars, whether it's from an accident like this or from acne.

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

In the news: Telomere Testing

A recent article by United Press International highlighted some of the cool things going on with telomeres, which we hope to start testing at our practice soon.

The article keys in on a study published in Circulation: Journal of the American Heart Association, and found that intensive exercise helps prevent the shortening of telomeres, which are DNA that protect chromosomes from damage.

That's fantastic, but why is it important to prevent that? A good introduction to telomeres is this article from the BBC in 2003. A 20 year study on telomere testing, which first was introduced to the world around then, found that telomere length can determine if one will be likely to live 15+ past the age of 60.

"People with shorter telomeres were found to be at greater risk of developing age-related diseases, and were nearly twice as likely as others to die over the next 15 years or so, especially from heart disease and pneumonia.

A team led by Dr Richard Cawthon, from the University of Utah, Salt Lake City, studied 143 people over the age of 60.

They found those with telomeres in the top half for length lived for four to five years longer than those whose telomeres were among the shortest half. "

So our conclusion is: go exercise!

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

A glimpse at Mentor's upcoming cohesive gel form stable implant: in Sweden

Just returned from Sweden where I visited Charles Randquist at his lovely Victoria kliniken in Saltsjöbaden. I was sent there along with other US plastic surgeons, Mindy Haws (Nashville, TN), Stephen Schantz (Lexington, KY) and Kaveh Alizadeh (New York).

We spent an intensive few days learning about Mentor's cohesive gel form stable implant (pictured above), aka the CPG, and also about Allergan's similar 410 implant.

Dr. Randquist's results were excellent, and I learned a few tricks. He took us out to a wonderful restaurant - (Toby Keith was also dining there).

Sweden was fun - albeit rainy and cold. The question is - why send us for training on something not yet FDA approved? Does this mean this implant is coming closer to approval? I hope so and will start using it as soon as available.

Here's a picture of the view from Dr. Randquist's OR in Sweden:


Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Study: 62% of plastic surgeons are also patients

An interesting but not surprising study was highlighted by Baltimore Sun health blogger Kelly Brewington.

"In a survey of 276 members of the American Society of Plastic Surgeons, 62 percent said they had gone under the knife for at least one procedure. Most receive minimally invasive procedures such as laser hair removal chemical peels and Botox -- no word of whether they throw Botox parties. A third had gone under a surgical procedure, with liposuction being the most common."

I wasn't polled by the ASPS for this study, but I would've bumped the numbers up a bit. In the last couple of months I've tried both Ulthera and Zeltiq. Can't wait to show off the final results at the end of December, as both treatments take about 3 months to fully take effect.

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Cosmetic Surgery Tax Back on the Health Care Bill?

All the way back in July, there was some media hysteria about a 10% cosmetic surgery tax that was mentioned by a Treasury official. As we blogged back then, it was overblown because the Senate Finance Committee had never even discussed such a thing.

In Senate Majority Leader Harry Reid's latest proposed healthcare reform bill, a 5% cosmetic surgery tax is being proposed.

From the Associated Press:

"At issue is a proposal in the 10-year, nearly $1 trillion health care draft unveiled by Senate Majority Leader Harry Reid, D-Nev., that would slap a 5 percent excise tax on elective cosmetic surgeries and procedures. The plan, projected to raise $6 billion, wouldn't apply to surgery to fix a deformity or injury, but would include procedures such as face lifts, liposuction, cosmetic implants or teeth-whitening.

The plastic surgeons may have seemed like an appealing bunch to pick on given that they had already been skeptical of the Democrats' overhaul proposal. But they say it will be a blow to countless American women — of every income level.

"The common misconception is that this is going to tax wealthy, suburban Republican women," said Dr. Phil Haeck of Seattle, Wash., the president-elect of the American Society of Plastic Surgeons. In fact, he said, of the 86 percent of cosmetic surgery patients who are female, 60 percent of them have incomes between $30,000 and $90,000."

It has also proven to be inefficient for the government to collect on cosmetic surgery tax. It is alleged that in New Jersey, where a similar tax is in effect, it costs the state $3.39 for every $1 that is collected.

Whether or not the bill passes, there is probably going to be somewhat of a rush to plan cosmetic procedures before an extra 5% is added onto the bill.

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Join Our Facebook Fan Pages!

Join our Facebook fan pages! Along with tips, before/after photos, and videos to come from inside our treatment rooms and surgical suites, we are doing a day of giveaways on Friday, November 20.

For Dr. Goldberg's Skin and Laser Surgery Specialists of NY/NJ: NYC Beauty Buzz on Facebook with Dr. Tracy Pfeifer.

For SMAC in Boca Raton: SMAC Boca Health & Beauty Experts.

We will be giving away hundreds of dollars worth of beauty products and spa treatments across the two groups, so if you live near New York City or Boca Raton, join and try to get in on the action on Friday!

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Evolence officially being discontinued

We blogged a month ago that Evolence, a collagen-based filler that we both like to use in our practices, was in trouble. Specifically, Colbar, the company that makes it and a recent acquisition of Johnson & Johnson, was on the selling block.

Last week Colin Stewart at the OC Register's In Your Face blog reported that the company is officially pulling Evolence from the market. It will no longer be manufactured.

From the article:

"Lambros and J&J said Evolence didn’t produce adverse reactions in patients.

“Evolence has had a lot of good press among injectors,” Lambros said. “I was just at a big plastic surgery meeting in Seattle where they were actively promoting the product.”

Last month, an Israeli newspaper reported that J & J planned to sell Evolence’s manufacturer, the Israel-based subsidiary, ColBar, after it sold only $25 million of the filler in a year, far below expectations.

J & J purchased ColBar for a reported $159 million."

It seems that with all of the cosmetic fillers on the market currently, there wasn't room for one more.

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

The latest and greatest in aesthetic technology at the Strata Medical Event in NYC

Dr. Goldberg and I just taught at a Strata Med Event this weekend in New York. There were about 75 docs there - most dermatologists but other specialties as well.

This was one of the most organized and structured events we have ever done. It was split between didactice and demonstrations, moderated by Irvine dermatologist Dr. Christopher Zachary who missed his calling as a stand up comic!

Also teaching was NY celebrity dermatologist Dr. Doris Day, and my close friend, plastic surgeon Dr. Lawrence Bass. We discussed Botox, Dysport and newer non-FDA approved botulinum toxinds like Xeomin (Merz) and Puretox (Mentor). Dr. Bass and I did live demonstrations of Botox in the upper and lower face. We also spoke about different fillers including hyaluronic acids - Juvederm, Restylane and Prevelle silk, Radiesse, Sculptra and Evolence (even though J and J just pulled it from the market).

We were pretty comprehensive and did the usual nasolabial folds and lips but also some fun things like Radiesse cheek lifts and chin augmentation and hand rejuvenation. Dr. Goldberg gave a great talk on the state of the aesthetic industry and demonstrated the Syneron e-matrix system and the new Lumenis Lightshear Duet - a super fast and virtually painless hair removal system.

Dr. Day demonstrated the Lumenis Active and Deep FX and Dr. Bass the Palomar system. I demonstrated Sciton's TRL concept and did 2 combination microlaserpeel/profractional treatments. It was a great meeting, and I am looking forward to the next one.

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Can parrots unlock new secrets in anti-aging?

We offer some retinol-based skin care products at SMAC, including Retinol Night Repair, which doesn't require a prescription and still can improve the appearance of fine lines, wrinkles, hyperpigmentation, skin texture, and smoothness.

I also have several parrots as pets (see above). So imagine my surprise and interest when I saw this great article in the International Journal of Cosmetic Science from researchers in Milan.

Owing to their bright pigmentation and long lives, parrots' feathers apparently have some active molecules that have properties similar to anti-aging molecules like retinol. Studies are being planned that explore this phenomenon, and to develop new substances that are derived from animal metabolisms.

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

NY Times on "Spa Surgeries"

Camille Sweeney at the NY Times wrote a great article looking at the movement to more stringently regulate medical spas (Link).

The article cites an International Spa Association figure that they have increased by 85% to 1,800 across the country.

At our med-spa in Boca Raton, we have spent our medical careers dealing with cosmetic research and medicine. But many of the new med-spas popping up all over the country don't offer that level of expertise.

From the article:

“These places can offer a wonderful opportunity for a consumer to reduce stress and get treatment for the whole body,” said Lynne McNees, president of the International Spa Association. But, she added, “just because someone is in a white coat, it doesn’t mean he or she is a qualified to perform a procedure on you.”

Dr. Goldberg even got a good line in about laser hair removal: “In New York, legally, even a barber could do it, not that he would,” said Dr. David Goldberg, a cosmetic dermatologist in New Jersey, New York and Florida, as well as a law professor at Fordham University and a legal counsel to the Medical Spa Society."

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

ASPS Wrap Up

We attend a lot of aesthetic meetings and lectures around the world. Here's my account of this year's American Society of Plastic Surgeons meeting, held in Seattle from October 23 to 27.

I attended and lectured at the ASPS annual meeting: attendance was way down this year - owing to the location and sign of the economy. Very few east coast doctors made the trip.

I lectured at a pre-meeting course with my good friend Dr. Barry DiBernardo. We did our usual tag team about lasers in plastic surgery - this course was on facial rejuvenation so we concentrated on skin resurfacing with the Sciton tunable resurfacing laser and fractional carbon dioxide (multiple manufacturers) and Cutera systems.

We spent some time on new technology such as Ulthera - we both are early adopters and see a lot of potential in the technology (see previous posts). I then hustled over to Hot Topics to learn and lecture. Hot Topics is the best part about our annual meeting - all the new stuff.

I spoke about the Zerona laser - a low level laser that is supposed to cause fat loss. I dont see the science behind it and feel it is hype, but am not going to blast it completely until real data is in. My usual crew lectured at Hot Topics as well. Dr. Larry Bass spoke about Zeltiq (BTW my belly is shrinking!!!) and showed the most recent studies. We are really hot on this as well!

Dr. Michael Kane spoke about Revance - topical Botox - should be awesome when it gets approved - no needles! Dr. DiBernardo spoke about a few topics including the science behind laser liposuction. He really should get a gold star for the experimental work he has done on skin tightening with the laser. He also gave a seminar on the water-jet lipo machine that can be used for fat cell grafting.

Most of my days were spent in meetings with industry or committee meetings. Not that much fun and I needed a vacation when I returned. Bottom line from this meeting: nothing that new!

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Donda West Law passes

The OC Register's "In Your Face" blog refers to it as a "feel-good plastic surgery law," and "pointless" and that's pretty accurate.

"The key section of the bill says: "Prohibits a cosmetic surgery procedure from being performed by a physician and surgeon unless, prior to surgery, the patient has received a physical examination by, and written clearance for, the procedure from either the physician and surgeon who will be performing the surgery or another licensed physician and surgeon...

The author states that this measure is not directed at the many good plastic surgeons who require their patients to have a medical clearance before elective cosmetic surgery. The author believes that explicitly requiring in law a physical examination prior to surgery will reduce the risk of complications, including death, during or after cosmetic surgical procedures."

It is standard practice for us to get clearance on anyone over 40, and younger if there any medical issues. Anyone over 50 also gets a stress test. Better safe than sorry.

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Social Media has a place in plastic surgery practices

Facebook started out as a site for college kids to network and share photos from the weekend before. In September 2006, it became open to everyone with a valid e-mail address; including businesses.

Marie Czenko Kuechel, a plastic surgery consultant, spoke about the importance of social media at the QMP meeting. We, and our marketing firm A. Cohen Public Relations (led by Anne Cohen), are very committed to the future of social media being compatible with cosmetic medicine.

We're also committed to doing some out of the box things with social media, such as live coverage of procedures, treatment diaries, and beauty giveaways! Many other practices seem to just be using it to spam the Internet with marketing, but that will change as people learn to use the technology.

SMAC's Facebook page: http://tinyurl.com/yhougbl
Twitter: http://www.twitter.com/smacbocaraton

Dr. G's Facebook: http://tinyurl.com/ykog3wo
Dr. G's Twitter: http://www.twitter.com/drgoldberg

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

We blogged about a company called Syneron and their upcoming wrinkle-erasing eMatrix RF device a few times, most recently here (which Dr. G is involved in researching at SLSS in NY/NJ).

The latest word is that they're buying out one of their counterparts in the aesthetic RF market, a company called Primaeva which is developing its own device (which Dr. G is ALSO involved in researching.)

We are conducting research on both and are excited about the possibilities.

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Evolence manufacturer to be sold by Johnson & Johnson?

According to Israel's Globes Business Daily (via Colin Stewart's In Your Face blog), Johnson & Johnson is looking to sell Colbar, which manufactures the collagen-based filler Evolence.

From the blog post:
"J & J purchased ColBar for $159 million in late 2006 and now wants to shut it down or sell it for $20 million, Globes said...

There are several reasons for this. First, Johnson & Johnson does not specialize in aesthetic products, so its sales network, known as a powerhouse in other fields, is weaker in this one. Secondly, competition in the wrinkle removal market is fierce and steadily intensifying."

Too bad for the company, because we like the product and offer it at SMAC in Boca Raton and at Skin and Laser Surgery Specialists of NY/NJ; it's excellent for marionnette lines. I also hear that Evolence Breeze (a spinoff product) is excellent for upper lip lines, which is hard with other fillers.

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Zeltiq Treatment Diary

We finally received our Zeltiq device and had it installed last week. This has been previously covered on our blog, and Dr. Goldberg was one of the original investigators in their FDA trial.

Basically, the device cools fat and causes fat cell death without skin, muscle or nerve injury. The best areas to treat are the lower abdomen, love handles and back. Of course I tried the device! Ulthera last week, Zeltiq this week. Here's what happened:

Dr. Wagner marked the area on my lower abdomen to be treated.

We then applied the contact sheet on my lower abdomen and fired up the Zeltiq device. While standing the suction applicator was placed on the left side of my lower abdomen and the whole area was sucked into the area between the chilling plates. It didn't hurt - I just felt the suction.

Then I reclined in the exam chair with a pillow behind my back and one on my legs. Dr. Wagner turned on the cycle and the machine began cooling my fat.

Felt a little strange but minimal discomfort... I'd rate it 1-2 out of 10. After 5 minutes, as the fat cooled, I felt nothing. The cycle lasted one hour with a little massage segment built in at the 30 minute mark. I spent the time on the phone and on my laptop cleaning up the 150 emails from the weekend.

After one hour they removed the device. The skin on my lower abdomen was a bit puffy as it was sucked into the device for an hour, and my skin was cold! I went to get some lunch and then repeated on the right side of my lower abdomen, for two cycles. I spent another two hours working, then hit the gym.

By the time I got to the gym the area was normal temperature, a little numb and a little swollen, so I did back and cardio just like any other day. No additional discomfort by having my lower abdomen treated.

My take? It's easy! I could do this every week... the only problem is you have to wait 90 days for the result.

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Wrapup from Quality Medical Publishing Meeting

I just attended and presented at the QMP meeting last weekend in lovely and not too cold yet Chicago. For those of you who don't know QMP - they are a publishing house specializing in plastic surgery and dermatology books.

Karen Berger is the owner and she is a dynamo! I have written a number of chapters on lasers, anti-aging medicine and business for some of her recent books. Helped by her family, she runs an unbelievable aesthetic meeting.

This year marked their 5th meeting and it was excellent. I gave a master class on lasers including vascular, hair, ipl and resurfacing and then gave a second talk on non-surgical fat removal, cellulite and skin tightening. Of course, I mentioned my favorite and new toys including Sciton laser resurfacing and profractional, Zeltiq, Ultrashape, Liposonix, Invasix and of Ulthera.

That's me playing with the Keller funnel - a tool we use to help place silicone implants. In fact, I ended up investing in the company!

There were some fantastic lectures and I learned quite a bit. Syd Coleman from New York presented on fat grafting and stem cells and showed that some of the removed fat has higher stem cells counts than others. Bill Little from Washington, DC gave an excellent series of lectures on facial rejuvenation.

In particular the results of his combination of fat grafting to the lower eyelids with muscle hitch and laser resurfacing were truly phenomenal. His beautiful wife Cathy was there but more importantly i got to meet Emily - their yorkie who spent some time with us in the hotel bar feasting on filet mignon.

Mark Codner from Atlanta gave a wonderful overview of eyelid anatomy, and Glen Jelks from New York spoke from his long term eyelid experience. Joel Feldman from Boston taught me some neck tricks. He does a fair amount of men and ends up with movie star-esque jawlines.

Elizabeth Hall-Findley from Canada, Dennis Hammond from Grand Rapids and Tino Mendieta from Miami presented beautiful results of breast augmentation, lifts and reductions.

Al Aly from Iowa as always showed fantastic body contouring photos. Alex Verpaele from Belgium was there and showed updates to the MACS lift - the best part about seeing Alex besides his company at dinner was that he invited me to Belgium in June. Faculty dinner at a castle! We cant wait!

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Guess Who Tried Ulthera first in Boca Raton?

It's Ulthera, Ulthera, Ulthera here at SMAC. We were delivered the first Ulthera device for commercial use today.

We've blogged about it before; in a nutshell it is the absolute latest cosmetic technology that uses ultrasound to both a) visualize the layers of skin and tissue and 2) tighten the very same skin and deeper tissue.

On January 14, for example, we wrote that, "This revolutionary device has the potential to upend the non-surgical facial rejuvenation market." So we're excited.

We treated three patients for lower face and neck (off-label of course) as it is only FDA approved for eyebrow elevation at this time. We treated Cheryl(our aesthetician), Dr. Kushner (our anesthesiologist) and me! I have been waiting for Ulthera for three years - I was not going to have another day go by(Wait until next week for my zeltiq use!).

So is a non-surgical facelift a reality? - it will take a few months to find out.

My impressions - minimal to moderate pain. I used no pain meds or anesthesia.

You can see the video right here:



I would call it in some areas 4/10, most 2/10 for pain (Overshare: my kidney stone 2 weeks ago was 10/10). Some may need some Vicodin if you have a low pain threshold.

Took about 30 minutes - it was a first time treatment by Dr. Schwedelson - our new dermatologist.

Krystie - our pa - did the other 2 patients. A little red around eyes but no redness or marks anywhere else on the face. I went right back to seeing patients with none the wiser and went right out to dinner that night. My wife thinks there was a little initial tightening.

It really takes 90 days to see final results but based on today i will take a little Motrin and repeat before 90 days. I don't think I can wait that long for another treatment!

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Human trials announced for upcoming filler; it's activated by light

Plastic Surgery Practice recently reported on Kythera's upcoming filler, which is currently titled "ATX-104."

Kythera’s recent announcement of their light activation process of wrinkle fillers represents the logical next step in non-invasive facial contouring. At the present time, physician injectors inject wrinkle fillers into the skin and with that the technique ends.

Once the filler is injected into the skin there is very little that can be done to modify that treatment. Because of this, patients do the best with expert injectors who have years of experience. Kythera’s process will allow us to modulate, with light sources, the filler even after it is injected into the skin. The will allow for even better contouring then we are currently able to achieve. This process also marries the exciting laser/light developments of the past 2 decades with today’s wrinkle filler treatments.

Kythera is a leader in the area of new innovative non-invasive treatments. We are currently involved in FDA trials of their fat melting substance – deoxycholate. Companies such as Kythera are leading us into the next generation of cosmetic treatments. What remains unknown is when these treatments will receive FDA approval.

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

CNN: Robots are the future?

CNN.com recently covered the variety of new robotic technologies that have trickled out since the debut of the "Da Vinci" system in 1991.

"We are trying to produce complex machines to replace surgical tools, which are hand tools. It's like when industry moved from a chisel and hammer to machine tools."
That analogy is fitting in that many of our current surgical tools are more technology dependent these days.

For example, any of our laser technology, as well as Ultrashape, Ulthera, and Zeltiq, all have highly-sophisticated readouts and calibrations that are performed with a computer, as well as varying handpieces that have to be swapped out manually to achieve the desired result for a patient.

I can foresee a day where I will sit in an adjacent room and have robots do all the work!

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Radiofrequency devices challenging laser resurfacing

Laser resurfacing has, for over a decade, been the best way of treating wrinkled aging skin. Ten years ago, the procedure was messy: 10 days of oozing and bleeding was a common problem.

Today, fractional lasers like Solta’s Fraxel Repair and Sciton’s ProFractional have led to great results and a much quicker healing time. Lasers produce their greatest effect on the surface of the skin; the effect lessens as the laser penetrates deeper into the skin. This approach is now being challenged by Syneron with its new eMatrix radiofrequency device.

The eMatrix is also a fractional wrinkle erasing device. However, unlike lasers, radiofrequency devices produce a greater effect in the deeper layers of the skin- where the wrinkles are. We are doing some of the major research on the revolutionary new Syneron eMatrix device. With the economy improving, and more people seeking non-invasive cosmetic treatments, eMatrix represents an exciting new way to deal with aging skin.

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Syneron-Candela Merger aftermath

This past week Syneron, a leader in the laser business, purchased and merged with Candela another titan in the laser industry. Although on the surface this is simply another merger, to those of us who have been practicing laser medicine and surgery, this is no small marriage. Candela for all intensive purposes put today’s laser technology on the map. The Candela pulsed dye laser, developed twenty-five years ago, remains the gold standard for the treatment of children’s portwine stains. This company also manufactures quality devices for laser hair removal, acne treatments and a variety of other skin problems.

Syneron is chaired by the founder (Shimon Eckhouse) of today’s intense pulsed light (IPL) technology. If Candela began the current era of laser technology, Mr. Eckhouse is directly responsible for the currently used hundreds of thousands of IPL devices. Syneron has now also combined radiofrequency and light based technologies as well as developed exciting new radiofrequency based devices.

The merger of Candela and Syneron represents a marriage of the greatness of the past in laser technology with the present in light based devices. The future for both physicians and patients will only be bettered by this union.

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Ulthera in action

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Ulthera approved by the FDA

Ulthera has been a hot topic on our blog and is a technology that we've been tracking for a long time. I'll quote our post on this in November of last year:

"They have some major ultrasound patents that they are using to combine facial imaging and tightening into one package. First, they use the ultrasound handpiece to create a sonogram looking into the patient's skin and everything underneath. After reviewing that information, the same handpiece can be adjusted to send low levels of heat energy to a precise depth below the outer layers of the face.

The energy causes to tighten, and then grow new collagen over time. Pending FDA approval, this could be really good for the "SMAS" (i.e. the facial suspension system of the face that is targeted by traditional facelifts), the sub-skin muscular layer, and also the neck."

Stay tuned, we're getting this machine soon and I'm volunteering to be its first patient! We will post live on Twitter and upload pictures weekly to show my progress.

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Nanosheets could be a game changer one day

From Plastic Surgery Practice:

"In an initial report on the fabrication of free-standing nanosheets for biomedical applications, scientists at Tokyo's Waseda University in Japan have developed a biodegradable thin film of only about 20 nanometers thickness that could replace surgical stitches.

With collaboration from the National Defense Medical College, the Japanese researchers published its findings in the journal Advanced Materials. "This approach would constitute an ideal candidate for an alternative to conventional suture/ligation procedures, from the perspective not only of a minimally invasive surgical technique but also reduction of operation times," says Shinji Takeoka, a professor in the Department of Life Science and Medical Bioscience at Waseda University."

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

The future of plastic surgery and dermatology: why we bank stem cells

A Scientific American article on a recent study published by the Proceedings for the National Academy of Sciences found that it is possible to use fat, usually obtained via liposuction, to obtain pluripotent fat cells.

In English: the traditional way of getting stem cells is to scrape skin cells, mess with their internal clocks for a few weeks, and then get some of them to be usable. If you're using liposuctioned fat, you have stem cells that are ready to go.

Stem cells have many exciting possibly future applications in cosmetic surgery. More research is required for them to be reliably used, but some of our patients are already banking their stem cells from liposuction by freezing them at a facility, so if they need them someday, they are ready to go.

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Five Continents Congress Kickoff

This week, Dr. Pozner and I will be attending the first ever 5 Continents Congress of Laser and Aesthetic Medicine in Nice – in the heart of the French Riviera. The meeting was the brainstorm of 7 cosmetic dermatologists from around the world.

The meeting originators included aesthetic physicians from Switzerland, Germany, Belgium, Israel, Hong Kong and the US. The 2 United States organizing physicians are Dr. Michael Gold from Nashville, TN and me.

The 7 of us realized that no one country dominates the field of non-surgical cosmetic medicine. Both our attendees and faculty come from all 5 continents – thus the name 5 Continents Congress. The cross fertilization of ideas will educate all of us and lead to even better treatments for our patients.

The meeting will last 3 days and will cover body sculpting, fat melting, facial rejuvenation, laser liposuction, wrinkle fillers and botulinum treatments. New technologies and controversies will represent a large part of the meeting. Techniques not yet available in the US will be a significant part of the meeting. On the agenda will be new fillers such as Voluma and botulinum toxins such as Dysport and Xeomin. Stay tuned for more information as the meeting evolves.

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

WSJ on glut of med-spa lawsuits

The Wall Street Journal Law Blog recently posted on the latest trend in cosmetic surgery: a spike in lawsuits regarding laser hair removal.

This quote comes from the National Law Review, which the WSJ referenced in the article:

"While most states require that a doctor supervise such procedures, lawyers say it’s not happening. Some states, including Florida, New York and Illinois, are considering legislation that would more tightly regulate medical spas. In the meantime, medi-spa claims are showing up on dockets around the country.'

And plaintiffs’ lawyers say that that’s part of the problem. “No one really regulates them. I think that’s part of the problem,” says Thomas Boleky of Beutel Hurst Boleky, a personal injury firm in Chicago."

This trend only applies to both the chains and mom and pop operations that have sprung up across the country; no supervision from doctors equals lots of problems. The regulations vary from state to state as to who can run the machines.

This is not a problem at SMAC: we literally wrote the book on some of these procedures.

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Government pushing for truth in celebrity endorsements?

It was recently reported that Oprah and Dr. Memhet Oz are going after opportunistic Acai berry marketers, who parlayed them discussing the product on their show into putting their faces and "AS SEEN ON OPRAH" into their advertising materials.

As you can see in the video above, the government is also becoming concerned with celebrity endorsements, by attempting to verify if the celebrities actually use the product.

The top example of this trend in our field is Virginia Madsen, the 45 year old actress who made waves in 2007 by becoming a spokeswoman for Allergan's Botox product. She says she only has had the product injected "sparingly" but Allergan has yet to produce a before/after picture.

On the other hand, they have been far more forthcoming with spokeswoman Brooke Shields' Latisse use:

Brooke's Gallery | See the Before & After images of Brooke Shields on LATISSE®

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Why armpit botox is popular

The NY Daily News put up a slideshow of 17 celebrities who were caught on camera sporting sweaty armpits.

Dr. G, in his February interview with the blog Stylelist, said that when big events like the Oscars are coming up, movie stars flock for armpit Botox to prevent this situation in their biggest moments.

No one is perfect all the time, and that includes celebrities. And for us "normal" people, there is no shame in buying some peace of mind against the horrors of giant pit stains. Not everyone has Jennifer Lopez to console them!

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Interview with Gretchen Rossi of Real Housewives

Dermatologist Dr. Michael Gold of Tennessee and I were recently interviewed by Gretchen Rossi, a star of Bravo's hit show Real Housewives of Orange County.

When she isn't on the show, she's working on an interesting site called The Gretchen Project, which "follows her through her pursuit of beauty." The site aims to educate her fans and general consumers on medical/beauty topics via interviews with doctors and other experts.

The topic of our interview was the upcoming “Lasers and Aesthetic Medicine on 5 Continents“ Congress, a 3 day international conference held in Nice. Dr. Gold and I are members of its scientific committee.

The interview is here.

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Breasts: Downsize or Upgrade?

According to blog The Frisky, the trend in Hollywood is breast reduction or downsizing to modest implants.

We haven't really seen this trend in South Florida. Most of the time, the prevailing wish is "higher and bigger."

Another trend is that we often see women after a reduction getting implants, especially in cases where there was a reduction as a late teen followed by having kids.

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Lipstick down, Botox Up.

Dubai newspaper The National is saying that American lipstick sales are going down, while Botox and Restylane are on the way up. This is in contrast to the former prevailing wisdom that lipstick sales boom during recessions, while supposed luxuries like cosmetic surgery wane.

From the article:

"But this time around, that is not happening. In 2008 annual lipstick sales actually dropped five per cent, according to Inside Cosmeceuticals, which tracks cosmetics purchases in the US and UK.

Now, it seems, Americans – both men and women – are splurging on a more modern luxury: cosmetic injections.

The American Society of Plastic Surgeons reports that surgical cosmetic procedures like nose jobs and tummy tucks dropped off nine per cent from 2007 to 2008. However minimally invasive procedures such as Botox, which eases wrinkles, and Restylane, which puffs up sagging skin, are up more than five per cent."

Thanks for reading,

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Sculptra FDA-approved for cosmetic use

Sculptra (aka Poly L Lactic Acid) has been around for a few years as an FDA-approved solution to facial atrophy. Many doctors, us included, have either used or read extensively about its use off-label for cosmetic applications, as it is an appealing filler that can last over two years in some cases.

What's unique about it is that, as this Early Show interview yesterday on CBS confirms, the filler actually attracts your body's natural collagen to help maintain the new structure that is being built in the face.

We have been very excited about Sculptra for a long time and covered it in the past here, here, and here.

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Don't worry about Vitamin D when it comes to sunscreen

There has been somewhat of a chorus in the last 20 years in the world of dermatology and skincare that sunscreen use has a downside of diminishing Vitamin D production.

For example, a 1988 article in the Archives of Dermatology claimed that long-term or "chronic" use of sunscreen caused low body stores of Vitamin D in test subjects.

A February article in the NY Times by Anahad O'Connor followed up on this, citing a 1995 study from Australia that said that "normal" or flawed sunscreen use by regular users usually allows enough sunlight exposure for adequate Vitamin D production.

The latest affirmation of this view came in yesterday's edition of the British Journal of Dermatology. Mary Norval and H.C. Wulf of the University of Edinburgh Medical School, which said that the alarming studies of the past were borne of "very strictly controlled conditions."

So there's still no excuse not to use sunscreen. We recently were published in the West Boca Forum with an article imploring people to use sunscreen and use it often, so they don't have to come see us later!

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Something lighthearted for Friday...

Californian Senator Lynn Meriweather proposed a bill recently in Washington DC called the Hold Surgeons Accountable Act. Crafted to fight the rise of unlicensed plastic surgeons, she seems to have a bit of a personal stake in it.

I've never heard of a Dr. Teddy Rolex in Maryland though. Good job by the Onion.


Congresswoman Says Botched Plastic Surgery Most Important Issue Facing U.S.

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Link: Migraines mitigated by forehead lifts

From friend and colleague Bahman Guyoron in Cleveland [CNN]:
"Other migraine treatments either temporarily prevent the symptoms or they may reduce the symptoms after the migraine headaches start," says Bahman Guyuron, M.D., a professor and the chair of the department of plastic surgery at the University Hospitals of Cleveland and Case Western Reserve University. "What we are offering is essentially a cure."

In a study published in Plastic and Reconstructive Surgery, Guyuron and colleagues looked for people who had migraines that started in a specific region on the front, side, or back of the head. The researchers injected Botox into these trigger points to temporarily paralyze the muscle; if the injections helped relieve the migraines, the patients were randomly divided into two surgical groups.

After the Botox wore off, one group had a face-lifting surgery combined with the removal of muscle tissue or nerves in the area that triggered the migraines. Fat or muscle was used to fill in the area after tissue was removed.

The second group had a sham procedure, in which incisions were made but all muscles and nerves remained intact. A total of 75 patients were involved in the study.

In the year after the procedure, 57 percent of those who had the actual surgery reported the complete elimination of migraine headaches, compared with just 4 percent in the sham surgery group. In addition, 84 percent of those who had the surgery reported at least a 50 percent reduction in migraine pain compared with just 58 percent in the sham group."

Thanks for reading,

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

New botulinum based filler on the way

Plastic Surgery Practice is reporting today that a "next generation" neurotoxin based on Botulinum toxin type A is on the way, via an agreement between Medicis Corporation and Revance Therapeutics.


"Under the terms of the agreement, Medicis will pay Revance $10 million at signing, as well as milestone payments totaling approximately $94 million upon successful completion of certain clinical, regulatory, and commercial milestones; and a royalty based on sales and supply price, the total of which is equivalent to a double-digit percentage of net sales."

The terms of the agreement indicate that nothing will begin happening with this until 2010.

Thanks for reading,

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton