Video: Allergan CEO on Botox Sales during bad economy

Courtesy of TheStreet.com

Yet another Botox competitor coming: Xeomin

An article this week on Modern Medicine's website had a rundown of Botox's upcoming competitors.  It had two that have been mentioned repeatedly over the last few months: Dysport and PurTox not far behind, but it also threw in Xeomin, which is made by a company called Merz. 

Merz is a well-respected German company.  They sell other dermatology products in the US and will be well-received when they come to the Botox market in this country... Xeomin is already available in Europe.

Here's what ConsultingRoom.com had to say about it: 

"It is widely accepted that the bacterial protein present in other products play a role as promoters of an immune reaction, resulting in a loss of effect and reduction in duration of activity. Studies show that Xeomin(r), without the complexing proteins, has the lowest content of protein of all of the available botulinum toxins and furthermore show that repeated application of Xeomin(r), even in high doses, does not induce the formation of neutralising anti-bodies.

This means that Xeomin(r) is able to provide similar results to those achievable with the other products without the risk of antibody formation, providing continual long lasting effects. This could be relevant when large doses are being used for medical indications, but many industry experts questions the relevance when this product is used for cosmetic purposes."

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

Florida Society of Dermatology and Dermatologist Surgery Meeting Wrap-up

Just attended the Florida Society of Dermatology and Dermatologic Surgery (FSDS) 2009 annual meeting in Boca Raton, Florida at the gorgeous Boca Raton Resort and Club.

Luckily this is only a few miles from our office so none of the usual trauma of getting there! I gave 3 lectures - thefirst on fractional resurfacing, the second on non-invasive fat removal including Ultrashape, Liposonix and Zeltiq), and the third on body skin tightening and cellulite with the Alma's Accent RF device.

Dr. James Spencer, president of the society, ran a wonderful meeting. There were some excellent presentations by local and visiting doctors.

Dr. William Coleman, a dermatologist from from New Orleans and editor of the prestigious Journal of Dermatologic Surgery also presented on the Ultrashape device as well as on injection lipolysis and mesotherapy.

Mark Nestor and Glynis Ablon gave excellent laser lectures on Sciton and Syneron devices.

Joel Cohen of Denver spoke about filler complications and their management and Stephen Mandy of Miami beach (I found out he was a former race car driver!) gave excellent talks on fillers and facial rejuvenation.

All in all - excellent meeting!!!!

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

Guilty Pleasure: Fake or Real plastic surgery show on E! Network

The E! network has had a new show lately that I haven't seen yet, and isn't even advertised on their website or channel, but it's called "Fake or Real."

The premise? A panel of celebrities and Dr. Robert Rey of Dr. 90210 fame judge contestants, who are trying to trick them into either thinking their looks came naturally or with the aid of cosmetic procedures.

Don't think less of Dr. Rey if he gets a few wrong; Dr. Pozner said even he can't tell if someone has had well-done plastic surgery. All the more reason to go to an expert.

Is 'Fake or Real' Fake? [Hartford Courant]

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: NYU Conference on Non-Surgical Facial Rejuvenation

Just returned from NYU, where I attended a conference on emerging technologies in plastic surgery. The focus was on non-surgical facial rejuvenation.

It was hosted by noted NY plastic surgeons Dr. Larry Bass and Nolan Karp - there was an excellent faculty including myself, noted plastic surgeon Z. Paul Lorenc and Boston plastic surgeon Brooke Seckel. Also presenting were Long Island dermatologist Jeanette Graf and NY oculoplastic surgeon Joseph Eviatar.

Many subjects were covered, from the new botox alternative Dysport to fillers, lasers and energy sources.

In particular, we performed live demontrations of Botox, Radiesse, Restylane, Juvederm, Sculptra, Sciton Profractional, micro laser peel as well as Fraxel and Palomar's new "groove" laser. I presented new technology such as Ulthera and RFAL (Invasix) facial procedures.

There was also an excellent lecture by Dr. Seckel and subsequent discussion of different wavelengths for laser liposuction.

As an aside - the faculty dinner at Greenwich Village's WD-50 restaurant was excellent!

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

Used breast implants for sale on Ebay...

Thank you to @Sarah_Schorno on Twitter for alerting me to this item on Ebay...

"This item is a PAIR of 360CC slightly used silicone GEL implants by McGhan Medical...."
This is a stunt that has been done before by a celebrity, and it seems to be more of a novelty for someone who wants to display them in their home, rather than for placing them in a breast augmentation procedure. Other, more dangerous items like DIY Juvederm and cheap, possibly fake Botox have come and gone on Ebay in recent months as well.

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

What did Manny Ramirez do with hormones?

A big shocker came in baseball this week, as it was announced that Los Angeles Dodger slugger Manny Ramirez was being suspended 50 games for testing positive for HCG in a random drug test, as well as having testosterone levels 4-10 times higher than what is normal.

"Although anti-doping experts have said HCG is commonly used to replenish testosterone after a cycle of steroids, sources close to Ramirez have suggested the HCG was prescribed to combat issues surrounding sexual performance."

Dr. Mitchell Matez is our specialist in alternative and naturopathic medicine at SMAC, and is a leading expert on bioidentical hormone therapy in Boca Raton and the country. He offered some insight into this news item, and doesn't buy the PR spin from the Ramirez camp:

"HCG (Human Chorionic Gonadotropin)is used in men to mimick the effects of LH (Luetinizing Hormone). LH is the pituitary hormone that stimulates the testicles thereby increasing testosterone production. It is mostly used by atheletes/bodybuilders/etc. to counteract the unpleasant side effects of testicular shrinkage and decreased testosterone production that is common with anabolic steroid use.

While I tend to doubt the story, it theoretically could be used as a sexual enhancer. A young healthy athlete such as Manny Ramirez would likely have a significant increase in his Testosterone levels with the use of HCG. Higher test levels yields increased libido and better
erectile function. Most likely the lack of native Testosterone production and testicular atrophy seen during and after the use of anabolic steroids played a role here, but he could actually be using this as a primary method to boost Test levels. Either way he's fried."

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center
Sanctuary Plastic Surgery

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

What is Azzalure?

Galderma, a prescription skin treatment business under the umbrella of the L'Oreal and Nestle companies in Europe, is releasing a Botox competitor called Azzalure. According to a Bloomberg report, it is expected to contribute to cutting Botox's international market share by 4%.

The article is a bit misleading because it ignores the fact that Azzalure is actually the exact same product as Dysport, which is already being sold in Europe with Ipsen. It just packaged as a different product.

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

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center
Sanctuary Plastic Surgery

Hormone replacement decreases signs of facial aging?

Dr. Bahman Guyuron, et al. had an excellent article published in April's issue of Plastic and Reconstructive Surgery. Here's a writeup of it in the LA Times' Booster Shots blog by Shari Roan.

They studied 186 pairs of identical twins at the Twins Day Festival in Twinsburg, Ohio, with questionnaires and digital images. After an independent review, they found that:

1 . Higher BMI was associated with older look in twins younger than 40 but younger look in twins over 55.
2. Older appearance in smokers.
3. Older appearance with increased sun exposure.
4. Younger appearance on hormone replacement.
5. Younger appearance with alcohol avoidance.
6. Older appearance with divorce.
7. Older appearance with antidepressant use.

Very interesting article that tells us much of what we suspected - smoking, sun damage and alcohol consumption (how much is good vs bad) are bad for aging while hormones are helpful.

Interestingly enough, hormone replacement affects serotonin levels much like antidepressants and a point may be made that lack of estrogen causes aging while a sign of lack of estrogen may be antidepressant use. This study fits in well with our philosophy at SMAC of prudent, healthy living and hormone replacement.

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center
Sanctuary Plastic Surgery

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

Forbes: Allergan CEO defends Botox from new challenger

From Forbes:

"Each of these botulinum toxins behaves in practice quite differently," Allergan Chief Executive David Pyott said in an interview with the Associated Press. "We've said for quite a while that switching from one to another is like saying 'I'm going to stop speaking English and start talking to you in German.'"

Pyott stressed that Botox and Dysport are not interchangeable because the drugs are dosed and injected differently."

Update from Dr. Goldberg, whose practice in New Jersey was one of the 80+ test sites for Dysport: "Side by side studies have already been done in Europe. The Allergan CEO is correct. There are doing differences, so they are not apples and apples. On the other hand both products work and both products work well. Doctors will need to learn the dosing differences-and they will."

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center
Sanctuary Plastic Surgery

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

Playboy: 2/3 of women prefer minimal pubic hair

In a recent issue of Playboy Magazine, readers were polled with the eternal question:

"How do you prefer a woman to keep her bikini triangle?"

Waxed bare - 40%
Landing strip - 25%
Trimmed short - 20%
"Light bush" - 9%
Natural - 6%

It's very interesting and telling that 2/3 of those polled prefer women with minimal pubic hair.

This is reflected in the strength of laser hair removal as a popular procedure. In fact, it is second only to Botox as the most popular procedure of 2008, according to statistics from the American Society of Aesthetic Plastic Surgery.

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center
Sanctuary Plastic Surgery

Dr. David J. Goldberg
Sanctuary Medical Aesthetic Center
Skin Laser and Surgery Specialists of NY/NJ
Laser Hair Removal [Amazon]

What happened in Vegas at ASAPS...

Greetings after a great meeting of the American Society for Aesthetic Plastic Surgery in Las Vegas.



The Hot Topics seminar was very interesting today. I gave a talk on Ulthera for neck tightening. It generated a lot of interest... see previous posts for more on it, but it looks like they are progressing with their technology. No word yet on FDA approval.

Dr. Michael Kulick from San Francisco presented his Eleme Smoothshapes results for cellulite. Very scientific study with 3-d vectra analysis. and it showed the best cellulite results I have ever seen.

Dr. Mark Jewell presented Liposonix and Jeffrey Kenkel presented Ultrashape data. Very good fat reduction results from both companies. Dr. Sydney Coleman presented some of the latest research on Zeltiq, which as you know from reading this blog, freezes fat to eliminate it. All of these fat reduction technologies are looking good.

Dr. Malcolm Paul presented the latest RF-assisted liposuction results with Invasix Bodytite. Very significant skin tightening! Dr. David Kung presented Bodyjet water assisted liposuction - technology looks good for fat harvest, and it's been in the media a lot for the novelty of the water.

V. Leroy Young presented an update on Juvista update; great early clinical work for this scar reduction technology. We'll be hearing more about it later on.

Dr. Louis Bucky presented on fat grafting to the breast and Dr. Coleman made some excellent comments. It looks like this procedure is getting much more established. I guess I should start doing this in Boca Raton!

Currently I have been using it for correcting some breast augmentation complications but it may be time to start using for augmentation.

Finally, Reloxin is no longer Reloxin, I guess they are going to use the European name of Dysport.

Thanks for reading,

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center
Sanctuary Plastic Surgery

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

ASAPS Meeting in Vegas

I am in Vegas, presenting on hot topics like Ulthera neck tightening, Sciton Prolipo (especially abdominal etching), and on lasers with Dr. Barry DiBernardo at the Cosmetic Medicine Symposium.

It should be a great meeting, and when I get back I will update you on the hottest items.

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center
Sanctuary Plastic Surgery