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