Cosmetic MD Nation

miraDry: The Perfect Solution, No Sweat!

2011-08-29T10:41:00.010-04:00

Excessive armpit sweating is a huge problem that has very few treatment options. Antiperspirants offer temporary, yet meager results. While Botox injections require a huge amount of product with effects lasting only six to nine months, a new treatment called miraDry could be the answer for patients suffering from hyperhydrosis. In February, the FDA approved miraDry, a new medical device that uses electromagnetic energy to disable the sweat glands. miraDry heats up and disables the sweat glands without damaging any of the surrounding tissue. Sweat glands often do not regenerate, so patients receiving treatment see a dramatic reduction in underarm sweat. Completely non-surgical, this procedure does not require surgical incisions or cuts.

miraDry promises to deliver results lasting up to 12 months. The procedure is delivered in a series of three one-hour treatments spaced three months apart. In my personal experience, patients have seen results even after one treatment. Almost any skin type can be treated.

My offices in Manhattan and Hillsborough, New Jersey are now offering this unique technique to a limited number of patients.

David J. Goldberg, M.D.

Director, Skin Laser & Surgery Specialists of NY/NJ

Chief of Dermatology

Hackensack University Medical Center

Clinical Professor of Dermatology

Director, Laser Research

Mount Sinai School of Medicine,

Clinical Professor of Dermatology

Chief, Dermatologic Surgery

UMDNJ- New Jersey Medical School

Dr. Goldberg Lectures about Bella Contour

2011-06-10T12:32:00.013-04:00

Yesterday, Dr. David Goldberg spoke to the beauty editors from all the prominent women’s magazines in the U.S. on Bella Contour, the revolutionary new painless body contour and cellulite treatment at the Waldorf Astoria Hotel in New York City.

This weekend the Aesthetic Plastic Surgery and Anti-Aging Medicine: The Next Generation meeting is taking place in the same location. The APSAM meeting covers a number of current and emerging aesthetic procedures, including anti-aging stem cell treatments, the latest in non-invasive body contouring, and facial healthy skin approaches.

David J. Goldberg, M.D.
Director, Skin Laser & Surgery Specialists of NY/NJ
Chief of Dermatology
Hackensack University Medical Center
Clinical Professor of Dermatology
Director, Laser Research
Mount Sinai School of Medicine,
Clinical Professor of Dermatology
Chief, Dermatologic Surgery
UMDNJ- New Jersey Medical School

Research: Cosmetic Procedures

2011-05-23T09:52:00.011-04:00

Research activities at Skin Laser and Surgery Specialists are going strong. We are currently evaluating the new eMatrix device from Syneron, which produces different results depending on the tip we utilize. On lighter skin we are using the machine to treat photoaging, where as for darker skin types we are using the eMatrix to tighten skin and diminish the appearance of acne scars. To provide patients with a youthful look and healthy skin we are also assessing the Viora Reaction, which combines RF energy and vacuum therapy to treat cellulite, as well as Ultherapy as a non-surgical approach to lift, firm, and tighten skin on the face. In addition, we are testing out Allergan Voluma, which is a volume filler for natural facial recontouring, as well as Medicis’ Dysport for relief from oily skin and facial flushing. Ultimately, we look forward to presenting our results next month at the Aesthetic Plastic Surgery and Anti-aging Medicine meeting at New York’s Waldorf Astoria Hotel as well as at the FACE meeting at London’s Royal College of Physicians.

Update from the American Society of Plastic Surgeons Annual Meeting

2011-05-18T15:22:00.010-04:00

Last week I attended the American Society of Plastic Surgeons Annual Meeting (ASAPS), which proved to be very exciting. Experienced doctors from across the country, including myself, lectured on various hot topics including fat grafting and the roles stem cells and acellular dermal products, such as Alloderm and Strattice, play in the procedure. My favorite talk was by Dr. Barry DiBernardo on Cellulaze, the new Cynosure device for long-term cellulite improvement. I also enjoyed Boston dermatologist Jeff Dover’s presentation on the amazing results of Bella Contour, a new body-contouring product. I had the pleasure of sharing my expertise on the skin tightening procedures Sciton, SkinTyte, and the new Ultra Shape as well as co-chairing a session on laser complications with Atlanta’s Dr. Foad Nahai. I also filmed segments for The Plastic Surgery Channel on laser resurfacing and cellulite. ASAPS further ignited my excitement for future innovation and advancements in plastic surgery. I have a number of upcoming meetings with companies interested in testing new products and am eager to see what this year holds for research.

Dr. David Goldberg Lectures at L'oreal Corporate Headquarters

2011-05-10T11:04:00.004-04:00

Last week, CosmeticMDNation Cosmetic Dermatologist, David J. Goldberg, MD, was invited to speak at L'oreals US research center in Clark, NJ. The talk was in honor of the 100 year anniversary of L'oreal's commitment to skin care. Dr. Goldberg's lecture focused on various devices used to rejuvenate the skin on the face and body. Devices discussed included Fraxel, FX, eMatrix, CoolSculpting by Zeltiq, Accent, Viora, and VelShape. The final portion of his presentation focused on the future of skin rejuvenation combining energy based treatments such as described in combination with great skin care products such as those made by L'oreal.

Relief for Migraine Sufferers Boosts Allergan’s Stock after Fed Crackdown

2010-10-21T09:38:00.003-04:00

For migraine sufferers, the recent FDA approval of Botox as a migraine treatment gives them access to the only thing that might actually work—injections of Botox.

Migraine victims have long awaited a drug that would avoid migraines, not just treat them after they start. Studies prove Botox’s ability to block nerves that cause a migraine. In one study, chronic migraine sufferers getting Botox injections had 9 fewer days of headaches per month compared with those receiving a placebo, who reported 6.7 fewer.

In another study that was funded by Allergan, Botox users reported 7.8 fewer days per month of any headaches (including migraines) compared with 6.4 days’ fewer headaches reported by those receiving the placebo injections.

Guilty Plea

Allergan had previously been ordered by the Justice Department to pay $375 million in fines for unauthorized promotion of Botox for headaches and cerebral palsy from 2000 to 2005. The fine was lowered to $350 million upon Allergan’s willingness to plead guilty to the charges. Allergan was also ordered to forfeit $25 million in assets and to stick to a 5-year mandated plan to disclose any payments to doctors and annually certify that their various divisions meet federal health care requirements.

Who can use it?

Men and women who have a migraine headache at least 15 days a month with pain lasting at least four hours qualify for treatment. It is assumed that health insurance carriers will approve this as a covered expense, since no other treatment has provided similar results. Treatment includes multiple injections around the neck and head every 3 months.

Allergan spokesperson, Caroline Van Hove, believes that insurers are unlikely to fight coverage of the drug since “this is a population that hasn’t responded to any of the conventional treatments.” Botox was cleared for migraine treatment earlier this summer in the UK and the company anticipates approvals in the rest of Europe and Canada yet this year.

Stock Market Reaction

Allergan (AGN) is running around $72 per share this month (Oct 2010). A month ago it was averaging $66 per share. The company, which generated $1.3 billion in 2009 sales, may earn $1 billion more in annual revenue with the migraine approval, said Aaron Gal, a Sanford C. Bernstein & Co. analyst in New York, in a May 2010 report.

Cranberry Juice Can Stop Staph in its Tracks!

2010-10-15T13:32:00.002-04:00

For many years, cranberry juice has been recommended to help prevent and treat urinary tract infections. Researchers have now discovered how cranberry juice works to avoid bacterial infections, such as Staphylococcus aureus (S. aureus). In urine samples collected from those who drank cranberry juice, the bacteria were not able to link together and form a film or stick to the wall of the container. This process is calld “biofilm formation.” When bacteria cannot stick together, they are more likely to be flushed out during urination instead of creating an environment for the bacteria to thrive.

The bottom line? Future studies may lead to attempts to engineer invasive medical tools such as catheters, cannulae and others to make them more bacteria-resistant.

AAFPRS: Non-Invasive Procedures Continue to Rise

2010-10-08T10:30:00.003-04:00

A recent article from the Examiner analyzed the latest plastic surgery statistics released by the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). Not unlike last year, the AAFPRS survey reported a significant increase in non-invasive treatments amongst their 2009 plastic surgery trends.

According to the AAFPRS, non-invasive cosmetic treatments rose 47% in 2009. The Examiner sites the current economic standing as an influencer in consumer behaviors. Dermal fillers and botulinum toxin A injections are growing in popularity because, even though their results are temporary, they are much more cost effective compared to invasive surgery.

Of the physicians surveyed, another 80% reported that patients were seeking non-invasive treatments as means to staying competitive in the workplace. The procedures with the largest amount of growth were as follows:
• Poly-l-lactic acid (Sculptra®)-up 71%
• Chemical peels-up 52%
• Hyaluronic acid (Juvederm®, Restylane®)-up 48%
• Botulinum toxin type A (Botox®, Dysport®)-up 45%

The majority of surgeons surveyed (77%) reported that patients are also more educated about their plastic surgery options. Patients are spending more time researching different procedures, costs, recovery time and physician qualifications before even stepping into a surgeon’s office.

The survey also found that women continue to be the majority of facial plastic surgery candidates, accounting for 84% of all non-invasive and surgical procedures.

The surgical procedures with the increases and decreases were:
• Ablative skin resurfacing (up 57%)
• Revision surgery (up 18%)
• Facelifts (up 14%)
• Lip augmentation (DOWN 52%)
• Rhinoplasty (DOWN 13%)

As we continue to see FDA approval for new products such as Xeomin and PurTox, the number of non-invasive procedures performed will surely continue to rise. New non-invasive technologies are continually being developed and put on the market.

Aesthetic Surgery Market Expected to Double by 2017

2010-10-05T14:23:00.003-04:00

The cosmetics industry is growing, but by just how much? According to iData Research, a Vancouver-based pharmaceutical market research firm, the market for facial aesthetics, lasers and cosmetic surgery is expected to double—exceeding $3 billion by 2017.

The U.S. market for facial injectables is currently worth almost $860 million. The expected introduction of new injectables—such as Mentor’s PurTox and Merz's Xeomin—as well as their increasing therapeutic uses will contribute to market growth.

“A growing number of doctors are looking at the therapeutic potential of botulinum A. There are more cosmetic procedures performed using botulinum A than therapeutic; however, therapeutic procedures use higher doses of the drug, therefore these two markets are similar in value,” says Kamran Zamanian, Ph.D., iData CEO.

The iData report predicts that the value of the botulinum toxin A market segment alone will reach $543 million within seven years. Cosmetic Surgery Times also cited laser skin resurfacing, hair removal and lipolysis as the fastest-growing market segments.

Perhaps the FDA approval of new devices, such as Zeltiq, (and hopefully Ultrashape and Liposonix) will help the market meet or even exceed these predictions. I supposed we will have to wait seven years to see!

In UK, Regaining Pre-Baby Body Is A Priority

2010-09-16T15:29:00.005-04:00

Immediately following childbirth, it is hard for a woman to regain her pre-baby body. Child bearing can lead to sagging skin, stretch marks, weight gain, cellulite and drooping breast. A new survey conducted by British TV show My Face My Body reveals that 39% of UK women would consider a ‘mommy makeover’ procedure after having children.

The researchers interviewed 326 women and found the top body concerns for women post-pregnancy to be:

Weight-34%
Stretch Marks-24%
Loose Skin-21%
Cellulite-14%
Sagging Breasts-7%

An overwhelming 93% of women admitted that reclaiming their pre-baby body was a priority to them, regardless of whether or not their partner shared their concerns. Of the men interviewed, 71% said they didn’t care about their partner gaining weight after childbirth. On the contrary, 67% of women feared their partners would not find them attractive post-baby.

"While most women enjoy being pregnant and the changes it brings to their bodies, many are concerned about these changes, such as weight gain and stretch marks, becoming permanent,” said My Face My Body presenter Stephen Handisides.

The survey also found that 57% of women would undergo a cosmetic procedure while they were still in the hospital following labor. For a mother who is considering plastic surgery, I urge you to wait at least six months following childbirth to allow the body to heal properly.

For women who are considering plastic surgery as a way to regain their body following pregnancy, the ‘mommy makeover’ is a popular option. The ‘mommy makeover’ can be any combination of procedures including liposuction, abdominoplasty, breast lift, reduction or augmentation.

In our Florida office we see many 'mommy makeovers', with breast surgery, especially breast lifts with implants, being the most popular. The difference in the popularity of aesthetic breast surgery in the U.S. and U.K. may be due to national trends, or even regional trends for South Florida.

Allergan to Pay Over $600 Million Settlement

2010-09-14T13:14:00.004-04:00

Allergan, the maker of Botox®, is being forced to pay over $600 million following a civil settlement and charges that marketed the popular drug for off-label purposes. According to the New York Times, Allergan was marketing Botox®—which is currently used to treat wrinkles and hyperhidrosis—for the off-label treatment of migraines.

Botox® is currently not approved by the Food and Drug Administration for the treatment of migraines. The issue was not that Botox® was being used to treat migraines; it was that doctors were receiving incentives from Allergan if they actively promoted the headache treatment to their patients. The Justice Department issued this statement:

“In 2003, Allergan doubled the size of its reimbursement team to assist doctors in obtaining payment for off-label Botox® injections. Allergan held workshops to teach doctors and their office staffs how to bill for off-label uses, conducted detailed audits of doctors’ billing records to demonstrate how they could make money by injecting Botox®, and operated the Botox® Reimbursement Hotline, which provided a wide array of free on-demand services to doctors for off-label uses. Allergan also lobbied government health care programs to expand coverage for off-label uses, directed physician workshops and dinners focused on off-label uses, paid doctors to attend “advisory boards” promoting off-label uses, and created a purportedly independent online neurotoxin education organization to stimulate increased use of Botox® for off-label indications.”

Allergan, based in Irvine, CA, admitted to marketing unapproved uses of Botox®—including treatment of headaches and blepharospasm—between 2000 and 2005. The company agreed to pay $225 million to resolve civil charges that it endorsed falls Medicare and Medicaid claims, however, they denied liability. The company is schedule to pay between $610-$615 million in the third quarter of 2010, nearly half of Botox®’s $1.3 billion from last year.

Botox® was originally approved by the FDA in 1989 for the treatment in hyperhidrosis and then again in 2002 for wrinkle reduction. There is still concern as to whether or not the settlement will have an effect on the FDA’s decision on whether or not to approve Botox® for migraine treatment. The FDA’s decision is due to be announced at the end of October.

Could Invisible Bra Set Off New Trend?

2010-09-13T14:06:00.003-04:00

Cosmetically, women can achieve the appearance of perkier breasts through breast augmentation or breast lifts. A new product, which guarantees a long-term boost, may be something to watch out for.

Breform™ surgical breast support is a new system termed as the “invisible bra”. A polyester mesh material is inserted through surgically under the skin. Breform™ is placed under the epidermis of the breast and stitched to the layer of fat above the breast tissue.

The material, which is cone-shaped, looks like a bra and can enhance the shape of the breast without undergoing surgery. Reportedly, Breform™ feels completely natural and cannot be felt through the breast skin.

Breform™ is inserted under the skin via an incision around the nipple with the assistance of general anesthesia. Just as with any surgery around the nipple, there is the possibility of loss of sensation. Breform™ claims that any lost nipple sensation, however, should return within six months following insertion.

TopNews.co.uk reports that a Breform™ procedure, which is manufactured by Aspide Médical in St Etienne, France, costs and average of 5,900GPD—or $9,100. While Breform™ can be used as an alternative to breast reduction in certain patients; the benefits of the product can also be reaped if used in conjunction with augmentation and reduction.

So what is our take on the invisible bra? Breform™ may be beneficial to ensure optimum results and prevent future sagging in patients who have undergone breast augmentation or reduction. By itself, however, Breform™ does not seem to be worth the investment. Breform™ is currently only available in parts of Europe and Asia, however, it has already received national media attention in the U.S.

Botox® Efficacy Enhanced By Oral Supplements

2010-09-09T14:52:00.000-04:00

According to recent research conducted by Charles Soparkar, M.D., Ph.D., F.A.C.S., a dietary supplement that combines zinc and phytase increases the effectiveness of Botox® Cosmetic on patients. Plastic Surgery Practice reports that the supplement, trademarked as ZYTAZE™, is patent-pending and may be available to patients as early as this month.

The study analyzed 44 patients who had taken the oral supplements prior to being injected with botulinum toxin (Botox®, Dysport®, or Myobloc®). Forty-one of the 44 patients showed noticeable results. Multiple subjects were being treated for blepharospasm, or eyelid spasms, and had previously responded poorly to the injections.

Soparkar and his team will present the findings at the American Society of Ophthalmic Plastic & Reconstructive Surgery’s 41st Annual Fall Scientific Symposium in Chicago on October 14, 2010.

"Surprisingly, the results showed that in over 90% of the patients studied, the zinc/phytase combination resulted in a remarkable improved responsiveness to treatment of blepharospasm using the same amount of botulinum toxin as previously used," Soparkar told Plastic Surgery Practice.

"The toxins seemed to have greater effect and last longer. Potentially, this could mean using less toxin, offering patients financial savings, greater safety, and more consistent results."

Perhaps future findings will prove that the natural inclusion of diets rich in phytase and zinc can also improve the results of botulinum toxin injections. Pythase can currently be found in many grains and oil seeds, while foods like oysters and wheat germ are great sources of zinc.

Zeltiq Gets FDA Approval for Fat Reduction

2010-09-08T14:40:00.003-04:00

Today, CoolSculpting by Zeltiq received FDA approval for non-invasive fat reduction. CoolSculpting uses cryolipolysis technology to virtually freeze fat away.

According to the company, CoolSculpting by Zeltiq results in a 20% fat reduction in the treated areas on patients. Results can typically be first seen three weeks following the treatment with maximum results seen over the course of two to four months. The treatment usually takes 1-2 hours and can be repeated over time for more pronounced results.

Prior to the approval of CoolSculpting, there had been a gap in the body sculpting market for a non-invasive fat reduction method that involves no needles and no downtime. By targeting the underlying fat, CoolSculpting leaves the skin tissue intact and unaffected.

The Skin Laser & Surgery Specialists of New York and New Jersey and the Sanctuary Medical Aesthetic Center in Boca Raton, FL, are home to CoolSculpting by Zeltiq. For more information, feel free to contact our offices with any questions or concerns you may have about CoolSculpting by Zeltiq.

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 Your Diet Prevent Skin Cancer?

2010-09-07T13:20:00.004-04:00

Using sunscreen and avoiding sun exposure are two things we stress at our office in Boca Raton. However, living under the hot Florida sun doesn’t make it easy to avoid UVB rays. The good news is that a recent study has found a diet that can help protect against skin cancer.

Dr. Niva Shapira of Tal Aviv University’s School of Health Professions recently contributed to a study published in Nutrition Reviews that found a diet rich in omega-3 fatty acids and anti-oxidants can prevent sun cancer. By penetrating the skin and causing photo-oxidation, sun exposure damages both the immune system and the skin. The Mediterranean diet—which contains foods such as yogurt, fish, and olive oil—is said to fight the oxidizing effects of the sun.

During the study, Dr. Shapira dn Professor Bodo Kuklinski of Rostock University gave two groups of subjects two different beverages to drink: soda and a drink high in antioxidants. The two groups were then exposed to the sun 5-6 hours daily for a period of two weeks.

At the end of the two weeks, the group who drank the antioxidant beverage had fifty percent few oxidation products in the blood than the group who drank soda. The study also found that antioxidants such as carotenoids delay tissue damage that can lead to skin cancer.

According to Dr. Shapira, this information is imperative as free radicals and other environmental factors are now limiting the effects of sunscreen. While avoiding sun exposure is the best advice, it is impossible to do. By combining the use of sunscreen, an antioxidant diet and protective clothing you are promoting skin health.

While omega-3 fatty acids and antioxidants can be found as supplements, altering your diet to naturally contain these nutrients is the most effective way to reap the benefits.

"In foods, many vitamins and various antioxidants and bioactive ingredients work to support one another and the body's natural protective mechanisms. Synergies between the nutrients in your food, which make a significant contribution to health, may contrast with the relative isolation of a vitamin supplement,” says Dr. Shapira

Following this study, the Israeli Cancer Association included nutritional information as part of the “Smart in the Sun” advisories for the first time this year.

Some foods to avoid include red meat, alcohol, and processed food. Photosensitizing foods, which include parsley, cilantro, figs, dill and celery, can increase the damage done by the sun. Visit the Mayo Clinic’s webpage dedicated to the Mediterranean diet for more information on what suggested foods to eat.

Appointment-Booking Site Gets Big Investments, Has Drawbacks

2010-08-25T15:43:00.003-04:00

CNET recently reported some new information about a New York-based start-up called ZocDoc. ZocDoc is an online doctor and dentist appointment-booking site that allows consumers to schedule visits based on time, specialty, location, and insurance coverage—at not extra charge. ZocDoc is looking to expand its service area with a $15 million Series B venture round led by the Founders Fund along with
contributions from Khosla Ventures.

Currently, ZocDoc only services the New York, San Francisco, Washington, D.C., and Chicago metropolitan areas. The website is currently promoting a user vote to choose what their fifth city should be from different options including Boston, Philadelphia, Seattle and Los Angeles.

Expanding won’t be easy, however. The staff at ZocDoc will have to aggregate new doctors and advertisers, set up medical profiles that are customized to the existing search criteria and enable users to book appointments online. Considering this service is free for patients, positive feedback from doctors and advertisers is required to make the expansion a success.

ZocDoc’s ambitions have grabbed the attention of some big names in eCommerce. Their first round of investors included Salesforce CEO Mark Benioff as well as Bezos Expeditions—the firm run by Amazon.com CEO Jeff Bezos. Khosla Ventures, who is investing for their second time
around, is run by Sun Microsystems founder Vinod Khosla. Khosla has been focusing a lot of attention lately on health care and clean technology.

The Founders Fund is another heavy hitter, with its principals including PayPal co-founder Peter Thiel and Napster co-founder, as well as Facebook, Inc. president, Sean Parker.

ZocDoc certainly has its benefits: book appointments from home, see doctor reviews, weeding out doctors by insurance plans accepted. However, how will this affect the plastic surgery industry if ever implemented? The ease of online booking might supersede the importance of having the patient discuss with with a patient coordinator prior to an in-office consultation. Deciding to undergo plastic surgery is a very personal decision, and taking the first step by book a consultation online is not the ideal way to go about it.

Body Contouring Market Trends 2009-2013

2010-08-25T12:23:00.001-04:00

With rising rates of obesity, particularly in the U.S., North America will see a surge of interest in the body contouring market over the next few years. As the demand for body contouring devices increases, more plastic surgeons will adopt these technologies into their offices.

BusinessWire.com predicted the upcoming trends in the body contouring market from 2009 until 2013. With new and existing companies delving into new innovations, such as laser-assisted liposuction (LAL) and cryolipolysis, there will be a higher frequency of body contouring devices available to consumers.

The recession will, however, have a slight impact on the body contouring market growth. With a reduction in disposable incomes, patients will forego or postpone these elective procedures as a way to conserve cash. This will cause many surgeons to have a limited amount of revenue to invest these new devices that can cost upwards of $100,000.

While there was a decline in device sales from 2008 to 2009, Millennium Research Group assumes there will be an economic revival recorded for early 2010.

Cynosure launched SmartLipo MPX in the U.S. and Canada during the second quarter of 2008. SmartLipo MPX was the first dual-wavelength LAL device available in the market. Another big launch in the end of 2009 was CoolTouch’s CoolLipo, Palomar Medical Technologies' SlimLipo, Syneron's LipoLite, Elem Medical’s SmoothLipo and Sciton's ProLipo PLUS.

In addition, UltraShape’s Contour 1 was the first transdermal ultrasound device available in Canada. In 2009, Medicis received Health Canada approval for LipoSonix, which has had difficulty getting FDA approval. When transdermal ultrasound devices become available in the U.S., perhaps they will grab a hold of the body contouring market. Zeltiq cryolipolysis device has been available for off label fat removal since last summer. In many practices (including ours) it has taken off and provides consistent, safe non-surgical fat removal.

Furthermore, growing obesity rates and the more desirable results from body contouring devices suggest that there will be considerable market growth over the next few years.

A Forecast For the North American Facial Injectable Market

2010-08-24T07:55:00.006-04:00

Cosmetic injectables are hands down the most popular aesthetic treatment in North America. The North American facial injectable market consists of four different types of fillers: collagen, Hyaluronic acid (HA) dermal fillers, botulinum toxin (BTX), and particle and polymer filler (PPF). There is a modest growth projected for facial fillers between 2010 and 2014 based on their rising popularity and the approval of new products.

According to BusinessWire.com, the more facial filler products that are available in the future, the greater the competition will be. Companies will have to spend more time and money on creating brand awareness. This will lead to a more informed audience, which can create a whole new set of challenges for the companies who make the injectables. While the recession may hinder the growth of filler companies slightly, it is predicted that they will still remain profitable over the next few years.

The introduction of Sculptra Aesthetic and Dysport® in 2009 into the PPF and BTX markets created new competition for Botox® Cosmetic. While Botox® remains the king of the throne, the “Dysport® Challenge” helped increase the popularity of the new injectable.

It is also projected that the collagen filler market will shrink excessively in 2011 following Allergan and ColBar LifeScience’s withdraw from the market in 2010. With new products expected to gain Canadian and U.S. approval, it will be interesting to see how the market responds. New facial injectables, which can be introduced into any product segment, could theoretically affect average selling prices and heighten competition within the market.

Patients Need Less Botox® Over Time for Same Results

2010-08-16T08:47:00.002-04:00

A recent study performed by Oregon Health & Science University shows that patients can decrease the frequency of Botox® injections after approximately two years and still see similar cosmetic benefits.

The study was run by Roger A. Dailey, M.D., F.A.C.S., professor and Lester Jones Endowed Chair of oculofacial plastic surgery in the OHSU School of Medicine. "After two years of treatment at recommended intervals, patients can potentially cut the frequency, and thus the cost, of their Botox® treatments by half," said Dailey.

Dailey’s study was presented at the American Society for Aesthetic Plastic Surgery conference in Washington, D.C., on April 24. Allergan, Inc., the maker of Botox® Cosmetic, sponsored the study with an unrestricted educational grant.

The study also found Botox® to have a wrinkle-preventing—or prophylactic—effect. Patients who were administered injections between their 30s and 50s not only eliminated existing wrinkles, but also prevent new wrinkles from forming.

Previous studies suggested that patients should be injected with Botox® every three months in the glabellar region—the area between the eyebrows—to maintain a wrinkle-free appearance. According to Dailey, the frequency and cost of the treatment deterred some patients from starting or continuing a Botox® regimen.

The study monitored 50 women between the ages of 30 and 50. The women were injected regularly with Botox® over the course of two years. "We found that after the patient receives Botox© Cosmetic injections every four months for two years, the frequency of the injections can be changed to every six months and still achieve good results," said Dailey. "This demonstrates patients have the ability to achieve good results with broader treatment schedules and ultimately at a lower overall treatment cost.”

According to the American Society for Aesthetic Plastic Surgery, 2,557,068 patients underwent Botox® treatments in 2009 (257,786 of which were men). Botox® was approved by the FDA for cosmetic purposes in 2002.

Botox® Competitor Approved by FDA For Medical Use

2010-08-16T08:40:00.002-04:00

Earlier this month Merz Pharmaceuticals, a North Carolina-based company, announced the FDA approval of Xeomin® (incobotulinumtoxinA). Xeomin® is a botulinum toxin type A-based drug that is used to treat patients with blepharospasm (eye spasms) or cervical dystonia (neck spasms).

A recent epidemiology study conducted in Rochester, MN, found that focal dystonia, which includes both named conditions, affects 295 million people in the United States.

Two significant studies that were conducted on patients with cervical dystonia and blepharospasm were imperative to the FDA’s decision to approve Xeomin®. Findings from additional European studies comparing Xeomin® to Botox® were also included in the data that was submitted to the FDA.

Similar to Botox® and Dysport®, Xeomin® is injected into the muscle to control spasms from the nerve. The advantage of Xeomin® is that is allows more biological activity and it doesn’t require refrigeration to preserve its integrity.

As for right now, Xeomin® is only FDA approved for medical purposes and not cosmetic. Merz Pharmaceuticals is optimistic, however, that the drug will be approved for its secondary purposed in the future.

Hyperoxia Shown To Reduce UVB Wrinkles, Skin Thickening

2010-08-16T08:13:00.003-04:00

According to Cosmetic Surgery Times, a new study suggests that oxygen treatments (hyperoxia) could prospectively battle skin damage and wrinkles caused by ultraviolet light.

Performed by researchers at the University of Tokyo, mice were place in oxygen chambers after extensive exposure to UVB radiation. The mice who showed who were treated with hyperoxia had fewer wrinkles and less thickening of the skin than those who were not treated.

The researchers split 24 hairless mice into three groups: the control group (no UVB exposure), UVB exposure (three times a week for five weeks) without treatment, and UVB exposure (three times a week for five weeks) followed by two hours of hyperoxia after each treatment. Researchers found that both the UVB and UVB-plus-oxygen groups showed changes to their skin, however, the wrinkling and thickening in the latter group’s skin was less severe.

“Although hyperoxia may be used for humans to prevent acute UVB-induced skin damage, potential oxidative damage should be considered. … Further studies to determine the possible oxidative side effects of hyperoxia are needed before it can be applied in humans,” the researchers wrote.

These finding are critical in developing new anti-aging treatments, however, more research is needed to analyze any side effects.

Advances in Reconstructive Technology Said to Improve Function, Aesthetics

2010-07-29T08:09:00.003-04:00

Patients who have suffered facial trauma or bone loss are often faced with difficulties chewing, speaking, swallowing, or even breathing. While the aesthetics of facial reconstruction are important, the ability to restore adequate function to the face is imperative. Researchers at the University of Illinois and the Ohio State University Medical center have applied a new technique to create custom-made implants for both form and function.

Based on its design and composition, the face is by far the most complicated part of the human skeleton. According to Glaucio Paulino, the Donald Biggar Willett Professor of Engineering at University of Illinois, mid-face reconstruction is difficult due to the unique shape and functions of the bones, as well as its high exposure to bacteria through the mouth and sinuses.

Reconstructive surgeons traditionally graft bones from other parts of a patient’s body to sculpt the skull portion. Considering bone density and shape differs greatly throughout other parts of the body, patients also suffer cosmetically as well and functionally following facial reconstruction. The two universities applied an extensive type of 3-D modeling, called topology optimization, to design the custom implants. Topology optimization is primarily used to engineer skyscrapers and automobile parts, however, may become advantageous to the medical industry.

The technology helps engineers to create pieces that meet high aesthetic standards while performing at optimal levels. Topology optimization is ideal when paired with facial reconstruction, allowing engineers to develop patient-specific bone replacements with precision. The engineering process calculates different variables including blood flow, chewing forces, soft tissue support and sinus cavities.

The researchers aspire to adopt topology optimization in the future for the purpose of tissue engineering. If successful, tissue and bone can be recreated for different parts of the body that require reconstruction. Such progression in medical technology could prospectively supersede the necessity for bone grafting from a patient or cadaver.

Don't Get Mad, Get Botox®

2010-07-27T19:38:00.004-04:00

Getting rid of wrinkles is a reason for anyone to smile. A recent study found that Botox® could also improve someone’s mood simply by limiting his or her ability to frown.

The study, which was performed by researchers at the University of Wisconsin on 40 volunteers, tested how the patients reacted to emotional statements following an injection of Botox®. The subjects were asked to read messages that ranged from “angry” to “sad” to “happy”. Researchers then gauged the patient’s mood by observing how long it took to respond to each statement.

The subjects of the trial took slightly longer to respond to the negative statements following their treatment than they had before their Botox® injections. The elongated response time indicated that the brain had a harder time processing the negative emotion following the treatment.

"There is a long-standing idea in psychology called the facial feedback hypothesis Essentially, it says, when you're smiling, the whole world smiles with you. It's an old song, but it's right," says the study’s author, David Havas.

The facial feedback hypothesis, which dates back to Charles Darwin in the late 1800s, is the idea that one’s facial expressions can have an effect on emotional experience.

According to the research leader professor Arthur Glengerg, the brain would normally send signals to the facial muscles to frown, and in return the extent of the frown would be sent back to the brain. Under the influence of Botox®, the muscles in the face are weakened and the intensity of the emotion is in turn disrupted.

Botox® can also have the same effect on happiness as well. When injected into the lower part of the face, Botox® can obstruct a normal smile and in turn effect the brain’s ability to comprehend pleasure levels.

LipoSonix Not FDA Ready

2010-07-15T13:57:00.003-04:00

Streetinsider.com reported recently that the FDA issued a letter to Medicis, the maker of Dysport®, notifying the company that data presented in the 510(k) application to market the LipoSonix system was insufficient. According to the FDA, Medicis must file a new submission with additional information before LipoSonix can be marketed in the U.S.

The FDA's letter to Medicis offered guidance as to the additional information needed to obtain 510(k) clearance. Medicis plans to pursue a meeting with the FDA to present the additional data and to formulate the next steps. The letter from the FDA did not request nor highlight any missing safety data and acknowledged that the agreed primary endpoint of the clinical trial was achieved.

LipoSonix technology uses ultrasound energy to destroy fat cells without harming the skin. The destroyed fat tissue is transported to the liver where it is processed as energy. The treated fat is permanently removed, leaving the patient with a slimmer, more contoured body.

According to Medicis, the LipoSonix system is unlike body contouring technologies because it is highly targeted and has the ability to concentrate energy at specific depths of abdominal fat. By doing so, underlying tissues and non-targeted areas are not damaged.

Results are typically seen in about 8 to 12 weeks. LipoSonix is currently available in Canada, France, Germany, England and Spain.

Novabel® Pulled From Market

2010-07-15T13:46:00.002-04:00

Novabel®, a dermal shaper harvested from marine algae extract, has been taken off of the market by Merz Pharmaceuticals. The decision came after numerous patients reported temporary bruising, swelling and lumps, particularly around the under eye area.

Novabel® is currently marketed as a safe and virtually pain-free treatment with minimal side effects and results that last up to twelve months. However, due to these latest patient complaints, Merz has decided to cease production on Novabel® until they are able to re-release the product without any kinks. Biocompatibles’ CellMed branch, the developers of Novabel®, are currently working with Merz to address the problem.

"I am confident that our CellMed team will have a safe and effective technique for sensitive areas ready for evaluation in the next few weeks," said Biocompatibles’ chief executive Crispin Simon.

Novabel® differs from traditional dermal fillers like Restylane® and Juvederm® as it is not made of hyaluronic acid. Traditional fillers are likely to have more pronounced side effects in sensitive areas than Novabel®. Until the latest issues are resolved, Merz will suspend the product until they can accurately market Novabel® for it’s minimal side effects.

Novabel® was released in the U.K. in February of this year and is not yet FDA approved. With promising results expected from Novabel®, we hope that Merz will have it back on the market soon.

New Topical Cream Claims to Increase Elastin, Reduce Wrinkles

2010-06-30T08:12:00.004-04:00

For years, scientists have been researching methods to restore the skin’s elasticity, in hopes to reduce and prevent wrinkles in any skin type. Elastin, a protein in connective tissue that permits tissues in the body to resume their shape after stretching or contracting with regular movement, begins to diminish by the age of 12 or 13 when the body decreases production. As a result, the elastin fibers begin to deteriorate. This leads, over time, to the typical signs of aging, such as fine lines, wrinkles and sagging.

On Monday, Revance Therapeutics, a biopharmaceutical research company based in California, released a new product called Relastin™, the first product to clinically demonstrate an increase of elastin in the skin. It is said to restore a youthful complexion by penetrating the skin and working with the skin’s cells to promote new elastin growth.

A press release by Revance Therapeutics claims that clinical studies with Relastin ™ resulted in a visible difference in 84% of studied subjects following four weeks of testing. The new topical treatment has been shown to hydrate, tighten and smooth the skin in a manner similar to cosmetic injectables and other more invasive treatments.Relastin™ is released as Eye Silk for the under-eye area and Skin Revitalizer for all-over facial use.

Niqeuette Hunt, vice president of cosmetic and OTC products for Revance Therapeutics, is excited about the product’s release. "Relastin™ works from the inside out to foster the restoration of elastin and create a healthier, more youthful appearance,” she says. “Many products have claimed to be ‘cosmetic breakthroughs,’ but Relastin’s™ clinical studies prove remarkable effectiveness.”

According to Revance Therapeutics, clinical data shows that skin treated with the patent-pending Zinc Firming Complex™ found exclusively in Relastin™ contained more elastin than untreated skin. Following two weeks of testing, users of the product noted visible differences and experienced a decrease in dark circles, a reduction in eye puffiness and minimized fine lines and wrinkles.

If Relastin™ lives up to the claims of the clinical trials, other heavy-hitters in the cosmetic industry may have a run for their money. A topical cream that boosts elastin production would have a more permanent effect than current popular treatments for wrinkles. Rather than freezing the muscles with Botox® Cosmetic, or plumping the wrinkles with dermal fillers, Relastin™ is said to address the issue at its root. While this could be the next fountain of youth, it is important to hold out on further studies and trials to prove the product’s capabilities.

Survey Shows Growing Desire for Plastic Surgery in U.S.

2010-06-25T11:37:00.004-04:00

According to a survey done on RealSelf.com, consumer interest in plastic surgery is increasing despite the recession. The survey, which was developed by Harris Interactive®, interviewed 2,148 U.S. adults aged 18 years and older. While the American Society of Plastic Surgeons reported earlier this year that the 2009 numbers were down, the American desire to be more attractive has renewed. Harris Interactive® surveyed 2,148 adults online and 69 percent said they would choose to have cosmetic work done if money wasn't an issue. This is a 15 point ( 54%) jump from November 2009, when the survey was taken.

Of those surveyed who would get cosmetic work done, 29 percent would choose a tummy tuck, 23 percent would select liposuction, and 13 percent would opt for a face lift. According to the American Society for Aesthetic Plastic Surgery (ASAPS), the top five surgical procedures in 2009 were: liposuction, breast augmentation, blepharoplasty, rhinoplasty, and abdominoplasty. The data from both sources suggests that the desire for plastic surgery procedures is based on people preferring more sizable changes over minor nips and tucks.

The survey also reported that the three most popular cosmetic treatments desired by women are the same procedures often associated with the “Mommy Makeover”. Forty-six percent of women aged 35-44 would have an abdominoplasty if money weren't an issue. Of women aged 18-34, 34 percent would undergo a tummy tuck. Another 34% of women aged 35-44 would undergo a breast lift, and 28 percent would choose liposuction. With cosmetic surgery among men growing in popularity, 29 percent of men surveyed would undergo liposuction. The survey also recorded the cosmetic procedures people planned to undergo within the next 12 months in order to gauge future trends in plastic surgery. Of the people surveyed, 23% plan a hair removal procedure, 11% seek dermal fillers, while only 3 percent noted they will have Botox® injections in the coming year. As far as surgical cosmetic procedures, here is the top 5 lineup: blepharoplasty (27%), hair replacement (18%), face lift (13%), abdominoplasty (12%), and breast lift (12%).

It is interesting to see if this survey, taken from a small sample of subjects, will accurately predict the upcoming trends in cosmetic surgery. Will laser hair removal throw Botox® off its throne? Will breast augmentation be ousted by the tummy tuck? We will have to wait and see!

*Chart and data courtesy of MedSpaRX.com

Big Changes in the Corporate Aesthetic World

2010-06-22T09:36:00.010-04:00

There have been big changes in the aesthetic corporate world recently. With heavy hitters from Mentor, Medicis, and Allergan all resigning within the past week, we are left to wonder what is next for aesthetic medicine.

Josh Levine, former Mentor CEO, resigned last week. Levine joined Mentor in 1996 as Vice President of Domestic Aesthetic Sales. In January 2000, Levine resigned from the company briefly to join a start-up practice management organization, the Plastic Surgery Co., where he was the Chief Development Officer. His time with the Plastic Surgery Co was short-lived, as he resigned the position in September 2000 to rejoin Mentor as Vice President of sales and marketing. Levine served in roles of increasing responsibility and was promoted to President and Chief Operating Officer of Mentor in 2003. Mr. Levine was instrumental in the sale of Mentor last year to Johnson & Johnson.

Following the January 2009 acquisition of Mentor by Johnson & Johnson, Levine had commented that the deal "allows Mentor to expand our product portfolio and significantly grow our global reach." It appears that Levine may now be dissatisfied with the new directions of Mentor, considering his resignation comes at the end of the mandatory wait period following the acquisition. Although there are no reports as to new employment, we are sure he will be inundated with offers as Mr. Levine is one of the most experienced and capable in the aesthetic industry.

Robert Grant, the former Allergan Vice President, resigned last week to take over the presidency of Bausch and Lomb Surgical Division, an Aliso Viejo-based eye surgery business. Grant has spent almost a lifetime in the aesthetics business and is quite possibly moving to maybe a safer, but surely not as exciting, endeavor. Under Grant’s leadership since 2006, Allergan Medical amassed an all-star product lineup that includes Botox Cosmetic ®, Juvéderm ®, the Lap-Band ® surgical weight loss device and Latisse ®.

Perhaps Grant made his decision to join the B & L team based on his experience as an independent board director at Acufocus, Inc., a Carlyle Group and Versant Ventures-backed clinical stage ophthalmic device company. This appears to be a lateral move for Grant, however, he has not been assigned a seat on the Board of Directors of B & L. Is his move indicative of something internally up at our leading aesthetics company Allergan, or Grant's vision of an increasingly regulated, and maybe less attractive, industry to come? Stay tuned here!

Finally, Joe Cooper, the former VP of Corporate and Product Development at Medicis, has also resigned. Similar to Levine, Cooper had been with Medicis since 1996. Cooper has served as Executive Vice President, Corporate and Product Development since July 2006. Prior to joining the Medicis executive team, he held management positions with Schein Pharmaceuticals, Inc. and G.D. Searle

According to BusinessWeek, Cooper "has decided to pursue career opportunities outside of Medicis." This is not the first time Cooper left Medicis for greener pastures. Earlier in the decade he went off to run a start up. Cooper returned to lead the way in his business development role with important strategic investments in Revance ®, Dysport ® and Liposonix ® for Medicis.

There are certainly big shoes to fill in the aesthetic industry and hopefully Allergan, Mentor, and Medicis won’t fall behind with the alterations to their corporate lineups.

Everything You Ever Needed to Know About Cellulite

2010-06-17T17:12:00.005-04:00

Cellulite is no one’s friend. While most people are familiar with its appearance, not everyone is aware of how cellulite is caused or treated. Cellulite, or the dimpled appearance of the skin found on the hips, thighs, and buttocks, is found on 80% of women. Cellulite is a lot less common in males due to differences in the way fat, muscle and connective tissues are dispersed in men and women's skin.

What causes cellulite?

Cellulite is caused by fibrous connective cords that unite the skin to the underlying muscle. The cords secure the skin to deeper structures with the fat lying in between. As the fat cells build up, they push up against the skin, while the long, tough cords are pulling down. This creates the dimpling of the skin

Does everyone have the same cellulite?

Mild cases of cellulite can only be seen when the skin is pinched, while more severe cases create the appearance of rumpled and bumpy skin with areas of peaks and valleys. Cellulite is most common around the thighs and buttocks, however, it can also be found on the breasts, lower abdomen and upper arms.

Does weight gain cause cellulite?

While weight gain is not a direct cause of cellulite, however, heavier persons may have more pronounced dimpling. Contrary to widespread misconceptions, thinner people are susceptible to cellulite as well.

How do I get rid of my cellulite?

There is no proven ‘cure’ for cellulite, however, maintaining a healthy lifestyle can reduce it’s appearance:

Maintain a normal weight…heavier persons can have a more pronounced cellulite

Quit smoking

Reduce your intake of high-fat foods, salt, alcohol, coffee and highly processed foods

Eat plenty of fiber

Drink an adequate amount of water daily to cleanse your body of toxins

Exercise regularly

For Boca Raton residents that are still not satisfied with the appearance of their cellulite, there are numerous cosmetic treatments available. At Sanctuary Medical Aesthetic Center, we hava a number of sevices that we use to diminish cellulite including the Alma Accent Device, Elemes Smoothshapes and Synerons Velashape 2. These devices use radiofrequency and /or light energy to treat loose skin and cellulite with minimal pain and downtime. For optimal results, 6 to 8 treatments are usually performed at 2-4 week intervals.

Tanning Beds: Another Deadly Addiction

2010-06-15T08:11:00.003-04:00

A recent study by two New York researchers has concluded that indoor tanning bed usage may be just as addictive as using tobacco or drugs. Study authors Catherine E. Mosher, PhD, of Memorial Sloan-Kettering Cancer Center and Sharon Danoff-Burg, PhD, of the University at Albany interviewed 421 students from a large Northeastern university about their indoor tanning habits.

The students studied were given a questionnaire normally used to pinpoint drug and alcohol addiction. The questionnaire was altered to accurately reflect the students’ relationships with indoor tanning. Of the 421 students, 229 had tanned in indoor salons. Of these, 160 met the researcher’s criteria for indoor tanning addiction.

According to the research, approximately two out of every five students were considered tanning addicts based on the questionnaire that measured their levels of depression, anxiety and substance abuse. Furthermore, the research claimed that students addicted to tanning were also more likely to have high anxiety and abuse other addictive substances.

"In addition to appearance enhancement, motivations [for tanning] include relaxation, improved mood, and socialization," the study concluded.

While critics have questioned the study’s definition of addiction, it is not hard to believe that people can be addicted to something that is potentially deadly. We’ve all heard of junk food or heroine addicts, however, when was the last time vegetable addiction was an issue?

As studies are continually released proving the harmful effects of tanning beds, it is important for consumers to examine alternate options to obtaining that summer glow. While taking adequate measures to prevent harmful exposure to UVA/B rays is essential, it is also important to have regular check ups with a dermatologist to catch early signs of skin cancer. For patients in the Boca Raton area, it is also important to understand the harmful side effects of the hot Florida sun and the heightened risks of skin cancer.

Pentagon Study to Regrow Soldiers' Limbs

2010-06-01T15:27:00.003-04:00

The first phase of the Pentagon’s plans to regrow soldiers’ limbs has been completed—to an extent. Scientists have been able to create undifferentiated cells from human skin.

The goal of Phase Two is to turn those undifferentiated cells into muscle tissue. Muscle tissue was chosen because it’s the type of tissue that’s routinely regenerated; ie, working out in the gym causes muscle tissue to develop, as any dedicated body builder knows. Laying about, such as in the case of invalids, causes the muscles to become weak. In the body, if muscle tissue is traumatized past a certain point, and is destroyed, a scar results. Scientists are hoping that by creating muscle tissue outside the body, they can avoid this scarring process.

To convert the undifferentiated cells into muscle cells, the cells must have myosin and actin—two proteins key to forming cellular cytoskeleton which will eventually build muscle filaments. Once this is accomplished, the cells will be placed into a matrix of tiny biomaterial threads. A this point the scientists aren’t certain whether collagens or fibrinogens will be part of the thread. This is one of the many mysteries in the process that will, ultimately, be solved.

Cellthera Inc. and the Worcester Polytechnic Institute (WPI) just got a one-year, $570,000 grant from Darpa, the Pentagon’s research division, to grow the new tissues. "The goal is to genuinely replace a muscle that’s lost," stated biotechnology professor Raymond Page. "I appreciate that’s a very aggressive goal." And it’s only one part in a more ambitious Darpa program, Restorative Injury Repair, that aims to "fully restore the function of complex tissue (muscle, nerves, skin, etc.) after traumatic injury on the battlefield."

As in many cases of medical and scientific advances, what starts on the battlefield may, ultimately, end up in the operating suite of an aesthetic plastic surgeon. Facial surgery got its modern-day start by Vilray Blair, the first chief of the Division of Plastic and Reconstructive Surgery at Washington University who treated wounded WWI soldiers with facial injuries, setting the standards for craniofacial reconstructive procedures, many of which were later affirmed in face lifting procedures.

Based on that history, one wouldn’t be surprised that, once the Pentagon is able to recreate limbs lost in war, we might be able to recreate breasts lost to cancer and, ultimately, replace aging parts of our faces as well.

Proton Pump Inhibitors Increasing Skin Aging?

2010-05-27T09:19:00.003-04:00

Skin aging has long been important to human beings and in recent years this field has received tremendous attention by both researchers and the general population. Cutaneous aging includes two distinct phenomena, intrinsic aging and photoaging, and is characterized mainly by the loss of collagen fibers from dermis.

PPI's (by inhibiting the stomach's hydrochloric acid secretion) raise the pH of the stomach juices and surrounding environs to a markedly more alkaline milieu.... and increase intralysosomal (inside the lysosome) pH. By changing the original acid base balance to a more basic medium TGFB secretion is decreased and lysyl oxidase which needs copper to do its job in cross linking collagen to make new skin can't do it's enzymatic best because it may not get the "copper on demand" it requires even though the supply is there.

With this new information on how proton pump inhibitors can accentuate skin aging, they should no longer be viewed as a safe first line therapy for acid reflux.It has been known for some time that PPI's prevent the absorption of certain vitamins (specifically B12)and minerals (specifically calcium) promoting osteoporosis. What we tend to forget is that they primarily prevent normal digestive processes from occurring leading to a myriad of gastrointestinal problems, physician visits and other prescription drug usage with their attendant side effects.

Unsupervised Physician Extenders Are a Key Malpractice Concern

2010-05-21T10:55:00.004-04:00

Dr. Goldberg was recently interviewed by Denise Napoli of Skin & Allergy News magazine. Here is the published May, 2010 article in its entirety.

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Improper use of "physician extenders," a lack of informed consent, and patient dissatisfaction are some of the top reasons why patients sue, and all are easily preventable, according to Dr. David J. Goldberg.

The first - the use of unsupervised or improperly trained physician assistants, nurse practitioners, or other physician extenders - hits home for many dermatologists. According to the American Academy of Dermatology, in 2010, 36% of physicians will use NPs and PAs in their practice, up from 30% in 2007 and 20% in 2002, Dr. Goldberg said at a cosmetic dermatology seminar sponsored by Skin Disease Education Foundation in Santa Monica, Calif. "NPs and PAs who work for core physicians are clearly the most qualified nonphysicians to perform these procedures," said Dr. Goldberg, director of dermatologic laser research at Mount Sinai School of Medicine, New York. Many have received cosmetic training through the Aesthetic Extender Symposium (www.aestheticextendersymposium.com), he said.

However, there are still risks. A 2006 American Society for Dermatologic Surgery survey found that 51% of ASDS members reported seeing nonphysician, nonsupervised physician-extender complications in their practice, with the two most common being misdiagnosed skin cancer and scarring following dermatologic procedures.

"If the [physician extender] is sued, so will be the provider who is affiliated with the PE," said Dr. Goldberg, who also is on the faculty of Fordham University School of Law in New York.

Poorly informed or uninformed consent is another moneymaker for medical malpractice lawyers in the field of dermatology, according to Dr. Goldberg. "Because dermatologists tend to see large numbers of patients, there is a tendency to be overwhelmed by the paperwork associated with quality informed consent," he said.

One procedure to be especially careful about is botulinum toxin type A injections - there were 2,464,123 in 2008, according to the American Society for Aesthetic Plastic Surgery. The black box warning on Botox reads "swallowing and breathing difficulties can be life threatening and there have been reports of death."

Dr. Goldberg encouraged physicians to instruct patients to read the warning on botulinum toxin "each and every time" they receive it. He also encouraged discussion about these risks and the procedure's other rare but potential side effects, including generalized muscle weakness, diplopia, ptosis, dysphagia, dysphonia, dysarthria, and urinary incontinence.

He noted that many of these potential complications have never been reported with the cosmetic use of botulinum toxin.

Finally, Dr. Goldberg said that dermatologists can keep legal troubles at bay simply by keeping patients happy. He cited a 2006 retrospective chart study of all patients who received botulinum toxin injections over a 2-year period at a private dermatology clinic. The retention rate was 55%. However, the "institution of a 2-week posttreatment evaluation increased the retention rate from 55% to 67%," said Dr. Goldberg (Dermatol. Surg. 2006;32:212-5).

"Probably more important in keeping patients happy - and keeping them coming back - is to communicate with patients," he advised. "Treat each patient as if they are special. Pay total attention to their concerns. They will appreciate your one-on-one interaction with them."

Dr. Goldberg is a founding director of the Aesthetic Extended Symposium. SDEF and this news organization are owned by Elsevier.

Using Light-Activated Technologies for Battlefield Injuries

2010-05-12T13:14:00.003-04:00

A recent research study by the Air Force Office of Scientific Research shows that conventional sutures as well as glues and staples used to repair wounds in the skin or to reconnect nerves, blood vessels, tendons and corneal incisions, can be replaced with Photochemical Tissue Bonding. According to Dr. Irene Kochevar (Massachusetts General Hospital Wellman Center researcher and Harvard Med School professor), "We have demonstrated that this technology is very helpful in medicine for the Air Force because it produces better healing and functional outcomes than the same wounds that were treated with conventional materials.”

Bonding (aka nanosutures) is achieved when a dye is applied to the wound, after which the wound is exposed to green light for a brief time. The dye absorbs the light and then proceeds to molecularly bond proteins on the surface of the tissues. "No glues, proteins or other materials are used that might stimulate an inflammatory response," said Kochevar. "An immediate, water-tight seal is formed between the tissue surfaces leading to reduced inflammation in the near term and better scar formation in the long term."

Researchers plan to continue to assess the efficacy of this new technology, particularly as to how it might be made even more effective in the field. If all goes well, they hope to create a shorter treatment time and an even stronger bond. "We are approaching this challenge by identifying the basic molecular mechanisms responsible for light-activated crosslinking," she said. "We believe that this information will show us how to improve the efficiency and effectiveness of the nanosuturing technology on the battlefield."

Valeant Pharma to Purchase Vital Science Corp

2010-05-12T12:40:00.001-04:00

According to a Socaltech.com report, Valeant Pharmaceuticals (VRX.N) will purchase Vital Science Corp., a Toronto-based manufacturer of over-the-counter dermatology products in the 2^nd quarter of 2010. They have recently acquired two other dermatology firms, both in Brazil. One of the firms, a private Brazilian company focusing on branded generics and OTC products, reported annual sales in the 49 million Brazilian reals range (about 26.7 million dollars US) with an average compounded growth of 15% per year. Purchase price for this company is reported to be approximately 56 million US$ and will be consummated in the 2^nd quarter of 2010.

"This latest transaction, along with Valeant's acquisition of Instituto Terapeutico Delta Ltda last month, will be our second acquisition in Brazil this year," stated J. Michael Pearson, chairman and chief executive officer. "We see strong synergies between these two acquisitions and our current operations in Brazil and believe that the combination of all three businesses will provide Valeant with expanded opportunities for growth in Brazil and enhance our Latin American franchise. This new business operation has had product sales that have grown in excess of 30% over the last year, while also achieving operating margins greater than 20%. Incorporating our new, state-of-the-art manufacturing plant in Indaiatuba will also provide us the ability to achieve significant growth and synergies across all three businesses."

The company has been on a shopping spree over the past few years, with purchases in 2009 of EMO-FARM, Mexico’s Tecnofarma S.A. de C.V. (Tecnofarma); Private Formula Holdings International Pty Limited (PFI) in Australia; Canadian skincare firm, Laboratoire Dr. Renaud and another US company. Last May, Valeant bought trademarks, inventory and intellectual property for dermatology products that were sold in New Zealand and Australia.

Valeant Pharmaceuticals International (Valeant) is a multinational specialty pharmaceutical company that develops, manufactures and markets pharmaceutical products. Their specialty pharmaceutical and over-the-counter (OTC) products are marketed under brand names and sold in the US, Canada, Australia and New Zealand. Valeant also has branded generic and OTC operations in Europe and Latin America, which focus on pharmaceutical products that are bioequivalent to original products and are marketed under company brand names. The Company’s product portfolio consists of 380 products with approximately 2,000 stock keeping units. The Company’s products are sold through three segments: Specialty Pharmaceuticals, Branded Generics/Europe and Branded Generics/Latin America.

Part III of III from the ASLMS Meeting in Phoenix

2010-04-27T13:33:00.003-04:00

Dr. Goldberg and I attended the ASLMS meeting in phoenix last weekend. This is my favorite meeting of the year as we see new products and evaluation of existing products. The clear winners this year in terms of number of presentations and buzz were Zeltiq and Ulthera—devices that we have blogged about before, and which we have in our offices. The scientific studies on Zeltiq were very clear - excellent results and efficacy of 20-30% per treatment. That is what we have been seeing in our Boca office - very satisfied patients with consistent results. The Ulthera data mostly came from Asia, where they have had the device for some time. Results with the older protocol were good but newer data from a number of physicians showed that the newer protocols of dual layers and increased numbers of "lines" placed, leads to better, more consistent results.

We had 2 posters from the Boca office at ASLMS. The first was on healing times after fractional resurfacing and microlaserpeel with the Sciton TRL (tunable resurfacing laser). See attached. We showed that healing times are affected by a number of variables, including depth of microlaserpeel, depth of fractional treatment and density of the treatment. This gave us the data for use in our practice to be able to treat patients more effectively and with limited downtime.

The second poster we presented was about face lifting and laser resurfacing. See attached. We showed the safety and efficacy of treating patients with the Sciton TRL system. The key to successful treatment was to perform deep resurfacing on the non-undermined areas and to use the lighter fractional settings on the undermined flap.

Dr. Jason Pozner

Part II of III from the ASLMS Meeting in Phoenix

2010-04-27T09:56:00.006-04:00

At the 30^th annual American Society for Lasers in Medicine and Surgery (ASLMS) meeting in Phoenix. Arizona last weekend, I presented a variety of talks. These included: 1) Pearls and Problems in the Laser Treatment of Unwanted Hair and Pigmented Lesions; 2) My Approach to Laser Facial Rejuvenation; 3) Problems with Laser Treatment in Medspas; 4) The Use of the Cutera Pearl Fractionated Er:YSGG laser for wrinkles around the mouth; and 5) a 10 Year Look at Laser Treatments of Tattoos in our Offices.

The highlights of my talks focused on the novel laser treatment concepts including the use of 1) the new Syneron eMatrix fractionated radiofrequency device for acne scars; 2) treatment of resistant melasma with multiple sessions of Q-switched Nd:YAG laser treatment; 3) the increasing incidence of complications seen at poor quality, low priced medspas; 4) the success we can now have in treating wrinkles around the mouth and 5) the future of newer lasers for more effective treatment of tattoos.

Last weekend we were in Phoenix. This week, Dr. Pozner and I are both lecturing at the American Society for Aesthetic Plastic Surgery (ASAPS) meeting in Washington, DC. Stay tuned!

Dr. David J. Goldberg

Dr. Charles Townes, recipient of Special Recognition Award at ASLMS Meeting

2010-04-21T11:05:00.006-04:00

Last week we attended the ASLMS (American Society for Laser Medicine & Surgery) meeting in Phoenix. One of the highlights of the meeting, besides celebrating the 50th anniversary of the operation of the laser, was the Special Recognition Award given to Dr. Charles Townes, an American Nobel Prize-winning physicist and educator. We were excited to see this award presented, as Townes is known worldwide as the “Father of Lasers,” having developed laser technology to the benefit of millions, both in military and medical uses.

Townes, born in 1915 in South Carolina, graduated summa cum laude from Furman University at the tender age of 19. He completed a master’s degree in physics at Duke and a PhD from Cal Tech with a thesis about isotope separation and nuclear spins. Keep in mind that this was back in 1939, when these technologies were in their infancy. As an early member of the Bell Telephone Laboratories, his work in radar bombing systems and microwave technology, which led to his appointment to the faculty at Columbia University, led to uses of ammonia gas in masers (microwave amplification through radiation), which ultimately produced laser technologies. He and his research assistants were the first to detect complex molecules in the galaxy, as well as the measurement of the mass in the black hole in our galaxy’s center. With the assistance of Arthur Schawlow, he wrote Microwave Spectroscopy, which was published in 1955. During his tenure at Bell Labs, Dr. Townes was asked to help with the development of a radar system for WWII aircraft. Although Dr. Townes did not serve in the military, he and his team contributed to the war efforts by creating more accurate and precise radar systems, though none of them were ever mass-produced by the military. Some of the new systems developed were used as prototypes in the early B-52 bombers.

Dr. Townes went on to become the VP and Director of Research for Washington DC-based Institute for Defense Analyses, a nonprofit group that advised the government. After 2 years in that position, he became Provost and Professor of Physics at MIT, specializing in research of quantum electronics and astronomy. In 1967, he became a professor at University of California, on the Berkeley campus.

We'll be posting more details from the event later this week! Don't miss our upcoming info about the ASAPS (American Society for Aesthetic Plastic Surgery) conference this weekend!

Dr. Jason Pozner and Dr. David Goldberg

Part I of III from the ASLMS Meeting in Phoenix

2010-04-20T10:35:00.005-04:00

This past weekend Dr. Pozner and I attended the 30th annual American Society for Lasers in Medicine and Surgery (ASLMS) meeting in Phoenix. Arizona.

ASLMS is the one meeting where the latest in next generation energy based cosmetic treatments is always first presented. Attendees come from all over the world – although the volcano in Iceland, and its impact on flights to and from Europe, did deter some Europeans from coming. The meeting consisted of a wide variety of workshops, panel discussions and abstract sessions with the singular goal of learning what’s new, what’s old and what will be soon arriving in cosmetic laser treatments.

Although the economic recession has led to some pull back from laser manufacturers, there was great interest in the new approaches to the non-surgical treatment of the aging face and neck, body sculpturing, and fat removal. In addition, it was clear that improved cellulite and melasma treatments remain the next 2 great frontiers in the cosmetic treatment of the skin. In my next blog I will focus on my own particular lectures.

Dr. David Goldberg

Publishers of New Beauty Mag buy 2 more pubs

2010-04-12T16:23:00.004-04:00

Our friends at Sandow Media, publishers of New Beauty magazine, on whose board Dr. Pozner serves, has completed the acquisition of Interior Design magazine and the Furniture Today group of publications.

These two pubs add powerful and influential brands to Sandow's group of publications as well as more than 100 new employees. This important deal doubles the size of Sandow Media and continues to position the firm as a leader in the media industry.

Our congrats to Sandow!

Facial Implants - The New Face Lift?

2010-04-12T09:22:00.008-04:00

It’s not news that beginning in our 50’s, people begin to lose bone density, leading to a shortening in height over time. What is news is that this bone atrophy isn’t limited to our long bones, but extends into the bones of our face, including the eye sockets, the jaws and the cheek bones.

Traditional face lifting procedures have focused on injecting fillers or fat to plump the facial contours, along with lifting and tightening loose muscle before removing excess skin. The “new” face lift may very well add facial implants as a standard as Dr. Ramirez often performs in our plastic surgery practice in Boca Raton, FL.

Results of a study were presented at a recent conference of The American Society of Plastic Surgeons. The University of Rochester research study divided 120 men and women into three age groups of 20-40, 41-64 and 65+. CT scans revealed that the oldest group had shorter jaws and receding chins compared with the younger two groups. A follow-up study of another 120 individuals showed that not only were the jaws and chins smaller in the oldest age group, but the upper rim of the eye socket and the cheekbones were sunken as well.

"It is very well known that skin and (facial) fat atrophy as we age," said lead researcher Dr. Robert Shaw, Jr., also at the University of Rochester. "But patients would come back from a traditional face lift, and we would look at pictures of them when they were young and they didn't look like them. We needed to look at what else was going on with aging. It is not just that your skin is getting less elastic with age, you are also getting decreased support from the bone.”

As a result of this research, says senior researcher, Dr. Howard Langstein, also of University of Rochester, "there will be more attention paid to the skeleton.” We are not saying that traditional face-lifts are obsolete," he continued. "But in order for us to give a patient the best bang for the buck, we should also think about augmenting bones."

As recently as August of 2008, New York Magazine ran an article touting the benefits of fat injections as the “new face lift.” Liposuctioned fat from a person’s belly, hips or thighs could be strategically injected into the face to create baby-smooth skin and model’s cheeks. Although both fat injections and skin stretching will still be part of the face lifting procedure, it’s highly likely that facial implants will rapidly begin to take their place on a regular basis.

It's worth noting that many of our patients also represent younger individuals who have what's often termed a "weak" jawline. This may or may not be coupled with a receding chin but either way, the introduction of a mandibular matrix system can offer astonishing results for these patients.

New Injection for Small Varicose Veins Approved by the FDA

2010-04-08T16:55:00.005-04:00

The FDA announced on March 31st that polidocanol (marketed in the US as Asclera) has been approved as a treatment for varicose veins. Asclera works its magic by damaging the cell lining in the blood vessels, causing them to close. Eventually the blood vessel is replaced by other types of tissue. The product is approved for veins less than 1 mm in diameter and reticular veins 1-3mm in diameter. (As a reference, there are 24 mm to one inch).

There are three primary types of venous problems: varicose veins, reticular veins and spider veins. Spider veins are generally very tiny, while varicose veins are quite noticeable and generally develop on the legs. Reticular veins are mild and generally cause little in the way of discomfort. Vein treatments generally include lasers, broad band light and/or sclerosing agents.

Few side effects were noted by the FDA, including leakage or blood collection from the injected vessels at the injection site, as well as potential for bruising, irritation, discoloration and discomfort at the injection site.

Osiris Therapeutics to Reincorporate in Maryland

2010-04-06T08:33:00.003-04:00

Osiris Therapeutics (NasdaqGM: OSIR) has filed with the SEC a proposal to reincorporate its stem cell products company in Maryland in order to save on taxes. Apparently, the annual franchise tax in Maryland would run the company around $300 compared with its now-Delaware franchise taxes of over $160K in 2009, with a planned raise to $180K in the near future.

As indicated in the SEC document, Peter Friedhi, a Swiss-based investment banker and company director, owns 44.4% of Osiris common stock. Venturec, part of the Zurich, Switzerland-based New Venturetec, of which Friedhi is Investment Manager, owns 12.1%.  With the interest in stem cell products, the company grew to $14.6 million in net revenues for the year 2009 compared to a net loss of $33.5 million in 2008. In late afternoon trading this past Thursday, Osiris stock stood at $7.40, with a range in shares between $5.35 and $15.20 over the last year. Osiris Therapeutics is considered one of the leading stem cell therapeutic companies, creating products in the inflammatory, orthopedic and cardiovascular areas. The company currently has several biologic drug candidates under evaluation including Prochymal for inflammatory, autoimmune and cardiovascular illnesses, as well as Chondrogen for knee arthritis. Osiris participates fully in the development of its products including R&D, manufacturing and distribution.

Amniotic Cells Reprogrammed for Stem Cell Use

2010-04-01T10:02:00.006-04:00

The journal Cellular Reprogramming has revealed a Mount Sinai School of Medicine study showing that skin cells found in human amniotic fluid can be reprogrammed, after which the cells were identical to human embryonic stem cells.

"We induced amniotic fluid skin cells to return from their final differentiated stage back to an undifferentiated stem cell stage from where they can develop into any cell type of the body," said the study’s lead author, Dr. Katalin Polgar, Assistant Professor of Medicine, Cardiology and Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine.

Just as exciting, when compared with cultured adult skin cells, the amniotic cells created cell colonies nearly twice as quickly and in nearly 200% greater volume. Polgar goes on to state, "There remains today a need in stem cell research for an easily reprogrammable cell type. Our study shows that reprogramming of cultured, terminally differentiated amniotic fluid cells results in pluripotent stem cells that are identical to human embryonic stem cells, and that it is much easier, faster and more efficient than reprogramming neonatal and adult cells." This can help fill the need for stem cells desperately needed for research and development of new regenerative therapies, such as for heart, liver, kidney and other organs; replacement of neurons in patients suffering with Alzheimer’s and Parkinson’s and even in the creation of treatments through the use of personalized stem cells banks.

Dr. Polgar states that using stem cells from amniotic fluid could reduce the need for testing drugs on animals and can help personalize the delivery of medications. "Their potential use in toxicology models could reduce the need for experimental animals.”

"These reprogrammed amniotic fluid cells have the ability to self-renew indefinitely. Pluripotent stem cells created from amniotic fluid cells shed from the fetal skin maintain all the potential of embryonic stem cells without using embryos, thereby eliminating ethical concerns associated with human embryonic stem cells obtained from preimplantation embryos," Dr. Polgar said.

Artefill--it's back!

2010-03-26T09:56:00.005-04:00

Artefill, approved by the FDA in October of 2006 is a long-term filler for nasolabial folds and marionette lines. Lots of us liked it very much but during the recent economic slowdown the company went bankrupt. The product retained its FDA-approved status, however, and the company waited for another pharmaceutical firm to take over.

Artefill’s efficacy and safety profile have been validated through many clinical trials pre- and post-FDA approval and over 20,000 patients have been treated with Artefill since it’s introduction to the U.S. market.

I am happy to say Artefill is again available since Suneva Medical purchased the company for over $200 million for the rights to produce the product.

Botox Rival Issues a "Pepsi Challenge"

2010-03-17T18:06:00.002-04:00

Remember the Pepsi Challenge? Commercials showing everyday folks surprising themselves by how much more they enjoyed Pepsi than Coke in a blind taste-test?

Medicis Pharmaceutical Corp. is taking its Botox competitor, Dysport, to the streets with a similar come-on. According to the Dysport Challenge, consumers can enjoy a two-pronged wrinkle option: use Medicis' generous rebates to try Dysport, but if you don’t like it as much as Botox, they’ll give you $75 toward your next Botox injection.

Over the year since Dysport gained FDA approval, it has captured less than 10% of Botox’s marketshare. Spurred by growing competition at its heals, Allergan has been pushing Botox into consumer awareness as a treatment for migraines and sweating. In fact, although such off-label uses for Botox aren’t technically approved by the FDA, they account for over 50% of the drug’s annual revenue.

While this kind of marketing may be raising eyebrows among medical ethicists, we don’t see a problem with it. After all, the Dysport promotion is targeted at cosmetic patients. How is this unlike a competition between Maybelline and Cover Girl mascaras?

Drs. Jason Pozner & David J. Goldberg
Sanctuary Medical Aesthetic Center, Boca Raton
Sanctuary Plastic Surgery, Boca Raton
Skin Laser Surgery Specialists of NY/NJ

Florida Medspa Death Highlights Need for Tougher Regulation

2010-03-16T16:10:00.005-04:00

According to the International Medspa Association, medspas (defined as a spa that provides medical services) have grown by 85% in last 2 years – despite the US economic recession. Medspa annual revenues are now in excess of $2 billion, according to the Aesthetic Medicine News. Some of these medspas are within the offices of cosmetic dermatologists and plastic surgeons. Many other medspas are not. Some of the medspas that are not within physician offices are overseen by on-site cosmetic dermatologists and plastic surgeons; others, often, are not. This past week an ABC News Nightline episode highlighted what can go very wrong in this latter setting. ABC News highlighted a patient who died during a liposuction procedure performed at an unlicensed Florida medspa by a physician with almost no cosmetic training.

I, as a NY and NJ cosmetic dermatologist and attorney who teaches Health Care Law at NY’s Fordham Law School, was interviewed by ABC's Nightline about the lack of medspa regulations in so many states. The issue arises not only with procedures such as liposuction, but with techniques that range from laser hair removal to wrinkle filler injections. It should be noted that the states of New York, Vermont and Georgia do not even consider laser hair removal the practice of medicine–even though horrendous facial scarring can occur when this procedure is not performed correctly.

Societies such as the American Academy of Dermatology (AAD), American Society for Dermatologic Surgery (ASDS), the American Society for Lasers in Medicine and Surgery (ASLMS), and the American Society for Aesthetic and Plastic Surgery (ASAPS) have put forth guidelines to promote safety for medspa type procedures. Guidelines are not law. No medspa is forced to follow these guidelines. It will ultimately be up to society, through their pressure on legislators, to push through tougher regulations for the growing medspa industry.

There is no question that procedures performed at the unlicensed medspa in Florida are much less expensive than similar procedures performed within our offices. It can also be argued that complications can occur during any procedure. This is certainly true. However one must also wonder if the unfortunate death that occurred in the Florida medspa is a terribly tragic example of “you get what you pay for”.

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

The Sturge-Weber Foundation Honors Dr. David J. Goldberg

2010-03-09T12:41:00.003-05:00

The Sturge-Weber Foundation honored Dr. David Goldberg with one of the industry’s highest awards at a tribute dinner held in Miami on March 05, 2010. As our regular readers know, Dr. Goldberg is a pioneer in the field of dermatology and director of Skin Laser & Surgery Specialists of New York and New Jersey.

According to Karen Ball, President of the Sturge-Weber Foundation, “Each year, the Sturge-Weber Foundation singles out one outstanding leader in dermatology to receive what has become one of the highest accolades that can be achieved in our field. Dr. Goldberg is one of the true pioneers in dermatology, who has worked tirelessly to bring cutting edge technologies, innovative techniques and promising new treatments to the practice of medical and cosmetic dermatology. His work with skin lasers is unparalleled, and he is widely recognized as one of the world’s leading dermatologists. We are extremely pleased to honor him at our annual dinner.”

Dr. Goldberg is world-renowned for his innovative work with skin lasers, cosmetic dermatology and facial rejuvenation techniques. The Sturge-Weber Foundation honor is another in a long list of awards and honors received by him. He was the first recipient of the prestigious Leon Goldman award, named after the founder of laser surgery. In addition, he was named one of the top ten laser surgeons in the United States by Self magazine; one of the best doctors in America by both Woodward/White, Inc. and Doctors Inc.; and one of the best dermatologists in New Jersey by New Jersey Monthly. A prolific author who has contributed to more than 10 academic textbooks and 125 papers, Dr. Goldberg also serves as a clinical professor and Director of Laser Research at the Mt. Sinai School of Medicine.

Dr. Goldberg said, “I am extremely humbled to be named the Sturge-Weber Foundation honoree this year. The Foundation has accomplished so much in their mission to improve the quality of life for people with port wine stain birthmarks and associated conditions. I look forward to continuing to contribute to finding new treatments that can bring hope and relief to patients and their families.”

I'm proud to be a business partner, friend and colleague of David Goldberg, and am delighted to share his award with our readers.

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

The future of facial fillers, the Liquid Facelift, and the latest facial rejuvenation techniques

2010-03-02T15:17:00.004-05:00

Demand for non-surgical cosmetic treatments continues to increase dramatically as a new generation of facial fillers and liquid facelift techniques promises better results in the battle against aging, while avoiding the risks inherent in facial plastic surgery. While hyaluronic acid fillers have earned an excellent track record for safety and effectiveness in treating fine lines and wrinkles around the eyes, nose and mouth, there are exciting new volumizers in the pipeline that are able to accomplish large-scale facial sculpturing without surgery.

Juvéderm™ VOLUMA™, a long-lasting hyaluronic acid volumizer that has been widely available in Europe over the last 2 years, is currently undergoing FDA studies in the United States. It is hoped that this product will be available in 2011. VOLUMA™ works to restore fuller, softer, and more youthful contours to the face by replacing lost volume in the cheeks, chin and cheekbones. VOLUMA™ provides smooth, natural-looking results that have been shown, in European studies, to last up to 18 months.

Belotero® is another hyaluronic acid material that is expected to be FDA approved in 2010.

The proliferation of facial filler and volumizer products available today is both a blessing and a challenge for people seeking non-surgical facial rejuvenation. With such a wide range of treatment choices available, it can be difficult for patients to know how to choose the treatment that’s best for them. A qualified, experienced physician can help you navigate the facial filler landscape and choose a treatment best suited to achieve your specific goals.

The 34^th Annual Hawaii Dermatology Seminar, sponsored by the Skin Disease Education Foundation (SDEF), brings together the world’s leading dermatologists to discuss current challenges and future directions in the field of dermatology. For further information about the SDEF, visit www.sdefderm.com.

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

NY Plastic Surgeon Group Pleads Guilty to Felony Misbranding of a Drug

2010-02-25T10:01:00.004-05:00

A large Albany, NY plastic surgery group has pleaded guilty in federal court to felony misbranding of a drug. The Plastic Surgery Group, a well-known association of seven board-certified plastic surgeons, pleaded guilty to using a non-FDA approved TRI-toxin on its patients seeking treatments with BOTOX® for facial wrinkles. During the time period of February 2004 until December, 2004, approximately 150 patients were injected with the unapproved substance, believing they were being treated with BOTOX®.

The group, whose members include Dr. Douglas Hargrave, Dr. E. Scott Macomber, Dr. Steven Lynch, Dr. John Noonan, Dr. William DeLuca, Jr., Dr. Jeffrey Rockmore and Dr. Susan Gannon, was ordered to pay restitution in the amount of $106,686, and a fine of $200,000, in connection with it's plea of guilty to one felony count of misbranding drugs. Additionally, Doctors De Luca, Hargrave, Rockmore, Lynch and Noonan were sentenced to probation with community service, and ordered to pay restitution in the amount of $106,686, as well as a fine of $5,000. The group's practice administrator, Peter M. Slattery, and RN Susan F. Knott, were also sentenced and ordered to pay restitution in the amount of $106,686, and fines in the amount of $1,000 and $500, respectively. Drs. Macomber and Gannon were not individually charged.

We see the use of non-approved toxins and fillers in South Florida, New York and New Jersey all the time. However, it is unusual to see plastic surgeons involved. Usually the people serving up non-approved injectables are non-physicians from other countries. Consumers need to be aware of this practice and seek appropriate providers for their aesthetic care.

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

SmoothShapes Cellulite Treatment on The Doctors

2010-02-24T07:38:00.011-05:00

Cellulite treatments are extremely popular, inasmuch as approximately 90% of all women will develop cellulite, which is normal fat pressed up against the tissues beneath the skin. At Sanctuary Medical Aesthetic Center in Boca Raton, cellulite treatments are in demand on a daily basis, especially since Floridians show so much skin in our warm weather. Various treatments, including lasers, massage, diet and exercise, have been touted to effectively treat the challenge of cellulite.

SmoothShapes is a combination of two laser energies that work together to mobilize the fat from the fat cell so it can be taken up by the body. In addition to the laser energies, it uses gentle massage and suction to stimulate blood flow to the treated areas. It's one of several treatments for cellulite, and was recently featured on The Doctors, NBC's daily medical program.

Click this link to see the SmoothShapes segment from The Doctors program. You'll need to click Featured Videos and then the SmoothShapes video on the right.

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

It's the big things that move you...

2010-02-23T13:24:00.004-05:00

A long-standing problem with breast implants, particularly saline implants that are a bit on the larger size, has been their tendency to move around over time, often requiring a breast lift to shore them up. The tiny silk worm is coming to the rescue in the form of a silk-based biodegradable mesh that provides more support than skin alone.

As Colin Stewart reported last week in his "In Your Face" blog, Allergan’s recent purchase of the cosmetic and reconstructive surgery unit of Serica Technologies, SeriScaffold, the above-mentioned silk-based mesh, joins Allergen’s ever-growing product line which includes the Natrelle brand of breast implants, Botox, Juvederm and Latisse, all big favorites among the beautiful.

“Serica’s scaffold biomaterial expertise provides Allergan with a new tissue engineering platform technology for use in tissue regeneration, including breast augmentation, revision and reconstruction and bariatric applications,” said company spokeswoman Caroline Van Hove.

“The technology represents the first silk-based medical device cleared by the FDA. We are always looking for ways to bolster our medical aesthetic franchise, and our acquisition of Serica is another example of our intent to further develop our leadership and expertise in breast aesthetics and reconstruction.”

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

Hawaii Dermatology Seminar #2

2010-02-22T16:06:00.008-05:00

The recently-ended 34^th annual Hawaii Dermatology Seminar has lived up its reputation of being the original and, perhaps, the most well organized of all the Hawaii dermatology meetings. The first 4 days of the meeting were dedicated to medical and pediatric dermatology. The last 2 days were dedicated to advances in cosmetic dermatology. Some of the most well know leaders in the field lectured. These included Drs. Suzanne Kilmer from Sacramento, Michael Gold from Nashville, Roberta Sengelman from Santa Barbara, Thomas Rohrer from Boston and Christopher Zachary from Irvine, CA.

Among the more interesting discussions was a talk about Zeltiq cryolipolysis of women’s fatty upper arms, the soon-to-be-released Belotero wrinkle filler and the role of Matrix fractional radiofrequency treatment. Also discussed were more controversial issues such as Zerona low level light treatment’s effect on dissolving fat. Attendance was up at this year’s Hawaii Dermatology Seminar. Dermatology, and specifically Cosmetic Dermatology, is alive and well.

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

The Hawaii Dermatology Seminar

2010-02-17T06:46:00.004-05:00

I am currently co-directing the Hawaii Dermatology Seminar on the Big Island of Hawaii. This meeting has a long 34-year history of providing quality education to dermatologists from throughout the United States. My co-directors, Joe Fowler, MD from Louisville, KY and Christopher Zachary, MD from the University of California at Irvine, are well-recognized leaders and teachers of all aspects of dermatology. The meeting is divided into 5 segments expanding into 5 days.

The first day is dedicated solely to melanoma – a timely topic considering that the meeting takes place in sunny Hawaii. The next 2 days are dedicated to medical dermatology including acne and psoriasis. The 3^rd day covers pediatric dermatology with the final 2 days dedicated to cosmetic laser treatments and other new aspects of cosmetic dermatology. I will give you an update on these last 2 days at the beginning of next week.

David J. Goldberg, MD

Allergan acquires Serica's graft technology

2010-02-13T11:21:00.008-05:00

Allergan, Inc, makers of Botox, Latisse, lapband and breast implants, acquired the cosmetic and reconstructive surgery unit of Serica Technologies yesterday. The primary products of this Serica division, and a logical addition to Allergan’s product line, are biodegradable silk-based scaffolds for skin grafting, reconstructive surgery and breast augmentation. The transaction did not include rights to Serica's veterinary or orthopedic products, which were spun-out to a new company, Alacer Technologies, Inc.

The news came on the heels of the Monday's FDA approval of Allergan's Juvederm XC, a new version of its popular Juvederm dermal filler. Juvederm XC numbs the treatment area within seconds, reducing the need for other anesthetic.

It’s our view that this is one more example of the onrush of integration among the larger aesthetic companies.

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

Antioxidants in Berries Prevent UV Skin Damage, Wrinkles

2010-02-10T21:32:00.004-05:00

A study done by researchers at Hallym University in the Republic of Korea shows that the topical application of the antioxidant ellagic acid markedly prevents collagen destruction and inflammatory response—major causes of wrinkles—in human skin cells following the exposure to UV-B. UV-B is the sun’s skin-damaging ultraviolet radioactive rays that accounts for 90% of the symptoms of premature skin aging.

Ellagic acid is an antioxidant found in raspberries, strawberries, cranberries, pomegranates, and an assortment of other fruits, vegetables, and nuts. The study showed that ellagic acid worked to protect against UV damage by blocking the production of MMP (matrix metalloproteinase), an enzyme that breaks down collagen in damaged skin cells and causes coarseness. Ellagic acid also reduces the expression of ICAM, a molecule involved in inflammation.

This study is consistent with the view that topical application of materials containing a variety of berries can be helpful for the skin. This is the basis of the CoffeeBerry product in Stifel’s Revale skin care line since 2006. CoffeeBerry itself is rich in antioxidants and is often recommended over green tea for anti-aging purposes.

Because of ellagic acid’s ability to inhibit skin tumors at various stages their typical life cycle, it may be valuable in cancer therapy or possible prevention in the future. Even if you are feeding your skin a good dose of berries, I wouldn’t skip out on the sunscreen just yet.

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

3D Imaging Coming-of-Age

2010-02-05T17:26:00.007-05:00

A lot of patients wonder about what the results of their plastic surgery procedure will look like. Although in depth explanation of the technical aspects of the surgery can provide significant insight into what the outcome will be, some patients want something more visual. Many medical professionals in the cosmetic industry now use Vectra 3D imaging to assist patients in envisioning their procedure. Using advanced hardware and imaging equipment, Vectra is able to create a full 3D rendering of patients that simulates the results of rhinoplasty, facial rejuvenation, breast augmentation, or facial implants.

Vectra Before/After

A key feature of this device is the ability to visualize changes in one’s physical features in real time. This means doctors can adjust the image to reflect the cosmetic goals of their patients for the most desirable surgical outcome. The Vectra 3D Scanner represents a fundamentally new approach to helping patients decide how they want to look.

In our cosmetic surgery practice, we use the Vectra to help "size" patients with different volume implants although we will also fill a brassiere with implants to give patients an impression of how they look in clothes. We find the combined sizing method helps us better understand patients wishes.

On the technical side, this 3D consultation can acquire a full set of data in as little as 1.5 milliseconds, with one-shot, multi-capture, continuous and rotatable views. This gives patients unprecedented flexibility and confidence in participating in the details of different procedures. Keep in mind, surgery is both art and science, so actual outcomes may not precisely match that of the 3D projection.

Three-dimensional imaging is a coming-of-age technology that will soon be a norm in the cosmetic surgery industry. While at the International Master Course on Aging Skin Annual Meeting in Paris, many doctors presented using Vectra 3D imaging. I foresee this technology becoming a standard for both presentations at medical conferences as well as in cosmetic practices.

Added Benefits of Beautiful Lashes

2010-02-03T16:15:00.006-05:00

Following the FDA approval of Latisse® (active ingredient Bimatoprost), there has been an ongoing buzz surrounding the proven effects of the eyelash enhancing drug. Latisse®, however, did not originate as a cosmetic product. The popular eyelash treatment was originally used to treat glaucoma patients. Bimatoprost was re-approved by the FDA for cosmetic purposes once lash growth was acknowledged as a side effect to the drops.

Although Lattise® was originally used for glaucoma treatment, more benefits of the common cosmetic product having been discovered. The use of Latisse® for hair growth on the scalp is now being explored, as well as eyebrow growth. Patients seeking full eyebrows like Megan Fox or Kiera Knightly may benefit from the alternative uses of Latisse. There may be a future for Bimatoprost in the hair-loss industry, although treatments may be costly.

The compound Bimatoprost has also been shown to reduce adipose tissue in mammals, or what is commonly referred to as body fat. Studies are currently underway to test injections of the compound on fatty deposits in the human body. The cosmetic industry may see a future fat reduction treatment that mirrors Botox and filler injections, making weight loss more attainable for patients. That doesn’t mean its time to bail on a healthy diet and exercise. It may take many years for said treatments to be approved by the FDA. Bimatoprost is currently only used in the U.S. for glaucoma treatment and eyelash growth under the Lumigan and Latisse® labels.

Latisse® is also a very safe treatment with minimal side effects. During clinical trials, only about 4% of users reported having the most common side effect: itchy and/or red eyes. Bimatoprost has passed FDA regulations twice now, for both medical and cosmetic purposes, similar to Botox’s dual approvals in 1989 and 2002.

A Nutritional Approach to Sun Protection?

2010-02-01T14:18:00.003-05:00

Since we never fail to mention it, we hope that all our patients understand the importance of applying a high-level sunscreen to reduce their exposure to damaging ultraviolet A rays. Some recent news suggests that the Greek-style Mediterranean diet may also play a part in avoiding skin cancer.

Although the Mediterranean region is known for its hot and sunny weather, it’s been found that the area’s population has a relatively low level of skin cancer. This suggests a strong correlation between diet and skin cancer prevention.

What’s in the Mediterranean diet that might influence this? Dietary antioxidant vitamins, minerals, and phytochemicals, and n-3 polyunsaturated fatty acids, n-9 monounsaturated fatty acids, and low pro-inflammatory n-6 polyunsaturated fatty acids all have protective properties. It appears that these protective properties extend not only to functional issues, such as cardiovascular health, but to the skin’s ability to ward off photo-oxidative radiation from then sun.

More studies are in the works, and we’ll keep you updated with them as we receive them.

Cytori's PureGraft: Removes and Reinjects Patient's Fat in 15 Minutes

2010-01-19T12:04:00.001-05:00

The FDA has approved Cytori's PureGraft system, which is a bedside device "capable of removing, purifying and re-injecting a patient’s fat tissue in about 15 minutes."

We haven't posted on this before, but investors sure seem to be excited about Cytori's product, as shares of CYTX are at an all-time high of 8.34 right now.

We are still awaiting news on PureGraft's approval for use in Europe. The product will be officially launched at the American Society for Aesthetic Plastic Surgery meeting in late April.

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

South Beach Symposium Wrap-up

2010-01-18T16:09:00.003-05:00

This past weekend Dr. Pozner and I both lectured at the 8th annual South Beach Symposium. This Miami Beach meeting, run by Dr. Mark Nestor, is always a very practical symposium with a large variety of lectures focusing on both medical and cosmetic dermatology.

Dr. Pozner ‘s lectures focused on fractional devices such as Sciton (we use Sciton Erbium lasers) and I discussed the science of mesotherapy. I talked about our research with Kythera’s deoxycholate and on newer attempts at mesotherapy for cellulite that do not require the currently used, and highly controversial, Lipostabil approach. Mesotherapy has yet to be embraced by mainstream dermatology and plastic surgery. This may change as a more serious scientific approach is given to the techniques of mesotherapy.

One of the more interesting discussions at the meeting was a look at newer approaches to using one’s own fat for filling wrinkles (and perhaps even enlarging breasts). Although this technique has been around for well over a decade, newer approaches may be simpler, less traumatic and lead to even better results. Stay tuned!

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

IMCAS Buzz: Syneron merges with Candela, acquires Primaeva

2010-01-18T15:35:00.004-05:00

Last Monday, Dr. Pozner and I returned from the 12th annual International Master Course on Aging Skin (IMCAS) in Paris, France. I have been the only American on the organizing committee of IMCAS for all of these 12 years, and have watched this meeting grow from its original meeting with only a couple of hundred physician attendees to what is now one of the leading international meetings dedicated to cosmetic dermatology and plastic surgery.

This year, there were over 3,200 physicians in attendance from over 40 countries. For American physicians the meeting is fantastic because we learn of new European cosmetic approaches that are not yet available in the US. Our European counterparts also learn of American approaches from of us.

There was a buzz at the meeting about the Syneron merger with Candela and the possible purchase of Bioform by the German company Merz.

Syneron has rapidly become a major international manufacturer of new laser and laser-like technology. Candela has always been well respected since their early development of the first pulsed dye laser. There was much discussion about Syneron’s new eMatrix fractional radiofrequency devices.

They share in common with other such devices such as Solta’s Fraxel Repair, Lumenis’ FX and Sciton’s Profractional lasers the ability to deliver fractional pulses for laser resurfacing of aging skin. What makes the eMatrix different is that it is a radiofrequency device and not a laser. It is possible that this machine may be highly effective for treating acne scars and will be safer for treating darker skin types.

I also had the opportunity to present our recent research on the Primaeva skin tightening device. Primaeva was recently also purchased by Syneron. The Primaeva skin tightening approach, as well as Ulthera’s focused ultrasound technique, is an attempt to produce more consistent non-surgical skin tightening.

Merz, in Europe, has become a leading manufacturer and distributor of new wrinkle fillers and Botox-like substances. Belotero, the new Merz hyaluronic acid was much discussed at the IMCAS meeting. This product awaits FDA approval in the US.

Despite Merz’s well deserved reputation in the European cosmetic market, they are relatively unknown in the US. Their attempt to purchase Bioform with their very popular Radiesse filler gives Merz a well needed foothold in the US cosmetic market while they await FDA approval of their popular European injectable cosmetic products.

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

Guest Post: Dr. Michael Gold

2010-01-18T08:12:00.003-05:00

I have just returned from IMCAS - regarded as one of the more innovative derm and plastic meetings of the year. What makes IMCAS great is that, as the first meeting of the year, we have the opportunity to work with companies and to listen to lectures from experts from all over the world on the most cutting edge treatment modalities for aging skin. This year was no exception and I was honored to be included in the program lecturing on a variety of innovative new devices for the aesthetic world.

These included the eMatrix from Syneron, a new bipolar radiofrequency device that has been quite successful in treating acne scars and deeper lines and wrinkles. We introduced the newest version of this device and some of the clinical data we have with it - very exciting technology.

We also discussed the numerous cellulite devices on the market, including the VelaShape from Syneron and the SmoothShapes from Eleme - and presented the clinical trial data we have obtained with the SmoothShapes and the reduction in thigh circumference which can be achieved with these machines. I also had the honor to speak on the new cold fat removing device, the Zeltiq - and introduce it to some of the European luminaries working with the product. This machine uses cold to destroy the fat cells and to remove inches from your skin.

And I spoke on some of the new fillers and toxins which are on the market - and those which are coming. This included the use of the Anteis "Pen" - a novel injection system which puts fillers and even toxins in the skin in exact measurements and with less pain - not yet available in the US market but someday - and something very exciting as well.

IMCAS is a great meeting - to share experiences with colleagues and friends.

Dr. Michael Gold
Gold Skin Care, Nashville TN

Topical Botox is for real

2010-01-16T08:03:00.000-05:00

One of the best presentations at the IMCAS was by Dr. Michael Kane, a plastic surgeon from NY, who presented the phase 2b data from Revance's RT001 - also known as "topical botox."

This topical preparation allows the botulinum toxin molecule to penetrate the skin and affect the targeted underlying musculature. In the study Dr. Kane presented, they developed a wrinkle score for crows feet - periocular wrinkles and showed the results of the Revance toxin. The preparation significantly improved the wrinkles at rest - which was most impressive as all the other toxin studies show improvement with motion. The toxin is also thought to be very effective in treating axillary hyperhydrosis - aka underarm sweating.

Bottom line - no needle botox is going to be a blockbuster.

Revance is privately held, but we'll go to a quote from Colin Stewart's "In Your Face" blog for the details on their deal with Medicis.

"...Medicis Pharmaceutical, which sells the popular dermal filler Restylane and the new Botox-like injection Dysport, decided in 2007 that RT001 was promising enough that the company paid Revance $20 million for an option to buy it.

In the deal, Medicis acquired a 10 percent stake in Revance plus an option to buy the company outright or to acquire an exclusive North American license for RT001."

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

Merz adds Bioform to become Merz Aesthetic

2010-01-13T18:08:00.002-05:00

I recently went to Merz's advisory council. They introduced their Belotero hyaluronic acid fillers to a group of US dermatologists and plastic surgeons. We hope that it is FDA approved soon. I got a turn at injecting it in Paris and it is very smooth and may last longer than Restylane and Juvederm, which represent the current generation of hyaluronic acid fillers in the US.

For the European market, they introduced Novabel - an alginate facial shaper that has a duration of effect of at least 12 months. It uses a proprietary technology called Geleon. With their recent Bioform acquisition, Merz is becoming a huge player in the aesthetic marketplace.

According to Merz, they're also introducing a new neurotoxin called Bocouture/XEOMIN, which they bill as "a neurotoxin free of complexing protein, available today to customers outside of the United States for aesthetic and neurological use and currently in phase 3 trials for aesthetic indications in the United States."

We'll keep you updated!

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

Live from the IMCAS!

2010-01-07T18:26:00.002-05:00

We're off to the annual International Master Course On Aging Skin, held in beautiful Paris.
That picture was taken by me today! Dr. Goldberg is very involved with the planning of the IMCAS. It focuses on many products and treatments that are currently being used in Europe, but are not yet available in the United States.

In our coverage of last year (here and here) there were extended looks at treatments like Ulthera, and fillers such as Novielle, Voluma and Revanesse.

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 NEW Ultrashape coming soon

2010-01-05T15:27:00.004-05:00

Ultrashape is introducing a new machine that combines RF with ultrasonic waves for fat removal.

Yes, it is a NEW device. Dr. Goldberg and I have been at the forefront of non-surgical fat removal in the US, having been involved in the current generation Ultrashape FDA trial (before/after from Good Morning America pictured above, still awaiting approval), as well as using the Zeltiq device off-label for cosmetic purposes.

Dr. Pozner recently attended the Liposonix advisory board meeting as well. Basically, we are involved with all the non-surgical fat removal devices from the major companies.

Dr. Goldberg will be helping Syneron launch the new Primaeva fractional radiofrequency skin tightening device at IMCAS. Primaeva and Ulthera represent the 2 newest approaches to improve non-surgical skin tightening.

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

Bioform (makers of Radiesse) bought by Merz Pharma Group

2010-01-04T17:44:00.005-05:00

Merz Pharma Group, in Germany, announced today that they're buying Bioform Medical for $253M today.

Bioform will now be known as Merz Aesthetics, and they are most prominently known for producing the popular dermal filler Radiesse, which consists of calcium-based microspheres suspended in a water-based gel.

According to the ABC News report on this event, BioForm is "developing a surgical adhesive intended to be used in repairing large blood vessels, and an injectable treatment for varicose veins."

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 on In Your Face Blog

2009-12-23T09:28:00.003-05:00

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

2009-12-19T11:12:00.003-05:00

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"

2009-12-17T10:32:00.002-05:00

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

2009-12-11T18:01:00.003-05:00

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