CNN: Robots are the future?

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

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

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

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

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

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

The Aesthetic Show: Add the Soniceye to upcoming hot list

While in Vegas last weekend I also attended and lectured at The Aesthetic Show, run by Michael Moretti, publisher and editor of the Aesthetic Guide - this is a huge show that included many specialties. I lectured on fractional resurfacing, specifically on Sciton's erbium profractional and the many studies we have performed at SMAC with this device, and on non-surgical fat removal with Ultrashape, Liposonix and Zeltiq.

There were many excellent presentations, including NJ's Dr. Barry Dibernardo and Brazilian plastic surgeon Alberto Goldman on laser liposuction. Diane Duncan gave and excellent update on the Invasix's RFAL - Bodytite machine that i have been working on as well. More to follow from this meeting over the next few days with a guest blog.


The best part of this meeting was the new toys from industry. The coolest thing I found was a device called Soniceye, distributed by Sound Surgical Technologies (who sell the VASER system). This device is a hand held ultrasound transducer developed for the Department of Defense to be used in the battlefield, to help with intravenous access of wounded soldiers. There is a heads up display, and you can see me testing the device in the photo above. Might be great someday for liposuction or vein treatment. More to come!!!!

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

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

What happened in Vegas at ASAPS...

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



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

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

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

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

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

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

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

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

Thanks for reading,

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center
Sanctuary Plastic Surgery

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

The War on Fat: Updates on Zeltiq and Ultrashape

Here's what happened at the ASLMS conference regarding Zeltiq and Ultrashape:

For Zeltiq, a study was presented by Elizabeth Tanzi from Washington D.C. Co-authors were Jeffrey Dover, A.J Burns, Syd Coleman, Richard Fitzpatrick, Jerome Garden, David Goldberg, Roy Geronemus, Suzanne Kilmer, Flor Mayoral, Robert Weiss and Brian Zelickson. It was titled "A prospective clinical study of noninvasive cryolipolysis for subcutaneous fat layer reduction - interim report of available subject data."

This was a multi-center, prospective, non-randomized, IRB-approved study of male and female patients with back or flank fat. One side was treated and the other side untreated as a control. There was interim data on 32 patients which showed a visible contour change in the majority of patients. 10 patients had Ultrasound measurements which showed an average reduction of 22.4% in all patients at 4 months.

What you need to know: This was a very promising study of this technology. As we've covered before, it has received its CE mark in Europe (the equivalent of FDA approval). And it was a hot topic at the American Academy of Dermatology meeting, the Hawaii Dermatology Seminar, the International Masters Course on Aging Skin conference, and the American Society of Plastic Surgeons meeting.

Dr. Goldberg was mentioned in the list of co-authors of the study and the tests were conducted at his practice, Skin Laser Surgery Specialists of NY/NJ.

A little more on Zeltiq from a previous post:

"Cryolipolysis by Zeltiq involves the precise delivery of cold to unwanted fat areas such as love handles. Initial work was done on animals, but data was recently presented at the American Society for Dermatologic Surgery meeting, showing that dramatic results can be seen in humans... Patients sit and read the newspaper while their fat is frozen away! Our NJ office is one of the FDA sites where we are treating love handles. "

Here is a four-month before/after after one treatment with Zeltiq:
Regarding Ultrashape, Guilherme Almeida, Leticia Almeida, Andrezza Facci, Elaine Marques, marcia Paes and Thais Notarangelli III, all of San Paulo, Brazil presented a study using external focused ultrasound for body contour with the new 1hz hand piece compared to the 3 hz hand piece.

This study showed results of 83 patients with 354 treatments with the Ultrashape's new 1hz hand piece (this was the hand piece we used in our US FDA trial at SMAC- see previous posts). Patients had 3 treatment sessions of all areas and were imaged with the Canfield's vectra 3d system. All patients showed at least 1.2cm of reduction of circumference per session with an average of 1.8cm. Satisfaction rate was 86%. Conclusions from this study comparing to previous treatments with the older handpiece were similar efficacy and 30% quicker treatment times.

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center

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

Fat Wars: Zeltiq update from American Academy of Dermatology Meetings

Update on the fat wars - Zeltiq (www.zeltiq.com) - has a unique system for fat removal through cryolipolysis that we've blogged about a few times.

I just learned that it received its CE mark, which is the European equivalent to FDA approval. They are now able to sell the device in Europe. The FDA's studies are ongoing, however.

Thanks for reading,

Dr. Jason Pozner
Sanctuary Medical Aesthetic Center

IMCAS Wrap Up: Day 2

Drs. Michael Kane and Mark Jewell presented the initial science behind Liposonix, while Dr. Afschin Fatemi from Germany presented his early clinical experiences. Most interesting were the combined deep and superficial treatments he performed with this ultrasound device. Dr. Goldberg recently talked about ultrasound devices with Self Magazine (PDF).

Dieter Manstein, MD presented his work with the Zeltiq cryolipolysis device, which Dr. Goldberg is also working with for a clinical study. For the uninitiated, Cryolipolysis is a patented method that removes fat via a precise cooling process.

It's going to be an interesting next few years with the war between the fat removal devices. We posted on this a few months ago after the ASPS conference. Dr. Goldberg was a coauthor of an abstract recently presented about the early clinical wok with the Zeltiq device.

Here's Dr. Goldberg sharing a moment with Bob Tyson from Zeltiq at their booth:

On another note, it was standing room only in the lectures about fractional laser resurfacing. Many physicians presented about the different fractional lasers out there, including Dr. Goldberg and myself. I spoke about fractional laser complications as did Dr. Christopher Zachary shown in the photo below sharing a moment with Dr. Michael Kane.

Back from the ASPS conference...

I'm back to work after the annual meeting of the American Society of Plastic Surgeons in Chicago. The best part is always getting an insider's preview of the upcoming technology that no one else has seen yet.

On Monday, I was on a panel hosted by Dr. Daniel Dubin (Vice Chairman of Leerink Swann, founder of MEDACorp) about non-invasive body contouring technology.

The main focus was on non-surgical fat removal and centered around three devices that are awaiting FDA approval:

The first two are very interesting ultrasound devices. The UltraShape and Liposonix both use ultrasound waves to break up fat deposits, which the body then treats as regular fat and flushes them out via the liver. Liposonix was acquired by Medicis a few months ago, so along with Reloxin they'll have a lot of new products coming out next year.

The third is the Zeltiq. It uses a process called Cryolipolysis, which precisely cools fat to induce it to break down.

FYI: Our practice in Boca is actually one of six sites in the country that are conducting FDA tests for the UltraShape, while Dr. Goldberg is conducting Zeltiq tests at Skin and Lasers in New Jersey.

These are absolutely the newest non-invasive procedures and pending FDA approval, you'll be reading about them in every women's magazine and seeing them done on TV in a couple of years.

Dr. Jason Pozner,
Sanctuary Plastic Surgery