Celebrity Plastic Surgery, News, Gossip

By Steven Dayan, MD

As Americans debate healthcare reform and our elected officials search for methods of funding the proposed one trillion dollar plan, plastic surgery has been thrust to the forefront of the conversation as a vehicle for generating revenue. Affectionately known as the “Botax”, a play on the most popular cosmetic medical treatment in the world, the tax would charge a 5% tax not just on Botox, but on all “cosmetic” medical procedures performed by a licensed medical professional.

This is not the first time such an idea has been proposed. A similar bill for taxing plastic surgery procedures was signed into law in New Jersey in 2004. However, it has fallen far short of its expectations. Having collected 59% percent less than what was projected and costing three to four dollars in government expense for every dollar collected, its failings have resulted in its repeal lead by assembly member, Joseph Cryan, the original sponsor. However, Governor Corzine vetoed the repeal and the law remains in place.

The concept of taxing products and services that are considered self indulgences is not new. Sumptuary taxes or “sin taxes” on cigarettes, alcohol, and gambling started as early as the 18^th century when our early government taxed whisky and tobacco. Sin taxes are justified by many as a penalizing tax on society tolerated ills that are both financially and morally burdensome to the nation.  Self indulging ‘sin’ behaviors are tolerated in the U.S. by a silent majority despite the fact that there will be 100,000 deaths from alcohol related diseases this year, one in two people will be involved in an alcohol related car accident in their lifetime, and 440,000 deaths per year occur from tobacco related disease. The costs go far beyond the dollars. Therefore, to justify the impact on society by penalizing and dissuading those that choose these vices makes argumentative sense. While sin taxes have been deemed worthy funding for important initiatives, cosmetic medicine has now been arbitrarily selected to join this celebrated group of self fulfillment “sins” based primarily on a misconception from its past.

Besides the bureaucratic nightmare, questionable feasibility, and overt gender discrimination that relates to this proposed bill, an equally valid concern is the likely violation of personal freedoms and the negative influence on the least publically understood, but perhaps most valid field of medicine to society. Prior to hastily including cosmetic medicine within the feast of sins from which to cipher a relatively small amount of revenue a closer look at cosmetic medicine, its origin, role and impact on American society today is warranted.

If cosmetic medicine were a team, Botox would be its mascot.  It is the most popular cosmetic treatment in the world and has forever changed medicine; arguably, it has shaped a generation. Its breakthrough properties and subsequent popularity are partially responsible for the cosmetic tax even becoming a consideration. Prior to Botox, cosmetic medicine was a contained small branch of reconstructive surgery centered on a few physicians per city catering to a niche population. However, much like the tremendous breakthrough influence antibiotics had on the way we think of and treat infections, steroids had on the management of acute and chronic inflammatory diseases, and insulin on the mitigating morbidity and mortality of a highly perilous viscerally targeted autoimmune process, Botox has forever changed the way cosmetic medicine is measured, perceived, and delivered.

Prior, the niche population seeking aesthetic medicine was not considered representative of society on a whole, and conventional wisdom categorized them as belonging to one socioeconomic class, self-absorbed, or possibly seeking treatment for a personality disorder. It was not only elective, but also selective medicine not designed and/or deliverable to the majority.

However, a look back reveals the valuable role this “cosmetic” field has played and continues to play in society. Cosmetic medicine, yet to be defined, originated not as a treatment to enhance the beauty of the elite, but more as service trade allowing one to pass into society rid of discriminating characteristics.  Beginning with the Romans and Greeks, plastic surgery allowed conquered nomadic populations to assimilate and hide evidence of a nefarious past or membership to an unacceptable cult. In a society where nudity was celebrated, the first cosmetic surgeries were performed on early Hebrews, Egyptians, and Phoenicians who desired circumcision reversal.

For 2500 years, cosmetic medicine philosophy and techniques didn’t change much until the early 20^th century following World War I when for the first time soldiers survived battlefield wounds and returned home with disfiguring facial wounds that prevented them from being visible in public. Much like the early Greeks and Romans, disenchanted post World War I cosmetic surgery patients were the disfigured who wanted to return to society or “pass” without being recognized. They desired form, function, and assimilation.  One of the early post World War I surgeons was Jacque Joseph; a German surgeon who was known for his skills at reconstructing complex facial wounds of veterans, translated his skills and knowledge to alter characterizing facial features such as the noses of the healthy ethnic males and females wanting to look “more German.” And thus was born elective cosmetic surgery. However, the goal of this new trade was not perfecting the human form or achieving ultimate beauty, but making patients happy by allowing them the ability to integrate seamlessly into society.

However, following World War II and the advent of antibiotics and safer forms of anesthesia, cosmetic surgery migrated from a tool of inclusion to a tool of separation. Since the days of Nefertiti and Cleopatra, those who have felt they belong to the elite class of society used whatever they could to separate themselves from the underclass. Cosmetic medicine became an instrument of the privileged to flaunt their identity. Like many of newest trends and fads in pop culture, it started with movie stars. Famous pin-ups such as Marilyn Monroe and Rita Hayworth were getting plastic surgery.   Cosmetic medicine was use to separate the starlets from the common folk. No longer was it a vehicle to blend unnoticed into society, rather it was now being used to stand out. And cosmetic surgeons, in parallel, responded by offering physically altering treatments that were bold, large, and sure to emphasize sexually characterizing features of beauty and youth.

Cosmetic surgery lost some of its original manifesto of allowing one to pass into society unnoticed. Now it became a tool to reinforce class distinction, and a level of being obviously altered was tolerated. Moreover, while wanting to look one’s best is a cornerstone of human behavior, the ability to extend attractiveness or youthfulness beyond what was predetermined genetically became a possibility for an emerging upper class, perhaps leading to its current misrepresentation as a “sin”.

In fact, it was Botox that spread cosmetic medicine to the masses. For the first time, working class individuals seeking cosmetic improvements entered into the market and the demand skyrocketed over 3600% in the past 10 years.[1]

Besides the cosmetic improvement, patients were mentioning they received more favorable treatment from others after receiving Botox.   This posed an interesting question. What was causing the perception of better treatment? Was it that after undergoing a cosmetic medical procedure one feels better and projects a better image or was it that others perceive the treated person more favorably because they are more attractive, resulting in the advantageous treatment?

It is well known and researched that the subtleties humans find attractive in one another are often perceived at a subconscious level. Evolutionary biologist have done extensive studies validating the importance of certain physical characteristics such as symmetry, youthfulness, and body proportions as important indicators of beauty and maximum fertility. Moreover, for hundreds of thousands of years, humans have been enhancing gender specific character traits, whether it’s with clothes, makeup, perfumes, or adornments attempting to appear more fertile and attractive to a potential mate. And to the unknowing observer, people who get cosmetic medical treatments are thought to be more attractive, successful at dating, and even better athletes.[2]

Perhaps the perceived improved treatment from others is not solely due to a physically improved appearance, but as a result of an invigorated self-esteem resulting in projection of a more favorable attitude that is reciprocated. A report published early this year indicated that cosmetic treatments alleviated symptoms of depression, and while this study was small and uncontrolled, it launched an interesting dilemma for further discussion.[3] In a double-blind randomized placebo controlled study, patients who received Botox showed an improved quality of life at two week and up to three months after their treatment.[4] It is easy to speculate that one who feels better about the way they look experiences an improved self-esteem, acts more confidently, and remits a better quality of life. Furthermore, Botox has been shown to correlate with an increase in a more positive mood.[5] In which case, would treating a disease that affects 9.5% percent of our population[6] with cosmetic treatments or plastic surgery still be subjected to a cosmetic tax? Conversely, perhaps the 10 million Americans treated this year with cosmetic procedures¹ can apply for a cosmetic tax exemption believing they suffer from a mood disorder disease. As we begin to study and objectively quantify the benefits of cosmetic medicine to the individual, what is cosmetic becomes even more blurred.

Although cosmetic medical treatments have been labeled as a vain luxury for the rich and famous to discuss while sipping champagne on their yachts, a closer look reveals that these treatments have a much bigger role for many individuals from all backgrounds. Yes, Botox can reduce wrinkles, but it also can provide facial symmetry to stroke victims, reduce migraine headaches, and prevent excessive sweating. Once the theme of sci-fi movies, surgical facial transplants are now a reality, allowing hope to the severely disfigured and banished from society. Breast implants are a potential feminine saving procedure for the 1 in 26  women who will undergo cancer curing mastectomy.[7] Does a 50-year-old post-menopausal breast cancer survivor need her breast? No, not for survival, but certainly it is a critical quality of life and cosmetic issue. Will this be subjected to a cosmetic tax? Where do we draw the line between what is and what isn’t cosmetic?  What about the 57% of females who suffer from balding[8] or the 1.1 million HIV victims who experience facial wasting?[9]

These patients undergo treatments to alleviate the cosmetic effects of these conditions, none of which are medically necessary for survival, but all of which have a cosmetic and quality of life issue.

Also up for discussion, what about children with ears that stand out, young developing females with asymmetric breast, or teenagers with acne? How about treatments for obesity? Is it or isn’t it a disease? If a disease, then liposuction, stomach stapling, and facelifts after massive weight loss will not be subjected to a cosmetic tax? Where does it stop?

Should we arbitrarily consider taxing other cosmetic indulgences such as manicures, massages, and eyebrow waxing? Who will decide what is and isn’t cosmetic- the physicians, a government body, or perhaps a cosmetic czar?

And if the doctor, in attempts to protect his or her patients, doesn’t collect the tax according to the letter of the law and is subject to an audit, will his/her patients’ records be subpoenaed and exposed to the public? Will privacy laws prevail or will Americans tolerate their individual freedoms being compromised in the name of a cosmetic tax?

No longer is cosmetic medicine a treatment limited to an elite class. The majority, 90%, undergoing cosmetic medical procedures are now middle class households earning less than $90,000.[10] And as benefits are becoming further established, more of the population wants to take part in it.

Botox and cosmetic procedures are becoming increasingly affordable, no longer are the benefits exclusive to one class of society. Cosmetic medicine today is a field of study providing improvement in quality of life issues for many Americans. The widespread availability, increasing competition, and proven benefits have driven the price of non-surgical cosmetic medical treatments closer to that of a hair cut than a facelift. The effects of cosmetic medicine on our society are just beginning to be realized, but if millions of Americans can enjoy a better quality of life, what impact would this have on their productivity both at work and at home? It is intuitive to assume that one who enjoys a better quality of life contributes more positively to society both economically and emotionally. Unlike other sins that can be erosive to society, such as alcohol, cigarettes, and arguably fast food, scientific and empirical evidence indicates cosmetic medicine can provide value and strength to society.

At a time when taxing cosmetic procedures is being debated and our elected legislators may be in charge of judging what is or isn’t cosmetic, we need to examine the effects cosmetic medicine has on both the individual and society with clear objectivity. Cosmetic medicine is not a field devoted to stretched faces, large breasts, and thin tummies. The caricature of Pamela Anderson, Joan Rivers, or Kenny Rogers is not the norm and does not define the practice. Rather, it is a field of medicine that today is developing products and services that make one feel better about themselves.

Conventional wisdom likes to brand cosmetic physicians as purveyors of beauty and this couldn’t be further from the truth. Our research and scope of medicine is targeted toward making the majority of Americans feel better about themselves with safe and effective treatment options.  Cosmetic medicine allows traumatized victims, whether congenitally, physically, or emotionally, a path for returning to society and being productive. In addition, it gives all classes of individuals additional tools to obtain an improved quality of life and satisfy one of the most primal human instincts, wanting to look our best.

Cosmetic medicine is a field of medicine that is designing, developing, and delivering treatments that provide a bolt of self-confidence to an individual and a surge of well being that is contagious and beneficial to society. The bureaucratic difficulties of instituting the tax plus the compromise of personal freedom and disproportionate targeting of the middle class, all suggest an arbitrarily suggested misguided tax. Encourage Americans to invest in themselves, don’t dissuade it.

About Dr. Steven Dayan

Dr. Steven Dayan (www.drdayan.com) is a certified member of the highly elite American Academy Of Facial Plastic and Reconstructive Surgery, a selective group consisting of 2,700 qualifying surgeons throughout the world.  He is a clinical assistant professor at the University of Illinois who is in private practice in Chicago and is a recognized surgical expert in his field. He is a requested speaker both nationally and internationally on topics ranging from Botox and collagen, to identifying the validity of latest advancement in cosmetic procedures and products.  Dr. Dayan actively participates in laboratory and clinical research which have proved instrumental within the advancement of minimally invasive medical procedures and plastic surgery.

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Jason Pozner, MD

Laser Liposuction is a minimally invasive, cosmetic surgical procedure which combines traditional liposuction techniques with laser treatment. Compared to older or traditional liposuction methods, laser-assisted lipolysis is generally thought to be safer, easier and quicker, providing more precise body contouring along with a skin tightening effect and minimal downtime.

Laser liposuction can be performed on many areas of the face and body, including the abdomen, arms, back, buttocks, chin, flanks, hips, knees, male chest, neck, thighs and waist. The laser enables many more individuals to be treated who previously would have needed surgery along with liposuction, often due to loose skin. Smaller areas and contour deformities not suitable for treatment with traditional liposuction are ideal for treatment with laser liposuction due to the enhanced precision of the laser. Laser liposuction can also treat areas with little or no fat like the submental area, or the area beneath the chin, as well as areas which have previously been treated with liposuction for improvement of contour deformities and skin laxity. Individuals who cannot afford the lengthy recovery associated with other treatments will find laser liposuction to be a particularly appealing treatment due to the rapid recovery and minimal downtime.

Laser liposuction is most often performed on an outpatient basis with local anesthesia, thus eliminating the risks associated with general anesthesia. Each targeted area can typically be treated in less than one hour. During the procedure, a small cannula fitted with a single laser fiber is inserted through small incisions in the treatment area. Because the incisions are small, there are no visible scars. Once the cannula is inserted, the energy from the laser liquefies the fat cells which are then drained away. The laser provides an additional skin tightening effect for improved contour, and the precision of the laser also helps to preserve the surrounding tissue.

There is little downtime or recovery associated with laser liposuction and most patients are able to return to their normal routine and work within one to two days. Patients report less discomfort, bruising and swelling than with traditional liposuction. The results of laser liposuction are long-lasting with sensible diet and exercise.

There are many different types of laser available for use, including the ProLipo Plus™ by Sciton. This minimally invasive, ultra high-powered laser system melts away unwanted fat while also tightening the skin. This technique helps to maintain firmer, smoother, more evenly toned skin with fewer risks and less downtime than traditional liposuction. There are also several new laser liposuction devices which are currently being studied and offering promising results. BodyTite™ from Invasix is a new all-in-one technology which uses radio frequency internally to achieve simultaneous lipolysis and skin tightening. This new technology allows for much shorter procedural times, improved results and fewer side effects. Another company, Zeltiq, is developing a patented technique called Cryolipolysis™. This new approach to fat removal uses precisely controlled cooling of fat cells for removal without harming the surrounding skin or tissue. This technology can be used to safely remove fat cells near nerves, muscle and bone.

Jason Pozner, M.D., F.A.C.S. (www.spsboca.com), can truly claim aesthetic surgery and skin care as his life’s work. The son of a successful health spa and diet center physician in New York, Dr. Pozner is certified by both the American Board of Plastic Surgery and American Board of Surgery, and is a member of the American Society of Plastic Surgeons, the largest and most prestigious organization of board-certified plastic surgeons in the world.

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By Lois W. Stern, Editor-at-Large MakeMeHeal.com

A 5% excise tax on plastic surgery included in the Senate’s health care reform bill? You must be kidding! Dubbed as Botax, the government’s rationale is an estimated $6 billion in additional revenue over the next decade generated through this proposed tax. Some legislators think this is a clever measure to help close the gap in our nearly trillion dollar budget deficit. But once the veils are all pulled aside, the Bo-tax bill appears to be just another desperate measure to avoid taking a hard look at some of our more blatant health care problems. Isn’t it time for our government to take some fiscally responsible steps toward fixing the mess we are in?

The Bo-tax bill is poised to tax cosmetic  surgery procedures that are not necessary to ameliorate a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma or a disfiguring disease. But there is a large gray area that the legislation does not specifically define. What about the woman left with weakened abdominal muscles after birthing her twins? Will her abdominoplasty (tummy tuck) fall under the category of a luxury procedure and be taxed accordingly? Consider the woman whose breasts are intact but asymmetrical in size, or droop so heavily that they need to be uplifted with a heavily wired bra. Should she be taxed for her breast lift, breast reduction or augmentation? Who ultimately decides whether a given procedure is cosmetic or essential? Necessity or luxury? I see a bureaucratic nightmare in the making. Don’t physicians face enough challenges in tending to their patients’ daily needs, supervising staff to modernize and computerize their records, filing bills and insurance claims? Do they really need to be turned into tax-collectors besides?

If we allow our government to adopt this tax, why should they stop at plastic surgery? Think of all the other non-essential services and procedures that could be taxed. With an additional 5% added to other non-essentials in our lives, perhaps our government could tax haircuts, therapeutic massages, yoga classes . . . and raise many times the estimated $6 billion over ten years.

We have heard cries of sex discrimination and given the fact that nearly 90% of elective cosmetic surgeries are performed on women, the female gender does appear to be getting the brunt of these proposed taxes. Why women are the major consumers of cosmetic surgeries is a topic for another day, but suffice it to say that the majority of cosmetic interventions have gone mainstream, performed on middle class women in the workplace or those striving to arrive there. In this incredibly tight job market, looking a few years younger, a bit wider-eyed and perkier can reap dividends. There is little doubt that this proposed tax clearly discriminates against women. But of larger concern is how it fosters a prejudice by undermining and trivializing women’s motivations for cosmetic surgery. The proposed Bo-tax has become a mockery, subtly reviving an atavistic attitude of cosmetic surgery as an idle pastime for women endowed with riches and frivolous focus. Yet according to the American Society for Aesthetic Plastic Surgery (ASAPS), about 1/3 of cosmetic surgery is consumed by women making less than $30,000 a year and about 70% by those making less than $60,000 a year.

To be absolutely fair, the government should not stop here. Why not hear it for the boys as well and impose a 5% tax on Viagra, Cialis, and other erectile dysfunction drugs, hair restoration procedures, gym memberships.. Where does it stop? Why not impose a tax on dental procedures as tooth whitening and porcelain veneers? If our legislators set their minds to it, no doubt they can think of dozens more items to include in this proposed Health Care bill to erode our needs and well-being.

Without question our nation is facing severe fiscal challenges. Our Washington lawmakers have their backs firmly pressed against the proverbial wall. But if the Bo-Tax seems a foolish solution to our woes, where do we look for the needed income to support our broken health care system?

We have a persistent problem of illegal immigration with the presence of nearly 12 million illegal immigrants in this country. Without a doubt, many of these illegals are contributing to our society, paying their way and funding their own health care. But all too often their medical care is funded by Emergency Medicaid through the Emergency Medical Treatment and Active Labor Act, signed by President Reagan in 1986. Additionally, this medical care, which is written off as bad debt or charity by local hospitals, has unfairly burdening our health care system. Make no mistake about it, each and every hard working USA citizen indirectly pays for those costs through extra hospital fees and insurance premiums.

Consider for a moment the New York Times article dated November 21, 2009: Hospital Falters as Refuge for Illegal Immigrants. Fifteen illegal Mexican immigrants turned to taxpayer supported Grady Hospital, an Atlanta based facility, for their dialysis treatments at a cost of $50,000 per year per patient. Grady lost $3.5 million on their dialysis clinic last year, a situation that clearly was becoming financially hopeless. In an effort to resolve their issues without turning their backs on these illegals, Grady recently entered into a signed agreement with MexCare to pay $18,000 for every patient relocated – ($6750 in travel expenses and escort fees, a $750 administrative fee, and payment for 30 dialysis treatments).

It is difficult to find a just balance between humanitarian care and fiscal responsibility once illegal immigrants are housed within our borders. But immigration reform is clearly needed as an issue of top priority in addressing our own broken health care system. The Bo-tax seems trivial, yes even ridiculous, by comparison!

Next on the list is the waste in our health care system. According to a white paper released on Oct. 26, 2009 from the financial research firm Thomson Reuters, the U.S. health care system wastes some $700 billion a year—one-third of all spending—on inefficient practices and outright fraud. By reining in wasteful spending, the report said, the potential exists to trim health care costs, which continue to take up increasing percentages of the gross domestic product. This firm identified six categories of waste, with unwarranted use topping the list at 40 percent. Unwarranted use included items such as direct patient care that had little to no value (i.e. ordering the prescription of costlier brand-name drugs when less costly generics would suffice, ordering diagnostic tests unwarranted for specific medical condition, etc.). Dangerous, fraudulent use made up the next-largest category of wasteful behavior at 19% (i.e. misbranding of prescription drugs by pharmaceutical companies and the intentional provision of unnecessary, and in some cases inappropriate, diagnostic services). Other sources of healthcare waste included administrative inefficiency (17 percent), provider inefficiency (12 percent), lack of care coordination (6 percent), and the continued growth of preventable conditions as obesity and smoking-related illnesses (6 percent). The real job of our government is to cut the waste and utilize the remainder more effectively and efficiently. Doesn’t the Bo-tax seem frivolous in comparison? The quick fix 5% Bo-tax revenues of an estimated $6 billion over the next 10 years is infinitesimal in comparison to the wastes reported in our broken healthcare system.

The dirtiest words around Washington, Pork Barrel politics, are also know by the euphenism, earmarks. Simply stated, Pork Barrel politics involves spending that is intended to benefit constituents of a politician in return for their political support, either in the form of campaign contributions or votes

Typically, “pork” involves funding government programs to spread out among all taxpayers funding or services whose benefits are concentrated in a particular area or amongst a particular segment of the population. Although the current administration and the leaders of both congressional parties had promised to cut back on pork funding, the Citizens Against Government Waste (CAGW) tell a very different story in their annual Pig Book, which they refer to as it “the book Washington doesn’t want you to read.” This watchdog group has issued its book each year since 1991, with a list of member projects inserted in annual spending bills. The past year’s 10,160 projects – valued at $19.6 billion in the cost to taxpayers – represent a 14 percent increase over last year’s spending on “pork”. This despite the fact that the number of these pet projects went down 12.5 percent during the same period, and that Congress now requires members to identify their own earmarks, enabling taxpayers to see the name attached to each project. Of the 10,160 projects in this year’s Pig Book, CAGW identified 221 earmarks worth $7.8 billion that were funded in violation of Congress’s own transparency rules - far more than the projected $6 billion that could be gathered over the next10 years by the 5% Bo-tax bill.

Clearly our healthcare system is broken, but the 5% Bo-tax is hardly a reasonable remedy to fix it. Come on Washington, you can do better – much, much better. It’s time to discard your smoke and mirrors and tackle the serious issues that are undermining our current health care system. Take an objective look at the hard issues and underlying causes that have brought us to this precipice. Then work on some sensible solutions –solutions that fix what is wrong rather than imposing a new tax that makes little sense.

If you want to help stop the Cosmetic Tax Bill, take a moment to click here:

http://www.stopcosmetictax.org/tellafriend

Lois W. Stern, Editor-At-Large at Makemeheal.com, is the published author of two books: Sex, Lies and Cosmetic Surgery www.sexliesandcosmeticsurgery.com and Tick Tock, Stop the Clock www.ticktockstoptheclock.com/ as well as a number of magazine articles. Her Professional Edition DVD is a popular aid to office staff while interacting with their patients. She and Patty Kovacs are the co-founders of http://coast2coastbeauty.com/CURRENT_NEWS.html. Check it out!

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By Patty Kovacs, Editor-At-Large, Make Me Heal

Laser (Light Amplification by the Stimulated Emission of Radiation) is a “light pump” which applies principles of radiation physics to very narrowly segregate light of selected wavelength and then “pump” the light radiation to high intensity. These beams of selected wavelength are varied in intensity and in duration of the emitted pulses.

Laser treatments have advanced in the plastic surgery market at the very speed of light itself for the past decade. Today’s patients are heading into their plastic surgeon, dermatologist, and medical laser specialist to consider the latest options for skin rejuvenation. The menu of advanced laser, non-surgical options are ever growing in numbers. Plastic surgeons are adding laser treatments to the overall improvement for their patients, and dermatologists are seeing unprecedented growth in patient requests for laser treatments. Recent laser and skincare advances enable dermatologic surgeons, plastic surgeons, and anti-aging physicians to treat a variety of skin conditions that previously required invasive procedures and a long recovery period.

Laser skin resurfacing softens wrinkles and depressed scars, as well as removes pigment related to sun damage, thereby creating a more youthful appearance to the skin. Sometimes called “laser peeling”, laser resurfacing is a precise, effective, and long-lasting method of skin rejuvenation, resulting in dramatic improvements to the appearance of treated skin.

Research has shown that laser resurfacing treatments also stimulate the formation of new collagen to provide better support for the skin, resulting in a smoother and more even appearance to the skin. Laser resurfacing treatments must be tailored to the nature and extent of skin damage, skin type and individual requirements for recovery time.

While physicians and laser treatment specialists can now prevent, maintain and even restore a youthful appearance to men and women of nearly all ages, it’s important to remember that healthy skin and good skin care habits should begin as early as childhood and can actually help in the development of self-confidence and positive self-esteem. Remember, maintenance is less expensive than repair and daily habits that are inexpensive can really make a visible difference. But, oh what a skin improvement these lasers create. Bring on the Light!

Dozens of laser companies today make anywhere from three to ten laser systems each, creating a market overflowing with more than a hundred lasers, all lighting the way for your attention to skin repair.

I first decided to give a call to Dr. Brandith Irwin, board certified Dermatologist, Director of the Madison Skin & Laser Center, frequent guest of Oprah, and author of The Surgery-Free Makeover.

“Originally, laser companies tested their lasers themselves for long periods of time before releasing them to the world at large. Their very reputation depended on delivering a safe and reliable device that got good results for patients. But due to more intense competition now, laser companies all vie to be the first to get to market with their new devices, each with the ‘newest’ technology. While this ‘new’ technology may be promising, lasers are more often released before the results are clearly defined and before the treatment parameters are definitely established. That means, all too often, that doctors and consumers do the ‘testing’ of the devices themselves,” says Dr. Irwin. “Good laser centers that operate ethically will never try to ‘hard sell’ you or get you to commit before you walk out the door. An excellent, ethical doctor wants you to think over what’s involved, to do your homework, and never use before-and-after photos as your main study material.”

Today’s principal applications of lasers in facial skin rejuvenation are reduction or removal of wrinkles, lines and age spots so to “resurface” the skin.

Powerful, rapid pulses can be directed toward resurfacing skin with- surprise!- no bleeding. Laser skin resurfacing offers reduced risk of infection, precisely controlled surgical effects, and one-day outpatient treatment.

After-effects and recovery times vary with different laser procedures. Your doctor should always carefully explain the risks, after-effects, and benefits of recommended procedures.

A broad range of dermatologic applications for lasers include:

Skin resurfacing - removal or improvement of wrinkles & lines, aging, and photo-aging

Treatment of superficial brown pigmentation, age spots and deep pigmented lesions such as port wine stains and birthmarks

Removal or improvement of scars (acne included)

Removal of some skin cancers

Removal or improvement of vascular moles or skin warts

Removal of tattoos

Removal of unwanted hair

I decided to best follow the light with what many dermatologists are calling the Gold Standard of lasers, the Fraxel re:pair ™ (or Fraxel repair).

Fraxel repair is currently hailed as a revolutionary procedure in the treatment of wrinkles, age spots, sun spots, sun-induced redness, scars and irregularities of the skin because it has the capability of tightening and rejuvenating the skin with “extreme safety.” Fraxel repair significantly corrects aged or damaged skin by utilizing a new technology known as Fractional Deep Dermal Ablation (FDDA™). Recovery time is less than traditional laser treatments and the procedure has proven more effective than skin treatments used in the past.

I spoke with leading laser expert, Dr. William Groff, board certified Dermatologist, La Jolla Cosmetic Surgery Center, which, according to Solta Medical (the manufacturers of Fraxel re:pair,™ performed more Fraxel re:pair™ procedures in 2008 than any other practice worldwide.

Dr. Groff actually worked on the original prototype of the Fraxel, having been greatly involved with research and development of the technology since its inception. He teaches the procedure to other physicians around the world and is considered by his medical colleagues as one of the most respected sources on laser treatments.

“While the Fraxel repair resurfacing laser has more social downtime depending on the aggressiveness needed for each case, it’s one of my favorite treatments for moderate to severe sun damage, acne scarring, as well as Melasma. I’ve actually had virtually 100% success treating Melasma with the Fraxel,” exclaims Dr. Groff. “With the Fraxel repair, we adjust the treatment from a light treatment to a more aggressive treatment, depending on each patient’s specific needs,” says Dr. Groff.

The Fraxel works on a microscopic level breaking the treatment area, penetrating the dermis and resurfacing the uppermost part of the skin. The process allows the skin to stimulate itself while expediting the production of collagen and elastin, resulting in a tight, smooth, fresh look to the face.

Fraxel repair leaves microscopic areas of the skin untouched allowing for faster healing than if the entire area were treated all at the same time. It’s considered safe for sensitive areas like the neck, chest, arms, hands and legs and effective in treating sun spots and age spots, deep lines and wrinkles, uneven skin tone and texture, skin irregularities, precancerous lesions, reduction of scarring (including acne scars, traumatic scars and surgical scars), and lightening of stretch marks.

Specifically, patients can expect to see softening of deep lines and wrinkles, a significant reduction or elimination of age spots or sun spots, smoother/ even skin tone and a tighter.

PICTURE

Photo courtesy: La Jolla Cosmetic Surgery Center

Patients are given a topical anesthetic cream, pain medication and nerve blocks prior to the procedure to numb the general treatment area, thus patients experience little to no pain. But of course, patients can request the option of having general anesthesia if preferred.

PICTURE

Photo courtesy: La Jolla Cosmetic Surgery Centre

A patient can expect redness, swelling, and crusting for 7 to 10 days, all of which are normal signs indicating the skin is healing and deep tissue is being repaired, and patients generally return to normal activities within 6-10 days of treatment.

The UltraPulse Encore Total FX/Active FX™ Laser combines the safety of fractionated laser therapy with the efficacy of CO2 laser treatments. The UltraPulse Encore Total FX™ (fractionated CO2) laser deeply penetrates with microscopically small but highly effective CO2 laser “microbeams” removing sun damaged and scarred tissue, stimulating the body to produce new, healthier collagen. In addition, patients sometimes elect to have the surface of their skin treated with a second laser pass designed to blend color imperfections (”Active FX™”), resulting in a significantly improved appearance of the treated skin. Wrinkles and scars are substantially diminished and skin color made more uniform. Doctors can treat both facial and neck skin, resulting in a natural looking outcome. Loss of pigment has been reported so the expert skill of your laser technician or physician is important. Healing after this treatment is usually fairly rapid, with minimal care required for only a few days. Redness of the treated skin generally heals over the subsequent week. Most patients’ appearance continues to improve for months after this laser therapy. One or two treatment sessions are generally required to achieve most patients’ goals.

The Erbium Carbon Dioxide (CO2) laser ablates delicate tissue, layer by layer, permitting clear definition of landmarks and optimal depth control. It is used to treat lines, wrinkles, acne scarring, certain other scarring, “sun spots” and other skin conditions. Dr. Groff finds this laser particularly effective for the deeply imbedded lines above the upper lip often caused by smoking or genetics.

The Alexandrite Laser works by using light to target the pigmented area and break it up. The result is fading of pigment in the treated area. While some areas respond with just one treatment, others may require multiple treatments over several visits. When multiple treatments are required, significant improvement should be noted with each visit.

Long-Pulsed Yag Laser Treament effectively treats all skin types, including tanned skin, offering unmatched treatment capabilities in permanent hair reduction, leg veins, facial veins, and wrinkles and skin tightening.

The Candela Vbeam® Perfecta pulsed dye laser treats underlying vasculature and epidermal pigmented lesions without damaging the surface of the skin. Dr. Groff recommends the Candel VBeam® Perfecta along with the Smooth Beam for the most effective treatment for specifically diminishing pore size should that be a patient’s main issue. Perfecta uses micro-pulse technology to provide visibly effective treatments without any open wounds, facial crusting, “purpura,” or laser bruising. No anesthesia is required, and no skin irritating “topicals,” ointments or gels are applied for Vbeam treatment. It is used to treat conditions such as facial and nasal veins, sun spots and freckles, diffuse redness and rosacea, psoriasis, even unsightly scars and warts; and can be used on the face and body.

The Cutera Pearl laser received FDA approval in March, 2007, and has been successfully used to on patients of all ages with sun damage, uneven skin texture and fine lines and wrinkles; however, the most common age group seeking this treatment is between ages 25-60. Pearl smooths the skin’s texture and softens fine lines and wrinkles on the face, neck, upper chest, and hands.

The treatment takes approximately 10-15 minutes for a full face and patients say it feels like a series of mild, brief pinches.

After the Cutera Pearl treatment, the skin will look like it’s sunburned. Ointment is applied to the treated skin to keep it moist. The skin will need to be kept moist for 3–4 days. Any outdoor activity will require protective clothing and one should responsibly limit sun exposure for a few days following the treatment. Make-up is fine after three days when the top layer of superficial skin tissue peels off revealing new, healthy, vibrant skin underneath.

Many patients experience excellent results after one treatment. Some patients want a second treatment for best results. Some fractionated technologies treat only small portions of the face during each treatment, thus 4-6 treatments, each with 4-6 days of downtime and spaced a month apart are required to treat the face.

The Profile® laser brings a new approach to laser hair removal. This infrared laser can selectively target microstructure hair follicles.  It’s effective for lighter skin types and, because of the relatively low absorption of this light by melanin, it’s a good choice for darker skin types.  Additionally, the ability to safely treat sun-tanned skin makes this a treatment of choice for active individuals who spend a lot of time in the sun.

I spoke about the Profile laser with respected friend and anti-aging expert, Dr. Daniela Paunesky, Director of www.AtlantaAntiAging.com, board certified in Internal medicine, Anti-Aging medicine, certified in Bariatric medicine and internationally recognized medical specialist featured in several of Suzanne Somers’ books.

“The Profile laser selectively targets hair follicles and heats them with infrared energy.  Unlike other processes, the laser beam treats many hairs at once, making treatment of large areas practical and easier for the patient.  The Profile employs a unique computer-guided scanning system that automates the treatment, ensuring that your skin is rapidly, evenly treated.  The computer sets the parameters and places the beam in an optimum pattern for the patient’s skin so to ensure a safe, fast, effective and gentle treatment,” explained Dr. Paunesky.

What precautions should be taken before and after any laser treatment? Avoid the sun a few weeks before and after treatment or until your practitioner gives the ok. It’s best to avoid electrolysis, plucking or major waxing a few weeks prior to treatment. If you’ve had a history of perioral herpes, tell you physician or treatment specialist and prophylactic antiviral therapy may be prescribed. Always discuss your desired results and the improvements you expect to achieve. Together with your physician or laser specialist, you can decide if your expectations will be met and if a particular laser treatment is the best option for you.

Lasers will continue to evolve and be perfected. Make sure you have a good relationship with your doctor or laser specialist and that the staff is friendly and respectful. Ask friends whom you trust for their recommendation. Do your skincare homework. Good doctors appreciate patients who respect their time and experience and applaud you for resourceful medical research, not just here say.

Patty Kovacs, Editor-At-Large at Makemeheal.com, is a published author and beauty expert. Patty is the Executive Producer/Host of The Health and Beauty Revolution Show on wsRadio. Her 800+ interviews include over 450 New York Times best-selling authors. Patty

www.wsRadio.com/HealthandBeautyRevolution

www.PattyKovacevich.com

www.Coast2CoastBeauty.com

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By Dr John Saia MD

Times are tough and money is tight. Budgets for cosmetic surgery and even reconstructive plastic surgery are down. Women are actually choosing not to have reconstruction after breast cancer surgery. People were trying things out for themselves before the economy tanked. They just seem to be pushing it a bit harder these days. Is DIY plastic surgery really dangerous?

Well it can be. I have posted at my Cosmetic Surgery Truth blog about such stories. The most recent was a silicone injection nightmare. Liquid silicone is not even used by licensed plastic surgeons, but DIY types think of it as a permanent filler. When injected into the face it tends to become infected and “scars in” like hardening plaster. It cannot be removed with a needle but usually requires surgery to cut it out. Stay away from liquid silicone injections.

I review cases of proposed negligence for the California Medical Board and have seen fake Botulinum toxin injections that were of animal grade product. On the internet you can see cases in new stories of people in salons injecting all kinds of things into people.  When you go to a qualified plastic surgeon you pay for professional grade advice and quality medical care. You can go elsewhere but you are accepting risk in doing so.

What can you do by yourself? I would recommend only over the counter strength facial peels. No injections. No surgery. A few years ago, I saw a woman who had obtained a doctor’s office strength facial peel and applied it herself. She came into the office a week later crying “help” with a face that looked like it had been hit with sandpaper. I had her sign an agreement that I was not responsible for her results and could not promise her anything. She turned out OK considering, but many others will not.

When you choose to self-inject Botox or a filler like Restylane, you first have to know what you have materials wise. Many people don’t know the difference between safe and unsafe products (like liquid silicone) and get themselves into trouble. Then you have to know how to do it. Doctors and nurses are probably better equipped to do this and some do self-treat themselves. For others you are accepting more risk and I can’t recommend that.

John Di Saia MD is a board certified Plastic and Reconstructive Surgeon. He has been board certified by both the American Board of Surgery and the American Board of Plastic Surgery. He reviews cases for the California Medical Board in their expert reviewer program and contributes to a number of medical journals and internet forums. His practice is founded on the concept of a Higher Level of Care.

Ask Dr. John Di Saia A Question On Makemeheal.com.

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By Peyman Solieman, MD & Jason Litner, MD

By all accounts, cosmetic plastic surgery is on the rise in America for ethnic patients. In fact, in 2007, ethnic minorities accounted for 22 percent of the nearly 11.7 million surgical and nonsurgical cosmetic procedures performed in the United States, an increase of 105 percent from 2000. More specifically, in 2007, Hispanics underwent 1,011,071 procedures (up 153% from 2000) while African-American cosmetic surgeries increased 170%.

Yet, we see a number of ethnic patients every month who tell us they’ve had a hard time finding a surgeon who seems to make a practice of doing “ethnic plastic surgery”. Why?

Well, in our opinions, there are a few reasons for this:

The aesthetic is different. We now know that there is tremendous variation in anatomy among and between ethnicities and an equally wide variation in the desired aesthetic.

When it comes to rhinoplasty, which is by far the most popular facial surgical procedure among ethnic minorities, the nuances of ethnic differences in facial structure and aesthetics require a different type of surgeon: one who moves beyond the “one size fits all“ model to tailor results.

If a surgeon is not experienced with the nuance of ethnic rhinoplasty, this can be hard to accomplish in a natural-looking way. Which brings us to the final point…

The procedures are different. For a typical rhinoplasty in patients of European ancestry, the focus is usually on making the nose smaller, reducing a bump, etc. and so we trained to remove some tissue in order to accomplish this. Ethnic noses can tend towards thicker skin, softer tip cartilage, weaker septal cartilage, excessive nostril flare, and sometimes lower nasal bridges. For these patients, the emphasis is typically on narrowing and adding to the bridge, refining and supporting the tip, and on specialized procedures such as alar base reduction (nostril narrowing).

Achieving these goals relies heavily on more advanced grafting techniques in order to have thicker skin drape favorably and show the desired degree of refinement. It is critical to build up tip structure in order to provide not only adequate support but also lasting tip shape and definition. At the same time, most of our patients are seeking refinement in the way of a thinner tip that is not over-built and rock hard. So, there is a balance that needs to be struck and a fairly unforgiving line that needs to be walked. Luckily, with the increase in interest from ethnic patients, we are sure to see more and more surgeons interested in achieving fantastic results for them.

Please let us know if you have any more detailed questions related to Ethnic facial surgery. You can ask both the doctors questions directly just by clicking the link:

Ask Peyman Solieman, MD and Jason Litner, MD a Question

About Peyman Solieman, MD & Jason Litner, MD

At their practice named PROFILES (www.beverlyhillsprofiles.com), both Drs. Solieman and Litner meet and consult with you from your initial consultation through to your surgery and at every visit thereafter. We’re the only center that does that, and our great results and satisfied patients are the reasons why.

Ask Peyman Solieman, MD and Jason Litner, MD a Question

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By: Make Me Heal Staff

Just in time for the holidays and for consumers looking to keep looking their best at an economy budget, Makemeheal.com has just launched  Classifieds, which aspires to become the Craiglist and coupon site for plastic surgery, dermatology, and beauty treatment deals, promotions, and sales.  Now, plastic surgeons, dermatologists, spas, skin care companies, and beauty professionals of all kinds can advertise their deals and promotions in one place and consumers looking to save money can find them in one spot.

On Makemeheal.com’s Classifieds you can now find Botox, Breast Augmentation, Liposuction, and spa treatment deals in your local city.

“Makemeheal.com’s Classifieds app offers a strong and proven way for advertisers to connect with millions of consumers seeking deals on beauty treatments and products.  With the recession and unemployment levels being where they are today, people cannot afford the treatments and surgeries they used to at the prices of yesterday, so doctors and beauty professionals are stepping up and giving better deals than before.  Makemeheal.com is here to facilitate the awareness of these deals to consumers. The consumer and professional both win,” says Ariel Perets, President of Makemeheal.com.

Classifieds enables you to search for deals by city and state.

Check out Classifieds at: www.makemeheal.com/classifieds

Learn more about the benefits of advertising on Makemeheal.com’s Classifieds.

ABOUT MAKE ME HEAL

Makemeheal.com is the world’s largest website for all things plastic surgery, beauty enhancement, and anti-aging.  With 1.5 million members and over 900,000 unique visitors per month, Make Me Heal is a one-stop portal for all the products, services, and information resources needed by the consumer.  Serving all major countries in the world, Make Me Heal’s shopping division is comprised of over 100,000 products, including the leading brands of recovery and preparation products for every type of plastic surgery and non-surgical cosmetic procedure. Beyond plastic surgery products and services, we offer one of the largest selections of beauty and science-based antiaging skin care.  Make Me Heal also has specialized boutiques in other areas including bras, shapewear, and lingerie, anti-aging nutrition and supplements, breast cancer products, weight loss, maternity, wigs, and numerous other departments. With over 1 million members and as the largest social networking hub for plastic surgery, Make Me Heal hosts over 100 message boards, tens of thousands of personal blogs, and numerous video and text chat rooms.  Make Me Heal has the web’s largest library of before and after plastic surgery photos and videos.  Also, Make Me Heal has the web’s largest and only patient-reviewed directory of leading plastic surgeons, dermatologists, and beauty professionals.  Further, Make Me Heal’s News Division is a leading information source for all things plastic surgery, anti-aging, celebrity plastic surgery gossip, and beauty-related entertainment news.

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By, David Shafer, MD

Liposuction is a general term used to describe removal of fat using a suction machine. Tumescent liposuction is the most popular method. In this technique, tumescent solution is injected into the area of fat to be removed. The tumescent solution typically contains lidocaine (to reduce pain) and epinephrine (to minimize bruising). After the solution is injected, liposuction is performed using cannulas (long, thin tubes) to suck out the fat. Fat can be removed from almost anywhere on the body. The most popular areas are the abdomen, waist, back, bra rolls, thighs, buttocks, and chest. Liposuction is usually performed under anesthesia to help minimize any discomfort and to monitor your body during the procedure. Awake liposuction is also possible, but it takes a motivated patient and surgeon since the tumescent solutions must be injected very slowly and the suction performed very meticulously. The volume removed during awake liposuction is also much less than can be removed under general anesthesia in a hospital or surgical center. All types of liposuction are based on variants of the tumescent technique. Liposuction is only for healthy patients.

Recently, laser liposuction (particularly Smartlipo) has received considerable attention and popularity. Smartlipo involves an extra step after the injection of tumescent fluid and before sucking out the fat. During the Smartlipo procedure, a small fiberoptic cable is inserted under the skin and uses a laser to destroy or melt the fat cells. The laser can be set to different modes with different wavelengths to focus more on destroying fat and/or heating up the skin. It is thought that heating the skin leads collagen production and a slight tightening of the skin. After the laser treatment with Smartlipo, the surgeon then performs traditional liposuction with smaller cannulas to remove the melted fat. In most cases, Smartlipo can be performed while you are awake. The advantages are potentially a quicker recovery, slightly smaller incisions, focused treatment and potential for slight skin tightening. Disadvantages, however, are less aggressive treatment since you are awake and can feel the movement of the cannula, smaller volumes of fat removed, inadequate skin tightening and potential for skin burns if you are being treated by an inexperienced surgeon. Also, you should keep in mind that the Smartlipo machine is also sold to doctors who are not plastic surgeons and they perform the procedure with little or no training in liposuction.

In my Manhattan plastic surgery practice, I use both Smartlipo MPX and Power-Assisted Liposuction. I use the Smartlipo MPX, a dual-wavelength laser lipolysis machine, for patients who have small or focused areas requiring liposuction such as love handles, abdomen, arms and neck. I perform these procedures in an accredited, office-based operating room while my patients are awake. In most cases, we perform the procedure on a Friday and patients are ready to go back to work on Monday. For patients requiring larger volume liposuction on multiple areas of their body, I perform Power-Assisted Liposuction in a hospital or surgical center while the patient is under general anesthesia. The Power-Assisted Liposuction (PAL) machine uses a vibrating cannula to quickly breakup the fat and easily such it out. This is a great device for larger volumes of fat to be removed. This can still be performed as an outpatient procedure. However, in the hospital setting, the patient has specialized monitoring. Our priority is patient safety and every precaution is taken to ensure that the procedure is safe and effective.

Whether Traditional or Smartlipo is best for you should be determined in consultation with your plastic surgeon. In either case, liposuction should not be viewed as a weight-loss procedure. Rather, it should be considered a body contouring procedure. Liposuction is not going to prevent you from gaining weight. It will, however, remove fat from specific areas and make drastic changes to your body shape. I like to tell patients that liposuction is a “second chance” to have a nice body. For one reason or another, you let your body get out of control and need fat removed. After liposuction, the patient needs to maintain a healthy lifestyle, eat a balanced diet, and exercise regularly to maintain the results.

Dr. David Shafer completed his plastic surgery residency at the world famous Mayo Clinic. He was then selected to continue his education at the prestigious Manhattan Eye, Ear & Throat Hospital. While most plastic surgeons go directly into practice after residency, Dr. Shafer had the honor to operate with many of the world’s most distinguished plastic surgeons. This unique experience allowed Dr. Shafer to advance his skills to a level that most surgeons take a lifetime to develop. Dr. Shafer continues to operate at MEETH and now teaches the next generation of plastic surgeons from NYU, Columbia and Cornell.

Ask Dr. David Shafer A Question on Makemeheal.com

Visit us at www.ShaferPlasticSurgery.com.

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By John Di Saia, MD

When a reality show contestant ruptured her breast implants after jumping 20 feet off a rope swing, I felt compelled to address the concern that some breast augmentation patients have about this problem.

Bursting a breast implant is not usually so dramatic as what the reality show girl experienced.  Then again, it is uncommon for a patient to know when the break occurred. Breast implant rupture is usually a low key event. Maybe in this case the lady did do some soft tissue damage as well as the break seems to have occurred with a fall from some height. It is conceivable to cause a muscle tear although I have only seen small ones. Torn muscle can hurt.

Usually the implant ruptures quietly and slowly over a few days the breast gets smaller (with a saline implant). If the implant is a silicone gel type, the rupture may not be noticed for quite a while. This is one of the reasons the new FDA recommendations are for breast MRIs periodically after silicone gel breast implant surgery.

The “fix” involves removal of the broken implant and frequently the capsule of scar tissue around it. Silicone gel implants generally have a larger amount of this scar reaction and in removing this scar the healthy tissue available to cover the implants gets thinner. This can be a problem if done repeatedly or if the reaction is long standing or extensive as the breast can be left looking more foreign. The newer generation silicone gel implants will hopefully have less of this reaction than their predecessors, but the truth is we don’t have enough information yet to really say that. The answer to how surgeons minimize this potential problem is a matter of opinion.

John Di Saia MD (www.ocbody.com) is a board certified Plastic and Reconstructive Surgeon. He has been board certified by both the American Board of Surgery and the American Board of Plastic Surgery. He reviews cases for the California Medical Board in their expert reviewer program and contributes to a number of medical journals and internet forums. His practice is founded on the concept of a Higher Level of Care.

Ask John Di Saia a question on Makemeheal.com

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By Dr. David Shafer

Dysport is often called the “New Botox.” However, Dypsort has actually been available in Europe for therapeutic indications since 1991 and for cosmetic applications since 2001. In April 2009, Dysport (officially known as BoNT-A/D) was approved in the United States for the “temporary improvement in the appearance of moderate to severe glabellar lines.” These are the lines between your eyebrows. However, just like Botox Cosmetic, Dysport can be used “off-lable” for treatment of crow’s feet (squinting lines around your eyes), forehead wrinkles, chemical brow lifts, platysmal bands (neck bands) and sweaty palms and armpits.

The molecule in Dysport is exactly like Botox Cosmetic but is covered by a different coating, which dissociates (dissolves) at a different rate. That is why the onset of action of Dysport is thought to be faster than Botox Cosmetic since the coating comes off faster. In Botox Cosmetic Treatment the usual onset of action is 3 to 7 days where the Dysport onset of action seems to be a few days faster. The dosing is different with Dysport, so there may be some confusion when translating Botox “units” with Dysport “units.” This is why you need to see an injector who has experience specifically in Dysport injections. Also, there is a learning curve with Dysport injections, so you may not initially achieve the same results as you are used to receiving with Botox Cosmetic.

There is also some confusion about the pricing of Dysport with many reports on the Internet and advertising claiming that it is cheaper than Botox Cosmetic. There is a discrepancy in the potency of units. A “unit” of Botox is not equivalent to a “unit” of Dysport, so unit pricing is not comparable. There is a slight savings with Dysport, but it is about 5% - nothing substantial. So, do not expect to go to your plastic surgeon to achieve the same results as Botox Cosmetic for half the price. However, with competition, hopefully prices will come down. Allergan (Botox Cosmetic) is currently offering a $50 mail-in rebate for Botox Cosmetic customers and Medicis Aesthetics (Dysport) is offering a $75 mail-in rebate. With these rebates and introductory pricing, you may be able to get a better deal than your last injection.

In the end, it is great to have another minimally invasive product approved on the market which can give consistent and noticeable results with virtually no downtime and minimal risks.

Dr. David Shafer completed his plastic surgery residency at the world famous Mayo Clinic. He was then selected to continue his education at the prestigious Manhattan Eye, Ear & Throat Hospital. While most plastic surgeons go directly into practice after residency, Dr. Shafer had the honor to operate with many of the world’s most distinguished plastic surgeons. This unique experience allowed Dr. Shafer to advance his skills to a level that most surgeons take a lifetime to develop. Dr. Shafer continues to operate at MEETH and now teaches the next generation of plastic surgeons from NYU, Columbia and Cornell.

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