What’s the difference?

pH – the level of acid present – is the crucial difference between over-the-counter skincare products and those you’ll find from a plastic surgeon.

Here’s a general reference to guide you.

• pH of 1-2 = high strength acid
• pH of 3- 4 = medium strength
• pH of 5-6 = weak
• pH of 7 = neutral

Although common skin care products may advertise a high concentration of alpha-hydroxy or glycolic acid, they will most often carry a pH of 7, which is considered neutral. High quality medical grade skin care products from a cosmetic surgeon contain strong acids with a pH level of 1 or 2.

It’s true that run-of-the-mill skin care products are very safe, but they won’t give you the results your looking for. If you want to cleanse your skin, improve your complexion, and protect against the signs of photo-damage, pay attention to the pH level rather than the advertised concentration of acid.

Pennsylvania based company Cohera Medical introduced TissuGlu to improve the safety and efficacy of the tummy tuck surgery and other procedures. By adhering the flaps of tissue created during the tummy tuck, accumulation of fluid may be reduced, thereby reducing the likelihood of complications.

Patrick Daly, Cohera Medical president and CEO says, “This unique product will ultimately help surgeons address a critical need and improve patient care.”

40 patients are expected to be enrolled in clinical trials this November to investigate the safety and efficacy of this surgical adhesive.

Tummy tuck surgery

The tummy tuck is a very common cosmetic surgery designed to reduce the appearance of a protruding abdomen, a condition that often appears as a result of weight fluctuations and pregnancy.  To read more about this procedure, click here to see the tummy tuck page of Dr. Samaha in Boston, Massachusetts.

The lawsuit isn’t intended to increase Botox sales, but rather increase the physician’s ability to access safety information such as possible risks, benefits, dosing, patient selection, etc. regarding off-label applications.

Although Botox is typically used (and approved) to treat wrinkles on the face and forehead, a breadth of other treatment applications exist.

According to current U.S. law, physicians are permitted to administer medicine for any application they deem appropriate.  They aren’t however, allowed to market medicine for any application they please.

A similar article titled “Satisfaction and quality of life in women who undergo breast surgery: A qualitative study” is available on Biomed Central. Here’s a brief summary of those 6 factors as they relate to breast augmentation, breast reduction, and breast reconstruction:

1. Satisfaction With Breast Characteristics
This is clearly the main goal of any elective breast surgery.  Participants of the study commented about improvements in breast shape and the clothing options that were now available to them as a result.  One patient with breast implants comments, “I have really nice voluptuous, rounded, normal-sized perky breasts and I am sooo happy with them.”

2. Improved Physical Well-Being
Breast reduction patients can get relief from back and neck pain, which often allows increased activity and better health.

3. Improved Psychological and Social Well-Being
Patients in the study shared the positive changes in self perception and experiences in social settings. Increased confidence and feeling as if you fit the perceived “norm” of the female body are said to be a common benefits of breast surgery.

4. Improved Sexual Well Being
Enhancements in breast shape and size can bring improvements in sexual pleasure, largely because it alleviates “negative feelings about the breasts” that often cause women to feel less attractive.

5.  A Positive Surgery Experience
Women who experienced a good surgeon-patient relationship – with open, honest communication – expressed more satisfaction with breast surgery.  Patients who had an adverse relationship with the surgeon or staff reported being fearful, uncomfortable, and less satisfied.

6. Overall Satisfaction
Researchers also included the simple category of general satisfaction.  Would you undergo the surgery again?  One breast augmentation patient responds, “there is not one day that goes by that I am not so pleased that I did it.”

Sculptra was recently featured on the NBC Today Show “Today’s Health” segment. After a treatment demonstration and some patient testimonials, Dr. Roshini Raj of the NYU school of medicine appears on the show to explain the details on Sculptra treatment. She covers the advantages and disadvantages of Sculptra and compares the filler to Botox.

Sculptra was recently FDA approved for cosmetic use. While the wrinkle filler has been used off-label in cosmetic applications for a long time, the recent FDA clearance has spawned a renewed interest of the drug in the cosmetic surgery industry and in the media. At Boston Plastic Surgery, we routinely use Sculptra to treat a wide range of facial imperfections.

People who undergo liposuction aren’t necessarily overweight.  In fact, many are actually in good shape.  But at a certain age, a shift occurs regarding weight fluctuations.  It doesn’t matter if we run on the treadmill, use the elliptical, lift weights, or practice Yoga and Pilates, we still may have unrelenting dimples, bumps and bulging areas. They don’t go away! The saddlebags (big puffs on the outer thigh) often don’t respond to exercise or diet.

Fortunately there are new, less invasive Liposuction procedures available that require little downtime. Sometimes, you can even walk out of the doctor’s office by yourself right after the treatment.

Our technique uses sound waves to break up the fat cells, making them easier to remove. The cannula is so tiny it causes minimal trauma to the area so there is less bruising and swelling than with traditional Lipo. In some cases the incision is so small you don’t even have to stitch it – that’s why the recovery is so fast.

Generally patients take the day off after the procedure and go back to work after that. Patients have minimal discomfort and can take a pain medication, but most don’t need it.

If you are interested in smoothing out and reducing areas of your body that bother you, discuss your options with Dr. Samaha.  Also, please remember that ultimately, the most important Liposuction tool is the operator.

For more information on Sculptra, see our homepage or contact Boston Plastic Surgery.

• Pimples appear out of nowhere.
• Dry skin in desperate need of hydration appears overnight.
• Folds around the nose and deep lines in the brow and around the eyes appear more pronounced.

What’s worse, if you had skin problems before, stress will only make them worse, and these issues can persist for weeks and months, even years.

Our bodies are reacting to external challenges.  Stress creates an adrenaline surge that elevates the level of cortisol in the blood. Cortisol tells fat cells to dump sugar into the bloodstream for energy – which is great if you need to outrun a raging elephant but not so great on your body or your skin. Over time stress can damage your body in ways that are not so attractive when we examine ourselves in the mirror.  In addition, we rarely do our bodies or our skin any favors during hard times. As a matter of fact, that is when we sleep less, drink more and eat all the wrong foods.

Although all these issues can be resolved in time, first you have to ‘de-stress.’ Until that time comes, here are 5 professional tips to help you get by:

1. Keep your hands away from your face, stop touching and stop popping those pimples! Keep your hands busy with a pencil or squeeze one of those strengthening balls. For goodness sake, get rid of that magnifying mirror!
2. Go visit your doctor or cosmetic physician and pick up a few acne fighters.
3. Get yourself a therapeutic facial, even if you’re on a budget. Treat yourself to some downtime; even bring your teenage kid in for a facial with you. A twofer! It will be therapeutic and quite relaxing for you both.
4. If you or your kids are using benzoyl peroxide be sure not to use it at the same time as you’re using bleaching products (Hydroquinones) or copper peptides. You can use both products, but not at the same time.  Use one in the morning and the other in the evening.
5. If you’re using high quality skin care products, try a chemical peel! Because a peel removes the built up dead skin on the surface of your face, it allows therapeutic products to penetrate and get the job done more quickly and more effectively. Even a rejuvenating mask or anti-acne mask will give you a great head start on de-stressing your “epidermal anxiety!”

These are the type of questions asked by researchers during the Beauty for Life survey, a collaborative effort facilitated by the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons.  ASAPS President Renato Saltz says the survey was intended to help physicians “understand what patients are most concerned about at different stages of their lives.”

Survey respondents were divided into age groups to determine what each generation values in physical appearance of the self, and physical appearance of ones partner.

Respondents in their 20s, 30s, and 40s indicated that a “fit, well proportioned body” was what they found most appealing in another person.  But when it came to their own physical characteristics, the same group, across the board, said they were most concerned about their own faces.  While the abdomen and hips were said to be areas of significant concern (especially for those in their 30s), facial appearance was said to be more important for most.

The reasons given for maintaining an attractive physical appearance included the following:

1. Boosting self confidence
2. Making new friends
3. Attracting partners
4. Increasing opportunities

In all age groups, cosmetic procedures ranked fairly high, alongside diet, exercise, and skin care.  Through the link below you can easily view the results (in a pdf file) of the Beauty for Life survey.

http://www.surgery.org/private/download/BFLUserSurvey.pdf

In a clinical trial, surgeons operated on 49 patients to ‘deactivate’ their migraines at their respective ‘migraine trigger sites.’  26 patients in a “sham surgery group” received what was basically a placebo.

One year later, 57 percent of the patients in the actual surgery group reported complete elimination of migraine headaches, compared with only 4 percent in the sham surgery group. Furthermore, 83 percent of the actual surgery group observed at least a 50 percent reduction in migraines.

Author of the study, Bahman Guyuron MD calls the procedure a “meaningful addition to the field of reconstructive plastic surgery,” and we definitely agree.  Plastic and Reconstructive Surgery is the official journal of the American Society of Plastic Surgeons. You can read the official press release at plasticsurgery.org.

Pharmaceutical company sanofi-aventis announced yesterday that federal clearance had been given to use Sculptra in facial cosmetic procedures. Although (off-label) cosmetic use of Sculptra has been happening for years, the original FDA approval of Sculptra was for treating lipoatrophy, i.e. facial fat loss, in AIDS patients. Professionals in the industry are excited to get official clearance for this long-lasting dermal filler.

The updated FDA clearance now specifies the following cosmetic purposes:

1. Treatment of mild-severe nasolabial folds
2. Treating Wrinkles and contour irregularities

Regulators based their evaluation of Sculptra on a study of 233 patients that had received treatment with the filler on nasolabial folds (smile lines). According to the official press release, the aesthetic results of Sculptra “were maintained up to 25 months after the last treatment session.” No seriously adverse reactions to Sculptra occurred during the study.

For more information about wrinkle filler treatment with Sculptra in Boston, contact us at Boston Plastic Surgery.

According to The Speaker’s Lobby, a FOX News blog, the idea came from a treasury department official, but it sounds as if the tax proposal is “off the table” for now.  Apparently, most finance committee members have not even heard of the proposal.  An LA Times blog claims the tax was to be introduced as a ten percent charge that would be tacked onto elective procedures like a tummy tuck, breast augmentation, rhinoplasty, and other popular cosmetic enhancements.

There are two strong objections that those of us in the industry would level against this proposal.  First and foremost, such a tax would be paid almost entirely by women.  Despite the growing popularity of cosmetic procedures for men, women still make up over 90 percent of the patient demographic in the United States.  Obviously, imposing a tax such as the one in question would unfairly discriminate against women.  Think about it this way: would a tax be imposed on men who purchase expensive tattoos, fashionable clothing, or bodybuilding equipment?  It doesn’t seem likely.

Second, a common misconception that’s probably at work here (which may have been true in the past) is that only the rich and famous pursue cosmetic surgery.  Maybe you can remember the New York Times story by Natasha Singer titled “Who Is the Real Face of Plastic Surgery?”  Ms. Singer discussed the fact that a large number of patients choose to finance their cosmetic procedures, just as they would a new car.  Also, let’s not forget the 2004 survey conducted by the American Society of Plastic Surgeons; it revealed that nearly “a third of people considering plastic surgery reported average household incomes below $30,000.”

There are many ways to remove unwanted hair including shaving, plucking, electronic tweezers, radiofrequency tweezers, waxing, depilatories (creams), electrolysis (inserting a needle into each hair follicle one at a time followed by an electric spark to burn out the follicle). Most of these methods are temporary. The only permanent and effective treatment to remove unwanted hair is with laser hair removal.

Lasers send a low-energy beam through the skin. The dark pigment (melanin) present in the shaft of the hair follicles absorbs the laser beam. Initial hair reduction is seen immediately after treatment. Permanent results require repeated treatments because of the hair growth cycles.

There are different types of lasers that can be used to remove unwanted hair.  The first lasers approved for hair reduction by FDA were the ruby, alexandrite and diode lasers. But these could only be used on select individuals and not those with tans or ethnic skin.

Using today’s technology, we benefit from lasers with longer wavelengths such as the Cutera Coolglide and Prowave lasers, which have the ability to treat darker skin types – including African-American skin, Asian skin, and those with a tan.

One of the biggest benefits is convenience; immediately following your hair removal treatment you can return to work, school or any of your regular activities.

You may be able to diminish the appearance of dark circles with Jane Iredale’s Eye Amazing Treatment Plus Concealer (Circle/Delete), which offers 3 different skin tone choices to pick from:

Number 1 combines Light and Medium Yellow for light shades
Number 2 offers Medium Peach shades
Number 3 offers deep yellow and deep brown shades

This top of the line concealer contains Jojoba Ester and Avocado Oil as moisturizers, it is high in vitamins A, C, D & E to nourish the under-eye area, and combines Zinc and Titanium Dioxide to protect the tender area under our eyes from the sun’s UVA and UVB rays.

Of course, for those of us who need more coverage, you can combine Jane Iredale’s Active Light with Circle/Delete. Or you may want to use Circle/Delete as a standalone product.

We can show you how to apply one or both products to get the best results.

Hear what patients have to say about this product:

“I can actually blend and control the dark circles under my eyes with this product. The yellow tone blends perfectly with my skin tone and disappears after applied. The consistency is just right!”

“This is the best concealer – not cakey but smooth and literally transparent when applied! It allows you to fake flawless skin and cover any dark circles and blemishes. I’ve purchased this a handful of times and stock up when I remember to order as I can’t be without it for a day!”

“You get a two color creamy concealer that you can blend and that goes on smooth. You don’t have to go around with raccoon-eyes! It doesn’t smear when I use mascara and it really does provide continuous coverage when working long hours. It is great, no complaints.”

Team 5 Investigates recently aired this story on medical spa laser treatments. The news team uncovered some questionable practices taking place at local laser centers and med-spas, and also featured local Boston dermatologists offering their professional opinion on practitioners administering laser treatment with “no medical training whatsoever.”

If you’re seeking a laser skin resurfacing procedure in Boston, there are plenty of options available, but as the story illustrates, you’re much safer with a qualified plastic surgeon or dermatologist.

The American Society for Aesthetic Plastic Surgery produced this educational video, and is devoted entirely to advancing the field of cosmetic plastic surgery through education and research.  See our breast augmentation page or the ASAPS procedure page for more information on breast augmentation.

Today’s advances in chemical peeling have made the results outstanding. Now, peels can actually tighten the skin as they peel away layers and “brighten” even sun-damaged skin. Yes, you do need to be prepared to undergo some tingling upon application (less discomfort than waxing), outlay some money and be out of action for three days, but the results will be worth it – your skin will never look better!

Everyone will comment that you glow. Your skin will look dewy and soft, because let’s face it people, at age 50 your skin doesn’t look dewy without doing something! So if you’re not ready for surgery this is the best place to start by trying a safe and effective treatment under medical supervision.

To prepare for the peel and get the best results, you should begin using a range of day and night medical grade skin care products. They can stimulate collagen production and cell turnover and put some elasticity back in your skin.

Plan ahead and be ready to hunker down for three days (post-peel) with some wine, old movies, TIVO or DVR some of your favorite shows, catch up on some good books or magazines and have some great food in the fridge – be prepared not to answer the door unless you know who it is. By day five, you should be wearing makeup again and be resuming your normal activities.

Here are some of the best peels on the market, that we provide at Boston Plastic Surgery.

• Glycolic acid peel
• MicroPeel® Plus
• Booster peels
• Lactic acid peels
  

See our anti-aging peels page or contact us for more information.

Those interested in cosmetic and facial plastic surgery should first go through a sort of ‘lifestyle makeover,’ modifying their habits until they have reached a satisfactory state of health.  At Boston Plastic Surgery, we want our patients to have the best surgical experience possible, so we ask them to focus on being healthy first.  The ideal patient refrains from smoking or using illegal drugs, has a stable weight, and realistic expectations about cosmetic surgery.

For more specific information on health and surgery outcomes, contact us for a consultation.

Keeping an open mind to new networking possibilities while focusing on the core responsibilities of your profession can be quite a juggling act. The overwhelming stream of information so characteristic of our age has led some people to shun networking tools that have become trendy, with Twitter perhaps being the most obvious example. For what professional purpose would a physician send out 140 character tweets? Well, there are a few reasons:

The value of social media for our surgical practice (this blog for example) is found in education, and in opening the channels for further correspondence. We want to let the community know what we’re doing and how we might be of service.

Dr. Christian Sinclair, who maintains a blog about palliative care, tells the NYTimes, “I can help to inform the public, I can put the knowledge I have out there. And if there are patients or families who need this knowledge, I can help them because of this network.”

Last month, we wrote a story about surgery consultations being done through video chat services and email correspondence, which was a perfect example of how surgeons and other physicians can use internet tools to connect with patients. When you’re seeking a physician with the right amount of expertise, getting out the yellow pages just won’t cut it anymore; it’s more convenient, and probably wiser, to get to know the doctor’s areas of expertise and surgical portfolio before scheduling a consultation, which in some cases may require traveling.

When it comes to the medical profession, the point is to provide a service, and for surgeons that service is actualized in the operating room. But that doesn’t mean surgeons shouldn’t augment the service they provide by using all the latest networking and communication tools this generation is so fortunate to have.

As the warmer weather is upon us and we wear less clothing, it’s time to reveal the skin that has been hidden under our clothes all winter and spring.  Is that a frightening thought? Don’t despair: we’re with you on this – you don’t need stretch marks to ruin your summer. 

Here are some simple solutions to get your skin in warm weather shape, so you too can be comfortable enough to enjoy all the warm weather activities.

Laser Resurfacing has become more precise in recent years and can reduce the appearance of stretch marks after a series of treatments.  The laser zaps the top layer of skin and stimulates collagen production deep within the skin’s layers. This helps remove uneven skin tone, scars and other skin problems on the skin’s surface and restores your skin to a much healthier state.

Fractional Non-ablative Laser Most doctors agree that once stretch marks are white, a fractional non-ablative laser is a very effective treatment. It feels like rubber band snaps on the skin, your doctor will either recommend prescription-strength ibuprofen, acetaminophen and/or topical anesthetic. Most patients will need 4 or 5 treatments, every six to eight weeks. You can expect to improve the texture of stretch marks by nearly 50% after completing a series of treatments. 

Microdermabrasion Treatments are another effective method for treating stretch marks. This procedure buffs away the top layer of skin and also stimulates collagen production. Most patients need between 3-6 treatments to see a noticeable difference, but it is still cost effective and the results are pretty stellar.

Prescription Retinoids are the only topical products that have been demonstrated to be effective for treating and improving stretch marks in the early stages. For red stretch marks, a retinoid cream applied daily for six months has been shown to improve the appearance by about 14%. For white stretch marks, color will not be restored but a prescription strength retinoic cream can help even out texture. As always, talk directly to your doctor about the benefits, the method of use and any risks. For example, you shouldn’t be using retinoids while either pregnant or breastfeeding. 

Other non-invasive skin treatments, such as chemical peels and/or prescription topicals used in combination with microdermabrasion treatments, can help improve the texture and tone of your skin. Consult with us further about skin care so you can get that body ready for this summer’s season.

If your skin is in need of rejuvenation, a few microdermabrasion treatments each year can make a big difference.  Microdermabrasion removes the top layer of skin to reveal a fresh, healthy layer underneath. It also stimulates collagen production, which improves skin elasticity.  It’s an easy procedure, and it can reduce the appearance fine lines, wrinkles and even some forms of skin damage.  If you use skin care products (we recommend medical grade), it can increase penetration, so your daily skin care regimen is more effective.  For many patients, this combination of at-home skin care and microdermabrasion is all it takes to achieve smoother more silky looking skin. 

If you exhibit age spots, zap them away with a laser or Chemical Peel. Rejuvenate your skin while reducing or removing age spots. 

Therapeutic Facials are another great way to remove dead skin cells from the skin’s surface, and they feel great! If you don’t need an intensive treatment but want to freshen up your look, a facial may be the right treatment choice.

Sunscreen is important any time of year, but especially during these hot summer months. Choosing the right sunscreen for your face – one that addresses your skin type and skin conditions – is not always easy.  Use a sunscreen every day. For days spent mostly indoors, use a foundation with an SPF15 or higher. For outdoors you want at least an SPF45 that is waterproof or water-resistant. The right sunscreen can prevent sun damage, skin problems, and even skin cancer.  Harmful UV rays can damage skin cells deep within the skin’s surface, making your cells vulnerable to toxins (free-radicals) in the environment. We can help you select the right sunscreen for your skin.

Self conscious about unwanted facial or body hair? Laser hair removal can erase excess hair to keep your skin looking smooth and buff, reducing the need for shaving and waxing. 

Let us help you maintain the health of your skin. Come visit us at Boston Plastic Surgery to find out which treatment will work best for your skin type; then look forward to looking hot all summer long!

What optometrists labeled a ‘complication’ or side effect of using prostaglandins was “hypertrichosis,” a condition characterized by darkening, thickening, and lengthening of the eyelashes.   

 Allergan offered the topical prostaglandin Lumigan in 2001, a drug that contained the active ingredient bimatoprost. Two important precursors to Latisse occurred after the FDA gave clearance for Lumigan.

• Jan Marini Skin Research Inc had over $2 million worth of product seized by the Food and Drug Administration.  The product, Age Intervention Eyelash, evidently contained bimatoprost, which was unapproved for cosmetic use at the time. Allergan later filed a patent infringement suit against Jan Marini and several other companies that had tried to market bimatoprost in their eyelash enhancing drugs.
• Some doctors started prescribing Lumigan off-label to enhance eyelashes.  Knowing the desirable side effects it could produce. But Lumigan wasn’t formulated for cosmetic use and many believed more research was needed to confirm the safety of topical prostaglandins for cosmetic use.  

Clinical trials and further research is exactly what Alllergan Inc did.  278 healthy adults with minimal to moderate eyelash prominence applied bimatoprost or a placebo to their lash line.  The results were favorable; researchers observed that the average patient’s eyelashes were 25 percent longer, 106 percent fuller, and 18 percent darker, while only 3.6 percent experienced itchy eyes and redness, and only 2.9 percent experienced skin hyperpigmentation.  

Latisse received FDA approval late last year for the treatment of ‘inadequate’ eyelashes.  Allergan now owns the patent on use of bimatoprost for eyelash enhancement.

For more information on Latisse in Boston, Massachusetts, contact us.

The SkinMedica product line is designed to supplement the skin’s healing abilities. To counteract the loss of skin elasticity that comes with age, SkinMedica products contain restorative ingredients like vitamins C and E, retinol and NouriCel-MD®.  SkinMedica products also contain a patented blend of ‘growth factors’ like soluble collagen, antioxidants, and matrix proteins. 

Environ skin care products use intensive vitamin therapy to nourish and protect your skin.  These exclusive products are made from high quality ingredients that are free from fragrance, preservatives, colorants, and animal extracts.  Daily treatments with Environ products really can reduce the signs of aging.  

Contact us at Boston Plastic Surgery for more information on these exciting skin care products!

According to news sources in the UK, Ms. Halep complained that her large (34 DD) breasts have slowed her reaction time on the court and caused discomfort. “It’s the weight that troubles me – my ability to react quickly”, she told The Sun.

In 2008, Halep won the junior French Open. She is now ranked 317th in the world.

Women pursue breast reduction surgery for a several reasons, increased mobility being just one of them. One breast reduction patient stated, “Before I didn’t want to run anywhere. Even across the street if something happened I would not run. It was painful and embarrassing” (Klassen 2009).

Beside issues with physical activity, many women hope to alleviate irritation around their bra strap and underneath the breast, pain in the back and neck, and discomfort during sleeping.

The procedure can be described as a ‘normalizing’ experience for women. Once the surgery is complete, patients often say they are less self-conscious, they fit into more ‘regular’ sized clothes, and that they typify what is perceived as ‘the norm’ of the female body.

While a full summary of the results can be accessed (via MS Word document) here; some of the noteworthy findings are as follows:

 - Most respondents described themselves as healthy individuals. 95 percent said they incorporated exercise into their lives, and 78 percent cited healthy eating habits.
 - Nearly 70 percent of the respondents who had been treated with Botox also opted for dermal filler treatment.
 - Within the respondents, the most common patients were married, working mothers between the ages 41-55 with a household income of under $100,000.
 - 66 percent of the respondents said they received Botox treatment 2-3 times per year.
 - 72 percent of the respondents chose Botox to treat glabellar lines – the vertical lines that appear between your eyebrows.
 - 63 percent of the respondents chose dermal fillers to treat facial wrinkles and folds, mostly the nasolabial folds or ‘smile lines’ that travel from the nose to each side of the mouth.
 - 87 percent reported that they discussed their treatments with others, and 70 percent said they received support from the people they told.

The piece raises some interesting ethical questions: While the procedures could certainly be beneficial to individual nurses in the short term, would such a practice harm the nursing profession as a whole?  

According to reporter Dan Bilefsky, nurses in the region “insist they are under enormous pressure to look good in a society where attractiveness is often as highly prized as clinical skills.”  Critics argue that the incentives could promote an idealized body image for nurses, in a profession already suffering from misconceptions about technical competence.  A spokeswoman from the Czech nurses association suggests that nurses are still perceived as “low level workers” with little to offer besides manual labor.  Nurses after all, aren’t intended to be models, but caregivers that provide an enormous benefit to the medical profession and the public they serve.  A misplaced emphasis on their physical appearance could undermine public perceptions of their competence and value.

Still, others may not see any problem with offering incentives through procedures like breast augmentation or rhinoplasty; perhaps they’re analogous to employee discounts at a retailer, vacation packages, or other career perks.  

The supposed ethical problems brought by these surgical incentive programs probably aren’t a product of the programs alone, but rather an objection to the sexism and discrimination that underlie them.

3 concerns women often express about their skin include:

 - Wrinkles

 - Age Spots

 - Sagging Skin

All of these conditions indicate premature aging due to sun damage. If you don’t address sun-damaged skin quickly it may lead to undesirable skin conditions later in life – conditions like uneven skin tone, sun spots and severe wrinkles.

Fortunately, we now have decades of research available on cell rejuvenation, skin health and the ways in which certain ingredients aid this process. It is a proven fact that products containing the three key antioxidant vitamins – A (Retin, Retinyl, Retinoic Acid or Retinol); C (Ascorbic Acid); and E (Tocopherol), as well as the nutrient Niacin, accelerate cell turnover.

Vitamin A is beneficial in multiple ways; the most important benefit is probably the stimulation of collagen growth.  Vitamin C and E are super-charged rejuvenators, and the nutrient Niacin acts as a sort of damage control.  Together these components naturally rejuvenate by ‘turning on’ the cells that make collagen and elastin. When combined in a product, they can effectively treat signs of premature aging.

The TODAY SHOW recently featured the NIA24™ product line, which contains several of these potent ingredients. 

 One of the most important factors in skin health is retaining moisture and replenishing the water in our skin. NIA24™ deeply hydrates skin while also protecting against the environment.  It also reverses pre-existing skin damage by aiding body’s natural repair mechanisms.  The ‘power ingredient’ in NIA24™ is NIACIN.

Niacin prevents melanin production from reaching the skin to reduce unwanted pigmentation.  Once you start using NIA24™ new sun spots will stop appearing the next important step in the process will being  - gentle exfoliation. You will shed off those brown spots and sun damaged areas revealing healthy, clear skin underneath. 

For more information on NIA 24 and other skin care products at Boston Plastic Surgery, see our homepage here.

These type of services are becoming more popular as more internet-savvy patients choose to research surgery procedures online.  CNN reports that some surgeons have gone as far as implementing a “virtual consultation” using live chat services like Skype or iChat.  These platforms are known for being user-friendly.  One East coast surgeon claims that roughly 15 percent of his patients opt for the virtual consult.

Surgeons in foreign countries have also capitalized on new technology, which has allowed them to reach a wider clientele.  For patients, it’s a great way to gather information or determine if they are comfortable with a surgeon.   Michael Boeckle, who helps schedule surgery “vacation packages” for patients, says “patients usually do not pick their doctor by price, but by how comfortable they feel with the information they have received.”

If you decide to contact us, we can ensure your privacy. We’ll also do our best to address your questions in a timely manner.

Rather than rebranding the drug ‘Reloxin’ as planned, Medicis decided to retain its original European name, Dysport

The April 30th announcement coincided with a 3 percent drop in Allergan’s (maker of Botox) shares, and a 14 percent increase of Medicis shares.  Analysts and industry professionals expect Dysport to carry a slightly lower price tag, and possibly capture as much as 30 percent of the botulinum toxin market.

Botox and Dysport both perform the same basic function – neuromuscular blocking to relax and prevent wrinkles. Dysport however, is said to be more diluted than Botox and thus more cost effective for providers.  The recent FDA approval of Dysport also came with a unique warning label describing the risks associated with the botulinum toxin.

For more information on wrinkle treatments in Boston, see our homepage.

Latisse is FDA approved for the treatment of hypotrichosis, i.e. inadequate eyelashes.  It is available by prescription only.  If you are interested or would like more information, contact our Boston plastic surgery office. 

Many doctors use Botox to treat headaches, and their basic procedures are hardly different than those of wrinkle treatment.  It isn’t entirely clear how the Botulinum toxin provides relief; it may work to inhibit certain pain-transmitting nerves.  But evidently, many people suffer from fewer headaches after being treated with Botox.

As reported in the Journal of the American Academy of Dermatology, researchers from Allergan Inc. conducted surveys about sweating, revealing that almost 3 percent of the U.S. population (7.8 million people) believe their sweating to be excessive.  At the time of the survey (in 2004), less than half of the respondents had sought medical help for the problem.  Botox blocks the localized release of a specific chemical that stimulates sweating, and so the FDA approved it for this use years ago.

Last March, the New York Times published a story on the off-label use of Botox to help those who have suffered a stroke and have trouble relaxing certain muscles.  According to the experts, “only about 5 percent of the stroke patients who could benefit from its use ever get it.”

Patients with even more obscure conditions have found success using Botox. In Feb 2008, USA Today reported that radio personality Diane Rehm (of National Public Radio) had received routine off-label treatments of Botox for a vocal disorder called spasmodic dysphonia.

Aside from these therapies, surgeons and dermatologists are finding even more cosmetic uses for Botox. Dr. Lawrence Reed recently told an ABC news affiliate that “we’re at the tip of the iceberg where Botox is going to be used.”  Reed has apparently been pioneering some interesting new cosmetic applications.

For acne, Dr. Reed injects Botox just below the skin:  “It decreases the muscle pump and blocks the production of oils, so we use it for acne,” he claims.  Other patients of Dr. Reed found success using Botox to relax certain muscles and actually make their eyes appear larger, and to supplement laser skin resurfacing.

If you’re considering Botox for any off-label use, make sure you choose a qualified physician.  Despite the optimism surrounding Botox as a ‘wonder drug’, there have been complications and side effects associated with off-label use and inexperienced providers.  For more information on Botox in Boston, Massachusetts, see our homepage or contact us.

This video is a recent episode of ‘The Doctors’ which features Dermatologist Jessica Wu showcasing Allergan’s new eyelash enhancement drug, Latisse.

Dr. Wu claims (or rather boasts) that Latisse can give you “crazy long spidery lashes” in just 4 months. You apply Latisse to the base of upper eyelashes once each night, “just like liquid eyeliner.”  According to The Doctors, the results should yield lashes that are 25 percent longer and 100 percent thicker!

See the video for a before & after photo; it is quite impressive. If you are interested in learning more about Latisse in Boston, call 617-786-7600 or email our office.

Finlo Rohrer of BBC news speculates that media – especially the tabloid scrutinization of celebrities – has popularized the concept of ‘man boobs.’ Tony Blair and UK conservative party leader, David Cameron, were pictured shirtless during the summer of 2006, which led several media outlets to “comment on their moobs.”

The weblog www.manboobs.uk, which according to one reader, has “plumbed the depths of poor taste,” pokes fun at the concept, but further popularizes it.  American television sitcoms like Seinfeld and Friends have done the same.  According to Rorher, this popularity could lead to “more men making their way through the surgeon’s doors.”

So what is the deal with male breasts?  Here are a few things you might not know:

• Gynecomastia that forms breast tissue in males, is a relatively common condition that is often mistaken for simple excess fat. It can affect newborns, pubescent boys, and adults.  While it isn’t serious (unless it is a sign of something else), it can be painful and embarrasing.

• While obesity can cause a condition of excess breast tissue, real gynecomastia is caused by a hormone imbalance.  In either case, surgery can alleviate the symptoms.

• Medications, or illegal drugs like marijuana and anabolic steroids can cause gynecomastia. Particular drugs that are used during treatment for prostate cancer are to blame.

• Gynecomastia can also be caused by genetic conditions like Klinefelter’s Syndrome.

• Surgery isn’t the only option: in cases of pubertal gynecomastia, the condition will often disappear over time or when puberty is over.  Other cases have shown improvement without any interventions; one case published in the June 2008 issue of Endocrine Practices documented a rare case of bilateral gynecomastia in a 60 year old man. The patient’s examination results were normal, but he reported a daily intake of 3 qts soy milk.  Once the patient ceased his intake of soy milk, his condition improved and his hormone imbalance was resolved.

For many patients, surgery is the right choice.  It can restore the proper masculine appearance that people expect. If you are interested in learning more about male breast reduction, contact us for a consultation.

Allergan recently announced the ‘Latisse Wishes” campaign at a star-studded Hollywood charity event, featuring celebrities like Brooke Shields, Marisa Tomei and Mandy Moore. The campaign pledged support for Make-A-Wish, the non-profit organization that aims to grant wishes for suffering children.

Latisse is Allergan’s latest offering and the first drug to be approved by the FDA for the treatment of hypotrichosis, a condition characterized by inadequate eyelashes. The Latisse Wishes campaign was launched by Allergan with a $500,000 initial contribution to Make-A-Wish.

Hollywood beauty expert and participant Anastasia Soare enthusiastically expressed her support, saying “I constantly work to help make women’s beauty wishes come true, and now we can help children’s wishes come true through the LATISSE™ Wishes campaign.”

It’s no coincidence that the Make-A-Wish foundation was chosen as a beneficiary for Allergan’s campaign; the superstitious “blowing on an eyelash to make a wish come true” provides a clever marketing strategy, backed by philanthropy.

The campaign is encouraging consumers to help double the donation amount by visiting www.Latisse.com and registering their support. From now until the end of the year, Allergan will donate 5 dollars for each new registration, up to one million dollars.

Latisse is now available at our office in Boston; give us a call for more information.

Spokespersons from Medicis Pharmaceutical say they expect to receive FDA clearance for Reloxin later this year. When this occurs, it could bring the first real Botox competitor to the U.S. market – a market which helped Allergan Inc. net about 1.3 billion in revenue last year.

One Los Angeles dermatologist spoke to Bloomberg news about the study, saying “the side effects are the same as Botox” and “many of our patients liked it even better.”

Reloxin, like Botox, is composed of a particular botulinum toxin that has been proven to relax the muscles that cause wrinkles in the face.

While Reloxin has been sold outside the US for over 15 years under the name Dysport, Botox has still managed to claim over 80 percent of the worldwide market for the neurotoxin.  One analyst speculates that “Reloxin may be priced 15 percent lower than Botox” which could allow it to take a significant share of the market.

The reports reveal that 355,671 breast augmentation surgeries were performed in 2008, compared to 341,144 liposuction procedures.

In a recent press release, ASPS President Alan Gold, MD comments that “for the first time in the twelve years these statistics have been collected, liposuction is a runner up in popularity to breast augmentation. There is no doubt that this turnabout will generate discussions in the medical community and the public at large.”

Dr. Gold theorizes that “changes in fashion, i.e. décolletage baring styles, might be a factor behind this change.”

Of the 10.2 million cosmetic procedures undergone in America in 2008, 92 percent were had by women.

The top five surgical procedures in 2008 are as follows:

1. Breast Augmentation
2. Liposuction
3. Eyelid Surgery
4. Rhinoplasty
5. Abdominoplasty

The top five non-surgical procedures in 2008 include:

1. Botox
2. Laser Hair Removal
3. Hyaluronic acid wrinkle fillers (Juvederm, Restylane)
4. Chemical Peel
5. Laser Skin Resurfacing

Complaints about skin blotches are common and you will be happy to know that we carry a viable solution – the entire Obagi® therapeutic skin care line.  Most people have heard of Obagi® but not everyone is aware that it is the #1 Skin Care sold line exclusively to physicians.

Obagi® is known for its corrective and effective Nu Derm® System, also known as Corrective and Enhance®, which smoothes fine lines and fades brown spots and other skin imperfections in just a few months.

Most people have relatively different skin characteristics that change throughout the aging process.  Dark spots, uneven tone and even a ‘mask’ over the nose and cheek area may appear after pregnancy or use of birth control.  Obagi’s, Clear™, uses prescription strength Hydroquinone to correct discoloration and equalize skin tones to enhance color uniformity.  Its active ingredient has ‘fading properties,’ which proactively correct the early signs of damage by regulating the production of cells responsible for pigment in your skin.

There is a reason why Obagi® is #1 with physicians – It actually works!  Many popular skin care product lines don’t deliver results, especially o.t.c. products.  Prescription products are carefully formulated to achieve visibly dramatic results. Obagi® is a medical grade skin care program so you will need to speak with Dr. Samaha before purchasing.

If you’re interested in lightening those dark spots on your face, chest and hands or are interested in other Obagi® products give us a call at (617) 786-7600 or request a free consultation here. You will look better and then feel so much better about your one and only face.

Even if you have a friend with persistent pigmentation problems, put them in touch with us. We now know if this type of pigmentation problem goes untreated, and if you continue to over expose your skin to the sun, darkening can occur to the point where even make up won’t cover it up.

If you have saline implants, you’re not in any danger, although it will certainly look and feel strange. If you have silicone implants, the only way to know if there is damage is by MRI.

Your breast implants may be under warranty, which helps with the cost of replacement.

Breast implant failure can be caused by a variety of problems. In some cases, the problem occurs when the implants are filled above or below the manufacturer’s recommended fill range. Other times, texturing of a saline implant can result in excessive wrinkling and premature wear, causing the implant to fail.

Sometimes the implant itself may have a defect in its valve or seam. Isolated sutures placed inside the pocket for implant positioning may also inadvertently wear and breach implant integrity over time.  Even regular wear and tear can cause breast implant deflation, and your lifestyle can also play a role in how long your breast implants will last.

A deflated implant can be safely and successfully removed and replaced surgically in a procedure similar to the original breast augmentation surgery. Typically your same breast augmentation incision is used to approach the deflated implant.

Recovery from breast implant repair surgery is usually easier than the original surgery, since the pectoralis muscle has already been stretched.

When it is applied to the base of the lashes, Latisse keeps hairs in their growth phase, producing longer,thicker and darker lashes. The effects are not permanent;the patient must keep using Latisse to maintain the look and eyelashes return to normal after discontinued use.

Latisse was developed almost by accident. Like many new drugs in recent years, positive side effects noticed during clinical trials prompted further research. In this case, a drug called Lumigan was being developed for glaucoma patients and during its third phase of trials, researchers noticed an interesting effect – significantly longer, fuller eyelashes. The active ingredient (bimatoprost) was reduced, and now Latisse is available for consumer use.

Call us at Boston Plastic Surgery for more details about Latisse!

Fraxel laser manufactuerer, Reliant Technologies was purchased last year in a cash and stock deal worth 87.5 million.

The new stock ticker symbol will be recognized as “SLTM” on the Nasdaq.

In a press release, President and Chief Executive Stephen J. Fanning announced, “the name and ticker symbol changes are a great start to the New Year and a key milestone in the integration of the acquisition of Reliant Technologies Inc.”

The brand new design of both websites (Fraxel and Thermage) offer more color, more user-friendly features which is a noticeable departure from their previous, more ‘clinical’ designs.

About 10,000 medical and cosmetic surgery practices have received the product, an achievement that defines Radiesse as one of the leading dermal fillers on the international market.  The only comparable products that have reached such a pinnacle are fillers composed of collagen or hyaluronic acid, which have both been on the market longer.

Radiesse has been available for cosmetic use in Europe since 2002, but in 2006 the United States FDA expanded its approved use to include  facial cosmetic applications, as well as reconstructive and therapeutic uses.

At Boston Plastic Surgery, Dr. Samaha uses Radiesse for deep wrinkles, smile lines, non-surgical nose reshaping, and to fill scars.

While no personal information has been released about the patient, news reports state that the operation was the “most complex face transplant in the world.”  Nearly all the structural and functional facial components were replaced.  Surgeons precisely integrated facial structures like the nose and lower eyelids, while restoring different tissues like veins and nerves.

The revolutionary process was largely made possible by the team leader, Maria Siemionow, who has spent a great part of her career on research and development for such procedures.  Siemmionow was able to lead a group of professionals from a variety of disciplines, including bioethics, dentistry, anesthesia, transplant and others.

In a related Wall Street Journal article, Siemionow stated,”patients with facial disfigurement have very difficult challenges in society. We hope that one day we may be able to help the tens of thousands of patients who are quietly suffering.”

To boost their image, Mentor intends to not only supply breast implants, which is currently about 90% of its revenue, but also plans to launch a new set of products called PurTox – a neurotoxin that will fight facial wrinkles.

Mentor already competes with Allergan in the breast implant industry and now with the estimated FDA approval for PurTox to begin in mid to late 2010, Allergan’s Botox will no longer be the only wrinkle paralyzer on the block.

CNN News aired a segment this week on the controversial new breast augmentation method that is gaining ground in Japan and worldwide; stem cell assisted lipotransfer uses a patient’s own fat and cells to successfuly perform breast augmentation.

Dr. Kotaro Yoshimura of Tokyo, appears in support of his method, as well as cancer survivor that was one of his patients. She says “I hope women are able to choose this type of surgery.” According to the news program, clinical trials are underway in America.

Products like Juvederm, Restylane, Radiesse and others that continue to flood the market will be a focus.  Over the last six years, the FDA has received roughly 900 reports about complications related to injectable wrinkle-fillers.  Is this a reason to be concerned?

It might sound alarming, but the complications and side effects associated with fillers are still extremely rare.  Demand for wrinkle reducers like Botox and fillers like Juvederm has exploded in recent years, leading many improperly trained persons to administer them in non-medical settings.

The majority of industry professionals will attribute most of the reported complications to situations like these.  There are also well known, labeled problems that can occur on an infrequent basis, like minor swelling or allergic reactions, with the latter being a subject of greater FDA interest.

According to a recent MSNBC news article, Allergan spokeswoman Caroline Van Hove said “no serious problems were seen in clinical trials of Juvederm, and the most common complaint since its approval was swelling in 0.4 percent of patients.”  Also, Food and Drug Administration officials noted that the “reports had several limitations such as failing to say when the problems started.”

Safety and proper training is of the utmost importance with almost any cosmetic procedure, so we recommend that all patients seek a knowledgeable plastic surgeon with the right qualifications.

For more information on the FDA panel discussion, the briefing is located here.

The topic Dr. Samaha will discuss is titled The Evolution of Body Contouring and it is scheduled to begin at 7:50 p.m.

Medical professionals, social workers and other interested persons are expected to attend.  After attending the seminar, participants will possess better understanding of a variety of topics including: risk status of obese patients, the impact of weight loss on the metabolism, surgical treatment of obesity, exercise, lifestyle importance and much more.

Registration is at 6 p.m. at the Marriott Hotel in Quincy, Massachusetts. For more information call 617-472-1000.

A Florida plastic surgeon recently described the status of modern breast cancer treatments and the efforts of the medical community to minimize its adverse effects through reconstruction and prevention.

Dr. Richard Bosshardt writes that society’s recognition of the breast is an ancient phenomenon since historically, many people have viewed them as symbolic of “femininity and desirability.” In light of this observation, it isn’t difficult to understand why the possibility of breast removal or disfigurement can be so frightening.

Many women know to focus on prevention and are aware of the breast cancer statistics, but aren’t informed about positive developments on the horizon. New information shared by Dr. Bosshardt in the Orlando Sentinel suggests that ‘genetic markers’ have become excellent risk indicators, narrowing the search for a definite cause. Breast implants, bras and high-fat diets have not been shown to increase the risk of cancer.

And finally, doctors have begun practicing “breast conservation” rather than outright breast removal. Reconstruction has become more sophisticated than ever and patients often look better as an end result.

Art Caplan is the Director for the center of Bioethics at the University of Pennsylvania. Last summer, Caplan delivered a lecture at the Chautauqua Institution about living longer and enhancing our bodies through the use of advanced medical technology.

Caplan argues against people he calls “new puritans” who present moral objections against the medical technology which enables us to live longer and look better. In reference to cosmetic enhancement, he remarks, “not everybody is reading these scientific advancements with joy.” One person in his audience had spoken of a family member having a face lift, and a younger woman responded with criticism saying, “that’s terrible. It’s unbelievable that you would do that, you should simply accept the changes [of aging] as they come – it’s basically unethical.”

That is the “puritanical” attitude Caplan rejects. Various arguments come from the right wing and the left, with objections to medical technology that are just not convincing, as he would argue.

His argument in favor of embryonic stem cell research is this: we’ve already doubled our lifespan since ancient times. There is no “natural order of things” when it comes to how long we should exist or how good we should look during that time. Stem cell technology need not come from new sources, but embryos that we already use for other purposes.

What we use to repair disease, we can also use to enhance ourselves. There might be whole body rejuvenation, including the mind, with the help of this technology. Skin, organs, hair and everything in between could be enhanced with regenerative cells. Similar things have successfully been done to small organisms. If we fund it now and conquer these frivolous (and perhaps not so frivolous) arguments now, real anti-aging can become a reality.

If you are interested in hearing more about Caplan’s take on anti-aging or you’ve pondered the moral implications of cosmetic surgical enhancement, you should listen to the lecture at Minnesota Public Radio.

A Florida resident recently made news headlines for her “misplaced heart” and unconventional medical use of breast implants.  Fox News reported that a woman named April Pinkard actually had breast implants to correct a rare heart condition.

When she was only four years old, Pinkard had a lung removed due to disease present at birth.  30 years later, Dr. Mohammed Choudhury discovered something very strange during a physical examination of Ms. Pinkard.  Her heartbeat was virtually absent.

She recalls that day, saying “he listened [for] my heartbeat one day and it just wasn’t there.” Closer medical exams led doctors to conclude that her heart had shifted or “floated” out of its proper position.  An operation was immediately necessary.

At the Jacksonville Mayo Clinic, surgeons found that the heart had moved considerably.  The immediate solution was to fill her chest cavity with water, then float the heart back into its natural position.  But something had to be done to prevent the condition from re-occurring. To fill the void left by her lung and immobilize the heart, doctors placed implants in her chest.  She told one reporter, “you can hear it move.  If I push on my chest you can feel the squishes.”

Ms. Pinkard still faces health related problems, most notably, the possibility of a lung transplant in the near future.  But she is a strong-willed lady and apparently has some talented, innovative medical professionals on her side.

The theory behind introducing stem cells to the procedure predicts that the regenerative properties of the cells will help prevent the body’s rejection of transplanted tissue.  A stem cell-fortified fat product should promote the formation of new blood vessels, bonding the reintroduced tissue to its surroundings.  The results would be nothing short of a natural implant.

New York plastic surgeon Dr. Sydney Coleman was published in the medical journal Plastic and Reconstructive Surgery for his innovative breast augmentation technique, which employs a controversial fat grafting/transplant method.

Fat is taken from other areas of the body (just as it is commonly done during liposuction) and added to the breast.  The technique hasn’t caught on due to certain risks, such as death of, and calcification of the grafted fat and/or mammogram interference.

Surgeons in Europe and Japan have experimented with techniques and reported success. However, FDA approval of any stem cell product would be required for use in the United States and more research on the long term effects of fat grafting is necessary.

The American Society for Aesthetic Plastic surgery is recruiting patients for a study.  More information on the study is available at ClinicalTrials.gov