ISSUE: Jan/Feb 2004
Cosmeceuticals & Anti-aging
Mastering Vitamin C
oung Pharmaceuticals is a not-so-young company which has built a solid reputation as an R&D leader on the effects of vitamin C in all its forms. That research has led to any number of private label and brand name products which are on the shelves in dermatology offices around the world. In 1977 the company started its journey by manufacturing generic corticosteroids. Marketing strictly to plastic surgeons and dermatologists, the company eased into the private label market by formulating products specifically for their customers...
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Dermatology
Dermal Fillers Update
An ideal filler substance would combine permanence and minimum antigenicity (Krauss MC. Recent advances in soft tissue augmentation. Semin Cutan Med Surg 1999;18:119-127). This criterion is not met by fat nor collagen from any source (bovine and cadaver), all of which are reabsorbed by the body over time. To address this, various nonresorbable substances have been added to encourage a more lasting effect. The substances include polytetrafluoroethylene (PTFE) and polymethylmethacrylate (PMMA) microspheres. Depending on their chemical composition and structure, materials offer different biocompatibility. Smooth walled particles are encapsulated with fibrous tissue within the recipient tissue, and particles with an irregular surface can initiate an inflammatory response (Allen O. Response to subdermal implantation of texturized microimplants in humans. Aesthetic Plast Surg 1992:16;227-230). Less inflammation is associated with a longer lasting filler effect.
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Laser & Light Technology
Vascular Lasers
LASER & LIGHT BASED DEVICES FOR THE TREATMENT OF VASCULAR LESIONS
expanded with the use of lasers and light-based devices. Very frequently physicians will treat most lesions with the same laser or IPL device. The objective of this article is to provide guidelines as to which lasers have been proven best for various lesions classes. The four basic groups of lesions which are treatable with non-surgical lasers are: Port Wine Stains, Hemangiomas, Facial Telangectasias, Leg Telangectasias. Each of the above categories has subcategories defined by vessels with differing color, diameter, depth, and geometry. For example, rosacea can be considered a subcategory of facial telangectasia and has several classifications of its own. Don’t be discouraged. I will attempt to outline a basic practical guide as to what has proven to work best for these classifications.
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Legal Case of the Month
Medical Director Liability
AN ACCIDENT WAITING TO HAPPEN?
The proliferation of medical spas and the vertical integration of medical services into salons and spas have given new meaning to the existing role of medical directors. In the past, medical directors really had a limited, albeit it important, role in the medical environment. Their role was clearly defined. Accordingly, the risks which were presented to them and their organization were narrowly focused and simple to address. This traditional role has evolved; and a discussion of this evolution is appropriate since many medical directors, spa owners, and even general counsel are unaware of the pitfalls of this developing role.
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Medical Spas
Medical Aesthetics Training
SAFE AND EFFECTIVE TREATMENTS ARE PERFORMED BY WELL TRAINED PROFESSIONALS
ore and more physicians are adding non-invasive aesthetics. The services are especially profitable for them for several reasons. First, the services can be delegated to support personnel, such as nurses, physician’s assistants and medical aestheticians while the physician is performing physician-only care. Second, no insurance company is involved in the payment of this care; it’s a beautiful cash cow for the practice. Third, new patients are introduced to physician-only services while having non-invasive services. The positives for adding these services are very attractive...
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Men’s Aesthetic Procedures
Gynecomastia
A Procedure Requiring As Much Sensitivity As Skill
f all the men’s aesthetic procedures, it is difficult to imagine any more critical to a man’s psyche than gynecomastia. An emotionally charged condition, gynecomastia affects some 35 to 60 percent of the adult male population. While excess male breast development is often caused by either an imbalance in hormones or by obesity, the etiology is for the most part difficult to pinpoint. It is clear that upwards of 70 percent of all males will develop some level of gynecomastia during puberty and early adulthood....
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Plastic Surgery
The Transmalar Subperiosteal Mid-Face Lift
MINIMAL SKIN AND SUPERFICIAL MUSCULOAPONEUROTIC SYSTEM DISSECTION: A DURABLE,NATURAL APPEARING LIFT WITH LESS SURGERY AND RECOVERY TIME
Over the past several years we have employed a procedure to elevate the mid-face using an approach developed and championed by E. Ronald Finger, M.D. in Savannah, GA. I had the pleasure of being business partners with Dr. Finger for several years while I was in practice in Savannah. I have kept in close contact with him since my move to California, and we frequently discuss our latest ideas in new ways to do the things which we enjoy most in plastic surgery. During one of my many trips to Savannah, I learned Dr. Finger was in the early stages of development of what would become the transmalar subperiosteal mid-face lift. After working with Dr. Finger on several of these procedures, we began slowly integrating this procedure into our practice here in California. Since that time, we have completed many of these procedures and have been very happy with the results obtained with this addition to our facelift procedure. This procedure is often performed in conjunction with endoscopic brow lift procedures where we use three small incisions in the scalp instead of the old bicoronal incision from ear to ear across the top of the scalp....
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