By: Dr. Ben Lee

When a woman purchases a dress in a department store, she may feel satisfied with the way the dress fits, return home and notice it is too snug or just not flattering and return the garment. In this day and age of adjustable cigarette lighters, car seats, hair dryers, beds, and the Victoria’s Secret “click� bra, women have the option and flexibility to adjust and change the size of a breast implant. Breast augmentation is now one of the most popular cosmetic surgery procedures performed in the United States. In 2003 alone, 280,401 women underwent this procedure. What is the number one complaint associated with breast augmentation? The answer is patient dissatisfaction with size!

Often, women seek breast augmentation and merely know that they want to be “bigger� or “fuller.� Frequently a patient can overestimate the size she wants to be or underestimate the “ideal cup size.� It is often difficult for a patient to know exactly what she wants until she sees how a fuller breast actually fits her proportions. Without the benefit of an adjustable implant, patients often have to undergo multiple breast augmentations until the doctor and patient feel it is an ideal aesthetic result. Repeated surgery entails one or more postoperative recovery periods which impedes a patient’s personal and professional life.

Patients now have the option to change their implant size after surgery. Traditional saline implant surgery involves creating a pocket, placing and filling the implant, and closing the incision (all done with a patient lying flat and unconscious on the operating table). The filling tube is left inserted in the implants and brought out between the stitches of the closed incisions. A small piece of gauze is placed over the incision, incorporating the filling tube, hidden within the supportive bra. With the patient now awake and in a sitting position, the surgical dressing is removed; and saline is added or subtracted within seconds according to the patient’s preference. The tube is then removed and the incisions are self-sealed. As a result of this technique, patients can go up or down one full bra size.

The good news is that there is no pain associated with the removal of the filling tube, as the incision for the filling tube is only 1/8 inch in diameter with a self-healing incision. With the adjustable breast implant technique, not only can patients change the size of the implant without pain or further surgery, but they can also choose the shape and position which will provide the most ideal aesthetic result.

The reaction to the adjustable implant has been uniformly positive. Most patients do underestimate the size they want to be. This is especially true when women have loss of breast volume following pregnancy. For any woman who has ever felt trepidation when considering breast augmentation, the adjustable filling tube gives her complete flexibility and control over her aesthetic outcome—an attribute which is rare with any cosmetic procedure.

Dr. Ben Lee, M.D., M.B.A., is a Board-Certified Plastic and Cosmetic Surgeon who has been in practice since 1988 and currently practices in Denver, Colorado. Working closely with various well known reconstructive surgeons at the prestigious Duke University Medical Center, Dr. Lee has developed a deep respect for the excellence and dedication which plastic surgeons apply to those in need of their expertise. Dr. Lee and his staff are committed to providing state-of-the-art cosmetic and reconstructive surgery services, with special interests in aesthetic and reconstructive surgery, facial cosmetic surgery, and body contouring. For more information visit www.drbenlee.com

By: Boris M. Ackerman, M.D.

The world of advertising and public relations has brought physicians’ names to the public on a continuing basis. Ten years ago if a doctor called himself a plastic surgeon, the patient knew precisely what that term meant. Recently, doctors in various sub-specialties such as dermatologists, gynecologists, ophthalmologists, and even dentists are performing plastic surgery procedures. This can leave prospective patients utterly confused about how to find the best and most qualified surgeons. But how, wonders Dr. Ackerman, a board certified Newport Beach Plastic Surgeon “is a prospective patient to know who is a diligent, excellent, caring physician, and who is a charlatan?” Dr. Ackerman wants to disseminate information the public can use and heed as caution when selecting a plastic surgeon in a country now brimming with doctors who call themselves “plastic surgeons.”

Finding a plastic surgeon
The first step in choosing a plastic surgeon is to develop a list of names. There are several sources, some better than others. According to Dr. Ackerman, “word of mouth is a great place to start the search as one will always boast of the creative handiwork of a flawless facelift.� Confer with friends who have undergone plastic surgery for the names of their surgeons, or ask your family physician or local hospital. Also, The Plastic Surgery Information Service of the American Society of Plastic Surgeons (ASPS) offers a search for plastic surgeons by name, state, or zip code by calling toll free, 1.800.635.0635, or visiting their web page, http://www.plasticsurgery.org/find_a_plastic_surgeon/index.cfm.

Doing your homework
Once you have composed a good list of plastic surgeons, you should check their credentials. More important than where a surgeon went to school is the type of training he/she has received. You want to be sure that the surgeon completed an accredited residency program specifically in plastic surgery. The American Medical Association (AMA) lists where and what type of training a physician has undergone: http://www.ama-assn.org/iwcf/iwcfmgr206/aps?18817608/. A physician performing plastic surgery should also be certified by the American Board of Plastic Surgery (ABPS). Although board certification is not the only measure of professional competence, it indicates that the doctor has completed the necessary education and experience to bear this distinction. “Beware of those physicians who are ‘board certified,’ but not recognized by the American Board of Medical Specialties (ABMS),� advises Dr. Ackerman, who is board certified by the American Board of Plastic Surgery, which is the only plastic surgery board approved by the ABMS at this time.

The Consultation
The initial consultation with a doctor is another key step in assessing if you have found the right plastic surgeon for you. It is important to develop a good rapport with the surgeon. “You don’t have to like your surgeon as a friend, but do you think he/she has you, the patient, at heart as his first consideration?� asks Dr. Ackerman. During the consultation, the doctor will evaluate you as a candidate for surgery. But, this is also a chance for you to evaluate the surgeon. The surgeon should answer all of your questions and address each of your concerns. Also, Dr. Ackerman advises you to ask for the names of patients who have undergone the surgery you are considering, and for permission to speak with them about their experiences. Below are some more good questions to consider asking the surgeon:

• How long is the estimated operating time?
• What is the expected recovery time?
• Where will the surgery be performed - in a surgical center or hospital?
• What kind of anesthesia will be used?
• Will postoperative medication be necessary?
• Will there be any noticeable scarring?
• What realistic results can I expect?
• Will the doctor be performing the procedure from first cut to last stitch?
• What are the risks associated with this procedure?

Boris M. Ackerman, M.D., is a board certified Plastic Surgeon specializing in facial rejuvenation with Endoscopy and Laser Liposculpture and Breast Surgery. He was one of the first surgeons in California to utilize the laser in plastic surgery. Dr. Ackerman has been in private practice in Newport Beach since 1987. He graduated from the Massachusetts Institute of Technology and received his Doctorate of Medicine from the Dartmouth Medical School. He performed his postgraduate training at Cedars-Sinai Medical Center in Los Angeles. Dr. Ackerman is on staff at Hoag Hospital in Newport Beach and is an active member of the American Society of Plastic and Reconstructive Surgeons and the Orange County Medical Association. He was recently seen on the Discovery Channel’s Plastic Surgery Before and After, and MTV’s I Want A Famous Face.

Written By: Dr. Des Fernanades

The IONZYME® DF MACHINE is a patent pending machine which introduces the use of intensified Iontophoresis and active Sonophoresis. The sound waves from the Sonophoresis are the same as the sound made by dolphins, which produces better penetration through the skin than conventional Ultrasound. As a result the special Environ® treatment serums and gels are able to penetrate even deeper into the skin and are, therefore, more active and provide much quicker, more effective results.

The IONZYME® DF MACHINE has been specifically designed for Environ skin care treatments and becomes the first machine available with this potency. The machine provides facial treatments which are at the very forefront of scientific skin care. Specific Environ® products used in these treatments contain the optimum strengths of vitamin A and C plus additional growth factors. This creative system enhances the penetration of these products through the skin providing far greater penetration of the active vitamins (ingredients) and essential factors into the skin.

The technique offered through this machine is crucial because skin has a natural, waterproof barrier which hinders the penetration of chemicals. The IONZYME® DF MACHINE manages to overcome this resistance with two tried and tested methods:

Iontophoresis – involves the use of an electrical current to facilitate greater penetration of vitamins into the skin.
Sonophoresis – involves the use of sound waves to transport vitamin molecules through the skin.

Iontophoresis is used for relatively large surface areas such as the face and neck, whereas Sonophoresis is used on limited areas such as the upper lip and the concentration of character lines around the eyes, on scar tissue, and on pigmentation marks. Both methods can be combined, where necessary, for intensive treatments.

While there are already machines available which can supply both galvanic currents and ultrasound, the ultrasound in those machines is done at high energy (1.1MHz) sound and, therefore, does not use the same special electro-magnetic (sound) wave properties. The sound used in the DF machine is at the limit of the range of hearing and is not dangerous, whereas the ultrasound waves can be.

The IONZYME® DF MACHINE offers:
• Simple Iontophoresis with continuous or intermittent current up to a maximum of 2.0mA.
• The Iontophoresis uses a pulsed wave pattern which is part of the patent.
• Using a pulsed current dramatically minimizes the potential for electric burn.
• Extremely comfortable Iontophoresis ensuring that the client is barely aware that such a powerful modality is being used.
• The most efficient form of Iontophoresis.
• Whole-field Iontophoresis is done in preference to the tiresome use of rollers.
• Sonophoresis only.
• Iontophoresis for large areas in addition to Sonophoresis for small areas. Combined Iontophoresis and Sonophoresis through one probe for small areas providing the most intensive treatment.
• Constant frequency of sound (cannot be altered).
• Far greater penetration of vitamins into the skin.
• Easy and comfortable to use.
• Rapid client satisfaction and visible results.

Environ® skin care products are sold through Doctors, Beauty Therapists, and trained Sales Consultants.

For more information or for your nearest retailer, visit www.environ.co.za or call 1 (877) 337-6227

Over the last decade, we have become a society obsessed with maintaining youthful appearance. To meet popular demand, manufacturers have inundated the shelves of drugstores, mass-market retailers and even supermarkets with a sea of anti-aging beauty products. The average consumer can spend an inordinate amount of time trying to sort through all of the claims and ingredients. One would almost need a degree in chemistry to understand some of the catch phrases on anti-aging skin care products. Existing legislation does not require the cosmetics manufacturer to prove that the product will help the consumer. The burden of choosing falls on the consumer. The key to choosing correctly lies in being able to read and understand ingredient labels.

There are many phrases used on the bottles and packaging of skin care products, particularly those marketed for anti-aging, which are meant to lure the consumer into purchasing the advertisement as opposed to the true product. To what degree is this marketing tactic fact or fiction? Legally, cosmetic manufacturers do not need to prove that the products do what they claim to do. This begs the resounding question: What Really Works and What Doesn’t?

First, it is important to note that the FDA requires that all cosmetics display a product ingredient label and specifies that the ingredients must be listed in order of their relative amounts as contained in the product. It is common to find that the ingredient which gets all of the media hype is the one contained in the smallest amount. By knowing this, it is easier to determine whether a small amount of an ingredient is worth the excessive difference in price between a designer name product or a similar, less expensive product.

Olay Regnerist
Product Claim: Olay Regenerist helps regenerate your skin’s appearance without such drastic measures as chemical peels, cosmetic surgery or laser. Clinical tests have proven that amino-peptides can help regenerate damaged skin. Olay has now proven that Regenerist, using this technology, also regenerates your skin by renewing the outer layer to give you younger-looking skin.

The Regenerist name implies it regenerates skin, which cannot be accomplished topically. The ingredients contained in this product ARE good moisturizers and anti-oxidants, but these are found in many good skin care products.

Alpha Hydrox 10% AHA Anti-Wrinkle Treatment
Product Claim: Proven to significantly reduce the appearance of fine lines and wrinkles. Safely lifts dead cells from the skin’s surface to revitalize and help restore youthful, healthy, radiant looking skin. Renews moisture, refines texture, improves elasticity, and skin tone.

The 10% pure Glycolic AHA contained in this product will reduce the appearance of fine lines and wrinkles. Unfortunately, there is nothing listed in the ingredients which would renew moisture in the skin.

RoC® Retinol Correxion™ Deep Wrinkle Night Cream
Product Claim: This exclusive combination of pure Retinol and an essential mineral complex is clinically proven to visibly reduce deep wrinkles while you sleep.

‘Exclusive’ and ‘reduce deep wrinkles’ are good marketing tools, but there is nothing in the ingredients to fill in wrinkles, especially deep ones.

Dr. Karina Bibicheff

Certified by the American Board of Internal Medicine and licensed in New York, New Jersey and California, Dr. Bibicheff specializes in the latest European and American anti-aging technologies. Her Mesotherapy training includes certifications from the Canadian School of Mesotherapy and Advanced Mesotherapy training from Dr. Philippe Petit, International Society of Mesotherapy, Paris, France. She holds Anti-Aging Face Treatments, Non-Surgical Skin Rejuvenation and Acne Treatment certifications from the American Academy of Dermatology, as well as certifications and advanced training in Injectable Cosmetic Fillers, Sclerotherapy, and Laser Hair Removal. Dr. Bibicheff is the director of the VITA Ageless Medical Aesthetics Spa in Roslyn, NY.

Skincare Technology, Inc. announced it has received a letter from the U.S. Food and Drug Administration (FDA) (#K042630) giving the company the right to sell the company’s innovative Revitalight unit for: the treatment of Moderate Inflammatory Acne Vulgaris (blue pulsator); Promote Increased Blood Flow (red and amber pulsators); Facial Massage (red and amber pulsators); and Relief of Pain (red and amber pulsators).

The announcement was made by Jim Raim, President and CEO of Skincare Technology, Inc., which developed and markets the patented Revitalight Skin Care System. The Revitalight Skin Care System incorporates red, amber, and blue LED (Light Emitting Diode) light in its treatments. According to Mr. Raim, “We are pleased that our revolutionary device can be marketed for the treatment of acne. This is important news for everyone who suffers from acne, especially for young men and women, teens and adults who want relief from this condition which can have a devastating impact on their appearance.�

Specifically, the FDA’s letter allows Skincare to market the Revitalight’s Blue Pulsator device for treating moderate inflammatory acne vulgaris (blue light) and pain (red and amber light). Revitalight is unique because it is capable of focusing its LED beam so one is able to direct all the light energy to a specific problem area, rather than use the “broad brush� approach other LED devices employ.

Skincare Technology, Inc.
888.807.7546
www.revitalight.com

Reliant Technologies announced that the U.S. Food and Drug Administration (FDA) has cleared its breakthrough FRAXELâ„¢ Laser for the specific treatment of melasma, a disturbing skin pigmentation which presents as patterns of dark brown patches on the face and is associated with pregnancy, female hormonal activity, and certain drugs. Until now, the stubborn skin condition has been resistant to available therapies, with traditional laser and pulsed light treatments considered unsatisfactory due to lackluster results, significant downtime, or the risk of adverse complications.

“We are delighted to finally have a successful laser treatment to offer patients who have been forced to view the world and be viewed by the world through a mask which could never be removed,” says Dermatology Laser Expert Cameron K. Rokhsar, M.D., of New York, NY, who authored a landmark paper on the topic. “With the Fraxel laser’s unique approach of using millions of microscopic thermal spots to gently resurface only portions of skin at a time, we can now penetrate deep enough to eliminate the melanocytes which cause melasma.”

Melasma typically occurs on sunexposed facial areas, notably the cheeks, forehead, upper lip and nose and is most common in women of child-bearing age and among male and female adults of dark-skinned races. Although the exact incidence is unknown, this embarrassing skin disorder known as the mask of pregnancy is estimated to affect nearly 6 million women in the U.S.

“By employing fractional resurfacing with its distinctive wound healing response, we can not only resolve the excessive and undesirable pigmentation at the dermal junction, but also avoid aggravating surrounding melanocytes in order to prevent inflammatory posttreatment responses,� explains Study Investigator Richard Fitzpatrick, M.D., La Jolla, CA.

Reliant Technologies
650.473.0200
www.reliant-tech.com

The Palomar Lux1064â„¢ Handpiece delivers the safest, most comfortable and effective leg vein clearance available. Using the ideal wavelength to target deep-lying vessels and fluences of up to 700 J/cm2, the Lux1064 causes vessels to shrink and fade from view in a few treatments or less. Patented Smooth Pulse delivery, combined with Active Contact Cooling, allow the Lux1064 to provide far more comfortable treatments than competing lasers.

The Lux1064 is an attachment for the Palomar StarLuxâ„¢ Pulsed Light and Laser System, which delivers the highest total energy of any available lightbased system.

Palomar Medical
Technologies, Inc.
800.PALOMAR (725.6627)
www.palomarmedical.com

Organon announced the launch of AnesthesiaNow.com, a new and free online professional information service for anesthesiologists around the world. AnesthesiaNow.com offers a comprehensive, high-quality medical information resource to help healthcare professionals stay up-todate with the latest developments in anesthesiology.

The content of AnesthesiaNow.com is guided by an independent advisory board consisting of Paul G. Barash, Yale Medical School in New Haven, CT; Jerrold H. Levy, Emory University Hospital, Atlanta, GA; and Rajinder K. Mirakhur, Queens University, Belfast, UK. The site is managed by the Current Medicine Group and is supported by an educational grant from Organon. AnesthesiaNow.com offers subscribers a wealth of specialist information at no cost, including:
• An online literature service with links to full text articles from leading medical journals
• Featured articles providing a concise review of the latest research and clinical trial findings
• Monthly e-mail alerts to ensure that subscribers have instant access to the latest developments in anesthesia.

Future content of the site will be determined through continued close collaboration with leading anesthesiologists and may include topics such as:
• Case studies
• Conference reports
• Links to key journal sites, congresses, and other useful online information.

“AnesthesiaNow.com is a new educational site which has been developed to help clinicians in anesthesiology keep up-to-date with a minimum of effort as well as supporting their attempts to track down information they need,� says Professor Paul Barash, Advisory Board Member and Professor of Anesthesiology at Yale Medical School in New Haven, CT. “It provides a great deal of information tailored to the interests and needs of healthcare professionals and researchers in the anesthesia community.�

Organon USA
973.325.4500
www.anesthesianow.com

Opusmed is pleased to announce that its LumiPhase-Râ„¢ LED device has been cleared by the U.S. Food and Drug Administration (FDA) for treatment of wrinkles, rhytids, and fine lines in the periorbital region.

According to a clinical study of 48 patients reviewed by the FDA, three blinded observers (MDs) assessed that after 12 treatments, 87% of patients had a measurable reduction of their wrinkles in the periorbital region. Corroborating clinical results, PRIMOS measurements revealed an overall decrease in fine lines, wrinkles depth (Rz value), and in surface roughness (Ra value), a pore size associated quantitative appreciation. Non-thermal optical LED energy using the right combination of parameters significantly promotes dermal collagen metabolism, enhancing procollagen type I while simultaneously decreasing MMP-1 production. Diffuse redness is also improved.

Dr. Daniel Barolet, Dermatologist, Director of the Derma-Laser Clinic and Chief Scientific Officer of Opusmed, said: “In our continuous quest for efficacious non-invasive treatments, this FDA clearance confirms that a new generation non-thermeal pulsed LED such as LumiPhase-R clearly provides a safer, no side effects, no downtime photo-aged skin improvement alternative. We believe that it is opening the way to new treatment territories for ‘baby boomers’ demanding ‘soft’ treatment and maintenance solutions to aging skin, and willing to start taking better care of their skin at an earlier age. LumiPhase-R’s unique Photoinduction™ intracellular processes improve overall skin condition on several aspects and efficaciously complement most current photothermal treatments, for increased patient satisfaction.�

Opusmed Inc.
514.343.4141
www.opusmed.com

NeoStrata Company, Inc. is pleased to announce that the company is the recipient of the prestigious American Academy of Dermatology (AAD) Gold Triangle Award for the successful 2004 media campaign for Exuviuance by NeoStrata Skin Healthy Tanning Mousse.

The award was presented to Lynda Farrington-Wilson, NeoStrata’s Vice President, U.S. Market Development, at the Ninth Annual Gold Triangle Awards Ceremony, which took place during the AAD’s Annual Summer Meeting at the Hyatt Regency in Chicago. Judging was conducted by a distinguished panel of AAD members. “We are extremely honored to receive this important award,� says Lynda Farrington-Wilson. “It validates our commitment to use our cutting edge technology to create healthy skin care products and to educate consumers about the importance of skin health.�

The Gold Triangle Awards are conducted annually by the AAD to recognize and honor media, industry, health community, public service, and individual efforts that further understanding of dermatologic issues and encourage healthy behaviors in the medical, surgical, and cosmetic care of skin, hair, and nails.

The NeoStrata Company is dedicated to improving lives through scientific discovery. The Exuviance by NeoStrata Skin Healthy Tanning Mousse was introduced in January 2004 as a healthy and realisticlooking alternative to indoor and outdoor tanning. It is one of the many products NeoStrata has developed to support a healthy lifestyle.

NeoStrata Company, Inc.
609.520-0715
www.neostrata.com