Laser Fat Destruction & Eyelid Burns

Although many cosmetic surgeons now recognize that lower eyelid bags are more commonly due to tissue loss rather than true fat protrusion, there are many who are still excising lower eyelid fat. Apparently a very small subset of these is attempting to remove this fat by making a small incision in the lateral lower lids, inserting a fiber from the "LaserTight" device and attempting to melt the fat and tighten the skin. This is a procedure that is new to me, and on the surface appears fraught with hazard. There are muscles near the fat that, if injured, could make it difficult for both eyes to move in a coordinated fashion. Furthermore, bleeding from eyelid surgery can rarely result in loss of vision, and this procedure is performed without direct visualization.

Lifestyle Lift Fakes Reviews

Lifestyle Lift agreed to pay $300,000 in costs and penalties to the State of New York for having its employees post fictitious reviews of its services. The company had ordered employees to pretend they were satisfied customers and write glowing reviews of its face-lift procedure. Lifestyle Lift also created its own site of what appeared to be independent face-lift reviews, concealing the fact that this site was controlled by the company.
"It's an incredible violation of consumer trust and it's a pernicious element of the Web that some companies have embraced this idea, under the guise of reputation management," said Thomas Seery, founder of RealSelf.com, a site on which he said Lifestyle Lift had posted misleading reviews.
Andrew M. Cuomo, New York's attorney general, said in a statement that Lifestyle Lift's "attempt to generate business by duping consumers was cynical, manipulative and illegal."

Cosmetic Surgery Chains

You will hear people mention the "art of medicine" or the "art of surgery", although these terms are used infrequently by those who want to homogenize medicine and are more comfortable with the term "health care providers" than the terms "doctor" or "physicians". Nevertheless, there are clearly differences between physicians as well as well as between physicians and non-physician "providers". There is considerable skill that is required for the proper performance of many procedures, and this is especially true of cosmetic surgery. That makes the existence of cosmetic surgery chains problematical.

Liposuction for Biodiesel ? Fat powers SUV in LA

The Beverly Hills Courier reported that a radiologist, Dr Alan Bittner, who was medical director of Beverly Hills Liposculpture, apparently fled the country after the Medical Board of California raided his office and home, in response to complaints that some of the liposuction procedures had been performed by his office manager and girlfriend, Stephanie Darcy. Bittner had posted in his blog, lipodiesel.com, that he had converted the suctioned fat into deisel to power his SUV. This is technically feasible, but is illegal in this country.

Tale of a Patient

A patient came in today for a medical probelm. It turned out that she had seen me years ago, She commented about how well I had aged, and the conversation turned to cosmetic procedures. She told that she was quite unhappy with her surgery that had been performed by a respected local plastic surgeon. She said that all she wanted was a "neck lift" or, in reality a face-lift or MACS-lift. He told her that if he were to operate she would have to have a brow lift and eyelid surgery as well. She reluctantly went along with it because she had been told that he was "the best". She spent over $20,000.

Patient in Trouble

What follows is a comment that was posted to this weblog 08/31/08.
"I had radiesse 3 weeks ago and now have terrible nodules under my eyes, are these permanent?  How can they be treated? 

M. Smith"

What Happens When You Have A Problem?

People are becoming more aware that it is a smart move to have their cosmetic procedures done at a facility where there is a physician that has expertise in skin problems, a dermatologist or a plastic surgeon, on site. At the recent meeting, Controversies and Conversations in Laser and Cosmetic Surgery, this topic was discussed. Several important points were brought up.

The Doctor is Not In

There are a number of cosmetic procedures, usually noninvasive, that are performed by RNs or nurse practitioners. In the past I have discussed the desirability of having a physician, particularly one well trained in the area of cosmetic surgery, on the premises to supervise the treatments. Recently we have been seeing a problematic variant of the undesirable situation where the patient is treated by an unsupervised nurse. What we have been seeing is a new patient coming to a cosmetic practice and being seen only by the nurse and then treated by her, without the physician ever being involved. It is possible that the physician retrospectively reviewed the patient's chart some time after the patient had departed, but this is far from optimal for patient safety.

Lipotourism

Every so often we see a patient who has traveled to another country for the purpose of having a cosmetic procedure preformed. They are usually quite proud of getting a bargain compared to US prices, and at times are willing to overlook what would be considered by most people to be unacceptable results. Apparently the number of people going this route is increasing.

How to reduce your chances of being taken for a ride

Recently we had a new patient who was interested in improving the fine lines on her eyelids. This is not necessarily an easy task, but it can be accomplished. As the conversation developed, it became clear that she had been previously treated for this. She had gone to one of the nationally syndicated laser chains with the same request, and was told that they could help her. However, as the treatment was starting, the nurse placed eye shields that covered the lines that she most wanted treated. When the woman pointed this out to the nurse she was told "Oh, we can't treat there."