Sculptra: An Old Filler Resurrected

 Sculptra is a unique filler that was first approved in the US in 2004, for treating facial lipoatrophy (fat loss) in AIDS patients. It consists of a suspension of particles of poly-L-lactic acid, a material that has long been used in the skin as an ingredient in absorbable sutures. Although it was legally used for cosmetic purposes immediately after its initial approval, it received official FDA approval for this indication in July 2009.

Fractional CO2 Resurfacing: Does The Emperor Have Any Clothes?

In an article published in the October 2010 issue of Lasers in Surgery and Medicine, the authors examined the results of fractional ablative CO2 resurfacing in 9 Chinese patients. The patients were being treated for skin rejuvenation and acne scars. Overall, the vast majority of the patients were pleased with their results, and there was mild to moderate improvement. However, there were significant problems with post treatment increase in skin color, and the authors raise the question of whether the results were enough to justify the treatment.

People Who Don't Get The Message

Today I received an email asking if we have a specific brand of CO2 laser. People who ask this kind of question have absolutely no idea what they're doing, and are at great risk of getting into trouble. In this Wild West world of cosmetic surgery, people get the idea that there is a magic machine or a magic procedure that will take care of their problems. That's absolute nonsense. Let's say there were such a magic machine, but it was operated by a moron who was also a crook, and had no previous experience with the machine. Would this be a good choice?

Long Term Foreign Bodies

To the best of my knowledge, the Threadlift, using the Contour Threads, is no longer performed. The threads were removed from the market because sales had plummeted due to unsatisfactory results. There still are people who have these threads implanted, and some of these continue to have problems.
In the May 2008 issue of Dermatologic Surgery there is a report of a woman who had threads placed in her forehead to elevate her brow. After the procedure there was some elevation of the brow, and the threads were not visible. However, two years later the patient returned and the threads were clearly visible above her lateral eyebrows. The threads were surgically removed.

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.

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.

It's a Jungle Out There

I have repeatedly written about the necessity of choosing a reputable specialist to assist you in cosmetic enhancement. This field is largely unregulated and action is often taken only after some catastrophe occurs. The Centers for Disease Control has recently reported about 3 patients from North Carolina who had kidney failure after injections of a mixture of silicone oil, probably adulterated, and saline for buttock enhancement.

Efficient Surgery

At a recent conference on rejuvenation of the aging skin, the physicians in the audience were able to respond electronically to questions posed by the conference organizers. When polled about the type of anesthesia used in facelift surgery, 2/3 of the audience responded that they used general anesthesia. Another significant percentage responded that they used conscious sedation. A relatively small percentage indicated that they used conscious sedation. When the pannelists were asked, most responded that they use  general anesthesia, commenting that it was  "more efficient"

Fraxel Re:store safety

Today we have multiple ways to treat a limited number of problems. Sometimes it is difficult to decide which treatment is the best for the task at hand. Effectiveness is the first criterion. If there is a high probability that the treatment won't do the job, it's really not worth considering. This, unfortunately, is a problem that we see in patients who have been to medispas. Generally they have a limited choice of treatments and we've seen numerous instances where they have recommended treatments that are clearly ineffective, rather than tell the patient that they should look elsewhere.

Cosmetic Surgery Disasters II

Florida is the only state in the nation that has required mandatory reporting of adverse events after an office procedure. This data is publicly available and has now been collected for seven years. The Agency for Health Care Administration cross checks these reports against malpractice filings and against patient complaints. Although the information represents only adverse events, and there is no estimate of the total number of procedures preformed, the data is nevertheless very interesting. It is also worth noting that this information only relates to procedures performed in offices. There is no information about the complications resulting from procedures performed in surgicenters.