Basal Cell, Squamous Cell, and Melanoma Discussed

By D.J. Verret, MD

Basal cell carcinoma, squamous cell carcinoma, and melanoma are the three most common types of skin cancer and affect millions of people each year. Skin cancer is the most common type of cancer in the United States but fortunately most types are easily treated. Unfortunately, the most aggressive form, melanoma, kills thousands of people each year. The key to treatment though is prevention.

There are three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma. Melanoma requires aggressive treatment and there are very well defined guidelines about treatment. The other two types can be more conservatively treated. Depending on the stage, location, and size, several treatment options exists. Topical medications can be used which help to 'burn' the skin cancers, cryotherapy can be used to freeze the tumors, and surgical excision can be used to completely remove the tumors.

If surgical excision is the treatment of choice, for basal cell and squamous cell carcinomas in sensitive areas such as the face, eyes, ears, nose, and lips, Mohs micrographic surgery may be necessary. Mohs surgery is named after Dr. Frederic Mohs, an early 20th century surgeon who developed a special technique of examining pathologic skin specimens. The procedures allows for presevervation of as much normal tissue as possible.

An ounce of prevention is worth a pound of cure with skin cancer. Use of appropriate sunscreens, excess sun avoidance, and tanning avoidance are good ways to help prevent skin cancers from forming. These tumors don't generally appear overnight and are the result of a lifetime's worth of sun exposure and sometimes sun abuse.

A family or personal history of skin cancer and significant sun exposure warrant yearly head to toe skin examinations by a primary care physician or dermatologist. The sooner is a skin cancer is diagnosed and treated, the better the cosmetic and medical prognosis can be.

About the Author:

For more information about lip enhancement or earlobe repair, visit Dr. Verret on the web or call for a consultation 972.608.0100.

Are the best laser clincs making the most money?

Is you're medical spa, cosmetic surgery center or laser clinic providing the best medical care or just making the most money? Are they mutually exclusive?

There's a New Yorker article detailing the commencement address Atul Gawande Atul Gawande delivered this commencement address, titled “Money,” to the graduates of the University of Chicago Pritzker School of Medicine. It expands on the themes he touched on in his recent article about health-care costs in McAllen, Texas, which figured in President Obama’s speech on health care.

The text of this speech is available in this Medical Spa MD: best medical spas?

How to Tell if Your Doctor Knows Jack.

Istockphoto

From Health magazine

Watch for these red-flag phrases that suggest your “skin-care specialist” is subpar, says San Francisco ophthalmologist Krista Ramonas, MD, who has treated medical and aesthetic patients for six years.

“You’ll look 20 years younger.”
Beware the cosmetic doctor who overpromises, Ramonas says. Instead of flattering you, he should be discussing what you can reasonably expect from the procedure and addressing possible side effects.

“I’m an artist.”
The prima donna who tosses this phrase around may value her vision over standard operating procedures. “There is a little bit of art to it,” Ramonas points out, “but there’s a lot more science. We have certain parameters we all have to follow.”

“I’m so good, I’ve never seen complications.”
That may be code for “not very experienced,” Ramonas says. “Medicine is always about being prepared for complications.” You need a doctor who can handle the unexpected.

Of these, the greatest is the 'Artist'.

Posted via web from Laser Treatment MD

Get These 5 Answers Before Getting Plastic Surgery Or Laser Treatments.

Istockphoto

From Health magazine

Not every doctor is qualified to perform every procedure. Do you really want to turn your body over to someone who doesn’t really know what they’re doing? Here are five questions you should ask before you get a cosmetic tweak from a doctor working outside of her specialty.

How many times have you done this procedure?
Ideally, you should hear “hundreds” or “thousands,” not “dozens” or something vague like “more than I can count.” Also ask the doc how long she’s been doing the procedure (less than a year means there’s still a learning curve) and how many times a week she does it (too few times a week means she’s less likely to have fresh product or offer you free touch-ups if you aren’t happy).

Do you own or rent your laser?
Renting may be a tip-off that the doctor isn’t doing the procedure often enough to make owning worth it. Rented lasers aren’t always calibrated correctly, which could mean an increased chance of a burn. Also, not every laser is suitable for every skin type, so be wary of the physician who has only one. Ask about the number of fillers being offered, too.

What muscle causes the lid to droop?
If a doctor can tell you it’s the levator muscle, then he probably knows enough facial anatomy to avoid or fix this problem that can result from a poorly placed Botox injection.

How did you learn how to do this procedure?

If the answer is, “I took courses,” ask: Who taught them? How long did they last? Look for the MD who has completed multiple courses and takes continuing-ed classes in the field. If she trained with a top plastic surgeon, ask, “How did you find time for that?” She may let it slip that the training only took one afternoon.

Will you be the one doing the procedure?
It doesn’t matter how many hours of training your gyno has in fillers if his assistant is the one shooting you up. If something goes wrong, you want to know that the med school grad is right there to manage the complications. Remember: You’re paying for the expertise of the best-trained person in that practice.

Of course you'll want to be somewhat circumspect when asking all of theses questions. You don't want an angry plastic surgeon performing your liposuction or boob job.

Posted via web from Laser Center

I recently purchased Dysport from Discount Medspa.

I recently purchased Dysport from Discount Medspa. Did it myself, and the results were just fine. I did experience ptosis in the left eyelid, but that was my own fault for injecting too close to the brow. The ptosis only lasted about 10 days.This occurance is very common even for all those professionals out there...about 3 to 5% of patients get the temporary droopy eye. I do recommend doing a great deal of research before you decide to inject yourself, but overall I have been pleased. Maybe the price of getting it done at a spa will go down someday, who knows. I know in my case, the expense is what brought me to purchase on line. No regrets. Just be very careful.

via medicalspamd.com

This woman is a damn idiot! Injecting herself with some 'Botox' substitute she bought online.

Not only is she an idiot, she's completely wrong. In seven years I've never seen tosis (droopy eyelid from Botox) from any physician.

Posted via web from Medical Spa RX: Wholesale Botox

Plastic surgery for Tiger’s mistress?

Photos: Above, recent online photos of Rachel Uchitel. (Photos courtesy of Gala.de and TheImproper.com) Below, Rachel Uchitel yesterday in Los Angeles. (AP photo)

Plastic surgeons and celebrity watchers gave party hostess Rachel Uchitel a once-over as soon as the tabloids thrust her into the spotlight last week as the alleged mistress of golfing great Tiger Woods.

She flatly denies the allegation, but Uchitel’s photos on the Web have provided evidence for cosmetic doctors to analyze. For example, plastic surgeon and blogger Dr. John Di Saia of San Clemente and Huntington Beach wrote:

[Her photos] show her to be an attractive woman who has probably seen the inside of a plastic surgeon’s office before. She seems to have had breast implants at the least from the images we have seen.

The online Plastic Surgery Channel commented on the uncertainties surrounding Uchitel:

Her lips do suggest lip injections, and her chest suggests breast augmentation. Uchitel would likely deny rumors of plastic surgery, just as she has denied other rumors. But, in all cases, she may be telling the truth.

The Talk Surgery site went far beyond what the photographic evidence supports when it called her a “Surgery Diva.”

via inyourface.freedomblogging.com

Posted via web from Laser Center

Model's death highlights plastic surgery risks...

More of this tragedy playing out today.

Argentine model dies after plastic surgery:

• Model Solange Magnano died after complications following plastic surgery
• Injecting fat or silicone into the buttocks can lead to a blockage of blood supply to the lungs
• "No cosmetic surgery is totally risk free," says top cosmetic surgeon

London, England (CNN) -- Following the death of a former Miss Argentina after complications arising from plastic surgery, questions are being raised about the risks of cosmetic surgery.

Solange Magnano, 37, died in hospital, after being transferred from a clinic where she underwent an elective surgery on her buttocks last Wednesday.

Nigel Mercer, president of the British Association of Aesthetic Plastic Surgeons, last month described the cosmetic surgery industry an "unregulated mess" in the journal Clinical Risk.

Following revelations of Magnano's death, he told CNN, "Unfortunately, the things we're saying about this type of surgery keep being proven right by people having major disasters."

Magnano is reported to have died from a pulmonary embolism, a blockage of the blood supply to lungs.

It is currently not known if Magnano's death was a result of her surgery and there is no suggestion that it came about through surgical error, but there are risks associated with buttock-enhancement surgery.

Mercer said Magnano may have had a solid implant in her buttocks, a relatively low-risk procedure, but he said it's possible that she had liquid silicone injected into her buttocks -- a "highly unpleasant" procedure that is banned in most countries. An alternative would have been to extract fat from another part of her body using liposuction, and then inject the fat into the buttocks.

"With a pulmonary embolism something blocks blood supply to the lungs and circulation literally stops dead," Mercer told CNN.

"The lump in the lungs can be stuff you've injected into the patient -- their own fat or a lump of silicone -- or it can be clots from leg veins as a result of deep vein thrombosis (DVT)."

While DVT is not common with cosmetic surgery, Mercer said that operations on the pelvis, buttocks and legs carry a much higher risk of causing the condition.

"No cosmetic surgery is totally risk free," Mercer told CNN. "Even having botox and fillers is not risk free. There's a chance of infection, bruising or bleeding with any procedure."

via cnn.com

Posted via web from Laser Treatment MD

Miss Argentia dies after Brazilian Buttlift.

Plastic surgery marketing in Argentina is booming, with medical spa advertising a common experience for Argentine women. Plastic surgery advertising is seen as putting tremendous pressure on wome to have proceedures like liposuction, breast augmentation, and Brazilian Buttlifts.

The result is sometimes a tragedy, like the death of Solance Magnano, a former Miss Argentina.

From a news story.

38-year-old former Miss Argentina Solange Magnano died after complications arising from plastic surgery on her buttocks.

Solange Magnano, the 1994 winner and a mother of 8-year-old twins, died of pulmonary embolism Sunday three days after having a gluteoplasty, a procedure that involves placing implants to enhance firmness. News of her death shocked her fans. The cause of her death was under investigation, the authorities said. Officials said the injected liquid went into her lungs and brain.    

In the past half decade, the number of people seeking plastic surgery in Argentina has soared by 60 percent, to around 50,000. Estimates say that 1 in 30 Argentines has gone under the knife, making plastic surgeons in Argentina some of the most experienced on the globe, attracting large number of medical tourists.

Medical tourism in Argentina has seen a huge jump over the past decade, and is projected to be a 100 billion dollar global industry by 2010, according to the Deloitte Center for Health Solutions, a U.S. research center focused on trends in the health care system.

via freelancemd.com

What a tremendous waste. Perhaps the worst quote of the story is that the 'injected liquid went into her lungs and brain'.

Posted via web from Laser Treatment MD

Medical Spa Legislation

Medical spas in the US and elsewhere have increased in numbers and are popular as medical tourism destinations. Several countries have reported problems of medical spas undertaking medical procedures that neither the spa nor the staff are qualified to do. Unfortunately, this reflects badly on the majority who are professional. They have tended to fall between the gaps in legislation, but one of the first countries seeking to remedy that is the USA. Nationally, the number of medical spas around the country has grown from 500 in 2004 to 2,500 today. If this growth rate continues, more states will follow the four who are preparing regulations, and almost every sate has discussed the idea.

According to the International Medical Spa Association, the official definition for medical spa is a facility that operates under the full-time on-site supervision of a licensed health care professional. The facility operates within the scope of practice of its staff, and offers traditional, complementary, and alternative health practices and treatments in a spa-like setting. Practitioners working within a medical spa will be governed by their appropriate licensing board, if licensure is required.

The death of a nurse, who had a liposuction procedure performed, has raised concerns over the safety of medical spas to the level that several states are progressing legislation. The proposed legislation is now travelling through several state medical boards in Massachusetts, New York, Florida, and Utah. Proposed legislation would require owners of medical spas to have certain credentials, dictate which procedures can be performed, and set a minimum level of training for those performing particular procedures. Legislation does not want to stop consumers having medical procedures in spas, but to ensure that the procedures are performed safely and by someone with the correct training.

The concern of cosmetic surgeons is the lack of training or experience of some employees at medical spas. An employee of a medical spa may start out performing one procedure and move to another more difficult procedure without much experience. Indeed, lack of experience with certain medical procedures has resulted in serious consequences for some customers, but more common is minor problems such as second-or third-degree burns from improperly conducted laser hair removal procedures.

Medical spas in the US offer treatments including laser hair removal and liposuction, as well as massages and other traditional spa treatments. The types of procedures performed in medical spas have expanded to include chemosurgery for skin cancer and reconstructive surgery.

Massachusetts health officials want to crack down on medical spas, following the lead of Florida, which has been preparing legislation for three years. In Massachusetts a medical spa task force has been set up to advise the state legislature on how best to regulate the facilities. It would prefer a system of federal regulation of medical spas as it would be more cohesive than a state-by-state model but believes that is unlikely to happen, as medical and other professional boards, like nursing, electrology and aestheticians boards, are regulated and licensed by individual states. But the government has just decided to take insurance regulation away from states into a national body, so national regulation is a possibility. The task force has proposed that spas be required to get licenses from the Massachusetts Department of Public Health, and recruit a physician or nurse with special training to remove age spots or tattoos with a laser. Non medical practitioners - cosmetologists, electrologists, and aestheticians - will be allowed to remove body hair using a laser, but only after special training and certification. The task force reported that doctors and other professionals not specifically trained in dermatology have begun offering laser skin procedures, presenting an unacceptable risk to patients.

Regulating medical spas is complicated because they combine many different professionals under one roof, including cosmetologists, electrologists, aestheticians, nurses, and physicians. In most US states each of these professions is licensed by its own board, and each has its own standards. There are no overall regulations governing who can do certain cosmetic procedures and what type of training is required, and there is no requirement that medical spas be licensed.

via imtjonline.com

Posted via web from Laser Treatment MD

Tumescent Liposuction vs. Laser Liposuction - Medical Spa MD

Liposuction: Is tumescent or laser liposuction better?

Plastic Surgeons today are using various types of liposuction. I prefer tumescent liposuction with thin cannulas instead of laser lipo. This is a manual method of liposuction that I believe yields the best liposuction result because the surgeon has the most amount of control.

Traditional tumescent liposuction

Tumescent liposuction has been around well over a decade and allows the surgeon to have complete control of the amount of fat being taken out. The  tumescent liposuction technique is mechanical as it involves the surgeon using a long rod called a cannula to extract the fat. The motion is a continuous back and forth rhythm to remove the fat. Since the motions are repeated over the course of 1-3 hours, your surgeon must be in good aeroebic shape to give YOU a good result!  Honestly, this is one reason why some surgeons do not use this technique!

While the basic technique used in tumescent liposuction has not changed, the size of the cannulas used to extract the fat have gotten much slimmer over the years. In the past, surgeons used larger 5mm cannulas , but  this sometimes resulted in lumpy or uneven results. Most surgeons now use 3mm or smaller cannulas.  This will increase the length of the surgery as it does take longer to remove the fat from small cannulas, but the results are well worth the longer surgical time!  The thinner 3mm cannulas produce excellent and consistent liposuction results. With thin cannulas, traditional tumescent liposuction can achieve the smoothest and most even result possible . 

Laser and ultrasonic liposuction

The new technologies for liposuction technique  include laser liposuction and ultrasonic liposuction. They emit high energy that liquefies and destroys tissue around the cannula. I do not think these technologies are worth the risks they pose to the patient. Both of these techniques essentially melt the fat under your skin. As they melt the fat, other tissues are damaged. I am not a fan of damaging tissue or fat cells that are not being extracted.  Often times, the extracted fat could be used for fat injections to rejuvenate another area of the patient’s body.  These technologies destroy that possibility. Additionally, these high energy ultrasound and laser technologies can have complications such as burning, and results can be very unpredictable as it is impossible to tell how much damaged tissue is left behind.

Best technique is tumescent liposuction with slender cannulas

In summary, the best technique available for liposuction is the  traditional tumescent liposuction technique with small diameter cannulas. It has stood the test of time. Sometimes the latest is not the greatest. I perform hundreds of liposuction procedures each year and I do not remember the last time a patient asked for a touch up for lumpiness or unevenness. Thin cannulas give you the best chance to get the result right each and every time!

Ricardo L Rodriguez, MD

via Medical Spa MD: Tumescent Liposuction vs Laser Liposuction.

Posted via web from Freelance MD

Liposuction Patient Training Video: Using thin liposuction cannulas.

Liposuction Training Video: Why thin liposuction cannulas give the best result.

Dr. Ricardo Rodriguez is a Yale trained, board certified plastic surgeon specializing in multiple procedure makeovers. He performs unique procedures such as the body lift, Brazilian butt lift, stem cell facelift, endoscopic brow lift, and lip lift. He is Medical Director of his own AAAASF accredited surgery center in Baltimore, Maryland.

via Medical Spa MD: Liposuction Technique ~ Thin liposuction cannulas.

Posted via web from Freelance MD

Medical Spa Marketing: Blogging for your medspa.

First, if you're not blogging for your medical spa,  laser clinic or plastic surgery practice you're probably still using a rotary-dial telephone. Start.

Your patients are busy, and in order to gain and keep readership on your site you need to provide your existing and potential patients with information that makes their lives better, easier, and less stressful. Laser clinic or cosmetic surgery websites face the temptation of turning every post into a dry marketing appeal. It’s up to you as the physician or clinic owner to overcome that obstacle and provide your med spa patients information about your services in a quick and easily digestible way.

So the question is... How do you do that? Here are seven ways you can engage readers of your med spa or plastic surgery blog and keep them coming back.

1. Offer Real Medical Advice

You've got real medical experience, share it. (Yes, you do have to be careful so you don't get sued but post a clear disclaimer and be smart about your 'opinion'.) If you like Thermage or Fraxel, say it. The very best way to gain loyal readers is by sharing your knowledge and giving them practical information they can use to make decisions. You can give your readers an instant benefit by avoiding abstract ideas and providing specific tips, advice and tools they can use right away.

2. Talk to Your Existing Patients

You’re already ahead of the game with this one, because your existing plastic surgery or med spa patients already have a connection to you, otherwise they wouldn’t be reading your blog. Better yet, impressing them leads to greater word of mouth referral. Get to know them by keeping an eye on comments (allow comments on your blog and don't delete them unless they're way over the line), watching for trackbacks and listening to feedback in other forums. All of this input can be material you can use to make your posts resonate with your individual readers.

3. Share Personal Stories

Business is business and personal is personal, right? Not anymore. Today there is an increasing amount of overlap between the two, and people want to know a little more about the person behind the med spa, laser clinic or plastic surgery center, beyond a cv and medical marketing speak. So give a little of yourself to create a stronger relationship with your readers. Women (and our market is women) want to know that they can trust you. If all you ever post is your latest laser hair removal ad, you're just not as trustworthy as a the plastic surgeon who loves his kids and has a dog.

4. Go Non-Surgical Again

Throw in an occasional post that’s not exactly med spa or plastic surgery related. If it bombs, it bombs and you know to go a different route next time. But if it is successful, you can insert some comic relief, mindless banter and maybe even a personal story as listed above to give your patients a brief change of pace. Talk about how expensive Botox is. How Thermage charges for every tip you burn. How you worry about providing the best patient care.

5. Keep It Short and Sweet

You could probably write some very long posts when you’re discussing your latest business endeavor or what it took to build out your med spa or plastic surgery practice. If that much information is necessary, split it up into a multi-part series. Use lists, subheads and images to break up heavy content whenever possible.

6. Share The Conversation With Your Patients

Ask directed and specific questions at the end of your posts to encourage reader commentary. For every few posts where you provide advice, throw in a post that asks for the answer. Involving your readers will give them an opportunity to take an active role in your blog. Ask them if they'd like a membership as part of your offering. Talk about your patient referral perks. Ask who they think provides the best patient care. Ask if they can help your med spa provide better care...

7. Give Potential Patients What They Want

Carefully read the comments provided by your existing and potential patients. They are invaluable because they allow you to tailor your posts to the information your readers are asking you to provide. Acknowledge the comments, answer the questions, and address the requests and you’re on your way to building great relationships with your readers.

8. Bonus: Protect Your Med Spa or Plastic Surgery Practice

OK I said seven ways. Here's a bonus.

Of course I'm not a lawyer... (see how I carfully did that) but your medical opinions are your own. Keep a clearly defined page that states that the content of your site is not to be used as medical advice and shouldn't be acted on without consulting a physician. There are any number of medical blogs that write about specific cases with this kind of disclaimer in place.

via Blogging for your medical spa.

Posted via web from Freelance MD

Medical Spa Marketing: Be remarkable.

If you want to be remarkable you have to provide an experience worth telling someone about.

Of course you looked at the image to the right. It's an ad for a condom and meant to get your attention.

Word of mouth marketing is one of your best friends as a medical spa. Happy clients bring in their friends and family. But what are you doing to make your medspa stand out? What is it about your clinic that's worth actually remarking about 'before' being asked?

Happy patients who like you are just a base line an a relatively low hurdle if you know anything at all about what you're doing and have the right IPLs or lasers. But clinics who are really making money have often learned that moving a patient from happy or satisfied to a zealot that actively seeks out opportunites to mention them can double their revenue. (Everyone has a couple of zealots. I'm talking about a large percentage of patients.)

The image above is unexpected and different, so it attracts interest and comment.

If you want to have patients remarking about you, you have to actually be remarkable.

via medicalspamd.com

If your laser clinic or plastic surgery center is not generating 'remarks' from your patients, do something that does.

Posted via web from Freelance MD

Medical Spa MD - Plastic Surgeon, Dermatologist, Cosmetic Surgeon, Laser Clinic & Laser Treatment Forums

Restylane, Juverderm and filler injections tips for physicians running medical spas and laser clinics.

The following is from a string of emails that were circulating among some of Medical Spa MDs Members. I've edited this somewhat to make it readable and get rid of all the extraneous copies. I'm also not displaying the identity or email addresses of the physicians in this thread.

Note: Some of the comments below might be out of order from the original thread. Emails' somewhat difficult to follow as a thread but you'll get the gist.

Filler Injection Discussion & Tips: Restylane | Juevederm | Evolence

1.  When I use the "push ahead" technique, I feel that I get better "plumping" per cc of filler.  I learned this from Kevin (thanks Kevin).

2.  When I use the "push ahead" technique, the filler fills a few millimeters in front of the needle tip.  You need to realize this to be able to put the material exactly where you want it.  Sometimes you have to "feel" the injection because you can't "see" the plumping.

3.  I mix 0.1 cc of lidocaine with epinephrine with my Juvederm.  This helps with bruising (epinephrine) and when the lidocaine goes away and the Juvederm attracts water, the two effects cancel each other and there is not as much enhancement after the injection due to the hydrophilic nature of the Juvederm.

4.  I use Juvederm Ultra under the eye and above the lip.  I use Juvederm UltraPlus everywhere else.

5.  I constantly complain to my Juvederm Rep about the 0.8 cc syringes.  I use lots of Radiesse because you get almost twice as much material for the same price.  Volume, volume, volume.  Please complain to your rep, maybe we can get them to change. 

6.  I hear the Evolence is very good.  We will be getting trained and start using it next month.

Thanks for the filler tips.Can you explain how you get the Lido with epi mixed into the Juvederm syringe? --PD

Fluid Dispensing Connector from Braun Medical Inc (you can get from PSS)

BD 1 ml Luer-Lok Syringe

This syringe allows you to get very precise amount of lidocaine (swish back and forth 20 times).

I use this syringe to put exaclty 1 cc of saline in my Botox Bottle. When I reconstitute the Botox (this gives it full strength per unit). The chances of intravascular injection might be lower with push ahead because the material will push the vessels out of the way as you advance --  Jeff

Hi Jeff,--I agree w/ #6.  I seem to get good augmentation, less redness, swelling and bruising with Evolence.  I use it for deeper fills in cheeks, NLF, etc.  Don't use it for lips or under eyes.  I do same with Lido w/ epi.  I tend to use Juvederm in lips.  Perlane / Restylane for other areas.  I agree w/ why Allergan uses 0.8 cc syringes. I've moved away from Radiesse.  I feel that the duration is not that much longer than a good correction with the HA's.  Besides, I believe a fair amount of the volume of Radiesse is a gel carrier, thus needing touch-ups at 2-3 months.  Perhaps that's why the went to the larger syringes? -- Don

The push ahead technique also moves small blood vessels out of the way, so you may notice less ecchymosis is overall pts. -- Greg

Jeff: --"Push ahead" has a higher risk of vessel cannulation & potential for vascular effects - skin necrosis in glabella, even potential for retro-grade flow to eye (causing visual loss).  I wouldn't recommend that technique for the periorbital area.

Restylane is recommended for the tear troughs;  it's less hydrophilic than juvederm - which means less post-treatment swelling.--Tom  --  [note from Jeff:  Tom is a plastic surgeon]

I would not use push ahead around the eye, I agree with Tom's comments. It works great for NLF. I was actually taught this by a PS -- Greg

Thanks Jeff for your kind comments. However I must make a few points in regards to fillers:

1) There are some areas that one has to still do the retrograde injection either b/c the purpose was to make a straight line (eyebrow lift and vermillion border and the bow-tie (the vertical lines connecting the base of nose and the upper lip border) AND when injecting the most inner 1/3 of the tear-trough to avoid risk of filler getting into the orbital space due to its close proximity to the orbital rim.

2) On the glabellar injection, it is best to first push and pull the needle thru the space underneath to break up the tissue before actually injecting the filler both in an anterograde and retrograde pattern

3) I ONLY use the 1/2 inch needles in all my injections

4) One can inject even Radiesse and/or Perlane via an 1/2 inch 30 gage needle. Why is this noteworthy to mention?? When I work on the lips and Marrionette's lines, I ususally first build the Vermillion border with Radiesse or Perlane (I get the best "lifting outcome" with heavier filler). I push the 1/2inch needle all the way forward then slowly and steadily inject while withdrawing (retrograde method). Then I re-evaluate how much of a correction I already get of the Marrionette' line and lifting up of the lip body. My next step is to inject into the most lateral lip section (about 1 cm distance) starting at the corner (using Perlane or Restylane or Juverderm). This time I inject slowly as I push forward (anterograde). Often I ended up correcting about 50% of the marrionette's line by going after the lip's border and most lateral body. Besides, the patient loveto see that they now could see their lip body all the way to the corner and more "smiley shape". The last step is the trickiest one, I use either Radiesse or Perlane on an 1/2 inch 27 gage needle. First placing my left thumb at the patient's lower half NLF's I retract the skin upward (about 2-3cm upward) then I approach my needle in an upward (vertical) position at about one centimeter lateral and one cm below the mouth corner of that same side. Then I aim diagonally toward the corner and start injecting anterograde just 1-2 mm below the imaginary horizontal line of the mouth corner (about 0.2 cc), then I withdraw the needle and reaim straight up and inject just below the horizonal line (0.2cc) then I do it one more time aiming diagonally outward (0.2cc). What was I attempting to do?? I was laying down a new flooring along the imaginary horizontal line. After the injection, release the left thumb. You will be surprised to see the retracted portion just rest right along this new floor, thus the Marrionette'line has been corrected. This is different from the common fanning technique of using the filler to "blow up" around the Marrionette's line. If you look carefully at those company's issued photos, the area around the Marrionette's line now appeared very swollen and puffed up. It is aesthetically unpleasant. It looked like the patient was beat up below the mouth. It reduced the profile of the chin.

5) For those of you that use fillers on the highly vascularized and shallow areas such as the temporal, crow's feet, undereye area lateral to the submalar area and along the lateral border of the cheek prominence (especially in those older skinny Caucasian ladies with much excessive very thin skin) I now emulate the same technique used in the hand. I would pinch to levitate the skin itself above the bony structure, then I bolus Restylane into the empty space. Then I massage it down. This elimates the risks of injecting into the vessels and nodules.

Interesting discussion.  So Kevin, how do you account for the difference in that anterograde injection you need less filler than in retrograde injections, assuming all else being equal?

Second, I am understanding one group claims anterograde injection carries a higher risk of vessel cannulation and possible intravascular injection, while another group claims that anterograde injection "pushes away" blood vessels, thus decreasing the risk. Not sure how anterograde increases risk of intravascular injection any more than retrograde.  If you push the needle ahead, transfixing a vessel, then begin injection, you can still conceivably deposit some material intravascularly, can you not?  Am I missing something here?

I also found an interesting idea of sub q bolus technique in areas of thin skin, ie crowsfeet, etc.  Anyone else try this method? ~ Don

Tom:

I do agree with you about those risks with anterograde injection. The key is always the skills in doing it, be it retrograde or anterograde. One always has to be very carefully doing anything around the eyes. However, the anterograde techinique has been advocated some of the best known experts such as Arnold Klein, MD and Kent Remington, MD. I also believed that the filler amount used was critical. It takes much more amount to get the same result with the often taught retrograde technique compared with the anterograde one. For example, I almost never required more than one full syringe in correcting bilateral NLF's vs what was typically used ( 2 syringes) by most others. I attached the before and after of a case wherein I used Readiesse to correct her NLF's and Marrionette's lines with anterograde technique. The after photo was taken right after. You can still see some of needle marks. I used one full 1.3 cc syringe, 1/2inch 30g for the Vermillion border and 1/2inch for NLF's and Marrionette's line. Notice also there was no "puffy/swollen look" medial to the Marrionette's line often seen with retrograde and fanning technique used by most others. ~ Kevin

All interesting comments.  The only place, I use “push ahead” is in the cheeks when doing them via the intra-oral route. (Apparently Radiesse is no longer teaching this method because may practitioners couldn’t get the hang of it but it works for me.)  I might try it in the “safe” areas such as NL folds.  We use only Radiesse and Juvederm and  I find that neither filler lasts as long as advertised in “first-timers”.  I’ve also had disappointing longevity in my older patients (>65) with both types fillers despite using numerous syringes.  I’m sure this has to do with their inability to generate collagen around the filler once the carrier gel is gone.  Does anyone know the age range of patients done in the filler studies? ~ SD

I came across this old thread way down in my inbox and read it again.  I’m not sure who wrote #4 below.  It sounds interesting but I’m having a hard time visualizing it.  Do you steadily move the needle forward  toward the lip edge as you are injecting or do you hold it in place while the area fills?  I’d love to see a drawing on where you start.  ~ SD

SD: I wrote those threads. The techniques that I described were similar to what you could see watching the video instruction on www.thederm.org by Kent Remington and his colleagues (lower face injection portion) THe only thing new from my thread was when fixing the Marrionette's line, his doctor (Nowell Solish) injection upward and anterograde from the lower part toward the lip corner only one time vs what I now do is I do the same thing but with a fanning pattern where (with the skin lifted about 1-2cm upward with the other thumb) I laid down "three such "anchoring points" along an imaginary horizontal floor starting from the lip corner going laterally for about 3-5cm long. Here I used something firmer such as Radiesse or Perlane. Having done this, you would release the thumb letting the skin go back down. Often you will see the Marrionetter's line is much improved because "part of that Marrionette's line" now is positioned along the horizontal flooring that you just created. ~ Kevin

PS: It is hard for me to send over some graphic illustration but I will attempt to do this in the future

via Medical Spa MD: Juvederma, Restylane, & Filler Injection Tips for Physicians.

Something worth knowing. How is your plastic surgeon or dermatologist communicating with other physicians to keep abreast of the latest information about treatments?

Posted via web from Medical Spa RX: Wholesale Botox

3 Different Types of Skin Cancer - Find Out What Are They

By William Wallace

One of the most common forms of cancer is skin cancer. It is easy to prevent it, and it is very curable, but it must be detected early on. There are three main types of skin cancer that you might see on your skin.

Squamous cell carcinoma, the first skin cancer you should know about it, comes from getting too much sun. For that reason it is most often found on the face and ears. Squamous cell carcinoma starts off as a bump and later turns into an open sore that doesn't heal. If you go without treatment, it will get bigger and bigger. This type of skin cancer can also spread to more parts of your body if you do not get it treated.

A type of skin cancer is called basal cell carcinoma. The face, hands and neck are where these are usually located, and up to seventy five percent are included in all diagnosed skin cancers. If you detect it early enough, basal cell carcinoma can be treated very effectively. If you have a sore that bleeds and is irritated, that may be basal cell carcinoma. This cancer can also look like a fresh scar.

Melanoma is the last and potentially the most dangerous of all the types of skin cancer. Melanoma can be found on any part of the body, but is usually found on the arms and legs and is often mistaken for a mole or a freckle. Melanoma is particularly dangerous because it can come from an existing mole that has recently changed size, shape, or color.

It is imperative that the melanoma type of skin cancer be found and eradicated early to prevent the problems that will come with the later stages of this skin cancer.

You can do a great deal to prevent skin cancer from occurring. Make sure that you take precautions when you are out in the sun to protect your skin at all times. Wear a sunscreen every time you are outside no matter the season.

The best chance you have of surviving skin cancer is to detect it early. Make sure to cover your exposed areas with clothing and protect your head and face by wearing a hat. Be aware of any changes in your skin.

About the Author:

Want to Find Out What Are the Skin Cancer Warning Signs? If you want to know about skin cancer detection you can read at www.SkinCancerWarningSigns.info Find out how to do skin cancer detection and have a 100% survival rate.

Active FX Laser Skin Resurfacing

Active FX laser skin resurfacing is gaining popularity at medical spas, laser clinics and plastic surgery centers. It’s main competitors are Thermage, Fraxel, and other skin tightening or laser skin resurfacing treatments.

Here’s an overview of Active FX and some links to more information.

The goal of laser skin resurfacing is simple: replace damaged skin with new, fresh skin. Techniques for skin resurfacing have made enormous advances, allowing nearly everyone to achieve close to flawless complexions. Many systems allow for light, moderate or deep laser resurfacing. The primary targets of laser skin resurfacing include:

• Fine lines and wrinkles of the face, especially around the upper lip, cheeks and forehead
• Loose eyelid skin
• Crow’s feet around the eyes
• Pucker marks (smoker’s lines) and frown lines
• Brown spots and splotchy, uneven skin tone
• Scars, especially acne scars
• Loose skin around the neck and jowls

How it Works

The gold standard of laser resurfacing systems, the UltraPulse® CO2 laser delivers thousands of tiny laser pulses in a pattern over the skin. Each pulse heats a column of tissue eliminating pigment discolorations at the surface and creating a zone of heating deep in the tissue. Unique to the UltraPulse Encore, these zones of heating shrink collagen and tighten the skin immediately*. The CO2 laser also offers the benefits of heating deeper layers of skin tissue, thereby stimulating collagen remodeling, tightening* the skin further. Patients can select from a range of treatments depending on the needs of your skin and lifestyle.

What is ActiveFX “fractional” laser resurfacing?

ActiveFX is a fractional laser procedure performed in a single treatment with minimal patient downtime. During the procedure, a high-energy beam of laser light is used to smooth out lines, wrinkles and scars, remove brown spots and other irregularities, and tighten the skin. It also stimulates formation of new underlying collagen to continue improvement over time. With fractional laser treatment, only a fraction of the skin’s surface is treated by the laser, leaving small “bridges” of untouched skin. This technique makes the healing process much faster and enables you to get back to normal activities sooner.

Is ActiveFX right for you?

Treated areas should be washed twice a day with cool water and a mild soap. Use our lotion twice daily to treated areas for 3 to 5 days or until healing is complete. Treated areas should be protected from direct exposure to sunlight. Sunscreen with SPF greater than 15 should be used at all times on the treated areas.

ActiveFX is ideal for you if you:

• Have a busy lifestyle or cannot be away from work for a long time
• Want noticeable results with minimal downtime
• Want to treat dyschromia, fine lines, wrinkles and skin laxity*

What you can expect from ActiveFX

Most physicians perform the procedure in the office with a topical anesthetic cream that is applied 30-40 minutes before the ActiveFX procedure begins. There is little to no pain associated with the procedure – most patients say they feel warmth similar to sunburn. You can drive yourself home after the procedure. With a gentle washing and moisturizing regimen, your photodamaged skin will begin to flake off within 2 days. After about 3-5 days, your doctor will probably let you wear make-up. Pinkness should be gone in about a week.

ActiveFX benefits

ActiveFX treatment produces a dramatic effect on the skin:

• Causes immediate skin tightening*
• Reduces wrinkles and fine lines, and softens deeper frown lines
• Noticeably improves skin tone and texture
• Stimulates new collagen formation and plumps the skin

The results of ActiveFX laser treatment are long-term and, with proper sun protection, can persist for many years. Most effects of treatment become visible right away, whereas others – such as new collagen formation, which leads to continued inner tightening – build up gradually and become more evident over time. Therefore, most people look even better 3-5 months after the procedure.

Additional Information on ActiveFX

http://www.aesthetic.lumenis.com/wt/page/activefx

http://www.lumenis.com/wt/page/pr_1170434066

http://www.skinandhealth.com/details/wrinkles_treatment#wrinkles_co2

Redness after IPL & Laser Treatments: DeepFX & ActiveFX

Reliant UltraPulse Fractional CO2 Laser

Active FX: Physician User Group ~ Medical Spa MD

via botoxpatient.com

Some fantastic info on Active FX laser resurfacing from Botox Patient. Love it.

Posted via web from Laser Center

Need a breast lift? Try an plastic surgeons internal bra?

Breast lift plastic surgery coming to a medical spa near you.

Bras are an often uncomfortable but necessary evil for the majority of women.

But if you've got serious bra issues and can't be bothered with a different strap arrangement for every occasion, plastic surgery now has the answer.

Israeli plastic surgeon Eyal Gur has invented the Cup & Up bra and there's no straps to be worried with... on the outside at least.

In fact, the invention is an alternative to breast implants and promises perky breasts for years without any of the drawbacks of implants.

The first guinea pig has already had her internal bra fitted and surgeons say it was a huge success.

Avi Cohen, managing director of Orbix Medical, the company helping to develop the bra, told the Daily Mail: "The operation went really well and the woman, who is in her 30s, has made a good recovery.

"The bra has given her the lift she wanted. Her breasts look natural and she is happy with the result. The surgeons have done a fantastic job."

The Cup & Up involves a kind of internal silicon bra. The 'straps' are attached to the ribs with titanium screws, stitched to silicon 'cups' and then it's all tightened into place.

As gruesome and unpleasant as that sounds, those of you in need of a lift can be in and out of hospital in a morning as the keyhole operation takes just 40 minutes.

Mr Cohen believes the internal bra will become widely available throughout Europe within the next 18 months.

"We have enough women volunteers in the trial and we will be doing our second patient just before Christmas.

"In a year's time we will have enough evidence that it works. Then we will be able to get the green light from the European medical licensing authorities."

Call us cautious, but we think we might wait a little longer.

via rubyroom.aol.co.uk

Posted via web from Laser Treatment MD

Reconstructive Plastic Surgery Not Likely Among Certain Races?

Less-acculturated Latinas with breast cancer are less likely to have reconstruction surgery after a mastectomy, say researchers at the University of Michigan Comprehensive Cancer Center.

Amy Alderman, MD, MPH, assistant professor of plastic surgery at the U-M Medical School and lead author conducted a study to examine trends in breast reconstruction among different races, including white women, African-American women, and Latina women. The group of Latina women was further divided into women who were either highly acculturated into American society or less acculturated.

After looking at 806 women who were treated for breast cancer, researchers found 41% of white women and 41% of highly acculturated Latinas underwent reconstruction, while only 34% of African-Americans and 14% of less acculturated Latina did.

The study authors found that the lagging reconstruction rates did not correlate to lack of interest. More than half of the less-acculturated Latinas said they would have like more information about breast reconstruction.

When patients' satisfaction with their surgery was measured, the highest satisfaction rates were among white women who were satisfied with their treatment (94%) compared with the lowest rate, 56%, among less-acculturated Latinas who did not receive reconstruction.

Furthermore, this group was also less likely to report that their surgeon explained breast reconstruction, and they were less likely to be referred to a plastic surgeon than the other racial groups. The study also showed similar trends for African-American women, although the most significant data was among the less acculturated Latinas.

“Reconstruction is important to these women, but significantly more of the less-acculturated Latinas did not know how to get it. It suggests significant unmet needs for this vulnerable group. They have a desire for reconstruction, but no one's telling them about it,” Dr Alderman suggested.

The study authors suggest that more efforts be made to present breast reconstruction options to all patients, including those who speak only Spanish. Further research is planned to understand how language and other cultural issues affect whether women receive breast reconstruction.

via oncologynursingnews.com

Posted via web from Laser Treatment MD

Venezuelans Borrow for Plastic Surgery

Unfazed by a recession and rampant inflation, image-conscious Venezuelans show no signs of cutting back on the facelifts, liposuction, and breast augmentation that have become de rigueur beauty treatments.

"There is never a question of not doing it, but of how you can do it. We all want to get everything done," said Helen Patino, a 37-year-old former model who had her first breast augmentation when she was 21 and her third about three months ago.

Venezuela's inflation is the highest in Latin America, up more than 20 percent in the first 10 months of this year and the South American nation is in recession after a five year boom.

Hard times may even encourage cosmetic procedures as people look for ways to lift their spirits, with many dipping into savings or taking on debt to get operations, surgeons say.

"The financial crisis has spurred people to spend more on themselves ... to console themselves in this crisis. I have not seen demand diminishing," said Peter Romer, a plastic surgeon in Caracas.

For Iris Delgado, a 57-year-old dental technician, a lack of funds was not an obstacle to getting a recent eyelid tuck.

"With the economy, one has to make sacrifices, because you don't have the money. So, you get it from credit cards, from family and you pay for it," said Delgado, who borrowed 7,000 bolivares -- about $3,250 -- for the procedure, a move she saw as a hedge against inflation in plastic surgery prices.

Like Delgado, many go into debt to finance plastic surgery, according to those in the industry.

"It's an investment that people make and they look for money everywhere," said Romer, adding that one of his patients moved into a smaller apartment to get a makeover and another traded her car for a facelift.

Leoncio Barrios, a social psychologist at the Central University of Venezuela, said such stories are the exception. "The majority of middle and lower-income women do not have property to sell or the capacity to save," he said.

via abcnews.go.com

Posted via web from Laser Center

Plastic surgeons get Botox too

I've always wondered if doctors are more or less apt to seek treatment for medical conditions. Well, when it comes to plastic surgery, the doctor is often the patient, a new study finds.

In a survey of 276 members of the American Society of Plastic Surgeons, 62 percent said they had gone under the knife for at least one procedure. Most receive minimally invasive procedures such as laser hair removal chemical peels and Botox -- no word of whether they throw Botox parties. A third had gone under a surgical procedure, with liposuction being the most common.

Women surgeons were more likely than men to have cosmetic surgery. The study about the survey -- appearing in the December issue of Plastic and Reconstructive Surgery -- suggests they can be an asset to patients who are trying to decide which kind of reconstructive surgery to receive.

via weblogs.baltimoresun.com

It would be interesting to know if laser clinics and medical spas see an up-tick in treatments like Thermage, Fraxel, laser treatments or filler injections between female and male plastic surgeons. I'd certainly guess that laser hair removal and photofacials are more common among female docs running skin clinics.

How to run your medical spa or laser center in turbulent times.

If you’re involved with or own a medical spa, this question is no doubt on your mind.

In this article, I will give you several tips and tools to evaluate your laser centers culture and operations, so you can successfully navigate any economic downturn… And live to sell another day when the inevitable upturn comes around.

What is the Passion and Purpose of Your Medical Spa?

You reap what you sew. When you engage proactively and passionately in your business you will undoubtedly be successful and see your practice expand. It helps to articulate your passion for your medical spa.

At Assara Laser, our passion is to “help clients look and feel great, not fake.”

Why the Recession Drastically Affects Your Laser Clinics Bottom Line

You’ve probably noticed that generating revenue is not as easy as it once was. There are myriad reasons for this; from the decline in disposable income, to unemployment hitting record highs and tanking real estate valuations. As if these facts were not bleak enough, credit markets are virtually frozen so business owners are finding it nearly impossible to obtain small business loans and lines of credit. Refinancing current loans has become difficult for small businesses.

In short, we're operating in the perfect storm.

Accepting Reality and Responsibility Today

The easy way out is to close up shop and blame the recession. This will not help you going forward, it will not pay your devoted employees their wages, and most of all, it will not help your clients “look and feel great, not fake.” So, accept responsibility. 

The hardships of the recession create a fact-pattern, problem to be solved; not a reason for failure. To paraphrase Michael Jackson, start, first, with the man in the mirror. Think about the following questions. And pay attention - there will be homework at the end of this article!

Finding Your Medspas Winning Competitive Difference?

Let’s be honest. The quality of your laser clinc's treatments are probably not drastically better than that of your competitors. The proprietary equipment and IPL or laser systems (Thermage, Fraxel, Titan) that you use are, for the most part, available to the competitive skin clinic market at large.

You may believe (and tell clients) that your microdermabrasion treatments are better because you use a diamond-tipped wand or aluminum oxide crystals. You may think that your IPLs or laser hair removal treatments are better because you use cryo-cooling or because you use chilled air cooling, or because you use a diode laser or because you use alexandrite lasers . . .

BUT . . .

Step in to your clients' shoes. To them, the bells and whistles of your Thermage or Fraxel device don't matter. Your clients already expect expert advice and cutting edge cosmetic lasers, IPLs and skin tighening equipment, so merely meeting this fundamental requirement is not a winning competitive difference.

What does matter to your clients are presentation, client interaction, customer service, reliability and consistency. Consider this carefully.

What is each of your medspas clients worth? 

At Assara Laser, one of the most popular packages is our $449 per month Unlimited Laser Hair Removal Program. On average, a client that signs up for this program will remain a member of the Program for 7 months, depending on the results they wish to achieve. How much is a single unlimited client worth to us?  A client in the program for 7 months, making a monthly payment of $449 is worth $3,143. For many laser clinic owners, a single laser hair removal client is worth more than a home mortgage payment!

Do you treat every single potential laser treatment client that contacts your laser clinic as if they’re worth $3,000?

What is your time and effort worth?

Before my partners and I built Assara Laser, I was an attorney. I still practice corporate law as a labor of love, when a friend or business contact has an exciting deal. I normally discount my rate to about $400 per hour, as law isn’t my primary source of income. 

Assume an hour of your time is worth $400.  Assume further that, every time your customers complain, you are willing to give a discount, or a free treatment and that, collectively, free and discounted treatments account for a 20% loss in your revenue. To make up for this lost revenue, how much more work do you have to do? 

Well, let’s add 20% to your 10 hour day, which now makes it a 12 hour day. If your annual sales are say $1,000,000 per year, you’ve lost $200,000. This translates into 500 hours more of work you must do to bring your revenue back to status quo!

Is there a big difference between a day that starts at 9:00 a.m. and ends at 7:00 p.m. versus ending at 9:00 p.m.  You betcha there is!  Is there a big difference between a loss of $200,000 and a loss of zero. You betcha there is!  And these differences drastically affect your quality of life.

How Do You Avoid Mistakes?

Mistakes are costly. A happy client is worth more than $3,000, and will likely refer business, the best and cheapest form of marketing. A single angry client will result in you working 2 hours more per day for the following seven work days, and will possibly diminish your reputation by badmouthing your medspa. 

A lot of people think excellent customer service means free treatments. It doesn’t. Excellent customer service means delivering what you promise. You know the limitations and effectiveness of your treatments so promise only what you can deliver and do it consistently, with a smile on your face!

via Medical Spa MD

Posted via web from Laser Treatment MD

Plastic Surgery in China

via suomenkuvalehti.fi

Su Huiqing, 32 shows the cut lines drawn for a liposuction procedure to be carried out at a plastic surgery hospital in Fuzhou in southeastern China’s Fujian province. Plastic surgery has become commonplace practice in China as a quick fix solution to looking more beautiful or losing weight. Su became obese after years of taking hormones to treat an illness. She now weighs 150kg and plans reduce her weight to 75kg in a year.

Posted via web from Laser Center

Botox Tax? Health care fight swells lobbying.

Companies and groups hiring lobbying firms on health issues nearly doubled this year as special interests rushed to shape the massive revamp of the nation's health care system now in its final stretch before Congress.

About 1,000 organizations have hired lobbyists since January, compared with 505 during the same period in 2008, according to a USA TODAY analysis of congressional records compiled by the nonpartisan CQ MoneyLine.

Overall, health care lobbying has increased, exceeding $422 million during the first ninth months of the year, according to the Center for Responsive Politics, which tracks money in politics. That's more than any other industry and a nearly 10% jump over the same period in 2008. The center's Dave Levinthal said the frenzy of new lobbying activity makes financial sense.

"If lobbying didn't work, people wouldn't do it," he said.

via usatoday.com

Botax coming to a medical spa near you.

Posted via web from Medical Spa RX: Wholesale Botox

Medical Spa + Plastic Surgery Marketing Video

Here's a decent video on handling challenging patients over the phone. Try Freelance MD if you're looking for medical spa or plastic surgery marketing and advertising.

via Freelance MD: Medical Spa Marketing

Cynosure used hair removal lasers: Medical Spa MD

Buying used cosmetic lasers can be tricky.

For those of you that have had problems with Cynosure there is help, for those that do not or have not had problems you are lucky.  Not all of Cynosure service department is bad, there are a few good technicians and some that are just there for a job. 

Cynosure hair removal lasers are very good if maintained properly.  There are few things that you must be aware of:

1. Flash lamp pulses on the Cynosure: Do not go over 1 million on the yag and 750,000 on the alex.
2. Keep track of your voltage: Do not run the laser over 820v, this could lead to pump chamber failures and blown power supplies.  These will be very expensive repairs.
3. Inspect your hand pieces every time you use them, making sure that there are not large pits and / or burn spots inside.  Keep your windows clean and change frequently.  If your hand piece is getting hot during use, then you have problems with it, and the hand piece needs to be checked.

If you are thinking of having your Cynosure laser service by a third party company, just remember not everyone can work on them, even some of the manufacture’s technician have problems working on them. There are many after market parts available as well but you get what you pay for. Would you take your Mercedes to Bob’s Auto for service?  I know of only a couple technician outside of Cynosure who can repair them.  We make sure that you get what you would expect from the manufacture.   

If you are thinking of purchasing a used Cynosure laser or other cosmetic laser, please have a technician that knows the laser look at it for you before you put any money down.  Would you buy a used car from a fly by night dealer without having your mechanic look at it? I have seen and heard every nightmare you could think of, I have also seen some very good deals.  I had a lady call me that purchased a laser that had blown the power supply on it 2 weeks after purchasing the laser.  That same laser was about to be sold to a customer of mine that wanted me to help him find a laser.  I told him that this laser in poor shape and that it would need very costly repairs.  I was not surprised when the lady called me and gave me the serial number of the laser.  It does not cost to get a second opinion on something that could save you in the long run. 

Posted via web from Laser Center

Ovarian Cancer! Can Alternative Medicines Really Work Against Ovarian Cancer?

By Grahaam A. E. Maartin

Ovarian Cancer! The question we are going to ask is. Do herbal products like N-Tense and Graviola Really work? The results seem very positive, enough to sayYes!

Are you frightened by the thought of getting Ovarian Cancer? Do the words "Ovarian Cancer" worry you? The words are very emotive aren't they? Well now it appears that there is some very good 'natural' help available to you Graviola and N-Tense!

Usually, the large majority of doctors and medical practitioners although to be fair, not all, do not support the use of natural products like Graviola and N-Tense in treating "Ovarian Cancer". Often calling them "fringe or quack" remedies, simply because the medical institutions don't teach the students about them.

The fact that many of these herbal remedies may really be quite beneficial to you is now supported by growing evidence. N-Tense and Graviola are two in particular that are showing promising results in patients with Ovarian Cancer, sometimes in case where traditional chemo doesn't work. Would you use it?

In 2001 The HSI organisation (Health Sciences Institute) featured an article with the headline "Billion-dollar Drug Company nearly squashes astounding research on natural cancer killer" It says. "Cancer conquered with miracle tree from the Amazon found to be 10,000 times stronger than chemotherapy". Can you believe that! 10.000 times stronger and yet some unethical greedy pharmaceutical company tried to squash it because they couldn't patent a plant that just might stop Ovarian Cancer! Disgusting! That tree was Graviola! So what exactly is Graviola?

Graviola is a tree that is indigenous to the Amazon Rainforests and some other parts of South America. It's not really a huge rainforest tree, in fact it is a relatively small evergreen "shrub" (in Rainforest terms) growing to only 5 to 6 metres tall. But in terms of having cancer cell fighting properties, it's an absolute giant!

Much of the research already completed has found that plenty of the annonaceous acetogenins or phytochemicals (chemical compounds that occur naturally in plants) found in the seeds, stem and leaves of Graviola tree are cytotoxic against various cancer cells and tumour cells. In herbal medicine, all these plant parts are used.

That is the very good because, quote:- (Cytotoxic: Toxic to cells, cell-toxic, cell-killing. Any agent or process that kills cells. Chemotherapy and radiotherapy are forms of cytotoxic therapy.) The HSI article says the tree has been studied in over 20 laboratory tests since the'70s, and it has shown to: Effectively target and kill malignant cells in 12 different types of cancer, including pancreatic, lung, colon, prostate and Ovarian Cancer. Be 10,000 times stronger in killing Ovarian Cancercells than Adriamycin, a commonly used chemotherapeutic drug. Selectively hunt down and kill cancer cells without harming healthy cells, unlike chemotherapy.

Also a plant screening program back in'76 by the National Cancer Institute also showed that Graviola showed active cytotoxicity against cancer cells and various researchers have been following up on this research ever since and have found that Graviola was a cancer killing dynamo. Herbal products have been used worldwide almost since the time when man first walked on the earth, (well for thousands of years at least.) If you or your loved ones suffer from this terrible ailment, then I would strongly recommend that you read the HSI article on Graviola and N-Tense here. It's a real eye opener!

In addition to the above it has been shown that taking additional herbal products such as "Immune Support" to boost the immune system may be beneficial!

So, could Graviola and N-Tense help you in the fight against Ovarian Cancer? It appears that the answer is a resounding yes!

Health Disclaimer! This information must not be taken as professional or personal medical advice or instruction. Never take action based solely on this article's contents. You should 'always' consult with a professional health practitioner on important matters relating to your own health and well-being. The information and opinions expressed here are believed to be sound and accurate, based on the author's best information available at the time. Any reader, who fails to consult with the appropriate medical and health authorities, "assumes ALL responsibility of any resulting injuries". The publisher is not responsible for errors or omissions.

About the Author:

For over a decade Grahaam A.E.Maartin has been involved in the field of herbal medicine and seen some remarkable results. More info on Graviola & N-tense can be found at Raintree Health Ltd or R T Goods

Plastic surgery advertising regulation push in Britan.

Cosmetic surgery can carry risks as well as benefits

Several newspapers have reported the dangers associated with cosmetic surgery, including a lack of regulation in some areas of the industry. The reports also feature warnings from Nigel Mercer, the president of the British Association of Aesthetic Plastic Surgeons, who voiced his views as part of a series of medical articles on cosmetic surgery.  Mr Mercer called for tighter regulation and testing of drugs, procedures and implants to offer more protection to patients.

The Times reported that the number of cosmetic surgical operations conducted by “audited members of the profession” has more than tripled to 34,000 since 2003, but that many additional procedures are being carried out on the black market. The newspaper says that these are “fuelled by internet promotions, magazine advertising and aggressive discounting”.

 

What is the basis for these news reports?

The reports were based on a special edition of the journal Clinical Risk, which featured several articles on the issues surrounding cosmetic surgery. These issues include the potential for physical and psychological harm, and the need for tighter regulation of the industry, better training programms for surgeons and measures to improve patient experience.

Nigel Mercer, president of the British Association of Aesthetic Plastic Surgery, wrote an accompanying editorial arguing that the availability of consumer credit and a change in public attitudes has led to an explosion in cosmetic surgery in recent years. According to Mercer, this growth, combined with increasing public expectation and media hype, has resulted in “the perfect storm in the cosmetic surgical market”.

 

What is cosmetic surgery?

Cosmetic surgery, sometimes called aesthetic surgery, was described by a doctor in the journal Clinical Risk as being “purely elective, a lifestyle choice undertaken to enhance physical appearance, improve self-esteem and boost confidence”. Another doctor says that it differs from all other forms of surgery in that it is a treatment for “want” rather than for “need”.

In the 2005 Regulation of Cosmetic Surgery report, published by the Department of Health, cosmetic surgeries are defined as “operations and other procedures that revise or change the appearance, color, texture, structure or position of bodily features, which most would consider otherwise to be within the broad range of ‘normal’ for that person”.

Cosmetic surgery differs from plastic surgery, which is generally surgery to repair or reconstruct tissue or skin damaged by congenital (inherited) disease, injuries or burns. The primary role of plastic surgery is to restore function, and aesthetic improvement is secondary.

 

How is cosmetic surgery currently regulated in the UK?

At present, there are measures and standards to help regulate the industry but some cosmetic surgeons operate outside these regulations. Some treatments and procedures are unlicensed for cosmetic use, but can be given the discretion of doctors, or “off license”, by some clinics.

Surgical practice in the UK is regulated by the General Medical Council (GMC) and practicing surgeons should be enrolled on its specialist register. However, some concessions are made for private cosmetic surgeons who have been practicing since before April 2002. By satisfying certain criteria, these doctors can practice without the need to be on the specialist register.

Invasive cosmetic surgery and laser treatments are also regulated under the Care Standards Act 2000. The Healthcare Commission inspects all registered establishments that carry out invasive procedures and laser surgery in the UK, and has the power to revoke practice licenses and to take enforcement action.

Some cosmetic surgical procedures are not covered by current regulations, such as Botox injections and injections of aesthetic fillers. Botox is not licensed for cosmetic use, but it can be prescribed “off license”, in which circumstances the doctor assumes liability for its use. Most fillers are tested in the UK as “devices” rather than as drugs. This means that they are regulated based on the standard of their production and not on whether the treatment works.

The Department of Health report concluded that the regulatory situation for cosmetic surgery was not satisfactory because of the group of doctors who can practise without being on the GMC specialist register and the lack of clarity around the definition of “fillers”. Although practitioners of cosmetic surgery must demonstrate certain competencies, these may not be the equivalent standard of NHS consultants.

 

What do these journal articles say about cosmetic surgery?

The authors of these articles have argued several opinions, including that:

• Patient psychology should be considered by clinical staff as issues of mental health and body image may be behind the desire for cosmetic changes. These could also arise in people who feel disappointed or upset by the results of their surgery.
• Surgeons should keep records detailing their patients’ expectations and provide them with guidance on whether these are realistic.
• There are risks associated with any type of surgery and patients should be informed of these and their surgeon’s success rates when considering procedures.
• It is important that patients are given time to consider their options. Doctors should also inform patients about alternative treatments that may be available.
• Before procedures are carried out, it should be clear who will be financially liable for the correction of any complications.
• There may be some merits to adopting a regulation system similar to that in France. Under this system, patients must be given information on costs, risks and the surgeon’s qualifications to perform their selected procedures.
• The way that cosmetic surgery is marketed should also be regulated.

What is the problem with plastic surgery marketing?

Mercer says that cosmetic procedures are often marketed using special offers, including vouchers, two-for-one deals and surgery holidays, and that these practices contribute to an “unregulated mess”. 

The articles also feature a call to ban advertising of cosmetic procedures, stating that, like tobacco, there should perhaps be a Europe-wide ban on advertising all cosmetic surgical procedures, including on internet search engines. While advertising can be powerful, says Mercer, it is often misused by the cosmetic surgery industry and misinterpreted by those it is aimed at.

 

Where can I find more information on reputable plastic surgeons?

The British Association of Aesthetic Plastic Surgery is a not-for-profit organization based at the Royal College of Surgeons. It was established to advance the education and practice of cosmetic surgery for public benefit. While it is not a regulatory body, it has long been involved in giving the public information on the safety of cosmetic surgery.

Its research into cosmetic surgery tourism was discussed at a recent conference and its press releases highlight a number of dangers associated with unregulated procedures, including DIY injectable treatments available over the internet.

via nhs.uk

Posted via web from Laser Treatment MD