Florida bans liposuction in unregulated offices

Tallahassee, Fla. — Liposuction in Florida became safer recently with the adoption of new regulations and restrictions on where the procedure can be performed. 

Gov. Rick Scott signed the new regulations into law in April; they are scheduled to take effect in January 2013. Supporters of the new restrictions include the Florida Society of Plastic Surgeons, the Florida Medical Association and the Florida Board of Medicine.

According to the new rules, all liposuctions that remove more than about two pounds of fat must now take place in regulated offices equipped with lifesaving equipment and a doctor specially trained in lifesaving techniques. Offices will also have to be inspected by the state or undergo accreditation.

Some doctors foresee internists and nonsurgeons giving up the procedure, rather than attempting to meet the new, stricter regulations. 

There is also concern that the new regulations will raise the costs of some procedures, but backers of the new law insist safety is the impetus for the law. There have been reports of cases in Florida in which unregulated doctors or medical spas performed liposuction using sedative pills or creams rather than appropriate anesthesia, the Sun-Sentinel reports. 

The American Society for Aesthetic Plastic Surgery notes that it requires its members to operate in accredited, state-licensed or Medicare-certified facilities.

By: Paul Gillette

Study suggests zinc oxide may be harmful

Rolla, Mo. — New research proposes that zinc oxide, a common ingredient in sunscreens, may not be as effective as previously thought and may actually cause damage to cells.

Cell toxicity studies done by researchers at Missouri University of Science and Technology suggest that zinc oxide, when exposed to sunlight, may release free radicals, potentially increasing the risk of skin cancer, Newswise reports. The studies noted greater potential cell damage was related to longer exposure of zinc oxide to sunlight.

According to the study, which is being prepared to be published in Toxicology and Applied Pharmacology, scientists immersed human lung cells in a solution containing very small amounts of zinc oxide and studied the reactions to different types of light exposure over varying amounts of time. The researchers found that zinc oxide-exposed cells deteriorated more rapidly than a control group, with a dramatic decrease in cell viability upon exposure to ultraviolet (UV) rays.

Exposure to three hours of UVA resulted in the death of half of the lung cells in the zinc oxide solution. After 12 hours, only about 10 percent of the cells were alive, Newswise reports.

According to the study authors, the zinc oxide absorbs UV rays, which may produce free radicals. These molecules proceed to bond with and damage other molecules. The study expands on earlier research published in the January 2009 edition of the Journal of Nanoparticle Research.

The authors noted that research on zinc oxide’s possible effects on other cells is still in the preliminary stages, and advised people not to draw conclusions about the safety or dangers of sunscreen based on this early research.

“More extensive study is still needed. This is just the first step,” said Yinfa Ma, Ph.D., a professor at Missouri S&T and one of the study’s lead authors. “I still would advise people to wear sunscreen. Sunscreen is better than no protection at all.”

By: Paul Gillette

Success rates of fat grafting injections to face and breast are improving, physician says

 

 Success rates of fat grafting injections to face and breast are improving, 

physician says...

 

 

Philadelphia — Although complication rates for fat grafting to the face and breast are low, researchers are continuing to work to improve variable results, says Louis P. Bucky, M.D. 

Furthermore, Dr. Bucky says, "Those variable successes are what cause us many times to overdo fat grafting, particularly to the face, and to some degree to the breast." He is a Philadelphia plastic surgeon in private practice. 

Small volumes for face
Many physicians have achieved excellent results with small-volume (under 100 cc) fat grafting, Dr. Bucky says. For example, to treat a young female patient with Parry-Romberg syndrome, Dr. Bucky says he injected 80 cc to her face, using a topographical mapping method, then another 43 cc 18 months later.

"Two years later, she had gained weight, and her facial fat looked fuller,” he says. “Likewise, when she lost weight eight years postoperatively, her face looked a little thinner." Overall, he says, the patient was very satisfied with her results. 

Also around this time, Dr. Bucky treated an older male patient using the same approach. However, one year postsurgery, it was impossible to see any change between this patient's preoperative and postoperative photos. "This variability leads us to question what we do," and to study the variables involved in an attempt to minimize their impact, he says. 

"To summarize, many of our colleagues and leaders in plastic surgery have done a good job over the last 10 years in looking at new techniques and what's happening during fat harvesting and purification, at how we store and inject the fat, and at biological characteristics of the recipient site,” Dr. Bucky says. 

Confronting conundrums
To build upon this knowledge, Dr. Bucky says that he and his colleagues have examined common fat-grafting challenges in the laboratory. In a series of studies, they transferred human fat into the cranial area of nude mice and analyzed the fat's viability and variability. 

"When we all started fat grafting," he says, "there was a lot of talk about freezing fat" for future use so that patients would not have to undergo harvesting procedures for subsequent injections. To test this theory, Dr. Bucky and his colleagues used the nude mouse model to compare the viability of fresh and frozen fat and found that fresh specimens performed significantly better (Tuma GA, Godek CP, Hubert DM, et al. American Society of Plastic and Reconstructive Surgeons Scientific Meeting. Los Angeles. Oct. 14-18, 2000). "Therefore," he says, "freezing fat is not recommended." 

As an alternative to frozen fat, "We're fortunate today to have fillers that do a great job, and in some cases, they could perhaps be the primary plan for certain areas of the face,” he adds. 

In research involving human subjects, "We asked questions like, ‘Does fat from people older than 65 years transfer better than fat from people under 35?’" In this regard, he says that nine months postinjection, "We found that older patients maintained about 35 percent of their fat, and younger patients maintained about 55 percent (Kanchwala SK, Bucky LP. Facial Plast Surg. 2003;19(1):137-146)."

Dr. Bucky says that because younger patients retain more injected fat than older patients do, plastic surgeons must take care not to over-inject large volumes into younger patients' faces. When used in the breast, he says, fat grafts should smooth and fill. "But the face needs to have shape and contours. If you overdo it, you lose these,” he says. 

In one such case, a 31-year-old female patient presented to Dr. Bucky two years after receiving fat grafting to the brow and face (performed by another physician) that had resulted in asymmetry. Specifically, he says, her left brow and cheek were overfilled and did not move symmetrically with the rest of her face. 

"There isn't a great treatment for this problem,” he says. “I used microliposuction, using injectable cannulas for aspiration. I went percutaneously through the nasolabial fold and through an upper blepharoplasty incision to try and defat the area." Six months after this procedure, although the patient looked slightly hollow on the left side of her face, she could animate much more normally and was much happier with her results, Dr. Bucky says. 

"This begs the question: Is there an appropriate amount we should be overfilling the face? Are large or small aliquots of fat better?" Dr. Bucky says. To address these questions, Dr. Bucky and his colleagues injected different amounts of fat into nude mice at different time intervals. "We found histologically and volumetrically that there was increased angiogenesis in the small aliquots, and much more fat necrosis in the larger ones." 

This study's findings suggest that fat grafting has a limited diffusion mechanism, Dr. Bucky says. Therefore, he does not recommend over-injecting the face with large fat volumes. 

Similarly, he says that it's important to limit hypoxia. "While that's not critical in the face, it has changed the way I do fat grafting when I'm performing a facelift," he says. Now, he harvests and grafts fat at the beginning of the procedure or does these steps at the end, rather than harvesting fat upfront and storing it for up to two-and-a-half hours before injection. 

Complications unveiled
As for complications of facial fat grafting, Dr. Bucky says, the periorbital area — particularly the lower lid — is probably the most prone. In this area, he says, typical complications can include a shelf-like appearance and isolated lumps. 

"This problem should not be treated with steroid injection,” he says. “If you see it early, you can massage it or try needle aspiration. But typically, a very small direct excision is the best way to treat an isolated lump. 

“The best way to avoid one is to inject retro- or suborbicularis, preperiosteally,” he adds. “You can do it directly, but just stay underneath the orbicularis. Unlike the variability of the hyaluronic acids, which provide a little more flexibility, fat still is particulate. So you need to inject more deeply and have adequate soft tissue coverage to avoid trouble." 

Dr. Bucky says that in his practice, the best patients for facial fat grafting are those who are already planning lower-lid or facial rejuvenation procedures and want to blend the cheek-lid junction. "Typically, we use small volumes — 0.3 to 1.5 cc, a small cannula and feathered injections, not isolated deposits," he says. 

Fat grafting works well as monotherapy, Dr. Bucky says, but he typically uses dermal fillers instead for this purpose. 

Breast grafting
Regarding fat grafting to the breast, "It was very easy when we were doing small-volume fix-up to reconstruct small-volume defects," Dr. Bucky says. However, lipoaugmentation of the breast is a very different process. "It can achieve tremendous results, but it needs a lot of thought to (address) the reliability issue." 

The face is better vascularized than the breast, he says, "But it also has the limitation of having more motion." He says, however, the breast is generally harder to treat. Patients who require breast reconstruction often have fibrosis in the area. Additionally, "We have larger volume requirements, and we're trying to expand a mechanically limited envelope and asking fat to do things it can't,” he says.

Nevertheless, large-volume reconstructions are easier than large-volume augmentations because revisions are part of the reconstructive process, Dr. Bucky says. 

"Small-volume reconstructive surgery has a built-in backup plan. We have an opportunity to do fat grafting when we take the expander out and put an implant in," and another revision opportunity at the time of nipple reconstruction. Typically, he says, these procedures are covered by insurance.

"Where we will really shine in small-volume fat grafting is in improving the soft-tissue envelope of our everyday results," he adds. 

In large-volume fat grafting to the breast, "There are many more demands on reliability." To meet these demands, Dr. Bucky says that pre-expansion, performed before fat grafting, is gaining popularity.

Research has shown that such pre-expansion achieves mechanical decompression, thereby increasing vascularity and upregulating growth factors and making the procedure much more reliable (Khouri R, Del Vecchio D. Clin Plast Surg. 2009;36(2):269-280, viii). "Preoperative overexpansion is far better than trying overcorrection," Dr. Bucky says. 

A study co-authored by Dr. Bucky showed that preoperative expansion for three weeks before fat grafting allowed patients to maintain on average 60 percent of the grafted volume two years postoperatively (Del Vecchio DA, Bucky LP. Plast Reconstr Surg. 2011;127(6):2441-2450). "There were no revisions in this group," he says, adding that the fact that the grafting procedure could be done in two hours resulted in less hypoxia. 

“Large-volume fat grafting has great promise to dramatically improve what we are doing both in reconstructive surgery and cosmetic surgery, with and without implants,” Dr. Bucky says. “But we need pre-expansion, and we must provide an efficient, reliable process in order to get these results." 

By: John Jesitus

Food scientists create process for pain-free bandages

State College, Pa. — Scientists at Penn State University may have found a way to take the “ouch” out of bandage removal.

By using starch spun into fine strands, the researchers created a process by which bandages could degrade into glucose and be safely absorbed by the body.

Penn State researchers used a solvent to form the starch into a fluid, which can then be and spun into fibers and combined to form paper-like mats, Medical News Today reports. 

On an industrial scale, companies may use this technology to make bandages and medical dressings from these starch fibers. Since starch degrades into glucose, a substance that the body can absorb harmlessly, the bandages wouldn’t need to be removed, but rather would be absorbed over time, researchers said.

Starch is a polymer that doesn’t normally dissolve completely in water. The investigators worked around this by using solvents and special equipment to aid in dissolving starch while still retaining its molecular structure.

Cellulose and petroleum-based polymers are typically used as raw materials in making fibers, but rising costs and environmental concerns are encouraging research into different materials.

By: Paul Gillette

Detoxifying your Body to Improve Hormone Balance, Increase Metabolism and Help Lose Weight!

Enjoy this article from Medaus and learn why it is important to detoxify your body! Rest-assured that Las Vegas Laser and Lipo carries a GREAT Detox Supplement!

Detoxification is a process by which your body transforms toxins and medications into harmless molecules that can easily be eliminated from your body. In order to be healthy and achieve weight loss, your body has to have the ability to detoxify well. We’ve talked a lot about toxin exposure – BPA and pesticides in our food and phthalates and parabens in household and cosmetic products – and how to reduce exposure to these toxins. But how do you help your organs and body remove these toxins? That’s what we’ll discuss today.

It’s possible that toxic exposure is as big a contributor to obesity as poor diet and sedentary lifestyle. Understanding the best way to keep your detoxification organs healthy and to overcome problems associated with exposure to high levels of toxic environmental chemicals will help with weight loss. With simple lifestyle choices and utilizing some appropriate nutrients, you can keep your detoxification organs working well and increase your body’s ability to remove toxins. Common symptoms of toxin buildup in your body include headache, fatigue, muscle aches, asthma, allergies, skin disorders, and chronic infections.

Your body has four main detoxification organs: the kidney, the liver, the skin, and your gastrointestinal tract. Each of these has a different ability to break down the toxins and to detoxify medications. These abilities are based on your genetic makeup but are also modified through your diet, lifestyle, and environmental exposures.

Detoxification is mainly accomplished in two phases in your liver. In phase I, enzymes change the toxic compounds or medications into intermediate metabolites, or compounds. This is the first line of defense, and if it’s not functioning well, you’ll have toxic buildup in your body. In phase II, other enzymes convert the intermediate metabolites created in phase I into molecules that dissolve in water and can easily be removed from your body. This is where the kidneys and gastrointestinal tract come into play. Your skin, the fourth detoxification organ, is the body’s largest absorptive organ. It lets water, minerals, medications, and toxins in and out of the body. Its main goal is to protect the body from invaders, let in water to maintain hydration, keep you cool by sweating and remove toxins.

There are many nutrients you can take in supplement form to aid detoxification, and those are listed in chapter 12 of The Complete Idiot’s Guide to Hormone Weight Loss. Some common nutrients like herbs, green tea, vitamin C and B vitamin complex can make a big difference in the health of your liver. Saunas and steam baths and colon hydrotherapy are also good ways to detoxify your body.

Fortunately, we carry a great DETOX supplement. I use it and feel great!  Dr. Z

"Quicker, safer, less pain..." -Dr. Z

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Needle-free method for breast reconstructive surgery being tested in Jacksonville

 

April 25, 2012 - By: Charlie Patton

Michelle Stapleton doesn't "care for needles."

Which is one of the reasons she was open to the suggestion by physician Ankit Desai that she become part of a clinical trial Jacksonville's Desai Center of Plastic & Reconstructive Surgery is conducting.

"I prayed about it and it felt right," said Stapleton, a 42-year-old mother of two.

Stapleton, who lives in the Bartram Springs subdivision, underwent a double mastectomy on March 1 after she was diagnosed with breast cancer. Now she is preparing for reconstruction surgery.
Traditionally, that preparation has involved putting an expandable implant beneath a woman's pectoral muscle and then using a needle to inject saline solution into the implant each week for about three months. That would gradually expand the tissue and create a pocket in preparation for eventually replacing that implant with a permanent silicon or saline implant. This technique is used only with breast reconstruction, not augmentation, in which the implant is placed on top of the pectoral muscle.

Stapleton is testing a new tissue expanding system called XPAND. That is short for AirXpanders Patient Activated Controlled Tissue Expander System for Breast Reconstruction. Because she had both breasts removed, she received two implants, each with a carbon dioxide reservoir. Stapleton regularly places a remote control against her chest and uses it to trigger the release of a small amount of carbon dioxide into each of her implants. Eventually, after the XPAND implants have created large enough pockets under her pectoral muscles, they will be removed and replaced with permanent implants.
The XPAND system has several apparent advantages over the traditional method of tissue stretching, said Michael Fallucco, a plastic surgeon with the Desai Center.

"You get a better result in stretching if you can expand little by little," he said.

Using a needle to inject saline involves the patient coming to the doctor's office once a week for the injection of about 60 cubic centimeters. Each time Stapleton operates her remote, she releases 10 cubic centimeters of carbon dioxide. But she can do that as many as three times a day if she wants, which means the process of expansion can be completed in weeks, not months.

Best of all, as far as Stapleton is concerned, she doesn't have to come to the doctor's office weekly for a needle stick.

"The process is far more comfortable and there is no risk of infection," Desai said.

When she releases the carbon dioxide "I don't feel anything," Stapleton said. "It's not painful."

"We're all for less pain," Fallucco said.
Stapleton said her 5-year-old daughter Addison is fascinated watching her mom use the remote control, which emits a sound when she operates it.

"My daughter thinks this is my music player and it makes my boo-boos better," she said.

The Desai Center is one of 10 sites across the country involved in the clinical trial of the Xpand system, which must ultimately be approved by the federal Food and Drug Administration based on the trial results. It's the only site in Florida involved in the trial. Stapleton was the first patient to participate at the Desai Center.

The Desai Center's randomized trial is being monitored by the Jacksonville-based East Coast Institute for Research.

"It's not just the Mayo Clinics and the Shands Jacksonvilles who do academic research," said Rushab Choksi of the East Coast Institute.

Stapleton, who is undergoing chemotherapy, plans to have reconstructive breast surgery in July, about four weeks after her chemo is scheduled to end.

Researchers unlock secrets of stratum corneum

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Solna, Sweden — Researchers in Sweden have successfully described the function and structure of the topmost layer of skin at the molecular level, creating new possibilities for large-scale drug delivery via the skin and also opening the door for greater understanding of skin diseases.

The research team, from Karolinska Institutet near Stockholm, developed a new and experimental approach, in which the scientists rapidly froze skin samples and studied the samples under a low-temperature electron microscope. The results have revealed the secrets of skin’s perviousness, which may significantly increase the number of drugs administered via the skin, rather than via pills or injections, News Medical reports.

Aside from the implications on drug development, the study also opens the door for new understanding of how skin diseases manifest themselves in the outer layer. Researchers hope that a new understanding of the molecular level of skin will lead to new and improved treatments.

"This may be a breakthrough for dermatology," said Lars Norlén, M.D., Ph.D., principal investigator and associate professor at Karolinska’s Dermatology and Venerology Unit. "Our team has devoted the past 20 years to unlocking the mysteries of the stratum corneum. Understanding how this protective barrier has developed is an important step towards explaining why life on land exists and is even possible.”

By: Paul Gillette

Bioengineered follicles grow hair on bald mice!

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Tokyo — Transplanted hair follicles derived from adult stem cells have demonstrated normal hair cycles in bald mice, according to a recent study published in Nature Communications.

Researchers at Tokyo University of Science bioengineered hair follicle germ cells from adult epithelial stem cells and dermal papilla cells. They then implanted the bioengineered cells into the skin of bald mice, resulting in normal hair cycles and other signs of normal function, including piloerection, or goosebumps, Medical News Today reports. Along with normal functioning, the implanted hair follicles also developed the correct structures and made the right connections with surrounding tissue, according to the report.

“Our findings suggest that the transplantation of a bioengineered hair follicle germ can restore natural hair function and re-establish the cooperation between the follicle and the surrounding recipient muscles and nerve fibers,” the authors wrote. “Thus, the transplantation of bioengineered hair follicle germ is potentially applicable to the future surgical treatment of alopecia.”

Aside from raising hopes of a cure for baldness, the study is a significant advance toward next-generation organ replacement regenerative therapies, which will enable the replacement of damaged organs, according to the report. Notably, the study used adult stem cells, rather than embryonic, and it also marked the first time bioengineered follicles were fully functional and integrated into surrounding tissue, according to the report.

By: Paul Gillette

VERY IMPORTANT: The Push for Daily Sunscreen!

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Wall Street Journal - Health and Fitness

brought to you by Las Vegas Laser and Lipo; which carries one of the best and most effective physician's strength physical SPF's on the market from Skinceuticals (division of Loreal):

The Myths of Daily Sunscreen 

 By: Elizabeth Holmes

Few People Apply It the Right Way, New Labels Try to Help; a Shot Glass of Protection in the Morning!

Even the most diligent, well-intentioned daily sunscreen wearers are likely doing it wrong.

That's because, for women, protecting yourself from the sun is more complex than just choosing an SPF number. The sunscreen in foundation or tinted moisturizer isn't enough for everyday protection. And the sunscreen in cosmetics mostly offers protection against one type of ultraviolet ray, and makeup isn't applied as thoroughly or frequently as needed.

And though dermatologists recommend wearing a sunscreen every day, most people don't. Only about one in five people wears sunscreen properly on a consistent daily basis, says Neil Sadick, clinical professor of dermatology at Weill Cornell Medical College in New York.

"Even if they are using a makeup with a sunscreen, I would tell my patients they're not getting enough protection," he says.

 

A face creamcontaining antioxidants helps prevent thesun's rays from causing free-radical damage, say some dermatologists. Free radicals can damage protein structures within cells and accelerate aging and wrinkles. Some creams also contain sunscreens.

 

 

 

 

 

2. Sunscreen

A broad-spectrum sunscreen—which protects against UVA and UVB rays—should have an SPF of at least 15. People with fairer skin or a history of skin cancer should opt for SPF 30.

 

On a daily basis, people should wear a small shot glass worth of sunscreen.

Apply about an ounce, or a small shot glass full, on all exposed skin, including face, neck,chest, ears, hands and feet, 15 minutes before going outside.

Choices abound: Some sunscreens for the face are tinted;some face moisturizers contain sunscreen.

3. Makeup

 

Cosmetics with SPF act as an extra shield against the sun, especially when the SPF comes from a physical sunscreen, like zinc oxide. Many dermatologists suggest applying makeup before sunscreen, but they admit most women won't want to smear sunscreen over their finished makeup.

What the FDA Guidelines Mean

• Products that pass a test to show they protect against both UVA and UVB rays will be labeled 'broad spectrum' followed by an SPF number
• Any product with an SPF of 14 or lower and products without broad spectrum status are required to carry a warning that reads, in part, 'This product has been shown only to help prevent sunburn not skin cancer or early skin aging.'
• The terms 'sun block,' 'water proof' and 'sweat proof' can no longer be used. Products that pass an FDA test can be labeled 'water resistant' up to 40 or 80 minutes.
• A product can no longer claim to offer all-day protection. All sunscreens must warn users to reapply every two hours.

New guidelines by the Food and Drug Administration aim to protect consumers from skin cancer through greater testing and clearer labeling on sun-protection products, including cosmetics with sunscreen. The guidelines take effect June 18, though it will take time to clear out-dated products from store shelves.

More than two million people are diagnosed with skin cancer each year, according to the Skin Cancer Foundation. The incidence of melanoma, the most dangerous form, continues to rise in most age groups in the U.S. It increased eightfold in women ages 18 to 39 from 1970 to 2009, according to a recent study from the Mayo Clinic. It pointed to the use of tanning beds by young women as a possible cause for the increase.

Gabrielle Bogan, 24 years old, who works in advertising in Pittsburgh, went tanning as often as 10 times a month in her teens, but stopped when she found two moles on her scalp. They weren't cancerous, but she began using a sun-protection factor of 45 as part of her daily routine. "I like the fact that this [sunscreen] has a bit higher of an SPF," Ms. Bogan says.

But a product's SPF indicates only its ability to defend against sunburn-causing ultraviolet-B rays—and not against ultraviolet-A, which penetrate deeper into the skin and cause premature aging. (Both types contribute to skin cancer.) For example, a person wearing SPF 50 could spend considerable time in the sun without getting burned. "They think they're getting protected but they're getting the silent damage from UVA," says Steven Q. Wang, director of dermatological surgery and dermatology at the Memorial Sloan-Kettering Cancer Center site in Basking Ridge, N.J. 

Sunscreen products that pass a new FDA test will now say "broad spectrum," followed by the product's SPF, to indicate its effectiveness for both types of rays. Dermatologists recommend wearing a broad-spectrum sunscreen with at least SPF 15 every day. The UVA component is important as window panes—at home or office or car—often block UVB but not UVA rays. 

Adding sun protection into makeup or a moisturizer is a challenge, says Curtis Cole, vice president of skin care innovation at Johnson & Johnson consumer products, which includes the popular skin care line, Neutrogena.

 

Makeup with SPF less than 15

"Formulators have to do a lot of extra work to get the feel and the texture of them so that they're still 'consumer delighters'," Dr. Cole says. 

Zinc oxide and titanium dioxide, often called physical sunscreens, provide a physical barrier, but may leave a white residue if not formulated correctly, says Dr. Cole. So-called chemical sunscreens are oil based—not a desirable quality in most skin products. Also, the pigments in foundation or tinted moisturizer can interfere with the products' photostability, or their ability to remain effective once exposed to the sun, Dr. Cole says.

L'Oréal USA, which includes the Maybelline brand, added more UV filters to a handful of its products in order to meet the new FDA guidelines, says Anthony Potin, assistant vice president of skin care and sun care research and innovation at L'Oréal USA. The company also developed a line of sunscreen products specifically geared to the guidelines. L'Oréal Paris Sublime Sun hit store shelves in February with the proper formulation and packaging. 

On a daily basis, people should wear a small shot glass worth of sunscreen to cover face, ears, neck, hands and any other exposed skin, says Dr. Sadick.

Cosmetics brands including L'Oréal, Neutrogena, Clarins and Chanel, are marketing new thinner, liquid sunscreens specifically designed to layer under makeup and be lighter and drier than traditional sunscreens.

People typically wear about a half to a third of the recommended amount of sunscreen. As a result, they get half to a third of the coverage—an SPF 30 suddenly becomes SPF 15 or SPF 10, says Dr. Deborah Sarnoff, senior vice president of the Skin Cancer Foundation and clinical professor of dermatology at NYU Langone Medical Center.

Neutrogena makes its products with a higher SPF than most cosmetic companies for that reason. "Even when they put on too little, they're still getting a meaningful amount of protection," Dr. Cole says.

 

A CoverGirl compact with SPF 22 (bottom) and a Neutrogena compact with both UVA and UVB protection (top).

The FDA is considering a proposal to cap the SPF indicator at "50+," based on research that anything higher than 50 is only slightly better. Neutrogena says it has published research that suggests otherwise.

On the other end of the spectrum—very low SPFs—the FDA has already drawn a line in the sand. Products that do not pass the broad spectrum test or those with a SPF of 14 or lower will be required to carry a warning that reads, in part, "This product has been shown only to help prevent sunburn not skin cancer or early skin aging."

Men should also be wearing sunscreen every day, especially those who are bald or losing their hair, as there is more skin likely to be exposed in the direct line of the sun.

 

Laura Mercier tinted moisturizer with SPF 20

Lip balm with at least SPF 15 is also important, especially for men; women get some protection from matte lipstick. Dr. Sarnoff recommends special attention to the bottom lip, as that area tends to catch the most sun.

Most sunscreen brands must overhaul their packaging due to the FDA's new guidelines. Products must carry a "Drug Facts" panel, similar in prominence to over-the-counter pain relievers, listing active ingredients, uses and warnings. The FDA guidelines also require a specific size and font on what can be small containers.

"It's very difficult to do that in an aesthetically pleasing way," says Lisa Hawkins, senior vice president of marketing, education and events for Christian Dior Perfumes, "particularly on a luxury good package."

Dior, which sells its products around the world, is creating a U.S.-specific line of packaging, a "hugely costly and complex endeavor," says Ms. Hawkins. It is also considering narrowing its offerings in the U.S.

Las Vegas Laser and Lipo carries the most effective physician's strength SPF on the market by Skinceuticals! Call 702-360-6686 to order! Special pricing effective until May 31, 2012!

Platelet-Rich Plasma Procedure May Improve Facial Appearance

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Platelet-rich plasma (PRP) therapy involves injection of the patient's own platelets and fibrin for the cosmetic treatment of wrinkles or scars in the face, hands, and neck. Known to some as the "vampire facelift" (a term trademarked by Alabama cosmetic surgeon Charles Runels), it is less invasive than plastic surgery, takes about 20 minutes for each treatment, and offers improvements for up to 18 months. Cost of the procedure is generally similar to that of fillers and may range from $600 to $1800 per treatment.

 

However, the efficacy and safety of PRP for cosmetic treatment have not been studied in controlled clinical trials. To learn more about the role of PRP therapy in cosmesis, Medscape interviewed Alan Matarasso, MD, and Lauren Zeifman, rPA-C, both in clinical practice in New York City. 

 

Dr. Matarasso is Clinical Professor of Plastic Surgery at Albert Einstein College of Medicine and has hospital privileges at numerous New York City medical institutions, including Manhattan Eye, Ear & Throat Hospital and New York Eye & Ear Infirmary. His contributions to many areas of aesthetic surgery include pioneering advances in surgical and noninvasive techniques. He is widely published and is the senior scientific editor of the Aesthetic Surgery Journal.

Medscape: Please define the PRP therapy procedure for improving facial appearance.

 

Dr. Matarasso and Ms. Zeifman: Selphyl® (UBS Aesthetics; Bethlehem, Pennsylvania) is a patented system for safe and rapid preparation of platelet-rich fibrin matrix, which is a type of regenerative medicine that uses platelets to rejuvenate the skin.

Medscape: What is the rationale behind the use of PRP therapy to improve facial appearance?

Dr. Matarasso and Ms. Zeifman: A steady trend over the past 15 years has been for patients to seek less-invasive procedures for facial rejuvenation. Selphyl has been used by surgeons over the past 7 years to speed up soft-tissue healing from sports injuries as well as to treat burn victims and patients with severe ulcers. It is also used as an adjunct to implant therapy in dentistry.

Selphyl is now being used cosmetically to treat volume loss in the face, hands, and neck -- particularly the crepey skin under the eyes and neck -- as well as wrinkles, acne scarring, and stretch marks.

Medscape: By what mechanisms do injections of PRP restore facial appearance?

 

Dr. Matarasso and Ms. Zeifman: Platelets play a role in stopping bleeding and in repairing damaged blood vessels and cells in the body. Platelets also contain substances called "growth factors" that activate and rejuvenate cells in our body. Unlike fillers that use various synthetic substances, Selphyl uses the patient's natural biology to address skin defects and volume loss, triggering production of new cells and collagen formation.

Medscape: How long does the procedure take, and how is it performed?

 

Dr. Matarasso and Ms. Zeifman: This cutting-edge rejuvenation is a quick 20-minute procedure. After 9 cm³ of blood (approximately 1 vial) is drawn from the patient, it is spun down in a centrifuge for 6 minutes at a precalculated speed to retrieve the most viable fibrin and platelets. After centrifugation, the platelet and fibrin component of the blood (the top layer) is extracted and reinjected into the area of concern.

Medscape: What type of results can generally be expected?

 

Dr. Matarasso and Ms. Zeifman: The results are subtle, with gradual improvement in the injected area over a 3- to 5-week period. Full correction occurs at 4-7 weeks and can last as long as 18 months.

Medscape: What are the risks or complications?

 

Dr. Matarasso and Ms. Zeifman: Because this filler is made from the patient's own blood, there is no risk for rejection, infection, or an allergic reaction.

Medscape: For what types of patients is this procedure most and least suitable?

 

Dr. Matarasso and Ms. Zeifman: Any patient who wishes to reduce volume loss, fine lines, and textural changes of the skin is suitable for this procedure. It also appeals to the patient who is looking for a natural approach to volumizing the face and treating or reducing fine lines.

Medscape: How long are the improvements maintained? If necessary, can the procedure be repeated, and if so, with what anticipated outcome?

 

Dr. Matarasso and Ms. Zeifman: Selphyl can be repeated, and better results are seen with a total of 2-3 treatments given 3-4 months apart. Patients can expect to see better results as they receive more treatments. With time, the results of Selphyl get better and better.

Medscape: How does PRP therapy compare with injections of filler, Botox(Botox® Cosmetic; Allergan, Inc; Irvine, California), or surgical facelifts?

 

Dr. Matarasso and Ms. Zeifman: This procedure can be combined with dermal fillers, Botox injections, and laser surgery, as well as facial surgery. PRP builds tissue over time, whereas traditional filler breaks down over time.

Medscape: In what situations might PRP therapy plus filler injections be helpful?

 

Dr. Matarasso and Ms. Zeifman: It is nice to layer Selphyl with traditional fillers. If a patient has volume loss with a lot of fine lines and textural changes, I like to inject Selphyl to create a new foundation of collagen and use dermal fillers for the fine lines.

Medscape: What is your overall opinion of the role that PRP therapy should play in facial restoration?

 

Dr. Matarasso and Ms. Zeifman: PRP therapy is very promising in facial restoration. Results are optimal when patients receive a combination of PRP, dermal fillers, and laser therapy.

By:  Laurie Barclay, MD; Alan Matarasso, MD; Lauren Zeifman, rPA-C

New Silicone Breast Implant Approved by FDA!

Dr. Z is sharing this article from:

March 9, 2012 — The US Food and Drug Administration (FDA) today approved a new silicone gel–filled breast implant, bringing the number of such products in the United States to 3, but continued to warn that women who receive any of these implants require lifelong monitoring.

The new silicone breast implant, made by Sientra, is indicated to increase breast size in women aged 22 years and older, and to reconstruct breast tissue in women of any age.

Sientra's product joins 2 other silicone-filled implants made by Allergan and Mentor that are currently on the market.

The safety of silicone breast implants has come into sharp focus after the French version of the FDA recalled implants made by Poly Implant Prothese (PIP) in 2010. PIP had used a nonapproved, industrial-grade silicone that is more prone to ruptures and leakage. As many as 300,000 women worldwide received the implants, and roughly 2000 have lodged complaints about adverse events, which include 8 cases of cancer.

In December 2011, the French government offered to pay to have the PIP implants removed from 30,000 French women.

PIP folded in 2010, but the company's founder, Jean-Claude Mas, continues to make headlines. Now facing charges of causing bodily harm, as well as committing fraud, Mas was jailed earlier this week by French authorities for not paying his bail.

Silicone Breast Implants Are Not "Lifetime Devices"

 

Here in the United States, the FDA has sounded cautionary notes about silicone breast implants. Last year, it reported that 20% of women who receive implants for breast augmentation will need them removed within 10 years. That percentage goes up to almost 50% for women who receive implants for breast reconstruction. The agency advised women with silicone implants, but not saline-filled implants, to undergo magnetic resonance imaging for silent ruptures 3 years after implantation, and every 2 years afterward.

Nevertheless, the FDA deems the new Sientra implant and those from Allergan and Mentor as safe. "Data on these and other approved silicone gel–filled breast implants continue to demonstrate a reasonable assurance of safety and effectiveness," said William Maisel, MD, deputy director for science in the FDA's Center for Devices and Radiological Health, in a press release.

Dr. Maisel also reiterated the need for watchfulness.

"It's important to remember that breast implants are not lifetime devices," said Dr. Maisel. "Women should fully understand risks associated with breast implants before considering augmentation or reconstruction surgery and recognize that long-term monitoring is essential."

The FDA's approval of the Sientra implant was based on 3 years of clinical trial data on 1788 women. Adverse events and outcomes, which resembled those for other silicone breast implants, included capsular contracture, reoperation, implant removal, asymmetry, and infection.

The agency attached a number of conditions to its approval of the new implant. Sientra must:

• follow the 1788 women who participated in the clinical trials for 7 more years;
• study 4782 women who receive the implant for 10 years for signs of long-term local complications such as capsular contracture, rheumatoid arthritis, and breast and lung cancer; and
• conduct 5 case–control studies to evaluate the link between the silicone implants and rare connective tissue disease, neurological disease, brain cancer, cervical/vulvar cancer, and lymphoma.

By: Robert Lowes

Brazil Makes Plastic Surgery Tax-Deductible!

Wow!! Wouldn't this be neat in the USA??

This article from Allure is brought to you by Dr. Zimmerman... 

Tall and tan and young and lovely—with tax-deductible boobs!

American women have a new reason to envy the girls from Ipanema. Earlier this year, Brazil made cosmetic surgery—including breast implants, liposuction, and tummy tucks—deductible from income taxes. And the deductions are retroactive to procedures performed as far back as 2004.

Brazilian officials apparently did the math and now believe the increase in income for medical personnel will more than compensate for the projected loss of revenue. “We concluded that cosmetic surgeries are also about health, physical and mental, and should be included in the list of deductible expenses,” Brazil’s tax boss, Joaquim Adir, told Bloomberg.

The U.S. government recently considered the idea of a 5 percent levy on cosmetic procedures—the “Bo-tax,” as it was nicknamed—but dropped the notion in favor of a tanning-bed tax. Nevertheless, Connecticut charges a 6.35 percent premium on plastic surgery, and Washington state and California are considering getting in on the tax act, too.

Those states should think twice, says Gary Smotrich, a past president of the New Jersey Society of Plastic Surgeons. His state, which currently levies a tax, will begin gradually phasing it out this year, after watching patients go to tax-free New York and Pennsylvania instead. The losers, says Smotrich, are not the much-talked about 1 percent, but “the middle-class women who are the majority of patients for these procedures."

Tell us, do you think cosmetic surgery should be tax-deductible?

 By: Joan Kron, Contributing Editor at Large

Chocolate as Brain Booster!!!

Chocolate as Brain Booster 

by:

Flavanol is a potent type of antioxidant, a compound that is associated with the capacity to scavenge free radicals and consequently modulate oxidative stress. David Camfield, from Swinburne University (Australia), and colleagues engaged 63 subjects, ages 40 to 65 years, to drink a daily chocolate beverage over a 30-day study period. All participants received the chocolate drink, but in differing cocoa flavanol concentrations: the first group consumed 10 g of dark high-flavanol chocolate (corresponding to 500 mg cocoa flavanols), the second group received 10 g of conventional dark chocolate (250 mg of cocoa flavanols), and the third group received 10 g of dark chocolate (containing only a few cocoa flavanols). 

The researchers asked the subjects to perform spatial working memory tasks, during which concurrent  computer tomography brain scans were conducted. Whereas no differences were found between the groups regarding the accuracy or reaction times in performing the memory tasks, the team did observed via the brain scans that subjects who consumed the chocolate beverage containing either the medium or high proportion of cocoa flavanols were less strained by performing the tasks, as compared to those in the control group. Positive that these findings suggest that higher flavanol chocolate lowers stress levels in the brain, thereby allowing those subjects to achieve the same performance with lower resource usage, the study authors submit that their data provides " evidence of increased neural efficiency in spatial working memory function associated with chronic cocoa flavanol consumption.”

American Society for Aesthetic Plastic Surgery: New Ultrasound Technology Promising for Silicone Gel Breast Implant Monitoring

Significant potential advantages over MRI in screening and diagnosis of breast implant shell failure 

New York, NY (PRWEB) February 15, 2012 

Will high-resolution ultrasound become the new screening and diagnostic method for imaging silicone gel breast implants? A recent study suggests that portable, surgeon-performed, high-resolution ultrasound may have advantages over magnetic resonance imaging (MRI) when screening for implant failure. Preliminary results from the study demonstrated that high-resolution ultrasound provides excellent visualization of current fourth- and fifth-generation silicone gel implants in scanning models. In addition, in vivo surgeon-performed ultrasound accurately identified implant status and correlated with radiologist-performed ultrasound, MRI, and surgical findings. The results of the study, “Surgeon-Performed High-Resolution Ultrasound in the Detection of Silicone Gel Breast Implant Shell Failure: Background, In Vitro Studies, and Early Clinical Results,” appear in the February issue of the Aesthetic Surgery Journal. 

“Our preliminary findings show that portable, surgeon-performed, high-resolution ultrasound is feasible for screening silicone gel breast implants, matching the capabilities of MRI in detecting shell failure,” said lead author Bradley Bengtson, MD, FACS, a plastic surgeon in private practice in Grand Rapids, Michigan. “Although we are still working to define the role of this technology in the screening and diagnosis of patients with different silicone gel breast implant styles, there are several obvious benefits over MRI, including convenience, cost, availability, and dynamic, real-time visualization of the implant.”

Funded in part by a grant from the Aesthetic Surgery Education and Research Foundation (ASERF), the multi-part study evaluated several currently available base and transducer systems, using them for both in vitro and ex vivo scanning model assessments of a variety of normal and damaged implant models (Phase 1). These technologies were also applied clinically to provide imaging experience in three patients previously diagnosed with unilateral implant failure (Phase 2). A preliminary prospective evaluation was then performed to compare the accuracy of MRI, surgeon-performed high-resolution ultrasound, and radiologist-performed high-resolution ultrasound scans in predicting the shell integrity of 29 implants in 15 consecutive breast implant patients who subsequently underwent secondary implant surgery (Phase 3). In Phase 1, all hardware models easily detected both intact and intentionally damaged shells in currently marketed fourth-generation responsive gel implants and in investigational, fifth-generation highly cohesive gel devices. Although multiple transducers were able to detect shell failure, the 12-MHz head produced the best images at the normal clinical depth range. Confirmatory scans in Phase 2 correctly identified the side of rupture and were consistent with MRI and surgical findings. In Phase 3, high-resolution ultrasound accurately predicted implant shell integrity in all 29 imaged breasts (100%) as confirmed at the time of surgery in both symptomatic and asymptomatic patients. MRI is currently is currently recommended by the US Food and Drug Administration (FDA) for device surveillance.

“For both the patient and the surgeon, portable, high-resolution ultrasound has many potential benefits over MRI in the setting of breast implant screening,” said co-author Felmont Eaves, MD, Associate Clinical Professor at the University of North Carolina at Chapel Hill and immediate past president of the American Society for Aesthetic Plastic Surgery (ASAPS). “This office-based technology may also have broader applications, such as hand and facial fracture identification and treatment, vein surgery and ablation, visualization prior to shaped implant rotation, identification and management of seroma, and general breast evaluation.”

A prospective study is currently ongoing to help define the sensitivity and specificity of high-resolution ultrasound in the evaluation of current implant designs.

“Portable, high-resolution ultrasound that can be performed by the surgeon has the potential to enhance many areas of aesthetic breast surgery practice,” said Foad Nahai, MD, Editor-in-Chief of Aesthetic Surgery Journal. “We look forward to more information from this study.”

About ASJ:

The Aesthetic Surgery Journal is the peer-reviewed publication of the American Society for Aesthetic Plastic Surgery (ASAPS) and is the most widely read clinical journal in the field of cosmetic surgery, with subscribers in more than 60 countries

 

 

Platelet-Rich Plasma Procedure May Improve Facial Appearance

 

Platelet-rich plasma (PRP) therapy involves injection of the patient's own platelets and fibrin for the cosmetic treatment of wrinkles or scars in the face, hands, and neck. Known to some as the "vampire facelift" (a term trademarked by Alabama cosmetic surgeon Charles Runels), it is less invasive than plastic surgery, takes about 20 minutes for each treatment, and offers improvements for up to 18 months. Cost of the procedure is generally similar to that of fillers and may range from $600 to $1800 per treatment.

 

However, the efficacy and safety of PRP for cosmetic treatment have not been studied in controlled clinical trials. To learn more about the role of PRP therapy in cosmesis, Medscape interviewed Alan Matarasso, MD, and Lauren Zeifman, rPA-C, both in clinical practice in New York City. 

 

Dr. Matarasso is Clinical Professor of Plastic Surgery at Albert Einstein College of Medicine and has hospital privileges at numerous New York City medical institutions, including Manhattan Eye, Ear & Throat Hospital and New York Eye & Ear Infirmary. His contributions to many areas of aesthetic surgery include pioneering advances in surgical and noninvasive techniques. He is widely published and is the senior scientific editor of the Aesthetic Surgery Journal.

Medscape: Please define the PRP therapy procedure for improving facial appearance.

Dr. Matarasso and Ms. Zeifman: Selphyl® (UBS Aesthetics; Bethlehem, Pennsylvania) is a patented system for safe and rapid preparation of platelet-rich fibrin matrix, which is a type of regenerative medicine that uses platelets to rejuvenate the skin.

Medscape: What is the rationale behind the use of PRP therapy to improve facial appearance?

Dr. Matarasso and Ms. Zeifman: A steady trend over the past 15 years has been for patients to seek less-invasive procedures for facial rejuvenation. Selphyl has been used by surgeons over the past 7 years to speed up soft-tissue healing from sports injuries as well as to treat burn victims and patients with severe ulcers. It is also used as an adjunct to implant therapy in dentistry.

Selphyl is now being used cosmetically to treat volume loss in the face, hands, and neck -- particularly the crepey skin under the eyes and neck -- as well as wrinkles, acne scarring, and stretch marks.

Medscape: By what mechanisms do injections of PRP restore facial appearance?

 

Dr. Matarasso and Ms. Zeifman: Platelets play a role in stopping bleeding and in repairing damaged blood vessels and cells in the body. Platelets also contain substances called "growth factors" that activate and rejuvenate cells in our body. Unlike fillers that use various synthetic substances, Selphyl uses the patient's natural biology to address skin defects and volume loss, triggering production of new cells and collagen formation.

Medscape: How long does the procedure take, and how is it performed?

 

Dr. Matarasso and Ms. Zeifman: This cutting-edge rejuvenation is a quick 20-minute procedure. After 9 cm³ of blood (approximately 1 vial) is drawn from the patient, it is spun down in a centrifuge for 6 minutes at a precalculated speed to retrieve the most viable fibrin and platelets. After centrifugation, the platelet and fibrin component of the blood (the top layer) is extracted and reinjected into the area of concern.

Medscape: What type of results can generally be expected?

 

Dr. Matarasso and Ms. Zeifman: The results are subtle, with gradual improvement in the injected area over a 3- to 5-week period. Full correction occurs at 4-7 weeks and can last as long as 18 months.

Medscape: What are the risks or complications?

 

Dr. Matarasso and Ms. Zeifman: Because this filler is made from the patient's own blood, there is no risk for rejection, infection, or an allergic reaction.

Medscape: For what types of patients is this procedure most and least suitable?

 

Dr. Matarasso and Ms. Zeifman: Any patient who wishes to reduce volume loss, fine lines, and textural changes of the skin is suitable for this procedure. It also appeals to the patient who is looking for a natural approach to volumizing the face and treating or reducing fine lines.

Medscape: How long are the improvements maintained? If necessary, can the procedure be repeated, and if so, with what anticipated outcome?

 

Dr. Matarasso and Ms. Zeifman: Selphyl can be repeated, and better results are seen with a total of 2-3 treatments given 3-4 months apart. Patients can expect to see better results as they receive more treatments. With time, the results of Selphyl get better and better.

Medscape: How does PRP therapy compare with injections of filler, Botox(Botox® Cosmetic; Allergan, Inc; Irvine, California), or surgical facelifts?

 

Dr. Matarasso and Ms. Zeifman: This procedure can be combined with dermal fillers, Botox injections, and laser surgery, as well as facial surgery. PRP builds tissue over time, whereas traditional filler breaks down over time.

Medscape: In what situations might PRP therapy plus filler injections be helpful?

 

Dr. Matarasso and Ms. Zeifman: It is nice to layer Selphyl with traditional fillers. If a patient has volume loss with a lot of fine lines and textural changes, I like to inject Selphyl to create a new foundation of collagen and use dermal fillers for the fine lines.

Medscape: What is your overall opinion of the role that PRP therapy should play in facial restoration?

 

Dr. Matarasso and Ms. Zeifman: PRP therapy is very promising in facial restoration. Results are optimal when patients receive a combination of PRP, dermal fillers, and laser therapy.

 

By: Laurie Barclay, MD; Alan Matarasso, MD; Lauren Zeifman, rPA-C