Botulinum Toxin Gel May Ease Crow's Feet

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New York — A new botulinum toxin-based gel has the potential to help smooth crow’s feet without the need for needles, HealthDay News reports. 

In part of a new phase 2 trial, 90 patients with moderate-to-severe crow’s feet were randomly assigned to be treated either with a placebo gel or the botulinum toxin gel. Almost 90 percent of the latter had a clinically meaningful reduction in wrinkles, compared with 28 percent of those receiving placebo. 

In a second study involving 180 adults with crow’s feet, about 40 percent of those treated with the botulinum toxin gel responded favorably, researchers said.

The new research is encouraging because it demonstrated that the gel “noticeably softened crow’s feet,” said lead author Michael Kane, M.D., a plastic surgeon at the Manhattan Eye, Ear and Throat Hospital. Dr. Kane has served as an investigator and consultant for Revance Therapeutics, Mountain View, Calif., which has been trying to develop an alternative to Botox (onabotulinumtoxinA, Allergan) for several years. 

Effects of the gel last for about four months, comparable to the duration of Botox injections, investigators said.

With phase 3 studies yet to be done, still to be determined are whether the gel would work better than injected toxin, how much treatments would cost and when the gel might be available, Dr. Kane said. 

The study’s findings were released last week at the American Society of Plastic Surgeons annual conference in Denver. 

By: Bill Gillette

Illinois Woman Dies After Injecting Beef Fat into Face

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Chicago — An Illinois woman died of a bacterial infection after injecting her face with hot beef fat in an apparent attempt to self-treat wrinkles, although the cause of death appeared unrelated, ABC News reports.

According to ABC News Chicago affiliate WLS-TV, Janet Hardt, 63, of Homewood, Ill., boiled beef, extracted the fat and injected it into her face earlier this month. Shortly thereafter she went to the hospital complaining that her face felt as though it were burning.

The woman had infections and scarring in her mouth and on her lips, but an autopsy attributed her death to peritonitis, according to the report.

“There are a lot people out there doing self-injections for wrinkles, but I don’t know of any medical associations that would recommend this,” American Society of Plastic Surgeons President Phillip Haeck, M.D., was quoted as saying. “It’s not worth taking a chance with your face to try to save money when it could ultimately cost you a lot more money.”

Ms. Hardt reportedly had injected her face with the beef fat several times and also had undergone several legitimate plastic surgery procedures. Because she injected herself multiple times with the animal fat, she was at risk of developing an allergic reaction, ABC News quotes Dr. Haeck as saying.

“One of the injections could cause the skin to erode or ulcerate,” he said. “We know that injections of animal proteins do not cause systemwide failure, but it tends to cause local reactions. A lot of people who have allergic reactions to animal proteins will say that their face is burning, like this woman did. That’s probably what was going on here.” 

By: Bill Gillette

Faster Eating Leads to Weight Gain

Dr. Z is sharing this article from: Healthy Aging Review

Do you scarf down a meal like you just spent 40 days in the Sahara Desert without food? Or do you savor every flavor? Beware speed-eaters. If you eat in record time, you are more likely to gain weight.

A study from New Zealand has found that women who inhaled their food were heavier than women that slowly chewed their food completely. Approximately 1,600 women between 40 and 50 years old were asked to rate how quickly they ate and provide their height, weight, and other lifestyle factors. About 32% of women were fast eaters, while 15% considered themselves slow eaters. Those that ate the slowest had the lowest body mass index. Researchers suggest that speed-eating can influence how many calories are taken in before you feel full.

Eating behaviors can become habitual, which makes speed-eating a hard habit to break. To develop healthier eating habits, focus on eating. Don’t be preoccupied by watching television or rushing to eat before your next appointment. Instead of standing in the kitchen with a box of cereal in one hand and chocolate bar in the other, sit down at a kitchen table with a good nutrient-dense meal to stay more focused on the eating task at hand.

By: Alan Muir

Reference:

Leong SL, Madden C, Gray A, Waters D, Horwarth C. Faster self-reported speed of eating is related to higher body mass index in a nationwide survey of middle-aged women. J Am Diet Assoc. 2011 Aug;111(8):1192-1197.

Biggest Skincare Myths Exposed

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(HealthNewsDigest.com) - Dr. Sandra Lee is a board certified Southern California dermatologist who empathizes with her female patients who feel they are doing everything ‘right’ and still remain unsatisfied with the appearance of their skin. What’s more, she often sees patients who feel they are doomed to bad skin based on myths that “you get the genes your parents have.” She seeks to set the record straight on what really does sabotage the skin and dispels the most common myths mothers or the media have passed on to their daughters.

Trying to scrub away acne: Acne is not a hygiene problem; it's a hormonal issue. Excessively cleaning your face won't get rid of acne. Instead of attempting to scrub your pimple-prone skin into submission, wash it gently with a foaming face wash that's designed to lift off dirt without irritating skin. And if you do feel compelled to enlist a scrub, use it no more than once a week, choosing a product that has even-sized, round beads, not rough particles

Sunscreen: The big mistake women make is trusting the sunscreen label that reads 'all day protection. The truth is that no sunscreen lasts more than four hours; you're kidding yourself if you think you can put it on once and forget about it. Regular sunscreen use is even more important if you are treating your face with Retin-A or alpha- or beta-hydroxy acids, or getting peels or microdermabrasion -- all of which can leave skin more sensitive to the sun's ultraviolet rays.

Alcohol: Consider alternating drinks with water. Drinking alcohol causes dehydration and dilated blood vessels both of which make skin look tired and unhealthy. Try to drink one glass of water per alcoholic drink consumed -- this will help skin stay hydrated.

Stress: Stress causes your body to go into survival mode by pumping adrenaline to heighten the senses. While this is healthy if you are in danger, prolonged periods of stress can take a toll on your skin. When the body is in survival mode, the most vital organs like the heart, lungs and brain work overtime. The skin, a less vital organ, becomes deprived of nutrients which eventually affects its appearance. Combat stress by incorporating relaxation techniques into your routine like yoga, meditation and deep breathing.

Not hydrating your skin enough: Because you think you don't need it. Drinking 8 glasses of water a day, and applying a moisturizing cream to your face regularly can save you the headache of dealing with a cracked and sensitive skin.

Sleeping with make up on will leave your skin's pores clogged and prevent it from breathing. No matter how tired you feel clean your face before going to bed.

Using harsh cleansers to clean your skin will strip away the natural oils that protect it from dirt, pollution and other factors that can easily damage your skin. Do your skin a favor and use mild cleaners, they're much gentler and still effective.

Applying your usual facial moisturizer to your "under-eye" area is really harsh. This area is the most delicate area in your face and it's where fine lines will appear first, so having a specialized eye cream is a must after the age 25.


Lack of sleep can effect how your skin looks dramatically, leading to dark circles, and dull looking skin. Get at least 8 hours of sleep each night and you'll wake up to a much more fresh looking skin.

Thinking that "More is better". When it comes to your skin, more is actually worse, too much washing, too much cream, too much scrub can totally damage your skin.

Washing your face at the wrong time: Always wash your face after you rinse out your hair products and conditioner in the shower, never before. Many conditioners contain pore-clogging isopropyl myristate and other hair products often contain coconut oil -- both are common acne-causing ingredients that you don't want to leave on your skin.

Thinking that what you eat will only affect your body weight, not your skin, in fact what you eat shows directly on your face. Eating too much sweets and fatty food will leave your skin looking unhealthy, a healthy diet is very important for a healthy younger looking face.

Not using a retinoid: Retinol, a form of vitamin A, is the only topical ingredient proven not only to prevent lines and wrinkles but to minimize the ones you already have. Past the age of 30. Dr. Lee recommends seeing a dermatologist for a higher-concentration prescription retinoid (like Retin-A, Differin, or Tazorac, for example), but there are also many great over-the-counter creams that contain lower concentrations of retinol.

Myth #1: Your skin will age just like your mom's.
The reality: Sure, genetics play a role in how your skin looks, from the size of your pores to its texture and color. But banking on aging like your mom or grandmother is a big mistake. Habits make more of a difference than genetics. The biggest culprit in aging is sun exposure, and your drinking, smoking, stress, and sleep habits play a role, too. Skipping sunscreen, imbibing too often, coping ineffectively with stress, and sleeping on your side or stomach can all exacerbate and create wrinkles, adult acne, and texture changes.

Myth #2: The SPF number tells you how much protection you're getting from the sun.
The reality: There are two types of damaging sun rays: UVA, which are responsible for aging the skin; and UVB, which are responsible for burning it. The SPF number on a bottle of sunscreen only gives a guide for how much UVB protection the product offers. It doesn't tell you whether or not the product protects from UVA rays (which are also responsible for melanoma). All sunscreens protect from UVB rays. To fully protect yourself, however, look for a product that contains UVA-blocking ingredients, too, such as zinc oxide, titanium dioxide or avobenzone (Parsol 1789), and reapply often.

Myth #3: You need a separate sunscreen and moisturizer.
The reality: Sunscreens already add moisture to your skin because of their ingredients. So if you have oily skin, you may want to skip the separate moisturizer. For those who prefer to wear both products, apply the moisturizer first; allow to dry, then apply the sunscreen. Either way, be sure to wear sunscreen daily: Every day is a sun day, even if it's cloudy or overcast.

Myth #4: Most of the sun damage you incur happens before age 18.
The reality: Recent studies have shown that by age 18, you've only accumulated 18 to 23 percent of the sun damage you'll incur over a lifetime. That means that there's still time to protect your skin from the sun and put off sun-induced aging. Do this by using sunscreen and products with sun-damage reversing ingredients such as vitamin C and retinol.

Myth #5: Cosmetic creams can turn back time for your skin.
The reality: There's no such thing as a miracle in a bottle. As you age, your facial bones shrink, you lose fat under the skin, and your skin begins to become loose. Rubbing on a cream isn't going to address these things. What's more, cosmetic skincare products cannot, by FDA law, include medications, which are the only things that truly change the structure of the skin. What cosmetic creams can do: Temporarily plump up and hydrate your skin. For the best chance at turning back time, see your dermatologist for medications or procedures.


Sandra Lee, M.D. is a board certified dermatologist and a member of the American Academy of Dermatology, the American Academy of Cosmetic Surgery, the American Society for Dermatologic Surgery, and the American Society for MOHS Surgery. She was raised in Upland, and after completing undergraduate school at UCLA, traveled to the east coast to attend medical school at Hahnemann University School of Medicine in Philadelphia, PA. Her internship was completed at Allegheny General Hospital in Pittsburgh, PA, and she completed her dermatology residency training at Southern Illinois University in Springfield, IL. Additionally, Dr. Lee had fellowship training in laser, dermatologic, and cosmetic surgery with the internationally recognized cosmetic surgeon and dermatologist, Dr. Richard E. Fitzpatrick of Dermatology Associates of San Diego.

She now practices in Upland, California where she divides her office time among general dermatology, dermatologic surgery, and cosmetic surgery. She has special interests in Mohs micrographic skin cancer surgery, tumescent neck and body liposuction, eyelifts, and laser resurfacing. She also has been extensively involved in clinical studies, is published in multiple journals and medical textbooks, and lectures at a national level to fellow dermatologists and cosmetic surgeons. For more information, visit: www.skinps.com

 By Dr. Sandra Lee

Breast fat grafting gets thumbs up!

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San Diego — Officials of Cytori Therapeutics, based here, say British surgeons have successfully used the company’s adipose-derived regenerative cell (ADRC) fat grafting procedure — which the company calls RESTORE — in reconstructive breast surgery, Medical News Today reports. 

The company says clinical outcomes were reported at the Association of Breast Surgery Conference in Manchester, England, earlier this month. The procedure was separately investigated in Cytori's own RESTORE 2 trial, according to Medical News Today. 

The British surgeons’ report results from an independent, prospective study of 23 patients who received ADRC-enhanced fat grafting for the correction of breast-contour defects following cancer treatment or benign conditions including implant complications, using Cytori’s Celution System. Patients were treated between September 2008 and November 2010 with follow-up between three months and two years. The results showed that 19 of the patients, or 82 percent, reported good to excellent results, with a mean satisfaction score of 5.1 (1 being worst, 6 being best). 

The results further showed a high level of investigator satisfaction, with a mean satisfaction score of 4.3. Study findings demonstrated a low complication rate. 

Overall, the company says, the study results suggest the RESTORE procedure is a viable breast reconstruction option.

By: Bill Gillette
Cosmetic Surgery Times E-News

Botox-Maker Allergan Tests Eyelash Lengthener for Baldness

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Allergan Inc. has moved its eyelash treatment into the second clinical stage of testing as a therapy for baldness and expects to see data by the middle of next year, Chief Executive Officer David Pyott said. 

The product, Latisse, was approved in 2008 to aid in eyelash growth, and generated $82 million last year for the Irvine, California-based company. Allergan is currently testing Latisse for men and women against placebo. U.S. regulators generally require three stages of trials before approval. 

The tests follow a business model Allergan successfully implemented with Botox, its top-selling product with $1.42 billion in revenue last year. Initially approved for therapeutic uses in 1989, Botox’s wrinkle-smoothing properties were identified as a side effect. The product was then cleared in 2002 as an injection to smooth frown lines between the brows. Latisse is a version of Allergan’s glaucoma drug Lumigan, which was found to stimulate lash growth as a side effect of therapeutic treatment. 

“The docs used to start laughing, because there are patients luckily that only have glaucoma in one eye and so they’d come in and say, ‘Doc I’ve got these beautiful eyelashes over here, what should I do?’” Pyott said today during an interview in New York. Now, for baldness, “We know anecdotally it works. The question is, how well does it work?” 

Allergan declined 39 cents, or less than 1 percent, to $78.18 at 4 p.m. in New York Stock Exchange composite trading. The shares have gained 14 percent this year.

Added Sales

Latisse may gain up to an additional $200 million to $500 million in annual sales by 2020 if it’s proven to spur hair growth, estimated Ronny Gal, an analyst with Sanford C. Bernstein & Co. in New York. The product is designed to work similarly to other hair-loss therapies such as Johnson & Johnson’s Rogaine, said Gal, who recommends buying Allergan shares. 

“It will grow hair from the existing follicle, and help you maintain the hair you’ve got,” Gal said in a telephone interview today. “It’s clear it works in principle, because we know it grows eyebrows and we know it grows lashes.” 

Allergan won approval last month for the use of Botox as a therapy for urinary incontinence, and in October as a treatment for chronic migraine headaches. The company estimates the product will produce $1.55 billion to $1.59 billion in revenue this year, and foresees about $100 million in sales from Latisse.

Fewer Botox Treatments Still Effective

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Portland, Ore. — New research suggests that patients getting Botox (onabotulinumtoxinA, Allergan) treatments can reduce wrinkles with half as many sessions after 20 months, Medical News Today reports.

The research, conducted at Oregon Health & Science University’s Casey Eye Institute, sought to determine whether less frequent Botox treatments could provide longer-lasting reduction of glabellar rhytids. The study included 50 women ages 30 to 50 who received regular Botox injections for two years. 

Medical News Today quotes Roger Dailey, M.D., who led the study, as saying, “We found that after a patient receives Botox Cosmetic injections every four months for two years, the frequency of treatments can be changed to six months with comparable wrinkle-reducing results and high patient satisfaction. Patients who are unwilling to undergo Botox treatments every three months indefinitely because of cost, convenience or other concerns may reconsider if they could achieve similar results with two to three treatments per year.” 

While a treatment schedule of every three months is likely to achieve the best results in the least amount of time, the study concluded that other schedules offer similar results at less cost. 

The study also shows the injections have a prophylactic effect. Dr. Dailey, head of the Casey Aesthetic Facial Surgery Center, says patients who begin getting Botox treatments between their 30s and 50s are able to prevent dynamic wrinkles from forming and eliminate existing wrinkles. “Observations during our subjects’ final visits also suggest that further wrinkle prevention could be achieved with continued treatment beyond two years,” Dr. Dailey tells Medical News Today. 

By: Bill Gillette
Cosmetic Surgery Times E-News