May, 2009

Xarelto: a new drug to reduce surgical risks

One of the most worrisome problems for surgeons is known as venous thromboembolism VTE - blood clots such as deep vein thrombosis and pulmonary embolism. These can occur after long operations, even in seemingly healthy people - and can be a life-threatening problem. In the past, we've used compression stockings, pneumatic sequential compression devices, or injectable blood thinners, like heparin and lovenox, to successfully reduce, but not completely eliminate, the risk of VTE's. However, these ...

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Thomas Fiala, MD 5/29/2009 Comments(0)

Redheads & Surgery

Back when I was a general surgery resident, one of the sayings passed down from our surgery professors was that "redheads were trouble", because they seemed to bleed a bit more than the average patient during a typical procedure. It was like a surgical superstition, a part of surgical lore that hadn't been proven scientifically, and yet was well known by all wise surgeons. In the last few years, some researchers have started to look at the connection between natural redheads and surgery, and it ...

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Thomas Fiala, MD 5/26/2009 Comments(0)

Q-Med announces Restylane with lidocaine

This week, Q-Med , the Swedish pharmceutical company that is the home to Restylane and Perlane, announced Restylane® Lidocaine and Restylane Perlane™ Lidocaine as the latest additions to their Restylane family of dermal fillers. These products have the familiar Restylane and Perlane hyaluronic gel fillers, together with a small amount 0.3 % of lidocaine, a commonly used local anesthetic, to help minimize the discomfort of the procedure. According to the studies, the fill effect of the...

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Thomas Fiala, MD 5/23/2009 Comments(1)

Thread Lifts Don't Work - part 2

For those of you who are unfamiliar with the term, the Thread Lift was a much-hyped procedure in which a special type of barbed suture would be placed under the skin, to draw the loose facial tissue upward. The idea was to get a facelift-like lift, without actually doing a real facelift. It sounded so promising - just have a few of these magic threads inserted into your cheeks during your lunch break - and voila! - a younger looking you. A number of companies make and promote these barbed suture...

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Thomas Fiala, MD 5/23/2009 Comments(0)

Australian MD saves boy's life with household drill

Here's a great story of performing under pressure: A doctor in rural Australia used a household drill to bore into a skull of a young boy with a head injury, to drain a potentially-lethal blood clot. The local hospital did not have neurosurgical tools or a neurosurgeon on site, and the young boy was in trouble. According to details on the BBC News website, Dr Rob Carson performed the procedure on Nicholas Rossi, 13, after the boy fell off his bike and hit his head. The boy was initially fine, bu...

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Thomas Fiala, MD 5/21/2009 Comments(0)

Saline Lip Implants

I noticed a new to me product at the 2009 ASAPS meeting: a saline-filled lip implant. I kid you not. Known as VeraFIl, it has actually been FDA approved for about a year. Essentially, it is a tapered tubular implant with a silicone shell and a gore-tex outer coating. A tunnel is made in the substance of the lip under anesthesia, and the device is placed and filled - like some sort of miniature saline breast implant. Theoretical advantages: - permanent lip enhancement Possible problems: - encapsu...

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Thomas Fiala, MD 5/19/2009 Comments(0)

ASAPS 2009: new technologies in body contouring

At the recent ASAPS meeting, a number of breakthrough new technologies were presented, as potential alternatives / improvements on the standard liposuction technique. Bear in mind that most of these wonder gadgets are still in the developmental phase, and do not yet have FDA approval. But some of the before & after photos looked pretty exciting! Definitely something to watch for over the next few years! The techniques presented included: Focused external ultrasound for fat reduction: "Liposo...

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Thomas Fiala, MD 5/12/2009 Comments(0)

ASAPS 2009: breast implants & biofilms

One of the big topics of discussion at ASAPS this year was biofilms . Biofilms are a type of bacterial contamination that loves to form on solid, implanted devices like man-made heart valves, contact lenses, orthopedic implants, and yes...breast implants. There is a growing body of research that suggests that these biofilms are linked to the #1 unsolved problem of breast implants - capsular contracture. Implant-associated biofilms don't cause fevers, redness or typical infection issues. They are...

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Thomas Fiala, MD 5/12/2009 Comments(1)

Best new concept at ASAPS 2009 - Revance therapeutics

Sounds like science fiction, right? - a wrinkle-fighter that works without needles... One of the coolest products in development that I heard about at the ASAPS meeting belongs to a company called Revance therapeutics , based in Palo Alto, California. They seem to be the first ones to have cracked the problem of getting large molecules into the skin. Usually, large molecules can not be absorbed transdermally, so relatively few medications can be compounded in a gel or patch formula. While there ...

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Thomas Fiala, MD 5/10/2009 Comments(0)

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