Spring Specials 2010

Yes...they're here!! Plastic Surgery specials for Spring 2010 (Feb - Apr).

You can find all the details on our website (link)

Included are discounts on breast augmentation, Botox, Juvederm, microdermabrasion and laser hair removal.

Now you can get the best - for a little less! Yay!!

Was it worth it? - the least satisfactory procedures

According to the readers poll over at RealSelf.com, here is the "rogue's gallery" as of today - the procedures at the bottom of the barrel on the "was it worth it" scale. The 20% satisfaction rating for lipodissolve, for example, means that 80% of people didn't think it was worth the cost.

You can see the full list here (link)

Procedure.........Percentage satisfied.........Average cost

Velashape...............32%............................$2785

Mesotherapy ............32%...........................$2282

Lifestyle lift..............28%..........................$5470

Cellulite treatment......25%..........................$2557

Lipodissolve...............20%..........................$1918

Astute readers of this blog will recognize many of these offenders from previous posts and discussions! Four out of five of these procedures have minimal science or proof of efficacy to back them up.

Interestingly, the Zerona non-invasive fat zapping laser was not on this list. But this device didn't rate well either: Realself voters only gave the Zerona a 20% rating, which ties with Lipodissolve for last place. Ouch!!

CNN article on "wanna-be" cosmetic surgeons

Here's an article from CNN Health, which talks about how many physicians are trying their hand at cosmetic medicine and cosmetic surgery, regardless of their training, board certification, or experience.

Link

It's clear that some physicians think that the "grass is greener" on the plastic surgery side of the fence...but they don't want to invest the time to train properly in plastic surgery, since that takes years. So, more and more frequently, these docs take a one-day course on saturday, then start using their new laser or liposuction machine on monday. It's a recipe for problems, and the patient is the one who suffers.

I think the most insightful quote in the article is this one, from Dr. Brent Moelleken, a plastic surgeon in California. "If patients heard about a plastic surgeon expanding his practice to include Pap smears and hysterectomies, they would be horrified. But they think little of having laser procedures or liposuction done by a gynecologist. And there is no law against either."

Remember, just because it's cosmetic doesn't mean it isn't real surgery, with real potential for complications. Do your research. Stick with experienced, credentialled surgeons who practice within their field of training. Review their before and after pictures. Talk to some other patients. Extra time taken when selecting your surgeon pays dividends later.

Plastic Surgery Predictions for 2010

Remember the old Johnny Carson sketch, "The Great Karnak"? Well, these predictions may prove to be about as accurate, but here goes...

1. Botox vs. Dysport. So far, this corporate shoot-out has been pretty low-key. But I expect the marketing and tug-of-war between the two corporate behemoths to increase significantly in 2010, as people (both patients and physicians) become more comfortable with Dysport. IMO, there's plenty of room for both in the ever-expanding non-surgical market. Of course, the real game changer is Revance Therapeutics' topical formulation - Botox cream. But that's probably a few years away yet.

2. Market Consolidation. I expect two forms of market consolidation in 2010, continuing what we were seeing in the rough economic waters of 2009. Smaller product lines will either drop out, or be absorbed by larger corporations. Mergers and buyouts of small to mid-size aesthetic companies will continue, as we've seen in the laser industry in 2009.

3. Increasing regulation of medi-spas. It's taken a while, but regulators at the State level are beginning to wise up that medi-spas are doing treatments and procedures that until recently, were only done in physicians' offices or surgery centers. So, they should have similar safety regulations and oversight. The recent med-spa related liposuction death in Florida has added fuel to this fire.

4. Pragmatism towards current minimally-invasive procedures. When ever any new technology is introduced, there are 3 phases: an excitement / hype phase, a reassessment phase, and the final "here's-the real-deal" phase. I'm hopeful that in 2010, we'll be approaching the pragmatic phase about laser-assisted liposuction (LAL), and that we'll see more good science about the degree of skin tightening that LAL really produces.

5. Continued interest in fat grafting. Especially once the technology for turbo-charging fat grafts with stem cells gets approved by the FDA, this is the next "big thing" in both aesthetic plastic and reconstructive surgery.

6. Will the "gummy-bear" breast implants arrive in 2010? Maybe in the second half of the year. The real question is whether American women will accept the trade-offs of larger incisions and the "super-firm" feeling of the implant for a possibly lower contracture rate and lower rate of gel migration. I think textured, standard gel implants will undergo a surge in popularity - especially for revisional cases.

7. More "me-too" products. Whether it's in the injectable filler, botox, or laser arena, I think companies will try to introduce their spin on currently existing products, to gain a share in the lucrative cosmetic market. There will be more HA fillers, more fractional lasers, more liposuction devices - each touting that their product is "just as good as Brand X". (The FDA 401 (k) equivalency process encourages imitation, rather than innovation.) This will, of course, be more confusing for consumers. If the new products don't catch on rapidly, I suspect, prediction # 2 will take place, and the product will sink out of sight, more rapidly than before. Better then, to stay with the tried-and-true / market leaders.

That's all Dr. F. has for now. Happy New Year, everybody!

Trade your air miles for plastic surgery?

Finnair, Finland’s biggest airline, has an offbeat new idea for frequent flyers: Exchange your air miles for plastic surgery!

According to the airline's website, the cosmetic procedures are performed at the Nordstroem Hospital in Helsinki. All the usual procedures can be obtained with air miles - but it takes one heckuva lot of points! Earning the 3.18 million points for breast augmentation surgery requires 120 round-trip, business-class flights between Helsinki and New York, according to a points table on Finnair’s Web site.

Customers who want to redeem their air miles for cosmetic surgery must first book a 95-euro consultation at the hospital before using loyalty points for the surgery voucher.

This is prime material for late-night comics! What will they think of next?

Senate Dems propose a 5% cosmetic surgery tax

As part of the 2000 page Senate proposal for health care reform released today, Senate Democrats are proposing a 5% tax on cosmetic surgery. More details can be read in the New York Times report (here). The way this proposal is worded, non-surgical cosmetic procedures such as Botox, Restylane and Juvederm, laser treatments and pretty much any cosmetic treatment performed by a licensed professional would be taxed as well.

We've talked about cosmetic surgery taxes before, pointing out how they are unfair to consumers. (see earlier blog here).

Why? Because they are a tax primarily on women, who represent 90%+ of our cosmetic surgery patients - and it's unfair and unconstitutional to disproportionately tax a single group. It's sexist!

Also, this is not a "tax on the rich" - the vast majority of our patients are average, middle-class Americans who are simply trying to fix a physical feature that bothers them.

Although the patient would be taxed, get this, according to the proposal, the physician would be financially liable if the tax were not paid. Unbelievable!

You can read the actual text of the bill here (click for link)

If you would like your voice to be heard about this tax on women, please contact our Democratic State Senator for Florida, Senator Bill Nelson at:
716 HART SENATE OFFICE BUILDING WASHINGTON DC 20510
(202) 224-5274
billnelson.senate.gov

Miss Plastic Surgery 2009

Here's an offbeat story for you....

This weekend, the Miss Plastic Surgery Hungary 2009 competition is taking place in Budapest. Yes - believe it or not - it's a beauty competition for women, ages 18 to 30, who have had at least one cosmetic surgery procedure under anesthesia, and freely admit it. Liposuction, breast augmentation, rhinoplasty, facelifts - it's all OK in this competition.

And here I thought that cosmetic surgery was the "deep, dark secret" of most pageants.

According to the pageant officials, the contest will "help to show how Hungarian cosmetic surgery techniques have advanced, providing a way for women to look naturally beautiful as well as improving their self-image". So, the quality of the surgical results is apparently as important to the judges as the beauty of the women.

The Miss Plastic Surgery Hungary pageant is open to any woman with a Hungarian residence, regardless of her nationality or birth place. More than 100 women have signed up. The first place finisher receives a new apartment, the runner up drives away in a new car, and the second runner up will win a vacation for two to Kenya.

:)

A tax on cosmetic surgery??

Rumors are flying about the possibility of a new 10% tax on cosmetic surgery. Apparently, this is one of the more creative methods that the Senate Finance Committee has proposed, to help pay for the President's new healthcare system.

I, for one, certainly hope that this doesn't come to pass. While this tax might look like "easy revenue", it is essentially an unfair tax.

Why? - because it unfairly discriminates against women, who are 95% of the consumers of cosmetic surgery. And that's not right.

Usually excise taxes are designed to tax products or services that have a negative effect on the public health. Taxes on tobacco products and alcohol - which have well been proven to have detrimental effects on the public health - would be classic examples of excise taxes. Cosmetic surgery just makes people feel better about themselves. It doesn't have a negative health effect.

Could we argue that it would just be another form of "luxury tax" on the ultra-rich? No, not really - the vast majority of my patients are average Americans, who are middle-income earners; the waitress whose has been saving for a breast augmentation, the mom with three kids who wants to fix her tummy now that her kids are grown. They are certainly not the ultra-rich.

Experience with a similar cosmetic surgery tax in New Jersey did not pan out well. Tax revenues were reportedly only 25% of what was estimated.

An ideal tax (admittedly an oxymoronic phrase!) should be broad-based and non-discriminatory. A cosmetic surgery tax would be neither.

Cosmetic surgery and the competitive edge: looking good and the job market

Here's some interesting data from a press release from the American Society of Plastic Surgeons:

"Faced with news of difficult economic times, and a belief that hiring is based on looks, millions of American women are looking at cosmetic medical procedures to give them a competitive edge in the workplace. In a new telephone survey compiled by the American Society of Plastic Surgeons (ASPS) of 756 women between the ages of 18 and 64, many reveal cosmetic plastic surgery procedures now appear to be an important rung on the success ladder.

- 13 percent (more than 1 out of 10 of the 115-million working-age women) say they would consider having a cosmetic medical procedure specifically to make them more confident and more competitive in the job market.

- An astounding 3 percent (nearly 3.5-million working women) say they've already had a cosmetic procedure to increase their perceived value in the workplace.

- 73 percent (almost three out of four or, 84-million working women) believe, particularly in these challenging economic times, appearance and youthful looks play a part in getting hired, getting a promotion, or getting new clients.

- 80 percent (four out of five or 92-million working women) think having cosmetic medical procedures can boost a person's confidence."


Actually, this trend is not really that new. Men have been coming to me for years, getting their upper eyelids fixed, so they don't look like the "sleepy, old-guy-past-his-prime". Executives often have specifically told me that they want to look more like their youthful and energetic business competition, and want to have surgery to give the appearance of still being in their prime, rather than being perceived as being "tired" or "over-the-hill".

Investing in yourself is always a wise investment!

"We Fix Cheap Haircuts"

True story: I was walking around downtown Orlando recently, and I came across an old-time barber shop. "Haircuts for men and boys", the sign said, "eight dollars". Seemed like quite a deal.

About a block further down the same street, I came across another barber shop. This one had a sign in the window, "We fix cheap haircuts".

I laughed at the sly reference to their low-cost competition down the street. If you think about it though, the world of plastic surgery is not that different.

Sometimes the "cheap haircut" is surgery that has been performed outside of the U.S., usually in South or Central America, with the patient returning to Florida with an infection, an open incision, thick scars, or a crummy-looking result. (I've seen all of these issues!)

Sometimes the "cheap haircut" is cosmetic surgery that was performed locally, by people that advertise ridiculously low-cost liposuction or breast augmentation surgery.

These patients with complications from inexpert surgery all tell the same sad story: "It seemed like a good idea at the time. I was hoping to get a deal on cosmetic surgery....and look what happened".

Either way, the total price for the initial surgery PLUS the required fix-up procedures is far more expensive than having it done right the first time, by a real board-certified plastic surgeon in an accredited surgery facility with U.S. level standards of quality. Worse yet, sometimes the problems can't be undone.

It's unwise to gamble with cheap cosmetic surgery....or cheap haircuts, for that matter. While some patients are satisfied with their discount surgery, why spin the roulette wheel with your health? Like that old slogan, "It may cost a little more, but I'm worth it!"

Capital One exits cosmetic surgery financing

Capital One is pulling out of the health care financing market -- removing one financing option for medical services. As of April 10, 2009, Capital One is not accepting any new installment loan applications for cosmetic surgery, or any other medical expenses.

If you already have an approved Capital One loan, you're OK - that won't be affected.

While understandable from a business point of view, it's too bad. Capital One provided a helpful service, and their loan plan was one of the more popular ones with many of our patients.

Herbal Supplements and Surgery - Safe or not?

Herbal supplements are everywhere. And cosmetic surgery patients love them - in a recent survey, 55% of cosmetic surgery patients surveyed took 2 or more supplements, compared to only 24% in the general population. The most commonly used supplements in the survey were: chondroitin, ephedra, echinacea and glucosamine.

Some supplements have some serious side effects that may be problematic, if you are having general anesthesia and surgery.

Here's a quick guide to which supplements should be stopped, and the reasons why. The general recommendation is to stop these supplements two weeks before surgery.

These supplements can cause bleeding problems:
Chondroitin / Glucosamine --- can also cause low blood sugar
Fish Oil
Garlic
Ginger
Gingko
Ginseng --- can also cause low blood pressure under anesthesia
Saw Palmetto
Vitamin E

These supplements affect drug metabolism and can cause excessive sedation:
Echinacea
Goldenseal --- can also cause photosensitivity reactions from laser light
Kava
St. John's Wort --- can also cause low blood pressure under anesthesia
Valerian

Ephedra ("Ma-Huang") - can cause cardiac arrhythmias, stroke, heart attack, low blood pressure under anesthesia


Since the whole idea of cosmetic surgery is to have a wonderful outcome and to minimize the risk of complications, the problems these seemingly-innocent supplements can cause are just not worth it. Please avoid them - and have a smooth recovery!