Credit: Flickr/Mulad

Christmas is just a few days away and shoppers’ emotions are running high as they ransack malls searching for the perfect last minute gift idea . Finding the perfect present for the man or woman who has everything can be stressful, especially when time is scarce. But surprisingly enough, this year’s gift giving dilemmas could be solved with a simple call to a local plastic surgeon’s office.

More and more men and women are choosing to purchase gift certificates or surgical consultations for loved ones this Christmas. Popular procedures such as breast augmentation, liposuction and Botox injections are topping many Christmas lists this year according to Tampa based plastic surgeon Dan Diaco, MD.

“It makes a wonderful present. Most girls are very, very, very, happy to get something like this under the tree,” says Diaco.

Men are also happy recipients of plastic surgery gifts for Christmas. According to Diaco, the most requested procedures for men are Botox injections, frequently referred to as “bro-tox.” Men also lean towards chemical peels which can treat a variety of superficial skin problems such as sun damage and fine wrinkles, as well as Juvederm injections which can reduce moderate to severe facial wrinkles and add volume to the skin.

Diaco insists that the end results are priceless: “Their face lights up. They get excited. It changes their lives.”

Plastic surgery may be the perfect gift for your “someone special” this year, but remember that it’s important to seek out a board certified plastic surgeon. Thorough surgical consultations and evaluations are essential to determine if a patient is an ideal candidate for plastic surgery.

If you’re planning to give the gift of cosmetic enhancement this year, it’s best to give an envelope filled with informational brochures because in most cases, you will not be able to purchase the procedure without a patient consultation first.

Source: WTSP News

While plastic surgeons in the past had largely used Restylane for its previous FDA approved treatment of lines and wrinkles, this new approval opens up the doors for Restylane lip augmentation. Previously, though it was not FDA approved, plastic surgeons could use the injectable for Restylane lip augmentation, as an off-label treatment.

This announcement comes after the release of findings from a recent study of Restylane lip augmentation treatments. In the study conducted by 12 doctors, it was found that Restylane was “well tolerated and highly effective for lip augmentation for up to six months.”

When measured on several points, researchers found Restylane lip augmentation to be effective and long lasting. The effects of the treatment are said to least up to six months for many patients. Those patients who participated in the study were so pleased with the results of their Restylane lip augmentation, in fact, that 80% of them chose to undergo another treatment after six months.

Restylane is an injectable gel comprised of hyaluronic acid, a key hydrating component of your skin. When injected beneath the surface of your skin at the site of a wrinkle, Restylane provides immediate correction. During a treatment for thin lips, your plastic surgeon will inject a specific amount of the product into your upper and sometimes lower lip. This form of Restylane lip augmentation will provide immediate volume to your lips, creating a larger kissable area.

If you struggle with thin lips, we encourage you to learn more about Restylane lip augmentation in Bellevue. Please join the mailing list of plastic surgeon Dr. Leff to find out about specials on Restylane and other non-surgical treatments.

While there is no definitive evidence that using Botox to prevent wrinkles is effective, experts say that over the last few years there has been an increase in the number of 20-something patients who are getting Botox, Dysport and other injectables to try and ward off future wrinkles.

Statistics from the American Society for Plastic Surgeons show that in 2010 almost 78,500 people in their 20s received Botox in this country, an 11 percent increase from 2009.

So what do the doctors think? Plastic surgeon Arthur Perry thinks the concept of trying to prevent future wrinkles is “nutty.”

“You don’t want to use a drug unless you need the drug, and Botox is a drug,” he said.

Brian Glatt, a plastic surgeon, finds that regular use of Botox seems to make the muscle-relaxing effect last longer so patients don’t need to come in as often for treatments. This may occur because the muscle undergoes atrophy, or wasting, after prolonged periods of not being used, Glatt said, which could mean that wrinkles wouldn’t form as easily on a young person who has had treatments for years.

Also, if Botox is used regularly, the wrinkles that return when it wears off may not be as severe, said Glatt.

However, Perry feels that even if Botox was proven to prevent future wrinkles, it should not be used for that purpose. “It makes no sense whatsoever to do that,” he said.

Plastic surgeon Steven Pearlman goes by what you could call the “rest test.” He said to wait until lines show up before getting Botox. The wrinkles must be there when your face is at rest, not contorted through smiling or grimacing, he said. “Unless someone has lines at rest, they’re not a candidate for Botox.”

So how can you prevent wrinkles? Two of the best ways are to wear sunscreen and avoid smoking, according to the experts.

When looking at a group of 50 women, aged 30 to 50 who were being treated for glabellar lines, the study found a decrease in treatments did not yield a decrease in results. The study discovered that after a patient has undergone regular Botox treatments every four months for two years, the frequency can be lowered. The frequency of how often to get Botox may not dramatically effect its effectiveness.

In fact, the study found that patients who had completed the initial two-year treatment and then received Botox injections only every six months achieved similar results. This is when compared to those who continued receiving Botox treatments every three months.

Though Allergan, the maker of Botox, may still recommend continued treatment every three months, those looking for a cost-effective alternative could reduce the number of yearly treatments.

As an added benefit, the study found that the patients in the age group also experienced a reduction in the formation of wrinkles when Botox use was continued past two years.

Study researcher David R. Neal, PhD, a psychology professor at the University of Southern California, said, “If you have a poker face because your facial muscles are paralyzed, you can’t read others emotions as well.”

However, even Neal admits that it’s a “fairly subtle” effect. “People are not becoming automatons. It’s just a matter of weighing whether the aesthetic and self-esteem boost outweighs any subtle impact on your ability to perceive others emotions,” he added.

In the study, women who had their facial folds treated with Restylane were able to read others’ emotional states with about 77% accuracy, while those who had Botox had 70% accuracy.

Why would Botox have this effect and not other fillers? According to Neal, evidence suggests that people use mimicry to register and label the emotional states of others, so something that limits one’s ability to reproduce another person’s expression of emotions, such as Botox — which has a paralyzing effect on facial muscles in the immediate vicinity of the injection site — would likely impair one’s ability to register or label those emotions.

Andrew Jacono, MD, a facial plastic surgeon in New York City who reviewed the study, said that the findings likely only apply to those who use excessive amounts of Botox.

“When Botox is overdone, it doesn’t look right and people aren’t perceived in the right way,” Jacono said. “The goal is to try to make sure when you get Botox, it is done in a subtle way so you can look better and maintain your ability to emote and read others.”

“It’s a toxin-free alternative to treating unwanted lines and wrinkles, similar to what is being done with Botox and Dysport,” said study co-author Francis Palmer, director of facial plastic surgery at the University of Southern California School of Medicine in Los Angeles. He added that in the early clinical trials the procedure appears to have the same clinical efficacy and safety comparable to the existing techniques.

To perform the procedure, which takes about 15 minutes using local anesthesia, doctors use small needles that deliver cold to nerves running through the forehead. The cold freezes the nerve, which interrupts the nerve signal and relaxes the muscle that causes forehead lines. The technique does not permanently damage the nerve, Palmer said.

Researchers said they are still refining the technique but that the results last about the same amount of time as Botox, which works for about three to four months. However, unlike Botox, which takes a few days to kick in, the effects of the cryotechnology are seen immediately, according to the researchers.

The current study had 31 people, all of whom had fewer wrinkles after two to eight injections, and the level of discomfort was comparable to that from Botox or fillers, Palmer said.

If this new technique is eventually approved by the FDA, it would offer consumers an alternative to a neurotoxin injection for getting rid of forehead wrinkles. Statistics from both the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery for 2010 showed that Botulinum Toxin Type A, which includes Botox and Dysport, was the number one non-surgical cosmetic procedure.

The company will eventually seek FDA approval, but it might seek approval in Europe first.

Dr. Joel Schlessinger presented the findings at the American Society for Dermatologic Surgery 2010 Annual Meeting. His results were of a subset analysis of a phase 3 clinical trial designed to evaluate the effectiveness of Dysport.

An analysis of the Dysport group, made up of 1160 participants, found that 19.7 percent of the patients responded to Dysport on day one. Three days was the median response time to Dysport treatment. The study was not a comparative one with Botox; the other group was placebo.

“There are many different neurotoxins out there, and they have different types of effects on the injected individual, depending on the physical and molecular makeup of the neurotoxin,” said Dr. Schlessinger. He went on to say that Dysport appears to take effect faster than Botox, by about two days. “That can be very helpful for a person who is looking for a faster onset, especially if [he or she] has a social function coming up,” he said.

The “study that validates what clinicians have observed clinically with the use of [Dysport] with regard to its early onset of action in many patients,” said Dr. Elliot Weiss, from the Laser and Skin Surgery Center of New York in New York City.

Contact Dr. Leff at Overlake Plastic Surgeons to learn more about non-surgical options.

Three injectables received FDA approval in February 2010 for lidocaine versions in the U.S.:

• Juvederm XC
• Restylane-L
• Perlane-L

The products performed similarly to their lidocaine-free predecessors in terms of efficacy and safety, according to Dr. Michael H. Gold, a clinical assistant professor of dermatology at Vanderbilt University School of Medicine and School of Nursing.

In the clinical trials, he says, “the incorporation of lidocaine has surely provided a higher comfort level for patients.”

Dr. Gold says that, based on his clinical experience, when a patient undergoes an injection that includes even a small percentage of lidocaine, “Most patients say they barely feel the second stick. To me that is the home run of lidocaine in these fillers.”

Patients were blindfolded in the 72-patient trial of Juvederm XC, and their nasolabial folds were treated with either Juvéderm or Juvederm XC. Patients assessed pain levels during treatment and then 30 minutes and 24 hours post-treatment. Ninety-three percent reported less pain when treated with the lidocaine version versus the non-lidocaine version of Juvéderm.

A method for doctors mixing lidocaine with Radiesse was also cleared by the FDA in July 2009. “Originally, I was against doctors mixing a lot of fillers because I was afraid of potential changes in the products themselves,” says Dr. Gold. But once the FDA clears these products, especially those premixed by manufacturers, “I’m pretty comfortable with it.”

Dr. Leff offers Juvederm XC, Restylane-L, and Perlane-L procedures, as well as the non-lidocaine versions of the fillers, at his Bellevue office.

The full article, “Fillers with lidocaine among latest injectable advancements,” is available at Cosmetic Surgery Times.

Just like the regular Restylane formula that has been available for years, Restylane – L is made with clear stabilized hyaluronic acid gel, a natural substance that already exists in the body.

To reduce the discomfort of injection, the anesthetic lidocaine has been added.  In clinical studies of Restylane–L, 71 percent of the 60 participants reported less pain after injection into the nasolabial fold than with Restylane alone.

Restylane L and Perlane L are now available in Bellevue.  Contact us for more information.

The American Society of Plastic Surgeons just released their 2009 statistics.  In collaboration with Seattle-based company RealSelf.com, the society says that plastic surgery is up 69 percent for the decade and “consumer interest continues to rise.”

Given the economic situation and the fact that elective surgery is typically considered a luxury purchase, these are strongly positive statements by both parties.

Minimally invasive procedures appear to be the driving force behind the 10-year trend.  Procedures like Botox, Injectable Fillers, and Laser Skin Resurfacing have increased 99 percent since the year 2000.  People have many reasons to visit their plastic surgeon these days.  One of the biggest reasons is skin renewal.  “Skin is in,” says ASPS President Michael McGuire.

Read more from the ASPS on PlasticSurgery.org and check out the RealSelf blog for more information on this story.