Inland Cosmetic Surgery

Allergan Inc announced FDA approval of Juvederm XC last week, the latest filler in the U.S. to contain the anesthetic lidocaine, for increased comfort during injection.

During the FDA approval process, a clinical trial was cited where 93 percent of the 72 participants reported a more comfortable procedure with Juvederm XC. “Before the introduction of Juvederm XC, it often took up to 30 minutes for an anesthetic block to take effect.” said Charles Boyd, MD, Boyd Cosmetic Surgical Institute and clinical investigator in a company news release.

The new filler follows in the footsteps of Prevelle Silk, another wrinkle filler containing lidocaine. In 2008 however, when Prevelle Silk was introduced the response from surgeons was lukewarm. “The issue with a hyaluronic acid filler with lidocaine is that it doesn’t work until you actually start injecting patients, and these injections are so quick, by the time the lidocaine takes effect, you’re almost finished” said Dr. Joe Niamtu to Cosmetic Surgery Times.

Traditional pain control methods (numbing cream and dental blocks) are quite effective, so it may take some time for Juvederm XC to gain popularity, even if it does offer a significant improvement in pain control.

The results cited by Allergan sound great and the safety profile is very similar, so it could really take off. We’ll know more as Juvederm XC finds its way to cosmetic surgery practices here in southern California.

Most of us in Southern California like to start the New Year on a positive note, taking stock of our accomplishments and focusing on things we could improve. If time has etched lines, wrinkles and grooves into your face, finding a solution may be near the top of your resolutions.

Have you thought about Botox?

Botox Cosmetic may be the single most popular non-surgical procedure to reduce or eliminate fine lines.

Wrinkles form gradually

Crow’s feet, lines and even deep grooves appear on our faces over the years, the result of our natural expressiveness, lifestyle habits, and the tendency to move our facial muscles in habitual ways. For instance, you may squint a lot (when you’re concentrating, when you’re worried, when the sun is bright, or when you are trying to focus your vision.) As the years go by, this repetitive motion begins to carve lines in your face and can eventually result in a permanent expression of worry or intense concentration.

We frequently notice these facial lines and wrinkles on friends and strangers alike. At times, we also find ourselves looking at someone and wondering, “Why is she so angry?” or “Why is he so uptight and stressed?” We’re talking about that vertical line that runs down the center of the forehead: one of the most obvious facial flaws, in otherwise attractive men and women.

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A “liquid Facelift” is a non surgical alternative to the traditional face lift, made possible by recent technological advancements in wrinkle fillers.  This breakthrough procedure is a cost effective solution for patients who are concerned about looking tired all the time, and are beginning to see loss of volume in the cheeks and the loosening of the skin.

A Liquid Face lift will rejuvenate the skin to achieve a refreshed and younger look without the expense or downtime of a traditional facelift.  At Inland Cosmetic Surgery we provide expert injections by our experienced and highly trained Surgeons and Physicians’ Assistant.  The Liquid Face Lift replaces lost volume in the cheeks, under-eye hollows, and corrects deep creases in the nasolabial folds and frown line area.  These new generation, long-lasting wrinkle fillers stimulate collagen production and improve skin tone while rejuvenating the skin.

There are various wrinkle fillers that can be used and each Liquid Face Lift is personalized to meet the patient’s needs and provide the best result possible:

• Radiesse is a long-lasting wrinkle filler that instantly adds volume and smoothes the skin while stimulating collagen production.   Radiesse is commonly used for cheeks and jaw line as well as hallows around the eyes.
• Hyaluronic acid fillers like Juvederm or Restylane can be used for enhancing the lips, correcting deep nasal labial folds, restoring the eye area.
• Botox or Dysport is used to treat wrinkles in the forehead, between the eyes, to slightly lift the eyebrows, and to treat crow’s feet.

Give the gift of beauty this holiday season!  Gift cards are available if you want to get a Liquid Face Lift for that special person in your life!

Local 12 news in Ohio recently aired this story to answer the question “What is a Botox Breast lift?”

Reporters explain that while the breast lift has documented results, and Botox is considered practical and effective, the so-called Botox Breast Lift is not a cost effective cosmetic treatment people should pursue.

The most common theory behind the Botox breast lift posits that injections of botulinum type a can relax muscles and affect a woman’s posture in such a way that simulates lifting of the breasts.  Dr. Mark Mandell Brown, a cosmetic surgeon practicing in the midwest, answers the question conclusively:

“Rather than spend four or five or ten thousand dollars on a breast lift, lets do $200-$300 of botox. Are we just throwing away the 300 dollars then? Yes. Is there any research to support that this would be even remotely effective? No. In reality, the tissue’s too heavy for that to happen.”

You can see the video here in the local 12 media center.  To read more about breast lift surgery or botox in Rancho Cucamonga, see our website.

The liquid facelift is basically soft tissue augmentation with injectable fillers, but the goal is to achieve results that are similar to surgery.  Yet the results are said to be “typically more subtle than surgery.”  This topic is getting lots of media attention: Harper’s Bazaar is the latest to pick it up and interview some of the physicians that say they’re doing it.

The Best Beauty section of the Bazaar September issue includes before and after pictures and a discussion of professional techniques for administering injectables.  On their website, you can also view a similar online article with some facts and figures about the most popular wrinkle fillers.

The idea of a liquid facelift isn’t exactly a “touch up” here and there, but a relatively extensive  series of injections.  According to the authors, you can expect to pay at least $3,000 for a full liquid facelift.  A Florida dermatologist by the name of Dr. Fredric Brandt explains, “I resuspend the face with Botox, lifting up the brows, neck, jawline, and tip of the nose and then fill in and replace volume around the eyes and cheeks.”

Wrinkle fillers may be effective for replacing lost volume, and Botox has many excellent cosmetic applications, but it’s difficult (perhaps impossible) to see how either could achieve the skin-tightening benefits of an actual face lift.

The liquid facelift has also been discussed on The Doctors (NBC), Rachel Ray Show, New Beauty Magazine, Dr. 90210, FOX News, Cosmetic Surgery Times, and more exposure is said to be in the works.

While people sound plenty optimistic about the economy this week, competition in the job market is still pretty fierce.  At our Rancho Cucamonga location, we’ve had more than one patient say they suspect that age, or their appearance has affected their job prospects to some extent.

When you’re in competition with young adults fresh out of college, who often accept a significantly lower wage, you need to present yourself in the best possible light.  To get an advantage, many job seekers  turn to their hair stylist for a new look, or their local cosmetic surgeon for Botox or Dysport.

Botox is the most popular non-invasive cosmetic procedure in the country.  According to the American Society of Plastic Surgeons, more than 5 million treatments were done last year.  The cost of a single treatment will vary, and it pays to keep an eye out for monthly specials and events.

If you are going for treatments prior to a job interview, give yourself at least 7 days to heal and let the treatment take effect. Remember, doing well on an interview is not only about how you look, but whether you exude confidence about yourself and your ability to do the job.

It’s true – we’re carrying the brand new Botox competitor, Dysport. Dysport is marketed by the pharmaceutical company Medicis, the same company that brings you Restylane and Perlane.  We weren’t expecting it until mid-July but it’s available in our office as of today. 

If you’re interested, don’t hesitate to give us a call.

Dysport is a neuromuscular wrinkle blocker that has been used in the UK since the 90s.  In clinical studies, Dysport acts much like Botox, though in some areas it is said to work even faster. Dysport was found  safe and effective in a study of over 2,900 patients in 80 clinical studies throughout the country, which led to its FDA approval in May. 

We’re passing some savings along to our patients with the launch of Dysport.  The current price is $4 per unit.  It should be noted that dosing is slightly different for Dysport.  For glabbelar lines (frown lines) the cost is $200. Availability is somewhat limited, so please call our office to schedule treatment now. At Inland Cosmetic Surgery, we will always try to pass on savings from the manufacturers, but we can’t promise how long they’ll last.

A survey conducted by researchers from the American Society for Aesthetic Plastic Surgery (ASAPS) has given us some insight about patients who choose wrinkle treatments. Researchers sent questionnaires last March to 687 patients who had received Botox and/or dermal filler treatment.

The following statistics illustrate the motivations of the ‘typical’ patient. Who is the ‘typical’ patient?  According to the survey results, she is “a married, working mother between 41-55 years of age with a household income of under $100,000.”

• Roughly 70 percent of the respondents claimed that Botox and dermal fillers play an important role in their cosmetic routine.  About the same number of respondents said they used both treatments.
• When asked what their motivation was for pursuing Botox treatment, 34 percent said their appearance looked “stressed” or “angry”. Others said that a friend, family member, or their physician had recommended it, or they were preparing for a social event. 66 percent said they received Botox treatment 2-3 times per year. 72 percent of the respondents chose Botox to treat glabellar lines – the vertical lines that appear between your eyebrows.
• When asked about their motivation to use hyaluronic acid fillers, the majority (63 percent) of patients reported a desire to remove facial wrinkles and folds – mostly the nasolabial folds that travel from the nose to each side of the mouth.

A full summary of the survey results is available (in an MS Word doc) here.

Featured in the latest issue of Archives of Facial Plastic Surgery is a medical study on the safety of the wrinkle relaxing injectable, Reloxin.  The new drug, which is expected to be an alternative to Botox, was evaluated for its use on moderate to severe forehead wrinkles (or glabeller lines).  The results of the study appear optimistic.

While FDA approval has not yet been granted for Reloxin to be sold in the U.S., Medicis Pharmaceutical expects FDA clearance later this year.  They’re introducing Reloxin with the hope that it will be the first direct competitor to Botox, in a market that helped Allergan Inc. net $1.3 billion last year with the wrinkle relaxing drug.

A California dermatologist who was involved in the study commented to Bloomberg news, saying “the side effects are the same as Botox” and “many of our patients liked it even better.”

The active ingredients of Reloxin and Botox are very similar; they each contain a particular ‘botulinum toxin’ that has been proven to relax the muscles that cause wrinkles in the face.

While Reloxin has actually been sold overseas under the name ‘Dysport’ for about 15 years, Botox has still managed to claim over 80 percent of the worldwide market for the neurotoxin.  One market analyst speculates that “Reloxin may be priced 15 percent lower than Botox” which could allow it to take a significant share of that market.

Unless you’re living under a rock, you know that consumer demand for Botox and injectable is still growing. Botox is a common household name and over the last ten years has grown to be a part of our everyday lives.

A recent FDA report reveals 900 reports of adverse events over the past six years. The FDA will also convene a panel of experts to review the safety and efficacy of cosmetic fillers now on the market.

The problems reported to the FDA, although extremely rare, included facial numbness, swelling, and in the worst cases, severe allergic reaction and disfigurement.

Safety is extremely important and we recommend that you have Botox and all injectables with a trained cosmetic surgeon.