We’ve always known that Botox is an effective wrinkle fighter. But now, new evidence shows it can actually prevent wrinkles from forming in the first place. According to research from Dr. Roger Dailey’s group at Oregon Health and Science University (OHSU), patients who begin receiving Botox injections between their 30s and 50s were able to prevent wrinkles from forming in the glabella (frown) and forehead regions, as well as eliminating existing wrinkles. To my knowledge, this is the first time I’ve seen scientific evidence of the long-suspected prophylactic effect of Botox.

In addition, after about two years of regular Botox therapy, Dr. Dailey and associates found that patients could reduce the frequency of Botox® Cosmetic treatments, and still receive most of the same wrinkle-smoothing cosmetic benefits.

Dailey studied 50 women ages 30 to 50, who received regular Botox® injections for two years. “We found that after the patient received Botox® Cosmetic injections every four months for two years, the frequency of the injections can be changed to every six months and still achieve good results,” Dailey said. “This demonstrates patients have the ability to achieve good results with broader treatment schedules and ultimately at a lower overall treatment cost.

Ever wonder how you might look with a Juvederm treatment?

Now you can, with a web-based photo manipulation tool from Allergan, the makers of Juvederm. You can even upload your own photo!

While the simulation is not 100% perfectly realistic, it’s certainly fun to move the sliders around on the screen, and watch wrinkles come and go!

Click here for the link.


Here’s a story from CBS News – it belongs in the “You’ve got to be kidding me ” file. These women had buttock injections from a bogus MD in a hotel room. With bathroom-type silicone caulking. In large volumes. This story did not end well.

Astute (no pun intended) readers of this blog should recognize several “red-flags” already…..


Women Hospitalized After Fake Silicone Injections: 6 Individuals Thought They Were Improving Their Curves But Ended Up Getting Tumor-Like Infections Instead

J-Lo and Kim Kardashian have curves women would kill for. This may have been the shapely image six New Jersey women were trying to achieve when they got injections from bogus medical providers to enhance their behinds, but instead ended up in hospitals with severe tumor-like infections.

“The product used was, first of all, not manufactured with the intention to inject into the body,” Dr. Steven Marcus of NJ Poison Control told CBS station WCBS-TV.

Health officials believe bathroom caulk may have been used in the injections. It’s made from silicone and used to seal cracks in tubs and tiles in bathrooms.

Poison control officials said the women were lucky to be alive. “You could inject this into a vein, and then that substance floating in your bloodstream could damage your heart, your brain, you could have a stroke from it,” Marcus said.

The women, five of them from Essex County, apparently got the injections in motel and hotel rooms. The Board of Medical Examiners was investigating to see if they all got it from the same unlicensed provider.

“I was thinking about doing that,” for a more plump buttocks, said Joan Sorbino of Newark, but she’s thankful she didn’t. “Very scary,” she said.

“If you have somebody whose entire buttock is injected with this material, you occasionally will need to do a fairly radical incision as if it were a cancer,” said Dr. Mark Granick, chief plastic surgeon at University Hospital. “Plastic surgeons don’t inject large volumes of anything in anybody. It’s just not safe. You can have a buttock implant put in. Some doctors will do that, and buttock implants are also well-tested and relatively safe, although they do have a separate set of complications,” Granick said.

With any kind of procedure, you should always check with the American Society of Plastic Surgeons to make sure your surgeon is legitimate.

(Dr. Fiala’s note: In addition, only FDA-approved, medical-grade products should ever be used for any kind of injection. In general, for buttock augmentation procedures, I recommend fat grafting techniques or appropriately designed and approved buttock implants.)

Dysport, as most readers of the Plastic Surgery Blog know, is the new competitor to Botox. Like David taking on Goliath, they have announced an exciting new marketing promotion, called the “Dysport Challenge”. It just started March 1, and runs until April 30, 2010.

It’s actually quite a deal, especially if you are someone who likes the wrinkle-fighting effects of either Botox or Dysport.

Within 14 days after your first Dysport treatment, you must sign up for the Dysport Challenge, download your Dysport Coupon Rebate Form from dysportusa.com (link) and mail the rebate form and itemized receipt.

If you love it, you can get another $75 rebate on your second treatment of Dysport. Even if you didn’t like Dysport for some reason, and prefer the effect of Botox, you can still get a $75 Rebate Check from Medicis, the makers of Dysport, on your Botox treatment!

You must wait a minimum of 3 months between your first and second treatments.
First treatment must occur between March 1 and April 30, 2010.
Your second treatment must occur between June 1 and September 30, 2010.
Itemized receipts must be submitted with forms.

Allergan, Inc. announced today it has received approval from the U.S. Food and Drug Administration (FDA) for JUVÉDERM® XC, which is JUVÉDERM with a little xylocaine added in. Xylocaine, known in the U.S. as lidocaine, is a local anesthestic agent used for numbing the skin, and this should make the injection process significantly more comfortable for our patients.JUVÉDERM® also received their “one year indication” from the FDA, which means they are now permitted to advertise as having “the first and only hyaluronic acid dermal filler approved by the FDA to last up to one year from initial treatment”.

In the clinical study comparing JUVÉDERM XC (with lidocaine) to regular non-lidocaine JUVÉDERM, 93 percent of patients reported less pain when treated with the new formulation of JUVÉDERM, while maintaining a similar safety and effectiveness profile to the non-lidocaine formulation of JUVÉDERM®.

Of course, don’t use this product if you have a lidocaine allergy.


This press release is from our colleagues over at the PSP (Plastic Surgery Practice) website.
******The Physicians Coalition for Injectable Safety recently launched a campaign aimed at reminding consumers that no pharmaceutical filler or injected device is presently FDA-approved for large volume injection to the buttocks.

The popularity and hype surrounding buttock augmentation and other large-volume body enhancing injections on blog sites like RealSelf.com and outside U.S. borders is an alarming and potentially deadly trend, cautions the Physicians Coalition for Injectable Safety. Permanent fillers such as polymethylmethacrylate (PMMA), silicone, and polyacrylimide used in augmenting buttocks and hips can not only result in disfigurement but have resulted in death and serious injuries both in the U.S. and abroad.

The recent death of a woman in Argentina following buttock augmentation was not a result of plastic surgery,” says Brazilian plastic surgeon Joao Carlos Sampaio Goes, MD, PhD, and past president of the International Society for Aesthetic Plastic Surgery. It (was) the result of a dangerous practice with fillers that are not intended to be used in this way.” Buttock augmentation is a hot topic in the media and a popular procedure of surgical tourism,” often performed in countries where standards are less stringent.

Recent headlines of death in the U.S. include cases in Tampa, Florida where an unlicensed, non–medical provider allegedly injected two women with a homemade combination of industrial silicone oil and saline to augment or enhance the shape of their buttocks, and a woman in the Bronx who died after illegal silicone injections resulted in the substance migrating to (traveling) her lungs, producing respiratory failure.”

Wow, that was fast. One prediction – market consolidation – is already coming true.

CnnMoney.com reports that Merz Pharma Group (“Merz”), a privately-held company based in Frankfurt, Germany, is going forward with a buy-out of BioForm Medical, in a $253 million stock deal.

BioForm Medical is the maker of RADIESSE dermal filler. Merz has several fillers used in Europe – but not in the U.S., and is about to come out with a Botox-competitor, named Xeomin.

For patients though, not to worry: Radiesse will still remain in the U.S. marketplace.

This story from WFAA-TV in Dallas / Fort-Worth….Undercover officers raided the home of a Mansfield (Texas) woman who they say was selling “do-it-yourself” wrinkle treatments.

Police confiscated boxes, computers and more at the home of Laurie D’Alleva. Texas Attorney General Greg Abbott charged the woman with illegally offering prescription drugs — including botulinum toxin (Botox) injections — without a license.

The legal action also alleges that D’Alleva operated illegal Web sites to market her products. The state obtained a restraining order to keep her from selling the drugs and shut down her Internet sites, Discount Medspa and Ontario MedSpa.

The sites included video demonstrations of how to use the prescription drugs, along with customer testimonials about the results they were getting. Doctors caution that self-injecting or taking any drug without the authorization of a doctor can be harmful — even deadly.

The state said D’Alleva falsely claimed that her membership in the “Texas Medical Council” authorized her to sell prescription-only products. There is no such organization. According to court documents, undercover investigators bought a “Newbie Starter Kit” from D’Alleva which contained the prescription Restylane in a filled syringe. They also purchased Dysport and Freeze, both of which contain purified neurotoxins, which are used for wrinkle-reduction.

Comment: I don’t know what “Freeze” is – it’s certainly not an FDA-approved Botox product. People must have short memories: remember the “Tritox” business in South Florida, where some self-injectors of a home-brew botulinum product ended up in the ICU on ventilators?

Don’t self-inject. Don’t use unapproved, untested compounds, just to save a few bucks.

Hot off the press….I just spoke with our Allergan reps: we will be one of the select few practices in Florida to offer this unbeatable combo bargain.

Buy Latisse (Allergan’s eyelash growing treatment) for only $99 per box (regularly $120) and receive a rebate of $50 on a Botox treatment performed before the end of November, with the manufacturer’s coupon. Call the office for details, at (407) 339-3222.

Fine print: Limit of 2 boxes of Latisse. While supplies last. Not combinable with other offers.

Here’s an interesting new finding for people struggling with their weight, as reported on BBC News (link), and published in the latest issue of the medical journal The Lancet: in a randomized, controlled study, the injectable diabetes treatment Victoza(liraglutide) helped overweight people lose significantly more weight than prescription Xenical, which is one of the leading weight-loss medications. Victoza (liraglutide) is awaiting FDA approval here in the U.S.A.

This is actually an exciting, unexpected finding, and holds promise for treatment of diabetes, metabolic syndrome and obesity.

In this 20-week European study, 564 individuals with obesity were randomly assigned to one of four Victoza (liraglutide) doses, to placebo, or orlistat. All individuals were given a 500 kcal diet and increased their physical activity throughout the trial.

Participants on Victoza lost significantly more weight than did those on placebo or orlistat. Weight loss increased with the dosage of Victoza, and was 7·2 kg (15.8 lbs) in the high dose group, compared with only 2·8 kg with placebo and 4·1 kg with orlistat. The medication also reduced blood pressure, and reduced the prevalence of prediabetes in the 20 week trial.

If Victoza (liraglutide) does meet FDA criteria, it will be interesting to see whether people will accept the idea of a daily injection for weight loss treatment. With any new drug, it’s also very important to fully understand the potential side effect profile, as well.

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