Answer: Maybe. Lithera, Inc. – a privately held pharmaceutical research group, recently presented some exciting results of a randomized, double-blinded study of their new injectable lipolysis drug, called “LIPO102″ at the ASDS meeting.

In the study, volunteers were injected weekly in 22 locations in the abdomen and flanks with the drug, over 8 weeks. On average, the study group lost about 1/2” more of abdominal circumference than the control group did, without diet or exercise. Computerized 3-D imaging was used to take the measurements.

The fat reduction worked best in patients who were younger than 40 years and relatively thin.

Here’s the interesting part: the ingredients in LIPO-102 are salmeterol xinafoate and fluticasone propionate. Asthma patients might recognize these medicines better as the very same ingredients that are used in Advair, the FDA-approved inhaler. The same beta receptors that are used to help relax the airways for asthma and COPD patients are also found on fat cells, where a beta agonist can trigger lipolysis. Dosing and administration, of course, are quite different between the two products.

Kybella Injections for Double Chin Reduction Before After Pictures

Kybella for Chin Fat Reduction Before & After Photos

Kybella Injections for Double Chin Reduction Before After Picture

Kybella for Chin Fat Reduction Before & After Photos

Lithera isn’t the only group with an injectable agent for melting fat, though. Kythera Biopharmaceuticals is also working on the same concept, with a totally different injectable formula called “ATX-101” (Kybella now FDA approved 2015) which is also in the testing phase.

Impression: All very exciting, but very preliminary stuff. It may be the next generation of non-surgical body contouring, or it may turn out to be more trouble than it’s worth. Much more research is needed.

This week in Orange County, California, the “Botox Bandit” was sentenced to five years in prison for committing multiple burglaries, fraud and identity theft against several Orange County businesses. The California woman got her nickname after using fraudulent checks to pay for more than $3,000 worth of Botox treatments, in addition to a string of other crimes.

Melissa Chesney, 46, pleaded guilty to 21 felony counts, including nine counts of burglary, five counts of identity theft, four counts of forgery, two counts of grand theft, and one count of possession of a controlled substance.

According to the D.A.’s office, Chesney admitted using fake identities and fraudulent checks at six different businesses between February and May 2009. She also admitted to committing burglary and grand theft against a department store in January 2009, and burglary, forgery, possession of a fraudulent driver’s license and possession of methamphetamine in February 2009.

Sounds like her facial wrinkles were the least of her problems!!

Source: O.C. Register

The FDA has approved ceftaroline fosamil (Teflaro), an injectable cephalosporin antibiotic, to treat adults with community-acquired bacterial pneumonia (CABP) and acute bacterial skin and skin structure infections (ABSSSI), including methicillin-resistant Staphylococcus aureus (MRSA).

“These are serious and potentially life-threatening infections for which new treatment options are needed,” said Edward Cox, MD, of the FDA’s Center for Drug Evaluation and Research.

Ceftaroline (Teflaro) was evaluated in 4 separate clinical trials, in patients ages 18 years and older (two each in CABP and in ABSSSI).

In the CABP trials, the effectiveness of ceftaroline was comparable to ceftriaxone, a proven antibiotic.
In the ABSSSI trials, Ceftaroline demonstrated efficacy and safety comparable to the control arm of vancomycin plus aztreonam.

The drug should not be used in patients with sensitivities to cephalosporin antibiotics. The most commonly reported side effects were diarrhea, nausea, and rash.

Source: MedPage Today

Macrolane is an injectable hyaluronic gel product from Q-Med, the makers of Restylane, which is available in Europe, but not in North America yet. Over there, Macrolane has been tried for body contouring applications, including breast augmentation – hence the catch-phrase “boob jab” for an injection of Macrolane to the breast.

In this month’s Plastic and Reconstructive Surgery online is a preliminary publication (ahead of print) of a study from Sweden, looking at a 12 month study of 24 women who had Macrolane VRF30 injected into their breasts for cosmetic augmentation purposes. (Click here for abstract)

Twenty-four women (average age = 37 years) were treated. The Macrolane VRF30 gel, up to 100 cc per side, was injected in the subglandular position with the aid of local anesthesia. Since Macrolane is slowly absorbed by the body, it was fully expected that the results would change over time: at six months post-injection, 83% were pleased with the improvement, and at 12 months, 69% were still considered improved.

While there were no major complications or systemic issues, capsular contracture around the injected material was still the most commonly reported adverse effect, with 25% of patients reporting undesirable breast firmness due to this problem.

The authors concluded that this gel is worthy of further study, and may be an option for patients that want non-surgical improvement of breast volume. Personally, I find the reported 25% incidence of capsular contracture to be a lot higher than I would like to see.

Speaking of HA gels, I’ve often wondered: why not make a breast implant that is filled with a hyaluronic gel, instead of saline or silicone? Might give the feel of a silicone gel implant, but be easy to clean up in case of deflation. Hmmm…..You read it here first, at PSB!

Happy Halloween!!

I am pleased to report that we are trialling Cytori’s PureGraft 250 device. Our goal is to enhance and improve the results of fat transfer procedures with this clever system (seen here).

The FDA-approved device uses a filtering process, called “lipodialysis” (by Cytori), to help clean and filter liposuctioned fat, in order to make it suitable for grafting to other areas of the body. The purified fat is then ready for placement, using a special micro-droplet syringe called the Cytori CelBrush. The PureGraft system is designed to purify the fatty mixture without the need for transferring the fat into a high-speed centrifuge, which is a very time consuming process.

We’re excited about this new gadget. If it lives up to the manufacturer’s claims, it will be a great little tool in the OR!

In journalism, reporters are always excited when they “scoop” the competition – and report on a story before the other guys. So, I’m pleased to report a bit of a “scoop” here. Last May, we discussed the thread lift technique (link here) and commented on how it didn’t work for very long, and how the results were subtle and short-term at best.

Just this week, in the highly respected Yearbook of Plastic and Aesthetic Surgery, I see two reports on threadlifts. The authors note that the results are dismal:

“rates of revision surgery…are high after threadlift”

“time to revisional surgery is short”

“results achieved by threadlift are subtle and short-lived”

“threadlift is not a minimally invasive replacement for rhytidectomy (facelift)”

“the threadlift provides only limited short-term improvement”

Summary: There are surgeons locally that recommend and use threadlifts. Just say no – don’t have threadlift procedures done. The experts feel they are a waste of time and money, as they are quite ineffective and don’t last.


I’m pleased to announce that we’re in the final stages of getting a new booklet ready for our prospective patients. Tentatively titled “Plastic Surgery 101: what you need to know before your consultation”, the e-book will be provided online free of charge to patients that schedule a consultation with us.

It will cover important topics, like:
– how to select a plastic surgeon
– how to evaluate before & after photos
– the importance of Board Certification
– what to look for in a surgery center
– who should not have plastic surgery
– preparing for surgery
– tips for a smooth recovery
– helpful trustworthy online resources

…and more.

Hopefully, our patients will find it a useful primer, answering many questions, and helping to put their mind at ease before they see us for a consultation.

Just another example of “value-added service”!

Congratulations to our friend, supermodel Rachel Lynn. This past weekend, the lovely Rachel won Miss Biketoberfest 2010 at Daytona. That makes three years in a row that she’s won this competition. Far more than just a pretty face, Rachel has serious plans for a future career in anesthesiology, and is working hard on her med school pre-requisites.

See her sense of humor with photos like this one. (link)

Congratulations, Rachel!

According to multiple reports, the FDA today approved the use of Botox, the wrinkle fighter from Allergan, for chronic migraine headaches. (link)

“Chronic migraines” are those that occur more than 14 days out of each month. Botox has not been shown to work for the treatment of episodic migraine headaches, or for other forms of headache. The Botox treatments are given every 12 weeks, which could get quite costly. I’m sure though, that the people that suffer through the pain, nausea and vomiting and light sensitivity of repeated migraines will be happy to have another treatment option.

And they’ll have fewer wrinkles, too!

It’s medical terminology time. Today’s word is “seroma”. Read this, and impress your friends with your knowledge!

A seroma is a fluid collection which may show up after surgery. Different than a hematoma, (which is a collection of blood within the tissues) a seroma is typically a watery, yellow-colored fluid pocket that has accumulated in one main area beneath the skin. Seroma fluid looks a lot like the fluid you would see inside a large blister. Seromas are considered a minor complication – more of an annoyance, really – after surgery.

Surgeries in which large dissection pockets are created, such as a tummy tuck, a body lift operation, a mastectomy, or certain types of breast reconstructions have a higher rate of developing these fluid accumulations. It can happen after liposuction, too. Some times the patient just notices the area getting larger without any particular symptoms, sometimes seromas cause a low-grade burning sensation in the area.

We try to prevent these annoying seromas by several methods: compression, use of surgical drainage tubes, or internal “quilting” sutures. Each surgeon has their favorite method, and there is still debate at plastic surgery meetings about which technique is best. For example, the drain tubes used after a tummy tuck help to prevent a seroma from accumulating, allowing the tissue layers to heal back together correctly.

How do you know if you have a seroma? In the classic case, we look for a “fluid wave” during the post-operative check-up. This is where we lightly tap on the skin in one area, and see or feel the skin moving back and forth (like an ocean wave) somewhere nearby. Big seromas can look like a water balloon jiggling beneath the skin. Ultrasound scans can also be used to detect seromas.

The treatment is to aspirate the fluid. Usually this can be easily done with a needle and syringe, and a little local anesthesia. Once the fluid is out, it looks and feels better.

Seromas seem to occur more frequently in our body lift / gastric bypass patients, but can happen to anyone. Fortunately, for most people, after an aspiration or two, they go away and don’t typically cause any long term issues.

Plastic Surgery In Florida