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Medical Spa MD is a world-wide physician community for clinicians in skin clinics, laser centers and medspas with thousands of physician members around the world. By using this site you agree to our terms of service and fine print.

Monday
Jan232017

New Botulinum Toxin Undergoing Clinic Trials: Daxibotulinumtoxina

More competition might be coming for Botox, Dysport and Xeomin.

Three cosmetic injectables are currently available in the market (Botox, Dysport, and Xeomin). A fourth one is shaping up as the next competitor against the botulinum toxins. Revance Therapeutics Inc. is gearing up to produce the newest in the botulinum toxin market. The daxibotulinumtoxina is the newest to gain interest.

The neurotoxin is currently undergoing trials since early 2016. It claims that it will have a longer effect on the face against those available in the market. A 2011 study have found the effects of daxibotulinumtoxina for injection (RT002), which shows its efficacy and longevity.

How would this affect the three existing neurotoxins?

So far, Botox is the popular choice of neurotoxin, it being the first and proven effective for treatment of glabellar and lateral canthal lines. Xeomin and Dysport treats Cervical Dystonia and the glabellar lines. Many have expressed their concerns with the existing neurotoxins, most specifically with the possible side effects (e.g. ptosis).

Why does it matter?

Revance will include a peptide technology called: TRANSMTS in their (what they claim) a highly purified botulinum toxin to produce a longer-lasting effect. Aside from treating any aesthetic concern, daxibotulinumtoxina will also treat plantar fasciitis--- which is also undergoing study— and cervical dystonia. The neurotoxin will also come in a topical form.

Peptides have been used also for some cosmetics, with some calling it as an alternative to Botox having anti-aging effects for the face. Most studies regarding peptides are focused mostly on cosmetic products (i.e. make-up).

Botox, Dysport, and Xeomin have been met with their own criticisms from patients and physicians. The daxibotulinumtoxina could be a game changer in the market. Trials are underway for the daxibotulinumtoxina. Not much can be said about the trials but so far, the sample has not experienced any serious or adverse effects. According to clinicaltrials.gov, the study for the efficacy of daxibotulinumtoxina will be released on 2018 at the latest.

References:

http://www.revance.com/pdfs/diffusion-and-duration-of-new-type-a.pdf
https://clinicaltrials.gov/ct2/show/NCT03014622?term=DaxibotulinumtoxinA&rank=4
https://clinicaltrials.gov/ct2/show/NCT02973269?term=DaxibotulinumtoxinA&rank=2

Friday
Jan202017

Dr. Peter Jenkin - Dermatology Associates of Seattle, WA

With more than 30 years of experience in Dermatology, Dr. Peter Jenkin shares how he got into cosmetic medicine and his approach to staffing and marketing.

Dr. Peter Jenkin - Dermatology Associates of Seattle, WAName: Dr. Peter Jenkin
Clinic: Dermatology Associates of Seattle
Location: Seattle, WA
Website: https://www.daseattle.com

Brief Bio:

Dr. Jenkin completed his dermatology training at McGill University in Montreal in 1980. He was in private practice for 20 years in Canada before moving to Seattle and worked for PacMed and Virginia Mason until he purchased Dermatology Associates in January 2010. Dr. Jenkin is an outdoor enthusiast, loves skiing, hiking and racing cars. When he is not treating patients he can often be found speaking about skin diseases at local seminars or visiting his grandchildren.

How did you first get into cosmetic medicine?

My interest was piqued in cosmetic medicine back in the mid-1980s when I started to use a CO2 laser which was followed in 1987 by the development of the first pulsed dye laser. I was always fascinated by the new advances which extended the range of things we could do to help patients with their cosmetic concerns. That trend has been followed by making those treatments less invasive and safer.

None of these treatments were available when I did my dermatology residency...

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Friday
Jan062017

Dr. Jenny Weyler - Aponi Aesthetics, Massachusetts

Starting out as a Primary Care Physician, Dr. Jenny Weyler branched out to aesthetics, exclusively practicing the field since 2010 in our interview with the Physician.

Dr. Jenny Weyler - Aponi Aesthetics, Massachusetts

Name: Dr. Jenny Weyler
Clinic: Aponi Aesthetics
Location: Worcester, MA
Website: http://aponiaesthetics.com/

Brief Bio:

I am a Board Certified family practice doctor, who graduated in 1992 from the Medical College of Pennsylvania (now part of Drexel University) in Philadelphia, PA. I completed my family practice residency in 1995 at the University of Massachusetts in Worcester, MA. I practiced as a primary care physician from 1994-2004, and then worked in an Urgent Care clinic from 2004-2010. In 2010 I started taking classes to learn aesthetic injections, and I opened my own business in December 2010. Initially we did some primary care here, but I loved doing aesthetics so much, and that part of the practice grew so quickly that we became exclusively aesthetic providers in 2014 and changed our name to Aponi Aesthetics.

How did Aesthetics interest you and it influence your practice?

When I was doing primary care I always loved doing procedures: stitches, mole removals, biopsies and any minor surgical procedure. Learning aesthetic injections was a great way to incorporate my love of procedures with the excitement of learning a whole new field of medicine. The results are so obvious, amazing and gratifying. People love the results, so the clients are enthusiastic and how could I not love making people look and feel better? As I honed my skills in injections, I started to learn more about lasers and skin care products and we added that to our repertoire as we went along. I have logged well over 100 hours of direct hands-on training in injectables and laser safety and use, as well as many more hours of lectures on the same subjects. Aesthetics is constantly evolving and advancing, and I love...

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Friday
Jan062017

Dr. Jennifer Trent - American Dermatology Associates, Florida

With more than 10 years of experience under her belt, Dr. Jennifer Trent practices medicine and writes journal articles and text books in Dermatology, in our interview with the Florida-based Dermatologist.

Dr. Jennifer Trent - American Dermatology Associates, Inc., FloridaName: Dr. Jennifer Trent
Clinic: American Dermatology Associates, Inc.
Location: Sarasota, FL
Website: http://www.americandermatology.net/

Brief Bio:

Jennifer Trent, MD FAAD completed a 6 year combined BS-MD at the University of Miami with an undergraduate major in biology and a minor in chemistry. While in medical school, she interrupted her formal course to participate in a 2 year research fellowship in Dermatology at the University of Miami. The focus of her work was hos-pital care of dermatology patients, toxic epidermal necrolysis, and wound care. Dr. Trent graduated from Medical School with research distinction as well as the Univer-sity of Miami Department of Dermatology’s medical student of the year award.

She completed her internship in internal medicine and her residency in Dermatology and Cutaneous Surgery at the University of Miami/Jackson Memorial Hospital. Dr. Trent has presented her research on toxic epidermal necrolysis and methicillin re-sistance staphylococcus aureus several times at the Society of Investigative Dermatol-ogy and the annual American Academy of Dermatology meetings. She was recipient of the Celia and Samuel Resnik Award for dermatology research from the University of Miami Department of Dermatology and the prestigious Young Investigators award for research from the American Academy of Dermatology for her work on toxic epider-mal necrolysis. Dr. Trent has also received several awards for teaching from the Uni-versity of Miami Department of Dermatology.

At what point in your life did you discover your interest in cosmetic medicine?

Ever since I started medical school, I was also fascinated by the skin. How it exists as this beautiful intermediary between the harsh environment and our delicate bodies. It is a strong but vulnerable gatekeeper. During my residency at the prestigious University of Miami Department of Dermatology, I learned that dermatologists are artists. We can “re-sculpt”...

Dr. Jennifer Trent - American Dermatology Associates, Inc., Florida

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Thursday
Jan052017

Labioplasty, Vaginoplasty... Where's The Line Around Genital Cosmetic Surgery

What's going on with the growing trend of labiaplasty and genital surgery?

aesthetic labioplasty

There's been a pretty dramatic increase in genital aesthetics in the last decade. What's up with that? Is it market demand or are aesthetic clinic just getting better at marketing to a deeply personal fear.

In the United States, it's being circulated that a labiaplasty surgeon can earn up to $250,000 a month (which seems unrealisticly high). Simone Weil Davis, professor of American studies, told Shameless magazine in 2005 that surgeons are perpetuating the idea that there is a right way for women's genitalia to look; because most women see only their own vaginas or pornographic images, it is easy to make them doubt themselves, and for cosmetic surgeons to provide an answer.

But not everyone is on the hooha beautification bandwagon...

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Tuesday
Jan032017

Physician Burnout in the Cosmetic Medicine Community

Physicians are under immense pressure, which could lead to exhaustion that may cost their time in the practice but also their patients. In this article, we tackle the causes of burnout in the field of cosmetic medicine.

Physician Burnout in the Cosmetic Medicine Community

It is not uncommon for any working adult to say, “I’m tired, I want to quit”.

Physicians may feel this burden heavier others considering the amount of pressure over a career.

Medscape has done a study on physician burnout and bias last January. Measures of burnout were based on low sense of personal accomplishment, feeling of cynicism, and loss of enthusiasm for work. In cosmetic medicine (i.e. dermatology and plastic surgery), the top reason for burnout is bureaucratic tasks. Other reasons cited were computerization of practice, outcome of the Affordable Care Act, and lower received income.

In an article by dermatologist, Dr. J. Michael Knight, he points out the causes of burnout for aesthetic medicine practitioners (i.e. dermatology and plastic surgery). He further elaborates on the causes also enumerated by Medscape, which contribute to the physical and mental exhaustion of a doctor in cosmetic medicine. Bureaucratic tasks and adoption of telemedicine seem overwhelming to cosmetic practitioners. Time is mostly dedicated to patients, and the growing use of technology in the clinic seems a never-ending race. 

Patients are also a key factor in physician burnout. In cosmetic medicine, old procedures evolve and new procedures are implemented. With the increase of insecurities brought upon by social media and peers, more individuals look to aesthetic practitioners for their source of self-esteem. That demand increases, making it difficult for some physicians to fulfil a patient’s request. That could have a butterfly effect as that one patient could network to more individuals seeking treatment, which could mean less inquiries and walk-ins for new and potential patients. 

As similarly pointed out by the surveyed doctors in Medscape, low income is a cause for physician burnout as well. Some physicians know that costs are piling up, yet are paid less than most. In an example by Knight, they overshadowed by the deals presented by online sites that would entice their patients to purchase cheaper procedures done by non-physicians. Knight adds that it does not help they are working more hours with lesser pay. 

One way to prevent this from happening again is to educate and inform the staff about this occurrence. Acknowledging that physician burnout is important. The fact that other physicians take notice, staff could be made aware of the pressures faced by physicians whether it is medical or practice related. 

Another way is to make time for other activities. It will be difficult considering the demanded number of hours, but it is always recommended to make time for yourself or the activities that you once did which could help take your mind off work. A recommended activity is exercise, as it is one of the best ways to relieve any stress.

Aside from this, Mayo Clinic presented nine strategies to avoid burnout and you could find the resource here: http://www.mayoclinicproceedings.org/article/S0025-6196(16)30508-0/pdf

Article Links:

http://modernaesthetics.com/2016/06/physician-burnout-careers-in-crisis-part-1
http://www.medscape.com/features/slideshow/lifestyle/2016/public/overview
http://www.medscape.com/features/slideshow/lifestyle/2016/dermatology
http://www.medscape.com/features/slideshow/lifestyle/2016/plastic-surgery
https://wire.ama-assn.org/life-career/avoiding-burnout-strategies-senior-physicians
http://catalyst.nejm.org/physician-burnout-endemic-healthcare-respond/
http://medicaleconomics.modernmedicine.com/medical-economics/news/what-price-physician-stress-and-burnout?page=0,0

Tuesday
Jan032017

Patients Do Better With Female Physicians?

Female doctors patients may have lower death and readmission rates. Does that have any relevance to your clinic?

JAMA Internal Medicine published a study about patients favoring women as their doctors. The study is centered on readmission and mortality rate among the elderly. The authors selected random data, in which a third of the physician sample were female. 

For the study, researchers examined hospital readmissions and mortality data for a random sample of traditional Medicare beneficiaries 65 or older who ended up in acute-care hospitals from Jan. 1, 2011, through Dec. 31, 2014. Those data consisted of slightly more than 1.5 million hospitalizations, in which patients were seen by 58,344 physicians. About a third of those physicians were women.

The researchers adjusted the data to account for different characteristics of hospitals and patients, as well as physician characteristics that were not based on sex, such as experience level. These types of adjustments ensure that the study's findings do not simply reflect a situation where male physicians are seeing sicker patients, for instance.

The female physicians tended to be younger––their average age was 42.8 years, compared with 47.8 for men. They also were more likely to have training in osteopathic medicine and to have treated fewer patients.

Findings:

  • Patients treated by women had mortality rates of 11.07%, compared with 11.49% for those seen by men.
  • Readmission rates were 15.02% among those seen by women, compared with 15.57% for male physicians.

Dr. Ashish Jha, co-author of the study, also can’t figure out the discrepancy, raising concern about how men could be thought of not being better practitioners. In addition, he suggests that issues like gender and pay gaps should be further discussed finding the latter unacceptable. 

In the case of cosmetic medicine, a study by Huis In ‘t Veld; Canales; and Furnas, with the latter two being plastic surgeons part of the research as well. The sample consisted of 200 patients, all of which were female. In addition, the study delved in which areas of concern that the patients want to undergo on.

Study findings:

  • Among the sample, 26% chose a female surgeon, and another 12.5% chose the female surgeon (Furnas) in the study
  • Area of concern for those who favored a female surgeon: breast, body, face, and genitalia
  • Generally speaking, gender did not matter so long as the surgeon had a reputation and experience

In another research, a study was published in 2015, modelled from an older study conducted to British patients. The sample consisted of 515 women, with only 500 accomplishing the provided questionnaire. Similar to the above research, gender also did not matter as knowledge and experience were the major factors for choosing surgeons as well. 

Study findings:

  • Among the sample, 190 patients preferred female surgeons.
  • More than half (59%) had no preference to which gender. 

This raises the question as to why patients choose female physicians, which could pose a gender gap issue in practicing physicians. For cosmetic medicine, a reason linked for female patients choosing female doctors is due to the intimate areas of the body. In addition, patients favored female doctors because of more comfort and lesser embarrassment. 

Studies cited:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5131538/
https://www.ncbi.nlm.nih.gov/pubmed/27913412
http://www.modernhealthcare.com/article/20161219/NEWS/161219912

Sunday
Jan012017

Dr. Bertha Baum - Hollywood Dermatology, Florida

Dr. Baum shares how she got into cosmetic dermatology and some management and marketing tips for fellow physicians in our interview.

Dr. Bertha Baum - Hollywood Dermatology, Florida

Name: Dr. Bertha Baum
Clinic: Hollywood Dermatology
Location: Florida 
Website: www.drbaum.com, www.hollywooddermatology.com

Brief Bio:

Dr. Bertha Baum is a Florida based board certified dermatologist & cosmetic surgeon, considered a skin care expert who provides her patients with the most current and advanced treatments for all conditions which affect the skin, hair, and nails. Throughout her career, Dr. Baum has built a reputation as a top cosmetic dermatologist by providing leading-edge treatments, dedicated and personalized patient care, and excellent aesthetic results.

What can you tell us about Hollywood Dermatology?

We do a lot of internal marketing, for example once or twice a month we run an event and a promotion for our loyal or VIP patients. Also we offer our patients the benefits of the Brilliant Distinctions program or the Galderma Aspire rewards. We have done some marketing on local magazines but we truly believe in word of mouth because our patients are satisfied and they send more patients and thats our success. We have Instagram and Facebook and try to be as active as we can promoting new procedures or the latest in skin care products.

Dr. Bertha Baum - Hollywood Dermatology, Florida

We do a lot of Botox, Dysport and some Xeomin; also all the fillers available in the market. Laser can be a big source of profit once the machine is paid because you are able to charge and not pay for the product. Plasma PRP is also another great source of income with excellent results

We still do clinical dermatology in our office so it was a very busy day at the office and I told one MA that was not with me in the rooms at that moment to get blood from a patient for plasma. After 5 minutes I go back into a clinical derm patient it was actually a full body exam and their first visit and I see the patient had a band aid on her arm freshly placed and as soon as I introduced myself she says “wow I’ve been to a lot of Dermatologist and they have never done bloodwork on my first visit, you are very thorough.” I realized that the MA had done in on the wrong patient and explained to the patient there had been a mistake, thank God the patient understood the situation and then told the MA she had gone to the wrong room to get bloodwork for plasma. I’m grateful this was not a big mistake but we definitely learn from...

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