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Entries in Botox (117)

Wednesday
Aug012012

Increased Botox Longevity With A Zinc Supplement

Botox & Zinc? Does Zinc make Botox last longer?

An American Academy of Cosmetic Surgery news brief has reported that a Houston oculoplastic surgeon, Dr. Charles Soparkar, has come up with a way to make Botox (and presumably all botulinum toxin neuromodulators) more effective and last longer. In a modified double blind, randomized, placebo-controlled, crossover pilot study and a subsequently completed formal study, the duration of effect was increased by 30% in over 90% of the patients studied. The study included both cosmetic and medical indications (blepharospasm, hemifacial spasm).

The theory goes like this: Botulinim toxin is very dependent upon zinc for effectiveness. Unfortunately, 50% of the US population is zinc deficient. Apparently, dietary zinc can be poorly absorbed due to binding elements found in many foods called phytates. Dr. Soparkar’s group posited that adding zinc to the diet of patients having a weak response or short duration of effect to botulinum toxin may be beneficial. Additionally, a phytate munching phytase enzyme was added to increase zinc bioavailability.

The result is a prescription medication called Zytaze. Each capsule contains 25mg of highly bioavailable zinc citrate and 1500 mg of Phytase. Patients take 2 caps daily for four days prior to AND on the day of injection. The drug is supplied in a 10 cap pack and cost $60 - $80. The result has been less frequent and decreased amounts of toxin needed and potential patient savings. (However, does the cost of the drug nullify these advantages?) This is great news for patients and a potential niche offering in the commoditized botulinum marketplace. Maybe not so great for practices depending on a high turnover of renewable products and services. 

Who else has experience with Zytaze?  

Saturday
Jul282012

I Want To Be A Fibroblast!

medical spa md fibroblastWhat criteria is most important when choosing a treatment or technology to stimulate fibroblasts for skin rejuvenation?

Being a dermatologist focused on aesthetic treatment options for improving skin's condition  it's quality and overall appearance I clinically and scientifically overlook tons of different approaches.

Basically, and I think we can agree on this, many treatments try to target the fibroblast. Its about the stimulation of this branched tissue cell who's function is to maintain the structural integrity of connective tissues by continously secreting precursors of the extracellular matrix such as ground substance, a variety of fibers notably the reticular and elastic ones and cytokines.

The goal in many skin rejuvenation treatments is to activate and stimulate the fibroblasts... and there are countless strategies to do this: You might choose chemical peels, energy based devices such as non-fractionated or fractionated resurfacing lasers, intense pulsed light (IPL), infrared light or radiofrequency. One might think of dermal filler substances such as hyaluronic acid or – better – calciumhydroxylapatite (there are even publications on a stimulating effect botulinum toxin type a...). Further one might consider microneedling, dermabrasion, etc..

Or think about "newer" technologies such as platelet rich plasma, carboxytherapy, nitrogen plasma energy, kinetic HA (kinetic Hyaluronic Acid). And last but not least cosmeceuticals (this list is not exhaustive!!).

Which strategy to choose? It's actually very difficult to find way through this jungle!

I would like to encourage and activate the discussion here and ask for your opinion: What are the most important criteria for you when you do your choice? Is it about mangeability, about downtime, about scientific proof, about safety, about treatment protocols (such as e.g. multiple treatments), about clinical experience of other physicians, about availability, about the learning curve, about the deligability, about the costs?

What's your decision maker here?

Saturday
Jul282012

Pioneer Of Non-Surgical Rhinoplasty, Dr. Alexander Rivkin In LA

Dr. Alexander Rivkin is an international authority on non-surgical cosmetic treatments who provides non-invasive and non-ablative treatments in Southern California.

Name: Alexander Rivkin, MD
Clinic: Westside Aesthetics
Location: Los Angeles, CA 
Website: Westside Aesthetics

That's Interesting: After several years of being an Allergan Clinical Educator, Dr. Rivkin was recently honored with Diamond level status: recognition that he is among the top 1% of Botox providers in the nation

He is a prominent member of the national teaching faculties for Allergan, Contura, Johnson and Johnson, Medicis and Bioform. He is also a member of the physician advisory board for Contura and serves on the boards of a number of charities including the Lynne Cohen Foundation for Breast and Ovarian Cancer Research.

I first met Dr. Rivkin somewhere around 2002 when I was attending a "medical spa conference" and Westside Aesthetics was on the tour. At the time, Westside Aesthetics was located above a salon but now Westside Medical Spa is tucked away on Gayley Avenue near UCLA. 

Dr. Rivkin is renowned for non-surgical alternatives to commonly performed cosmetic procedures. He was the first physician in the country to offer the Non-Surgical Nose Job, his signature method for non-invasive correction of cosmetic nasal irregularities.

Click to read more ...

Monday
Jul232012

Dr. Roy Kim - Plastic Surgeon In San Francisco

Dr. Roy Kim San Francisco,Board Certified Plastic Surgeon

Dr. Roy Kim shares his thoughs on social media, marketing, technologies and treatments including the Iguide neck lift system.

Name: Roy Kim, MD
Location: San Francisco, CA
Website: drkim.com

That's interesting: Dr. Kim has gone to Guatemala several times, and he has operated on patients from Rwanda as well. 

Dr. Kim is also an investigator in several elite clinical trials regarding facial fillers, the Iguide system, and cohesive or “gummy bear” implants and is a member of Operation Access, a way for local San Franciscans to get free health care.

You've got a blog on your site, you're on Facebook, Google +, LinkedIn and Twitter. You seem to be comfortable with social media and reaching out to patients online. How much of your marketing efforts are now online and are they working?

Most of my marketing efforts are concentrated on

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Saturday
Jul072012

Dr. Anna Rosinska Of Body Focus Laser & Longevity Center In Midland Texas

Dr. Anna Rosinska Board Certified Physician Midland, TexasOA dermatologist from Poland, Dr. Anna Rosinskas aesthetic practice also offers medical weight loss and wellness medicine in Texas.

Name: Anna Rosinska
Clinic: Body Focus Laser & Longevity Center
Location: Midland, TX
Website:askDrAnna.com

Personally, I’m most interested in integrative medicine, which is the combination of traditional medical therapy with complimentary natural components that address each patient in a holistic way.

That's interesting: Dr.Rosinska was voted a Silver Medalist in Midland’s Top 100 Businesses and Personalities in category for Midland’s Favorite Physician in Year 2008. Dr.Rosinska was also voted a Gold and Silver Medalist in Midland’s Top 100 for 2009 (Best Physician and Weight Loss Clinic) and Silver Medalist in Weight Loss Clinic category in 2010 .

Can you tell us a little bit about how your interest grew in cosmetic medicine?

I always had an interest in weight loss and as one of the very few female physicians at that time in our area I had huge female patient population. My ladies were frequently complaining about

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Monday
Jun252012

Dr. Calvin Lee, Surgical Artistry In Modesto, California

Building and managing a medical spa, vein clinic and cosmetic practice with his plastic surgeon wife is truly a dream come true for this physician.

Dr. Lee, Modesto CA Surgeon

Name: Calvin Lee, MD
Location: Modesto, CA
Clinic: Surgical Artistry
Modesto Plastic Surgery
Websites: SurgeryToday.com, InjectionArtistry.comBigVeins.com

Thats interesting: Dr. Calvin Lee is a regional speaker for Allergan. He has lectured about the Latisse product in Reno, Fresno, Modesto, Santa Rosa, and Napa.

The genesis of Dr. Calvin Lee as an aesthetic physician

I was a busy general surgeon with a heavy load of trauma surgery. Conflicts with my six member general surgery group landed me without a job. This allowed me to reflect upon how I wanted to prioritize my time and my life. I wanted to spend more time growing artistically with my violin. I also wanted to continue making web pages to share information. And most importantly I wanted to spend more time with my wife who is a plastic surgeon. During my phase of soul-searching, I enrolled in a year long Medical Acupuncture course affiliated with Stanford University and added acupuncture to the list of skills that I have.

In 2006, my wife and I started Surgical Artistry which is mainly a plastic surgery practice.

Click to read more ...

Wednesday
Jun202012

Dr. Lisa Lynn Sowder, A Female Plastic Surgeon In Seattle

Dr. Lisa Lynn Sowder

Dr. Lisa Lynn Sowder manages an accredited surgical facility and plastic surgery practice in Seattle, WA.

Name: Lisa Lynn Sowder MD FACS
Clinic: Seattle Plastic Surgery
Location: Seattle, WA
Website: sowdermd.com

That's interesting: Dr. Lissa Lynn Sowder is past president of the Northwest Society of Plastic Surgeons and the Washington Society of Plastic Surgeons, past chair of the King County Medical Society Grievance Committee and former Trustee of the King County Medical Society.

Your operating room is certified by the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF). How much benefit is there for a physician who owns their own surgical suite instead of using other facilities?

The headaches are staffing and supplying the operating room. Equipment needs to be maintained and replaced. Supplies need to be ordered. The floor needs to be mopped, etc. Employees need to be trained. There is a boat load of paperwork necessary for AAAASF certification. Just doing it all right isn’t enough – it all has to be documented and documented and documented. It’s expensive and

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Monday
Jun112012

Botox, Dysport, Xeomin: How Many Neuromodulators Should Your Practice Offer?

Botox, Dysport, XeominWith Botox, Dysport, and Xeomin available and being marketed directly to your patients by thier manufacturers, how many — and which ones — do you need?

In the United States, we currently have three neuromodulator products (Botox - Allergan, Dysport - Medicis and Xeomin - Merz) approved by the FDA for treatment of the glabella complex.

These products are also frequently used “off-label” for treatment of the upper-, mid- and lower-face. Botox has over a ten year-track record of safe and effective use and is the best-selling neuromodulator worldwide. Dysport was similarly approved as a cosmetic treatment in 2009. Of note, a recent injunction against Merz unrelated to safety or efficacy has delayed the nationwide rollout of Xeomin.

Given that we have multiple agents to choose from, there are a number of issues to consider when choosing which neuromodulator(s) to offer to your patients. I’ll focus on Botox and Dysport as Xeomin is currently unavailable and has yet to receive its nationwide rollout pending the legal controversy.

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