Top 5 Medical Spa Treatments In 2011

The top nonsurgical treatments in 2011?

1. Botox: 5.7 million treatments (up 5% from 2010)
2. Filler Injections (Juvederm, Restylane, Perlane, etc) 1.9 million treatments (up 5% from 2010)
3. Laser Hair Removal: 1.1 million (up 15% from 2010)
4. Chemical Peels: 1.1 million (down 3% from 2010)
5. Microderm: 900,000 (up 9% from 2010)

Source: American Society of Plastic Surgeons

An Interview With Dr. Mary Lupo Of Lupo Center For Aesthetic Dermatology

Since 1983, Dr. Mary Lupo has been at the forefront of non-surgical skin rejuvenation.

As the founder of Tulane University's resident's cosmetic clinic, a Platinum plus Botox and Juvederm provider, and a clinical instructor for Allergan, Dr. Mary Lupo knows her way around injectables. In fact, she launched Botox to physicians in Austrailia in 2007. We wanted to hear what Dr. Lupo has to say about how she manages her dermatology clinic and her lifestyle as a physician.

Name: Mary P. Lupo MD FAAD
Location: New Orleans, LA
Website: drmarylupo.com/index.html

That's interesting: Dr. Lupo received the Peterkin Award for original research in skin lipids and inflammation in patients with atopic dermatitis. Author of over 50 publications and presentor of over 230 presentations. Researcher, author, lecturer, teacher. Founding co-director of the Cosmetic Boot Camp in 2005. Past-president of the Women’s Dermatological Society and former member of the board of directors of the American Society for Dermatologic Surgery.

Click to read more ...

Warren Seiler MD, A Laser Center & Medical Spa In Alabama

Dr. Seiler is a speaker, preceptor and physician trainer for Lumenis Laser Company and injection trainer for Allergan (manufacturer of Botox & Juvederm).

Birmingham Alabama is home to Seiler Skin, Cosmetic Laser Center & Medical Spa, a single-physician clinic run by Dr. Warren Seiler and his wife. We sat down with Dr. Seiler to find out what he thinks of the current crop of cosmetic lasers, how he runs his clinic, and hear what advice he has for other physcians.

Name: Dr. Warren B. Seiler III
Location: Homewood, AL
Website: seilerskin.com

That's interesting: Dr. Seiler is a Board Examiner and the Executive Director of the American Board of Laser Surgery and co-author of the ABLS examination text book and board certification exam.

As a single physician owner, how does your clinic operate?

My practice, Seiler Skin Cosmetic Laser Center, is a single physician driven cosmetic practice. I personally perform the laser and injectable procedures. I have a very good medical aesthetician working directly under me who helps patients with skincare programs, Hydrafacial, chemical peels, and laser hair removal. My wife is our marketing and website director and she is co-owner with me in the practice. We run the practice together, but we have an office manager that helps.  I perform fractional CO2, Fraxel, Thermage, Laser Hair Removal, Laser Spider Vein treatments, IPL, and others. Botox and Juvederm are the only injectables, although I have tried many others, I feel they are the best. Our practice is really the only one in Birmingham in which the physician specializes entirely in cosmetic laser procedures and nothing else, which really helps to offer the experience that I provide.  

Click to read more ...

Can Nurse Practitioners Offer Botox?

By Carolyn Buppert, NP, JD

Can Nurse Practitioners offer Botox, Restylane, Juvederm and other cosmetic treatments on their own?

The answer to this question is going to be state-specific. Here are the steps to follow:

1. Read your state's Nurse Practice Act section on scope of practice for nurse practitioners to answer these questions: What acts require physician collaboration or supervision? How is collaboration or supervision defined? (Boards of Nursing in the United States: State-by-State Web Links)
2. Go to your state's Board of Medicine Websites and search for any policies on provision of botulinum toxin (Botox®). Note that botulinum toxin is a prescription medication, so a prescription or order for the medication must be written and someone must administer the drug. If your state has policies on botulinum toxin, note the requirements for prescription and administration. Some states consider administration of botulinum toxin a medical act, and some states consider it to be within the scope of a registered nurse. Prescribing is always a medical act.
   
   If you live in a state that requires no physician collaboration when nurse practitioners prescribe, then as long as the Board of Medicine has no requirements with respect to botulinum toxin, you are free to proceed with your practice idea. If your state requires physician collaboration in order for nurse practitioners to prescribe, then you'll need to line up a collaborator. In most states, the collaborator does not need be on site, but in some states, the collaborator must practice at the site with specified frequency. Follow the rules as they relate to any prescribing.

About: Carolyn Buppert, NP, JD is an attorney practicing in Bethesda, Maryland.

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Allergan Q1 Profits: Botox, Dysport, Juvederm Ultra XC

Allergan's Q1 Earnings Call: Allergan's thoughts on it's Botox and Juvederm Ultra XC growth.

You might want to visit our Select Partner Medical Spa RX after reading this.

First quarter sales increased year-over-year 11.2% in dollars and 6.9% in local currencies, boosted by the strong pickup in the sales of medical devices, which grew 18.4% in dollars and 13.4% in local currencies. The growth in the Medical Aesthetics businesses was even stronger outside the U.S. in all regions and across a wide range of countries, with surprisingly strong performance in Europe.

Operating performance was strong, with non-GAAP earnings per share at $0.65, marking an increase of 18.2% versus the result for Q1 of 2009, and comfortably exceeding the Q1 expectations shared with you, the investment community, of $0.57 to $0.59.

Earnings growth was driven by strong gross margin expansion, especially in the Medical Device segment. Careful spending in the selling, general administrative area, whilst we increased investment in R&D by 11.1% on a non-GAAP.

Within SG&A, we however doubled our DTC expenditures versus Q1 of 2009, which of course was the low watermark for spending when the world economy was in crisis. Our plan is to continue to invest in 2010 across our brands and into the recovery of our markets.

During the quarter, we were pleased that we continued to strengthen our R&D pipeline, supplementing our internally development programs with acquisitions and licenses. In January, we acquired Serica, a company with proprietary technology for use in tissue regeneration especially applicable to breast reconstruction, as well as the license for Ser-120 in Phase III clinical development for nocturia. Strategically, we have made good progress in building up a portfolio of urology assets.

We also furthered our aspirations to be the leader in medical aesthetics also in Asia, by reacquiring the rights to BOTOX Cosmetic in Japan and China and expanded our footprint in fast-growing emerging markets by establishing direct operations for all of our businesses in Turkey, effective from the second quarter.

After the out-licensing transaction with Bristol-Myers for neuropathic pain, we've increased our degree of R&D focus on our core specialty areas.

Now I’d like to comment on our expectations for 2010. For the full year earnings outlook, we have brought up the bottom of the EPS range by $0.02 to $3.11 and have left the top end of the range at $3.15 which at the time of the last earnings call expressly excluded the costs of any healthcare reform bill in the United States. With the increase of the Medicaid rebate, extension to managed Medicaid and expansion of eligible hospitals in the so-called 340B program, we estimate that the cost of healthcare reform in 2010 will be approximately $12 million. This is now included in our outlook.

Turning to BOTOX

Sales growth has picked up relative to trends seen across 2009, with growth versus the first quarter of 2009 at 11.3% in dollars and at 6.6% in local currencies. Sales of $331 million were only modestly lower sequentially than Q4, which is always seasonally the highest quarter of the year. Most of this increase was due to the more economically sensitive aesthetic side of the business, as the benefits of the upper-limb spasticity FDA approval in March occurred too late in the quarter to contribute to our sales results.

Outside the U.S., we enjoyed very strong double-digit increases across a wide range of countries, with surprisingly strong growth in several of the main European markets. These global markets are precisely where we are successfully dealing with multiple competitors.

It would therefore seem that the market is recovering as we can measure our market share with only a short time lag. In Europe, on the aesthetic side, we’re holding share at just under 80%, as we deal with the incursions of both Merck’s, with their Zymine and Bocatua [ph] brands and Galderma with Azzalure.

On the therapeutic side, it seems that most of ZMM’s market share gains have been at the expense of Dysport. In the U.S., BOTOX sales growth is less buoyant, as there was no base of Dysport sales in the prior year, but it is clear that the market is growing again.

We estimate that in the aesthetic market, Dysport had somewhere between 13% and 14% share in the first quarter. We'll be curious to see the lasting impact of the Dysport Love It or Leave It promotion after it terminates at the end of May.

In the therapeutic market, Dysport’s share is so far negligible, given the long history and experience of BOTOX use. In Europe and the U.S., we have recently introduced a 200-unit vial, which is useful for injectors treating large muscle groups, as well as for differentiation from competition. Regarding global market share for the fourth quarter, the last quarter for which data is available, we estimate that BOTOX held 79% share in a market growing 13% year-over-year.

Regarding the clinical program for BOTOX for chronic migraine, the clinical trial results of our PREEMPT program were published in Cephalalgia, the journal of the International Headache Society. Regarding facial aesthetics, we've experienced an even stronger rebound in sales than observed with BOTOX. Dermal filler sales grew year-over-year, a very strong 42.4% in dollars, and 34.5% in local currencies, with great growth in all operating regions of the world, with Europe again surprising on the upside.

Juvederm & Juvederm Ultra XC

In the U.S., we've seen huge growth in the JUVÉDERM line since the launch of JUVÉDERM Ultra XC, this is the lidocaine-containing product, in early February. Although we have gained some market share, it would seem that the market is responding strongly to the reduction in treatment pain experienced with this lidocaine-containing product and already a substantial share of the mix is attributable to JUVÉDERM Ultra XC.

We have just initiated print advertising for JUVÉDERM XC and have a PR campaign with TV host Dayna Devon, as our spokesperson to further drive growth. In Europe, we launched new additions to the JUVÉDERM product line, JUVÉDERM Smile at the IMCAS Conference in Paris in January and JUVÉDERM Hydrate at the Anti-Aging Conference in Monaco in March. JUVÉDERM Smile was also approved in South Africa, JUVÉDERM XC in Korea and JUVÉDERM Ultra Plus in Taiwan.

Voluma was recently launched in Brazil and also approved in Taiwan.

Based on our analysis of the world market in Q4, which we estimate grew 12%, it is clear that global market growth has accelerated since then. Our analysis also points to JUVÉDERM market share gains in all regions of the world. Beyond superior product performance characteristics, Allergan also benefits from having full product line.

At the end of the first quarter, Allergan's cash and cash net of debt positions totaled approximately $2 billion and $471 million, respectively. Allergan continued to maintain exceptional cash flow generation capabilities in the first quarter, with operating cash flow after capital expenditures of approximately $161 million, an increase of approximately $56 million over the first quarter of 2009.

Restylane Big Lips Overdose

If you're looking to see what a Restylane or Juvederm lip filler overdose looks like... well, then look no further.

This collection of lip augmentation overdoses is brought to you from Russia, where it looks like you can buy your Juvederm or Restylane wholesale and it's sold in 2-liter bottles.

Plastic surgery is booming thru Russia and it appears from these lip augmentation photos that the natural look isn't really in. There are enthusiasts in Russia tracking down Russian ladies with poor results on social networks and publishing them in special communities, sometimes making fun of them, but sometimes admiring their marvelous lips.

Click to read more ...

Medical Spa RX: Botox sales through November.

Here's a chart showing the number of wholesale Botox, Dysport, Restylane, Juvederm and Sculptra orders through MedicalSpaRX.com since the site was launched. You'll see immediately that the number of individual orders per month is growing dramatically.

The numbers above show just how good physicians are finding Medical Spa RX's service and pricing. Almost everyone who's placed a 'test order' of a single vial of Botox as I've suggested before has come back within the next 30 days and placed additional orders, adding to a growing number of physicians who are using RX for the majority of their filler and Botox. (308 orders in November and 87% growth over October.)

I've received some email questions about Medical Spa RX and how it works. Here's some info.

Medical Spa RX is a Select Partner of Medical Spa MD. The RX site an exclusive portal made available exclusively for Medical Spa MD Members to harness the collective buying power of a community of more than 4,000 physicians worldwide.

This exclusive arrangement means that Medical Spa RX has access to a large community of Medspa MD Physician Members, and those same physicians have collective buying power that they don't have by themselves. This large community means that RX can price 100mu of Botox at wholesale prices, much lower than they normally sell it for.

And we've been extremely diligent in makeing sure that Medical Spa MD Members are being taken care of. As far as I'm aware we've never had a single complaint about Medical Spa RXs service or products.

I should note here that Medical Spa RX and Medical Spa MD are completely different entities. Medical Spa RX is a Select Partner who offers exclusive services to our Members. (Any technology provider or service company who can provide meaningfull value to our Members is welcome to apply.)

For those physician or medical spa Members who have not yet ordered your Botox through Medical Spa RX and are in a position to do so, I'd highly recommend giving them a chance by placing a small test order of whatever you use most, Botox, Restylane, Juvederm of Dysport. You can see clearly from the chart above that physicians are obviously ordering more and more.

We're ecstatic that Medical Spa RX is doing so well for our Members and hope that other technology and service providers will make their offerings available to our community. We're actively seeking additional parthers to help. If you're a reputable company who would like to apply to become a Select Partner, please contact us using this form. (You'll need to provide significant benefits to our Members.)

Note: Any post mentioning Botox on Medspa MD is a spam magnet. Spam will be ruthlessly deleted and the spammer reported and blocked.

Medical Spa MD: Filler Injection Tips (Restylane, Juverderm)

 Restylane, Juverderm and filler injections tips for physicians running medical spas and laser clinics.

The following is from a string of emails that were circulating among some of Medical Spa MDs Members. I've edited this somewhat to make it readable and get rid of all the extraneous copies. I'm also not displaying the identity or email addresses of the physicians in this thread.

Please leave your thoughts below as a comment.

Note: Some of the comments below might be out of order from the original thread. Emails' somewhat difficult to follow as a thread but you'll get the gist.

Filler Injection Discussion & Tips: Restylane | Juevederm | Evolence

1.  When I use the "push ahead" technique, I feel that I get better "plumping" per cc of filler.  I learned this from Kevin (thanks Kevin).

 

2.  When I use the "push ahead" technique, the filler fills a few millimeters in front of the needle tip.  You need to realize this to be able to put the material exactly where you want it.  Sometimes you have to "feel" the injection because you can't "see" the plumping.

 

3.  I mix 0.1 cc of lidocaine with epinephrine with my Juvederm.  This helps with bruising (epinephrine) and when the lidocaine goes away and the Juvederm attracts water, the two effects cancel each other and there is not as much enhancement after the injection due to the hydrophilic nature of the Juvederm.

 

4.  I use Juvederm Ultra under the eye and above the lip.  I use Juvederm UltraPlus everywhere else.

 

5.  I constantly complain to my Juvederm Rep about the 0.8 cc syringes.  I use lots of Radiesse because you get almost twice as much material for the same price.  Volume, volume, volume.  Please complain to your rep, maybe we can get them to change. 

 

6.  I hear the Evolence is very good.  We will be getting trained and start using it next month.

Thanks for the filler tips.Can you explain how you get the Lido with epi mixed into the Juvederm syringe? --PD

Fluid Dispensing Connector from Braun Medical Inc (you can get from PSS)

BD 1 ml Luer-Lok Syringe

 

This syringe allows you to get very precise amount of lidocaine (swish back and forth 20 times).

 

I use this syringe to put exaclty 1 cc of saline in my Botox Bottle. When I reconstitute the Botox (this gives it full strength per unit). The chances of intravascular injection might be lower with push ahead because the material will push the vessels out of the way as you advance --  Jeff

Hi Jeff,--I agree w/ #6.  I seem to get good augmentation, less redness, swelling and bruising with Evolence.  I use it for deeper fills in cheeks, NLF, etc.  Don't use it for lips or under eyes.  I do same with Lido w/ epi.  I tend to use Juvederm in lips.  Perlane / Restylane for other areas.  I agree w/ why Allergan uses 0.8 cc syringes. I've moved away from Radiesse.  I feel that the duration is not that much longer than a good correction with the HA's.  Besides, I believe a fair amount of the volume of Radiesse is a gel carrier, thus needing touch-ups at 2-3 months.  Perhaps that's why the went to the larger syringes? -- Don

The push ahead technique also moves small blood vessels out of the way, so you may notice less ecchymosis is overall pts. -- Greg

Jeff: --"Push ahead" has a higher risk of vessel cannulation & potential for vascular effects - skin necrosis in glabella, even potential for retro-grade flow to eye (causing visual loss).  I wouldn't recommend that technique for the periorbital area.

Restylane is recommended for the tear troughs;  it's less hydrophilic than juvederm - which means less post-treatment swelling.--Tom  --  [note from Jeff:  Tom is a plastic surgeon]

I would not use push ahead around the eye, I agree with Tom's comments. It works great for NLF. I was actually taught this by a PS -- Greg

Thanks Jeff for your kind comments. However I must make a few points in regards to fillers:

1) There are some areas that one has to still do the retrograde injection either b/c the purpose was to make a straight line (eyebrow lift and vermillion border and the bow-tie (the vertical lines connecting the base of nose and the upper lip border) AND when injecting the most inner 1/3 of the tear-trough to avoid risk of filler getting into the orbital space due to its close proximity to the orbital rim.

2) On the glabellar injection, it is best to first push and pull the needle thru the space underneath to break up the tissue before actually injecting the filler both in an anterograde and retrograde pattern

3) I ONLY use the 1/2 inch needles in all my injections

4) One can inject even Radiesse and/or Perlane via an 1/2 inch 30 gage needle. Why is this noteworthy to mention?? When I work on the lips and Marrionette's lines, I ususally first build the Vermillion border with Radiesse or Perlane (I get the best "lifting outcome" with heavier filler). I push the 1/2inch needle all the way forward then slowly and steadily inject while withdrawing (retrograde method). Then I re-evaluate how much of a correction I already get of the Marrionette' line and lifting up of the lip body. My next step is to inject into the most lateral lip section (about 1 cm distance) starting at the corner (using Perlane or Restylane or Juverderm). This time I inject slowly as I push forward (anterograde). Often I ended up correcting about 50% of the marrionette's line by going after the lip's border and most lateral body. Besides, the patient loveto see that they now could see their lip body all the way to the corner and more "smiley shape". The last step is the trickiest one, I use either Radiesse or Perlane on an 1/2 inch 27 gage needle. First placing my left thumb at the patient's lower half NLF's I retract the skin upward (about 2-3cm upward) then I approach my needle in an upward (vertical) position at about one centimeter lateral and one cm below the mouth corner of that same side. Then I aim diagonally toward the corner and start injecting anterograde just 1-2 mm below the imaginary horizontal line of the mouth corner (about 0.2 cc), then I withdraw the needle and reaim straight up and inject just below the horizonal line (0.2cc) then I do it one more time aiming diagonally outward (0.2cc). What was I attempting to do?? I was laying down a new flooring along the imaginary horizontal line. After the injection, release the left thumb. You will be surprised to see the retracted portion just rest right along this new floor, thus the Marrionette'line has been corrected. This is different from the common fanning technique of using the filler to "blow up" around the Marrionette's line. If you look carefully at those company's issued photos, the area around the Marrionette's line now appeared very swollen and puffed up. It is aesthetically unpleasant. It looked like the patient was beat up below the mouth. It reduced the profile of the chin.

5) For those of you that use fillers on the highly vascularized and shallow areas such as the temporal, crow's feet, undereye area lateral to the submalar area and along the lateral border of the cheek prominence (especially in those older skinny Caucasian ladies with much excessive very thin skin) I now emulate the same technique used in the hand. I would pinch to levitate the skin itself above the bony structure, then I bolus Restylane into the empty space. Then I massage it down. This elimates the risks of injecting into the vessels and nodules.

Interesting discussion.  So Kevin, how do you account for the difference in that anterograde injection you need less filler than in retrograde injections, assuming all else being equal?

Second, I am understanding one group claims anterograde injection carries a higher risk of vessel cannulation and possible intravascular injection, while another group claims that anterograde injection "pushes away" blood vessels, thus decreasing the risk. Not sure how anterograde increases risk of intravascular injection any more than retrograde.  If you push the needle ahead, transfixing a vessel, then begin injection, you can still conceivably deposit some material intravascularly, can you not?  Am I missing something here?

I also found an interesting idea of sub q bolus technique in areas of thin skin, ie crowsfeet, etc.  Anyone else try this method? ~ Don

Tom:

I do agree with you about those risks with anterograde injection. The key is always the skills in doing it, be it retrograde or anterograde. One always has to be very carefully doing anything around the eyes. However, the anterograde techinique has been advocated some of the best known experts such as Arnold Klein, MD and Kent Remington, MD. I also believed that the filler amount used was critical. It takes much more amount to get the same result with the often taught retrograde technique compared with the anterograde one. For example, I almost never required more than one full syringe in correcting bilateral NLF's vs what was typically used ( 2 syringes) by most others. I attached the before and after of a case wherein I used Readiesse to correct her NLF's and Marrionette's lines with anterograde technique. The after photo was taken right after. You can still see some of needle marks. I used one full 1.3 cc syringe, 1/2inch 30g for the Vermillion border and 1/2inch for NLF's and Marrionette's line. Notice also there was no "puffy/swollen look" medial to the Marrionette's line often seen with retrograde and fanning technique used by most others. ~ Kevin

All interesting comments.  The only place, I use “push ahead” is in the cheeks when doing them via the intra-oral route. (Apparently Radiesse is no longer teaching this method because may practitioners couldn’t get the hang of it but it works for me.)  I might try it in the “safe” areas such as NL folds.  We use only Radiesse and Juvederm and  I find that neither filler lasts as long as advertised in “first-timers”.  I’ve also had disappointing longevity in my older patients (>65) with both types fillers despite using numerous syringes.  I’m sure this has to do with their inability to generate collagen around the filler once the carrier gel is gone.  Does anyone know the age range of patients done in the filler studies? ~ SD

I came across this old thread way down in my inbox and read it again.  I’m not sure who wrote #4 below.  It sounds interesting but I’m having a hard time visualizing it.  Do you steadily move the needle forward  toward the lip edge as you are injecting or do you hold it in place while the area fills?  I’d love to see a drawing on where you start.  ~ SD

SD: I wrote those threads. The techniques that I described were similar to what you could see watching the video instruction on www.thederm.org by Kent Remington and his colleagues (lower face injection portion) THe only thing new from my thread was when fixing the Marrionette's line, his doctor (Nowell Solish) injection upward and anterograde from the lower part toward the lip corner only one time vs what I now do is I do the same thing but with a fanning pattern where (with the skin lifted about 1-2cm upward with the other thumb) I laid down "three such "anchoring points" along an imaginary horizontal floor starting from the lip corner going laterally for about 3-5cm long. Here I used something firmer such as Radiesse or Perlane. Having done this, you would release the thumb letting the skin go back down. Often you will see the Marrionetter's line is much improved because "part of that Marrionette's line" now is positioned along the horizontal flooring that you just created. ~ Kevin

PS: It is hard for me to send over some graphic illustration but I will attempt to do this in the future

Do it yourself Botox? ABC News wants to talk to you.

Have you tried do-it yourself plastic surgery or home Botox injections?

In tough economic times, many try to cut costs, including in their beauty regimen. Despite the risks, some people have decided to skip the doctor -- and obtain and self-administer cosmetic treatments.

If you have self-injected products like Botox, Restylane, Juvederm, silicone, and other substances, 20/20 would like to hear your story.

Please fill out the form below, including information about your experience, and a producer may be in contact with you.

You can tell ABC all about it here.

Medical Spa RX: Canada Botox hits a new milestone.

Medical Spa RX has had it's first physician who has reordered Botox 5 times. In fact, there are a number of them. Woot!

Oddly enough, I consider 5 reoders of Botox significantly significanly more impressive than only 4. (I don't know why. Perhaps because Medical Spa RX has only been offering Botox for the last 4 months so 5 orders would be more than monthly.)

Medical Spa RX has been shipping orders for something on the order of 4 months now so 5 orders is telling me that we've got a number of physicians who switched to Medical Spa RX very shortly after we launched it and have been using it exclusively. (My clincs usually orded Botox or Restyland monthly so that's where my logic lies.)

We've been extremely diligent in makeing sure that Medical Spa MD Members are being taken care of by Medical Spa RX and as far as I'm aware we've never yet had a single complaint about the service or product.

I should note here that Medical Spa RX and Medical Spa MD are completely different. Medical Spa RX is Select Partner who offers exclusive services to our Members. (Any technology provider or service company who can provide meaningfull value to our Members is welcome to apply.)

For those physician or medical spa Members who have not yet ordered your Botox through Medical Spa RX and are in a position to do so, I'd highly recommend giving them a chance by placing a small test order of whatever you use most, Botox, Restylane, Juvederm of Dysport.

Also, if you haven't heard about the group buy option, there's nothing like it to harness buying power.

Update on 10-11-2009 by Medical Spa MD

Just a heads up. Many of these posts attract a huge number of spam comments. As such, posts are monitored daily. Any specific and identified comments are welcome but all spam comments or anonymous flaming comments are removed and IP addresses identified and/or blocked.

Is Botox & Restylane carrying your Medical Spa?

More studies on Medical Spas, Botox & Restylane seem to be pointing to the steady climb of filler injections, even when other cosmetic medical treatments might be less steady.

Are Botox, Restylane and Juvederm appointments steady for you?

From the  article:

During times of economic uncertainty, economists have noted that American women load up on affordable luxuries as a substitute for more expensive items such as clothes and jewellery.

Dubbed the “Lipstick Indicator”, it was charted first during the Great Depression, when industrial production in the US was cut in half, but sales of lipstick climbed 25 per cent. In more recent periods of belt-tightening, including the Second World War and the 1973 oil embargo, general spending declined, but cosmetics sales held strong. Most recently, lipstick sales jumped 11 per cent in the months after the September 11 attacks on New York and the Pentagon.

But this time around, that is not happening. In 2008 annual lipstick sales actually dropped five per cent, according to Inside Cosmeceuticals, which tracks cosmetics purchases in the US and UK.

Now, it seems, Americans – both men and women – are splurging on a more modern luxury: cosmetic injections like Botox, Restylane, Juvederm and Sculptra.

The American Society of Plastic Surgeons reports that surgical cosmetic procedures like nose jobs and tummy tucks dropped off nine per cent from 2007 to 2008. However minimally invasive procedures such as Botox, which eases wrinkles, and Restylane, which puffs up sagging skin, are up more than five per cent.

“Botox and filler have carried us through this recession,” said Dr Herbert Parris, at the Ageless Remedies Clinic in Denver, which does laser treatments, facials and microderm abrasions.

He credits the rise in part to the fact that Botox patients have a 97 per cent satisfaction rate, on average, with Restylane and other fillers causing satisfaction about 60 per cent to 70 per cent of the time.

“It’s a quick hitter,” he said. “An easy pick me up.”

Clients at Ageless Remedies have sharply cut back their spending on other treatments such as facials, chemical peels and microderm treatments, according to clinic director Donna Reichert. But women – and increasingly men – keep walking through the door for injections.

“I think in part it is the instant gratification,” said Ms Reichert, noting that one often needs three months of treatment to see results from laser or chemical peels.

“With injections, they see the results right there right now. It is not as pricey as a facelift, which can cost as much as $12,000 [Dh44,000]. They can come in and spend $300 and see results.”

In America’s youth- and beauty-obsessed culture, some analysts believe there may be a larger factor at play.

“There have been a number of studies showing that there is both a ‘beauty premium’ and an ‘ugliness penalty’, in the labour market,” said Dr Nancy Etcoff, a Harvard Medical School psychologist and author of Survival of the Prettiest.

“Better looking women and men earn more than average looking people and unattractive people earn significantly less.”

At a time when joblessness is rising and, and companies are laying off workers, Dr Etcoff and others believe some may be rationalising expenditures on cosmetic dermatology to stay competitive in the job market and reduce visible signs of stress, like forehead wrinkles.

“Some may be downsizing from surgery to cosmetic dermatology. Others may be considering both and end up deciding that they can get a comparable benefit from dermatology with a lot lower cost,” said Dr Etcoff.

Click to read more ...

Medical Spa RX: Botox, Juvederm, Restylane from Canada... or money in your pocket?

Our newest physician resource and premier provider, Medical Spa RX, is now open and taking orders from licesnsed physicians anywhere in the world for the most commonly used injecatbles including; Botox, Juvederm Ultra 2, Juvederm Ultra 3, Juvederm Ultra 4, Restylane Touch, Restylane Vital , Sculptra, Dysport (Reloxin), and Radiesse.

Medical Spa RX is the first of the resource portals and services that we're  making available to our Members. There are many more in the works that include other medspa products, advertising and marketing partnerships, SEO, and IPL and laser companies. We hope to have the support of our physician and medspa community as we look to harness the buying power and influence of the thousands of doctors who know and trust Medial Spa RX as the one place on the web where physicians can be part of a community and get absolutely unvarnished opinions from other doctors.

Since Medical Spa RX is the first of these partners to go live, it begs a number of questions around when, how and why to use Medical Spa Rx instead of your regular Botox, Juvederm and Restylane providers or pharmacies.

First, let me tell you that Medical Spa RX is a new pharmacy store front exclusively for Medical Spa MD Members from a major Canadian pharmacy that has been in business for many years and currently ships to physicians all over the world. 

Medical Spa RX as a complely seperate and unique entity from this pharmacies regular portals. Why? The prices on Medical Spa RX are much lower than their regular sites and are offered exclusivley through Medical Spa MD to our Members. (If you're not already a Member of Medical Spa MD you can join here for free.) You can't find better service or products anywhere. We've been buying Botox, Restylane and Juvederm for years. Beleive me, we know.

Since Medical Spa RX is a pharmacy in Canada, it rases a number of questions around how easy it is to order across borders, if it's the same Botox and Juvederm sold elsewhere, if it's illegal, and where it's from.

Some of the best reasons to use Medical Spa RX are already being addressed by well know physicians in our community.

...For myself, I'm happy to see this site offering to exercise a little muscle and pricing power by aggregating all of the individual docs and clinics on the site. I'd like to see even more of it. ~ Charles MD

...As with most scope of practice issues, it's really malpractice that might be the deciding factor. If this were something that was not FDA approved in the US it could be much dicier... the mesotherapy problems in Brazil spring to mind, or heart valves made in wherever. I'd place the risk that buying Botox from Canada would come back to bite you at about the same level as accidentally stabbing the patient in the eye with the needle (never heard of it). ~ JRB MD

TF brings up a good point, but we're all been using Botox off label for the last fifteen years of course. (Seems somewhat ridiculous to be using any drug off label and then nit-pick as to what order the words are in on the label as though that matters.) And, of course, it appears that this pharmacy ships world wide.

The most obvious question is: Is it the same Botox, Juvederm or Restylane that I get from my reps. Since Canada is pretty close on the medical front I'm sure that it is. (Bill, my Canadian MD friend will appreciate that.) I would be very reticent to order from South America or Asia. From Canada? Not so much.

Having been on the site for going on 4 years now and having purchased an IPL and laser through the classified listings, I've come to rely on the opinions of the other long time members. Certainly I see the price as being the biggest attractor but I'm also attracted to the idea that this community now has leverage; buying leverage, reputation leverage and whatever other leverages exist. I'm well aware from my visiting technology reps that they're well aware of Medical Spa MD and what the community says about them.

I would guess that those physicians who have not been a part of this site for as long might do otherwise and think of Medical Spa MD as just another occasional resource. It is not, at least for me. For the first time as a single clinic I feel that I'm on a level playing field with the big boys. (Not to be gender specific.) Since Medical Spa RX is offering these kinds of prices exclusively to our community, I'm more than inclined to support them and hope to have other businesses recognize the power of this community in the future. It can only benefit us all.

I would like to buy retail Botox from my Botox rep for these prices... but that's not going to happen. Saving $3000-$5000 a month on Botox and Restylane is money in my pocket that I can use. ~Dermgal

Dermgal's absolutely right that saving $1500 or more a week in Botox and Restylane quickly adds up.

As for the Botox, Restylane and Juvederm, it's the same product sold through every reputable pharmacy. The cost is much lower because it's priced for countries other than the U.S. The copy on the outside of the box probably does not have the same wording as the product sold in the U.S.

While Medical Spa RX can ship anywhere in the world, there are some qualifications. Countries outside of North America aren't afforded the same guaranteed delivery since it's impossible to gurantee that worldwide.

Is it FDA approved? Certainly the drug itself is since Botox, Juvederm, Restylane and the rest are, but since the packaging might not be it's up to individual physicians to make that call. If you're not comfortable ordering product from another country, that's completely understandable. Don't. But if you're a doctor who is paying more for Botox and Restylane than you need to be, take a look at Medical Spa RX's prices. Better yet, contact Medical Spa RX and talk to them about their quality, service and gurantees. We're very comfortable that you'll never need to use another pharmacy.

(Surface Medical Spas and other clincs I know personally order almost all their injectables for every one of their clinics from outside of the US according to their medical director and have never had any problem.)

For our part at Medical Spa MD, we're not looking to promote anything other than a service to our Members and save them money as part of our growing network of physicians. We're actively seeking other pharmacies to partner with (including those in the U.S.) and when we find one that can provide the service levels, competitive pricing, and benefits to our Members that Medical Spa RX does, we'll be happy to provide that service as well.(If you're not already a Member of Medical Spa MD you can join here for free.)

So, if you're in a position where you need to save as much money as possible while still receiving the very best customer service and product, I'd urge you to join other members of Medical Spa MD in supporting this newest initiative and make a test order and see for yourself. Certainly the only way that Medical Spa RX can offer such deeplly discounted products is through the aggregated buying power of all of our members.

Take a moment to contact Medical Spa RX and see for yourself how much money you can be saving.