Dr. Alex Kaplan, Celebrity Laser Spa & Surgical Center In LA

Dr. Alex Kaplan has targeted a niche market...celebrities.

Name: Alex Kaplan MD
Clinic: Celebrity Laser Spa & Surgical Center
Location: Los Angeles, CA
Website: CelebrityLaserSpa.com

That's interesting: The Kaplans are big proponents of the "Made in the USA" movement, purchasing Made in the USA office supplies and products whenever possible. When you come to Celebrity Laser Spa, know that you are supporting a small business, real people and all things Made in the USA too!

Can you share your career path as a cosmetic surgeon?

I attended residency in combined general and plastic surgery at University of Chicago.  After attending 5 years there. During residency at UCLA, I volunteered to provide laser tattoo removal at a gang intervention program in East Los Angeles. This gave me the idea to start a cosmetic laser practice specializing in laser tattoo removal. My medical spa was one of the first to specialize in laser tattoo removal. We started making a name for ourselves, growing over the years and adding a variety of other services to the practice, and we are now well-known in Los Angeles as Celebrity Laser Spa & Surgical Center.

How is your practice organized? What types of medical technologies do you have and how did you select them?

From the beginning I have taken care to use technologies that offer a proven value to patients. I strive to offer procedures that offer a unique advantage over other techniques, If I don’t think a product works well, or the science behind it doesn’t make sense, I wont offer it at my practice. I am one of the first providers for new technologies, such as Tickle Lipo, Dermapen and Picosure.

I am the sole owner of CLS and work with several mid-level providers and

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Stem Cells and Regenerative Medicine - Ready for Prime Time?

The future looks promising for stem cell therapies in aesthetic medicine.

The arguments for and against the use of stem cells for research and medical therapeutic applications have existed for decades and will no doubt increase in volume and intensity for some time to come. Vast amounts of public and private money are currently pouring into the research for these polarizing fields and a Google search on these topics will populate dozens of new articles not only domestically but also globally on a daily basis. The hopes of uncountable patients and their family and friends are intricately entwined on unlocking possible therapeutic applications to cure a myriad of maladies from spinal cord injuries, Alzheimer’s disease, diabetes and heart failure to rare genetic disorders that claim the lives of children daily. In short, stem cell research and regenerative medicine are in the early explosion phase of discovery, application, and no doubt ongoing controversy.

Initial shockwaves of fear and objection arose partly from the need for using embryonic stem cells for this research.  Fortunately, it is looking more promising that we can use easily obtainable cells from existing and abundant adult tissues and engineer highly selected cells from these tissues to become culturable and guidable stem cells. Ideally, this would negate the use of embryonic stem cells and eliminate at least this one-of-many passionately debated aspects of controversy (there are many!). To date, cells from bone marrow, skin, and adipose amongst others are being used to isolate adult stem cells, and from these it is hoped that we can “reverse engineer” them into pluripotent cells that can be used to generate selected tissue types for clinical use. How many of us don’t have an extra area or two of excess fat that could potentially be used to save our life at some point in the future?  While we don’t have proven reliable human applications as yet, the future does look promising. I am seeing more and more presentations at our plastic surgery meetings on stem cell research and regenerative medicine and the buzz and excitement are palpable. It is important to note that all involved seem to share a sense of cautious optimism and emphasize the need for careful control over the research and applications.  The FDA is very involved with all aspects of clinical use of stem cells as the field evolves and becomes more complex.

The future is exciting for stem cells and regenerative medicine. I fully agree with careful oversight and deliberate planning and control as research progresses. I follow the fields closely and am hopeful that in the near future we can offer hope to those patients with difficult illnesses and medical conditions that are currently not largely treatable. And all the better if we can obtain easily available and harvestable tissues to affect the research and clinical applications. Now I invite a lively and constructive discussion from the readers!

Dr. Barry L. Eppley, Indianapolis Double Board Certified Plastic Surgeon

Dr. Eppley is both a licensed physician and dentist. He's board certified in Plastic and Reconstructive Surgery as well as Oral and Maxillofacial Surgery.

Name: Barry L. Eppley, M.D., D.M.D.
Clinic: Eppley Plastic Surgery
Medical Spa: Ology Spa 
Location: Carmel, IN 
Website: eppleyplasticsurgery.com, ologyspa.com

You're using SmartLipo technology. What do you think of SmartLipo's efficacy?

It is important to recognize that Smartlipo, like any technology, is a tool and has no magical properties. It is only as good as the skill and experience of the physician holding it. When used properly and judiciously, my experience has been that it can lead to better outcomes and less bruising. One of Smartlipo's biggest claims to fame has not been particularly useful for me...being able to do most of the procedures under local anesthesia. But this may be reflective that many of my patients are looking for treatment of multiple body areas with bigger volume reductions and it is often combined with other procedures which need to be done under general anesthesia anyways. Its biggest disadvantage is that it is a very costly device and requires extra time to pre-treat the areas before suction evacuation. Thus it requires a motivated user and one who believes that the cost and extra time to do it are worth it to their practice.

How do you evaluate and make your technology comparisons and decisions based on efficacy and cost? 

I view technologies and devices as either comparative or innovative. This means does it offer similar treatments as other technologies or devices on the market (with some claimed minor advantage) or is it the only one that can produce its aethetic effects. Most cosmetic technologies are comparative and thus must be judged primarily from a business perspective on its return on investment. Every technology costs a lot more than the price tag when you factor in labor, disposables (if they exist) and marketing. One must look very carefully at the cosmetic market and have realistic projections about what it can really generate. Very few technologies fall in line with ‘buy it and they will come’. Most sales are driven and do not magically fall off the street and through the door. This understanding allows me to apply a basic capital purchase philosophy... if it can not generate in gross sales what it cost to buy in one year or less, it is not a good business decision.

Innovative technologies, uncommon as they are, are different. Because they have less competition and offer something new, being an early adopter is less of a business risk. When the market cap is undefined, it is sometimes easier to take the risk.

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Italian Plastic Surgeon, Dr. Egidio Riggio's "Zenith System" For Breast Augmentation

Dr. Egidio Riggio focuses on innovation and research related to plastic surgery, both aesthetic and reconstructive. 

Name: Egidio Riggio, M.D.
Location: Milan, Italy
Website: chirurgiaplastica.mi.it/it/home/

That's interesting: Dr. Egidio Riggio is the creator of an innovative philosophy and aesthetics of an original surgical approach to breast augmentation he calls the "Zenith System" which he claims lead to more natural breast augmentation results. He has performed mor than 100 cases and published this proceedure in the international journal of cosmetic surgery most authoritative, Aesthetic Plastic Surgery August 2012.

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Dr. An Po Chung, Plastic Surgeon Performing Fat Transfer In Taiwan

Name: An Po Chung M.D., MSC
Location: Taipei, Taiwan
Website: 4flower.com.tw

Dr. An Po Chung is a professional member of Taiwan Surgical Society of Specialist, Taiwan Plastic Surgery Medical Association, Physicians Cosmetic Surgery in Taiwan Medical Association specialist Deputy Secretary-General of facial plastic surgery Medical Association and International Cosmetic Surgery Medical Association.

Can you tell us what is it like practicing cosmetic surgery in Taiwan in comparison with what you see in other countries?

From my experience of attending several international conferences, I noticed that cosmetic surgery in Taiwan is not so different from the other countries. However, the patients in Taiwan prefer minimal invasive cosmetic surgery. Some of them have unrealistic high expectations of non-invasive treatment such as filler and Botox.

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Nick Carr MD, FRCSC, Canadian Plastic Surgeon & Educator

Dr. Nick Carr shares his thoughts on the medical education system in Canada as a plastic surgeon and eductor.

Name: Dr. Nick Carr 
Location: Vancouver, Canada
Website: skinworks.ca

That's interesting: Dr. Nick Carr is a Royal College Examiner in Plastic Surgery.

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Dr. Alexander E. Handschin, Plastic Surgeon In Germany

With several specializations in surgery, Dr. Alexander E. Handschin shares his practice style changes in Germany.

Name: Dr. Alexander E. Handschin
Location: Hamburg, Germany
Website: drguth.de

That's interesting: Dr. Handschin belongs to the following professional organizations: the Board of General Surgery in Switzerland and Germany, Board of General Surgery in Switzerland and Germany, and Specialisation Board of Hand Surgery. He is also a fellow of the European Board of Plastic, Reconstructive and Aesthetic Surgery (EBOPRAS).

With the advent of Botox therapy and hyaluronic acid fillers, non-surgical options have certainly increased over the past years. I believe that these tools are adding to the possibilities of a plastic surgeon, since their indications do not necessarily interfere with surgical options.

The use of autologous fat-transplants has certainly seen a significant rise, and I believe that additional knowledge will emerge from this technique. Also, the use of stem cells, such as adipose-derived stem cells poses a great potential for plastic surgeons.

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Stem Cells & The Vampire Facelift

If you attend medical conferences, or read the trade journals, you’ve no doubt heard about stem cells and their incredible potential in the healthcare industry. These cells have the ability to repair or replace damaged cells, reduce inflammation, and possibly even have a role in disease prevention and cure.

Lately, these cells have been the target of much interest in the cosmetic field. Platelet-rich plasma (PRP) is the portion of the blood that remains after centrifugation has separated out the red cells. This fraction is unusually rich in growth factors and stem cells, that have the ability to repair damaged skin, and act as a long-lasting filler to volumize the face. The PRP is activated using calcium, and then is immediately injected into the donor’s face.

At Canyon Lake MedSpa, we have been using the patented “Vampire Facelift” technique (Regen Labs) in conjunction with standard HA or CHA fillers. We inject the filler using standard technique and then layer the PRP on top. Although still very new to this technique, we believe we are seeing the early effects including improved skin tone and color. Research has documented significant prolongation of filler effect, but we have not been doing this procedure long enough to attest to that yet.

Since we are only minimally manipulating the blood (centrifuging and decanting off the PRP) in a completely closed system, and re-injecting it into the same patient, there is virtually no risk.

In our next article we will discuss, in greater detail, tips on collecting and injecting PRP, how to educate patients and the outcome of our patients’ results.

There has been tremendous interest in the very-well marketed “Vampire Face Lift” and we have experienced an increase in our Med Spa new-patient visits as a result of this interest.

Interview With Serbian Board Certified Plastic Surgeon, Dr. Gorana Kuka.

Dr. Gorana Kuka works in private plastic surgery practice at the Colic Hospital with patients coming from around Europe.

Name: Gorana Kuka, MD
Clinic: Colic Hospital
Location: Belgrade, Serbia
Website: dr-colic.com

That's interesting: Dr. Gorana Kuka is board certified by Serbian Medical Society.
She is a member of ISHRS (International Society for Hair Restoration Surgery), IPRAS (International Confederation for Plastic, Reconstructive and Aesthetic Surgery) and a women for women organization that aims to supply help by female surgeons to patients.

Your website is translated in eight different languages including English, German, French, Russian and Italian. Where do your patients come from? Are you seeing 'medical tourism'?

Since around 60% of our patients are coming from abroad, we had to translate our webpage into different languages. Most of our patients come from Switzerland, Germany and Austria. Some of them are of Serbian origin and some of them are foreigners. They have found about us either from their Serbian friends living abroad, or looking through internet for aesthetic surgery of best quality and lower fees.

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Adipose-Derived Stem Cells In Cosmetic Surgery: Ready For Prime Time?

Are adipose-derived stem cells in cosmetic surgery ready for prime time use in your cosmetic practice?

Google “aesthetic stem cell treatments” and you will be greeted with a panoply of therapeutic offerings ranging from mundane to fantastic. Injecting your own adipose derived stem cells can lift your face, tighten your skin, enlarged your breast, slow the ageing process and even put some zip in your libido if injected into anatomically correct nether regions. Cosmeceutical manufacturers are even putting non-viable stem cells into facial creams hoping to knock 10 years off your visage. These marketing claims have captivated the public with the promise of a minimally invasive fountain of youth.

Adipose-derived stem cells are multipotent and possess the ability to differentiate into fat, bone, cartilage, nerves and pancreatic tissue.  They also secrete cytokines that are angiogenic, antioxidative and immunosuppressive. They release a whole host of growth factors that facilitate wound healing and tissue regeneration. Stem cells hold great clinical potential and offer considerable commercial possibilities.

We are all very enthusiastic about the promise and potential offered by the emerging field of adipose- derived stem cell science. Encouraging data from hundreds of ongoing international trials support a bright future for aesthetic and regenerative applications and real progress has been made in developing methodologies and protocols for every day clinical use. Yet many are advising caution.

A recent review in Plastic and Reconstructive Surgery notes that there is considerable uncertainty about the true clinical potential of adipose-derived stem cells and too much remains unknown about their fundable biology to be used safely and reliably. There are several contradictory studies about whether these cells promote or repress cancer growth. There are no standard protocols yet developed for adipose-derived stem cell applications. We still are unsure of the number of cells required per treatment or how many treatments are needed to achieve a desired clinical outcome predictably. In short, we are not quite sure what we are doing yet with adipose-derived stem cells despite the encouraging science and our best intentions.

A lot remains unknown about how to effectively and safely use this new technology. To market aesthetic stem cell procedures outside of clinical trials to the public seems a bit deceptive considering the current state of the art. What do you think??

Dr. Robert Cohen, Breast Enhancement Specialist In Scottsdale, AZ

As a plastic surgeon in Scottsdale, Dr. Rober Cohen specializes in cosmetic surgery of the breast.

Name:Robert Cohen, MD, FACS
Clinic: Scottsdale Center For Plastic Surgery
Location: Scottsdale, AZ
Websites: robertcohenmd.com, cohenbreastsurgery.com

That's interesting: Dr. Cohen published a textbook chapter on technology and robotics in plastic surgery while at Dartmouth.

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Plastic Surgery Face Lift.. Or Stem Cells From Korea?

The same company in Korea that's cloning dogs and cats is now offering anti-aging treatemtns that are being touted as a delaying tactic for plastic surgery and face lifts:

Those who view aging as an ugly inconvenience usually turn to plastic surgery to nip and tuck their troubles away. Little do they know the answer for reversing the aging process might be found in their own stomachs.

Run in conjunction with the Beijing Tian Tan Puhua Hospital, which offers stem cell therapies to last-hope Parkinson’s and spinal cord injury patients, the RNL Puhua Plastic and Cosmetic Medical Center offers stem cell therapy for the face that may reverse the aging process using the patient’s own body matter.

Using a treatment developed by Korean company RNL Bio—the same company that clones dogs and sells them on the international market for upwards of USD$150,000—the Puhua Center offers non-invasive beauty treatment alongside traditional plastic surgery staples like liposuction, face peels and eye tucks.

For a cool ¥28,000, patients can have fat cells removed from their abdomens using a needle and local anesthetic. Two weeks later, after doctors have grown a crop of stem cells from the collected fat cells, patients return to have doctors inject the stem cells into their faces in a series of shots that plump out skin, erase wrinkles and generally take a decade off your appearance, says Ingela Palomäki, a former Beijing Tian Tan Puhua Hospital marketing representative and current director of Fortune Cookie, a stem cell product import/export company. Included in the price is a stem-cell top-up six months later. Patients can also have their stem cells stored at the clinic for ¥1,500 per year. Stem cells have a shelf life of about 15 years. The clinic is currently the only place in the world offering the therapy, Palomäki says.

RNL Bio flew in aging South Korean celebrity Kyung-gyu Lee for a test-run of the treatment at the clinic’s inauguration less than half a year ago.

“Koreans are flocking here by the busloads for the treatment,” Palomäki says. “It’s buying time.”

Because the treatment uses the patient’s own cells, there is no risk of the body rejecting the injections, she points out. The only concern is that the stem cells could copy cancer cells in the body—so cancer patients and survivors will want to take a pass.

While the U.S. and other countries weigh the benefits of stem cell therapies, many patients from abroad are already coming to Beijing for therapies they hope might make them forever young.

This use of technology solutionos around bio-engineering and stem cells could well percipitate a break through. Nanotechnology is an other area that offers the promise of using a nonsurgical medical technology in lieu of traditional plastic surgery.

Thermage and Botox are examples of technology that sprang from other areas of medicine in just this way.