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Entries in Thermage (31)

Thursday
May112017

Dr. Michele Green - A Manhattan Dermatologist

New York Dermatologist Dr. Michele Green shares about her background in the cosmetic field, the way she runs her office, and the devices she uses in her practice.

Dr. Michele Green - Manhattan, NYName: Dr. Michele S. Green MD
Location: Manhattan, New York City
Website: http://www.michelegreenmd.com/
Brief Bio: Dr. Michele S. Green is a board-certified dermatologist based in NYC. She is a graduate from Yale University, with an MD from Mount Sinai Medical School in NYC, and has since opened her own private practice on the Upper East Side of Manhattan, and treats both medical and cosmetic dermatology patients with an emphasis on anti-aging and skin cancer prevention.

I use a range of laser treatments for skin rejuvenation and skin tightening. Popular laser treatment requests include Thermage for facial skin tightening, V-Beam, Fraxel dual laser and its “mini-fraxel” counterpart, the Clear+Brilliant, or eMatrix which helps produce new collagen and rejuvenate the skin’s appearance. I utilize the BBL laser which is my favorite IPL laser because of the ST skin tightening handpiece. While all new technologies and developments are of interest, we are very specific with picking the ones that we use for each condition and do not have...

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Tuesday
May092017

Dr. Ron Shelton - Cosmetic Lasers & Surgery In Manhattan, NY

With more than 27 years of practice under his belt, Dermatologist Dr. Ron Shelton gives us an insight about his experiences and running his practice in New York City.

Dr. Ron Shelton - Manhattan, NYName: Ron Shelton MD
Website: www.thenyac.com
Location: Manhattan, New York City
Brief Bio: An industrious, forward thinker, Dr. Ron Shelton, in 2001, brought together an accomplished group of surgeons to holistically address the needs of both cosmetically-minded patients and those needing Mohs surgery and reconstruction for skin cancer.

New York Aesthetic Consultants included Cosmetic Dermatologic and Plastic Surgeons. It was one of the first medical spas in New York City. In July 2014, Dr. Shelton was invited to join the prestigious NYC laser practice, Laser and Skin Surgery Center of New York. Both Dr. Shelton’s and LSSC’s practices have benefited by this merger as the Midtown NYC cosmetic dermatology practice has more than 60 lasers and devices and a dedicated research division for the development of new laser technology.

Our practice has 8 full time dermatologists and several part time dermatologists and a plastic surgeon. We practice in Midtown Manhattan and Southamptom Long Island, but my full time practice is limited to our NYC practice, in which I see patients from 8 AM to 5 PM, Monday through Friday. We have many administrators including the executive practice administrator, COO, office manager, nursing manager, laser research manager, many RNs and a few medical assistants. I perform all laser and cosmetic device treatments for my patients. We do not have ancillary providers perform lasers in our practice. Half of my practice is cosmetic dermatology including laser resurfacing, laser treatment of discoloration (facial erythema, lentigines, tattoo removal), body sculpting / skin tightening with liposuction and minimally invasive (ThermiTight) and non invasive treatments (Thermage, Ultherapy, ThermiSmooth, CoolSculpting, UltraShape, SculpSure), volume augmentation with fat injections as well as many of the hyaluronic acid treatments (Voluma, Vollure, Volbella, Juvederm, Restylane, Belotero) and other fillers and Sculptra. Botox is very commonly performed. The other half of my practice deals with skin cancer treatment with excisions, and Mohs Micrographic Surgery and Reconstruction.

The list of devices we have is quite long, approximately sixty and they encompass many types of lasers and devices. We have only one IPL. We have gentle laser toning with Cutera XEO Laser Genesis and PicoSure focus lens array and Clear & Brilliant and Permea. Lasers for resurfacing include Fraxel Restore/Dual, and Fraxel Repair.

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Thursday
Sep292016

The obesity epidemic trend continues to push new patients to cosmetic clinics

Obesity remains a growing trend across the US (and the world) and there should be a corresponding growth in cosmetic treatments that treat obese patients.

According to the Center for Disease Control and Prevention, in the US alone, around 36.5% people are obese. This is a cause for any number of health-related alarms, but will continune to drive new cosmetic medical technologies to address the effects. While any number of clinics are offering liposuction for to remove love handles or a lettle extra belly fat, more is being uncovered about the effects of plastic or cosmetic surgery especially to Massive Weight Loss (MWL) patients who have undergone bariatric surgery.

It is important to note the psychological effects and the experiences faced by patients after surgery. Studies show that most patients appear to have a positive reaction towards their newer self, but there are also negative effects that some patients report.

In the studies referenced below, researchers find that majority of their sample patients were better able to identify with their new selves (However, the sample size was only 20) and the researchers used physical health; self-esteem/appearance; social acceptance; mental health; intimacy/sexuality; social network; and self-efficacy towards eating as measures.

Findings

  • Greatest change was found in physical health (Score = 21.06)
  • The surgery seems a success for the patients considering their perception of self and their body image.
  • A minority (n = 4) find it difficult to adjust with their new bodies and needed both recuperation and intervention be available after their bariatric and plastic surgery.
  • With regard to identity transformation, the majority are satisfied with their results and embraced their new body conformation.
  • Confidence played a major part with several participants as it helped them get through any issues they have encountered.

So how should providers at each end of the spectrum (bariatric surgery vs tumescent liposuction, Thermage, etc) set up patient expectations?

Clinicians, including support staff, should be prepped to answer questions and identify patients who might be at risk for acceptance of their new look including:

  • Discuss with patients the possible outcomes that may occur against the patient’s expectations. 
  • Staff should be educated on how best to deal with patients who might have unrealistic expectations.
  • Any cosmetic 'fat removal' treatment should be accompanied by a diet and excercise plan. (You might want to consider getting local gyms to offer a discount for your patients as a form of co-marketing.)

 

References:
Gilmartin, SJ, Long, A and Soldin, M (2015) Identity transformation and a changed lifestyle following dramatic weight loss and body contouring surgery: An exploratory study. Journal of Health Psychology, 20 (10). 1318 - 1327. ISSN 1359-1053

Jumbe, S., Meyrick, J. and Harcourt, D. (2016) Patient’s experienceof life after weight loss surgery: Psychological adjustment. In: Appearance Matters 7, Royal College of Surgeons, London, 28-30 June 2016. Available from: http://eprints.uwe.ac.uk/29251
Avashia, Y., Nair, N., Berhane, C & Panthaki, Z. (2013). Preoperative evaluation of the postbariatric patient. In Thaller, S. & Cohen M. (Eds.), Cosmetic Surgery After Massive Weight Loss. London: JP Medical Ltd.

Friday
May242013

Dr. Jose A. Garcia, Medical Director of Aura Laser Skin Care

Dr. Jose A. Garcia takes part in molding new physicians in cosmetic medicine and surgery. Is he seeing a paradigm shift in medical education?

Name: Jose A. Garcia, MD, FACOG, FACS, FICS, FAACS
Clinic: Aura Laser Skin Care
Location: Kirkland/Bothell, WA
Website: AuraLaser.com

That's interesting: From the inception time of Aura Laser Skin Care back in 2005, we looked at the many technologies that were available and decided to go with the ELOS technology by Syneron. ELOS stands for electro-optical-synergy and combines both radio frequency with light energies to produce safe and effective treatment. Furthermore, for laser hair removal, Syneron uses the 810 diode which is fast and works for all hair color and skin types. We initially looked at the ND Yag by Cutera as well as the Alexandrite. The problem was that the Alex is painful and good for skin types 1 and 2. The ND Yag is best suited for skin types 3,4, and in some cases 5. That meant that we had to purchase 2 lasers or a combo Alex-Yag laser as opposed to only one laser with Syneron.

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Friday
Apr192013

Brian Buinewicz MD, Plastic Surgeon At Le MedSpa In New Jersey

Juggling tasks at the medspa, at a hospital and at the university is no easy task. Let's see how Dr. Buinewicz handle multiple responsibilities and manage priorities.

Name: Dr. Brian Buinewicz
Clinic: Le MedSpa of Buckingham and Flemington
Location: Doylestown, PA and Flemington, NJ
Website: lemedspabucks.com

Your clinic basically offers a holistic approach in a sense that it covers everything from face, to body and even health and nutrition. How did you grow your business? How is your clinic organized? 

Our practice is a dual physician based practice covering all of the patient’s needs from nutrition, exercise, primary health care, weight management in addition to our full service medical spa and plastic surgery services. The business grew naturally by constantly offering the best and newest treatments for our patients. We evolved over the years to have a “tool chest” full of options to offer our patients, not just surgical intervention, for example. When the only tool you have is a hammer, the whole world becomes a nail.

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Tuesday
Oct162012

Michael A. Persky, MD, FACS In Encino, CA

Dr. Persky considers his work to be as much an art form rather as a medical procedure.

Name: Dr. Michael A. Persky
Clinic: Persky Sunder Facial Plastic Surgery
Location: Encino, CA
Website: drpersky.com

What IPL or laser technologies are you using? What technologies do you like? Which do you dislike and why?

We have used the complete line of Fraxel lasers since their inception. Initially, many colleagues were skeptical about the results we were seeing, now Fraxel lasers have become the gold standard for laser skin rejuvenation and resurfacing. We do not use IPL in our practice, but feel that our Fraxel Dual laser treats brown spots like “an IPL on steroids”.  We currently are using Ulthera to non-invasively lift and tighten the face, neck, and eyebrows as well as treating fine lines around the mouth and eyes. We find that when combined with Sculptra and other facial fillers, results are quite satisfying for both patient and physician.

Technology companies may tell the physician anything to sell them the item. Physicians must do their “due diligence”, and not believe everything that they are told. Technologies such as Thermage have not lived up to their hype, and others like Zerona are just plain “snake oil”. The latest technology that we are most excited about is Cellulaze, a minimally invasive one time treatment that effectively treats cellulite.

What treatments have you observed to be the most profitable? Have you dropped any treatments?

Surgical treatments are most profitable. Next come non-invasive treatments such as Ulthera, Fraxel, and CoolSculpting. Injectables are profitable as well, including Sculptra, Botox, Dysport, Juvederm, Restylane, and Radiesse. The use of cannulas for injection has revolutionized our use of Radiesse for “quick” facial volumization. We have dropped laser hair removal and radiofrequency skin tightening treatments.

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Monday
Oct012012

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

Dr. An Po Chung Taiwan Plastic Surgeon

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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Monday
Sep102012

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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