Cosmetic Medicine = Patient Complaints

In 2010, a Customer Experience Report showed that poor quality and rude customer service is the main reason why a customer leaves a businss. I'ts the same deal for your clinic. It is not about price, instead it all boils down to proper customer service.

Everyone's who's worked in any cosmetic practice has dealt with the overly-demanding, never happy patient, many of whom are particularly hard and abusive of your staff. The way you deal with these patients can have a pretty dramatic effect on how many headaches you have to deal with, and how productive your team is. (You'll also lighten the potential downside of any potential medical liabilities since patients who like their physicians are much less likely to sue.)

Here are some tips in dealing with irate patients and complaints in general:

Compose yourself. As Forbes puts it, Remember, the customer is not angry with you, they are displeased with the performance of your treatment or (most commonly) the quality of the service you provide. Your personal feelings are beside the point.Think about the situation positively.

Listen well. Give your complete focus to your customer, and make sure they know it. Allow your client to tell her side of the story. Do not interrupt her while he narrates his side of the story. Be an active listener.

Be emphatic. Your body language should communicate that you understand why your patient is upset. Empathize with her. Respect and understanding go a long way toward smoothing things over.

Apologize. The legitimacy of the customer's complaint does not matter. If you want to keep your patient and difuse the situation,  you will need to apologize for the problem that they have or perceive to be having. A simple and straightforward "I'm sorry" can do miracles in diffusing a customer's emotional rant.

Present a Solution. When you have the solution to the client's problem, tell her that you would correct the situation immediately. If you can't take care of it immediately, ask for your patients opinion on how she wants to address the situation. Allow her to identify what will make her happy. Work a solution together. Explain the steps that you are going to do to fix your patient's problem.

Take Action. It is important that you do what you have promised your client. This is crucial in fixing your relationship with unhappy patients. 

You can always go beyond expectations. You may also give out gift certificates or coupons to "compensate" for your client's inconvenience. You can make a follow-up call a few days later to your client to make sure that she is happy with the resolution.

Of course, experience is the best teacher. Every encounter with a client is a unique one but every experience is a great chance to improve your relationship.

Each complaint is an insight for you to improve your business better. Proper resolution of complaints will surely increase client loyalty.

Read more on:

http://www.forbes.com/sites/thesba/2013/08/02/7-steps-for-dealing-with-angry-customers/

http://www.restaurantdoctor.com/articles/complaint.html#ixzz3YqYaWMQZ

http://www.mindtools.com/pages/article/unhappy-customers.htm

Lifestyle Lift Abruptly Shuts Down

According to the Better Business Bureau's website, Lifestyle Lift is believed to be out of business.

The Wall Street Journal reports that the company, which claims to offer a “minor one-hour procedure with major results,” abruptly shut down a majority of its 40 surgery centers Monday and announced it would consider filing for bankruptcy.

The company, founded in 2001 by Dr. David Kent, had 40 surgery centers nationwide offering what it billed as a less-invasive face-lift procedure that required only local anesthesia and a shorter recovery time. Its advertisements boasted that the services are affordable for everyday people who want to “look as young on the outside as you feel on the inside.”

In a letter to employees sent Sunday and reviewed by The Wall Street Journal, Dr. Kent said the company “has made the decision to temporarily cease operations until further notice.” The letter tells employees not to report to work “until further notice unless otherwise instructed.”

In a letter sent to employees over the weekend, Dr. David Kent – the founder of the company – said he made the “decision to temporarily cease operations until further notice.”

“The future of the Company is uncertain and therefore it is currently developing both a wind down plan to close the business and a reorganization plan to accommodate a new investment,” the letter states.

A spokesperson for Michigan-based Lifestyle Lift tells the WSJ that the company is considering its options, one of which is filing for bankruptcy.

As of Monday, Lifestyle Lift is only providing some post-operation checkup procedures.

As one of the 'franchise model' cosmetic medicine businesses Lifestyle Lift saw dramatic growth before a series of setbacks. In 2008 it sued Realself for allowing negative reviews to be posted on the site. Realself countersued claiming that Lifestyle Lift employees were posting fake counter-reviews in violation of the sites user agreement (commonly known as 'astroturfing').

Santa Clara University School of Law professor Eric Goldman, who advised RealSelf on the case, posted about the issue on his personal blog:

No matter how many times I see it–and in the Internet era, I see it all too frequently–I always shake my head in disappointment and frustration when a company uses trademark law to lash out against unflattering consumer reviews. To these companies, trademark law is a cure-all tonic for their marketplace travails, and trademark doctrine is so plastic and amorphous that defendants have some difficulty mounting a proper defense. As a result, all too frequently, the threat of a trademark lawsuit causes the intermediary to capitulate and excise valuable content from the Internet.

In its answer, RealSelf goes on the offensive and alleges that Lifestyle Lift directly or indirectly posted shill reviews to the Lifestyle Lift discussion, thereby breaching RealSelf’s user agreement. Off the top of my head, I can’t think of another lawsuit where the message board operator sued a company for shill postings, so I think this case may be breaking important new legal ground.

The bruhaha led to an investigation by the New York Attorney General’s office and in 2009, then-attorney general Andrew Cuomo announced Lifestyle Lift would pay $300,000 and stop posting fake reviews online.

Cuomo said in a statement at the time that Lifestyle Lift’s “attempt to generate business by duping consumers was cynical, manipulative and illegal.”

Getting Naked on the Internet: What does the law say?

Medical   

Telemedicine and Cyber Security

The Health Information Portability and Accountability Act (HIPAA) is a federal law that protects the privacy of your personal health information (PHI). HIPAA includes several rules and provisions that set guidelines and requirements for the administration and enforcement of HIPAA. The relevant ones for the exchange of PHI in the digital cyberspace are the Privacy Rule1, the Security Rule2, and the aptly named Health Information Technology for Economic and Clinical Health (HITECH) Act3.

Telemedicine is a burgeoning field of medicine that incorporates digital technology such as electronic health records (EHR), information sharing, and videoconferencing to enhance the interaction between physicians and their patients, and ultimately, improve the delivery of healthcare. Having been a plastic surgeon for several years now, I’m all too familiar with meeting people at social events, and immediately getting bombarded with intrusive and unusual questions and requests as soon as my chosen profession is ousted. Sure, it’s unlikely that a woman will disrobe and expose herself in front of me and my wife at a friend’s dinner party, but get us into an online “private” videoconference call, and who knows what body parts will make an abrupt entrance into the conversation. Physicians must approach with caution, says American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) President Stephen S. Park, M.D. in a recent article4. But, for me and most physicians I know, I feel like the cat is already out of the bag. Considering the amount of texts, emails, online chats, phone conversations over internet and satellite lines, and selfies of both pre- and post-op patients I’ve been privy to, I’m sure I’ve already broken too many laws, and completely disregarded the good doctor’s advice. The truth is, though, that we’ve only begun to scratch the surface.

Telemedicine may involve the electronic exchange of PHI which is protected under HIPAA law. Security considerations with telemedicine involve making sure unauthorized third parties cannot eavesdrop on or record a videoconferencing session where sensitive PHI is transmitted seamlessly, and unfortunately, innocently. Recently, a monumental data breach at one of the nation’s largest insurance providers has spurred a bipartisan political effort to reexamine HIPAA as it relates to telemedicine, possibly adding costly and cumbersome requirements to encrypt EHR data5. Additionally, a recent report done by BitSight Technologies, a cyber security risk analysis and management firm, found that healthcare and pharmaceutical companies ranked the lowest among the four industry categories studied6. Suffice it to say, people are taking heed of this emerging new threat.

The aforementioned laws, rules, and regulations guide the generation, maintenance, and implementation of telemedicine HIPAA compliance. We must be cautioned, though, that HIPAA compliance does not necessarily equate to actual cyber security, and that simply meeting standards set forth in these regulations may not be enough. As more public attention and scrutiny rise to the forefront of media exposure, look for the healthcare industry to take the cyber security threat much more seriously.

Daniel Kaufman, MD
Discreet Plastic Surgery

Bibliography
1. http://www.hhs.gov/ocr/privacy/hipaa/administrative/privacyrule/
2. http://www.hhs.gov/ocr/privacy/hipaa/administrative/securityrule/
3. http://www.healthit.gov/policy-researchers-implementers/health-it-legislation-and-regulations
4. http://cosmeticsurgerytimes.modernmedicine.com/cosmetic-surgery-times/news/cosmetic-virtual-consult
5. http://medicaleconomics.modernmedicine.com/medical-economics/news/senate-review-hipaa-security-medical-records-light-anthem-breach
6. http://info.bitsighttech.com/bitsight-insights-industry-security-ratings-vol-4-rc

Embezzlement & Employee Theft Can, And Probably Will, Happen To You.

Medical Spa Employee Embezzlement & TheftEmployee embezzlement and thefts are the most common crimes in any cosmetic practice... in fact, it's pervasive.

Believe me it can and it did happen to us. It’s still hard to believe that I saw the evidence and ignored it because I just could not believe what my eyes were seeing. Instead of going with my gut instinct I listened to a mountain full of lies from my Physician Assistant so the first lesson learned is trust what your eyes are seeing and rely less on distracting noise.

When all was said and done, our P.A. had stolen over the course of just 14 months, more than $200,000 in Botox, Fillers and Laser Treatments. 

How was she able to accomplish this?  The theft occurred in three primary ways.

  1. With Botox/Dysport she would mix the proper dilution of 2.5 and then draw out a full syringe of properly diluted Botox and re-inject another syringe of saline. She would then take the syringe of Botox and put into her mini-cooler posing as a lunch box which she brought every day to keep it cold and then treat patients out of her house. The evidence of this was apparent with patients complaining of poor results. She would cover herself with some inventive lies such as; Botox out too long and I did not want to waste it, the refrigerator was not cooling to proper levels, she put the Botox in the freezer and the solution crystalized and weekend the Botox, I may have accidently put in too much saline and I used Dysport and it does not work as well as Botox.  Looking back I can clearly see the evidence but listened to her lies and excuses.
  2. On fillers her number one excuse was that the product “leaked” while injecting and she was forced to use another syringe. Other excuses were the patient had a bad result so to keep them happy she offered a free syringe, a reaction that forced her to remove and re-inject later and I threw in some free syringes because she bought a package of Fractional Laser Treatments.  Most of the time, she was simply pocketing the syringes to again inject patients of our practice at her house.
  3. Watch you consults and close ratios. We have been in a bad economy so this was hard to gage.  She would “feel” out the patient during the consultation and those who she believed would be players she would offer discounts for Fractional Laser, IPL’s, Matrix etc. if they paid her directly in the room in cash. I was tipped off by this from a competitor who called me and told her one of their patients told them about this. After firing my P.A. within weeks we had identified 36 patients who paid cash in the room.  She told those patients she was the co-owner so it was ok to pay in the room… To add insult to injury we had to complete their treatments as well.

Submit your own story about medical clinic embezzlement or theft here

After having gone through this we put in some practices that I wish we had done all along.  We now perform a Botox and filler audit every Friday. Every unit of Botox is logged onto a log sheet by patient and same for fillers. If we are off by more than 5% I will meet with my NP to go over the discrepancy.  On lasers shot counts are logged for every patient. As an example if Mary comes in for a Fractional Laser Treatment and the beginning shot count was 45,000 and ending shot count was 45,400 then the next patient for the same treatment should begin at 45.401. We also now provide to each patient our policy of ONLY paying for services at the front desk during check out.

I was also amazed to find out that every staff member suspected what was going on but was afraid to say anything because they did not want to cause any problems if they were wrong. Lastly review your insurance policy for theft coverage. I was mortified to find that ours only covered $10,000 which left us loses of about $200,000.00. We were able to absorb the losses but many others might have been forced to lay off staff or worse go out of business. As a non-physician owner I trusted far too much that a professional medical practitioner would not steel. I now understand all too well that the white coat which commands respect could also have hidden prison stripes and to use my eyes and cover my ears…

Dealing With Anonymous Patient Reviews As A Physician

Reputation Management for Doctors

The internet is a double edged sword to the Plastic Surgeon.

Patients from near and far can read about and research our skill and services but at the same time a handful of malicious people can significantly tarnish a great reputation which we have strived to achieve and maintain.

As a surgeon and as a human I have always strived to maintain the highest ethical and moral pathway. Most of us went into medicine to help people. What we do as cosmetic surgeons may not save lives but it does save quality of life and that is evident in our patients' smiles and behavior after successful cosmetic surgery. As doctors we strive to achieve and maintain a pristine reputation but as in anything else in life, it is impossible to please all the people all the time.

The internet has given a voice to everyone but it seems like angry, bitter, malicious people take advantage of this soap box and platform much more often than normal happy folks. You can see this on comments on YouTube or blogs or chat rooms of all kinds - not just medical or plastic surgery related.

But in our field, we depend on our reputation and while you may have thousands of happy patients, a small handful of unhappy ones can affect your reputation. Personally I have seen that the vast majority of my negative online anonymous patient reviews or ratings are from people who I have either never seen in my office or have seen but refused to operate on as patients. I recently had a "1 star negative review" on YELP from a person who has never even come to my office nor met me but decided that she did not want to pay $100 for an hour of my time for a consult and felt obligated to give me a negative rating for not offering free consults! We have all had such occurrences. But how do you deal with it?

My method has always been dealing straight forward with any and all comments.  If it is out there then it begs clarification and a reply from my staff or office managers or even myself.  There has to be accountability.  In the restaurant industry, restaurants can actually review and rate their patrons, not just vice versa! As physicians, we have to respect patient confidentiality and HIPAA but that does not mean we must be silent and let any anonymous person's comments go without a reply or clarification especially when most of us work so hard to do the right thing and practice with skill, ethics and integrity.

Resources for physicians:

Embezzlement In Skin Clinics & Laser Centers

Did the $300 a patient handed to your receptionist to cover a photofacial go into the cash drawer... or the staffer's pocket?

American Medical News (1/17, Elliott) reported that medical office embezzlement "is common at medical practices, and experts say the risk is especially high at the beginning of the year."

This is because "patients are paying an ever-larger share of their medical expenses, and, with most deductibles resetting on the first of the year, a significant amount of cash may pass through staffers' hands."

Download the free, members-only report: Medical Spa Embezzlement & Employee Theft Scams

According to a survey released in November by the Medical Group Management Association, "nearly 45% of practice managers reported cash stolen before or after it was recorded on the books." For that reason, "prevention strategies are particularly important to minimize the risk because a business's insurance may not cover the entire loss, which can be significant."

As every physician running a clinic knows, embezzlement by staff is a problem... I'm going to put together some information on preventing embezzlement and finding embezzlers that will show you how to make sure this is not happening in your clinic and how to make sure that it never does.

Submit your own story about medical clinic embezzlement or theft here

Another 'Silicone' Ass Injection Death

Underground cosmetic procedures have become a growing cause of concern for health regulators.

This kind of thing is just as bad as the do it yourself Botox self injections.

From CNN

Claudia Aderotimi, 20, died early Tuesday, shortly after receiving buttocks enhancements in a hotel room near Philadelphia International Airport, according to police. The procedure allegedly cost $1,800.

Police say singer Black Madam -- whom they have identified as Padge Victoria Windslowe, 41 -- is believed to be the person who injected Aderotimi with a substance that was supposed to be silicone.

Aderotimi and three other women had traveled from England to undergo the cosmetic procedure in Philadelphia, police said.

Last month, New York officials arrested a woman for allegedly illegally injecting liquid silicone as part an underground business she ran out of her home, according to the Manhattan U.S. attorney's office.

She allegedly charged more than $1,000 for a round of shots and faces up to three years in prison if convicted.

Last year in New Jersey, state health officials launched an investigation into infections related to cosmetic injections after six women were hospitalized for complications.

The women developed symptoms after injections for buttocks enhancement and received surgical and antibiotic treatment, according to the state health agency. All the injections apparently were administered by unlicensed medical providers.

Investigators have had a difficult time tracking these procedures because they are performed by unlicensed providers.

"It's hard to tell how many people are utilizing that [type] of service," said Dr. Tina Tan, a New Jersey state epidemiologist.

Tan has heard reports of caulk and other products being used in the injections, as well as injection substances being purchased outside of medical supply stores, she said.

Not surprisingly, injecting these materials can result in serious health complications and death, she warned.

Hollywood Body & Laser Center: Practicing Medicine Without A License

Hollywood Body And Laser Center seems to have been preforming cosmetic medicine and prescribing mediciations out of their Sandy, Utah location.

The owner of the Hollywood Body and Laser Center in Sandy Utah was jailed Thursday, accused of representing himself as a doctor and performing medical treatments and dispensing prescription medications.

While you don't expect these types of things to actually be happening outside of a motel room, they do.

What's most surprising is that the investigation started in 2008 and it took them this long to make an arrest and (presumably) stop this.

(After our interview with Mr. Adrian Richards, an English plastic surgeon, I'm not sure if any of this would actually be illegal in the UK.)

From the news article

 William Ricker Ferguson, 51, was booked into the Salt Lake County Jail for investigation of aggravated assault, practicing as a pharmacist without a license, practicing medicine without a license, selling, dispensing or otherwise trafficking prescriptions without a license and forgery, all felonies.

A Sandy police press release said an investigation included the Division of Occupational and Professional Licensing. Police identified Ferguson as the owner of the cosmetic procedures business, at 7430 S. Creek Road, which is the corporate office for locations elsewhere in Utah and in other states, according to the company's website.

The Sandy laser clinic, located at 7430 S. Creek Rd., came under investigation by police and the Utah Department of Occupational and Professional Licensing in January 2008, after complaints surfaced regarding owner Richard Ferguson.

Investigators from both Sandy police and the licensing department discovered several illegal actions since 2008, including one incident when an undercover investigator attempted to purchase HCG and Latice under the pretext of giving it to a girlfriend and was able to obtain them without a prescription from laser clinic staff members.

According to charges filed in the 3rd District Court Thursday, the Provo owner left one woman in June 2008 with third-degree burns all over her face and the herpes virus during attempts to give her an Active FX laser treatment on her face.

Charges also list an incident in March 2009 when another woman required skin grafts to repair damage done to her stomach when the 51-year-old defendant attempted to administer liposuction treatment.

Prosecutors say Ferguson refused to refund another woman's money in October 2009 after a laser hair removal procedure wouldn't work on her blond hair. Charges state the woman called several establishments that told her the laser treatment would not work on her blond hair.

A former medical director for the laser center told police that the defendant was using his name and information to obtain controlled substances and HCG without his authorization, charges state. Staff members said Ferguson would use a copy of the medical director's signature to order HCG from a company based out of Florida, and another doctor's signature to write prescriptions.

Ferguson was charged with one count of second-degree felony aggravated assault and another third-degree felony count of the same charge, as well as one count of unlawful conduct of practicing as a pharmacist without a license and three counts of unlawful conduct of practicing medicine without a license, both third-degree felonies.

Prosecutors also charged the defendant with two counts of selling, dispersing or otherwise trafficking prescriptions without a license and 10 counts of forgery, all third-degree felonies.

Medical Spa Horror Stories: Woman Dies From Silicone Butt Injections

Illegal medical spas and filler injection services are up and running, and actually killing people.

If it weren't bad enough that there are websites marketing "do it yourself Botox injections" and "filler injection kits" for home use, there are still people out there who are willing to go to a motel room and have non-physicians inject them will industrial silicon.

Two sisters who were selling Botox, filler injections, and butt augmentation in motel rooms are now on the run. Police say they performed illegal cosmetic surgery from inside their residential home and are the cause of one woman’s death.

Some of their patients (victims) went to police after experiencing infections and hardened body parts after receiving silicon injections. One woman, 22-year-old Mayra Lissette Contreras, would die from respiratory failure a day after getting some silicone shots in her buttocks. The sisters were arrested and charged with practicing medicine without a license but were released on bond and have probably fled to Mexico (see below). 

There's always plenty of  smartass advice to give to anyone who may ever contemplate injecting themselves with fake botox or getting cosmetic surgery while bent over someone’s kitchen counter, but I just couldn’t do better than the advice given by by Deputy Chief Kirk Albanese. “If you are receiving an injection at a home in a residential area, that should be the first warning sign that you shouldn’t be there.” But I will add that whether or not a facility is residential or not,  it’s normally not a good idea to receive cosmetic treatment from a 50-year-old woman who looks like a creature commonly seen in movies being chased around by villagers with pitchforks.

Sisters sought after woman dies from silicone butt injections


Sisters Guadalupe Viveros, left, and Alejandra Viveros, above, allegedly ran an illegal cosmetic filler injection service and squirted silicon into anyone with a check book.

Guadalupe Viveros, 53, and Alejandra Viveros, 50, may have fled the country after Mayra Lissette Contreras, 22, of Pacoima died Friday after receiving the injection, police said. An autopsy was pending Wednesday, said Ed Winter of the Los Angeles County coroner's office. Initial reports indicated that Contreras died from respiratory distress.

The Viveros sisters were investigated last month by the Los Angeles Police Department after other patients complained that the fillers, typically injected in the face or the buttocks, made them ill. The sisters were taken into custody June 21 for practicing medicine without a license, police said. They were held on $20,000 bail before being released.

They were supposed to be arraigned on Monday, but they skipped their arraignment. Police realized that they are probably on the run, and since the two women have connections in Mexico, authorities suspect they have fled south.

Police say the Viveros sisters are not doctors. Neither is licensed to perform medical procedures in the United States.

They have been allegedly operating an illegal cosmetic surgery business and performing expensive procedures in their home rather than in a licensed operating room, cosmetic clinic or doctor`s office. Patients told police they developed infections and said the silicone used by the sisters turned to hard plastic once inside their body.

LA police are searching for these two women and believe they could be in Mexico. People with information on their whereabouts as well as victims are asked to come forward and contact the Los Angeles Police Department.

LA Times article

And if you thought this was a one-of-a-kind event...

San Diego transgender woman dies after illegal silicone injections.

A 45-year-old transgender woman who received illegal silicone injections at a party in a private home in San Diego has died after nearly a month on life support, the county medical examiner said on Monday.

Patricio Gonzalez, who police said received silicone injections to her hips, buttocks, cheeks and lips, died on Sunday. Gonzalez and at least nine other people were injected at a so-called "pumping party" on June 19, police said.

"Pumping parties," where people seeking a more feminine appearance have silicone injected into their bodies, have been on the upswing in the last few years, experts say. The silicone used at the parties is often industrial-grade material like floor sealant.

The Food and Drug Administration banned direct injections of silicone in 1992 and the substance has been known to migrate within the body and cause chronic, degenerative illnesses.

Gonzalez and another transgender woman received more silicone than the other party guests and suffered immediate respiratory problems, prompting the Los Angeles-area woman who was administering the silicone to flee, police said.

Police have issued an arrest warrant for Sammia "Angelica" Gonzalez, 39, who was injecting the party guests with silicone, is believed to have fled to Mexico.

Transgender women often have humiliating experiences with traditional surgery clinics, and surgeons often require a psychological exam before they will consider treatment.

Article

Hey Jay Calvert MD, What Kind Of Website SEO & SEM Is Best For Your Medical Spa?

SEO is fast becoming a necessity in the plastic surgeon - dermatologist - medical spa - laser clinic space.

The need to get your clinic's site ranked on the search engines (most importantly Google, Yahoo and Bing), has led to a proliferation of vendors, many of which engage in nefarious SEO and SEM tactics that cause a lot of irritation and can actually hurt you in the eyes of the search engines.

A case in point is the 'comment spam' that I regularly have to deal with and remove from Medical Spa MD a couple of times a day. These spam comments used to be the familiar junk websites but there's been an increasing trend towards comment spam from more legitimate physicians and medical spas.

This kind of spam is increasingly an irritation as the amount increases and can cost you dearly as websites start banning the IP address that the comment originates from, removes the comment, and reports your IP address to services that monitor and take action against spammers.

Here's an example of comment spamming that someone represending a cosmetic surgeon in LA, Jay Calvert MD FACS, left on a Medical Spa MD forum thread on marketing and advertising about Solta Medical Thermage and Fraxel.

Jay Calvert MD, FACS

The new name of the company sounds good and much better than before. I've heard of this before and been looking for it. I was planning to have a consultation from them for this anti aging services. I heard they're good on it.

Name = Cosmetic surgeon Los Angeles
Email = Dr.Calvert09@gmail.com
URL = http://www.jaycalvertmd.com

doctors actual email address = info@jaycalvertmd.com and cerissa@roxburysurgery.com

Dr. Thomas McHugh

Liposuction and Smart lipo procedures in Houston, Texas is offered at the plastic surgery practice of Dr. Thomas McHugh.
Ambreen Tariq
<a href="http://www.tpmchugh.com/liposuction.asp"> smart lipo Houston </a>

peter thomas
ambreen_directory@yahoo.com
http://www.tpmchugh.com/liposuction.asp

Dr. Shelton for Botox in NYC

Being in a profession where appearance and first impressions are important, I decided to have some “work" done. I never thought I would undergo such a procedure but in today's competitive world and being in my early 40s, I decided to take a proactive approach to aging, my skin and my overall appearance, and consulted Dr. Shelton for Botox in NYC, http://www.thenyac.com/botox-dysport/index.html. My life has never been the same since the procedure. http://www.thenyac.com/

You can see from the comment above that it's clearly spam. The grammer is poor, the comment is totally irrelevant, and there's a link and fake email address. This is clearly just an attempt to get a link from Medical Spa MD.

These spamming services typically use low wage Third World labor oversees to try to spam sites that already rank highly in the search engines in an attempt to build backlinks and increase their own rankings. It's crass, it wastes everyones time and lowers the quality of the sites that are spammed, and it doesn't even work that well. Since the quality is so low the majority of these links are removed anyway. Worse, if anyone reads this crap they think you're an idiot that can't write or spell. Who would want to be treated by a cosmetic surgeon or medical spa that can't spell or form complete sentences?

If you're going to insult me (and every other Medical Spa MD Member) by wasting my time employing this kind of BS, you can bet that it's not going end in the result you're hoping for.

So what should you do?

If you actually want to get high-quality website SEO and SEM services as either a do-it-yourself user that employs your front desk staff to do it five minutes a day, or you want to outsource your medical spas search engine marketing SEO experts that speak English and know what they're doing, contact Frontdesk SEO after you run a free SEO report on your site.

FDA Warns 6 Medical Spas About Lipodissolve Marketing

Lipodissolve (or liposolve or mesotherapy) is a staple in any number of medical spas, but the FDA has just issued a warning letter to 6 clinics that they've crossed the line in marketing lipodisolve to patients.

My own experience with lipodissolve mesotherapy is something of a mixed bag. Clinics that I've been associated with have offered liposolve in the past and I'm aware of one really scary incident where a woman had been treated in Park City over a large area (thights and stomach as I remember) and then went golfing. She colapsed at the golf course and was rushed to the ER at the University of Utah.

She recovered but the administering physician faced some pointed questions from the ER docs about what he'd injected and why.

(The lipodissolve treatment causes fluid accumulation and swelling temporarly. That fluid comes from the blood stream and when there's a large treatment area, that can be a lot of fluid. This can affect the patient's blood pressure and volume, in some cases dramatically. This patient's recent treatment combined with golfing in the sun, walking, and dehydration was enough that she tipped over and (I think) lost conciousness for a few moments.)

If you're offering lipodissolve, leave a comment below and detail your experiences, results and thoughts... especially if you're from one of the 6 medial spas named below.

Anyway, here's the FDA story via USNews.com

FDA Issues Warning on 'Fat-Melting' Spa Injections

There's no proof the procedures work and serious side effects can occur, agency says

Claims by spas that "lipodissolve" injections can melt away fat are unsubstantiated and the procedures' safety also remains in question, according to warning letters issued Wednesday by the U.S. Food and Drug Administration.

The FDA warned six U.S. based medical spas and a Brazilian company to stop making false claims about the drugs used in these procedures.

Sold on the Internet and used by some spas, lipodissolve is a procedure that its proponents claim will eliminate fat. U.S. companies claim that the drugs used in the procedure are safe and effective, but these products have never been approved by the FDA, the agency said.

"We are concerned that these companies are misleading consumers," Dr. Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research, said in a prepared statement. "It is important for anyone who is considering this voluntary procedure to understand that the products used to perform lipodissolve procedures are not approved by the FDA for fat removal."

Lipodissolve involves several injections that supposedly dissolve and remove small pockets of fat from areas of the body.

Lipodissolve is also known as mesotherapy, lipozap, lipotherapy, or injection lipolysis. The drugs most often used are combinations of phosphatidylcholine and deoxycholate.

Sometimes other ingredients such as vitamins, minerals and herbal extracts are added into the mix, the agency said.

However, there is no "credible scientific evidence that supports the effectiveness of any of these substances for fat elimination, and their safety when used alone or in combination is unknown," the FDA said.

The FDA has asked for a written response from the U.S. companies within 15 days outlining how they plan to correct the violations and prevent future violations. Failure to correct the violations could result in legal action, the agency said.

Each company has been cited for a variety of violations, including making "unsupported claims that the products have an outstanding safety record and are superior to other fat loss procedures, including liposuction," the FDA said.

Also, some of these companies have claimed that lipodissolve can treat certain medical conditions, such as male breast enlargement, benign fatty growths called lipomas, excess fat deposits and surgical deformities.

"The FDA is not aware of clinical evidence to support any of these claims," the agency said.

FDA officials have received reports of negative side effects from people who have tried the procedure, including permanent scarring, skin deformation, and deep painful knots under the skin in areas where lipodissolve drugs were injected.

Warning letters were sent to: Monarch Medspa, King of Prussia, Penn.; Spa 35, Boise, Idaho; Medical Cosmetic Enhancements, Chevy Chase, Md.; Innovative Directions in Health, Edina, Minn.; PURE Med Spa, Boca Raton, Fla.; and All About You Med Spa, Madison, Ind.

The Brazilian company receiving the warning letter sells lipodissolve products on two Web Sites: zipmed.net and mesoone.com, the FDA said.

The FDA also has issued an import alert against these Internet sites to prevent the drugs from being imported and distributed in the United States.

Well, the zipmed and mesoone sites are both down and have this simple statement.

Due to the current facts, Mesoone.com and Zipmed.net do not sell Lipodissolve vials anymore. Thank you. For more information access www.fda.gov

Leave a comment below.

Idiot Ass Augmentations Hospitlize Six In New Jersey

In the 'you've got to be kidding me' category... Six women in NJ ended up in the hospital after they were injected with 'bathroom tile calk' from unlicensed ass-injectors.

This rings of the other idiots who are/were injecting themselves at home with an unknown 'do it yourself Botox' substitute.

(CBS/AP)  Six women in New Jersey are recovering after they received buttocks-enhancement injections containing silicone used to caulk bathtubs.

State health officials say the women, from Essex County, apparently underwent cosmetic procedures from unlicensed providers.

Investigators have not determined if the cases are related.

No arrests have been made.

Instead of medical-grade silicone, the women received a diluted version of nonmedical-grade silicone.

"The same stuff you use to put caulk around the bathtub," said Steven M. Marcus, executive and medical director of the New Jersey Poison Information and Education System, according to The Star-Ledger.

State epidemiologist Tina Tan says there's the risk for more serious complications when infections are not treated early.

Gregory Borah, chief of plastic surgery at Robert Wood Johnson University Hospital in New Brunswick, told the newspaper the incident was "a tragedy."

Using over-the-counter silicone can cause abscesses that he said resemble "a big zit."

Borah, also president of the New Jersey Society of Plastic Surgeons, said the botched procedures underscore the need for patients seeking such enhancement to seek out licensed professionals in a sterile setting, the newspaper reported.

American Laser Clinics Trouble In Iowa

Armed guard protects ALC patients from the supervising physician who is supposedly overseeing their treatment.

American Laser Clinics operations are stopped by a medical board yet again.

This reminds me of the armed guard that American Laser Clinics stationed in the laser clinic to prevent the supervising physician from seeing patients... while they treated those very same patients under his 'medical direction'.

According to the Quad City Times:

A doctor who led a medical spa in Bettendorf has been sanctioned by the Iowa Board of Medicine.

Anthony O. Colby, of Iowa City, was the medical director and/or supervision physician at American Laser Center in Bettendorf, Coralville and West Des Moines, documents from the board said. The Bettendorf location is at 852 Middle Road.

The center’s West Des Moines office was also issued a cease-and-desist order by the board, saying that the center must stop “the unlawful practice of medicine in Iowa,” records indicate. The board says a person at that office performed medical services without proper physician oversight.

A spokesperson for American Laser Center, a chain with 225 clinics nationwide, could not be reached for comment. Colby could not be reached for comment, either.

According to board documents, Colby has insufficient training or experience to supervise individuals performing medical aesthetic services in Iowa. The board also alleged that Colby failed to properly supervise those who performed such services.

Specifically, at least one patient suffered serious burns on her arms after receiving treatment for hyper-pigmentation on her face and arms by a person under Colby’s supervision.

The board ordered that Colby not serve as the medical director for a medical spa that offers specific types of services or supervise anyone who performs those services.

He was ordered to pay a $5,000 fine and warned that any more violations could result in further disciplinary action.

As for American Laser Center in West Des Moines, the board determined that non-physicians were performing examinations, diagnosing medical conditions, offering treatment recommendations and performed medical procedures, including the use of lasers for the treatment of hyper-pigmentation and cellulite removal.

Dysport Reviews

Evidently Dysport is very friendly with some docs. Too friendly for the FDA when it comes to promoting Dysport before it's been approved.

From Pierce Mattie PR:

It appears it is not only bloggers that are feeling the heat from the government in regards to their relationships with the brands they write about, but cosmetic dermatologists as well. Recently the FDA made an example of Dr. Leslie Baumann by sending her a warning when she was sourced for several beauty magazine articles regarding her positive praise of Dysport, the newly approved Botox competitor created by Medicis prior to such approval. The warning appears to have more to do with disclosure than anything else, which, mark my words, will be the buzzword of 2010 due in part to both the FTC and FDA.

Dr. Baumann was given 10 days to "clean up her act;" I wonder how her publicists will handle that.

It is a publicist's job to land their client in A+ publications and in this fierce competitive world of Beauty PR, everyone wants to be first to be sourced for being in the know about the latest and greatest beauty treatment.

However, Dr. Baumann's publicists should've been more careful considering her relationship with Medicis as an "investigator" for Dysport. In all of the articles she was quoted in, not once did she disclose this relationship, but merely indicated her praise that the neurotoxin was more effective than Botox.

Nu U Medical Spas Sued By Illinois State Attorney General

Attorney General Lisa Madigan has filed a lawsuit against the Chicago-area medical spas, Nu U Med Spas, for performing unapproved procedures without a physician's supervision and luring patients through deceptive marketing.

This looks like it started with an expose by local Chicago television news.

The seven NuU Medspas in the Chicago area aggressively promote Lipodissolve, a series of injections that supposedly will melt your fat away.

The ads talk about reduced inches with no knives, no tubes, and no pain -- a deceptive ad, patients say.

NuU does not tell clients that Lipodissolve is not approved by the Food and Drug Administration.

"There is no study out there that shows clearly whether it works and what specifically are the risks of it," said Northwestern Memorial Hospital's Dr. Michael Lee.

That's not a problem, said NuU district supervisor Laura Rowsey, formerly a modeling school sales manager.

"This is a soy-based mineral with amino acids," Rowsey said. "Bruising and swelling is like your worst case scenario with this treatment."

But doctors have seen a number of Lipodissolve complications.

Cynthia Sacramento, who went to the Lincoln Park spa, suffered painful scar tissue buildup around her injection site that will require surgery.

Dr. David Song of University of Chicago Hospital said the entire injection area will have to be excised.

Sacramento said she's devastated.

Even proponents say Lipodissolve is for treating pockets of fat, not for bigger weight problems.

NuU in Lincoln Park signed another former client, who preferred to remain anonymous, up for $2,400 in treatments on his belly.

"I think it's a big scam, a waste of money," he said. "The only thing that got thin on me was my wallet."

NuU sales people are pressured to meet sales goals and arrange for many clients to finance their treatments. The money is collected up front and NuU claims it's not refundable.

"Our goal was to get $15,000 a day," said former NuU spa manager Patti Feinstein.

Feinstein recalled how Rowsey scolded her for turning away a skin cancer patient saying, "You are not going to make quota if you don't sell," Feinstein said.

Records show her spa sold made more than $200,000 a month.

Ouch. You have to love how a reporter makes a point of stating that the Nu U spokesperson was fromerly a sales manager for a modeling school. Looks like another slap-down for Nu U Medspas. Madigan's complaint claims that Nu U Med Spas try to lure customers into buying "Lipodissolve, which is an injected therapy used to dissolve fat cells." Here's the full press release:

MADIGAN FILES LAWSUIT AGAINST CHICAGO AREA Nu U MEDICAL SPAS

Attorney General Alleges Nu U Performed Unapproved Procedures Without Physician Supervision And Used Deceptive Marketing to Lure Patients

Chicago — Attorney General Lisa Madigan today filed a lawsuit in Cook County Circuit Court against Nu U Med Spas for deceptively marketing and performing unapproved, unsupervised cosmetic treatments that caused some patients to experience extreme pain and lasting injuries.

“These procedures have yet to be thoroughly researched and sanctioned by the proper medical authorities,” Madigan said. “Despite lacking concrete scientific evidence, Nu U purposefully misleads consumers into believing that their medical spa treatments are safe and effective. I’m very concerned that the health and safety of Illinois consumers who visit Nu U Med Spas are at risk.”

The Chicago-based medical spa chain allegedly uses high-pressure sales tactics based on deceptive marketing claims to induce consumers into purchasing a series of medical and beauty treatments, including Lipodissolve, which is an injected therapy used to dissolve fat cells, according to Madigan’s complaint. Nu U allegedly claims its treatments will “liquefy fat quicker” and can “rid your system of that life long battle of the bulge,” but Nu U fails to inform consumers that its treatments haven’t been approved by the U.S. Food and Drug Administration (FDA) as safe and effective treatments. Both the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons do not recommend using Lipodissolve for fat reduction due to the lack of research that shows its effectiveness.

Further, because Lipodissolve is an injected treatment, it requires a physician’s order, but Nu U allegedly administers the fat-reducing treatment without a doctor’s order. In fact, despite its outward claims, Nu U allegedly fails altogether to monitor and evaluate patients by licensed physicians at all seven of its Chicago area locations.

Madigan’s complaint further alleges that the Nu U personnel rush consumers into signing contracts, medical consent forms and financing documentation for treatments but fail to review the documents with consumers. The defendants allegedly pressure consumers to sign up for health care financing but fail to inform consumers that by signing the financial documentation they are authorizing an automatic credit card charge. Nu U allegedly refuses to provide refunds when requested, even in the event that a consumer has not received all of the contracted treatments.

Madigan’s lawsuit charges Nu U with violating the Illinois Food, Drug and Cosmetic Act, the Illinois Medical Practice Act and the Illinois Consumer Fraud and Deceptive Business Practices Act. It asks the court to permanently enjoin the defendants from owning or operating medical or beauty clinics in Illinois and to order the company to pay civil penalties of $50,000, an additional $50,000 penalty for each violation committed with the intent to defraud, an additional $10,000 penalty for each violation committed against a senior citizen 65 years of age or older, and the costs associated with the investigation and prosecution of the lawsuit.

To be honest, this looks like some grandstanding on the part of the Attorney General. Lipodissolve is used in perhaps thousands of medical spas and cosmetic practices around the country without 'painfull scar tissue build up' and complications.

And what does it actually mean when. "Dr. David Song of University of Chicago Hospital said the entire injection area will have to be excised."? An entire treatment area excised from needle sticks? Seems fishy to me. Might well be something of a hatchet-job.

Anyone have thoughts on this?

Do it yourself Botox, Restylane, & Juvederm Disasters.

So while there are still a number of people posting on how much the love Laurie D'Alleva and her videos touting the benefits of do it yourself Botox, there are a growing number of people who still have a non-paralyzed thought or two that are coming forward to talk about the problems you might have pumping fillers into your face. Perhaps the do it yourself Botox crew are also attracted to Trepanation.

Here's a story from ABC News: Watch the video on "20/20"here.

Some consumers are ordering prescription-only cosmetic products online and injecting themselves at home. One woman who self-injected her face with filler said it caused bags and lumps under her eyes, and a hard, infected pustule on her cheek.

For millions of Americans, the solution to crow's feet, thin lips, and frown lines is at the end of a syringe, or in a bottle. A quick trip to a medical spa, dermatologist or plastic surgeon for a Botox injection, lip augmentation or chemical peel offers the promise of a youthful look.

But these cosmetic procedures -- and the medical expertise that comes with them -- don't come cheap. For a single treatment of Botox, doctors charge about $380; for lip-plumping injections, over $500; and for a chemical peel, a whopping $700.

These high prices are enough for some consumers to take their business away from medical professionals, and go instead to the Web. They are "doing it themselves," ordering prescription-only products online, and injecting themselves at home.

Laurie D'Alleva, of Mansfield, Texas, is a big fan of "DIY" beauty injections and treatments. She is the face of a DiscountMedSpa.com, a website stocked with what she claims are pharmaceutical-grade cosmetics, similar to Botox, Restylane, and Retin-A. 

Self-injecting botulinum toxin might sound dangerous, but D'Alleva, 39, tries to put her customers at ease with informational videos, complete with tips and pointers on how, and where, to inject. "It doesn't hurt... It's easy," D'Alleva claims in one video, as she stands in front of a mirror and injects her face repeatedly.

Disaster isn't what "Alex," a paramedic, had in mind when she visited DiscountMedSpa.com a few months ago. In her 40s and dating, she just wanted to improve her look, and save some money. She asked ABC News not to disclose her identity.

After viewing "every one" of the instructional self-injection videos on D'Alleva's site, Alex was convinced she could do it herself, since using needles was part of her job.

"Why should I pay somebody else that got a few hours of training to do something I think I can do pretty easily?" she said she thought at the time.

Alex paid $450 for a DiscountMedSpa.com products including an injectable facial filler. She says she injected the products under her eyes and alongside her mouth.

But "the next morning, I woke up horrified by what I saw," she said. "Literally, my heart started pounding, and I thought, 'What have I done, what am I going to do?'"