The Wacky World Of Oversized Breast Implants

Three New York women who underwent breast augmentation surgery say they never wanted to look like Pamela Anderson and are suing because of oversized implants.

The three are suing Dr. Brad Jacobs, saying he left them deformed by stuffing oversized implants into their breasts.

"I wanted to leave with a 34B -- but the day after my surgery, I was huge," Felice Rosenbaum of Manhattan told the New York Post. She said when Jacobs was finished she was a double-D, with the aching ribs and shoulders to prove it. "I was a small D -- now I'm a double-D, nearly a triple-D," she told the Post. "I didn't want them bigger, I wanted them repaired because they were leaking."

Nothing Brings Out Anger Like Thermage

It's surprising to me how polarizing Thermage as a treatment seems to be. There are 5 threads on Thermage going on in the Physician to Physician discussion area. While the 'pro' Thermage docs seem to be relatively calm, the 'con' side is much more strident in their views. ( It appears that the docs panning Thermage appear to be plastic surgeons but who knows.) It seems to be particular to Thermage for some reason, Cutera's Titan or Fraxel  don't seem to evoke nearly the outrage.

Here's a sample: 

If you feel that you must scam your patients because you don't have a real treatment or can provide a real surgical intervention for them because you're not qualified to be doing what you are trying to "sell" to unsuspecting patients...

Pretty strong stuff. Most doctors hesitate to accuse other physicians of running scams on their patients but Thermage seems to push some right off the edge.

Lawrence Of Arabia & Physician Turf Wars

I was watching Lawrence of Arabia tonight while I caught up on some of my online reading.

While I was reading a quote from a plastic surgeon that condecendingly belittled cosmetic treatments perfomed by physicians who were not 'board certified' plastic surgeons. I find this argument to be entirely self-serving.

I was struck by a parallel from Lawrence of Arabia where Lawrence (Peter O'toole) says:

So long as the Arabs fight tribe against tribe, so long will they be a little people, a silly people.

The turf wars that are common to medicine are pedantic and petty for the most part and docs know it.

Top Ten Causes Of Skin Allergys

• Nickel (nickel sulfate hexahydrate). A metal frequently encountered in jewelry and clasps or buttons on clothing.
• Gold (gold sodium thiosulfate). A precious metal often found in jewelry.
• Balsam of Peru (myroxylon pereirae). A fragrance used in perfumes and skin lotions, derived from tree resin.
• Thimerosal. A mercury compound used in local antiseptics and in as a preservative in some vaccines.
• Neomycin sulfate. A topical antibiotic common in first aid creams and ointments, also found occasionally in cosmetics, deodorant, soap, and pet food
• Fragrance mix. A group of the eight most common fragrance allergens found in foods, cosmetic products, insecticides, antiseptics, soaps, perfumes, and dental products.
• Formaldehyde. A preservative with multiple uses. It's found in paper products, paints, medications, household cleaners, cosmetic products, and fabric finishes.
• Cobalt chloride. Metal found in medical products; hair dye; antiperspirant; objects plated in metal such as snaps, buttons or tools; and in cobalt blue pigment.
• Bacitracin. A topical antibiotic.
• Quaternium 15. A preservative found in cosmetic products such as self-tanners, shampoo, nail polish, and sunscreen or in industrial products such as polishes, paints, and waxes.

Medical Board Accuses Second Doctor In Medspa Death

The North Carolina Medical Board filed unprofessional conduct charges Thursday against a doctor who headed a laser hair removal clinic where a student died last year.

Shiri Berg, a 22-year-old North Carolina State University student, died of a Lidocaine overdose Jan. 5, 2005, after she applied a powerful anesthetic gel to her legs in preparation for a laser treatment at Premier Body Laser and Skin Clinic, in Cary.

The medical board alleged that Dr. Samuel Wurster, the former director at Premier Body, acted improperly by authorizing Triangle Pharmacy to blend the prescription-strength gel and then permitting the laser clinic to distribute the gel to patients without a physician taking a medical history or giving a physical examination...Link to the entire story.

Mobile Transcription Service

I was introduced yesterday to Copytalk, a transcription service based in India that records up to 4 minutes of voice, transcribes it, and sends it your or any 4 email addresses you want the same day. (It's $50 a month for unlimited transcriptions.)

Complexity Causes 50% Of All Returns

If your med spa or laser clinc is built around so many options that your brochure looks like the Sears catalogue, you may want to read this article: Complexity causes 50% of product returns, which goes on to say:

Half of all malfunctioning products returned to stores by consumers are in full working order, but customers can't figure out how to operate the devices. Product complaints and returns are often caused by poor design, but companies frequently dismiss them as "nuisance calls.

The average consumer in the United States will struggle for 20 minutes to get a device working, before giving up.

Most of the flaws found their origin in the first phase of the design process.

This last one might be viewed as the most important. During the design of a system program or product, most of the problems with interface or use that are going to crop up are built into the system. Make any system you build adhere to a single, simple rule: Be able to explain the entire offer/system/pricing in one short sentence.

Restylane & Dermal Filler Injections

Dermal fillers, which plump up wrinkles and firm up the skin, are among the hottest and fastest-growing new treatments. Last year, more than 1 million Americans used injectable soft-tissue fillers such as Restylane, Sculptra, and Radiance to compensate for the loss of fat and collagen in the face that comes with age. Restylane, a gel made from hyaluronic acid, has been the subject of several positive clinical trails in the United States and Europe, and the risk of an allergic reaction is very low (1 in 1,600). Most fillers are naturally absorbed by the body and have shown no evidence of building up over time or causing long-term problems. But they are still relatively new. Some people have their own fat injected, which is extremely low risk. Such fat is absorbed fairly quickly, and the effects usually last no more than a couple of months, doctors say.

Restylane is typically injected into the creases from the side of the nose to the corner of the mouth and along the upper lip to fill out fine lines. Restylane and other hyaluronics last three to six months and can cost anywhere from $400 to $1,000 and up, depending on how many vials you need. "Hyaluronics give very nice corrections if the patient isn't too far along," says Robin Schaffran, a Beverly Hills, Calif., dermatologist. "But if you need to use a lot of material it could lump up, and the person would be better off with a face-lift." Sculptra, which is injected deep under the skin to stimulate collagen production, can last up to two years and typically costs at least $3,000 for two treatments.