9 Questions to Ask When Considering a Facelift

From time to time, the American Society for Aesthetic Plastic Surgery (ASAPS) sends out informative articles about cosmetic surgery. Here's an abstract of one I recently received as a board certified plastic surgeon member

What to think about when you want a facelift

Despite the growing use of Botox and injectable fillers, the facelift, continues to be a popular choice for longer-lasting results. The ASAPS reports in 2012, 119,006 facelifts were performed, a 2.5 percent increase vs 116,066 facelifts in 2011

Here are 9 things to think about when considering facial rejuvenation:

1. Am I a good candidate for a facelift? Ask your plastic surgeon. He or she will advise you, considering your age, skin type and goals.

2. What kind of facelift should I get? Finding the right surgeon is more important than deciding on the right surgical technique. Look at the surgeon's facelift results. If you like them, trust the surgeon's advice to get the results you want.

3. How long does the surgery take, and what is the recovery time? A mini-facelift takes less than two hours. A standard facelift usually takes three to four hours and may take up to six when combined with other things like eyelid or brow surgery. Recovery times differ but, generally, noticeable swelling goes down in 10 to 14 days.

4. How will I look different? A good facelift should make you look younger, more rested and relaxed.

5. What should I look for in a plastic surgeon? Carefully inspect the before-and-after photos on the surgeon's website. You may also ask to see additional photos during your initial consultation. Make sure your surgeon is certified by the American Board of Plastic Surgery (ABPS).

6. What are the risks? As with any surgery, a facelift procedure carries risks. Infection is rare, but possible. Bleeding after a procedure may result in hematomas. Healing is usually uneventful (unless you are a smoker) and nerve damage is usually temporary. The risks are closely related to your surgeon's skills, but there are risks even in the best surgeon's operating room.

7. Should I wait to lose weight before having a  facelift? If it is just a few pounds it won't make much of a difference. If it is more, hold off until you feel comfortable with your weight.

8. How long will the effects of a facelift last compared with fillers? Unlike the temporary results from fillers, which may require follow up treatments in a few months, results of a facelift will last for years. How long, of course, depends on skin quality, significant weight changes and environmental factors such as excessive sun exposure.

9. Should I undergo other procedures together with my facelift? A procedure commonly done in conjunction with facelifts is a blepharoplasty or eyelid lift. These procedures are frequently performed together, as indicated by need.

If you choose me as your surgeon, these questions and any others you may have will be discussed to your satisfaction during your consultation with me, for which I charge nothing.

Put your best face forward onlin

Nothing brings attention to self-image like social media in today’s age of high definition and instant recall. Pictures on Facebook, Instagram and Pinterest can go from several hundred to multiple thousands. Even your professional LinkedIn profile asks for a headshot. This awareness has caused some to run to their board certified plastic surgeon’s office for a ‘facebook facelift.’  What is this you ask?  Social media and online dating sites have changed the way people get to know you, stay in touch with you or are introduced to you for the first time.  How you look online is suddenly just as important as a first impression in person, so some people turn to cosmetic surgery to put their best face forward. Depending on your age, genetics and lifestyle, the recommended treatment will vary.  Young men and women in their 20s often choose procedures that will help them gain aesthetic symmetry or proportion. Perhaps their nose shape or size overwhelms the face. Others could have thin lips or a weak chin. These problems can be addressed by surgical procedures that can help improve facial balance or by using fillers that can increase volume in deficient areas.  In your 30s, when the first signs of facial aging appear. You will have to work hard to stick to a proper skincare routine that exfoliates, hydrates and adds nutrients to your skin. The first signs of wrinkles and the loss of volume can be treated with injections of Botox and fillers. If you see yourself with bags under the eyes, the beginnings of creases when you smile and patches of brown spots from sun damage, you may want to talk to a board certified plastic surgeon about nonsurgical treatments and an anti-aging strategy.  If you are a "mature" internet-user keeping in touch with family and friends can also benefit from Botox, fillers and skin rejuvenation techniques; however, a face lift might be worth consideration.  Men and women are having face lifts earlier to get in front of the aging curve - some from their late 40s to early 50s. The skin and body is healthier, so surgery could be easier and keep you looking younger for longer.  Lastly, keeping the skin clear and bright is key to looking good at any age. A tan might have an immediate good effect. But years of harsh UV rays without sun protection can cause premature wrinkling. With laser skin resurfacing, microdermabrasion and chemical peels, along with staying out of the sun, you can improve skin while preventing further aging.  Even if just sharing with close friends, many are choosing to improve how their faces look in photographs. From nonsurgical procedures that can refresh your look, to a more in-depth procedure that can turn the clock back, talk with a board certified cosmetic surgeon about ways to put your best look on display.

There is no product that can't be made cheaper..

... and less effective... or more dangerous

There’s an irresistible urge that draws us a scent  of a ‘bargain’. Everyone wants to save money. But hold on just  minute. Some of those irresistible bargains just might include serious repercussions, particularly the “deals” related to maintaining your youthful appearance.

The Federal Drug Administration (FDA) warns that “deals” on Botox injections and filler products, might not be such a good idea.

According to a recent TV news segment, some med spas in the United States are promoting some non-approved "Botox" and filler products, that cost less than the real thing. These are being offered via online “deal” sites.

According to the reports, "Most commonly, the med spas dilute the injected product” making it “less than optimal for what you are paying for." In other words, the injections may not work as well, or could even cause more trouble than the so-called savings.

In fact, many plastic surgeons and dermatologists say that they end up having to “fix” the results of the faulty products. But, with so many phony products out there, how do you protect yourself from diluted or faulty versions of a filler?

Simply.ask to see the box. Make certain it's an FDA approved product like “Botox,” “Dysport” or “Juvederm.”

These are specific FDA-approved brands. Which means they have been tested for efficacy and safety

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Yes. There  is one other precaution you can take - Use a board certified cosmetic surgeon.  After all, you are having a foreign substance injected into your system. Doesn't it make sense to have a properly trained and qualified surgeon on board? 
Instead of saving a few bucks, you could be saving your health.

You lead with your chin. Tighten it up.

So many options for firming up a sagging jawline

Lifts, liposuction, injections and lasers

In “I Feel Bad About My Neck,” Nora Ephron wrote, “Our faces are lies and our necks are the truth. You have to cut open a redwood tree to see how old it is, but you would not if it had a neck.” 

She had a point. But an equal embarrassment sits right above the neck. It's the sagging jaw line.   

When you reach your early 40s, you may notice the "drop zone", the skin between your neck and jaw. Once a taut right angle, it's now simply dropping. When a friend pulls back the skin in front of her ears and asks, “Tell me the truth, don’t I look better like this?” We answer dishonestly: “Don’t be silly. You look great the way you are.”

Aging jaw and neck are challenging. The neck has three layers: skin, fat, and muscle. Sagging muscles and bulging fat are located under the thin skin. To make it worse, a thin rope-like material called platysma tends to split into a V-like formation of two cords that stick out especially when they contract. To witness this, if you’re over 40, look in a mirror, say “eee,” and watch what happens. "Horrors!" you say to yourself. A colleague in Manhattan observes, “Trying to fix all of that with potions and lotions is like waging a two-front war on a sheet of thin ice.” He recommends a neck lift for women in their early to mid-40s who are not ready for a facelift.

Neck Lift/Facelift

The neck lift wraps sagging muscles crosswise to the jaw to restore that all-important right angle. Compared with a facelift, sutures are smaller, there is less pulling and recovery time is much shorter. However, a neck lift has traditionally been part and parcel of a facelift and many plastic surgeons believe it should remain so. The reasoning is that, anatomically, the muscles of the neck are connected to muscles of the face, so if you try to tighten just the neck muscles, you will do you face a disservice. Using this line of reasoning, even if your big complaint is your neck, you will get better results with a facelift. If you’re confused about which procedure is right for you, have me give you feedback while perusing your very own unique face and neck.

Liposuction and the double chin

The face and neck are usually treated at the same time, often in conjunction with liposuction to sculpt the area beneath the chin and jaw line. Weight gain can lead to looser skin, weaker muscles and free falling fat, all of which may contribute to your drop zone. Younger patients who have fatty necks but no significant facial aging may be treated with liposuction alone. Some plastic surgeons also might use laser or light technology to tighten necks.

Preventive Botox

Botox in areas where wrinkling and creases can occur may prevent deeper lines from forming and will help maintain a youthful appearance. Defer those angry or tired lines so people will not notice that you’ve had anything done.  Botox can also soften those V-shaped platysma cords.

Your own belly fat

Another alternative is injecting fat from the belly into the jawline area to provide extra volume. This will include the bonus of your own stem cells. Extra stem cells are separated from the fat via centrifuge and then added, making the skin glow more and enhancing collagen.

  

Even though you might favor one of these options, it’s a good idea to have an open mind when you come in to see me for free consultation. It's best to let me suggest the very best procedure in view of your very own unique facial characteristics. 

I'd like to share with you an article concerning injectables that I recently received from the American Society for Aesthetic Plastic Surgery.  As a cosmetic surgeon in Fort Myers, Florida, who is a board certified member of the ASAPS, I receive these insightful articles regularly. It's the kind of information a lay person would not normally be exposed to. I will excerpt it here:

"In the hands of a licensed, expert injector, wrinkle treatments such as Botox and Dysport or a Hyaluronic Acid Filler, such as Juvederm or Radiesse, could help you rejuvenate and refresh your look. 

In the increasingly competitive plastic surgery field, however, an alarming number of unlicensed, unqualified individuals are trying to pass themselves off as plastic surgeons.

There also are the ever-present unscrupulous individuals offering back alley Botox, illegal silicone butt injections and other toxic, non-medical procedures. 

A recent news article highlighted a woman who lured a UK woman to the US and injected illegal, toxic silicone into her buttocks in a hotel room, which caused her death from a pulmonary embolism. 

It has never been more important for you, as a consumer, to do your research. Find out if your injector is qualified and the facility where you are being injected is accredited, and look at the label before anyone begins injecting.

There have been a number of new procedures and updates as well. The increasing use of social media and web-cam chat programs encourage what some like to call the “Facetime Lift,” which uses injectables like Botox and fillers, in conjunction with surgery, to create better angles and volume in certain areas. 

Recently, a German-based company, Kythera Biopharmaceuticals has completed clinical trials in Europe on a new injectable that could help you lose that double chin. Instead of having a costly liposuction procedure for thousands of dollars, you could have an injectable that targets small pockets of fat and save the cost of having an invasive surgery, the time for the procedure and a lengthy recovery. The company is currently doing clinical trials in the US that should be completed by mid-2013. At that time the company plans to submit the product to the US Food and Drug Administration (FDA) for approval to sell here in the States. 

Men might not be the big beauty spenders, but don’t underestimate their growing use of popular injectables. Over 10% of all Botulinum Toxin type A injections are for men, making it the most popular plastic surgery procedure for both sexes. Many men who work on Wall Street or high-stress work environments that are very competitive are turning to injectables to look refreshed and compete in the workforce. The subtlety and less dramatic changes achieved from injectable procedures also draw men in, one news source reports. They are looking for improvements, not a complete makeover.

Whatever your reason for choosing an injectable procedure, be sure to do your research. Pick an injector based on experience and medical licensing, not solely on cost.

Options for facial rejuvenation

This is information from another communique from the American Society for Aesthetic Plastic Surgery, of which I am a member as a board-certified cosmetic surgeon. 


Options for Rejuvenating Your Face - Surgical solutions and non-surgical alternatives

When you go to your high school reunion, you don't want your classmates to squint at your name tag in confusion. You want them to instantly recognize you and think that you look well-rested and "good" for your age.  In the past there was only one way to rejuvenate your face: it took a scalpel, several weeks off from work and a nice chunk of change. Today, however, nonsurgical options that promise to turn back the clock are proliferating at a dizzying rate. 

Is it overwhelming to consider so many options on your own? Instead, schedule a free consultation with me or any board-certified plastic surgeon equipped with the latest and greatest nonsurgical innovations. 

Face-to-face with your doctor, you can be presented with procedures that offer the results you want. Both surgical and non-surgical options yield improvements but, as you may expect, the level of improvement will not be the same and the surgical option will yield more significant and more durable changes.

So you can go into your consultation with some knowledge, here is a "heads-up" (pun intended), from hairline to the base of the neck, about some surgical and non-surgical approaches to facial problems that occur with aging:

Drooping Forehead

Surgical: A forehead lift involves incisions in the hair-bearing scalp to rejuvenate the upper third of the face through lifting. 

Non-surgical: Botox is injected in the forehead to soften frown lines. Botox and fillers may be injected around brows to lift and add fullness.

Dark Circles, Eye Bags, Hooding of the Upper Eyelid

Surgical: Blepharoplasty removes fat deposits, excess tissue or muscle from the eyelids to improve the appearance of the eyes.

Non-surgical: Frown lines can be softened and Crow's feet minimized with injections of Botox or Dysport; three times a year in both areas will do the trick. When injected above the eyebrows, Botox or Dysport can also give a ten-degree lift to the arch and a slight lift to the tail. To get rid of under eye bags, a plastic surgeon or dermatologist can inject your own fat, which will last 2 years or more, or hyaluronic acid, which will last up to a year.

Sagging Cheeks

Surgical: With aging, the distance between the eyes and cheeks increases. In the midface lift, the malar fat pad overlying the upper cheek is lifted to its youthful position with either sutures or an absorbable implant, restoring a youthful, heart shaped face. 

Non-surgical: A doctor can restore high, full youthful cheeks using injectables such as Restylane, Radiesse, Juvederm or other fillers. Injected over the cheekbones or in depressions, fillers can add fullness to sunken or sagging cheeks for more than 18 months.

Droopy Nose

Surgical: With aging, the tip of the nose may drop down and inwards towards the face. The drooping tip may cause a slight hump on the bridge and appear to cover up part of the upper lip, especially when you smile. A rhinoplasty procedure rejuvenates the nasal tip, which is re-supported with a cartilage graft. An added bonus is that re-elevation of the tip can improve nasal air flow.

Non-surgical: If Botox is injected at the base of the nose by a skilled injector, slight nasal tip elevation may be achieved, resulting in a nose that stays turned upwards, rather than droopy - even with big smiles. If your nose droops when your face is static, Botox will not help. Injectable fillers such as Juvederm may be used for nose shaping/augmenting purposes in a non-surgical rhinoplasty. 

Thinning upper lip and droopy mouth

Surgical: With age, the upper lip lengthens, sags and thins. An upper lip lift shortens the lip by removing a small ellipse of skin under the nose-lip junction, creating fuller mucosal show. The corner lift, removing a small triangle of skin above the corners of the mouth, elevates a downturned mouth, making you appear happier.

Non-surgical: Volumizers, such as Juvederm Ultra Plus and Perlane, injected in the lips, can restore the ideal volume ratio of upper to lower lip, creating fuller plumped lips. "Smoker's" or "lipstick bleed" lines can be treated every six months with Botox to soften them and micro droplets of fillers to plump them.  Lips may also be injected with collagen or your own fat harvested from another site. Both liquid collagen and fat are absorbed, so repeat treatments are necessary to maintain results. Newer, longer-lasting options include implantable materials like AlloDerm and SoftForm.  

Sagging jawline, neck, prominent neck cords

Surgical: Many different varieties of facelift approaches smooth the face and neck skin, tighten the underlying tissues and muscle and remove excess skin. 

Non-surgical: To camouflage a sagging jawline, Juvederm or Restylane may be injected, lasting up to 18 months. Botox or Dysport, fillers and laser treatments can be used to reduce the appearance of neck cords. Fillers may be injected to smooth a pebbly chin. Fillers can be injected to reduce smile lines between the nose and mouth corners. Botox or Dysport injections can make neck cords recede. Neckline appearance can be softened with mini doses of hyaluronic acid fillers combined with Botox or Dysport.

Get the best results by finding a medical professional with the appropriate board certification. 

Be sure to ask how long and how often this doctor has been doing the procedure you desire. In a tough economy, nonsurgical facial rejuvenation seems to offer a cost-effective alternative for looking good. But, does it really? Ask your doctor how frequently you'll need to repeat the nonsurgical procedure. Then consider your age and do the math. You may find that a surgical procedure is more economical in the long run - or you may not. Some believe that fillers help skin regenerate natural collagen, and neuro-toxins like Botox help retrain your muscles so the face creases less. 

Final advice: schedule your surgical or non-surgical procedure far enough in advance of an important event, so that you are healed and look your best.  

PS: I am currently offering three special "non-surgical packages" for the Holiday Season:

Happy, Holiday Face Special  #1 -  25 units of Botox, one syringe of filler (Juvaderm or Restylene) and a regional peel, i.e., around the mouth or the eyes or even the forehead. $999.

Happy, Holiday Face Special # 2 - 40 units of Botox, two syringes of filler,and a regional peel . $1,400

Happy, Holiday Face Special #3 - 50 units of Botox, two syringes of filler and  a regional peel,  X2. $1,800

Call my office - 239-939-5233 - for more information or to set up an appointment. And put on a Happy, Holiday Face.

Botox (R) and OAB

OAB is not a new government agency. At least, not this OAB, which stands for "overactive bladder". (But who knows? There also may be a government agency with the initials OAB).  

Women who suffer from OAB, or "overactive bladde", also have episodic bladder incontinence.  In other words, the bladder muscle starts squeezing to push urine out before you’re ready to go — even if your bladder isn’t full. These contractions can create strong sudden urges to go, which can lead to leaks. Signs and symptoms of overactive bladder may mean

• A strong, suddden urge to urinate.
• Involuntary lossof urine immediately following an urgent need to urinate.
• Frequent urination, usually eight or more times in a 24-hour period.
• Awakened two or more times at night to urinate.

Although you may be able to get to the toilet in time when you sense an urge to urinate, frequent and nighttime urination, as well as the need to suddenly stop what you are doing can disrupt your life.

Now, a new study out of Duke University found that an injection of Botox in the bladder worked as well as pills daily and was more effective in completely resolving symptoms. It appears that women with OAB will have “another” choice.

I issue these little health bulletins based on my continuing research as a Fort Myers Florida cosmetic surgeon. But they are not and should not be considered medical advice. Always see your physician before considering treatment for any condition.

NEW INDICATION FOR BOTOX

Today's question from Fort Myers plastic surgeon, Dr. Robert Brueck MD: What will they think of next?

I guess the only limitations of finding uses for Botox is your own imagination.

Now they are injecting Botox in a patients stomach. These injections are NOT in the patients skin on the outside, but are actually injected with a needle to the mucosa or lining of the stomach.

I was watching a doctors' show – it seems there are as many as there are 7-11 stores – and a gastroenterologist was injecting Botox into a patients stomach.

The idea is that by injecting Botox into someone’s stomach it slows down the emptying of the stomach – hence – the patient feels “full” and does not eat as much.

At last, a new weight loss program (?).

The GI doctor (gastroenterologist) who spoke about this has had her stomach injected and has lost 7 pounds over several weeks. Who knows a “Botox” cocktail may be just around the corner.

Botox Sales are Rising

Dr. Brueck sends items of news and interest from his Fort Myers Plastic Surgery practice.

Botox sales in the second quarter of 2011 were up a solid 16% for the quarter, the dollar volume was $418 million. I think sales of Botox/fillers are up because in a weak economy they are more affordable. Also younger patients are now coming in, in their 20’s 30’s to start Botox.

Botox - Move Over - Here comes competition

Welcome to the latest edition of Dr. Brueck's blog on plastic surgery. As a board certified Fort Myers cosmetic surgeon, Dr. Brueck reports here regularly.

The FDA recently approved a new “miracle” wrinkle remover and its name is Xeomin.

Don’t ask me how to pronounce it. But more competition is better than less. The price competition will be great both for Doctor and more importantly the patient.

Botox got FDA approval in 2002 and has grown to a $1.3 billion industry. Dysport was approved in 2009 and in that short period of time it has garnered maybe 20+% of the market.

The new Xeomin will be made by Merz -Restylene form - and be available in the spring. A big question remains: how long will Xeomin last relative to Botox and Dysport?

The success of Xeomin will depend on price and longevity. It has the potential to be a huge winner.

Stay tuned. More to come. Sign up for RSS feed of Dr. Brueck's blog to stay up with plastic surgery news.

DYSPORT VS. BOTOX - Dr. Brueck comments

Dr. Robert J. Brueck MD, regularly blogs here concerning matters of health, skin care and cosmetic surgery. Fort Myers Florida is the location of his practice.

Nothing like a little competition... (unless it’s health care in Lee County where we have NO choice of hospitals.)

But there are other competitions ongoing. Botox for years had NONE-Natta-Nothing.

Now Dysport comes along.

And now – a little drum roll, please - the results of the first randomized clinical trial are in. The study was a 30-day study with 90 patients done at University of California, San Francisco. The patients had Botox on one side of their face (crow's feet) and Dysport on the other (also crow's feet).

The results showed that 67% of patients in the test preferred the Dysport side vs. the Botox side.

The trial involved only crow's feet. Stay tune. there will be more to come.

BOTOX - Dr. Brueck MD finds more is less!

Dr. Robert J. Brueck MD FACS frequently blogs on subjects of health and beauty from his plastic surgery practice in Fort Myers, FL. This message is about Botox.

I recently read about a study done at the University of Oregon Casey Eye Institute. The study monitored 50 women who had received Botox injections on a regular basis for 2 years. What they found was, if you get Botox regularly every 4 months for 2 years once you reach 2 years you can prolong injections intervals from 4 months to 6 months.

The study also showed a prophylactic effect when it comes to wrinkles. Women between the ages of let’s say 30-50 can prevent the development of permanent dynamic wrinkles. But to me this is only common sense. The less you crease the paper - the less permanent the fold of the crease becomes. Maybe, in the end, more is less.

SHOULD 8 YEAR OLD GIRLS GET BOTOX?

Dr. Robert J. Brueck MD is a Board Certified plastic surgeon in Fort Myers and Cape Coral, Florida. He periodically comments on subjects related to cosmetic and aesthetic surgery that interest him. You can read more about Dr. Brueck at his web site, Beauty-by-Brueck.com

Remember seeing in the T.V. news about the mother in California who let her 8 year old daughter get Botox to help her in a beauty contest?

Now, in the State of New Jersey, a bill is moving through the State of Legislature that would make Botox for minors illegal accept in cases authorized by a licensed physician.

According to statistic compiled by the American Society for Aesthetic Plastic Surgery (of which I am a member) teenagers received more than 12,000 injections of Botox in 2009.

The shocking part of all of this to me is that we somehow feel the need to pass a bill to legislate responsible parenting. How sad. How pathetic. Where have our morals, our values, our sense of family gone.

It is a sad commentary on society today and I PRAY America wakes up before it is too late.

Man Awarded $212 after Botox treatments

Another blog entry from Dr. Robert Brueck MD, Board Certified Plastic Surgeon in Fort Myers.
He reports periodically on matters pertaining to health and plastic surgery.

WOW $212 MILLION

Now that’s a lot of money - a whole lot of money. You knew it was just a matter of time before someone would sue and potentially open the flood gates of litigation concerning Botox.

The lawyers for 67 years Douglas Ray Jr. claimed Botox caused severe brain damage to their client. Mr. Ray had received Botox treatments for hand tremors and writers cramps. He claims that the Botox injections left him disabled almost totally, and have cost him 650,000 in medical bills. Allergan says Mr. Ray was apprised of the potential risks. Mr. Ray was diagnosed with CADASIL (it’s a long one- Cerebral autosomal dominant Arteriopathy with subcortical infarcts and leukoencephalopathy - I won’t even begin to explain it!) This is a genetic stroke condition Mr. Ray inherited long before he received Botox. So here we go again - the chicken and the egg. Allergan is considering an appeal, at $212 million, I think I would too.

BOTOX FAILURE

Dr. Robert J. Brueck MD FACS, Fort Myers Board Certified plastic surgeon,
uses this blog to report on news and information pertaining to health and cosmetic procedures.

Many times patients come in to see me and complain that the Botox treatment doesn't last. I always tell my patients the results will vary from one patient to the next depending on their particular metabolism.

Now, there may be an answer. I must state I have NOT tried this product. There is a new product called Zytaze, which is a patent pending zinc and phytase supplement.

In a study of 44 patients they found that patients who started the supplement 4 days before their injection showed improved efficacy and/or duration 93% of the time. The company producing this product is Ocusoft, so you can go to ocusoft.com to learn more before making your decision.

Thank you for stopping by. Please make a note to watch WINK-TV, Channel 5, in Fort Myers at 11:00 am on Sunday, to see my interviews on subjects related to skin health and plastic surgery.

HOW BOTOX REDUCES WRINKLES from Ft. Myers plastic surgeon, Dr. Brueck

Another in the series of blog messages from Dr. Robert J. Brueck MD, Board Certified Plastic Surgeon practicing in Fort Myers, Florida. This report contains information about Botox injections.

When patients come in and inquire about Botox-Dysport, many of them have misconceptions or have been misinformed regarding the subject.

I tell patients that the injection of the substance causes paralysis of the particular muscle group, which helps eliminate the development of frown lines so many people have between their eyebrows or around their eyes.

Botox does NOT reverse aging or rejuvenate skin. It merely prevents repetitive frowning that causes the wrinkles to become deeper and more pronounced as time goes on.

A recent study done by Dr. Roger Dailey-a professor at Ohio State University, found that after 2 years of treatment with these agents patients could cut the cost and the frequency of the injections that they would normally require.

In his study of 50 women, ages 30 to 50, he found that if the women received injections every 4 months for 2 years the injections could be delayed for up to 6 months and still receive the same results. This would then result in a decrease in the frequency and amount of Botox required.

So there you have it, a nice study that may help you and your planning.

Tax Bites Man: Thoughts from Plastic Surgeon Dr. Brueck

There used to be a saying among newspaper editors, "When a dog bites a man, that's not news. But when a man bites a dog, that's news!"

So I guess it isn't news when a new tax takes a bite out of our lifestyle. But when a tax is rescinded, or threatened but not enacted, that's news!

So the news today is that the threatened tax on cosmetic filler treatments, such as Botox, has been taken of the Congressional table - for the moment anyway. It has been replaced by a proposed tax on tanning salons.

I suppose we should be grateful, but.... it is unsettling to be happy about an unnecessary tax just because it doesn't have immediate impact on us

We were spared for the time being, but America will be crippled by this new “health” bill that will increase taxes, deficits and premiums for everybody. I guess the plunderers of Washington will continue. They are like crack addicts; they can’t get enough of new taxes. Soon, November 2010 will be here, and in the end we may have the final say.

And, if you are considering a filler or botox treatment, you may want to schedule it soon. Who knows when the tax vampires will be around again with their BoTAX.

Give me a call at 239-939-5233 to talk about fillers, skin care and any thing cosmetic, including chin, neck, and face lifts. Or check out my web site, which is filled with interesting nformation about cosmetic plastic surgery subjects.

Not ANOTHER Tax? Aren't you taxed enough?

(Ed: Dr. Robert J. Brueck, MD FACS of Fort Myers and Cape Coral FL , feels compelled to speak his piece about the new proposed tax of 5% on cosmetic surgery. His comments follow.)

What a total sham and disgrace this whole concept and idea is.

If our legislators would spend as much time thinking about cost reduction and cutting expenses as they do on taxing us into the eternal abyss with new and creative taxes, we would be much better off. When and where will it finally end?

This administration has created a deficit in one year equal to the deficit in all of Bush’s last 4 years. The spending is totally outrageous and out of control and is creating an enormous Armageddon for America.

I read where the city government of Pittsburgh wants to TAX the tuition paid by all students at universities within the city limits of Pittsburgh. This would raise approximately 60 million dollars a year and go to reduce the pension costs and obligations of city employees!

Did they ever think for one second that these benefit packages and wage structures were out of line and unsustainable? Maybe they should cut benefits and salaries and not create new taxes.

They now want to tax the buying and selling of stocks, but ONLY 0.25% FOR NOW. It’s like a state income tax that the legislators sell to the citizens of a state, with the promise that it will never go above 1.5% and then 5 to 10 years later it’s up to 4, 5 or 6%.

The bottom line is that POLITICIANS cannot be trusted with our money. End of discussion.

In keeping with the tax on cosmetic surgery and the push for health care "reform", we are told that $500 million will come from cuts and cost savings in Medicare expenditures and this will help offset the increased cost of health care spending, so that it will be “budget neutral”.

These are the same people that said a trillion dollar stimulus, ie: pork barrel, bill will keep unemployment under 8% and create 3.5 million new jobs. The result a year later is that we’ve lost 3 million jobs on top of the 3.5 million we were promised which creates a deficit of 6.5 million jobs. Unemployment is at 10% and will probably go higher. In reality, it is much higher because so many people have just thrown their hands in the air and said, "enough is enough.”

The administration claims that there is this much waste in Medicare and my response is simply, "where the was the government 2, 5, or even 10 years ago that allowed hundreds of billions of dollars of waste to occur?" These are the same people who want to come now and control 17% of our gross national product. And of course their response is, if we have this red ink, these loses, this fraud, this embezzlement, all we have to do is tax the people just a little bit more.

The Botox cosmetic tax will be broad ranging, ie: ANY cosmetic procedure, Botox, fillers, dental caps, teeth whitening, braces, etc. the list is endless. This tax is also discriminatory because 90% of cosmetic procedures are performed on women.

These are not sin taxes like cigarettes, which place a tremendous burden on the health care system. This is clearly a tax on the middle class who earn $30 to $60 thousand a year. According to The American Society of Plastic Surgeons, 60% of all cosmetic procedures are from this income group.

I remember the President saying “NO NEW OR INCREASED TAXES ON THE MIDDLE CLASS” THEN WHAT IS THIS?

This increased cost may also cause some people to risk cosmetic procedures overseas such as Costa Rica and other areas of the Caribbean and around the world. I think most plastic surgeons have seen the results of these people who have gone offshore to “save money”. This will greatly increase their risks.

This tax will also create a new level of bureaucracy to enforce and collect this “new tax”. A while back New Jersey tried this approach and it was a nightmare and total failure. When ,oh when, will we ever, ever learn.

Each and every day my anger grows when I see our government slowly, in unrelenting fashion; erode our individual rights and freedoms.

IT IS TIME FOR ALL OF US TO WAKE UP AND BE HEARD!

~~~~~~~~~

Dr. Brueck is a Board Certified plastic surgeon practicing in Fort Myers and Cape Coral, FL. For more information about his specialties, please visit his web site at Beauty-by-Brueck.com. To schedule a free consultation with Dr. Brueck, please call Judy at 239-939-5233

Now they want to tax how you look.

Thoughts from Dr. Brueck, Fort Myers plastic surgeon, on the latest government threats to tax cosmetic surgery and non-surgical procedures.

When will it ever end?

It seems every time I pick up the newspaper I read about healthcare. The amount of material is staggering.

It seems that the opinions of the party in control change like the wind. The cost of government healthcare is projected to cost 1 to 1.6 trillion dollars over the next 10 years. But, alas, it will be budget neutral.

Sure, we can all believe that - we only need to look at Medicare with its $30 to $60 trillion in unfunded liabilities; Medicaid which is bankrupting many states (look up Tenncare) and last, but not least, Veterans Care. We all have read about the horrible conditions at Walter Reed Hospital and the care that our war heroes get.

To my count, that is three strikes and in America, three strikes and you are out. To maintain “budget neutrality” the powers-that-be are proposing a 10% tax on ALL cosmetic procedures.

When will this never-ending litany of new taxes end? This administration is already spending our country into the brink of bankruptcy. If they spent as much time on our deficit and decreasing it as they do on dreaming up new taxes our country would certainly be far better off.

I recently resigned from the AMA, the FMA and the American College of Surgeons. It was done with much thought. It was a very difficult decision to make. But these organizations “support government health care” and all of this with no tort reform.

I recently wrote to the chairman of the AMA and a similar letter was sent to the head of the American College of Surgeons. I think it says it all. Something to ponder in a spare moment.

July 29, 2009
James Rohack, M.D.
American Medical Association
515 North State StreetChicago, IL 60654

Dear Dr. Rohack:

Recently I resigned from the AMA and recent events have solidified the purpose of my decision. I am utterly shocked, appalled, and disheartened by the AMA elite endorsement of Obama Care. The AMA “elite” have sold our patients, our physicians and the greatest healthcare system in the world down the river.

There is no question our system has flaws but remains the preeminent healthcare system in the world. Why do so many presidents and foreign dignitaries come to America to receive lifesaving medical care? The free medical marketplace breeds innovation and new technology, life saving pharmaceuticals, etc. There isn’t one socialized system that can compete with ours.

We hear about the “great Canadian system” yet thousands of Canadians cross the border every year to receive their care here in America. In 2005 the Canadian Supreme Court opened the doors to private medicine and healthcare in their country. Why, because the socialized system was broken and was not serving the Canadian people.

Over 15,000 people died in France in 2003 because of a heat wave. When was the last time that happened in America?

Look at the list of Nobel Prize winners in medicine over the last 20 or 30 years and the case is quite clear and obvious. 8 out of 10 of the last major medical advances such as MRI’s and CT scans were developed here in America. If you suffered from an MI in the 80’s and made it to the ER the survival rate was about 60%, today it’s over 90%. Stroke survival rates today are twice as great as they were 25 to 30 years ago.

Look at the longevity table today versus 20 or 30 years ago. Yet we still have that bastion of healthcare that is so vital, so precious to doctor patient relationship and now you want the government to intrude and destroy and destroy they will.

Mark my word. They are like an insidious cancer growing and advancing not to be stopped. We need less government control in medicine and in our lives in general. Healthcare is 20% of our gross developmental products. I do not want the government to control anymore of lives than they already do.

Look at the government medicine we now have, Medicare is going broke, Medicaid is breaking every state budget in the union and then let’s not forget the great government controlled Veteran’s healthcare system which is a shamble and a disgrace to our proud men and women serving in our Armed Forces.

To put 20% of our gross developmental product in the hands of our totally irresponsible government is abhorrent. A short time ago the house passed a cap and trade bill and in large NO ONE ever read the bill and now they are trying to rush through and ramrod a healthcare bill down our throats that NO ONE once again has read. I wonder what they want to hide!

Of course they want to rush it through for the sake of not having it read, discussed and digested so that they can have more control of our lives. Just like the takeover of the banks, the insurance companies and the car companies. When and where will government control of our lives and our country end.

The government’s reasoning is that we have 50 million uninsured. It’s interesting how that number has grown from 35 to 50 million. If we look at that numbers it’s really not all that significant. Of that number 10 to 12 million are illegal aliens and should not be entitled to healthcare. It’s also estimated that 14 million of these uninsured qualify right now for SCHIPS/Medicaid. Several million of these uninsured can afford insurance but elect not to have it.

The census figures also show that 18.3 million of the uninsured were under 34-years-old. Many have elected not to have coverage because they feel healthy and secure in their present situation. Many millions are uninsured for short periods because they are between jobs.

When all is said and done a Blue Cross Blue Shield study in 2003 found that there were approximately 8.2 million Americans without coverage for long periods of time. We also hear of the tremendous costs of uncompensated care and the shifting of expense from the non-payer to the payers.

A Kaiser Family Foundation study in 2008 said that the TOTAL uncompensated care was 56 billion dollars. So we are going to turn our healthcare system over to the government with a projected cost of 1 to 1.5 trillion dollars over 10 years.

We all know about government efficiency. I am sure their numbers are accurate. Look at the VA healthcare system. This has been in place for decades and it’s government run and look how it’s in shambles. We all recently saw pictures flashed across the screen about the poor conditions of our Veteran’s healthcare facilities.

We are also told that we need a government option to create competition. With over 1500 healthcare plans in America today this is nothing more than a ploy to get the government’s foot in the door and gain total control of our lives. Even if the government plan loses money don’t worry we have the taxpayers to fall back on.

Look at the postal system which now is projecting a deficit of 10 billion dollars and of course who is going to pay for it, the taxpayers. We will just throw another 10 or 15 billion here to subsidize another losing government proposition. Maybe we will give the government’s plan some free government subsidies.

What government program over the last 10, 20 or 30 years has run efficiently and under budget? The answer is none. Do we subsidize Amtrak, the postal system, you name it. The list goes on and on and to think that this is going to be budget neutral is foolhardy.

We also always read about Medicaid fraud, Medicare fraud, durable medical good mills and so forth. When was the last time that we read about a Blue Cross Blue Shield or Human fraud? It doesn’t exist because the private sector is far more efficient in delivering healthcare. It is also possible that the private sector might be better keepers and stewards of our hard earned dollars.

To pay for this we are told that we can “squeeze” $500 billion in savings from Medicare. Yet the enrollees in Medicare is set to grow by over 30% as the baby boomers are set to retire over the next several years. Now you tell me how you cannot take away from the quality of healthcare for our senior citizens by squeezing a half a trillion dollars from their budget and yet have their enrollment increase 30 to 40%.

They must have some Houdini pulling the levers at the Medicare center. Past history has always shown us that we can’t trust the wisdom and brilliance of bureaucrats in Washington.

Our president talks about the out of control spiraling healthcare costs but recent trends seem to refute his claim. Here are some facts:

1970 – 10.5%
1980 – 13.0%
1990 – 10.9%
2000 – 6.6%|
2003 – 8.6%
2004 – 6.9%
2005 – 6.5%
2006 – 6.7%
2007 – 6.1%

This really is a promising trend.

As a loyal American I want free market capitalism to be given a chance ahead of a huge government bureaucracy filled with corruption and waste. Free market capitalism is what has made our country the richest, the strongest, most prosperous nation in the world.

Repeat Webster’s definition of tyranny “repressive government control”. I question what direction our country is going. I am certainly appalled at your decision to support Obama Care and I certainly have no plans in the future to ever again become a member of the AMA and will actively campaign to have other friends of mine who are active members to renounce their membership as well.

With Warmest Regards,

Robert J. Brueck, M.D.

Cosmetic Surgery - To Tell or Not to Tell

Frequently patients will ask me, “Dr. Brueck, when can I go out in public and be presentable?”

I guess only you can answer that.

It depends on whether you want anyone to know if your lack of apparent aging is due to the crafty art and skill of your plastic surgeon or the fact that you are blessed with “good genes.”

But when apparent lack of aging is due to non-surgical procedures most Americans are willing to offer a confession. A recent survey from the Aesthetic Surgery Education Research Foundation (ASERF) found that nearly 9 out of 10 or 87% of respondents openly discussed their use of Botox and dermal fillers. These non-surgical treatments are now mainstream.

Just who are these women who openly confess their use of Botox and fillers?

They usually are married, working mothers, age 41-55, with a household income under $100,000. These women are health conscious and philanthropic in their views and many volunteer for charitable organizations. The reason for doing this is “to look more relaxed, less stressed-out”.

So there you have it. A new interactive conversation, open, honest, and why not?