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.

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.

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.