Finally – A Non-Invasive Machine That Delivers on the Promise

We are all used to the myriad of vendors who scurry up to us at every conference or torment our office staff for a 10 minute appointment to discuss the next GREAT non-invasive cosmetic surgical miracle machine.  Everybody promises everything….and seldom is the technological “punch” anywhere near the nirvana alluded to in the glitzy ad brochures. How many of you have $100,000 dollar machines in a back room with dust covers over them?  They are expensive doorstops!!  So typical of this industry.

As you can surmise, I have a jaundiced view of the whole “gadget” biz in cosmetic medicine. I like using cold steel, but appreciate the demand for non-surgical alternatives in this market. I have NEVER purchased a laser box (the economics just don’t make sense to me).  I dodged the Smart Lipo frenzy………..whew.  So, as a certified Negative Nellie, I have finally crossed over to the other side and am totally thrilled with the results a new minimally invasive technology is delivering.  In my mind, they deliver EXACTLY what was promised  in the hype.

ThermiAesthetics is a relatively new company employing temperature controlled radio frequency technology for multiple applications that really work.  Basically, ThermiRF delivers radiofrequency energy in a multitude of platforms – the common denominator being using thermal energy to safely shrink tissue.

In my mind the ‘home run’ for this technology can be found in two applications: ThermiTight is a minimally invasive procedure where a micro-probe in passed under the skin and withdrawn in a controlled fashion, heating the dermis underneath.  This results in significant skin shrinkage and is best used in the lower face and neck (great for jowls).  It also shrinks skin in the arms, abdomen and above the knees. ThermiVa is a topical application, designed to shrink labia, tighten vaginal mucosa, increase vaginal moisture and sensitivity and even cure mild to moderate stress incontinence. Really!

Ya sure, you may quip…………..but it delivers as promised.  My staff, my wife, my patients are all raving about it.  Easy, cheap and relatively painless.  Who can ask for anything more? Sure, the technology is relatively new and the longevity of the procedures is still being figured out.  But so far, I think this technology is a refreshing home run – delivering as promised – even for a cynic like me. Check them out.

Media Training Boot Camp For Health Care Professionals - A Wow Experience

Media training for doctors (or medspas)?

The media loves covering the cosmetic medicine industry.  The public hunger for this information is insatiable.  For providers of these coveted services, the media can serve as a powerful tool to spread the word to the masses of the latest and greatest – what’s hot and what’s not.  It can also help define WHO is hot or not.  In the competitive tussle of the cosmetic medical marketplace, whether or not your business is successful is determined, in part, by the media ‘footprint’ you cultivate over time.  With so much competition, those who conquer the visibility factor can separate themselves from the fray.  A good web site and blog , smart use of social media and speaking to groups of potential patients are critically important.  Yet, as the competitive heat continues to rise, there may be a need to transcend to the next level.  Becoming a media ‘personality’ is a great way to achieve this end.  This requires a unique skill set that we are all capable of acquiring but whom many find intimidating. 

I was fortunate to attend the “Dr. You” Media Training Boot Camp for Doctors program presented in a joint effort by the Discovery Channel and Harvard Health Publications held October 19 – 21 at the Discovery Channel Global Headquarters.  This excellent course is designed for health care professionals who want to step up their media exposure.  It is ideal for those who either want to stand out more visibly in their local market or are interested in advancing to become a nationally recognized "Go-To" expert and thought leader.  Features of this course included:

• Live TV interview practice
• Video sessions using a teleprompter
• Tips on how to become a sought-after professional speaker or “Go-To” expert
• Insights in obtaining and working with a publicist
• Radio interview coaching
• How to become a best-selling author
• Strategies to maximize your online presence

 A tall order indeed, and they delivered!  Their top notch faculty included a 15 year producer for the Oprah show who also works with Dr. Oz, the Chief Medical Expert for the Discovery Channel, the Chief Editor of Books at Harvard Health Publications, and several top notch media experts, web strategists, and literary agents.  The training was very personalized and the immediate feedback was right on (sometimes painfully so!). The class mix ranged from rank amateurs (most of us) to savvy professionals wanting a little polish.  The faculty went over and above to 'bring us along' and made this a great experience.  We all ended the program wanting more – and hopefully they will let the huge success of this 'pilot' program convince them to expand upon this even further in the near future.

 If and when this course is offered again, I recommend you jump on it.  You will be very glad you did.

SIMON Says: “Run Forrest Run!”

Saying ‘No’ to Prospective Cosmetic Medical Patients

Certainly, everyone is entitled and should have access to cosmetic medical and surgical services. However, depending on your particular risk tolerance, there are certain times when you might want to just 'pass' on treating a patient.  Knowing which patients to sidestep is a gray art and is frequently based on hunches and ‘gut’ feelings.  This subtle impression, as described in Malcolm Gladwell’s book 'Blink: The Power of Thinking Without Thinking', is correct more often than not.  However, there are more objective guidelines available to help decide whether or not to dance with a particular patient. Several of these tips have been developed and expounded upon in numerous papers by Dr. Mark Gorney and in the book 'The Patient and the Plastic Surgeon' by Dr. Robert Goldwyn.  Consider running for the hills if:

• The patient is a SIMON – single,immature, male, overly expectant, and narcissistic.  Even worse if they answer to SIMON-SLAP (SIMON + still lives at parents). 
• You don’t click with the patient – or just plain dislike them
• The patient is critical of previous physicians but thinks you hung the moon.
• The patient is rude to your staff.
• The patient demands a guarantee.
• You are asked to do something you can’t deliver.
• Anyone in a hurry to have surgery – gotta do it now!
• The surgiholic patient.
• Patients wanting procedures because they are prodded by friends or family members.
• The out-of-town patient who has to bolt before you are comfortable with them leaving.
• The patient who is vague, indecisive and leaves the driving to you.

Unfortunately, patients don’t walk into your office with a label on their shirt saying ‘I’m going to be a real problem’.  Listen to the voices in your head and apply the above principles.  Cosmetic medicine is supposed to be fun – don’t let a rogue patient slip through the cracks and haunt you.  It just isn’t worth it!

Increased Botox Longevity With A Zinc Supplement

Botox & Zinc? Does Zinc make Botox last longer?

An American Academy of Cosmetic Surgery news brief has reported that a Houston oculoplastic surgeon, Dr. Charles Soparkar, has come up with a way to make Botox (and presumably all botulinum toxin neuromodulators) more effective and last longer. In a modified double blind, randomized, placebo-controlled, crossover pilot study and a subsequently completed formal study, the duration of effect was increased by 30% in over 90% of the patients studied. The study included both cosmetic and medical indications (blepharospasm, hemifacial spasm).

The theory goes like this: Botulinim toxin is very dependent upon zinc for effectiveness. Unfortunately, 50% of the US population is zinc deficient. Apparently, dietary zinc can be poorly absorbed due to binding elements found in many foods called phytates. Dr. Soparkar’s group posited that adding zinc to the diet of patients having a weak response or short duration of effect to botulinum toxin may be beneficial. Additionally, a phytate munching phytase enzyme was added to increase zinc bioavailability.

The result is a prescription medication called Zytaze. Each capsule contains 25mg of highly bioavailable zinc citrate and 1500 mg of Phytase. Patients take 2 caps daily for four days prior to AND on the day of injection. The drug is supplied in a 10 cap pack and cost $60 - $80. The result has been less frequent and decreased amounts of toxin needed and potential patient savings. (However, does the cost of the drug nullify these advantages?) This is great news for patients and a potential niche offering in the commoditized botulinum marketplace. Maybe not so great for practices depending on a high turnover of renewable products and services. 

Who else has experience with Zytaze?  

Adipose-Derived Stem Cells In Cosmetic Surgery: Ready For Prime Time?

Are adipose-derived stem cells in cosmetic surgery ready for prime time use in your cosmetic practice?

Google “aesthetic stem cell treatments” and you will be greeted with a panoply of therapeutic offerings ranging from mundane to fantastic. Injecting your own adipose derived stem cells can lift your face, tighten your skin, enlarged your breast, slow the ageing process and even put some zip in your libido if injected into anatomically correct nether regions. Cosmeceutical manufacturers are even putting non-viable stem cells into facial creams hoping to knock 10 years off your visage. These marketing claims have captivated the public with the promise of a minimally invasive fountain of youth.

Adipose-derived stem cells are multipotent and possess the ability to differentiate into fat, bone, cartilage, nerves and pancreatic tissue.  They also secrete cytokines that are angiogenic, antioxidative and immunosuppressive. They release a whole host of growth factors that facilitate wound healing and tissue regeneration. Stem cells hold great clinical potential and offer considerable commercial possibilities.

We are all very enthusiastic about the promise and potential offered by the emerging field of adipose- derived stem cell science. Encouraging data from hundreds of ongoing international trials support a bright future for aesthetic and regenerative applications and real progress has been made in developing methodologies and protocols for every day clinical use. Yet many are advising caution.

A recent review in Plastic and Reconstructive Surgery notes that there is considerable uncertainty about the true clinical potential of adipose-derived stem cells and too much remains unknown about their fundable biology to be used safely and reliably. There are several contradictory studies about whether these cells promote or repress cancer growth. There are no standard protocols yet developed for adipose-derived stem cell applications. We still are unsure of the number of cells required per treatment or how many treatments are needed to achieve a desired clinical outcome predictably. In short, we are not quite sure what we are doing yet with adipose-derived stem cells despite the encouraging science and our best intentions.

A lot remains unknown about how to effectively and safely use this new technology. To market aesthetic stem cell procedures outside of clinical trials to the public seems a bit deceptive considering the current state of the art. What do you think??