Medical Spa MD + Others

It's been an interesting last few weeks for us at Medical Spa MD.

We've seen in increase in the number of inquires around partnering with Medical Spa MD. While I'd normally guess it had something to do with the successes that our current partners are having... but I don't think that information is public knowledge.

In the last three weeks we've been approached by or talked to a number of consumer facing websites, medical publications, potential authors, and even some technology providers and pharmacies.

We're also launching a number of internal iniatives. We've emailed a few of our Members to ask what would be of the greatest benefit. (If you've received an email please give us your thoughts.)

We'll see how this pans out for Medical Spa MD but I'm hopeful that we'll be able to work out some additional deals and benefits for Medspa MD Members.

Plastic Surgery Product Placement

Be Born Again

To promote Dr. Kim's plastic surgery office, this life scale poster was placed at the entrance of his office and by the elevator in the main lobby of the hospital building.

via dfckr.com

A slick little promo for a plastic surgery practice. You have to love well done attention-getting advertising and medical spas and plastic surgery clinics are certainly rife with products that lend themselves to great advertising and marketing. I've got perhaps hundreds of these types of ads that I keep as something of a library.

Do it yourself Botox? ABC News wants to talk to you.

Have you tried do-it yourself plastic surgery or home Botox injections?

In tough economic times, many try to cut costs, including in their beauty regimen. Despite the risks, some people have decided to skip the doctor -- and obtain and self-administer cosmetic treatments.

If you have self-injected products like Botox, Restylane, Juvederm, silicone, and other substances, 20/20 would like to hear your story.

Please fill out the form below, including information about your experience, and a producer may be in contact with you.

You can tell ABC all about it here.

The Hidden Dangers of Beauty

Normally, I barely listen to the radio when driving in my car, but today on the John Tesh Radio Show (Sunday) my ears perked up when he started to discuss the hidden "dangers" of young girls using makeup too early. Dangers in makeup? Really?

The broadcast was entitled "The Ugly Truth About Young Girls Wearing Makeup". The line that grabbed my attention was "the sooner your daughter starts wearing makeup, the sooner it might kill her!" This was a quote coming from Stacy Malkan, a cosmetic expert who wrote the book Not Just A Pretty Face: The Ugly Side of the Beauty Industry. According to the John Tesh website, Malkan states "by the time most North American girls become teenagers, many have a daily make-up ritual that includes lipstick, mascara, eyeliner, nail polish and perfume, not to mention skin lotion, shampoo, conditioner, and hair color treatments." She goes on to say "in fact, experts estimate that a typical young girl now walks around with at least a dozen layers of beauty products on her body! As the makeup layers add up, so does her exposure to dangerous chemicals, and that’s very bad news for a young girl’s health."

Apparently the culprits are chronic exposure to parabens and phthalates which have been found to disrupt hormone levels during adolescent years which may result in early puberty. Malkin continues to state "one study found that HALF [sic] of all North American girls now begin to show signs of breast development by the age of 10 – which is more than two years sooner than females from our grandmother’s generation. Other studies link those unusual hormone levels to a higher depression rate among young girls, and a higher risk for breast cancer! That’s why experts recommend women of all ages find out exactly what chemicals go into their makeup."

There is a website suggested for reference to verify the ingredients in certain beauty products and cosmetics and it is called the Skin Deep Cosmetic Safety Database. I was instantly intrigued and raced to my Mac when I got home to give it a try! Here's how my products scored:

(Scale: 0-2=Low hazard; 3-6 Moderate Hazard; 7-10 High Hazard).

• Cleanser: 3 (moderate hazard) 
• Toner: 7 (high hazard) 
• Moisturizer: 5 (moderate hazard) 
• Eye Cream: 6 (moderate hazard) 
• Lip Cream: 7 (high hazard) 
• SPF 30: 7 (high hazard) 
• Concealer: 4 (moderate hazard) 
• Foundation Primer: 5 (moderate hazard) 
• Foundation: 9 (high hazard) 
• Loose Powder: 5 (moderate hazard) 
• Blush: 7 (high hazard) 
• Bronzing Powder: 8 (high hazard) 
• Eyeshadow: 7 (high hazard) 
• Mascara: 8 (high hazard) 
• Lipstick 6: (moderate hazard) 

My gosh, I'm a walking carcinogen!!! Like most women, I use an array of products, from medical grade like Obagi, spa grade like SkinCeuticals, high end department stores like Merle Norman, Estee' Lauder and Laura Mercier, right down to drug store brands like Maybelline. It seems no company's products were completely safe. And, makeup is just the beginning for young girls!

More and more young girls are taking their skin care regimens to the next level by having microdermabrasion treatments and chemical peels, with some escalating to laser and injectable therapies. Putting aside the various protocols for acneic adolescents, there has actually been a rise in the U.S. of young girls undergoing laser hair removal, photo facials, dermal filler procedures, even laser lipolysis. Where do we draw the line as clinicians? 21? 18? 16 with parental consent? I know in our medical spa we have been approached by parents inquiring as to what our policy is for treating adolescents for non-medical related conditions. The number one request is laser hair removal for ethic skin types predominately for excess facial hair. Many clinicians feel it is a low-risk procedure which can lift a child's self-esteem. Some clinicians disagree and feel a child is much too young to be exposed to laser therapies.

I'm not a laser expert and am uncertain as to if many aesthetic equipment manufacturers have performed clinical trials on adolescents for laser procedures (other than port wine stains). I'm more apt to believe the answer to this questions will become clearer as the years go on and by remembering the first rule is to "do no harm".

That, and to throw away your teenager's makeup!

Do it yourself laser hair removal... Unhappy medical spas?

The're are a growing number of 'home laser hair removal' devices appearing on the market. This article on do it yourself laser hair removal supposes that medical spas and laser clinics are feeling the heat.

Want to get rid of some unsightly hair, but don’t want to spend the big bucks for electrolysis or a laser clinic? Now, you can buy your own laser and do it yourself.

And people are.

The growth of the at-home cosmetic-device market, which includes personal lasers, has some professionals buzzing. At an annual conference hosted by the American Society of Plastic Surgeons, Barry DiBernardo, a New Jersey surgeon, delivered a talk in Seattle about the pros and cons of the DIY market on the ASPS’s “Hot Topics” panel.

“We have to make sure that the patients are getting good, safe treatments. If they are getting good, safe treatments, then whether they are doing it at home or not, I’m not as worried,” DiBernardo told Wired.com by phone. “What I’m worried about is that they are seeing things in the Skymall on the airplane and spending hundreds of dollars, thousands of dollars on something that is not going to work or is unproven.”

New cosmetic medical devices including DIY lasers are expected to explode into a $1.3 billion market 2013, up from just $296 million in 2008, according to the analyst group Medical Insights. The growth in the market appears to be coming from light-based products that claim to either remove or grow hair on the human body. The Silk’n Hair was the first at-home laser device to be approved by the FDA, in 2006, although it didn’t come on the market until early 2008.

The laser hair removers damage the hair follicles that are in their growth phase, generally leading to some permanent reductions of body hair. DiBernardo questioned whether the lasers used in the home devices were powerful enough to get the kind of results that clinics achieve.

“In general, these devices are low-powered versions of the doctor versions. We’ve been doing hair removal since 1998, so we know that they work and how well they do,” he said. “I think these home devices have some effect, but they legally can’t have the power of what we fire at people.”

From nother nice post from Wired:

My own experience is that people looking to do it yourself home laser hair removal (or skin tightening or complexion light-based photo-therapies) are really looking to save money and are buying a device in the hope that it will work. Patients who are actually interested in laser hair removal or skin tightening are put off by these types of home remedies. I've never heard that a laser clinc or medical spa is suffering from this, but I may be wrong.

Does anyone running a medical spa or laser hair removal clinc feel differently? Is laser hair removal at a medspa moving to home laser hair remvoal that a do it yourself laser treatment?

Medical Spa MD: End of the Road for Evolence

I must say I am a little disappointed in my former company of employment, but on November 3rd Johnson & Johnson, Inc. announced that they will no longer be manufacturing or marketing Evolencedermal filler in the United States just a year after they received their FDA approval.

Ortho Dermatologics porcine derived collagen filler was gaining in popularity with many clinicians across the U.S. praising the product for its ease of injection and smoothness in appearance and feel. Although few in number, the main complaint of the product from a consumer standpoint was that they wished it lasted longer. However, many went on to say the look and feel of the results far outweighed its lasting effects.

Johnson & Johnson, Inc. has not stated a definite reason for why the product is being pulled from the U.S. market. A statement on their website reads:

"On November 3, 2009, we announced our intention to discontinue the manufacture and marketing of EVOLENCE^®products. Patients and medical professionals who may currently be using EVOLENCE^® products can be assured that they remain effective for the approved indications with a favorable safety profile. EVOLENCE^® products will continue to be supported for medical inquiries and adverse event reporting, in accordance with regulatory requirements."

Medical Assistant's can not inject Botox!

I've seen and head about medical estheticians, medical assistants and even front desk staff administering Botox injections.

It's not legal, as this story on the prosicution of a medical assistant clearly shows.

Betty Guerra’s monthslong nightmare is over.

The 45-year-old former medical assistant learned today from her attorney that the 10 felony counts against her on allegations of “unlawful practice of medicine” will be dismissed, she said.

“I always believed things would work out the right way,” she said tearfully. “I cannot be punished for something I didn’t do.”

Guerra’s July arrest sparked controversy over what medical assistants can and cannot do. Specifically, there was confusion over whether they are able to give shots.

Guerra was accused of unlawfully administering cosmetic injections, an act commonly performed by medical assistants throughout Nevada.

The state attorney general’s office did not specifically say charges against Guerra would be dropped but indicated it won’t be pursuing the case.

“The complaint against Betty Guerra submitted to the Attorney General’s Office by the Board of Medical Examiners has been contradicted by the subsequent actions by the Board,” Attorney General Catherine Cortez Masto said in a statement. “Therefore, it is fair for us to conclude that it would be difficult to prosecute this case beyond a reasonable doubt.”

Guerra’s attorney, Jason Weiner, said this evening that the attorney general’s office had sent him a copy of an unfiled motion dismissing the case earlier in the day. He would not be able to provide the Review-Journal with a copy of that motion until Wednesday, he said.

After Guerra’s arrest, physicians became concerned about what duties their medical assistants could perform.

Former medical board director Louis Ling said that upon reading a 30-year-old law, he concluded that the assistants could not give shots. With flu season coming on, he then attempted to draft emergency regulations that would allow them to give flu shots, but not Botox or other cosmetic injections.

However, that effort was shot down when a judge recently ruled that the board, in considering the regulations, had violated the open meeting law.

The board later reversed its position, determining that state law allows medical assistants to administer everything from flu shots to Botox. Medical assistants could give shots as long as they are under the “direct supervision” of a physician. Most health officials and doctors take that to mean the physician is on premises.

Ling resigned on Friday.

Guerra, a mother of three who was a physician in her native Peru, said she has been under incredible stress since her arrest and lost her job because of the publicity surrounding her case.

“It was a nightmare. I could not even sleep or eat all this time, wondering what was going to happen.”

Still, she said she harbors no anger.

“Now, I start all over. But it’s just another experience in my life.”

Via Review Journal story.

Fake Botox or not, Discount Medspa is going to jail.

Via an almost unbeliveable story on Wired:

A website that sells a prescription drug similar to Botox without requiring a prescription claims it has more than 2,000 customers. Some have learned how to inject the botulism-derived drug into their own faces from YouTube videos produced for the site.
 

Discountmedspa sells a variety of other DIY cosmetic treatments, including prescription Renova, and lip-filling gels. The botulinum toxin-derivative for sale on the site is Dysport, produced by the pharmaceutical company Ipsen and is a competitor of Allergan’s Botox. The site simply calls it “the Freeze.”

A Grand Prairie, Texas, woman, Laurie D’Alleva, who appears to be the site’s proprietor, performs treatments on herself in self-made videos posted to the site’s YouTube channel. In one video, D’Alleva pulls out a vial of what is presumably Dysport and a syringe filled with saline.

“It’s important to remember that you are mixing the potency of the botox,” she says, mixing the contents of the vial with the saline solution. She then injects her forehead and the areas around her eyes.

Ipsen received FDA clearance to sell Dysport in the United States a few months ago, but it’s a prescription medication. It’s the first direct competitor for the branded Botox, which is the most popular cosmetic treatment in America. Doctors did more than 2.4 million Botox procedures in 2008, according to the American Society for Aesthetic Plastic Surgery. In recent years, the vast amounts of money spent on the treatment have attracted scams and knockoffs, which the FDA has had to crack down on. In May, the FDA also ruled the drug needed a tougher “black-box” warning label to reflect an increased understanding of the small, but real risks of the treatment.

In the U.S., it is illegal for anyone but a doctor or nurse practitioner to prescribe drugs to patients and only pharmacists can dispense drugs to people.

Video: The original YouTube video was pulled by DiscountMedSpa on Wednesday, October 28. Wired.com had saved the source and has embedded that video in the story.

In a blog post response to a customer’s skeptical query, Laurie provided the following explanation for the legality of her site and the provenance of her products.

I know there is much information out on the net about fillers and Botox ‘knock-offs’. This is not what I am selling! The products I have are from a company names Ipsen… I have a connection that allows me to get products that are not usually available in the states because I purchase other products in their line. Now the trick is I have to market it and label it under my own brand, to keep them and myself from getting into any legal trouble. It does take a leap of faith, but I assure you I have over 2000 customers now who love the products and are saving literally hundreds of thousands of dollars between us!

“I watched a Doctor on YouTube.com do this to a patient and he warned people not to inject below the eyes however I had to put a smile on my face too,” Lesley commented on a blog post. “The trick to this is to hold a pencil just at the corner of one side of your mouth and inject two units of Freeze at the very bottom of your chin. This will cause your [sic] very end of your mouth to turn up. Then do the other side the same way. If you don’t get it even you may have a crooked smile so be very careful that the injection is placed in exactly the same place as the other side.”

Her recommendation for another user is to “watch YouTube.com and you will learn a lot of some of the Doctors [sic] secrets to recreating your face the way you want to look.”

Other women describe mishaps with over-injecting the drug.

“My Dr. would never inject the crows feet. I did and got GREAT results!” wrote a commenter named Pat. “Unfortunately, I can’t read those little hash marks on the syringe too well and over injected above the brow on one side. A week later I’m now sporting a half closed and swollen eye, and look ready for Halloween!”

the Texas Department of State Health Services released the following statement, but would not comment further.

“The Texas Department of State Health Services is aware of discountmedspa.com through a complaint we received. That complaint status remains open and under review,” the agency wrote.

The complaint was made under the Texas Food, Drug and Cosmetic Act, which regulates the sale of prescription drugs like Dysport in the state.

“Botox is a prescription drug that must be dispensed or sold by a licensee pharmacy and only with a prescription from a licensed practitioner. Any over-the-counter sale of Botox is illegal,” the agency affirmed.

Unbelieveable that people could be so dumb as to inject themselves with Botox... or anything else for that matter. Discount Medspa's owner is definately headed for the slammer.

Side Note: Our partner site, Medical Spa RX, is a licensed and regulated phamacy that sells wholesale Botox and other fillers exclusively to licensed medical professionals only.

Perky Boobs + Nipple surgery?

Who’s your nipple role model?

Have no idea what I'm talking about? (Nipple surgery to change the shape, color or size of your areolae.)

According to the Daily Mail, a cosmetic surgery clinic called the Harley Medical Group in London has reported a 30 percent rise on nipple surgeries in the past year, including more from women who haven’t recently undergone mastectomies.

With a price tag of roughly $3,200: ‘padding’ the areola with extra skin as to push the nipple out, ‘popping out’ inverted nipples, and even getting tattoos to change the areolae’s pigmentation. 

One doctor from the clinic thinks celeb nipple slips are the cause. “Until now celebrities didn’t expose their nipples so they were no ‘nipple role models,’” explained Dr. Riccardo Frati, a plastic surgeon with the Harley Medical Group.

Bootox: Botox & Restyland injections in your feet?

I came across this article from Australia on Botox and Restylane being injected in womens feet.

IT'S the subject of whispered conversations over cocktails deep within Flemington's Birdcage. The secret weapon a flock of fashionistas rely upon to teeter upon 10cm stilettos all day long at the races.

Botox and filler injections for the feet are the latest crazes in cosmetic surgery to make their way to Flemington - and the solution, according those with cash to splash, to the old racing conundrum of how to wear those towering pumps and not end up carrying them home after the final race has been run.

For about $1500, some doctors, such as Bondi-based cosmetic surgeon Michael Zacharia, will inject hyaluronic acid (Restylane) into the balls of the feet.

The fluid, commonly injected into joints to treat osteoarthritis, numbs the parts of the foot that become strained by wearing sky-high heels.

And judging by the height of the footwear that was racing out the door of Melbourne boutique Miss Louise yesterday, 10cm heels will indeed be spotted around the Birdcage today.

Dr Zacharia, who has been doing the procedure for just over a year, said the foot filling provided "internal padding for the feel at that point of pressure underneath the balls of the feet. Instead of using those silicon pads inside your shoes, this is an internal way of doing it."

The procedure, however, is a lot more expensive than purchasing a pair of silicon inner-soles. At $750 per foot, the fillers will last for about six months.

Dr Zacharia said three or four people this week had told him they wanted the foot fillers for the Spring Racing Carnival, but he warned those considering the treatment that the sensation immediately following the injections could be uncomfortable.

"I've been told that for about 10 minutes afterwards it feels like you are walking with marbles in your feet, or it's like there is something in your shoe," he said.

The other procedure women are turning to is "bootox" - having Botox injected into the balls, arches and soles of the feet to paralyse the sweat glands, which Dr Zacharia said would also set you back about $1500.

Australasian College of Podiatric Surgeons president Mark Gilheany said while women might think the procedures were magic solutions to stiletto-fatigue, foot fillers could be masking symptoms of more serious problems.

He warned that for people experiencing a significant amount of pain standing in heels it could be a sign of partially dislocated bones or torn ligaments.

"If you require something of that (surgical) nature then you could have an underlying problem," he said.

"It's not something that is routinely done and I haven't seen any clinical trials to say whether the injection of a biological cushion into the foot is effective.

"If there was anything that really worked I'm sure I would know about it. It seems like a waste of time when you can stick a cushion in your shoes and take some paracetamol."