LASER ASSISTED LIPO: HELPFUL OR HYPE?

At our most recent ASAPS (American Society for Aesthetic Plastic Surgery) meeting in Washington, DC, two board certified plastic surgeon colleagues presented both sides of the laser liposuction debate. Dr. Barry DiBernardo of New Jersey is a proponent of laser liposuction while Dallas-based Dr. Jeffrey Kenkel is less excited about lasers’ inclusion in liposuction.

The ASAPS’ annual statistics show that Lipoplasty (the medical term for fat removal) is the second most popular cosmetic surgery procedure in America. Nearly 300,000 of them were performed in 2009. Since the first laser-assisted Lipoplasty device was approved by the FDA in 2006, surgeons have been in a hot debate about whether it’s a great new tool or just good marketing on the part of companies such as SmartLipo.

Basically, laser-assisted Lipoplasty means that a laser is used to break up the fat cells before they are suctioned out of the body. A tiny incision is made through which a laser probe is inserted and aimed at the fatty tissue to rupture the fat cells. Then the laser is pulled back toward the skin to stimulate the skin cells to tighten, a feature that doesn’t happen in traditional liposuction.

"Over the last two-and-a-half years there has been extensive research and development into laser-assisted lipoplasty, including multiple rounds of research and comparative studies published in peer-reviewed journals," said Dr. DiBernardo, a plastic surgeon in Montclair, NJ. "Ultimately, laser-assisted lipolysis has come to be an important tool in the fat loss armamentarium."

"It is important to note that no device is a magic wand," added Dr. Kenkel, a plastic surgeon in Dallas, TX. "Despite any hype generated by manufacturers, physicians, patients, or the media, results are ultimately practitioner-driven."

The bottom line? Any kind of cosmetic surgery should be done by a board certified plastic surgeon, not someone who has taken a weekend course or two. No tool can replace the skill and experience of a board certified plastic surgeon. Check out my website to see the before/after photos that I’ve shared regarding SmartLipo, a technique I have found to be highly effective!

To your health & beauty,

Dr. Joe Danyo

Fixing Dark Circles Beneath the Eyes Due to Tear Trough Deformity

If you notice dark circles beneath your eyes or a hollow under the lower lid area, you might have what’s called a tear trough deformity. Sounds scarier than it actually is! A tear trough deformity is just a furrow or channel that develops beneath the lower eyelid—usually with aging but some people have this naturally just due to their genetic makeup. When light hits the tear trough area of the eyes, the furrow creates a shadow, which can also look like dark circles beneath the eyes. Now, if the area under your eyes is puffy or baggy, this makes everything look a bit worse. The tear trough area can be remedied with just some injected filler, but if you have puffiness under the eyes, that must be treated with a lower blepharoplasty.

In my Delaware plastic surgery practice, I’ve found Juvederm to be terrific as a filler to get rid of that shadowy area. It fills the area nicely, is an easy gel to insert and lasts long enough to satisfy those with this problem. Call us if this is an issue for you and let’s see how quickly we can help you get rid of it!

To your health & beauty,

Dr. Joe Danyo

Those with vitiligo may experience less skin cancer

How often have you heard the phrase, "Always wear sunscreen!"? Often, right? It's the mantra repeated by dermatologists, plastic surgeons and skincare experts all over the world. Well, in an interesting turn of events, a recent study reported in the New England Journal of Medicine shows that people with vitiligo (a chronic skin problem that removes the pigmentation from patches of their skin) are a bit more immune to skin cancer than the rest of us.

The University of London study involved 4300 men and women, some of whom had vitiligo and some who did not, in an attempt to identify gene patterns to help them know who "might" get vitiligo based on their genetic makeup. What they found were 7 genes connected to vitiligo. There were 2 possible combinations of these 7 genes: one gene pattern for those who had vitiligo and another for those who did not. Oddly, all 4300 tested had one of the two combinations of these 7 genes. Those likely to develop vitiligo had a gene combination that simultaneously decreased their risk of skin cancer, while those with a gene combination that increased their risk of skin cancer also showed a decreased risk of vitiligo.

In laypersons' terms, it means that even if you have the genes most likely to develop vitiligo, that doesn't guarantee that you'll develop it. In fact, only about 1% of the world's population has vitiligo. It just means that you may be more susceptible to getting it--but at the same time, you still have a decreased likelihood of developing skin cancer.

This is important news for those with vitiligo, for whom few treatments really do much good, other than depigmenting the rest of the body to match those areas that have lost pigmentation. Narrow band light has shown to be of some help but other than blister treatments, tattooing and skin grafting, little help is available to most people with this skin disorder.

To your health & beauty,

Dr. Joe Danyo

FDA approves new treatment for varicose veins

Last Wednesday, March 31st, the FDA announced that a new treatment for varicose veins has been approved. The generic name, polidocanol (marketed in the US as Asera) works by causing damage to the cell lining of the veins, which makes them close up and eventually disappear, replaced by other types of tissue. Asclera is designed and approved for veins smaller in diameter than 1 mm in diameter as well as reticular veins that are between 1 and 3 mm in diameter. (For Americans that's 1/24th to 1/8th of an inch).

There are three types of vein problems: varicose, spider and reticular. Spider veins are extremely small—you often get them around the ankles and sometimes on the upper thighs, as well as on the face. They can ache, burn and swell and spider veins on the legs can cause night cramps. Varicose veins are the most noticeable and are often located on the calves. Reticular veins are generally very mild and cause little discomfort. In our practice, sclerosing agents, such as the new Asclera, have been a treatment of choice along with laser treatments.

To your health and beauty,

Dr. Joe Danyo

All About Fat Transfer

Imagine transferring your own extra fat into places that you’d like a little more roundness—perhaps your buttocks, the backs of the hands, to fill and plump facial wrinkles, into the breasts instead of implants. This state-of-the-art technology isn’t a dream. It’s already here. Here being all over the world and here in the Delaware Valley/Philly area.

Fat transfer is called by several different names: fat transplantation, fat injecting and microlipoinjection to name only a few. What’s really funny about fat transfer is that it’s actually pretty old. It was created in 1893 by Franz Neuber, a German doctor whose patient had a pit in her cheek. He removed fat from her upper arm and injected it into her cheek and voila! She had no more pit in her face. In 1895, Dr. Karl Czerny used fat from a patient’s flank area to create larger breasts. So you see, this isn’t altogether a brand new technology.

One of the concerns many have about fat transfer is that, even though your body will never reject it, your body might absorb it! In order to avoid this, the fat has to be processed carefully during the liposuction to retain some of the factors and stem cells within the fact. Thankfully, treatments like SmartLipo allow us to extract fat with the SmartLipo system and then inject it into our patients. The factors help the fat to “take” without all of it being absorbed.

A Nose Job Without Surgery?

If you spend any time out in public, you’re bound to run across someone who has had a nose job here in Delaware (rhinoplasty by its proper name). Although most rhinoplasty procedures are done in the operating room, depending upon the reason to have one, a rhinoplasty can sometimes be accomplished through injectable fillers and Botox. This procedure is often called "the 15-minute nose job."

For those individuals with a severely deviated septum, a huge hump, a broken nose or a nose that is too large for their facial features, the 15-minute nose job isn’t appropriate, as it simply won’t provide enough correction. The 15-minute nose job is best for those who have the following concerns:

• A nose that is uneven;
• A bump that can be improved by filling out the nearby tissues;
• A drooping nasal tip;
• Nasal dents, depressions or grooves;
• A flat bridge of the nose
• A saddle nose or a scooped nose.

OK, it’s not exactly 15 minutes—maybe 20—but it is fast, vastly less expensive, much less risky, and the results are immediate with little down time. The 15-minute nose job requires no general anesthesia, no packing and no sutures. Plus, you’ll leave the office with the finished product, in most cases. You might wish to take the rest of the day off but, depending on the amount of filler needed and any temporary swelling you might experience, it’s possible you’ll just return to your work or social schedule immediately!

If you’ve been thinking about a nose job and want to investigate the potential of having either a rhinoplasty or the non-surgical version, schedule a visit with me. The 15-minute nose job doesn’t work for every nose, but it is appropriate for many of them. And if that’s not the rhinoplasty that works for you, I’ll show you my before/after rhinoplasty photos!

Dysport issues the Dysport Challenge!

Were you around in 1975 when the Pepsi Challenge commercials were running? Everyday folks were blind-folded in the local grocery store and served 2 types of cola. They were amazed that they liked Pepsi better than Coke.

Well, the makers of Dysport, a competitor to Botox, have created their own version of this popular commercial. It’s called the Dysport Challenge. Now, our office doesn’t use Dysport, we love our Botox, so we aren’t in the challenge, but we wanted our readers to know about the lengths that cosmetic companies will go to to get their business!

Since Dysport was approved slightly more than a year ago by the FDA, it’s taken only 10% of Botox’s thunder in terms of marketshare. However, Allergan, the makers of Botox, were spooked enough to push more of their non-cosmetic Botox uses to the public, such as a treatment for migraines and excessive sweating. In fact, those non-cosmetic uses make up more than half of Botox’s annual revenues!

This kind of medical marketing has upset some medical ethicists. I’d be interested in knowing what you think about this kind of promotion? Is this no different than the battle of the colas or does this signal a trend that might invade even our more disease-oriented medications, like perhaps Lipitor vs Zocor?