Archive for the ‘wrinkle fillers’ Category

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Cosmetic Surgery Trends: Predictions for 2011

Friday, December 24th, 2010

cosmetic surgery trends for 2011Looking ahead to the New Year, cosmetic plastic surgeons around the country weighed in on upcoming trends in cosmetic surgery to the American Society for Aesthetic Plastic Surgery (ASAPS), who came up with a list of “predictions” for 2011.

Two areas where they anticipate growth are face lift surgery and injectables.

Demand for face lifts and other facial rejuvenation surgery will increase as the economy continues to improve. Non-surgical facial rejuvenation procedures will also see growth, but people who have been putting off face lift surgery for the past few years because of the economy will be ready in 2011, the society predicts.

The growth and popularity of injectables, already the most popular non-surgical procedure according to ASAPS’s 2009 statistics, will continue to increase as fillers continue to evolve and new products and brands enter the market. Botox, Dysport, and Restylane are just a few of the many choices for today’s consumer.

One area where they see change ahead is in fat reduction techniques. While liposuction will remain the standard in surgical fat reduction, new non-surgical techniques, such as Velasmooth, will continue to be developed — including freezing, zapping and lasering fat — as alternatives to surgery.

Another area of change in the past decade is the increase in the diversity of the cosmetic surgery patients, and the society predicts this trend will continue to grow stronger than ever.

“Aesthetic surgery and cosmetic medicine will continue to spread across the spectrum of our population, as plastic surgeons further tailor treatments to meet the sometimes unique needs of that expanding population,” the society predicts. One example of this targeted treatment is Asian blepharoplasty, an eyelid surgery technique developed specifically for Asian patients.

The full list of cosmetic surgery predictions is available at surgery.org.

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Study Looks at First Impressions after Restylane Injections

Monday, November 15th, 2010

filler injection in laugh linesHyaluronic acid fillers, such as Restylane, are effective at correcting nasolabial folds — commonly known as smile lines — and a new study also shows receiving the treatment can affect the first impression you make on others.

The Chicago Center for Facial Plastic Surgery had 22 participants who received Restylane injections in their nasolabial folds, and then photos were taken of their faces at the baseline, optimal correction visit and four weeks after optimal correction.

Next 304 evaluators rated their first impressions in several categories for each photo; in total, 5,776 first impressions were recorded.

The study’s findings indicated a significant improvement in mean first impression at the optimal correction visit in several categories, including attractiveness, financial success, relationship success and athletic success.

“Full correction of the nasolabial folds with hyaluronic acid filler significantly and positively influences the first impression an individual projects,” the authors concluded.

Dermatologist Dr. Kenneth Beer commented on the study: “When used correctly, they [hyaluronic acid fillers] help restore more youthful proportions. For women, this includes higher cheekbones, fuller temporal areas, and more sculpted facial features. Hyaluronic acids may also be used to camouflage the bone loss associated with menopause and its loss of reproductive capacity. Transforming a postmenopausal face into one that has the features of a premenopausal face will have a profound effect on first impressions.”

The abstract is available online, and the study was published in the November issue of the Dermatologic Surgery journal.

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Dysport Gives Patients Quick Results

Saturday, November 6th, 2010

Dysport logoDysport and Botox, which are both offered by Dr. J. Timothy Heffernan in Seattle, are famous for their ability to temporarily reduce glabellar lines— known as frown lines—which appear on the smooth part of a person’s forehead, between and above the eyebrows. While both are effective, a new study indicates that Dysport may work up to two days sooner than Botox.

Cosmetic surgeon Dr. Joel Schlessinger presented his findings at the American Society for Dermatologic Surgery 2010 Annual Meeting; the results were of a subset analysis of a phase 3 clinical trial designed to evaluate the effectiveness of Dysport.

An analysis of the Dysport group (n = 1160) showed that 19.7 percent of the participants responded to Dysport on day one. Three days was the median response time to the Dysport treatment.

Dr. Schlessinger said, “There are many different neurotoxins out there, and they have different types of effects on the injected individual, depending on the physical and molecular makeup of the neurotoxin.” He went on to say that Dysport appears to take effect slightly faster than Botox, by about two days. “That can be very helpful for a person who is looking for a faster onset, especially if [he or she] has a social function coming up,” he added.

The “study … validates what clinicians have observed clinically with the use of [Dysport] with regard to its early onset of action in many patients,” said Dr. Elliot Weiss from the Laser and Skin Surgery Center of New York in New York City.

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Now’s the Time to Try Dysport and Save Money Trying It

Monday, August 9th, 2010

Frown lines injectionIt’s the perfect time to try Dysport if you’ve been considering it for your frown lines because the Dysport Challenge—going on through September—could save you up to $150. Since the challenge started in March over 100,000 patients have registered for the challenge, according to Medicis, maker of Dysport.

The way the challenge works is that patients who try Dypsort save $75. After the procedure, if they select that they “love it” they can get a rebate for $75 off their next Dysport injection. If they choose “leave it” then they get a $75 rebate off another get another botulinum toxin type A product, such as Botox.

Over 90 percent of the over 22,000 patients who took the challenge between March 1 and May 9, 2010, chose “love it,” according to Medicis. Less than 3 percent of all registrants have made a selection to “leave it” since the program started.

“We are pleased to announce this tremendous support by both physicians and patients for the Dysport Challenge,” said Jonah Shacknai, Chairman and Chief Executive Officer of Medicis, which also markets dermal fillers Restylane and Perlane. “Medicis made a bold statement of confidence in the brand by offering patients the opportunity to try Dysport and save up to $150 total.”

Approved by the FDA in April 2009, Dysport can treat severe frown lines between the eyebrows and is the first botulinum toxin competitor to Botox in the United States to receive approval. Dysport works much like Botox, using botulinum toxin type A to temporarily relax wrinkles. Dysport blocks the chemical triggers that cause specific facial muscles to contract, which allows wrinkles to flatten out.

The Dysport Challenge is open to patients 18 and older and full details are available at www.DysportUSA.com.

Dr. Heffernan’s Seattle cosmetic surgery practice offers both Dysport and Botox.

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XEOMIN Botulinum Toxin Approved for Treatment of Eyelid Spasms

Wednesday, August 4th, 2010

injectablesXEOMIN is a botulinum toxin type A product that has just been approved by the FDA for the treatment of adults with cervical dystonia or blepharospasm. Other products of this type approved in the U.S. are Botox and Dysport.

XEOMIN—a product of Merz Pharmaceuticals—received FDA approval based on the results of two U.S. clinical trials. In addition, a study cited in the Journal of Neurological Sciences said XEOMIN showed “non-inferiority” to Botox when used in the same doses to treat cervical dystonia, concluding it is a safe and effective treatment for the disorder, which is a neurological movement disorder in which sustained muscle contractions cause twisting of the neck. XEOMIN is also approved to treat excessive eyelid spasms (blepharospasm).

While XEOMIN has not been approved for cosmetic purposes, it could be in the future, and until then doctors may start to offer it as an off-label option to patients.

XEOMIN differs from Botox and Dysport in that it doesn’t require refrigeration prior to reconstitution. Merz believes this quality may “simplify product distribution and storage and help ensure product integrity at the time of injection.”

In early 2010, Merz announced it would be acquiring BioForm Medical, maker of the Radiesse dermal filler. Following completion of the acquisition of, Merz will be rebranded “Merz Aesthetics.”

Despite more competition, Botox does not show signs of slowing. An earnings release from Allergan this week reported that Botox sales rose 7 percent in the quarter to $360.5 million. Additionally, the Allergan report noted that the FDA has extended a review of Botox as a migraine therapy by three months. If approved for use as a migraine treatment, Botox sales could expand even further.

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Collagen Injectables Discontinued as Popularity of Hyaluronic Acid Fillers Grows

Monday, July 12th, 2010

Radiesse before & after photosThe latest issue of Dermatology Times reports on the changing U.S. injectables market, given the news that most collagen fillers will be gone from the market at year’s end.

In January 2010, Allergan announced it would be discontinuing its collagen line of fillers— CosmoPlast, CosmoDerm and bovine products Zyderm and Zyplast—at the end of the year. The company halted production of the products last year, but manufactured sufficient inventory to meet estimated market demand through the end of 2010, according to Kelly Lao, manager of corporate communications.

In late 2009 Johnson & Johnson had announced that it was discontinuing its collagen filler Evolence.

“For my generation of dermatologists, collagen was the gold standard of fillers—this is what we were taught to use,” says Seth L. Matarasso, M.D., clinical professor of dermatology, University of California School of Medicine, San Francisco. “But the market is changing. Welcome to the brave new world of fillers.”

“The discontinuation of the sale of our collagen products … is in response to declined market interest … since the introduction of hyaluronic acid dermal fillers like Juvéderm have become more popular,” Ms. Lao says.

“There is an overwhelming popularity of the new kid on the block: the hyaluronic acids. They have been embraced universally, and suddenly collagens aren’t as popular,” says Dr. Matarasso.

The popularity of hyaluronic acid products, which includes Restylane, Perlane, Juvéderm, Radiesse and Sculptra, is due to factors that include:

  • Longer-lasting results
  • Appear to give a better fill
  • Some contain lidocaine for less painful injections

Upcoming improvements of hyaluronic acids, according to Dermatology Times, will provide more volume and contour-changing ability and the ability to fill deeper lines.

Read the full story, “Dermatologists prepare for departure of collagen from U.S. market,” online at Modern Medicine. (Before and after photos of Radiesse patient, courtesy of radiesse.com)

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Injectables with Lidocaine Offer Pain Relief

Tuesday, June 22nd, 2010

Restylane logoOne of the latest advancements in the U.S. injectable fillers market is lidocaine-containing versions of popular hyaluronic acid fillers, reports the July 2010 issue of Cosmetic Surgery Times. Lidocaine is a local anesthetic that is injected directly into the body area and decreases pain by temporarily numbing that area, according to WebMD.

Three injectables won FDA approval in February 2010 for lidocaine versions in the U.S.:

The products performed similarly to their lidocaine-free predecessors in terms of safety and efficacy, according to Dr. Michael H. Gold, a clinical assistant professor of dermatology at Vanderbilt University School of Medicine and School of Nursing. Furthermore, “The incorporation of lidocaine has surely provided a higher comfort level for patients [in the clinical trials],” he says.

Dr. Gold adds that in his clinical experience when patients undergo an injection that includes even a small percentage of lidocaine, “Most patients say they barely feel the second stick. To me that is the home run of lidocaine in these fillers.”

In clinical studies by Medicis to support FDA approval, the addition of lidocaine to Restylane and Perlane substantially reduced pain experienced by patients, while demonstrating adverse event safety profiles similar to those of Restylane and Perlane, according to the Medicis release.

A method for doctors mixing lidocaine with Radiesse was cleared in July 2009. “Originally, I was against doctors mixing a lot of fillers because I was afraid of potential changes in the products themselves,” says Dr. Gold. But once the FDA clears these products, especially those premixed by manufacturers, “I’m pretty comfortable with it.”

“Fillers with lidocaine among latest injectable advancements” is available online at Modern Medicine. Learn more about Restylane, Perlane, and Radiesse in Seattle.

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Anticipating Weather Changes and the Fraxel Dual

Wednesday, September 30th, 2009

fraxel-re-store-dual-wavelength-before-and-after-photoThe first touch of fall is in the air today.  Clouds, light rain, south wind, sounds familiar?  We certainly have had a beautiful summer this year and I guess it is about time to expect to pay our dues a little bit with the normal fall weather change.

I want to remind everyone though that the ultraviolet skin harming rays will continue to pass through the cloud cover and we should not forget to wear our sunscreen even in the cloudy weather.

On the development side we are recently investigating the new FDA approved dual technology Fraxel laser.  We wrote about this in one of our previous entries.  This is very exciting technology because it allows the use of two very effective wavelengths.  The wavelengths can be used in combination to markedly decrease the number of treatments necessary to get the same clinical effect. Also,the wavelengths can be used separately for more specific skin needs.

Those patients who have some bothersome brown spots can now have those treated using the longer of the two wavelengths, without requiring topical anesthesia.  This will significantly shorten your visits and provide quick and predictable results.  We’ll keep you advised right here as we get closer to introducing this technology.

To the men who are reading this, we are scheduling a special pre-holiday men’s only event.  The event is scheduled for November 5, 2009, at the Sorrento Hotel from 6 p.m. until 8 p.m.  We have our special visitors that night talking about Radiesse, Fraxel, and the latest approaches to physical fitness.

We look forward to seeing all of you there.

J. Timothy Heffernan, M.D.

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Enhance Yourself – Enhance Your Job Prospects

Wednesday, August 12th, 2009

istock_000008859561xsmallCompetition on the job market is fierce these days, and many people are considering the possibility that age, or their appearance, may be affecting their job prospects to some extent.

To get a little extra edge, many job seekers have turned to their hair stylist for a new look, or their local surgeon for Botox or Dysport wrinkle injections.  When you have to compete with young adults just out of college, who often accept a much lower wage, you need to present yourself in the best possible light.

Men and women are using some of their extra time to get a little touchup, with injectables like Botox, a wrinkle filler, or even eyelid surgery.  Botox is the number one minimally invasive cosmetic procedure in the U.S; according to the American Society of Plastic Surgeons, more than 5 million treatments were done last year. The cost of a single treatment will vary, and it pays to keep an eye out for monthly specials and events.

If you are going for treatments prior to a job interview, give yourself at least 7 days to heal from Botox and other injectables. Remember, doing well on an interview is not only about how you look, but whether you exude confidence about yourself and your ability to do the job.

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Which Dermal Filler is Right For Me?

Thursday, July 9th, 2009

istock_000008969660xsmallRemember when the FDA first approved Collagen in 1982?  There was hope of looking more youthful, fear of potential allergic reactions, painful injections, and lots of swelling. Sometimes it took as long as a week before you finally looked normal.

Today we have a much wider range of safe, effective dermal fillers to choose from. They can be injected into the tiny lines around the eyes, the lines that have formed below the mouth, and the folds around the nose. They even can even fill-in areas that have lost volume, such as thinning lips and those deep furrows that develop between the eyebrows. Having any of these areas injected can take years off the face. It may even allow you to postpone cosmetic surgery, like a face-lift, for years.

All these new fillers can be used quickly, in an outpatient setting, and you’ll look great almost immediately.  Of course the downside is, fillers are temporary (lasting anywhere from a few months to a year), and some patients experience minor bruising and swelling.

The question many people want answered is: “Which one should I choose?”
The majority of the new fillers (not all) are made from Hyaluronic Acid, a natural substance found in the body. Below is a list and brief description of the dermal fillers that are available only from qualified practitioners:

  1. Restylane – a hyaluronic acid based filler touted as “the world’s best-selling dermal filler.” It is used for correcting moderate facial wrinkles and folds.
  2. Perlane – very similar to Restylane, it is designed primarily for treating deeper and more severe wrinkles and folds.
  3. Radiesse – this thick compound is made with (natural, biocompatible) calcium based microspheres in water based gel.
  4. Prevelle Silk – this hyaluronic acid gel filler is commonly used for lip augmentation treatments.
  5. Juvederm – Like Perlane, this popular filler is designed for treating deeper wrinkles and restoring volume to the face. It’s been called the “liquid facelift” treatment.
  6. Evolence – one of the newer injectables on the market, Evolence is made with purified porcine collagen. It helps create plumper cheeks and lips, and has a reputation for quick results and minimal bruising.

As with any cosmetic procedure, you should choose a doctor you trust and one who operates a practice that makes you feel comfortable. Remember, the use of injectables is an art, not just a science.  At our Seattle surgery office, we can help you make the right choice among the best dermal fillers available today.

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