In an entry on 6/28/08 I wrote, "Health and Beauty correspondent Marta Waller of KTLA, Channel 5 in Los Angeles has documented her Fraxel re:pair experience in a daily video blog available at KTLA.com and at The Chicago Tribune.com.......You can see the first installment at http://ktla.trb.com/news/health/ktla-video-dairy-marta1,0,3083829.htmlstory. Ms. Waller will also be featuring the story on the KTLA evening news, followed by the Morning News. Look for her segment on Channel 5 this week." Well apparently there has been a "managerial change" over at KTLA, so the segment has been postponed. You can still tune in to KTLA, Channel 5 in Los Angeles, evenings at 10-11pm to see the beautiful Ms. Waller covering health and beauty topics. As Jackie Gleason used to say, "Ralph, one of these days" you will be seeing her segment on her experience with Fraxel repair by Reliant (Reliant was bought by Thermage this week in a deal to be finalized later this year. but that's another blog topic). Be well.

The newest facial filler has been approved in the United States, Evolence. With rumors that traditional bovine (cow hide) collagen will not be available soon, this new product will be used in those patients who are unable to tolerate hyaluronic acid fillers. It is a porcine (pig skin) derived collagen product (we will have to ask the Rabbi if it is Kosher to inject). It is said to last 6 months (we'll see), and unlike previous collagen products will not require allergy skin testing prior to use. It is owned by Johnson and Johnson, so expect to hear about it a lot real soon. I have included their press release below: Herzliya, Israel and Morris Plains, NJ (June 30, 2008) − The U.S. Food and Drug Administration ("FDA") today announced the approval of EVOLENCE® for the correction of moderate to deep facial wrinkles and folds, such as nasolabial folds. EVOLENCE® is a new advanced collagen-based structural dermal filler, and a first of its kind product. The introduction of EVOLENCE® marks the first dermal filler entry for the Aesthetics Group of OrthoNeutrogena. While new to the United States, EVOLENCE® has been available in other markets such as in Canada, Western and Eastern Europe, Israel, South Korea and Russia since 2004. "EVOLENCE® represents a new generation of facial fillers, an innovative structural agent providing beautiful, immediate results by replacing the collagen lost with long-lasting, naturally sourced collagen," said Annie Heremans, M.D., Ph.D., Vice President, responsible for the Company's research and development of the Medical and Aesthetic Dermatology franchises. "We are pleased to enter the U.S. aesthetic space with a differentiated dermal filler designed for optimal patient outcomes. Given our rich heritage in skin care and and commitment to science, we anticipate EVOLENCE® will be a welcome addition to current aesthetic treatment options." EVOLENCE® will be introduced throughout the second half of 2008, in coordination with physician training, to ensure optimal patient satisfaction and outcomes. EVOLENCE® represents a breakthrough in aesthetics. As one of nature's most fundamental and abundant building blocks, collagen comprises up to 80% of the dermis and it helps maintain skin strength, structure and support. Collagen naturally breaks down as a person ages, leading to the appearance of wrinkles, lines and folds. EVOLENCE®, and its proprietary GLYMATRIX™ Technology, uses naturally sourced collagen to replace the body's lost collagen, adding volume and structural support in depleted areas, for a more naturally youthful appearance. In addition, no pre-test is needed, and GLYMATRIX™ Technology delivers longer-lasting durability than previous collagen dermal fillers. Results are visible and immediate at the time of treatment, with minimal to no bruising or swelling, allowing physician and patient to gauge the amount of wrinkle correction with more precision. EVOLENCE® is recommended for the correction of moderate to deep facial wrinkles and folds, such as nasolabial folds, to be injected in the mid-to-deep dermis. "We now have a collagen filler that does not require a pre-test and delivers immediate, beautiful and natural-looking results that last with minimal to little downtime for the patient," said Z. Paul " said Z. Paul Lorenc, M.D., F.A.C.S., Assistant Professor of Surgery, New York University School of Medicine and Principal Investigator on the EVOLENCE® U.S. pivotal study. "EVOLENCE® consistent and predictable results for all patients with every treatment."

At the recent Facial Cosmetic Surgery 2008 Meeting in Las Vegas, Steve Dayan, MD of Chicago, IL spoke on noninvasive methods of facial rejuvenation. His new book, "Instant Beauty" outlines methods to "look your best in one hour or less". Originally wanting to entitle the book "First Impressions", Dr. Dayan emphasized how we all strive to make an excellent first impression in those precious first seconds. One of Dr. Dayan's quotes is, "It is about making people feel better". By using the noninvasive techniques now available, properly trained physicians can truly improve that first impression.

Dr. Persky is the only facial plastic surgeon in Southern California to offer all three of the currently available Fraxel laser treatments. Fraxel refine provides safe, gentle resurfacing for patients in their 20's and 30's. You can prevent or address the first signs of aging, such as fine lines and mild pigment problems without downtime. Fraxel restore treatment offers patients in their 30’s, 40's and 50's a noninvasive solution to wrinkles around the eyes, acne scars and brown spots, helping your skin to regain its youthful glow. Fraxel repair treatment is designed for patients in their late 30's to 70's looking for a preemptive strike to treat deeper wrinkles and skin laxity without a surgical facelift. If you'd like to find out which treatment best suits your condition, you can e-mail your photo to drpersky@aol.com, or better yet, come to our office for a personal consultation. Be well.

Fraxel Re:pair by Reliant has hit the internet in a most unique manner! Health and Beauty correspondent Marta Waller of KTLA, Channel 5 in Los Angeles has documented her Fraxel re:pair experience in a daily video blog available at KTLA.com and at The Chicago Tribune.com. Ms. Waller truly "stuck her neck out" for this investigative report. She recently underwent Fraxel repair treatment of her face, eyes, nec, and décolletage at my office. You can see the first installment at http://ktla.trb.com/news/health/ktla-video-dairy-marta1,0,3083829.htmlstory. Ms. Waller will also be featuring the story on the KTLA evening news, followed by the Morning News. Look for her segment on Channel 5 this week. I believe that Ms. Waller's story with video documentation will be of value to men and women who desire a more beautiful and younger appearance with a single non-invasive office based treatment. The story will answer many of the questions, and clear up some of the confusion regarding this incredible cutting edge treatment. Fraxel re:pair by Reliant fractionated CO2 laser technology is truly where facial plastic of the next 10 years is headed.

I was recently asked by Colin Stewart of The Orange County Register what I would recommend if the talented and naturally beautiful star, Ms. Sally Fields, presented for a consultation in my office. My first answer was that it would depend on what she came to the office seeking. I do not believe in "telling" patients what they need. Over the years I have had numerous patients share their horrid experiences with cosmetic physicians who recommended procedures for features that the patients had not even given a thought about. At any rate, just about anyone seeking to look their best and a few years younger while they are at it, will benefit from Fraxel re:pair by Reliant . To see the OC Register article go to http://inyourface.freedomblogging.com/2008/06/16/cosmetic-doctors-advise-sally-field-how-to-fix-her-face/.

Sweet dreams funny man, you made us laugh at ourselves. May your soul be bound to eternal life.

There were so many television cameras around our office the past two days that I would not have been surprised had Steve Carell, Jenna Fischer, and their Dunder Miffin Corporation pals shown up. Earlier in the week, BBC correspondent Ms. Kate Spicer came in for a consultation and filmed a Fraxel repair treatment for an hour show that will air this summer in Europe. Today, KTLA, Channel 5 in Los Angeles, filmed a full face, eyelid, neck, and décolletage Fraxel re:pair treatment on their health reporter, the lovely Ms. Marta Waller who will be documenting her experience in a daily video blog (http://ktla.trb.com/news/health/). Talk about sticking your neck out for your job. Ms. Waller should look even younger and more beautiful when she accepts her Emmy for this investigative report, above and beyond the call of duty.

In the early years of rhinoplasty, having a nose that looked operated on was somewhat of a status symbol, so much so that a few surgeons had characteristic noses that they created consistently on their patients. In New York City there was the "Diamond" nose, and in Los Angeles the "Parkes" nose. Today, the goal of any good cosmetic surgery is a natural look. Recently in my practice I have come to realize that there are thousands of people who have a minor bump, hump, or tip disproportion that has bothered them for a long time, but feared having it repaired because they did not want the rest of their nose and appearance changed. They didn't want to end up with the Dr. "you fill in the name" nose job. Now those slight nasal "offending parties" can be corrected with a subtle rhinoplasty. The procedure is quicker and easier for the patient as the nasal bones are not broken, the nasal septum (center divider of the nose) is not operated upon, and there is no packing placed into the nose. There is no to minimal bruising, swelling, or pain. Nasal breathing can be improved at the same time. The downtime is only 4 to 5 days, and full normal activities can be resumed in 14 days. Patients need no longer fear that their entire look will change. Call our office to find out if that little thing that bothers you about your nose can be taken care of with the subtle, finesse rhinoplasty.

I have been fortunate to use Previle Silk hyaluronic acid filler with lidocaine on a few of my patients. It is the first FDA approved hyaluronic acid filler available in the United States. It is manufactured by Mentor Corp. in lovely Santa Barbara, CA. The word "silk" aptly describes the product as it flows and fills very smoothly. It is too early for me to judge how long it will last. It is stated that it should last for 90 days. I like using the product for it's anesthetic effect, and then follow it with the longer acting fillers at the same sitting. This "new kid on the block" will rapidly become a popular hyaluronic acid filler. Patients have been very pleased with the comfort of injection, and I appreciate not having to use dental blocks to fill the lips.

I just returned from The Aesthetic Show at the Mandalay Bay Hotel in Las Vegas. Over the next week or so I hope to share with you the highlights of the meeting. The largest buzz of the meeting was non-invasive aesthetic treatments for fat sculpting and facial rejuvenation. Laser and light treatments are definitely in, and the wars on cellulite have officially begun. Fractionated CO2 lasers for facial rejuvenation (Fraxel repair, Deep FX, mixto, smartxide dot, and others) are the wave of the future for non-surgical facial rejuvenation. Fat and cellulite are very popular treatment options. Smartlipo and Vaser high definition body sculpting were featured with impressive results. Alexander Rifkin, MD of the Westside Medspa in Westwood, CA presented the non-surgical rhinoplasty. Stephen Mulholland, MD, (SpaMedica med spa clinics) and Mark Tager, MD presented pearls from their recent book, "The Art of Aesthetic Practice, How to Profit form the Cosmetic Boom". The Silk N home laser hair reduction device was presented. David Matlock, MD presented his Laser Vaginal Rejuvenation techniques, including The G-Spot Shot (TM). Imagine my surprise when I arrived to the meeting on the first day a little late (as a facial plastic surgeon) into the large, darkened convention center general session room with a vagina projected on the screen. After rushing from the airport to the convention center, I thought that I had walked into the wrong medical convention. As I recover from the excitement of the weekend meeting, I hope to expand upon some of the new treatment modalities that were presented. Saturday night I visited the World Series of Poker, and I later was fortunate to see comedian Steven Wright perform. Unknowingly, he summarized what is new in plastic surgery in one of his dry witty jokes, “I just got the most spectacular technology. It is the greatest new, advanced technology. It is incredible. In fact it is so futuristic and advanced that you don't even need it". Be well.

The results thus far with Fraxel repair treatments have been excellent. Patient satisfaction has been extremely high in 100% of my patients. The tightening in the eyelid area, jaw line, and jowl/neck areas has been impressive. This is an incredible technology that can be adjusted and customized to individual patient needs. It is truly a "Wow" experience for patients, their friends, and families. It is a very powerful laser. I am fortunate to have had extensive experience with the previous traditional CO2 lasers over the past 20 years. I believe that my “surgeon” background is also very helpful in the meticulous treatment around the eyelids and face, as well as with post-treatment wound care. We are now including pre-treatment Botox of the glabella and crow' feet area, post-treatment hyperbaric oxygen therapy, as well as specific skin care products with the treatment.

I am excited to be spending this upcoming weekend in Las Vegas at The Aesthetic Show. There will be three days of conferences, exhibits, and candid conversations between cosmetic providers. I find that the personal exchanges outside of the formal lectures and conferences are the most informative aspect of attending these conferences. In an informal setting, experts can exchange new ideas as well as confirming what really works and what doesn’t. I look forward to returning to Los Angeles next week and sharing with my patients and bloggers, "What happened in Vegas". Be well.

There is no recipe for an excellent rhinoplasty. Everyone is different. A beautiful nose gets out of the way of the eyes and mouth. The nose then "fits" the face. Choose your surgeon most carefully. They should have experience, they should be Board Certified in plastic surgery, facial plastic surgery, or otolaryngology (ENT), but most importantly they must have an artist's aesthetic sense.

Fraxel Re: pair laser, manufactured by Reliant, is at the cutting edge of the future of facial plastic surgery. It is a pre-emptive strike against a facelift, and in those patients who begin their treatment at the early signs of aging in the face and neck (jowling and lax skin with wrinkles), a facelift may never be necessary. Addtionally, ttreatment of the upper and lower eyelids results in youthful eyes. It is safe, effective, and quick with a very short social downtime period. The results are a natural younger version of you, without the "pulled” look of too many unfortunate surgical facelifts. There is no cutting, operating room fees, or anesthesiologist involved. This is truly where the future of facial plastic rejuvenation surgery is heading.