I am one of a limited number of U. S. physicians trained and certified to inject Evolence, the brand new collagen product brought to us by Johnson and Johnson.
From my experience with Evolence the strengths are that it is FDA approved to fill nasolabial folds (laugh lines), it stimulates platelet aggregation which helps to decrease bleeding and bruising from the injections, patients look good immediately after the injection with minimal swelling and therefore can return to normal social activities immediately. It is a natural collagen product derived from pig tendon, manufactured by a company in, of all places, Israel.
Unlike previous collagen products, it is cross linked with the natural sugar ribose which prevents the breakdown of the product. In studies against hyaluronic acids (Restylane, Juviderm) it has been shown to last as long, and even be present up to 12 months after injection. Pig collagen is genetically so similar to human collagen that in tests of over 500 patients there were no allergic reactions. No allergy skin test is required before using this collagen product. Studies have shown that similar to hyaluronic acids, Evolence stimulates fibroblasts and natural collagen production after it is injected.
On the down side, "something's not Kosher" about injecting pig collagen into humans (there have been discussions with both Jewish and Islamic clergyand scholars). Vegans and vegetarians have not voiced their views yet. Not that there is anything Kosher about injecting Botox or any of the other injectables currently used in cosmetic surgery.
Also, the product is firm and therefore it is not advised to inject into lips. It is injected through a 27 gauge needle which is slightly larger than the needles used for hyaluronic acids. The studies averaged about 3 syringes (3 ml) to correct the nasolabial folds which can potentially become costly.
We will be hearing a lot about Evolence in the near future as it is promoted by powerhouse Johnson and Johnson. It will likely become another of the many popular injectable facial fillers available to those who desire to look more youthful.
CLINTON AND COSMETIC MEDICINE
As Hillary Clinton, 60, basks in the spotlight at this week’s Democratic National Convention, doctors say she appears to have used some of the tools of cosmetic medicine to fight against the signs of aging.
But Clinton would still benefit from more skin-rejuvenation treatments to further the process, they say.
Minimally invasive injections and laser treatments are what the doctors see some evidence of, not nip-and-tuck-style plastic surgery.
If Clinton has had Botox injections, though, the photo above is evidence that only a modest amount, at most, was used in her forehead. Otherwise, she wouldn’t be able to make that expression.
You might think otherwise if you only looked at her smooth forehead in the photo below.
Plastic surgeon Dr. Michael A. Persky of Encino suggests that the skin on Clinton’s face looks as though it was firmed-up with a Fraxel re:store laser.
Made by Reliant Technologies of Mountain View, Calif., the re:store device is a non-ablative erbium fractionated aser, which rejuvenates the skin with 1 to 2 days of recovery time.
Persky says:
Hillary Clinton may have had Fraxel re:store treatments, a series of no-downtime laser treatments that help with skin tone, texture, and color, with minimal tightening of the skin. She also may have had Botox and dermal fillers (Restylane, Juviderm, Preville Silk). Ms. Clinton does not appear to have had any major plastic surgery.
That’s the type of treatment that Newport Beach dermatologist Dr. Vince Afsahi recommends for Clinton:
Many prominent women we treat in our office prefer a subtle-yet-effective transformation when they embark on a skin rejuvenation program. Because they are in front of the camera on a daily basis, non-surgical modalities for treating the signs of aging are recommended.
Fillers such as Juvederm for the laugh lines, lip lines, and cheek augmentation can be used. Botox is wonderful for the crow’s feet, frown lines, and glabella [between the eyebrows].
A favorite of many of patients is laser and light based treatments such as photofacials to freshen up the skin, reduce pore size and sun spots before a big event. Most of these procedures can be done with little downtime and the patient returns to work quickly.
Beverly Hills dermatologist Dr. Don Mehrabi proposes a series of anti-wrinkle Botox injections plus skin-rejuvenating laser treatments:
Hilary Clinton would easily most benefit from Botox injections to the crow’s feet, forehead, and the area between the eyebrows. Her most significant improvement would be to do a fractional resurfacing procedure to even out her skin texture and get rid of the lines under her eyes.
Fillers in her laugh lines and the areas around and below her mouth would be great, but the top two suggestions would be Botox and laser resurfacing.
Near the convention site in Denver, Dr. Tahl Humes says that Clinton appears to have benefited from wrinkle-fighters such as Botox. “It appears that she has restored a youthful look with a combination of injectables,” said Humes, a specialist in internal medicine who owns Vitahl Medical Rejuvenation Spa in Denver and conducts training sessions on cosmetic injections and Cutera cosmetic laser systems.
The Daily News of New York quoted Humes earlier this month and said, “A source tells us Clinton visited a New York plastic surgeon early this month and received injections of a ‘dermafiller’ in her face.”
Persky suggested that Clinton should move on to treatments with a Fraxel re:pair laser, a newer skin-rejuvenation device that has attracted wide praise from dermatologists. For Clinton, that “would result in a healthy and rested natural appearance,” he said.
For the full article go to http://inyourface.freedomblogging.com/2008/08/26/doctors-propose-more-work-on-hillary-clintons-60-year-old-face/
Stay tuned next week for equal time for Republicans, Cindy and John McCain.
Be well.
Copyright © 2008 Orange
The current edition of C Magazine, with the beautiful and talented Ms. Meg Ryan on its cover has an article about Fraxel re:pair laser treatment written by Shana Dishell. The photo in the article is the best published photograph of my right hand since The Los Angeles Times photo of the same right hand holding a baseball during the perfect game I pitched for Hamilton High School 3/21/71 against University High School. This is not to imply that I either pitched against or ever treated Ms. Ryan, only that her beautiful face on the cover and my right hand on page 88 just happen to appear in this month's C Magazine. Be well.
These are common general questions that are frequently asked about Accent XL treatment of fat and cellulite:
1: How much does Accent cost per area?
Some practices measure the areas by the size of the palm of their hand and charge approx. $150.00 to $250.00
I have found that to be unrealistic, as the areas can vary in size and for maximum results a larger area needs to be covered. In general, bilateral saddle bags and under the buttocks (the banana) is about $500.00 each treatment.
The face is $500.00 to $750.00 each treatment. Arms can range from $500.00 to $1000.00 depending on the coverage. It is always best to come in for an evaluation, and packaging is available for a further discount.
2: How many treatments will it take?
It varies according to what we set for a goal and the condition of the skin as we begin, also the type of target, i.e.; fat, skin, cellulite? Hydration plays a key role in the success of the treatments. It is important to understand these will not be surgical results. We are working with changing the quality and integrity of the skin, and adipose tissue, not removing it.
3: Dose ethnicity play a role?
No
4: Does the type of fat or when it developed make a difference?
Yes. This can be evaluated at the consultation. "Baby fat" or "menopausal fat" respond as does cellulite and positional fat, the main characteristic of fat that responds the fastest is when it is more hydrated.
5: How long does it last?
There are studies that indicate tissue changes that last into the 16th month of evaluation though ultra-sonography, with evidence that there is ongoing collagen regeneration. As we age and face ongoing environmental factors, it is likely that most tissue will continue to age. Cellulite has other variables that will affect the longevity of the treatment, but with diet and exercise, a touch up treatment every 16 months is recommended.
6: Are there any side effects?
Some people experience slight nausea, and or diarrhea when the abdomen is treated, as well as potential break through bleeding between a menstrual cycle. There have been no complications or side effects in our practice that has been noted as ongoing or permanent.
7: Who is a good candidate?
Anyone who would like to improve the integrity of their skin and accomplish a more youthful look, as well as those who have from minimal to extreme cellulite. Each person is consulted individually as to what will help them be more successful in achieving their goals. Diet and exercise are discussed. NOTHING, will ever replace healthy nutrition. All healthy supplementation and eating habits that are incorporated will enhance the success of the treatment.
8: Is there a guarantee?
No, Places that offer guarantees actually charge for them like an insurance policy. You pay more up front and then they will give you more treatments, if you are not happy. Yet
Recently while cleaning out my desk I came across an article with Audrey Hepburn's list of beauty tips. Ms. Hepburn, an internationally acclaimed beauty, was allegedly a carrier for the Belgian Underground Anti-Nazi Movement in WW II as a teen. She learned the importance of a good heart as well as good character early.
Here is her list:
1. For attractive lips, speak words of kindness.
2 For lovely eyes, seek out the good in people.
3. For a slim figure, share your food with the hungry.
4. For beautiful hair, let a child run his or her fingers through it once a day.
5. For poise, walk with the knowledge you'll never walk alone.
6. People, even more than things, have to be restored, renewed, revived, reclaimed, and redeemed; never throw out anybody. Remember, if you ever need a helping hand, you'll find one at the end of your arm. As you grow older, you will discover that you have two hands--one for helping yourself, the other for helping others (by the way, Kirk Douglas in a recent article said that helping others keeps the elderly from becoming depressed).
7. The beauty of a woman is not in the clothes she wears, the figure that she carries, or the way she combs her hair. The beauty of a woman is seen in her eyes, because that is the doorway to her heart, the place where love resides. True beauty in a woman is reflected in her soul. It is the caring that she lovingly gives, the passion that she shows. And the beauty of a woman only grows with passing years.
Thank you for your wisdom Audrey, you were physically beautiful, but your soul will remain eternally beautiful.
The PSP eReport reports that 55,000 bottles of Botox A was confiscated by Chinese police. This is an excerpt from the PSP eReport:
The Chinese State Postal Authority is warning Wednesday that terrorists may use mail services to deliver lethal biochemicals.
"Beijing police have detained 11 suspects involved in the illegal sales and mailing of Botox bacteria," the report states.
"Botox—more commonly known for its use as a cosmetic treatment—is a highly poisonous neurotoxin. Botox A can be mixed with powders, liquids, food or medicine and delivered to people by mail. Recipients could die of respiratory failure," the official warning said.
More than 55,000 bottles of a Botox A powder preparation have been seized by police.
Police in Xinjiang Uygur Autonomous Region have also investigated a case in which explosives were concealed in ziran, a traditional Xinjiang seasoning. The package was found on July 9 in a taxi along with a letter instructing people to use the explosives in attacks on areas around the upcoming Olympic Games.
Source: Xinhua News Agency
Let's hope that the only Botox in Beijing is Botox Cosmetic by Allergan, keeping a few frown lines and crow's feet away.
Fraxel re:pair laser treatment has gone global. Though the Fraxel repair laser treatment is still only available in the United States in a limited number of practices, I have been fortunate to have the privilege to treat patients from all over the world. Patients from out of town are seen the day after the procedure, 3 days after the procedure, and one week after (some patients need only stay for 3 days after the treatment). With a short 8 to 10 day visit to Los Angeles (Encino), they are able to return home looking years younger and more beautiful. Should you wish to consider a "facial rejuvenation" vacation, our office staff will be happy to make arrangements for you and recommend local hotels to meet your needs.
We have used Accent XL in my practice for the past year without any complications. When performed properly, the Accent XL cellulite treatment is very safe, and patient satisfaction rates have been very high. If too extensive of a treatment is performed at one time, some patients may complain of short lasting nausea due to the break down of too many fat cells.
Our nurse who performs the treatment has been treating patients for over two years without any problems. As with all aesthetic treatments, the results and complication rates are dependent on the physician or nurse performing the treatment,as well as the technologythe technology. Therefore choose your practice most carefully, particularly in today's market place where everyone from podiatrists to attorneys are running med-spas with a "supervising physician".
