Dr. Persky is now offering Sculptra to patients who wish to re-volumnize their face with a long lasting filling agent. Studies have shown results lasting up to 30 months. Sculptra works by stimulating the patient's own collagen production. Sculptra is very effective for patients in their 30's and 40's who are showing early signs of aging, as well as in patients over 50 who have lost bone and fat volume in their face. Depending upon how much volume needs to be replaced, the treatment entails using one to two vials of Sculptra, one to four times, separated by about six weeks. Contact me if you have any questions about Sculptra. Be well.

The current Health Care Bill lead authored by Sen. Henry Reed ( D,Nev) that is before the Senate for approval has added a 5% tax on "elective cosmetic surgical procedures" which includes Botox and fillers. A $350 Botox treatment will be $367.50, that $10,000 facelift will be $10,500. Hopefully plastic surgery spokeswoman Ms. Joan Rivers will be able to convince the lawmakers to defeat the bill based on the same arguements that our country's founding father's used in Boston, "Taxation without representation!". Sen. Nancy Pelosi (D, CA) will have saved a fortune in taxes by having her work done prior to passing the bill, but will be a major contributor to the tax in the future. For those of you who are contemplating elective cosmetic procedures, now is the time to book to save at least 5%. Be well.

Two weeks ago Dr. Persky treated our first two patients with the newest Fraxel laser, the Fraxel Dual Laser System. Both patients already have fabulous "Wow!" results.

Using a new wavelength and Thulium laser, the new Fraxel restore Dual Laser System is set to take fractional resurfacing to a new level. The laser is able to not only restore the skin on the face, but on large portions of the body as well. It treats sun damaged superficial skin and in a single quick and pain free office treatment greatly diminishes brown pigmented skin lesions. Both patients experienced no pain, 2 days of redness and minimal swelling followed by about 4 to 5 days of a thin peel. One patient went to work the next day while the other said definitely stay home for a day or two. At 10 days both patients commented how clear their skin appeared, and the most common reaction from friends and family was that they "had make-up on" when they did not. My initial reaction was the same, I actually asked both if they were wearing make up. There was also a noticeable improvement in volume in the face. Both patients have commented that they want the treatment on their arms, legs, and chest as well.

The machine boasts several advantages, including greater ease of use for the physician and a shorter treatment time. Solta Medical (Hayward, Ca) states that the machine will allow greater comfort for the patient and faster results. Fractional resurfacing is a procedure that has been largely limited to the face so the addition of an effective superficial treatment for the body is welcome.

The Dual Laser will be used to complement the other Fraxel® family of products, which includes the Fraxel restore laser system, the Fraxel repair laser system and the Fraxel refine laser system, which have swiftly become the cosmetic industry standard for fractional aesthetic skin rejuvenation treatment. Fraxel brand fractional laser systems treat only a fraction of skin at a time, leaving the surrounding area intact for fast healing, as opposed to traditional laser treatments which are more aggressive.

A recent study conducted in by the Aesthetic Surgery Education & Research Foundaton (ASERF) found that the typical aesthetic injectable patient is a married, working mother between the ages of 41 to 55 years of age with a household income of less than $100,000.

Among Botox cosmetic patients, nearly 70% also received treatment with hyaluronic acid fillers (Restylane, Juvederm). The areas most commonly treated included glabellar lines for Botox users (72%) and nasolabial folds for hyaluronic acid patients (63%).

Since this study was completed, the collagen stimulating injection product Sculptra has been FDA approved for cosmetic use. In the near future, Sculptra should become one of the more popular aesthetic treatments as it is the most cost effective product for restoring the volume loss in the face assoiciated with aging.

Lauren Johnson, a 12 year old girl, appeared with her mother this morning on NBC's Today Show, "sneezing" every few seconds. She has been "sneezing" every few seconds for the past two weeks after returning from a sleep over. According to estimates she is "sneezing" about 10,000 times per day.

Nancy Synderman, MD was doing all she could to hide her disbelief of an actual medical condition, "peeling back the layers of the onion", suggesting a tic, Munchausen’s Syndrome, or a psychogenic poor imitation of a sneeze. Dr. Synderman pointed out that unlike a normal sneeze that comes through the nose and coincides with involuntary eye closing, Lauren's "sneeze" is through her mouth with her eyes open. Additionally, Lauren only "sneezes" when awake. The politically correct Dr. Synderman stopped short of suggesting that the "sneezing" was a much better idea to get those 15 minutes of fame than Balloon Boy's recent publicity stunt.

In the old days, the antipsychotic medication Thorazine was used to break cycles of tics, hiccoughs, or other "mysterious" medical conditions. Hopefully Lauren will have stopped her "sneezing" before she appears in People Magazine, The Jay Leno Show, and David Letterman. Otherwise, start the IV and get the Thorazine ready. G-d Bless You times a million.

To see the Today Show segment go to http://www.huffingtonpost.com/2009/11/11/the-girl-who-cant-stop-sn_n_353744.html.

Michael Stampar, MD (Punta Gorda, FL) and Edgar Fincher, MD (Los Angeles, CA) presented their experience with Pelleve`(Ellman International), a new radiofrequency procedure for the treatment of mild to moderate facial wrinkles and skin laxity, this past weekend in Beverly Hills.

Dr. Stampar shared his extensive and impressive experience with the technology. Patient satisfaction rates have been very high for both physicians. Radiofrequency (RF) energy is applied to the patient's facial skin resulting in gentle heating of the skin and underlying deeper tissues that results in collagen stimulation over time. Patients experience an immediate improvement in skin tone with elevation of brows, cheeks, and jowls as well as reduction of the depth of wrinkles during the 45 to 60 minute non-invasive procedure.

As with other RF technologies, additional improvement occurs over a 6 month period as more collagen is produced. Usually a series of 3 treatments separated by a minimum of 4 weeks are recommended for optimal, long lasting results. A maintenance treatment one to two years after the initial series helps to keep patients looking their best. Dr. Stampar prefers Pelleve` over Thermage because of consistant results with Pelleve`.

He stated that Accent XL can give similar results to Pelleve`, but Alma's Accent XL machine costs 3 to 4 times as much as Ellman's Pelleve`. Ellman International has a winner with it's new Pelleve`. Our office has offered the Accent XL technology over the past two years with excellent results, and will continue to use the non-invasive, effective treatment.

U.S servicemen and women who suffer facial injuries in combat may be eligible for free reconstructive medical care through a national group of plastic surgeons that includes Michael A. Persky, MD, FACS.

Dr. Persky is among about 170 doctors with the American Academy of Facial Plastic and Reconstructive Surgery who is participating in the new Faces of Honor program that was launched in October at the AAFPRS Meeting in San Diego.

The program compliments the academy's Face to Face program, which began in 1992 and provides free medical care to victims of domestic violence and children overseas who suffer facial deformities. Faces of Honor was the brainchild of academy past-president Donn Chatham. Chatham said the idea for the program grew from his belief that Vietnam vets were not treated well by America in general and his concern that U.S. soldiers in Iraq and Afghanistan are also fighting an unpopular war.

"Last year, a National Guard unit from my community was deployed to Iraq. Within a few weeks, one of the men was killed, leaving a young wife and young baby," he said. "I began trying to figure out a way that either I or other colleagues might be able to somehow show our appreciation to what these men, women and families were going through."

Noting that about one-fifth of the survivable injuries from Iraq and Afghanistan involve the face, head and neck, Chatham said, "This seemed like a possible service we could offer them. It's a public thank you to all the brave men and women who have done what most of us were not asked to do. And, if we can help improve the quality of life for just a handful of veterans, it will be a good thing."

The program is meant to supplement care already provided by the Department of Veterans Affairs.

"The VA medical system has many fine and well-trained (physicians), and I believe most veterans with injuries receive excellent care," Chatham said. "The idea with Faces of Honor was to offer an additional level of reconstructive care to those veterans who may have returned to their homes and may possibly not be living anywhere near a VA facility."

For more information about Faces of Honor, visit the program's Web site at www.facesofhonor.org.

The porcine (pig) based collagen product from Israel, EVOLENCE, will no longer be available. Johnson and Johnson announced yesterday that they will no longer sell the product because of poor sales. Since buying the rights to EVOLENCE from the Israeli company Colbar, J & J is out a little over $1 million. This week, Ortho Dermatologics notified plastic surgeons using EVOLENCE that marketing and manufacturing of the wrinkle filler would be discontinued, effective immediately.

According to the official notification, the company may “talk to interested parties about the possibility of EVOLENCE® market re-entry under different ownership.”

They also assured physicians that EVOLENCE was, and remains, an “effective option” for wrinkle reduction, with a “favorable safety profile.” I have used the product in a handful of patients. My patients have had excellent results with the product without any adverse effects. It will still be available (while it lasts) in my practice for those patients who either prefer it or who are unable to have hyaluronic acid fillers because of allergic reactions.

Was EVOLENCE® destined to fail? An Israeli company called ColBar LifeScience was responsible for development of Evolence (they even had rabbi's approve it as Kosher because the pigs used to produce the collagen product were not allowed to have their hoofs touch the floor), and they had been marketing the drug outside the U.S. since 2004.

When Johnson & Johnson acquired the company and received FDA clearance for Evolence in the summer of 2008, they were optimistic about the filler because of its unique composition of naturally sourced porcine collagen. Evolence was radically different than the popular hyaluronic acid offerings that dominate the market; it had all the benefits of the old collagen fillers, lasted longer, and required no allergy test.

However, some experts predicted a struggle for the animal-based collagen filler. The Wall Street Journal quoted J&J consultant Kenneth Beer saying, “they couldn’t have picked a worse time [to enter the market.]” Others expressed concern about the drug’s source: “Porcine products historically haven’t done well, and many people prefer lab-grown products,” said analyst Ronny Gal in a 2008 report.

It might be a stretch, but could it be fear of the swine flu and all things porcine that killed Evolence? Doubt it, it's the economy.