The FDA has approved a new hyaluronic acid facial filler Prevelle Silk. Hyaluronic acid (HA) is the filler material in Restylane, Perlane, and Juviderm. Preville Silk is the first hyaluronic acid product to contain lidocaine, a local anesthetic. In a controlled study, patients reported significantly less pain during injection with Preville Silk as compared to the other HA products that do not contain lidocaine. The new product is manufactured by Mentor Corp. of Santa Barbara, CA. It is still to be seen how long the product will last compared to the other currently available facial soft tissue fillers. I will keep you posted, if you have any questions contact me.

Sagging facial skin results from the loss of volume from the face, and the aging of the superficial skin. Traditionally surgeons correcting the problem pulled the sagging tissue and cut away the excess. You can tell who those patients are when you see them walking down Rodeo Drive in Beverly Hills, Park Ave in Manhattan, and Collins Drive in Miami. Natural results can be obtained today by restoring volume to the face, and then by treating the face and neck with Fraxel repair. In the great majority of my patients, this will restore an amazing youthful, rested appearance to the face. This will not leave a patient as "tight" as they might be after a surgical facelift. In some cases of excessive skin "sag", traditional surgery may still be needed.

Recently a woman under went extensive body plastic surgery. It was the policy of her surgeons to send flowers and a get well card to their post operative patients. They received a phone call from the puzzled woman who asked the doctors why they send her the flowers and a get well card. After investigation, it was discovered that the patient had stolen the woman's identity, and had paid for the surgeries with ATM and credit cards. She was surprised at her post operative appointment when after having her stitches removed; police hand cuffed her and took her off to jail. Just another reason why we like to have a copy of our new patient’s driver's license.

Fraxel is the original fractional non-ablative laser system, and has established a strong track record of solid clinical research, FDA clearances, and proven results. It has earned the endorsement of top aesthetic physicians world-wide and patients ask for it by name. Unfortunately, asking for Fraxel by name, and thinking that you are getting Fraxel treatments do not guarantee that you are getting treated by Fraxel technology. Like O.J. Simpson's attorney's defense strategy, confusion of the facts is beneficial to laser companies and practioners that are coming out with their version of "fractional" treatments. I was in the operating room yesterday with two nurses who had received a Sciton laser "profractional" treatment. I thought that the recently treated nurse had some sort of surgery due to the swelling and bruising of her face one week after the treatment. The other nurse was one month out from her treatment and said that she experienced the same swelling and bruising, and felt that her wrinkles around her eyes and sagging neck skin were worse now than before the treatment. These are educated, sophisticated nurses who actually work with the treating doctor, and even they said they thought that they were getting a Fraxel treatment. This is just one story of the confusion that benefits other laser company technologies, and at the same time confuses patients and detracting from Fraxel's reputation, when in fact they never came close to receiving a Fraxel treatment. Due to the success of the innovation and excellence of Reliant Technologies Fraxel product, almost every other laser company in the skin resurfacing business is coming out with a "fractionated" product, but that is not the same as Fraxel. (See my realself.com article entitled "Fraxel, Schmaxel, Steve Trachsel" copy and paste http://www.realself.com/question/how-do-find-best-doctor-fraxel-treatment#tip-40399). What distinguishes Reliant's Fraxel from the copycat fractional technologies? 1. More clinical results and patient follow-up than any other fractional CO2 device on the market with no cases of delayed onset hypopigmentation up to 18 months post treatment. 2. Treats up to 4 times faster than any other ablative device on the market. 3. Delivers the broadest range of fractional ablative treatment in a single handpiece- superficial to deep (5-70mJ); mild to aggressive (5-70% coverage). 4. Clinically demonstrated to penetrate beyond 1.5 mm removing up to 6 grams of dermal tissue leading to greater skin tightening (15 to 25 grams are removed in a facelift). 5. Only fractional ablative device with built-in smoke evacuation- greater ease of use; faster treatments, greater patient comfort, and shorter downtimes. 6. Superior access in small areas and around the eyes. 7. Continuous motion scanning technique--affords optimal uniformity of treatment zones resulting in greater efficacy and faster healing. Fraxel is the gold standard of "fractionated" technology. Just because it is called "fractional”, does not guarantee that it is Reliant's Fraxel. If Fraxel is what you desire, make sure that you are getting Reliant's Fraxel.

What's next, Botox causes pregnancy in men? Once again Botox is in the news. An Italian neurologist has injected "experimental, not for human use" botulinium toxin into the whiskers of rats. The neurologist reports that the botulinium toxin was later found in the rat brain. The conclusion of this study when it hit the news service was, "Botox found to travel to the brain". This study would have been meaningful if actual "Botox" from the Allergan Corporation was used in the relative miniscule dose that is used in humans. The same experimental "not for use in humans" botulinium toxin has caused severe life threatening problems when unscrupulous people actually used "bogus Botox" on humans (seehttp://www.msnbc.msn.com/id/11040763/). Allergan's Botox product remains as safe as it has been when used by reputable physicians. But then again, that news doesn't sell.

BBC Interview NOTE: Fortunately, the writers strike has been settled. This interview and blog entry was from January 2007.......................................................................................... Let's settle the Writer's strike already. The BBC was by our office this week for an interview. (You can see the interview by copying and then pasting http://news.bbc.co.uk/player/nol/newsid_7180000/newsid_7182500/7182525.stm?bw=nb&mp=wm&news=1&nol_storyid=7182525&bbcws=1). BBC correspondent Peter Bowes did a piece on how the strike is affecting business. With award season here, Hollywood's A-listers can postpone their "touch-ups" before the Golden Globes as it appears the red carpet will not be rolled out this year. The people most affected by the strike are the ones who are least able to afford the lack of work. Again, our A-list patients are not missing their appointments for Fraxel, Botox, Restylane, and Juviderm. It's actually a very good time for some of them to get in a surgical procedure or two, fat transfer or blepharoplasty anyone? It is the behind the scenes people, the young writers, costumers, set designers, cameramen/women, grips, and yet to be discovered actors and actresses that are feeling the brunt of the strike. Let's get them back to work! Once again hopefully the strike can be settled very soon.

How do the stars get so thin? (and how do their trainers keep them that way?) KYM DOUGLAS has come out with her second book on the inside secrets of Hollywood and beauty, The Black Book of Hollywood Diet Secrets. Kym is the host of television makeover shows and the image consultant on The View. She appears regularly on Soap Talk, Good Day Live, Before & After’noon, and Your Weekend with Jim Brickman. Kym co-authored the book with CINDY PEARLMAN, a nationally syndicated writer for the New York Times Syndicate and the Chicago Sun-Times. Her work has appeared frequently in Entertainment Weekly, People, Self, In Touch, and National Geographic among others. After success with their first book, The Black Book of Hollywood Beauty Secrets, Kym Douglas and Cindy Pearlman are back with exercise tips and eating strategies from a Who’s Who of Hollywood beauties. The Black Book of Hollywood Diet Secrets takes readers inside the fridges and out to the gyms of the stars, uncovering the daily regimens that keep celebrities like Cameron Diaz, Demi Moore, and Beyoncè Knowles in A-List shape. They’ll dish on stars’ daily diet plans and tell us how the stars bounce back after baby, stay slim after forty, drop a quick twenty pounds, outsmart a Fat Day, and see fast results from exercise. Kym and Cindy have done it again, from (A)niston to (Z)eta-Jones. From The Black Book of Hollywood Diet Secrets: • Heidi Klum and Cindy Crawford eat a salad dressed with vinegar BEFORE they go out to dinner. The vinegar is an appetite suppressant. • Oprah and Rachael Ray drink Wulong Slimming Tea. • Denise Richards, Jessica Simpson, Michelle Williams all detox with So-Cal cleanse. • Demi Moore and Sharon Stone eat prunes to ease bloating AND to prevent wrinkles. For those of you who prefer a great novel , Ken Follett's "The Pillars of the Earth" takes place in 12'th century England, and has been one of the better reads of my life. Enjoy. --------------------------------------------------------------------------------

Here is a video (http://media.vmsnews.com/MonitoringReports/020408/543291/J001313023/:) of the Fraxel Re:pair laser on the Today Show. If you have interest in this technology, please call 818 501-3223 for a consultation.

There is a brand new laser treatment called Fraxel re:pair™. It was debuted at the American Academy of Dermatology last week in San Antonio, Texas. On January 31, 2008 an impressive demonstration was highlighted on NBC’s Today Show. The unique feature of this treatment is that patients in their 30’s to 50’s can get face and neck tightening without a surgical facelift. Patients in their late 50’s to 70’s can have deep wrinkles removed without the downtime of surgery or more aggressive lasers. Like the previous Fraxel technologies, Fraxel re: pair is a fractionated laser that treats a predetermined percentage of the skin while leaving normal surrounding skin to help with the healing process. The laser is a carbon dioxide laser which actually removes tissue. The surrounding normal skin shifts to fill the void left by the lasered area. There is noticeable shrinkage and tightening of the skin during the procedure. I am currently doing my due diligence to make sure that this promising technology delivers what it says, that both patient and physician satisfaction is high, and that there are few to no complications with the treatment. In the meantime, the Fraxel 1500 laser is still the gold standard for skin rejuvenation in my practice. Stay tuned for more on Fraxel re: pair. If you have any experience with the treatment, please write your experience on my blog.