I know that you have heard this before, only to be disappointed with having set your TIVO in vain, but I have been told by pretty high sources that my appearance on EXTRA discussing Fraxel re:pair has been "etched in stone" for Tuesday November 25, 2008 on NBC at 7:00 pm, for what that's worth in "Hollywood". I hope that you and your family have a loving and warm Thanksgiving.

The talented and lovely Ms. Marta Waller had Fraxel re:pair this past summer, and was kind enough to have her experience video documented. You can find the entire 12 episodes of the video documentary on You Tube (http://www.youtube.com/results?search_query=fraxel+repair&search_type=&aq=f). Dr. Persky's appearances on PBS' "American Health Journal", BBC's "Super Botox Me", and KDOC's "OC DayBreak" can also be found on the same You Tube site. Dr. Persky will appear on NBC's EXTRA this Friday, November 7, 2008 at 7 pm. Thanks to Ms. Waller for sharing her Fraxel re:pair adventure with all of us.

I was recently asked about a "quick fix" rhinoplasty on the plastic surgery patient chat line RealSelf.com. This is another case of "if it sounds too good to be true....then it usually isn't". The question involved a quick fix to narrow the bottom part of the nose. Rhinoplasty has been described as the most difficult of all facial plastic surgical procedures by the greatest plastic surgeons in the world. Sculpting the nose to blend in with the other surrounding facial features is the goal. A beautiful nose "gets out of the way" of attractive eyes, cheeks, jaw line, and mouth. Narrowing the base of the nose can be one step in a rhinoplasty, very rarely the only step. When one area of the nose is altered, the rest of nose is usually sculpted to fit the change. The most essential aspect of rhinoplasty is the proper diagnosis of what is causing the perceived problem. Once the diagnosis is made, then a properly qualified rhinoplastic surgeon can carry out the necessary maneuvers to accomplish the desired results. It is essential to choose your rhinoplasty surgeon most carefully. Everyone's nose is different, and surgeon’s skills and aesthetic senses of beauty differ. Take your time and make sure that you and your surgeon are "on the same page" with regard to your expectations and the surgeons ability to meet those expectations. By all means avoid the "quick fix". The first rhinoplasty operation is your best chance at getting the excellent result that you desire. Revision rhinoplasty is more difficult because of what has been removed as well as scar tissue.

Dr. Persky will appear on NBC television's EXTRA scheduled for Friday November 7, 2008 at 7:00 pm. He will be discussing Fraxel re:pair laser rejuvenation treatment. The appearance will be as an "EXTRA Life Changer", where the public asks questions and Dr. Persky gives answers from the web cam in his office. Please give us and NBC EXTRA your feedback on the segment. Thanks.

Plastic Surgery Practice (PSP) reports in their current e-report that "Lipotec has introduced a nonsurgical way to give patients full lips, a new method of vehiculizing hyaluronic acid called Hilurlip. The name doesn't exactly roll off the tongue, but the manufacturer is making big claims for its product. Hilurlip is an oil suspension containing particles of sodium hyaluronate, which is processed to the point at which the particle size is reduced and homogenized up to 1µm—the company claims that this enhances the product's penetration and efficacy, and can provide up to an 18% increase in lip volume. These particles expand when they come in contact with skin water, and reportedly provide long-term plumping of the lips. Hilurlip also contains the tripeptide GHK, a well-known RCS scavenger that protects the lips against photodamage and loss of collagen elasticity. The product can be incorporated into water-free lip care formulations, such as glosses and lip balms. The company advises against using the product in lipsticks. Source: Lipotec" I for one will believe it when I see it. I remain skeptical at this time about product claims of penetrating topically through the skin barrier to impose their effect. How many millions of dollars have been wasted on Strivectin anti-wrinkle cream, and its claims that it is "better than Botox"? Please comment if you have had any experience with these products.

And here is another story of trying to find that inexpensive botox fix, only it is not FDA approved Botox, it is a very dangerous bogus botulinium toxin: A Texas-based anesthesiologist convicted last year of injecting unsuspecting patients with a Botox substitute on Friday started serving a 2-year federal sentence. Gayle Rothenberg reported to a minimum security women's facility about 100 miles northwest of Houston. Her lawyer, Joel Androphy, had hoped to keep her free pending the outcome of an appeal, but the 5th Circuit Court of Appeals rejected that request. A jury found Rothenberg, 56, guilty of conspiracy, nine counts of mail fraud, misbranding a drug for sale, and lying to federal agents. At sentencing in June, she called using the fake injections "a mistake." Androphy said his client maintains her innocence. "We're going to fight this thing all the way through," he said last Monday. Rothenberg and her husband, Saul Gower, were accused of using botulinium toxin Type A as a cheaper alternative to Botox. Gower, a 57-year-old lawyer who served as office manager of the Houston-based Center for Image Enhancement, pleaded guilty to misbranding a drug for sale and lying to a federal agent about it. He received probation. There have been 68 arrests and 29 convictions of practioners injecting imposter non-FDA approved Botox and fillers. Over 1000 patients have been treated with these illegal injections. Please choose your physician most carefully.

Two recent occurrences remind me once again to inform the public of the importance of choosing your treating physician very carefully when it comes to facial cosmetic surgery, particularly with Botox and facial fillers. I was interviewed last week for a television show called, "1000 Ways to Die". I was asked to comment about a 40 year old woman who wanted to look younger, yet wanted the cheapest Botox possible. She found a "guy" who came to her house and injected her with what he claimed to be "Botox", but which was non FDA approved botulism toxin. Within hours she could not breathe, and died. The question that I was asked was, "So Dr. Persky, what do you think about this "Botox" death from a "cosmetic treatment". I responded that this was not a Botox death from a cosmetic treatment because the woman had been treated with a Botox imitation, and likely received a gigantic dose of the toxin. This was a case of murder by an unqualified injector using non FDA approved botulism toxin. There have not been any reported deaths from cosmetic FDA approved Botox injections in the many years that it has been used. So in trying to get the cheapest price, this woman paid the ultimate price, her life. Botox injections and the injections of facial fillers are medical procedures that should be performed by qualified and trained cosmetic physicians in their offices, not in someone's kitchen.

The Physicians Coalition for Injectable Safety reported that cheaper, unbranded, unapproved and counterfeit cosmetic injectables are a threat to your looks and your health warns . There have been 210 investigations with 68 arrests and 29 convictions of health care professionals (I use that term very loosely in this case), and over 1000 unknowing patients have been scammed. In an article published in the San Antonio Business Journal, The Coalition charged with educating consumers on safe choices in cosmetic injections and eradicating the use of counterfeit and illegally imported cosmetic injectables suggests all consumers follow very cautious steps for both safe, and positive outcomes: -- Doctor: Ask specifically about your doctor or injector's qualifications. Choose a doctor who specializes in treating all cosmetic concerns of the face, such as a board certified plastic surgeon, facial plastic surgeon, oculoplastic surgeon or dermatologist and who examines you, prescribes and performs cosmetic injections in a licensed and properly equipped medical facility. Establish a positive and on-going relationship with your doctor and follow-up as directed. A nurse or physician's assistant may perform your injection if you elect, but a licensed physician must prescribe the treatment. -- Brand: Ask specifically the brand name of the injectable recommended for you, the approval status of regulatory agencies in the country where you will be treated (the U.S. FDA in the United States) and about any potential outcomes and the likelihood of adverse events. If your doctor does not offer, ask specifically to see the packaging and identifying marks that can verify authenticity, including the serial and lot number (which as a matter of proper procedure must be recorded in your medical chart). For reference, images of all U.S. FDA approved brand logos and packaging are available at. www.injectablesafety.org/html/ataglance.php. -- Safety: If you suspect your injector is not properly trained, is not following proper procedure or is injecting you with a non-branded, non-approved or unsafe substance, do not accept treatment. Follow-up by anonymously reporting suspected illegal activity to your local FDA field office that can be found at http://www.fda.gov/consumer/updates/oci072307.html. To learn more about the benefits of cosmetic injections, the uses for approved cosmetic injectables, to plan for your treatment, see video of live, appropriately administered injectables and more visit www.injectablesafety.org and http://www.realself.com/injectable-safety-campaign. Choose your physician carefully.

Nobody's perfect. That why for the rest of us there's cosmetic surgery, makeup judiciously applied, proper lighting, and enough distance to keep things a little fuzzy and out of perspective. A very intelligent, entertaining, and most beautiful patient was in my office today. She can afford to see the most popular as well as expensive Beverly Hills cosmetic physicians, yet she chose my practice for her facial procedures. After her rhinoplasty months ago I asked, "What was it that made you choose me to operate on your nose?" She answered with one word, her friend’s name (who had rhinoplasty here a few months before), and then simply added, "Seeing is believing". She has subsequently trusted her face to me with fillers and Botox. She shared an experience from her workout at the gym this morning. In the class, the lights are dimmed for the hour of the workout, and most people look better in the wall to wall mirrors in the dimly lit room. The inevitable moment of truth comes at the end of class when the bright lights are turned back on. In one of those "ah-ha" moments she came up with another cosmetic insight, "You can look good with the lights on!" with emphasis on the “can”. With a non-invasive, safe and effective treatment that combines the precise and individually tailored use of Restylane, Juviderm, or Radiesse and Botox, the Liquid Facelift rejuvenates the face without the cost and downtime of surgery. It is an excellent choice for my patients who work under the scrutinizing eye of high definition television and film. Patients look rested, healthy, and great with or without the lights on. Seeing is believing.

In a national NBC syndicated television story that originated on WCAU-TV in Philadelphia, the Fraxel laser is described as a “Fall Face Fix” that can reverse the harmful effects of the summer’s sun. Fraxel treatment will do a lot to improve sun damage, acne scars and the overall appearance of skin. The segment makes reference to the Today Show segment featuring Kathie Lee Gifford and notes that the Fraxel re:store laser is FDA cleared for discoloration, roughness, sun damage, acne scars and wrinkles. To view this video go to http://www.fraxel.com/downloads/NBC%20Phila%20Bernstein.wmv.

Dr. Persky appeared on the front page of today's Los Angeles Daily News in an article entitled "Cosmetic Surgery Gets a Lift" written by Barbara Correa. Here are links to the articles, which ran today in the LA Daily News: http://www.dailynews.com/ci_10585601 http://www.dailynews.com/ci_10585602 The article addresses financing of elective cosmetic procedures. We now offer Care Credit financing in our office. Be well.

Dr. Persky will be featured on the local PBS television station KOCE in Los Angeles, and Orange County discussing Fraxel re:pair laser skin rejuvenation. The show will air Wednesday October 1, 2008 at 7:30 p.m., and then again on Friday October 3, 2008 at 1:30 p.m. The viewing party and wrap party will be held at Les Deux in Hollywood with the stars from the Hills....just kidding about this part. Be well.

Colin Stewart, cosmetic medicine columnist of the Orange County Register asked me to comment on whether my patients still request facial features "like Angelina Jolie's" -- or have other celebrities edged her out? The most common request from my patients regarding a feature of Angelina Jolie's that they would like on them is Brad Pitt! Second to that are lips, most patients would love to have her lips, while others do not want their lips to "be as full as Angelina Jolie's". Angelina possesses the classical features of beauty that were described by Leonardo da Vinci during his anatomy studies and drawings of 1511. His proportions are used by plastic surgeons today. Angelina's face is very symmetric. Her face can be divided into 3 equal thirds horizontally, her forehead, her brows to her upper lip, and her upper lip to chin. Likewise, vertically her face can be divided into equal fifths, each the width of the distance between her eyes. Her forehead is flawless (Botox?). Her nose fits her face and allows us to focus on her beautifully shaped eyes. And then of course those sexy Angelina lips. Are they real or not? I won't tell, but only Angelina and her injector know for sure. Enough on her, Brad, know that you are still the most requested feature of Angelina that my patients request. Check out the Orange County Register later this week for the complete article.