Botox for Acne?

For the past decade, Botox (and now Dysport too) has been the primary wrinkle cure for smoothing the forehead and erasing crow's feet.  Less well known are its established uses in...

• reshaping the eyebrows, especially increasing the arching of the brows
• getting rid of "bunny lines" on the sides of the nose
• lifting the corners of the mouth (to soften sad frowns)
• diminishing the banding of the neck muscles
• minimizing sweating in the arm pits, hands, and feet

And now one report published in the Journal of Drugs in Dermatology suggests that Botox can effectively treat acne.  17 of 20 patients treated with Botox into the skin noticed that...

• their skin was less oily
• their pores were smaller
• their acne improved

I am excited to offer this option to my patients in Ventura, especially for those who have not had success with benzoyl peroxide, antibiotics, salicylic acid, light therapy, Accutane, and other types of acne treatments.

Package Deals in Plastic Surgery: Why They Make Sense

I have increasingly seen advertisements for plastic surgery "packages":

• New mommy makeovers:
  • Breast enhancement
  • Tummy tuck
  • Liposuction

• Surgical facial rejuvenation:
  • Browlift
  • Eyelids
  • Facelift
  • Necklift

• Non-surgical anti-aging:
  • Fotofacial/intense pulsed light lasers
  • Botox or Dysport
  • Fillers (like Juvederm, Restylane, Radiesse, or Sculptra)

My wife has been skeptical.  "Aren't those packages just gimmicks to sell additional services?"

Yes, but that's a good thing.  These bundled procedures do work well together.  Combining services can lead to results that are greater than the sum of their individual parts.

Consider the "new mommy makeover."  All women know that pregnancies and breast feeding cause both the breasts and the abdomen to swell.  In many women, the skin never snaps back to its pre-pregnancy elasticity.  Lifting or augmenting the breasts makes the chest look great.  However, the whole torso is not balanced until the tummy is also flattened and tightened.  So, combining breast enhancement with a tummy tuck does produce the best proportions.

Non-surgical solutions can also be performed concurrently to optimize results.  For example, the "11's" between the eyebrows will usually respond to Botox or Dysport; a 60-80% improvement is typical.  However, for some patients, 60-80% is not good enough; they want 90% erasure of the wrinkle.  So, adding a little bit of filler beneath the relaxed wrinkles (such as with Restylane or Juvederm) can nearly eradicate the 11's.

Fillers can even be used to enhance a surgery.  Everybody knows that a face/neck lift can improve the cheeks, jowls, jaw line, and neckline.  However, the area around the mouth is usually not rejuvenated.  So, I will often recommend Restylane or Juvederm to minimize the "smoker's lines" radiating from the lips.  Combining these fillers with the face/neck lift can produce the most harmonious result.

The 5-Finger Solution for Aging Hands in Ventura County

Practicing in Ventura, Oxnard, and Camarillo, in Southern California, I have many patients who have been sun worshippers.  Botox, soft-tissue fillers, lasers, and facelifts have rejuvenated their faces, but many women are concerned that their hands "still give me away."

My "5-Finger" solution for aging hands:

• Radiesse:  Calcium hydroxylapatite, better known as Radiesse, is a safe way to plump up the backs of your hands.  It fills the tissue beneath the skin, thereby hiding tendons and veins.

• IPL:  Intense Pulsed Light treatments are like lasers.  They remove freckles and age spots, while improving the texture of the skin.

• Moisturizer:  Dry, cracked skin itself looks old.  Hydrating the skin with a good moisturizer refreshes and rejuvenates the skin.

• Sunscreen:  At least SPF 30!  Prevent any more damage by wearing sunscreen all the time--even when you are not intending to be outside.  (It's amazing how much sun you get just by driving around town and by walking to and from your car between errands.)

• Readjust when you "play" outside:  I certainly don't want to ruin your good times.  Lord knows that we could all use more exercise.  However, try to avoid being in the sun when its rays are strongest--between 10 am and 3 pm.  Of course, when you go for your morning run or when you are playing in that afternoon softball game, don't forget your sunscreen.

Cosmoceutical Industry Hit Hard by Recession, Part 2: The Portrait Plasma is Gone

The second recent bankruptcy of a major cosmetic-medicine corporation is that of Rhytec (based in Massachusetts), which never sold enough of its Portrait Plasma devices.

The Portrait Plasma rejuvenated the skin with innovative technology.  Rather than heating the skin with a laser, it used plasma--the so-called fourth phase of matter (along with solids, liquids, and gases).

I never used this device, but it did generate a lot of positive buzz.  Supposedly, the results were at least equivalent to the Fraxel re:pair, but perhaps less plagued by depigmentation and color changes.

The Rhytec bankruptcy has left many Portrait Plasma owners scrambling for a source of the disposable nozzles necessary to deliver the plasma energy.  Since the British parent company has remained standing (at least for now), there is a chance that more nozzles may be available in the future.  However, if I were a patient in the middle of a series of treatments, I wouldn't delay my schedule!