Aesthetics

Kissimmee, Fla. — In dermatology practices today, two basic types of procedures exist: "desire-based" cosmetic procedures and "disease-based" procedures, such as the removal of a skin cancer. Traditionally in medicine, physicians have employed a set of relatively objective criteria to define an acceptable outcome in the second type of procedure. It is the first category, elective and cosmetic procedures, where the physician must satisfy another, more subjective, set of criteria — one that is frequently the cause of disappointment, remorse, dissatisfaction, anger and, all too often, malpractice litigation.

Fort Worth, Texas — The proliferation of new fillers creates both opportunity and risk for cosmetic dermatologists. Paul M. Friedman, M.D., clinical assistant professor at the University of Texas Medical School, Houston, says knowledge and technical expertise are vital for using the fillers to both the dermatologist's and the patient's benefit.

San Antonio — After three decades, the cosmetic profession is finally starting to sit up and take notice of autologous fat transfers, according to plastic surgeon Tolbert Wilkinson, M.D., F.A.C.S.

Peptides clearly represent the most novel active in the current cosmeceutical market.

San Francisco — Along with helping patients, the advent of biologic drugs has restored some much-needed luster to the practice of medical dermatology.

National report — Anecdotal evidence indicates that the onion extract/allantoin gel product Mederma (Merz Pharmaceuticals) might be an effective first-line therapy for diminishing scars and associated symptoms.

National report — Acne scarring is a multifaceted problem that may involve multimodal treatment, says Gerald N. Goldberg, M.D.

They used stereology, which would make it possible to uniquely identify a melanosome in a plane.

Biofilms are resistant to antiseptics and antibiotics for a number of reasons.

New York - American dermatologists have been ignoring cellulite, but they need to start paying attention, says Mitchel Goldman, M.D., medical director of Dermatology/Cosmetic Laser Associates in La Jolla, Calif.

Philadelphia - The state of the art in lip augmentation isn't about fillers or filling technique but a conceptual breakthrough, says Sydney R. Coleman, M.D., a plastic surgeon with a New York City practice.

Boston - The past year has been full of new developments for botulinum toxin (BT), says Neil Sadick, M.D., F.A.C.P., F.A.A.C.S.

New York - American dermatologists have been ignoring cellulite, but they need to start paying attention, says Mitchel Goldman, M.D., medical director of Dermatology/Cosmetic Laser Associates in La Jolla, Calif.

Newport Beach, Calif. - Anti-aging therapies are shifting as the U.S. Food and Drug Administration approves an assortment of fillers and as researchers continue to study the use and safety of botulinum toxin.

National Report - Dermatologists have known for years that retinoids suppress the development of skin cancers. Recently this underutilized application has been dramatically illustrated in a case report.

Philadelphia - To plastic surgeon Kenneth Olshansky, M.D., it's as clear a choice as washing hands prior to surgery. Given a nearly 95 percent cure rate, Mohs micro-graphic surgery is the method of choice for treating certain lesions.

FortWorth, Texas - The appearance of most scars can be dramatically improved using resurfacing or ablative types of scar revision, according to Eric M. Finley, M.D., who spoke on this topic at the Texas Dermatological Society's Fall CME meeting here.

Stanford, Calif. - Chin-jowl implants are a valuable adjunct for optimizing the results of minimally invasive facelift procedures and neck liposuction, says Greg S. Morganroth, M.D., who spoke at "The Next Step: Mastering Cutaneous Outpatient Procedures," a continuing education program at Stanford University.

Philadelphia - The state of the art in lip augmentation isn't about fillers or filling technique but a conceptual breakthrough, says Sydney R. Coleman, M.D., a plastic surgeon with a New York City practice.

New York - Facelifts are rapidly becoming obsolete, according to Mitchel Goldman, M.D.

New York - Roger Amar, M.D., a French anatomist, plastic surgeon and inventor of the FAMI (facial autograft muscle injection) procedure, introduced an effective new procedure to enhance aging cheeks at the American Academy of Dermatology's Academy '04.

New York - Skin rejuvenation procedures now are being accomplished with the help of some new technology - and a few not-so-new techniques that have undergone their own rejuvenation.

New York - The four recently defined subtypes of rosacea are likely caused by different pathogenic factors, and thus respond to different therapeutic regimens, according to Michelle T. Pelle, M.D.

National report - California pharmaceutical manufacturer Allergan is taking steps to reassure doctors and patients about the safety of Botox after four people became critically ill after they were treated with an unapproved raw botulinum toxin.

Santa Barbara, Calif. - The U.S. Food and Drug Administration has approved Inamed Corp.'s Captique, a non-animal-based hyaluronic acid gel to combat facial wrinkles. It is the newest dermal filler to enter the U.S. market.

Stanley A. Klatsky, M.D., believed in cosmetic surgery when few of his plastic surgery peers would even discuss its existence.

Many reliable sources will be providing physicians and staff input regarding all the changes set forth by the American Medical Association (AMA) and the Center for Medicare & Medicaid Services (CMS) for fiscal year 2005. Based on the display copy of the Nov. 2, 2004 Federal Register, the 2005 AMA CPT book, and the ICD-9-CM Book for 2005 published by the World Health Organization, pertinent changes for dermatology practices are summarized below:

Philadelphia - The advent of tumescent infiltration in the late 1980’s and its widespread adoption in the 1990’s was a revolutionary event in the history of liposuction, says Gerald H. Pitman, M.D. Since then, theory and technique have been moving forward in graduated steps.

Philadelphia, Pa. - Calling a new laser from Reliant Technologies "one-stop shopping for aging skin," Lawrence Bass, M.D., presented his take on the Fraxel laser as well as a number of intense pulsed light systems as part of a discussion of advances in cosmetic laser surgery at the American Society of Plastic Surgeons here.

A San Francisco-based plastic surgeon says Botox (Allergan), used prior to browlift surgery, actually leads to an improved permanent outcome in that procedure.