Dubious Advertising of Cosmetic Procedures

Patients occasionally draw my attention to apparently wonderful outcomes in advertisements for cosmetic surgery procedures (often accompanied by an orgy of self congratulation by the treating practitioner). Patient photos are generally displayed without reference to any time frame between the before and after photos. This can prove very deceptive to unsuspecting patients. For instance a tremendously impressive wrinkle free outcome from laser or fractionated laser can simply be a reflection of  swelling and inflammation in the weeks that follow such a procedure. I have now seen so many patients who have spent thousands of dollars on fractionated laser (and endured a period of intense pain and discomfort) only to see wrinkles returning after several months when the inflammation (reactive swelling) has finally settled down. While it is fair to state that fine wrinkles and blemishes can improve with lasers, similar outcomes can often be gained with either chemical peels in salon or topical applications +/- fine needle skin rolling at home at a tiny fraction of the cost!

Before forking out time, pain and money on some laser procedures take the test:
See if you can find any long term (12 month post treatment) outcomes posted on Google images for fractionated laser treatments:
http://www.google.com.au/search?q=fraxel&hl=en&biw=1920&bih=911&prmd=imvns&source=lnms&tbm=isch&ei=Vp54TpP7AuqfmQXUyc26DQ&sa=X&oi=mode_link&ct=mode&cd=2&sqi=2&ved=0CGYQ_AUoAQ

This answer is likely to be no!

Try chemical peels images next:
http://www.google.com.au/search?hl=en&biw=1920&bih=911&tbm=isch&sa=1&q=chemical+skin+peels&btnG=Search&oq=chemical+skin+peels&aq=f&aqi=&aql=&gs_sm=s&gs_upl=25l3438l0l5437l17l16l0l7l7l1l370l1663l1.1.3.2l7l0

Then try needle rolling next:
http://www.google.com.au/search?hl=en&biw=1920&bih=911&tbm=isch&sa=1&q=dr+des+fernandes+skin+rolling+images&oq=dr+des+fernandes+skin+rolling+images&aq=f&aqi=&aql=&gs_sm=e&gs_upl=26317l28027l0l28268l7l7l0l6l0l0l326l326l3-1l1l0

Very little difference in outcomes can be seen between these techniques. The only difference is the high price one is likely to pay for the laser option!

Finally it is worth inspecting this forum for some interesting patient experiences with fractionated lasers.
http://www.realself.com/fraxel-laser/forum

Cosmetic Physicians Society Australasia & Australasian College Cosmetic Surgery

The last few weeks have been eventful for me as I was elected to the medical council Australasian College Cosmetic Surgery (ACCS)  and I was also invited to speak on the topic of a new injecting system for facial fillers at the most recent meeting in Sydney of the ACCS & Cosmetic Physician's Society Australasia (CPSA): http://www.cosmeticphysicians.org.au/events.asp?pageid=16&event_type=E

CPSA NSW & ACT CME Meeting plus ACCS Clinical Audits
Wednesday 7 September 2011
          Topics and Speakers:
Change starts here: The science behind HA injectables and new aesthetic trends from Europe:
          Silvia Scherer Managing Director Anteis Aesthetics
          
          Anteis Injecting System:
          Dr Ron Feiner

Educational events such as this always generates an exchange of ideas among colleagues and speakers, stimulating new ideas and directions in one's own practice.

The Anteis firm in Switzerland have created outstandingly engineered filler products along with a brilliant injecting device for a seamless and more comfortable delivery of  injections via blunt ended needles. http://www.anteis.com/AestheticDermatology/injectionsystem.php
  
The managing director of Anteis, scientist Ms. Silvia Scherer, spoke with authority on her firm's outstanding scientific record and leading edge innovations in the field of injectable fillers.

I have been very impressed with the Anteis range of fillers for some years now and (unlike my experience with almost every other manufactured filler I have used) I have had  no significant complications with their product range. This is a very important issue, for as doctors we are ethically obliged to provide patients with the best outcome and
also the safest experience that we can personally deliver. An added bonus is that the Anteis range is of the highest scientific standard while  being cost effective.

This company has clearly worked very diligently to achieve the respected pharmacological standing it has attained and well deserves the accolades and awards that have been bestowed upon it. http://www.anteis.com/News/awards.php
Congratulations Anteis.

Skin Peels, Laser, Vitamin A and Skin Rejuvenation

When I commenced cosmetic practice in 1999 one of the first skills I acquired was chemical peeling for facial skin rejuvenation. Glycolic and TCA peels were the vogue and the results often pleasing. Beauticians now perform a variety of peels with good effect and I personally  feel happy to leave this work to these beauty professionals. However what I have found in practice is that home based daily applications of Vitamin A rich topical creams (combined with cosmetic skin roller needling if necessary) give absolutely remarkable skin rejuvenation outcomes with diligent long term use. For the most part chemical peels become unnecessary. Such an approach is very cost effective for patients.

Vitamin A also mitigates against skin cancer when used over time, so this is a very valuable added benefit.

I am so impressed with the Vitamin A topicals like AVST (http://environskincareaustralia.com.au/products/avst-range/index.htm) and skin needle rollers (as devised and invented by Cape Town South African plastic surgeon Dr. Des Fernandes) http://www.beautymagonline.com/pages/skin_needling.htm     http://www.ctfa.co.za/pebble.asp?relid=3263&t=153
that in most cases treatments by fractionated laser treatment for skin rejuvenation are frequently rendered unnecessary. It should be appreciated that even after laser resurfacing for skin rejuvenation a long term home based skin care regimen is essential to maintain healthy youthful skin.
So patients can  save a lot of pain, downtime, risk and money by adhering to a daily regimen of high standard home based skin care and always sensible sun protection.