Botox safety update

There is some new information on the recent news regarding Botox safety. A consumer group called on "Black Box" labeling of Botox due to alleged deaths related to its use. Apparently one death has been connected to Botox use for cosmetic purposes in 2003.

According to a news release issued by Allergan on January 25, Dr. Sef Kurstjens, Allergan's Chief Medical Officer, responded to allegations that in 2003 a death had occurred in a person who had been injected with Botox® for cosmetic use. A medical review of this actual case showed that the patient died from complications associated with staphylococcus pneumonia, not from the Botox® injection that the patient had received seven weeks earlier. This conclusion is consistent with the treating physician's assessment.

I don't see how it would be physiologically possible for Botox to give someone pneumonia. Could this be an overreaction by a group who is against the use of Botox for cosmetic purposes. Maybe the people in this group have a lot of wrinkles...

Source

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Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Sylvester Stallone - Plastic Surgery?

Has Sylvester Stallone had plastic surgery? Although I haven't seen the new Rambo movie, I did see him being interviewed the other day. His appearance is very interesting. At times I think he looks really bad, and at other times he looks pretty darn good. I noticed on the interview that he had a nice, sharp jawline, which is pretty uncommon for a 61 year old man. This could be a sign of a facelift. Other than that, his eyelids show remarkably little aging in the photos above. This may be a sign of well-done blepharoplasty surgeries. He also appears to take good care of this skin, possibly with chemical peels and medical grade skin care. It's also possible that some of his "nutritional" supplements may affect the way he looks, although I wouldn't be able to comment much on that.
I enjoyed Rocky Balboa but have no plans to see Rambo. Please God don't get it in his head to make Stop, Or My Mom Will Shoot, Again!

Photo credit: prphotos.com

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Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

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Safety of Botox

A U.S. consumer group called Public Citizen has recently asked the FDA to reconsider the safety of Botox treatments. They pointed to some 16 deaths following Botox treatments, citing complications such as paralysis of the esophagus and aspiration pneumonia.
Botox is currently the most common medical cosmetic treatment today. According to the American Society of Plastic Surgeons, last year over 4.1 million Botox cosmetic treatments were performed. It is currently FDA approved for treatment of glabellar wrinkles, which are the frown lines between the eyebrows. Any other treatments are considered 'off-label.'
I believe Botox is a very safe treatment if performed in the right hands. Over the past few years we have performed probably 500+ Botox treatments in my practice without a single known significant complication. If it is injected cosmetically for the upper face (where it is most effective), I can't see how someone would get a complication like that mentioned above. The worst that can probably happen is drooping of an eyelid (very rare) or a bruise (somewhat common).
I surmise that the esophageal and lung complications may have resulted from Botox being injected for non-cosmetic reasons. It is currently being used for more indications than can be mentioned here, including TMJ, migraines, and various muscle spasm problems. It's possible that poorly performed treatment for a non-cosmetic indication could result in the bad complications cited by the Public Citizen.

For the article on the Public Citizen, click here.
For the reply by the American Society of Plastic Surgeons, click here.

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Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Dr. Jan Adams on Larry King Live

Dr. Jan Adams, the plastic surgeon involved with the Donda West tragedy, spoke out on Larry King Live last night. Here is a link to the video on CNN.com:
Click here.

It is definitely interesting to hear his side of the story. Very appropriately, he did not comment specifically about Donda West, as her medical information is private patient-doctor privilege and should not be revealed on nationwide TV. I have no comment on his DUI convictions, but did find his take on Board-certification interesting. He did complete residency training in plastic surgery with a fellowship in aesthetic plastic surgery (like myself) but for some reason did not get board-certified. Some surgeons don't. This still places him in a much higher place than many other doctors performing plastic surgery such as OB-Gyns and ER docs.

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Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Nicole Kidman - Botox Free

Nicole Kidman was recently photographed attending the Australian Open with a strangely different look on her face (see 1st photo). Could it be that she had to quit Botox while she is pregnant? I think so. Botox injections can give a person what I call the "Botox brow." (See 2nd photo) It is an overarching of the eyebrows that can give a somewhat sinister look. Botox does tend to wear off after 3-4 months, and the first photo may be what Nicole looks like au naturel.

I wouldn't Botox someone if they were pregnant either.

Photo credit: 1st photo: socialite's life 2nd photo: prphotos.com

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Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Dolly Parton - 26 Years of Plastic Surgery Changes

TMZ.com celebrated Dolly Parton's 62nd birthday yesterday with a set of before-and-after photos. She hasn't had anything done, don't you think? (well, maybe a facelift, upper and lower blepharoplasty, rhinoplasty, browlift, fat grafting, Botox, breast implants, Restylane, and chemical peels...but who's counting?)

To view streaming video of a short segment of E!'s Celebrity Plastic Surgery: The Good, The Bags, and The Ugly, click here.

Source: TMZ.com


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Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Courtney Love's Lips are Normal??

In previous posts I reported on Courtney Love's plans to reverse her previous plastic surgery. The last post had photos of what appeared to be a sutured-up lower lip. This recent photo show what appears to be normal-looking lips. It looks like her surgeon did a nice job. I think she looks pretty good for Courtney Love.
Unfortunately her hair looks like she stole it from Dog the Racist Bounty Hunter or a medieval princess...

Photo credit: dlisted.com

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Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Michael Douglas - Plastic Surgery?

Has Michael Douglas had plastic surgery? There are some (in)famous photos which do show what appears to be a facelift, however what else has been done? In my opinion, the big thing that stands out is how wide open his eyes are. The above photo is from his Wall Street days, while the below photo is very recent. It looks as though he's either had an upper blepharoplasty or an endoscopic browlift. I would bet on the former, but he may also have had both I suppose. The reason his neckline continues to sag, even with a possible facelift, is because the skin of most 63 year old men with a history of sun damage does not have the strength to hold up as long as some women's. The skin can tend to sag again somewhat quickly. Unfortunately, I see this in some of my older male facelift patients as well.

Photo credit: prphotos.com

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Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

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Attention Production Companies and Literary Agents

I am currently researching literary agents and production companies for a book on medical school I've written. If there are any blog readers who are one or the other and would be interested in discussing this with me, please email me at miplasticsurgeon@yahoo.com, or call my office at (248) 650-1900.
Thanks!

Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Ed on NBC

Not much new regarding plastic surgery today. For those of you who are sentimental like I am, here is a youtube video from the Season 3 finale of my all time favorite show, Ed. If you are a fan like me, I think you'll like this one. I miss this show.

LA Times Article on Donda West

Yesterday the L.A. Times ran a comprehensive article featuring more information on the tragic death of Donda West after plastic surgery. They cite evidence that she had possible severe atherosclerotic heart disease, hypertension, borderline diabetes, and evidence of pneumonia due to aspiration. These are some very worrysome factors when one considers she underwent 5 1/2 hours of body surgery, which is more traumatic than facial surgery such as a facelift or blepharoplasty. To her surgeon's defense, however, patients sometimes don't inform their plastic surgeon about all their medical history, so as not to be turned down for the procedure. What Donda West told her surgeon and anesthesiologist, however, is not publicly known. The story continues to unfold...

Link to article: here

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Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Update on the Death of Donda West

The final coroner's report on Kanye West's mom, Donda West, was released Thursday. Although the results are inconclusive, there was no sign that surgery error caused her death. According to CNN.com:

The exact cause of death couldn't be determined but there was no sign of "surgical or anesthetic misadventure" in the death of Donda West, Kanye West's mother, a coroner's report said Thursday...
The report noted that coronary artery disease, the liposuction and mammoplasty, and multiple postoperative factors could have played a role, but said the exact contribution of each factor couldn't be determined...
The investigation found "therapeutic levels of medication" but no unusually high levels....
"The final matter of death could not be determined," the coroner's office said in a statement.
Asked if West would still be alive if she hadn't undergone the surgery, Winter said: "She could, possibly. But she could have also died because of pre-existing cardiac issues."

If one good thing can come out of this tragedy, hopefully it is that prospective patients will ensure their plastic surgeons are board-certified and take all the safety precautions necessary to prevent something like this happening. It has reinforced the rule in my practice that all patients over 40 must get preoperative clearance from their internist of family doctor.

Photo credit: prphotos.com

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Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Quick links

Here are a few quick links if you have a few minutes to kill:

1. Body Philosophy presents: 26 Good, Bad, and Downright Unkissable Celebrity Mouths. See photo to the left. Do you recognize any of these lips?

2. Celebrity Plastic Surgery is Hot, from Cityrag.com.

3. Catholic hospital sued for refusing breast augmentation on a transgender person. Now I've heard everything... Link.

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Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Lisa Rinna Sounds Off on Hollywood Plastic Surgery

Lisa Rinna has recently discussed her views on plastic surgery in an interview with TV Guide. Here is an excerpt:

TVGuide.com: As for plastic surgery... is it pretty much assumed that women in Hollywood will get certain things done?
Rinna: You have to if you're going to work in this business for a certain amount of time; you just don't see older women with a bunch of wrinkles on television. It's not aesthetically as attractive to look at. If you don't fit the norm, you're not going to work...Whatever you want to do personally is absolutely 100 percent what you should do. But if I'm really honest, if you want to work in this town in your fifties, people have plastic surgery, that's what they do!

It's refreshing to see that she is not bashing plastic surgery and people who have it, like some Hollywood stars do. While I think her lips look pretty darn bad, she has always seemed like a down-to-earth, nice person from here.
For the rest of the interview, including more thoughts on plastic surgery, click here.

Photo credit: prphotos.com

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Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Heidi Montag's Lips - Swelling or Overdone?

Click here for image and my comments on PageSix.com.

Heidi Montag has been photographed recently with extremely large lips. There are three possible reasons for this: (1) She's had her lips augmented with Restylane and too much was used, (2) She was only a day or so from having them done so they are still extremely swollen, or (3) She accidentally ran into a wall.
Hopefully her 15 minutes will be up soon... (but then what will I have to write about?)

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Janice Dickinson Admits Plastic Surgery "Addiction"

Supermodel Janice Dickinson has gone on record admitting a plastic surgery "addiction." According to Starpulse.com, she has had approximately $100,000 in plastic surgery and has stated:

"Believe me, I'm a 900-year-old dinosaur and without 14 inches of make-up and 32 pounds of fake weave I wouldn't look the way I do. I want to be the best-looking corpse there is.
I'm honest about it; I haven't got a problem with it. I borrow bits from everyone. Every six months I fly to Dallas to get Botox and I also get collagen injections.
I'm addicted to cosmetic surgery."

That's not healthy.

Click this link for my previous post on the "first Supermodel."

photo credit: prphotos.com

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Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Top 5 Celebrity Plastic Surgery Stories of 2007

I hope you are all having a nice New Year. I've compiled my list of the Top 5 Celebrity Cosmetic Surgery Stories of 2007. Here they are:

5. Breast Augmentation is announced as the #1 plastic surgery of 2006, the first year ever that breast implants are the top plastic surgery. Fashion followers Heidi Montag, Kellie Pickler and Brooke Hogan immediately rush off to the local plastic surgeon to get themselves a pair (or so it appears). Click for link.

4. Dr. Quinn Medicine Woman admits to some plastic surgery medicine herself. While a contestant on Dancing with the Stars, Jane Seymour states she's had blepharoplasty, breast augmentation, and Botox in the past. Soon after, voters boot the classy star from the show, possibly in a display of jealousy. No one can look as good as she does without some help! Click for link.

3. Septoplasty surgery sweeps Hollywood, however instead of just straightening the septum like this surgery is supposed to do, celebrities re-enter the spotlight with noses that are straighter, thinner, and more contoured. Stars like Ashley Tisdale, Cameron Diaz, and Jennifer Aniston reportedly go to the same Beverly Hills septoplasty surgeon to get their "septoplasty-plus."

2. Lipodissolve, or mesotherapy, gains national attention as celebrities such as Britney Spears are rumored to have had the controversial treatment for fat reduction. Although practioners initally flooded the media with sometimes outrageous claims, scrutiny ensues, culminating in skeptical articles in Allure magazine and the bankruptcy of the largest nationwide Lipodissolve chain, Fig. Click for link.

1. Kanye West's mom, Donda West, dies just days after breast reduction, tummy tuck and liposuction surgery. A media frenzy ensues, as her prominent Beverly Hills plastic surgeon is revealed to lack board-certification (although he did complete a plastic surgery residency) and have several questionable features of his past. At the request of the West family, her surgeon walks off an interview on the Larry King Live set, the first to do so in King's several decades of live TV. The importance of finding a surgeon certified by The American Board of Plastic Surgery and undergoing preoperative clearance is emphasized to the public. Click for link.

That's it! It's been an exciting year in celebrity plastic surgery, and the upcoming year is bound to bring more exciting and interesting news. I look forward to covering it with you.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.: