FDA Approves Botox Competitor Dysport / Reloxin!

BIG news in the plastic surgery field. The FDA approved the drug Dysport (otherwise known as Reloxin) today for the treatment of fine lines in the glabella (between the brows). This is the first bona-fide competitor to Botox, as it is also a Botulinum Toxin Type A.

I've mentioned Reloxin in this blog before, as well as on the Rachael Ray show a couple months ago. Plastic surgeons (and patients) hope that this can act as an economic bailout for the 4 million Americans who pay several hundreds of dollars for each Botox treatment. I think we would all welcome a price war between Allergan (makers of Botox) and Medicis (makers of Dysport).

How does Dysport compare to Botox? Other than the fact that they are both Botulinum Toxin Type A, it's difficult to tell. However, if Dysport is priced competitively with Botox and has similar efficacy, we may see a multi-billion dollar product reaching your plastic surgeons' offices in the next 30-60 days. Stay tuned!

Source: Globe Newswire

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

Saline or Silicone Gel? The Results May Surprise You...

A recent survey published in the Aesthetic Surgery Journal shows what the current preferences are for breast augmentation surgery. According to a survey of 1746 board-certified plastic surgeons and members of the ASAPS:

- Sixty percent of surgeons are still using saline implants, and the vast majority of them are using them 75-100% of the time.

- The majority of surgeons (64%) preferred an incision near the breast crease, while 25% preferred an incision around the bottom half of the areola.
- The average implant size reported by 81% of surgeons was 300 to 400 cc (which is approximately a small to a full "C" cup bra).
- Smooth implants, rather than implants with a textured surface, were most often preferred by 92% of respondents because it was the surgeon's preference, less wrinkling, or overall better results for the patient.
- Ninety-six percent of surgeons used round, rather than anatomically-shaped, implants.
- The most common position for implant placement was under the muscle (62% of surgeons).

With the exception of the majority use of saline implants, these statistics reflect what I see in my practice. I estimate that I use saline implants only 25% of the time, since most patients seem to prefer gel. I utilize three incisions (underneath the breast, around the areola, and the armpit), with the most common being underneath the breast. My average size implant is probably 350-375cc, and I usually use smooth round implants placed under the muscle. I find that these choices usually minimize any complications and revisions.

To view a breast augmentation I performed on Fox News, click here.

Statistics source

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

Does Sharon Stone Have Breast Implants?

This photo from The Blemish.com shows what appears to be Sharon Stone's breast implants. She looks like she's lost a lot of weight, revealing the round edges of breast implants that may be positioned below the muscle (hence the space between them). It's possible she may also have a capsular contracture, or excess scar tissue that can accumulate around the implants, causing them to look round and hard. Sometimes the scar tissue can be really thick, other times it can be just a Sliver!

I think her face looks great, though!

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

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Seven Plastic Surgery Tips to Survive the Recession

With the recession as bad as it is (I'm hearing that some plastic surgery practices are down 80%!), I thought I'd think up some ways my readers can still have their plastic surgery... but on a budget. Here are my Seven Plastic Surgery Tips to Survive the Recession:

7. Try Saline Implants Instead of Silicone Gel - Although not as natural-looking or feeling, saline breast implants are still nice implants, and may have a lower complication rate. They can also save you a cool grand in implant costs.

6. One Cream to Rule Them All - If you could only use one anti-aging cream for your face, it should be Retin-A. Not only does it improve acne, but it also smooths wrinkles, exfoliates, thickens collagen, and clears blemishes. And it costs less than a hundred bucks for a big tube. Do not use if you're pregnant, though.

5. Try Sculptra instead of conventional fillers - Although not FDA-approved for general cosmetic use yet, many surgeons are using Sculptra off-label to fill in hollowness under the eyes and overall gauntness. Unlike traditional fillers which last only 6-12 months, it can last 3-5 years.

4. Opt for Regular Lipo Over Ultrasonic or Laser Lipo - I recently returned my VASER machine since I didn't see a significant improvement over traditional liposuction in my patients, therefore not justifying the higher price tag.

3. Try Chemical Peels Instead of Lasers - A good TCA peel (like the Blue Peel) is comparable to laser treatments, but carries a much smaller pricetag. Whereas a laser can cost $150,000 to purchase, what are the costs for the supplies of a generic TCA peel? A couple bucks.

2. A Little Botox Goes a Long Way - Many patients are saving money on Botox by using a smaller amount and spreading it out over multiple areas. Instead of injecting 20 units in the forehead, they may have 10 units in the forehead and 10 units in the frown lines.

1. Let Your Insurance Pay For It - Do not take this wrong. Health insurance will not pay for your breast augmentation, tummy tuck, or facelift, BUT it might pay for your upper eyelid lift if you can prove the excess skin of your eyelids severely disturbs your vision. It may also pay for your breast reduction, if your breasts are massive and create severe pain.

If anyone has any other suggestions on how to save money and still have plastic surgery, please comment!

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

Susan Boyle Gets Her Brows Waxed

Britain's Got Talent and YouTube star Susan Boyle has gotten her bushy eyebrows waxed. They look sooooo much better than before. If you haven't seen her absolutely fantastic performance on YouTube, you can check it out here. She has an amazing voice. I'd buy one of her CDs!

Photo credit: Pacific Coast News

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

Rupert Everett or Wax Figure?

Wow. What has happened to Rupert Everett's face? I really liked him in My Best Friend's Wedding, but it looks like the British actor is now planning to go for even younger roles! His skin is now smooth and wrinkle free, a possible consequence of Botox and chemical peels. I surmise that he's also undergone a facelift and injections of fillers, possibly Sculptra, to soften his cheeks and deep lines. He now looks like a very young Ray Liotta!

Photo credit: Popwatch

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

Michael Douglas and Plastic Surgery

Michael Douglas continues to look younger than his 64 years. A recent post on Right Celebrity analyzes this.

In my opinion, he's had a good amount of work done. I would count an upper and lower eyelid lift (blepharoplasty) and facelift (maybe more than one) among the surgeries he may have had. Overall he does look pretty natural, especially when compared to some other plasticized male celebrities his age.

One of the keys to avoiding an overly operated, feminized look in male plastic surgery patients is to limit any tightening of the cheek area. Some male celebrities who've had obvious overdone facelifts exhibit a 'sweeping look' to the cheeks, making them look tight and overly pulled in an upward direction. I tend to focus my tightening more on the lower face and neck in men, as this tends to take off the years without making them look like they're in a wind tunnel or a skydiving George H.W. Bush.

Photo credit: prphotos.com

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

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A Bra That Firms Your Breasts?? I Doubt It!

Anna Chan from MSNBC.com has recently asked me to analyze the claims of the Victoria's Secret Bust Firming Bra. According to the manufacturer, regular wearing for eight hours a day for four weeks results in an 18% increase in the firmness of the breast. Check out the article here to see what MSNBC.com's writer thought about it after wearing the same bra every day for seven weeks! They also include some of my oh-so-insightful opinions ;)

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

Quick Links

Here are some links to take up your time:

1. A friend of mine writes an entertaining and humorous blog, Confessions of a PA (Physician's Assistant) student. Check it out if you're interested in the life of a physician's assistant. Click here.

2. A new documentary about plastic surgery, Youth Knows No Pain, will have its world premiere on Tuesday, April 28th at the Walter Reade Theatre in the Lincoln Center in New York City. Filmmaker Mitch McCabe spends two years on the road, visiting doctors, reconstructive surgery experts, and real-American characters who have gone to varying lengths to stay forever young. You may even catch a glimpse of me, although I doubt I made the cut! Click here for tickets.

3. Kim Kardashian has announced that one of the members of the Kardashian family is going to undergo plastic surgery to look "totally different." Click here for details.

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

Stevie Nicks: Botox Users "Look Like Satan's Children"

Fleetwood Mac's Stevie Nicks has recently admitted to having used Botox and disliking it:

WWD: You said in a recent interview that you were relieved to still look like you. And you do. Is this the result of good work or no work?

S.N.: You mean like plastic surgery? No.
I had Botox and I hated it. For four long months, I looked like a different person. It almost brought down the whole production of the last tour. It was so bad, I would look into the mirror and burst into tears. Botox is becoming the new face of beauty and it’s unfortunate because it makes everybody look like Satan’s children. Everybody has pointed eyebrows. Everybody looks related. All the Desperate Housewives look like sisters.
If you’re an unattractive girl who’s trying to be beautiful with Botox, forget it. If you are a beautiful girl who’s trying to be beautiful with Botox, you will look like you’re angry all the time. You’d have to tie me down to get me to do it again.

In certain cases when people with arched brows have Botox, it can give them an overarched "Botox Brow." This can easily be treated by injecting a few more units above the eyebrow region. Most patients can also avoid this look by injecting less than the usually recommended 17-20 units in the forehead.

Overall I think Stevie is being a bit too harsh. I don't think that Eva Longoria looks like Marcia Cross's sister!

If you'd like to try using the Botox treatment visualizer (upload a photo of yourself and see what you'd look like with Botox), then click here.

Story credit: In Your Face blog
Photo credit: prphotos.com

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

Update on Donda West's Surgeon

It appears that there is one (possible) final postscript to the tragic death of Kanye West's mom, Donda West after having plastic surgery. Her surgeon, Dr. Jan Adams, has just surrendered his medical license for the State of California. He has recently been given a one year jail term for drunk driving.

Sad story all around. Many physicians carry medical licenses in more than one state, so it's possible that he can still practice as a plastic surgeon in another state, like Florida, even though he surrendered his California medical license. Since I have practiced in both California and Michigan, I carry medical licenses in both states.

Unfortunately, I can think of a couple cosmetic surgeons in my area who should maybe have their license revoked too!

Happy Good Friday!

Source
Photo credit: prphotos.com

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

Ann Coulter - Breast Implants?

Quick post today, since I've been busy with many, many other things...

Here's a link to Make Me Heal.com's post on Ann Coulter and possible breast implants.

For my previous posts on Ann Coulter, click here and here.

p.s. Yes, I assume the Playboy magazine is photoshopped...

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

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Kylie Minogue Admits to Botox

Aussie singer Kylie Minogue has admitted to using Botox in the past, but states that she's now "a lot more natural." According to the Mirror:

"I'm definitely not one of those people who says, 'You shouldn't do this.' Everyone individually can do what they want. “I also think it doesn't have the stigma that it had when I was growing up. For all time women have wanted to, for the most part, look their best.
It's just that what we have available to us today is - what it is today. I'm preferring to be a lot more natural these days. I've tried Botox, I've tried all... You're damned if you do and damned if you don't."

I've always thought that she displayed a bit of the Botox brow, like her fellow Aussie Nicole Kidman, however her brows have always been a bit over-arched. Botox or not, she does look great at 40!

For a previous post on Kylie Minogue and Botox, click here.

Photo credit: prphotos.com

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

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Plastic Surgeon? Cosmetic Surgeon? Phony Doc?

Recently there have been several articles detailing bad events that have occurred at the hands of people who aren't board-certified plastic surgeons. Here are a sampling:

1. A family practice physician who considers himself a specialist in cosmetic surgery and advertises as a plastic surgeon was recently reprimanded by the State Board of Medicine for prescription fraud. He wrote prescriptions for patients and family members, using them to obtain drugs "for his own personal and unauthorized use." Click here for the story.

2. A Bronx mother dies after undergoing silicone injections by a "non-medical, unlicensed person." Click here for story.

3. A Head and Neck surgeon is accused of performing liposuction without a patient's consent. She had planned on having a tummy tuck only, but accuses him of performing a facelift and liposuction too. Click here for story.

The American Board of Plastic Surgery and the American Society of Plastic Surgeons holds its members to strict ethical guidelines which many other "cosmetic"-type societies do not. It's not surprising, then, that most of the crazy plastic surgery-related news comes from physicians who are not certified by the American Board of Plastic Surgery.

Here are two well-written articles by laypeople who focus on the difference between a "Plastic surgeon" and "Cosmetic surgeon."

1. What's the Difference Between a Plastic Surgeon and Cosmetic Surgeon?
2. Cosmetic Surgery Advice-- Consider the Source.

On my website I've written "How to Choose a Plastic Surgeon." Click here for it.

It's not enough for your "cosmetic surgeon" to have just stayed at a Holiday Inn Express last night!

Thanks for reading.

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

Lauren Conrad - Plastic Surgery?

The Hills star Heidi Montag has received a lot of press about her plastic surgery. What about her friend / enemy Lauren Conrad? Has she had plastic surgery too?

I doubt it. The most common plastic surgeries in a woman her age are breast augmentation, rhinoplasty, and liposuction. Her breasts don't appear augmented, her nose doesn't show signs of previous surgery, and she's too thin to benefit from liposuction. IMHO she's a natural beauty.

And then there's Heidi...

photo credit: prphotos.com

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

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Stem Cells - The Future of Breast Augmentation?

Stem cells are now being used for Breast Augmentation overseas. Specifically, the procedure is gaining in popularity in Japan and is being introduced in Great Britain. The procedure involves removing fat from the abdomen (fat is rich in stem cells) and using a machine to concentrate the stem cells prior to injecting it into the breasts. It's estimated that women can achieve a cup size or greater enhancement to their breast size.

What are my thoughts on stem cell breast augmentation?

First of all, it's going to be a long time before the FDA approves any devices designed to concentrate stem cells for cosmetic breast augmentation. With 1 in 9 women developing breast cancer in their lifetime, it is extremely important for physicians to be sure that stem cell breast augmentation does not increase the risk of breast cancer, delay or interfere with the diagnosis of breast cancer, or worsen the prognosis of breast cancer if it is diagnosed.

Second, many physicians are performing fat grafting to the breast, which is the closest thing we currently have to stem cell breast enhancement. The big difference between the two is that generic fat grafting to the breast doesn't have as high a concentration of stem cells, but the stem cells are still present. One of the controversies surrounding fat grafting to the breast revolves around possible mammographic changes that can occur with the surgery. For this reason, I perform fat grafting to the breasts very sparingly, and only when breast implants are not possible. I have been happy with the results in the rare patients whom I perform this on, however.

For now, stem cell breast augmentation is only available for women who are willing to travel overseas. For the rest of Americans, it's Breast Implants or Bust! ;)

Story source: timesonline.uk
Photo credit: prphotos.com
For the ASPS cautionary statement regarding fat grafting to the breast, click here.

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

A Bra That Prevents Breast Cancer?? No...

There's an interesting segment from Good Morning America which analyzes the Brassage. This is a bra manufactured by Intimate Health which claims (according to the program) to massage away toxins from the breast, thereby preventing and possibly treating disease and infection, and maybe even cancer.

Before you run out and buy this bra, I would caution that there is no science that supports that a bra prevents or treats any illnesses. "Removing toxins" is a pretty popular term nowadays as a catch-all for any whacky or off-the-wall treatment that claims to improve a person's health. Technically, I remove toxins every hour or two when I use the bathroom.

While the GMA broadcast completely discredits the Brassage, I wouldn't be so quick in dismissing it. In fact, I would put it on a pedestal with two other well-known and revolutionary bras: The Bro and The Manzier.

For the GMA broadcast, click here.

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

Brooke Shields, Latisse, and Make a Wish

Brooke Shields, famed eyebrow specialist Anastasia Soare, and Allergan (makers of eyelash enhancer Latisse) have teamed up to help the Make a Wish Foundation. The Latisse Wishes campaign was begun to help raise money for the Make a Wish Foundation, on the idea that people make a wish when they blow on an eyelash. The company has donated an initial amount of $500,000 to Make a Wish, and plan to donate another $5 for each person who signs up on www.Latisse.com up to a total of $1 million.

So far we are seeing very good results from Latisse. I am currently in the middle of filming a local TV segment where we follow a woman who's using it. So far, five weeks into her treatment, she's noticing a nice enhancement of her eyelashes.

I've never been one to make a wish on an eyelash that falls out. I just hate it when one falls out and sticks to my cheek for several hours.

photo credit: prphotos.com

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

Plastic Surgery, the Recession, and 2008 Statistics

The statistics for plastic surgery in 2008 are finally in. According to the American Society of Plastic Surgeons, just over 12 million plastic surgery procedures were performed last year, up 3% from 2007. While nonsurgical procedures like Botox (up 8%) and injectable fillers (up 6%) increased to 10.4 million (up 5% overall versus 2007), surgical procedures like breast augmentation (down 12%) and liposuction (down 19%) decreased to 1.7 million (down 9% overall versus 2007). There were over 4.9 million reconstructive procedures performed in 2008, up 3% versus 2007.

We are definitely seeing a trend toward people having less invasive, less expensive procedures performed over the past year, likely as a result of the recession. As plastic surgeons' surgery numbers decline, much of their time is now being spent with a needle, not a knife, and performing more reconstructive procedures. Some surgeons are even trying to resurrect their reconstructive referrals as a way to bring in patients. Here in my state of Michigan, this trend has, unfortunately, been going on for several years.

For the 2008 ASPS statistics, click here.

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

How Fast Are You Aging?

There is an interesting quiz on Parade.com that you may enjoy. It asks you 21 questions to determine how fast you are aging. The questions range from the obvious (do you smoke?) to the not-so-obvious (did you grow up with a dog?). I scored a 74, which means that I am aging like a Giant Tortoise. Check it out here if you have a few minutes to spare.

Thanks to Cosmetic Makeovers for the link.

Thanks for reading.

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