Fat removal without Surgery?

The use of phosphatidylcholine (Lipostabil®, Nattermann - Germany) through superficial injections to destroy adipocytes has recently become popular in Europe. It is injected directly into the subcutaneous fat through multiple injections, administered over multiple treatment sessions.

This treatment breaks down fat, which is then discharged over the liver and metabolized. It has been authorized for intravenous use to prevent and treat fat embolisms and liver diseases. Lipostabil® is currently only licensed as an intravenous medicine, for the prevention and treatment of blood vessel blockages by fat particles (fat embolism).

The concept is appealing. However, the use of this treatment to reduce subcutaneous fat must be critically analyzed in the scientific literature. The American Society of Aesthetic Plastic Surgeons (ASAPS) received FDA authorization to initiate a double-blind, placebo-controlled 46-week study to examine the safety and efficacy of these injections (also marketed as Flabjab™, Lipomelt, Liposdissolve and Fat-Away). Results are still pending.

Current concerns around injection lipolysis for subcutaneous fat include :
Lack of evidence-based scientific data
Technique in early stages and has not been evaluated for safety and reliability
No long-term results available
Not FDA approved for cosmetic treatment
Severe caution in patients with liver disease
Performed by non-physicians
Requires multiple treatments
Causes local inflammatory reaction, with possible hyperpigmentation or scarring

Injection lipolysis will not replace any traditional liposuction, but may be helpful in the future for very specific fat deposits in select individuals. It is not approved or licensed for cosmetic use. Product safety has not been established for subcutaneous use for cosmetic purposes. Consumers should be aware of this if offered the product.

Cosmetic Surgery for Men

Think women are the only ones obsessed with preserving their youthful looks? Think again. These days, men are just as likely as women to opt for a cosmetic surgery procedure. With people living longer, healthier lives, it’s no surprise that both genders want to look as young as they feel. Most men want cosmetic procedures for two primary reasons: to look younger for a competitive edge in the workplace and, if divorced or single, to project an image of vigor and attractiveness. But men who end up in consultation with me often say they don't think they look as good as they feel. Others are inspired by their wives who themselves have had successful procedures.

The biggest concern most men have regarding aesthetic procedures is downtime. They want to be able to return to the office as soon as possible. As a result, the non-surgical procedures have seen the biggest increase over the past few years.The most common cosmetic surgery procedures for men are rhinoplasty, hair transplantation, blepharoplasty, and liposuction. Rhinoplasty continues to be the most common surgical procedure. Botox was the most common non-surgical procedure, and with a 233% increase since 2000. (American Society of Plastic Surgeons)

Skin Resurfacing: Peels, Lasers, and Dermabrasion

Skin resurfacing smoothes any skin imperfections. Resurfacing removes or reduces wrinkles and fine lines of the entire face, softens deep laugh and frown lines, repairs sun-damaged skin, removes age spots, and improves scars, including those from acne. It diminishes the outward signs of aging and revitalizes the tone and condition of the skin. Resurfacing may be done in conjunction with facelift and eyelid surgery, as well as with many other facial cosmetic procedures, including Botox or injectible fillers.

Resurfacing removes damaged skin tissue, layer by layer, revealing the new skin underneath. Based on the areas treated and the method utilized, the procedure takes between fifteen to thirty minutes. The areas that have been treated will appear red, irritated and moist for the first few days, which is completely normal. It is important to follow your physicians post-resurfacing instructions.

The are 3 primary methods for skin resurfacing: chemical peels, laser, and dermabrasion. The differences among these methods are not as significant. Depth of resurfacing is a more important factor in determining aesthetic outcome. The deeper into the skin, the more profound and lasting cosmetic outcome. However, the risks also increase as well.

Straining, bending and lifting should be avoided during the early period following your skin resurfacing procedure. Exercise or other strenuous activities may need to be delayed a few weeks longer.

Most patients are able to return to work in seven to ten days with makeup. The post-treatment redness gradually fades over a matter of weeks, leaving the skin with a fresher, smoother, more polished and youthful appearance. After the skin has healed, the routine use of sunscreen is recommended to protect your skin from damaging ultraviolet rays.

Speak to your physician to see if skin resurfacing is right for you.

Botox Cosmetic: Myth #2

Time to debunk another myth about Botox Cosmetic. Many patients confuse the Botox and injectible fillers, such collagen, Restylane, and fat.

Myth #1: Botox is a filler

Fact: Botox is not a filler. Botox temporarily relaxes the muscles which cause wrinkles. The relaxation is not immediate, and is seen a few days after treatment. It's great for forehead, glabellar, and crow's feet wrinkles.

Injectable fillers add volume directly to the skin and plump up wrinkles. Its effects are immediate.

Both Botox and injectable fillers are temporary non-surgical methods for facial rejuvenation. Repeated treatment would be necessary to maintain the cosmetic benefit. In addition, both may be used at the same time for synergistic cosmetic enhancement!

Incisionless Rhinoplasty

What is incisionless rhinoplasty? It's a rhinoplasty approach that uses no external incisions. There is also less swelling and nasal numbness too! This approach, also known as endonasal rhinoplasty, has seen a resurgence thanks to celebrities like Ashlee Simpson.


Any approach for rhinoplasty should be specific to the particular patient and surgeon. Speak to your facial plastic surgeon to see if incisionless rhinoplasty is right for you.

Teens and Cosmetic Surgery

More people are considering cosmetic surgery, which includes teenagers. According to American Society of Plastic Surgeons (ASPS) statistics, 40 percent of all teens want plastic surgery, and more than 331,000 have had some cosmetic surgery.

All teens are self-conscious about their image. I haven't met a teenager who didn't wish to change a thing or two. Fortunately, most of the extreme self-consciousness during this age goes away with time.

A person's body continues to change through the teen years. Body parts that might appear too large or too small now can become more proportionate over time. Getting in good shape through appropriate weight control and exercise can do great things for a person's looks without surgery. In fact, it's never a good idea to choose plastic surgery as a first option for something like weight loss that can be corrected in a non-surgical manner.

However, there are a few cosmetic surgical procedures that are appropriate for teenagers:

1. Rhinoplasty is the most common cosmetic procedure requested by teens. The nose has finished most of its growth by 13 or 14 in girls and 15 or 16 in boys.
2. Otoplasty (ear pinback) is one of the few operations performed on young children, even as young as 5.
3. Scar revision. Various cuts and scratches from regular play may be amenable to simple revisions.

No procedure should be done without the explicit consent of the parents, or legal guardian. I speak with both the patient and the parents at the same time, to help educate everyone on a patient's specific needs.

Botox Cosmetic: Myth #1

I'll be debunking myths of the various cosmetic procedures. Today, we'll start with the most common non-surgical aesthetic procedure, Botox.

Myth #1: Botox is a poison and causes botulism

Fact: Botox is not a poison. Botulism is from a foodborne bacteria. Botox cosmetic is a medically purified protein, which can only be prescribed by a physician.

Botox is safe, and has been used for over 16 years to treat a variety of medical conditions.