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Cartoon: The Alternative To Botox…

Dealing With This Canadian Pharmacy Is More Trouble Than It’s Worth

Looking to obtain a break on my practice’s botulinum toxin of choice (Myobloc) I yielded to curiosity and ordered from a Canadian Pharmacy…Northwest I figured we would try to break the price point of this popular product. Thankfully I used my credit card.

Botulinum toxin must be kept cold to retain its potency. We traditionally receive this product on dry ice and have never had much of a problem with effectiveness. I was promised by the pharmacy rep that this product would arrive cold within 2-5 days of shipping. Only after I gave her my credit card information did she share with me that the product would be coming from Great Britain. This was not welcome news. I was reassured that the product would be cold and usable.

The product arrived Read more »

*This blog post was originally published at Truth in Cosmetic Surgery*

The Most Popular Plastic Surgery Procedures By Age Group

The American Society of Aesthetic Plastic Surgery publishes statistics every year indicating which cosmetic operations are on the rise. A journalist at the OC Register asked a group of plastic surgeons why this might be. Being that I am opinionated (why do you think I blog here,) I figured I’d take a shot at some of these:

I. Statistic: TEENS – Nosejobs and Otoplasty (commonly referred to as “ear pinning”) on the rise

Dr D: Part of the development of the teen psyche involves becoming aware of social norms. As they do this, they also become aware of differences and develop standards of beauty. Many of these teen nose jobs are justified as medically-needed, but appearance usually factors in. Otoplasty is a similarly social operation.

II. Statistic: YOUNG ADULTS – Breast implants. Ages 19-34. 166,000 a year. (ASAPS)

Dr D: “Beauty standards” are important motivators here as well. Young adults in the workplace (and social groups) see those around them doing these things and often being complimented. Some of these patients may also be seeking after childbirth “body repair.”

III. Statistic: EARLY MIDDLE AGE – Liposuction. Ages 35-50. 143,000 a year. (ASAPS)

Dr D: A slowing metabolism in this age group combined with more involved work schedules (with increased sedentary time) equals increased trouble “holding back the fat.” Liposuction is easy and can help with that. Add some post-pregnancy issues here as well.

IV. Statistic: YOUNG ADULTS – Botox. Ages 19-34. 371,000 a year. (ASAPS)

Dr D: The fad of Botox use in the really young is an advertising phenomenon as there is no good reason for young people to do this other than to “feel” hip.

My opinions of course. :)

*This blog post was originally published at Truth in Cosmetic Surgery*

Can Botox Be Done Well?

Reader Question:

All I see online is bad Botox stories.  Can this ever be done well? Why is it so popular?

Botulinum toxin injections temporarily paralyze muscles where they injected. While this sounds scary, it can be done to reduce certain facial movements that make people look concerned (the look of consternation,) and older (crow’s feet,etc). As is usually the case in plastic surgery, too much of an otherwise good thing can make people look weird. Just look at Read more »

*This blog post was originally published at Truth in Cosmetic Surgery*

New Jersey Attempts To Outlaw Cosmetic Botox For Minors: Will The Legislation Work?

TRENTON — Minors in New Jersey wouldn’t be able to get Botox injections unless a doctor says it’s medically necessary and documents the reason, under a bill moving through the Assembly. The Assembly Health and Senior Services Committee approved legislation Thursday to clamp down on doctors injecting people under 18 with botulinum toxin for cosmetic purposes. The Federal Drug Administration already bars anyone under 18 from getting Botox for cosmetic reasons. The new state legislation would go further by requiring doctors to document in a patient’s chart the noncosmetic medical reason for performing the procedure on a minor. Botox is used widely to smooth out facial wrinkles, but also can be used to treat headaches and spasms.

This prospective law in New Jersey would make Botox injections illegal in minors without a doctor’s statement that it is medically necessary. Unfortunately this is not to say such a law would have the desired effect. There are docs who will write those “permit slips.” Watch how many of these Botox-using minors get headaches.

I am not really a fan of laws restricting the flow of medicines. I do not believe they work well. Then again Read more »

*This blog post was originally published at Truth in Cosmetic Surgery*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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