Aesthetics

Washington D.C. - Experts in the art of facial rejuvenation are now able to restore or enhance the "pillars" of the face - chins, cheekbones, and jaw lines - for many patients who have lost the strength of these characteristics at midlife. As a result, more patients are enjoying the permanent, yet reversible changes that can be made to the face using a variety of volumetric implants.

New York - Comparing the pros and cons of facial rejuvenation techniques such as dermal fillers, Botox, and nonablative lasers is like comparing the pros and cons of peanut butter and jelly. They are completely different products that aren't nearly as effective alone as they are together. That's what oculoplastic surgeons Stephen Bosniak, M.D., New York, and Marian Zilkha, M.D., Brazil, found in their study of FDA-approved Restylane and Perlane (pending approval).

Philadelphia - Practitioners can avoid the complications of typical mid-face rejuvenation and improve the most important area of the nasojugal crease to rebuild the cheek with autologous fat transplantation of the mid-face region, according to Suzan Obagi, M.D.

Washington - Dermatologists and their patients have numerous cosmeceutical products from which to choose. Those doctors who categorize the agents can better help their patients understand how the novel therapies fit into skincare regimens.

Waikoloa, Hawaii- Since the advent of botulinum toxin type A (Botox) for cosmetic purposes, its use has been guided by two primary sources: clinical study and practice.

National Report - With an ever-increasing array of products and technologies available to treat scars, it might be tempting to overlook the basics. However, that's the worst thing you could do for your patients and your practice.

Washington - Choosing patients with the appropriate weight and exercise history is critical to the long-term success of the liposuction procedure, according to Naomi Lawrence, M.D. "Liposuction is an excellent and efficacious procedure, when you pick the right candidate - someone with a stable weight," she said.

Washington - When it comes to sun protection methods, there are some new options on the horizon. While many have yet to be approved for use in the U.S., they are showing promise as future preventive methods, according to Darrell S. Rigel, M.D., a dermatologist, clinical professor of dermatology at New York University, and a past president of the American Academy of Dermatology.

Las Vegas - Whether patients seek treatment of problem veins and vascular lesions for cosmetic or medical reasons, dermatologists have many tools at their disposal that offer alternatives to hospital-based procedures, said Margaret Weiss, M.D., who is in private practice at the Maryland Laser, Skin & Vein Institute and Dermatology Associates, Hunt Valley, Md. Dr. Weiss, a specialist in the treatment of unwanted veins, provided an overview of office-based treatment of veins and vascular lesions at the Fall Clinical Dermatology Conference here. She is assistant professor of dermatology, Johns Hopkins University School of Medicine.

The arena of cosmeceuticals, cosmetics, and skincare has undergone dramatic changes in the past 25 years. Why, 25 years ago there were no cosmeceuticals, in fact the word had not yet been coined by Dr. Albert Kligman, and the most sophisticated product in the over-the-counter skincare market was a petrolatum, mineral oil, and glycerin moisturizer. Exciting changes have occurred on many fronts, including the development of new ingredients, new classes of products, and new biologic actives.

British Columbia - While dermatologists tend to think of Botox as a primary therapy, some are looking at it as an adjunctive therapy, offering benefits from longer- lasting results to better wound healing and less scarring.

Washington - Recent regulatory decisions about hyaluronic acids and hyaluronic gels have brought facial wrinkle fillers even further into the fold of the impulse purchase.

Waikoloa, Hawaii - Many modalities are available for minimizing patient discomfort during laser and radiofrequency procedures, but for optimal benefit, method selection should be tailored to the patient's needs as well as the type of procedure, said Suzanne L. Kilmer, M.D., at the annual Hawaii Dermatology Seminar in January.

Amsterdam -- Combined use of an artificial skin substitute and stem cells may promote healing of difficult wounds, according to Sadanori Akita, M.D., Ph.D., senior assistant professor in the division of plastic and reconstructive surgery at Nagasaki University, Japan. "When dealing with serious wounds, such as extensive burn wounds, acceleration of wound healing is critical for survival," Dr. Akita said. "There is an unmet surgical need for better treatments for difficult wounds, especially in cases requiring resurfacing of large skin defects, and in contaminated or poorly vascularized wounds caused by irradiation or systemic diseases such as diabetics."

Rome - Transplantation of autologous cultured epidermal grafts after erbium: YAG laser removal of achromic epidermis offers a rapid, safe, and effective technique for treating large, stable vitiliginous lesions, according to Liliana Guerra, M.D.

Waikoloa, HI - Bexarotene 1 percent gel (Targretin) is a useful alternative modality for the treatment of mycosis fungoides, said Joan Guitart, M.D., at the annual Hawaii Dermatology Seminar.

Houston - Treatment of localized hyperhidrosis can be very gratifying for both affected patients and the physician, according to Ramsey F. Markus, M.D.

Moderator: What cosmetic dermatology issues are you most often encounteringin your practice today?

Growing numbers of patients are turning to cosmetic dermatology to combatthe ravaging effects of excessive sun exposure on the skin. The topicalretinoids have an important role as complements to the cosmetic proceduresused to treat photoaging. Two well-known dermatologists, Mary Lupo, MD,and Emil Tanghetti, MD, recently participated in a teleconference to discussthe benefits of the topical retinoids, used as both pretreatment and posttreatmentto these procedures and to accelerate wound healing in photodamaged skin.

Baltimore -- Developing an algorithm for using non-ablative lasers and light sources will enable effective and efficient treatment of patients who present for skin rejuvenation, said Robert A. Weiss, M.D.

Munster, Ind. - Gray's Anatomy and Hollinhead's Anatomy for the Surgeons have been physicians' resources for decades, but new research being done may redefine some of the basics doctors have taken for granted.

Washington, D.C. - A unique, new technology in the form of laser-mediated photodynamic therapy offers advantages for skin rejuvenation not seen from other non-ablative or ablative technologies, according to Roy G. Geronemus, M.D., director of the Laser & Skin Surgery Center of New York.

Washington, D.C. -- When it comes to complications from laser resurfacing, prevention is the best medicine. For patients, this means picking the most qualified doctor available. For doctors, it's sometimes a matter of knowing your limitations.

Philadelphia - Of all the cosmetic procedures that make hands appear younger, sclerotherapy delivers the most dramatic, long-lasting results, according to Lee Schulman, M.D., a phlebologist at Schulman Vein and Laser Center in New York City.

Washington - As dermatologists accumulate knowledge about the injection of botulinum toxin Type A, the safer the procedure is becoming, according to Alastair Carruthers, M.D.

Washington, D.C. - Despite the growing popularity of new modalities, the CO2 laser remains the gold standard for tissue tightening and contraction of the skin, said Sue Ellen Cox, M.D. However, the choice of therapy largely depends on the age and mindset of the patient, she added.

Q How much life insurance coverage is recommended for a physician who has a family?

Recently I gave a talk about the use of Botox for pain at Memorial University in Newfoundland. Wonderful facility - but the screen was positioned directly over my head, making it almost impossible for me use my laser pointer. It was then that I realized my PowerPoint presentations are put together in ways that greatly reduce or eliminate the need for a laser pointer - and at the same time make my presentations more effective and easier for the audience to follow. I put down my laser pointer and did fine without that high-tech crutch.

Summit, NJ - A long-pulse 532-nm frequency-doubled Nd:YAG laser (DioLite Laser, Iridex) offers another safe and effective alternative for nonablative facial skin rejuvenation in appropriately selected patients, according to the results of a randomized, split-face clinical trial conducted by Paul J. Carniol, M.D.

Philadelphia - Citing a paucity of reliable information on how much blood loss occurs during liposuction surgery, a Seattle-area cosmetic surgeon has devised a statistical model for predicting blood loss. Furthermore, the data from the ongoing study confirms that blood loss is related to factors other than just the total volume of aspirate.