Aesthetics

National report — The recent Florida case of four people paralyzed by botulism after receiving massive doses of unapproved bulk botulinum toxin type A may represent the tip of the iceberg regarding bogus Botox.

New York — Interest in tumescent liposuction has expanded to a variety of new indications, including postmenopausal "lumpy" back fat deposits and as an alternative to more invasive procedures such as abdominoplasty and surgical mammoplasty, according to Naomi Lawrence, M.D.

Buenos Aires — "Controle sus lunares por una piel sana" (control your moles for a healthy skin) is a message that people throughout Argentina heard repeatedly last November, thanks to the efforts of Rebeca Rubinson, M.D., and her colleagues at the Sociedad Argentina de Dermatologia (SAD) here. Dr. Rubinson is a pediatric dermatologist affiliated with Hospital Abel Zubizarreta in Buenos Aires and the coordinator of the 2004 campaign on recognition and prevention of skin cancer.

New York City — While comprehensively covering the subject of fillers in the clinical setting at the recent meeting for the American Society for Dermatologic Surgery (ASDS), celebrity dermatologist Fred Brandt, M.D., feels compelled to start with hyaluronic acids, saying, "I think that's the biggest revolution in fillers now."

Miami Beach, Fla. — "Make sure you really see what you're looking at." A point that might well be called the "Klein Oath" for all cosmetic procedures, was what Botox pioneer Arnold W. Klein, M.D. repeatedly emphasized as he addressed the topic "Botulinum Toxin Type A 2004: My Perspective" at the H & H Dermatology Seminar here.

Tampa, Fla. — A new filler product unlike any available before is showing good results in correcting the signs of fat loss or lipoatrophy in the maturing face. The product called Sculptra? (Aventis) is an injectable implant that contains microparticles of poly-L-lactic acid, a biodegradable, synthetic polymer from the alpha-hydroxy-acid family.

Miami Beach, Fla. — Although the man behind Goldie Hawn's outrageously puffed lips in the movie First Wives Club was among the first to experiment with collagen in the lips, Arnold Klein, M.D., admits that, for that scene, he injected Ms. Hawn's lips with saline.

Kissimmee, Fla. — In dermatology practices today, two basic types of procedures exist: "desire-based" cosmetic procedures and "disease-based" procedures, such as the removal of a skin cancer. Traditionally in medicine, physicians have employed a set of relatively objective criteria to define an acceptable outcome in the second type of procedure. It is the first category, elective and cosmetic procedures, where the physician must satisfy another, more subjective, set of criteria — one that is frequently the cause of disappointment, remorse, dissatisfaction, anger and, all too often, malpractice litigation.

Fort Worth, Texas — The proliferation of new fillers creates both opportunity and risk for cosmetic dermatologists. Paul M. Friedman, M.D., clinical assistant professor at the University of Texas Medical School, Houston, says knowledge and technical expertise are vital for using the fillers to both the dermatologist's and the patient's benefit.

San Antonio — After three decades, the cosmetic profession is finally starting to sit up and take notice of autologous fat transfers, according to plastic surgeon Tolbert Wilkinson, M.D., F.A.C.S.

Peptides clearly represent the most novel active in the current cosmeceutical market.

San Francisco — Along with helping patients, the advent of biologic drugs has restored some much-needed luster to the practice of medical dermatology.

National report — Anecdotal evidence indicates that the onion extract/allantoin gel product Mederma (Merz Pharmaceuticals) might be an effective first-line therapy for diminishing scars and associated symptoms.

National report — Acne scarring is a multifaceted problem that may involve multimodal treatment, says Gerald N. Goldberg, M.D.

They used stereology, which would make it possible to uniquely identify a melanosome in a plane.

Biofilms are resistant to antiseptics and antibiotics for a number of reasons.

New York - American dermatologists have been ignoring cellulite, but they need to start paying attention, says Mitchel Goldman, M.D., medical director of Dermatology/Cosmetic Laser Associates in La Jolla, Calif.

Philadelphia - The state of the art in lip augmentation isn't about fillers or filling technique but a conceptual breakthrough, says Sydney R. Coleman, M.D., a plastic surgeon with a New York City practice.

Boston - The past year has been full of new developments for botulinum toxin (BT), says Neil Sadick, M.D., F.A.C.P., F.A.A.C.S.

New York - American dermatologists have been ignoring cellulite, but they need to start paying attention, says Mitchel Goldman, M.D., medical director of Dermatology/Cosmetic Laser Associates in La Jolla, Calif.

Newport Beach, Calif. - Anti-aging therapies are shifting as the U.S. Food and Drug Administration approves an assortment of fillers and as researchers continue to study the use and safety of botulinum toxin.

National Report - Dermatologists have known for years that retinoids suppress the development of skin cancers. Recently this underutilized application has been dramatically illustrated in a case report.

Philadelphia - To plastic surgeon Kenneth Olshansky, M.D., it's as clear a choice as washing hands prior to surgery. Given a nearly 95 percent cure rate, Mohs micro-graphic surgery is the method of choice for treating certain lesions.

FortWorth, Texas - The appearance of most scars can be dramatically improved using resurfacing or ablative types of scar revision, according to Eric M. Finley, M.D., who spoke on this topic at the Texas Dermatological Society's Fall CME meeting here.

Stanford, Calif. - Chin-jowl implants are a valuable adjunct for optimizing the results of minimally invasive facelift procedures and neck liposuction, says Greg S. Morganroth, M.D., who spoke at "The Next Step: Mastering Cutaneous Outpatient Procedures," a continuing education program at Stanford University.

Philadelphia - The state of the art in lip augmentation isn't about fillers or filling technique but a conceptual breakthrough, says Sydney R. Coleman, M.D., a plastic surgeon with a New York City practice.

New York - Facelifts are rapidly becoming obsolete, according to Mitchel Goldman, M.D.

New York - Roger Amar, M.D., a French anatomist, plastic surgeon and inventor of the FAMI (facial autograft muscle injection) procedure, introduced an effective new procedure to enhance aging cheeks at the American Academy of Dermatology's Academy '04.

New York - Skin rejuvenation procedures now are being accomplished with the help of some new technology - and a few not-so-new techniques that have undergone their own rejuvenation.

New York - The four recently defined subtypes of rosacea are likely caused by different pathogenic factors, and thus respond to different therapeutic regimens, according to Michelle T. Pelle, M.D.