XEOMIN OR BOTOX

Dr. Robert Brueck MD, Fort Myers Florida plastic surgeon reports:

It is sort of like a heavy weight bout between two heavy weight fighters.

They take their gloves off and now it’s serious.

Botox maker Allergan has won a court injunction blocking Merz from selling their competing brand Xeomin. Apparently some Allergan employee’s came to work for Merz. So in the meantime while they “duke” it out, the roll-out of Xeomin will be blocked.

Round two to follow.

AN APPLE A DAY MAY BE GOOD AFTER ALL

As a Fort Myers MD and plastic surgeon, I try to keep up with news related to skin care.

Now there's this:

Maybe we should put those potato chips and chocolate cookies aside (even though they taste good), and start munching on apple slices and carrot sticks.

A new study revealed if you only eat ONE – that’s right – not two – extra servings of a fruit or vegetable, it can enhance the appearance of your skin. The study involved 35 college students and after 6 weeks, independent observers noticed an increase in the redness and yellowness of individuals who ate extra fruit/vegetables. They feel the carotenoids in the fruits/vegetables was the causative culprit.

Sounds good.

CAN WE EAT OUR WAY TO MENTAL HEALTH

Have you heard about the “Mediterranean” diet and how healthy it is?

It is a diet centered on fresh fruits, vegetables, fish, grains, nuts and olive oil, not to mention a moderate amount of alcohol.

A recent study found that people who followed this diet had better blood vessels in their brains.

Maybe it's the other way around. Maybe being smart directs you to a healthier diet.

That causal relationship is the kind the kind I constantly question as a plastic surgeon in Fort Myers, Florida

The total number of surgical cosmetic procedures...

...performed in 2011 showed women having 1,493,615 total which was 91.2% of all procedures while men had 144,909 total surgical procedures which was 8.8% of the total numbers. As a Fort Myers plastic surgeon, I find these stats instructive.

Cosmetic procedures by age groups – male/female:

18 and under 34,663

19-34 456,400

35-50 665,381

51-64 382,378

65+ 99,701

Top 5 cosmetic procedures:

Breast augmentation 316,848

Liposuction 283,669

Tummy tuck 142,657

Blepharoplasty 124,635

Breast lift 122,054

Top 5 cosmetic procedures for men:

Liposuction 41,663

Rhinoplasty 24,553

Blepharoplasty 22,905

Gynecomastia 17,645

Facelift 10,400

Some year to year comparisons:

1997 2011

Tummy tuck 34,002 149,410

Breast augmentation 101,176 316,848

Breast lift 19,882 127,054

Liposuction 176,863 305,332

Facelift 99,196 116,086

Browlift 55,090 28,200

Interesting stuff, eh?

MERCURY IN SKIN CARE PRODUCTS

As a Fort Myers plastic surgeon, I am an avid reader of the FDA alerts.

The FDA recently published a warning about mercury contained in certain skin care products ie. lotions, soaps, and/or cream. They have been marketed as anti-aging treatments.

The products are manufactured abroad and have been imported illegally.

Exposure to mercury can have serious health consequences. It targets kidneys and the nervous system.

My suggestion would be to go to the website at http://www.fda.gov/ Once there, look for updates.

HOW TALL YOU ARE MAY MAKE A DIFFERENCE

We all have been inundated about America’s obesity epidemic and it’s real. As a Fort Myers plastic surgeon, I am regularly exposed to people who are threatening their health by not reducing their body mass.

Now, a newly released study shows men taller than 6 ft. have a significantly lower risk of developing heart failure than men who are 4 inches shorter.

Other studies have shown that taller men have a lower risk of heart attacks.

The current study involved over 22,000 doctors who were studied for 22 years!

There were 4 height categories. So I wonder when the word leaks out if platform shoes will be a hot seller! Hmmm.

NEW WAY TO LOWER MELANOMA RISK

This is a new and novel way to lower melanoma mortality rates.

Recruit and hire more dermatologists to your community.

A recent study out of Case Western Reserve found the greater density of dermatologists per patient population, the lower the mortality rates for melanoma.

Simple. Easily executed and one I heartily endorse as a Fort Myers plastic surgeon.

LYMPHEDEMA FOLLOWING BREAST SURGERY

Lymphedema can occur after almost any kind of breast surgery.

It usually occurs after a modified radical mastectomy. It can occur after a lumpectomy or simple mastectomy. There have been reported cases after breast reduction or rarely breast augmentation, neither one of which I have seen in 33 years of practice as a Fort Myers Plastic Surgeon.

Lymphedema can occur almost immediately after surgery or years later. Usually it manifests as non-painful swelling of hands, fingers or arms. The patient may complain of tightness – or heaviness.

Lymphedema can NOT be cured so we treat it symptomatically. The normal course of therapy is a technique of complete decongestive therapy (CDT) provided by a certified lymphedema therapist. There are things a patient can do to help control lymphedema – good nutrition, good skin care, exercise, maintain a stable weight. If there is a lot of swelling keeping the extremity elevated – wearing compression garments – avoid repetitive exercises of the involved extremity. Several sites to go to for help include:

1. National Lymphedema Network www.lymphnet.org

2. Lymphology Association of North America www.ch-lana.org

HOW YOUNG WILL I LOOK?

One question I’m always asked as a Fort Myers plastic surgeon is how much younger will I look? Wow – that’s a tough one to answer – it’s so subjective. I read about a recent study in the “Archives of Facial Plastic Surgery.” It was done by a group of researchers at the University of Toronto.

Patients were ages 45-72 and placed in 3 groups.

Group 1: face/neck lift

Group 2: face/neck lift, upper and lower blepharoplasty (eyelid)

Group 3: face/neck lift, upper and lower blepharoplasty, coronal lift (forehead)

They then asked medical students to be the judges. They asked the students about there chronological age before and after surgery.

Group 1: patients looked 5.7 years younger

Group 2: patients looked 7.5 years younger

Group 3: patients looked 8.4 years younger

So I guess we can conclude the more facial plastic surgery you have, the younger you’ll look!

SLEEPING PILLS – LURKING DANGER?

Several people I know as a Fort Myers plastic surgeon, many of whom are my patients, take sleeping pills either occasionally or on a regular basis.

In a recent study, 10,000 people who took sleeping pills was compared to a group – similar in age and health history – who did not take sleeping pills.

The shocking news – people who used sleeping pills were more than 5 times likely to die of ANY cause over the study period. Even light users ie: 1-10 pills per year had a 3.6% greater risk of dying.

A word of caution – these statistics do NOT necessarily mean that the sleeping pills were the cause of the increased death rates because it may mean people who take sleeping pills have other health issues as well.

But,it makes you wonder!

NEW MELANOMA DRUG

It's exciting to announce a new drug approval, especially one with such promising potential.

As a Fort Myers cosmetic surgeon, I am very aware of the threats associated with melanoma skin cancer. Melanoma is a type of skin cancer than can move to other locations in the body, in other words, metastisize. About half of the metastatic melanoma cancers have a mutation in the BRAF gene.

A new drug that targets that specific BRAF mutation was recently approved by the FDA. Its use was found to double the survival lifespan of people with that type of metastatic melanoma.

Tumors shrank in 30% of patients while the progression of the disease was stopped or slowed in another 33%.

The name of the new drug is Zelboraf. You can read more about it here.

HOPE ON THE HORIZON

Keeping track of health issues is a major purpose of this blog by Fort Myers plastic surgeon, Dr. Robert Brueck.

Quexa – a name that a small pharmaceutical company called Vivus hopes to become a national name – a national brand – a blockbuster.

We all know and have read about the obesity “ epidemic” in America. Well, we now have a new drug to combat it.

This could be the first new FDA drug approved in the last 10 years for weight loss. It is a controlled release combination of two older generic drugs – the stimulant phentermine (appetite suppressant) and piramate (increased sense of “fullness”).

Now that the Federal advisory panel voted 20-2 to approve it, it will go to the FDA for final approval. Usually the FDA will go along with whatever the findings are from the advisory panel.

The two year studies of Onexa showed a slight increase in heart rates in some patients but also a reduced blood pressure. Because of the topiramate, there is a slightly increased incidence of facial clefts in newborn babies. The company will recommend women taking the drug be placed on birth control pills.

I guess now we can all go out and enjoy a piece of coconut cream pie with some Ben & Jerry’s ice cream – help is on the way!

Video Games. Good, bad or what?

Sometimes, the things I write about on my Fort Myers cosmetic surgery blog are very serious. Sometimes they are just curious.

I have always been a big opponent of video games. To me, they are a useless nonsensical waste of valuable time. Heck, you could be golfing – reading a good book – doing something productive. But I recently read an article that caused me to pause and re-examine my position.

Video games, according to recent research can change a persons brain in a very POSITIVE way.

Individuals can improve hand-eye coordination (any surgeons out there?). Also, playing action games can speed up one's decision making ability by 25%. Video game players can make choices and act on them four times faster than most people.

Also, seasoned video game players can concentrate on 6 things at once. Some of this research was conducted at Rochester University.

However, there can be downsides as well. Studies done on some compulsive gamers shows they can be introverts, maybe depressed and overweight. I guess in the end there may be merit in the saying “moderation in all things”.

One amazing thing to me was that there are scientists/psychologists who spend their lives studying the effects of “gaming” on individuals lives. That would be a great “occupation” to stump the panel on the old, I mean really old, T.V. game show, “What’s My Line?

THE LIQUID FACELIFT

I've been reading about this more and more and am somewhat perplexed – annoyed because I feel, as a Fort Myers Florida plastic surgeon, it is not a sensible alternative to a traditional face lift.

A liquid facelift is, yes, non-surgical and that has a certain amount of appeal to some patients. It is the injection of a variety of fillers into areas of the face that need building up or augmentation. I have seen patients who have spent thousands of dollars for a temporary “I’m a youthful Hollywood star” look.

The reality is it is oh-so-fleeting.

Injecting fillers is easy to do, but results can be disappointing because a patient's body may “absorb” or metabolize the filler in a matter of months. I’ve had patients tell me they got an injection on a certain date and in a month or so it was gone.

It’s no one's fault, but to spend thousands of dollars with no long term benefits really does not make much sense. I think a good alternative would be to do injections of one's own fat/stem cells with platelet rich plasma. This is the patients own tissue and in the long term less expensive.

Always remember, if you have loose skin you can’t shrink wrap it away. It needs to be surgically removed.

In the end I guess you need to be prudent in your choices and weigh all the benefits/consequences especially the economic ones.

Plastic Surgery Stats from 2011

WHAT ARE WE DOING? WHERE HAVE WE BEEN?

The top 5 surgical procedures in 2011 were:

breast augmentation - 307,000 up 4%

nose reshaping 244,000 down 3%

liposuction 205,000 up 1%

eyelid surgery 196,000 down 6%

facelift 119,000 up 5%

With the rise in popularity of facelifts, tummy tucks fell from the top 5.

Botox/disport 5.7 million up 5%

tissue fillers 1.9 million up 7%

chemical peel 1.1 million down 3%

laser hair removal 1.1 million up 15%

micro dermabrasion 900,000 up 9%

With the recession, it is not surprising to see the growth of non-surgical

procedures.

Actually, without local statistics, but observing as a Fort Myers plastic surgeon, I think our profile is very similar.