Should More Doctors Be Using Social Media Tools?

Given the fact that we’re writing a cosmetic surgery blog, it seems we should take part in the discussion started by Doctor Pauline Chen in the New York Times.  She writes, “I blog, I tweet and I use Facebook,” saying they are “enormously useful” tools for her work. Blogger Tara Parker-Pope responds by asking, “Do you think more doctors should be using social media?”
Keeping an open mind to new networking possibilities while focusing on the core responsibilities of your profession can be quite a juggling act. The overwhelming stream of information that is characteristic of our age has led some people to simply shun networking tools that have become trendy, with Twitter perhaps being the most obvious example. For what professional purpose would a physician send out 140 character tweets? Well, there are a few reasons:

The value of social media for our surgical practice (this blog for example) is found in education, and in opening the channels for further correspondence. We want to let the community know what we’re doing and how we might be of service.

Dr. Christian Sinclair, who maintains a blog about palliative care, tells the NYTimes, “I can help to inform the public, I can put the knowledge I have out there. And if there are patients or families who need this knowledge, I can help them because of this network.”

How else can surgeons and other physicians connect with prospective patients? When you’re seeking a physician with the right amount of expertise, getting out the yellow pages just won’t cut it anymore; it’s more convenient, and probably wiser, to get to know the doctor’s areas of expertise and surgical portfolio before scheduling, and traveling to, a consultation.

When it comes to the medical profession, the point is to provide a service, and for surgeons that service is actualized in the operating room. But that doesn’t mean surgeons shouldn’t augment the service they provide by using all the latest networking and communication tools this generation is so fortunate to have.

What to Expect During Rhinoplasty Recovery

After rhinoplasty, or ‘nose reshaping,’ most people say the recovery was easier than they expected.  People usually return to work somewhere between 1-2 weeks after the procedure. The downtime largely depends on job requirements and considerations regarding the splint that must be worn for about a week.

On the day of surgery, patients should expect a mild headache and some nasal congestion.

Although we don’t use any packing inside your nose, which allows easier breathing, some congestion is normal during the first week due to swelling inside the nose.  During this time we ask patients to keep the inside of their nose moist with a saline nose spray.  This also helps to gently wash the inside of the nose.  It’s also important during this time to refrain from doing anything that will increase your blood pressure or heart rate.  

A small splint is worn on your nose to help protect it for one week.  If the bones were moved, than some bruising around your eyes can occur, which typically goes away in 7-10 days.  

A significant amount of swelling gets resolved during the first 2 weeks.  The majority of it will be gone in the first 2 months.  After that you will see subtle changes in your nose as the healing continues.  The tip of your nose may feel slightly numb and tingly at first, but these sensations will improve and disappear over the next 6 months to a year.

As long as you follow our post-operation instructions, you can usually return to normal social activities at about 10-14 days.

Dysport Now Available in Las Vegas

 The new FDA approved wrinkle blocker Dysport has arrived at Cosmetic Surgery of Las Vegas.  Those anticipating Botox treatment should know they now have an alternative.

Pronounced dis-port, the drug has been launched in the United States by Medicis Pharmaceutical and the French company Ipsen.  Dysport has been used by medical practitioners in the UK since 1991.

We’re excited to offer Dysport to the people of Las Vegas.  Given the immense popularity of Botox - a drug used in 2.4 million cosmetic procedures in the U.S. last year - we’re expecting great things.  

Cosmetic indications for Dysport include glabellar lines, i.e. forehead wrinkles.  For more information on this exciting new offering, contact us today.

How Long Does Swelling Last After Rhinoplasty?

A patient asked about the recovery from rhinoplasty; she writes “I had Rhinoplasty surgery 3 weeks ago and my nose is still swollen. Is it normal for swelling to persist that long?”

Yes.  It can be difficult for your body to ease swelling around the nose.  After about 2 weeks, people you don’t know won’t even notice the swelling.  Those who see you daily may notice it 3 weeks after surgery (depending on how well they know your nose). Most people won’t examine your nose that closely and therefore, won’t understand why you look different.  They might think you’re just well rested, or perhaps that you’ve changed your hairstyle.  

You will likely notice it and feel it for about 3-6 months from surgery.  Rhinoplasty changes your nose quickly at first as most of the swelling goes away, and then it changes little by little throughout the healing process.

What’s The Price of Rhinoplasty in Las Vegas?

There are three main factors that influence the price of rhinoplasty (in Las Vegas, or elsewhere):  The patient, the doctor, and the location.

The Patient:

The big question is “Have you ever had rhinoplasty before?” Rhinoplasty is a meticulous and exacting surgery that challenges many surgeons.  Performing revision surgery raises the bar even higher.  If you’ve had rhinoplasty surgery in the past, and you aren’t happy with the results and want changes, the cost will likely be more.  

If this is your first rhinoplasty, what would you like changed? Changes such as softening a bump on the nose will likely cost less than narrowing the entire nose and changing the appearance of the tip.

The Surgeon:

Remember, plastic surgeons may all have the same title, but they don’t all have the same skills. The skill and expertise of the surgeon plays a role.  A known skilled surgeon may charge more while a lesser skilled plastic surgeon may charge very little.  This is by no means a hard and fast rule.  So how do you judge what you’re paying for?  Consult with the surgeon, assess his comfort level with the topic and surgery, compare this with other surgeons you meet with, and view their before and after pictures.  But don’t just base it on price. 

The Location:

It’s likely that rhinoplasty surgery in Beverly Hills will be more expensive than the same surgery in El Paso.  That doesn’t necessarily mean you will have a better plastic surgeon in Beverly Hills.  The most important thing for you to do is check out the doctor and the ‘before and after’ photos; this will provide you with a decent foundation to compare prices.

In Las Vegas, the cost at my practice is $6990 for an initial rhinoplasty.  This includes the costs of anesthesia, the surgery center, and all of your post surgery visits. This summer (June-August) we’ve chosen to reduce the price of rhinoplasty to $5990!

How Latisse Eyelash Enhancement Came to Fruition

The past decade has seen many drugs gain immense popularity for uses that were never originally intended; such is the case with Allergan’s latest offering, Latisse.  The hot new eyelash enhancer was born out of a group of popular medications called topical prostaglandins, drugs frequently used to decrease intra-ocular pressure in glaucoma patients.

A documented ‘complication’ or side effect of using topical prostaglandins was “hypertrichosis,” a condition characterized by darkening, thickening, and lengthening of the eyelashes.   

 Allergan offered the topical prostaglandin Lumigan in 2001, a drug that contained the active ingredient bimatoprost. Two important precursors to Latisse occurred after the FDA clearance was granted for Lumigan.

Jan Marini Skin Research Inc had over $2 million worth of product seized by the Food and Drug Administration.  The product, Age Intervention Eyelash, evidently contained bimatoprost, which was unapproved for cosmetic use at the time. Allergan later filed a patent infringement suit against Jan Marini and several other companies that had tried to market bimatoprost in their eyelash enhancing drugs.

Some doctors started prescribing Lumigan off-label to enhance eyelashes.  Knowing the desirable side effects it could produce. But Lumigan wasn’t formulated for cosmetic use and many believed more research was needed to confirm the safety of topical prostaglandins for cosmetic use.  

Clinical trials and further research is exactly what Alllergan Inc did.  In one early study, 278 healthy adults with minimal to moderate eyelash prominence applied bimatoprost or a placebo to their lash line.  The results were favorable; researchers observed that the average patient’s eyelashes were 25 percent longer, 106 percent fuller, and 18 percent darker, while only 3.6 percent experienced itchy eyes and redness, and only 2.9 percent experienced skin hyperpigmentation.  

Latisse received FDA approval late last year for the treatment of ‘inadequate’ eyelashes.  Allergan now owns the patent on use of bimatoprost for eyelash enhancement.

For more information on Latisse in Las Vegas, contact us.

Breast Reduction Planned For Romanian Tennis Champ

Tennis star Simona Halep, who won the junior French Open just last year, told reporters that she will get a breast reduction in the fall.  

According to news sources in the UK, Ms. Halep complained that her large (34 DD) breasts have slowed her reaction time on the court and caused discomfort. “It’s the weight that troubles me – my ability to react quickly”, she told The Sun.

Ms. Halep is now ranked 317th in the world.

Women pursue breast reduction surgery for a several reasons, increased mobility being just one of them. One breast reduction patient stated, “Before I didn’t want to run anywhere, [not] even across the street. If something happened, I would not run.  It was painful and embarrassing” (Klassen 2009).

Beside issues with physical activity, many women hope to alleviate irritation around their bra strap and underneath the breast, pain in the back and neck, and discomfort during sleeping.

The procedure can be described as a ‘normalizing’ experience for women. Once the surgery is complete, patients often say they are less self-conscious, they fit into more ‘regular’ sized clothes, and their shape is more characteristic of ‘the norm’ for the female body.

Why Do People Use Botox or Wrinkle Fillers?

Researchers with the American Society for Aesthetic Plastic Surgery (ASAPS) have used patient survey data to give us some insight about why patients choose wrinkle treatments. Researchers sent questionnaires last March to 687 patients who had received Botox and/or dermal filler treatment. 

The following statistics illustrate the opinions of the ‘typical’ patient. Who is the ‘typical’ patient?  According to the survey results, “a married, working mother between 41-55 years of age with a household income of under $100,000.”

Roughly 70 percent of the respondents claimed that Botox and dermal fillers play an important role in their cosmetic routine.

When asked what their motivation was for pursuing Botox treatment, 34 percent said their appearance looked “stressed” or “angry”. Others said that a friend, family member, or their physician had recommended it, or they were preparing for a social event. 66 percent said they received Botox treatment 2-3 times per year. 72 percent of the respondents chose Botox to treat glabellar lines – the vertical lines that appear between your eyebrows.  

When asked about their motivation to use hyaluronic acid fillers, the majority (63 percent) of patients reported a desire to remove facial wrinkles and folds - mostly the nasolabial folds that travel from the nose to each side of the mouth.

Nearly 70 percent of the respondents who had been treated with Botox also opted for dermal filler treatment.

A full summary of the results is available (in MS Word) here.  For more information on the latest wrinkle treatments in Las Vegas, see our homepage.

Do Looks Matter in a Recession? Maybe a Little More in Sin City

Unemployment is up and so is the competition to keep your job. Those laid off from their jobs are now looking for new ones. Those who have a job want to keep it. But in Las Vegas it seems you need more than just great skills. You need to look the part. Vegas is, after all, a city where exceeding the public’s expectations is the rule of thumb. 

At a time when more and more people are applying for the same job, or just trying to hang on to the one they’ve got, putting your best ‘face’ or ‘body’ forward might just be the difference maker. Especially in a city where being in the public eye dominates the job market. 

In the past, my patients would commonly emphasize personal motivations for cosmetic surgery such as “wanting to freshen up”, wanting “my old body back”, or “always wanting to do this”. Now, their personal motivation may have a little added slant. A slant that leans towards their job and is expressed with “I want to keep my tips up” or “I want an edge over the other employees”. Regardless of this new slant, my patients are educated to understand they must be driven by personal motivation and not by or for anyone else or reason; and that any new confidence they feel as a result of their procedure may allow them a new experience – but that’s just bonus. 

The slowing economy is also causing changes in the types of cosmetic surgery requests that I’m receiving. People want less expensive procedures with less recovery time and more visible results. They want procedures that freshen the appearance of the skin, soften wrinkles, and provide a younger look, such as facial peels, Botox, or Restylane. Although the results are temporary, lasting 3-6 months depending on the procedure, the cost ($300-$500) tends to fit into the budget easier. 

A demand still exists, however, for those procedures that still provide visible changes, but have longer lasting results. These procedures - i.e. breast augmentation, facelifts, and rhinoplasty - carry a longer recovery times (2-3 weeks) and start around $4500. 

So what’s dropping off? It’s the less visible procedures such as breast lifts, tummy tucks, and liposuction, where results are often hidden under clothing. Instead, people are taking cost, time away from work, and visible results into consideration and turning to the gym and diet to make any changes they can on their own. 

Just a couple of years ago, the country’s fascination with cosmetic surgery led to incredible levels of growth in the field. For example, according to the American Society of Plastic Surgeons recent survey of their members, between the years of 2000 and 2008, the number of breast augmentations increased 45%, tummy tucks increased 94%, and Botox increased 537%. Between 2007 and 2008, however, breast augmentations decreased by 12% and tummy tucks by 18% while Botox, the low recovery, low cost procedure showed an 8% increase. In this same time period, the number of cosmetic procedures performed dropped in those ages 20-29, while it continued to increased in the 30 years old and over population. An indication of those with more disposable funds or more concerns about appearance…or both? The American Academy of Cosmetic Surgery showed differing trends between men and women with cosmetic procedures between 2007 and 2008. When in the past both men and women were steadily getting more procedures, now men were undergoing 2% fewer while women continued to increase with 29% more. Does this reflect societies differing emphasis on appearance between genders? My practice speaks to it; with both age and gender. 

Paying for cosmetic procedures and surgery has also changed. When in the past most payments were dominated by credit cards, now cash and financing have come to the forefront. Many patients using cash have either maxed out their credit cards or decided to stay away from credit cards all together. Other cash users just find it easier to save up and set aside the cash little by little in their ’surgery fund’ until they’re ready for surgery. Financing companies such as Care Credit and Cosmetic Surgery Loans are also being used more frequently. Here, patients are able to apply for various payment plans, including no interest plans, so they can have their procedure now and while making payments over time. Of course in this situation credit scores play a role in approval and interest rates. 

Patients aren’t the only ones adapting in this slowing economy. It’s unfortunate when people do need cosmetic surgery and can’t afford it. Recently, a woman who suffered a rupture of her saline breast implant came to my office. The plastic surgeon that placed her breast implants was no longer available. In a situation where food, rent, and her job were top priorities, paying for implant replacement surgery wasn’t at the top of her list. I adapted to her by offering her discounted surgery fees so she could proceed with surgery and get back to what’s important to her life. My practice has also adapted by providing monthly specials so patients can receive more of what they want with less money. 

So what will the future hold? 

More women, older patients, less costly procedures, less recovery time, and more visible procedures? Certainly the economy will play a role in why and what people demand in the cosmetic surgery world. It’s possible with competition for employment getting tougher, and with all things being equal, looks just might improve your changes of getting or keeping that job. For now, however, some seem to be finding a bit more confidence in the job market from fulfilling their desires with cosmetic surgery. 

 - Dr. Samir Pancholi