Cityrag on Celebrity Plastic Surgery 2008

Cityrag.com has a photo collage of celebrity plastic surgery in 2008. Many of these photos have been shown on this very blog, but a few of them are new to me. Which is the scariest? I would have to give my vote to Carrot Top. Click here for the site.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Cityrag on Celebrity Plastic Surgery 2008

Cityrag.com has a photo collage of celebrity plastic surgery in 2008. Many of these photos have been shown on this very blog, but a few of them are new to me. Which is the scariest? I would have to give my vote to Carrot Top. Click here for the site.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Dr. Youn's Top 9 Plastic Surgery Predictions for 2009

Here are #4-#1 of Dr. Youn's Top 9 Plastic Surgery Predictions for 2009.

#4: Nonsurgical Liposuction Techniques Run Rampant... As Do Disappointing Results. One of the hottest procedures today is nonsurgical liposuction. Cosmetic practices throughout the country are advertising fat reduction via injections (mesotherapy and Lipodissolve), external lasers, external ultrasound, and even by freezing the fat (called cryolipolysis). While these techniques sound intriguing, none have actually been proven to safely work...yet. The American Society of Plastic Surgeons (ASPS) is currently conducting an FDA-approved study on Lipodissolve, with the initial results due in the near future. While the only proven way to safely and effectively remove fat is via liposuction, 2009 may bring considerable advances to some of these, so far, unproven modalities.

#3: Eyelash Enhancing Medication "Latisse" Hits Big in a Blink. Recently an FDA advisory panel recommended approval for this eyelash stimulating medication from Allergan, the makers of Botox. Peak sales are estimated to reach $500 million, as this treatment will be the only one of its kind. I expect Allergan will see huge profits from this topical medication, as will the physicians that dispense it. And people will walk around with Tammy Faye Baker eyes...

#2: Stem Cells are the Future in the U.S., but the Present in Other Countries. Stem cells are currently all the rage in potentially curing cancers, developmental abnormalities, and other medical problems... but are they the future for plastic surgery as well? Actually, stem cells are currently being used by some pioneering (and some reckless) surgeons outside the U.S. Dr. Vincent Giampapa introduced a stem cell facelift in France back in October and a handful of surgeons are performing breast enhancement with stem cells in Japan and Europe. So will we see stem cells being used by plastic surgeons in the U.S. in 2009? Not likely. The FDA is cautious with allowing procedures like these to be performed here in the States, and with good reason. Scientists need to prove that the use of stem cells for indications like these is safe and effective before allowing patients to undergo it. Until then, Americans will need to travel abroad for these extremely controversial treatments.

And finally we reach...
#1: Botox-Competitor Reloxin will act as an Economic Bailout for Millions of Botox Users in 2009. FDA approval for Medicis's cosmetic botulinum toxin Reloxin is expected sometime in the new year. This may prove to be a relief to patients and plastic surgeons who have been forced to buy Botox at increasing prices each year. I currently charge my patients $650 for Botox injections to three areas, and the price of the Botox product itself accounts for at least half of that charge. Reloxin will be the first legitimate Botox competitor to challenge Allergan's monopoly on this market, and hopefully bring prices down for the most popular cosmetic treatment in the U.S. It can end up being an economic bailout for the millions of people who undergo cosmetic botulinum toxin treatments several times a year.

So there you have it! Dr. Youn's Top 9 Plastic Surgery Predictions for 2009. I'm interested to hear if you think I missed anything! (And don't comment that the plastic surgery market will suffer due to the economy. This is not a prediction, but an expectation...)

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Dr. Youn's Top 9 Plastic Surgery Predictions for 2009

Here are #4-#1 of Dr. Youn's Top 9 Plastic Surgery Predictions for 2009.

#4: Nonsurgical Liposuction Techniques Run Rampant... As Do Disappointing Results. One of the hottest procedures today is nonsurgical liposuction. Cosmetic practices throughout the country are advertising fat reduction via injections (mesotherapy and Lipodissolve), external lasers, external ultrasound, and even by freezing the fat (called cryolipolysis). While these techniques sound intriguing, none have actually been proven to safely work...yet. The American Society of Plastic Surgeons (ASPS) is currently conducting an FDA-approved study on Lipodissolve, with the initial results due in the near future. While the only proven way to safely and effectively remove fat is via liposuction, 2009 may bring considerable advances to some of these, so far, unproven modalities.

#3: Eyelash Enhancing Medication "Latisse" Hits Big in a Blink. Recently an FDA advisory panel recommended approval for this eyelash stimulating medication from Allergan, the makers of Botox. Peak sales are estimated to reach $500 million, as this treatment will be the only one of its kind. I expect Allergan will see huge profits from this topical medication, as will the physicians that dispense it. And people will walk around with Tammy Faye Baker eyes...

#2: Stem Cells are the Future in the U.S., but the Present in Other Countries. Stem cells are currently all the rage in potentially curing cancers, developmental abnormalities, and other medical problems... but are they the future for plastic surgery as well? Actually, stem cells are currently being used by some pioneering (and some reckless) surgeons outside the U.S. Dr. Vincent Giampapa introduced a stem cell facelift in France back in October and a handful of surgeons are performing breast enhancement with stem cells in Japan and Europe. So will we see stem cells being used by plastic surgeons in the U.S. in 2009? Not likely. The FDA is cautious with allowing procedures like these to be performed here in the States, and with good reason. Scientists need to prove that the use of stem cells for indications like these is safe and effective before allowing patients to undergo it. Until then, Americans will need to travel abroad for these extremely controversial treatments.

And finally we reach...
#1: Botox-Competitor Reloxin will act as an Economic Bailout for Millions of Botox Users in 2009. FDA approval for Medicis's cosmetic botulinum toxin Reloxin is expected sometime in the new year. This may prove to be a relief to patients and plastic surgeons who have been forced to buy Botox at increasing prices each year. I currently charge my patients $650 for Botox injections to three areas, and the price of the Botox product itself accounts for at least half of that charge. Reloxin will be the first legitimate Botox competitor to challenge Allergan's monopoly on this market, and hopefully bring prices down for the most popular cosmetic treatment in the U.S. It can end up being an economic bailout for the millions of people who undergo cosmetic botulinum toxin treatments several times a year.

So there you have it! Dr. Youn's Top 9 Plastic Surgery Predictions for 2009. I'm interested to hear if you think I missed anything! (And don't comment that the plastic surgery market will suffer due to the economy. This is not a prediction, but an expectation...)

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Breast Reconstruction article in the NYT - there's really nothing "hidden" about it

Being someone who did advanced fellowship training in breast reconstruction, I was interested in the article in today's New York Times, "Some Hidden Choices in Breast Reconstruction".

I came away somewhat disappointed. The article tangentially discusses the issue of some advanced breast reconstruction techniques and how they aren't always offered or discussed by surgeons. It mostly centers around some of the more advanced microsurgical breast reconstructions using what are called "perforator flaps", which are much more laborious then traditional muscle flap surgeries or implant based reconstruction techniques. Those operations are very elegant, lengthy, and complex cases whose "true value" is hard to demonstrate either in outcome data or to bean counters (who just pay attention to how much things cost). The editorial tone is basically suggesting that there's some conspiracy to not talk about these procedures to patients and that these advanced procedures are the most ideal reconstruction.

I have a few thoughts on this

1. I touched upon the resources and cost to the system of demanding the most exotic types of surgeries for all comers last October 2007 entitled "A Breast Reconstruction Lawsuit - Can We afford Cadillacs for all?" which involved a patient suing her insurer for NOT covering a redo operation with one of the perforator microsurgical flaps discussed in the article.

I asked the question then:

In a scenario like the one involved here (lawsuit over non-coverage), should someone have the right to demand complex and expensive surgery when less expensive options are available?

I'm conflicted here. It does not seem completely outrageous to me for this company to deny this request or at least ask the patient to pay part of the balance difference given the particulars as I understand them. She had an acceptable reconstruction with implants, and needs a quick & relatively inexpensive surgery to maintain her result. In other countries with state-funded ("universal") health care programs, I suspect there's no way in hell this would be approved. In an era of cost-containment, all health care costs are going to be scrutinized and there will be hard choices to make. Luxuries like exotic breast reconstruction almost two decades after the initial surgery seem hard to justify in that context

We just cannot afford the most exotic procedures and technologies for every indication in every patient. Complicating this issue with breast surgery is that these types of procedures are arguably cosmetic procedures rather then functional surgeries (ie. a reconstructed breast reproduces a secondary sex characteristic but does not lactate). As a society in the US, we've come treat this topic differently through legislation guaranteeing breast reconstruction after mastectomy. This did not however, promise funding however, and the savaging of reimbursement for the long procedures and large amount of aftercare have functionally served to ration patients access to breast reconstruction.

2. Surgeries involving your own tissue have significantly more morbidity up front then tissue expander/implant procedures. They are not appropriate for everyone, particularly the very fit, smokers, obese patients, or the elderly. The complications from these operations can be MUCH more spectacular then expander procedures.

In general, I think TRAM, DIEP, and other described flaps are best reserved for young patients with small-medium breasts who are only having one sided mastectomies. The benefit in them is the natural "aging" of the flap more like the remaining breast. For bilateral mastectomies I (and most surgeons) think it is an absolute no-brainer to use tissue expanders in most patients in terms of recovery, cost, and symmetric result of the reconstruction. The improvements in implant designs that we should have available this winter make this an even stronger recommendation for most patients. Surgeon's who

I'm trained in just about everything, but I do implant based reconstruction on probably 7 or 8 out of ten patients as it's the best choice for most people. Keep in mind, that's coming from someone (me) who's favorite operations are TRAM's and Latissimus breast reconstruction. IF you look at the rest of the world, similar % of patients are reconstructed in this fashion which I think represents a collective pragmatic balancing of costs and benefits.

Rob

Dr. Youn's Top 9 Plastic Surgery Predictions for 2009

I hope you are enjoying your holiday weekend! I have looked into my crystal ball and compiled my list of Dr. Youn's Top 9 Plastic Surgery Predictions for 2009. Here are #9-#5:

9. Plastic Surgery Vacations will become more and more popular. As the nation undergoes a dire economic recession, greater and greater numbers of people will pack their sunblock, passports, and ice packs as they combine plastic surgery and vacations. Americans will travel to Mexico, Brazil, and even India in an attempt to save money and look better. This trend will unfortunately bring about an unprecedented number of disturbing complications, as people bring their botched results back to the U.S. for American plastic surgeons to treat. The lucky ones will come back looking both rested AND younger.

8. Fat, from both from animals and people, will become a new Green resource. I've already reported on the renegade Beverly Hills radiologist who used liposuction fat to power his SUV to work each day. With the continued push toward "green" energy, scientists and some physicians will continue their work on Biofuels, with liposuction fat on the periphery of this trend. No, I don't plan on ever doing this.

7. Sculptra will gain FDA approval as a liquid facelift for the general population. Sculptra is currently only FDA-approved for treatment of HIV-associated facial wasting. Sculptra has been used in Europe for many years under the name Newfill, and is the only injectable filler that can produce generalized volume replacement in the face without excessive cost. With the realization that facial volume loss is an integral component of the aging process, this treatment may take center stage in the fight against facial gauntness.

6. 2009 will bring with it a plethora of new extreme, bizarre, and unusual plastic surgeries. 2008 brought us such plastic surgery oddities as cosmetic leg lengthening, the G Shot, the Boob Jab, and the Acupuncture Facelift. I expect fringe medical practitioners to do the same in 2009. Can we expect to see actual rib removal to thin the body, removal of the omentum (fat around the intestines) to decrease a protuberant tummy, or tummy tucks performed at the time of C-sections? Time will tell.

5. Will Gummy Bear Implants Boost Busts in 2009? In November 2006 the FDA lifted the ban on silicone gel implants... at least the fourth generation ones. Since then plastic surgeons and patients in the know have been waiting for FDA approval of the form-stable, "gummy bear" breast implants. These are the firm, textured, tear-drop shaped implants that are made to retain their shape and not conform to the shape of surrounding tissues. They are already in widespread use throughout many other countries in the world. Will the FDA approve these implants for general cosmetic use in 2009? Thousands of plastic surgeons and patients hope so.

Tomorrow I will post the rest of Dr. Youn's Top 9 Plastic Surgery Predictions for 2009. Stay tuned! Same bat time... same bat url.

Thanks for reading.

Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Dr. Youn's Top 9 Plastic Surgery Predictions for 2009

I hope you are enjoying your holiday weekend! I have looked into my crystal ball and compiled my list of Dr. Youn's Top 9 Plastic Surgery Predictions for 2009. Here are #9-#5:

9. Plastic Surgery Vacations will become more and more popular. As the nation undergoes a dire economic recession, greater and greater numbers of people will pack their sunblock, passports, and ice packs as they combine plastic surgery and vacations. Americans will travel to Mexico, Brazil, and even India in an attempt to save money and look better. This trend will unfortunately bring about an unprecedented number of disturbing complications, as people bring their botched results back to the U.S. for American plastic surgeons to treat. The lucky ones will come back looking both rested AND younger.

8. Fat, from both from animals and people, will become a new Green resource. I've already reported on the renegade Beverly Hills radiologist who used liposuction fat to power his SUV to work each day. With the continued push toward "green" energy, scientists and some physicians will continue their work on Biofuels, with liposuction fat on the periphery of this trend. No, I don't plan on ever doing this.

7. Sculptra will gain FDA approval as a liquid facelift for the general population. Sculptra is currently only FDA-approved for treatment of HIV-associated facial wasting. Sculptra has been used in Europe for many years under the name Newfill, and is the only injectable filler that can produce generalized volume replacement in the face without excessive cost. With the realization that facial volume loss is an integral component of the aging process, this treatment may take center stage in the fight against facial gauntness.

6. 2009 will bring with it a plethora of new extreme, bizarre, and unusual plastic surgeries. 2008 brought us such plastic surgery oddities as cosmetic leg lengthening, the G Shot, the Boob Jab, and the Acupuncture Facelift. I expect fringe medical practitioners to do the same in 2009. Can we expect to see actual rib removal to thin the body, removal of the omentum (fat around the intestines) to decrease a protuberant tummy, or tummy tucks performed at the time of C-sections? Time will tell.

5. Will Gummy Bear Implants Boost Busts in 2009? In November 2006 the FDA lifted the ban on silicone gel implants... at least the fourth generation ones. Since then plastic surgeons and patients in the know have been waiting for FDA approval of the form-stable, "gummy bear" breast implants. These are the firm, textured, tear-drop shaped implants that are made to retain their shape and not conform to the shape of surrounding tissues. They are already in widespread use throughout many other countries in the world. Will the FDA approve these implants for general cosmetic use in 2009? Thousands of plastic surgeons and patients hope so.

Tomorrow I will post the rest of Dr. Youn's Top 9 Plastic Surgery Predictions for 2009. Stay tuned! Same bat time... same bat url.

Thanks for reading.

Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Merry Christmas!

I hope you are all having a nice Christmas. I took a break from plastic surgery and other projects today to spend time with family and watch an excellent movie called Slumdog Millionaire. I highly recommend it.

I wish you all the peace and hope brought by a small baby over two thousand years ago in the town of Bethlehem. Thank you for taking the time to read my blog.

Back in a flash with my plastic surgery predictions for 2009.

God bless,

Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Merry Christmas!

I hope you are all having a nice Christmas. I took a break from plastic surgery and other projects today to spend time with family and watch an excellent movie called Slumdog Millionaire. I highly recommend it.

I wish you all the peace and hope brought by a small baby over two thousand years ago in the town of Bethlehem. Thank you for taking the time to read my blog.

Back in a flash with my plastic surgery predictions for 2009.

God bless,

Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Quick Links

Here are some quick links for you to check out while I prepare my next post. Check them out for your celebrity plastic surgery fix.

1. There is an amusing site called Nicole Kidman's Forehead. Can you believe someone started a blog focused only on her forehead? Click here to check it out.

2. Socialite Life has a photo gallery of prominent celebrities who have had (mostly bad) plastic surgery. There are some regulars here (Lara Flynn Boyle, Kenny Rogers) but also some unexpected ones (Calista Flockhart, Ray Liotta). Click here to check it out.

3. The first face transplant in the United States has been performed at Cleveland Clinic. 80% of her face has been replaced by the face of a cadaver. Can you imagine what it would be like to look into the mirror and see someone else's face? Click here for the article from CNN.com.

Photo source : Nicole Kidman's Forehead

Thanks for reading,
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Quick Links

Here are some quick links for you to check out while I prepare my next post. Check them out for your celebrity plastic surgery fix.

1. There is an amusing site called Nicole Kidman's Forehead. Can you believe someone started a blog focused only on her forehead? Click here to check it out.

2. Socialite Life has a photo gallery of prominent celebrities who have had (mostly bad) plastic surgery. There are some regulars here (Lara Flynn Boyle, Kenny Rogers) but also some unexpected ones (Calista Flockhart, Ray Liotta). Click here to check it out.

3. The first face transplant in the United States has been performed at Cleveland Clinic. 80% of her face has been replaced by the face of a cadaver. Can you imagine what it would be like to look into the mirror and see someone else's face? Click here for the article from CNN.com.

Photo source : Nicole Kidman's Forehead

Thanks for reading,
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Putting Vanity (And Botox) On Hold

There are more and more articles appearing regarding the state of plastic surgery in today's economy. An excellent article by New York Times writer Natasha Singer called Putting Vanity (and Botox) on Hold finds that people are re-evaluating their priorities and spending less on plastic surgery today. One estimate finds that business is down 30-40 percent in Orange County, one of the biggest markets for plastic surgery in the country. In addition, many people are foregoing the more expensive surgical procedures and substituting less expensive injectable procedures as a way to stall aging until the economy improves, 401K's recover, and people feel more comfortable with larger purchases.

Here in Metro Detroit, we have all breathed a sigh of relief as President Bush proposed a $14 billion loan to bail out the auto industry. While times here are very tough, the collapse of even one of the Big 3 U.S. automakers would have been absolutely devastating, with hundreds of thousands of people projected to lose their jobs as a result.

I don't put my political opinions in this blog, but I feel the need to do it just this one time. I'd like to give out a "You're a Self-Serving Jackass" award to the following people who led the opposition to the automakers' bailout: Senator Mitch McConnell, Senator Bob Corker, Senator Richard Shelby, and even native Michigander Mitt Romney. How many billions of dollars are we spending on Iraq and Afghanistan, and you won't even give a $14 billion LOAN to an industry which supports millions of American jobs? Shame on all of you.

Whew! It's nice to get that off my chest. Now back to celebrity plastic surgery. Tomorrow we will focus on Nicole Kidman's forehead...

Thanks for reading.

Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Putting Vanity (And Botox) On Hold

There are more and more articles appearing regarding the state of plastic surgery in today's economy. An excellent article by New York Times writer Natasha Singer called Putting Vanity (and Botox) on Hold finds that people are re-evaluating their priorities and spending less on plastic surgery today. One estimate finds that business is down 30-40 percent in Orange County, one of the biggest markets for plastic surgery in the country. In addition, many people are foregoing the more expensive surgical procedures and substituting less expensive injectable procedures as a way to stall aging until the economy improves, 401K's recover, and people feel more comfortable with larger purchases.

Here in Metro Detroit, we have all breathed a sigh of relief as President Bush proposed a $14 billion loan to bail out the auto industry. While times here are very tough, the collapse of even one of the Big 3 U.S. automakers would have been absolutely devastating, with hundreds of thousands of people projected to lose their jobs as a result.

I don't put my political opinions in this blog, but I feel the need to do it just this one time. I'd like to give out a "You're a Self-Serving Jackass" award to the following people who led the opposition to the automakers' bailout: Senator Mitch McConnell, Senator Bob Corker, Senator Richard Shelby, and even native Michigander Mitt Romney. How many billions of dollars are we spending on Iraq and Afghanistan, and you won't even give a $14 billion LOAN to an industry which supports millions of American jobs? Shame on all of you.

Whew! It's nice to get that off my chest. Now back to celebrity plastic surgery. Tomorrow we will focus on Nicole Kidman's forehead...

Thanks for reading.

Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Where are the chips? Nando's "double breasted" laugher

Love it!

Rob

Scarlett Johansson - Breast Implants? Naw...

Scarlett Johansson has been placed onto many Hollywood's most attractive women lists. Some people have speculated that she may have breast implants. This photo from Hollywood Tuna is as good proof as any that her chest is completely natural. While she may have had a rhinoplasty, I doubt she's had a breast augmentation. Overall she looks very glamorous and is only looking better with time.

Photo Source

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Share |

Scarlett Johansson - Breast Implants? Naw...

Scarlett Johansson has been placed onto many Hollywood's most attractive women lists. Some people have speculated that she may have breast implants. This photo from Hollywood Tuna is as good proof as any that her chest is completely natural. While she may have had a rhinoplasty, I doubt she's had a breast augmentation. Overall she looks very glamorous and is only looking better with time.

Photo Source

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Share |

Do People Really Want Long Eyelashes That Badly?

There is an interesting post of Dr. Rob Oliver's Plastic Surgery 101 blog regarding the upcoming product from Allergan, makers of Botox and Natrelle breast implants. The product is called Latisse, and its function is to make eyelashes fuller, longer, and even darker. Peak sales are estimated to become $500 million.

I was interviewed about this product months and months ago to test doctor and patient interest. I didn't think that patients would be that interested in this product, but after talking to several women (including my office employees), I think I was wrong. After it obtains FDA approval we'll see how popular it gets.

Source

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Do People Really Want Long Eyelashes That Badly?

There is an interesting post of Dr. Rob Oliver's Plastic Surgery 101 blog regarding the upcoming product from Allergan, makers of Botox and Natrelle breast implants. The product is called Latisse, and its function is to make eyelashes fuller, longer, and even darker. Peak sales are estimated to become $500 million.

I was interviewed about this product months and months ago to test doctor and patient interest. I didn't think that patients would be that interested in this product, but after talking to several women (including my office employees), I think I was wrong. After it obtains FDA approval we'll see how popular it gets.

Source

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

The economic meltdown for dummies (via Rick Ferri)

No Plastic Surgery today!

If you've watched the chaos in the financial markets and wondered how in the heck this happened, I'd like to point you a conference call by the investment management company, Portfolio Solutions. I have no money invested with this company per se, but I do admire one of the principals there, one Rick Ferri. Mr. Ferri is an accomplished author of financial books like the super, "All About Asset Allocation" and a regular contributor on the Boglehead Forum (a site concerning index investing as advocated by Vanguard Investments founder, John Bogle).

Mr. Ferri's discussion of the mechanics of how we got to where we are is really interesting and Ferri is an excellent communicator, even for "dumb skin doctors" like me.

Click here to go to the archived speech.

Rob

Demi Moore - $3 Million of Plastic Surgery?

In a recent interview, actress Demi Moore addressed the rumors that she's had $3 million worth of plastic surgery:

Do you get irritated by all the rumours suggesting you paid $3 million for surgical procedures on your face and body?
“Yes, it’s irritating - and it’s also not true. But to fight it feels futile because it just perpetuates the myth. The truth is I have no problem with enhancing one’s looks or fixing something that’s changed. It’s always an option, but I can’t see me ever getting something like that done.”

Now, in my opinion she looks fantastic. While I do think she is a natural beauty, I also believe she's likely had some work done. Three million dollars worth though? That's ludicrous.

A successful plastic surgery practice grosses about a million dollars a year. That means that Demi would have to have undergone three years worth of plastic surgery by a single plastic surgeon to cover the three million dollars worth she's rumored to have had. If each procedure roughly costs ten grand, then that would mean she would have had 300 surgeries! Not even Jocelyn Wildenstein can claim that!

Source

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Share |

Demi Moore - $3 Million of Plastic Surgery?

In a recent interview, actress Demi Moore addressed the rumors that she's had $3 million worth of plastic surgery:

Do you get irritated by all the rumours suggesting you paid $3 million for surgical procedures on your face and body?
“Yes, it’s irritating - and it’s also not true. But to fight it feels futile because it just perpetuates the myth. The truth is I have no problem with enhancing one’s looks or fixing something that’s changed. It’s always an option, but I can’t see me ever getting something like that done.”

Now, in my opinion she looks fantastic. While I do think she is a natural beauty, I also believe she's likely had some work done. Three million dollars worth though? That's ludicrous.

A successful plastic surgery practice grosses about a million dollars a year. That means that Demi would have to have undergone three years worth of plastic surgery by a single plastic surgeon to cover the three million dollars worth she's rumored to have had. If each procedure roughly costs ten grand, then that would mean she would have had 300 surgeries! Not even Jocelyn Wildenstein can claim that!

Source

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Share |

Another one (....er, two) bite the dust! The body count rises in aesthetic medicine.

Artes Medical and Rhytec Inc. are the latest notable cosmetic medical companies to fold.

From the OC Register

Artes medical made a permanent dermal filler called Artefill which never gained much of a following. It was a gel based formulation of plastic "microspheres" made for injecting in deep layers of the skin. Most doctors have been reluctant to use these types of permanent fillers (like micro-droplet injectable silicone) as they are ruthlessly unforgiving for imprecise injections. If they're permanent and you have issues, then you have a permanent issue versus one that will regress as it's reabsorbed.

As hyaluronic acid fillers like Jevederm or Restylane are more user friendly and they go away after awhile, they are more of an attractive material. For a little longer lasting material for similar indications as Artefill, I think most people would use Radiess, which lasts closer to two years or so in duration. It's an extremely underated product IMO.

Rhytec's plasma based system was fairly novel and appeared at one time to have a lot of advantages. Compared to traditional laser resurfacing of the face with carbon dioxide or erbium lasers, it carried much less risk of pigmentation changes. I loved the candor of the Dermatologist quoted in the article who took some shots at other technologies that have been popular but have been panned off the record by many doctors.

Before Rhytec’s bankruptcy filing, Dr. Christopher Zachary, chairman of the UCI Department of Dermatologist, bemoaned the loss of a company with an innovative and effective therapy. He said, "Unlike companies that market laserlipo devices that are selling like hot cakes and are universally gimmicks and which have made companies like Syneron and Cynosure very healthy bottom lines, Rhytec, which makes a device that actually works, looks like it is in a major tailspin. Such is the cynical life of an aesthetic device manufacturing company."

Rob

Victoria Beckham Comments on Her Breasts

According to the Daily Mail, Victoria Beckham has commented on why her breasts look so round and grapefruit-like:

'I know how a dress should sit. I've worn so many in the past and when I see the photographs I think, crikey, my boobs are up round my neck again, because the corsets are too short and not cut high enough'.

She's made millions on that look, but it's nice to see that she has figured out it is no longer working for her. Crikey! She isn't a Spice Girl anymore!

To check out MY explanation of why her breasts look excessively round (hint: it's not due to a corset!), click here.

Photo credit: prphotos.com

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Victoria Beckham Comments on Her Breasts

According to the Daily Mail, Victoria Beckham has commented on why her breasts look so round and grapefruit-like:

'I know how a dress should sit. I've worn so many in the past and when I see the photographs I think, crikey, my boobs are up round my neck again, because the corsets are too short and not cut high enough'.

She's made millions on that look, but it's nice to see that she has figured out it is no longer working for her. Crikey! She isn't a Spice Girl anymore!

To check out MY explanation of why her breasts look excessively round (hint: it's not due to a corset!), click here.

Photo credit: prphotos.com

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Plastic Surgery by Morticians? Not Really...

I was interviewed recently for an article on MSNBC.com focusing on the procedures morticians are asked to do nowadays to make people look as good as possible after they die. Apparently they perform some pretty complex plastic surgery-like procedures to make people look even younger than they did when they passed on. Here's my quote from the article:

“Society is unfortunately getting more and more vain as time goes on,” says Youn. “Fifty years ago, no one would have thought about how good they’re going to look when they die, but now that’s probably something the ‘Real Housewives of Orange County’ talk about. If they die, they want to look good in their casket. It’ll be one last time to show off their new outfit and their plumped lips.”

It's funny, my next door neighbor, Dave Temrowski (also quoted in the article) is a prominent mortician in this area, and while we've talked about our occupations at length, we never really saw the similarity in what we do. In fact, I probably learned more by talking with the journalist than she did in talking with me!

Click here to read the MSNBC article, Final Touch : A Cosmetic Lift for Your Funeral?

Thank you to Diane Mapes for contacting me for this article.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Plastic Surgery by Morticians? Not Really...

I was interviewed recently for an article on MSNBC.com focusing on the procedures morticians are asked to do nowadays to make people look as good as possible after they die. Apparently they perform some pretty complex plastic surgery-like procedures to make people look even younger than they did when they passed on. Here's my quote from the article:

“Society is unfortunately getting more and more vain as time goes on,” says Youn. “Fifty years ago, no one would have thought about how good they’re going to look when they die, but now that’s probably something the ‘Real Housewives of Orange County’ talk about. If they die, they want to look good in their casket. It’ll be one last time to show off their new outfit and their plumped lips.”

It's funny, my next door neighbor, Dave Temrowski (also quoted in the article) is a prominent mortician in this area, and while we've talked about our occupations at length, we never really saw the similarity in what we do. In fact, I probably learned more by talking with the journalist than she did in talking with me!

Click here to read the MSNBC article, Final Touch : A Cosmetic Lift for Your Funeral?

Thank you to Diane Mapes for contacting me for this article.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Allergan "eyeing" FDA approval of new eyelash stimulating medicine Latisse

Allergan, maker of the popular Natrelle breast implants and BOTOX cosmetic is apparently poised to receive FDA approval of their next potential blockbuster. The new product, Latisse, is a topically applied drug which is effective for growing and thickening eyelashes. While that sounds like a superficial indication, there is expected to be a huge pent up demand for such a product.

From Seeking-Alpha

Allergan received an approval recommendation today from a FDA advisory panel for Latisse (bimatoprost solution 0.03%) as a cosmetic medicine treatment which would represent the first and only FDA-approved product to enhance eyelashes (making them darker, longer, and thicker). Latisse would be packaged with a special applicator to apply the drops on the edge of the eyelid as compared to the current use of bimatoprost as Lumigan, which is already on the market as a treatment for glaucoma to lower eye pressure.

Allergan estimates peak sales for Latisse of $500M, compared to trailing 12-month sales of $4.4B, with an expected FDA action date by mid-2009 on the pending NDA. Allergan is also a component in the ETFI Cosmetic & Reconstructive Medicine Index and could be a takeover target for big pharma after Johnson & Johnson (JNJ) agreed to pay $1.1B for breast implant maker Mentor (MNT) – although the market cap of Allergan is much larger at $11.7B with a wider range of businesses such as specialty pharma, medical devices, and cosmetic medicine.

Last Winter, cosmetic manufacturer, Jan Marini, was forced to pull a similar product off the market by the FDA because (as I understand it) they 1) didn't have FDA labeling approval to promote themselves for that indication, 2) didn't have any clearance to sell a prescription glaucoma drug (which was the active ingredient) over the counter, and 3) Allergan had patent rights on the substance that was the active ingredient. Talk about ballsy! A blurb last winter from the "Truth in Aging" blog about this can be read here.

I guess I must just have the "vision" thing for this sort of product as I kind of shrugged my shoulders when I heard about it before. However, pre-market surveys indicate there is a BIG market for it, and the price of this product is going to be fairly low. Expect every Tom, Dick, & Harry fringe aesthetic medical provider to be pushing it I predict.

Rob

Jamie Lynn Spears - Liposuction?

According to a magazine, Jamie-Lynn Spears may have undergone liposuction while she was pregnant.

"She didn't know she was pregnant when she filled out the health questionnaire prior to the procedure," a second source reveals. "Her mom approved the injections and went through tons of red tape to get the clinic to administer them to an underage patient."

Every operating center I've ever worked out of administers a pregnancy test to every female prior to plastic surgery. If the test comes back positive, nearly all of the patients will claim that it is "impossible" that they are pregnant. We then repeat the test, which always comes back positive again, and finally cancel the surgery.

Having to cancel the surgery is a bummer for me, but at least I get to go out for a long breakfast and read the paper.

Source

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Jamie Lynn Spears - Liposuction?

According to a magazine, Jamie-Lynn Spears may have undergone liposuction while she was pregnant.

"She didn't know she was pregnant when she filled out the health questionnaire prior to the procedure," a second source reveals. "Her mom approved the injections and went through tons of red tape to get the clinic to administer them to an underage patient."

Every operating center I've ever worked out of administers a pregnancy test to every female prior to plastic surgery. If the test comes back positive, nearly all of the patients will claim that it is "impossible" that they are pregnant. We then repeat the test, which always comes back positive again, and finally cancel the surgery.

Having to cancel the surgery is a bummer for me, but at least I get to go out for a long breakfast and read the paper.

Source

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Breast Implant designer commits suicide from Yew seeds(!)

A South African man died who'd designed a novel type of silicone breast implant recently committed suicide by eating poisonous yew berries from a nearby graveyard of all things.

From Wikipedia on the Yew tree toxicity:

The major toxin is the alkaloid taxane. The foliage remains toxic even when wilted or dried. Horses have the lowest tolerance, with a lethal dose of 200–400 mg/kg body weight, but cattle, pigs, and other livestock are only slightly less vulnerable.[7] Symptoms include staggering gait, muscle tremors, convulsions, collapse, difficulty breathing, and eventually heart failure. However, death occurs so rapidly that many times the symptoms are missed.

Jonathon Hamilton a talented design engineer who had recently lost majority control of his an implant business he'd founded when he was forced to sell stock to cover his debts. His company "Smart Implant" has a proprietary design where the filler of an implant is composed of hundreds of solid silicone beads instead of a viscous silicone gel.

Having never seen one of these implants in person, I'm not sure there's much to this departure from conventional design that is much of an advantage but it's an interesting idea. These type of implants are not available in the United States and I'm not aware that they've even applied to the FDA to conduct clinical trials here.

Rob

Artes Medical Files for Bankruptcy

Yet another cosmetic company bites the dust. Artes Medical, makers of the permanent filler Artefill, has filed Chapter 11 Bankruptcy and may be forced to liquidate its assets. The websites for both Artes and Artefill are already shut down. This announcement follows the recent bankruptcy by Rhytec, Inc., makers of Portrait. Should the economy continue in recession, I foresee more companies in the plastic surgery market going belly-up in the future. I would expect that many of the laser manufacturers (there are dozens of them) are having trouble with the recent credit crunch combined with the high cost of these machines (often in the 6 digits). These may be the next companies to make news due to economic woes.

I've never used Artefill, since I am very wary of permanent fillers. Liquid silicone has been the most used permanent filler and has produced some disastrous results. In addition, the face changes as it ages. Who's to say that a filler injected at the age of 40 will still look good at the age of 50? Plus, if the patient doesn't like how it looks, the only remedy for the permanent filler is to cut it out. That's no fun.

Maybe they should change the slogan of Artefill to "the First to Not Last!"

To read more about Artes Medical and bankruptcy, click here.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Artes Medical Files for Bankruptcy

Yet another cosmetic company bites the dust. Artes Medical, makers of the permanent filler Artefill, has filed Chapter 11 Bankruptcy and may be forced to liquidate its assets. The websites for both Artes and Artefill are already shut down. This announcement follows the recent bankruptcy by Rhytec, Inc., makers of Portrait. Should the economy continue in recession, I foresee more companies in the plastic surgery market going belly-up in the future. I would expect that many of the laser manufacturers (there are dozens of them) are having trouble with the recent credit crunch combined with the high cost of these machines (often in the 6 digits). These may be the next companies to make news due to economic woes.

I've never used Artefill, since I am very wary of permanent fillers. Liquid silicone has been the most used permanent filler and has produced some disastrous results. In addition, the face changes as it ages. Who's to say that a filler injected at the age of 40 will still look good at the age of 50? Plus, if the patient doesn't like how it looks, the only remedy for the permanent filler is to cut it out. That's no fun.

Maybe they should change the slogan of Artefill to "the First to Not Last!"

To read more about Artes Medical and bankruptcy, click here.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Who Has The Smoother Skin?

There is something terribly wrong when a 63 year old's skin is as smooth as a 17 year old's skin. Good plastic surgery isn't this extreme. Check out dlisted.com for more photos.

To view an interview I did with the Fox News Channel on Priscilla, click here.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Who Has The Smoother Skin?

There is something terribly wrong when a 63 year old's skin is as smooth as a 17 year old's skin. Good plastic surgery isn't this extreme. Check out dlisted.com for more photos.

To view an interview I did with the Fox News Channel on Priscilla, click here.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Kayne West's nurse cousin now being investigated in Donda West case

The death of Donda West, mother of hip-hop star Kanye West, the day after undergoing plastic surgery last year was big news. The surgeon involved in the case received a great deal of criticism and the implication was that he'd commit ed some horrible malpractice on Mrs. West.

I talked about this last Spring (see here), going over the autopsy report that was released online. The report vindicated Dr. Adams of some technical mishap, but was inconclusive on what actually caused her death. I speculated she vomited and aspirated with subsequent respiratory arrest, a not uncommon scenario we see in hospitals and nursing homes in elderly or infirmed patients.

A new wrinkle is being looked out apparently. Could Donda West's death be from an overdose of her pain medicine given by her cousin? I still think my aspiration idea is more plausible, but the role of pain killers could be a component in that mechanism (ie. narcotics can cause post-operative nausea/vomiting and a stuporous patient is more like to aspirate). I'm not sure that's a fair suspicion to throw on someone unless her toxicology had abnormally high serum levels of her pain medicine.

From the UK's Daily Mail

Police have now launched a probe into the possible role of her nephew, Stephan Scoggins, 46, a registered nurse who was allegedly supervising her post-surgery care.

A source tells American magazine People that investigators are looking into the alleged possibility that Scoggins administered too much of the painkiller Vicodin in a short period of time.

The insider also alleges that Scoggins left West in the care of a friend and Kanye's assistant to attend a baby shower prior to her death.

Last January, a Los Angeles coroner ruled that West died of 'multiple post-operative factors,' clearing West's embattled surgeon Dr. Adams of responsibility.

An investigator for the California Department of Consumer Affairs has issued subpoenas asking individuals 'to testify in the matter of the investigation of Stephan Scoggins,' a source tells the publication.

Rob

Johnson and Johnson Buys Mentor for $1.07 Billion

How much does it cost to buy the US's top breast implant manufacturer? Johnson and Johnson recently acquired breast implant manufacturer, Mentor Corp, for a reported $1.07 billion. For those of you who hold stock in this company (like me, albeit not a whole lot), the purchase has caused the stock to skyrocket in price nearly 90%. What does this mean for the plastic surgeon and the plastic surgery patient?

Probably not much. J & J has been promoting their new dermal filler Evolence, which competes with Juvederm from Allergan (the other breast implant manufacturer). Mentor is currently working on PurTox as a competitor to Botox, but it likely won't be FDA approved for another year or two. I almost exclusively use Mentor breast implants, and have had a good relationship with the company. I hope that the J & J purchase doesn't affect how the company does business with its doctors and patients. I doubt that it will, but time will tell.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Johnson and Johnson Buys Mentor for $1.07 Billion

How much does it cost to buy the US's top breast implant manufacturer? Johnson and Johnson recently acquired breast implant manufacturer, Mentor Corp, for a reported $1.07 billion. For those of you who hold stock in this company (like me, albeit not a whole lot), the purchase has caused the stock to skyrocket in price nearly 90%. What does this mean for the plastic surgeon and the plastic surgery patient?

Probably not much. J & J has been promoting their new dermal filler Evolence, which competes with Juvederm from Allergan (the other breast implant manufacturer). Mentor is currently working on PurTox as a competitor to Botox, but it likely won't be FDA approved for another year or two. I almost exclusively use Mentor breast implants, and have had a good relationship with the company. I hope that the J & J purchase doesn't affect how the company does business with its doctors and patients. I doubt that it will, but time will tell.

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Breast implant maker Mentor Corp. now "augmenting" Johnson & Johnson's portfolio

Santa Barbara-based Mentor Corp., one of the the largest manufacturers of silicone breast implants, is in the news today with word of a takeover bid by Johnson & Johnson. If you're a shareholder in Mentor, you're going to be making some serious coin today. J&J is paying $31 for each Mentor share, a big 92% premium to Friday's closing price but well off its 52-week high of $40.82 about 11 months ago.

Mentor, and rival Allergan, have been locked in a real dogfight for market share of the American (and world) market in breast implants. Mentor today gets almost 90% of its revenue from breast implants, most of which are sold for cosmetic proposes. To survive, Mentor had been desperately broadening their portfolios to include dermal fillers, a BOTOX alternative ("PurTox") , an Alloderm alternative (NeoForm), and medical grade skin care lines. Their expansion to this point has run right into the teeth of the financial market downturns, and their earnings and stock price had been pummeled to this point. A real interesting transcript of the company's on the record discussions with institutional investors last week seemed kind of defensive. You can read it over at the excellent Seeking Alpha website of financial stories. They sure kept this deal under wraps!

This seems like an excellent opportunity to achieve synergy with some of J&J's research and development capability and distribution networks. It puts them on more equal footing with the large corporate entity Allergan.

Rob

A must see video guide for "Lost" fans

I was talking to someone the other day who had just discovered ABC's TV series "Lost". The storyline and mythology of that great show is formidable and can be overwhelming to most casual fans as it is extremely self referential to earlier episodes and full of allegory and oblique symbols. There is NO way for most people to decipher this show and catch all that the creators are "burying" on screen.

To the rescue come's "Seanie B" on Youtube. This guy takes each episode and breaks them down in detail, pointing out things you'd never have picked up. It really takes watching the show to a new level. Sean's "channel" on Youtube can be found here.

Below is a clip from Season 1


Rob

Patrick Swayze

Several websites are reporting that actor Patrick Swayze's battle with pancreatic cancer is worsening.

Patrick recently got word that the cancer had spread to his liver and that is what his doctors said would begin the countdown to the end," a source told National Enquirer magazine.

If true, this is terrible news. Pancreatic cancer is one of the most aggressive and difficult-to-treat of all cancers. Long-term survivability is uncommon. I wish him and his family the best through this horrible time.

I thought Patrick Swayze was fantastic in Ghost and Dirty Dancing, although his most entertaining shoot ever may have been with Chris Farley on the Chippendales SNL segment...

Photo credit: prphotos.com

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Patrick Swayze

Several websites are reporting that actor Patrick Swayze's battle with pancreatic cancer is worsening.

Patrick recently got word that the cancer had spread to his liver and that is what his doctors said would begin the countdown to the end," a source told National Enquirer magazine.

If true, this is terrible news. Pancreatic cancer is one of the most aggressive and difficult-to-treat of all cancers. Long-term survivability is uncommon. I wish him and his family the best through this horrible time.

I thought Patrick Swayze was fantastic in Ghost and Dirty Dancing, although his most entertaining shoot ever may have been with Chris Farley on the Chippendales SNL segment...

Photo credit: prphotos.com

Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:

Quick thought for the day! Maybe we've already reached bottom on the stock market.

I just noticed, but last week was the best week in 34 years for the S&P US stock index, up 19%!

I've written before how much of a believe I am in all things Bogle (see last July's "Bogleheads of the World Unite!" (John Bogle being the father of passive index investing). Bogle's advice on staying the course and relying on age appropriate asset allocation offer some comfort at times like these.

In the words of investment guru Larry Swedroe "while it is almost 100% certain that the economic news will get worse (with unemployment certainly headed much higher) stock markets are FORWARD looking, leading indicators, something most investors either don't know or forget.". While we're still in choppy waters and lower earnings in early 2009 can erase this progress, history suggests we may be nearing the bottom of a 40% decline in the market's value.

If you don't stay invested and contribute during this period, you're going to miss out on historically low equity prices. When you look at a decade or more's worth of behavior of the market, there are only a few trading days where the growth of the market index value for an entire bull market is largely established. Last week was likely a clump of these days. Stay the course!

Rob