Thermage: Do plastic surgeons hate everything non-surgical?

First, I'll state that I like Thermage.

But plasticized raises the questions that have been haunting Thermage since the early days.

Thermage is a radiofrequency device that is meant to create skin tightening and collagen remodeling. It takes multiple treatments to acheive desired results, and is somewhat uncomfortable.

There seems to be a growing consensus among surgeons that Thermage is not everything they hoped it would be. When looking at a presentation by the medical device company that sells Thermage, it is at times difficult to distinguish between the before and after images. We have to strain our eyes to tell the difference (see here). Also, issues with fat atrophy and scarring have surfaced.

The issues story about Thermage fat atropy and scarring that plasticized points to:.

"I was shocked and dismayed over the scars that resulted from this reportedly safe and non-invasive procedure,” said thermage patient, Laurie.

Thanks to White, Laurie doesn't appear to be disfigured. At first glance, you can't tell she suffered second-degree burns to her neck. It's taken her two years of reconstructive procedures, but today she hopes White can hide her last remaining scars.

 Of course my account rep Chris addressed these questions with me just last week. I've invited Chris to submit some posts and rise up to defend Thermage's name. He's said that he'll check with corporate to see if they'll let him.

Update on Sat.12.5.07 by Jeff Barson

Thermage Corporation has responded to this post here:  Thermage Safety - The Whole Story

Plastic Surgery & Teens.

From Australia: Teens want bigger boobs.

Darryl Hodgkinson, a cosmetic surgeon for 26 years, says he is treating more teenagers now than he did a decade ago — between 3 and 5 per cent of his patients are teenagers.

There are "psychological consequences of having a real physical deformity like a really big, fat bottom". Surgery such as liposuction to remove fat that won't budge with exercise and diet can help adolescents with a negative self-image suffering extreme social distress, he says. His price starts at $5000 and his youngest liposuction patient was 15.

Dr Bruce Fox, a Melbourne cosmetic surgeon of 25 years, operates on about six adolescents a year. Last year he had a patient who was 17. This year he has performed liposuction on an 18-year-old. He says it is not a weight loss technique, but a procedure to correct a body shape that might be "size eight up top and 10 or 12 downstairs".

How not to handle plastic surgery malpractice pubicity.

My Surgery Nightmare: An unhappy patient takes on her plastic surgeon.

Plastic surgeons are among, if not the most, likely physician objects of malpractice claims. And when patients want to punish you, they now have resouces. Case in point; mysurgerynightmare.com.

The reasoning is simple. Where an unwanted outcome in cardio-thorasic surgery is marked off as a given possibility, people who are looking at plastic surgery don't have the same expectation of risk. Cosmetic treatments are viewed as flawless and doctors often minimize the possibility of an unwanted outcome.

A poor result strikes directly at a patients ego and perception of self. Not something you want to damage and remain friends.The

The level of communication and networking now available on the web gives anyounparalledled access to spreading their views.

From the site:  

***UPDATE: Dr. Sykes tried to force me to take down this website by suing me for defamation. On January 26th, 2007 the California Court of Appeal unanimously ruled that Dr. Sykes' claims had no merit.  The Court found that my website contributed to the public debate regarding plastic surgery.  The Court also said that the statements on my website regarding Dr. Sykes were either true or were matters of opinion.  It said Dr. Sykes was unable to show that there was any false information on this website.  Since the Court of Appeal ruled in my favor, Dr. Sykes and his attorney have continued claiming that my website is misleading.  But the Court considered and rejected all of their arguments.

And there's this:

In a sworn deposition on October 26, 2004 it was asked of Dr. Sykes if he's ever been a defendant in any other medical malpractice lawsuits.  His answer was "I think three others."

The fact is Dr. Jonathan Sykes has  MANY medical malpractice lawsuits filed against him.

Medical malpractice lawsuits* were filed against Dr. Sykes on  9/9/2005 ,  7/21/2005,  4/12/2005,  7/12/04,  5/25/2004,  12/01/2003, 12/11/2002,  4/15/2002,  12/12/2001,  8/18/2000 and 11/14/1991.

 Does Dr. Sykes really want eveyone to know that he was sued three seperate times in 2005?

Certainly there is widespread distain for all things legal among physicians. Just take a look over at Kevin MD where there's continual back and forth among docs and malpractice attorneys. 

Part of the problem is the inherent conflict of interest in plastic surgery and other elective procedures. Where a doc in an ER is not choosing patients and is generally on salary, a cosmetic plastic surgeon is performing and elective procedure and benefiting directly from the payment.

Ah, there's the rub.

Lip augmentation gone Frankenstein!

Misadventures in lip augmentation.

"Pop star Pete Burns revealed today he is suing his plastic surgeon for "wrecking his career and life".

Burns, singer with 1980s pop band Dead or Alive, has had several cosmetic procedures on his face and is suing a Harley Street surgeon for an estimated £1million over a botched attempt to remove lip implants.

In an exclusive interview he told the Standard he looked like he had been "mutilated with a Stanley knife" after surgery to correct the original problems left his top lip hanging off...

Burns said: "It has taken away my life and my career. I saw doctors in London who said the only option was to amputate my lips. I was suicidal."

In 2000 Burns went to Dr Maurizio Viel at the London Centre for Aesthetic Surgery to have a lip implant removed.

But instead of having the original implant taken out, he was injected with a filler called Evolution and then later with another called Outline.

Despite complications, Dr Viel persisted and injected more of the substance - only for the problems to escalate, causing swelling, blisters, discharge and lumps.

Eventually the singer was left so disfigured he could not eat normally, could only drink through a straw and did not leave his house for months."

Lip augmentation is still a proceedure that has risks. Lip amputation?

 
In Park City, we perform a lot of fillers, but in any normal situation, we avoid the permanent ones like Silikon 1000. There are docs that use this stuff like it was apple juice just because it's cheap and they can charge more for 'permanent fillers'.

It's not always just the cost or how much you can make. Putting a patient at increased risk just to save money or charge more for a treatment is not ethical behavior. 

Hat tip: Plastic Surgery 101 

Plastic Surgery: Patient Lotteries

Plastic surgons are, 'appalled at this new scheme but unfortunately not surprised'.

Plastic surgeons have criticised a company for running the world's first cosmetic surgery "superdraw".

The British Association of Aesthetic Plastic Surgeons (BAAPS) accused Europa International of "plumbing new depths".

It said the company was using marketing gimmicks to attract customers to surgery abroad.

But John Babbage, co-founder of the Prague-based company, said there was no difference between somebody winning surgery, and paying for it.

People are encouraged to enter the company's draw via text or phone through a section on their website entitled "win your surgery for just £1.50".

The monthly draw gives people in the UK the chance of winning £6,000 towards cosmetic surgery.

Hat tip to Kevin MD 

It's a plastic surgery kind of Christmas.

New Face for the giving.

A 2005 survey by the American Academy of Facial Plastic and Reconstructive Surgery found that 40 percent of cosmetic surgeons had a patient who received a surgical procedure as a gift. Women typically receive the gift from their husbands or mothers, doctors said.

American Academy of Cosmetic Surgery wins in California.

As acknowledged by the American Board of Cosmetic Surgery and affirmed by the Superior Court of California, cosmetic surgeons include qualified physicians from the fields of Dermatololgy, Facial Plastic-ENT surgery, Oculoplastic surgery, General Plastic Surgery, Oral Maxillo-Facial Surgery, and General Surgery.

Via: Plasticized

The Academy has reported, via e-mail and through Newsline, the recent victory in California for cosmetic surgeons, whereby the Superior Court of California ordered the Medical Board of California to grant ABCS's Application for specialty board certification. This decision was recently challenged by the Medical Board, which filed a Motion for a New Trial.

...The ABCS allows for cosmetic surgeons, including ENT's, Oculoplastic surgeons, and cosmetic dermatologists to have certification for the specialized skills in which they are trained. Certification through ABCS is often acheived through fellowship training in cosmetic surgery, which occurs after a residency in a surgical specialty.

and Edward Lack MD isn't mincing words when he says..  

"I would hope this will end the dispute once and for all and stop the needless waste of money and time over what is only a turf battle. As the number of board certified plastic surgeons who join the American Academy of Cosmetic Surgery and take board exams from the American Board of Cosmetic Surgery increases, the obstructionists who often hide their identities in the American Society of Plastic Surgery will lose more and more prestige as the public views them as the self-seeking propagandists that they are."

Gore (Gortex) throws in the plastic surgery towel.

Gore & Associates to Exit the Plastic Surgery Market

 This exit includes ...'all of the GORE Subcutaneous Augmentation Material (GORE S.A.M.) products including TRIMENSIONAL 3-D implant extended chin, nasal dorsum and malar, sheets, sutures for plastic surgery applications, facial slings and strands.'

Obviously the risk / reward ratio wasn't working for them.

Plastic Surgery: 50 reasons not to get a boob job.

With silicon breast implants just reapproved by the FDA, there's sure to be a lot of attention over the next few years about cosmetic medicine and safety.

While not quite 50, here are some strongly worded opinions on 48 reasons not to get a boob job.

Plastic Surgery Celebrity Photos: The good, bad, and ugly of celebrity surgical results.

I stumbled upon this vicious celebrity plastic surgery web site. It's no great wonder why the paparazzi are so loathed. It makes you feel sorry for these poor celebrities.

What's more surprising is that even plastic surgeons get nasty and call it "entertainment".

I am a Board Certified Plastic Surgeon who has been featured on Dr. 90210 on E! The comments on the site are my opinion alone and should not be taken as fact. I have not treated any of the celebrities presented here and the information and opinions should be taken for entertainment value only.

Entertainment value? I'm stunned that this guy has any patients. This is truly base.

Warning: If you're a plastic surgeon in LA let's hope you don't see one of your patients.