Monday, December 23, 2019

The MeDical (MD) codes

The MeDical (MD) codes have transformed the way that fillers are used and we are proud to offer this treatment at health + aesthetics.




Wednesday, December 18, 2019

Sculptra and Dermal Filler Combo



http://www.RajaniMD.com -Combination procedures in facial filling, collagen stimulation and body sculpting represent the theme for 2017 and beyond. 

Ageing has become an option that people can prevent and delay should they choose. 

Monday, December 16, 2019

How is Dermal Filler Different to Botox?

 by Dr Timothy Beazleigh

How is Dermal Filler Different to Botox?



People are often confused by the difference between Botox and dermal filler treatments, assuming they are the same. Whilst Botox is a muscle relaxant and is used to minimise muscle contraction thus reducing fine lines and wrinkles on facial movement, dermal filler is used specifically to restore volume to deeper, lines, creases and folds that are usually static i.e. permanently visible on the face even when the face isn’t moving.


Traditional areas to treat with standard dermal fillers – including Juvederm and Restylane – are the nasolabial folds (corner of the nostrils to corners of the mouth), marionette lines (corners of mouth to chin/jowls) and the smokers lines (above the top lip). Thicker, more volumising fillers including Juvederm Voluma are used specifically to the mid face region to augment cheek bones, restore volume and plumpness to the lower cheeks and redefine the chin and temples. Fillers are also used to enchance and recontour lips.


As a treatment with dermal fillers requires the needle to penetrate the dermis deeper than for a standard Botox treatment, there is usually more opportunity for bruising to occur as the blood vessels are not visible to the practitioner (beyond the superficial layer), but bruising is by no means a standard side effect and occurs in approximately 50% of treatments.


Juvederm is the filler of choice at Melior Clinics Botox & Facial Aesthetic London Clinic as, being monophasic, it is smooth in consistency and also contains a built in anaesthetic, making the process a lot more comfortable for the patient.


Tuesday, December 10, 2019

Restoring Facial Volume: Fat Grafting vs. Fillers


For many years, facial rejuvenation was limited to skin resurfacing with lasers and peels, 
and various surgical soft tissue repositioning procedures. However, our options have 
expanded with the understanding of muscle relaxation via neurotoxins such as Botox,
 and the evolution of our knowledge of how fat atrophy in the face leads to stereotypical 
architectural changes with aging. Plastic surgeons can now add volume to refresh the face. 

In order to achieve a youthful but natural appearance for my patients, I use a combination 
of muscle balancing, skin resurfacing and tightening, as well as volume restoration.

 Ultimately, when the battle of gravity versus skin plays out over time, 
surgical repositioning is required.



Restoring Facial Volume: Fat Grafting vs. Fillers

Tuesday, November 26, 2019

'Pharmaceutical companies raping patients here in the U.S.': Jury acquits Tulsa neurologist charged with using unapproved Botox

By Curtis Killman Tulsa World
A jury acquitted a Tulsa neurologist on Monday of charges accusing him of billing Medicare for patient treatments with Botox that was not approved for use in the United States.
Dr. Gregory Sinclair Connor, 61, faced up to 10 years in prison had he been convicted of the fraud charges.
“Don’t ever underestimate the power of the government to abuse its citizens,” Connor’s attorney, Mark Lyons, said after the verdict was rendered.
Lyons said he didn’t know exactly what caused the jury to issue the not guilty verdicts.
“I can’t speculate, but what we did submit into evidence in front of the judge was proof on 34 other occasions throughout the U.S., U.S. Attorney’s Offices have declined to prosecute (these types of cases) because there is no prosecutive merit in it,” Lyons said.
“They tried, in my estimation, to make Dr. Connor a test case here for the quote Botox Police unquote, which has been railed against before Congress, in the newspapers and at the FDA,” he said.
U.S. Attorney Trent Shores issued the following statement following the verdict:
“The American justice system is the best in the world, in part because the ultimate verdict is determined through a fair and transparent process established by our Founding Fathers.
“The government must prove its case beyond a reasonable doubt. A defendant is guaranteed the opportunity to see and hear all the witnesses against him and may, if he so chooses, present a defense. Today, the jury returned a verdict of not guilty, and we will respect that verdict.”
Connor denied knowing that his use of the Botox, which prosecutors said was packaged for use in other countries, was illegal.
A grand jury on April 2 initially named Connor in a six-count indictment alleging health care fraud, fraud related to the use of misbranded drugs and aggravated identity theft related to the use of a patient’s identity while committing health care fraud.
On Sept. 5, a grand jury returned a superseding indictment that added 35 counts of health care fraud. Prosecutors dismissed two of the four identity theft counts, leaving a total of 39 counts for trial.
Prosecutors say the investigation into Connor’s activities began in January 2017, when U.S. Customs and Border Protection agents intercepted a package addressed to his practice, Neurological Center of Oklahoma, at 6585 S. Yale Ave. in Tulsa.
The package contained Botox that was labeled differently from Botox approved by the U.S. Food and Drug Administration, prosecutors said.
A subsequent investigation by the FDA found that Connor had been using Botox from sources not approved by the FDA that was destined for other countries, including Pakistan, Malta and Great Britain, according to prosecutors.
Connor said he had sought a cheaper source for the drug in part because his Botox treatments cost more than Medicare would allow and because he believed that the drug’s manufacturer, Allergan, was “immoral.”
Over the course of a year, Connor estimated that he lost about $600 on each Medicare patient he treated with Botox before switching to a cheaper supplier of the drug.
Prosecutors say Connor’s business records indicate that he stopped purchasing Botox directly from Allergan, which was the sole FDA-approved supplier, in 2009.
Prosecutors claimed that Connor bought Botox from an unapproved FDA supplier beginning in 2009. Trial evidence indicated that the Botox at issue was purchased from a company that claimed to be in Canada.
FDA regulations require that Botox used in the U.S. be purchased through a California supplier that has been approved by the FDA, according to testimony from an FDA investigator.
Connor maintained that the Botox he used was safe and effective.
One patient of Connor’s testified that Connor used Botox to treat his muscle spasms.
“He’s been the best doctor I ever had,” said Gordon Couger when asked about Connor.
Couger said he was unaware that the Botox used to treat him in 2014 was not approved for use in the U.S. by the FDA.
“No,” Couger replied when asked if knowing so would change his opinion of Connor. “The shots worked.”
Connor testified Friday that at the time he didn’t know whether the Botox he used had been approved for use in the U.S.
“All I know is the boxes looked exactly the same,” Connor said, adding that he achieved “fantastic results” when he treated patients with the Botox made for other countries.
But Assistant U.S. Attorney Melody Nelson was dubious of Connor’s claim about the legality of his actions.
“If he is not the person who is supposed to know you are supposed to use FDA-approved drugs, who is?” Nelson asked during closing arguments Friday.
Lyons said Connor will continue to treat patients with Botox. But, Lyons said, Connor has been purchasing the drug from the sole FDA-approved source.
“This is just pharmaceutical companies raping patients here in the U.S. and, more importantly, since these were all Medicare patients, just raping the government for excessive fees,” Lyons said.


Tuesday, November 19, 2019

BOTOX® Cosmetic (onabotulinumtoxinA) Important Information

BOTOX® Cosmetic (onabotulinumtoxinA) Important Information


Indication

BOTOX® Cosmetic is a prescription medicine that is injected into muscles and used to improve the look of moderate to severe frown lines between the eyebrows (glabellar lines) in people 18 to 65 years of age for a short period of time (temporary).

IMPORTANT SAFETY INFORMATION

BOTOX® Cosmetic may cause serious side effects that can be life threatening. Call your doctor or get medical help right away if you have any of these problems any time (hours to weeks) after injection of BOTOX® Cosmetic:
Problems swallowing, speaking, or breathing, due to weakening of associated muscles, can be severe and result in loss of life. You are at the highest risk if these problems are pre-existing before injection. Swallowing problems may last for several months

Spread of toxin effects. The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice (dysphonia), trouble saying words clearly (dysarthria), loss of bladder control, trouble breathing, trouble swallowing. If this happens, do not drive a car, operate machinery, or do other dangerous activities

The dose of BOTOX® Cosmetic is not the same as, or comparable to, another botulinum toxin product.

There has not been a confirmed serious case of spread of toxin effect when BOTOX® Cosmetic has been used at the recommended dose to treat frown lines.

Serious and/or immediate allergic reactions have been reported. These reactions include: itching, rash, red itchy welts, wheezing, asthma symptoms, or dizziness or feeling faint. Tell your doctor or get medical help right away if you are wheezing or have asthma symptoms, or if you become dizzy or faint.

Do not take BOTOX® Cosmetic if you: are allergic to any of the ingredients in BOTOX® Cosmetic (see Medication Guide for ingredients); had an allergic reaction to any other botulinum toxin product such as Myobloc® (rimabotulinumtoxinB), Dysport® (abobotulinumtoxinA), or Xeomin® (incobotulinumtoxinA); have a skin infection at the planned injection site.
Tell your doctor about all your muscle or nerve conditions, such as amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), myasthenia gravis, or Lambert-Eaton syndrome, as you may be at increased risk of serious side effects including severe dysphagia (difficulty swallowing) and respiratory compromise (difficulty breathing) from typical doses of BOTOX® Cosmetic.

Tell your doctor about all your medical conditions, including if you have: plans to have surgery; had surgery on your face; weakness of forehead muscles, such as trouble raising your eyebrows; drooping eyelids; any other abnormal facial change; are pregnant or plan to become pregnant (it is not known if BOTOX® Cosmetic can harm your unborn baby); are breast-feeding or plan to breast-feed (it is not known if BOTOX® Cosmetic passes into breast milk).
This product contains albumin taken from human blood. Steps taken during donor screening and product manufacturing processes make the risk of spreading viral diseases extremely rare. In theory, there is also an extremely rare risk of contracting Creutzfeldt-Jakob disease (CJD). No cases of spread of viral diseases or CJD have ever been reported for albumin.

Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal products. Using BOTOX® Cosmetic with certain other medicines may cause serious side effects. Do not start any new medicines until you have told your doctor that you have received BOTOX® Cosmetic in the past.

Especially tell your doctor if you: have received any other botulinum toxin product in the last 4 months; have received injections of botulinum toxin, such as Myobloc®, Dysport®, or Xeomin® in the past (be sure your doctor knows exactly which product you received); have recently received an antibiotic by injection; take muscle relaxants; take an allergy or cold medicine; or take a sleep medicine.
Other side effects of BOTOX® Cosmetic include: dry mouth, discomfort or pain at the injection site, tiredness, headache, neck pain, and eye problems: double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of your eyelids, and dry eyes.
For more information refer to the Medication Guide or talk with your doctor.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see BOTOX® Cosmetic full Product Information including Boxed Warning and Medication Guide.

Monday, November 4, 2019

Lip Augmentation

Lip augmentation creates fuller, plumper lips and reduces fine wrinkles around the mouth. Lips may be injected with collagen or with fat transferred from another site in the patient's body. Both liquid collagen and fat are absorbed and repeat treatments are necessary to maintain results. Newer, longer-lasting options include implantable materials like AlloDerm and SoftForm.


Technique:


A natural or synthetic biocompatible material, or the patient's own fat, is injected or implanted in the lips. One injection is usually sufficient to produce the desired result, which may be temporary, depending on the material used. Injections may need to be repeated periodically. Proper placement of the injected material is important. AlloDerm, a natural collagen sheet made from donated skin, is inserted through tiny incisions inside the corners of the mouth. Once the AlloDerm implant is in place, it eventually becomes integrated with the natural tissues. Gore-Tex, SoftForm and soft ePTFE are other synthetic implant options.

Further options include:


  • Autologen - injectable dermal implant material made from the patient's own skin.
  • Dermalogen - injectable Human Tissue Matrix (HTM) procured from donor tissue.
  • Fascia - injectable donor tissue made from the dense white connective tissue that supports body structure. Can also be done as a surgical implant.
  • HylaForm - a crystal-clear injectable gel; the hyaluronic acid in Hylaform is similar to that naturally found in the body.
  • Radiance - calcium hydroxylapatite
  • Restylane - crystal-clear injectable gel; the hyaluronic acid in Restylane is very close to that naturally found in the body.
Another augmentation choice is laser lip rejuvenation, which tightens the natural collagen and elastic tissue beneath the lips.

Monday, October 28, 2019

Danger zones for dermafillers !!!

The high risk areas for arterial/venous occlusion when injecting dermafillers are the temple, glabella, nose, cheek, nasolabial folds, lips, and lower face. It is virtually the entire face. Injury of vessels may result in embolisation (resulting in visual loss), blockages (tissue necrosis), severe bruising, and volume compression. There can also be injury to nerves.

Monday, October 21, 2019

Wrinkle Injections Medicine

Muscle relaxing injections serve best to smoothen out the face wrinkles.  They work by blocking the function of muscle that cause wrinkles.  Different types of injections are available and it is our choice to choose the best among them.


Wrinkles around mouth  is an issue of which lots of folks experience particularly ladies.   Majority of these facial lines could appear anywhere on your face although it seems that the most noticeable part is whenever it forms lines from the bottom of your nose all the way down to the edges of your mouth.
The presence of wrinkles around mouth affects your self-esteem.  They customarily appear on the area from the base of your nose down to your mouth.  The worse thing is that its location makes them so obvious.  That is why when you see them in the mirror you want them to be removed straight away.
It has long been suspected that wrinkles around mouth has been more of a problem for women than for men.  Those wrinkles are called perioral wrinkles, and a recent study indicates that biology may be the culprit in terms of women being more prone to them than men.
There are many factors that cause wrinkles around mouth.   The most typical is the excessive facial movements and expressions like when you're frowning, thinking too hard, smiling or annoyed.   Environmental components such as too much sun exposure and pollution can result into early aging that will be the reason behind your wrinkles.
People want to get rid of wrinkles around mouth as it can make a positive change to their entire appearance.  And one can adopt a lot of ways to get rid of wrinkles around mouth.  Since unhealthy skin can also be one the culprits, you can get rid of wrinkles around mouth, by making some substantial changes to your diet.  Usually a diet which constitutes of vitamin E filled fruits and vegetables can help you to combat wrinkles, and in certain cases, the development of wrinkles can get delayed as well.
One of the first sign of aging is the wrinkles around the mouth which are called the smile lines.  As the production of collagen slows down with aging, the skin's elasticity breaks down, resulting in those wrinkles.  It is further hastened by smoking and sun exposure without proper care.  But the good news is, there are many professional skin care products that will help you to reduce wrinkles around mouth.  There are some natural home remedies as well.
The most expensive skin care is not necessarily the best one either.  On the contrary, an inexpensive product may show tremendous results on your skin simply because it may contain more effective natural ingredients.  It is highly recommended that when choosing an anti-wrinkle product, select one with ingredients that are safe and natural, especially when using on wrinkles around mouth.

Thursday, October 17, 2019

Wrinkle Injections: Dysport Vs Botox


Dysport vs. Botox; what treatment is the best treatment for wrinkles and frown lines? Both drugs have the same active ingredient: Clostridium botulinim toxin type A. Both are approved by the US FDA. Both work in the same way, by paralyzing facial muscles. So what are the differences?
 http://www.canadiancosmeticsurgery.ca/latestNews_detail.asp?id=888

Wednesday, October 16, 2019

Dr. Patrick J. Treacy

We have all seen individuals whose mood has changed positively following BTX-A injection in the brow area. Now there is growing evidence that treatment of the glabellar area may actually be used to treat depression. In this paper Dr. Patrick Treacy looks at the current data to support this theory.
Depression affects over 120 million people globally, making it one of the leading causes of disability in the world. Although there are various effective treatments, therapeutic response remains unsatisfactory and depression can develop as a chronic condition in a considerable proportion of patients. Negative emotions, such as anger, fear, and sadness are prevalent in depression and also are associated with hyperactivity of the corrugator and procerus muscles in the glabellar region of the face. In 1872, Charles Darwin recognised these features as a very specific expression of sadness and attributed them to the activity of so-called ‘grief muscles’ in the glabellar region. He also formulated a new theory called the ‘facial feedback hypothesis’, which implied a mutual interaction between emotions and facial muscle activity. More recently, Larsen et al. have shown experimental evidence that voluntary contraction of facial muscles can channel emotions, which are conversely expressed by activation of these muscles.
Heckmann and others (1992) have published data suggesting that treatment of the glabellar region with botulinum toxin produces a change in facial expression from angry, sad, and fearful to happy and this can impact on emotional experience. Many therapists, including Sommer (2003) have shown that patients who have been treated in the glabellar area reported an increase in emotional wellbeing and reduced levels of fear and sadness beyond what would be expected from the cosmetic benefit alone. Hennenlotter (2009) went one stage further and showed that botulinum toxin treatment to the glabellar area stopped the activation of limbic brain regions normally seen during voluntary contraction of the corrugator and procerus muscles. This indicated that feedback from the facial musculature in this region in some way modulated the processing of emotions. Many other researchers have continued down this road with Havas (2010) noting that the processing time for sentences with negative affective connotation was prolonged in women after glabellar botulinum toxin treatment and Neal and Chartrand (2011) speculating that the treatment interfered with the ability to decode the facial expression of other people. This is where things were until recently with many authors suggesting that this capacity to counteract negative emotions could be put to some clinical use during the treatment of depression.
https://www.linkedin.com/pulse/20140608174205-31515886-botox-and-depression

Wednesday, October 2, 2019

TOP 12 MYTHS ABOUT INJECTABLES



1.    Botox and fillers work the same way.
No, Botox (a brand of anti-wrinkle injection) and dermal fillers work differently and treat different concerns. Anti-wrinkle injections (Botox and Dysport) are muscle relaxants. Dermal fillers restore volume and hydration.
2.    Botox and fillers can remove movement and emotion from the face. 
Dosage is individualised to the client. The perfect amount of anti-wrinkle injections and dermal fillers should be tailored to allow natural expression.
3.    Botox is addictive. 
Cosmetic injections are not physiologically addictive; however, people may like the result so much that they work it into their grooming budget.
4.    Injectables are painful.
Everybody has a different pain threshold. Typically ice is sufficient to take the sting out of an anti-wrinkle treatment. 
When a client is having dermal fillers, we apply a pharmaceutical grade topical numbing cream prior to the treatment. The product itself also has an in built numbing agent, Lidocaine, to help alleviate any tenderness through the procedure. 
5.    It is easy to tell who has had injectables.
Ideally no one should suspect you have had cosmetic injections. The goal is to look like you are well rested and rejuvenated.
6.    Botox is expensive.
Depending on the level of your dosage and what product is used (Botox or Dysport), prices will vary.  
7.    All types of injectables are the same.
Laser Clinics Australia offers two different brands of anti-wrinkle injections, Dysport and Botox. There are slight differences in dosing and costing, but are both very similar in that they are both muscle relaxants, which create a smooth, rejuvenated and youthful appearance.
 8.    Fillers require downtime.
 There can be some downtime with cosmetic injections; however, they tend to be mild and transient.
 9.    If I stay out of the sun my botox will last longer.
No, the environment will have no impact on the effects of your treatment.
 10. Botox doesn’t last if you exercise regularly or aggressively .
There is no evidence-based research to suggest that this is the case. If you are noticing that longevity may be an issue, it is important to work with your injector to find an appropriate and safe dose that is both aesthetically pleasing and lasting.
 11. Botox can be poisonous. 
Botox and Dysport are TGA approved, and have a multitude of therapeutic uses.
For cosmetic purposes it is essential that an experienced and qualified doctor or registered nurse administers the treatment at manufacturers recommended dosage.
 12. The effects of botox are permanent.
Anti-wrinkle treatments typically last 3-4 months depending on the muscles injected and dose. As every client is different, the injector will create an individualised tailored plan to maintain a refreshed appearance. This may include incorporating dermal filler to achieve the desired aesthetic goal. 
 For more information visit www.laserclinics.com.au

Friday, September 20, 2019

What Are Facial Fillers?

What Are Facial Fillers?

Facial fillers are products such as collagen, hyaluronic acid and calcium hydroxyl apatite that rejuvenate facial skin by reducing or eliminating wrinkles, raising scar depressions, enhancing lips and replacing soft-tissue volume loss through facial injections. With age, our skin becomes more susceptible to wrinkles and sagging. Exposure to sun and years of muscle movement ( squinting, chewing, smiling ) contribute to tissue breakdown of the skin.



Facial fillers are temporary to long-lasting solutions administered through a few tiny facial injectionson specific areas of the face. Various types of facial fillers are available; each is designed with one or several purposes, such as wrinkle reduction and lip augmentation. A qualified dental or medical professional can help you determine which facial injections and what injectable fillers treatments are right for you. Facial fillers will volumize creases and folds in the face in areas that have lost fat and collagen as we age. Hyaluronic acid is the natural filler substance in your body. The face starts to lack volume and appears aged with deeper nasolabial folds, unaesthetic marionette lines, a deeper mentalis fold, the lips start to thin, and turning down the corners of the lips. Hyaluronic acid fillers such asRestylane and Juvederm are then injected extraorally right underneath these folds to replace the volume lost which creates a younger look in the face. Dermal fillers can be used for high lip line cases, asymmetrical lips around the mouth, lip augmentation, and completing cosmetic dentistry cases by creating a beautiful, young-looking frame around the teeth