Lights, Cameras, Action! Announcing the debut of “Curbside Consults” Vlog series!

Very expensive red carpet graphic!

Very expensive red carpet graphic!

And...I'm Back!  Just a quick post to let you all know that the Vlog series has begun!  Check-out my newest creation "Curbside Consults" a video series of quick, to the point, informational consults about those issues that we all hold dearest to our hearts.  Learn how thermage works.  Find out what exactly does cause cellulite!  The mysteries behind French mesotherapy unvieled!  All videos are hosted on www.youtube.com/user/dr212renew.  If you like what you see, subscribe!  It's as easy as clicking the little yellow box marked "Subscribe." 

Stay Beautiful!

Dr. Lisa

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Posted in Uncategorized | Tagged , , , , | Comments closed

LIGHTER & BRIGHTER SKIN WITH LUMIXYL!!

 

Fly and be free of troublesome darkspots!

Fly and be free of troublesome darkspots!

Hello all!  Sorry that I haven’t written in awhile, but I have been so busy working to bring you new technologies and products from around the world that I haven’t had time to tell you about them!!  One product that has been flying off of my shelves as fast as I can restock it is a skin lightening cream called Lumixyl.  Everyone is familiar with the good old fashioned lightening creams available over the counter at the local drugstore.  These creams contain a mild concentration of a drug called hydroquinone.  Prescription strengths of hydroquinone are also available, but here’s the rub—hydroquinone is imperfect and has side effects!  Some people with a bluish undertone to their skin find that their dark spots become even darker after using the lightening agent hydroquinone.  There has been some talk in the European Union about banning hydroquinones because some data suggest that it could cause pre-cancerous changes in freckles.  However,  these studies are inconclusive and hydroquinone remains available in the United States (for now).

Enter Lumixyl!!  Discovered by researchers at Stanford University, Lumixyl is a non-toxic, non-irritating peptide of naturally occurring amino acids that targets discoloration and dark spots on the surface of the skin.  Lumixyl works by inhibiting the enzyme responsible for the production of melanin in the skin.  Lumixyl is 40% more effective at lightening these dark spots than hydroquinone!  Lumixyl brings results with none of the risks of hydroquinone.  Study subjects comparing the prescription medication TriLuma ($300/tube- contains irritating Retin A, 4% Hydroquinone, and a skin-thinning steroid) versus Lumixyl ($120/tube- completely safe, practically edible) showed patients with persistent melasma responded to the Lumixyl cream!  Continued use will give you brighter, more luminous skin.  Buy it, try it, love it!  Call the office at 212-799-1411 to reserve your Lumixyl before the shelves are bare again!

Stay tuned to hear more about my new skincare line from Australia!!

Have a Beautiful Day!

Dr. Lisa

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Posted in DOCTOR TALK- Scientific Journal Update, Dark spots (Age Spots), Melasma, Uncategorized | Tagged | Comments closed

Mesotherapy Is the Fountain of Youth!!

Even if the needles WERE that big, I'd still do mesotherapy (but they are tiny, trust me)!

Even if the needles WERE that big, I'd still do mesotherapy (but they are tiny, trust me)!

 

 

Why yes, I am truly crazy!!  Here I sit, in front of my computer, typing away with a 70% Glycolic Acid peel on my face, trying to erase some of the signs of jetlag before Mr.212Renew gets home!  Anyhow, I just had to write to you about one of the most promising things that I caught wind of while in Monte Carlo.  No, it’s not a new laser.  No, it’s not a new filler.  It’s an affordable skincare treatment that has been popular for years in Europe but has not quite caught on so much in the United States-- until now!  I’m talking about mesotherapy.  Most Americans have been exposed to mesotherapy as a controversial treatment for cellulite that involves the injection of phosphatidylcholine a.k.a. “dishwashing detergent” into areas of unwanted fat [eeeewwww]!  That, I will politely refer to as “American mesotherapy.”  I am talking about European mesotherapy, which involves the injection of vitamins, minerals, and vital amino acids into the middle “meso” layer of the skin.

Pause!  10 minute timer is up, wash off AHA peel, apply numbing cream, set timer for 20 minutes, AND…Blog!

Okay, so, what inspired me to get into mesotherapy?  I’ll tell you, I met a female physician from South Africa who looks to be 26 years old but claims that she is actually forty-six!!  Only 3 years older than me, yet looks younger??  This will not stand!!  [Needless to say, she is my new best buddy]!  She told me that, in her practice, she combines a traditional AHA peel, followed by cryotherapy where she freezes the skin to -18C, then follows with mesotherapy where she injects the vitamins & minerals into the middle layer of the skin.  The glow is unbelievable!  [Don’t worry, I am going to get the cryotherapy machine too, but let me tell you about how mesotherapy works, and yes, I HAVE THE VITAMINS- They are SO GOOD- I don’t know whether to inject them or take a bath in them]!

As I implied earlier, “meso” is fancy Latin doctorspeak for “middle.”  Patients ask me time and again what products that they can put on their skin, or what vitamins they can take to prevent their skin from aging.  The truth is, fancy creams don’t penetrate the stratum corneum layer of the skin (that’s why it’s commonly known as the “horny-layer” as in tough like a rhinoceros skin- you cheeky monkeys)!  If an ingredient DOES penetrate the stratum corneum to reach the underlying collagen, it is considered a drug, and therefore needs a prescription, and is not available over-the-counter at those froo-froo department stores, e.g. those $$$$ potions don’t work!!  Conversely, vitamins that we take by mouth are fantastic, but even in the highest concentrations don’t reach the “watershed” circulation where the collagen actually resides.  Enter mesotherapy!  Originally developed by the French physician Michel Pistor in 1952, mesotherapy involves miniscule injections of vitamins and minerals into the middle “meso” layer of the facial skin using the tiniest needle and the subtlest hand possible [namely, mine]!  This places the vitamins and essential amino acids directly into the layer of the collagen where they are most needed (the watershed).

The technique itself is simple, just apply numbing cream, and then gently but quickly inject the vitamins just beneath the surface of the skin.  “Bop, bop,bop!”  The procedure is repeated every 2 weeks for 5 sessions, then monthly thereafter. 

Who are fans?  Let’s just say that my jet-set clients from France & Spain see people like (who’s that 50 something year old pop singer who looks thirty and dates pro-baseball players?), or (what’s the name of that sexy raven-haired Spanish actress who won an Academy Award for playing a nut-job in Barcelona?) sitting in the waiting rooms of these physicians.  I rest my case.

So, my pretties, that is my most exciting news.  I have an absolutely scrumptious mixture of vitamins, minerals, amino acids, nucleic acids, and coenzymes that I am currently keeping to myself, but once I unleash them through my practice to you, believe me, I will be preaching it!!

Stay Beautiful!!

 

Dr. Lisa

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Posted in Anti-Aging, mesotherapy | Tagged , , | Comments closed

We’re Back….

 

I took a bath in Monaco alright, but not this kind!!!

I took a bath in Monaco alright, but not this kind!!!

Hi everybody!  So glad to be back in the US of A!  Monte Carlo was exceptional.  We arrived in Nice, spent the day in old Nice and explored the beautiful historical Eze Village, then off to Monte Carlo.  We visited the local sites, had a reception with Prince Albert, and I donated 100 Euro at the Roullete table because his castle looked like it needed some new paint!!  The meeting was wonderful, there were over 4,000 physicians from 102 countries represented. We met some great new friends, including physicians from Dubai, Moracco, Italy, Germany, Japan, Russia, Moncao, France, Indonesia, and South Africa.  We have a REAL global network here!  I also have some yummy new things to tell you about advances in skin care.  I promise to tell you in my very next post, once I get over jet-lag!  In the meantime, I have prepared a little slideshow for you, so get your popcorn ready and click on  http://www.youtube.com/watch?v=EVaBbShkylg to see all of our hijinks!!

 

I missed you all!

Have a Beautiful Day!

Dr. Lisa

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Posted in DOCTOR TALK- Scientific Journal Update | Comments closed

DR212Renew is off to Monte Carlo!!

Wishing you were here!

Wishing you were here!

 

I am so excited to be going to Monte Carlo next week to lecture at the 2009 World Congress in Anti-Aging and Aesthetic Medicine!  This meeting is the best!  It is the largest international meeting of physicians and anti-aging practioners in the world.  As many of you know, I attended the meeting last year in Paris.  Now, we are off to sunny St. Tropez [with our sunscreen!] to get a sneak-peak at the latest and greatest advances in all of the lasers and lights and machines that go “bing!”  This meeting is attended by over 5,000 physicians from around the globe, and I will be lecturing on two different occasions.  On Friday evening, I will be conducting an hour long workshop teaching the physicians how to use the newest Thermage 16.0 body tip that I have exclusive rights to use in my New York office.  This tip is 5 times as large, cuts the treatment time in half, and doubles the results [check out the videotape of me having the procedure performed on myself after you finish reading this, just go to the sidebar & click on my YouTube channel-DR212Renew- don’t forget to subscribe]!

On Saturday, I will be giving a podium lecture on the newest advances in body tightening techniques.  I really look forward to making more new friends, sharing techniques with other physicians, and showing them a thing or too as well.  As always, I will be keeping an eye out for things to bring back to New York City because only the best will do for you, my pretties!!

See you when I return!

Luv n’ Hugs,

Dr. Lisa

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Posted in DOCTOR TALK- Scientific Journal Update, Thermage | Tagged | Comments closed

News from the Wierd- Cryotherapy

Me, emerging from the cryo chamber!

Me, emerging from the cryo chamber!

Imagine stepping into a giant, wood-paneled freezer chilled to -275 degrees Fahrenheit, colder than your kitchen freezer (0 degrees F); colder than the top of Mount Everest (-76 degrees F), colder even than the lowest temperature ever found in nature on the ice fields of Antarctica (-129 degrees F) and staying in there for up to three minutes being chilled by liquid nitrogen, oh, did I forget to mention that the only thing that you will be wearing is a frostbite-protecting headband over your ears, gloves, knee socks, and a pair of clogs…would you do it?  Well, whole-body cryotherapy is the latest insider health-fitness-and-beauty craze to bubble up from Eastern Europe.  The cold-shock method was devised for medicinal purposes, but the benefits are now attracting the superhealthy sports elite who are harnessing it as a treatment for injuries as well as a performance enhancer (last year, German researchers tracked 50 Beijing-bound Olympians who underwent regular whole-body cryo treatments and found significant overall improvements).

The beauty by-product is the promise of rejuvenated skin and diminished cellulite.  The theory is that when the body is subjected to extreme drops in temperature, the brain is prompted to withdraw blood from the skin surface back into the body’s core, thus stimulating the nervous system to release hormones, including adrenaline, endorphins, serotonin, and testosterone.  Once the chill is over, blood is pumped vigorously back around the body, increasing the supply of nutrients and oxygen, a response that lasts up to two hours.  The attraction is the flood of endorphins.  People who have tried cryotherapy state that “my skin looks better.  My hair’s stopped falling out.” The hormone system is being stimulated.  Exposure to extreme cold has also been shown to stimulate the body into burning fat deposits.  As you leave the cryochamber, a sensation of internal cheerfulness rises through the body, like a runner’s high.  And the giddy underglow of freshness remains in the skin for up to 3 days, the face really does look fresher.  People can build up to going into the chamber three times a day (at $60 per session).

But does cryotherapy do anything measureable to the body?  Western science is still giving the cold-shoulder to cryotherapy and it has been met with a chilly response by hard-core academic medicine as well.  Currently, Cryo is in the same position that acupuncture was years ago.  So, should you try cryotherapy?  If you have the means, and if it feels good, do it!

 

Have a Beautiful Day!

Dr. Lisa

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Posted in Tales of the Wierd (extreme beauty alert)! | Tagged | Comments closed

Dmystified- should I be taking a vitamin D supplement?

 

The simplest way to boost levels is by soaking up ultraviolet rays, prompting the skin to manufacture D, but in gray northern climates the sun is too weak from November through February to trigger the viatamin’s synthesis.  Even in sunnier environments like Arizona or California, deficiency is common because most people are sun-phobic.  A sunscreen as weak as SPF 8 can inhibit the vitamin’s production, and SPF 50 (mine) can shut down the production entirely.  Experts have long known that D, along with calcium, boosts bone strength.  And new research shows that the vitamin may help prevent breast cancer by decreasing cell proliferation, and that D levels are low in those with MS.  So what is a girl to do?

To D or not to D- that's not the question, what a funny tanline she'll have!

To D or not to D- that's not the question, what a funny tanline she'll have!

Despite its nickname “the Sunshine Vitamin” people are still afraid to throw aside the risks of sunbathing [i.e.wrinkles, agespots, and skin cancer] for the benefits of nature’s best production source of Vitamin D, a vitamin that is currently claimed to prevent stress fractures in bone, ward off breast cancer, protect against multiple sclerosis, and even boost immunity against the flu [I wish that I had known that LAST week]!  The confusion is actually the fault of physicians, for we in the medical community have been saying for years to wear your sunscreen!  All the time!  Now that people are becoming more and more aware of the bad side-effects of the sun, we have pulled a complete 180 turnaround and now many of my clients in Manhattan wear sunscreen even when they are indoors because they are afraid that too much sunlight is streaming through their office windows.  Most people know that Vitamin D is good for you, but for the most part, sun exposure is bad for you, and the studies up to this point have been inconclusive as to which type of Vitamin D to take if you did want to add it to your supplement regimen.  According to Anthony W Norman, Ph.D., a long-time D researcher and professor of Biochemistry at the University of California at Riverside vitamin D is crucial for good health.  The catch is getting enough; according to the latest estimates, half of us fall short because we are sun deprived.  

  1. Take a supplement- 1,000 to 2,000 I.U.’s of D3 per day.
  2. Eat a D rich diet- salmon, tuna, sardines, milk, and eggs.
  3. Soak up (a little of) the sun- just 10 to 15 minutes a few times a week on sunscreen-free arms  and legs will provide all of the D that you need.

So, getting the appropriate amount of Vitamin D is as easy as 1,2,3!

 

Have a Beautiful Day!

Dr. Lisa

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Posted in Anti-Aging | Comments closed

Tap into Your Own Fountain of Youth with Adult Stem Cell Therapy!

Super High Tech Animation of Stem Cell Therapy!

Super High Tech Animation of Stem Cell Therapy!

 

Wait!  Hold on, I know what you are thinking, “I would never consider using stem cells, SHHHHH!  That’s sooo controversial, you should never talk about politics, religion, or, well, I forget the other thing that you are not supposed to talk about in polite company, but I’m sure that stem cell research is on that list.”

Hear me out for a second.  Remember that I am a molecular geneticist by training.  Before I went to medical school, I was slicing, dicing, and julienne frying the genome for the sake of creating vaccines for the betterment of my fellow humankind (some of my research contributed to the creation of the Gardasil vaccine for cervical cancer).  However, one college degree didn’t seem to be enough of a challenge for my brain cells, so I ordered a double and graduated Summa Cum Laude with a BS in molecular genetics, and a BA in comparative religion and a minor in medical ethics (so there)!  That being said, I want you to please lend me your ears [or in this case, your eyes since you’re reading this, [ I’m also an eye surgeon, so you can trust me with them as well] while I tell you a little bit about  adult stem cell therapy and how everyone can benefit from it.

First of all, what is a stem cell?  Well, before we are born, the growing embryo (early fetus) is filled with cells that are living the “American Dream” they can grow up to be anything!  Once the sperm fert ilizes the egg, an overwhelming cascade of molecular events orchestrates this one cell to become a walking, talking, drooling bundle of joy in about 9 months.  How can this happen?  Well, each cell in a developing fetus starts out as an unemployed college freshman.  It hasn’t been told what to think, it doesn’t have any skills, it just walks around campus, looking at bulletin boards until it stumbles across an interesting environment, then it hangs around and gets indoctrinated into a major course of study and before you know it, graduates with a degree—“ Congratulations!  You’re a heart cell!”  ”Great work, you’re a skin cell!”  “Why couldn’t you be more like your cousin Lenny, HE’s a brain cell!”  In other words, each of the stem cells has the POTENTIAL to become anything, it just depends upon the crowd that it’s hanging around with, and the molecular markers that are turned off and on at any given time during development.  However, once a cell does specialize in a particular function, it usually can’t be converted into a different type of cell, it’s stuck in a routine [beat the heart, beat the heart, beat the heart…every day it’s the same thing].   It gets to be kind of old really fast –exactly!  No cell lives forever, they eventually are put out for retirement only to be replaced by a new up-and-comer.  Only, some cells, like nerve cells, when they die, they can’t be revived and brought back to life.  They are so super specialized that they only get one shot in this lifetime.  This is why we can’t cure the blind, or help people with spinal cord injuries to walk again, or to reverse the brain damage from head injuries or stroke victims.  Gone forever.   In medicine we have a saying “time is tissue” and in the event of a stroke or heart attack, we only have a certain timeframe (usually less than 90 minutes) to try to save those dying cells.

Okay, enough doom and gloom.  How would you feel if I told you that there is a medical treatment that could limit, or even potentially reverse the damage that unfortunately happened, and that it wasn’t a drug, that it came from your very own blood… wouldn’t you want it?!  This treatment does exist, and it is called “Adult Stem Cell Therapy” and I can get you started on the path to insuring your own personal health today, right this minute.  Give me 4 hours of your time, and for the next 20 years you can be safely reassured that if you are faced with a [God Forbid] catastrophic event such as a spinal cord injury, heart attack, or cancer, that your own stem cells are banked and available to you in your time of need.  Here is how it works:

I am a certified medical provider for a company called NeoStem [www.neostem.com].   If you would like to collect your own stem cells, you come to my office and I do a standard history and physical exam and then I provide you with the paperwork to have a small sample of your blood drawn right around the corner from my office in Manhattan.  This small blood sample is to make sure that you are healthy enough to donate blood, and that your blood meets the same standards required of a volunteer blood donor.  Once the laboratory tells me that everything is okay and that you are healthy enough to undergo the stem cell isolation process, I will write you a prescription for a medication called Neupogen {New-Pa-What?].   Don’t be frightened, we have been using Neupogen for years to help people with low white blood cell counts boost their immunity.  Essentially, Neupogen invites the STEM CELLS IN YOUR BONE MARROW  to come on out into your bloodstream and join the party!    You need two little shots of Neupogen (though a teeny-tiny thin needle, Neupogen is administered the same way as insulin).  Ever hear the phrase “Timing is of the essence?”  Well, the way that this proceeds is that you need to take the Neupogen shot once a day for two days in a row, and THEN you can pass go and gather up your stem cells while you may!

Once you’ve done the Neupogen twice as directed, then you can go to one of several NeoStem facilities in the country (there is one right around the corner from my office in Manhattan).  Plan to spend about 3 hours there watching a movie or otherwise entertaining yourself as your newly minted stem cells are isolated from your blood through a simple IV process called “plasmapheresis.”  Plasmapheresis simply means having the blood drawn from one arm to be run through a fancy machine that picks out only the stem cells and then gives you back your blood through another IV line [okay, there is no tap-dancing around this, there will be an IV in each arm, one arm going out, another arm going in, but like I said, give me 3 hours of your time, and I’ll give you 20 years of stem cells- aren’t you worth it?].

You only have to collect your cells once at the facility (although you can chose to do so more than once, I’ll tell you about that in a bit…].   Once your stem cells have been collected, that’s it,  NeoStem takes it from there.   The amount of blood that you donate is approximately less than ½ of a cup!  From this ½ cup of blood some will be stored under a certain process in case you were to need it immediately in the [God Fobid] event of chemotherapy.  The rest of the stem cells are cryogenically stored for use in the distant future.  The stem cells have been shown to maintain their functioning for up to 20 years.  The NeoStem storage facility is currently located in Los Angeles, California.

What are some medical circumstances where having access to your own stem cells might be beneficial to your final outcome?  Well, the list grows every day but includes:  Age-Related Macular Degeneration, Alzheimer’s disease, Autoimmune Disease, Bone Repair, Cartilage Repair, Congestive Heart Failure, Crohn’s Disease, Diabetes, Heart Disease, Leukemia, Liver Disease, Lupus, Lymphoma, Multiple Myeloma, Muscular Dystrophy, Multiple Sclerosis, Nerve Degeneration, Parkinson’s Disease, Radiation Sickness, Spinal Cord Injury, and Stroke.

So, why did I get involved with stem cell therapy…for beauty’s sake of course!!   Aside from being selfish and wanting to help myself and others to store their own stem cells for their future health, we are behind the times when it comes to using this therapy for anti-aging purposes!  I have several patients who travel internationally and they have received embryonic stem cells from sheep in Germany, France, and Russia for anti-aging purposes!  Think about it, aging is caused by inflammation.  The stem cells go to areas in the body where inflammation is present and miraculously transform themselves into the tissue type that has been injured.  These are “shovel-ready” cells that are able and willing to perform any job required, all the body need s to do is ask them.  Imagine aging backwards, what a curious case!  You can do stem-cell therapy if you injure your knee running on the treadmill, or simply because you just want to look younger with improved vitality.

Okay doc, it all sounds too good to be true, what’s the catch?  Here it is.  Donating and storing your own stem cells is as easy as 1-2-3 here in the United States, but getting them transfused when you want them involves a little hop and skip across the border because the therapy is not yet FDA approved in this country [and likely, will not be for the next 18 months of so thanks to a little thing known as big government].  Does that mean that stem cell therapy is unsafe?  Absolutely not, it means that the FDA is arcane.  The FDA was put into existence to monitor the quality of drugs and machines that are used for medical purposes in this country.  The FDA is not allowed to tell doctors how they practice medicine or use those approved drugs and devices.   This is because each patient is different and when the FDA was formed, they were intentionally limited in their scope of regulating medicine so as to preserve the sanctity of the doctor-patient relationship.  Usually, a drug or medical device is approved for one purpose, but if the physician finds that it will be helpful for treating another condition, it is legal for the doctor to do so [this is called “off-label use”].  For instance, the FDA approved the drug “Zyban” as a stop-smoking aid, although this same medicine had been in use for treating depression for years.  So why isn’t stem-cell therapy FDA-approved in the United States?  The answer is – “beats me. “ The stem cells are actually not a drug, they are your own cells.  Stem cell therapy is the technical equivalent of giving you a blood transfusion with your own pre-donated blood.  The sticking point is that the cells are frozen, [funny, don’t we already know that frozen sperm and frozen embryos work just fine?]  and this is why we have to jet to a lovely tropical paradise to receive them when you need them [for now].  There ARE some facilities that use stem cells for therapy, but in order to participate, you must actually have the disease being treated and then qualify to be included in these academic studies.  In mu mind, I really believe that we will be treating ourselves with our own stem cells in about 18-24 months when the FDA approves their use, but in the meantime, I will be going to the lovely spa facility that already exists in beautiful, sunny Mexico to get my beauty boost [tragic, but somehow, I’ll survive]. 

The second sticking point is the cost, the drugs and the collection fee are expensive, and insurance doesn’t cover it.   The actual storage fees are affordable, and since you only have to donate once, it makes a better investment of your money than a mutual fund right now…

I hope that this informative.  I look forward to showing you the videotape of my own stem cell therapy from sunny Mexico very soon, until then…Adios!”

Have a Beautiful Day!

Dr. Lisa

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Posted in Anti-Aging, DOCTOR TALK- Scientific Journal Update, Stem Cells | Comments closed

Botox- are you a man or a mouse?

 

Oh Boy, Botox makes me JUMP for joy!

Oh Boy, Botox makes me JUMP for joy!

 A controversial study raises the concern that the popular anti-wrinkle treatment Botox may travel from its injection site into the brain.  For the study, published in April 2008 in the Journal of Neuroscience, researchers injected botulinum toxin--the active ingredient in Botox- into the whisker muscles of rats.  Researchers then looked at the connected brain areas for signs of the toxin.  Within three days of the injection, they found remnants of a protein broken down by the toxin in an area of the brainstem.  The toxin also moved from one hippocampus, which controls long-term memory and spatial navigation, to the hippocampus on the oppossite side of the brain, and from the superior colliculus, the part of the brain associated with eye-head coordination, back to the eye.  The study found that brain cell activity was disrupted both where botulinum neurotoxin was injected and in some of the distant-but-connected sites. 

But, the dose injected into the rat's whisker pad was about 150-fold higher than the dose typically used for facial twitching.  The Italian scientists also injected the neurotoxin into the hippocampus and the superior colliculus, the brain region that receives signals from the eye.

Joseph Jankovic, MD, professor of neurology and director of the Parkinson's Disease Center and Movement Disorders clinic at Baylor College of Medicine in Texas conducted the first double blind, placebo-controlled study of botulinum neurotoxin A in the early 1980's.  Dr. Jankovic  said that he has treated thousands of patients with botulinum toxin and has never observed side effects related to adverse activity of Botox in the brain or spinal cord.  He added that no such CNS effects have been described, even in patients injected therapeutically or inadvertently with very high doses of botulinum toxin.

Dr. Jankovic said that Botox is safe when used appropriately and by trained physicians.  First approved by the FDA in 1989 for blepharospasm, further studies on strabismus, facial spasm, cervical dystonia, hyperhidrosis, and cosmetic indications subsequently led to the federal green light.  A list of reported side effects for each of these conditions is provided on the FDA website and on the labeling.

But, Dr. Jankovic said that toxic spread into the brain would have resulted in cognitive, spinal, and other neurological problems that have not been documented in any of the millions of patients treated with Botox worldwide and thousands of articles published on its clinical use.

So, what to make of all of this data?  The bottom line is that Botox can be found in the brains of rats, when it is INJECTED into the brains of rats--DUH!  So, despite popular belief, it IS possible to have both Beauty and Brains!

To see my interview with Fox 5 News NYC on this very topic, go to my official website www.lisazmd.com and click on the news section!

Have a Beautiful Day!

Dr. Lisa

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Posted in Botox, DOCTOR TALK- Scientific Journal Update | Tagged | Comments closed

Tighty-whities are back in, better tighten your skin!

See how loose the measuring tape gets after Thermage?

See how loose the measuring tape gets after Thermage?

Thanks to evolving technologies in laser and light source medicine more and more men and women are choosing to postpone having a surgical facelift well until their early to late 60’s if at all.  Most patients who opt for a nonsurgical approach to rejuvenation site several reasons including fear of an overly- pulled and unnatural look , fear of the risks from general anesthesia,  fear of the surgical procedure itself, and an un-willingness to suffer through the necessary downtime to allow for the healing to take place.  As an oculoplastic surgeon, it is a given that I like to operate.  Surgical procedures do have their place, and in my years of taking care of patients I have developed a keen sense of what people are looking for as far as a result is concerned, and sometimes that means a face-lift (rhytidectomy), or a neck-lift (platysmaplasty), or both.  Generally, the conversation begins when I ask my patient to “show me with your hands what you want to achieve…”  [every woman knows  this maneuver because we do it all of the time in front of the mirror at home when no one is looking]!  If the patient shows me a dramatic difference with his or her fingertips, I say, “that’s a face-lift.”  This usually elicits a wide-eyed look of shock and the statement, “but, I don’t want surgery.”  That’s when we can enter into a realistic results- oriented discussion of what non-surgical skin-tightening treatments like Thermage can deliver.


Before I begin to explain to you what Thermage is and how the procedure is performed, you should know a little bit about me.  I am on oculoplastic surgeon (a doctor that specializes in eyelid surgery) and a laser skincare specialist.  My fellowship training in minimally invasive techniques of facial rejuvenation was a private fellowship with a surgeon who maintained practices in New York City and Rio De Janeiro, Brazil.  I am a member of the American Society of Lasers in Medicine and Surgery and have extensive experience with laser and light source technologies in the field of aesthetic medicine.  I have the pleasure of treating an international clientele who visit me from all corners of the globe.  This compels me to stay in step with the global community by participating in international meetings, most recently  the 2008 World Congress on Aesthetic and Anti-Aging Medicine in Paris, France. In brief, I am constantly searching for the best technologies available to offer my elite clientele.  I have been using Thermage since its inception and I have seen the technology evolve up until the present day.  In my opinion, Thermage is the best skin-tightening technology available and I have performed literally hundreds of procedures in my practice.  I have trained countless physicians how to perform this procedure safely and effectively and I am proud to have received the Thermage Pinnacle award two years in a row.  You could say that I am considered something of an expert in Thermage.     

What is Thermage and how does it work?
 

Thermage is a nonsurgical skin tightening procedure that is performed in the doctor’s office. Thermage uses radiofrequency energy (radiowaves) to lift and tighten the skin. Here is how it works.  Our skin is comprised of several layers, the surface layer of the skin is called the epidermis.  This is the skin layer that burns or freckles when we are in the sun.  Below the epidermis is the dermal layer, which consists of many proteins that give our skin structural support.  The two main proteins are collagen which provides tensile strength, and elastin which lets the skin “bounce back” by giving it elastic pull [hence the name].  Below the dermal layer is the layer containing fat, blood vessels, and sensory nerves. When we are younger, the collagen in our skin is abundant and in a tight rope-like meshwork. As we age, sun exposure, genetics, smoking, and gravity makes the collagen less abundant and it loses its organized network, and the rope begins to fray. This is what causes our skin and the supporting soft tissues in the face to sag.  Thermage works like a shrink wrap if you will. The Thermage tips have pre-programmed computer chips with a pre-set number of heat pulses.  Each burst of radiofrequency energy is sandwiched between a cooling burst of cryogen. So, I tell my patients that they will feel cool, then a little pinch of heat, then cool again.  What happens is that the pre-cooling phase protects the epidermal layer of the skin and safely transmits the RF energy directly to the precise dermal level where the collagen resides. The post-cooling phase locks the nurturing heat into the dermal layer for added effect and patient comfort.   Each little burst of heat causes the existing collagen in the skin to contract like a shrink wrap.  Patients see an immediate, subtle effect from the initial contraction of the collagen that already exists in their skin at that moment in time.  Then, about 3 months later, as a result of the skin having been heated by the Thermage procedure, the fibroblast cells (whose job it is to make more collagen) migrate to the area, lay down more collagen, and more dramatic lifting occurs gradually over time as this new matrix of collagen is spun. This is a good thing, considering that after the age of 30 years our innate collagen production decreases by 1% per year and the level of collagenase (the collagen eraser) increases.  Essentially, we are fighting a losing battle in our skin and we are our own worst enemy! 
How do I know if I am a candidate for the Thermage Procedure?
Now that you understand how Thermage works it is easy for you to understand how we determine who will be a good candidate for the Thermage procedure. The results that one can expect from Thermage depend entirely upon how much collagen exists in the skin at the time that the candidate is being considered.  The more collagen that you have, the better your initial result will be, and you can expect more profound results once the collagen remodeling begins [3 months post-procedure].  If there is not a lot of collagen left in the skin (excessive sun damage, thin, fragile, crepe-like skin) then the result will not be as dramatic because there is not a lot of collagen left to contract.  Now you can understand why I have 28 year old models coming to my office seeking Thermage as a “preventative treatment.”   Aside from the collagen level in the skin (analyzed clinically), Thermage patients should be within about 15 pounds of their ideal weight (otherwise gravity works against me) and have a solid bone structure. That’s it!
Does Thermage Hurt?
The procedure itself is not painful.  I know that there are a lot of blog sites out there, and everybody has a friend of a friend who said that Thermage hurts. Believe me, 99% of my patients have the procedure performed without the need for pain medication.  The only time I may advise the patient to take a medication is when I am treating the neck [which can be a bit uncomfortable], but nothing that one little pain pill 15 minutes prior to the procedure can’t cure.  When Thermage first came out the procedure was painful,  I’m not going to lie to you. That was during a time when physicians were still figuring out how to best use the technology and the powers were turned up higher.  Patients would require a pain-killer and an anti-anxiety medication and they were still flying out of their chairs.  Some people even requested to be “put asleep” under general anesthesia. Those days are gone.  What we have learned is that it doesn’t matter how hot the skin is, but how long the minimum temperature is maintained.  Multiple passes over the area at lower powers actually yield the best results. 

What is the difference between the old and the new Thermage NXT machine?

Another major advancement was the introduction of the Thermage NXT device in January 2007.  I was the first physician in New York City to purchase the Thermage NXT and it has made a big difference for my patient’s and my own comfort level.  The new NXT machine, coupled with the new tips, has increased the efficiency of the procedure by 30% so that my patients enjoy more dramatic, immediate effects with less discomfort.  Sometimes I have patients who have had Thermage in the past with the old technology, who claim that “nothing ever happened.” These are the hardest patients to win over, but I tell them that with the new machine and the new tips, they will look in the mirror afterwards and see results.   Another question that I get asked frequently is, “have you ever treated anybody and not seen a result?” The answer to this question is “no.”  If I don’t feel that a patient is a good candidate for Thermage, I offer another collagen boosting procedure such as facial resurfacing –[everybody leaves my office on a positive note].
What parts of the body can be treated with Thermage? 
Thermage is FDA-approved for treatment on the face, eyelids, lips, neck, hands, arms, legs, and buttocks.  In May 2008, I was the first physician in New York City to debut the new Cellulite treatment tip.
What is a Thermage Tip?
There are a variety of Thermage treatment tips available, and I have all of them in my office.  The tips are one use per patient only.  With the exception of the eyelid tip the Thermage tips measure 3.0 cm2.  The Thermage STC tip is for the face.  The eyelid tip is smaller and the heat penetrates less deeply taking into consideration that the eyelid skin is the thinnest skin on the body.  The hands also have a special tip that penetrates less deeply because the hands have little subcutaneous fat.  The Thermage DC tip is for treating the body and heats a little more deeply.  Finally, the Thermage CL is the exclusive cellulite tip that has undergone some adjustments  in its cooling parameters to address some of the factors that give rise to cellulite formation including increasing the bloodflow to the area and repairing the damaged collagen that allows for the fat to dimple beneath the skin. 

What can I expect during the procedure? 

I tell all of my patients that I know exactly what all of my procedures feel like because the first patient that gets treated with any new technology is me!  I have performed Thermage on my face twice and on my eyelids twice.  First, the patient washes his or her face, signs a consent form, and then I take pre-treatment photographs.  Pain medication as needed is provided after the consent is signed.  A sticky patch is placed either on your back, your upper arm, your stomach, or your thigh (depending upon which area is to be treated) and you are then connected to the machine. This is the grounding pad that captures any stray radiowaves circulating in the skin near the treatment area.  The first pulse that you feel from the machine will be cool only (no heat) as the machine takes a pre-treatment skin measurement of your skin’s resistance.   I start by selecting a setting that I know will be cool, then a little warm, then cool again.  This allows you to get used to the whole sensation. Then, I increase the heat in a step-wise fashion and advise you that my goal is on a scale of zero to four, zero being “I didn’t feel that at all” to four being “don’t ever do that again,” I want you to be at about a 2 or 2.5.  In other words, I want you to feel some heat, but not so much that you pull away from me. That’s it!  Once we find your comfort level, I tell you that there will be no more surprises and then we can have a nice time chatting away until the procedure is completed.
How long does the procedure take?
These are estimates only - the actual amount of time depends upon the number of pulses and tips required to achieve the desired effect.
Face = 50 minutes
Face & Neck = 1 hour and 15 minutes
Eyelids = 20-40 minutes
Abdomen = 90 minutes to 1 hour and 15 minutes
Front of legs = 1 hour and 15 minutes
Back of legs = 1 hour and 15 minutes to 2 hours
Buttocks = 1 hour and 15 minutes
Arms = 1 hour and 15 minutes
Hands = 40 minutes
Again, these are approximations and the actual time required depends upon individual circumstances.

What can I expect after the procedure?

Immediate, natural looking results!  The skin may appear to be a little flushed [like you just got off of the treadmill], but this goes away in about 5 or 10 minutes, that’s it!  There is no downtime and no restrictions are imposed upon your activities after the procedure.  You can immediately apply make-up (or not) and go about your day.  The epidermal layer of the skin is left intact; all of the important changes have occurred beneath the skin surface and will continue to occur over the next three to six months.  You can go into the sun if you like [but, please don’t!  We just spent all of this time building more collagen and sun exposure is the number one collagen destroyer].

When will I see additional skin tightening?

This is where you have to have faith.  Collagen remodeling takes at least three months to occur.  There are no exceptions to this rule for the human species.  Your body needs this minimum amount of time for this important change to occur.  However, from my experience, this is what you can expect-- The initial result will be very good.  Then in about 6 weeks, there will be the beginning of an exponential improvement in the tightness of the skin that reaches its peak at about three months and then continues to improve at a more gradual rate up until six months. 
How long do the results last?
Technically, the results last about 2-3 years.  However, we continue to get older every year on our birthday, so the aging process continues.  In practice, most of my patients like the procedure so much that they usually want to have it performed about every year and a half to two years for maintenance purposes.
How many times do I have to come back for the Thermage procedure?
Thermage is a one-time procedure.  The radiofrequency energy penetrates more deeply into the dermis than some of the other devices that rely in infrared technology.  Infrared doesn’t penetrate very well  into the skin and that is why it is always being combined with something weird like suction or laser light.  That is also why you have to go back 4 to 5 times to see the same results with infrared versus the one time treatment of Thermage. 

Who is absolutely prohibited from having the Thermage Procedure?

Those with a pacemaker or implantable defibrillator
Those with large pieces of metal in the body (if you can have an MRI, you can have Thermage)
Pregnant women
Are there any risks to the procedure?
Thermage is safely performed on people of all skin-tones.  In the past, there were reports of some people sustaining burns or fat melting, but this is typically no longer the case.  With the new multi-pass protocol using lower energies the reports of burns are rare.  Fat melting nowadays usually only occurs on purpose when the operator “stacks” the pulses [delivers 4 to 5 bursts of energy in rapid succession to a small pre-determined area].  I  encourage my patients during these “power-sets” that usually occur below the chin or on the abdomen because to quote the personal trainers, “the results are worth it!”  
Can I have Thermage if I have fillers in my face?
Yes.  Thermage has been shown to not affect the integrity of any of the hyaluronic acid fillers [Restylane, Perlane, or Juvederm], Sculptra, Radiesse, or surgically placed fat fillers.  In fact, having the Thermage procedure could potentially eliminate or diminish your needs for these fillers in the future because the nasolabial grooves are improved by the Thermage technique. 
Would you recommend the Thermage procedure?
I’ve done the procedure on myself and my mother…twice!

Have a Beautiful Day!

Dr. Lisa

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Posted in Anti-Aging, NonSurgical Body Sculpting, Thermage | Tagged , | Comments closed