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Allergan Q1 Profits: Botox, Dysport, Juvederm Ultra XC

Posted: 12 May 2010 08:24 AM PDT

Allergan's Q1 Earnings Call: Allergan's thoughts on it's Botox and Juvederm Ultra XC growth.

You might want to visit our Select Partner Medical Spa RX after reading this.

First quarter sales increased year-over-year 11.2% in dollars and 6.9% in local currencies, boosted by the strong pickup in the sales of medical devices, which grew 18.4% in dollars and 13.4% in local currencies. The growth in the Medical Aesthetics businesses was even stronger outside the U.S. in all regions and across a wide range of countries, with surprisingly strong performance in Europe.

Operating performance was strong, with non-GAAP earnings per share at $0.65, marking an increase of 18.2% versus the result for Q1 of 2009, and comfortably exceeding the Q1 expectations shared with you, the investment community, of $0.57 to $0.59.

Earnings growth was driven by strong gross margin expansion, especially in the Medical Device segment. Careful spending in the selling, general administrative area, whilst we increased investment in R&D by 11.1% on a non-GAAP.

Within SG&A, we however doubled our DTC expenditures versus Q1 of 2009, which of course was the low watermark for spending when the world economy was in crisis. Our plan is to continue to invest in 2010 across our brands and into the recovery of our markets.

During the quarter, we were pleased that we continued to strengthen our R&D pipeline, supplementing our internally development programs with acquisitions and licenses. In January, we acquired Serica, a company with proprietary technology for use in tissue regeneration especially applicable to breast reconstruction, as well as the license for Ser-120 in Phase III clinical development for nocturia. Strategically, we have made good progress in building up a portfolio of urology assets.

We also furthered our aspirations to be the leader in medical aesthetics also in Asia, by reacquiring the rights to BOTOX Cosmetic in Japan and China and expanded our footprint in fast-growing emerging markets by establishing direct operations for all of our businesses in Turkey, effective from the second quarter.

After the out-licensing transaction with Bristol-Myers for neuropathic pain, we've increased our degree of R&D focus on our core specialty areas.

Now I’d like to comment on our expectations for 2010. For the full year earnings outlook, we have brought up the bottom of the EPS range by $0.02 to $3.11 and have left the top end of the range at $3.15 which at the time of the last earnings call expressly excluded the costs of any healthcare reform bill in the United States. With the increase of the Medicaid rebate, extension to managed Medicaid and expansion of eligible hospitals in the so-called 340B program, we estimate that the cost of healthcare reform in 2010 will be approximately $12 million. This is now included in our outlook.

Turning to BOTOX

Sales growth has picked up relative to trends seen across 2009, with growth versus the first quarter of 2009 at 11.3% in dollars and at 6.6% in local currencies. Sales of $331 million were only modestly lower sequentially than Q4, which is always seasonally the highest quarter of the year. Most of this increase was due to the more economically sensitive aesthetic side of the business, as the benefits of the upper-limb spasticity FDA approval in March occurred too late in the quarter to contribute to our sales results.

Outside the U.S., we enjoyed very strong double-digit increases across a wide range of countries, with surprisingly strong growth in several of the main European markets. These global markets are precisely where we are successfully dealing with multiple competitors.

It would therefore seem that the market is recovering as we can measure our market share with only a short time lag. In Europe, on the aesthetic side, we’re holding share at just under 80%, as we deal with the incursions of both Merck’s, with their Zymine and Bocatua [ph] brands and Galderma with Azzalure.

On the therapeutic side, it seems that most of ZMM’s market share gains have been at the expense of Dysport. In the U.S., BOTOX sales growth is less buoyant, as there was no base of Dysport sales in the prior year, but it is clear that the market is growing again.

We estimate that in the aesthetic market, Dysport had somewhere between 13% and 14% share in the first quarter. We'll be curious to see the lasting impact of the Dysport Love It or Leave It promotion after it terminates at the end of May.

In the therapeutic market, Dysport’s share is so far negligible, given the long history and experience of BOTOX use. In Europe and the U.S., we have recently introduced a 200-unit vial, which is useful for injectors treating large muscle groups, as well as for differentiation from competition. Regarding global market share for the fourth quarter, the last quarter for which data is available, we estimate that BOTOX held 79% share in a market growing 13% year-over-year.

Regarding the clinical program for BOTOX for chronic migraine, the clinical trial results of our PREEMPT program were published in Cephalalgia, the journal of the International Headache Society. Regarding facial aesthetics, we've experienced an even stronger rebound in sales than observed with BOTOX. Dermal filler sales grew year-over-year, a very strong 42.4% in dollars, and 34.5% in local currencies, with great growth in all operating regions of the world, with Europe again surprising on the upside.

Juvederm & Juvederm Ultra XC

In the U.S., we've seen huge growth in the JUVÉDERM line since the launch of JUVÉDERM Ultra XC, this is the lidocaine-containing product, in early February. Although we have gained some market share, it would seem that the market is responding strongly to the reduction in treatment pain experienced with this lidocaine-containing product and already a substantial share of the mix is attributable to JUVÉDERM Ultra XC.

We have just initiated print advertising for JUVÉDERM XC and have a PR campaign with TV host Dayna Devon, as our spokesperson to further drive growth. In Europe, we launched new additions to the JUVÉDERM product line, JUVÉDERM Smile at the IMCAS Conference in Paris in January and JUVÉDERM Hydrate at the Anti-Aging Conference in Monaco in March. JUVÉDERM Smile was also approved in South Africa, JUVÉDERM XC in Korea and JUVÉDERM Ultra Plus in Taiwan.

Voluma was recently launched in Brazil and also approved in Taiwan.

Based on our analysis of the world market in Q4, which we estimate grew 12%, it is clear that global market growth has accelerated since then. Our analysis also points to JUVÉDERM market share gains in all regions of the world. Beyond superior product performance characteristics, Allergan also benefits from having full product line.

At the end of the first quarter, Allergan's cash and cash net of debt positions totaled approximately $2 billion and $471 million, respectively. Allergan continued to maintain exceptional cash flow generation capabilities in the first quarter, with operating cash flow after capital expenditures of approximately $161 million, an increase of approximately $56 million over the first quarter of 2009.

Fake Botox: Houston physician sentenced

Posted: 12 May 2010 07:42 AM PDT

The fake Botox case in Houston comes to a close with this sentence handed down.

A Houston, Texas physician was sentenced to five months and 15 days in federal prison and three years of supervised release for injecting patients with fake Botox, prosecutors said on Friday.

Dr. Gayle Rothenberg is a local physician specialized in providing image enhancement services. She was also ordered to pay $98,426 in restitution to her affected patients. As a condition of supervised release, Rothenberg is prohibited from seeking reinstatement of her medical license.

Rothenberg and her former husband, Saul Gower, a local attorney, operated The Center for Image Enhancement located at 2000 Bering Drive in Houston.

Rothenberg ordered and administered a drug called Botulinum Toxin Type A that was labeled with the warning “FOR RESEARCH PURPOSES ONLY, NOT FOR HUMAN USE.” Despite this label, Rothenberg injected more than 170 patients with the substance and represented to patients that they were receiving Botox Cosmetic, manufactured by Allergan Inc.

Rothenberg also admitted that she advertised in brochures, magazines and websites that she specialized in treating facial wrinkles with Botox Cosmetic, even though she intentionally stopped ordering it due to the price increase in 2004 and began ordering the unapproved drug from a company named Toxin Research International because it was half the price of the other. She admitted that she did not tell her patients that they were receiving a different substance.

Gower pleaded guilty in 2008 to misbranding of a drug while being held for sale and making false statements to an agent. He then, cooperated with agents and testified against his ex-wife in exchange for a sentence of 4 years’ probation.

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Effective Link Building Strategies to Increase Your Laser Clinic's SEO

If you are new to "link building", it really isn't as hard as it seems.

Basically, link building is just a link from another website back to your own medical spa or laser clinic. The more back links your site has, the higher it will rank on the major search engines.

Link building can be very time consuming, but the FrontDesk SEO tool can really help you go out there and find the sites you should be listed on. This saves you a tremendous amount of time.

Because you will be resubmitting the same text over and over again, make yourself a document that you can keep all of your submission text on. This should include your Page Title, your website's URL address, a brief description of your practice, and important keywords. Website submissions also ask for a name of the submitter and email address. I would suggest setting up a email address with Google or Yahoo, one that you only use for submissions, this way your personal email won't become inundated with confirmation and/or spam emails as a result of your submissions.

View: 5 minute video introduction to linkbuilding and SEO

There are several types of link building methods you can do. Some are just basic data submissions, and some are blog and article submissions. I will describe the differences amongst the major link building methods:

Article Submission

There are directories on the web designed just for submitting articles and some for writing blogs. When you submit something you wrote about your practice or even a particular therapy you offer, you can attach hyperlinks to keywords in your article that direct the reader back to your website. Some quality sites are Squidoo, Hubpages, Blogger, and Wordpress.com. Let me show you how this works with just one line taken from a blog I wrote on my own blogpost:

"It's your body and you do have to be careful of who you choose to perform your laser lipo procedure. While no physician can have a 100% satisfaction rate, don't be afraid to ask questions about how long a physician has been performing these procedures, who they trained with, how many procedures do they perform a month, and also if they have any satisfied patients you can chat with. Also, it's important to ask to see a before and after photo book with their patients, and not someone else's."

By choosing a keyword you think your reader would be interested in, you can immediately direct them right to that page on your website with the hyperlinks.

Google considers a "Yahoo Directory" link as a quality back link. Unfortunately, they charge an annual fee of $300. It may be worth submitting to; however, there is no guarantee from Yahoo Directory that your site will be accepted.

Directory Submissions

DMOZ is a directory worth submitting your site to. DMOZ is an Open Directory Project (ODP) mainly known as DMOZ which stands for "directory.mozilla.org" and is owned by Netscape. While DMOZ can substantially increase your SEO ranking, it's tough to receive their approval and the entire process could take months. If you are fortunate enough to receive their approval, many smaller directories use the DMOZ directory categories so if you can become listed with DMOZ this would mean you would also become listed on many other web directories as well.
There are other major directories you can submit to such as the BOTW (Best Of The Web) directory ($99/year or $299/permanent).

Social Bookmarking

Social bookmarking is changing in it's effectiveness all the time. In social bookmarking websites, users save links publicly (not personally on their own computers) to web pages that they want to store and/or share with others. Usually, these bookmarks are shared within an individual "group" someone may subscribe to (such as "Laser Hair Removal"). You can add descriptions to your bookmarks in the form of metadata, or meta tags, so that other users can understand what the content is of your bookmark without having to download it beforehand. Different types of "descriptions" can include comments or even reader's votes (favorable or not - like on YouTube or Digg). Again, FrontDesk SEO makes this process relatively easy.

Blog Comments

MedicalSpaMD is a blog and, like most blogs, it is highly susceptible to spammers like we have all seen and Jeff so diligently tries to eliminate on a daily basis as it can be a true nuisance for people like us who use this site as a valuable tool for your practices.

If you want to find blogs to participate in and comment on, try to find quality blogs that are related to what you do as a profession. Again, FrontDesk SEO can help with this. And when you add your comments, try to make them content-relative because not only do your comments add value to the blogpost in general, they also have greater chance of staying on the blogpost with a link back to your website.

Press Releases

Press Releases have worked well for me, and I'm not too proud to say that I didn't write the ones that really worked. There are a lot of good and bad example press releases out there and I am no exception. Writing a quality press release is an art and, frankly, I don't have the talent for them and pay someone else to do it. Let me give you an example of my own good and bad press release experiences.

While this press release still continues to give my website hits, all it is is words: Paula's Bad Example

Now look at the one I paid Fran Acunzo from Acara Partners to do for us. It includes a photo, links and even video: Paula's Good Example

If writing a good press release including videos and back links is not your forte, then it's worth it to farm it out. Just writing a good press release is half the battle. Submitting it to the right press release agencies that will index it effectively for you is the other half.

Social Media Sites

Social Media sites such as Facebook, Twitter, Flickr and YouTube work very well by providing quality and relevant back links to your site that all the major search engines love.

So, this is back linking in a nutshell and we can really go deeper into the categories, but I fear you will become bored or even glassy-eyed if you're not a geek like me. So if you don't have someone out there performing these activities for you and you really are serious about your web presence, you really might want to take a look at FrontDesk SEO and see what it can do for you. Just remember, building links doesn't increase your website's internet presence overnight. It does take some time, like my good friend Jeff keeps reminding me! In a world of available "instant results", it's hard to be patient sometimes!

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Safer Plastic Surgery

Safeguards For Your Simple Cosmetic Medical Treatment

The days are gone when plastic surgery was only for the rich and famous as well as being something that you had to hide under the floor boards. Now, it’s appreciated and even in vogue to get plastic surgery. Individuals do it for many factors - to help feel good about themselves, to get rid of some form of medical problem, or just to shed weight expediently. What ever the reason why, it is critical for you to agree to common health and safety procedures since even though it’s cosmetic, any hazards are certainly not. So until you consent to alter your physical appearance, here is just what you need to do:

Locate a licensed surgeon: The most beneficial thing to consider in plastic surgery isn't the fee; it’s precisely how knowledgeable your surgeon is. You’re getting this since you would like to enhance your physical appearance, and it is solely having a highly regarded and proven physician that can you make sure that the outcomes are as anticipated. So even should you are required to fork out a lot more, pick a physician who is certified and capable to do aesthetic surgery as well as someone that has experience within the specific surgery that you're interested by.

Insist on a comfortable office: Cosmetic surgery is like every medical procedure in that you'll be under the effect of anesthesia and you'll go through blood loss. Consequently, just in case anything at all goes wrong, it is ideal to have your surgical treatments conducted at a hospital at which crisis care can be obtained over a 24x7 basis. But if the procedure will be scheduled at a private aesthetic surgical practice, find out about healthcare services which are near by and where you possibly can get urgent care .

Stick to guidelines: And finally, it is very important to stay within your doctor’s guidance before and following the treatment. You could have to stop smoking cigarettes and/or stop specific drugs (if you’re on prescription medications). Additionally, after the procedure is conducted, you might be in a reasonable amount of discomfort, but seek advice from your physician before you decide to commence taking painkillers by yourself. It may very well be a while before you begin witnessing benefits, notably with liposuction and other surgical treatments performed on the facial skin, so you must be patient. You may also be required to undertake physiotherapy in some cases, so check with a medical expert in order to give you all the information prior to deciding to sign on the dotted line.

It may very well be cosmetic, but the perils exist simply because it’s surgery in the end. But if you ever take on the essential safeguards plus stick to recommendations, there’s no need to worry about aesthetic surgery.

By-line: The guest article is written by Teresa Jackson, she writes on online nurse practitioner school.

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Free SEO Report : Do it yourself SEO software.

Free SEO report for your medical spa or plastic surgery website from Frontdesk SEO.

A free SEO website report from Frontdesk SEO lets you know how your website is ranking on the search engines.

Frontdesk SEO offers do-it-yourself search engine marketing software for businesses who want to use their existing staff—hence the 'frontdesk' monkier—to build search engine rankings, increase visibility for their potential patient population, and drive traffic locally.

Frontdesk has a free SEO report that can give you a feel for how well you're doing in the cut-throat competition online.

And, if you really want to dominate your local market, Frontdesk offers outsource SEO packages that's unique, combining monthly phone interviews, press releases, social media, blogging and article distribution to give you some serious marketing power.

What can you say? It's free!

Filed under  //   Free SEO Report   medical spa advertising   medical spa marketing   plastic surgeon advertisng   plastic surgeon marketing   SEM   SEO  

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Unapproved Botox

A Plastic Surgery Group out of Albany, along with several of its staff, have been charged following guilty pleas that they were using non FDA approved Botox products on their patients.

The Plastic Surgery Group, LLP (TPSG), of Albany has been sentenced and ordered to pay restitution in the amount of $106,686, and a fine of $200,000, in connection with TPSG's plea of guilty to one felony count of misbranding drugs.

The company was sentenced in Federal District Court in Albany, along with Doctors William F. DeLuca Jr., Douglas M. Hargrave, Jeffrey L. Rockmore, Steven M. Lynch, and John D. Noonan, who were all sentenced to probation with community service and ordered to pay restitution in the amount of $106,686 and a fine of $5,000.

TPSG's practice administrator, Peter M. Slattery, and supervisory nurse Susan F. Knott were also sentenced and ordered to pay
restitution in the amount of $106,686, and fines in the amount of $1,000 and $500, respectively.

All the individuals were sentenced in connection with their guilty pleas to one misdemeanor count of misbranding drugs.

According to plea agreements, starting in approximately February 2004 and continuing to December 2004, defendant TPSG ceased using the FDA-approved BOTOX and BOTOX Cosmetic and began exclusively using a non-FDA approved TRI-toxin on its patients seeking treatments with Botulinum Toxin Type A for facial wrinkles.

Five physicians, whose professional corporations were partners of TPSG (the "treating physicians"), with the assistance of TPSG nurses, injected approximately 150 patients with the unapproved product.

The charges follow an investigation by the Food and Drug Administration, Office of Criminal Investigations, New York Field Office.

Not nice telling people you're injecting them with BOtox and using TRI-toxin.

Filed under  //   Botox  

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Zerona Lasers

There's a fantastic post on Zerona lasers here.

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Are the best laser clincs making the most money?

best medical spasIs you're medical spa, cosmetic surgery center or laser clinic providing the best medical care or just making the most money? Are they mutually exclusive?

There's a New Yorker article detailing the commencement address Atul Gawande Atul Gawande delivered this commencement address, titled “Money,” to the graduates of the University of Chicago Pritzker School of Medicine. It expands on the themes he touched on in his recent article about health-care costs in McAllen, Texas, which figured in President Obama’s speech on health care.

The text of this speech is available in this article in the New Yorker:

No one talks to you about money in medical school, or how decisions are really made. That may be because we’ve not thought carefully about what we really believe about money and how decisions should be made. But as you look across the spectrum of health care in the United States—across the almost threefold difference in the costs of care—you come to realize that we are witnessing a battle for the soul of American medicine. And as you become doctors today, I want you to know that you are our hope for how this battle will play out.

Kevin MD has this on: Can doctors resist the lure of money?

That’s a tall order for many American physicians.

In his speech, which is an extension of his celebrated New Yorker piece, he looks at so-called “positive deviants,” or doctors who practice higher value, higher quality care, than everyone else.

What makes these doctors so special? In essence, they have to “resist the tendency built into every financial incentive in our system to see patients as a revenue stream.”

Indeed, “These are not the doctors who instruct their secretary to have patients calling with follow-up questions schedule an office visit because insurers don’t pay for phone calls. These are not the doctors who direct patients to their side-business doing Botox injections for cash or to the imaging center that they own. They do not focus, the way business people do, on maximizing their high-margin work and minimizing their low-margin work.”

Unfortunately, most American doctors fail to resist the allure of money. In some cases, it’s greed. But in many others, patients and business have to be intertwined simply to keep the doors open. Doctors cannot practice quality medicine while bankrupt.

Changing physician behavior needs to be accompanied by fundamentally modifying the incentives that influence doctors. Without radical physician payment reform, Dr. Gawande can implore future doctors to fight the financial incentives all he wants, but most will realize that resistance alone will be futile.

So where does that leave us? Are plastic surgeons and medical spas practicing medicine first, or business? How, if ever, does cosmetic medicine differ from 'real' medicine? Is there any ethical guideline that applies or is cosmetic medicine fundimentally different?

The political aspects of health care reform march on.

Filed under  //   laser center   laser clinc   Medical Spa   medical spa marketing   plastic surgeon   plastic surgery   plastic surgery marketing  

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How to Tell if Your Doctor Knows Jack.

plastic-sugeon-trust
Istockphoto

Watch for these red-flag phrases that suggest your “skin-care specialist” is subpar, says San Francisco ophthalmologist Krista Ramonas, MD, who has treated medical and aesthetic patients for six years.

“You’ll look 20 years younger.”
Beware the cosmetic doctor who overpromises, Ramonas says. Instead of flattering you, he should be discussing what you can reasonably expect from the procedure and addressing possible side effects.

“I’m an artist.”
The prima donna who tosses this phrase around may value her vision over standard operating procedures. “There is a little bit of art to it,” Ramonas points out, “but there’s a lot more science. We have certain parameters we all have to follow.”

“I’m so good, I’ve never seen complications.”
That may be code for “not very experienced,” Ramonas says. “Medicine is always about being prepared for complications.” You need a doctor who can handle the unexpected.

Of these, the greatest is the 'Artist'.

Filed under  //   Medical Spa   medspa  

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Medical Spas a new resort for day spas.

Medical spas that provide Botox wrinkle treatments, laser hair removal, and liposuction and facial toning are faring better amid times of slower consumer spending. [Jupiter Images]
Spas and salons in New Jersey are hurting, along with the rest of the economy, but the relatively pricier medical spas among them seem to be better off, so says Hannelore Leavy, executive director of the International Medical Spa Association, in Union Township, which has 350 members worldwide, including about 30 in New Jersey.

The medical spa industry is faring better because its patrons are more affluent than those that patronize conventional day spas, Leavy said.

“In every recession, people buy more cosmetics because they want to look and feel good,” she said. Medical spas provide that “instant gratification,” she said.

Medical spas typically provide Botox wrinkle treatments, laser hair removal, and body contouring procedures like liposuction and facial toning, many of which have to be done under medical supervision, Leavy said.

Salons providing basic services like haircuts and nail jobs are also handling the recession better than expected because those are necessities, said Leavy, who also heads the 800-member Day Spa Association from her Union office. The day-spa industry has been badly hit because massages, facials and herbal wraps are considered luxuries, not necessities, she said.

Leavy said she is seeing the impact of the recession on the membership rolls of both her associations. The Day Spa Association, for example, has lost some 10 percent of its members over the past year.

But there is opportunity even within the day-spa industry, said Rosemary Weiner, chairwoman of the Association of Salon and Spa Professionals, also in Union Township. She said she found a ready buyer last December for her 3,500-square-foot Brass Rose Spa and Salon, in Blairstown, and secured a price just a couple of hundred dollars apart from what she sought.

Weiner said her association helps its roughly 100 members with counseling on retaining customers, better packaging of services and cost-control strategies. Leavy’s Day Spa Association has also put out a recession survival guide for its members, and has designated members in each state on the lookout for legislative changes.

One recently proposed legislative change fought by Weiner’s association was the state’s effort to ban Brazilian waxing, or waxing of the genital area, citing injuries. The association persuaded the state to drop the ban proposal, instead rewriting the legislation to address concerns.

“New Jersey would have been the only state in the country to ban it,” Weiner said. “It would have impacted salon and spa owners, and caused them a huge loss of revenue.”

The state remains one of the most stringent in terms of regulating medical spas, Leavy said, requiring doctors to serve as their promoters or investment allies — but she said her association welcomes such regulation.

“It’s not easy to hang out a shingle and start a [medical spa] business,” she said.

Filed under  //   Botox   cosmetic surgeon   Laser Clinic   laser hair removal   laser treatment   Medical Spa   medical spa advertising   medical spa marketing   plastic surgeon advertisng   plastic surgeon marketing   skin clinic  

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Model's death highlights plastic surgery risks...

Click to play

More of this tragedy playing out today.

Argentine model dies after plastic surgery:
  • Model Solange Magnano died after complications following plastic surgery
  • Injecting fat or silicone into the buttocks can lead to a blockage of blood supply to the lungs
  • "No cosmetic surgery is totally risk free," says top cosmetic surgeon

London, England (CNN) -- Following the death of a former Miss Argentina after complications arising from plastic surgery, questions are being raised about the risks of cosmetic surgery.

Solange Magnano, 37, died in hospital, after being transferred from a clinic where she underwent an elective surgery on her buttocks last Wednesday.

Nigel Mercer, president of the British Association of Aesthetic Plastic Surgeons, last month described the cosmetic surgery industry an "unregulated mess" in the journal Clinical Risk.

Following revelations of Magnano's death, he told CNN, "Unfortunately, the things we're saying about this type of surgery keep being proven right by people having major disasters."

Magnano is reported to have died from a pulmonary embolism, a blockage of the blood supply to lungs.

It is currently not known if Magnano's death was a result of her surgery and there is no suggestion that it came about through surgical error, but there are risks associated with buttock-enhancement surgery.

Mercer said Magnano may have had a solid implant in her buttocks, a relatively low-risk procedure, but he said it's possible that she had liquid silicone injected into her buttocks -- a "highly unpleasant" procedure that is banned in most countries. An alternative would have been to extract fat from another part of her body using liposuction, and then inject the fat into the buttocks.

"With a pulmonary embolism something blocks blood supply to the lungs and circulation literally stops dead," Mercer told CNN.

"The lump in the lungs can be stuff you've injected into the patient -- their own fat or a lump of silicone -- or it can be clots from leg veins as a result of deep vein thrombosis (DVT)."

While DVT is not common with cosmetic surgery, Mercer said that operations on the pelvis, buttocks and legs carry a much higher risk of causing the condition.

"No cosmetic surgery is totally risk free," Mercer told CNN. "Even having botox and fillers is not risk free. There's a chance of infection, bruising or bleeding with any procedure."

Filed under  //   Brazillian Buttlift   Buttlift   cosmetic medicine   cosmetic surgeon   cosmetic surgery   plastic surgeon   plastic surgery   plastic surgery death  

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