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

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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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Miss Argentia dies after Brazilian Buttlift.

Plastic surgery marketing in Argentina is booming, with medical spa advertising a common experience for Argentine women. Plastic surgery advertising is seen as putting tremendous pressure on wome to have proceedures like liposuction, breast augmentation, and Brazilian Buttlifts.

The result is sometimes a tragedy, like the death of Solance Magnano, a former Miss Argentina.

From a news story.

38-year-old former Miss Argentina Solange Magnano died after complications arising from plastic surgery on her buttocks.

Solange Magnano, the 1994 winner and a mother of 8-year-old twins, died of pulmonary embolism Sunday three days after having a gluteoplasty, a procedure that involves placing implants to enhance firmness. News of her death shocked her fans. The cause of her death was under investigation, the authorities said. Officials said the injected liquid went into her lungs and brain.    

In the past half decade, the number of people seeking plastic surgery in Argentina has soared by 60 percent, to around 50,000. Estimates say that 1 in 30 Argentines has gone under the knife, making plastic surgeons in Argentina some of the most experienced on the globe, attracting large number of medical tourists.

Medical tourism in Argentina has seen a huge jump over the past decade, and is projected to be a 100 billion dollar global industry by 2010, according to the Deloitte Center for Health Solutions, a U.S. research center focused on trends in the health care system.

What a tremendous waste. Perhaps the worst quote of the story is that the 'injected liquid went into her lungs and brain'.

Filed under  //   Brazillian Buttlift   Buttlift   cosmetic surgeon   cosmetic surgery   plastic surgeon   plastic surgery   plastic surgery advertising  

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Breast Augmentation + Liposuction: Venezuelans commonly borrow for plastic surgery.

Venezuelans commonly borrow for plastic surgery.

In the subway you can see ads for clinics that offer credit for plastic surgery, Thermage, Fraxel, laser hair removal, breast augmentation, laser treatments and Botox treatments, and that women who work use their vacation bonuses and borrow from their work savings accounts. The cosmetic surgery and medical spa industry will make sure that cosmetic work remains within reach to ensure a steady flow of income.

plastic surgery marketing & advertising

THE NEED TO BE BEAUTIFUL

Despite the hefty price tag, the choice to get plastic surgery, Botox, or laser treaments is not considered a luxury for some Venezuelans.

"We need to be beautiful," said Patino.

Competition among women, by far the biggest consumers of plastic surgery in Venezuela, to look their best is fierce, and social pressure to get work done is high.

"Socially, there is a lot of demand, especially from men, to have a good body," said Prem Pratita, a 27-year-old who had a breast augmentation a few weeks ago.

In this image-conscious country, famous for beauty queens who win record numbers of international pageant titles, the idea of getting cosmetic surgery is instilled at a young age.

Patino recalls how, as a child, her mother and aunt dreamt of surgery to get rid of wrinkles. Now, with a child of her own, the subject is already on the table.

"I told my husband, 'Look honey, if she has your nose, she's going to get plastic surgery,'" said Patino.

Some young women even describe moving up a few cup sizes through plastic surgery as a rite of passage.

"It's a transformation from being a girl to being a woman," said Pratita, who said she was one of the last in her circle of friends to have the procedure.

"Everybody has a breast augmentation. Three or four of every seven women have one," said plastic surgeon Angel Pena, who likens his surgery to body decoration practiced for centuries.

"By nature, human beings have the desire to look better ... this desire is timeless and it's a desire that doesn't depend on your economic situation ... it's not that frivolous."

Filed under  //   Boob Job   Botox   Breast Augmentaion   Facelift   Fraxel   Thermage   Tumescent Liposuction   liposuction   plastic surgeon   plastic surgeon advertisng   plastic surgeon marketing   plastic surgery  

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Need a breast lift? Try an plastic surgeons internal bra?

Woman fastening bra behind her back
Breast lift plastic surgery coming to a medical spa near you.

Bras are an often uncomfortable but necessary evil for the majority of women.

But if you've got serious bra issues and can't be bothered with a different strap arrangement for every occasion, plastic surgery now has the answer.

Israeli plastic surgeon Eyal Gur has invented the Cup & Up bra and there's no straps to be worried with... on the outside at least.

In fact, the invention is an alternative to breast implants and promises perky breasts for years without any of the drawbacks of implants.

The first guinea pig has already had her internal bra fitted and surgeons say it was a huge success.

Avi Cohen, managing director of Orbix Medical, the company helping to develop the bra, told the Daily Mail: "The operation went really well and the woman, who is in her 30s, has made a good recovery.

"The bra has given her the lift she wanted. Her breasts look natural and she is happy with the result. The surgeons have done a fantastic job."

The Cup & Up involves a kind of internal silicon bra. The 'straps' are attached to the ribs with titanium screws, stitched to silicon 'cups' and then it's all tightened into place.

As gruesome and unpleasant as that sounds, those of you in need of a lift can be in and out of hospital in a morning as the keyhole operation takes just 40 minutes.

Mr Cohen believes the internal bra will become widely available throughout Europe within the next 18 months.

"We have enough women volunteers in the trial and we will be doing our second patient just before Christmas.

"In a year's time we will have enough evidence that it works. Then we will be able to get the green light from the European medical licensing authorities."

Call us cautious, but we think we might wait a little longer.

Filed under  //   boob job   breast augmentation   breast lift   cosmetic surgeon   cosmetic surgery   medical spa   plastic surgeon   plastic surgery  

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Reconstructive Plastic Surgery Not Likely Among Certain Races?

Less-acculturated Latinas with breast cancer are less likely to have reconstruction surgery after a mastectomy, say researchers at the University of Michigan Comprehensive Cancer Center.

Amy Alderman, MD, MPH, assistant professor of plastic surgery at the U-M Medical School and lead author conducted a study to examine trends in breast reconstruction among different races, including white women, African-American women, and Latina women. The group of Latina women was further divided into women who were either highly acculturated into American society or less acculturated.

After looking at 806 women who were treated for breast cancer, researchers found 41% of white women and 41% of highly acculturated Latinas underwent reconstruction, while only 34% of African-Americans and 14% of less acculturated Latina did.

The study authors found that the lagging reconstruction rates did not correlate to lack of interest. More than half of the less-acculturated Latinas said they would have like more information about breast reconstruction.

When patients' satisfaction with their surgery was measured, the highest satisfaction rates were among white women who were satisfied with their treatment (94%) compared with the lowest rate, 56%, among less-acculturated Latinas who did not receive reconstruction.

Furthermore, this group was also less likely to report that their surgeon explained breast reconstruction, and they were less likely to be referred to a plastic surgeon than the other racial groups. The study also showed similar trends for African-American women, although the most significant data was among the less acculturated Latinas.

“Reconstruction is important to these women, but significantly more of the less-acculturated Latinas did not know how to get it. It suggests significant unmet needs for this vulnerable group. They have a desire for reconstruction, but no one's telling them about it,” Dr Alderman suggested.

The study authors suggest that more efforts be made to present breast reconstruction options to all patients, including those who speak only Spanish. Further research is planned to understand how language and other cultural issues affect whether women receive breast reconstruction.

Filed under  //   breast cancer   breast surgery   mastectomy   plastic surgeon   plastic surgery   reconstructive plastic surgery  

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Plastic surgery advertising regulation push in Britan.

plastic surgery marketing

Cosmetic surgery can carry risks as well as benefits

Several newspapers have reported the dangers associated with cosmetic surgery, including a lack of regulation in some areas of the industry. The reports also feature warnings from Nigel Mercer, the president of the British Association of Aesthetic Plastic Surgeons, who voiced his views as part of a series of medical articles on cosmetic surgery.  Mr Mercer called for tighter regulation and testing of drugs, procedures and implants to offer more protection to patients.

The Times reported that the number of cosmetic surgical operations conducted by “audited members of the profession” has more than tripled to 34,000 since 2003, but that many additional procedures are being carried out on the black market. The newspaper says that these are “fuelled by internet promotions, magazine advertising and aggressive discounting”.

What is the basis for these news reports?

The reports were based on a special edition of the journal Clinical Risk, which featured several articles on the issues surrounding cosmetic surgery. These issues include the potential for physical and psychological harm, and the need for tighter regulation of the industry, better training programms for surgeons and measures to improve patient experience.

Nigel Mercer, president of the British Association of Aesthetic Plastic Surgery, wrote an accompanying editorial arguing that the availability of consumer credit and a change in public attitudes has led to an explosion in cosmetic surgery in recent years. According to Mercer, this growth, combined with increasing public expectation and media hype, has resulted in “the perfect storm in the cosmetic surgical market”.

What is cosmetic surgery?

Cosmetic surgery, sometimes called aesthetic surgery, was described by a doctor in the journal Clinical Risk as being “purely elective, a lifestyle choice undertaken to enhance physical appearance, improve self-esteem and boost confidence”. Another doctor says that it differs from all other forms of surgery in that it is a treatment for “want” rather than for “need”.

In the 2005 Regulation of Cosmetic Surgery report, published by the Department of Health, cosmetic surgeries are defined as “operations and other procedures that revise or change the appearance, color, texture, structure or position of bodily features, which most would consider otherwise to be within the broad range of ‘normal’ for that person”.

Cosmetic surgery differs from plastic surgery, which is generally surgery to repair or reconstruct tissue or skin damaged by congenital (inherited) disease, injuries or burns. The primary role of plastic surgery is to restore function, and aesthetic improvement is secondary.

How is cosmetic surgery currently regulated in the UK?

At present, there are measures and standards to help regulate the industry but some cosmetic surgeons operate outside these regulations. Some treatments and procedures are unlicensed for cosmetic use, but can be given the discretion of doctors, or “off license”, by some clinics.

Surgical practice in the UK is regulated by the General Medical Council (GMC) and practicing surgeons should be enrolled on its specialist register. However, some concessions are made for private cosmetic surgeons who have been practicing since before April 2002. By satisfying certain criteria, these doctors can practice without the need to be on the specialist register.

Invasive cosmetic surgery and laser treatments are also regulated under the Care Standards Act 2000. The Healthcare Commission inspects all registered establishments that carry out invasive procedures and laser surgery in the UK, and has the power to revoke practice licenses and to take enforcement action.

Some cosmetic surgical procedures are not covered by current regulations, such as Botox, Restylane, and Juvederm injections and injections of aesthetic fillers. Botox is not licensed for cosmetic use, but it can be prescribed “off license”, in which circumstances the doctor assumes liability for its use. Most fillers are tested in the UK as “devices” rather than as drugs. This means that they are regulated based on the standard of their production and not on whether the treatment works.

The Department of Health report concluded that the regulatory situation for cosmetic surgery was not satisfactory because of the group of doctors who can practise without being on the GMC specialist register and the lack of clarity around the definition of “fillers”. Although practitioners of cosmetic surgery must demonstrate certain competencies, these may not be the equivalent standard of NHS consultants.

What do these journal articles say about cosmetic surgery?

The authors of these articles have argued several opinions, including that:

  • Patient psychology should be considered by clinical staff as issues of mental health and body image may be behind the desire for cosmetic changes. These could also arise in people who feel disappointed or upset by the results of their surgery.
  • Surgeons should keep records detailing their patients’ expectations and provide them with guidance on whether these are realistic.
  • There are risks associated with any type of surgery and patients should be informed of these and their surgeon’s success rates when considering procedures.
  • It is important that patients are given time to consider their options. Doctors should also inform patients about alternative treatments that may be available.
  • Before procedures are carried out, it should be clear who will be financially liable for the correction of any complications.
  • There may be some merits to adopting a regulation system similar to that in France. Under this system, patients must be given information on costs, risks and the surgeon’s qualifications to perform their selected procedures.
  • The way that cosmetic surgery is marketed should also be regulated.

What is the problem with plastic surgery marketing?

Mercer says that cosmetic procedures are often marketed using special offers, including vouchers, two-for-one deals and surgery holidays, and that these practices contribute to an “unregulated mess”. 

The articles also feature a call to ban advertising of cosmetic procedures, stating that, like tobacco, there should perhaps be a Europe-wide ban on advertising all cosmetic surgical procedures, including on internet search engines. While advertising can be powerful, says Mercer, it is often misused by the cosmetic surgery industry and misinterpreted by those it is aimed at.

Where can I find more information on reputable plastic surgeons?

The British Association of Aesthetic Plastic Surgery is a not-for-profit organization based at the Royal College of Surgeons. It was established to advance the education and practice of cosmetic surgery for public benefit. While it is not a regulatory body, it has long been involved in giving the public information on the safety of cosmetic surgery.

Its research into cosmetic surgery tourism was discussed at a recent conference and its press releases highlight a number of dangers associated with unregulated procedures, including DIY injectable treatments available over the internet.

via nhs.uk

Filed under  //   botox   cosmetic surgery   plastic surger advertising   plastic surgery  

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Cosmetic surgeons demand ban on advertising... cosmetic surgery!

An estimated 100,000 cosmetic surgical procedures are performed in Britain each year, many by doctors who have had no specialist training in cosmetic surgery. In addition, hundreds of thousands of non-surgical procedures are done, including Botox for wrinkles and laser treatments to rejuvenate skin, many by non-medical staff with little or no training.

The 200-member Baaps represents the top surgeons in the business who performed 34,187 surgical procedures in 2008, twice the number in 2004. More than 90 per cent of them were on women. The most popular procedure was breast augmentation, demand for which rose 30 per cent last year.

But Mr Mercer, who combines private practice as a cosmetic surgeon specialising in facelifts with his work as an NHS consultant in reconstructive surgery for cancer patients, said the market for cosmetic surgery, of which Baaps surgeons account for less than one third, was an "unregulated mess".

He added: "There has been a massive increase in marketing, including discount vouchers, two-for-one offers and holidays with surgery. In no other area of medicine is there such an unregulated mess. What is worse is that national governments would not allow it to happen in other areas of medicine. Imagine a two-for-one advert for general surgery. That way lies madness."

Mr Mercer, in the journal Clinical Risk, which publishes articles on cosmetic surgery today, he warns that "the doctor's first duty to protect the patient" has been forgotten in the headlong rush to cash in. "The motive for performing any procedure must never be financial gain ... if we cannot self-regulate then regulation will eventually be imposed."

Citing experience in France, where all advertising of cosmetic procedures is banned, he says: "Perhaps, like tobacco, there should be a Europe-wide ban on advertising all cosmetic surgical procedures, including on the internet search engines."

Among those who can testify to the dangers is Jill Saward, the former lead singer of 1980s group Shakatak, who last year agreed to a facelift in the hope of reviving her career after her divorce. But she suffered complications aggravated by her high blood pressure and bitterly regretted the decision. Three months after the operation she still did not have full feeling and was warned full recovery could take a year.

"Surgery is not a quick-fix solution," she said. "The simple truth is that I could have died. I was an idiot, I should have thought much more carefully about the operation and its dangers. It was pure vanity."

Foad Nahai, president of the International Society of Aesthetic Plastic Surgeons, backed Mr Mercer's warning, and called for tougher regulations to prevent doctors practising without specialist training. A code of practice backed by self-regulation of cosmetic clinics was announced by the Government in 2007. Clinics are also subject to inspection by the Care Quality Commission. But Baaps says the measures do not go far enough.

Filed under  //   Medical Spa   cosmetic surgeon   cosmetic surgery   plastic surgeon   plastic surgery  

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iPhone Plastic Surgery

Have you ever wondered what you would look like with bigger breasts or poutier lips? Now you can find out using a simple app made for the iPhone. There are now two plastic surgery applications for the Apple iPhone that offer users information, games and the chance to see what they would look like with a face lift, new nose, and many other procedures.

The firs plastic surgery app - The Shafer Plastic Surgery App - launched in October. It's the first app of its kind amongst Apple's 85,000 offerings in the iPhone App Store. It was created by Dr. David Shafer of New York, and taps into more than 1,000 questions and answers about specific cosmetic procedures.

The second iPhone plastic surgery app will soon hit the iPhone App Store, and it's called "iSurgeon". iSurgeon was developed by Miami cosmetic surgeon Dr. Michael Salzhauer, who is also well known for authoring the 2008 book "My Beautiful Mommy" - a book aimed at helping 4 to 7 year old children cope with their mother's plastic surgery.

iSurgeon will feature a fun game mode that allows users to try their hand at surgery, giving people the chance to instantly modify images of themselves or their friends through breast augmentations, lip enhancements and dozens of other procedures.

The Shafer Plastic Surgery App is available for $2.99. iSurgeon will be free during its first month of release later in November.

Nice to see that your iPhone can manage more than just phone calls from your plastic surgeon or medical spa.

Filed under  //   Medical Spa   plastic surgeon   plastic surgery  

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Avoid A Facelift: Medical Spas, Laser Clinics, Skin Clinics & Laser Treatments.

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Facelifts have become a common cosmetic surgery for men and women. But surgery patients face a number of unwanted effects. Scarring, extensive recovery time, that artificial "stretched" look, and a permanent result that may be unwanted.

Fortunately, newly developed medical alternatives offer results to people wanting look younger without going under the knife.

As a leader in non-invasive cosmetic medicine, many medical spas, laser clinics and skin clinics now specialize in innovative new medical treatments for a youthful lift without the messy and painful recovery. Some medical spas have developed a unique non-surgical facelift for patients looking to gain the dramatic results of a surgical facelift but avoid a surgical facelift. Non-surgical facelifts include Thermage or Fraxel Skin Tightening followed by their signature Surface Point Lift as the non-invasive, yet exceptionally effective substitute for any surgical facelift. (Botox is also used.)

Thermage is an FDA approved radio-frequency technology that has been proven to tighten and contour the skin and its many underlying tissues without surgery. The treatment has the added benefit of stimulating the growth of new collagen throughout the skin. But there's a caveat. Thermage results are highly dependant upon the way the treatment is administered. Surface has developed specialized protocols that produce results that attract patients from other areas of the country who are looking to achieve maxim results.

Nonsurgical facelifts can be just as spectacular.

Point Lifts were created by specialists in non-surgical cosmetic medicine to replace the traditional invasive facelift. It can also be used for brows, jaw lines, necks, breasts, and even the derriere. They're perfect for the patient who does not want to undergo the harsh effects of a traditional surgical facelift including the associated, frustrating recovery period. Point Lifts are a physician procedure that "lifts" the treatment area in exactly the same was as surgical lifts, only there's no surgery.

The procedure involves placing a small, special suture under the skin through a tiny needle hole, leaving the skin to smooth with its own tension. The theme here is "No cutting. No stretching. No Stitches. No scars!" Most importantly, Point Lifts will not leave the face with that "stretched look" of traditional surgical lifts. Patients can resume their normal activities immediately with only minimal discomfort. Best of all, Point Lifts are completely reversible. Most people never knew they could have a fresh, younger lift without the troubles of surgery.

Filed under  //   cosmetic surgery   facelift   featherlift   laser clinic   laser treatment   medical spa   plastic surgery   pointlift   skin clinic   swiftlift   thermage  

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