News from Cosmedical
We like to provide our patients with
the most up-to-date information available about the various procedures
we provide. In addition, we like to educate our patients about
the various issues in the field of plastic surgery.
Please click on the
title, below, for the complete article:
Liposuction Breast Reduction Article Recently Published
February 2007
We are pleased to announce that Sherwood Baxt, MD just had his article "Liposuction Breast Reduction: a Prospective Trial in African American Women" published in the Plastic and Reconstructive Surgery Journal, February 2007. Dr. Baxt has been one of the pioneers performing this surgery and has performed this surgery on over 600 Patients. Click here to read the press release.
Tel: 201-265-1300 Ext. 6
Dr. Baxt Selected To Host National Teaching Seminar On SmartLipo™
January 19, 2007
Sherwood Baxt, MD has been selected by Cynosure to host a national teaching seminar regarding SmartLipo/Laser Liposuction at our office on Friday, January 19, 2007. Other doctors from around the country will be in attendance, learning the technique using laser liposuction. Dr Goldman from South America will be present. He has been using the laser liposuction for over 7 years and has been instrumental in developing the technology for Cynosure. This technique has been used worldwide for approximately the last 7 years and recently received FDA approval for use in the United States.
Tel: 201-265-1300 Ext. 6
First MD In New Jersey Selected To Own SmartLipo™
We are delighted to tell you that
Sherwood Baxt, MD will be the first MD in New Jersey selected to own
the recently FDA approved SmartLipo™ from Cynosure for laser body
sculpting. We have followed the evolution of this technology for
years. It will allow small areas to be treated under local anesthesia
with virtually no down time.
SmartLipo™ provides a minimally invasive
procedure that is less traumatic than conventional liposuction
methods. The laser tissue interaction produces less swelling and
faster healing time. The other unique feature of this laser is that it
will provide skin tightening over the area being treated. Please call
today to schedule your consultation.
Tel: 201-265-1300 Ext. 6
Fall
2006 Newsletter
We at Baxt Cosmedical are always
incorporating new treatments and procedures into our practice to get
the best results for our patients. We have been selected to be a
Juvederm test site prior to the January 2007 national launch of this
new hyaluronic acid product for filling lines and wrinkles on the
lower face. This product will be available to all of our patients in
January, so make sure you are on our email list and watch for an
announcement!
We are very excited about the results
our patients are getting with Photodynamic Therapy (PDT). It is FDA
approved for treating precancerous spots on the face, but it works
well for acne also! PDT is done in a quick office visit, there is no
discomfort at all. We place a solution on your face for a few minutes,
and then shine a light on the face for approximately 10 minutes. You
need to avoid the sun for 2 days after the treatment.
Make sure we have your email address so
we can let you know about the latest and greatest treatments, and
promotions! You can also check our website for information on many
procedures and helpful links. We look forward to seeing you soon in
our office. Call for your appointment today 201-265-1300.
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November 30, 2006
More
Doctors Turning to the Business of Beauty
By: Natasha Singer
In her three years as an obstetrician
and gynecologist in Brooklyn, Dr. Ngozi Nwankpa-Keshinro delivered
several hundred babies, conducted several thousand pelvic exams and
diagnosed everything from infections to infertility. But this year,
with a little additional training, she has entered a new field:
cosmetic medicine.
Skip to next paragraph Enlarge This
Image
Brica Wilcox for The New York Times Dr.
Ngozi Nwankpa-Keshinro turned to cosmetic medicine after three years
in obstetrics and gynecology. “When you clear up someone’s acne or
facial hair, they are as grateful as if you delivered their baby,”
she said. As one of the owners of a medical spa in Brooklyn that
opened in January, she has given dozens of clients Botox injections to
relax their wrinkles and Restylane injections to fill out their smile
lines and plump their lips.
“The two fields are as alike as an
apple and an orange,” Dr. Nwankpa-Keshinro said. “One can be
lifesaving, while the other is not. But when you clear up someone’s
acne or facial hair, they are as grateful as if you delivered their
baby.”
Cosmetic medicine also provides a more
relaxing lifestyle, she said. “And it’s very satisfying.” ...Read
More
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May 24, 2005
How
to Save Your Skin in the Season of Sun
By: Jane E. Brody
Catherine M. Poole, author with Dr.
DuPont Guerry IV of "Melanoma" (Yale University Press,
$16.95) and herself a melanoma survivor, urges parents to set a good
example by adopting sensible sun behavior and making sun protection as
automatic as fastening a seat belt.
Skip to next paragraph More Columns:
Personal Health "A person who has a history of severe sunburns as
a child or teenager is at an especially high risk for the development
of melanoma," Ms. Poole wrote. "Even just one or two bad
sunburns can increase the risk of melanoma in later life."
Everyone in the family should be using
sunscreen with an S.P.F. of at least 15 on exposed skin all year long.
Babies should always be kept out of the sun, and toddlers, older
children and adults should be well protected with hats and clothing or
sunscreen.
Most people who use sunscreen don't use
enough. It should take an ounce of lotion to cover an adult in a
bathing suit. Sunscreen should be applied about 20 to 30 minutes
before going out and reapplied on dry skin after swimming
("waterproof" screens are helpful, but not enough once
you're out of the water).
Look for sunscreens that protect
against both UV-A and UV-B rays. All sunscreens contain substances
that block the UV-B rays that cause sunburn (the S.P.F. rating refers
only to these agents). The most effective protection against
skin-damaging, cancer-causing UV-A rays comes from zinc oxide, Parsol
1789 (avobenzone) and Eusolex 8020, Dr. Kaufman reported. Some UV-A
protection is afforded by titanium oxide, oxybenzone and dioxybenzone.
Some experts have theorized that
sunscreens can actually promote melanomas and skin damage by
increasing the time people can spend in the sun before they burn, but
no studies have yet shown this. It should not happen if people are
careful to use sunscreens that block UV-A as well as UV-B rays.
Melanomas can also develop on the scalp
and in the eyes, so don't forget a hat and sunglasses, and on the
lips, which should be protected by sunblocking lip balm or lipstick.
Be sure to protect your skin on cloudy days, too, since clouds do not
filter out UV-A radiation.
People at the greatest risk of
developing melanoma, those with fair complexions who burn and freckle
readily, are also at high risk of developing superficial skin cancers.
People with a large number of moles and those with melanoma in close
relatives are also at increased risk.
Last year in "The Melanoma
Letter" published by the Skin Cancer Foundation, Dr. Marie-France
Demierre of Boston University School of Medicine
described the growing evidence for statins as a protector against
melanoma.
These cholesterol-lowering agents
interfere with the action of two oncogenes, mutations in Ras and Rho
proteins, that play a role in the development of melanomas. Laboratory
studies also suggest that statins may promote programmed cell death
and thus may be useful as therapy for melanoma patients.
But the wise person who ventures
outdoors would not rely on such chemoprotection at this point.
Sensible behavior in the sun provides the best protection, and only
you can apply it.
For more information, a helpful book is
"Sun Protection for Life" (New Harbinger) by Mary Mills
Barrow and John F. Barrow.
Our September
Newsletter
Liposuction (Scarless)
Breast Reduction
The Liposuction, or Scarless, Breast
Reduction has proven to be one of the most satisfying new procedures
performed at CosMedical NJ. It has truly revolutionized the treatment
of many patients with large breasts.
Most women with large breasts complain
of upper back and neck pain, along with severe grooves from their bra
straps and skin infections on their chest skin. The excess weight of
the large breast also causes the breast to sag with the nipple area
often pointing towards the floor. The traditional method of correcting
these problems involves surgery to remove extra skin, fat, and breast
gland while repositioning the nipple complex higher on the chest. This
operation corrects the problems caused by the extra weight and
repositions the nipple at the same time. The major downside of the
traditional operation is that it places a series of scars on the
breast itself. In some cases these scars heal very well while in
others, especially dark-skinned individuals, the scars can be
noticeable for life.
The Scarless Liposuction Breast
Reduction was developed because surgeons realized that the breast is
composed mostly of fat and this fat can be removed with safe and
proven liposuction methods. The early published reports on the
operation limited its use to those patients with little sagging
because it was felt that the operation could not correct sagging
adequately.
Innovations over the past few years
have, however, opened the operation to many more women. The greatest
innovation has been an increased awareness about what women want and
do not want from their breast surgery. Many women with large breasts
want the weight reduced and are not concerned about sagging. They have
always worn a bra and will continue to do so. They are happy to go
from a DDD to a C/D cup and reduce or eliminate their pain. They want
to be able to fit into normal clothes. They want to be able to engage
in sports and exercise normally. They do not, however, want a series
of scars placed on their chest and a recovery time of several weeks to
months.
The Scarless Breast Reduction uses a
small, ¼ inch incision under each breast through which a small tube (cannula)
is placed to remove the fat by suctioning. The milk glands, ducts,
nerves, and blood vessels, are left intact. The operation is done in
the office, rather than in a hospital, and in most cases takes about
one hour. Patients go home the same day and can usually get back to
work in 3-5 days. Full exercise can usually be performed within 2-3
weeks. Some bruising usually persists for 3-4 weeks and the breasts
are usually lumpy for 2-6 months. As the breasts heal, the skin
tightens and the breasts lift. The amount of lift depends on the skin’s
elasticity. Patients without stretch marks with good skin-tone will
often have a great lift, while in other patients the lift may be more
modest. In either case, as long as the patient understands that the
main reason for the surgery is to relieve the weight of the breasts,
they are very happy with the results. Most patients reduce their bra
size by 1-3 cup sizes.
The scarless breast reduction is
applicable to many patients, but not everyone. If sagging is a patient’s
main concern the operation may not be for them. There are also some
breast conditions that are better treated with a traditional
reduction.
NEXT MONTH:
Computer Imaging and Other Pre-Surgical Techniques
Please review our website for more
information and pictures and then call us at 201-265-1300.
We look forward to meeting you!
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January 25, 2002
Lipoplasty Becomes Safer
as Less Fat Is Removed
By SHARI SIMS
Cindy Laney, a former aerobics instructor,
often runs five miles and lifts weights. "But I always had these
bulges around my middle that no amount of dieting or exercise would get
rid of," she says.
This year, Ms. Laney, 36, decided to have
liposuction surgery. She had about four pounds of fat sucked from her
midsection and says she is thrilled with the results.
For the last five years, lipoplasty, as
liposuction is now medically termed, has been the leading cosmetic surgery
procedure in this country, with 385,000 procedures last year. People 35 to
50 have the most procedures. Women represented a vast majority, but men
made up 20 percent of the total last year, according to the American
Society for Aesthetic Plastic Surgery.
Most patients have an average of five
pounds removed. Over the last several years, the operation has become
safer, in part because smaller amounts of fat are removed. Most people can
return to work within a week and begin light exercise in two weeks or so.
Swelling usually goes down in about a week; bruising and some numbness
generally last about three weeks.
The risk of death, which in 1998 was 1 in
5,000, dropped to 1 in 47,415 from 1998 to 2000, according to results of
more than 94,000 procedures reviewed in the March/April 2001 issue of
Aesthetic Surgery Journal. Surgeons' reports suggest complications have
dropped as well; in the survey, the most common minor side effect was
postoperative nausea or vomiting, while the most frequent major
complication was skin peeling around the treated area.
Surgeons no longer routinely combine
lipoplasty with other major surgery, says Dr. Charles Hughes III, a
plastic surgeon in Indianapolis and the author of the journal article.
Smaller surgical tools with ultrasound
attachments that break down the fat before it is suctioned away have also
made the procedure safer.
Recently, some doctors have suggested that
lipoplasty can be a valid treatment for the "medically
overweight." In studies presented at meetings and published late last
year, some plastic surgeons said "large-volume lipoplasty"—
the "vacuuming out" of roughly 10 pounds of fat — could be
done safely and effectively. One group reported that the operation could
produce significant decreases in systolic blood pressure, fasting insulin
levels and total body weight that could possibly "improve overweight
women's cardiovascular risk profile."
Those last claims were based on a
relatively small study, focused on one-year follow-ups of 14 women who had
liposuction of their abdomens, flanks, backs and inner and outer thighs at
Georgetown University Medical Center. "These were basically healthy
women who were 30 to 50 pounds overweight, with a body mass index from 25
to 29.9, below the medical cutoff for obesity," said Dr. Sharon Y.
Giese, senior author of the study.
Others question whether it is the surgery
alone that is leading to better health.
"Is removing fat surgically just as
good for your health as via diet and exercise?" said Dr. Samuel
Klein, director of the Center for Human Nutrition at Washington University
in St. Louis. "That's an open question that's not answered in this
study."
Research suggests that the metabolic
benefits of weight loss come from losing fat throughout the body,
including areas like the tissues of the heart, pancreas and liver.
Removing localized fat deposits may or may not be as beneficial.
Dr. Gerald H. Pitman, a plastic surgeon in
New York and the author of one of the most widely read textbooks on
liposuction, said: "I always say that the three most dangerous words
in plastic surgery are `it's only liposuction.' In well-trained hands on a
carefully selected patient, lipoplasty is safe surgery. But the bottom
line is it's still surgery."
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January 25,
2002
VITAL SIGNS
Remedies: Wrinkles Gone. Headache, Too?
By JOHN O'NEIL
A number of studies presented at the
American Headache Society's conference in Seattle last week added evidence
that shots of Botox, botulinum toxin type A, could help with migraine and
tension headaches.
A total of 13 studies involving 650
patients were presented about Botox, which began to be investigated after
the patients of plastic surgeons started reporting that shots to remove
wrinkles were clearing up chronic headaches as well.
A study at the Houston Headache Clinic
found that migraine patients reduced their use of headache drugs by up to
75 percent after Botox shots. In a study at Baylor College of Medicine in
Houston, half of patients with chronic tension headaches reported
improvement three months after Botox shots, compared with 7 percent of
those given placebo injections.
Another set of studies presented at the
conference suggested that users of traditional drugs for migraines were
better off taking them at the first sign of a headache, rather than
holding off to see if the pains went away by themselves.
These studies involved triptans, a common
class of migraine drugs. In a study conducted at the Harvard Medical
School, triptans were given to 23 patients before their migraines moved to
the point that they developed skin hypersensitivity, pain caused by
touching their hair or scalps. The drugs eliminated all but two of the
headaches, the study found. But when treatment was delayed until the skin
became hypersensitive, the drugs worked in only 3 of 28 cases.
In another study, at the Palm Beach
Headache Center, about two-thirds of patients given triptan within two
hours of the start of the migraine said they were pain-free four hours
later, compared with fewer than a third of patients given placebos.
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July 14,
2002
That
Quest to Enhance Beauty Can Leave Scars
By SANA SIWOLOP
Like so many others, Katie O'Hara, a
nursing student at Sacramento State University in California, was looking
to enhance her appearance when she visited a day spa two years ago. In her
case, she wanted to remove a chain of flowers that she had tattooed around
her left ankle. (She never really liked it, she explained.)
She said she was considering laser
treatment by a physician but that an aesthetician at the spa persuaded her
to try a chemical peel, arguing that it was a superior method and less
expensive. Ms. O'Hara, who is 27, said she never went past the first stage
of treatment: less than two days after the aesthetician applied the peel
to a small portion of the tattoo, her foot began to swell, she was unable
to walk and, within a week, she was in a hospital emergency room. Had she
waited much longer to seek medical attention, she said the attending
physician told her, her foot probably would have had to be amputated.
Ms. O'Hara's story is startling but not
entirely unusual. Doctors and health officials around the country say that
a growing number of medically complex cosmetic procedures are being
offered in beauty salons, day spas and some nurses' clinics. And
sometimes, they say, the procedures are performed by unlicensed or
unqualified people, increasing the chances of something going wrong.
The procedures include some that many
consumers assume are relatively simple — Botox and collagen injections
for wrinkles, for example. Others are more complicated — like laser
treatments, chemical peels and microdermabrasion, an intense spray of tiny
crystals. Experts say many procedures are being falsely advertised —
often at seemingly low prices — to consumers who are assured that a
licensed physician will be supervising the procedure, when, in fact, that
may not always be the case.
"This is a pervasive problem,"
said Dr. Roy G. Geronemus, a clinical professor of dermatology at the New
York University School of Medicine. He said he knew of one Manhattan day
spa whose medical director is based in the Hamptons and not often on the
premises.
In Florida, Enrique T. Torres, chief
investigator for the Florida Department of Health, estimates that half the
74 arrests that his department has made since 1998 for people operating
without medical licenses have been for those offering fairly complicated
cosmetic procedures, including plastic surgery. But he said that was the
tip of the iceberg. The arrests, he said, are "absolutely nothing
compared to what is out here in the state," because too many
consumers "are looking for a cheap way out."
State officials elsewhere agree. Joseph
Tepedino, a supervising investigator for the Office of Professional
Discipline of the New York State Department of Education, says his office
is increasingly asked to investigate complaints about medically
unqualified individuals and businesses promoting cosmetic procedures,
especially on the Internet.
The Medical Board of California has been
working for the last year with the California Society of Dermatology and
Dermatologic Surgery, a professional group, to track cosmetic procedures
that are supposedly performed or supervised by licensed physicians but are
not. Jerome R. Potozkin, the society's president, said one concern was the
growing number of nurses who supposedly partner with physicians to set up
cosmetic practices, at least on paper. Sometimes, he said, the nurse
happens to be married to the doctor in question.
By law, nurses in California, as in many
other states, are not permitted to set up a medical practice without the
direct supervision of a physician. But Dr. Potozkin said he knew of at
least one nurse-owned company, which he declined to identify, that was
trying to do just that, mostly by sponsoring workshops for other nurses
around the country. The goal of the workshops, he said, was to lure other
nurses into the business. He said they are told that they need only attend
a one- or two-day course before they, too, can set up lucrative practice
offering cosmetic procedures like Botox injections, laser skin
rejuvenation and sclerotherapy, which uses an injected solution to reduce
the size of spider veins or small varicose veins.
"These are things that take years to
learn, not just a day or so," Dr. Potozkin said.
Physicians maintain that even seemingly
quick Botox injections — which the Food and Drug Administration approved
three months ago for minimizing frown lines — can cause complications
like eyelid or brow droop, double vision and paralysis of other muscles in
the face if they are performed incorrectly.
"Botox should not be taken
lightly," said Dr. Harold J. Brody, a clinical professor of
dermatology at the Emory University School of Medicine in Atlanta.
"You have to know facial anatomy, which is very complex and not
something that a beautician, cosmetologist or even a registered nurse is
trained to do."
Medical experts say they are also concerned
about laser procedures that are used to remove unwanted body hair,
birthmarks and scars, as well as to smooth out lines and wrinkles.
Improperly administered, lasers can cause burns, splotching or
irreversible pigmentation changes and scarring. (People with tans, for
instance, are not good candidates for laser hair removal.) Consumers who
are treated by nonphysicians may not be properly diagnosed for serious
conditions, including skin cancers, experts say.
The American Society for Dermatologic
Surgery, a professional group based in Rolling Meadows, Ill., a Chicago
suburb, said 45 percent of its 2,500 members surveyed recently reported an
increase in the number of patients they have treated over the last year
for complications from cosmetic procedures, including laser treatments.
Mr. Tepedino, the New York State
investigator, estimated that over the last year alone, his office received
about three dozen complaints about laser hair removal procedures in New
York City, with most of the complaints directed toward beauty salons and
spas. Previously, he said, his office typically received few if any
complaints in a year.
Seventeen states currently have no laws
specifying who can administer laser-based cosmetic procedures. Fourteen
states, including New Jersey, now require that lasers be used only by
licensed physicians, while nine states, as well as the District of
Columbia, allow physicians to delegate laser use if a licensed doctor is
on site. The remaining 10 states, including New York and Connecticut, let
doctors delegate laser use at their discretion.
According to the dermatologic trade group,
a physician may delegate certain cosmetic procedures, including laser hair
removal and microdermabrasion, to certified or licensed office personnel
like registered nurses, physician assistants and nurse practitioners. But
the supervising physician must be present when the procedure is being
done. The society says it does not recommend that physicians delegate any
procedure that involves injecting a substance into the skin, like Botox or
collagen.
Consumers can obtain more information at
the society's Web site, www.aboutskinsurgery.com.
The Spa Association, a trade group based in
Fort Collins, Colo., which has more than 1,800 members that include spas
and wellness centers, says it is also opposed to aestheticians and spa
employees providing consumers with Botox and collagen injections, as well
as laser procedures that require anesthesia. Melinda M. Minton, the
association's executive director, said that while all 50 states and the
District of Columbia require aestheticians to be licensed, each state has
different educational requirements, ranging from 300 to 1,500 hours of
combined classroom and practical training.
But schools for aestheticians also vary in
the amount of medical training that they require, Ms. Minton said. Her
group, whose Web site is www.thespaassociation.com, advises consumers to
seek out paramedical aestheticians, who are trained to assist physicians
and who typically receive more training in areas like emergency procedures
and hygiene.
Health officials advise consumers
considering cosmetic procedures to check first with their state agency
that oversees cosmetology, to see if particular individuals or businesses
are licensed, as well as whether any complaints have been lodged against
them. But they also caution consumers to steer clear of day spas or salons
that offer procedures at seemingly cut-rate prices — for example, Botox
injections in urban areas that are priced at $250 or less, sharply
undercutting the standard fee of $350 to $500. In those cases, the low
price may mean that the Botox is watered down, so its effects may not last
as long or may even raise the risk of complications.
The dermatologic society recommends that
consumers ask about possible side effects of medically complex cosmetic
procedures and about the number of times a procedure has been performed by
a particular person. For laser-based procedures, the society says
consumers should ask whether the laser system is appropriate for their
skin type, hair color, complexion and body area.
MS. O'Hara, the nursing student who was
trying to have a tattoo removed, can now recall some red flags when she
was having her chemical peel. Before her procedure, she said, her
aesthetician asked her not to scream, to prevent anyone in the waiting
room from becoming disturbed. To remove the tattoo, she said, the
aesthetician used both a chemical peel and a pumice stone and
"scrubbed it until it was raw," and hurt. She said the attending
physician at the emergency room suspected that her infection resulted from
unsterile conditions.
Ms. O'Hara eventually sued the aesthetician
for negligence, though, she said, she settled her case out of court last
fall for $2,000. Even so, she still bears a scar at the site of the tattoo
removal, something that should not have occurred. Ms. O'Hara says she is
now seeing a physician to have the rest of the tattoo removed with a
laser; so far, she said, that procedure has not produced any scarring.
Rick Lopes, a spokesman for the California
State Bureau of Barbering and Cosmetology, finds such cases worrisome.
"Beauty should not hurt," he said. "If something is
painful, then either that person is performing something incorrectly, or
they're going beyond the scope of what they're licensed to do."
