After years of having only one wrinkle relaxer available for use in the U. S.—that is, Botox, the FDA has now approved a new wrinkle relaxer called Dysport. Like Botox, Dysport is FDA approved only for use in the frown line area. However, as with Botox, Dysport has shown itself to be useful in what is called in the industry “off-label uses”. In the facial area, wrinkles in the forehead, “crow’s feet” wrinkles at the corners of the eyes, and even the fine lines around the mouth—”smoker’s lines”, can be relaxed and made to appear less prominent with Dysport. However, while both Dysport and Botox are effective in reducing wrinkles, keep in mind that they may differ as to the length of time before results are seen as well as the length of time the results will last. As always, the amount of the product used should be tailored to each patient and not be administered “cookbook-style”. The amount of product needed to achieve a good response differs with each patient. Some patients need more than the recommended amount of wrinkle relaxer (for example, men often need more units than women in the same facial areas), while others can achieve a good result with less.

Dysport has been promoted as a cheaper alternative to Botox, but as always, “buyer beware”. Patients need to be careful when comparing fees as a cheaper price may simply mean using less units of the product. An inadequate dose equals an inadequate response! Cheaper is not always better and it remains to be seen if the test of time will reveal differences in performance between Dysport and Botox which will ultimately lead phyicians to choose one over the other.

Anger, frustration and disbelief is often heard in the voices of those who inquire about corrective surgery after bypass surgery. After their surgery with its quick and dramatic weight loss, individuals are often left with loose, sagging skin in their breasts, upper arms, thighs, abdomen, and flanks. Just when they are feeling more confident and good about themselves, they look in the mirror and see extra skin hanging off multiple parts of their bodies. Unfortunately, they are often under the assumption that because their health insurance paid for the gastric bypass surgery, it will pay for the cosmetic surgery needed afterwards. Their disappointment and frustration arises when they find out—-

A. Health insurance will not cover these procedures as they are considered “cosmetic” and not medically necessary.

B. Most patients need several corrective procedures to get the results they desire.

For example an abdominoplasty (tummy tuck) is often needed but with the addition (and added expense) of a circumferential (that is–recontouring around the entire waist/abdominal area)technique is needed. Breast surgery such as breast augmentation or mastopexy (breast lift)is often needed and in many cases, both procedures are required. Body contouring procedures such as thigh lift, body lift and liposuction of various areas are often also necessary to achieve the look the patient desires.

C. And most importantly, the patient often finds that these procedures are costly as they should be performed only by board-certified plastic surgeons with expertise in these areas.

These procedures take years of training and experience to master and should always be performed by accomplished plastic surgeons under general anesthesia in a certified facility.

See before and after pictures