Now that the holidays are over, the media is once again concentrating on the proposed congressional healthcare bill. One of the components of that bill is a federal surtax on cosmetic procedures—surgical and non-surgical. This is considered a “vanity tax” which allegedly will help to pay for insuring the uninsured. The perception is that only wealthy people go to plastic or cosmetic surgeons and thus it is their responsibility somehow to partially bear the burden of insuring the uninsured millions. However, information gathered by the American Society of Plastic Surgery has revealed that not only are 91% of cosmetic patients women, but that 60% of these women earn between $30,000-$90,000 yearly. The desire to look good and feel good about oneself is hardly limited to the wealthy upper classes. New procedures, especially non-surgical procedures such as Botox and fillers, fit the budgets of many individuals and cosmetic surgery patients no longer reflect only the rich and privileged in our country.

The Society is protesting this tax primarily on the basis that it singles out one demographic in our society and places an unfair tax burden on them. With much debate going on in Washington at the moment, we will not have to wait long to learn whether this “vanity tax” on cosmetic procedures will be included in the bill or not.

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.