Aesthetic Dermatology

The Donda West Law protects patients.

On Oct. 11, 2009, California Gov. Arnold Schwarzenegger signed into law a bill requiring a health check and a written clearance before patients can undergo plastic surgery. Assembly bill 1116, the Donda West Law, was inspired by the death of entertainer Kanye West's mother, Donda West, who was the former chairwoman of the Chicago State University English department. She died on Nov. 10, 2007, because of complications from cosmetic surgery. A physical was not performed before she underwent surgery.

There are a growing number of people opting to have elective cosmetic surgery who may not be aware of the risks involved. Sometimes patients may think they are well enough for surgery, but they are not. Prior to the bill's approval, patients could undergo elective cosmetic surgery in California without having a physical. If the law would have been in effect before Donda West's surgery, she might still be alive.

Yolanda Anderson, the niece of Kanye West's late mother and one of my constituents, joined me in helping to pass this bill, and she is now working with legislators in other states to pass similar measures in her aunt's memory.

The law, which went into effect on Jan. 1, will protect citizens from unnecessary bodily trauma that could result from elective cosmetic surgery. Specifically, the law requires physicians and surgeons to complete a physical examination, including a complete medical history on their patients, prior to performing elective cosmetic surgery.

As the price comes down for cosmetic surgery and the stigma of undergoing elective procedures disappears, cosmetic surgery is becoming more accessible. Aggressive marketing of procedures has led people to believe that they are safe and makes the risks seem almost nonexistent. This measure will make people more aware that there is an element of risk and that a medical clearance is critical.

The Donda West Law strikes an appropriate balance between the patient and the surgeon. It will protect both from harm: the patient from unnecessary bodily trauma, and the surgeon from having to deal with the injury or loss of a patient if he or she is not physically fit at the initial scheduled time of the elective cosmetic surgery.

By Wilmer Amina Carter (D-Rialto), a member of the California State Assembly and the sponsor of the Donda West Law.

The new law is 'feel good' legislation.

The Donda West Law smacks of good politics. A popular musician on the heels of a tragedy jumps into action to fix the system and to make sense of the senseless death of his mother. Politicians love the play. This is reelection gold. A movie plot could be no better. The real question is: Will it make a difference?

Sadly, the answer is probably not.

The law requires a history and physical examination of a potential cosmetic patient before surgery. I have been doing this routinely for over a decade. Will this make cosmetic surgery safer? If a physician needs to look at the law before doing the right thing, the patient is probably better off going to someone else. You cannot use legislation to make a better doctor.

An important issue not addressed by the law is that of medical clearance. Patients with multiple medical problems, or those who are in questionable health, should have medical clearance in addition to a history and physical examination. Knowing when to obtain this takes good judgment on the part of the physician. In the actual Donda West case, a prior consultant plastic surgeon reportedly wanted to have such an evaluation, which might have saved her life.

The new law allows the required history and physical to be performed by a physician, nurse practitioner, or a physician's assistant. The assumption is made that such an individual will know what to do with the results of the examination and, more importantly, when to go further in a preoperative evaluation.

Maybe the legislature will be kind enough to use their vast experience in clinical medicine to provide physicians with a flow chart to tell us what we need to do. Suffice it to say, I do not believe they understand clinical medicine well enough to produce effective law.

Medicine is already over-regulated, so what good does it do to add more regulation? It would be better to give physicians the tools to weed the incompetent out of health care. Our malpractice tort system just lines the pockets of the legal profession at a high price. Doctors know who the good and the bad in medicine are, but they are really unable to effect change. Instead of creating “feel good” legislation, how about addressing medicine's problems by means of real change?

By Dr. John Di Saia, a board-certified plastic surgeon in Orange County, Calif., and author of the “Truth in Cosmetic Surgery” blog at www.cosmeticsurgerytruth.com

The Donda West Law protects patients.

On Oct. 11, 2009, California Gov. Arnold Schwarzenegger signed into law a bill requiring a health check and a written clearance before patients can undergo plastic surgery. Assembly bill 1116, the Donda West Law, was inspired by the death of entertainer Kanye West's mother, Donda West, who was the former chairwoman of the Chicago State University English department. She died on Nov. 10, 2007, because of complications from cosmetic surgery. A physical was not performed before she underwent surgery.

There are a growing number of people opting to have elective cosmetic surgery who may not be aware of the risks involved. Sometimes patients may think they are well enough for surgery, but they are not. Prior to the bill's approval, patients could undergo elective cosmetic surgery in California without having a physical. If the law would have been in effect before Donda West's surgery, she might still be alive.

Yolanda Anderson, the niece of Kanye West's late mother and one of my constituents, joined me in helping to pass this bill, and she is now working with legislators in other states to pass similar measures in her aunt's memory.

The law, which went into effect on Jan. 1, will protect citizens from unnecessary bodily trauma that could result from elective cosmetic surgery. Specifically, the law requires physicians and surgeons to complete a physical examination, including a complete medical history on their patients, prior to performing elective cosmetic surgery.

As the price comes down for cosmetic surgery and the stigma of undergoing elective procedures disappears, cosmetic surgery is becoming more accessible. Aggressive marketing of procedures has led people to believe that they are safe and makes the risks seem almost nonexistent. This measure will make people more aware that there is an element of risk and that a medical clearance is critical.

The Donda West Law strikes an appropriate balance between the patient and the surgeon. It will protect both from harm: the patient from unnecessary bodily trauma, and the surgeon from having to deal with the injury or loss of a patient if he or she is not physically fit at the initial scheduled time of the elective cosmetic surgery.

By Wilmer Amina Carter (D-Rialto), a member of the California State Assembly and the sponsor of the Donda West Law.

The new law is 'feel good' legislation.

The Donda West Law smacks of good politics. A popular musician on the heels of a tragedy jumps into action to fix the system and to make sense of the senseless death of his mother. Politicians love the play. This is reelection gold. A movie plot could be no better. The real question is: Will it make a difference?

Sadly, the answer is probably not.

The law requires a history and physical examination of a potential cosmetic patient before surgery. I have been doing this routinely for over a decade. Will this make cosmetic surgery safer? If a physician needs to look at the law before doing the right thing, the patient is probably better off going to someone else. You cannot use legislation to make a better doctor.

An important issue not addressed by the law is that of medical clearance. Patients with multiple medical problems, or those who are in questionable health, should have medical clearance in addition to a history and physical examination. Knowing when to obtain this takes good judgment on the part of the physician. In the actual Donda West case, a prior consultant plastic surgeon reportedly wanted to have such an evaluation, which might have saved her life.

The new law allows the required history and physical to be performed by a physician, nurse practitioner, or a physician's assistant. The assumption is made that such an individual will know what to do with the results of the examination and, more importantly, when to go further in a preoperative evaluation.

Maybe the legislature will be kind enough to use their vast experience in clinical medicine to provide physicians with a flow chart to tell us what we need to do. Suffice it to say, I do not believe they understand clinical medicine well enough to produce effective law.

Medicine is already over-regulated, so what good does it do to add more regulation? It would be better to give physicians the tools to weed the incompetent out of health care. Our malpractice tort system just lines the pockets of the legal profession at a high price. Doctors know who the good and the bad in medicine are, but they are really unable to effect change. Instead of creating “feel good” legislation, how about addressing medicine's problems by means of real change?

By Dr. John Di Saia, a board-certified plastic surgeon in Orange County, Calif., and author of the “Truth in Cosmetic Surgery” blog at www.cosmeticsurgerytruth.com

The Donda West Law protects patients.

On Oct. 11, 2009, California Gov. Arnold Schwarzenegger signed into law a bill requiring a health check and a written clearance before patients can undergo plastic surgery. Assembly bill 1116, the Donda West Law, was inspired by the death of entertainer Kanye West's mother, Donda West, who was the former chairwoman of the Chicago State University English department. She died on Nov. 10, 2007, because of complications from cosmetic surgery. A physical was not performed before she underwent surgery.

There are a growing number of people opting to have elective cosmetic surgery who may not be aware of the risks involved. Sometimes patients may think they are well enough for surgery, but they are not. Prior to the bill's approval, patients could undergo elective cosmetic surgery in California without having a physical. If the law would have been in effect before Donda West's surgery, she might still be alive.

Yolanda Anderson, the niece of Kanye West's late mother and one of my constituents, joined me in helping to pass this bill, and she is now working with legislators in other states to pass similar measures in her aunt's memory.

The law, which went into effect on Jan. 1, will protect citizens from unnecessary bodily trauma that could result from elective cosmetic surgery. Specifically, the law requires physicians and surgeons to complete a physical examination, including a complete medical history on their patients, prior to performing elective cosmetic surgery.

As the price comes down for cosmetic surgery and the stigma of undergoing elective procedures disappears, cosmetic surgery is becoming more accessible. Aggressive marketing of procedures has led people to believe that they are safe and makes the risks seem almost nonexistent. This measure will make people more aware that there is an element of risk and that a medical clearance is critical.

The Donda West Law strikes an appropriate balance between the patient and the surgeon. It will protect both from harm: the patient from unnecessary bodily trauma, and the surgeon from having to deal with the injury or loss of a patient if he or she is not physically fit at the initial scheduled time of the elective cosmetic surgery.

By Wilmer Amina Carter (D-Rialto), a member of the California State Assembly and the sponsor of the Donda West Law.

The new law is 'feel good' legislation.

The Donda West Law smacks of good politics. A popular musician on the heels of a tragedy jumps into action to fix the system and to make sense of the senseless death of his mother. Politicians love the play. This is reelection gold. A movie plot could be no better. The real question is: Will it make a difference?

Sadly, the answer is probably not.

The law requires a history and physical examination of a potential cosmetic patient before surgery. I have been doing this routinely for over a decade. Will this make cosmetic surgery safer? If a physician needs to look at the law before doing the right thing, the patient is probably better off going to someone else. You cannot use legislation to make a better doctor.

An important issue not addressed by the law is that of medical clearance. Patients with multiple medical problems, or those who are in questionable health, should have medical clearance in addition to a history and physical examination. Knowing when to obtain this takes good judgment on the part of the physician. In the actual Donda West case, a prior consultant plastic surgeon reportedly wanted to have such an evaluation, which might have saved her life.

The new law allows the required history and physical to be performed by a physician, nurse practitioner, or a physician's assistant. The assumption is made that such an individual will know what to do with the results of the examination and, more importantly, when to go further in a preoperative evaluation.

Maybe the legislature will be kind enough to use their vast experience in clinical medicine to provide physicians with a flow chart to tell us what we need to do. Suffice it to say, I do not believe they understand clinical medicine well enough to produce effective law.

Medicine is already over-regulated, so what good does it do to add more regulation? It would be better to give physicians the tools to weed the incompetent out of health care. Our malpractice tort system just lines the pockets of the legal profession at a high price. Doctors know who the good and the bad in medicine are, but they are really unable to effect change. Instead of creating “feel good” legislation, how about addressing medicine's problems by means of real change?

By Dr. John Di Saia, a board-certified plastic surgeon in Orange County, Calif., and author of the “Truth in Cosmetic Surgery” blog at www.cosmeticsurgerytruth.com

As the Senate continued to debate the Democrats' health reform proposal, it was not clear whether a proposed 5% tax on elective cosmetic surgery, including injectables, would survive the floor fight and the eventual conference committee to reconcile the House and Senate bills.

Physician groups—not just dermatologists—have united in opposition to the tax, saying that it is discriminatory, and, they point out, it has proven to be an inefficient means of collecting revenue in the only state with such a tax.

Even so, the American Academy of Dermatology expects more states to look at a cosmetic tax as a potential revenue source this year, Dr. David Pariser, president of the AAD, said in an interview.

New Jersey has taxed elective cosmetic procedures since 2004, levying a 6% fee at the point of sale—the physician's office—but the state has had a 59% shortfall based on projected revenue estimates, according to the Stop Medical Taxes Coalition. The newly formed group, which is sponsored by Botox maker Allergan Inc., represents 22 medical organizations, the AAD, the American Society for Aesthetic Plastic Surgery (ASAPS), the American Society for Dermatologic Surgery Association, the American Association of Neurologic Surgeons, and the American Society of Breast Surgeons.

The American Medical Association also came out in opposition to the tax. In a letter to Senate Majority Leader Harry Reid of Nevada, the AMA said that it “strongly opposes taxes on physician services to fund health care programs or to accomplish health system reform.” The organization said that it was concerned that the exceptions outlined in the bill weren't clear enough or broad enough.

And, said the AMA, the tax could be expanded in the future to cover other health care items or services that might not be considered medically necessary.

The Stop Medical Taxes Coalition wrote to all 50 Senators in late November, outlining its objections. A chief argument: The tax would fall disproportionately on working women.

According to survey data collected by the American Society of Plastic Surgeons in 2005, about one-fourth of the women planning to have surgery in the next 2 years reported income of $30,000–$60,000 a year, suggesting that the tax would hit middle earners, not high-income women.

“This tax is effectively a 'Soccer Mom' tax that will adversely impact mainstream American wives and mothers, who are the majority of plastic surgery patients,” Dr. Renato Saltz, president of the ASAPS, said in a statement.

In a separate letter, the AAD said that the proposed tax would insert the government into the physician-patient relationship “in a new way,” partly because it would be in charge of determining what was medically necessary. Under the proposal's language, an HIV-infected patient with lipoatrophy might be taxed for seeking treatment for what is arguably a disfiguring condition, the AAD wrote.

Rather than tax these patients, the AAD suggests that the federal government levy tanning bed users.

“A federal tax on indoor tanning could deter individuals, especially young people, from the practice,” Dr. Pariser said.

In New Jersey, the tax has led to patients choosing not to have procedures, and it has driven them to seek treatments in neighboring states, said Dr. David Goldberg, a dermatologist with practices in both New Jersey and New York. He said that he had New Jersey patients who went to his New York office to avoid the tax.

Also, “it is not a cost-effective tax,” said Dr. Goldberg, because the administrative costs for the program outweigh the revenue. In an interview, he predicted that state legislators would probably succeed in repealing the tax, especially since there is a new Republican governor friendly to the anti-tax effort and the state is seeking to enhance revenues and bolster savings.

For that same reason, Dr. Pariser said that he expects many states in the coming year to look at a cosmetic tax as a source of revenue. It is especially likely in Connecticut and New York, he said.

The AAD is calling on state societies to help mobilize dermatologists against such tax efforts, Dr. Pariser said.

As the Senate continued to debate the Democrats' health reform proposal, it was not clear whether a proposed 5% tax on elective cosmetic surgery, including injectables, would survive the floor fight and the eventual conference committee to reconcile the House and Senate bills.

Physician groups—not just dermatologists—have united in opposition to the tax, saying that it is discriminatory, and, they point out, it has proven to be an inefficient means of collecting revenue in the only state with such a tax.

Even so, the American Academy of Dermatology expects more states to look at a cosmetic tax as a potential revenue source this year, Dr. David Pariser, president of the AAD, said in an interview.

New Jersey has taxed elective cosmetic procedures since 2004, levying a 6% fee at the point of sale—the physician's office—but the state has had a 59% shortfall based on projected revenue estimates, according to the Stop Medical Taxes Coalition. The newly formed group, which is sponsored by Botox maker Allergan Inc., represents 22 medical organizations, the AAD, the American Society for Aesthetic Plastic Surgery (ASAPS), the American Society for Dermatologic Surgery Association, the American Association of Neurologic Surgeons, and the American Society of Breast Surgeons.

The American Medical Association also came out in opposition to the tax. In a letter to Senate Majority Leader Harry Reid of Nevada, the AMA said that it “strongly opposes taxes on physician services to fund health care programs or to accomplish health system reform.” The organization said that it was concerned that the exceptions outlined in the bill weren't clear enough or broad enough.

And, said the AMA, the tax could be expanded in the future to cover other health care items or services that might not be considered medically necessary.

The Stop Medical Taxes Coalition wrote to all 50 Senators in late November, outlining its objections. A chief argument: The tax would fall disproportionately on working women.

According to survey data collected by the American Society of Plastic Surgeons in 2005, about one-fourth of the women planning to have surgery in the next 2 years reported income of $30,000–$60,000 a year, suggesting that the tax would hit middle earners, not high-income women.

“This tax is effectively a 'Soccer Mom' tax that will adversely impact mainstream American wives and mothers, who are the majority of plastic surgery patients,” Dr. Renato Saltz, president of the ASAPS, said in a statement.

In a separate letter, the AAD said that the proposed tax would insert the government into the physician-patient relationship “in a new way,” partly because it would be in charge of determining what was medically necessary. Under the proposal's language, an HIV-infected patient with lipoatrophy might be taxed for seeking treatment for what is arguably a disfiguring condition, the AAD wrote.

Rather than tax these patients, the AAD suggests that the federal government levy tanning bed users.

“A federal tax on indoor tanning could deter individuals, especially young people, from the practice,” Dr. Pariser said.

In New Jersey, the tax has led to patients choosing not to have procedures, and it has driven them to seek treatments in neighboring states, said Dr. David Goldberg, a dermatologist with practices in both New Jersey and New York. He said that he had New Jersey patients who went to his New York office to avoid the tax.

Also, “it is not a cost-effective tax,” said Dr. Goldberg, because the administrative costs for the program outweigh the revenue. In an interview, he predicted that state legislators would probably succeed in repealing the tax, especially since there is a new Republican governor friendly to the anti-tax effort and the state is seeking to enhance revenues and bolster savings.

For that same reason, Dr. Pariser said that he expects many states in the coming year to look at a cosmetic tax as a source of revenue. It is especially likely in Connecticut and New York, he said.

The AAD is calling on state societies to help mobilize dermatologists against such tax efforts, Dr. Pariser said.

As the Senate continued to debate the Democrats' health reform proposal, it was not clear whether a proposed 5% tax on elective cosmetic surgery, including injectables, would survive the floor fight and the eventual conference committee to reconcile the House and Senate bills.

Physician groups—not just dermatologists—have united in opposition to the tax, saying that it is discriminatory, and, they point out, it has proven to be an inefficient means of collecting revenue in the only state with such a tax.

Even so, the American Academy of Dermatology expects more states to look at a cosmetic tax as a potential revenue source this year, Dr. David Pariser, president of the AAD, said in an interview.

New Jersey has taxed elective cosmetic procedures since 2004, levying a 6% fee at the point of sale—the physician's office—but the state has had a 59% shortfall based on projected revenue estimates, according to the Stop Medical Taxes Coalition. The newly formed group, which is sponsored by Botox maker Allergan Inc., represents 22 medical organizations, the AAD, the American Society for Aesthetic Plastic Surgery (ASAPS), the American Society for Dermatologic Surgery Association, the American Association of Neurologic Surgeons, and the American Society of Breast Surgeons.

The American Medical Association also came out in opposition to the tax. In a letter to Senate Majority Leader Harry Reid of Nevada, the AMA said that it “strongly opposes taxes on physician services to fund health care programs or to accomplish health system reform.” The organization said that it was concerned that the exceptions outlined in the bill weren't clear enough or broad enough.

And, said the AMA, the tax could be expanded in the future to cover other health care items or services that might not be considered medically necessary.

The Stop Medical Taxes Coalition wrote to all 50 Senators in late November, outlining its objections. A chief argument: The tax would fall disproportionately on working women.

According to survey data collected by the American Society of Plastic Surgeons in 2005, about one-fourth of the women planning to have surgery in the next 2 years reported income of $30,000–$60,000 a year, suggesting that the tax would hit middle earners, not high-income women.

“This tax is effectively a 'Soccer Mom' tax that will adversely impact mainstream American wives and mothers, who are the majority of plastic surgery patients,” Dr. Renato Saltz, president of the ASAPS, said in a statement.

In a separate letter, the AAD said that the proposed tax would insert the government into the physician-patient relationship “in a new way,” partly because it would be in charge of determining what was medically necessary. Under the proposal's language, an HIV-infected patient with lipoatrophy might be taxed for seeking treatment for what is arguably a disfiguring condition, the AAD wrote.

Rather than tax these patients, the AAD suggests that the federal government levy tanning bed users.

“A federal tax on indoor tanning could deter individuals, especially young people, from the practice,” Dr. Pariser said.

In New Jersey, the tax has led to patients choosing not to have procedures, and it has driven them to seek treatments in neighboring states, said Dr. David Goldberg, a dermatologist with practices in both New Jersey and New York. He said that he had New Jersey patients who went to his New York office to avoid the tax.

Also, “it is not a cost-effective tax,” said Dr. Goldberg, because the administrative costs for the program outweigh the revenue. In an interview, he predicted that state legislators would probably succeed in repealing the tax, especially since there is a new Republican governor friendly to the anti-tax effort and the state is seeking to enhance revenues and bolster savings.

For that same reason, Dr. Pariser said that he expects many states in the coming year to look at a cosmetic tax as a source of revenue. It is especially likely in Connecticut and New York, he said.

The AAD is calling on state societies to help mobilize dermatologists against such tax efforts, Dr. Pariser said.

Welcome to our first post for our new blog, "Skin of Color" for Skin & Allergy News Digital Network.

During the past several years, dermatologic issues pertaining to people of color have become more pervasive in the literature and in the media. Research has shown that differences in skin properties and pathophysiology do exist among people of different ethnicities. It is likely that these differences attribute to an increased prevalence of certain skin conditions in darker skinned people, as well as differences in disease presentation and response to treatment. Because there is a general lack of awareness of exactly what these differences are, clinicians are often less confident in the diagnosis and management of skin conditions seen in their darker skinned patients.

The goal of our blog is to inform clinicians on advances in the management of patients of color. We invite you to make our blog the place where you find the most current information and trends that will be applicable to your daily practice. Please share with us your own experiences and together we will further the understanding and delineate the unique qualities of skin of color patients.


Special Invitation from Dr. Naissan Wesley:
I had the privilege to serve as the Guest Editor of the June 2009 issue of Seminars in Cutaneous Medicine and Surgery entitled "Dermatologic Issues in People of Color." This issue was the first of its kind, and was dedicated to providing the most up-to-date information about dermatologic conditions that affect people of color. Each article was written by authors who are leading authorities on pigmented skin, many of whom are also pioneers in the research and education of their respected topics.

***************
A free subscription to upcoming issues of Seminars in Cutaneous Medicine and Surgery is available to qualified dermatologists. Simply click here and complete the registration form to receive your subscription.
***************

This special issue is divided into the most clinically relevant topics pertaining to skin of color, including management of common skin disorders, pigmentary disorders, skin cancer, diseases affecting hair, and cosmetic considerations. "Dermatologic Issues in People of Color" begins with a comprehensive update on managing common disorders in darker skin types led by Dr Andrew Alexis, Director of the Skin of Color Center at St. Luke's-Roosevelt Hospital Center. Dr A. Paul Kelly, pioneer in skin of color education and research and Chairman of Dermatology at King-Drew Medical Center, provides an update on the pathogenesis of another common condition, keloids, and a practical approach to their management.

Disorders of pigmentation can be devastating for patients both socially and psychologically, and unfortunately preferentially affect people with darker skin. Dr Pearl Grimes, leader of dyschromia research, Clinical Professor of Dermatology at the University of California Los Angeles and Director of the Vitiligo and Pigmentation Institute of Southern California, provides a comprehensive review of the pathogenesis and most ground-breaking treatments for post-inflammatory hyperpigmentation and melasma. Dr Rebat Halder, dyschromia expert and Professor and Chairman of the department of dermatology at Howard University College of Medicine, reviews the latest advances in the etiology and pathogenesis of vitiligo and provides an evidence-based approach to the management of the vitiligo patient.

Although skin cancer is a well-described subject within the field of dermatology, the etiopathogenesis in people of color is not as clear. The next two articles focus on skin cancer in people of color, as Dr Brooke Jackson, Mohs surgeon and Director of the Skin Wellness Center of Chicago, reviews nonmelanoma skin cancer, and Dr Mohammed Kashani-Sabet, Director of the Melanoma Center at the University of California San Francisco, leads a discussion of recent melanoma trends among African-, Asian-, Latin-, and Native-American people.

Other than pigmentary disorders, diseases affecting hair are one of the most common complaints among those with skin of color and especially African-American patients. Hair care practices among African-American women are often poorly understood by non-African-American clinicians, yet important for dermatologists to understand given the propensity for some of these practices to lead to hair disorders. Dr Amy McMichael, Professor of Dermatology at Wake Forest University School of Medicine and editor of Hair and Scalp Diseases: Medical, Surgical, and Cosmetic Treatments, provides an in-depth review of common hair care practices in African-American patients and their consequences. Professor of Dermatology at the University of California San Francisco and hair authority, Dr Vera Price, addresses the diagnostic challenges that clinicians face when presented with hair loss and provides a practical approach to diagnosing and managing hair loss in women of color.

Finally, with ethnic patients now accounting for approximately 24% of cosmetic patients, an 11% increase since 2007, cosmetic considerations in skin of color are addressed. Dr Eliot Battle, laser authority in darker skin types and director of Cultura Medical Spa, reviews the indications, benefits, potential risks, and treatment of complications associated with the use of lasers in darker skin.

Dr. Talakoub and I reviewed differences in perception of beauty and cosmetic procedures performed in people of different ethnic backgrounds. As a special opportunity for our online readers at the Skin of Color blog, we are making our article, Differences in Perceptions of Beauty and Cosmetic Procedures Performed in Ethnic Patients, available to you

We hope you enjoy our article and invite you to register to receive your free subscription to Seminars in Cutaneous Medicine and Surgery


Organizations with a Special Interest in Disorders of Skin of Color

Skin of Color Society
http://skinofcolorsociety.org
Upcoming meeting: March 2010, Miami, Fl

Cicatricial Alopecia Research Foundation (CARF)
P.O. Box 64158
Los Angeles, CA 90064
TEL (310) 475-2419
FAX: (310) 475-4883
www.carfintl.org
Upcoming meeting: CARF’s International Patient/Doctor Conference
Fall 2010
Los Angeles, CA
Please email: info@carfintl.org

National Vitiligo Foundation
P.O. Box 23226
Cincinnati, OH 45223
TEL: 513-541-3903
FAX: 513-558-0198
http://www.nvfi.org/

Welcome to our first post for our new blog, "Skin of Color" for Skin & Allergy News Digital Network.

During the past several years, dermatologic issues pertaining to people of color have become more pervasive in the literature and in the media. Research has shown that differences in skin properties and pathophysiology do exist among people of different ethnicities. It is likely that these differences attribute to an increased prevalence of certain skin conditions in darker skinned people, as well as differences in disease presentation and response to treatment. Because there is a general lack of awareness of exactly what these differences are, clinicians are often less confident in the diagnosis and management of skin conditions seen in their darker skinned patients.

The goal of our blog is to inform clinicians on advances in the management of patients of color. We invite you to make our blog the place where you find the most current information and trends that will be applicable to your daily practice. Please share with us your own experiences and together we will further the understanding and delineate the unique qualities of skin of color patients.


Special Invitation from Dr. Naissan Wesley:
I had the privilege to serve as the Guest Editor of the June 2009 issue of Seminars in Cutaneous Medicine and Surgery entitled "Dermatologic Issues in People of Color." This issue was the first of its kind, and was dedicated to providing the most up-to-date information about dermatologic conditions that affect people of color. Each article was written by authors who are leading authorities on pigmented skin, many of whom are also pioneers in the research and education of their respected topics.

***************
A free subscription to upcoming issues of Seminars in Cutaneous Medicine and Surgery is available to qualified dermatologists. Simply click here and complete the registration form to receive your subscription.
***************

This special issue is divided into the most clinically relevant topics pertaining to skin of color, including management of common skin disorders, pigmentary disorders, skin cancer, diseases affecting hair, and cosmetic considerations. "Dermatologic Issues in People of Color" begins with a comprehensive update on managing common disorders in darker skin types led by Dr Andrew Alexis, Director of the Skin of Color Center at St. Luke's-Roosevelt Hospital Center. Dr A. Paul Kelly, pioneer in skin of color education and research and Chairman of Dermatology at King-Drew Medical Center, provides an update on the pathogenesis of another common condition, keloids, and a practical approach to their management.

Disorders of pigmentation can be devastating for patients both socially and psychologically, and unfortunately preferentially affect people with darker skin. Dr Pearl Grimes, leader of dyschromia research, Clinical Professor of Dermatology at the University of California Los Angeles and Director of the Vitiligo and Pigmentation Institute of Southern California, provides a comprehensive review of the pathogenesis and most ground-breaking treatments for post-inflammatory hyperpigmentation and melasma. Dr Rebat Halder, dyschromia expert and Professor and Chairman of the department of dermatology at Howard University College of Medicine, reviews the latest advances in the etiology and pathogenesis of vitiligo and provides an evidence-based approach to the management of the vitiligo patient.

Although skin cancer is a well-described subject within the field of dermatology, the etiopathogenesis in people of color is not as clear. The next two articles focus on skin cancer in people of color, as Dr Brooke Jackson, Mohs surgeon and Director of the Skin Wellness Center of Chicago, reviews nonmelanoma skin cancer, and Dr Mohammed Kashani-Sabet, Director of the Melanoma Center at the University of California San Francisco, leads a discussion of recent melanoma trends among African-, Asian-, Latin-, and Native-American people.

Other than pigmentary disorders, diseases affecting hair are one of the most common complaints among those with skin of color and especially African-American patients. Hair care practices among African-American women are often poorly understood by non-African-American clinicians, yet important for dermatologists to understand given the propensity for some of these practices to lead to hair disorders. Dr Amy McMichael, Professor of Dermatology at Wake Forest University School of Medicine and editor of Hair and Scalp Diseases: Medical, Surgical, and Cosmetic Treatments, provides an in-depth review of common hair care practices in African-American patients and their consequences. Professor of Dermatology at the University of California San Francisco and hair authority, Dr Vera Price, addresses the diagnostic challenges that clinicians face when presented with hair loss and provides a practical approach to diagnosing and managing hair loss in women of color.

Finally, with ethnic patients now accounting for approximately 24% of cosmetic patients, an 11% increase since 2007, cosmetic considerations in skin of color are addressed. Dr Eliot Battle, laser authority in darker skin types and director of Cultura Medical Spa, reviews the indications, benefits, potential risks, and treatment of complications associated with the use of lasers in darker skin.

Dr. Talakoub and I reviewed differences in perception of beauty and cosmetic procedures performed in people of different ethnic backgrounds. As a special opportunity for our online readers at the Skin of Color blog, we are making our article, Differences in Perceptions of Beauty and Cosmetic Procedures Performed in Ethnic Patients, available to you

We hope you enjoy our article and invite you to register to receive your free subscription to Seminars in Cutaneous Medicine and Surgery


Organizations with a Special Interest in Disorders of Skin of Color

Skin of Color Society
http://skinofcolorsociety.org
Upcoming meeting: March 2010, Miami, Fl

Cicatricial Alopecia Research Foundation (CARF)
P.O. Box 64158
Los Angeles, CA 90064
TEL (310) 475-2419
FAX: (310) 475-4883
www.carfintl.org
Upcoming meeting: CARF’s International Patient/Doctor Conference
Fall 2010
Los Angeles, CA
Please email: info@carfintl.org

National Vitiligo Foundation
P.O. Box 23226
Cincinnati, OH 45223
TEL: 513-541-3903
FAX: 513-558-0198
http://www.nvfi.org/

Welcome to our first post for our new blog, "Skin of Color" for Skin & Allergy News Digital Network.

During the past several years, dermatologic issues pertaining to people of color have become more pervasive in the literature and in the media. Research has shown that differences in skin properties and pathophysiology do exist among people of different ethnicities. It is likely that these differences attribute to an increased prevalence of certain skin conditions in darker skinned people, as well as differences in disease presentation and response to treatment. Because there is a general lack of awareness of exactly what these differences are, clinicians are often less confident in the diagnosis and management of skin conditions seen in their darker skinned patients.

The goal of our blog is to inform clinicians on advances in the management of patients of color. We invite you to make our blog the place where you find the most current information and trends that will be applicable to your daily practice. Please share with us your own experiences and together we will further the understanding and delineate the unique qualities of skin of color patients.


Special Invitation from Dr. Naissan Wesley:
I had the privilege to serve as the Guest Editor of the June 2009 issue of Seminars in Cutaneous Medicine and Surgery entitled "Dermatologic Issues in People of Color." This issue was the first of its kind, and was dedicated to providing the most up-to-date information about dermatologic conditions that affect people of color. Each article was written by authors who are leading authorities on pigmented skin, many of whom are also pioneers in the research and education of their respected topics.

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A free subscription to upcoming issues of Seminars in Cutaneous Medicine and Surgery is available to qualified dermatologists. Simply click here and complete the registration form to receive your subscription.
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This special issue is divided into the most clinically relevant topics pertaining to skin of color, including management of common skin disorders, pigmentary disorders, skin cancer, diseases affecting hair, and cosmetic considerations. "Dermatologic Issues in People of Color" begins with a comprehensive update on managing common disorders in darker skin types led by Dr Andrew Alexis, Director of the Skin of Color Center at St. Luke's-Roosevelt Hospital Center. Dr A. Paul Kelly, pioneer in skin of color education and research and Chairman of Dermatology at King-Drew Medical Center, provides an update on the pathogenesis of another common condition, keloids, and a practical approach to their management.

Disorders of pigmentation can be devastating for patients both socially and psychologically, and unfortunately preferentially affect people with darker skin. Dr Pearl Grimes, leader of dyschromia research, Clinical Professor of Dermatology at the University of California Los Angeles and Director of the Vitiligo and Pigmentation Institute of Southern California, provides a comprehensive review of the pathogenesis and most ground-breaking treatments for post-inflammatory hyperpigmentation and melasma. Dr Rebat Halder, dyschromia expert and Professor and Chairman of the department of dermatology at Howard University College of Medicine, reviews the latest advances in the etiology and pathogenesis of vitiligo and provides an evidence-based approach to the management of the vitiligo patient.

Although skin cancer is a well-described subject within the field of dermatology, the etiopathogenesis in people of color is not as clear. The next two articles focus on skin cancer in people of color, as Dr Brooke Jackson, Mohs surgeon and Director of the Skin Wellness Center of Chicago, reviews nonmelanoma skin cancer, and Dr Mohammed Kashani-Sabet, Director of the Melanoma Center at the University of California San Francisco, leads a discussion of recent melanoma trends among African-, Asian-, Latin-, and Native-American people.

Other than pigmentary disorders, diseases affecting hair are one of the most common complaints among those with skin of color and especially African-American patients. Hair care practices among African-American women are often poorly understood by non-African-American clinicians, yet important for dermatologists to understand given the propensity for some of these practices to lead to hair disorders. Dr Amy McMichael, Professor of Dermatology at Wake Forest University School of Medicine and editor of Hair and Scalp Diseases: Medical, Surgical, and Cosmetic Treatments, provides an in-depth review of common hair care practices in African-American patients and their consequences. Professor of Dermatology at the University of California San Francisco and hair authority, Dr Vera Price, addresses the diagnostic challenges that clinicians face when presented with hair loss and provides a practical approach to diagnosing and managing hair loss in women of color.

Finally, with ethnic patients now accounting for approximately 24% of cosmetic patients, an 11% increase since 2007, cosmetic considerations in skin of color are addressed. Dr Eliot Battle, laser authority in darker skin types and director of Cultura Medical Spa, reviews the indications, benefits, potential risks, and treatment of complications associated with the use of lasers in darker skin.

Dr. Talakoub and I reviewed differences in perception of beauty and cosmetic procedures performed in people of different ethnic backgrounds. As a special opportunity for our online readers at the Skin of Color blog, we are making our article, Differences in Perceptions of Beauty and Cosmetic Procedures Performed in Ethnic Patients, available to you

We hope you enjoy our article and invite you to register to receive your free subscription to Seminars in Cutaneous Medicine and Surgery


Organizations with a Special Interest in Disorders of Skin of Color

Skin of Color Society
http://skinofcolorsociety.org
Upcoming meeting: March 2010, Miami, Fl

Cicatricial Alopecia Research Foundation (CARF)
P.O. Box 64158
Los Angeles, CA 90064
TEL (310) 475-2419
FAX: (310) 475-4883
www.carfintl.org
Upcoming meeting: CARF’s International Patient/Doctor Conference
Fall 2010
Los Angeles, CA
Please email: info@carfintl.org

National Vitiligo Foundation
P.O. Box 23226
Cincinnati, OH 45223
TEL: 513-541-3903
FAX: 513-558-0198
http://www.nvfi.org/

This article aims to familiarize the reader with the history of liposuction. The author documents the landmark events and characters in the development of this revolutionary and widely known procedure. Included is a historical discussion of the obstacles and the triumphs the practitioners and the procedure itself has seen, as well as a review of relevant scientific data placed in its appropriate historical context up through modern day.

*For a PDF of the full article, click on the link to the left of this introduction.

This article aims to familiarize the reader with the history of liposuction. The author documents the landmark events and characters in the development of this revolutionary and widely known procedure. Included is a historical discussion of the obstacles and the triumphs the practitioners and the procedure itself has seen, as well as a review of relevant scientific data placed in its appropriate historical context up through modern day.

*For a PDF of the full article, click on the link to the left of this introduction.

This article aims to familiarize the reader with the history of liposuction. The author documents the landmark events and characters in the development of this revolutionary and widely known procedure. Included is a historical discussion of the obstacles and the triumphs the practitioners and the procedure itself has seen, as well as a review of relevant scientific data placed in its appropriate historical context up through modern day.

*For a PDF of the full article, click on the link to the left of this introduction.

Laser-assisted liposuction (LAL) is a recent innovation within the field of liposculpture. In addition to body contouring, the indications of LAL are skin retraction in areas of flaccidity and fat melting for challenging surgical cases including revisions, areas of dense fibrosity, and large-volume cases. A photothermal effect explains the effects of LAL on tissue, regardless of the wavelength used. Advantages of LAL include reduced bruising, edema, pain, and recovery time. Disadvantages are most often related to thermal effects on tissue, such as skin blistering. Currently, 3 wavelengths, 980, 1064, and 1320 nm, are Food and Drug Administration-approved for LAL. Comparative studies examining the safety and efficacy of LAL have appeared in the medical literature. Technical considerations, emerging technology, and future indications are important to the success and continued development of this procedure.

*For a PDF of the full article, click on the link to the left of this introduction.

Laser-assisted liposuction (LAL) is a recent innovation within the field of liposculpture. In addition to body contouring, the indications of LAL are skin retraction in areas of flaccidity and fat melting for challenging surgical cases including revisions, areas of dense fibrosity, and large-volume cases. A photothermal effect explains the effects of LAL on tissue, regardless of the wavelength used. Advantages of LAL include reduced bruising, edema, pain, and recovery time. Disadvantages are most often related to thermal effects on tissue, such as skin blistering. Currently, 3 wavelengths, 980, 1064, and 1320 nm, are Food and Drug Administration-approved for LAL. Comparative studies examining the safety and efficacy of LAL have appeared in the medical literature. Technical considerations, emerging technology, and future indications are important to the success and continued development of this procedure.

*For a PDF of the full article, click on the link to the left of this introduction.

Laser-assisted liposuction (LAL) is a recent innovation within the field of liposculpture. In addition to body contouring, the indications of LAL are skin retraction in areas of flaccidity and fat melting for challenging surgical cases including revisions, areas of dense fibrosity, and large-volume cases. A photothermal effect explains the effects of LAL on tissue, regardless of the wavelength used. Advantages of LAL include reduced bruising, edema, pain, and recovery time. Disadvantages are most often related to thermal effects on tissue, such as skin blistering. Currently, 3 wavelengths, 980, 1064, and 1320 nm, are Food and Drug Administration-approved for LAL. Comparative studies examining the safety and efficacy of LAL have appeared in the medical literature. Technical considerations, emerging technology, and future indications are important to the success and continued development of this procedure.

*For a PDF of the full article, click on the link to the left of this introduction.

Lasers, both in single and multiple wavelength designs, have recently been introduced to enhance the results of liposuction. Safe parameters of fluence and temperature have not yet been described. In this study, I describe a series of laser lipolysis patients treated with a dual wavelength (1064/1319 nm) laser where internal and external temperatures have been measured. From this series of 36 patients treated with a 1064/1319-nm wavelength laser for laser lipolysis, we calculated the specific heat of the fat and tumescent fluid combination to be 4.7 J/(g°C). The average increase in temperature measured in the subcutaneous space was 16°C.

*For a PDF of the full article, click on the link to the left of this introduction.

Lasers, both in single and multiple wavelength designs, have recently been introduced to enhance the results of liposuction. Safe parameters of fluence and temperature have not yet been described. In this study, I describe a series of laser lipolysis patients treated with a dual wavelength (1064/1319 nm) laser where internal and external temperatures have been measured. From this series of 36 patients treated with a 1064/1319-nm wavelength laser for laser lipolysis, we calculated the specific heat of the fat and tumescent fluid combination to be 4.7 J/(g°C). The average increase in temperature measured in the subcutaneous space was 16°C.

*For a PDF of the full article, click on the link to the left of this introduction.

Lasers, both in single and multiple wavelength designs, have recently been introduced to enhance the results of liposuction. Safe parameters of fluence and temperature have not yet been described. In this study, I describe a series of laser lipolysis patients treated with a dual wavelength (1064/1319 nm) laser where internal and external temperatures have been measured. From this series of 36 patients treated with a 1064/1319-nm wavelength laser for laser lipolysis, we calculated the specific heat of the fat and tumescent fluid combination to be 4.7 J/(g°C). The average increase in temperature measured in the subcutaneous space was 16°C.

*For a PDF of the full article, click on the link to the left of this introduction.

Internal liposuction remains the standard and most reliable method to remove fat and contour the face and body. The recent introduction (2006 FDA clearance) of a higher and more controlled energized internal laser system is purported to increase tissue contraction and damage unwanted fat deposits through dual 1064 nm/1320-nm wavelengths that are initially used at a deep level of subcutaneous fat, and subsequently at a shallow level beneath the dermis along with liposuction. Using classical principles of selective photothermolysis, the sequential exposure of these wavelengths on target tissue chromophores results in selective thermo-lipolysis and thermo-denaturation of collagen fibers (H2O) within the septal architecture and lower reticular dermis for enhanced skin retraction (accommodation) and contraction. This article reviews this innovative laser system, discusses the latest clinical protocol changes, tabulates the measurements of time and energy during each phase of treatment and temperature endpoints, and correlates the histologic findings to energy deposition. The collected objective data are used to improve on the safety and efficacy treatment profiles at 11 sites in 75 consecutive patients. Further clinical studies and comparative trials are recommended to validate these outcomes.

*For a PDF of the full article, click on the link to the left of this introduction.

Internal liposuction remains the standard and most reliable method to remove fat and contour the face and body. The recent introduction (2006 FDA clearance) of a higher and more controlled energized internal laser system is purported to increase tissue contraction and damage unwanted fat deposits through dual 1064 nm/1320-nm wavelengths that are initially used at a deep level of subcutaneous fat, and subsequently at a shallow level beneath the dermis along with liposuction. Using classical principles of selective photothermolysis, the sequential exposure of these wavelengths on target tissue chromophores results in selective thermo-lipolysis and thermo-denaturation of collagen fibers (H2O) within the septal architecture and lower reticular dermis for enhanced skin retraction (accommodation) and contraction. This article reviews this innovative laser system, discusses the latest clinical protocol changes, tabulates the measurements of time and energy during each phase of treatment and temperature endpoints, and correlates the histologic findings to energy deposition. The collected objective data are used to improve on the safety and efficacy treatment profiles at 11 sites in 75 consecutive patients. Further clinical studies and comparative trials are recommended to validate these outcomes.

*For a PDF of the full article, click on the link to the left of this introduction.

Internal liposuction remains the standard and most reliable method to remove fat and contour the face and body. The recent introduction (2006 FDA clearance) of a higher and more controlled energized internal laser system is purported to increase tissue contraction and damage unwanted fat deposits through dual 1064 nm/1320-nm wavelengths that are initially used at a deep level of subcutaneous fat, and subsequently at a shallow level beneath the dermis along with liposuction. Using classical principles of selective photothermolysis, the sequential exposure of these wavelengths on target tissue chromophores results in selective thermo-lipolysis and thermo-denaturation of collagen fibers (H2O) within the septal architecture and lower reticular dermis for enhanced skin retraction (accommodation) and contraction. This article reviews this innovative laser system, discusses the latest clinical protocol changes, tabulates the measurements of time and energy during each phase of treatment and temperature endpoints, and correlates the histologic findings to energy deposition. The collected objective data are used to improve on the safety and efficacy treatment profiles at 11 sites in 75 consecutive patients. Further clinical studies and comparative trials are recommended to validate these outcomes.

*For a PDF of the full article, click on the link to the left of this introduction.

Radiofrequency (RF) devices such as ThermaCool TC (Solta Medical Inc., Hayward, CA) offer a nonablative and noninvasive treatment option for unwanted skin concerns of the head, neck, and body. Relatively fewer studies address RF treatment on the body when compared with the head and neck. The purpose of this report is to investigate the use of the ThermaCool TC system with the novel Thermage Multiplex Tip for the enhancement of body shape. Additionally, this report will review the literature of RF technology with a concentration on body shaping. Twelve subjects underwent ThermaCool TC treatments using the Thermage Multiplex Tip. Waist circumference, standardized photographs, skin laxity score, global aesthetic improvement score, and patient satisfaction surveys were assessed at baseline and several follow-up visits after treatment. Average waist circumference and skin laxity scores decreased after ThermaCool TC treatment, using the Thermage Multiplex Tip at follow-up visits held at 1, 2, 4, and 6 months after treatment. Global aesthetic improvement score and patient satisfaction surveys reflected these objective clinical improvements. RF devices, such as the ThermaCool TC offer a nonablative and noninvasive treatment option for unwanted skin findings of the head, neck, and body.

*For a PDF of the full article, click on the link to the left of this introduction.

Radiofrequency (RF) devices such as ThermaCool TC (Solta Medical Inc., Hayward, CA) offer a nonablative and noninvasive treatment option for unwanted skin concerns of the head, neck, and body. Relatively fewer studies address RF treatment on the body when compared with the head and neck. The purpose of this report is to investigate the use of the ThermaCool TC system with the novel Thermage Multiplex Tip for the enhancement of body shape. Additionally, this report will review the literature of RF technology with a concentration on body shaping. Twelve subjects underwent ThermaCool TC treatments using the Thermage Multiplex Tip. Waist circumference, standardized photographs, skin laxity score, global aesthetic improvement score, and patient satisfaction surveys were assessed at baseline and several follow-up visits after treatment. Average waist circumference and skin laxity scores decreased after ThermaCool TC treatment, using the Thermage Multiplex Tip at follow-up visits held at 1, 2, 4, and 6 months after treatment. Global aesthetic improvement score and patient satisfaction surveys reflected these objective clinical improvements. RF devices, such as the ThermaCool TC offer a nonablative and noninvasive treatment option for unwanted skin findings of the head, neck, and body.

*For a PDF of the full article, click on the link to the left of this introduction.

Radiofrequency (RF) devices such as ThermaCool TC (Solta Medical Inc., Hayward, CA) offer a nonablative and noninvasive treatment option for unwanted skin concerns of the head, neck, and body. Relatively fewer studies address RF treatment on the body when compared with the head and neck. The purpose of this report is to investigate the use of the ThermaCool TC system with the novel Thermage Multiplex Tip for the enhancement of body shape. Additionally, this report will review the literature of RF technology with a concentration on body shaping. Twelve subjects underwent ThermaCool TC treatments using the Thermage Multiplex Tip. Waist circumference, standardized photographs, skin laxity score, global aesthetic improvement score, and patient satisfaction surveys were assessed at baseline and several follow-up visits after treatment. Average waist circumference and skin laxity scores decreased after ThermaCool TC treatment, using the Thermage Multiplex Tip at follow-up visits held at 1, 2, 4, and 6 months after treatment. Global aesthetic improvement score and patient satisfaction surveys reflected these objective clinical improvements. RF devices, such as the ThermaCool TC offer a nonablative and noninvasive treatment option for unwanted skin findings of the head, neck, and body.

*For a PDF of the full article, click on the link to the left of this introduction.

Controlled cold exposure has long been reported to be a cause of panniculitis in cases such as popsicle panniculitis. Cryolipolysis is a new technology that uses cold exposure, or energy extraction, to result in localized panniculitis and modulation of fat. Presently, the Zeltiq cryolipolysis device is FDA cleared for skin cooling, as well as various other indications, but not for lipolysis. There is, however, a pending premarket notification for noninvasive fat layer reduction. Initial animal and human studies have demonstrated significant reductions in the superficial fat layer thickness, ranging from 20% to 80%, following a single cryolipolysis treatment. The decrease in fat thickness occurs gradually over the first 3 months following treatment, and is most pronounced in patients with limited, discrete fat bulges. Erythema of the skin, bruising, and temporary numbness at the treatment site are commonly observed following treatment with the device, though these effects largely resolve in approximately 1 week. To date, there have been no reports of scarring, ulceration, or alterations in blood lipid or liver function profiles. Cryolipolysis is a new, noninvasive treatment option that may be of benefit in the treatment of excess adipose tissue.

*For a PDF of the full article, click on the link to the left of this introduction.

Controlled cold exposure has long been reported to be a cause of panniculitis in cases such as popsicle panniculitis. Cryolipolysis is a new technology that uses cold exposure, or energy extraction, to result in localized panniculitis and modulation of fat. Presently, the Zeltiq cryolipolysis device is FDA cleared for skin cooling, as well as various other indications, but not for lipolysis. There is, however, a pending premarket notification for noninvasive fat layer reduction. Initial animal and human studies have demonstrated significant reductions in the superficial fat layer thickness, ranging from 20% to 80%, following a single cryolipolysis treatment. The decrease in fat thickness occurs gradually over the first 3 months following treatment, and is most pronounced in patients with limited, discrete fat bulges. Erythema of the skin, bruising, and temporary numbness at the treatment site are commonly observed following treatment with the device, though these effects largely resolve in approximately 1 week. To date, there have been no reports of scarring, ulceration, or alterations in blood lipid or liver function profiles. Cryolipolysis is a new, noninvasive treatment option that may be of benefit in the treatment of excess adipose tissue.

*For a PDF of the full article, click on the link to the left of this introduction.

Controlled cold exposure has long been reported to be a cause of panniculitis in cases such as popsicle panniculitis. Cryolipolysis is a new technology that uses cold exposure, or energy extraction, to result in localized panniculitis and modulation of fat. Presently, the Zeltiq cryolipolysis device is FDA cleared for skin cooling, as well as various other indications, but not for lipolysis. There is, however, a pending premarket notification for noninvasive fat layer reduction. Initial animal and human studies have demonstrated significant reductions in the superficial fat layer thickness, ranging from 20% to 80%, following a single cryolipolysis treatment. The decrease in fat thickness occurs gradually over the first 3 months following treatment, and is most pronounced in patients with limited, discrete fat bulges. Erythema of the skin, bruising, and temporary numbness at the treatment site are commonly observed following treatment with the device, though these effects largely resolve in approximately 1 week. To date, there have been no reports of scarring, ulceration, or alterations in blood lipid or liver function profiles. Cryolipolysis is a new, noninvasive treatment option that may be of benefit in the treatment of excess adipose tissue.

*For a PDF of the full article, click on the link to the left of this introduction.

Body contouring is a rapidly growing sector of esthetic procedures and dermatologic surgery. Currently, liposuction is one of the most popular cosmetic procedures with considerable research being conducted into devices that would facilitate fat emulsification. The advent of ultrasound-assisted liposuction presented physicians with a great tool in approaching more superficial as well as fibrous adipose irregularities. Additionally, our increasing understanding of laser, light, and radiofrequency interaction with adipose tissue is allowing for these energy sources to be used noninvasively to improve body contours. This article will provide an overview of the vibration amplification of sound energy at resonance third-generation ultrasound device for liposuction as well as the VelaShape platform for noninvasive adipose and cellulite reduction. As body contouring technology and coinciding experience grow, so will the ability to achieve the aims of more efficient, safer, and cosmetically pleasing body sculpting.

*For a PDF of the full article, click on the link to the left of this introduction.

Body contouring is a rapidly growing sector of esthetic procedures and dermatologic surgery. Currently, liposuction is one of the most popular cosmetic procedures with considerable research being conducted into devices that would facilitate fat emulsification. The advent of ultrasound-assisted liposuction presented physicians with a great tool in approaching more superficial as well as fibrous adipose irregularities. Additionally, our increasing understanding of laser, light, and radiofrequency interaction with adipose tissue is allowing for these energy sources to be used noninvasively to improve body contours. This article will provide an overview of the vibration amplification of sound energy at resonance third-generation ultrasound device for liposuction as well as the VelaShape platform for noninvasive adipose and cellulite reduction. As body contouring technology and coinciding experience grow, so will the ability to achieve the aims of more efficient, safer, and cosmetically pleasing body sculpting.

*For a PDF of the full article, click on the link to the left of this introduction.

Body contouring is a rapidly growing sector of esthetic procedures and dermatologic surgery. Currently, liposuction is one of the most popular cosmetic procedures with considerable research being conducted into devices that would facilitate fat emulsification. The advent of ultrasound-assisted liposuction presented physicians with a great tool in approaching more superficial as well as fibrous adipose irregularities. Additionally, our increasing understanding of laser, light, and radiofrequency interaction with adipose tissue is allowing for these energy sources to be used noninvasively to improve body contours. This article will provide an overview of the vibration amplification of sound energy at resonance third-generation ultrasound device for liposuction as well as the VelaShape platform for noninvasive adipose and cellulite reduction. As body contouring technology and coinciding experience grow, so will the ability to achieve the aims of more efficient, safer, and cosmetically pleasing body sculpting.

*For a PDF of the full article, click on the link to the left of this introduction.