Facelift, cosmetic surgery, and skin care blog from Los Angeles surgeon Dr. David Rahimi

Latisse Shampoo grows hair; Now This Is News...

nospam@example.com (David Rahimi) — Wed, 01 Feb 2012 19:14:17 +0000

I have several female patients on a Shampoo that contains Sprinolactone, Rogaine, and Latisse. It is prescription compound and expensive but the results are good.

Here is a recent article on cnbc about Latisses and its use in hair loss:

http://today.msnbc.msn.com/id/45259102/ns/today-today_health/t/latisse-your-dome-eyelash-enhancer-also-thickens-thin-hair/

Dr. David Rahimi

Laser Liposuction for Excessive Armpit Sweating explained.

nospam@example.com (David Rahimi) — Fri, 27 Jan 2012 22:10:56 +0000

Excessive sweating in the armpit area can be safely treated with tumescentLiposuction.

If Drysol has failed and Botox is not an option; consider liposuction.

The literature is clear:

It is safe and effective and practically scar-less!

http://www.ncbi.nlm.nih.gov/pubmed/16681657

and

http://www.ncbi.nlm.nih.gov/pubmed/15842397

and

http://www.ncbi.nlm.nih.gov/pubmed/14507230

and

http://www.ncbi.nlm.nih.gov/pubmed/10759833

and

http://www.ncbi.nlm.nih.gov/pubmed/17634083

The procedure is performed using local anesthesia and mild sedation. Downtime is 3 to 5 days and the results are impressive.

Cost: $2500 to $3500

A. David Rahimi, MD, FAAD, FAACS.

The New Venus Freeze; does it work? I am highly skeptical.

nospam@example.com (David Rahimi) — Tue, 24 Jan 2012 19:19:47 +0000

I have learned one thing after 14 years of clinical practice of Dermatology and Cosmetic surgery. Don't believe in any new treatment or laser that is not supported by peer reviewed, scientific, double blinded, and properly controlled studies. As far as I know the safety and efficacy of this treatment has not been shown.

http://www.youtube.com/watch?v=IGe50z_SR58&feature=related

I am biased and a strong advocate for the Coolsculpting or Zeltiq technique. Peer reviewed article and scientific histological studies show that it is safe and effective. Please read more about this on our website (under procedures).

A. David Rahimi,MD,FAAD,FAACS.

Can aggressive laser treatments kill normal facial pigmentaion?

nospam@example.com (David Rahimi) — Tue, 17 Jan 2012 23:14:57 +0000

YES; Agressive CO2 laser or Dermabrasion can permanently kill the normal skin pigmentaion. This is very dificcult, if not impossible, to treat.

Avoid permanent problems such as this by using fractional lasers such as the Mixto CO2 laser.

A. David Rahimi,MD,FAAD.

A new way to defy Aging; Clear and Brillinat Laser.

nospam@example.com (David Rahimi) — Tue, 17 Jan 2012 18:30:09 +0000

Ready to take control of the aging process?

Aging skin is a fact of life. The good news is the earlier you start taking care of your skin, the more you can prevent the signs of aging and maintain a younger look. What you do in your 20s and 30s will affect how you look in your 40s, 50s and beyond. Adding Clear + Brilliant to your collection of skin care tricks – at any age – will help you recover the glow, luminosity and smoothness your skin, and you, deserve.

Clear + Brilliant takes skin care to a whole new level.

This unique treatment expands skin care to not only address unwanted signs of aging, but gives you the power to help prevent them:

Visibly illuminated skin tone
Renewed, ultra-soft and smoother texture
Naturally radiant and glowing skin
Improved tone, texture and radiance
Reduction in the appearance of pores

Uncover your brilliance

Comfortable, fast, effective, affordable
Minimal downtime
Safe for all skin types

Treatments cost as little as $300 - with a purchase of a package of 4 (normally $400/treatment)

All skin types can take advantage of this laser: Asian, Hispanic, Middle eastern, Armenian and more...

All treatments performed by Dr. A. David Rahimi; experience counts. I have performed over 100000 laser

treatments in the past 12 years.

www.foreveryoung.net

A. David Rahimi,Md,FAAD,FAACS.

Derma Rollers…Are they Effective? Safe?

nospam@example.com (David Rahimi) — Tue, 18 Oct 2011 21:05:19 +0000

Any device that states it can: “Help clear Acne, Acne scars, Grey or Thinning hair, and much much more is Full of hot Air!

Please watch this video on the correct use of Derma Rollers! Pretty complicated and sophisticated for a non-medical person. None of the patients who I have asked have been using these devices appropriately.

http://www.youtube.com/watch?v=p1NH-5-PUIc

Post inflammatory hyper-pigmentation (dark brown pigmentation), hypertrophic scarring (thickened scars), and spreading of Herpes and bacterial infections are possible outcomes of using these devices incorrectly.

A. David Rahimi,MD,FAAD,FAACS.

Ethnic Skin

nospam@example.com (David Rahimi) — Thu, 13 Oct 2011 19:21:04 +0000

Dermatological and Cosmetic Services for
Patients with Dark and Olive-Toned Skin

Some physicians shy away from treating Hispanics, Asians, and African Americans because their skin heals differently than those with white or European skin. African American skin is prone to developing thick and unsightly scars and Hispanic and Asian post-op patients can develop light or dark skin discolorations.

These risks often prompt less-experienced physicians to discourage patients with darker skin tones from seeking laser treatments, chemical peels or cosmetic surgery. This isn't the case at with Dr. Rahimi and the Forever Young clinic.

With over 10 years of conducting and perfecting his treatments in such ethnically diverse cities as Washington D.C., New York, and now LA, Dr. Rahimi has become an expert in treating dark and olive-skin complexions. The following procedures have been tailored by Dr. Rahimi to specifically treat darker and olive skin tones. All of these treatments are minimally invasive, requiring only local anesthesia and minimal sedation. What's more, when the treatments are done in combination with each other, the results are far greater than when one treatment is done alone.

Chemical Peel

Chemical peels improve irregular color and fade deep lines. A superficial chemical peel removes the top skin cell layers, eliminating dead skin, tightening pores, and producing new collagen and elastic fibers. Recovery takes about seven to 10 days. Results may not be completely evident for up to a year but will last for many years.

Manual Epidermal Dermabrasion

Manual Epidermal Dermabrasion (MED) works to diminish fine lines, wrinkles, traces of acne and pigmentation. A scalpel is used to exfoliate superficial epidermal layer of skin before using a compressor to extract milias, tiny subcutaneous cysts, keratosis, and superficial rough spots. Carbon dioxide mixed with acetone is then applied, creating a "local freezing" that penetrates through the skin and is long-lasting. The procedure immediately refines and tightens the skin and promotes new collagen synthesis that lasts for weeks.

Commercial Fillers and Fat Transfers

Commercial fillers and fat transfers can be used to smooth out lines in the skin or lips. Commercial fillers include Restylane, a naturally occurring substance in the body that is based on non-animal hyaluronic acid. Restylane dissolves safely and naturally within the body over time. The longevity of the results depends on many factors such as the structure of the skin, lifestyle and age, as well as on the degree of perfection sought. The fat transfer technique involves removing fat from one part of the body, such as the thigh, and painlessly injecting it into the treated area. Excess fat can be frozen for future fat transfer procedures (Forever Young has a licensed & State approved Tissue Bank). The results from both commercial filler and fat transfer procedures last for years.

Thermage CPT

Thermage CPT is a highly advanced, non surgical technique used to achieve lasting skin tightening with no down time. This treatment involves heating the skin and underlying structures with radio-frequency followed by external cryogen cooling. The combined effect creates an immediate collagen contraction giving the appearance of tighter, younger skin. The Thermage CPT system is the most effective noninvasive, non-ablative (meaning no injury to the skin and hence no oozing, bleeding, etc.) radio-frequency system available. Improvement appears slowly over weeks as collagen remodels and the skin and underlying structures tighten. Results last from one to two years.

CoolTouch 3 Plus Laser Treatment

CoolTouch 3 Plus Laser Treatment removes acne scarring gradually and without surgery. This laser treatment is particularly used for deep acne scarring. Unlike other laser treatments, the CoolTouch laser protects the outer skin and sensitive nerve endings with a unique cooling spray while the precise laser pulses light onto the skin to stimulate fibroblasts cells (the cells that produce natural collagen in the skin's foundation). The laser pulses of light penetrate the skin, giving a sensation similar to a slapping of a tight rubber band. Because this is a cellular process, the results of the CoolTouch 3 Plus Laser Treatment happen over a period of months. Multiple treatments are encouraged.

Tuliplift Facelift

This mini-facelift procedure has been personally developed and patented by Dr. Rahimi himself. Dr. Rahimi has designed the Tuliplift Facelift to work very well with dark and olive skin tones. The minimally invasive procedure lifts sagging skin and tightens the neckline. And because the Tuliplift Facelift is done entirely under the skin, it requires only small incisions and produces a minimal risk of scarring. Patients usually recover within seven to 10 days, and have results that last for years.

And the newest Additions:

Mixto Fractional CO2 laser

(For the treatment of Acne scarring and discolorations)

and

Clear and Brilliant Laser

(This laser was introduced in 2011 to tone and refine the skin and remove brown spots.)

Read about these procedures under the "Procedures" section. Watch videos and look at dozens of Before and After photographs.

www.foreveryoung.net

Skin Needling and Platelet Rich Plasma.

nospam@example.com (David Rahimi) — Tue, 11 Oct 2011 17:36:13 +0000

This is a great article that shows how Skin Needling and Platelet Rich Plasma in combination with long wavelenght lasers can greatly improve the appearance of "icepick" and "rolling" Acne Scarring:

We use a similar technology at Forever Young,Inc to correct acne scarring.

www.foreveryoung.net

http://www.cosderm.com/PDF/024040177.pdf

Combined Use of Skin Needling and Platelet-Rich Plasma in Acne Scarring Treatment

Gabriella Fabbrocini, MD; Valerio De Vita, MD; Francesco Pastore, MD; Luigia Panariello, MD;Nunzio Fardella, MD; Rossana Sepulveres, MD; Elio D’Agostino, MD; Norma Cameli, MD; Antonella Tosti, MD

Platelet-rich plasma (PRP) contains autologous growth factors, which could act synergistically with growth factors induced by skin needling in order to enhance the wound-healing response. The combination of treatments, carried out by using skin needling and PRP application, should enhance both efficacy of skin needling and PRP application. The objective of this study is to establish the effectiveness of the combined use of skin needling and PRP application in acne scarring treatment. Twelve patients affected with rolling acne scars were enrolled. Each patient underwent 2 sessions of treatments, each consisting of skin needling followed by PRP application on the right side of the face and skin needling alone on the left side of the face. Digital photographs of all patients were taken. Photographic data were analyzed by using the Sign Test (a,.05). The study showed that the scars severity grade in all patients was greatly reduced on all of the face, but the improvement was more efficient on the side treated with both skin needling and PRP. Our study showed that the combined use of skin needling and PRP is more effective than skin needling alone in improving acne scars.

Drs. Fabbrocini, De Vita, Pastore, Panariello, and Fardella are from the Department of Systematic Pathology, Division of Clinical Dermatology, and Drs. Sepulveres and D’Agostino are from the Department of Cellularand Molecular Biology and Pathology, University of Naples Federico II, Italy. Dr. Cameli is from San Gallicano Dermatologic Institute, Rome, Italy. Dr. Tosti is from the Department of Internal Medicine, Geriatrics and Nephrology, Division of Dermatology, University of Bologna, Italy. The authors report no conflict of interest in relation to this article. Correspondence: Gabriella Fabbrocini; MD (gafabbro@unina.it).

Clear and Brilliant Laser by Solta is ideal for Asian and Hispanic Skin

nospam@example.com (David Rahimi) — Thu, 06 Oct 2011 17:32:09 +0000

Solta Medical has a brand new Laser called: Clear and Brilliant.

I believe that this laser will be greatly appreciated by patients with sensitive skin and patients with a darker skin complexion. I have written extensively about Olive and Ethnic skin and appropriateness of laser for this group of people.

The Clear and Brilliant laser is ideally suited with patients with darker skin color. It addresses superficial skin imperfections, large pores, fine lines and helps lift the skin. I have treated patients with Asian and Hispanic background with no post inflammatory hyper or hypo-pigmentation. In other words, I have not noticed any light or dark spot arising from the laser treatments.

The procedure takes about 20 minutes and is performed after the application of a topical numbing cream.

Redness lasts for a few hours and patients can return to work immediately. Post operative care is minimal and includes sunscreen and moisturizers.

A series of 3 to 5 treatments are needed to achieve long lasting results. all procedures are performed by the Doctor.

Please make an appointment for a complimentary consultation to see if you are a good candidate for this procedure.

With Clear + Brilliant we are committed to the safety of our treatments. However, as with any cosmetic treatment, there are risks, and we encourage those interested in a procedure to discuss the risks with their physician before moving forward with any elective treatment.

· Indications for Use

Contraindications

· Complications

· Complaints and Adverse Events

· Expected Responses to Treatment

· Protecting your New Skin

· Sun Protection

· Routine Skin Care

Indications for Use

The Clear + Brilliant Laser System is indicated for use in aesthetic procedures requiring the coagulation of soft tissue, as well as for general skin resurfacing procedures.

In the skin, water is the primary absorber (chromophore) of the laser wavelength used in Clear + Brilliant. It can be safely used on all skin types.

Clear + Brilliant includes an Intelligent Optical Tracking System (IOTS™) that senses skin contact with the treatment tip rollers, and the motion of the tip relative to the skin surface. This feature ensures safety and uniform delivery of the treatment.

Your treatment provider will perform a pre-treatment consultation and decide, together with you, if Clear + Brilliant is adequate for you and the course of treatments will need.

Contraindications

Not all individuals will necessarily react the same way to the laser treatment.

The following (but not limited to) contraindications are routine for many laser treatments and may also be associated with Clear + Brilliant treatments. Your provider will perform a pre-screening and request you to sign a consent including these (but not limited to) contraindications:

diagnosis / possibility of actinic keratosis, Melasma, rosacea, or other significant skin conditions (e.g. skin cancer, active infections, cold sores, open wounds, rashes, burns, inflammation, eczema, psoriasis),
predisposition to keloid formation or excessive scarring,
diagnosis of a condition that may compromise the immune system, such as HIV, lupus, scleroderma, and/or systemic infections,
known sensitivity to light or if photosensitizing agents/medications are being taken,
systemic steroids (e.g. prednisone, dexamethasone), which should be rigorously avoided prior to and throughout the course of treatment,
use of retinoids should be avoided for at least 2 weeks prior to and during treatment,
individuals undergoing Accutane™ (Isotretinoin) treatment or with drugs in a similar class,
if skin is still recovering from a cosmetic procedure, such as a chemical or mechanical peel, or laser resurfacing,
if Botox injections, or dermal fillers (such as collagen) have occurred within the past 2 weeks.

Solta Medical Inc. has no clinical information or experience concerning the use of Clear + Brilliant on pregnant women or nursing mothers.

Complications

There is a very low incidence of side effects and complications associated with laser treatment. The following complications are very rare but may be associated with non-ablative laser treatments in general. This is not intended to be an all-inclusive list, nor a substitute for informed consent, which should be provided by every individual.

Complication	Description of Complication
Discoloration	The possibility of temporary and permanent skin color change is known to exist with any laser treatment. Post-inflammatory hypo-pigmentation and hyper-pigmentation are known complications of many laser treatments and may occur with Clear + Brilliant laser treatment. Following appropriate instructions for sun protection will lower the risk for pigmentation changes.
Infection	A risk of infection exists whenever the skin is wounded. The possibility for infection exists even with non-ablative fractional laser devices such as Clear + Brillaint. If observed, infection should be treated appropriately with topical and/or systemic medications.
Prolonged Redness	Mild-moderate transient erythema is an expected response with any laser treatment. However, if erythema is severe or persists significantly longer than expected, re-treatment should be avoided until the condition resolves. Reaction may vary on a person-to-person basis.
Burns/Blistering	The base of all laser treatments is the heating of soft tissue in a controlled manner. Extended burns and/or blisters should be treated appropriately with appropriate medications.
Scarring	The possibility for scarring exists with any laser treatment, even with non-ablative laser devices such as Clear + Brillaint. Local scarring may occur directly from laser exposure if treatment procedures are not followed properly, or from infection or physical irritation such as picking and rubbing.
Delayed Wound Healing / Skin Textural Changes	Following any laser treatment, re-epithelialization may not occur as expected due to an individual’s physiology (i.e. poor wound healing ability, or post-treatment care). This may result in undesirable textural changes.
Temporary Bruising	Temporary bruising may develop over the treated areas.

Complaints and Adverse Events

Solta Customer Service should be contacted if Clear + Brillaint is involved in a complaint or adverse event.

Expected Responses to Treatment

Expected Responses	Description
Erythema (Redness)	Mild to moderate erythema (redness) typically develops immediately after treatment and diminishes or resolves within 12 to 24 hours after treatment. A small degree of redness may last longer in some cases.
Edema (Swelling)	Mild to moderate edema (swelling) typically develops immediately after treatment and diminishes or resolves within 12 to 24 hours after treatment. A small degree of swelling may last longer in some cases.
Itching / Dryness	These are common symptoms once the skin has healed initially. Flakiness and dry crusting will gradually clear. Use of bland moisturizers and/or sunscreens that have previously been shown to not cause irritation should help this condition.
Increased Skin Sensitivity	The skin can become more sensitive to touch and temperature changes. This is a sign that the skin is regenerating and daily use skin care products may be applied to soothe the skin. These sensations typically diminish within a few days after treatment.
Pain or Discomfort	Post-treatment cooling gels, cooling masks, or handheld fans may be used to alleviate discomfort. Over-the-counter itch and pain relievers may be used if necessary (e.g. Benadryl®, Claritin®, Tylenol®, etc). Solta has no knowledge of the effects of NSAIDS (e.g. Motrin®) on the outcome of treatment.

Protecting Your New Skin

For treatments associated with Clear + Brilliant, new skin (epithelium) will start to form within 24 hours but will remain covered by the old superficial layer of the skin (stratum corneum). This new skin formation usually lasts for 4 days, but can be longer for some skin types. During that time, normal exfoliation will reveal the repaired skin tissue. You can protect it by avoiding aggressive exfoliation and by applying moisturizers and sun screen frequently.

Sun Protection

Sun exposure before and during treatment can increase the risk of unwanted pigmentation. After treatment the skin is more sensitive to the sun, which can increase the risk of unwanted pigmentation and sunburn. Post-treatment individuals should plan to use a high SPF sunscreen on a regular basis. Ideally, a dual UVA/UVB sunscreen should be applied containing both a physical sun block (either or both zinc oxide or titanium dioxide) with a sun protection factor of 15 of above. Applying sunscreen helps maintain good results. In general, it is recommended that direct sunlight is avoided and to wear sun-protective clothing (i.e. a wide-brimmed hat) when possible.

Routine Skin Care

Most skin care products can be used the day after treatment. Avoid the use of retinoids and topical corticosteroids for 1 – 2 weeks before and after treatment. Avoid systemic steroids (e.g., prednisone, dexamethasone) throughout the course of the Clear + Brilliant treatment

Sun exposure is Good in moderation; Vitamin D and Cancer link

nospam@example.com (David Rahimi) — Wed, 05 Oct 2011 16:06:46 +0000

As Dermatologists we often warn our patients against direct sun exposure. We see patients with horrifying and disfiguring Basal Cell Cancer, Squamous Cell Cancers and Melanoma. I have come to the understanding that modest amount of Sun exposure is good both for our physical and psychological health. Below is an article discussing the possible health benefits of Vitamin D in preventing internal Cancers.

A. David Rahimi,MD,FAAD

www.foreveryoung.net

Study Shows Three-Fourths of Cancer Patients Have Low Levels of Vitamin D

By Charlene Laino
WebMD Health News

Reviewed by Laura J. Martin, MD

Oct. 4, 2010 (Miami Beach, Fla.) -- More than three-fourths of people with a variety of cancers have low levels of vitamin D, and the lowest levels are associated with more advanced cancers, a new study suggests.

High-dose supplements increased vitamin D levels to normal in most patients studied, but it is too soon to know if supplementation improved their outlook, says researcher Thomas Churilla, MS, a third-year medical student at Commonwealth Medical College in Scranton, Penn.

The findings were presented here at the annual meeting of the American Society for Radiation Oncology (ASTRO).

Vitamin D and Cancer Risk

Vitamin D is found in some foods, especially fatty fish, milk, and fortified cereals. Vitamin D is also obtained by exposure to sunlight.

Some studies have suggested a link between low vitamin D levels and cancer risk and progression, but others have not. None has proven cause and effect.

Research in the laboratory suggests that vitamin D has anti-tumor properties, regulating genes involved in the multiplication and spread of cancer cells, Churilla tells WebMD.

For the study, the researchers collected blood samples from 160 men and women with cancer and measured their levels of vitamin D. The five most common diagnoses were breast,prostate, lung, thyroid, and colorectal cancers.

Among people in the study, 42% had vitamin D insufficiency, defined as levels between 20 and 30 nanograms per milliliter (ng/mL) of blood. An additional 32% had vitamin D deficiency, with levels less than 20 ng/mL.

Vitamin D Levels and Stage III Cancer

The average level of vitamin D was about 24 ng/mL. People with levels below 24 ng/mL were nearly three times more likely to have stage III cancer than those with higher vitamin D levels.

Criteria for different stages differ by type of cancer. But in general, stage III indicates more extensive disease than lower stages: larger tumor size and/or spread of the cancer beyond the organ in which it first developed to nearby lymph nodes and/or adjacent organs.

There was no association between low vitamin D levels and even more advanced, stage IV cancers that have spread throughout the body, however. Churilla says that could be because patients with stage IV cancers may have already been seen by a variety of doctors who treated them for vitamin D deficiency.

Vitamin D Supplementation

As a second part of the study, the researchers treated patients with low vitamin D levels with 50,000 international units (IU) of vitamin D a week for eight weeks. The recommended dietary allowance of vitamin D for most people is 600 IU a day, but much higher doses are often needed for the short-term treatment of vitamin D deficiency. This type of treatment should only be done under a doctor's supervision.

Low Vitamin D Levels Linked to Advanced Cancers

Study Shows Three-Fourths of Cancer Patients Have Low Levels of Vitamin D

(continued)

Vitamin D Supplementation continued...

The average vitamin D levels of the supplemented patients rose to about 35 ng/mL -- in the normal range.

Now the patients have to be followed for months and years to see if vitamin D supplements appeared to reduce the chance of cancer spread and extend lives, Churilla says.

Phillip Devlin, MD, a radiation oncologist at Harvard Medical School, tells WebMD that such a study does not show cause and effect, only an association between low vitamin D levels and stage III cancer.

Churilla agrees. It could be that people with stage III cancer are more likely to have low vitamin D levels because they are sicker and don't eat as well or get out in the sun as much as people with less advanced cancer, he says.

Devlin says the study generates interesting ideas that need to be tested in larger, longer studies.

"We do not recommend vitamin D supplementation for cancer patients at this point," he says.

These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.

We are now a Center for Clear + Brilliant by Solta Medical.

nospam@example.com (David Rahimi) — Thu, 29 Sep 2011 20:53:34 +0000

INTRODUCING CLEAR + BRILLIANT

Solta Medical, the makers of Thermage and Fraxel, has recently introduced a new laser geared toward younger patients looking to prevent the signs of aging. The launch of Clear + Brilliant, a fractionated laser with minimal downtime, introduces a new category of laser treatments geared toward patient who are looking for more than run-of-the-mill spa treatments, but, as of yet, do not require the full transformative effects of more aggressive laser treatments, such as Fraxel.

Early reviews have been quite favorable. We are proud to offer Clear + Brilliant at Forever Young, Inc. Call today to schedule an appointment!

www.foreveryoung.net

323 653-7700

What is Clear Brilliant laser?

Clear and Brilliant is an FDA approved fractional laser device developed by Solta Medical targeted to work for skin rejuvenation and resurfacing on most common body parts (face, neck, hands, chests, etc.) that exhibit the early signs and symptoms of aging like the freckles, lines, fine lines, and wrinkles. It is the only laser system noted to be classified in between the less aggressive or common topical peels/solutions and the more aggressive or ablative cosmetic and laser aided treatments.

Clear + Brilliant can work as a preventive treatment and improve the current state of the skin or used as an early cure when skin problems starts to reveal. The treatment is non-invasive, no sensations of pain can be felt, and only minimal or negligible downtime is associated with it. A lot of cosmetic surgeon who are using this new treatment also find it best to couple a fractional laser treatment with Clear + Brilliant on other parts of the body right after the first procedure to ensure uniformity of treatment for the body.

How does Clear + Brilliant works?

The device works in the same principle with the rest of skin resurfacing and rejuvenating treatments and devices, but, with one major difference; laser diodes incorporated in the Clear + Brilliant unit emit a milder laser light and heat suitable for the milder skin conditions.

Clear and Brilliant laser skin resurfacing is simply, skin peeling aided by laser. The resurfacing process starts by delivering laser light and heat to the surface of the targeted skin area. This eventually destroys and removes the outermost layer of the damaged skin. As the process of healing starts, new deposits of collagen are produced, which is essentially suppler, elastic, healthy, and youthful looking. Since lines and wrinkles is directly related with the depletion of the collagen deposit on that area, the production of new collagen in those areas will mean, elimination of these signs of aging.

The process of laser skin rejuvenation on the other hand also involves delivering laser heat energy on the dermal layer of the skin. But instead of eliminating the entire outer layer of the targeted skin area, minor scattered damages are induced. Production of new collagen is still the end goal but the milder process will translate to a faster recovery period. The average Clear + Brilliant treatment would only last from 7 to 15 minutes.

Is Clear Brilliant laser treatment effective?

Though still on its introductory phase, Clear and Brilliant has already gained popularity and acceptance from most patients and practicing surgeons. It had successfully tapped into the need of young adults for a milder laser skin treatment but more effective than the common anti-aging and skin problem creams available on the market. The treatment is effective in eliminating lines, wrinkles, age spots, freckles, etc. and eventually reveals clear and brilliant skin characterized by improved skin tone and texture, smoother, fresher, and a healthier looking one.

Among the doctors who use Clear + Brilliant in making their patients satisfied and happy is Dr. Scott M. Gerrish. He wrote in a review that: “Patients loved what we were doing with the original Fraxel, but now we’re doing it better with Clear + Brilliant. Everyone wants to slow the appearance of aging. Nobody wants downtime or painful treatment – this is the perfect solution.”

Clear + Brilliant is also a great partner for all other laser based skin rejuvenation/resurfacing treatments like Fraxel, Thermage, etc to target other body parts which require milder treatment and maintain a uniform skin tone and texture.

Who may undergo Clear Brilliant laser treatment?

Clear and Brilliant is ideal for patients searching for a milder alternative than the existing ablative and non-ablative laser-aided skin treatments. It is also a cost effective anti-aging treatment option still in comparison with other laser devices. Individuals who are generally frustrated on the efficacy of chemical peels and photo facial agents are suggested to take advantage of this new technology. Aside from aesthetic purposes, the device can also treat mild to medium-severe skin problems like Melasma, instances of scarring, freckles, lines, wrinkles, etc. But patients with pre-existing skin problems should initially consult a qualified doctor first.

Clear and Brilliant health risks and health hazards

Clear and Brilliant is non-invasive therefore it’s generally safe. The developers of the device noted that minor side-effects like skin redness may exhibit on certain patients but such occurrences will not hinder the patient from exercising his or her regular routine and schedule. Also, post treatment results will vary from one patient to another. Long term effects and complications are still yet to be studied.

How much does Clear Brilliant laser costs?

Currently, there are no price reviews yet for the treatment. A prospective patient usually will need to complete 3 to 6 sessions when it is intended to cure or correct a skin condition, for maintenance and regular skin rejuvenation, a monthly or quarterly session is enough. Costs would also be determined by the availability of the device in a certain state or locality and of the surgeon or technician capable of administering the treatment.

At Forever Young treatments cost between $300 and $400; depending on the packages booked.

All treatments are performed by Dr. A. David Rahimi and include topical/local anesthesia.

www.foreveryoung.net

How to Chose your Cosmetic Surgeon

nospam@example.com (David Rahimi) — Wed, 28 Sep 2011 16:06:24 +0000

What Patients Should Know About Cosmetic Surgery and Their Cosmetic Surgeons

Plastic Surgery and Cosmetic Surgery Are Not the Same Thing.

Cosmetic surgery and plastic surgery are different specialties requiring different education, training, and experience. Cosmetic surgery involves procedures designed to enhance appearance (Common procedures include breast implants; chemical peels; chin, cheek, and nose augmentation; face lifts; hair transplants; liposuction, and tummy-tucks). Cosmetic surgery was developed, and is practiced, by dermatologists, facial plastic surgeons, general surgeons, gynecologists, oral and maxillofacial surgeons, ophthalmologists, otolaryngologists, plastic surgeons, and doctors from other fields. Unlike cosmetic surgery, plastic surgery is dedicated to reconstruction of facial and body defects due to birth disorders, trauma, burns, and disease.

There are currently no residency programs in the U.S. devoted exclusively to cosmetic surgery. And, residency programs in dermatology, general surgery, obstetrics and gynecology, oral and maxillofacial surgery, ophthalmology, otolaryngology, and plastic surgery do not include training on every cosmetic procedure. Therefore, doctors seeking to learn the vast array of cosmetic surgery procedures must do so after completing their residency training. Understanding this fact is necessary to understanding the difference between "cosmetic surgery" and "plastic surgery."

Residency training required to become board certified in plastic surgery may not include training with respect to many common cosmetic procedures. Therefore, while the title "board certified plastic surgeon" tells you the doctor has received certain training and experience with respect to "plastic surgery," it does not tell you the same thing with respect to "cosmetic surgery," and it does not tell you the doctor has more or less "cosmetic surgery" training than a board certified dermatologist, facial plastic and reconstructive surgeon, general surgeon, gynecologist, oral and maxillofacial surgeon, ophthalmologist, otolaryngologist, or other doctor. Therefore, to find the most qualified doctor for a specific cosmetic procedure, patients must compare doctors' overall (residency and post-residency) training and experience with respect to that procedure.

Cosmetic surgery patients need to understand that the education, training, and experience required for a doctor to become competent in cosmetic surgery is not the same as that required to become competent in plastic surgery. The Article's suggestion to the contrary is simply false. See Diagram A.

Diagram A
Diagram A illustrates the Article's false premises that all board certified plastic surgeons, and only board certified plastic surgeons, are qualified to perform all cosmetic procedures. Cosmetic surgery patients who believe these false premises are misled into relying on incomplete and inaccurate information when choosing their physician. As a result, patients fail to consider many well-qualified cosmetic surgeons, and fail to properly evaluate physicians' education, training, and experience regarding their cosmetic procedure. As a result, their safety is jeopardized by: (1) having their choice of qualified cosmetic surgeons arbitrarily reduced;¹ and (2) potentially being directed to physicians with little or no cosmetic surgery experience.

The fact is that there are physicians in various specialties who obtain the necessary post-residency education, experience and training to become qualified to perform cosmetic surgery, and there are others who do not. Therefore, a physician's competence, skill, and ability with respect to a cosmetic surgery procedure depends on their education, training, and experience regarding that procedure, and not on their particular board certification. See Diagram B.

Diagram B
Diagram B correctly illustrates that within each discipline there are physicians who received specialized education, training, and experience in cosmetic surgery (inner circle — "Qualified Cosmetic Surgeons") as well as physicians who have not and are, therefore, not qualified to perform cosmetic surgery. Whether physicians from among the various disciplines are qualified to perform cosmetic surgery is determined by their education, training, experience, and proven competence with respect to the contemplated cosmetic procedure, and not by their underlying board certification. It is imperative that cosmetic surgery patients understand this fact. Those who only consider a physician's underlying board certification when choosing their doctor base their decision on incomplete information and reduce their choice of qualified cosmetic surgeons. See Diagram A.

Cosmetic surgery patients who believe that all board certified plastic surgeons, and only board certified plastic surgeons, are competent in cosmetic surgery may choose an unqualified physician (i.e., board certified plastic surgeon with inadequate or no training with respect to the given cosmetic procedure) and are, therefore, at risk. Compare Diagrams A and B.

Criteria for Evaluating Physicians.

The Article falsely suggests that hospitals evaluate doctors based on their board certification, and therefore patients should do the same. On the contrary, the criteria hospitals use to evaluate physicians specifically opposes relying on a doctor's board certification. Instead, the criteria for evaluating physicians applied by national healthcare organizations requires an assessment of the physician's education, training, experience, and proven competence. This criteria is consistently published by the American Medical Association ("AMA"), American Osteopathic Association's Healthcare Facilities Accreditation Program (HFAP), the Joint Commission, which accredits hospitals in the U.S., and the Federal Government. In fact, the U.S. Department of Health and Human Services expressly prohibits the granting of staff membership or hospital privileges solely on certification or membership in a specialty body or society.

Recognizing the potential abuse of specialty certification, AMA's House of Delegates adopted Substitute Resolution 88 regarding the delineation of clinical privileges:

Resolved that it is the American Medical Association policy that individual character, training, competence, experience, and judgment be the criteria for granting privileges in hospitals; and be it further resolved, that the physicians representing several specialties can and should be permitted to perform same procedures if they meet this criteria.

AMA's policy on "Board Certification and Discrimination" specifically opposes discrimination against physicians based solely on lack of ABMS or equivalent American Osteopathic Board certification. Importantly, all of these authorities agree the use of a single criterion, including board certification, in evaluating a physician is inappropriate and inconsistent with providing quality patient care.

Board Certification in Cosmetic Surgery.

Contrary to the Article's false information, there are multiple valid certifying boards that are not members of the American Board of Medical Specialties ("ABMS"), and, importantly, none of the ABMS member boards certify physicians in cosmetic surgery.

ABMS is only one of several private organizations that recognize medical specialty certifying boards that meet their membership requirements. Today, the three largest organizations that provide medical specialty board recognition include the ABMS (recognizing 24 specialty boards), the American Osteopathic Association's Bureau of Osteopathic Specialists (recognizing 18 specialty boards), and the American Board of Physician Specialties (recognizing 18 specialty boards). All three organizations assist their member boards in developing educational and professional standards to evaluate and certify physicians in their respective specialties. And, all three are private membership organizations that must consider, address, and foster the interests of their members. What a board's certification evidences about the education, training, and experience of those it certifies depends on its certification requirements; not on the membership association to which it belongs.

The American Board of Cosmetic Surgery ("ABCS") certifies physicians exclusively in cosmetic surgery. In addition to other certification requirements, all applicants for certification by ABCS must first be certified by one of the following ABMS or AOA member boards:

American Board of Dermatology;
American Board of Surgery;
American Board of Obstetrics and Gynecology;
American Board of Ophthalmology (with completion of an American Society of Ophthalmic Plastic and Reconstructive Surgery approved Oculoplastic Fellowship);
American Board of Otolaryngology;
American Board of Plastic Surgery;

or be recognized by the American Board of Oral and Maxillofacial Surgery (ABOMS) and have an MD degree. In determining certification, ABCS considers only eligible candidates who, by definition, have completed certain general surgical training and specific additional cosmetic surgery training. The residency and post-residency training required by an ABMS candidate's core board coupled with the additional training required by ABCS for certification meets or exceeds that which eligible candidates to any ABMS board (including plastic surgery) must obtain with respect to any certified cosmetic procedure. Without substantial post-residency training in cosmetic surgery, many if not most board certified plastic surgeons do not qualify for certification by ABCS.

Liposuction and the Tumescent Technique.

Importantly, the Article misrepresents facts about liposuction suggesting it is safer if performed under general anesthesia rather than local anesthesia when, in fact, the opposite is true. From the pioneering liposuction techniques introduced in Europe in the 1970s through the time it was introduced in the U.S. in the early 1980s, liposuction procedures were performed under general anesthesia. This changed in the mid-1980s when dermatologist, Jeffrey A. Klein, M.D., developed the tumescent technique. The tumescent technique, which involves local anesthesia, revolutionized liposuction and is much safer than liposuction under general anesthesia.

As confirmed in an article published in the Journal of Clinical Anesthesia (Liposuction: contemporary issues for the anesthesiologist), many physicians who perform liposuction have not made the effort to learn the new, safer procedure:

Unfortunately, many physicians and anesthesiologists, due to their limited training in tumescent anesthesia, still believe that modern general anesthesia is the safest route for liposuction. Consequently, many do not make the effort to learn the new technique that allows liposuction totally by local anesthesia. Although modern general anesthesia is considered safe, it may expose the patient to unnecessary risk given that a safer alternative is available. Now that liposuction can be performed totally by local anesthesia, it might be considered that general anesthesia is often abused in the world of cosmetic surgery. Kucera, M.D., Ian J., Liposuction: contemporary issues for the anesthesiologist. Journal of Clinical Anesthesia, 2006, 18: 380).

Most importantly, and as further confirmed by multiple fact based studies and articles over the past decade, liposuction patients of board certified plastic surgeons experienced a significantly higher death rate, insurance claims, and malpractice complaints, compared to other specialties performing cosmetic procedures.

How to Choose Your Cosmetic Surgeon.

Cosmetic surgery patients should ask their cosmetic surgeon the following:

How long have you been performing the specific cosmetic procedure?
What are the risks and possible complications? Before the surgery, your doctor should explain to you the risks and possible complications, and potential side effects, including the pros and cons of the procedure.
Where did you receive your training with respect to the procedure?
How much experience do you have performing the procedure? How many have you performed in total? How many have you performed over the past year?
How do you define success with regard to the procedure? What is your success rate performing the procedure? How many of your patients have returned for revisions or corrections with respect to the procedure? How many of your patients have returned for revisions or corrections in general?
May I review "before and after" pictures of those who have had the procedure performed by you?
Where will you perform my procedure? Is the facility accredited? Cosmetic surgery is performed in various facilities such as hospitals, surgical centers, and office settings. An accredited surgical facility must meet certain minimum standards to obtain and maintain its accreditation. Some certifying organizations include the Joint Commission (formerly "JCAHO"), the Accreditation Association for Ambulatory Health Care ("AAAHC"), and the American Association for Accreditation of Ambulatory Surgery Facilities ("AAAASF").
Are there any alternatives to the procedure that may exist considering my desired result?

The Article was based on false and misleading information. Accordingly, we respectfully urge USA Today to correct the misinformation before cosmetic surgery patients rely on the Article and are harmed.

Respectfully Submitted on behalf of:

American Academy of Cosmetic Surgery, Angelo Cuzalina, MD, DDS, President
American Board of Cosmetic Surgery, Michael Will, MD, DDS, President
Cosmetic Surgery Foundation for Education, Research and Patient Safety, Suzan Obagi, MD, President; Jane Petro, MD, FACS, Executive Director
Robert Jackson, MD, AMA House of Delegates Cosmetic Surgery Representative

¹ The total number of physicians board certified in the named specialties since the Boards' inceptions (dermatology, general surgery, gynecology, ophthalmology, otolaryngology, oral and maxillofacial surgery, and plastic surgery) exceeds 176,840; with approximately the following breakdown among specialties: Dermatology: 14,330; General Surgery: 57,810; Gynecology: 49,110; Ophthalmology: 24,800; Otolaryngology: 15,960; Oral and Maxillofacial Surgery: 7,060; and Plastic Surgery: 7,770. Board certified plastic surgeons make up only 4.4% of the total number of board certified physicians shown. (ABMS 2010 Certificate Statistics; and Report of the ADA-Recognized Specialty Certifying Boards April 2011).

Bed Bugs!

nospam@example.com (David Rahimi) — Tue, 27 Sep 2011 20:25:16 +0000

Bedbug Insecticides More Harmful Than the Pest

By: FRANCES CORREA, Skin & Allergy News Digital Network

09/22/11

FROM MORBIDITY AND MORTALITY WEEKLY REPORT

Major Finding: In all, 111 illnesses and one fatality caused by improper use of bedbug insecticides were reported in 2003-2010.

Data Source: An analysis of data from seven states.

Disclosures: The investigators reported no relevant financial disclosures.

In recent years, the United States has seen an increase of bedbug infestations, according to the Centers for Disease Control and Prevention. However, the chemicals used to eradicate the bugs are causing more harm than are the bugs themselves.

In all, 111 illnesses and one fatality caused by improper use of insecticides were reported in seven states in 2003-2010, according to the CDC’s Morbidity and Mortality Weekly Report. The report analyzed cases in California, Florida, Michigan, North Carolina, New York, Texas, and Washington.

^{Photo courtesy CDC/Piotr Naskrecki}

Bedbugs don’t transmit disease, but misuse of chemicals and pesticides used to eradicate these insects can cause illness and even death.

The analysis showed that illnesses resulted most commonly from excessive insecticide application, lack of notification of pesticide application, and not washing or changing insecticide-treated bedding. In addition, 39% of pesticide applications were done by people living in the home who weren’t certified to apply the pesticides. Private homes were the site of 43% of the illnesses; 40% occurred in multiunit housing. Hotels were the source of only 3% of illnesses. A majority (67%) of illnesses occurred in people aged 25 years or older.

The most common symptoms of illness were headaches and dizziness (40% of cases), respiratory symptoms (40%), and gastrointestinal issues including nausea and vomiting (33%). New York City had the most cases of insecticide-related illness, representing 58% of cases (MMWR 2011;60:1269-74).

However, 81% of cases were considered low severity. The report also showed that 89% of the illness-causing insecticide exposures, including the fatality, were to pyrethroids, pyrethrins, or both, and were in toxicity category III.

Bedbugs themselves do not carry disease, and the CDC recommends using nonchemical methods for treating an infestation. For example, infested rooms can be heated to 118° F or cooled to 3° F for 1 hour. The CDC also recommends vacuuming, steaming, laundering, or disposing of infested items, and encasing mattresses and box springs in bedbug-proof covers.

Acne and Acne Scarring-review of the Literature.

nospam@example.com (David Rahimi) — Wed, 21 Sep 2011 17:15:55 +0000

Here are a series of articles on Acne and Acne scarring that I found particularly interesting.

We, at Foreveryoung, Inc., specialize on the treatment of Acne and Acne scarring:

Ablative skin resurfacing.

Chwalek J, Goldberg DJ.

Source

Skin Laser & Surgery Specialists of New York & New Jersey, USA.

Abstract

Ablative skin resurfacing has remained the gold standard for treating photodamage and acne scars since the development of the first CO(2) lasers. CO(2) and Er:YAG lasers emit infrared light, which targets water resulting in tissue contraction and collagen formation. The first ablative laser systems created significant thermal damage resulting in unacceptably high rates of scarring and prolonged healing. Newer devices, such as high-energy pulsed lasers and fractional ablative lasers, are capable of achieving significant improvements with fewer side effects and shorter recovery times. While ablative resurfacing has become safer, careful patient selection is still important to avoid post-treatment scarring, dyspigmentation, and infections. Clinicians utilizing ablative devices need to be aware of possible side effects in order to maximize results and patient satisfaction. This chapter reviews the background of ablative lasers including the types of ablative lasers, mechanism of action, indications for ablative resurfacing, and possible side effects.

Dermatol Surg. 2011 Aug 11. doi: 10.1111/j.1524-4725.2011.02110.x. [Epub ahead of print]

Evaluation of the Effect of Fractional Laser with Radiofrequency and Fractionated Radiofrequency on the Improvement of Acne Scars.

Peterson JD, Palm MD, Kiripolsky MG, Guiha IC, Goldman MP.

Source

Dermatology Cosmetic Laser Associates of La Jolla, San Diego, California.

Abstract

BACKGROUND Options for acne scar reduction include peels, subcision, fillers, lasers, dermabrasion, and surgical excision, although not all are applicable in darker skin types. A novel device with a handpiece combining optical and radiofrequency (RF) energies along with a fractionated RF handpiece is available for nonablative resurfacing. OBJECTIVES Our primary objective was to evaluate the improvement in acne scars and skin texture. Secondary objectives were determination of patient satisfaction and comfort and evaluation of scar pigmentation improvement. Patients received five treatments at 30-day intervals. Post-treatment follow-up visits were performed 30 and 90 days after the last treatment. RESULTS A 72.3% decrease (p<.001) was observed on the acne scar scale from day 1 to 210. From day 30 to 210, investigator-rated changes in scarring, texture, and pigmentation improved 68.2% (p<.001), 66.7% (p<.001), and 13.3% (p=.05), respectively. Patient satisfaction scores showed no significant change over time, although patient-evaluated overall improved scores increased 60% over baseline (p=.02). CONCLUSION This technology may be a useful, nonablative resurfacing treatment for acne scarring. Scarring, texture, and pigmentation improved significantly according to investigator-rated assessment parameters. Although patient satisfaction scores did not improve, overall improvement scores did. The study was supported by Syneron.

J Drugs Dermatol. 2011 Aug;10(8):907-12.

Evaluation of clinical improvement in acne scars and active acne in patients treated with the 1540-nm non-ablative fractional laser.

Isarría MJ, Cornejo P, Muñoz E, Royo de la Torre J, Moraga JM.

Source

Instituto Médico Láser, Servicio de Dermatología, Madrid (Spain). mjisarria@hotmail.com

Abstract

INTRODUCTION:

Acne is a characteristic condition of puberty; however, adults who continue to have acne outbreaks frequently attend dermatology clinics. Two conditions-active acne and residual scarring-often co-occur in these patients. The objective of the present study was to evaluate the improvement in scarring and active acne after treatment with a 1540-nm erbium: glass fractional laser.

MATERIAL AND METHODS:

The authors treated 20 patients with acne and scarring. Each patient received panfacial treatment in four sessions with a 1-month interval between sessions. Patients, the treating physician and a blinded observer evaluated the results in four areas: improvement in scars, improvement in pores, improvement in acne, and improvement in sebum secretion. Improvements were graded using the Global Aesthetic Improvement Scale. The evaluation was made 12 weeks after treatment finished.

RESULTS:

Patients presented an improvement in both acne and scars. In 80 percent of cases, patients felt that the appearance of the scars had improved, and the improvement was classified as very much improved in 40 percent. In 85 percent of cases, patients felt that active acne had improved, and the improvement was classified as very much improved in 45 percent. Pore size was evaluated as improved by 75 percent of patients. Sebum secretion improved in 80 percent of cases.

CONCLUSION:

A 1540-nm non-ablative fractional laser provides effective treatment of acne scars. Patient satisfaction is high and active acne lesions improve significantly. Treatment of this mixed condition (scarring and active acne) with a single device is reliable, with a favorable safety profile and a high degree of patient acceptance.

Acne vulgaris in children and adolescents.

Schnopp C, Mempel M.

Source

Department of Dermatology Biederstein, Technical University, München, Germany - nina.schnopp@lrz.tu-muenchen.de.

Abstract

Acne vulgaris is a very common inflammatory skin disease originating from the pilosebaceous unit. Peak incidence is at puberty, but acne can affect all age groups. Prepubertal acne is rare, but important to recognize as diagnostic and therapeutic procedures differ from pubertal acne. Acne neonatorum is a mild, self-limiting disease, whereas acne infantum commonly presents with moderate to severe lesions and high risk of scarring thus requiring early intervention. Mid-childhood or prepubertal acne raises the suspicion of hyperandrogenemia, further investigations are indicated to rule out underlying disease. The same applies to any patient with very severe acne, acne not responding to therapy or unusual clinical presentation. Etiopathogenesis of acne is not yet fully understood. Familiy history is the most important risk factor to develop severe acne and scarring. The relevance of life style factors such as smoking or diet is controversial. Lately high carbohydrate diet and dairy products have been implicated as aggravating factors. Mild acne normally responds to topical monotherapy, in moderate disease combination of two synergistically acting substances (e.g. benzoyl peroxid plus antibiotic, benzoyl peroxid plus retinoid, retinoid plus antibiotic, benzoyl peroxid plus azelaic acid) will improve clinical response. Retinoids and/or benzoylperoxid have been shown to be effective in maintenance therapy. In patients with severe disease or high risk of scarring systemic therapy with antibiotics, oral contraceptives with antiandrogenic properties and in particularly isotretinoin as most effective acne treatment should be considered early to avoid physical and emotional scars.

Curr Probl Dermatol. 2011;42:40-7. Epub 2011 Aug 16.

Dermatol Surg. 2011 Jul;37(7):945-61. doi: 10.1111/j.1524-4725.2011.02036.x. Epub 2011 Jun 17.

Treatment of acne scarring using a dual-spot-size ablative fractionated carbon dioxide laser: review of the literature.

Tierney EP.

Source

Department of Dermatology, Tufts University School of Medicine, Boston, Massachusetts 02111, USA. etierney29@gmail.com

Abstract

BACKGROUND:

Fractional photothermolysis has been reported in the literature to improve pigmentary and textural changes associated with acne scarring.

OBJECTIVE:

To review the literature for the treatment of acne scarring using nonablative fractional laser (NAFL) and ablative fractional laser (AFL) resurfacing.

METHODS:

Review of the Medline literature evaluating NAFL and AFL for acne scarring.

RESULTS:

NAFL and AFL are safe and effective treatments for acne scarring. It is likely that the controlled, limited dermal heating of fractional resurfacing initiates a cascade of events in which normalization of the collagenesis-collagenolysis cycle occurs. We present the results of a patient treated using a novel dual-spot-size AFL device. Three months after the final treatment, the patient reported 75% improvement in acne scarring and 63% overall improvement in photoaging.

CONCLUSIONS:

Fractionated resurfacing for the treatment of acne scarring is associated with lesser risks of side effects of prolonged erythema and risks of delayed-onset dyspigmentation and scarring which complicate traditional ablative laser resurfacing approaches. We present herein preliminary data suggesting that a dual-spot-size AFL device presents novel advantages of improving texture and pigmentation in acne scarring and photoaging.

Acne scarring-treatment via Mixto and Dermabrasion

nospam@example.com (David Rahimi) — Thu, 08 Sep 2011 15:16:37 +0000

Warning-graphic video

please visit us on facebook for this patient's before and after photos.

Follow the link on the right lower corner of the landing page.

Like us and become friends on FB for special promotions.

http://www.youtube.com/watch?v=chSbcbqjiNc

You are what you eat; food than can make your skin glow!

nospam@example.com (David Rahimi) — Thu, 25 Aug 2011 00:04:43 +0000

Interesting article; worth reading.

http://www.webmd.com/healthy-beauty/features/skin-food

Medical Complications of Cosmetic Surgery Across the Border!

nospam@example.com (David Rahimi) — Thu, 18 Aug 2011 15:59:25 +0000

I also have noticed an uptick in medical complications resulting from Cosmetic Surgery performed in Mexico.

A. David Rahimi,MD,FAAD,FAACS.

http://cosmeticsurgerytimes.modernmedicine.com/cosmeticsurgerytimes/article/articleDetail.jsp?id=735909&sk=09e614b472c2102e76c9067d6a094ae1

FREE BOTOX_ONE DAY ONLY_NEW PATIENTS ONLY

nospam@example.com (David Rahimi) — Wed, 17 Aug 2011 15:43:39 +0000

FREE BOTOX

Yes; there is such a thing as a Free Lunch!

One day only-8/24^th 2011

Come and visit us and receive one are (up to 20 units) of Botox FREE

(This is a $240 value-No other obligations-New Patients Only)

www.foreveryoung.net

Please tell your friends about us!

Zonya Villatoro

Office manager 323 653-7700

Laser Eyebrow Tattoo Removal using the Palomar YAG 5

nospam@example.com (David Rahimi) — Thu, 11 Aug 2011 18:54:38 +0000

Here are 2 links to youtube videos showing the YAG Tattoo removal laser in action:

http://www.youtube.com/watch?v=jm-qwA8nFZo

and

http://www.youtube.com/watch?v=ZBOkEQ6CNC4

Please make an appointment for a complimentary consultaion.

A. David Rahimi,MD,FAAD.FAACS.

We are now a Pinpointe Footlaser provider.

nospam@example.com (David Rahimi) — Fri, 22 Jul 2011 15:36:01 +0000

Two is better than one! We just added the Pinpoint Footlaser, for the treatment of nail fungus and warts, to our practice. Now we can treat you with the Cooltouch and the Pinpointe laser. The additional laser should increase the effectiveness of the nail fungus laser cure to almost 90 percent!

http://pinpointefootlaser.com/patients

Consultaion is always free.

A. David Rahimi,MD,FAAd,FAACS.

Pure laser Face Lift? Is it Possible?

nospam@example.com (David Rahimi) — Fri, 08 Jul 2011 18:24:12 +0000

I was recently asked by a patient if she could have a pure laser lift? She did not want to have any scars and basically no “cutting” surgery. The answer is a definitive YES. The procedure needs to be individualized to the patient’s age and skin color/texture.

I use a combination of 4 modalities to achieve a pure laser lift. Here is how:

I use laser micro-liposuction to remove excess fat in the jowl and under the chin/neck.

This is followed by an aggressive Thermage CPT to tighten the eyelids/forehead/and cheeks.

Autologous fat is harvested from the abdomen or thighs and concentrated using the Coleman Centrifuge. The fat is fortified with Plasma Rich Protein (PRP) and Stem cells. This viable micro fat grafts are then placed into the laugh lines and cheeks as needed.

Finally a fractionated CO2 laser (Mixto Laser) is used to remove sun damaged skin, brown spots and those vertical lines around the mouth and sides of the eyes! The skin basically shrinks back once the production of Collagen and Elastic fibers are stimulated.

The entire procedure is performed under local oral sedation and takes less than 2 hours.

Cost: $5000 to $9000 (includes OR fee, blood work, PRP, Garment, and laser /Surgeon’ fees)

Saline Injections for the Correction of Acne Scars

nospam@example.com (David Rahimi) — Tue, 14 Jun 2011 18:25:37 +0000

Saline (sterile salt water) injections can be a safe, inexpensive option for reducing depressed and rolling acne scars. The rolling and atrophic types of acne scars are caused by many different factors including thick fibrous bands that pull the center of the scars down and cause its adherence to the deeper reticular dermis and fascia.

I have described in the past how needling and subsicion in addition to fat transfer and Mixto CO2 resurfacing can reduce these types of scars.

A less invasive method of improving these scars is to inject the deepest portion of the scars with a bolus of sterile salt water. No one is allergic to salt water (our body is 90 percent salt water) and risks such as infection and bleeding/scarring are very small. Water molecules are very small and can hydro-dissect the acne scars and cause a small amount of bleeding into the deepest portion of the scars. This, in turn, causes Collagen and Elastic fiber synthesis and improves the deeper scars.

Five to seven treatments are usually needed to see a significant improvement. Saline injection is usually used in conjunction with Cooltouch lasers, peels, fat or fillers.

The treatments take 15 to 30 minutes and can be performed under local anesthesia. Downtime is usually 1-3 days .Most patients may return to work or school with minimal bruising and swelling that can last up to a week.

Cost :$250-$500 per treatment (depending on the size of the area involved).

All treatments are performed by Dr. A. David Rahimi. You will be treated by a double board certified Dermatologist and Cosmetic surgeon with over 14 years of clinical experience.

Dr. David Rahimi has performed over 100000 successful laser and cosmetic treatments.

Melasma

nospam@example.com (David Rahimi) — Thu, 02 Jun 2011 19:35:23 +0000

Melasma in Latin Americans

A recent article in the journal of Drugs and Dermatology by Maritza Perez, et al on Melasma causes and treatments was quite thorough. Although the cause of Melasma remains elusive (combination of genetic predisposition, hormone replacement, pregnancy, thyroid disorder, and sun exposure) better treatments are emerging.

Topical therapies include:

2%, 4%, 6%, 8% Hydroquinone cream

Retin A creams and gels

Differin Gel

Mild Corticosteroids (pulsed)

Azelaic Acid gels

Kojic Acids

Combination therapies of all of the above and SPF 50

Procedural approaches:

Glycolic peels (10%, 20%,30%,50%, 75%)

Beta Glycolic and Salicylic Acid peels

Microdermabrasion and O2 Facials

Lasers and Light Sources:

Photofacial (IPL)

CO2 Fractional Laser (Mixto Fraxel)

Erbium Fraxel (Alma laser)

MED (manual Epidermal Dermabrasions) -see list of procedures on this site

Treating Melasma is challenging and requires a lot of patience from

the patient and the practitioner.

Treatment packages of 5 treatments over 2-3 months start at $500.

Please see us for a complementary evaluation and an individualized treatment regimen.

A. David Rahimi,MD,FAAD,FAACS.

we now offer Laser Tattoo removal.

nospam@example.com (David Rahimi) — Sat, 21 May 2011 15:59:58 +0000

Starting next month we will offer laser Tattoo removal using the Palomar Q-Yag 5 system.

Remove dated Tattoos and get ready for a new job or a new relationship.

Read more about the art and science of tattoo removal :

http://www.palomarmedical.com/treatments/tattoo-removal.aspx

A. David Rahimi,MD,FAAD,FAACS.

Healing

nospam@example.com (David Rahimi) — Wed, 27 Apr 2011 21:46:19 +0000

The Mind, Body, and Soul

Kathleen Rosenblatt is a licensed Acupuncturist and author of several books.

I recently met her and listened to her CD titled: "Cellular Meditation" and was quite impressed.

Cellular meditation for stress release has been described as: practical advice, guided imagery and breath work to help normalize biochemical imbalances. I strongly believe in the power of imagery and use it often with my “light sedation approach”.

The 2 volume CD includes several morning and evening meditation sessions.

www.CellularMeditation.com

A. David Rahimi,MD,FAAD,FAACS.

Why I don't transfer fat into the breasts!

nospam@example.com (David Rahimi) — Fri, 22 Apr 2011 17:58:27 +0000

I stopped transferring fat into the breasts in 1999.

Dr. Mell Shiffman from newport Beach california reported similar findings. Most radiologist can not discern the difference between the occasional "fat transfer" calcifications and malignant breast cancer calcifications.

Breast injection skews mammograms

Apr 21, 2011
By: Bill Gillette
Cosmetic Surgery Times E-News

Beijing — Results of a new study show that breast augmentation procedures in which fat from the patient’s body is transferred to the breasts can cause false suspicion of breast cancer on follow-up mammograms, Medical News Today reports.

Researchers from Meitan General Hospital in Beijing looked at records of 48 women who underwent autologous fat injection for breast augmentation between 1999 and 2009. Follow-up mammograms obtained some years after the procedures showed “clustered microcalcifications” in eight of the 48 women, or 16.7 percent. In all eight cases, the microcalcifications were regarded as “highly suspicious” for breast cancer.

The abnormalities prompted biopsies, but none revealed breast cancer. Instead, the calcifications appeared to be related to necrosis of the injected fat cells. The study found that mammographic changes occurring after fat injection are indistinguishable from abnormalities associated with breast cancer.

Despite a long history of debate over the use of injected fat for breast augmentation, more recent studies have reported that the method provides very good results, and that any changes seen on mammograms are easily distinguished from abnormalities related to breast cancer.

In contrast, the new study finds mammographic abnormalities suspicious for breast cancer in one out of six women undergoing fat injection for breast augmentation.

According to the study, the clustered microcalcifications are indistinguishable from those associated with breast cancer, requiring a biopsy to help physicians make the correct diagnosis. Because of this issue, the authors write in the April issue of Plastic and Reconstructive Surgery, autologous fat injection for breast augmentation should be discontinued.

That recommendation conflicts with a paper published in the March issue of Plastic and Reconstructive Surgery, which concluded, “Radiographic follow-up of breasts treated with fat grafting is not problematic and should not be a hindrance to the procedure.”

How to prevent unsightly "sleep lines" on your face and chest??

nospam@example.com (David Rahimi) — Tue, 19 Apr 2011 18:36:42 +0000

The short answer: Try to sleep on your back! Yes it is easier said than done.

Here is an interesting article from CNN.com

(Health.com) -- Your preferred p.m. pose could be giving you back and neck pain, tummy troubles, even premature wrinkles. Here are the best positions for your body -- plus the one you may want to avoid.

The Best: Back position

Good for: Preventing neck and back pain, reducing acid reflux, minimizing wrinkles, maintaining perky breasts.

Bad for: Snoring

The scoop: Sleeping on your back makes it easy for your head, neck, and spine to maintain a neutral position. You're not forcing any extra curves into your back, says Steven Diamant, a chiropractor in New York City. It's also ideal for fighting acid reflux, says Eric Olson, M.D., co-director of the Mayo Clinic Center for Sleep Medicine in Rochester, Minnesota: "If the head is elevated, your stomach will be below your esophagus so acid or food can't come back up."

Back-sleeping also helps prevent wrinkles, because nothing is pushing against your face, notes Dee Anna Glaser, M.D., a professor of dermatology at Saint Louis University. And the weight of your breasts is fully supported, reducing sagginess.

Consider this: "Snoring is usually most frequent and severe when sleeping on the back," Olson says.

Perfect pillow: One puffy one. The goal is to keep your head and neck supported without propping your head up too much.

Next Best: Side position

Good for: Preventing neck and back pain, reducing acid reflux, snoring less, sleeping during pregnancy

Bad for: Your skin and your breasts

The scoop: Side-sleeping is great for overall health -- it reduces snoring and keeps your spine elongated. If you suffer from acid reflux, this is the next best thing to sleeping on your back.

Now for the downside: "Sleeping on your side can cause you to get wrinkles," Glaser says. Blame all that smushing of one side of your face into the pillow. This pose also contributes to breast sag, since your girls are dangling downward, stretching the ligaments, says Health magazine's Medical Editor Roshini Rajapaksa, M.D.

Consider this: If you're pregnant, sleep on your left side. It's ideal for blood flow.

Perfect pillow: A thick one. "You need to fill the space above your shoulder so your head and neck are supported in a neutral position," says Ken Shannon, a physical therapist at Brigham and Women's Hospital in Boston.

Not Ideal: Fetal position

Good for: Snoring less, sleeping during pregnancy

Bad for: Preventing neck and back pain, minimizing wrinkles, maintaining perky breasts

The scoop: Outside of your mother's uterus, resting in a tight fetal pose isn't a great idea. When you snooze with your knees pulled up high and chin tucked into your chest, you may feel it in the morning, especially if you have an arthritic back or joints, Olson says.

"This curved position also restricts diaphragmatic breathing," adds Dody Chang, a licensed acupuncturist with the Center for Integrative Medicine at Greenwich Hospital in Connecticut. And if you make this your nightly pose, you may bring on premature facial wrinkles and breast sag.

Consider this: Just straighten out a bit -- try not to tuck your body into an extreme curl.

Perfect pillow: One plump pillow -- the same as side position, to give your head and neck support.

The Worst: Stomach position

Good for: Easing snoring

Bad for: Avoiding neck and back pain, minimizing wrinkles, maintaining perky breasts

The scoop: "Stomach-sleeping makes it difficult to maintain a neutral position with your spine," Shannon explains. What's more, the pose puts pressure on joints and muscles, which can irritate nerves and lead to pain, numbness, and tingling.

"Think about the soreness you'd feel if you kept your neck turned to one side for 15 minutes during the day," Diamant explains. In this position you have your head to one side for hours at a time. You won't necessarily feel it the next day, but you may soon start to ache.

Consider this: Do you snore? "Stomach-sleeping may even be good for you," Olson says. Facedown keeps your upper airways more open. So if you snore and aren't suffering from neck or back pain, it's fine to try sleeping on your belly.

Perfect pillow: Just one (and make it a thin one) or none at all.

MRI Dyes can cause Skin Poisoning

nospam@example.com (David Rahimi) — Fri, 15 Apr 2011 18:12:27 +0000

MRI Dyes Poisoning Patients, Turning Skin into "Marble"

Friday, May 30, 2008 by: David Gutierrez, staff writer

NaturalNews presents Healing Miracles LIVE! April 21, 2011. Streaming live video.

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(NaturalNews) In some patients with kidney problems, a common dye used in magnetic resonance imaging (MRI) tests may lead to an incurable and potentially fatal disease that causes skin to turn hard and immobile.

Nephrogenic systemic fibrosis (NSF) is a poorly understood medical condition in which collagen builds up in the skin and makes it hard and immobile, making it come to resemble marble. NSF can also cause collagen to build up in the heart, lungs and liver, with potentially fatal consequences.

More than 95 percent of NSF cases are known to have occurred within three months of a patient being exposed to dyes made with a magnetic ion called gadolinium. Gadolinium dyes are used in MRIs because they bind to specific tissues, increasing the contrast and usefulness of the images.

In May, the FDA asked for a black box warning on all gadolinium-based products, warning that a single exposure may be enough to cause NSF in kidney patients. The FDA advised kidney patients undergoing MRIs to request that their physicians not use contrasting dyes in the exam unless it is absolutely necessary.

A black box warning is the strongest warning the FDA can issue without banning a product. However, the FDA has approved no other dyes for use in multi-purpose MRIs; only two other dyes are approved for certain liver problems.

According to Shawn E. Cowper, a dermatologic pathologist at Yale University who first identified NSF, as many as one in 20 kidney patients could be at risk if exposed to gadolinium.

"I don't think there's been a day in the last, probably, two years that's gone by that I haven't cried at least once about this," said Sarah Fracella, who developed NSF after receiving an MRI. Due to the hardening of her skin, Fracella has trouble sitting or walking, and is unable to open bottles.

"It's been the hardest thing I've ever had to deal with."

Articles Related to This Article:

• Cheap, all natural, one minute test outperforms MRI for diagnosing stroke

• MRIs Harm More than Help Women with Early Breast Cancer

• Aluminum in Medication Patches Causes Severe Skin Burns During MRI Scans

• The ADHD Scam and the Mass Drugging of Schoolchildren (Transcript)

• Questions Over Accuracy of MRI in Diagnosing Multiple Sclerosis (press release)

How to get rid of acne scars naturally?

nospam@example.com (David Rahimi) — Wed, 02 Mar 2011 21:40:09 +0000

By: A.David Rahimi,MD,FAAD,FAACS (www.foreveryoung.net)

I recently came across an article on howtogetridofstuff.com that addressed treating acne and acne scarring. The article started out sounding relatively reasonable, urging patients to see a dermatologist if they have “too many” acne scars, but then suggested the following remedies.

I will cover each suggestion and try to give you a more medical perspective. My comments with be highlighted at the end of each paragraph. The article is written by Marvin? – It is not clear what his medical qualifications are.

Drink lots of water: Water has amazing cleansing and rejuvenating properties. Some experts believe that the best way to treat acne scars naturally is to drink lots of water. Dead skin cells are shed off easier when your body is hydrated with enough water. New skin also grows faster and smoother when you have lots of water in your body.

I spend over 15 minute on pubmed.gov looking for even a single article that definitively shows drinking water affects acne or acne scarring. Pubmed.gov is the definitive research source and has every scientific article written in over 40 languages since the 1960s. It is free and can be accessed from any computer or library. Drinking lots of water” is going to do little you for your acne and certainly nothing for the scarring. Too much water can cause can cause a variety of problems from electrolyte imbalance to very rare cases of CNS injury. I agree that drinking water should be part of a healthy diet but it won’t do much for your acne scarring.

Eat fruits and vegetables: Fruits and vegetables contain lots of vitamins and minerals that can help your skin restore its former beauty. They also contain juices which keep your body hydrated every day. Eat lots of fruits and vegetables to make your skin grow healthier and heal acne scars.

Eating lots of fruits and vegetables is healthy but will not heal your acne scars; period.

Load up on lemon juice: Lemon juice is a kind of citric acid that's very effective in reducing or getting rid of acne scars. Drink several glasses of lemon juice each day to help your dead skin cells shed faster. New skin cells will also grow healthier and add elasticity to your skin if you load up on lemon juice.

Are they serious? Drinking several glasses of lemon juice will cause a big hole in your stomach and may seriously interfere with absorption of naturally occurring nutrients and vitamins. Once again-no scientific basis for this at all.

Continue reading "How to get rid of acne scars naturally?"

“Skin Needling” can erase smaller scars with no cutting or surgery.

nospam@example.com (David Rahimi) — Mon, 31 Jan 2011 21:21:10 +0000

Before and After photos of scar improvement with needling on our Facebook site:

http://www.facebook.com/#!/photo.php?fbid=189030387793715&set=a.189030057793748.51674.148514725178615

Skin Needling or Micro-Needling is a process that induces the formation of deep dermal collagen and enhances the appearance of deep rolling acne scars.

Acne and depressed scars are treated using very fine sterile needles (such as the Keith needle). The most depressed part of the scar is treated with repeated shallow (1-2mm) penetrations of the sterile needle. This procedure effectively separates the top scarred skin tissue from the deeper bound down scar tissue. A small drop of blood pools under the treated area and stimulates the induction of the stem cells. These, in turn, produce autologous growth factors and Interleukins. The body is essentially fooled into thinking that trauma has occurred at the depths of the rolling acne scars and repairs itself.

Several treatments two weeks apart are necessary to get a significant improvement. Eventually deep rolling scars level off with the surrounding skin. The needling process can be followed by the application of TCA acids or long wavelength lasers to further stimulate the production of collagen and elastic fibers.

The procedure is performed by Dr. A. David Rahimi and takes about 30 minutes to perform. A thick layer of topical anesthesia (EMLA cream) or local injection of Lidocaine with epinephrine significantly reduces any discomfort.

Like other procedures there are risks of excessive bleeding, infection, and even scarring. I have had good results with Needling; especially with difficult and depressed acne scars and self-inflicted sores on the face and chest area.

The cost depends on the area treated and can range from $250 to $500 per treatment.

Become friends with us on Facebook or on foreveryoung.net and receive special offers.

A. David RAhimi,MD,FAAD,FAACS.

Get rid of excess skin in the elbow and knee area with no cutting!

nospam@example.com (David Rahimi) — Tue, 18 Jan 2011 16:18:20 +0000

Do you want to get rid of your elbow and knee wrinkles?
No cutting and very little downtime.
You have to watch this video- The Mixto fractional laser is simply amazing!
I have been performing this technique for over 2 years with great results.

http://doctorspr.wordpress.com/2011/01/18/the-mixto-laser-is-featured-on-national-t-v-with-dr-sandra-lee/

A. David Rahimi,MD,FAAD,FAACS.

www.foreveryoung.net

323 653 7700

A “Gummy Smile” can be corrected with Botox or Dysport.

nospam@example.com (David Rahimi) — Tue, 28 Dec 2010 18:06:22 +0000

Gummy smile is an aesthetic disorder that can cause both men and women to be self conscious about their appearance and social interactions.

This condition is caused by the complex interaction between several facial muscles:

Levator Labii superioris alaeque nasi

Levator labii superioris

Zygomaticus minor

Risorius

I perform facelifts and am quite familiar with the interactions and positioning of these delicate muscles. A few units of botox, placed judiciously in the right position, can lower the upper lip a few millimeters and correct a "Gummy Smile”.

Allow your teeth to shine without being self conscious about over-exposure from your gums.

The procedure takes about 15 minutes to perform. There is no downtime, results are evident within 3-5 days, and may last up to 6 months.

The cost varies depending on how much Botox or Dysport is injected (Range $250-$500).

A. David Rahimi, MD, FAAD,FAACS.

Can fat transfer be used to make breasts larger? Is it safe?

nospam@example.com (David Rahimi) — Tue, 21 Dec 2010 17:23:54 +0000

I believe the question is not "If it is possible?"

The question should be: Is it safe?

I performed several breast augmentaions with autologous fat during my fellowship in 2000 (BAMBI).

I then learned from Dr. Mel Shiffman and others that the transfered fat can rarely become calcified. The calcification itself is not an issue as it is microscopic but it MAY mask an underlying breast cancer. Five to seven percent of American women develop breast cancer during their lifetime.

I hope that we can develop better modalities to distinguish calcification from fat transfer to the breast from the malignant calcification that is sometimes seen in breast cancer. Until then I recommend to proceed with caution.

Below is an update on fat transfer to the breast by one of the leading doctors in the field:

Update on Cell-Assisted Lipotransfer

by Jeffrey Frentzen

Kotaro Yoshimura, MD

Combining stem cells and liposuctioned fat—the latest permutation of doing fat transfer to the breast for augmentation—is one topic that is talked about in sometimes heated terms in the physicians' meetings, physician's practice, and at the dinner table.

In 2007, we first heard about a new stem cell-assisted treatment for breast augmentation that was developed by the Department of Plastic Surgery at the University of Tokyo. The procedure, dubbed Cell-Assisted Lipotransfer (CAL) by its creator, Kotaro Yoshimura, MD, also involves the use of adipose-derived stem cells that are isolated from liposuction aspirates. In this case, though, the processed cells are added to additional aspirated fat and then injected into the breasts.

Yoshimura is an assistant professor at the Department of Plastic Surgery in the University of Tokyo.

The CAL approach is different from other approaches tried in the United States, such as the LipoStructure procedure pioneered by Sydney Coleman in the United States. Using the CAL procedure, a single treatment can successfully increase breast volume by 120 mL to 160 mL—roughly two cup sizes (5 cm to 7 cm). For patients seeking to augment their breasts by 300 mL, the treatment needs to be performed twice; and for augmentations exceeding 300 mL, a combination of an implant and the stem cell technique is used to achieve the desired results.

Highlights of this procedure include the following:

The patient is under general anesthesia. A saline solution containing a weak local anesthetic and a vasoconstrictor is injected into the areas where fat is to be suctioned. This softens the treated area and constricts the blood vessels.
Via a tiny incision in the skin, a narrow metallic tube is inserted and a liposuction pump is used to suction subcutaneous fat.
Stem cells are obtained from parts of the aspirated fat and mixed with the fat to be reinjected.
The fat mixed with stem cells is transplanted by a special injector for transplantation, small area by small area over a wide area in order to prevent lumpiness.
Mild swelling and pain that occurs on the suctioned area or the injected area goes away in around 1 month.

I spoke with Yoshimura to get an update on the status of CAL in Japan and to find out if his procedure would be imported to the United States anytime soon.

PSP: Please report on clinical trials under way in the United States.

Yoshimura: To my knowledge, no clinical trials regarding adipose stem/progenitor cells have been done in plastic surgery in the US.

PSP: How many patients have you treated with the stem cell/fat tissue procedure, and what are the results, overall?

Yoshimura: More than 400 patients have been done by the end of 2009. Overall results are satisfactory and encouraging so far. Although clinical outcomes are very variable among patients and many factors—including operator factors and patients' factors—affect clinical outcomes, quality and naturalness of augmented tissue is excellent. Preserved tissue volume appeared to be much better than conventional methods.

PSP: What are the differentiating age/race/gender/demographics of the patients? What percentage received each procedure according to breast, face, hip, etc?

Yoshimura: The frequent age is between 30 to 50 years old, almost all are Japanese, and all are female other than four males. The procedures break down as 83% breast (55% augmentation, 15% implant replacement, and 13% reconstruction), 15% face, and 2% others. But there have been many breast reconstructions and facial reconstructions. Among the latter are acquired defects, Parry-Romberg disease, Lupus erythematosus, scleroderma, etc.

PSP: What were some outstanding characteristics of the patients treated in the breast? The patients treated in the face and on the hip?

Yoshimura: Natural contour and texture, softness, absence of artificial material, free of complications associated with implants, free of future risks for additional surgery, free of daily stress from implants.

Since 2008, there has been some new literature published about this procedure. See list below.

*See also "The Stem Cell Facelift" by Connie Jennings in the May 2009 issue of PSP.*
PlasticSurgeryPractice.com

Suga H, Araki J, Aoi N, Kato H, Higashino T, Yoshimura K. Adipose tissue remodeling in lipedema: adipocyte death and concurrent regeneration. J Cutan Pathol. 2009;36:1293-1298.

Suga H, Eto H, Inoue K, et al. Cellular and molecular features of lipoma tissue: comparison with normal adipose tissue. Br J Dermatol. 2009;161:819-825.

Suga H, Matsumoto D, Shigeura T, et al. Functional implications of CD34 expression in human adipose-derived stem/progenitor cells. Stem Cell Dev. 2009;18: 1201-1209.

Yoshimura K, Asano Y, Aoi N, et al. Progenitor-enriched adipose tissue transplantation as rescue for breast implant complications, Breast J. 2009;DOI: 10.1111/j.1524-4741.00873.x

Yoshimura K, Suga H, Eto H. Adipose-derived stem/progenitor cells: roles in adipose tissue remodeling and potential use for soft tissue augmentation. Regen Med. 2009;4:265-273.

Smoking and your skin

nospam@example.com (David Rahimi) — Thu, 09 Dec 2010 18:28:35 +0000

Very few things in life truly upset me. Smoking and the morbidity and mortality that it causes make my blood boil. I believe that we have failed as a society when we allow smoking to kill over 500000 people a year in the US alone. The figure is over 10 million deaths a year worldwide. That is almost 2 Holocausts a year directly related to smoking.

Smoking also ages the skin and causes degeneration of Collagen and Elastic fibers. It causes sagging of the skin and raises the risks of various skin cancers by lowering the immune system.

A recent study by the FDA found that even transient contact with cigarette smoke causes damage; even at a cellular level by damaging the DNA.

http://www.cnn.com/2010/HEALTH/12/09/tobacco.risk/index.html?hpt=Sbin

Help a loved one stop smoking.

Zei Gesund

A. David Rahimi, MD,FAAD,FAACS.

Heart Stem cell Treatment Trials at Cedars Sinai Medical Center.

nospam@example.com (David Rahimi) — Fri, 19 Nov 2010 18:33:49 +0000

Stem cell treatment of diseases affecting millions of Americans is gaining traction in the US. Below you can see excerpts from articles on the internet on clinical trials with stem cells to treat Myocardial infarctions, blindness, and even Parkinson’s disease.

The next logical extension would be treating aged and damaged skin via your own autologous stem cells. The field is still in its infancy and there is a lot we still need to learn.

These are truly exciting times and I feel privileged to be part of it.

A. David Rahimi, MD, FAAD, FAACS.

Heart Stem Cell Trial at Cedars Sinai – Patient’s Own Cells Injected to Reverse Heart Attack Damage

Finally the work and benefits of stem cells are beginning to evolve around us. The patient had a heart attack, had permanent damage and by injecting his own stem cells the efforts of this procedure will hopefully reverse the damage and scarring done by the attack. The program is under trial at Cedars Sinai in Los Angeles. "Cardio-spheres" are created and can even start beating in the dish. This was a big decision and we certainly hope it works for him. BD

Heart failure patient improves after clinical trial – Injection of Cardiac Stem Cells at University of Louisville

The cardiac stem cells injected into the scar tissue were removed from a portion of the upper chamber of Jones’ heart and were sent to Harvard University and Brigham and Women’s Hospital in Boston to grow the cardiac stem cells. The procedures is fairly simple and minimally invasive as well and it was estimated that he could return to work in a week. The patient will be monitored over the next 2 years to track his progress.

In the Los Angeles area we have a similar clinical trial in place at Cedar Sinai Hospital and this is amazing and something I want to make sure I follow as well as this is breakthrough technology for repairing the heart and his condition is improving almost daily.

Stem Cells Turn Cloudy Eyes into Clear Eyes

More exciting news on the potential use of stem cells. The story is from the University of Pittsburgh who has done quite a bit of research with stem cells and the testing now is limited to mice. This could potentially stand to emerge to be an alternative treatment to having a cornea transplant. The next step is testing mice with scars on their corneas.

In another related story a family made a trip to China for stem cell injections for a child who was going blind and now she can see. After the 3rd treatment of injections in to her spine, it started working, she could read and now has 20/30 vision. So far only 10 people had had the treatment with stem cells for the underdeveloped optic nerve. The entire treatment took 6 weeks.

Michael J. Fox on Parkinson’s Disease and Stem Cells – Oprah and the Daily Show

Michael Fox has written a new book, “Always Looking Up”, great title too by the way and has been appearing on several talk shows to promote the book. You can visit the Foundation to find out what is being done with a cure/treatment for Parkinson’s Disease at the Foundation Web site.

The Michael J. Fox Foundation

I have included a couple videos here, first from the Daily Show, and you can clearly see he has not lost his sense of humor, even tackling the question of which is more difficult, the disease or politicians.

What is even more amazing is his appearance on Oprah and the revelations from Dr. Oz on where and when he believes a cure may be here for the disease. The cure lies in stem cells, but perhaps not the way we have heard stem cells discussed in the past. The TED convention this year also offered a lot of information on stem cells and the video from the show is well worth watching and will help explain what regenerative medicine is all about. Cloning stem cells is on the horizon to be part of the cure. If you haven’t caught up with what’s going on with stem cell research, it’s well worth reading up. There are women walking around with bladders that have been grown from stem cells, heart valves are grown from stem cells, etc. If they can bring this technology to cure or better treat Parkinson’s, that would be great for all those who suffer.

Cloned cells bring hope of therapy for Parkinson’s disease

In the related reading below I went back and captured some of the prior posts I have made about Parkinson’s Disease to include some of the medical devices that are being used for treatment as well. When you watch and see how the implants are helping, it’s amazing. One woman was in such a terrible state, she was refined to a wheelchair, and with the device she can function almost pretty normal, and another victim of the disease was able to get a driver’s license, something that had never been possible before. Between research and development with stem cells and devices, there are great strides being made and helping bring a bit of quality of life to those stricken. BD

Acne Scar Treatment with Stem Cells

nospam@example.com (David Rahimi) — Wed, 17 Nov 2010 18:08:51 +0000

Why not allow your own stem cells and fat to fill in the acne scars on your face.

Here is a small segment out of an article from Mayo Clinic explaining what stem cells are and what they are capable of doing:

§ Adult stem cells. These stem cells are found in small numbers in most adult tissues, such as bone marrow. Adult stem cells are also found in children and in placentas and umbilical cords. Because of that, a more precise term is somatic stem cell, meaning "of the body." Until recently, it was believed that adult stem cells could only create similar types of cells. For instance, it was thought that stem cells residing in the bone marrow could give rise only to blood cells. However, emerging evidence suggests that adult stem cells may be more versatile than previously thought and able to create unrelated types of cells after all. For instance, bone marrow stem cells may be able to create muscle cells. This research has led to early-stage clinical trials to test usefulness and safety in people.

§ Adult cells altered to have properties of embryonic stem cells (induced pluripotent stem cells). Scientists have successfully transformed regular adult cells into stem cells using a technique called nuclear reprogramming. By altering the genes in the adult cells, researchers can reprogram the cells to act similarly to embryonic stem cells. This new technique may help researchers avoid the controversies that come with embryonic stem cells, and prevent immune system rejection of the new stem cells. But, it's not yet known if altering adult cells will cause adverse effects in humans. Researchers have been able to take regular connective tissue cells and reprogram them to become heart cells. The new heart cells were injected into mice with heart failure, where they improved heart function and survival time.

At Forever Young, Inc. we have devised a system where peripheral and fat stem cells are harvested via a sophisticated centrifugation process, concentrated and mixed with your own fat.

The fat and peripheral/fat stem cell are injected via blunt tipped canulas and No-Kor needles under the acne scars. This is followed by either a TCA peel or Mixto CO2 Fraxel (see my procedure section for more details on each of these procedures).

Downtime is about 5 days and several procedures are needed for deep scarring. Prices range from $1500 to $5000 depending on the procedures needed.

I hope to see you for a complimentary consultation.

A. David Rahimi, MD, FAAD,FAACS.

Stem Cell; what are they and what can they do?

nospam@example.com (David Rahimi) — Thu, 11 Nov 2010 18:35:44 +0000

While researching stem cell I came across a section on Mayo clinic’ website that concisely explains what stem cells are, where they can be found, and what are they capable of doing.

Here is the first paragraph and a link:

http://www.mayoclinic.com/health/stem-cells/CA00081

What are stem cells?

Stem cells are the body's raw materials — cells from which all other cells with specialized functions are generated. Under the right conditions in the body or a laboratory, stem cells divide to form more cells, called daughter cells. These daughter cells either become new stem cells (self-renewal) or become specialized cells (differentiation) with a more specific function, such as blood cells, brain cells, heart muscle or bone. Stem cells are unique — no other cell in the body has the natural ability to generate new cell types.

Where do stem cells come from?

Researchers have discovered several sources of stem cells:

§ Embryonic stem cells. These stem cells come from embryos that are four to five days old. At this stage, an embryo is called a blastocyst and has about 150 cells. These are pluripotent (ploo-RIP-uh-tunt) stem cells, meaning they can divide into more stem cells or they can specialize and become any type of body cell. Because of this versatility, embryonic stem cells have the highest potential for use to regenerate or repair diseased tissue and organs in people.

§ Amniotic fluid stem cells. Researchers have also discovered stem cells in amniotic fluid. Amniotic fluid fills the sac that surrounds and protects a developing fetus in the uterus. Researchers have identified stem cells in samples of amniotic fluid drawn from pregnant women during a procedure called amniocentesis. During this test, a doctor inserts a long, thin needle into a pregnant woman's abdomen to collect amniotic fluid. The fluid can be tested for abnormalities, such as Down syndrome, and fetal maturity. The procedure is generally considered safe for the developing fetus and the mother. More study of amniotic fluid stem cells is needed to understand their potential.

New at Forever Young, Inc: Stem cell Therapy.

nospam@example.com (David Rahimi) — Wed, 10 Nov 2010 20:37:10 +0000

New at Forever Young, Inc.

Stem cell therapy. I started my training at UCLA as an Immunologist and Microbiologist and have discussed the potential benefits of stem cell therapy in the past.

I had to do a lot of research and make sure the science behind using stem cell therapy in cosmetic surgery was sound. I had used PRP (Plasma Rich Protein) over 12 years ago in my cosmetic fellowship program. The results were good but the procedure was cumbersome and expensive. Well; the science has improved and the cost has come down drastically.

Starting this month we will merge stem cell therapy with a variety of procedures that we already do:

Stem Cell Fat Transfer

Stem Cell Face and Brow Lift

Stem Cell Body Rejuvenation

I will start posting several articles on uses of Stem Cells and PRP in sports medicine, general surgery, and cosmetic surgery.

I believe that stem cell therapy will be the driving force of much scientific advancement in the next decade.

A. David Rahimi, MD, FAAD, FAACS.

The art of Subcision and punch excision!

nospam@example.com (David Rahimi) — Thu, 04 Nov 2010 22:00:45 +0000

Lasers and chemical peels, in skilled hands, help improve the appearance of acne scarring. Some patients with deeper ice-pick and rolling scars need a more tailored approach. Lasers and peels alone are simply not enough.

Subcision with a No-Kor needle can make all the difference. The needle has a small sharp scalpel like tip that goes under the rolling scars and cuts the fibrous bands. This, in turn, causes bleeding into these newly created spaces. The trauma and the blood causes collagen synthesis and significant improvement of the scars.

Deeper scars need to simply be cut with a round scalpel called a “punch”. These punches come in various sizes: 1mm, 1.5mm, 2.0mm, etc. After the application of the laser I look at the skin with a strong light at an acute angle. This allows me to see the areas that need more attention. Subcision is performed and deeper scars are excised with the punch and sutured.

Even deep acne scarring can be improved by 40-50 percent this way. A touch up treatments a few months later can increase the improvement to 70-80 percent.

Click on this link and then click on the clinical photographs:

Set 7, 8, and 9 show before and afters of a young patient with deep acne scarring.

http://www.foreveryoung.net/mixto-fractional-co2-laser.html

We hope to see you soon for a free consultation.

A. David Rahimi, MD, FAAD, FAACS.

Nail Fungus Treatment with the Cooltouch Laser.

nospam@example.com (David Rahimi) — Thu, 04 Nov 2010 21:40:27 +0000

How does the laser work?

The Cool Breeze Laser by the Cool Touch Laser Company kills the fungal organisms and spores that live in and under the toenail. The laser is FDA cleared and approved for this particular use. The laser light passes through the toenail without causing damage to the nail or the surrounding skin. The Cool Touch Laser uses instantaneous temperature monitoring to ensure safe treatment of the nail with minimal discomfort.

It will take time for the previously infected nail to grow out and for the new nail to form. This can take 6 to 12 months depending on the rate of growth of the toenail.

How is the procedure performed? Is there any preparation? Any Discomfort?

During the first treatment session the nails are filed down with a Diamond Dermabrader to debride the dead skin and prepare the nail. A thin layer of topical anesthesia is applied to numb the skin around the nail plate. The procedure takes 20-30 minutes to perform and involves mild discomfort from heat.

The Cool Breeze Laser is applied by the doctor to cover the entire nail. When the appropriate temperature is reached a burst of Cryogen is released to cool the nail and stop the heating of the toenail. Patients are able to resume their regular activities right after the procedure.

Will the fungus (Onychomycosis) come back?

The cure rate is 70 to 80 percent. These rates are comparable to aggressive treatment with the oral medications such as Sporonox and Lamisil. Some individuals have a tendency to re-infection with the fungal organisms. A triple strength topical anti-fungal lotion is applied once or twice a week to prevent re infections.

Laser toenail treatment is not covered by insurance.

Click on this link, or cut and paste in your browser, to look at before and after photos.

http://www.cooltouch.com/laser_treatment_for_toenail_fungus_before_and_after_photos.aspx

Please call me if you have any questions:

Zonya V.

Office manager

323 653-7700

How Pulled is PULLED

nospam@example.com (David Rahimi) — Thu, 04 Nov 2010 19:37:41 +0000

Aesthetic cosmetic surgery is performed to restore “the youthful look”. We all can agree that some celebrities just go too far. Bruce Jenner, Heidi Montag, Donatella Versace, Jocelin Wildenstein, and Amanda Leopre are great examples.

I looked at their before and after photos on several popular sites and asked myself: How could this happen? These are intelligent, articulate people with the means to see very skilled cosmetic doctors! Are they aware that they looked better before their obsession with Cosmetic Surgery forever changed their faces?

I believe the problem is complex. Childhood insecurities, doctors that cannot say NO, and loved ones who don’t intervene are some of the factors. We (the public) probably make things worse by giving them even more attention.

Body dysmorphic syndrome is a pervasive problem. These celebrities represent extreme cases. I deal routinely in my practice with patients who have either unrealistic expectations or want a certain a look that I cannot provide. I politely say NO; discourage them from having “cutting” surgery and urge them to find ways to reduce stress in their lives. I do provide them with a sound, effective, and safe facial treatment regimen that promote Collagen synthesis and improves their skin tone.

“Less is more” echoes out of the examining room into the hallways. Most move on to find another practitioner that will provide them with what they need. Some realize my genuine interest in helping them look better without drastic surgery.

A. David Rahimi,MD,FAAD,FAACS.

Surgical versus Nonsurgical Rejuvenation

nospam@example.com (David Rahimi) — Thu, 04 Nov 2010 18:33:59 +0000

You have a choice. Almost everything aesthetic about the face can be performed surgically versus nonsurgical!

· Eyelid Surgery: Blepharoplasty versus Thermacool/Cooltouch laser/Botox/Dysport

· Facelift: Rhytidectomy versus Thermacool/Cooltouch/Fillers such as Radiesse/Juvederm, fat transfer, Mixto CO2 laser.

· Cheek Implants: Silicone Implant versus fat transfer, Radiesse, Juvederm.

· Forehead lift: Endoscopic Lift versus Volume replacement with fat, Thermacool

· Liposuction: Coollipo (laser liposuction) versus Coolsculpting (freeze the fat)

· Wrinkles: Surgical facelift versus CO2 Mixto Fraxel, chemical peels, filler, fat transfer

We will tailor a treatment that fits your desires, lifestyle and budget. Most of our treatments have minimal to no-down time.

We hope to see you soon for a complimentary consultation.

Thank you.

Zonya Vialltoro

Office manager

Forever Young, Inc.

Tel 323 653-7700

Human Embryonic Fibroblasts stem cells improve sun damaged skin

nospam@example.com (David Rahimi) — Wed, 03 Nov 2010 17:48:10 +0000

A recent article in Dermatology Times by Louise Gagnon was quite interesting and worth sharing with you. The article appeared in the October 2010 issue of dermatology Times pages 60-62.

The article starts by pointing out that “Growth factors that are developed via human fibroblast stem cells hold promise of skin rejuvenation without risk of toxicity or infection”. The article elaborates all the uses of human embryonic fibroblast stem cells and shows actual before and after photos that show quite drastic improvement in the cell texture, color, and tightness.

I received my BS from UCLA in Microbiology and had a special interest in immunology.

I believe this is the “future” of facial rejuvenation.

Here is another older article abstract by Dr Gold.

Human growth factor and cytokine skin cream for facial skin rejuvenation as assessed by 3D in vivo optical skin imaging

Journal of Drugs in Dermatology, Oct, 2007 by Michael H. Gold, Mitchel P. Goldman, Julie Biron

Growth factors, in addition to their crucial role in cutaneous wound healing, are also beneficial for skin rejuvenation. Due to their multifunctional activities such as promoting skin cell proliferation and stimulating collagen formation, growth factors may participate in skin rejuvenation at various levels. The present placebo-controlled study aimed to further investigate the antiaging effects of a novel skin cream containing a mixture of human growth factors and cytokines, which was obtained through a biotechnology process using cultured human fetal fibroblasts. Aside from clinical assessment of skin wrinkles, the skin surface topography was analyzed by 3D in vivo optical skin imaging using the Phaseshift Rapid in vivo Measurement of Skin (PRIMOS) device. This device allows fast, contact-free, and direct measurement of the skin surface topography in vivo at high resolution. This technique is quantitative and more reliable than a visual assessment of wrinkles using a scoring system, which is subjective and strongly dependent on investigator and assessment conditions. Using the PRIMOS device, which is also regarded as a more accurate method than the commonly used silicon replica technique, skin surface roughness was shown to significantly decrease between 10% and 18% depending on the roughness parameter after 2 months of twice-daily application of the human growth factor and cytokine cream. This was compared to treatment with the placebo formulation resulting in an approximate 10% decrease of 2 roughness parameters, whereas the remaining parameters remained unchanged. We found that topical application of growth factors and cytokines are beneficial in reducing signs of skin aging.

Drinking Green Tea can help prevent Skin Cancer

nospam@example.com (David Rahimi) — Tue, 02 Nov 2010 23:46:00 +0000

I recently read an article in the October issue of the Cosmetic Dermatology Journal that might interest you. I believe the title is self explanatory:

Green Tea and its Photoprotective and Anticarcinogenic Effects on the Skin. This article was written by Matthew Zarraga D.O. and David Judy, D.O.

Vol 23 No.10 October 2010 pages 446-449

www.cosderm.com

The article starts by mentioning that Tea is the most commonly consumed beverage in the world. It continues to details it’s in vivo and in-vitro photo protective and anti-carcinogenic effects. It concludes by saying that: both oral consumption and topical application of green tea can provide both chemoprotection and photoprotection”.

Look for products with green tea extract in them and try Trader Joe' Green Tea!

Asian countries that consume more green tea are known to have lower risks for many types of cancers. On a personal note: I stopped consuming carbonated drinks a while back. Plenty of water, 2 cups of coffee, and one or two cups of green tea at night have made a big difference in the way I feel.

A. David Rahimi, MD, FAAD,FAACS.

Sunscreens are Safe

nospam@example.com (David Rahimi) — Fri, 29 Oct 2010 15:08:15 +0000

Sunscreens Are Safe

An article in the Sun and News publication recently caught my eye. Recent negative news about sunscreens by some news outlets and non-medical writers has consumers questioning the safety and benefits of sunscreens.

“A review of all scientific studies (from 1966 to 2003) shows no evidence of a relationship between sunscreen use and increased risk of melanoma”.

Warwick L. Morison, MD

Professor of Dermatology at Johns Hopkins Medical Center

Sunscreens are not Card Blanche to bake in the sun. They do however have an important role in our daily lives.

A. David Rahimi, MD, FAAD, FAACS.

I highly recommend that you read the entire article in the Sun and Skin News publication by Perry Robins

Fall 2010 Vol 27, No 3

www.skincancer.org

Coolsculpting on Dr. Oz. (America's Doctor).

nospam@example.com (David Rahimi) — Fri, 29 Oct 2010 15:07:03 +0000

Dr. Oz, who is essentially “America’s doctor” refers to CoolSculpting as “revolutionary” and a “game changer,” and his genuine excitement about the procedure is evident.

Dr. Avram discussing the science behind CoolSculpting:

http://www.doctoroz.com/videos/cutting-edge-plastic-surgery-pt-2

Dr. Tanzi demonstrating the procedure on a patient:

http://www.doctoroz.com/videos/cutting-edge-plastic-surgery-pt-1

Look at my Coolsculpting before and afters on facebook!

nospam@example.com (David Rahimi) — Fri, 15 Oct 2010 20:55:56 +0000

Well, here I was.

I just paid almost 120K for my Coolsculpting "Toy" and had to try it out. I treated my own abdomen and love handles and was quite impressed. It melted away about 30-40 percent of the fat in about 6 weeks.

Finally, a non-invasive way to freeze away unwanted fat with no surgery. Judge for yourself...

http://www.facebook.com/#!/photo.php?fbid=1574789524102&set=a.1574788724082.83619.1066473146

A. David Rahimi,MD, FAAD,FAACS.

An Ounce of Prevention

nospam@example.com (David Rahimi) — Fri, 15 Oct 2010 20:50:46 +0000

Here is a link to a great article that was recently published in the Wall Street Journal. A must read for any one in their 30s and 40s:

http://finance.yahoo.com/family-home/article/111014/wrinkle-erasing-for-starters?mod=family-love_money

A. David Rahimi, MD, FAAD, FAACS.

Facelift, cosmetic surgery, and skin care blog from Los Angeles surgeon Dr. David Rahimi

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RESULTS:

CONCLUSION:

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Abstract

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