Though it may seem like it has been around forever given its widespread popularity and publicity including media exposure, BOTOX® Cosmetic (produced by Allergan, Inc.) is celebrating its 10th year anniversary of FDA approval for the treatment moderate to severe frown lines between the brows. In 2002, it was the first product to receive such an approval and it remains the standard by which all other competing products are measured. (The medical usage of BOTOX® goes all the way back to 1989 when it received FDA approval for its usage in the treatment of blepharospasm, an abnormal condition involving the eyelid.)

Ten years later, it remains the overwhelming market leader as well as the therapeutic standard for the treatment of facial wrinkles. I surely can strongly attest to this through my brief but disappointing experiences evaluating the competing wrinkle treatment alternatives, Dysport™  and Xeomin®.

As a celebration marking this 10 year milestone anniversary, the company producing BOTOX® Cosmetic has made available a limited time rebate on it which I can offer you and which can add up to a total of $200 in savings (if you undergo 3 treatments). In order to be eligible for this rebate, you must have your first treatment with Botox®Cosmetic before April 30, 2012. There is additional information on the limitations and restrictions to this offer at the product website.

For more information on Botox® Cosmetic treatments or on any other plastic surgery procedure that I perform or to schedule a consultation with me, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

As I noted in a previous blog (Surgery For Gynecomastia (Enlarged Male Breasts) Has Become Very Popular and Satisfying), surgery for gynecomastia (enlarged male breasts) continues to increase in popularity. This is a consequence of several factors: a greater awareness of the issue, the desire to have more sculpted, masculine breasts; feelings of insecurity, inferiority and self-consciousness of having feminine appearing breasts; and the knowledge that there are very effective and safe treatments for this condition. Men from all over the Valley – Scottsdale, Phoenix, Glendale, Mesa, Tempe, Chandler, and Gilbert as well as elsewhere – are seeking surgical treatment for their enlarged male breasts.

Treatment of gynecomastia usually consists of ultrasonic assisted liposuction (UAL) with or without direct excision of breast tissue. In rare cases of focal gynecomastia, commonly found in body builders who are using or have used anabolic steroids in the past, only direct excision of breast tissue is needed in order to obtain the desired result. The following patient of mine illustrates a typical case of enlarged male breasts.

This is a 22 year old male with gynecomastia that has persisted since puberty (photos A, C and E). He is so self-conscious about this that he will not even remove his shirt in public. There is no history of steroid, marijuana or any signficant alcohol use.

A) Enlarged male breasts before surgery - frontal

B) After treatment with liposuction

C) Enlarged male breasts before surgery - side

D) After treatment with liposuction

E) Enlarged male breasts before surgery - oblique

F) After treatment with liposuction

Treatment consisted of ultrasonic assisted liposuction (UAL) without any need for direct removal of breast tissue. A total of 325cc of fat was liposuctioned from both breasts using small incisions placed along the lateral aspect of the lower breast fold (photos B, D and F). The ultimate outcome was exactly what the patient had desired.

For more information on male breast reduction surgery for the treatment of gynecomastia or for any other plastic surgery procedure that I perform or to schedule a complimentary consultation with me, please contact my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

In November, I presented a report on Xeomin®, a newly available wrinkle treating neuromodulator that had been recently approved by the FDA. Available in various countries worldwide since 2005, it was touted as an alternative (cheaper?) to BOTOX® and a competitor of Dysport®. All three products are based on the same botulinum toxin A molecule but their formulations are different. They act by temporarily paralyzing the underlying muscles in order to treat wrinkles.

In November 2011, I was selected as one of only a limited number of physicians in the Scottsdale and Phoenix metropolitan area to able to offer Xeomin® for the treatment of wrinkles before its more widespread introduction planned some time later this year. The information provided and data available indicated that its effects and duration were similar to those of Botox®.

What were my findings in the 3 months that I have been offering Xeomin® as another option in the treatment of wrinkles?

Initially, my patients were very ecstatic. The onset of effect and its ability to treat wrinkles compared quite favorably to that of BOTOX®. Many of them had previously been treated with BOTOX® and stated that they noted little or no difference except in the much more appealing price. Then…

Suddenly and unexpectedly at six to seven weeks, they noted a fairly rapid return of their muscle function and with it – wrinkling again. This was a uniform finding in all the patients that I had contacted.

Not good at all – even at a significantly lower cost!

In comparison, my experience and the general consensus for the duration of effect for BOTOX® is around three to four months. Therefore, I can’t justify continuing to offer Xeomin® even at a significantly lower price knowing that it lasts around only half as long as the iconic and efficacious BOTOX®. (Note: I don’t offer Dysport® any longer either as I found it to be very unpredictable in effect as well as duration.)

So, if you are interested in treating those undesirable frown lines, Crow’s feet or other hated dynamic facial lines and creases, you still have the choice of BOTOX®, BOTOX® or BOTOX®!

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

Wouldn’t it be nice if you finally had the tummy tuck that you have always been dreaming about – the surgical dressing comes off and … BAM!

There it is: a flat and drum tight tummy that you have waited so long to have. Minimal swelling. Awesome looking belly button. Ready to prance around in a bikini.

Wow!

Guess what?

You’re probably still hallucinating from the Percocet!

What then should you truly expect with regard to the swelling of you abdomen following a tummy tuck and how soon it will resolve?

Usually there will be diffuse swelling for a few weeks following surgery which can fluctuate with activities and then it will gradually subside. While this will occur for the majority of the abdomen, many patients will actually notice the appearance of a firm convex band of swelling encompassing the incision which may become evident around 4 – 8 weeks postoperatively. This can surely be disconcerting. As long as there is no abnormal collection of fluid beneath the skin (seroma) or a hematoma that could somewhat mimic this protrusion, there is nothing to worry about.

By around 4 – 6 months, most of the swelling of your abdomen will have resolved. However, it can take up to a year for it to maximally disappear, at which point you can appreciate the more long term result. Of course, you will want to be active, exercising and eating appropriately in order to maintain your weight (or lose some if you need to).

If you would like more information on a tummy tuck or to schedule a complimentary consultation with me, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona