Much press has been given lately to Dysport the new botulism toxin wrinkle treatment that is being hailed as a Botox competitor.  I have reviewed some of the available safety and efficacy data and am not entirely convinced I would want to make the switch for my practice. Dysport does not seem to be radically different or offer any clear advantage over Botox in terms of cost and duration of efficacy.

 I have been using Botox since 1997.  I was invited that year to give a lecture in Brasilia, the capital of Brazil.   A Brazilian plastic surgeon was my co-presenter and he already had an extensive experience injecting thousands of patients. He mentored me in the art and science of using Botox for facial rejuvenation. Since that time, I have literally injected tens of thousands of units and  I (and, more importantly,  my patients) have been very pleased with the results. So, it is my opinion, that there is no compelling reason to switch from Botox to Dysport at this time.  "If it aint broke, don't fix it!"  I will continue using Botox in my practice.

As I previously mentioned, I attended the 2009 Annual Meeting of the American Society of Plastic Surgeons this past weekend. Many new technologies were discussed but the "Hot Topic" appeared to be fat. Presenters discussed:

• Moving fat around. For example, moving fat from one part of the body to another. In Miami, this is a very popular procedure to shape the buttocks.
• Saving fat. Researchers are looking into the feasibility of removing fat stem cells and using them to grow new breast tissue for breast reconstruction after mastectomy.
• New liposuction techniques. SlimLipo, ultrasound assisted liposuction, water assisted liposuction were all discussed.
• Freezing fat. Research is being done to determine if fat can be frozen externally for reshaping and contouring.

This month's Marie Clare magazine has a fascinating article on the proliferation of unlicensed professionals performing cosmetic medicine. While the article talks extensively about  individuals with no medical training who unscrupulously offer cosmetic procedures, it also discusses the increasing number of medical professionals outside the core cosmetic specialties of plastic surgery and dermatology (physicians, dentists and nurses) who are offering cosmetic procedures.  As per state and federal laws, any physician can put up a shingle to practice outside of their specialty. While this may be unwise, it is NOT illegal. It is perfectly legal for your gastroenterologist to perform your liposuction.  My professional opinion is that this is INCREDIBLY poor medicine and highly dangerous.  Taking a weekend seminar or on-line training does not prepare a person to perform cosmetic procedures or inject botox and fillers.  Fillers, Botox, cosmetic surgery - these are very specific treatments that need to be perfomed appropriately and safely by appropriately trained professionals.  Buyer beware!
 (If you are looking for a referral, you can check the website of the American Society of Plastic Surgeons and the the American Society of Aesthetic Plastic Surgeons.)