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ATTORNEY GENERAL CUOMO SECURES SETTLEMENT WITH PLASTIC SURGERY FRANCHISE THAT FLOODED INTERNET WITH FALSE POSITIVE REVIEWS

Dale Reynolds M.D. — Thu, 23 Jul 2009 16:00:00 GMT

Cuomo’s deal is first case in nation against growing practice of “astroturfing” on Internet

’Lifestyle Lift’ Will Pay $300,000 in Penalties and Costs to New York State

NEW YORK, N.Y. (July 14, 2009) - Attorney General Andrew M. Cuomo today announced a settlement with cosmetic surgery outfit Lifestyle Lift over the publishing of fake consumer reviews on the Internet.

Under the settlement, Lifestyle Lift will stop publishing anonymous positive reviews about the company to Internet message boards and other Web sites, and will pay $300,000 in penalties and costs to the State of New York. The case is believed to be the first in the nation aimed at combating "astroturfing," a growing problem on the Internet.

Lifestyle Lift employees published positive reviews and comments about the company to trick Web-browsing consumers into believing that satisfied customers were posting their own stories. These tactics constitute deceptive commercial practices, false advertising, and fraudulent and illegal conduct under New York and federal consumer protection law. The settlement marks a strike against the growing practice of “astroturfing,” in which employees pose as independent consumers to post positive reviews and commentary to Web sites and Internet message boards about their own company.

“This company’s attempt to generate business by duping consumers was cynical, manipulative, and illegal,” said Attorney General Cuomo. “My office has and will continue to be on the forefront in protecting consumers against emerging fraud and deception, including ‘astroturfing,’ on the Internet.”

Lifestyle Lift has more than 40 locations across the U.S., including Manhattan, Long Island and Syracuse. The company engaged in a concerted effort to bombard Internet message boards with positive stories about themselves. Lifestyle Lift’s president believed that negative Internet postings had significantly hurt the company’s reputation and thought the success of the company hinged on controlling messages posted online. Company employees were directed to create accounts with various Internet message boards and pose as satisfied customers of Lifestyle Lift. Employees also attacked legitimate message board posters who criticized Lifestyle Lift and tried to get those posts removed from message boards.

Internal emails discovered by Attorney General Cuomo’s investigation show that Lifestyle Lift employees were given specific instructions to engage in this illegal activity. One e-mail to employees said: “Friday is going to be a slow day - I need you to devote the day to doing more postings on the web as a satisfied client.” Another internal email directed a Lifestyle Lift employee to “Put your wig and skirt on and tell them about the great experience you had.”

In addition to posting on various Internet message board services, Lifestyle Lift also registered and created stand-alone Web sites, such as MyFaceliftStory.com, designed to appear as if they were created by independent and satisfied customers of Lifestyle Lift. The sites offered positive narratives about the Lifestyle Lift experience. Some of these sites purported to offer forums for users to add their own comments about Lifestyle Lift. In reality, however, Lifestyle Lift either provided all the “user comments” themselves, or closely monitored and edited third-party comments to skew the discussion in favor of Lifestyle Lift. Examples of these narratives can be downloaded at www.oag.state.ny.us/bureaus/internet_bureau/pdfs/LifestyleLiftStories.pdf.

According to the Attorney General’s settlement, Lifestyle Lift employees will no longer pose as consumers when publishing on the Internet. The company will not promote Lifestyle Lift’s services on the Internet without clearly and conspicuously disclosing that they are responsible for the content. The company will also pay $300,000 in penalties and costs to New York State.

The investigation was handled by Chief of the Internet Bureau Justin Brookman and Investigator Vanessa Ip, under the direction of Deputy Attorney General for Economic Justice Michael Berlin.TEST

23-Jul-09 11:00 AM

Family physician jailed for assault after botched cosmetic procedures.

Wed, 11 Mar 2009 15:00:00 GMT

Editor’s note: Media reports of non-ABPS-certified physicians who have left patients injured after going beyond their core training to perform cosmetic surgery procedures, have unfortunately, become all too common. However, recent weeks have seen an encouraging uptick in courts cracking down on those who have reached beyond their skills and subsequently put the public at risk.

Two of the following cases present instances in which physicians without core training in plastic surgery performed cosmetic procedures with disastrous results. In one, a family physician whose license had already been restricted to disallow facial surgery continued to perform several facial procedures that went awry, leading to his eventual guilty plea to an assault charge. Another details the case of a radiologist accused of substandard and damaging liposuction resulting in a lawful search of his home and office by his state’s medical board.

The third case outlines a court ruling holding a publisher responsible for fraud after a deceptive Yellow Pages® ad led to a patients disfigurement after a liposuction procedure.

A Canadian family physician who ignored a College of Physicians and Surgeons of Ontario (CPSO) – imposed restriction prohibiting him from performing facial surgery was sentenced to nine months in jail late last year.

Vincent Cheng, 43, Ameliasburg, Ontario, pled guilty to two counts each of aggravated assault and assault causing bodily harm for performing facial cosmetic procedures on two women that resulted in complications.

Cheng received a restriction against performing facial surgery by the CPSO in 2004, after several patient complaints were lodged against him beginning in 2000.

The criminal charges of aggravated assault and assault causing bodily harm resulted after two patients confirmed to police that they never would have consented to surgery by Cheng in 2005 had they known his license was under restriction, according to Ontario Police Detective Sgt. Mark Allison.

“In Ontario, you actually can ‘consent’ to an assault, which involves the use of force,” Allison says. “For instance, two guys in a fight give their implicit consent. But these two women would not have consented to the surgical activities had they known about Cheng’s restriction; therefore, they couldn’t consent to the ‘assault’ – the use of force. It becomes ‘aggravated’ because the assault resulted in maiming, a wound or disfigurement.”

Police launched their investigation after the two patients complained that Cheng- whose medical license was permanently revoked by CPSO in October 2006- performed a blepharoplasty and breast augmentation, respectively, in his office-based facility that left them with complications requiring correction by plastic surgeons.

“He knew he wasn’t suppose to be doing these (procedures) because the CPSO was clear in its intent when it handed down his license restrictions,” Allison syas.

While serving as plastic surgery division chief at the University of Toronto, PSEF President Peter Neligan, MD, Seattle ( who was recently named director of the Center for Reconstructive Surgery at the University of Washington Medical Center) was asked by the CPSO review the case. Dr.Neligan also served as a witness for the prosecution during sentencing.

To fulfill the CPSO roel, he requested 25 random charts that he pored over before a face-to-face meeting with Cheng.

“I found from the charts that his documentation was completely inadequate, and that’s dangerous,” Dr. Neligan says. “For example, in liposuction cases he didn’t document the amount of aspirate and how much fluid he had administered-and these were but the tip of the iceberg.”

“During our meeting I asked him about training, but the only plastic surgery training he had was as a medical student rotating on the plastic surgery service. I said, ’In other words, you’ve had no training in cosmetic surgery?’ He agreed that was the case. And his lack of knowledge of basic anatomy was frightening.”

During sentencing, Canadian Justice Richard Byers criticized Cheng for “becoming so greedy he became an outlaw,” according to an article by the Osprey News Network, owned by the Sun Media Network, Ontario. The article noted that Byers also criticized the CPSO for what he called its lack of oversight of Cheng: “I get the sense that the people in charge-the College- knows about this problem [of rogue physicians], but they can’t get their act together to deal with it,” Byers said.

CPSO spokesperson Kathryn Clarke says the College is working to strengthen patient safety in part by submitting proposals to the Legislative Authority of Ontario-similar in function to U.S. state legislatures-to give the College the ability to accredit office-based surgical facilities, as well as disallow physicians from advertising services for which they are not formally trained.

“We would like the ability to go into facilities to see how physicians are performing, look at their equipment and the personnel they work with and see how the facility is set up,” Clarke Says.

“We also would like the authority to prohibit physicians from using the title ‘surgeon’ or the word ‘surgery’ in their advertising if they aren’t board-certified as such,” she adds.

“Patients need to have the right information.”

In December, the Legislative Assembly of Ontario introduced the legislation as an amendment to the Regulated Health Professions Act of 1991.

Clarke says these proposals would have been introduced regardless of the Cheng case.

“He wasn’t specifically linked to this,” she says. “His behavior certainly was in the background, but it wasn’t the sole reason for moving forward with our initiatives.”

Dr. Neligan agrees with the College’s approach of submitting its own legislative proposals to better protect patients.

“It needs to do this if it’s going to prevent regulation from government-meaning having its oversight functions controlled by people other than physicians,” Dr. Neligan says. “Physicians should be making sure that they are protecting their patients.”

Radiologist ‘liposuclptor’ leaves county after home, office searched.

A Beverly Hills-based radiologist who performed liposuction procedures and used the modified aspirate to per his diesel fuel SUVs has reportedly left the country after the Medical Board of California conducted a search of his home and office on Nov. 14.

Search warrants targeting Alan Bittner, MD, were executed following several patient complaints, according to the Canyon News (Beverly Hills, Calif.). the Medial Board declined to release details of the case.

The Los Angeles Daily News reported Dec. 29 that several patients filed civil suit in 2008 against Dr. Bittner, medical director of Beverly Hills Liposculpture, for allegedly allowing his girlfriend-who does not hold a medical license-and an assistant to perform liposuction procedures that left the patients disfigured.

The Medical Board and San Francisco District Attorney filed suit against Dr.Bittner in 2003 for posting information on his website that was not based in truth, according to a Medical Board spokesperson, who declined to specify the alleged infraction. She added that Dr. Bittner corrected the information, and that no further action was taken against him at the time.

On his website (www.dralanbittner.com), Dr. Bittner’s website reports that he has left the United States for South America, in order to volunteer at a small clinic. “I am going back… to volunteer with a small clinic that is very similar to where my medical career began decades ago, where I can help those most in need,” according to the website.

Dr. Bittner gained attention last year for reportedly using liposuction-derived fat to power diesel vehicles although the practice of using human medical waste as fuel is against California law, according to Discover magazine’s online version (www.discovermagazine.com).

Misleading Yellow Pages ad leads to lipo ‘disaster,’ fraud ruling

An Oregon woman who underwent a liposuction procedure in 1997 by a dermatologist she believed was ABPS-certified-based on the physician’s deceptive Yellow Pages® advertisement-suffered a plastic surgery “disaster” that led to a $1.32 million fraud judgment against publisher Dex Media Inc. The decision was upheld by the Oregon State Supreme Court in late 2008.

At issue was Dex Media’s failure to properly consider “reasonable foresee ability” for consequences related to its printed material. The patient, M.M. Knepper, settled out of court in 2005 with the dermatologist Timothy Brown, MD for $175,000, according to the State Supreme Court decision obtained from the Oregon Judicial Department Appellate Court Decisions website (www.publicatoins.ojd.state.or.us).

Dr. Brown used a Yellow Pages advertisement to announce that he was “board certified” – but it did not refer to his certification in dermatology-which prompted Knepper to choose him for a tumescent liposuction procedure that resulted in chronic pain and misshapen skin. ASPS Life Member Lloyd Hale, MD, who testified as an expert witness on Knepper’s behalf in 2002, described her outcome as an “uncorrectable disaster”.

The State Supreme Court ruling affirmed the $1.32 million jury verdict against Dex for allegedly publishing the advertisement that misrepresented Brown’s qualifications with knowledge that the information contained within was inaccurate. In fact, the DEX sales representative convinced Dr. Brown to drop the reference to his dermatology certification in the ad, as well as place it under the heading, “Surgery, Plastic and Reconstructive,” the court document states.

However, Dr. Brown began performing liposuction only after receiving some limited informal training in how to perform that procedure,” according to the document.

Knepper testified that she never would have consented to the procedure by Dr. Brown had she known that he was ABPS-certified. Her pain and misshapen skin could not be corrected even after two follow-up procedures by Dr. Brown.

Dex attorneys argued that fraud was not present in this case, because there was no evidence the injury to Knepper was “a reasonably foreseeable consequence of the defendant’s conduct” – that there was no way to establish that by printing the ad, the publisher should have known that the adverse result was possible.

The state Supreme Court rejected that argument. “Dex had reason to expect that… and adverse result was more likely if Brown, rather than a board-certified plastic surgeon performed the liposuction,” it stated.

Dex also based its claim of innocence on the plaintiff’s failure to prove that it “acted maliciously, with the intention to harm another, or in reckless regard of consequence.” This, too, was rejected by the court: “This is not a case of the unwitting publications of an advertisement that turns out to be false. It is, instead, a case in which the publisher took a knowing and active part in the perpetration of the fraud.

“An advertisement that misrepresents a medical provider’s qualifications self-evidently creates a risk that a consumer who seeks treatment from the provider in reliance on that misrepresentation will suffer an adverse result that would not have occurred if the provider’s qualifications had been as represented,” the court stated.

11-Mar-09 10:00 AM

US Cosmetic Trends for Men

Thu, 26 Feb 2009 21:00:00 GMT

At Reynolds Plastic Surgery we like to keep current with industry trends. Here is an article we found interesting and have been passing around the office. Now, we would like to pass it on to you.

"Cosmetic Surgery Losing Stigma for U.S. Men, Rises 17% in 2007

By Michelle Fay Cortez

Feb. 26 (Bloomberg) -- American men, favoring Botox injections and liposuction, underwent 17 percent more cosmetic procedures in 2007 to more than 1 million treatments, according to the American Society for Aesthetic Plastic Surgery. Operations and less-invasive procedures among women still outnumbered those in men by 10 to one, and men mostly eschewed a buttocks operation that's gaining popularity, the society said yesterday. Botox, the biggest product from Irvine, California- based Allergan Inc., generated $1.21 billion in sales last year, a 23 percent gain, counting cosmetic and medical..."

To read the full article, please visit www.bloomberg.com

26-Feb-09 3:00 PM

El Paso Magazine - Best Doctors of 2009

Dale Reynolds, M.D. — Tue, 03 Feb 2009 15:00:00 GMT

Dr. R. Dale Reynolds, M.D.

Dr. Reynolds is a native third generation El Pasoan. He was trained in Houston in the largest medical center in the world under internationally renowned plastic surgeons.

While he is best known for his excellent cosmetic work, he still volunteers his time as the director of both cleft lip and palate clinics in the El Paso region. Dr. Reynolds is the only private practice plastic surgeon to provide this service for our community. This allows underprivileged kids to stay close to home instead of traveling hundreds of miles for treatment.

His ability as a pen and ink artist and excellent training translates into a combination of science and beauty like no one else can. His staff treats each patient with warmth and personal attention. Dr. Reynolds has an office on the Westside and the Eastside of town to better serve you.

Dr. Reynolds is the El Paso Times choice for plastic surgery articles and was selected as Best of the Best 2008 by What’s Up magazine. He is board certified by the American Board of Plastic Surgery and will be honored with induction into the American Society of Aesthetic Surgery in April 2009.

3-Feb-09 9:00 AM

Is a Mini Tummy Tuck Surgery for Me?

Richard Reynolds — Wed, 05 Nov 2008 18:00:00 GMT

R. Dale Reynolds, M.D.

Some patients have heard the term mini tummy tuck surgery but are unsure of what that is or if it is right for them. This abdominoplasty procedure is best for patients who have a limited amount of skin or fat excess in their lower abdomen (below their belly button). If the area above the belly button is relatively tight and without much fullness, then a full tummy tuck surgery may not be necessary.

The incision for the mini tummy tuck is about the length of a c-section incision and is low so it is well hidden. Other differences are that the belly button has no incision and the muscle layer is not tightened with a mini tummy tuck. However, most patients that need a tummy tuck surgery need a full tummy tuck. After childbirth or weight loss, the entire abdominal region is usually affected and anything less than a full abdominoplasty procedure will give suboptimal results. The full tummy tuck will remove significantly more tissue and it will tighten the abdominal muscle fascia. There is an incision around the belly button because the skin around it is redistributed. The incision is low and well hidden.

Liposuction can be combined with either kind of abdominoplasty procedure. Some liposuction is usually done as part of the procedure, but if an extensive amount is required in other areas, then you can discuss with your surgeon if this would be the best time to do this.

If you’re interested in a tummy tuck in El Paso, Dr. Reynolds and his knowledgeable, skilled staff at Reynolds Plastic Surgery will be happy to consult with you to see if you are a likely candidate. Out-of-state visitors and residents of El Paso with abdominoplasty needs can call or contact the office for more information at 915-532-6662.

5-Nov-08 12:00 PM

IS COSMETIC EYELID SURGERY OR A BROW LIFT FOR ME?

Richard Reynolds — Wed, 02 Jul 2008 15:00:00 GMT

Dale Reynolds, MD

Blepharoplasty, or cosmetic eyelid surgery, can be useful way to improve your overall appearance and diminish a haggard or tired look. Many people begin to consider surgery on their eyelids, or alternatively a brow lift, because they have a tired look about them even when they don’t feel tired. They are often asked by others if they are tired although they feel great.

In some patients, this begins early in their 20’s or even teens and is usually from darker skin in the area or from a prominence under the eyes which produces shadows giving the appearance of bags. This prominence is from excess fat around the eye itself. Redistributing or removing this via cosmetic eyelid surgery will remove the bags under the eyes. As the aging process continues, excess skin develops in the upper and lower eyelids. This usually becomes noticeable in the mid-forties and bothersome in the fifties.

Often, the excess skin in the upper eyelids can become such a problem that peripheral vision can be affected. Removing this excess skin from your upper eyelids during cosmetic eyelid surgery will significantly improve your appearance and will make you look more alert and more vibrant. If the skin was so excessive as to affect your peripheral vision, this will be corrected as well. Removing this excess skin from your lower eyelids will further improve the bags under your eyes, and in this age group, cosmetic eyelid surgery is usually done in conjunction with removal or redistribution of fat in the lower eyelid.

Approximately half of the patients that have excess skin in their upper eyelids could also benefit from a concurrent forehead lift (brow lift). Aging causes the forehead and eyebrows to descend causing bunching of the upper eyelid skin, and the excess skin in that area is accentuated by the descent of the brow. In these cases, if the brow lift is ignored, then there will only be partial improvement (usually around 75%). If a brow lift is performed, it can be done as an open procedure or as an endoscopic procedure. The open approach requires a longer incision but can often be hidden in the hair and is sometimes a better approach if the hairline is high. Numbness is more common with the open approach but usually resolves within a year. The endoscopic approach requires small incisions hidden in the hair, and the chance for numbness is greatly reduced. If the hairline is high, then caution must be used with an endoscopic approach because the hairline will be raised after the procedure.

If an extreme brow lift is required, the endoscopic approach may not be best. As with any procedure, there are risks that should be considered. There will be some asymmetry, swelling, and bruising for several weeks. Some patients are not candidates or are poor candidates for cosmetic eyelid surgery or a brow lift if they have excess laxity of their lower eyelid. These patients are at higher risk for ectropion (abnormal position of lower eyelid) post-operatively. If dry eyes are a problem before the brow lift surgery, then one should seriously re-consider surgery because dry eyes can become much worse post-operatively. If excess fluid has built up (edema) under the skin of the lower eyelid from an allergic response to the brow lift surgery, there may not be significant improvement with a lower blepharoplasty procedure. After an examination by your plastic surgeon, a recommendation will be made and risks complication will be discussed in detail taking into account your unique anatomy. Most patients are happy with the results after cosmetic eyelid surgery and look years younger. It can significantly improve a tired look and replace lost vibrancy to your face.

2-Jul-08 10:00 AM

Options for Facelift Surgery

Richard Reynolds — Fri, 23 May 2008 16:00:00 GMT

Dale Reynolds, MD

Is a lunchtime facelift a contradiction in terms? It really depends on what your plastic surgeon means when they say facelift surgery – a surgical or non-surgical facelift. Any “facelift” should improve the jawline, tighten the neck and remove the jowls in the lower face. There also may be some improvement in the nasolabial folds and marionette lines. A facelift shouldn’t be expected to help much with most other lines or creases in the face.

A classical facelift surgery involves removing excess skin of the face and neck to obtain a more youthful look. The most popular and effective facelift surgery technique involves tightening or removing some of the muscle layer (SMAS) under the skin so that the tension of the lift is not on the skin. This avoids the over-pulled, windblown look that everyone wants to avoid. In addition to an incision around the ear, an incision is often needed under the chin to tighten the muscle layer of the neck and to remove any excess fat in this area (if it cannot be removed by liposuction alone). For this type of facelift procedure, local anesthesia is required. Most plastic surgeons will also give sedation or a general anesthetic. It can usually be performed as an outpatient procedure and is often combined with eyelid surgery (blepharoplasty) or a forehead lift. Pain is usually minimal, but strenuous activity must be avoided for 4 weeks after surgery. Some swelling or bruising may occur, especially around the eyes.

Recently, some surgeons and non-surgeons have been promoting a less-invasive non-surgical “facelift.” Non-surgeons promote this for obvious reasons. Options include fillers (fat, Radiesse, Restylane, etc) or barbed sutures. A non-surgical facelift can be done with barbed sutures that are placed under the skin under a local anesthetic with the patient awake. It doesn’t last as long, look as natural, or do as much as a true facelift surgery. There may a place for the non-surgical facelift in young (30’s) patients that need minimal refinement or don’t have the time required or the desire to undergo a surgical recovery. The degree of change from this type of facelift procedure is less dramatic and only lasts several months to 2 years depending upon the procedure. While they are less invasive, they still carry risks and these should be understood. Patients have more options than ever before and must know what they want and how to obtain the best results possible by weighing the advantages and disadvantages of each procedure.

Some questions to consider asking your plastic surgeon before facelift surgery are:
-How much longevity should I expect from this procedure?
-What are the possible complications and likelihood of each?
-How long will the procedure take?
-What should I expect during recovery?
-How common are revisions and how are they handled?

It may also help to speak with other patients who have had a similar facelift procedure by the same plastic surgeon. Photographs may help but each patient has unique anatomy and everyone has a different potential for healing. An endorsement by happy patients after a facelift surgery by the same plastic surgeon is the best screening tool. To ensure a good experience make sure you are comfortable with your surgeon, your options, and the procedure you choose together.

This article, printed in the El Paso Times, was written by Dr. Reynolds, who is the local Plastic Surgery expert for the newspaper.

To schedule a consultation for a facelift surgery with Reynolds Plastic Surgery, contact us today.

23-May-08 11:00 AM

Having a Breast Augmentation Procedure

Richard Reynolds — Fri, 23 May 2008 16:00:00 GMT

Dale Reynolds, MD

Breast augmentation is a procedure used to enhance the size of a woman’s breast or to obtain more symmetry. For many women, the confidence boost this procedure gives them makes the potential side effects of breast implants well worth it. Childbirth often causes significant deflation and sometimes droopiness of the breasts which can often be reversed by filling this deflated breast with more volume. Often during development, a significant amount of breast tissue doesn’t form leaving ladies feeling less feminine.

In November of 2007, the FDA re- approved use of silicone implants for all women over 22 years old having a breast augmentation procedure, which ended a 14 year restriction due to the side effect of breast implants made from silicone experienced by many women. Advances in silicone implants mean that it is now safe to use silicone or saline implants for a breast augmentation procedure depending upon patient preference and anatomy.

The implants can be placed above or below the chest muscle if silicone implants are used. If saline implants are used, most plastic surgeons will place them under the muscle. Placing them above the muscle decreases post-operative pain and may decrease distortion during heavy chest muscle activity (important for body builders). Placing the implants below the muscle hides the upper portion of the implants (especially saline) and offers slightly more tissue coverage if tissue in this area was very deficient. Placing them below the muscle also decreases visibility or rippling of the implants.

Short-term side effects of breast implants include soreness, swelling, change in nipple sensation (increased or decreased sensation), and bruising. Most of these resolve completely within a few weeks to months. Some potential long-term problems include deflation, leak, rupture, capsular contracture (abnormal scar tissue around the implant), and rippling. All implants develop a capsule around them, but some can become hard or painful and may require removing this scar tissue. An MRI can confirm leakage of a silicone implant if suspected. Saline implants usually deflate entirely when there is a leak or rupture, so no additional studies are required. The implants will most likely have to be replaced at some point, but it is not necessary to change them at a fixed interval if there are no problems.

The breast augmentation procedure is performed as an outpatient, usually under a general anesthetic and takes about one hour. Breast augmentation recovery is typically short. Most patients experience mild to moderate soreness that improves significantly 2-3 days after surgery, and most patients are back to work 3-4 days after surgery. Most activities can resume immediately, but there are some restrictions on strenuous activity for 3-6 weeks. After 6 weeks, there are no restrictions. After undergoing a breast augmentation procedure, mammography continues at the same intervals, but a slightly different technique will be used.

This article, printed in the El Paso Times, was written by Dr. Reynolds, who is the local Plastic Surgery expert for the newspaper.

Contact Reynolds Plastic Surgery to schedule a consultation for a breast augmentation procedure.

23-May-08 11:00 AM

Botox Injection or Dermal Fillers?

Richard Reynolds — Fri, 23 May 2008 16:00:00 GMT

Every day, millions of patients receive a Botox injection or dermal fillers. Patients hear these discussed in the media daily, but there are so many options, and with new ones coming to the market each year, the choice can become confusing. Patients often ask for a Botox injection or dermal fillers when they usually need a combination of both.

Botox is a neurotoxin which temporarily paralyzes the muscle that it is injected into. A Botox injection acts by inhibiting muscular activity in the area of concern. By relaxing the muscle in the area, the folds or creases are no longer prominent and often disappear. Botox injection charges are calculated by unit or by area. One area is usually around $300, and 1 unit is usually $9-16 dollars. If the surgeon is charging less than $9/ unit, ask him or her to mix it in your presence and make sure that at least two mL are used because they may be using a diluted product. If charges are by unit, then the number of units required will vary by gender (men usually require more), area, and degree of muscular activity in each area. There are 100 units of Botox in one bottle. The forehead usually requires 30-50 units, the area between the eyebrows (glabellar region) usually requires 20-30 units, and the areas outside of the eyes (crow’s feet area or lateral orbital region) usually require 25-35 units of Botox injection. There are other areas which can also be treated like the neck bands, around the mouth or the nasal area.

Botox has other uses as well such as treating excessive underarm sweating or a spasm around the eye. Side effects and complications are very rare although it does take 5-7 days to paralyze the muscle.

Dermal fillers include an ever growing list of products. A few of the more popular choices are fat, Collagen (Zyderm, Cosmoderm), Radiesse, Restylane, and Juvederm. All dermal fillers have pros and cons and vary in composition and duration of effect, but all act to fill grooves or creases with volume rather than by acting on the underlying muscle. If you paralyze the muscle and fill the crease, you get more than a two-fold effect. There are at least twenty different kinds of fillers, so you should ask your plastic surgeon which one is best for you. Make sure you know which ones have been approved by the FDA and for what uses. Complications are uncommon with dermal fillers although bruising that can last for days or even weeks occurs 15-40% of the time. Stopping any aspirin or Motrin for two weeks before receiving dermal fillers will help minimize this possibility. The injection can be done quickly in the office with a nerve block or no anesthetic. If topical anesthetic is used (to numb the skin) then it is necessary to wait for 20-30 minutes to allow this to work. The size of the needle and the pain threshold of the patient determine the best type of anesthetic.

The Botox injection and dermal fillers are so popular because they are quick, effective, predictable, affordable and safe. Most patients are very happy with the results and this is the reason this area of Plastic Surgery continues to grow.

This article, printed in the El Paso Times, was written by Dr. Reynolds, who is the local Plastic Surgery expert for the newspaper.

Contact Reynolds Plastic Surgery to find out if a Botox injection is right for you.

23-May-08 11:00 AM

Body Contouring

Richard Reynolds — Fri, 23 May 2008 16:00:00 GMT

R. Dale Reynolds, M.D.

What is “body contouring” and is it right for me?

Liposuction surgery, abdominoplasty (or tummy tuck), buttock lift, thigh lift, body lift, belt lipectomy and buttocks (gluteal) augmentation all fall under the category of body contouring procedures.

Which procedure is right for you depends upon several factors. In general, patients with good skin tone and small pockets of fat deposits (or lipodystrophy) are best suited for liposuction surgery.

Patients with excess skin or loss of skin tone are often better candidates for a body contouring procedure where excess skin will be excised and tightened (resectional procedure). The abdominoplasty or tummy tuck deals with the front (abdominal) part of the lower trunk. An abdominoplasty or tummy tuck is often the best procedure for a woman trying to regain her youthful figure after the trauma of childbirth. It is best to wait to have an abdominoplasty until after childbirth is completed so the benefits of the surgery will not be lost. A buttock lift resects excess tissue (skin and fat) from the buttocks and lifts it into the correct position. This can be combined with an augmentation of the buttocks to increase fullness or rearranging the patient's own tissue to increase fullness (auto-augmentation). A thigh lift resects excess tissue from the thighs and repositions them correctly thus tightening the upper thigh.

A body lift combines the abdominoplasty, thigh lift and a buttock lift to re-contour the entire lower trunk. The body lift is a common body contouring procedure that is performed on our bariatric patients after they reach a stable weight. These patients often lose 100 to 250 pounds, and the excess skin they are left with can be quite limiting. The body lift is often the best option for patients who have always been a normal weight. Sometimes after pregnancy the tissue in this area is best dealt with using a body lift, especially if there is excess skin in the thighs and buttocks. A belt lipectomy is similar to the body lift in that it is a circumferential procedure (incision goes all of the way around the trunk) but the incision is higher and the thighs and buttocks aren’t lifted as much.

Buttocks (gluteal) augmentation or enhancement can be performed with fat translocation, tissue rearrangement, soft silicone implants or hard silicone implants. There are advantages and disadvantages to each and they should be discussed at length before deciding.

Most of these body contouring procedures, including liposuction surgery, thigh lifts, and buttock lifts are performed as an outpatient, but the circumferential procedures often require a brief stay.

All activities can resume at six weeks, after gradual increase in activities up to that point. It often takes six to 16 weeks to see the final result with these procedures. As with all procedures, some risks exist. Make sure these are discussed with your surgeon before proceeding.

This article, printed in the El Paso Times, was written by Dr. Reynolds, who is the local Plastic Surgery expert for the newspaper.

Contact Reynolds Plastic Surgery for a consultation to determine the right body contouring procedure for you.

23-May-08 11:00 AM

FDA Approves Radiesse Facial Filler for Two New Aesthetic Indications

noemail@reynoldsplasticsurgery.com — Wed, 27 Dec 2006 18:00:00 GMT

NEWS RELEASE FDA APPROVES RADIESSE FACIAL FILLER FOR TWO NEW AESTHETIC INDICATIONS Long – Lasting filler from BioForm Medical Approval for Treatment of Facial Wrinkles and Folds; and for the Correction of HIV- Associated Facial Wasting San Mateo, CA- December 27, 2006. BioForm Medical, Inc., a privately – held medical aesthetics company today announced that the U.S. Food and Drug Administration (FDA) approved Radiesse, the next- generation cosmetic dermal filler, for the long – lasting correction of moderate to severe facial wrinkles and fold such as nasolabial fords. Radiesse also received a second FDA approval for the long- lasting correction of facial fat loss (lipotrophy) in people with human immunodeficiency virus (HIV). Radiesse is the first filler with advanced calcium- based mircrosphere technology that not only provides volume replacement to wrinkles, folds and sunken depressions but also stimulates the body to produce new collagen;...

FDA Approves Silicone Implants

noemail@reynoldsplasticsurgery.com — Fri, 17 Nov 2006 21:00:00 GMT

FDA Approves Silicone Gel-Filled Breast Implants After In-Depth Evaluation Agency Requiring 10 Years of Patient Follow-Up After rigorous scientific review, the U.S. Food and Drug Administration (FDA) today approved the marketing of silicone gel-filled breast implants made by two companies for breast reconstruction in women of all ages and breast augmentation in women ages 22 and older. The products are manufactured by Allergan Corp. (formerly Inamed Corp.), Irvine, Calif., and Mentor Corp., Santa Barbara, Calif. “FDA has reviewed an extensive amount of data from clinical trials of women studied for up to four years, as well as a wealth of other information to determine the benefits and risks of these products,” said Daniel Schultz, M.D., Director, Center for Devices and Radiological Health, FDA. “The extensive body of scientific evidence provides reasonable assurance of the benefits and risks of these devices. This information is available in the product labeling...

What to Expect During your Breast Augmentation

noemail@reynoldsplasticsurgery.com — Mon, 11 Sep 2006 01:00:00 GMT

What to Expect Before and After Breast Augmentation Surgery What will happen before, during and after your breast augmentation surgery? Breast augmentation is a cosmetic surgery procedure to change the size and shape of a woman's breasts. Whether it is reducing the size of breasts that are too large, reconstructing breasts after surgery, or enhancing the size of the breasts, breast augmentation provides women with the body contour they are looking for. Dr. Reynolds is a plastic surgeon in El Paso that specializes in breast augmentation in all its forms. I strive to improve my patients appearance with breast augmentation, says Dr. Reynolds, I am committed to providing thorough consultations, pre-operative education, and post operative...

Technology Helps Doctors Ease Patients' Post-Surgery Pain

noemail@reynoldsplasticsurgery.com — Wed, 07 Jun 2006 14:45:00 GMT

SPRINGFIELD -- Surgeries on shoulders and knees are a little less painful in recent years with the arrival of the pain pump. That's a device that delivers local anesthetic directly to the site of surgery. Now plastic surgeons are borrowing the idea and giving their patients more immediate relief in the days following some major surgeries. Teena Dandurand was diagnosed with breast cancer about a month ago and her prognosis was good. But she was suddenly facing a double mastectomy and breast reconstruction that would borrow muscle and tissue from her lower tummy. That's a major surgery with a painful reputation. That was one of my biggest fears, the pain and hurting, Dandurand said Up until recently, like most surgeons, Dandurand's plastic surgeon, Dr. Rod Geter, controlled that post-surgical pain with narcotics primarily. That helped but really only cut the edge off the pain, said Geter. Geter decided to borrow an idea from surgeons who were working on knees and shoulders. ...

Backroom Cosmetic Procedures by Amateurs not Worth The Risk

noemail@reynoldsplasticsurgery.com — Thu, 01 Jun 2006 22:00:00 GMT

Many consumers are still unaware of the risks associated with aesthetic procedures performed by unlicensed practitioners. Recent reports from Chicago, California, Georgia and other locations document unsuspecting patients suffering from pain and disfigurement and in one case, death, when a woman was injected with cooking oil in a Salinas, California beauty salon. (PRWEB) May 21, 2006 -- Many consumers are still unaware of the risks associated with aesthetic procedures performed by unlicensed practitioners. Recent reports from Chicago, California, Georgia and other locations document unsuspecting patients suffering from pain and disfigurement and in one case, death, when a woman was injected with cooking oil in a Salinas, California beauty salon. Injectable fillers to enhance the bust, hips, buttocks or face are frequently administered in non-clinical settings by amateur or unlicensed practitioners. Unsuspecting patients have been injected with materials such as silicone, baby oil,...

New Techniques Greatly Reduce Capsular Contracture in Breast Augmentation Patients

noemail@reynoldsplasticsurgery.com — Wed, 25 Jan 2006 19:00:00 GMT

New Techniques Greatly Reduce Capsular Contracture in Breast Augmentation Patients

A recent tudy shows new methods greatly reduce capsular contracture in breast augmentation patients.

(PRWEB) January 23, 2006 -- When it comes to cosmetic surgery, patients deserve nothing less than perfection. Although breast augmentations and other implant related procedures are highly popular and rewarding, a condition known as "capsular contracture" can prevent optimal results.

Capsular contraction is the most common side effect/ risk of cosmetic and reconstructive breast implant procedures. A capsular contracture occurs when the normal fibrous capsule around the implant tightens and/ or thickens resulting in breast firmness, shape distortion and pain (in advanced states). This results in the need for further surgery and re-operations for the patient.

Current data demonstrates that 15-20 % of all patients who undergo cosmetic breast implant procedures and > 20 % of reconstructive and revision patients experience capsular contracture. Previous publications recommend combination breast pocket irrigation based on in vitro studies. Over the past six years, we have studied outcomes of these recommended breast pocket irrigations clinically in over 300 patients.

"This study culminates the past 8 years of work we have done on capsular contracture and how we can make breast augmentation and breast implant procedures safer and better for patients."

The Breast Lift Procedure at Reynolds Plastic Surgery Center of El Paso

Wed, 03 Feb 2010 22:20:07 GMT

Over the years, factors such as pregnancy, nursing, and gravity take their toll on a woman's breasts. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag. A breast lift, also known as a mastopexy, is a surgical procedure to raise and reshape sagging breasts--at least, for a time. No surgery can permanently delay the effects of gravity.

Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple. If your breasts are small or have lost volume--for example, after pregnancy--breast implants inserted in conjunction with mastopexy can increase both their firmness and their size.

We Offer a Consultative Approach to the Mastopexy Procedure

Located in downtown El Paso, Reynolds Plastic Surgery Center specializes in providing state-of-the-art techniques while addressing your specific needs and desires. Dr. Reynolds uses computer simulation to formulate a breast lift procedure that is best for your body.

The doctor and his knowledgeable staff are always available to answer your questions or concerns regarding the mastopexy procedure – schedule a breast lift consultation or call 915-532-6662 to speak with one of his assistants. We also invite you to learn more about Dr. Reynolds’ industry expertise: TX Health Magazine Discusses Breast Augmentation with Richard Reynolds, M.D. of Reynolds Plastic Surgery Center of El Paso.

Featured Pages

Mon, 01 Feb 2010 16:02:04 GMT

Home Page Reynolds Plastic Surgery Center of El Paso offers plastic surgery procedures for a variety of cosmetic and reconstructive needs. Before and After See images of plastic surgery before and after the procedure. Breast View pictures of patients before and after breast augmentation surgeries. Body Browse our body contouring photos to see examples of our work. Face Reynolds performs plastic surgery for the face. Rhinoplasty See examples of rhinoplasty before and after the procedure. Breast Procedures Reynolds Plastic Surgery provides El Paso breast augmentation and other cosmetic procedures. Breast Enlargement We perform procedures in El Paso for breast enlargement surgery. Breast Lift Over the years, skins loses its elasticity – reduce sagging with a mastopexy. Breast Reduction Surgery Large breasts can cause a number of medical problems –...

Ultrasonic Liposuction in El Paso

Mon, 01 Feb 2010 15:58:48 GMT

An emerging tool in body contouring, ultrasonic liposuction (also known as ultrasonic assisted liposuction or UAL) uses sound waves to disrupt fat cells and offers an effective solution to excessive fat. It’s combined with conventional suction assisted lipectomy to obtain maximum results in certain areas. The UAL procedure is often used in conjunction with tumescent liposuction to achieve optimal results.

Ultrasonic liposuction essentially liquefies (or melts) fat cells in a given area before it is removed via suction. Because it causes minimal blood loss and little bruising, the UAL procedure is the preferred method for removing fat from areas such as the neck, stomach, “love handles,” ankles, and chin.

The UAL Procedure

While most patients appreciate the faster recovery times and better tissue retraction, there is the danger of seroma, or the appearance of excess fluid where the fat has been removed. Aside from this, ultrasonic liposuction is able to treat dense, larger pockets of fat at one time. And because it tightens the skin as Dr. Reynolds removes the fat, the UAL procedure is an alternate solution for those with baggy skin.

Dr. Reynolds, whose office is located in downtown El Paso, will sit down and discuss your needs and desires with you, formulating a UAL procedure plan that is best for your body. Dr. Reynolds and his knowledgeable team members are always available to answer your questions – contact the center to schedule an ultrasonic liposuction consultation or call 915-532-6662 to speak with one of his assistants. Receive the care and expertise you deserve at Reynolds Plastic Surgery Center of El Paso.

Breast Reduction Surgery in El Paso

Mon, 01 Feb 2010 15:48:41 GMT

Women with very large breasts may experience a variety of medical problems caused by the excessive weight as well as back and neck pain, skin irritation, skeletal deformities, and breathing problems. Bra straps may leave indentations in shoulders and unusually large breasts can make a woman - or a teenage girl - feel extremely self-conscious. Often, only a breast reduction surgery can solve these problems.

Breast reduction, technically known as reduction mammaplasty, is designed for such women. The procedure removes fat, glandular tissue, and skin from the breasts, making them smaller, lighter, and firmer. It can also reduce the size of the areola, the darker skin surrounding the nipple. The goal is to give the woman smaller, better-shaped breasts in proportion with the rest of her body.

Personalized Reduction Mammaplasty Consultations

Reynolds Plastic Surgery Center in El Paso, Texas specializes in state-of-the-art surgical techniques, addressing your specific needs and desires after a detailed, personalized consultation. Dr. Reynolds uses the latest computer simulation to formulate a breast reduction surgery that works with your body.

The doctor and his staff are always available to answer your questions or concerns regarding a reduction mammaplasty – simply schedule a breast reduction surgery consultation or call 915-532-6662 to speak with one of his helpful assistants. We also invite you to learn more about Dr. Reynolds’ industry expertise in reduction mammaplasty techniques: TX Health Magazine Discusses Breast Augmentation with Richard Reynolds, M.D. of Reynolds Plastic Surgery Center of El Paso.

Our El Paso Lip Augmentation Services

Thu, 10 Dec 2009 16:44:20 GMT

Full lips are an aesthetically pleasing feature in most cultures, especially in the United States. We offer several options for lip augmentation including fat transfer, alloderm, collagen and restylane. We offer a wide variety of surgical and non-surgical services to give you the best result possible. When you come to our office, we will sit down and discuss your needs and desires. Using computer simulation, we will formulate a plan that is best for you. Perma Facial Implant - As seen on The Doctors TV show Dr. Reynolds is the first plastic surgeon in the El Paso area to offer permanent lip augmentation with the new groundbreaking Perma Facial Implant. The Perma Facial Implant is made of soft, solid silicone elastomer using an injection molding process to produce a naturally contoured implant with a smooth, non-porous surface. The implant cannot rupture or deflate, and may be removed at any time. Unlike other permanent lip augmentation implants, the Perma Facial Implant's smooth...

Thu, 10 Dec 2009 16:35:27 GMT

Only in El Paso: Plastic Surgery to Help You Achieve the Look You Desire For those seeking the best options in El Paso for plastic surgery, Texas-based Dr. Richard Dale Reynolds offers procedures at his office that are able to reshape normal structures of the body to improve a patient's appearance and boost his or her self-esteem. Among the many offerings of cosmetic surgery at his El Paso, Texas office, Dr. Reynolds features the following: Facial Refinement, which is the removing of excess fat, tightening of underlying muscles, and re-draping of the skin (more) Breast Augmentation, which is plastic surgery that is designed to enhance the size and shape of a woman's breast (more) Body Sculpting, a cosmetic surgery procedure that can help sculpt the body by removing unwanted fat and skin, and liposuction (more) ...

Before and After Photo Galleries

Mon, 28 Sep 2009 19:11:45 GMT

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Face | Breast| Body

Gynecomastia at Reynolds Plastic Surgery Center of El Paso

Tue, 22 Sep 2009 18:51:47 GMT

Gynecomastia is a medical term that comes from the Greek words for "woman-like breasts." Dr. Reynolds is a renowned plastic surgeon in El Paso, Texas, experienced in providing cosmetic surgery (and breast reduction) for men.

Though this oddly named condition is rarely talked about, it's actually quite common. Gynecomastia affects an estimated 40 to 60 percent of men. It may affect only one breast or both. Though certain drugs and medical problems have been linked with male breast overdevelopment, there is no known cause in the vast majority of cases.

Dr. Reynolds Offers Breast Reduction for Men

Breast reduction for men can help those who feel self-conscious about their appearance. The procedure removes fat and/or glandular tissue from the breasts and, in extreme cases, removes excess skin, resulting in a chest that is flatter, firmer, and better contoured.

We offer a wide variety of options to give you the best results possible. When you come to our office, we will sit down and discuss your needs and desires and, through computer simulation, formulate a plan that is best for you. Call Dr. Reynolds today at 915-532-6662 or contact the office to set up an appointment to discuss if gynecomastia surgery is right for you. Learn more about cosmetic surgery and breast reduction for men – read Dr. Reynolds’ article on the subject.

The Best Option in El Paso for Abdominoplasty

Mon, 14 Sep 2009 20:08:57 GMT

Abdominoplasty, also known as a tummy tuck, eliminates excessive fat around the abdomen. Most males accumulate fat in the abdomen and flanks (side handles) despite attempts at weight loss, and these areas continue to be a problem. Effective waist contouring is usually achieved through several options that are available to deal with this problem, including ultrasonic liposuction, conventional liposuction and excision. Often, a combination of these waist contouring options gives maximal results.

Along with abdominoplasty, liposuction is used to reduce the fat deposits in the side handle area or to remove excess tissue in the abdomen to create the look of a “six-pack,” or simply more definition. This type of cosmetic surgery for men works best for those who are close to their ideal weight.

Waist Contouring Gives Your Abdominal Area Noticeable Definition

Abdominoplasty can help men who feel self-conscious about their appearance, and our team offers a wide variety of solutions to give you the best results possible. When you come to our office, we will sit down and discuss your needs and desires, and through computer simulation, we will formulate a customized plan that is best for you.

Call Dr. Reynolds today at 915-532-6662 or contact the office to set up an appointment to discuss if abdominoplasty is right for you. Read more about Dr. Reynolds’ approach to cosmetic surgery and waist contouring for men.

Breast Enhancement Procedures at Reynolds Plastic Surgery Center of El Paso

Mon, 14 Sep 2009 19:58:20 GMT

Breast enlargement is a cosmetic surgery procedure to change the size and shape of a woman's breasts. Whether it is reconstructing breasts after surgery or enhancing the size of the breasts, breast enhancement surgery provides women with the body contour they are looking for. Dr. Reynolds is an El Paso-based plastic surgeon who specializes in breast augmentation surgery in all its forms. I strive to improve my patients’ appearance with breast augmentation, says Dr. Reynolds, I am committed to providing thorough consultations, pre-operative education, and post-operative care. Prior to your breast enhancement surgery, you will have an initial consultation with Dr. Reynolds. This is your chance to have all of your questions about breast enlargement answered. Dr. Reynolds will provide you with directions you must follow prior to the surgery. You may need to avoid smoking, certain vitamins and drugs, and some food or drink. Dr. Reynolds will also evaluate your overall health to make...