FibroCell Therapy:

This is the next thing in non-surgical aesthetics. It involves taking a small piece of skin from behind the ear [“punch biopsy”] and growing your cells in a culture medium. This produces millions of new cells. Then, these cells are returned back to you with an injection into the skin.
It’s going under the working name of “LAVIV” therapy by Fibrocell Science. Preliminary studies for wrinkles and acne scars have been promising. The company has done Phase 2 and Phase 3 studies, which were placebo controlled, multicenter and randomized [keep in mind…they were not double blinded!]
109 patients received Fibrocell treatment several weeks apart. There was a 43% cosmetic response vs. 18% placebo.

My Take: This is still some time off in the future. If it does work, it will work for fine wrinkles and mild acne scarring. It won’t build the volume that fillers do, but may have a role as an adjunct to filler work. Cost is another issue, and I imagine this won’t be cheap!

Update on Cellulite:

What is cellulite? My research has yielded some answers to this question. Cellulite is caused by a loss of collagen in the dermis and as a result the fat herniates upwards through the dermis and causes the lumpiness on the skin. It has nothing to do with “toxins” or “poor lymphatic flow” or other such nonsense. In fact, the study which I published in the Journal of Cosmetic Dermatology, which is a peer-reviewed medical journal, has shown that, quite uniformly, that women with cellulite have lost collagen in the dermis. In fact, earlier biopsies performed at Rockefeller University have also confirmed this finding. It has nothing to do with your weight, your shoes or clothing or anything else like this. It’s all about collagen.
So…what can be done? Collagen boosting creams do have some role here, but in my opinion, they work best if done in conjunction with some technology
Here’s a run down of the technologies which I think work: Intense Pulsed Light: for mild cellulite and light skin
Accent: About a 30-50% improvement in the texture of the skin and appearance
Smooth Shapes: All the advantages of the Velashape but it has a diode laser that targets fat.

Just remember….results can always vary and it’s impossible to predict who may and who may not get a response. Also, if it “sounds crazy”, it probably is!

Let’s face it. When it comes to acne scarring, very few things can really help, at least in my experience. A study out of Korea has shown that when “Fractionated Laser” [Fraxel, Affirm, CO2 lasers] are done for acne, in combination with subcision [which involves using a tiny 29-Gauuge needle and going under the scar], in conjunction with localized chemical peeling, the severity of the scarring decreased by 50%! That is an excellent outcome!. The fractionated laser, such as the Affirm, is excellent in improving the shallow acne scars. In the study done, 3-4 treatments were done. After the lasers were done, clients underwent peeling and subcision twice, 2-3 months apart. The peels used were quite “strong”, up to 100% TCA peels, which is much stronger than that used in the “South Beach” Peel.

AFFIRM LASER FOR SCARS

Non-ablative lasers, such as the Affirm, are safe and effective for treating scars. A study just performed by Dr. Vasily and published in the Journal of Drugs in Dermatology 2009. The study has shown an excellent improvement in 40% of scars and a good improvement in 30% of scars. A majority of scars that were more than 10 years old still responded. The aesthetic response was correlated with positive changes in the tissue [“histology”]

Photodynamic Therapy for Acne

This is a very useful treatment for acne, and one that can be used when you have “failed” the typical treatments that are used to treat it. What can you expect in terms of results? According to the Journal of the European Academy of Dermatology and Venerology 2009 has shown a 70% decrease in the “inflammatory” acne and a 66% decrease in the “non-inflammatory” acne. Also known as “PDT”, it is not for everyone and it requires you to really listen to the post-treatment instructions!!!

Taking Care of Your Skin in the Winter

The most important thing to remember is that you must use a moisturizer frequently for it to work, as well as continuing your sunblock because of UVA radiation. UVA radiation, which ages the skin, is constant throughout the year. Also, because the winter’s cold can irritate the skin, it is important to keep up your water intake! The sensitivity to the cold can make you more sensitive to chemical peels and microdermabrasions, but you can still do these procedures with proper attention to details. I advise my clients to be careful with over-exfoliation, especially when the skin has been beaten down by the cold. Also, just remember, just because its natural doesn’t mean it’s good. There is medically accepted term as “sensitive skin” and we all need to understand that this is a marketing term more than anything else. In truth, we all have sensitive skin!

Update in Health March 2010

Welcome to our March 2010 health update, where I list this month’s new findings in Medicine and Aesthetics. As always, this does not replace an actual medical visit and it is not intended for use in making important personal medical and treatment decisions. This is a “jump board” for information only.

Diabetes Care:

When it comes to Diabetes, doctors like to follow the “A1c” level as a means of determining if the blood sugar has remained in acceptable ranges. In a recent report, it seems that an A1c level less than 7.5 increases death rates among diabetes. This is probably due to that fact that hypoglycemia [low blood sugar] carries a real risk.

Osteoporosis/ Fosamax Nightmare?

Fosamax is a prescription drug used for osteoporosis. It is part of a class of drugs called Bisphosonates. These class of drugs are used to treat osteoporosis. They may also be associated with lower rates of breast cancer, though they are known to have side effect of producing osteonecrosis of the jaw. Now, a new concern is that the bisphonate drugs may paradoxically increase the rate of bone fractures…the exact thing they were supposed to prevent. There have been reports of atypical fracture of the femur bone. These seem to occur in folks taking these meds for more than 5 years. Two thirds of those that got fractures had them on both sides. Yikes! This risk has not been seen with Evista, which is a NON-bisphosphonate drug and the one that seems to decrease the risk of breast cancer. Some thought is that those on Fosamax may want to take a drug holiday after 5 years, or switch to Evista.

Colon Cancer Screen:

Wouldn’t it be nice if you could swallow a capsule and have it take pictures all the way down the tract when it was time for a colon cancer screen? Colon cancer is a preventable …if you get screened in time. The test of choice is a colonoscopy. I am not a fan of virtual colonoscopy because of the radiation exposure. A wireless capsule would be great…..but…..data presented at the 13th World Congress of Gastroenterology found the capsule was only 39% sensitive as a test when it came to imaging the colon. So…it’s not ready for Prime Time yet.

Green Tea and Lung Cancer:

Chemoprevention is a hugh topic in medicine and the quest for natural products that can actually decrease your risk of various cancers has been disappointing. With that perspective, another study has shown that current and former smokers who do not drink green tea have a 13x more likely risk of developing lung cancer vs. those who consume at least one cup a day. It seems to be the polyphenols in green tea. Of course, it would be stupid to think that you can still smoke and drink green tea and all will be good in the world. If you want to decrease your risk, you must stop smoking. Period.

Paxil and Tamoxifen Warning:

Women who take Paxil and Tamoxifen were up to 90% more likely to die of their disease vs. those who did not take this combination. This was a population study in Canada. Paxil is part of a class of drugs called SSRI’s. As a class, it is known to inhibit “P450 2Ds”, which is an enzyme which is needed to convert Tamoxifen to endoxifen. These results only seem to be seen with Paxil, not with the other SSRI’s. It may be due to the fact that Paxil is an irreversible inhibitor of this enzyme. So MD’s are therefore now recommending non-SSRI anti-depressants when some one is on Tamoxifen.

I want to thank Dr Fink for allowing me to be a guest blogger today. I started reading his blog and saw that he did not have any posts about why his patients come to him, and why they feel safe with him. I asked… he said yes,…so here I go… I have been a patient of Dr Fink for over 5 years. He has not only been able to help me slow down the process of aging with an amazing daily non- invasive skin care regiment along with a few yearly treatments of fillers. Dr Fink is also my Internal Medicine Doctor for many, many, reasons but primarily because the Doctor is ALWAYS IN! He really gives new meaning to bedside manner.

Aside from over 20 years of experience, Dr Fink’s practice reflects his diverse training and personal experiences. A clinical instructor in aesthetics, Dr Fink has taught Botox, Fillers and Laser throughout the US, Australia and Asia. In as such, he has performed or supervised thousands of cases. Further, Dr Fink maintains an active Concierge practice in both Internal Medicine and Pulmonary, providing a wide range of care and second opinions. His office is NOT a medical spa, and his philosophy has always been to invest in the people and the technology and not the frivolity of a “medspa”. Furthermore, Dr Fink’s office does not offer technologies that he personally feels don’t work, or that work well enough to justify a client spending money on them. Dr Fink continues to consult to the medical spa industry and teach lasers to aestheticians on a monthly basis.

So, if it’s a difficult case that seems to have eluded a diagnosis, or someone that simply wants to know what medical breakthroughs may apply to their case, or a trusting hand to do your Botox, filler or laser procedure, than his office is the place for you.

Dr Fink thanks for allowing me to boast about you and your practice and I will see you next week for my Kiss & Tell Party. If you don’t know about his Kiss & Tell Parties – check it out I promise you and your friends will have a blast and come out looking Kissable!!

Best,
Denise P