MERRY CHRISTMAS - Bo-tax defeated!!

Merry Christmas from us here at "PSB - the Plastic Surgery blog" to you. I hope that 2010 is much better for everyone than 2009!

Here's one bit of good news: due to an intense reaction to the highly unpopular "Bo-tax" proposal (discussed here), and a whole lot of political lobbying from organized plastic surgery and women's groups, it looks like the cosmetic services tax is going to be removed from the Senate bill. Hurray!! No more Bo-tax!!

Thanks to all who pointed out the ridiculous nature of this tax proposal, and those who contacted their Senators and got this done!

Surgical lip lifts

A lip lift is a procedure that pulls the red area of the lip, known as the "vermilion", upward. Recently, I have been seeing some websites that advertise this procedure, to help the mouth area look more youthful.

First - some background. There are two main families of lip lifts. The first type of lip lift can be done with an excision of skin in the area where the lip joins the skin. This is called a "vermilion advancement". The second type of lip lift is done with an excision of skin just beneath the bottom of the nose. This second type of procedure is sometimes called a "subnasal" or "bull-horn" lift, after the shape of the incision around the bottom of the nose. Both advance the vermilion upward. Lip lifts can be potentially useful for people that have an excessively long upper lip - either naturally or through aging.

The problem: like any incisional surgery, these lift operations do leave scars, which typically can look lighter than the surrounding tissue, making them hard to disguise. This is particularly true with the vermilion advancement method, in my opinion. With masterful surgical technique and perfect healing, the scars can look acceptable. With anything less, the scars may not turn out so well. It's a bit of a a gamble.

One variation on the vermilion advancement lip lift idea involves only lifting the corners of the mouth. This gives a "happier" appearance for those people who naturally have a downturned mouth. Master surgeon Dr. Robert Flowers has written about this - he calls his operation the "Valentine anguloplasty", because the tissue removed resembles a Valentine's day heart shape. While he makes it look good, not all surgeons are in the same league... If overdone, it can make the lip shape look artificial or even Joker-like.

Lip lift operations have their fans. I'm not one of them. I personally do not perform this operation as a cosmetic procedure for young or middle-aged women, out of respect for the troublesome scars that can occur, even with good surgical technique. In most cases, I prefer to do lip improvement by using fillers and treating wrinkles around the mouth with either laser resurfacing or chemical peels. I would recommend caution if you are considering a lip lift.

Update: DIY injections - ABC "20/20" expose

Television show "20/20" does an investigation on the do-it-yourself cosmetic injection craze and discount medspa.com in particular, and talks to some self-injectors who unfortunately had bad outcomes, who created difficult problems for themselves. Problems that are hard for any surgeon to fix....

(Link to video here)

Watching the video, it's shocking and quite scary to see the syringes of supposed fillers and other products, arriving from the "discount medspa" website with a home-made label, in a baggie. No official packaging. No holograms to indicate this is the "real stuff". No FDA-required package insert. No bar codes or lot numbers. Nothing. Just a plain syringe, an alcohol swab and a little paper label sitting in a baggie. The names of these discount products are not even remotely similar to what we use here in the U.S.A....who knows what ingredients are really in there.

And you are supposed to inject that into your face...? Crazy!!