Senate Dems propose a 5% cosmetic surgery tax

As part of the 2000 page Senate proposal for health care reform released today, Senate Democrats are proposing a 5% tax on cosmetic surgery. More details can be read in the New York Times report (here). The way this proposal is worded, non-surgical cosmetic procedures such as Botox, Restylane and Juvederm, laser treatments and pretty much any cosmetic treatment performed by a licensed professional would be taxed as well.

We've talked about cosmetic surgery taxes before, pointing out how they are unfair to consumers. (see earlier blog here).

Why? Because they are a tax primarily on women, who represent 90%+ of our cosmetic surgery patients - and it's unfair and unconstitutional to disproportionately tax a single group. It's sexist!

Also, this is not a "tax on the rich" - the vast majority of our patients are average, middle-class Americans who are simply trying to fix a physical feature that bothers them.

Although the patient would be taxed, get this, according to the proposal, the physician would be financially liable if the tax were not paid. Unbelievable!

You can read the actual text of the bill here (click for link)

If you would like your voice to be heard about this tax on women, please contact our Democratic State Senator for Florida, Senator Bill Nelson at:
716 HART SENATE OFFICE BUILDING WASHINGTON DC 20510
(202) 224-5274
billnelson.senate.gov

Save Money! Look Great! - New Internet Discounts

I'm pleased to announce two new specials for our Botox and filler (Juvederm, Restylane, Sculptra, etc.) patients.

Special #1: Bring a Friend and Save.

Book a filler or Botox appointment for yourself and a good friend at the same time. If the friend is a new patient to our practice, we'll give you a credit of 15% of the value of your friend's first completed treatment, which can be used for your own botox or filler treatment, or used in our medi-spa, either on the same day, or sometime in the future.

One small restriction: The credit can not be applied to surgical procedures.


Special #2: Internet special for loyal patients

Have you had three or more treatments with Botox in the past 15 months with us? Or three or more treatments with injectable fillers in the past 15 months in our office? Then you are a loyal patient and we'd like to give you a reward. Just mention the internet-only password of "PSB" when you come in, and we'll give you 50% off your next maintenance treatment with botox or fillers, up to the average dose that you usually get.

This is only for our loyal patients, as defined above.

See, it pays to read PSB - the plastic surgery blog!

New service: Same Day Botox

We're pleased to announce a new service for our patients. We call it "Same Day Botox" - and just like the name implies, we're opening up a limited number of appointments each day for people that want to have their treatment with Botox or any of the injectable fillers that same day. Just call early in the day to set this up.

Patients who have scheduled appointments for these treatments will still be seen at their usual times.

Talk about "instant gratification"! Call us for details: (407) 339-3222

FDA approves "12 month" indication for Evolence

This week, the FDA approved a labelling change for the collagen-based filler Evolence, permitting what is known as a "12 month indication". In simple terms, this means the FDA was satisfied that the product has a significant effect on correcting moderate to deep facial wrinkles or nasolabial folds for 12 months. The original label indication was for six-month duration.

Evolence is the first collagen-based filler to get this "12 month indication", and you can bet that it will be featured extensively in future marketing.

What is not yet clear to me, however, is whether Evolence really performs significantly better than some of the other available filler agents (which currently have the older "6 month" label from the FDA) at 12 months after injection. There is data, for example, that Restylane also has significantly lasting effects well beyond their 6 month label.

I expect Allergan and Medicis (makers of Juvederm and Restylane respectively) will be submitting their data to the FDA, hoping for a similar 12-month approval, if only for competitive marketing purposes.

Are you the typical Botox & Filler patient?

Here's an interesting press release from ASAPS (American Society for Aesthetic Plastic Surgery), discussing a new survey in which Botox Cosmetic and fillers like Restylane and Juvederm were now "mainstream" topics of discussion amongst patients, and not any big "secret". This matches with our experience - our female patients openly discuss their treatments, much like they were sharing make-up tips! What I find interesting in this survey is that 7 of 10 Botox users also have HA fillers done.


Survey Shows Majority of Respondents Openly Discuss Use of BOTOX® Cosmetic and Hyaluronic Acid Dermal Fillers

NEW YORK, NY (June 1, 2009) — Despite what some may think, people aren’t hiding their use of BOTOX® Cosmetic and hyaluronic acid dermal fillers. In fact, according to survey statistics released today by The Aesthetic Surgery Education & Research Foundation (ASERF), the research arm of the American Society for Aesthetic Plastic Surgery (ASAPS), nearly nine out of 10 respondents (87 percent) openly discuss their BOTOX® Cosmetic and hyaluronic acid dermal filler treatments with others, with seven out of ten (70 percent) receiving support from the people they told.

“In a similar survey issued four years ago, we dispelled the myth that Hollywood and corporate wives were the typical BOTOX® Cosmetic patient,” says ASERF President Laurie Casas, MD, a plastic surgeon practicing in suburban Chicago. “Now, demographic and perception data trends show us that aesthetic injectable treatments have continued to evolve into mainstream and accepted options for the everyday woman.”

Survey results found that the typical aesthetic injectable patient is a married, working mother between 41-55 years of age with a household income of under $100,000. The survey also found that women receiving aesthetic injectable treatments are health-conscious and philanthropy minded, with the majority incorporating exercise (95 percent) and healthy eating habits (78 percent) into their lives, and many volunteering with charitable organizations that matter to them (32 percent). In addition, nearly seven out of 10 respondents believe that BOTOX® Cosmetic (72 percent) and hyaluronic acid dermal fillers (65 percent) are important parts of their aesthetic routine.

“Interestingly, among BOTOX® Cosmetic patients, nearly seven out of 10 respondents also received treatment with hyaluronic acid fillers with the majority of respondents being treated with JUVÉDERM®,” says Dr. Casas. “Most people have great success with BOTOX® Cosmetic and dermal fillers; however, we need to make patients aware that even though injectables are not ‘surgery,’ their administration is a medical procedure with risks that depend on the training and experience of the clinician, the clinical setting and the technique used.”

Additional findings of the survey found that 72 percent of respondents received BOTOX® Cosmetic injections to treat their glabellar lines – the frown lines in between the brows, while 63 percent of those surveyed received hyaluronic acid dermal filler injections to treat their nasolabial folds – also known as the “parentheses” – the lines around the nose and mouth. A few of the most frequently cited reasons to receive treatment with BOTOX® Cosmetic was “to look more relaxed, less stressed” while patients reported choosing treatment with hyaluronic acid dermal fillers to “look more rejuvenated.”

Q-Med announces Restylane with lidocaine

This week, Q-Med, the Swedish pharmceutical company that is the home to Restylane and Perlane, announced Restylane® Lidocaine and Restylane Perlane™ Lidocaine as the latest additions to their Restylane family of dermal fillers. These products have the familiar Restylane and Perlane hyaluronic gel fillers, together with a small amount (0.3 %) of lidocaine, a commonly used local anesthetic, to help minimize the discomfort of the procedure.

According to the studies, the fill effect of the products is unchanged, but 90% of the patients tested said the new products made the treatments more comfortable than the standard formulation.

This allows the company to catch up with Allergan's Juvederm Ultra with Lidocaine product, which has been available in Canada and Europe for several months.

Availability of these products in the USA has not been announced. Hopefully, we'll see these later in 2009. It should be a pretty straightforward approval path with the FDA.

Here in the USA, Prevelle Silk has the combination of lidocaine and HA gel filler - but it is a much less concentrated product than either Restylane or Juvederm. I don't use Prevelle Silk often, as I don't find it is as long lasting around the mouth or smile lines.

Special offers on injectables

Good news for those patients who are fans of Juvederm, Restylane, Evolence and Botox: the manufacturers seem to be trying to out-do each other with special offers, rebates and coupons. That means savings for you.

Here's some of the current special offers:

Botox cosmetic
- Schedule your initial botox treatment before February 28, 2009 and receive a $50 rebate coupon from Allergan. Make your follow-up treatment between May 1 and July 1, 2009 and receive a second $50 rebate.


Juvederm Ultra and Juvederm Ultra Plus injectable gel
- Schedule your Juvederm treatment before February 28, 2009, and receive a $100 rebate coupon from Allergan with your second syringe of Juvederm.


Evolence collagen dermal filler
- Schedule your Evolence treatment before December 31, 2009 and receive a $50 rebate coupon for each syringe used, up to $150.


Restylane and Perlane injectable gel
- Schedule your Restylane or Perlane treatments before February 28, 2009, and get the "buy-one, get the second half-off" special.

It seems like the time to get those wrinkles treated, doesn't it!