LiveLongAgeWell

I received a number of calls and emails regarding my recent post on Botox, so here’s a brief update regarding two issues.

First regarding the cost. In the U.S. an average Botox treatment runs about $300 to $400 for “one treatment area” (in Brazil, about R$ 400), so before you agree to being injected, ask the doctor how many “areas” she wants to treat, and what will be the total cost. You might be able to negotiate that a bit, particularly for more than one area. Don’t be shy about asking. Many plastic surgeons are negotiating charges these days.

Expect to pay more in big cities and on the East Coast, but I wouldn’t make my choice based on price, but on the qualifications and experience of the plastic surgeon or dermatologist. And while you may have heard of “Botox parties” (most common in California)…personally, I would run away from any doctor who participated in such an event. Injecting “the most potent toxin known to man” is not a trivial medical procedure; it carries risks and you want it done in a relatively sterile environment, with the doctor paying attention only to you, not to a crowd and with an eye on his marketing presence.

The second Botox issue is that a new type of Botulinum toxin should be FDA approved this year; a decision is expected by mid-April.  Apparently the new form (brand name Reloxin, and already available in Europe as Dysport), has several potential advantages over the current Botox made by the Allergan Corporation.

The cost to your doctor for each vial of Reloxin will be lower than the cost of Botox, so the cost to the patient should be less. And while the new form is also, like Botox, a form of Botulinum toxin A—and very similar to the standard Botox—Reloxin contains less “protein load” so it is thought patients might form less antibodies to this new toxin, and so the beneficial effect might last longer. And the onset of action is said to be somewhat faster, though this is probably no big advantage.

Once Reloxin is released, for me personally, I wouldn’t run out and be one of my doctor’s first patients. Reloxin is said to spread in the tissues more than Botox, and the concentration of Reloxin is different than Botox, and for any new procedure, there is a “learning curve” for your doctor while she or he gets acquainted with the nuances of the new medicine. I’ll give another update when the drug is released. Some cosmetic experts are expecting “price wars”, but for sure, expect to see lots of new ads…

Next post….pills people are taking to boost brain power!

Today where I am in Brazil, nearing the end of Carnival, it’s like a ghost town. It doesn’t seem like its normal self. It’s cloudy, a little chilly…those were rain drops?

Few people are outside. Most all stores are shut. Good luck if your refrigerator is empty; maybe you’ll find a pastry shop open somewhere. Many people today seem more depressed than happy. Last night they were out late and relationships were tested. As in many cities and countries, walking around late at night here—depending on where you are—can be a little dicey. Elite police units were out in force and the streets swirled and danced with frenetic people; I saw no violence…

It was great that so many readers commented on the “Carnival begins” post. Comments tell me about you the audience, and help me write a better blog with the subjects you want. I encourage you to read the comments for views different from mine.

I am beta-testing a new widget application for LLAW, called QWIDGET, and it’s a way for people to leave comments more easily (I hope). Plus you can interact with others leaving feedback if you wish. Try it out by answering the question further along in this post. See what you think, and tell me if you’d like this QWIDGET to be part of the blog.

Last post I introduced the idea of cosmetic procedures and how Brazilians—seemingly more than U.S. Americans—seem more attuned to looking good (I enjoyed the one comment that Brazilians are more appearance-oriented because they go to the beach more, need to show skin, and want to avoid “visual pollution”…haha.) But beyond that, from the phone calls and emails I received, I know that cosmetic surgery is probably a more explosive topic than even cultural comparisons. Everyone seems to have a pretty strong opinion one way or the other, and here are some comments I have heard over the years:

1.    It’s great, I want it as soon as I need it, or before.
2.    No way, never. I’m happy the way I am.
3.    Do you know any good surgeons?
4.    It’s just wrong. We have so many bigger problems, plus the economy. There are many more important things to worry about.
5.    People who resort to plastic surgery are sad people. Just accept yourself the way you are.
6.    If someone wants plastic surgery, it’s fine, but it’s not for me.
7.    You can spend money on a trip or a piece of art or an expensive watch so why not this if you want?
8.    Too many people everywhere lack access to basic healthcare so why are we even considering this?
9.    Maybe if things get really bad, I’ll do something.

[qwidget question="173"]

My opinion, and this philosophy is incorporated into my book, is that you have the right to cosmetic surgery if you want, but consider other simpler measures first. Many people get good results from treatments like facial peeling or lasers or botox and sometimes even a different hairstyle or better posture will do more good than surgery, and with those you don’t run the risk, downtime, and expense of plastic surgery. Sometimes you just need more exercise and a better diet and six months.

The Brazilian attitudes about plastic surgery are more casual than in the United States. Friends and acquaintances here freely admit if they had some procedure. There is no shame here really, and there shouldn’t be. If you want it, maybe do it, and if you don’t like the idea, that’s great too. Just don’t be too quick to judge other people about plastic surgery, whatever their choice or belief….ok, some thoughts about cosmetic surgery:
1.    Don’t try to do too much (many complications occur because some patients push for multiple or excessive procedures all at the same time).
2.    Know the risks and that not everyone is happy afterwards, but most people get good results if they do the procedure they “need” and find a good surgeon.
3.    Find the best plastic surgeon you can.
4.    Research the various procedures and options.
5.    Be in good physical and mental shape before any surgery to decrease risks and maximize good healing. If you are depressed, surgery won’t cure your depression—better to see a psychologist or a doctor you trust first. If you smoke, don’t get plastic surgery.
6.    Ask lots of questions.

Next: follow-up “botox emergency”.

Today’s post was preempted by an “emergency” botox session. More about that in a week.

Monday—Part II on cutting your CT scan radiation risk.

Facial Fillers For Wrinkles

We are all probably aware of the huge popularity of botox for smoothing facial wrinkles, but you might not realize how big is the next new wave in cosmetic dermatology: “facial fillers”—substances injected into slightly depressed areas and wrinkles in the face to fill and smooth and give a younger appearance. Amazingly, about 1.5 MILLION of these procedures were performed last year. Most patients seems satisfied with the results but still, there are risks, and if you think you might ever consider one of these procedures, read this report and talk to your doctor first about the possible complications before getting plumped up.

“Health Care Town” In South Korea

Another surprising figure is that some 750,000 Americans last year sought medical treatment outside the U.S., typically because surgery here, even if you are covered by insurance, can be exorbitantly expensive. Americans are traveling for everything from open-heart surgery to hip replacements to face-lifts. The total cost, even including travel, can be a fraction of the cost in the U.S. It’s estimated that within several years, millions of Americans will be traveling abroad yearly for care.

It’s a trend worth watching, especially if you ever require an expensive operation. (Of course, quality and follow-up of care might be your primary concerns.) Read this fascinating New York Times article for a look at this phenomenon. Featured is the newest of the countries welcoming foreign patients, South Korea, where the government is building “Health Care Town” on a resort island, complete with prime beaches and a 18-hole golf course, presumably for whomever goes along with you on your trip.