Category Archives: Skin Care

Brilliant Distinctions Changes – Botox, Juvederm, Latisse

Brilliant Distinctions

Recent Changes to the Brilliant Distinctions Program

Update:  See updated section on the bottom – info directly from Allergan and the changes start May 15, 2013.

I heard some things about changes to the Brilliant Distinctions Program by our Botox Representative (from Allergan).  I’m not 100% sure of these changes, as I don’t operate the Brilliant Distinctions program (BD), but of course, our plastic surgery practice accepts the coupons and rebates generated from the BD program.

SkinMedica – get points for purchasing

  • Allergan acquired SkinMedica – a skin care product company – prescription and non-prescription based products.  You can now earn points for purchasing SkinMedica products.   Our office currently does not carry Skin Medica products.  I guess I wished it could have been easier / great if Obagi was somehow absorbed by Allergan, because we are a Obagi retailer and a user of Allergan products.  But that merger  didn’t happen.  Instead Valeant purchased Obagi for $348 million dollars in April 2013..  Valeant is based in Montreal.  Valeant has a dermatology portfolio.  Obagi is based in Long Beach, California, and posted revenues of $120 million in the year 2012.  Valeant Pharmaceuticals in September 2012 purchased Medicis for 2.6 billion.  Medicis makes Dysport, Perlane, and Restylane.
  • Around December 2012 Allergan purchased SkinMedica for $350 million

New Brilliant Distinctions Mall

  • Get points for shopping online
  • Similar to a program offered by Chase.
  • Many many vendors online, and shop as you normally would except click through a link from the Brilliant Distinctions website.

Bonus points are going away

  • As fast as it came, it is going away:  There was a bonus points program for the frequent users, in fact after about 12 visit, the bonus points added up to almost double the original amount which was originally $25 coupon after each Botox visit, and for those coming in on the 13th time and beyond, the $25 coupon got a bonus of another $25.  However this is bonus is going away I heard.

The $25 coupon per Botox visit or $25 per Juvederm syringe is dropping down to $20

  • I also heard that the $25 is dropping down to $20.  But the added ability to earn points from the BD Mall is supposed to more than make up for this difference.  I’d like to know if this works out for folks in the future.  Regardless, it is nice to have a program such as BD, so I guess we shouldn’t complain too much about the $25 dropping down to $20.

There’s the ability to print out a $10 coupon

  • This wasn’t available before.   I think this is to help the Latisse-only users use their coupons, because Latisse purchases used to take longer to build up to a coupon.

I just checked with several patients today regarding Brilliant Distinctions.  Most of these changes have taken place yet, but I know they are coming very soon – perhaps at the end of this month (May, 2013).

These changes the program summarized:

  • SkinMedica
  • BD Mall
  • Bonus Points going away
  • $25 return on each visit or each syringe is going down to $20
  • New!, ability to print out $10 coupon (half of the points required to print a $20 coupon).
  • New 9 month expiration period instead of I think it was 2 years before.

We’ll stay tuned and see how these changes take place and hopefully they will continue to keep our Botox / Juvederm / Latisse patients happy.

Surgical Artistry - Calvin Lee, MD / Tammy Wu, MD

Surgical Artistry | Calvin Lee, MD | Tammy Wu, MD
209-551-1888 | www.SurgeryToday.com
2336 Sylvan Ave. Suite C | Modesto, CA 95355

 

UPDATE:

We got this notice from Brilliant Distinctions.

Starting May 15, 2013:

Points Values: In simplifying the points structure, the values will alter slightly. We’ve added a new coupon value. You can now create a $10 coupon for 100 points. For 200 points, the coupon value will now be $20.

Expiration Period: Points will expire after 9 months of inactivity from earning. We will send you reminders if you are getting close to your points expiring.

Bonus Points: All bonus points accrued to date will remain in your account; however, no more bonus points will be issued. If you have questions, the Brilliant Distinctions® Customer Support line is a phone call away: 1-888-324-2745 (9am-8pm EST. M-F).

 

Summary:  See summary above also.  But there are some great added features ($10 coupon, BD mall, SkinMedical) and some things taken away (bonus points, $5 taken away from 200 points, and the expiration period ahs been shortened)

Honored to have Dr. Edward Katime at our office in Modesto, CA

Teaching and learning

Sometimes teaching is a great way to learn and we just had a wonderful opportunity to teach and learn.

We were honored to have Dr. Edward Katime in our office learning about Plastic Surgery (including breast augmentation procedures), Botox, fillers (Juvederm), Veins (Sclerotherapy and Laser), and Acupuncture.  We always feel that we learn a lot from having students in our office and as always, we learn a ton from our patients.

Dr. Edward Katime

Dr. Edward Katime at Surgical Artistry, Modesto, CA. As part of our educational process, we shared information regarding the style 410 breast implant (gummy bear breast implants)

He spent 4 days with me and we are very thankful for the patients who participated in our educational process at our office in Modesto, CA.  He is a UC Davis affiliated family medicine resident in his last few months of his training.  He is about to become a full fledged doctor.  He is also, like me, from New York City.  He also loves Modesto, CA.  And works at Doctors Medical Center.  He had excellent questions and our patients liked him very much.  I have a feeling that he is going to do very well.

I have been given the title of Assistant Professor from UC Davis and at one point I was even given a teaching award for this position as “the outstanding” community MD teacher.  I really don’t do enough to deserve the award, but sometimes I wish I could do more.

We wish Dr. Katime a bright future in medicine!

Lidocaine Info Important For My Surgical Practice – Maximums and Toxicity

lidocaine picture from drugs.com

Lidocaine

  • Also known as Xylocaine and sometimes Lignocaine
  • Local Anesthetic
  • Antiarrhythmic drug – for ventricular arrhythmias (but Amiodarone is mostly used for this)
  • The first Amino-Amide local anesthetic
  • First marketed in 1949
  • Alters signal conduction in neurons by blocking the fast voltage gated sodium channels in the neuronal cell membrane.  Thus prevents depolarization of the postsynaptic neuron.

Esters and Amide local anesthetics – way to remember which

  • Esters have only one “i” in the name: Procaine, Cocaine
  • Amides have over two “i”s in the name:  Lidocaine, Bupivicaine, Prilocaine.

Contraindications to using Lidocaine

  • Porphyria – rare inherited or aquired disorders of enzymes which produce porphyrins and heme resulting in neurological complications (abdominal pain, vomiting, neuropathy)  or skin problems.
  • Heme is one the best known porphyrin the pigment in red blood cells and cofactor of the protein hemoglobin.
  • Porphyrin means purple

Lidocaine overdose

  • can occur with topical creams
  • Treatment with IV lipid emulsions can reverse the effects of lidocaine toxicity.

Adverse Effects

  • Rare
  • Allergic reactions rare.
  • CNS (central nervous system) and cardiovascular effects
  • CNS at lower doses, cardiac at higher doses
  • CNS: nervousness, tingling around mouth, tinnitus, tremor, dizziness, blurred vision, seizures, depression, loss of consciousness
  • Cardiovascular effects: hypotension, bradycardia, arrhythmias

Insensitivity to Lidocaine

  • Genetic
  • Exists in some patients with ADHD and Ehlers-Danlos syndrome

Lidocaine Safety and Toxic doses

  • Particular care in calculating maximum safe dose for young children
  • Peak blood levels of lidocaine usually occur 10-25 minutes after injection – the point at which toxic effects are likely to be seen.
  • Maximum safe dose of lidocaine without vasoconstrictor (ie. epinephrine) is 3-4.5 mg/kg (duration of action 1 hour).  No more than 300 mg (30 cc’s of 1% Lidocaine) at once.
  • Maximum safe dose of lidocaine with vasoconstrictor is 5-7 mg/kg (duration of action 2-6 hours)

How to calculate Maximum safe doseage of Lidocaine

  • You need to know that 1% Lidocaine solution is 10 mg/mL
  • Example Calculation for a 70 Kg man:  Lido 1% with Epi:  keep under 7 mg/Kg.  7×70 = 490 mg for 70 kg man.  Divide 490 mg by 10 mg/ML = 49 ml.

How is this important to our Plastic Surgical and Acupuncture practice?

  • We use lidocaine in plastic surgical procedures – topical and subcutaneous – for removal of moles, injection of fillers such as Juvederm, and sometimes for Botox.
  • I also use injected  lidocaine as part of some trigger point deactivation practices in acupuncture.

Cosmetic Procedures at Surgical Artistry which may use Lidocaine

  • Liposuction – tumescent lidocaine
  • Mole removal – injected subcutaneous local lidocaine
  • Fillers – Juvederm – some formulations have lidocaine within the product
  • Fillers and Botox – sometimes we use topical lidocaine
  • Face Veins – sometimes we use topical lidocaine
  • Minor office surgeries – we use injected lidocaine in the subcutaneous level

 

What do we do at Surgical Artistry?

 

5 year patients choice     surgical artistry full page ad never boring

I get this question a good deal.  I think it’s probably somewhat confusing as to what we do and we offer a lot of procedures and products.  Basically we are a two surgeon medical group offering services in Veins, Acupuncture, Plastic Surgery, and General Surgery.  That can be quite a lot.  But even with that said, it’s somewhat confusing as to what each of these items involves.  So I thought I’d make a list which doesn’t include everything, but covers most of what we do:

DR. TAMMY WU PROCEDURES:

DR. CALVIN LEE COSMETIC and BOTOX PROCEDURES:

  • Botox for cosmetic
  • Botox for headaches
  • Botox for hand and axillary sweating
  • Botox for TMJ (jaw pain)
  • Fillers (ie. Juvederm)
  • Lip Augmentation with Juvederm or other injectable fillers
  • Vein Laser
  • Vein Injections (ie. with Asclera)
  • Face Vein treatment
  • Acne Consultation
  • Skin Care Consultation
  • Cosmetic Mole Removal
  • Microdermabrasion
  • Chemical peels (ie. Obagi Blue Peel Radiance and Obagi Blue Peel)

DR. CALVIN LEE ACUPUNCTURE PROCEDURES:

  • Acupuncture trigger point deactivation for muscle pain
  • Acupuncture for back pain / neck pain
  • Acupuncture for buttock pain (ie. pyriformis syndrome)
  • Acupuncture for IT band pain (side of thighs wrapping to below knee)
  • Acupuncture for fertility
  • Acupuncture for TMJ (jaw pain)
  • Acupuncture for stress / anxiety
  • Acupuncture for allergies
  • Acupuncture for fibromyalgia
  • Acupuncture for depression
  • Acupuncture for hormones (hot flashes, acne, menstrual cycle)
  • Acupuncture for facial rejuvenation (cosmetic)
  • Acupuncture to boost the immune system
  • General wellness Acupuncture
  • Anti-nausea acupuncture for those undergoing chemotherapy or pregnancy

  SKIN CARE PRODUCTS:

  • Obagi Line
  • NIA 24 Line
  • Various Skinceuticals

 GRADUATED COMPRESSION SOCKS:

To recover faster from workouts, prevent varicose veins, and prevent injuries

  • Calf sleeves from Sigvaris and CEP brands
  • Full calf sleeves from Sigvaris and CEP brands
  • Dress socks from Sigvaris
  • Thigh high and Pantyhose compression from Sigvaris.

 Contact Us:

Surgical Artistry - Calvin Lee, MD / Tammy Wu, MD

 

Transformation by Never Boring Graphic Design

Transformation by Never Boring

Never Boring is a Marketing, Advertising, Media Buying, Graphic and Web Design, Film and Multimedia Company located in Modesto, CA.  Today, they celebrated their 30th anniversary.

I wrote an article a few weeks ago about sunscreens for Contentment Health Magazine. In that article, I included a chart that I thought, if they had space, maybe they can cram it into the article.  They really pleasantly surprised me with what they with the chart.  They more than just crammed in the chart.  They made it into a work of art.

This chart is different than the Sunscreen activity chart that I blogged about earlier.

Here’s what I emailed:

Sunscreen ingredient Chart Text

I thought this was already pretty nifty visual in my own nerdy assessment.

and then after some wonderful “magic” by Never Boring:

Sunscreen Ingredients Chart UVA UVB for Chemical, Physical, and Hybrid components

Sunscreen ingredient chart transformed into a beautiful graphic

This is very much like the “before” and “after” pictures that we are so fond of in Plastic Surgery.

Bravo on the design!  Thank you for turning it into a masterpiece!

Note:  The model in the picture, has a great deal of sun damage on her face and hands.  She definitely needs a good sunscreen, otherwise, she will end up being a very good customer of Surgical Artistry (www.SurgeryToday.com).

Here’s the article online I wrote on Sunscreens for Contentment Health

article on sunscreen

Logo by Becky Li, Graphic by Rita Perez