Category Archives: Education

Lip Augmentation with Cannulas

First what are blunt tipped cannulas for fillers?

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

Borrowed over from the world of liposuction and the world of Huber needles for chemotherapy.  There are four benefits of using a cannula for filler (ie. Juvederm) injections:

  1. Tip is blunt, not sharp – so it won’t easily pierce unwanted delicate structures such as nerves and blood vessels
  2. Side exit port for the opening for extrusion of filler.  This is on the side so that the tip can be blunt.  So this reason goes along with the blunt tip reason.
  3. Flexible cannula.  This allows for less injury as well, it has the potential to wiggle around obstructions which are sometimes cause by the vitals structures of nerves and vessels.
  4. Long length.  this allows for fewer puncture sites.

Why do we care about blunt tipped cannulas?

In the end the results are for safety and less bruising.  But are the effects better looking when the swelling goes down?  for the most part I think so, for broad areas such as cheek and temples.

Picture is worth a thousand words

Perhaps a picture would help describe cannulas for injectable fillers:

blunt tip cannulas

blunt tip cannulas

Lip augmentation with cannulas?

Currently, for myself as an injector in Modesto, I’m a fan of cannulas for filling the central part (body) of the lips.  But for precision, I feel that I lose a little bit of the precision needed when working on the border of the lips.  Thus I still find myself gravitating to the regular needle.  I have also used longer needles.  So for now, there’s a role for both cannulas and needles in my practice for lips.  But for the most part, I’m doing most of the lip augmentations with needles.  I like the precision that I get with a short stiff needle.  However, I understand that there is more of a risk of bruising and swelling right after the procedure.  These are just my thoughts at my current level of comfort with cannulas.  For more of what I think, visit: my thoughts on Lip Augmentation with fillers: (209) 551-1888
(209) 551-1888

Day 3 Vegas Cosmetic Surgery Aesthetic Dermatology Conference

Today’s highlights involved meeting the worlds most prolific injector of Botox.  He works in Singapore.  He gave a great lecture about injecting Botox in a certain way which could work for some Keloid scars.  The protocol is detailed and he shared it with the attendees of the Vegas Cosmetic Surgery and Aesthetic Dermatology Conference.

I attended a few sessions on laser and Cool Sculpting.  Cool Sculpting is a method of non surgical fat reduction.  It uses the idea of cryolipolysis.  CoolSculpting is a trademark owned by Zeltiq.  They hosted a cocktail hour at the conference at around 6:15pm tonight.

I got a chance to greet the reps for Allergan at the Convention.  What was interesting today for me was getting more information about doing virtual patient follow ups.  I didn’t think I was ready for such a thing, but it’s out there.  It’s kind of like recording your post op visit on a secure youtube website and then having the doctor review it later and write you some secure email.

I particularly liked the sessions on TCA peeling.

We also spent some time with another cosmetic plastic surgeon from Modesto, CA.  It was good to see another familiar face at the meeting.

In the evening, there was a dinner program put together by Valeant – the owners of Restylane, Perlane, Sculptra, Dysport, Obagi, and Renova (a form of Tretinoin).  We saw some live amazing cosmetic injection techniques by some legendary doctors.

I am getting so overloaded with all this great information!


Day 1 Vegas Cosmetic Surgery 2013

First official day of the Vegas Cosmetic Surgery and Aesthetic Dermatology Conference 2013

I particularly got a lot great ideas and info regarding Botox and Fillers (Juvederm).  I was very interested in the way they treated complications.

I also attended sessions that talked about social media, habits of very successful cosmetic practices, blogging, reviews, thank you notes, patient surveys, and the usage of YouTube videos.  I hope to act on much of this.  It was almost info overload.  And this was only day 1.

Plastic Surgery Related Booths we visited

  • Operative headlamp company – about $800 for a head lamp.  3 hour-4 hour battery life. LED bulb!
  • Zein Obagi.  Looked at the differences between Zein Obagi and Obagi
  • Touch MD – incredible stuff indeed.  Touch MD is a technological way to visually share the plastic surgical consultation with the patient.  There’s a program component which resides on the computer and then there’s a “cloud” component where the data resides.  The data can be accessed from many other devices and webpages via secure methods.  This is a great addition to EMR.  And perhaps would be a great addition to our plastic surgical practice in Modesto, CA.  They said that currently they don’t have any doctors in Modesto, CA who have Touch MD.  It also has a back end for picture management.

We were originally going to see a show, but instead we talked with the guys at Touch MD.

TiZO3 and Lip Balm

We found an an amazing Sun Screen for the lips.  It is made by the Fallene company in their Solar Protection Formula line.  TIZO is among one of their products.  Dr. Tammy Wu said that she has been looking for a lip balm that is a physical / mineral based for awhile.  We just found the LipTect product at the Vegas Cosmetic Surgery conference.  Along with this, we also found the  TiZO3 sunscreen for the face.  It has Titanium, Iron, and Zinc.  It is Paraben, Oil, PABA and fragrance free.  It is also tinted and is a very water resistant formula.  We will have the LipTect (Lip balm) and TiZO3 sunscreen available for purchase at Surgical Artistry, Modesto, CA.  Dr. Calvin Lee (me) takes credit for introducing Dr. Tammy Wu to the booth, and Dr. Wu made the decision to make an opening order!  One more reason for this – it would be an great product to protect a lip augmentation investment.

Vegas Cosmetic Surgery and Aesthetic Dermatology 2013 Day 0

Day 0 of the Vegas Cosmetic Surgery and Aesthetic Dermatology Conference 2013

Date: June 25, 2013

Located at the Bellagio Resort Hotel, Las Vegas.  This is the 9th annual conference.  The 10th annual conference has already been set for June 18th-22nd, 2014.

Vegas Cosmetic Surgery at the Bellagio Hotel

Vegas Cosmetic Surgery at the Bellagio Hotel Picture by Dr. Calvin Lee.

My adventures on the day before the Vegas Cosmetic Surgery conference begins

Dr. Tammy Wu and I saw a very full day of office patients and ended at 5:15pm in our office, we were think that we would catch the 8:10pm flight out of a neighboring city: Stockton, and take the Allegiant Air flight to Las Vegas.  But it was delayed.  But because it was delayed.  I got some administrative paperwork done at the office.  I read some of the mail and paid some bills.  Dr. Tammy Wu got to inventory some of the Obagi that came to the office.  It was a massive order – I think it was about $16,000 worth of Obagi products that came in and we had to unpack these large Obagi Skin Care products and put them on our shelves.  Some of these were ordered specifically for patients.

Allegiant Air

  • Delayed 4 hours
  • Got my $2 water at the airport.
  • It was a packed waiting room at the Stockton, CA Airport.
  • The Allegiant Air plane didn’t take off till around 12:30pm.
  • Seating was quite uncomfortable for me – my neck just didn’t seem to fit the seats.
  • We arrived around 2:00am in Las Vegas
  • But good things:  Dr. Tammy Wu and I got to sit next to each other and Dr. Tammy Wu slept through most of that flight.  I was just too uncomfortable to sleep through the entire flight.  But it was a relatively short flight.

Strange Taxi Guy

  • Took us to an entrance of the Bellagio which was pretty far from the reception desk.  There was an entrance that was right by the reception desk, but I guess it would have taken the taxi driver longer to get out of that round about, etc.  We had to walk pretty far with our luggage.  At 2am, it just seems a little bit more confusing, and the Bellagio in Las Vegas is a pretty big hotel.
  • The trip from the Las Vegas Airport to the Bellagio hotel took about 10 minutes.
  • And the trip with tip was about $26.00 for us.  In retrospect, I wasn’t so sure the Taxi driver deserved any tip for dumping us off at a far entrance.

First thing we did in Las Vegas was check out the Bellagio Gym

We really came here for the conference.  Just a few months ago we were in Vegas already, so we weren’t all that motivated to check out all the sights of Vegas again.  But working out and and taking care of ourselves and preparing for our next half marathon (perhaps Santa Rosa Half Marathon?).  Dr. Tammy Wu hasn’t run in a long time, so she gave it a try today again at the treadmill.  I ran about 1 mile on the treadmill, and she ran about 2 miles.  One great thing about the gym was a cable weight machine where I was able to adjust the rotation and angle of the arm, and thus I was really able to stretch out my right shoulder which has been bothering me from some chronic over use with injecting, operating, inserting acupuncture needles, and worst of all, using a computer mouse to write blogs (ie. this one) / do social media, etc.

We ate at Noodles Restaurant in the Bellagio

We had to tell them about our Vegan and Gluten Free preferences.  They were very happy to accommodate.  I’m not Gluten sensitive, but Dr. Tammy Wu is.  So the dishes we got were:  Agadashi, Endamamme, steamed vegetables, soy flavored rice noodles stir fried with vegetables, and rice.  This was quite a good meal and we escaped with a $71 price tag.

Considered getting tickets to a Cirque du Soleil show.

O is showing at the Bellagio.  However we couldn’t decide quite yet.  The tickets ranged from $120 to $220 – I think.  Instead we looked at the sculpture gallery associated with the Cirque Du Soleil.  The sculptures were so artistic – they looked so anatomical – sort of like cosmetic surgery to us.  The artist was Richard Macdonald, and the sculptures were for sale.  They price tags for little sculptures were about $10,000 and the larger ones were around $150,000.  There were two sales associates which gave us info on the sculptures, but the price tag were a bit too expensive for me anyway.  One of them asked me about any other art pieces which I own.  I said that the closest thing I have to these things are my teddy bear “collection.”  They didn’t seem to understand.  Regarding the possibility of seeing a show, we wanted to see the schedule of the Vegas Cosmetic Surgery and Aesthetic Dermatology conference, but the registration desk for that event hasn’t been open yet.

Walked around the Vegas Strip and then went to Walgreens

It was a pretty hot day already today.  But I read in the weather forecast that it will be even hotter in the next few days, perhaps as high as 117 degrees F?  We shall see.  Good thing the air conditioners work well in the hotels.  At Walgreens, I got a quart of orange juice and a gallon of water to lug back to the Bellagio.  I considered taking the tram that connects the Aria hotel with the Bellagio, but we just walked around till the heat got too much.

Back to the Gym to stretch my shoulder.

By this time it was around 7:30pm.  The gym at the Bellagio is open from 6am to 8pm.  So it’s about to close.  I went back to the gym to use the Cybex Cable weight machine.  It wasn’t to lift weights, but I discovered that this was one of the best ways to stretch my shoulder joint.  So I was able to spend another 15 minutes with this type of stretching to help rehab my shoulder which is already getting much better with my own stretching.

Went to Jasmine Restaurant in Bellagio

The most fun thing about going on vacation for me is eating out.  So we tried the Jasmine Restaurant which was within the hotel grounds.  We’ve been sticking to restaurants which have an Asian flare because it seems easier for us to find gluten free vegan choices.  And they were happy to provide solutions for us.  We had two dishes the eggplant dish and the monkey mushroom dish – both were made gluten free and vegan.  We had two extra bowls of rice.  The price tag with tip came out to about $75.  Which we charged to our Bellagio room.

Early Registration at the Vegas Cosmetic Surgery and Aesthetic Dermatology conference

We finally got to pick up our materials and name tag.  We met Karen Miller who said she’d help us with our Vegan/Gluten free preferences – how nice!  The conference is 5 days long, and super packed with great cosmetic surgery information.  I am most interested in the cosmetic injectable portion of the course and there’s plenty of that information including demonstrations on the Botox and filler injections.

We spent the next hour picking out how we would spend our time at the Vegas Cosmetic Surgery and Aesthetic Dermatology Conference

It is somewhat complex with about 3 different activities going on at the same time.  There are also evening program going until 9:30pm.  I made sure to pack in as much Botox and Cosmetic Injectable info as I could get.  There is a whole bunch of stuff regarding social media, but I’m not sure I can get all that in.

Time flies when you’re having fun.  It’s about 12:10am now.

We’ll see how it goes!  Can’t wait to bring all this great information and education back to our plastic surgery practice in Modesto, California.


Free SEO tools online

My SEO history

Search Engine Optimization (SEO) has been a hobby of mine.  I was pretty good at it.  Good enough that I got swatted by Google’s protocol change – code name Panda


  • – my favorite tool!  You do have to find the “Check Position” button mixed in the middle of the ads.  It tells you your position on the search results!  See below, it’s part of a website with a suite of tools.
  • – might be a bit out dated but still a useful tool – click on Free Website Analyzer:  Tells you about Tags ie. Title (not really a tag), Description, Keywords, Robots, Author.  But it tells you how many urls you have linked to it and most cool: it tell you page load time (this is a user experience variable that is now used in SEO)
  •  – my favorite here is keyword position (you can see what position you have in a search result based on key search phrases).  It also has a page rank checker.  This is a slightly tricky site in that you might click on the ads by accident.  There’s enough here to keep on happy for awhile in SEO, including: Ping Tool (to notify search engines of changes to a website).  I tried the Reverse IP Domain checker, and it didn’t seem to work today.  The backlink checker is a bit awkward to use because you only see 10 backlinks at a time.  For example a page such as one of mine has 1820 backlinks.  There is a page rank checker here and it claims to have the ability to find fake page ranks, but I didn’t find this to be useful to me at this point, and can’t figure out whether it’s faking me out about the fakeness.
  • – I’ve used this for awhile to check Google Page Ranks
  • – I’ve also used this free seo tool for awhile to check back links to a particular page.
  • typing in “site:” – gives you a list of indexed websites of a page.  This is a very important tool for me – especially to see if a page that I made had been indexed or not.
  • – it gives you some information regarding load time and most importantly it reports any CMS editor that you are using.  This way you can see if it is wordpress, drupal, joomla, symphony, squarespace, etc.
  • Google Rich Snippet testing tool – get that picture next to your Google search.

There are more tools that use, but these are the best ones on my list so far.

My stuff

My page ( load time: not too bad:  6.4 seconds

My SEO.  But my attempts have been spotty.  I’ve learned a whole bunch of things in the process, and will hopefully be implementing more of what I learned.  Much of this takes a good chuck of time which I’m not entirely willing to do.  But I do enjoy doing it myself, so I’m also not willing to farm out the SEO process.

Search Phrase May 14, 2013 June 2012 Previous 2011
modesto plastic surgery #2 Local #2 Local #1
modesto plastic surgeon #2 Local #1 Organic #1
modesto botox #1 #3 #1
modesto breast augmentation #3 #4 #1
modesto tummy tuck #5 #3 #1
modesto veins #3 #2 #2
modesto spider veins #3 #5 #2
modesto acupuncture #1 #2 #1
modesto skin care #1 #2 #1
ask dr wu #11 can’t find #1
big veins can’t find can’t find #1

My main personal activities in my medical practice is Botox and Acupuncture, so I mainly focused on these.  I’ve briefly touched Dr. Wu’s practice but perhaps it will be more of a project for the next few months.

How’s this educational for a doctor?

I think all doctors should understand the basics of the internet. When I was in high school, I felt that doctors should know how to type well. When I was in college, I felt that all doctors should be able to make web pages. When I was in medical school, I had no thoughts. When I was in Surgery Residency, I thought bad thoughts. Then when I realized there was life after Surgery Residency, I thought that doctors should understand SEO (Search Engine Optimization). This allows us to share information responsibly and effectively. For me at Surgical Artistry, my world is General Surgery, Plastic Surgery, Acupuncture, Skin Care, Botox, Juvederm, Fillers, Latisse, Veins, and Lasers.