Wednesday, December 4, 2013
VOLUMA™ LARGE VOLUME FILLER
An attractive face is characterized by smooth round contours, high cheekbones and a clean, well-defined jaw line. These features together comprise the 'triangle of beauty' or 'heart of face', with its base at the top and summit below.
As we age, facial fat loss, gravity and a decrease of the skins natural elasticity conspire to reverse this triangle's composition. This results in a narrower, less youthful forehead and temple area, and a wider, heavier jaw line. Because the forehead and eyes lose padding, irregularities develop along with prominent veins. Once beautiful prominent eyes sink in to the sockets due to fat loss and atrophy of soft tissue enveloping the eyeballs.
Voluma™ is Allergan’s answer to more invasive procedures such as Dr. Lewis Obi’s larger volume stem cell concentrated fat injections (Adivive™). The advantage to Adivive is that 2 to 4 syringes of Voluma ($1500-$3000) may be performed in the office with minimal bruising and down time. This product was been used abroad for a decade and recently approved for use in the U.S. only this week. Allergan claims that results will persist for up to 18 months. Below are results after 2 to 6 syringes of Voluma™
For larger and more permanent soft tissue enhancement of the face, it is my opinion that the only safe filler is the patient’s own processed fat. Three years ago this month, I was provided with the first U.S. FDA approved Lipokit™/Adivive™ Fat Processing System from Medikahn in South Korea. Since then I have treated almost 200 patients without complications and significant long term results. Volumes used range from 25 to 60cc with an average take of between 60 to 90 percent depending on enhancements. Fees range from $3500 to $6000.
With the use of Platelet Rich Plasma (PRP) and stem Cell Assisted Lipotransfer (CAL), I have been able to enhance long term graft survival close to 90% (3 to 7 years).
The addition of laser neck tightening (SlimLipo™) was the basis for the OPERA Lift-Obi Palomar External Rejuvenation Esthetics. Down time for most patients with Adivive averages 5 to 7 days and is performed with local anesthesia and minimal sedation. An important component of my face lifting procedures has been the integration of large volume stem cell micro fat grafting to restore the “triangle of beauty” or the so called “heart face of youth”.
Monday, December 2, 2013
When I returned from the International Stem Cell Conference last week, my first case involved the use of five major systems at our licensed surgery center. During one three hour session, I was able to harvest fat from the abdomen to use as a large volume facial filler in a 71 year old patient. A portion of the fat was also processed as a rich source of stem cells (1000 times more than bone marrow). Simultaneously, our SlimLipo laser platform was used to tighten the abdomen and neck. The fat derived stem cells (50 million count) were used to inject into arthritic joints and inflamed tendons of the hands. Platelet Rich Plasma (PRP) was added to enhance both the cosmetic and therapeutic procedures. Shown below are a combination of systems that we have implemented in recent years which has advanced our clinic as one of the foremost private centers in the U.S.!
Adipose Derived Stem Cells (ASC)
There are 20 or more steps in processing fat into pure stem cells (SVF) that may be used for both therapeutic and plastic surgical procedures. These cells are accurately counted with our CountessTM stem cell counter: The potency of these stem cells are enhanced by the use of the patient’s blood using our MagellanTM platelet rich plasma system (PRP). Simultaneously, our surgery team assists me with the cosmetic procedures which in this male patient included SlimLipo of the abdomen and a non surgical face lift with stem cell concentrated fat!
71 year old patient with the first treatment one year ago
SlimLipo treatment and weight loss in another male patient
**Surgery team at the Lewis Obi Plastic Surgery Clinic for the above procedures included North Florida Anesthesia, Karen Webb RN, Michelle Zager ARNP, Pamela Moore, RN, Tina Nicholson SST and Kristin Williams SST.
Wednesday, November 27, 2013
FROM DR. LEWIS OBI AND HIS STAFF
including new staff members Kristin
It's a once in more than 70,000-year event: The first day of Hanukkah this year coincides with Thanksgiving. As a result, Jews everywhere are gearing up for "Thanksgivukkah," a mashup of Thanksgiving and the Jewish festival of lights. This lineup of the first day of Hanukkah with Thanksgiving
is incredibly rare.
Monday, November 25, 2013
International Federation for Adipose Therapeutics and Science IFATS New York 2013 Conference
It was another New York Marathon for me to attend a very exciting stem cell oriented international symposium this past weekend. There were more than 50 international stem cell researchers presenting hundreds of papers. Also, it was exciting to interact with my plastic surgery colleagues including IFATS co-founders Dr. Sydney Coleman of New York and Dr. Adam Katz of University of Florida. My last contact was LA plastic surgeon Dr. Joel Aronowitz who reconstructed Suzanne Somers' breast with stem cell enhanced fat.
Since I first began using fat as a filler more than 30 years ago, the science of adipose derived stem cells for regenerative and therapeutic medicine has advanced to orbital levels. This year I established the Cell Surgical Network of Florida and am already clinically applying a science which most of the IFATS presenters are only researching in laboratories. In contrast to American plastic surgeons, the use of stem cell science has reached high levels of success in European and Asian countries. During our four day meeting, more than 200 presentations by more than 50 authors from 25 countries shared their research and clinical experience. By the fourth day on Sunday, with New York City in a deep freeze, I was forced to take a break with my family.
Friday, November 22, 2013
"What Was I Thinking?"
Reversing Bad Decisions Is Our Specialty
Laser Treatments to Remove ALL Tattoo Ink Colors
MEDLITE C™IS THE MOST ADVANCED LASER PLATORM IN JACKSONVILLE
LESS PAIN - QUICKER AND FEWER TREATMENTS - MORE EFFECTIVE
MEDLITE C™ BY CYNOSURE
ONLY AT RENAISSANCE & LEWIS OBI PLASTIC SURGERY
INTRODUCTORY PRICING THROUGH DECEMBER!
Monday, November 18, 2013
Since the days of ancient Egypt, people have been using chemical exfoliation methods, also known as chemical peeling, to rejuvenate skin. The original chemexfoliant was lactic acid, an active ingredient of sour milk that was used topically by the nobles as part of an ancient skin rejuvenation regimen. In the Middle Ages, old wine with tartaric acid as its active ingredient was used for the same purpose. Today, these historical chemexfoliants are known to contain alpha hydroxy acids, which are the active ingredients responsible for the skin exfoliation. Modern day chemical peeling originally was promoted by dermatologists, such as P.G. Unna, who first described the properties of salicylic acid, resorcinol, phenol, and trichloroacetic acid (TCA).
Slowly, the early practitioners of chemical peels began to develop other peeling agents for varying depths of penetration. In the 1960s, Baker and Gordon developed a deep peeling agent, which was able to smooth deeper furrows, especially around the mouth. I first met Dr. Tom Baker as a medical student and pharmacist attending medical school at the University of Miami. For the next 20 years, Dr. Baker was one of my mentors in plastic surgery. In 1982, Dr. Baker and I co-authored a chapter entitled “Chemical Peeling and Dermabrasion” in Dr. Barnard Barrett’s plastic surgery book entitled “Patient Care in Plastic Surgery”.
facelift and phenol peel performed on first day of my practice
From the 1980's to the present, an explosion has occurred in the mass of research on this subject, with the elucidation of many different types of peels, each for a specific range of problems. Unfortunately, with the advent of skin resurfacing lasers, the last two generations of plastic surgeons are beginning to lose their expertise with ablative chemical peels. I am perhaps the last bastion of this valuable tool from Dr. Baker’s very first peel in the 1960’s. Although the majority of my patients are candidates for our Icon™ 1540 fractional laser hand piece, there is still a large population of patients who are better treated with a single and less expensive chemical peel.
Phenol was almost entirely replaced with the use of 35% TCA which avoids the skin bleaching effect of phenol and ablative lasers. The best time of year for these treatments is between October and March because of sun exposure restrictions. Recovery occurs usually within one week at which time make up and concealers may be used. Facial peels are usually pain free after treatment and almost any area of the body may be treated with TCA peels. The back of the hands responds well to TCA peeling and are generally treated with the face. Below are images of patients I have treated in the past.
Although the above example include an older age group, TCA peels may be performed in younger patients with solar (sun) damage and sun spots or freckles.
Fractional laser skin resurfacing is still used for most patients both for total and partial facial treatments and usually requires 2 to 4 treatments.
Total facial TCA chemical peels only requires one treatment with oral Valium and or/Percocet. As with laser resurfacing, synthetic or natural fillers may be used at the same time. It is not unusual to treat patients with SlimLipo neck tightening, Adivive stem cell fat grafting and TCA chemical peeling during a single session.
Thursday, November 14, 2013
NEW VOLUMA XC @ THE OBI PLASTIC SURGERY CLINIC AND MEDSPA
HISTORY OF DERMAL FILLERS
I was perhaps one of the first plastic surgeon to use fillers in the 1970s, with the introduction by Stanford University researchers of animal-derived collagen implants. By the 1980s, the use of collagen injections for wrinkles had entered the mainstream. While Americans were enjoying the benefits of bovine collagen fillers (i.e., Zyderm and Zyplast), other countries began to experiment with dermal HA fillers such as Hylaform and later Restylane in the mid to late 1990s. The beginning of the 21st century ushered in the introduction of newer nonbovine collagen fillers, CosmoDerm and CosmoPlast, and HA fillers, such as Captique and Juvéderm, as well as other synthetic fillers, Sculptra, Radiesse, and Artefill into the United States market. With different forms of soft tissue augmentation agents currently available in the United States and others in the pipeline, selecting the appropriate filler is challenging for physicians and patients alike.
It is now very exciting for me along with Lisa Hone, RN of Allergan™ to be one of the first in Jacksonville to offer Voluma™ XC to my patients. This is the first and only filler FDA-approved for deep injection in the cheek area to correct age-related volume loss. JUVÉDERM VOLUMA™ XC is for patients over the age of 21. Along with my nurse practitioner Michelle Zager we will be providing this exciting new product in early December. You may learn more about VOLUMA™ XC at our Renaissance and Obi Plastic Surgery Clinic party event on December 5 from 5 to 8 p.m.