Laser Liposuction in Houston, Texas

[ No Comments ] Posted on 07.10.08 under Uncategorized

Dr. Randy Birken, founder of Birken Medical Aesthetics of the Woodlands, offers in office tumescent laser liposuction, a smarter way to undergo fat reduction.

“While mesotherapy, or lipo-dissolve, works well for fat reduction, liposuction does it within one treatment and provides permanent fat elimination in the area suctioned.  This is a huge advantage for my patients,” Dr. Birken said.

Compared to traditional liposuction that is done under a general anesthetic within an operating room, laser liposuction is performed in the physician office with tumescent, or local, anesthetic - safely and painlessly.

For more information, visit www.birkenmedicalaesthetics.com

International Society for Cosmetogynecology Information on Laser Lipolysis

[ No Comments ] Posted on 06.28.08 under Uncategorized

What are the advantages of laser lipolysis?

1. Minimal Downtime - A few of our patients can return to work immediately, almost like a “lunchtime Liposuction.� We normally advise a day or two of rest.
2. Minimal Discomfort - During the procedure, there is no pain. After the anesthesia has worn off, it only feels like the aches and pains that follow a vigorous workout. The bruises too are much less with laser lipolysis than with standard liposuction techniques.
3. Less Traumatic -The fiber-optic cannula is inserted through a small puncture in the skin usually along creases that conceal the scar. As the laser melts the fats, it also coagulates the loose ends of small blood vessels. Compression garments are optional as the area will not bleed very much after the laser is removed. The granulation tissue (healing-tissues) does the rest of the work in contracting the treated area as well as the overlying skin.
4. Almost “Normal” Skin after 3 Months -It would be very hard to find the insertion points or tell by looking at the skin that any liposuction has ever been done. Skin contracts with the heeling tissues that replace the melted fats.
5. Safety - Laser lipolysis is less invasive than traditional liposuction, because there is less bleeding and anesthetic drugs used. In fact, in doing the procedure under tumescent technique, we have eliminated a lot of risks normally associated with general anesthesia.

Dr. Birken Accepted to American Academy of Cosmetic Surgery

[ No Comments ] Posted on 06.25.08 under Uncategorized

The American Academy of Cosmetic Surgery has accepted Dr. Birken as an associated member of their prestigious society.

Facial Rejuvenation Article from Baylor College of Medicine, Houston, Texas

[ No Comments ] Posted on 06.23.08 under Uncategorized

http://www.bcm.edu/oto/grand/07102003.htm

Fractionated Laser Resurfacing in Houston - Pearl and Fraxel Treaments

[ No Comments ] Posted on 06.22.08 under Uncategorized

Interesting article on fractionated laser facial resurfacing - similar to Pearl Laser treatments

http://linkinghub.elsevier.com/retrieve/pii/S1064740607000466

Titan Laser Facelift Article in HoustonMedCenter.com

[ No Comments ] Posted on 06.12.08 under Uncategorized

An article on HoustonMedCenter.com explains the Titan laser use for facial laxity can be found at

www.houstonmedcenter.com/articles/Titan-Laser-Procedure.php

Titan Skin Treatment Web Article

[ 1 Comment ] Posted on 06.09.08 under Uncategorized

TITAN SKIN PROCEDURE

The Titan skin tightening procedure is giving thousands of people the world over the chance to non-surgically improve the way they look.
As a former model, Erin Yates used to have a wash board stomach. But she says giving birth to four children changed all that. “I have gained a good 50 or 60 pounds with each of my children. I could never get my lower stomach area to really tighten up. There was no fat there, but the skin would just be saggy,� says Erin.

53 year old Fay Attias says, “I didn’t like my droopy neck and my jowls.� She wants to fight gravity, but she doesn’t want to go under the knife. “Everyone is afraid of being cut and pulled and tugged,� says Fay Attias.
Both Erin and Fay wanted to give their saggy skin a makeover so they tried the new Titan skin tightening procedure.
“The Titan skin procedure is a way to tighten skin that has no down time to it. It’s non-surgical and you can use it on the face, stomach, arms and the neck,� says Dr. Anu Momi.
The Titan skin tightening procedure uses an infrared light source to tighten skin and reverse the signs of aging. The source heats the dermis to cause collagen contraction while preserving the epidermis through continuous cooling. In addition, it can stimulate long-term collagen rebuilding that leaves patients with younger looking skin.
“The ideal candidate is someone who has very loose lax skin, almost puckering, where there is no integrity beneath it,� says Dr. Momi.
Patients usually see improvement after 2 or 3 treatments. “My skin is firmer and tighter. When I touch the area, it doesn’t feel flabby. There’s a softness to it now,� says Fay.
Erin has had 2 treatments on her stomach.
“I just noticed that I could pinch less, that there wasn’t as much loose skin,� she says.
Dr. Momi cautions that while results with the Titan skin tightening procedure can be dramatic, it’s not a magic bullet. “What you would definitely want to keep up with is weight loss program or an exercise regimen. If you increase your weight you will definitely lose your results,� says Dr. Momi.

Advance for Healthy Aging Article on Laser Lipolysis

[ No Comments ] Posted on 05.31.08 under Uncategorized

 

In the May/June 2008 publication of Advance for Healthy Aging, Dr. Jeffrey Katz and Dr. Jason C. McBean wrote an article on the benefits of Laser Lipolysis.  Here is part of that article.

 

Benefits of Laser Lipolysis
Laser-assisted lipolysis has several benefits over traditional liposuction under general anesthesia. First, patients easily tolerate the procedure. Because they’re awake, they may communicate during the operation and can stand. This allows us to optimize evaluation and correction, if needed. In addition, tiny incisions, which do not require sutures, allow drainage, prevent infection and heal within weeks of the procedure.

We’re unaware of any studies that compare laser lipolysis with liposuction using the tumescent technique. However, in our experience, the smaller cannula size, coagulation properties of the laser and its fat-melting abilities have made the procedure less traumatic than tumescent liposuction. Less trauma translates to shorter recovery times.

Laser-assisted lipolysis also appears to tighten the skin and reduce laxity, since the destruction and remodeling of collagen creates a thicker and more organized dermis. This feature makes laser-assisted lipolysis an ideal system for areas of localized adiposity, as well as localized laxity, after liposuction.

In-office Tumescent Liposuction Facts

[ 1 Comment ] Posted on 05.21.08 under In-Office Liposuction

Approximately 600,000 liposuction procedures are performed in the U.S.

A study from 2004-2005 reviewed 3,500 cases. Ninety percent of patients rated their anesthesia as excellent with no significant pain

After six months, ninety percent of patients had a high level of satisfaction

The clinical complication rate was six percent usual from hematomas, seromas, hyperpigmentation, hardness, and abrasions

There were no deaths, perforations of peritoneum or thorax, sensory nerve damage, pulmonary embolism, respiratory arrest, seizures, drug toxicity, or thrombophlebitis, with only one case of infection reported.

According to “Cosmetic Surgery� in Clinical Updates in Women’s Health Care published by the American College of Obstetricians and Gynecologists, April 2008, “For the appropriate patient, the results can be considered miraculous, achieving in a short session what would otherwise be unattainable.�

Are Bio-identical Hormones Right for Your Patients?

[ 4 Comments ] Posted on 05.12.08 under BioIdentical Hormones

Over the past several years, the buzz surrounding compounding, or bio-identical hormones (BHRT), grew louder in my ears, like a pesky mosquito that wouldn’t go away. While Suzanne Somers’ books, The Sexy Years and Ageless, provided enlightening information to the public, her media blitz expounding the virtues of BHRT seemed self-serving.

But the ever-present comments from my patients, such as “My friend takes natural hormones and is losing weight,” “My sister sleeps better on bio-identical hormones,” and “Bio-identical hormones are safer than synthetic hormones,” were hard to ignore without understanding these substances.

My first reaction was to dismiss BHRT. As a board-certified specialist, I read my journals and took the appropriate CME courses. The American College of Obstetricians and Gynecologists Committee Opinion from November 2005 emphatically stated that “there is no scientific evidence to support claims of increased efficacy or safety for individualized estrogen or progesterone regimens.”¹

So it would have been easy for me to reject bio-identical hormones. But as a physician, I have an obligation to explore the treatments my patients ask about. Do they actually feel better on bio-identical substances? Do they have more endurance, better sleep and improved libido? I needed to find out, but without the hype and high-priced courses offered by some physicians whose interest may be clouded by monetary factors.

While strolling through the plethora of “hits” from a Google search, past the glut of anti-aging sponsored Web sites, I find one with a genuine feel from Neal Rouzier, MD.² Was this good karma or just plain luck? Who knows, but off I went to Salt Lake City for a two-day weekend course titled, “The Effects of Hormonal Therapies on Quality of Life Issues: The Medical Management of Aging.” I was intrigued, but skeptical.

The upscale hotel accommodations contrasted with the Spartan conference room. Instead of sophisticated PowerPoint slides, Dr. Rouzier uses an overhead projector sans microphone, his voice loud and commanding. And so began a two-day course unlike any other CME seminar I have ever attended. From 8:00 a.m. sharp until almost 6:00 p.m., Dr. Rouzier meticulously covers all the topics with an occasional five minute respite for a bathroom break. Even lunch is a working session, as we cover seminal medical publications. Coupled with practical clinical applications, the course moves rapidly with constant edifications. It’s so enlightening that the two days seem like an hour lecture.

First, Dr. Rouzier presents material on human growth hormone (HGH), a pituitary substance that affects nearly every organ in the body. It’s necessary for proper growth and development. A landmark study by Rudman et al. concluded that diminished secretion of HGH was responsible, in part, for a decrease in lean body mass, expanded adipose tissue mass and the thinning of skin during old age.³

Various publications conclude that physiologic HGH replacement therapy might reverse or prevent some of the inevitable sequela of aging. Dr. Rouzier slowly and methodically walks up and down the conference room with his head slightly tilted downward, a gesture of contemplation, articulately referencing all the good things about HGH in the medical literature. The man, dedicated to the quest for knowledge, reviews a legion of medical publications per week. This is not a show, but a well-organized and researched seminar from a doctor who has practiced using bio-identical hormones for 10 years.

Just as interesting is the next section on testosterone, revealing that its physiologic replacement in men and women increases muscle mass, strength and endurance and decreases fat. It also increases exercise tolerance, as well as libido and sexual performance. Thoroughly, Dr. Rouzier covers a review article from the New England Journal of Medicine on the risks of testosterone replacement therapy and recommendations for monitoring. His survey is honest and fair while raising points about proper use and potential complications.⁴

What about DHEA, a substance patients ask about often? Is it for real? Can a hormone secreted by nerve tissue and adrenal glands result in a shift from a catabolic to an anabolic or protein-building state, reducing cardiovascular risks while improving mood, memory and energy? Articles from the American Journal of Physiology, the Journal of Endocrinology and Metabolism and the New England Journal of Medicine support some of these claims. One article from 1994 concluded that DHEA was associated with a remarkable increase in physical and psychological well-being in men and women.⁵ I lean back in my chair, a bit overwhelmed, but wanting to learn more.

Estrogen and progesterone, those much maligned hormones, suddenly seem amazingly safe and necessary from a bio-identical perspective. These are not just plant-derived hormones, but structures that are chemically identical and, therefore, physiologically beneficial, protecting against heart disease, stroke, osteoporosis, Alzheimer’s and memory disorders. They also can eliminate menopausal hot flashes and vaginal atrophy. Because progesterone is not progestin, a synthetic formulation, it ameliorates PMS and menopausal symptoms while lowering cholesterol, increasing bone density and providing a natural mood calming effect. A study from Hargrove et al. revealed that the combination of micronized estradiol and progesterone offered substantial clinical benefits for women with postmenopausal symptoms and an intact uterus.⁶

Dr. Rouzier is just warming up. His strongest opinions are saved for the controversial section on thyroid treatment, stating that it’s the “most misunderstood hormone.” Expertly, he dissects nearly 40 medical articles about thyroid treatment, emphasizing that bio-identical thyroid—not synthetic—reduces fatigue, improves thinning hair as well as cold intolerance, while promoting weight loss and reducing body fat.⁷ His wrath against the synthetics crescendos as he justifies bringing triodothryronine (T3) levels back to physiological levels, interspersing actual patient lab results on the overhead projector, teaching the correct interpretation of the most clinically useful blood tests.

Does the man ever get tired? I wondered if his Olympian stamina is related to his using bio-identical hormones? Maybe it’s the melatonin he takes, that great sleep promoter and immune enhancer that provides him with Superman endurance? Or could his encyclopedic knowledge be enhanced by pregnenolone, a hormone that may protect against memory loss? His educational program is more than impressive. It’s inspirational. Dr. Rouzier’s enthusiasm is contagious, especially when he relates clinical stories of patients who not only respond to BHRT, but who also stop taking other medications, such as statins, anti-depressants and bisphosphonates. I leave Salt Lake City anxious to begin bio-identical hormone assessment and treatment and to register for his part II and part III courses, further probing the mostly untapped benefits of hormone therapy.

Putting It into Practice

I re-read the 550 pages of Dr. Rouzier’s handout, searching for a way to begin BHRT counseling. How do I start? Will patients be interested in BHRT or satisfied with their current regimen? I don’t know, but the first patient I treat is my wife, who has been on synthetic estrogen and progesterone for several years. While she isn’t thrilled about being a guinea pig, she agrees to have blood levels tested, but remains skeptical to the concept. Eagerly, I wait for the results: an estrogen level pitifully low, the expected, almost nonexistent progesterone level, and testosterone and DHEA values well below optimal range.

“Are you game?” I ask. After some coaxing, she reluctantly agrees. Instead of one pill per day, she now takes three and uses a cream. She finds it inconvenient, but I ask her to be patient and to see what happens.

Surprisingly, most of my patients who take HRT are interested in either changing to BHRT or learning more about it. Even patients who have been off hormones are intrigued by the possibility of improved stamina and sleep, as well as weight loss. Lab tests are ordered, the results reviewed and patient consultations are made with recommendations for estrogen, progesterone and testosterone replacement, along with thyroid and DHEA supplementation, if indicated by suboptimal values and clinical symptoms. It will be a month before I see these initial patients again, so I cautiously watch my wife and wait to hear her take on it.

Just three days after starting her BHRT, she tells me she thinks something is working. I raise my eyebrows. “How so?” A tilt of her head suggests deep thought. “Not sure,” she says, “but I feel different, better, not sure exactly why or how.”

And so it goes with my patients. Most feel better, and many claim to sleep longer, have more energy, fewer hot flashes and/or night sweats. They seem happier, have less vaginal dryness, and most comment on their improved libido.

But not all will be elated, and sure enough, I’m right. Those with no or little clinical response have lab values consistent with minimal changes. Customizing the dosages, as well as the combination of estradiol to estriol and T4 to T3, makes me feel like an internist instead of a gynecologist. Yet, it all makes sense, and even these poor responders return with some improvement and positive feedback. The most difficult patient, my wife, also requires some tweaking to her hormone dosages and combinations until the desired values and clinical responses are met.

Anecdotally, I make an interesting observation. Every patient who takes testosterone seems to have better-looking skin. Is this for real or just my imagination?

“You’re right,” my wife says. “I now have some oil to my skin when before it was dry. My skin feels soft and silky like when I was young.”

I don’t want to get too excited. This seems like the real deal and maybe I should convert everyone to BHRT, but some drawbacks exist. First, because they are bio-identical substances, they cannot be patented by pharmaceutical companies and, therefore, are not regulated by the FDA. As physicians, we have the knowledge and expertise to use bio-identical hormones, but some clinicians feel uncomfortable using non-FDA approved medications.

Second, most insurance companies won’t cover these compounded hormones. Patients usually pay significantly more for them compared to hormones on insurance formularies.

Third, it takes time to find the right combination for each person. Several follow-up visits and repeat blood tests are needed so patients can reach optimal levels and realistic clinical improvement.

While BHRT may or may not slow the aging process, it works well clinically, improving quality of life and well-being. Many of my patients are happy with BHRT, and I’m glad I listened to them. This experience taught me that we need to learn from others. Often, the best ones to teach us are our patients.

For a list of references, go to advanceweb.com/healthyaging and click on the references toolbar.

Randy A. Birken, MD, is a clinical assistant professor at Baylor College of Medicine and medical director of Elan Medspa and Timeless Benefits Medical Spa in Houston.

Disclosure: Dr. Birken indicates that he has no affiliations with any commercial entities, directly or indirectly referenced in this article.

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