Cosmetic Surgery & Tax Deductions? – A New Twist for the Systemw
By Dr. R. Jarial | August 16, 2009
Most in Washington heard the news this week from a report in Congress Daily which stated that the Senate Finance Committee was plotting a 10 percent surcharge on all unnecessary cosmetic-surgery procedures, and that the idea had been broached to Chairman Max Baucus (D-MT) during a meeting with Office of Management and Budget Director Peter Orzag in mid-July.
House Speaker Nancy Pelosi, whose “refreshed” looks have spawned constant speculation, is also out of the loop. She has read the all news articles about it, her office says, but had no discussions on the subject. “As far as she knows,” says her press secretary Brendan Daly, “it’s not being seriously considered.”
So who decided to levy an excise tax on the cushy world of rejuvenation and self-improvement? Some point the finger at the Treasury Department’s economic adviser Gene Sperling.
The press aide for Finance Committee member Senator Kent Conrad says he was thoroughly mystified when he read the story and thought it was probably a spoof or joke.
The American Academy of Cosmetic Surgery, which boasts 2,500 aesthetic practitioners, was evehement in their opposition. Charlie Baase, communications director for the AACS, mentioned it would be discriminatory to females who comprise 90 percent of all plastic-surgery patients. Although some may think this may be the way to lipo the idle rich, in reality it is working women who would be targeted, specifically those who earn between $30,000 and $90,000 a year, and baby boomers attempting to kickstart or rekindle a career.
This type of revenue-raising has been proposed in several states before, with a minimum of success. The only state to adopt such a tax is New Jersey, which has failed to realize expected profits, and is facing strong opposition from the legislators who originally voted for the bill.
According to Dr. Malcolm Roth, a health and policy advocate at the American Society of Plastic Surgeons, the tax only added to the bureaucracy and presented the problem of deciding which procedures were taxable and which were not. There also was the dilemma of determining the fine line between necessary reconstructive surgery and cosmetic enhancement.
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The Lifestyle Lift and Controversy
By Dr. R. Jarial | August 16, 2009
Lifestyle Lift, a cosmetic surgery company, has reached a settlement with the State of New York over its attempts to fake positive consumer reviews on the Web according the New York attorney general’s office.
The company had ordered employees to pretend they were satisfied customers and write glowing reviews of its face-lift procedure on Web sites, according to the attorney general’s statement. Lifestyle Lift also created its own sites of face-lift reviews to appear as independent sources.
One e-mail message, discovered by the attorney general’s office, told employees to “devote the day to doing more postings on the Web as a satisfied client.”
The company will pay $300,000 in penalties and costs to the state. It has also agreed to stop publishing anonymous reviews on Web sites in the voices of satisfied customers and to identify any content created by employees, the statement said.
False reviews have become more of a problem as more people rely on sites like Yelp, Amazon or Epinions to rate and learn about products and services.
Some review sites have grown so powerful that consumer reviews can make or break a new business. Lifestyle Lift, which is based in Troy, Mich., and operates 32 centers nationwide, believed that negative reviews had significantly hurt its reputation, the attorney general’s office said.
Lifestyle Lift said in a statement that it “regrets that earlier third-party Web site content did not always properly reflect and acknowledge patient comments or indicate that the content was provided by Lifestyle Lift.”
The livelihood of review sites depends on readers trusting their content. Weeding out biased reviews from the sea of anonymous, user-generated submissions has been challenging.
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Breast Implants and the Economy
By Dr. R. Jarial | July 7, 2009
With the economy in the current state, people from all walks of life are watching their expenditures and holding off on big ticket items to some degree. Cosmetic surgery is no exception.
Breast augmentation has also been affected. There have been some articles in the press with a focus on how teens were pursuing implant surgery at increased rate compared to a number of years ago. In fact, as the economy slowed last year, so did the number of teenagers’ and adults’ breast implant operations.
Statistics collected by national organizations of cosmetic doctors show a long-term increase in the numbers of girls getting implants, ending with a short-term drop last year.
Nationwide, 18- and 19-year-old had about 9,000 breast enhancements last year, according to a survey by the American Society of Plastic Surgeons. That’s down 14 percent from the previous year, but up 388 percent from 1998.
A survey by the American Society for Aesthetic Plastic Surgery found similar trends. Their report said girls 18 and younger had about 4,100 breast enhancements last year, which was down 48 percent from 2007 and up 343 percent from 1998.
Plastic surgeons say they scrutinize the motivations of teenagers who seek breast implants.
Implants often need to be replaced after about 10 years, so a girl who gets them as a teenager could be setting herself up for a series of follow-up operations, plus other complications. As the non-profit site BreastImplantInfo.org states:
-Is it appropriate to perform cosmetic surgery on patients whose bodies are still maturing? Breast development can continue into the late teens and early twenties, so girls who think they need augmentation now might change their mind later.
-There are no epidemiological studies or clinical trials on the safety and long-term risks of breast implants and liposuction on patients younger than 18. So, the risks are unknown.
-Although the FDA approved breast implants only for women ages 18 and older, there are no legal restrictions on the procedure. The American Society of Plastic Surgeons has an official position against breast augmentation for most teens younger than 18, but there is no enforcement. The American Society for Aesthetic Plastic Surgeons has no official position regarding augmentation for teenagers.
-Breast augmentation has a very high complication rate that often requires additional surgery within five to 10 years. For a girl of 18, that means she will probably need another surgery while she is in her 20s, her 30s, and every decade after that.
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The Liquid Face Lift
By Dr. R. Jarial | June 23, 2009
With the availability of Botox and dermal fillers, a different approach is being developed in order to provide a gentle lift of the face. This has been referred to as the Liquid Face Lift. However, it is not a substitute for a surgical face lift.
The non-surgical approach of a Liquid Face Lift can:
- Provide a more rested look
- Reduce creases or folds
- Restore facial contours
The Liquid Face Lift involves the use of advance fillers with Botox. The new generation of fillers seem to provide more enduring results. These fillers include Juvederm Ultra, Juvederm Ultra Plus, Sculptra, Restylane, Perlane, and Radiesse. The dermal fillers replace lost volume in the face or can allow the body to regenerate collagen. The fillers can also provide a small lift and help with contour irregularities.
The use of Botox allows for the relaxation of wrinkles. It can also help improve the endurance of fillers. Within the face, there are muscles that pull up (levators) and pull down (depressors) the face. When Botox is placed in the depressor muscles, the levator muscles will work to help with lift effect.
As with any medical procedure, there is a varying degree of risk involved. This should be discussed with your physician.
Each person has unique facial features and different skin types. Also, sun damaged skin, collagen, and skin laxity can also affect results. Goals and desires vary from person to person. As with any procedure, refinements in technique are always on the horizon.
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The Generation of the Medspa
By Dr. R. Jarial | June 18, 2009
Even though dermal fillers and botox are available at an office of a board certified plastic surgeon, some people are opting to go to a medspa for their injections. The trend seems to be popular among women from 18 to 34 years old.
The medspa can offer other non-medical items to improve appearance.
Younger women are reportedly three times more likely to undergo a non-invasive treatment at a medspa than those 35 to 64 years old. Unfortunately, the under-34 set is also more likely to be indifferent about who’s performing the procedure. Although most would prefer that the medspa’s physician conduct their chosen treatment, it was found that more than half claim they would be comfortable if a physician wasn’t present.
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Fractional Laser & Acne
By Dr. R. Jarial | May 22, 2009
The use of fractional laser (or fractional thermolysis) is showing some promise a safe and effective way to treat some acne scars in patients with darker skin types. Sometimes, standard acne treatments, such as chemical peels, dermabrasion, and laser resurfacing can lead to an increase in pigment, particularly in individuals with darker skin.
The mechanism of action seems to be microscopic coagulation in columns and the ability not to injury surrounding tissue. In turn, this allows for faster production of collagen and skin epithelium.
Early studies are suggesting that fractional resurfacing is helpful. However, the finer points of treatment are still in a research phase.
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A New Filler with Lidocaine
By Dr. R. Jarial | April 28, 2009
Hello everyone…………….
There is some exciting news in the filler arena. A new filler is being tested with Lidocaine. The filler is hyaluronic acid that contains lidocaine and is being referred as “DEO-NADGL.”
Based on the prelimary studies, patient satisfaction is high……and more importantly, the volume of the injected areas are holding up to 4 months. As with any minor procedure, there are side effects that can occur, such as bruising, inflammation, and pain/ tenderness. These were reported as transient side effects.
This is an exciting development in that local injections for anesthesia (i.e., dental blocks) could potentially be avoided.
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Skin Cancer Prevention
By Dr. R. Jarial | April 7, 2009
Hello……….
Hopefully the snow is melting everywhere…..probably faster in some areas of the country. Spring and summer fever are fast approaching. Parkas are being put away in preparation for shorts, T- shirts, and flip-flops.
With the sun coming out and summer approaching, the buzz is to go out in the sun and catch some rays. With that said, skin protection is vital to prevent skin cancers from forming.
Skin cancers show no preference to age or race. For purposes of protection, a sunscreen with a high sun protective factor (or SPF) should be applied to sun exposed areas of skin. Also, things such as sunglasses and brim hats also offer protection
Unfortunately, too many people do not protect themselves from the sun. Whether it is on the beach or in a garden, the underlying process of skin cancer development is the same. There is a direct correlation between sun exposure and skin cancer development.
With simple measures, skin cancer development can be stopped. A little prevention today can prevent a lot of problems in the future.
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Fillers and Economics
By Dr. R. Jarial | March 1, 2009
Hi Everybody………..
I thought that I would make some comments on fillers. With tough economic times in the US and in the world, a lot of people who were considering “big ticket” items, such as a facelift, are opting to hold back because of financial reasons. Interestingly, some people are gravitating towards the use of fillers to enhance their appearance. These fillers include Juvederm and Restylane. Both products are used to help fill in fine lines on the face as well as augment certain parts of the face, particularly the lips. The effect is a subtle but natural change for enhancement of the face. While these are not meant to replace certain procedures, like a facelift, they can definitely contribute to providing a youthful appearance.
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Operation Smile
By Dr. R. Jarial | February 15, 2009
Hello Everyone…………
Just returned from the Baker Gordon Symposium in Miami. It was a nice meeting that updated us on new techniques on facial rejuvination.
Since tax season is among us, there is the possibility to give some tax free donations to various organizations. One of these organizations is Operation Smile. They are doing some great work around the world to help with treatment of children with cleft lips and cleft palates.
Consider making a donation to them if you are going to donate some money to an organization.
Dr. Ravinder Jarial
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