In the News

The Cellulite tip is here!

Thermage has introduced a number of advances in the past year. The latest is a special tip designed specifically for cellulite, and we are thrilled to be among the first in the Northwest to have it available. Other advances include the deep contouring tip, which we have been using since last year with exciting results. One recent patient who had the outer thighs and buttocks treated lost 2 inches of circumference immediately! (The effect is all through tightening and toning, not fat reduction.) We are continuing to have good results with Thermage immediately after liposuction, having proved the concept in a clinical trial last summer. Treatments are now faster and have less discomfort in addition to being more effective.

Thermage-liposuction combination enhances results

Thermage (rhymes with massage) is a nonsurgical technique for skin tightening that uses a radiofrequency current to stimulate collagen regeneration in the skin. It is used on the face and all areas of the body. You may see it advertised as a “nonsurgical facelift” or a “tummy tuck without surgery” but those types of statements are a setup for disappointment. But a recent clinical trial, in which I was a participant, found a way to enhance the results by applying the Thermage treatments immediately after liposuction. We were able to objectively measure skin shrinkage and prove that the combination of Thermage and liposuction works best.

View a patient who had Liposuction of the Neck with Thermage.

Dr. Baxter elected to International Society

I am honored to have been elected this year to membership in the International Society of Aesthetic Plastic Surgery. This is a very interesting group of skilled plastic surgeons from around the world, and it gives me an opportunity to learn about techniques and products years before we see them in the U.S.

Plastic Surgery Society position on Mesotherapy

A “hot topic” in recent years has been “mesotherapy”, otherwise known as injection lipolysis or lipodissolve. If you believe the marketing for it, everything from localized fat deposits to cellulite can be cured with a few simple injections and without the risk of surgery. The American Society for Aesthetic Plastic Surgery (ASAPS), the organization representing board-certified plastic surgeons who specialize in cosmetic surgery, has sponsored studies on mesotherapy and they recently issued a Position Paper. They stated “At this time, the Aesthetic Society does not endorse the injection of … drugs, vitamins, plant extracts, plant extracts, hormones, etc. into subcutaneous fat as practiced in mesotherapy/lipodissolve treatments. Such therapies not only lack objective proof of safety and efficacy, they also lack Food and Drug Administration (FDA) approval.

Liposuction, on the other hand, is known to be safe, effective, and relatively painless. Studies on mesotherapy are ongoing and it may very well prove at some point in the future to be a worthwhile therapy, but we don’t appear to be there yet.

FDA approves silicone gel implants

After a 14 year restriction on the use of silicone gel implants, the U.S. Food & Drug Administration announced on November 17 2006 that the implants are approved for unrestricted use. This follows an unprecedented and exhaustive evaluation, making gel implants the most intensively scrutinized medical device ever. Questions about silicone toxicity have long been dispelled, with the National Institute of Medicine reporting in 1998 that “a review of the toxicology studies of silicones and other substances known to be in breast implants does not provide a basis for health concerns.” In announcing the approval, the FDA Director of the Center for Devices and Radiological Health stated “The extensive body of scientific evidence provides reasonable assurance of the benefits and risks of these devices.”

I have been using gel implants as part of the Adjunct Study for several years, and have placed several hundred implants with very good results. Outside of the U.S., more than 90% of women choose silicone implants and now American women will have the same right to make their own informed choices. The video page on this website shows a procedure using silicone implants.

Threadlift sutures discontinued

Hanging by a thread?

You may have noticed that there is much less buzz recently about the “threadlift” procedure. In fact, threadlift as we have known it is a thing of the past, as the company distributing the Contour ThreadsTM recently announced that they are discontinuing the product line. A different product, the “Sihouette” suture, was recently approved and may prove to be useful.

In reviewing my own experience with threadlifts, I have come to several conclusions. I think the biggest reason for its demise was inflated expectations. It was marketed to both plastic surgeons, and physicians with no surgical training as a “non-surgical” option that could produce results similar to a facelift but with minimal or no down time. Eventually it became more obvious that the ideal candidate for a threadlift was not the same as someone who needed a facelift, and the results were not nearly as long-lasting even for appropriate patients. And although it is a minimally invasive procedure, there was still visible swelling and bruising for a week or so. Consider also that those without a background in plastic surgery are probably not in the best position to recommend that a patient might best be served by a surgical option.

An absorbable suture is rumored to be in the offing, which might make more sense since the result is temporary anyway.

VASER: The Ultimate in Ultrasonic Liposuction

Although we are moving closer to the goal of nonsurgical fat ablation with ultrasound, liposuction isn’t going to go away anytime soon. Certain areas of the body with denser fat such as the back, posterior hips, upper abdomen, and the male breast have always been more difficult and ultrasonic-assisted liposuction (UAL) is most effective at treating those areas. I have done thousands of cases of ultrasonic-assisted liposuction, and frankly I had not expected to see significant improvement in the technology. A new refinement of UAL called VASER has really opened my eyes however and after using it I am convinced that it is a substantial improvement.

There are several differenced between VASER and traditional UAL, including a solid cannula probe instead of a hollow one. The hollow design allows for simultaneous suction and ultrasound application but it is less efficient. A critical design feature of VASER is the design of the probe tip, which disperses the ultrasound energy more evenly into the tissue, similar to the technique for cataract removal. Gentle suction then removes the fat. Since the VASER cannula probe is small, the skin incision is small (about 4 millimeters, about the thickness of two stacked nickels.)

What does this mean in terms of clinical results? My impression, and that of others who have experience with VASER, is that there is less postoperative swelling, bruising, and discomfort. Patients are able to return to usual activities quickly and see results sooner.

Nonsurgical fat removal method under study

Dr. Baxter is a clinical investigator for Liposonix, a new company that is developing a device for nonsurgical fat removal. The technique uses high frequency ultrasound (HIFU) to destroy localized fat deposits. We are hopeful that many patients who would normally need liposuction will have a nonsurgical, painless alternative with no "down time" for recovery. This is still in the experiemental stages, however. If you are interested in participating in the clinical trials please call or email.

Smooth Round Saline Breast Implants Shown Superior

Several recent studies have confirmed that smooth round breast implants have features which other designs cannot duplicate. For example, the anatomical or "teardrop" implants, formerly marketed with the phrase "perfectly natural", cannot change shape in a natural way when the patient lies down. More importantly, X-ray studies showed that in the upright position, the round implants take on a natural teardrop shape identical to the more rigid anatomical devices. Several studies have also shown that the smooth round implants feel more natural.

Dr. Baxter Named One of America's Top Doctors in Survey

Dr.Baxter was recently voted one of the top doctors in America, and one of only a few in the Seattle area, in a recent survey of physicians. The poll was taken by the non-profit Center for the Study of Services, a Washington, D.C. based consumer organization. The survey asked physicians which doctors in their communities they "would prefer for the care of a loved one."

Back to the homepage