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Archive for July, 2010

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CPR update

Friday, July 30th, 2010

It is always intimidating to remember the rules for CPR. A couple of days ago, I read in the LA Times an article which referred to some studies done here and in Sweden. Essentially the message is this: don’t be afraid to just do chest compressions and leave out the breaths. A lot of people are scared or reluctant to perform mouth-to-mouth on strangers. These studies suggested that the crucial part of CPR is really the chest compressions to keep blood circulating.

You are supposed to do the compressions to the beat of “Stayin’ Alive” (in other words pretty fast)

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Thank you, Veterans!

Sunday, July 4th, 2010

For all that have served or are currently serving in the military (including our wonderful former employee and fellow Pi Phi Kelly McMullan who will soon join the Air Force for medical school) I give thanks for your dedication to our country and ensuring our safety.

I especially thank the Veterans of the Korean War, some of you who are my patients. It is mind boggling that 54,000 Americans lost their lives in this war.

Because of your selflessness and courage, my parents were able to come to this country and make their lives better. My mom came from an extremely poor rural area of South Korea and was given the opportunity to emigrate here, educate herself and meet my dad! My dad came from a wealthy family from North Korea, but lost everything in order to remain free. He had to endure a lot of hardship during the war (such as sneaking across the border more than once and being thrown into the middle of the action-see his recently published war story from the New York Times Op-Ed section-see Blogroll) but was able to come to the US and start anew.

On days when I am whining about having a less than average meal, I try to remember his story of feeling pains of hunger during law school. Freedom and opportunity are things that a lot of us take for granted. Maybe this July 4th we can think of it as more than a BBQ holiday!

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Restylane-L has arrived…

Sunday, July 4th, 2010

Restylane-L (Restylane with lidocaine, a numbing agent) is here. So far, so good.  Restylane-L’s numbing effects are a bit delayed and I’m not clear still if  the lidocaine really makes a significant difference. Most patients tell me they are pretty numb after an 30 min to an hour of topical lidocaine, but still feel some of the injections particularly around the corners of the mouth and near the upper smile lines. I’m not sure if the effects of Restylane-L will last as long (which in my experience is 9 to 12 mos and beyond), but for now we’re going with it. We’ve even seen a case of microscopic retained Restylane 2 years later during Mohs surgery.

Correct placement is much more important than quantity. I once had a patient younger than I am get 3 syringes put in her face at another office. In the end, she ended up spending more money and had a complication requiring laser treatments. Juvederm XC is the equivalent of Restylane-L. In the end, both Juvederm and Restylane are great products with no discernable difference in my opinion. Both look very natural in the end.

A lot of people also ask about Sculptra and fat transfer. I do perform fat transfer, but not Sculptra. I still think hyaluronic acid is the best way to go. I don’t perform Sculptra for several reasons, that being said, it is not because it isn’t a good product. It is much more expensive than hyaluronic acid fillers. With the amount of money it would cost, one could get many syringes of hyaluronic fillers. It also has a higher risk of nodules and is not used in the lips. Fat transfer is more invasive and because a large quantity of fat must be injected in order to get reasonable results, you can look younger but fatter/chipmunky due to unpredictable resorption. It is somewhat unpredictable in its final result in comparison to hyaluronic acid.

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