I am really on a roll here, or maybe it’s a rampage. It’s too soon to tell. Here is another “before and after” from yet another liposuction gizmo that is supposed to sculpt the fat layer and tighten the skin layer, all without surgery!

Take a close look at these photos. They are pretty impressive, don’t you think? But take a really close look. Mentally drop a straight line down from the point where her nose meets her upper lip. Then take a look at her chin. Her chin (AS IN CHIN BONE) has been moved forward. This ad thus implies that this non-surgical fat sculpting and skin tightening gizmo can actually move a chin and jaw bone. Maybe this lady’s chin and jaw were moved but if so, it was done using an orthognathic surgical procedure and it involved a bone saw and some metal screws and plates. Not exactly non-surgical or minimally invasive. Or maybe the ad folks just used Photoshop. Either way, this ad is more than highly misleading. It is fraudulent.

And again, the wretched thing is that these gizmos are heavily marketed to those without full training in Plastic Surgery. And those wannabe “plastic surgeons” who may be saying, “Wow, what a great result. I must have one of these!” don’t even know what orthognathic surgery is. I sure didn’t know it existed until I did my plastic surgery training.

Orthognatic surgery, by the way, is a field of plastic surgery and maxillofacial surgery which involves moving the bones of the face, usually the upper and/or lower jaw. And it’s not done with a “minimally invasive”, one bazillion dollar, fraudulently advertised gizmo with a “doesn’t know any better” doctor pushing the button.

I get buried in advertisements for the newest, latest, greatest, you gotta have it, gizmos that are supposed to make my practice and my results and my life in general even better that they already are. Of course, these gizmos average about $100,000 and – this is what really fries me – they are rarely available for demo prior to purchase. This is sort of like buying a fancy new car without a test drive.

Another thing that fries me is some of the very, very misleading advertisements that many of the manufacturers try to pass off as real results. Here is an example. This is from an ad for a non-invasive fat removal system that uses energy that passes through the skin and is directed at the fat layer. Wow, what a difference until you look carefully. (Plastic surgeons are trained to look carefully.) In the photo on the right, Mr. Sixpack is pinching a fat roll that starts above his bellybutton and in the photo on the right, he’s pinching a fat roll that starts below his bellybutton. So obviously the more fat pinched, the thicker the roll. I can do this myself – big fat roll and little fat roll. I bet you can do it too!

Okay, and just one more thing that fries me, and then I’ll stop, at least until my next blog entry: Most of these new technologies are marketed heavily to non-plastic surgeons. The family practice doc or gynecologist or even (I’m not making this us) ophthalmologist who may want a little piece of the cosmetic surgery action may see this ad and go, “Wow, I must have one of these!” These docs are not experienced with liposuction or other body contouring and may not look at these photos as carefully as a real plastic surgeon. So these non-plastic surgeons buy one, it doesn’t work very well but they have to keep promoting it and using it and in some cases, giving patients a really raw deal because they have already dropped $100,000 on it and they can’t sell it because after a while, everyone knows it doesn’t work very well. So beware of non-plastic surgeons using the “latest technology”. They likely just don’t know any better.

Last week I gave a talk to a dental study group on non-invasive procedures to improved the appearance of the mouth and lips. I spoke mostly about the various fillers I use to fill in wrinkles, bolster saggy areas and enhance lips. I also discussed the many, many non-invasive spa procedures that over-promise and under-deliver results.

During dinner I had a nice chat with some of the members about all of the various procedures and gizmos that are heavily marketed to plastic surgeons and the public. I was not surprised to hear that dentists are also heavily hit with marketing of the latest and greatest lasers for various indications.

I have seen many ads for “laser teeth whitening” over the years and asked my table mates if these devices worked. According to those who have used them, the lasers dehydrate the teeth and make them appear whiter for about two weeks. The benefit, like the Cheshire Cat fads away and there is no lasting benefit. And laser whitening makes the teeth more sensitive. The best way to whiten teeth, according to this group, is to use the trays with whitening gel. Also, the whitening strips sold along side toothpaste get a good review from dentists. Flossing is also important for an attractive smile. Even the brightest and whitest of teeth won’t hide nasty, boggy or recessed gums.

So forget about the big bucks for laser whitening. Buy (and use!) the white strips and remember to floss!

Take a look at this “before” and “after”.

As promised, here’s the inside of the brochure that shows the “results” and you can be sure these are the best results the company could come up with. The “CoolSculpting” gizmo is promoted as a non-invasive body contouring procedure. I would say non-invasive and ineffective.

Most of the doctors that will purchase this device or one of the dozens similar to it are non-surgeons. These doctors do not know how to do an abdominoplasty (tummy tuck) so they offer this instead. I’m sure they go into it with high hopes but how can they not be disappointed at such a “result’? Once they have paid the $$$$$$ for the gizmo, they need to promote it to make sure they get a decent return on investment.

If any of my abominoplasty patients had a result like this, they would feel ripped off. I suspect the doctors using “CoolSculpting” are going to have some unhappy patients. Geez, everyone could have saved all that time, money and gnashing of teeth by referring those patients to me!

Like most plastic surgeons, I just love shopping for new instruments and gizmos but like most plastic surgeons, I am also quite skeptical of stuff that seems too good to be true – especially very expensive stuff that doesn’t work very well (VES-DW, for short). Behold, on the left, the lastest sales brochure occupying my in-box.

This brochure might make someone like me (a plastic surgeon who would love to deliver abdomens like the one on the left to my patients) buy a “coolsculpting” system for a couple hundred grand. If the “coolsculpting” system delivered the aforementioned abdomen, I suspect there would be a line outside my office door extending down 16 flights of stairs and out onto the street. But alas; there is the inside of the brochure. See my next blog for the “results”.