Cleveland — A report published in the March/April issue of Aesthetic Surgery Journal seems to belie the conventional wisdom that “natural” or “herbal” over-the-counter products are free of risk, reports Medical News Today.

The report, co-authored by David J. Rowe, M.D., assistant professor of plastic surgery at University Hospitals Case Medical Center in Cleveland, notes that more than 40 percent of plastic surgery patients use herbal supplements in the two weeks prior to undergoing surgery. More important, the report warns that while some herbal supplements may provide benefits during recovery, commonly used herbal medications — such as ginkgo biloba, ginseng, garlic, Echinacea and valerian root, among others — can have deleterious effects when combined with surgery.

According to the report, the most significant — and potentially dangerous — effects of alternative medicines occur during and immediately after plastic surgery procedures. Medical News Today quotes Dr. Rowe as saying, “In considering the dizzying array of supplements available, the main concerns of the plastic surgeon are interaction with other medications, cardiovascular effects, alteration of coagulation and sedative effects.”

The report goes on to note that as many as 70 percent of patients may not disclose their use of such products to their surgeon, sometimes because they feel the doctor has little knowledge of — or may disapprove of — the supplements. Some patients simply fail to recognize the relevance of supplement usage to their medical care, write the authors.

“This article was written to help plastic surgeons and their patients identify potentially harmful herbal supplements, based on the most current scientific research,” says Dr. Rowe. “On the positive side, we also discuss how providing the correct supplements and nutrients after aesthetic surgery can be very therapeutic.”

In concluding their report, the authors recommend that patients be provided with a comprehensive list of supplements that must be avoided in the perioperative period to minimize potential surgical complications.

Buffalo, N.Y. — Researchers here say they have found that people who feel sensitive to rejection based on physical appearance are more likely to express interest in having cosmetic surgery than those who are less sensitive to appearance-based rejection. This effect is particularly true when people recall negative comments about their physical appearance, reports news source ScienceDaily.

The study, which appeared in the June issue of the journal Body Image, was conducted by a team led by Lora E. Park, Ph.D., assistant professor of psychology at the University at Buffalo. The study examined the role appearance-based rejection sensitivity — the tendency to expect rejection based on one’s appearance — plays in people’s interest in cosmetic surgery.

For the study, 133 American college students were randomly assigned to write an essay about a negative or positive comment on their appearance that they had received in the past. Compared with participants with lower appearance-based rejection sensitivity, those with higher sensitivity felt more rejected and expressed greater interest in getting cosmetic surgery after recalling a negative comment.

The study found that negative appearance comments were most often made about body weight, shape and size, while positive comments were most often made in reference to overall appearance.

ScienceDaily quotes Dr. Park as saying, “The results of this study suggest that individuals who anxiously expect rejection based on their appearance are vulnerable to the effects of negative comments about their appearance. Sensitivity to appearance rejection may therefore be a key psychological variable to consider when examining responses to teasing related to appearance, especially with regard to feeling rejected and expressing interest in cosmetic surgery.”

Palo Alto, Calif. — Coapt Systems Inc., based here, recently announced its launch of FDA-approved Hydrelle, a hyaluronic acid-based filler for treating facial wrinkles such as nasolabial folds, reports PRNewswire.

According to the company, Hydrelle is formulated with the anesthetic lidocaine for greater patient comfort. The company calls Hydrelle “a financially attractive alternative to traditional fillers such as Juvéderm by Allergan Medical and Restylane by Medicis Pharmaceutical.” The company adds that Hydrelle use requires approximately half the typical injection volumes of other fillers, thus requiring fewer syringes to correct facial wrinkles.

In a randomized, controlled US study of 208 patients, Hydrelle was shown to be safe and effective, the company says, adding that in a multicenter, international study, Hydrelle demonstrated patient/physician satisfaction and filler effectiveness for up to one year.

New York — A Manhattan-based skin-care company has launched a product it says minimizes irritation when applied prior to laser treatment.

Prescribed Solutions LLC's new Control Tactics Neurocosmetic Soothing & Daily Sensitive Skin Gel was developed with fractional ablative and other laser procedures in mind, according to the company.

"When the skin is pretreated before a laser procedure for as little as four days, inflammation, swelling and redness is dramatically reduced, meaning less inflammation immediately after the procedure and a faster recovery following it," says a statement released at the product's launch.

"Many healing gels are solely used as post-procedure products. Control Tactics' innovation is that excellent results are seen simply by using it as a pretreatment," says Aurelian Lis, president and chief operating officer of Prescribed Solutions. "The pretreatment capability is the point of difference with this product. This is the first time weíve seen a product that will minimize irritation from laser treatment [when used] beforehand."

Essentially, the patient desensitizes his or her skin by using Control Tactics at home for a few days before a laser procedure, Mr. Lis tells Cosmetic Surgery Times.

"Prtreating with Control Tactics is so powerful, physicians have been able to minimize pinpoint bleeding from fractional laser procedures," he says. "The end result is that it allows patients to undergo aggressive procedures with less downtime."

Solutions Study

Prescribed Solutions has conducted half-face studies to demonstrate Control Tactics' efficacy. Cohassett, Mass., dermatologist Richard F. Eisen, M.D., was involved in one of those studies. He tells Cosmetic Surgery Times that the best results are attained when the patient starts using the product twice a day, starting four days prior to fractional laser treatment.

"Then I instruct them to continue the treatment for four days after the laser procedure," Dr. Eisen says. "After treatment, patients are instructed to use the product every two hours while awake on the day of the treatment, then to use it every four hours the day after treatment. I then have them continue using it twice a day for two additional days."

He says so far, he has seen no side effects from the use of Control Tactics, adding, however, that "rash due to allergy to one or more of the ingredients is possible."

As for those ingredients, Mr. Lis says, "The gel incorporates the newest ingredients, such as neurocosmetics and a new nanoemulsion of Coenzyme Q-10. Control Tactics doesn't contain any steroids, so it's suitable for long-term use."

The Preferred Solutions Web site describes the new nanoemulsion as Coenzyme Q-10 combined with vitamin E (tocopherol) and vitamin C (ascorbyl tetraisopalmitate), and says that it ìsignificantly improves skin penetration and upgrades the bioavailability of oxidized CoQ-10.î The site also lists, among others, the ingredients oat beta-glucan (ìa potent wound healer that is approved in the EU to coat meshes for surgical implantation in the treatment of herniasî), phytomenadione (vitamin K) and arnica montana leaf extract, which according to the site minimizes post-procedure bruising.

Mr. Lis adds that because Control Tactics is steroid-free, it can be used as a daily gel for people with sensitive skin or rosacea.

"Many anti-inflammatory creams on the market contain hydrocortisone, which makes them only appropriate for short-term use," he says. "People with sensitive skin can have their natural anti-inflammatory regulators, such as IL-1, IL-8 and TNF-, out of balance, which causes inflammation. Control Tactics contains biomimetic peptides, which mimic these natural skin neuroregulators and restore an equilibrium."

Outside Perspective

Cosmetic Surgery Times asked two dermatologists about Control Tactics. Neither has used the product, nor do they have any disclosures to report in terms of testing it or acting as consultants for Preferred Solutions.

"I know of the company, but have not used their products," says David J. Goldberg, M.D., director of the Skin Laser & Surgery Specialists of New York and New Jersey and director of Mohs surgery and laser research at Mt. Sinai School of Medicine in New York. "Many of their products, in a laboratory setting, can have some of the benefits they claim. However, I am not aware of any peer-reviewed, published study showing any clinical benefit from their exact combination. The only products that I use following laser resurfacing that have proven — that is, published in peer-reviewed journals — benefits are those with growth factors. Two quality examples are products from SkinMedica and Neocutis." (Dr. Goldberg says other than selling SkinMedica and Neocutis products in his practice, he has no connection with those companies.)

Boston-based dermatologist Ranella Hirsch, M.D., past president of the American Society of Cosmetic Dermatology & Aesthetic Surgery, says she'd like to see more testing done on Contol Tactics.

"Several of their ingredients are interesting in the proposed combination," she tells Cosmetic Surgery Times. "However, I would want to see clinical data showing quantifiable improvement over existing treatment options before I were to start recommending the product to patients. Also, frankly, cost-effectiveness is a factor as well. I do not recommend that patients spend their money on anything I am not convinced delivers measurable results."

According to Preferred Solutions, Control Tactics' suggested retail price is $50 per 2 ounces. As for the pre- and post-laser treatments she uses, Dr. Hirsch says, "Many are common sense and inexpensive. Ice, soothing cleansers and moisturizers, and a bit of pre-treatment topical anesthetic are quite powerful when used properly. Also, I would hope never to lose my fervent belief in the power of successfully administered 'talk-esthesia.'" CST