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Michael Pickart
Interests: running, mountaineering, hiking, movies, sci fi, the New Yorker, my darn job!, ethnic restaurants
Recent Activity
Your Health Registers in Your Face (?)
A recent Danish study suggests that you may not need expensive cardiac testing to determine your risks of heart disease. Just look in the mirror. People who look old--with receding hairlines, bald heads, creases near their earlobes, or bumpy deposits... Continue reading
Posted Nov 7, 2012 at Pickart Plastic Surgery Blog
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A Silver Lining for Patients with French-Made PIP Breast Implants
I have previously blogged about my concerns with silicone breast implants manufactured by Poly Implant Prothese (PIP). A quick summary: The French company PIP used industrial-grade silicone in breast implants (rather than medical-grade silicone), thereby increasing the risk of rupture... Continue reading
Posted Feb 10, 2012 at Pickart Plastic Surgery Blog
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A Word About PIP/French Breast Implants
You may have read recently about safety concerns with French-made PIP silicone breast implants. If you are one of my patients, thankfully, you are not part of this European debacle. I am posting to reassure my patients that I do... Continue reading
Posted Feb 6, 2012 at Pickart Plastic Surgery Blog
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Hand Surgery #7: Tennis Elbow
Tennis elbow is a painful disorder of the side of the elbow. The medical name is lateral epicondylitis, but both names are incorrect! Tennis elbow is not more common in tennis players, and lateral epicondylitis is not an -itis (an... Continue reading
Posted Jan 8, 2012 at Pickart Plastic Surgery Blog
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Hand Surgery #6: Dupuytren's Contracture
In 1831, French surgeon Baron Guillaume Dupuytren first described a spontaneous, "deep scarring" disorder of the palmar surfaces of the hands and fingers.... Anatomy The skin of the palmar surfaces of the hands and fingers is special. Like the skin... Continue reading
Posted Jan 3, 2012 at Pickart Plastic Surgery Blog
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Hand Surgery #5: Ganglion Cysts
The most common tumor of the hand is not a cancer. It's a ganglion cyst.... Anatomy Bones meet at joints. Joints are lubricated by synovial fluid. Escape of the fluid is prevented by a joint capsule. Likewise, tendons are lubricated... Continue reading
Posted Dec 30, 2011 at Pickart Plastic Surgery Blog
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Hand Surgery #4: De Quervain's Stenosing Tenosynovitis
While trigger fingers involve inflamed flexor tendons (which bring the fingers into the fist) in their digital sheaths, de Quervain's stenosing tenosynovitis refers to inflamed extensor tendons of the thumb (which help you to hitch hike) as they traverse the... Continue reading
Posted Dec 27, 2011 at Pickart Plastic Surgery Blog
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Hand Surgery #3: Trigger Finger
A carpal tunnel release is the most common hand surgery that I perform. The second most common is a trigger finger release. A trigger finger (or trigger thumb) involves painful snapping or locking of the fingers or thumb. The medical... Continue reading
Posted Dec 22, 2011 at Pickart Plastic Surgery Blog
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Hand Surgery #2: Cubital Tunnel Syndrome
Carpal tunnel syndrome is, far and away, the most common nerve compression disorder of the upper extremity. The second most common is cubital tunnel syndrome.... Anatomy The cubital tunnel is... a passageway between... the bony prominence of the inside elbow... Continue reading
Posted Dec 19, 2011 at Pickart Plastic Surgery Blog
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Hand Surgery #1: Carpal Tunnel Syndrome
Many people are surprised to learn that plastic surgeons are trained to evaluate and to treat hand disorders. Around the USA, about 1/3 of all the hand surgery is performed by plastic surgeons. So, for the next few blog posts,... Continue reading
Posted Dec 13, 2011 at Pickart Plastic Surgery Blog
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Plastic Surgery After Weight Loss Works
Posted Nov 21, 2011 at Pickart Plastic Surgery Blog
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Not so sure that I agree, HTY Gold. Certainly, excessive amounts of Botox improperly placed can look strange, but subtle improvement are possible with Botox and Dysport. You might be surprised that even some of your close friends have given Botox a try. It really does work well when properly administered.
Michael C. Pickart, M.D., F.A.C.S.
Pickart Plastic Surgery, Inc.
1746 S. Victoria Ave., #250, Ventura, CA 93003
(805) 654-8800 | fax (805) 654-8802
To: info@pickartplasticsurgery.com
Commented Aug 13, 2011 on Perhaps, You Don't Need Botox Every 3 Months at Pickart Plastic Surgery Blog
Perhaps, You Don't Need Botox Every 3 Months
New research suggests that patients getting regular Botox treatments can eventually reduce wrinkles with half as many sessions. The research, conducted at Oregon Health & Science University, in Portland, sought to determine whether less frequent Botox treatments could provide long-lasting redu...
The 3rd Botox: Xeomin Gains FDA Approval for Cosmetic Uses
About 11 months ago, I blogged about that... Botox Dysport ...were about to get more competition from the newest kid on the block, Xeomin. http://www.pickartplasticsurgeryblog.com/2010/08/fda-approves-xeomin-the-3rd-botox.html On August 2, 2010, the FDA approved Xeomin for treatment for cervical dystonia (neck spasms)... Continue reading
Posted Jul 26, 2011 at Pickart Plastic Surgery Blog
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Dear Farzana,
Since your tummy tuck was just 3 months ago, it is possible that the epigastric fullness is just swelling. My diagnosis is consistent with your description of the fullness as spongy. Swelling can require 6-12 months for full resolution.
Please let your plastic surgeon know about your concerns. He may want to photograph the area to confirm its resolution over time.
FYI, sometimes patients have excess fat in the epigastrium that is not easily or safely removed during the tummy tuck itself. This fullness may be swelling, but it could also be some of that excess fat. Occasionally, I warn my patients that secondary liposuction is necessary to perfect the tummy tuck--6-12 months later. Please dont be alarmed! Just be aware that minor revision liposuction sometimes aids a result.
Congratulations on your otherwise terrific result!
Sincerely,
Michael C. Pickart, M.D., F.A.C.S.
Pickart Plastic Surgery, Inc.
1746 S. Victoria Ave., #250, Ventura, CA 93003
(805) 654-8800 | fax (805) 654-8802
To: info@pickartplasticsurgery.com
Commented Jul 22, 2011 on Abdominal Irregularities after a Tummy Tuck in Oxnard: One Year After Surgery at Pickart Plastic Surgery Blog
Abdominal Irregularities after a Tummy Tuck in Oxnard: One Year After Surgery
A few days after seeing another surgeon's patient, who was unhappy with a painful abdominal bulge one week after a tummy tuck, into my office walks in another dissatisfied 45-year-old tummy tuck patient from Oxnard--but she is one year after her surgery. I had a tummy tuck approximately 12 mont...
Terrific, Farzana! I am glad that you had such a positive experience. Most of my patients are thrilled about their tummy tucks, and unhappy patients are unusual.
Congratulations,
Michael C. Pickart, M.D., F.A.C.S.
Pickart Plastic Surgery, Inc.
1746 S. Victoria Ave., #250, Ventura, CA 93003
(805) 654-8800 | fax (805) 654-8802
To: info@pickartplasticsurgery.com
Commented Jul 22, 2011 on Abdominal Irregularities after a Tummy Tuck in Oxnard: One Year After Surgery at Pickart Plastic Surgery Blog
Abdominal Irregularities after a Tummy Tuck in Oxnard: One Year After Surgery
A few days after seeing another surgeon's patient, who was unhappy with a painful abdominal bulge one week after a tummy tuck, into my office walks in another dissatisfied 45-year-old tummy tuck patient from Oxnard--but she is one year after her surgery. I had a tummy tuck approximately 12 mont...
Perhaps, You Don't Need Botox Every 3 Months
New research suggests that patients getting regular Botox treatments can eventually reduce wrinkles with half as many sessions. The research, conducted at Oregon Health & Science University, in Portland, sought to determine whether less frequent Botox treatments could provide long-lasting... Continue reading
Posted Jun 30, 2011 at Pickart Plastic Surgery Blog
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FDA Approves Autologous Filler
There has been a lot of hype about stem-cell therapy for facelifting. As a Board Certified Plastic Surgeon, I find those claims comical. Please don't fall victim to clever advertising. However, the biologists have tremendously improved our understanding of cellular... Continue reading
Posted Jun 23, 2011 at Pickart Plastic Surgery Blog
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Dear Clara,
I recommend using the iopidine drops every 8 hours for no more than 1 week. I am not an ophthalmologist, but I have been told by my eye colleagues that long-term use of iopidine (more than 1 week) can predispose a patient to glaucoma. So, definitely curtail your iopidine use soon.
Usually, droopiness (better known as ptosis) lasts just 2-3 weeks, even though the anti-wrinkle effect of Botox and Dysport lasts 3-6 months.
I am so sorry that you have had an unexpected outcome. Please remain patient. It will resolve. Promise!
Sincerely,
Michael C. Pickart, M.D., F.A.C.S.
Pickart Plastic Surgery, Inc.
1746 S. Victoria Ave., #250, Ventura, CA 93003
(805) 654-8800 | fax (805) 654-8802
To: info@pickartplasticsurgery.com
Commented Jun 14, 2011 on First Complication with Dysport--But is it Dysport's Fault? at Pickart Plastic Surgery Blog
First Complication with Dysport--But is it Dysport's Fault?
Ms. LM has suffered the first significant complication that I have ever had with an injectable botulinum neurotoxin (i.e., Botox or Dysport)--ptosis, or drooping of the upper eyelid. Ms. LM is just 48 years old, and she has been a faithful Botox patient in my Ventura, California, office for over...
Dear Gwen,
I am sorry that you have had an unfortunate side effect of treatment with Botulinum Neurotoxin Type-A (BoNT-A) (more commonly known as either Botox or Dysport). Ptosis (or drooping) of the upper eyelid occurs in about 1-3% of BoNT-A treatment sessions. The rate of this complication appears to be about the same for Botox and Dysport, in expert hands.
Note that additional phrase in expert hands. Dysport is probably no more likely to cause ptosis than Botox if the health care provider is an expert with the use of Dysport. If he or she is just learning how to use the product, then all bets are off.
I have now been using Botox for 5 years and Dysport for 2 years. I have trained other physicians in the use of Dysport. So, I feel confident that I can call myself an expert on both products.
I dont think that Dysport truly spreads more than Botox, with my current technique. The only scientific study documenting an increased spread for Dysport relative to Botox examined sweating (which is also minimized by BoNT-A injections) rather than muscle activity, and the study was funded by the makers of Botox (who, of course, would want to discredit their competition). Moreover, in this study, the dilution of the Dysport was much greater than what I currently recommend.
Bottom line: Did the Dysport cause the ptosis because...?
Dysport is a poor product?Absolutely not!the injector is not an expert with Dysport (even if he/she is good with Botox)?Maybe.the injector used the wrong dilution of Dysport?Maybe.you are unlucky?Most likely.
Regardless, you seem fed up with both of the BoNT-As. I certainly would not try to convince you to get a treatment for which you lack confidence. However, I would reassure you that a future Botox/Dysport treatment remains unlikely to cause a repeat ptosis event (97-99%).
Also, more BoNT-As are about to be released. Merz Pharma already has FDA approval for Xeomins use for spastic muscle diseases; a cosmetic indication awaits an FDA verdict, which will, almost certainly, be positive. The Mentor Corporation is in clinical trials with Purtox, which also looks promising.
So, even if Botox and Dysport are not for you, Xeomin or Purtox might be. Im hoping that youll keep an open mind.
Sincerely,
Michael C. Pickart, M.D., F.A.C.S.
Pickart Plastic Surgery, Inc.
1746 S. Victoria Ave., #250, Ventura, CA 93003
(805) 654-8800 | fax (805) 654-8802
To: info@pickartplasticsurgery.com
Commented Jun 12, 2011 on First Complication with Dysport--But is it Dysport's Fault? at Pickart Plastic Surgery Blog
First Complication with Dysport--But is it Dysport's Fault?
Ms. LM has suffered the first significant complication that I have ever had with an injectable botulinum neurotoxin (i.e., Botox or Dysport)--ptosis, or drooping of the upper eyelid. Ms. LM is just 48 years old, and she has been a faithful Botox patient in my Ventura, California, office for over...
Thanks for the testimony! Yes, sunscreen works. Ignore all those comments about looking pasty; pale is healthy!
Sorry to have gone political on you. The law is not my specialty. Since public education has failed, I confess that I feel beaten. I just dont know where else to turn other than the Nanny State.
Michael C. Pickart, M.D., F.A.C.S.
Pickart Plastic Surgery, Inc.
1746 S. Victoria Ave., #250, Ventura, CA 93003
(805) 654-8800 | fax (805) 654-8802
To: info@pickartplasticsurgery.com
Commented May 15, 2011 on Cancer Alert: Why Are You Still Tanning? at Pickart Plastic Surgery Blog
Cancer Alert: Why Are You Still Tanning?
According to a new survey from the American Academy of Dermatology, more than 80% of young, white women use tanning beds or intentionally tan in the sun--despite their full cognizance of the deleterious effects of UV light. 3800 white, non-Hispanic females aged 14 to 22 years were asked about th...
Cancer Alert: Why Are You Still Tanning?
According to a new survey from the American Academy of Dermatology, more than 80% of young, white women use tanning beds or intentionally tan in the sun--despite their full cognizance of the deleterious effects of UV light. 3800 white, non-Hispanic... Continue reading
Posted May 6, 2011 at Pickart Plastic Surgery Blog
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Dear Angie,
These post-operative muscle spasms are normal for 1-4 weeks. Please call your Board Certified Plastic Surgeon. He should be able to allay your anxieties. I frequently prescribe Valium for muscle spasms; ask him whether Valium would be right for you.
Sincerely,
Michael C. Pickart, M.D., F.A.C.S.
Pickart Plastic Surgery, Inc.
1746 S. Victoria Ave., #250, Ventura, CA 93003
(805) 654-8800 | fax (805) 654-8802
To: info@pickartplasticsurgery.com
Commented May 4, 2011 on Abdominal Irregularities after a Tummy Tuck in Oxnard: One Year After Surgery at Pickart Plastic Surgery Blog
Abdominal Irregularities after a Tummy Tuck in Oxnard: One Year After Surgery
A few days after seeing another surgeon's patient, who was unhappy with a painful abdominal bulge one week after a tummy tuck, into my office walks in another dissatisfied 45-year-old tummy tuck patient from Oxnard--but she is one year after her surgery. I had a tummy tuck approximately 12 mont...
Restylane to Be the First FDA-Approved Lip Enhancer
Late last week, an FDA-advisory panel overwhelmingly voted to recommend approval for Restylane's use as a lip enhancer. While the whole FDA still needs to make a final decision, they typically accede to the advisory panel. Of course, using Restylane... Continue reading
Posted May 2, 2011 at Pickart Plastic Surgery Blog
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Dear Rookshire,
Yes, I have had patients like you who have had prolonged swelling. On occasion, the swelling required months of patience. Very frustrating for patient (and surgeon).
My suggestions:
Head elevation: Use an extra pillow at night
Cold compresses
Massage
Lots and lots of patience
Good luck! I bet that all will be well when it ends well.
Sincerely,
Michael C. Pickart, M.D., F.A.C.S.
Pickart Plastic Surgery, Inc.
1746 S. Victoria Ave., #250, Ventura, CA 93003
(805) 654-8800 | fax (805) 654-8802
To: info@pickartplasticsurgery.com
Commented Apr 14, 2011 on Under Eye Bags Caused by Muscle Hypertrophy at Pickart Plastic Surgery Blog
Under Eye Bags Caused by Muscle Hypertrophy
Hi, This has been a problem since I was a little girl. Now I'm 40 and want to improve the appearance of my under-eye bags, whether it is with surgery or fillers. I look tired all the time and my bags just keep getting bigger as I age. I went to another consultation for blepharoplasty (eyelid s...
Tax Deductions for Cosmetic Surgery: Legal?
Maybe. According the IRS, if you itemize your deductions on Form 1040, Schedule A, you may be able to deduct expenses you paid that year for medical care for yourself, your spouse, and your dependents. Specifically, you may deduct the... Continue reading
Posted Apr 13, 2011 at Pickart Plastic Surgery Blog
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