Whatever you call these criminals, they are changing the face of cosmetic medicine and forcing more and more doctors to require prepayment for facial rejuvenation, skin care treatments like microdermabrasion and other services.  Many are also no longer accept checks for services rendered and instead require cash or card payment for elective procedures that are not billed through insurance.

“From talking to our doctors, this is a problem that’s occurring from coast to coast,” said Jeff Karzen, spokesman for the American Academy of Cosmetic Surgery.

Physicians in a number of U.S. cities, including Arizona, Texas, California, Nevada and Florida, as well as internationally in the UK and Australia, have reported patients who received thousands in injectable filler and wrinkle relaxing treatments, such as Restylane and Botox, only to flee the doctor’s office without paying the bill.

After their cosmetic treatments are complete, those intending to pull the old dine-and-dash, or in this case, the prick-and-run routine typically give the doctor’s office staff some sort of excuse to leave, such as needing to withdraw cash from an ATM or go out to their car to get their purse or check on a waiting child.

Check fraud is another common practice for “Beauty Bandits,” as the doctor’s office won’t find out until the crook is long gone that they’ve knowingly written a bad check for cosmetic services they don’t have the means to pay for.

Highly publicized cases like those of Jaime Merk and Maria Chrysson, two “Beatuy Bandits” who got busted by Florida law enforcement after stiffing area doctors for thousands in beauty treatments, have forced physicians to become more aware of this increasingly common criminal practice.

So, when seeking cosmetic treatment, especially for the first time with a new clinic, don’t be alarmed if you are asked to pay with cash or credit upfront.  This is simply a precautionary measure that has become necessary for doctors to prevent fraud and revenue loss.

In this youtube video of an ABC News segment, Dr. Bruce Genter, a surgeon well known in Philadelphia is critical of acupuncture as a wrinkle treatment, citing the lack of scientific evidence for that purpose.

But when people claim that it works, are they seeing real results?  If so, is it a cost effective treatment method?

Julia Engstrom, who is featured in the video, says she has undergone Botox treatment and laser treatment in the past. She believes facial acupuncture has improved her skin texture and reduced her wrinkles. Nearing the end of 10 treatments, she says her improvements are a result of improved sleep and relaxation after acupuncture. “I’ve noticed that my skin is a lot smoother, [there’s] a lot less red pigment in there and the wrinkling seems to be a lot less,” Engstrom said.

Acupuncture, a process of strategic needle placement on the body, is said to bring improved health and well-being. In an article for Prevention magazine, licensed acupuncturist and Traditional Chinese Medicine practitioner Phyllis Olson asserts that acupuncture can indeed lessen the appearance of wrinkles. She attributes this to a core premise of acupuncture – that health is reliant upon the healthy flow of chi (energy) in the body, which can be disrupted for a myriad of reasons. Acupuncture treatments are believed to break up energy blockages that prevent optimal blood flow to certain places in the body, improving circulation.

Acupuncturist Beata Maslanka acknowledges that acupuncture doesn’t yield visible results that compare to Botox or other facial fillers, but claims that beauty actually comes from within; when internal imbalances are resolved, people look better overall. Olson agrees, noting that the treatments foster relaxation of facial muscles, thereby reducing wrinkles. “Aside from the light, momentary stings, acupuncture is really quite relaxing,” she adds.

The results Engstrom points to are hard to discern from the video, but one can wonder about the salutary effects of relaxation and optimism. Of course, people also have a tendency to see (and believe) what they want to see.

If acupuncture does produce any wrinkle-relaxing effects, how long can one expect them to last? NYC dermatologic surgeon Barney Kenet, MD tells Prevention: “If acupuncture relaxes the muscles, it might reduce wrinkling temporarily. As for the increased blood flow, at most it will probably give you a temporary rosy complexion–something you don’t want if you have an inflammatory condition such as acne or rosacea,” he warns. “Otherwise, cosmetic acupuncture is relatively harmless.”

Maybe it is harmless if you ignore the cost of acupuncture. The average price is about $60 to $100 per session, with 10 sessions recommended by Olson, followed by monthly maintenance procedures.

In contrast, the average Botox treatment in the US costs $472 and a single treatment will last 3-6 months. By comparison, this makes acupuncture wrinkle treatments appear costly as well as unproven. Dr. Genter, whose Philadelphia Botox patients offer proof of visible wrinkle reduction, says: ”If it increases your well-being that’s great, I just don’t know that it can make your face look younger.”

Have you considered BOTOX?

By now, you probably know that BOTOX is a highly diluted form of the botulinum toxin used to correct certain facial lines and wrinkles. FDA-approved in 2002, BOTOX injections may be the single most popular non-surgical procedure to reduce or eliminate facial lines, wrinkles and grooves.

Have wrinkles appeared out of nowhere?

Crow’s feet, lines and even deep grooves appear on our faces over the years, the result of our natural expressiveness, lifestyle habits, and the tendency to move our facial muscles in habitual ways. For instance, you may squint a lot (when you’re concentrating, when you’re worried, when the sun is bright, or when you are trying to focus your vision.) As the years go by, this repetitive motion begins to carve lines in your face and can eventually result in a permanent expression of worry or intense concentration.

On others, you might notice facial lines and wrinkles and wonder, “Why is she so angry?” or “Why is he so uptight and stressed?” You’re probably noticing that vertical line that runs down the center of the forehead: one of the most obvious facial flaws, in otherwise attractive men and women.

Why BOTOX?

BOTOX injections are a quick and cost-effective way to improve your looks. Performed by a highly experienced hand, the results are truly gratifying, softening the appearance of common lines and wrinkles:

• Around the eyes (crow’s feet)
• On the forehead (both vertical and horizontal lines and creases)
• Around the mouth (smile lines)

For days after BOTOX is administered, you will look in the mirror and continue to see increased improvement in your face as the treatment reaches its full effect. BOTOX requires only local anesthesia, if any at all. The procedure effectively blocks signals relayed between certain nerves and muscles, causing a temporary paralysis in specific facial muscles.

After Botox treatment, you’ll still be able to smile, frown, and make normal facial expressions. BOTOX generally lasts 4-6 months before it needs to be replenished. Over time, many of our patients notice that their facial wrinkles continue to diminish even when they have BOTOX treatments less often. It almost seems to “train” the muscles to be more relaxed, resulting in a more serene, pleasing image as time goes by.

You only have one face

A word of caution: You may have heard about “BOTOX parties,” where the treatment is administered to a group of women in someone’s home. We strongly recommend that you avoid this route. You only have one face. Don’t place it in the hands of someone whose knowledge of facial anatomy may be insufficient. Just because someone can inject BOTOX doesn’t mean he or she can do it properly or with an eye trained to give the best aesthetic result. A trained cosmetic surgeon will administer the treatment with your very own unique face taken into consideration. The only BOTOX party worth attending is the one done safely in our Owensboro, Kentucky office.

If you are between age 18 and 65, are not pregnant, nursing or living with a muscular disorder, you’re probably a good candidate. Talk to us about BOTOX and start the New Year on a brighter, more attractive note.

The following statistics illustrate the opinions of the ‘typical’ patient. Who is the ‘typical’ patient?  “A married, working mother between 41-55 years of age with a household income of under $100,000.”

Roughly 70 percent of the respondents claimed that Botox and dermal fillers play an important role in their cosmetic routine.

When asked what their motivation was for pursuing Botox treatment, 34 percent said their appearance looked “stressed” or “angry”. Others said that a friend, family member, or their physician had recommended it, or they were preparing for a social event. 66 percent said they received Botox treatment 2-3 times per year. 72 percent of the respondents chose Botox to treat glabellar lines – the vertical lines that appear between your eyebrows.

When asked about their motivation to use hyaluronic acid fillers, the majority (63 percent) of patients reported a desire to remove facial wrinkles and folds – mostly the nasolabial folds that travel from the nose to each side of the mouth.

Nearly 70 percent of the respondents who had been treated with Botox also opted for dermal filler treatment.

A full summary of the results is available (in MS Word) here.

Years ago, the Journal of the American Academy of Dermatology published the results of a survey (conducted by researchers from Allergan Inc) about sweating. It revealed that approximately 3 percent of the U.S. population (7.8 million people) experiences excessive sweating, and less than half of the respondents had sought medical help for the problem. Botox blocks the localized release of a specific chemical that stimulates sweating, so the FDA has approved it for this use.

Many doctors have used Botox to treat headaches, and their basic procedures are not much different than those of wrinkle treatment. Although it’s not entirely clear how the Botulinum toxin provides relief (it may work to inhibit pain-transmitting nerves), but many patients suffer through fewer headaches after getting Botox treatment.

Last March, the NY Times published a story on off-label Botox use to treat people who have suffered a stroke and experience difficulty relaxing certain muscles. According to the experts, “only about 5 percent of the stroke patients who could benefit from its use ever get it.”

Aside from these therapies, surgeons and dermatologists are finding even more cosmetic uses for Botox. Dr. Lawrence Reed recently told an ABC news affiliate that “we’re at the tip of the iceberg where Botox is going to be used.” Reed has apparently been pioneering some interesting new cosmetic applications.

For acne, Dr. Reed injects Botox just below the skin: “It decreases the muscle pump and blocks the production of oils, so we use it for acne,” he claims. They also found success using Botox to supplement laser skin resurfacing and other procedures.

If you’re considering Botox for any off-label use, make sure you choose a qualified physician. Despite the optimism surrounding Botox as a ‘wonder drug’, there have been complications and side effects associated with off-label use and inexperienced providers.

Although Medicis had planned to rebrand the product as ‘Reloxin’, they ultimately decided to retain its original European name, Dysport. (pronounced Diss-port).

Botox and Dysport both perform the same basic function – neuromuscular blocking to relax and prevent wrinkles. Dysport is said to be more diluted than Botox and perhaps, more cost effective for providers.

The April 30th announcement coincided with a 3 percent drop in Allergan’s (maker of Botox) shares, as Medicis shares jumped 14 percent. Analysts and industry professionals expect Dysport to carry a slightly lower price tag than Botox, and speculate that it may capture 30 percent of the market.