Someone asked me on my BOTOX FaceBook (not a super popular page, I only have 596 likes): “Did you go to grade school or high school here in Modesto?”. I’ve gotten this question a few times already. I wonder if they are wondering if I am another person with the same name.
Here’s my answer on FaceBook: When I came to Modesto, I had no connections. I didn’t grow up here nor did I have relatives that I knew about nearby. Same for my wife Dr. Tammy Wu. I grew up in New York City and I went to school in the suburbs there!! I picked Modesto to settle down for our medical practices because it seemed like a place that needed good doctors. It was somewhat random when I picked this place. But much of the decision making had to do with my Trauma Surgery career. There were plenty of trauma with car accidents and stabbings in this town for some reason. After a few years here, we decided we liked it enough to stay. Thanks for asking!!
I’m very honored to be picked as one of the first physicians in the US to be trained on Kybella (an injection that helps with fullness under the chin). I will be undergoing formal training in July, 2015 and I will be perfecting my technique and will be ready to roll out the product at Surgical Artistry in August. I’m currently spending time now studying up on the product.
Another public forum question I attempted to answer. This question comes from Corona, California. A photo was attached, but it isn’t entirely clear from the non-moving 2D photo – the goals and wishes of the patient. But I did my best to try to answer the question.
Here’s my answer which all the other doctors don’t seem to understand what I’m writing:
Lateral and Medial Pretarsal Obicularis Botox micro injections
What we’re discussing is consider off-label FDA use of Botox. In my experience, I have treated only 3 patients for eye lid raising with Botox. The injections are extremely tricky.
I would inject the lateral and/or medial aspects of the pretarsal obicularis (which is the eyelid muscle) – taking extreme care to avoid the middle part of that muscle which is connected to the levator (which lifts the eyelid). I would inject about 0.5 to 1 unit with each shot. I don’t want to go into too much detail because this is a discussion you need to have with your injector. The basic theory is that if we weaken a depressor (which are the sides of the eyelid), we help the levator become more dominant.
For mild imbalances in appearance, I would leave it alone. It’s possible for us to make things worse with our decisions and injections. With my only 3 patient trial of this method – this doesn’t make me the expert on this topic. It’s a very rare request.
Basically if your question was an academic style question, I would say that it could be done if I understood your question correctly. But in reality – check with your Botox injector!
Thank you for your question. Without having seen you in person, I’m answering the best I can without physical examination info. My comments are meant for a general public discussion to help others who may have similar concerns. I’m also using my answers to build up library of information for my own patients and also to see how my answers compare with other doctors. There is always much for us to learn from each other. My answers are generalized medical information only, not directed medical advice. For medical advice please see your doctor/surgeon in person.
Allergan to take over Kythera who makes Kybella for the neck.
Here’s an open letter I got from Allergan (the makers of Botox):
June 17, 2015
Dear Aesthetic Provider:
I am delighted to share with you that on June 16, 2015 Allergan and Kythera Biopharmaceuticals reached a definitive agreement under which Allergan will acquire Kythera. Kythera, headquartered in Westlake Village, CA, is focused on the discovery, development and commercialization of novel prescription aesthetic products.
The acquisition of Kythera would immediately enhance Allergan’s facial aesthetics portfolio with the addition of KYBELLA™ (deoxycholic acid) injection, the first and only approved non-surgical treatment for contouring moderate to severe submental fullness commonly referred to as a double chin. KYBELLA™ was approved by the U.S. Food and Drug Administration (FDA) on April 29, 2015.
This combination continues Allergan’s rich history of bringing innovation to you and your patients. KYBELLA™ will join a facial aesthetics offering which includes BOTOX®, JUVÉDERM®, VOLUMA, LATISSE® and SKINMEDICA providing you with a more complete offering of products to your patients. In addition, KYBELLA is a pivotal entry point for expanding the use of facial aesthetic products in men.
We are committed to keeping you informed as the combination of Allergan and KYTHERA progresses and are committed to working with you to ensure a smooth transition. We would expect that this acquisition will be completed by the third quarter of 2015. In the meantime, we will continue to operate as two separate companies and so there are no changes in current practices. Any information you require regarding the KYBELLA™ product or training, please visit mykybella.com or contact your local Kythera representative. More information is available on our website, www.Allergan.com.
Allergan Plc, the maker of wrinkle treatment Botox, agreed to buy Kythera Biopharmaceuticals Inc. for about $2.1 billion to add treatments for double chins and male pattern baldness.
At Surgical Artistry, we hope to have Kybella in our office soon.
Another attempt to answer a public forum question.
My answer:
Preconditioning the skin is key
It is convenient to pre-condition the skin with the OBAGI Nu-derm system. But there are other lines that can precondition the skin. I prefer that the patients precondition the skin with tretinoin and/or hydroquinone (preferably both) for at least 2 months before getting a OBAGI Blue Peel. The reason it’s convenient – both the Obagi Nu-derm system and the Obagi Blue Peel are made by Obagi.
I attempt to answer another public forum question. This one comes from San Ramon, California.
Latisse for under $125 for 5 mil bottle?
I am looking for more latisse, however, it seems as if the price has almost doubled over the last 2 years. Does anyone know of any place around the Bay Area that sells the 5 mil bottle for around 125?
My Answer:
Thanks for the info on the price doubling!
I have a practice in Modesto, California. Not too far from your location. If the price of Latisse had doubled, then I really need to catch up to that. I have kept my prices very close to the same for a long time – meaning since Latisse came out in 2009.
The 5 ML Latisse kit launched around August 2012 with a list price of $179 from the very start. And the suggested price was $120 for the 3 mL Latisse kit from 2009. The prices sold at pharmacies is much higher than these prices I’ve quoted for physicians offices. Perhaps you’ve been looking at pharmacy prices? These prices have always been higher than physician prices with my understanding.
I know a little bit about Latisse and have connections with Allergan who makes Latisse because I was one of the original Latisse speakers for the product – rolling it out for other physicians to carry in their offices. I had the honor of giving Latisse talks in Reno, Fresno, Modesto, Santa Rosa, Walnut Creek, Napa, and other places. But it has been several years since I’ve given a Latisse lecture.
3ML vs 5ML Latisse
There is of course the price difference. But with the 5ML, you are getting 67% more drug, and 133% more brushes. And the suggested usage duraing increases by 150%.
What I charge (if this helps):
Our practice doesn’t often have specials. Thus I try to keep the Latisse price consistent; a good value most of the time.
We charge $100 for the 3mL size Latisse which is the original size. And we charge $149 for the 5mL size Latisse which is the new larger size. From what I understand, the bottles are the same size but the 5 mL is filled up to the top. But there may be different batches with different tops on the Latisse bottles.
We also require that I personally make contact with the buyer of Latisse.
Answering your question:
To answer your question, I don’t know of anyone in the area selling Latisse for $125 or less.
I will look into the price doubling issue. Thank you for your comment and question.
Calvin Lee, MD
Giving Latisse Consultations in Modesto, California
Another public forum question that I attempted to answer:
I had Juvederm 2 wks ago and my top lip is protruding like a duck bill. Will it go away or should I have it dissolved?
I had juvederm ultra plus done 2 weeks ago in my lips and the top is still protruding outward like a duck bill. Will this go away or should I get Hyaluronidase to dissolve it and if I do use Hyaluronidase in the lips will it dissolve it completely and evenly?
My Answer:
Perhaps more filler for the bottom lip but first consider waiting 3 weeks?
It is sometimes possible that the upper lip swells more than the lower lip with Juvederm. In my hands – that happens often because there are just so many more components in the upper lip – thus I have to manipulate the needle and filler in that area more.
Sometimes the swelling could be present for a month after injections, but that is somewhat unusual in my humble opinion. But consider waiting till 3 weeks before deciding to do something different. And if that’s the case – you may just need more filler on the bottom and then you could have the results you wanted in the first place.
Lip fillers are a difficult project for me. I do it every day, but I am still humbled by the artistry and difficulty of the procedure. Best of luck to you.
Here’s my disclaimer:
Thank you for your question. Without having seen you in person, I’m answering the best I can without physical examination info and a one-on-one dialogue. My comments are meant for a general public discussion to help others who may have similar concerns. I’m also using my answers to build up library of information for my own patients and also to see how my answers compare with other doctors. There is always much for us to learn from each other. My answers are generalized medical information only, not directed medical advice. For medical advice please see your doctor/surgeon in person.
We had a good time dressing up in scrubs and playing the violin at Doctors Medical Center in Modesto, California 6/6/15.
I had an opportunity on Saturday to spend some time with two amazing brothers who have passion for violin and aspire to become surgeons. I heard about them through social media, and I wanted a chance to meet them. Doctors Medical Center and the Modesto Chamber of Commerce helped to set this up. We were able to give them a brief tour of the operating room areas, and we had a private concert in a large operating room which is used for storage and backup in case of disaster trauma. We played some violin for each other. I was especially intrigued that they wanted to become surgeons. I wanted to give them a friendly taste of surgery life. I especially enjoyed giving them a chance to try out our surgical outfits, and I think they enjoyed spending time in an operating room – in a non-threatening way. And I wanted to impart that performing surgery is much like performing musical instruments. Jorge and Sebastian have a great deal of potential. I am honored to be able to spend a few moments with them.
I also got to meet a very talented Modesto Bee writer. She says she normally writes crime stories, but in this case I think she’s wearing a different hat:
Getting interviewed by Modesto Bee’s Erin Tracy.
Below is the article from the Modesto Bee (text copied and texted), please visit the link below for the actual website which has a video and many other pictures. The pictures and videos in this blog are my own. But the article belongs to Erin Tracy and the Modesto Bee.
First, some of what I played that day on the violin:
Modesto Bee Article by Erin Tracy:
Operating room becomes concert hall for two Modesto boys
The operating table became a music stand, surgery lights transformed into stage lights, and forceps and scalpels were replaced with violins and bows for a special concert at Doctors Medical Center on Saturday.
Two Modesto boys – Jorge Mendoza, 12, and Sebastian Mendoza, 8 – had a booming business at the hospital last month during Lemonade Day, a nationwide program designed to educate children about business.
When violin-playing surgeon Dr. Calvin Lee learned the boys intended to use the lemonade stand’s profits for summer music camp and to save for a violin, he was intrigued.
When he was told Jorge also was interested in becoming a surgeon, he decided he had to meet the boys.
“I think playing the violin helps you become a better surgeon,” Lee said. “Because of the dexterity skills and the ability to break complex tasks down to a simple thing.”
He wasn’t able to make it to Lemonade Day, but with the help of hospital staff the doctor arranged for something even better: a concert in one of the operating rooms.
Jorge was dressed for the occasion in a sharp pinstriped suit, and Sebastian looked handsome in a blue plaid shirt.
Before entering the O.R., though, they covered up with green scrubs to match Dr. Lee. He taught them to tuck in the drawstring on the pants.
“Only the TV doctors let them hang out,” he said.
After a brief tour, the concert began in operating room 12.
Jorge and Sebastian first played a duet by Mozart, followed by a Beethoven solo by Jorge and Sebastian’s rendering of “Dragon Hunter” by Richard Meyer.
Then, Lee wowed the boys with Bach.
“As a trauma/general surgeon, Bach meant a lot to me,” he said. “When I hear the music of Bach, sometimes I feel like there’s somebody looking over me, guiding my hands.”
Lee worked as a surgeon at Doctors Medical Center from 2003 to 2006 but since has opened a plastic surgery practice, Surgical Artistry in Modesto, with his wife, Dr. Tammy Wu.
Wu was in the audience Saturday, along with the boys’ parents, Jorge Mendoza Sr. and Erika Mendoza, Modesto Councilwoman Jenny Kenoyer, Modesto Chamber of Commerce president Cecil Russell and hospital spokeswoman Tiffani Burns.
Jorge said he was initially a bit nervous about playing for Lee, “because I could tell he was going to be better than me and I’m so used to being really good since I only play at school.”
On Lemonade Day, he and Sebastian made a gross profit of $933.
After paying back the loan from their mother for overhead costs, the boys donated $125 to the Make a Wish Foundation. Sebastian bought a remote-controlled car, and Jorge used $190 to pay the balance owed for music camp after receiving a partial scholarship.
The remainder was put into savings accounts; Jorge is saving up to buy a violin, and Sebastian will use his to attend music camp with his brother in a few years when he’s old enough.
Same as what I wrote in my last blog. I believe that my Botox Artistry and Filler Artistry is enhanced by looking at nature. Studying the patterns, the colors, the geometry, and even the natural aging process of young plants to old plants. Here are pictures which I took on the last weekend in May 2015 around my home in Modesto, California.
Sunflowers and Bees
The sun plays a role in how we see our subjects. The shadows create an appearance of deeper depth. In my Modesto Dermal Filler practice, we use fillers to lesson some of the shadows and thus create an appearance of a smoother surface.
In this picture, the lighting comes from the back. The subject looks completely different. This is why I have an operating room light in my procedure room where I do most of my Botox and Filler work. The operating room light can be adjusted to come from above, from below, from behind and from the sides. I also like to be in the same room most of the time when I inject – this way I can get a feel of the fixed lighting and have control over a movable light.
A blurry background helps us take out distractions from our best features. This is what I like to achieve with Botox in my Modesto practice. I like to use Botox to help blur out the wrinkles which detract from beautiful features on or face – especially eyelashes and the eyes themselves. Botox works especially great around the sides of the eyes and between the eyes. So this picture to me is very much like performing a Botox treatment around the eyes. With fewer “distractions” the eyes really shine!
Beauty attracts company. Three bees on this beautiful sunflower.
And this is where I took the above photos. At first glance – it doesn’t seem beautiful. But it’s my job with Botox and Fillers to bring out the beauty that is already there. And that’s what I tried to do with the camera.
The next few pictures depict my study of young leaves of a sago palm
This picture shows the “older” but magnificent leaves of our Sago Palm
Beauty up-close is different from beauty from beyond
I have to look at a patient closely for one form of artistry but I have to keep in mind what a patients face looks like from a distance. This concept that I have to keep in my mind while injecting Botox and Fillers is represented by these two pictures which are near and further away:
The next two pictures show two different colored agapanthus blooms in different stages of bloom
Thank you for taking the time to visit my web page.
Out of a Bottle of Botox, comes a Bloom of Beauty.
I feel that what we see in nature is most beautiful. That’s what I try to achieve with my artistry with Botox and Fillers. It’s a sense of creating a natural look which is pleasing to the eye and exciting to the mind. Nature has a sense of symmetry, pattern and colors which relax and excite us all at the same time.
I spent some time in the last weekend of May, 2015 capturing a few glimpses of nature around my home in Modesto, California
Click above on the picture to enlarge. This is a sunflower growing on an empty lot near my house. The sun shines behind the weed-sunflower. I like how the bee is using the flower as sun-protection!
