Why did I pay double price for OBAGI?

I got this question today:

“I purchased Obagi 7 piece Nuderm kit and 0.05 tretinoin cream from you guys for 600$ and online it is anywhere from 250 to 330 dollars. Unfortunately I did not do any research prior to purchasing but I want to know why I have paid double the price”

This is a good question. Thank you for asking and giving me an opportunity to answer.

First, apologies for any confusion and it is always my goal to provide best value. I try to subscribe to the idea that price is what you pay, but value is what you get.

Second, I don’t personally have any experience ordering Obagi from any websites. Thus I can only comment on our own Obagi products on our physical shelves.

Third, if for some reason the pricing makes no sense from us. Just return it. No problem. Hopefully we’ll all be happy – that’s always my main goal is to have happy patients.

Here’s what I know:

$407.70 is the actual price of the Nu-Derm Obagi kit from our office. This is the original Obagi kit, not the FX kit (which removes the prescription products) The full size Obagi Nuderm set has 7 products and has a list price of $453.00 plus tax. We have it priced at 10% off all the time (as of the writing of this blog). Thus our price is $407.70 plus tax. (as of 8/2/15 – prices subject to change)
10% off from us on Obagi. We offer 10% off all the time and sometimes at special events we offer 20% or 25% off. I can definitely see that the internet might offer 20% off or even 30% off? But for my medical office to carry Obagi, I feel that it isn’t worth my effort to have more than 10% off all the time for Obagi. Otherwise, I would just encourage my patients to buy Obagi elsewhere. But I carry Obagi, so I can be responsible for the outcomes and ensure good results.
Free OBAGI follow ups with your MD or our office staff. I’m hoping what accounts for a better value at our physical location (Surgical Artistry, Modesto, CA) is that we will take the time to explain the products and adjust the usage of the products. Patients follow up with me (Dr. Calvin Lee) or with Dr. Wu. Most of these follow ups have no added charges. I think visits to the doctors office has some value – especially if we can make continued adjustments to the usage.
Easy Returns / exchanges. I also have a hassle free return policy on the patients who purchased Obagi after talking to me about it (Dr. Calvin Lee). I would say that if you feel the internet is a good purchase, then just return the products to us. My goal of having Obagi in the office is to help our patients look their best with Botox and Juvederm. Botox and Juvederm (and now Kybella) are my primary passions in the office. OBAGI is an adjunct.
REAL OBAGI. We know that our Obagi products are genuine.
Doctor’s Presciption for Obagi is included when purchasing from me (Dr. Lee). We also know that we are following the rules regarding prescription products. Clear and Blender which are two of the products in the normal kit and some kits have SunFader. These three products require a prescription from a doctor. I think there are some foreign countries where a prescription isn’t needed for these products – I am not sure.
Travel Size Nuderm Kit? Sometimes people want the Travel sized Nuderm Obagi Kit. But we don’t currently carry that. I don’t have the pricing on that kit, but I believe that it is in the $200’s. Sometimes the internet pricing is confusing and they might be touting the travel size rather than the full size?
Because there are 4 additional key products which we sometimes add to the kit, sometimes people think they paid $800 for the “kit”. But the Nu-Derm full sized kit at our office costs $407.70. Then you have to add these other products – which we also consistently take 10% off. There are four (4) add on products that people like to get. For our office, we take 10% off the list price which we revealed below
1. Elastiderm eye cream ($112. 10% off would be $100.80)
2. Tretinoin 0.05% or 0.10% – ($91-$102 depends on strength)
3. Vitamin C serum 15% or 20% ($93 – $115)
4. Professional C Peptide Complex Serum ($113)

But I do agree that the internet has great prices, and I myself have bought many other products from the internet. But I haven’t purchased Obagi over the internet and I wouldn’t be a good person to ask about how that would go. These would be my own personal concerns if I were to purchase them (and other skin care products) on the internet. The pricing is so good sometimes that the prices are cheaper than if I bought it wholesale directly from Obagi:

First, I am concerned about the prescription legality issues.
Second, I am concerned about the genuine vs. counterfeit versions. Especially if the prices are lower than my own wholesale pricing directly from Obagi. We have had several experiences with patients who have brought in counterfeit Obagi and patients who have suffered damages from counterfeit “Obagi” products.
Third, I am concerned about return policy.
And Fourth, I am concerned about the ability to follow up with a skin care professional and make continued adjustments if needed – especially if the products require prescription.

Those are just my own hurdles if I were thinking about purchasing skin care items (ie. Obagi) over the internet. I have to admit, that I have done for other skin care lines for myself (I have bad skin and am guilty of experimenting) and I will admit that I’ve learned (for myself) to regret it. I also purchased a washer and dryer over the internet – that was a BIG mistake for myself.

I will also agree that sometimes our prices “seem” high – this goes for Plastic Surgery, Botox, Veins, etc. But with a higher price, I hope to offer higher skill (such as better advice), follow up, better safety, less pain (in this case, less pain in the return process), better attitude from us, better communication and in the end, better results. That’s my dream practice is to offer these things at the highest level. I’ve built this practice of ours on highest quality with best value, not on lowest price, and I hope it’s worth it.

Thank you for reading about the Surgical Artistry version of the Obagi Nu-derm Kit.

Please feel free to visit my other web pages:

Components of my Botox Consultation

Consultation components for me Botox (and this can be used for Latisse, Obagi, Veins etc) include:

1. Expectations (how long to kick in, how long it lasts, and what results to expect?)

2. Risks (droopy lid/brow, etc)

3. Alternatives (patients need to be informed and make choices)

4. Contraindications (ie. pregancy/ Breastfeeding/ neurological diseases)

5. Identification of the problems in the patient (static lines vs. dynamic lines for wrinkles)

6. Discussion of possibilities with cosmetic injections (what can I do for them well – if not this time, perhaps next time).

7. Physical examination of existing scars, hemangiomas, pimples, infections, veins. Pictures document many of these things and palpation finds many issues as well. Visual inspection of the veins is important in an attempt to avoid intravascular injection and potential bad bruising.

What helps surgical dexterity? Piano practice!

I’m always thinking about Surgery, Botox, Kybella, and Acupuncture. I think that piano practice is a small subset of my surgical world which helps me with everything.

I just heard about a Concerto piano competition in Los Angeles which requires a video submission as part of the first round. If I make it past the judging of the video and make it to the next round, I have to play a movement from a piano concerto. I’ve never played a piano concerto before, but I might be able to figure it out.

But first, I’m not sure which video to send. Any suggestions on which video is best?

Version #1: Chopin Harp Etude

Version #2: Chopin Harp Etude

Mr. Bearthoven Version #3:

Mr. Bear and I wrote this piece together along with a strong influence from Chopin. I played the track first, then added Mr. Bear to the picture. I kinda made this by accident, but I’m glad it worked out. On another note, I am pretty sure that Chopin wouldn’t approve.

Does Acupuncture Help with Acne?

Acupuncture for Acne?

I got this question today and here’s my attempted answer:

Hi! I have tried acupuncture many times for Acne and still get requests for it – many times it’s in combination with other treatments for the patients – such as for stress or weight loss. My patients report that it helps with acne. But I’m not sure how well it really works. But I’m happy for the positive feedback from my patients. In my opinion, acupuncture is somewhat mediocre of a treatment for acne (in my hands). But because the side effects are low, I sometimes think that it’s worth a try. And by a “try” I usually tell the patients that we can try 4 sessions of acupuncture (spaced about 1 week apart) and if we see an improvement, then it’s worth continuing the acupuncture, if we don’t see an improvement, then it’s time to quit acupuncture. I currently charge $125 for the first visit then $75 for subsequent visits (prices subject to change – please call us). There is acupuncture for skin health and there is acupuncture for hormonal stabilization which are both modalities I use with acupuncture to try to help with acne. Feel free to call us if you want to schedule an appointment 209-551-1888. I also have other ways to treat acne along with acupuncture. It may involve prescribing antibiotics – topically for the skin. Or the Obagi Clenziderm system – all available with us. Or the Blue Peel Radiance which I would perform on the face for acne reduction – or perhaps a combination of all these things. Best of health!

Botox for Acne?

oh and on a side note – I can’t help but mention that Botox has been known to somewhat help with inflammatory processes of the skin – which includes Acne. Thus if there’s acne on the forehead and there are wrinkles in that same place – what a wonderful opportunity to try Botox! Same too for pebbly chin – we can inject Botox in the chin area! There is a new growing world of mesoBotox where Botox is injected in diluted amounts superficially into the cheek skin. This is supposed to create some tightness and I think it would reduce acne in that area – but I haven’t tried it enough to recommend it fully.

Calvin Lee, MD
Modesto Botox and Acupuncture

Summary:

For Active Acne we can try:

Acupuncture for skin health
Acupuncture for hormonal stabilization
Blue Peel Radiance
Obagi Clenziderm system
Topical Antibiotics – we also carry these in our office
Botox if on the forehead or chin.
MesoBotox for the cheeks perhaps something to try in the future.

Will Botox Help lift my inner eyelid? (public forum question)

Will Botox help lift my inner eyelid?

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.

Best wishes.

Calvin Lee, MD
Modesto Botox Injector, California

Kybella news: Allergan to aquire Kythera

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.

If you have any questions or concerns, please contact me at IR-AllerganCommunications@Allergan.com.

Sincerely,

Philippe Schaison
President Allergan Medical Aesthetics

Allergan to Buy Kythera Biopharmaceuticals for $2.1 Billion

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.

Actavis name change to Allergan!

Actavis purchased Allergan but is changing their name to Allergan.

Please visit our Modesto Botox page for more information.

Operating room becomes concert hall for two Modesto boys

IMG_6016 - cropped — 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. — 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.

Erin Tracy: (209) 578-2366, @ModestoBeeCrime

Read the actual Modesto Bee article here: http://www.modbee.com/news/article23302287.html#storylink=cpy
Then pictures in this blog are taken by Dr. Tammy Wu, Modesto Plastic Surgeon.

Screenshot from the Modesto Bee Newspaper 6/7/15

We can behave and pose for the camera. Yes we can!

Walking into the operating room areas at Doctors Medical Center in Modesto, California

Doctors Medical Center Modesto

There we go, I need some Botox for sure.

Thank you for visiting this page. Consider visiting my Modesto Botox home page.

Modesto Nature Photography last weekend in May

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

a sunflower facking the sun clearer center IMG_5763 - Copy - Copy — 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.

a sunflower sky — 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 single bee IMG_5542 - Copy - Copy - Copy — 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!

a bee colony IMG_5526 - Copy - Copy — 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

a sago twin — 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.

Botox Blooms 2 - Calvin Lee — Out of a Bottle of Botox, comes a Bloom of Beauty.

Visit my other webpages

January 2015 Modesto Nature Pictures – owls, goats, lady bug

New Zealand January 2015 Pictures – a chance to get away from Modesto for a Modesto Botox injector.

Calvin Lee, MD

Modesto Botox Artistry

Modesto Flower Photography – Botox/Filler concepts

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!

Click here to see the rest of my Modesto nature photos around our home.

Pimples after Botox

I attempt to answer another public forum question about Botox. This question comes closer to my office in Modesto, California – it is from San Jose, California!

Why do I break out since having Botox?

In the exact same area where the injection was; is where i break out. As if causing a “man made pore” from the needle which then does not close up and gets filled causing an ongoing blemish effect. I ONLY break out now where I’ve had the injections. But why??

My Pimples and Botox Answer:

Wonderful question. I’ve encountered this question about having breakouts in the area of Botox injections in my own practice in Modesto, California about 3 times. So this is rare. The world of medicine is complex, and sometimes it seems strange. I have not had a case of the “man made pore” – so I can’t address that question except to speculate that it may be a scar of sorts or somehow related to a cyst? I’ve had an experience where there was a reddish – pimple like reaction to only one of my needle pokes. I suspect in that patient that there was an underlying infection in that area – such a pimple – which then got exacerbated when I decided to inject Botox too close to that area. Botox injections are tricky, we want our injections to be in strategic places, but sometimes in our patients, blemishes and veins get in the way of an ideal placement – and thus I have to compromise in my decision and Botox strategy.

Regarding the break-outs in the Botox areas. For some of my patients, I’ve come to realize that they are sensitive to some of the antiseptic methods I use to help prevent infections from the Botox procedure. Sometimes they are allergic to the antiseptic. There are various ones available out there and perhaps switching to a different antiseptic could help. Meaning, having your injector/surgeon/doctor/nurse switch to a different agent. And there’s the possibility that the actual needle poke – which is a very mild form of skin trauma – could incite a inflammatory process.

Ironically (to your question of why does Botox cause more blemishes), I’ve found most of the time that Botox helps calm down inflammation in an area of skin. This may be due to reduced sweating or a direct effect on rashes and pimples by Botox. Also, Botox sometimes shrinks pores as with what we’ve seen with meso-Botox.

Thank you for your question, I’m just answer from my own personal experience as a Botox injector. 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.

I hope this discussion is somewhat helpful.

Calvin Lee, MD – Botox Surgeon
Botox injections Modesto, California