Innovations MedSpa News

Innovations MedSpa has been featured repeatedly on WFAA's Good Morning Texas. Select from the links below to view video recordings of these television broadcasts.

WFAA is the ABC television affiliate serving the Dallas / Fort Worth, Texas DMA (5th largest nationwide).

Note: If you have a specific question that you would like Dr. Johnson to answer during Good Morning Texas, please submit it via email at questions@innovationsmedspa.com.

FoxNews feature

Zapping Fat
November 7, 2007

Fox 4/KDFW is the FOX television station serving the Dallas / Fort Worth area.

CNN feature

December 13th, 2007, CNN filmed a news story about Innovations MedSpa by Bill Johnson, MD, to be aired in February, 2008.  The segment will show what can be done for the aging “Baby Boomer” population.

Innovations MedSpa is the first in the Metroplex with SmartLipo.

What is SmartLipo?
SmartLipo is a revolutionary new procedure that uses a laser to melt away localized fat. The laser is introduced through a tiny incision into the treatment area. As a result, there is minimal scarring. The laser vaporizers the fat, so no suction is required.  In the end, less fat is present. The laser also allows careful shaping of the treatment area. The result, a better contour and appearance to the body area treated.

How do we avoid loose skin?
SmartLipo uses a 1032 nm laser introduced into the subcutaneous fat. The 1032 laser is one of the best tools for skin tightening when used on the surface of the skin. When the laser is introduced into the subcutaneous fat the results are even more impressive. The laser heats the supporting connective tissue producing tightening of the collagen supporting the skin and fat.

Eventually new collagen is laid down and healthier, thicker skin results. The skin and connective is also tightened as the new collagen is laid down. The tissue tightening results in less loose skin after the procedure than with previous liposuction techniques.

What areas can be treated with SmartLipo?
SmartLipo can be used on almost any area of the body, including the chin, neck and face. SmartLipo’s ability to perform detailed contouring in small areas make it ideal for treating areas that previously have been difficult or impossible to treat with liposuction. Additionally, the skin tightening that occurs enhances the results in any area treated. SmartLipo makes an excellent combination with Acoustic Wave Therapy (AWT) and Thermage® for treating skin dimpling and looseness. Some common treatments areas are:

SmartLipo is ideal for small fatty deposits in any area. It also adds an important tool to treat slender persons who previously were difficult to treat with standard liposuction techniques. SmartLipo is greatly superior to mesotherapy and other techniques used to address small fatty areas. The Vaser technique is more appropriate for larger fatty areas that require the removal of greater amounts of fat. SmartLipo can then be added afterwards to tighten the skin after the removal of large fat deposits.

Does SmartLipo require anesthesia?
SmartLipo is performed using a type of local anesthesia known as Tissue Infusion Anesthesia (TIA). When using TIA a special fluid is injected into the treatment area. The fluid contains a local anesthetic along with other medicines to decrease bleeding.  Medicine is also added to decrease swelling and pain after the procedure. Some minor pain does occur during the infusion process. The SmartLipo procedure itself has little or no pain.

After the procedure you will probably be given a mild prescription pain medication. However, many patients require only ibuprofen or Tylenol for pain control. Post procedure pain tends to be the worst on the second day after surgery. Most persons experience some soreness but little or no post procedure pain.

What are the side effects of SmartLipo? In addition to the soreness mentioned above, there are a few side effects with the procedure. It is quite common for the treatment areas to drain after the procedure. The fluid that drains contains small amounts of fat that did not vaporize during the procedure. In order to allow the drainage and prevent infection (a rare side effect), the tiny incisions used for the procedure are allowed to close on their own. Bruising is another potential side effect.

Swelling is common after the procedure and can last for up to 2-3 weeks. Usually the swelling is gone after a few days. When performed on the face or neck, it is not uncommon to have some mild slurred speech from the anesthetic. This can also last 2-3 weeks, but usually is less. Other side effects are listed on your consent form and are rare.

What are the pre procedure instructions?
It is recommended that you eat only a light meal before your procedure. If the procedure is in the afternoon, a normal breakfast and a light lunch is best. Patients are given an antibiotic to take before the procedure and the day afterwards.  Sometimes, you may be given a mild sedative or pain medication to take before you arrive at the office. When pre-medication is given, it is important to have someone else to drive you. It is better if you do not loose a lot of weight before the procedure. This can lead to loose skin and make tightening the skin more difficult. In order to avoid excess bruising, it is best to avoid aspirin and other anti-inflammatory drugs for one week prior to the procedure.

What are the post procedure instructions?
After the procedure you will be given compression garments to wear in the treatment area for 3 weeks post procedure. This includes a chin and neck support (worn for one week) when that area is treated. You will be asked to return to the office the day after the procedure to change your dressings and check the drainage.

You will be asked to return again in 3-4 weeks to recheck the treatment areas and repeat pictures. It is also possible that “touch-up” treatments will be recommended at that time. Instructions will be given for managing and changing your dressings at home. Finally, it is important that you eat a healthy diet to maintain the improved body shape. We recommend anti-oxidants be added as vegetables or a supplement.

Who can have SmartLipo?
Although almost anyone can have SmartLipo, there are a few persons who cannot. Persons on anti-coagulants (blood thinners) such as coumadin should not have the procedure. The procedure should not be done on someone who has an infection in the treatment area. Patients with heart failure or severe kidney or liver disease should not have the procedure.

The best patients are those with small to medium sized localized fatty areas. Larger fatty areas can be treated, but it is usually best to use other technologies such as Vaser for larger fatty areas. Thin patients are ideal for the procedure. SmartLipo is excellent at eliminating those areas like “love handles” or lower tummy that just don’t seem to go away, no matter how hard you work at it. Heavier persons also benefit in selected areas or after Vaser or standard liposuction to help tighten the skin. SmartLipo is an excellent combination with AWT and Thermage®. Combined with AWT it can help the legs, arms, buttocks or abdomen to achieve a smooth, well contoured appearance. Combined with Thermage®, it can improve the contour of the face, arms, abdomen or buttocks to achieve a fresh, young appearance.

Use of Acoustic Wave Therapy (AWT) in the Treatment of Cellulite

Background:
Cellulite is defined as skin relief alterations that give the skin an "orange peel" or "mattress appearance".  Historically, few treatments have been truly effective. Several studies have shown extracorporeal pressure waves, similar to Acoustic Wave Therapy (AWT) to be effective in the treatment of cellulite.

Objectives:
To determine the effectiveness of Acoustic Wave Therapy (AWT) delivered using a ballistic pressure head (D-Actor) in improving the appearance of cellulite.

Methods:
Patients were recruited from phone calls and inquires made at a one location medical practice office. Patients were treated for cellulite based on their regions of complaint. An area was defined as a 20x30 cm area (typically the front or back of one thigh). Each area received 6 treatments consisting of 1,000 vertical pulses and 1,000 horizontal pulses. Patients had photographs and circumference measurements taken before and after treatment. Weight and electrical impedance measurements were taken before and after each treatment.

Results:
Adequate weight and body fat data was collected on 102 patients. Thigh circumference data was collected on 72 patients.  Patient satisfaction surveys have been completed by 19 patients to date. All patients contributing data had before and after pictures taken. Average weight loss was small, 0.19 lbs (0.08 kg), and fell short of statistical significance, p=0.21.  Similarly percentage body fat using lower body electrical impedance was small at 0.02% a non-significant change with  p=0.45. Thigh circumference decrease was significant at 0.45 cm, p=0.025.  Patients rated their posterior thigh treatment at 84% of perfect and anterior thigh treatment at 52% of perfect.  Only 11% of responders (2 patients) disagreed that they were more confident in revealing clothing.  Sixty eight percent of responders were more comfortable in revealing clothing and 74% were more comfortable with their body.  Only 11% (2 patients) disagreed that they were more confident in their body.  Seventy three percent of responders stated the treated area was closer to the appearance they desired.  Only 11% of responders (2 patients) responded that the area was not closer to the appearance they desired.  Before and after pictures reveal moderate to substantial improvement in the appearance of cellulite.  Continued improvement in cellulite appearance was seen for up to 4 weeks past the end of treatment (maximum duration of follow-up).

Conclusions: 
AWT delivered by a ballistic impulse method is effective for improving the appearance of cellulite in the majority of patients.  A small decrease in thigh diameter is also seen.  No significant changes in weight or body fat composition were seen,  The optimum number and timing of treatments and the use of complimentary techniques requires further study.

Cellulite is defined as changes in the surface contour of the skin that result in an "orange peel" or "mattress" appearance of the skin.1 In is present in post-pubertal females of all race and ethnic types, effecting 85-98% of this population. Cellulite is not defined as a pathologic condition, but it is a substantial cosmetic concern for many adult females. It can cause significant psychological and self-worth issues, and commonly affects clothing and activity choices. Several contributory factors have been proposed for the formation of cellulite: altered connective tissue septae, vascular changes, inflammatory changes,2 and protrusion of subcutaneous adipose tissue into the reticular dermis. Body mass index, thigh circumference, and the percent of fat in the thigh correlate with the severity of cellulite. Skin compliance (elasticity) has a negative correlation.3 Biopsy studies have pointed to sclerotic fibrous tissue strands to playing the predominant role in the “mattress” appearance.  Biopsy studies also confirm the role of fat protrusion into the reticular dermis in the severity of cellulite.4  Research has suggested pressure or acoustic waves are effective in disrupting the sclerotic fibrous septae responsible for much of the uneven appearance of cellulite.5 Acoustic wave therapy has also been demonstrated to increase the thickness of the reticular dermis and decrease the protrusion of fat into the area.6  It appears that acoustic wave therapy (AWT) is a promising new treatment for improving the appearance of cellulite. The purpose of this study was to demonstrate the effectiveness of AWT using a 20 mm ballistic head (D-Actor) in improving the appearance of cellulite.

Bibliography:

1: Dermatol Surg. 2005 Jul;31(7 Pt 2):866-72; discussion 872.
Botanical extracts used in the treatment of cellulite.
Hexsel D, Orlandi C, Zechmeister do Prado D.
Doris Hexsel Dermatologic Clinic, Brazil. dohexsel@terra.com.br

2: J Cosmet Laser Ther. 2004 Dec;6(4):181-5.
Cellulite: a review of its physiology and treatment.
Avram MM.
Division of Dermatology, David Geffen School of Medicine, UCLA Medical Center,
Los Angeles, CA, USA. mavram@mednet.ucla.edu

3: J Cosmet Sci. 2005 Mar-Apr;56(2):105-20.
Quantitative model of cellulite: three-dimensional skin surface topography,
biophysical characterization, and relationship to human perception.
Smalls LK, Lee CY, Whitestone J, Kitzmiller WJ, Wickett RR, Visscher MO.
The Skin Sciences Institute, Cincinnati Children's Hospital Research Foundation,
Cincinnati, OH 54267, USA.

4: Plast Reconstr Surg. 1998 Jun;101(7):1934-9.
 An exploratory investigation of the morphology and biochemistry of cellulite.
 Rosenbaum M, Prieto V, Hellmer J, Boschmann M, Krueger J, Leibel RL, Ship AG.
 Laboratory of Human Behavior and Metabolism, Rockefeller University, New York, NY, USA.

5: Biofactors. 2005;24(1-4):275-82.
Anti-fibrosclerotic effects of shock wave therapy in lipedema and cellulite.
Siems W, Grune T, Voss P, Brenke R.
Loges-School of Physiotherapy, Research Institute of Physiotherapy & Gerontology, D-38667 Bad Harzburg, Germany. werner.siems@loges-schule.de

6: STORZ MEDICAL AG
Dermatoligic pulse activation therapy – new ways to healthy skin.
Schulz, M ·
Unterseestrasse 47 · 8280 Kreuzlingen · Switzerland

Tel. +41 - 71 677 45 23 Fax +41- 71 677 45 04 E-mail
schulz.manfred@storzmedical.com

FOR IMMEDIATE RELEASE
August 3, 2005

CONTACT: Bill Johnson, M.D.
(817) 410-2990
1601 Lancaster #20
Grapevine, TX 76051

Latest acne laser treatments now available through local physician—without the side effects of drugs

GRAPEVINE — (August 3, 2005) — Until now, acne sufferers have had few choices when it comes to treatment, most of which have long been associated with a set of harmful side effects. However, alternatives are now available in the form of light-based therapy systems. With about 80% of people between the ages of 12 and 24 suffering from acne, this development represents a significant advance within the field of skin care. Laser acne treatments are slowly beginning to replace medications as the treatment of choice by concerned parents of teens as well as adults who suffer from acne.

Just last month, the FDA issued an alert that patients taking Accutane should be watched closely for symptoms that may indicate depression or suicidal thoughts. These indicators include sad mood, irritability, anger, loss of pleasure or interest in social or sports activities, sleeping too much or too little, weight/appetite changes and trouble concentrating. Other side effects posed by acne medications include vision and hearing loss, organ damage, high cholesterol, birth defects, seizures and stroke. The list is overwhelming enough to keep plenty of patients away.

On the other hand, many patients have responded positively to acne laser treatments even after other treatments have failed or produced unwanted side effects. “About 20 million Americans have acne bad enough to produce scars, but most people don’t realize that there is a proven, successful way to treat the acne and minimize this scarring,” reports Bill Johnson, M.D., of Grapevine-based Innovations MedSpa, one of the first physician groups in the metroplex to offer this technology. “Teens, young adults and older adults are all excellent candidates for these new treatment systems. Anyone with more than two pimples most of the time is also a good candidate.”

The skin care professionals at Innovations MedSpa utilize a combination of FDA-cleared light therapy acne treatments that are not only effective at removing acne-induced scars but also at reducing the acne itself. Aramis laser acne treatment works to shrink sebaceous glands, reduce skin oiliness and minimize the appearance of acne scarring. Unlike traditional acne treatments, there are no risks and no side effects associated with the Aramis laser. Omnilux light therapy is another essential part of an acne management program. This combination system delivers wavelengths that destroy bacteria that cause skin redness in acne, stimulate cells to help with the healing process and reduce the inflammation surrounding the acne lesions. WaterBeam is a special microdermabrasion process that uses pressurized water to apply topical therapies that penetrate deep into the skin. WaterBeam treatments can significantly enhance the clearing of active pimples.

Each of these acne treatment systems is proven to be successful at treating a great majority of acne cases without having to resort to drugs. “The combination of these treatments opens up the door to an entirely new generation of acne management in which dangerous side effects are no longer an issue,” says Dr. Johnson. “Medical skin care and light therapy systems are being pushed to the forefront while harmful drugs are now viewed as a last resort.”

Innovations MedSpa is a Grapevine-based physician practice that provides the latest trends in medical skin care. It also offers internal medicine expertise and emphasizes a proactive approach to health care by helping patients create healthy lifestyles and prevent illness. These preventive tools include general physicals, weight management consulting and health risk assessments and diagnostics. For more information call (817) 410-2990.

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