……on writing my textbook

In an earlier post, I described the work involved with writing a major cosmetic facial surgery text.  I literally spent 3-4 hours a day (and sometimes up to 11 hours) writing chapters on common topics of cosmetic facial surgery.  Being a major text from one of the best known medical publishers (Elsevier Saunders) there is no room for short cuts or nonfactual information.  Undoubtedly, young surgeons will use this text (and others) to learn how to do cosmetic facial surgery.  This means that everything has to be correct and referenced.  For the past quarter of a century, I have been a photography addict and it has paid off.  My text will contain several thousand images in a “step by step, how to do it” format.  Currently I am reviewing proofs (see picture) of all the pictures in each chapter.  Each image has to be rechecked for accuracy, clarity and to check that the captions are correct.

I am also knee deep in videos.  Contemporary textbooks contain DVD’s in the back cover that provide multimedia instruction on the various procedures.  Again, no room for amateurish movies.  I purchased a high end, high definition digital camcorder and although I already have movies of all my surgical procedures, I am remaking them in high definition to compliment this detailed book.  This is a task of awesome proportions.  Doing surgery and doing surgery for a movie is very different.  I have to narrate each step during the procedure and make sure that bloody gauze, drapes and instruments remain clean.  The videographer must focus on the key aspects of the procedure.  It is a lot of work but just the beginning.  The next step falls on my shoulders.  I must take all the raw video clips and assembly them into a movie.  This takes significant editing to makes sure that the movie flows properly, has transitions between scenes and the audio is acceptable.  Once this is put together, the movie must be rendered, or formatted to work on the average DVD player.  This editing process takes many hours but when I view the final product it is a warm and fuzzy feeling.

Having done most of the heavy lifting for this book, the next task will be to review all the text that I wrote and I hate that part.  It is hard for an author to go back and reread hundreds of pages (probably over a thousand) that he or she already wrote.  I am told by the publisher that the book should be available by July 2010.  Too long for me, but because the unusually large amount of color pictures, the book must be prepared overseas and shipped back and forth during production.  I am really excited to get that first copy as this project reperesents the most comprehensive and intense project that I will ever embark upon.

To find out more about cosmetic facial surgery and facial plastic surgery in Richmond, Virginia visit www.lovethatface.com

Joe Niamtu, III DMD

Cosmetic Facial Surgery

www.lovethatface.com

Botox without Needles?

For over 100 years, doctors have been administering medications with needles.  I can’t think of any single factor that patients of all ages hate about seeing the doctor that is worse than the fear of needles.  Besides scaring patients, many health care workers are injured or infected from accidental needle sticks.  There is nothing fun about needles!

There are hundreds of scientists and researchers constantly working on alternate medication delivery systems to get medications in the body without using needles.  We have made good progress with numerous medications.  Patients with chronic pain are able to get pain medication from patches applied to the skin and numerous other medications can be administered in this manner.  I predict that in the future, we will even be able to provide general anesthesia without needles or tubes in ones throat.

A topical, non injectable form of Botox (botulinum toxin A) is impressing researchers and is in phase II clinical trials. Revance Therapeutics is a private company in Mountain View, California that has developed a gel that is mixed with the Botox or Dysport that allows large macromolecules to cross the skin and provide local and targeted treatment of the muscle that causes “crow’s feet” wrinkles.  The company calls this technology TransMTS (macromolecule transport technology) and this technology is based on a single, straight-chain peptide that allows the skin to accept the medication instead of preventing absorption.  To get a bit more technical, adding a peptide as a separate component to the neurotoxin allows the medication to cross the skin. The peptide is said to form an ionic bond with the toxin and the peptide also has a protein transduction domain (PTD) which allows the medication to penetrate the skin.  The protein carrier featuring (PTD) holds on to the cell membrane and allows larger molecules to pass.   Currently, there have been over 600 crow’s feet regions treated with this technology with impressive clinical results and without complications.  Studies are also in place to use this topical application to the under arms for control of sweating.

No mention has been made of how long the treatment takes or how long it lasts and there will certainly be variables that effect results in given patients.  In any event this new technology is very exciting and representative of what the future holds for painless application of medicines.  This would be a very welcome addition in the cosmetic facial surgery arena.

To find out more about Dr. Niamtu and cosmetic facial surgery in Richmond, Virginia visit www.lovethatface.com

 

Joe Niamtu, III DMD

Cosmetic Facial Surgery

www.lovethatface.com