Sally's Blog

The Impact of Television Segments - By Sally K Caesar, RN

Every week there are TV or news segments detailing the latest/greatest make over product or procedure to turn back the hands of time. I can always count on several phone calls and questions coming in the next day asking me about what they saw, where they can buy that miracle product or more than a few folks asking me how quickly they can get on my schedule for that transformative lunchtime treatment. Honestly, I am a big fan of these physician based talk shows and news segments because it gives me another opportunity to educate not only the patient but myself as well. If there is a new technology, new product or new aesthetic service that I need to be aware of, believe me I will do all the research necessary to make sure this "new" anything is all it is touted to be.
However, (you had to know a however was coming...) what I feel is lacking in these "segments" is that nothing in medicine can be fully defined before the next commercial break. It takes even the most highly educated medical doctor an additional 3 years (or more) of study to become specialized in their chosen field of medicine. Can we really expect that precise dermatologic or skin care recommendations for every person, of every ethnicity and skin type be given in 15 minutes or less?
Recently a noted TV physician along side a noted NY dermatologist suggested that a tub of St. Ives moisturizer is all anyone needs for cheap "anti aging". Well, you guessed it, the next day an overwhelming number of people called or came in with tub in hand. I am sure this was excellent news for the St. Ive's company! Now I'll que up my own quickie skin care advice "segment"... There is a BIG difference between "anti-aging" and "hydration". Layering an emollient product on your skin will NOT correct your skin's accumulated history of photodamage not to mention the cellular response to our ever decreasing estrogen back to your regularly scheduled programming.
A TV "segment" is just that, a segment of information with partial clarity - even if it comes from a doctor! Oh and on a side note, be very cautious when believing all those terrifically animated "before and after" images or videos.....FYI Bugs bunny never aged either.

Is There A Doctor in the House?

With the medical aesthetic industry growing at an increasingly rapid rate and new "medical spa's" opening up everywhere, now more than ever it falls upon you, the consumer to be vigilant and educated before making any aesthetic medical treatment decision.  Suffice it to say that this type of medical care should never be a "Walk-In's Welcome" type of service, even when it comes to non-surgical aesthetic/cosmetic procedures.  Knowing "who the who's are" within a particular medical treatment facility, (and we are not talking Dr. Seuss here) is critical to your safety.

In 2010 the Kansas Medical Society convened a Task Force to study and make recommendations promoting quality and patient safety within all medical spa facilities.  However, the enforcement of these itemized recommendations seems to be the overriding concern - Hey, it's not breaking the law until someone get's caught or seriously hurt ... right?  WRONG!

Don't become overwhelmed, just start with one simple question that should be answered to your complete satisfaction ... "Is there a Medical Doctor in the house"?  Item #6 of the KMS Task Force recommendations states that; "Every medical spa at which services are provided that constitute the practice of medicine and surgery must have a Kansas-licensed physician as it's medical director."

Everyday words can be easily nuanced to communicate whatever you want them to say, however this has never been more true than within the aesthetic industry; words like "on site" or even that a physician is licensed in the state of Kansas....we are talking about some pretty hefty US geographic land mass here and of course "licensed and present" are two vastly different things!  I consult daily with men and women that have really, (that bears repeating) really bad results from non-surgical aesthetic procedures and these patients turn to me and say... "Please fix it".

My advise to you is PLEASE ask questions before doing anything, and in turn get very clear, precise answers!  Choosing your medical treatment facility is not about weather the "decor" is high end, it is far more important that the doctor is in the house.

If you would like to read the complete KMS Task Force recommendations for yourself, go to and keyword in medical spas.


To Tan or Not to Tan - There is NO Question

With malignant melanoma statistics on the rise, I still find myself in a verbal tango with all the steadfast tanning bed fans. I want to be as clear as I can with this entry because the folks who use these devices and very emphatically defend them I might add, cannot be easily dissuaded, even with all the medically documented facts that are spelling out increasingly alarming conclusions.  I hear over and over that "tanning beds are safer than sun exposure", "I just get a baseline tan that protects me from sun burns in the summer", "I look healthier tan than pale", "I am getting ready for vacation and I don't want to burn", or my favorite...."My skin is fine, there was something else wrong with those people who got cancer, it won't happen to me".  These are direct quotes told to me and unfortunately they also attest to the mindset of what medical professionals are up against.

In July of 2009 a prestigious medical journal stated the cellular mutation and carcinogenic effect of tanning beds upgraded their risk classification to be among other definite cancer causing agents, deeming tanning beds to be as deadly as arsenic.  If this correlation was not enough to deter someone, here are fully substantiated, medically documented facts and statistics that are worth your review:

    • Individuals who use a tanning bed before the age of 30 increase their personal risk of developing malignant melanoma cancer by 75%.
    • Malignant melanoma is the leading cancer diagnosis among young adults within the 20 year old demographic. This has been directly linked to tanning bed use.
    • There has statistically been a 50% increase in malignant melanoma cancer diagnosis for people within the ages of 15-39 from years 1980-2004....a 50% increase should get everyone's attention.
    • There is now a medically substantiated, bio-chemically linked diagnosis of "tanorexia" or "tanoholic" that is similar to the same addictive tendencies as that of a smoker or alcoholic.  This diagnosis is also closely related to body dysmorphic disorder or BDD.

Conclusions from these studies are that people are risking death for the sake of a tan.  To be honest, nothing about these reports are altogether new information, it has been known for a long time that there was a clear link to skin cancer and UV exposure.  The FDA established safety regulations back when sun lamps were popular...and I know many of you remember those wonderful devices.  Personally, I think the combo of a sun lamp and baby oil is how the broiler was invented!  Unfortunately all that has actually changed is that the statistics have now reached a sobering, frightening and deadly level - thus the current news worthy headlines.

The World Health Organization has recommended a ban on tanning bed use for anyone ages 18 and under.  CBS, FOX, NBC and ABC have all recently reported on these age specific changes being considered by the FDA which are:

    • An outright ban altogether.
    • Requiring a written medical order for a child's use (18 years or younger).
    • Having a signed parental informed consent.

If these changes are passed through the FDA, they would be mandated nationwide.  Right now there are only a hand full of health conscious states that have regulations already being enforced.

As I close this blog, another delightful quote I hear over and over is: "My salon has FDA approved beds" - let me spell this out clearly...there is absolutely NO tanning device that is FDA approved.  The only clearance ever given to these chambers if you will - (bed to me connotes peace and wellness-which in this circumstance is quite to the contrary) - is that the structure itself will not crush you; nothing whatsoever to do with the bulbs!

My father died from malignant melanoma, so yes I hold a very strong conviction towards this subject and for those of you who may be saying, ..."Oh, that's what this is all about"...well you're right..but now I am talking professionally to YOU.  My dad grew up (as did most of us baby boomers) without understanding what his UV exposure risk meant.  He was a lifeguard on a Chicago beach and back then there was no such thing as sunscreen even available.  He died at age 60, which is just over 20 years ago now.  Too much has changed today for anyone, no matter what your age to make this life altering mistake or say you didn't realize.  Parents...are you listening, will you knowingly sign this "informed" consent?  We don't get a lot of "do-overs" in life and when you hear a diagnosis of malignant melanoma given to you or a family member, it really won't matter how tan you are.


Is Your Face Recession Proof?


I am repeatedly asked if our aesthetic practice has felt the effects of the down turn in our economy.  Obviously this question cannot be answered with a simple yes or no.  What I can say is that there is a dramatic increase in the knowledge base and expectations of all our clients.  People have finally become tired of unsubstantiated product claims and are now in ever increasing numbers, looking to trusted medical professionals to help them wade through this confusing cosmeceutical product market. With Melanoma statistics sky rocketing and the "Boomers" seeing for themselves what the ravages of our baby oil "sunscreen" years left behind, women and men want actual correction not another empty promise wrapped in flashy packaging or a catchy buzz word!

I firmly believe that skin care today must focus on restoring the health of our skin instead of promising to change your birthday!  Healthy skin care must no longer be considered self indulgent.  Your skin is your body's largest organ and trust me, it has taken a beating!  Just like no two of us are the same, so it stands that no one product will work for everyone.  I recognize that what I am about to tell you will radically challenge what big cosmeceutical companies and marketing firms want you to believe, but there is still not any one product on the market today that will give us a facelift in a bottle and that my friends, is the truth!

Our sun damaged demographic is driving this industry.  Just open up those bathroom drawers and you will see for yourself the real financial bottom line.  Every dollar you earn must be respected, so before you toss into that drawer another bottle of empty promises, get the facts that will pertain only to you.

Turn off those magnifying mirrors, stop waiting for NASA to retrieve a miracle moon mask, and then come to the realization that you have to do something.  Start with a FREE, yes, FREE consultation and that my friends is recession proof!


Would You Like A Little Neurotoxin with your Haircut?

Are you kidding me?  Sounds inconceivable right?  Unfortunately this is all TOO real!  Recently, I have learned first hand that there are physicians and nurses traveling to local area Fitness Centers and salons selling Botox and injectable Filler treatments right there on the spot! REALLY?  When did it become acceptable to compromise everything that excellence in medical care must stand for.  I do not recall anything that states it is perfectly acceptable to set aside all standards of quality client...I mean patient care when you find an untapped albeit captive aesthetic, cash paying audience.  Perhaps I might suggest all that's missing from this dog and pony show is a banner strapped to their bumper saying "Today Only, Neurotoxin injected while you wait - Follow Me"... then seal the sales deal with the classic pitch, ... "But Wait There's More" and pull out a syringe of filler!

Make NO mistake, these medical treatments come with very serious potential complications as well as implications that should be considered before and after an injection treatment of this kind!  How accurate will a medical history be when the "client" is sitting next to their friends, neighbors or, not to mention complete strangers filling out paperwork (if indeed there is any paperwork). Should a complete medical history be taken, can it be concluded that someone in this type of social situation will be 100% truthful in regards to detailing all their very personal and private medical history?  Some very sensitive information must be documented in your medical history which will include listing all medications, past illnesses, immunizations, allergies, or if you experience even the occasional herpes out break.  Of course these physicians will be free and clear of liability because you signed what is called an "Informed Consent for Treatment", but were you really fully informed?

What's next, brain surgery at Jiffy Lube?  If this blog sounds flip to you, it shouldn't, it should sound like I am infuriated!  I have always held physicians and my nursing peers in the highest regard, but when the profit of a dollar supersedes excellence in medical care and patient safety, something has gone drastically wrong! I applaud those individuals who were in these facilities and found themselves questioning the appropriateness of this "Special Today Only" kind of medical service. Oh and did I forget to mention that we also wrap up this highly professional care by serving adult beverages!  We all know no bad decisions have ever been made while people are under the influence of alcohol in a social situation.  But hey, it is just a little neurotoxin and everyone's doing it, plus I see this kind of thing on "The Real Housewife's" TV Show all the time!  What could go wrong?

Whatever financial hardship these professionals find themselves in, it is my hope that you value your wellness much more than they value your dollar!


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