How long have you been injecting Botox in Modesto?

I got this question today via social media.

The quick answer as of today (11/5/18) is about 12 years.

I guess it’s a question regarding my experience.  I now see about 200+ patients per month for Botox injections in my Modesto office: Surgical Artistry.

Here’s sort of a timeline for my life in Modesto.

2001:  Interviewed in Modesto and accepted job with the McHenry Medical Group as trauma and general surgeon

2003:  Started my surgery career in Modesto.  I actually had my first job Modesto as a surgeon was with the Sutter-Gould Medical Group affiliated with Memorial Hospital.  I worked there for a few weeks to help fill in for a surgeon who had to leave suddenly for his military duties.

2003:  Started with the McHenry Medical Group as trauma and general surgeon

2006:  Started Surgical Artistry with Dr. Tammy Wu, Plastic Surgeon.  Went to obtain more education in AcupuncturePlastic Surgery was our big focus for Surgical Artistry.

2006:  Started practicing acupuncture and started doing Botox.  I had a slow start.  It seemed to be about 1-3 patients per week even for Botox and acupuncture.  I continued doing General Surgery till about the year 2010.  But starting in 2006, I started assisting in the world of pain pumps and stimulator spine implants which I still do today.

2013:  Reached platinum level for Botox injections and Filler injections with the Allergan company.  This is based on amount of Botox purchased from Allergan.

2014:  Reached platinum plus level for Botox and Filler injections.

2015:  Selected as one of the first surgeon injectors of Kybella – a injectable product to help dissolve the double chin.

2016:  Reached Diamond level for Botox and Filler injections.  At the time, this seemed to be the highest level there was for Botox purchased from Allergan in the USA.

2017:  I was honored by being awarded the Top 25 most loved injectors in the USA by RealSelf.com.  I got a featured advertisement in Glamour magazine.

2017:  Reached the Top 500 level for Botox injections / Filler implantations.  This was a level that I didn’t know existed till I got the award.  It comes with certain benefits like a priority customer service telephone number.

2018:  Started doing thread-lifting which I also call Suture-Lifting.

2018:  Maintained Top 500 level for Botox injections (and other Allergan products).  At this point, I realize that I started by seeing about 4 Botox patients per month in 2006 and now I have the privilege of seeing over 200 Botox patients per month.

I still have much more to improve regarding my skills, communication, and results.  Thank you everyone for trusting me with your injections.

 

Calvin Lee,  MD

What cosmetic services do you offer, Dr. Lee?

I got this question today on Yelp and perhaps this post will help others.

I am interested in hearing about the services you offer and setting up a consultation.

Mr. Bear wearing my name tag and he is with acupuncture needles in his head.

Here’s my brief answer:

Thank you for your inquiry via a message on Yelp. We are closed for the weekend. But Feel free to call (209)-551-1888 on Monday- Friday 8am-5pm for more information about what we offer at Surgical Artistry. The Botox / Filler consultation with me (Dr. Calvin Lee) is free so you can hear more about what I may be able to do and customize information and treatment for you.  Heres a brief listing of what I do:

Threadlifts

Threadlifts for building collagen and lifting.  These are dissolving PDO threads.  Sometimes I call this Suture-Lifting

I do Botox

I do Botox for wrinkles, headaches, jaw pain, gummy smile, shrinking pores, sweat reduction, trigger points.

Juvederm Fillers

I do fillers for lips and wrinkles, acne scars.  I really enjoy working on lips and tear troughs as some of my favorite things to do.  I also sometimes use Radiesse and Restylane.  I do hand rejuvenation fillers and also tear trough off label fillers under the eyes.  I am fond of working with a cannula for cheek augmentation and for tear trough.  I also regularly do chin augmentation with fillers and jaw augmentation, temple filling (by the forehead), ear lobe wrinkle filling, nipple projection for inverted nipples.  I also fill various indentations in muscles or the body from various trauma/scar or from steroid injections.  I see fillers as a surgical implantation which needs to be done with surgical care.

Dermapen – Microneedling

I do dermapen microneedling to help with acne scars, and wrinkle reduction / prevention, and to help grow collagen.

Kybella

Kybella injections for double chin.  Permanent fat reduction in the FDA approved neck area.  Visit my Kybella website for more information.  I’ve done some off label Kybella for bra roll and knee area.

Chemical Peels

To help with collagen growth, brightening the skin, tightening, and wrinkle prevention.  I do the Obagi blue peel radiance and the blue peel chemical peel – both these peels are by Obagi.

Acupuncture

I do acupuncture for back pain, fertility, stress, and many other issues. There is a branch of acupuncture known as cosmetic acupuncture.  Actually threadlifts and dermapen are just extension of cosmetic acupuncture.

Vein procedures

I laser veins on the face, chest, and legs.  I have a laser and I also do cosmetic sclerotherapy – which are injections into the small veins.  On the face, the laser is my favorite modality, but on the legs, the injections of sclerotherapy is my favorite vein treatment method.  I also do ultra sound examinations of the greater saphenous vein and lesser saphenous veins to assess reflux.

Mole removal

I do cosmetic mole removal from various parts of the body using surgical excision, and I try for the smallest and least obvious scar.  I feel that surgical excision is usually best – rather than burning off a mole.

Trigger point deactivation

Trigger points are tender points in the muscle. I can do dry needling, acupuncture ah-shi, lidocaine/marcine injections

Steroid injections into over-active scars

Some scars are overactive with redness, itching, and have a raised character. I can inject a steroid solution into the scars to make them less “angry.”

More

I actually do more items than what is listed on here, but this is a short description of what I can do.

 

Botox Anatomy Terms

Key anatomical highlights of the face and neck for Botox injectors (injectors of Kybella, Juvederm, etc)

Muscles

Procerus

Corrugator supercilii

Orbital part of Obicularis Oculi

Palpebral part of Obicularis Oculi

Frontalis (frontal belly of epicranius muscle)

Occipitalis (occipital belly of epicranius muscle)

Nasalis

Levator Labii superioris alaeque nasi

Levator Labii superioris

Zygomaticus minor

Zygomaticus major

Risorius

Masseter

Obicularis oris

Depressor anguli oris

Depressor labii inferioris

Mentalis

Platysma

 

Bones / foramens

Zygoma

Zygomatic

Temporal

Supracilliary arches

Supraorbital notch (Supraorbital nerve and artery)

Infraorbital foramen

Mandible

Mandible – mental protuberance

Mandible angle

 

Glands

Parotid

Submandibular gland (known also as submaxillary)

 

Arteries

Supratrochlear (from ophthalmic artery)

Supraorbital (from ophthalmic artery)

Facial – Angular

Transverse facial

Superficial temporal artery

Carotid

External Carotid

 

Nerves

Supratrochlear

Supraorbital

Zygomaticotemporal

Infraorbital

Marginal mandibular (branch of facial nerve)

Trigeminal

Facial

 

 

Skin folds / Surface anatomy

Jowls

Prejowel sulcus

Nasolabial folds

Marionette lines

Nasojugal sucus

Tear Trough defromity

eyelid lateral sulcus

festoon

Dorsum of nose

Bridge of nose

Ala of nose

Apex of nose

Tragus (of ear)

Glabella

Filtrum

Filtral Columns

Glogau-Klein Point (G-K point)

Vermillion Border

tubercles of lip

Oral commissure

Mental crease

ergotrid

Vertical rhytids

 

 

Terms

Neocollagenesis

Blepharoplasty

I love going to Botox and filler training sessions

As a board certified surgeon, I know that there are many ways to get surgeries done and every surgeon has their own developed tips and tricks over years of experience.  It’s always good to learn from others – especially in other parts of the world.

In the past few weeks, I’ve participated in two national-type training programs for Botox and Juvederm fillers.  I especially enjoyed watching other great injectors approach lip augmentation challenges.

Later today I am going to San Francisco to attend an international training program for Botox and Fillers/Juvederm.  The speaker is from Australia.

Here’s an interesting certificate that I got after one of the training programs – they sent it to me via email, but they used the bosses’ name on our practice.  Well, it’s the plastic surgeon wife, but I did the training program.  It’s worth mentioning that her full name is Dr. Tzuying Tammy Wu.  And you can visit her plastic surgery webpage here: www.SurgeryToday.com.  And you can visit my Botox webpage here.

Ethnic Botox for my Asian patients

I attended a Botox lecture yesterday in Fresno that included a small section on ethnic differences in use of Botox, fillers, and Kybella.

This made me think of my Asian patients.  I live in an area of California where there aren’t a huge population of Asian patients, but I have a good handful of Asian patients coming in for Botox and fillers.

Botox differences that I’ve observed

Compared to caucasian patients, our Asian patients are asking more for Botox for slimming the face, and there is more of a preference placed on crows feet botox over glabellar botox.  Glabellar area is the “11’s” between the eyes.  I’ve noticed that my Chinese patients are usually requested a lower dose for the glabellar botox, but the opposite is true for my Indian patients who frequently request or need more glabellar botox for the same effect.

I’ve also seen much more request from Asian patients regarding jaw slimming botox procedures.

Filler differences – Voluma

I’ve actually learned a few things from my Asian Botox / Filler patients who have received cosmetic injectables in Asia.  They tell me and teach me about rounding out the glabella and forehead and filling up the bridge of the nose.  This has helped me observe that this area tends to flatten with age in some Asians.  Also most of the cheek augmentation tends to be in the anterior direction more than in the lateral direction.  Thus the apple cheek result is what they are asking for with Juvederm Voluma injection – rather than more of an angle with the zygomatic arch.

Well, that’s what I’ve observed so far, and I hope to observe and learn more from my patients and I hope to continue to improve.

 

What is it like to be a doctor?

dr-calvin-lee-cropI was recently asked to answer these questions as part of a student’s assignment for school.  She wanted a surgeon to interview.  I have elected to answer these questions as the surgeon that I am today which is different from a decade ago when I was a trauma/general surgeon.  Now I am a surgeon who does acupuncture and cosmetic injections (Botox, Fillers, Kybella – neck, Asclera – veins).  For more information, consider visiting my other webpages www.InjectionArtistry.com and www.SurgeryToday.com 

  • Describe your work environment.

I am a surgeon with additional training with acupuncture and cosmetic injections.   I have worked as a general surgeon and trauma surgeon.   In 2006, I decided that I was going to dedicate my surgical skills to working with needles for the majority of my work as a doctor.  I became an acupuncturist and learned cosmetic surgery from my wife, Dr. Tammy Wu, who is a plastic surgeon.  Our practice is Surgical Artistry, and one of the main focuses of the practice is cosmetic surgery.  About once or twice a month, I have days where I assist the entire day in surgeries with Dr. Wu or other surgeons in our area.  For the most part, I am now mostly an office based doctor – as opposed to one who sees patients in the hospital.  I use three different acupuncture rooms to see patients with varying problems ranging from back pain, neck pain, headaches, athletic injuries to fertility acupuncture.  And then I have one large procedure room where I see my cosmetic injection patients.  The lighting and space design is different in each of these rooms based on the procedure intended for the room.  Surgical Artistry has two physicians – myself and my wife, and at this time 4 full time employees.  We like to keep our work environment clean and neat and be a sanctuary for health and wellness.  It has an open feel to the environment for our employees as we want to foster good communication with our team.  We believe in having our patients be beautiful both with health and appearance.

  • What’s a typical day at work like?

As a surgeon who focuses on acupuncture and cosmetic injections, I see patients from 8am-5pm.  I try to start on time as much as possible and I try to stick to the schedule.  I dislike having patients wait.  Half of my usual day is dedicated to acupuncture and the other half to cosmetic injections.  I go from room to room with no break in between.  I find time for my “breaks” when patients don’t show up or are late to the office.  That is when I prepare a batch of Botox, catch up on emails, enjoy some facebook (my facebook page), maybe even grab a quick bite.  I don’t take a formal lunch break.  I usually work till about 5:05pm.  That’s when I start to have time to write my office medical charts which are important to document the day’s work.  This allows me to record for future medical use when the patients come back, and thus, I can improve on their care.  The medical charting usually takes me about 1-3 hours.  Then I go home.  But sometimes I have to take care of business matters especially since Surgical Artistry is my business.  Sometimes there are employee matters, bills that need to be paid, or leaking roof issues.  So at times I don’t go home till 1am in the morning.   This is pretty much most of my days Monday-Friday.  There are a few days per month which I reserve for surgery assisting where I give my staff a break from my daily grind; I am not at the office on that day, I would spend my day at the hospital going from surgery to surgery.  And my staff spends that day catching up on their paperwork in the office.  The hospital and my office are not connected.  I think there are some lucky doctors who have an office inside a hospital.  Or maybe they consider themselves unlucky because they never get out of that work environment.  Regardless, I have to drive to the hospital from my office and I work at a handful of hospitals such as Stanislaus Surgical Hospital, Doctors Medical Center in Modesto, and Sutter Memorial Hospital in Memorial.  on Stanislaus Surgical Hospital’s home page, they actually have a picture of me as the operating surgeon on their header!

  • What are the three most important responsibilities of your job?

First most important responsibility is getting the patient the best results that I can.  Second most important responsibility is to do this as safely as I can.  This involves good technique and good knowledge.  The third most important responsibility is managing patient expectations – which means that I should spend the time communicating well with the patient and letting the patient ask questions, and I should try to think of questions that the patient might not have thought of himself/herself.

  • What technical skills do you need to do your job?

A tremendous amount of technical skills are required.  Skills involved in navigating around anatomy so that needles are placed accurate.  Steady hands are involved to insure precise delivery of Botox or filler.  Plus there is technique involved which help prevent injury to the patient if the patient were to flinch.  And there are techniques involved which ensures a sense of 3D space and tactile feedback at the tip of each finger.  These are skills which I think take many years to develop and I’m still trying each day to get better.  I became a surgeon because I am attracted to technical skills with my hands.  I received my MD degree in 1997 and every day since then, I’ve been continually trying to improve.

  • What people skills do you need to do your job?

To be a surgeon, acupuncturist, or cosmetic physician.  One has to love people and have a passion for other people’s health.  We are teachers to begin with and we need to teach patients about their current state of health and teach them how to improve upon it.  We have to be convincing as well to help steer them in paths which may not be apparent or easy to them – such as quitting smoking or eating more veggies.  We have to have people skills to communicate well.  And we have to have people skills to not only manage expectations, we have to manage our complications.  Surgeons are only as good as the complications that we’ve managed.  But those complications doesn’t just involve technical skill, they involve all sorts of people skills;  We have to listen, empathize, have compassion, instill confidence, communicate effectively, and most of all have patience.

  • Describe a recent problem on the job and how you solved it.

There are always problems, but by being a cosmetic physician and acupuncturist, my problems may not be as life threatening as a trauma surgeon’s problems.  I realize that it is somewhat less stressful for me since 2006.  But I have the same passion for making sure I focus completely on patient problems.  I’ll just describe something from yesterday’s line of work.  I had a patient come into the office for what seemed to be a routine cosmetic mole removal.  However, on examination and further questioning, it was revealed to me that it was a vascular type of lesion which had a history of bleeding.  The patient was worried that it was going to bleed further because when it did bleed, it was very severe.  I decided that I had to postpone some of my patients for a bit of time and take care of this bleeding mole like structure right away.  I first fired a vascular laser at the base of this lesion and then removed it like a mole and found the bleeding artery – which continued to bleed – but I was able to place an old fashioned figure of eight stitch around the bleeding artery and closed the skin incision which I purposely made.  We sent the mole like structure to pathology to rule out the possibility of cancer.  I discussed with the patient that if this lesion continues to bleed at home that he was to call me on my cell phone and I would meet him immediately at my office even if it was the middle of the night.  It bled more than the usual skin lesion removal because this lesion was in my opinion mostly vascular in nature.

I had anticipated this problem and thought the laser would stop the bleeding before I even began, made a decision to act on it right away, and encountered more bleeding which I had a plan which was my old fashioned stitching.  Then, I made plans for aftercare and in case other problems arise after he leaves (having the patient contact me and meet me at the office).  I’m glad I have a background in trauma surgery and bleeding is really not a big deal to me.

  • What kinds of information do you need use, analyze, and/or stay up to date on how to do your job efficiently?

There are medical journals pertaining to acupuncture and cosmetic injections which I read from time to time.  There are also national/international meetings on acupuncture and cosmetic surgery which I attend regularly.  There’s the collective wisdom of many doctors who can share experiences and ideas which will help my patients in Modesto.  Having the latest info helps me with another aspect of being a doctor – advising my patients on alternatives, even alternatives which I do not have.

  • How do you think your job will change over the next 10 years? Why?

I think for the most part the acupuncture will stay the same and perhaps become more popular with patients.  More and more people in the world seem to be exposed to acupuncture and the idea of healing with less side effects.  The art of acupuncture began about 5000 years ago, and I think much of the practice of acupuncture will stay the same.  But I do think that more points will be discovered as physicians are now more open about sharing.  Regarding cosmetic injections.  I think they will become more popular in the next 10 years as patients are looking for quicker procedures, less invasive and less downtime.

  • What technology and special tools are used by you and others at your workplace?

As a acupuncturist, I don’t think I have any special tools except my hands and a collection of acupuncture needles.  For the cosmetic side, there are many tools such as lasers which help with little red veins on the face, etc.  However, in my own preference of what I do at work, I try to rely mostly on my hands connected to instruments which do not require too much technology, except for the technology which rendered the instruments.  I like special needles for all of my work in acupuncture and cosmetic injections.  There is a lot to the property of a needle.  It is very much like a violin bow.  Needles may all look alike, but they have different characteristics – weight, flexibility, length, angle, sharpness, consistency from one batch to another, and the ability to stay sharp throughout the procedure.

  • What written materials are used at the workplace?

We have written materials on the safety of chemicals at the workplace.  We also have written protocols which I follow for some of the procedures that I perform.  Plus we like checklists.

  • What impact dose the workplace have on the local and global communities?

I particularly like it when I get patients who come from other cities and then get to spend some time enjoying our local economy here in Modesto.  For example, I had a patient from San Francisco, who said that she did all her Christmas shopping in Modesto and got to enjoy our lower sales tax rate.

In general, I think I am here to mainly help our patients in Modesto get the best care that they can.  Globally, I don’t think I’ll have much of an impact unless others want to learn my techniques.

  • What academic skills do you need for your job?

The most important academic skill is the ability to keep learning and improving.  My knowledge of the human body and experience with operating on the human body are at play every day in my work.

  • What are at least two ways you apply mathematics at the workplace?

One way is when I have to calculate the cost and dosage of Botox every day.  This is simple addition and subtraction.  But it is in play all the time.  Even when drawing Botox out of the bottle.  Then there’s the mathematics of injecting it out of the syringe.  You have to make sure you push and stop your thumb at the right moment and that’s math.  Botox arrives as a powder and precise but simple math skills are used to convert that powder into a liquid.  I also use math skills to determine how to best use 1 syringe of filler in a patients face.  The filler is a limited resource and we have a job to do which involves symmetry.   Then there’s more abstract and intuitive math which involves angles – especially when using a long needle.  Then there’s the mathematics of getting the procedures done under the price budget laid out by the cosmetic patient.

  • What are at least two ways you apply communication skills at the work place?

I like to have a detailed conversation with the patient in trying to understand their vision of beauty.  I have my vision, and many times the patient has their beauty.  I need to spend time understanding if my vision and their vision align.  If not, I need to really try harder to understand.  Then I have to communicate what I am capable of doing – which sometimes may not be enough for the patient.  And if I get the feeling that I can’t get my message across, or I can’t understand the patient, then I need to communicate that I am not the right person for the job.

  • What are at least two ways you apply scientific principles or social studies concepts in your work?

In cosmetic medicine, there’s the economical social studies concept of meeting the patient’s budget, and dealing with the supply and demand of Botox/fillers.  We also have to deal with the history of the patients responses to various treatments.  In the end, I want to have high yielding efficient results for the patients which they can afford.

We live in a world of science.  And medicine is the artful application of that science.  So I would say that all that I do as a doctor has a foundation in science which ultimately is an explanation of how things are in the universe.  However what we know of science at this point is just small window into how things are in the universe and sometimes we are misled of what we know of science.  But I would say that science is the best of what we know at this time.  As a surgeon, our main science disciplines is the science of anatomy, the science of physiology, and the science of physics.  The anatomy is the science of having identified body parts.  Naming these parts allows us to communicate efficiently with others.  physiology is the science of how these body parts function.  And as for physics, it is the nature of the interaction between surgeon, instrument, anatomy, and its impact on physiology.

  • What opportunities are there to use creativity or art in your job?

There is always creativity and art in my world of acupuncture, surgery, and cosmetic injections.  Every human being is different and every problem is somewhat unique.  Thus almost every solution for a patient requires creativity and art.  This is why I’ve called my medical practice: “Surgical Artistry.”  There are so many different instruments to use, so many different fillers, different needles, different angles, different locations.  Plus with limited budgets for cosmetic procedures, we have to think creatively to get the work done.  Compromises need to be thought of, but always without sacrificing safety.

As for Acupuncture. There are creativity needed in picking effective points for the patient.  Each problem has a unique set of problems.  Back pain patients sometimes even have the problem of not being able to lay on the table a certain way.  So we have to think of ways to get the patient comfortable – perhaps in a chair or perhaps with rolls under their knees, etc.

  • How long were you in school?

First 12 years got me past high school.  Then I did 4 years of college.  Then I did 4 years of medical school.  At this point I got my MD degree – but that’s without any formal surgery training.  Thus to continue on to become a surgeon,  I did 1 year of surgery internship, then I did 5 additional years of surgery residency.  At this point I became a board-eligible Surgeon.  As for acupuncture, I did 1 additional year after all the surgery training.  I think I took the short route compared to other surgeons.  There are many surgeons who spent more years in school.  I consider all those years to be formal schooling for me.  But in many ways I am still in “school” as my patients are my teachers.

  • How does your job affect your life?

My job is my life.  I think I don’t really have much of a life outside of my job.  It was much more this way when I was doing trauma surgery, but I got in the habit of living the job – always.  I married a surgeon too and we love what we do.  I initially picked surgery because I wanted to live that way of life.  Surgery isn’t a job, it’s a way of life.  But I think I need to start learning to live my life in a different way.  Perhaps it isn’t the healthiest way of life for me – I’m starting to realize that and I’m almost 50 years old.  In fact, I don’t really respond to my first name – which is really part of a person’s normal life.  I respond more to “Dr. Lee.”  As that’s who I am and the majority of my life I’ve been called “Dr. Lee.”  I know many people go through customer service and say that people feel comfortable when they hear their first names.  Not so much in my case… it’s usually my parents or my wife who call me by my first name, and usually if they are using my name, it might mean that I was in trouble.  But hopefully as I change my lifestyle and have a life outside of the medical world, I’ll regain my recognition for my first name again.

  • Why did you want this job?

I was drawn to the world of surgery.  I believe it was some sort of calling.  I think I liked it because it requires great responsibility and the capacity to make others happy.  Perhaps also, it was the ability to fix a problem rather quickly.  I also feel that I have a gift of using my hands and wanted to use my gift.  In addition, I was drawn to the world of acupuncture because I wanted to have medical solutions with low cost in terms of side effects – I wasn’t happy with some of the side effects created by medications.  But in the end, I came to realize that acupuncture is just another branch of Surgery.  Blade or needle, either way, we heal with steel.

 

 

Cosmetic Annual Growth by patient visits

Acupuncture, Botox, Juvederm, vein annual growth for Calvin Lee, MD

I am very thankful and proud. In 2006, I reinvented myself from General/Trauma surgeon to Acupuncture/Cosmetic Surgeon. In the operating room, I have been assisting in Tummy Tucks, Face-Lifts & breast surgeries done by my wife, THE Plastic Surgeon for the past 10 yrs. This graph shows the growth of what I do OUTSIDE the operating room, in our SURGICAL ARTISTRY office: Acupuncture & Cosmetic Injections. I use hundreds of needles per day. I started my practice with only 58 office visits in 2006. Last year I exploded to 3371 visits with one of the highest retention rates of patients in the country according to Allergan. I am so grateful to my patients for trusting me. I am also so grateful to my supportive parents, Dr. Tammy Wu, her parents/brothers and to those who have directly helped me grow this new world for me:

Jeannine M, Andrew M, Ken T, Christine Donham Landrum, Jacquie A,Jessica Vargas, Annabeth Ghiglia Allan, Lorena Redula, Katherine Ruth,Karla A Valente, Lynne C, Sarah S, Lea S.

Surgical Artistry Modesto Marathon, Heidi Ryan, Karen Kopecki Hodges Lozano, Vickie Chu-Hermis

Sutter Gould Medical Foundation, McHenry Medical Group (First Choice Physicians), Doctors Medical Center, Memorial Medical Center

Alyssa Petrino, Chris W, Jeran Wadlow, Suleika Bauer, Tadra Rex, Nicholas Eichhorn, Jennifer M, Brooke Cramer, Joe K, Jenny D, Tom Z, Cherise P.,Bree Alexander

Kempton Stephens, Katherine Barton, Paul B, Charles Cherrie Suntra,Enoch Choi

It has been a tremendous first 10 years at Surgical Artistry and I’m looking forward to the next 10.

Number of patients seen per year Calvin Lee - text - Botox

 

a botox 2015 statistics sign IMG_1370 - 4th version

a botox what we do sign IMG_1370Botox Retention Analysis

cumulative botox 2014 2015 with title

cosmetic acupuncture botox bar graph

quarterly comparison of botox units 2014-2015 - with frame

a shadow IMG_1036 - with text

 

2015 BOTOX Year in Review Statistics

2015 Botox Stats

a botox 2015 statistics sign IMG_1370 - 4th version

I had a previous posting regarding December Botox statistics for 2015.  I had probably made some assumptions.  But now that December 2015 is officially over, the numbers are more solid.

52,593 Units of Botox

For the year of 2015 I used 52, 593 Units of Botox.  That’s 4,382 units of Botox monthly if we divide that number by 12.  Or another way to think of it is that it’s about 43 Bottles of Botox per month (40 Bottles is a more rounded number).

694 syringes of Filler used in 2015

Fillers in my recording includes Juvederm, Belotero, Radiesse and Restylane.  If I divied 694 by 12 months.  I get 57.8 syringes of filler per month.  I guess I could say that I average about 55 syringes of filler per month.  I did hit 100 syringes of fillers used in the month of December – it was a busy month, and I purposely tried to work as much as I could in the month of December since patients had some time off to get cosmetic work done.

1371 Botox visits to my Modesto office in 2015

These visits are for Botox and doesn’t take into account visits for filler only.  I get this data from Allergan’s Brilliant Distinctions.  This calculates to an average of 114 visits per month.  And for fun, if I had about 20 days in the office per month, it would be about 5.7 patients seen per day in the Modesto office.  Sounds pretty low of a number?  Well, I also have a vein, acupuncture, and surgery assisting practice which I run at the same time.

See Botox Statistics from 2014 – there is a breakdown of my day – looking at the amount of time I spend with Acupuncture vs Botox vs Veins.

 

745 Patients seen for Botox AND Juvederm for 2015

This number (745) includes all Botox and Juvederm patients seen in 2015.  Tricky thing here is that it is only Juvederm and not other filler brands.  I got this data from Allergan’s Brilliant Distinctions.  I guess there’s fault in my numbers, but it’s still fun to follow – especially if there’s a nice positive trend.

I think it would be nice to know which percentage of these patients were new and which were recurring.  I wonder if I can set up Allergan’s Brilliant Distinctions Analytics program to figure that out for me.

51 places to get BOTOX injections in Modesto and surrounding cities

This list grows.  I get the info for this list from my patients who tell me about other Modesto Botox locations.  I have not visited these Botox sites personally.

Comparing to other years – Visits to patient ratio.

This isn’t a perfect ratio, because the visits are BOTOX only visits, and the # of patients is patients who have come to me for Botox and Fillers (Juvederm) – which means that there are some Filler patients who aren’t Botox patients.  But regardless the ratio is fun to look at.

  • In 2015 I had 1371 Botox visits from 745 patients for fillers/Botox.
  • In 2014 I had 1013 Botox visits from 546 patients for filler/Botox.
  • In 2013 I had 724 Botox visits from 396 patients for filler/Botox.

All these years, the ratio comes out to:

  • 2015 – 1.84
  • 2014 – 1.86
  • 2013 – 1.83

These ratios can be seen as how many times a patient comes to the office.  Sort of a measure of retention or rebooking.

Summary

The graphic on top of the page sums it up the best.

Please consider visiting my Botox practice in Modesto, CA.  We also carry Latisse 5ML and 3ML.

December 2015 Botox statistics per day

I’m writing this on 12/18/15.  These are basically notes to myself and eventually may be used as a guide in 2016 to help the Botox representatives in their national Botox database.  Allergan/Botox likes to do studies like that.  Data below from Brilliant Distinctions.  However, Brilliant distinctions isn’t used by all of our patients, and thus the data may be somewhat short; meaning that the actual numbers are probably higher than the ones reported below.  I have also found that many of my patients are from Doctors Medical Center in Modesto, CA.  And in general the majority of my patients are nurses.  I think this stems from my history of working at DMC much more than Memorial Hospital in Modesto, CA.

First 14 work days of December 2015 Botox statistics reveal:

  • 3774 units of Botox used.
  • 98 Botox patients seen (this would include Juvederm/dermal filler patients who received Botox.  But this would not include Juvederm/dermal filler patients who did not receive Botox).
  • 65 Syringes of dermal filler used.

How much Botox do I use per day?  269 units.

Using the data above from 14 days of work in December 2015, I come up with the following info:

  • 269.5 units of Botox used per day (per work day)
  • 7 Botox patients per day
  • 4.6 syringes of filler used per day.

What’s our average units of Botox used per patient?  38.5 Units.

  • 38.51 U of Botox is the average number of units used per patient over the 14 days of data collection.
  • 38.27 U of Botox is the average number of units used throughout my entire year of 2015 up to 12/18/15 – calculated from 1340 Botox visits and 51,283 U of Botox used for those 1340 Botox visits.

How much Botox is used per month?  42 Bottles.

  • As a rough estimate, if I take 51,283U of botox used and divide that by 12 months.  I would get 4,273 U of Botox used per month on average which would be 42 bottles of Botox a month on average.

How much filler do I use per month? 54 syringes per month.

As a rough estimate, taking 659 syringes of fillers used this year up to 12/18/15 and divide by 12 months, I would get 54.92 syringes per month.

Visit us in Modesto, California for Botox.

The data here is for my Surgical Artistry Modesto Botox practice.  Please feel free to visit one of my Modesto Botox webpages

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Lip swelling after Juvederm Question

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.

Thanks for reading.

Calvin Lee, MD
Cosmetic Injections in Modesto, California

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