I wrote this email in October 2018 to my Botox / Acupuncture office staff regarding “How many sessions of Acupuncture is necesssary”
I wrote this email in October 2018 to my Botox / Acupuncture office staff regarding “How many sessions of Acupuncture is necesssary”
I wrote a little blurb about myself recently.
🌱I am a Cosmetic Surgeon and Acupuncturist with a history in General Surgery and Trauma Surgery. I have a neuroscience and MD degree from Brown University. I was honored to have been accepted for college by all the Ivy League schools including the great Harvard University. But self-descriptively, I have been quite the slacker and I hope to make up for lost time and opportunity in the present and future. I slacked so much as a child that I was fired by my piano teacher around age 7. I took up the violin after that point. Now, I am mostly trying to teach myself piano. I respect my piano teacher’s decision for parting ways.
🌱In 2006, I started Surgical Artistry, a plastic surgery and acupuncture medical office in Modesto, CA with my wife, Dr. Tammy Wu, Plastic Surgeon. In 2019, we expect to finish building from the ground up, a new state of the art Plastic Surgical Center residing on 2 acres of land in our home town of Modesto, California. I spend my days working on my craft of injecting Botox, Fillers, and Kybella; treating veins, acne, back pain, fertility, stress; discussing nutrition, skincare and anti-aging strategies; performing acupuncture, cosmetic injections, surgeries, chemical peels, microneedling and threadlifts. My wife specializes in Breast Augmentation and Tummy Tuck surgeries and is a vice-principal of a K-12 school in Sacramento.
🌱My wife and I have been vegan since 2011. We love to run and we helped start the Modesto Marathon and Ripon’s Run Half Marathon.
My best wishes to all my breast cancer patients – all of them since I entered medical school at Brown University in 1993 (that’s when I was in my early 20’s). It was around that time I had started a breast cancer support group online and it was a great group and a great adventure. It has been a privilege to take care of all of you and to get to know you. About 12 years ago, Dr. Tammy Wu and I joined forces to regularly operate together on breast cancer. I recently reconnected with a few of my patients locally in Modesto – thank you. As a general surgeon, I would discuss options with my patient and I would surgically remove the breast cancer with Dr. Tammy Wu’s help, and then we would do the plastic surgical reconstruction – sometimes as a staged procedure and sometimes concurrently. I no longer take medical insurance and thus since around 2013, I stopped doing general surgeries. I mainly work as a minimal invasive cosmetic surgeon and I assist in the operating room on plastic surgeries and spinal implants of spinal pain pumps/stimulators . But I still think about my past. October is breast cancer awareness month. www.SurgeryToday.com
Above picture is that of Dr. Calvin Lee and Dr. Tammy Wu operating together in Modesto, California.
Key anatomical highlights of the face and neck for Botox injectors (injectors of Kybella, Juvederm, etc)
Orbital part of Obicularis Oculi
Palpebral part of Obicularis Oculi
Frontalis (frontal belly of epicranius muscle)
Occipitalis (occipital belly of epicranius muscle)
Levator Labii superioris alaeque nasi
Levator Labii superioris
Depressor anguli oris
Depressor labii inferioris
Bones / foramens
Supraorbital notch (Supraorbital nerve and artery)
Mandible – mental protuberance
Submandibular gland (known also as submaxillary)
Supratrochlear (from ophthalmic artery)
Supraorbital (from ophthalmic artery)
Facial – Angular
Superficial temporal artery
Marginal mandibular (branch of facial nerve)
Skin folds / Surface anatomy
Tear Trough defromity
eyelid lateral sulcus
Dorsum of nose
Bridge of nose
Ala of nose
Apex of nose
Tragus (of ear)
Glogau-Klein Point (G-K point)
tubercles of lip
“What’s your favorite part of owning this practice?” I got this question today from an employee. I think it’s a great question!
Here’s my response and I thought I’d just share:
First, I don’t really feel that I “own” the practice alone. I hope the employees can see that they own a piece of this too through their hard work.
I feel that this is all of ours together. I would love to share the successes of the practice. But I would take all the blame.
I work for the “employees” of the practice.
There is so much that I love about this practice so one favorite is hard to pin down.
I love what we do for our patients. I like having our own practice so that we can go beyond the “standard of care.” Others might strive to achieve the standards of care. For us – the standards are the minimum level. I like being able to go the extra mile and not have someone tell me that I’m wasting time.
And I love to be generous with my time with the patients when possible.
I like being able to make my own decisions that would result in outcomes which would be the very best for our patients.
And for the employees and our representatives who believe in us, I are very grateful for having them put their trust in us, and spending time with us. I hope to give back. I personally take a lot of pride in watching our team grow. And sometimes I do take pride in watching our team move on. Although sometimes sad for me on one level, but happy for me on another. I do want to prepare the team to be able to move on beyond what we do if they choose to do so – like become a nurse or doctor or work at another office. It is important for me to be able to give back to those who choose to believe in what we do.
I also have a lot of growing to do, and as I improve, I like watching the practice improve as well.
Hannah asked this Botox eye-droop question on email which I’d like to share with the rest of the office.
In the case of an eye droop due to the Botox drifting, why is it that the eye droop only lasts for 2 weeks if the Botox is active in the system for 3-4 months?
It’s because the Botox wasn’t injected directly into the eyelid. When a Botox droplet drifts into the eyelid muscle (Levator palpebrae superioris muscle) from the corrugator glabellar muscle it would only be a tiny droplet and wouldn’t last very long because it wouldn’t be a full dose. The lower the dose of Botox, the shorter the duration. Sometimes when I inject (with the patient’s urging) with a very high dose of Botox, I’ve notice that Botox can last 5-6 months! I’ve found in my own Botox practice that Botox duration of action is dose dependent.
Avoiding this shifting of Botox is why we have our patients refrain from rubbing or pressing on the Botox injected areas for about 4 days after the Botox injection.
I hope my explanation is clear.
Great Botox question!
How is this procedure performed?
I have been doing this procedure successfully with a blunt tipped micro-cannula. Most patients are relaxed and having a conversation with me while I’m doing the procedure, and are pleasantly surprised when I’m done because it didn’t take as long or hurt as much as they expected. The procedure is done in our procedure room at Surgical Artistry – the same room where we do most of our Botox injections. Care is taken to make sure the procedure is safe and comfortable. I make it a priority to use the Radiesse filler efficiently with no wasted product. Radiesse is carefully injected into the back of the hands to plump up that area to restore a youthful fullness to that area.
Is it painful?
Most of our patients say that this procedure isn’t very painful. We do use a numbing injection and mix numbing medicine into the filler syringe of Radiesse. I can usually do the procedure with one entry site – much like laparoscopic surgery.
How does it work?
Radiesse is a filler that is able to plump up the skin and subcutaneous space on the back of the hands and as an added bonus – promote collagen production. Thinning of the back of the hands reveals veins and edges of bones which can be a sign of aging. By thickening this area, the veins and bony appearance lessons as does the signs of aging.
How much does it cost?
There is a special going on at Surgical Artistry at the moment which is $1000 for two syringes of Radiesse, specifically reserved for the back of the hands. This is a significant discount. We normally charge $750 for a syringe of Volume Advantage Radiesse. This is the large sized Radisse syringe. There exists a smaller syringe, but we don’t carry that syringe currently at Surgical Artistry.
How soon will I see results, and how long will they last?
You will see the results right away. At first there may be some mild swelling, but after about 7-10 days the slight swelling resolves.
Will I need the same amount of filler the next time I get this procedure after the first round has worn off?
In my opinion, most patients will need the same amount of filler the next time. But because there is the possibility of collagen growth, it is entirely possible to get the same results with fewer syringes. I believe that most patients need 2 syringes, and some need three.
What are the side effects?
The side effects are minimal and mostly related to bruising, mild swelling, mild redness, and some mild dull ache for about a day or two afterwards. The active ingredients of Radiesse are naturally occurring substances in the body. Thus, the risk of allergic reaction is very small.
Who is this treatment for?
This treatment is for patients who are concerned about the thinning of the back of their hands due to aging.
Is there anyone who should not get this treatment?
I wouldn’t recommend this procedure in patients who have an active infection on the back of their hands. I also wouldn’t recommend filler procedures on patients who are pregnant or breastfeeding. Furthermore, I wouldn’t recommend this procedure on patients whom I feel are not appropriate candidates due to extremely thin skin or patients who don’t seem to need the procedure based on my assessment.
What filler is used for this procedure and what is it made of?
Radiesse is the filler I like to use for this procedure. The active ingredient is calcium hydroxylapatite which is a naturally occuring substance in our body
What is the recovery like?
Most patients go back to normal activities. But there is most likely some mild dull ache for the next day or two after the procedure. There is numbing medicine which I add to the syringe which can last up to 4 hours of numbness after injection.
Is there swelling after treatment and if so, how long does the swelling last?
Yes, there is some swelling after the procedure. For most patients it is for about 1-2 days. But I have heard up to a week for some patients as well. But the swelling is mild and just about all the patients go right back to work.
If I work with my hands, will I still be able to immediately after treatment?
For many things, such as typing, it is possible to go back to work immediately after treatment. But the numbing medicine might slow you down for the next 4 hours or feel a bit awkward. Furthermore, many report a very slight dull ache, which might affect performance a bit when it comes to lifting or working out, but most patients go right back to work after the procedure. In general, most patients consider this procedure a “lunch time” procedure where they take an hour off of work and then return immediately.
Our new employee asked me on emails:
Regarding blepharospasms, I was wondering if Botox could ever get rid of involuntary spasms if the muscles relaxed enough, or is Botox more of something that decreases the spasms, but can’t fully get rid of them?
So basically everything you said is right.
The answer is: It’s dose dependent.
So If I use high enough of a dose it will all “freeze” up and not move. But it would also look very frozen and weird on the patient. So I’m trying to strike a balance where it just spasms a little bit where it is manageable by the patient (not painful, and not eye-shutting) but it still looks normal without one side of the face being super frozen.
There are also some areas of the face where I don’t want to inject too much Botox for fear of creating ectropion.
Calvin Lee, MD
Written for Del Rio Magazine (Modesto, CA).
One of Dr. Calvin Lee’s goals is to continually improve Modesto. He is proud to help start the Surgical Artistry Modesto Marathon in 2009 and be a founder of the Gallo Center for the Arts. Recently, he was involved with starting Modesto Moves and Ripon-Manteca Moves – training groups for runners. Soon there will be a new half marathon called Ripon’s Run, and he is proud to be able to be the initial title sponsor along with DMC. Dr. Calvin Lee is a board certified General Surgeon who lives with his Plastic Surgeon wife, Dr. Tammy Wu, in Rancho Del Rio. He came to Modesto in 2003, joining the McHenry Medical Group as a trauma and general surgeon. In 2006, he formed Surgical Artistry with his wife. Now at Surgical Artistry, his practice involves a specialty of needles – for acupuncture, Botox and cosmetic injections.
With acupuncture he specializes in treating back pain. His Botox practice is at the “Top 500 level”, a designation given by the manufactures as one of the busiest 500 accounts in the country out of an estimated 30,000. With Botox he specializes in cosmetic injections, injections for plantar fasciitis, sweating under the arms, muscular trigger points, and headaches. With fillers, he enjoys working under the eye lid area, an area called the tear trough. He considers acupuncture, Botox, and cosmetic filler implants to be surgical procedures.
Most Surgical Artistry patients are not from Modesto. It’s an honor to have patient traffic come to Modesto. After visiting our office, many of our recurring patients tell us that they like coming here to shop because of the relatively lower tax rate – especially the patients from San Francisco.
Dr. Lee was born in New York City and had the honor of being accepted to all the Ivy League Schools and Stanford. He decided to enroll at Brown University where he met his wife in 1989. They were both part of a eight-year program which combined undergraduate with medical school. After that he went to Case Western Reserve and Southern Illinois University for Surgery training for the next 6 years.
He is also a violinist. He was soloist and concertmaster of orchestras at Brown and Harvard Universities and various orchestras in New York. He has played at Carnegie Hall twice on the violin. In 2009, YouTube in conjunction with the San Francisco Symphony had a contest and he one of two non-professional violinists who won a spot in the YouTube Symphony. This resulted in world wide media attention. He also toured as a violin soloist throughout parts of Asia. He thought about becoming a professional violinist, but in college, he developed a hearing problem; thus he decided that it was a sign that he needed to dive in wholeheartedly into medicine. He is teaching himself piano these days. Recently he participated in a piano competition in Beverly Hills which involved competing with piano teachers, and he won and performed a Beethoven Concerto with orchestra in Los Angeles. He loves his Los Angeles audience and plans to perform in Los Angeles again next year. He has a violin recital lined up in Modesto in September with music professors at Modesto Junior College.
For fun he enjoys making websites, blogging, spending time on FaceBook, marketing, eating vegan, and running.