Monthly Archives: November 2014

Email from Allergan about Actavis 11-19-14

I got this letter below from Allergan on 11-19-14 (today) addressing the merging of Actavis and Allergan.  Allergan wanted to stress that they would continue a high quality of research and development as they had before.  Karla from our office sent me a copy of this email which she got, and she wrote that  “It looks like Allergan will become part of Actavis soon.  This email confirms it and reaffirms their commitment to continuing research and development.”

Here’s the letter from Allergan, the makers of our cherished Botox, Juvederm, and Latisse.  For more information about these products, visit our Modesto Botox and Juvederm page.


The fight over Botox!



November 19, 2014

To our valued customers:

As announced in a press release earlier this week, we are pleased to share that Actavis and Allergan have entered into a definitive agreement under which Actavis will acquire Allergan in a deal valued at approximately $66 billion. Bringing our two companies together represents a powerful strategic combination, creating a dynamic, top 10 global pharmaceutical company.

We anticipate that the acquisition will close in 2Q 2015. Until then, it will be business as usual, with no impact to our operations or the high quality of service that you have come to expect from Allergan. Once the transaction closes, we will notify you of any relevant changes, and it is our goal to minimize any possible impact this could have on you, your patients, and our employees.

Like us, the Actavis culture is centered around innovation and customer service, and investment in R&D will remain one of the top priorities of the integrated company. The combined company will offer a broad portfolio of products in Eye Care, CNS/Neurosciences, Medical Aesthetics/Dermatology/Plastic Surgery, Gastroenterology, Women’s Health and Urology and Anti-infective therapeutic categories, as well as the highest quality generic, branded-generic and Over-the-Counter products. The combined company will provide an exceptional level of R&D support, with approximately $1.7 billion invested annually in brands, generics and biopharmaceuticals aimed at delivering high quality products to address unmet patient needs.

We want to thank you for your support and to assure you that we remain dedicated to exceeding your expectations and delivering products and services that make a difference to you and your patients. We look forward to sharing more details of our combined products and services in the future. In the meantime, if you have any questions, please contact your sales representative or visit our websites at and


Brent Saunders, CEO and President, Actavis

David Pyott, Chairman and CEO, Allergan

Allergan Merger / Actavis Takeover

BOTOX wars

The Botox company, Allergan, has consented to be bought by generic pharmaceutical maker, Actavis for $219 a share.  This gets in the way of the hostile takeover attempts led by Valeant Pharmaceuticals and hedge fund man, Bill Ackerman of Pershing Square Capital Management.   But it might be possible for Valeant to out-bid Actavis?

66 Billion? That’s a lot of Botox.

According to the sources, this take-over by Actavis, is worth $66 billion.

My precious! (picture by Calvin Lee, MD Botox injector in Modesto, CA)

Who is Actavis?

In the past two years, Actavis has purchased Forest Laboratories and Warner Chilcott.   Actavis’ CEO is Brent Saunders.  He used to run Forest Laboratories.  Actavis is headquartered in Dublin, Ireland and has administrative offices in New Jersey.

Who are the losers? Nobody?

Pershing Square Capital Management owns 9.7% of Allergan shares.  Valeant indicated that it may not try to beat Actavis’s offer.  Bill Ackerman and Valeant stand to benefit from the increased share price for Allergan; thus they wouldn’t lose either way.

My thoughts

This is a win-win-win for the three A’s:  Actavis, Allergan, Ackerman.  And it also seems to be a win for Valeant who will get 15% of Ackerman’s profits from the price increase in Allergan’s stock (which he owns nearly 10% of Allergan stock).  I also think it will be a win for Botox injectors and consumers.  Actavis will try to be more efficient with it’s administration of Allergan – with further cost cutting and unification of efforts.  And they have pledged to continue to have research and development within the Allergan family of products.  And most importantly in the end, I think the consumers (and doctors) will benefit.  I feel that the Valeant/Allergan merger (Vallergant – I’ve called it), might have cut too many costs and we’d lose on research/development.  Thus the new merger of Allergan and Actvis – there would be a better balance with continued research and developement.  So it will be a 6 way win-win-win-win-win-win:  Actavis, Allergan, Ackerman, Valeant, doctors/Botox-injectors, and patients.  That’s how you do mergers!   I certainly hope so.  Time will tell, and I hope to be here to talk about it.



Link to Allergan goes with Actavis instead of Valeant / Ackerman

Ackerman/Valeant walks away from Allergan

Wikipedia article on Actavis

Juvederm Voluma Injection Notes according to an Expert outside of the US

Tonight I participated in a live lecture on the web regarding Juvederm Voluma injection techniques.  I guess they call this format a webcast or webinar.

I joined a few minutes late.  But it seemed to start with a discussion of facial muscle anatomy followed by a discussion of facial fat compartments.

Here are my notes below for other Botox  injectors and Juvederm Voluma injectors if interested.  My personal technique is somewhat different because I use a cannula technique and he uses a direct needle technique.   Cannula technique at this time is considered off-label FDA usage.  But I feel that it is, in my hands, a safer technique.


Some Juvederm Voluma / Cheek filler highlights:

  • Lateral support is important – at the level of the zygomatic arch.
  • Females have fuller frontal cheek projection it seems than males.
  • Anterior cheek injections can unfortunately reinforce the ptosis of the cheek.
  • Cheeks become lower and more medial when smiling with age – age 40 vs age 50
  • With volume loss in the submalar area – danger sign for “sausage” look with nasolabial filling
  • The nasal flare shouldn’t be hidden with injections – avoid medial cheek injections.
  • People who may look good in the frontal view, might not look good in the oblique view.
  • Aspirate when injecting deep with Voluma
  • With infection risk, there is granuloma risk.
  • He labels the zymatic arch with v1, v2, v3
  • v4 is the soft area of the cheek below v1, v2, v3.
  • v=voluma
  • avoid treating v4 first because of lack of bone support.
  • He uses a pull upwards and backwards = “pinch traction” so the skin cannot go back to it’s original tendency after placement of voluma
  • A discussion of J1, J2, J3, J4.  These are Juvederm locations.
  • He talks about J4 as the vertical lip rhytids (lines) and talks about perpendicular injection to avoid elongation he says.
  • At Voluma injeciton site #4, there are many dangerous sites such as parotid gland, parotid duct, or the transverse artery.  He uses a fanning technique for injections.
  • Look at patients on animation and when looking down.  Animation meaning smiling.
  • Avoid voluma intra-orbit.
  • Malar crease – you can solve some of the ones which disappear when the patients smile.

Great presentation!  There is always much to learn from other Voluma injectors.

Disclaimer:  The above notes are not my thoughts.  They come from a surgeon who works outside of the United States.  They are interesting and I thought I’d share.  The talk on Juvederm Voluma was brought to us by Allergan.

Best cosmetic Surgeon Award

Best cosmetic Surgeon Award for Stanislaus County

Awarded November 2014 by Contentment Health Magazine in Stanislaus County

Below is the text from the magazine.  Thank you very much for the write-up.   We were pleasantly surprised with this best cosmetic surgeon award for Surgical Artistry.  It’s the first annual Best Of Stanislaus voting for Contentment Health and we were actually out of town when much of the voting was taking place.  We never even got a chance to vote for ourselves!

Best Cosmetic Surgeon:  Surgical Artistry: Dr. Tammy Wu and Dr. Calvin Lee
Best Cosmetic Surgeon: Surgical Artistry: Dr. Tammy Wu and Dr. Calvin Lee

(209) 551-1888 |

When you choose to go under the knife, it’s essential to have a surgeon you trust completely in charge of your procedure. When it comes to cosmetic surgery, there are few surgeons in the country as trusted as the experts at Surgical Artistry. Dr. Tammy Wu and Dr. Calvin Lee founded Surgical Artistry in Modesto 11 years ago. The married pair of ivy-league educated surgeons specialize in a full range of cosmetic surgical options to every patient along with procedures including Botox treatments, vein procedures and even acupuncture. Drs. Wu and Lee are known for their exceptional commitment to their patients and uncompromising pursuit of self-improvement. When you’re looking for fantastic plastic surgery or a cosmetic procedure, look no further than Surgical Artistry.


Dr. Tammy Wu, Board Certified Plastic Surgeon in Modesto is the Plastic Surgeon for Surgical Artistry.
Dr. Tammy Wu, Board Certified Plastic Surgeon in Modesto is the Plastic Surgeon for Surgical Artistry.

Please visit our Modesto Botox Home Page for more information.

Latisse Pricing changes at Surgical Artistry Modesto, California

Latisse pricing change to start 11/10/14

We are increasing the price of Latisse at our Modesto Surgical Artistry practice.  But it’s only slight – I hope you will understand.  We have tried to keep the prices low.

Original Size Latisse is now $100 per kit

  • The List price of Latisse 3ML is $125, our price is still better at $100.
  • Our pricing used to be $95

Large size Latisse is now $155 per kit

  • The List Price of Latisse 5ML is $180, our price is still better at $155 per kit
  • Our pricing used to e $145
  • The 5 ML kit, according to some of our Modesto Botox Patients, corresponds better to a Botox Cycle – which is every 3-4 months.

Our Latisse is authentic Latisse purchased directly from Allergan USA

  • It is not watered down, tampered, or shipped from another country outside of the USA.
  • Allergan is conveniently located in California.