Cosmetic Surgery Special: $250 off an procedure Feb 1-8th.  Can not be combined with patient financing.  Can not be combined with any other offer.

Latisse: Buy one box for $99, get one free (while supplies last)

Purchase a $75 treatment or gift certificate from Candessa: get a complimentary So Berry Gift set with lotion and massage/bath oil.

Personal Microderm Kit:  Purchase the PMD for $150 and get a complimentary Renew Serum ($38 value).

Sculptra:  Buy 2 Vials of Sculptra, get 1 free.

Silicone Breast Augmentation:  Get Free Botox or Latisse for you and a friend when a patient gets silicone implants.

2012 Holiday Book Feb Coupon:  Buy an peel, get a free facial.

Botox 10^th Anniversary Special:  Get $50 off plus 200 points.  2^nd treatment get $75 off.  3^rd treatment get $75 off.

A question that is frequently asked in our practice is: What’s the difference between Revitalash and Latisse?  We thought we’d show you a quick comparison of the two and what makes them different.

Latisse solution is a prescription strength liquid that is applied to the eyelashes nightly used to grow eyelashes, making them longer, thicker and darker.  The onset of Latisse is gradual, but the typical person sees a significant change in eyelashes within 2 months.  Latisse has been approved by the FDA and no longer requires a prescription written by your doctor.

Latisse is easy to apply.  Once nightly, remove applicator from it’s tray.  Then, holding the sterile applicator horizontally, place one drop of Latisse solution on the area of the applicator closes to the tip but not on the tip.  Then draw the applicator carefully across the skin of the upper eyelid margin at the base of the eyelashes (where the eyelashes meet the skin).  Dispose of the applicator after one use.

For additional questions, please call our office and speak with a member of our staff.  They’d be happy to answer all of your questions regarding Latisse.

Receive FREE Botox or Latisse for you and a friend when you get Silicone implants!

Dr.Kjar, plastic surgeon, offers complimentary consultations to patients that are interested in talking about a particular procedure and has some questions.  This is the best way to learn if a procedure is right for you and if you are ready to have cosmetic surgery.  Call our office today if you are interested in scheduling a consultation 801.295.9105.

Dark green: Accreditation and/or licensure required; Light green: No state requirement; some states encourage accreditation but do not require it.
Source: The American Association for the Accreditation of Ambulatory Surgical Facilities

Source: The American Association for the Accreditation of Ambulatory Surgical Facilities

Three patients of a former Phoenix emergency room doctor died after having cosmetic surgery at his offices. That helped persuade the Arizona board of medicine to publish guidelines in early 2008 about the kind of training doctors practicing outside of their specialties need to be competent in the procedures they do. The doctor, Peter Normann, was convicted of two counts of second-degree murder and one count of manslaughter and sentenced to 25 years in prison in September. He is appealing the conviction.As cosmetic surgery becomes more popular and lucrative, the temptation for physicians to branch into new, potentially risky procedures has never been greater, regulators, doctors and plaintiff lawyers say.

The two cases influenced the board’s decision in March to adopt a position statement that says doctors who expand their practices will be held to the same standards as more extensively trained physicians and must ensure they have enough education and training.

• STORY: Part 1: Lack of training can be deadly

• STORY: Part 2: Cosmetic surgery gets cheaper, faster, scarier

• VIDEO: Is the price for low-cost cosmetic surgery too high?

States are starting to address the growing issue of what some call “practice drift” — physicians working outside of the areas in which they’re trained and board certified. In addition to Arizona and North Carolina, at least nine other states spell out in statutes that doctors have to be competent in any procedures they perform.

“This is on the radar of many state boards,” says Humayun Chaudhry, a physician and CEO of the Federation of State Medical Boards (FSMB). “What doctors should or shouldn’t do when they change their area of focus is a concern for everyone.”

As cosmetic surgery surges in popularity and insurance payouts to doctors decline, the temptation for physicians to branch into new, potentially risky procedures has never been greater, regulators, doctors and plaintiff lawyers say. Insurance companies and hospitals typically prohibit doctors from practicing outside of their specialties, but office surgery facilities are unregulated in more than half of states. As interest in cosmetic procedures spreads outside of urban areas and coastal states, there are sweeping differences in state laws governing what kinds of surgeries doctors can perform and where.

“There are so many areas of medicine that are considered to be lucrative, that it’s attracted physicians to do those procedures who really aren’t trained to do them,” says Jim Leventhal, a Denver plaintiff attorney who chairs the American Association for Justice’s professional negligence section. “Laws need to be passed which regulate outpatient procedures requiring appropriate training to perform the procedure and appropriate training and equipment to respond immediately should a patient need emergency care.”

USA TODAY INVESTIGATION

PART 1: These women died after having liposuction. Their doctor wasn’t board certified – but their was no law to stop him.

• COVER STORY: Lack of training can be deadly in cosmetic surgery
• VIDEO: Risk of using doctors who aren’t board-certified plastic surgeons
• STORY: What questions to ask when picking a cosmetic surgeon
• VIDEO: What to consider in cosmetic surgery, lasers and injections
• STORY: Recent cases showing risks of using non-board-certified plastic surgeons

Unrelated practices

In September, USA TODAY published a two-part series about the risky ways some doctors are responding to a growing demand for inexpensive cosmetic surgery.

Many are expanding unrelated practices, such as in obstetrics or radiology, into cosmetic surgery. Clinics that employ board-certified plastic surgeons have also been accused of downplaying the risks and aggressively marketing cheap alternatives to traditional plastic surgery. The series reported on some of the deaths and injuries — especially from liposuction — that have resulted from this commoditization of cosmetic surgery.

Earlier this month, the Florida Senate‘s health regulation committee unanimously approved a bill that would require spas that provide beauty treatments and liposuction to comply with existing laws and safety rules that govern other surgery centers. Committee Vice Chair Eleanor Sobel, a Democrat, said her bill “fixes a problem that allowed facilities to avoid safety protections and inspections by declining to offer anesthesia and instead using pills or injections.”

Practice drift into cosmetic surgery may be more pervasive, but it’s just one of “the problems in medicine whereby doctors — or non-doctors — are doing things they don’t have the training and experience to do,” says trauma and cancer surgeon James Hinsdale, immediate past president of the California Medical Association. He says doctors with hospital privileges to perform certain procedures will branch into others, such as laproscopic procedures, once in the operating room.

Only 21 states require licensing and/or accreditation of offices where surgery is performed. “With cosmetic surgery, procedures are almost always done in the office, often without necessary and appropriate arrangements for emergencies,” North Carolina medical board spokeswoman Jean Fisher-Brinkley says of the national problem. “Doctors who drift typically do not have hospital privileges to do the procedures they are doing in the office (so) if complications do arise, the doctor often cannot even accompany the patient to the hospital.”

Without strong state laws, the courts become the regulator, says Kansas City, Mo., plaintiff lawyer Dan DeFeo. Until states have greater uniformity in laws, physicians will just move to where there’s a demand and less oversight, he says.

• MORE: Find out if a doctor is board certified in plastic surgery

• MORE: Find out if your doctor is licensed and has any in-state disciplinary actions

Arizona’s practice guidelines listed cosmetic surgery, pain management and erectile dysfunction as the most common areas attracting non-specialists.

USA TODAY INVESTIGATION

PART 2: Critics say some low-cost, high-volume cosmetic surgery clinics are under so much sales pressure that they don’t sufficiently screen patients or do adequate follow-up.

• COVER STORY: Cosmetic surgery gets cheaper, faster, scarier
• VIDEO: Is the price for low-cost cosmetic surgery too high?
• STORY: Non-surgical cosmetic options also have risks

Daniel Brookoff was an oncologist before he started practicing pain management in Denver. According to a lawsuit filed on her behalf, furniture chain owner Leslie Fishbein was treated for back pain by Brookoff and died of a heart attack after 30 injections of the powerful anesthetic Marcaine. The lawsuit charged the facility didn’t have adequate emergency equipment, staff or medications and that Brookoff was negligent.

• LAWSUIT: Read the Fishbein lawsuit

• RESPONSE: Read the response from Daniel Brookoff and HCA

Attorney Leventhal brought five cases against Brookoff and clinic owner HCA, including the lawsuit on behalf of Fishbein’s widower, Sam. After two of his patients died and three others suffered brain injuries, Brookoff committed suicide in April.

Brookoff’s attorneys confirmed the Leventhal lawsuits were settled out of court. In a response filed to Fishbein’s lawsuit before settlement, lawyers for Brookoff and HCA denied the allegations.

More than 50 patients claimed in a multi-plaintiff lawsuit that North Carolina ENT doctor Drago misrepresented his background, failed to use sterile equipment, let people who weren’t doctors perform liposuction and was negligent in surgery and anesthesia. A response filed by Drago’s attorneys said he met the “applicable standards of care.”

• LAWSUIT: Read the lawsuit against Paul Drago

• RESPONSE Read Drago’s response

The case was settled out of court. Drago lost his license to practice medicine in North Carolina, but he is now a doctor in South Carolina‘s state prison system.

Disciplining doctors

State boards of medicine can discipline doctors who are doing procedures they aren’t qualified or trained to do or who are putting patients at risk in an unsafe office surgery facility. These practices can fall under sweeping prohibitions against unprofessional conduct or “substandard care,” says Lisa Robins, FSMB’s chief advocacy officer.

VIDEO: Risk of using doctors who aren’t board-certified plastic surgeons.

David Henderson, executive director of the North Carolina Board of Medicine, says violation of the board’s position statement “could constitute unprofessional conduct.” Still, while it’s time-consuming to get a law passed, it would likely expedite the disciplinary process. “Instead of bringing experts in to testify what the standards of practice or unprofessional conduct are, we could simply introduce into evidence a copy of the law,” Henderson says.

But Scott Kirby, a doctor and medical director of the North Carolina board, says a law restricting practice drift could stifle doctors’ abilities to innovate. He says the board more closely scrutinizes substandard care allegations about doctors practicing outside of their specialties.

Dermatologists Brett Coldiron and John Starling have been fueling the fight against laws requiring accreditation of office-based surgery, which they say is costly and could restrict care for patients. They say data on Florida and Alabama’s surgical complications show plastic surgeons — who are required to work in accredited facilities by their membership boards — have far more complications than other doctors performing cosmetic surgery. Starling acknowledges, there is no data on how many procedures are done, by plastic surgeons or surgeons in general.

If a state doesn’t have formal guidance or a law covering office-based surgery and the doctors who practice it, “more people are going to get injured,” says Sidney Wolfe, a medical doctor and director of Public Citizen’s Health Research Group. “States should want to expand their existing authority.”

Some state efforts at regulation

Many state boards have adopted statutes, rules, policies and/or guidelines for the regulation of office-based surgery. According to the Federation of State Medical Boards, these changes focus on increasing safety during procedures by means including having enough trained personnel and “adequate malpractice insurance.”

Among state legislative and regulatory efforts:

New York. Bill would require that every facility operating as an office-based surgery practice or setting to have a certificate of registration along with a full accreditation.

Tennessee. Bill would require all cosmetic outpatient surgery clinics to be licensed and regulated by the state health department.

Florida. Would require doctors who perform office surgical liposuction and remove more than 1,000 cubic centimeters of supernatant fat to register with the Department of Health.

Alabama. Recently amended office-based surgery rules to require registration for doctors performing office-based tumescent liposuction procedures and procedures using propofol.

Washington. Final rules in January govern osteopathic physicians who perform surgical procedures and use anesthesia, analgesia or sedation in offices.

Dr.Kjar operates in only accredited surgical facilities.  Patient Safety is his number one priority.  Because it is not mandatory in the state of Utah for a doctor to perform surgery in an accredited medical facility, as a patient, do your homework and research the facility that you are having your procedure performed at.  Several links are provided above that you can click on and follow to see if a facility is accredited.

It’s SIMPLE:

• Browse through our calendar to see which deals you may want to take advantage of.
• Make sure to call or visit our office that day to purchase that product or treatment. If you can’t make it in, call and pay for it over the phone and we’d be happy to ship it to your home for free.
• Visit our Facebook page and watch each day for a GIVEAWAY.  We will be giving away 1 of the items listed on the calendar for that day.  If you are not already a fan of our Facebook page, click here: http://www.facebook.com/pages/Dr-Kjar-and-Candessa-Aesthetics/137491781004

$50 off your Botox treatment.  Now is the perfect time to get rid of your wrinkles for the holiday’s.  Botox usually takes a couple of days to set in, so make sure to make your appointment today to look great for the holiday’s.

You can also receive an additional $75 off  if you get Botox and Juvederm at the same time.  Juvederm is a wonderful injectable that is a small gel that helps reduce wrinkles around your nose and mouth.  Juvederm is also a great lip filler.

This additional offer is only good through November 30,2011.

So, you can receive $125 off Botox and Juvederm for a limited time!

Rules:

*Patient Must Purchase at least $200 worth of Botox

*Patient must register for the Brilliant Distinctions Program or send in a mail-in rebate for refund.

*Purchase an Ultra Peel and get a complimentary glo pumpkin scrub at home product.  VIP newsletter members get an extra 20% off their peel.

*Revitalash Holiday Gift Box $150 includes (1) Revitalash Advanced Eyelash Conditioner (1) Volumizing Mascara in Raven color and (1) Volumizing Primer $(198 value)

*Purchase any product over $150 and get a complimentary eyebrow wax/design and tint ($45 value).  Products include Revitalash, Latisse, Obagi, Jane and glo.

*Sculptra: $50 Rebates per vial (up to 3)

*Plastic Surgery Special: Purchase any cosmetic surgery procedure over $3,500 and get $250 off.  Pay with cash and get an additional 2% off.  Can not be combined with any other promotion.  Can not be combined with CareCredit financing.  $500 surgery reservation must be paid by November 30, 2011.