May 11, 2006 Few Americans had heard of a beauty treatment called
Thermage until Oprah Winfrey began championing it on her talk show. Billed as a procedure
to tighten skin, Thermage uses a radio-wave emitting machine to heat and expand collagen
beneath the skin’s surface.
In episodes with names like "How to Stop the Clock on Aging," "Look
Younger! Live Longer!" and "Look 10 Years Younger in 10 Days," Ms. Winfrey
introduced Thermage as one of the "latest cutting-edge treatments" and as a
"lunchtime face-lift" that requires no recovery time.
When Thermage was first showcased on "The Oprah Winfrey Show" in 2003, "the
show drove so much interest that our sales reps were selling machines over the
phone," said Stephen J. Fanning, president and chief executive of Thermage Inc.,
which sells machines to doctors for about $30,000.
And every time "Oprah" reruns one of its Thermage episodes, most recently last
summer, traffic on the Thermage Web site (thermage.com) spikes to 30,000 hits for the day,
Mr. Fanning said. Ten to 14 percent of the people who visit the site after seeing an
"Oprah" episode end up visiting a doctor’s office to have a facial
procedure, at an average cost of $3,500, he added.
Ms. Winfrey’s ability to create best-selling books with an endorsement on
Oprah’s Book Club is well known. Much less recognized is her Midas touch in the
beauty industry. With an average of about nine million viewers daily, the
"Oprah" show drives enormous traffic to cosmetics counters, spas and
doctors’ offices when she endorses a product or a treatment, according to beauty
industry executives.
"Getting on Oprah is like winning the lottery," said Marianne Diorio, senior
vice president of global communications for Estée Lauder. "Because her audience
really trusts her, if Oprah or her producers sincerely fall in love with some product or
person, the results can be spectacular," Ms. Diorio said.
The skin-care brand Philosophy was sold only in a handful of stores when Ms. Winfrey
included its Hope in a Jar moisturizer in a 1996 episode. "She took this obscure
little company and gave us national name recognition," said Cristina Carlino, founder
of Philosophy. The brand now sells in Nordstrom, Macy’s and Sephora stores and on
QVC. Last December, when Philosophy Amazing Grace Shower Gel appeared on
"Oprah," the product’s monthly sales increased to 18,000 bottles from 3,000
the previous December, said Ms. Carlino, who calls her manufacturing plant "the house
that Oprah built."
But a number of doctors say such an impact is more problematic when the beauty treatment
being featured is medical, with possible complications, rather than simply a cosmetic or
spa procedure. In its desire to be the first show to introduce the latest anti-wrinkle
options, "Oprah" sometimes features treatments before doctors have determined
how effective they are, who they are best suited for and how safe they are, according to
some leading dermatologists and plastic surgeons.
"Cosmetic procedures are presented in a casual, cavalier fashion that gives people a
false sense of security about safety," said Dr. Amy E. Newburger, a dermatologist in
Scarsdale, N.Y., who is a consultant on the Food and Drug Administration’s General
and Plastic Surgery Devices Panel, a committee that issues recommendations on whether new
devices should be approved.
Emphasizing that she offered her own opinion, not that of the agency, she added: "Do
you remember how angry Oprah was when she found out that fellow lied to her about his
memoir?" She was referring to James Frey, the author of "A Million Little
Pieces." "When is she going to get irate because these cosmetic treatments are
not the risk-free procedures she was told they were?"
Lisa Halliday, communications director of Ms. Winfrey’s production company, said in a
statement: "Harpo Productions Inc., as the producer of ’The Oprah Winfrey
Show,’ presents to its viewers content that reflects research-supported emerging
products and procedures."
A critic, Dr. Roy G. Geronemus, a clinical professor of dermatology at New York University
Medical Center, said that medical procedures were presented on the show as "a gross
oversimplification."
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"People see a physician on
’Oprah’ touting a new procedure," he added, "and they think that if
it’s coming from Oprah, it must be gospel."
He said viewers would be better served by segments that presented more than one
doctor’s view of a new technology. Most important, the show should explain that some
cosmetic procedures are so specialized that they are best performed by doctors with
extensive formal training in facial anatomy and not by general practitioners or nurses.
Last year Dr. Lisa E. Airan, a dermatologist in New York City, appeared on
"Oprah" in a segment about a new nonsurgical lower eyelid lift that she
developed with Dr. Trevor M. Born of Toronto. Ms. Winfrey told viewers that she had sent
her makeup artist, Reggie Wells, to have an "under-eye transformation" at Dr.
Airan’s Manhattan office.
Dr. Airan said in an interview this week that the procedure involves plumping up under-eye
hollows with deep injections of Restylane, a wrinkle filler. During the procedure, she
said, she is "injecting right onto the eyelid bone, between the covering of the bone
and the bone itself." On the show, Ms. Winfrey did not mention the more serious
complications of such an injection close to the eye, nor what skills a doctor needs to do
the treatment.
A number of dermatologists and plastic surgeons raised questions about the
procedure’s safety. Dr. Harold A. Lancer, a dermatologist in Beverly Hills, Calif.,
was so angered by the episode, which he saw when it was rebroadcast in March, that he sent
Ms. Winfrey an e-mail message calling the show’s dermatology component "highly
inaccurate" and "extremely deceptive." He said he received a form reply by
e-mail from Oprah.com thanking him for his response.
Dr. Sherrell J. Aston, chairman of the plastic surgery department at Manhattan Eye, Ear
and Throat Hospital, said that a doctor who doesn’t have experience operating on eye
tissue may not be competent to inject Restylane around the eyes. "If any injectable
went into the large vessels, it could block the orbital artery or vein, cut the blood
supply off to a major portion of the eye, and you’d go blind," he said.
Dr. Airan said that of the 600 patients on whom she and Dr. Born, a plastic surgeon, have
performed the eye lift, three developed prolonged under-eye swelling that lasted up to
three months. Television, she said, is not the place to discuss possible complications
— that issue is better addressed during an office consultation with each patient.
Critics of showing procedures like Dr. Airan’s on television without a discussion of
risks fear that demand for novel techniques will cause other physicians, with less
expertise, to offer them as well. And the techniques may be too new for all the
complications to have emerged.
In 2004 "The Oprah Winfrey Show" gave the first major television exposure to the
facial thread lift, in which threads made of surgical suture material are embedded in the
face and used to hoist lax tissue. Ms. Winfrey called it "a cutting-edge procedure
with no cutting edges" on the show.
Dr. Karyn Grossman, a dermatologist in Santa Monica, Calif., and New York City, said she
had just learned the thread-lift technique when she demonstrated it on "Oprah."
Ms. Winfrey’s producers "are interested in getting something out the door first
before it has been shown elsewhere," said Dr. Grossman, who has had positive results
performing the lift on her own patients.
Since that show was broadcast, doctors have reported complications from thread lifts
including scarring, indentations, bunching, dimpling, broken or lapsed threads, and
asymmetry, said Dr. V. Leroy Young, a plastic surgeon in St. Louis who is the outgoing
chairman of the emerging trends task force of the American Society for Aesthetic Plastic
Surgery.
Thirty of 51 plastic surgeons Dr. Young polled at the society’s annual meeting in
April said they thought thread lifts created more problems than benefits, he said. The
"Oprah" show reran the original thread lift episode last August.
"Oprah is well-intentioned and she doesn’t give bad advice," Dr. Young
said. "But if she told viewers that arsenic would make them beautiful, we’d be
getting hundreds of calls from people asking us for arsenic."
In the case of Thermage, the skin-tightening procedure, the dermatologist Dr. Patricia
Wexler first presented it on the "Oprah" show in 2003. Dr. Wexler, who is based
in New York City, told viewers that after a patient had a Thermage treatment, "the
jaw line gets tighter and tighter, just like a neck-lift." But last week she said it
is impossible for doctors to predict how well the treatment will work on an individual
patient.
"I tell patients it’s never a strikeout or a home run, but everyone will get on
base, we just don’t know which base ahead of time," she said.
Since the F.D.A. approved the treatment for use on eye wrinkles and folds in 2002,
Americans have had about 125,000 Thermage procedures and about 1,000 of the machines have
been sold, according to Thermage Inc. of Hayward, Calif.
The agency has collected 172 reports from doctors and patients of problems caused by
Thermage, including facial burns and indentations. Dr. Wexler did not address the
treatment’s complications on "Oprah," she said, because "the number of
burns were so few" that she did "not consider it a risk that was necessary to
discuss in detail."
Mr. Fanning, the chief executive of Thermage Inc., said in a statement that no medical
procedure is risk-free and "99.8 percent of the treatments have had no adverse
reports."
But Dr. Gary Motykie, a plastic surgeon in Los Angeles who has become a specialist in
treating burns caused by Thermage treatments, said the "Oprah" show should make
viewers aware of problems associated with new beauty devices. One of his patients who had
the treatment after seeing it on "Oprah" came to him with indented craters and
ripples in her face and neck where the procedure melted the underlying fat, he said.
"The patient wanted to know how this technology could get on TV," said Dr.
Motykie, whose practice does not offer Thermage.
Dr. Wexler suggested a possible answer. "I always say these shows are too
dreamy," she said. "They never talk about the bad because the bad doesn’t
sell." |
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