Is this a real threat or are we getting a little, uh, paranoid about what lengths terrorists will go to to build a bio-terror arsenal? The "hook" in this article sits precariously on the premise that a growing underground distribution network for Botox Cosmetic clones may beget a chemical Armageddon via Al Qaeda or some other Islamo-fascist organization. You be the judge. Officials fear toxic ingredient in Botox could become terrorist tool:

In early 2006, a mysterious cosmetics trader named Rakhman began showing up at salons in St. Petersburg, Russia, hawking a popular anti-aging drug at suspiciously low prices. He flashed a briefcase filled with vials and promised he could deliver more -- "as many as you want," he told buyers -- from a supplier somewhere in Chechnya.

Rakhman's "Botox" was found to be a potent clone of the real thing, but investigators soon turned to a far bigger worry: the prospect of an illegal factory in Chechnya churning out raw botulinum toxin, the key ingredient in the beauty drug and one of world's deadliest poisons. A speck of toxin smaller than a grain of sand can kill a 150-pound adult.

No Chechen factory has been found, but a search for the maker of the highly lethal toxin in Rakhman's vials continues across a widening swath of Eastern Europe, the Middle East and Asia. U.S. officials and security experts say they know the lab exists, and probably dozens of other such labs, judging from the surging black market for the drug.

Al-Qaeda is known to have sought botulinum toxin. The Lebanese Hezbollah movement, which the United States has designated a terrorist organization, and other groups have bought and sold counterfeit drugs to raise cash. Now, with the emergence of a global black market for fake Botox, terrorism experts see an opportunity for a deadly convergence.

"It is the only profit-making venture for terrorists that can also potentially yield a weapon of mass destruction," said Kenneth Coleman, a physician and biodefense expert.

Read the whole story.

The New York Times has posted a well-written article about virtual consulting that touches on the world of plastic surgery. Should Surgeons Meet Patients Online?

Since some family practitioners have begun using electronic visits, the American Academy of Family Physicians has established guidelines, including the stipulation that a physician should evaluate only established patients virtually, and only over “safe, secure, online communication systems.”

The American Society of Plastic Surgeons has no policy. Some plastic surgeons make it clear to their patients that communications through their Web site “are not necessarily secure” and that “you assume the risk of unauthorized use” of say, the topless pictures you send for evaluation.

Read it all.

The usually credible Plasmetic blog recently published a ringing endorsement of the Acculift "lunchtime lift" procedure, which has been booed publicly by surgeons posting on the RealSelf online forum. The Acculift was popularized by J David Holcomb, MD, a Sarasota, Fla-based facial plastic surgeon. Lunchtime Facelift offers permanent results:

Facial fillers like Botox are often chosen by people who wish to retain the youthful appearance of their faces. However, the effects are often temporary and touch ups are required after about 6 months. But now there is another quick procedure that literally melts away the problems of the face. Ideal for treating jowls and deep fold, the Acculift procedure, also known as the ‘Lunchtime facelift’, is a revolutionary facial contouring procedure. And, the best thing is, the results are permanent.

A visit to the Acculift Web site shows a brief description of the Acculift procedure as "Facial contouring." Images on this Web site are credited to Holcomb. Here is Dr Holcomb's short-form biography on his practice Web site:

Dr. J. David Holcomb, MD, is a double board certified Facial Plastic Surgeon, past president of the Florida Society of Facial Plastic Surgeons and current president of the Sarasota County Medical Society. He completed his residency training at the University of Iowa's Department of Otolaryngology – Head and Neck Surgery, which is consistently rated among the best in the country by US News and World Report.  Dr. Holcomb subsequently completed a fellowship in advanced cosmetic facial plastic surgery through the American Academy of Facial Plastic and Reconstructive Surgery.

There's nothing wrong with promoting oneself on the wings, let's say, of a minimally-invasive technique that you have created that has caught on (especially in the blogosphere). This approach to marketing one's practice is, I'm sure, gratifying on many levels. However, there is a backlash effect that happens on the Web.

In the case of the Acculift, physicians on RealSelf.com posted critical comments about the procedure, which is probably the last thing Holcomb -- or any surgeon -- wants to see. The prospective patient may automatically give increased weight to a "review" of a procedure versus any attempt by the doctor to legitimize the procedure in question.