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Will it hurt?

24 Nov

Pain is such an abstract and obscure concept. You can’t really define it. It has so many dimensions. In the hospital, we assess pain on a scale of either facial expression charts or numerically from 0-10. Zero being no pain, and 10 being the worst pain you’ve ever felt in your life. It is an individual experience; the numerical response to a stimulus can differ drastically from person to person. So, whether or not something will hurt is relative.

    Source: http://www.pamz.com

On a Scale of 0-10…

What’s the most painful thing I’ve ever experienced? First, a broken heart. That took a really long time to recover from… and I definitely still have scars! The second most painful thing I’ve ever endured is being in a car accident, which I also still have issues from. I’ve never gone through childbirth, never been divorced, still have both my parents, and never had a kidney stone. So my list has room to change. I’d like to point out that my list does not include Botox, Fillers, or my recent surgery. But that’s what this post is about. Do aesthetic procedures hurt as much as people think they will?

Beauty is Pain

We’ve all endured painful treatments in the name of beauty. Ever tweezed your eyebrows? Waxed your lip? Burned yourself with a curling iron? Stuck an eyelash wand in your eye? Walked more than a street block in stilettos? All painful, but relatable, every day examples of things women do in the name of beauty.

If you asked 100 women the same question, you’d get a 100 different answers. This is because women never have a “yes” or “no” answer. It’s always a story. So here’s a comparison story.

Q: How painful are stilettos?

A: Well, that depends.

  • How big are the stilettos
  • How long are you wearing them for
  • How far will you need to walk in them
  • Who makes them
  • How often do you wear stilettos
  • How often do you wear those particular stilettos (i.e. are they broken in)
  • What condition are your feet in (i.e. do you have any blisters)
  • What size are the stilettos vs. what size are your feet (i.e. does the shoe fit)
  • What are the road conditions for which you will be walking in them (i.e. changes in elevation)
  • What are the weather conditions for which you will be wearing them (i.e. rain or snow, inside or out)
  • Etc, ect, ect.

So, when you ask how badly something will hurt, there are many conditions which will change the outcome. It’s hard to explain the pain factor of beauty. The “Universal Pain Assessment Scale” does not really work when it comes to women and what they’re willing to endure. So… I decided to paint my own comparative scale. Because I love “Paint” (the computer program) and I love making stuff relatable.

The “LK Aesthetic Comparative Assessment Scale”

I’m not going to lie. This took me a long time to create, and it’s pretty scientific (although has no reliability or validity, it is merely my projections). This is how it works. Each treatment is rated in 3 dimensions on a scale of 1-5. Then those 3 numbers are added.

Chemical Peels

Laser Hair Removal


Laser on the Face



Eyeliner Tattoo


Botox


Fillers


Some fillers hurt more than others. The worst is the lips. I used that for the pain scale, but other areas hurt much less.

Tear Troughs    2

Cheeks        2

Marionette Lines    3

Naso-Labial Folds    3

Plastic Surgery

In all fairness… I think surgeries could be subcategorized. I heard liposuction isn’t really that bad. I guess it depends how well you are medicated too. Pain is relative.

I Hope this gave some perspective! Remember, this scale holds no scientific basis.

XOXO. LK.

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Belotero: The Buzz

18 Sep

I’ve been waiting to announce this for months!

Merz Aesthetics (the company that makes Radiesse) has released a new product: Belotero Balance. The product was FDA approved in November, 2011. My office was involved in clinical trials, so I (of course) got a sneak peak at the product, and have been anxiously awaiting it’s arrival.

Why am I so excited you ask? Well, first, I think Merz makes awesome products (Radiesse is my favorite to use!). Second, and most important, this product can go into vertical lip lines! That’s right. No more “smoker’s lines!” I have SO many clients who complain about “smoker’s lines” around their lips!

Prior to this product’s release, there were two ways to treat the vertical lip line: with Botox or with HA Fillers.

Botox


  • Some people like it, some people don’t. I’ve personally never had Botox injected in my lips (I have however had many, many syringes of Juvéderm), but I’ve been told it is a strange sensation. It feels weird to spit out your tooth paste, or use a straw, or kiss, because the muscle that is used for these things is “relaxed.” Obviously, you don’t want to relax it too much, or you’ll look like a stroke victim, so I’ve found it doesn’t last long in the lips.

Fillers (Juvéderm and Restylane)

  • As you can see from the picture below (this is a great example), by injecting product into the border of the lip (vermillion border), the vertical lip lines do visibly improve, but they are still there.

  • OR, you can have what I like to call “the monkey face effect” (I couldn’t find an excellent picture of this, but I’ve seen some real bad monkey faces. I would have tried to take a picture of this, but I’ve found people don’t respond well when you tell them they look like a monkey face from their filler. Or a cat face.)

Anyways, Back to Belo…

The Hyaluronic Family

Belotero is a hyaluronic acid injectable gel, like Juvéderm and Restylane. Belotero more easily integrates into the skin and adapts to facial contours than other HA’s because it is softer. This results in a more natural and subtle look (but may require more product in some areas). Belo is designed to treat superficial facial lines and moderate to severe wrinkles that are closer to the surface of the skin. Unlike Belo, fillers such as Juvéderm leave a bluish hue under the skin called the Tyndall Effect, when it is injected too superficially, like in vertical lip lines. Injections of Belo last up to 12 months, which is comparable to Juvéderm (Restylane lasts about 6 months—does anyone even use Restylane anymore? Anyone?).

Belotero is made of sugars which naturally occur in our skin. No allergy test is required, and treatment is very safe. Like with all injectables, bruising and swelling are always a possible. My friend Colleen who is a dental hygienist is going to hate me for saying this again, but, for those of you in Boston who don’t tell anyone you do this stuff (even though EVERYONE does it) the best excuse for bruising is a “dental appointment.”

For fine superficial folds/fine lines. Including:

  • Periorbital folds or “crow’s feet” (also referred to as Periorbital lines)
  • Perioral Lines (aka Smoker’s lines)
  • Tear troughs
  • Deep forehead lines

For medium wrinkles, moderate-to-deep folds, lip contouring, and facial contouring. Including:

  • Glabellar crease, or frown line (the line that forms between the eyebrows).
  • Nasolabial folds, or smile lines (from the edge of the nose to the corners of the mouth).
  • Mentolabial crease, or chin folds (horizontal line that forms across the middle of the chin).
  • Marionette lines (from the corners of the mouth to the chin and jawline).
  • Earlobes (which of course aren’t in my picture! Oops!)
  • Lips and philtrum (which is the area between the nose and the upper lip)

(Do you like my feather lashes? I love Halloween Eyelashes!)

The world of Aesthetic Medicine is always changing. New products are being developed as we speak. For the latest info on the best new technology, stay tuned! I’m psyched for my newly approved Sientra Silicone Breast Implants! One more month until surgery!!!!

XOXO, LK

Getting Implants– Entry 1

7 Sep

I’ve been working in Plastic Surgery for a few years, and I’ve never been under the knife. I finally made the decision to book a breast augmentation. This is my experience, from a patient point of view.

August 27, 2012

I guess I would consider this day an emotional roller coaster! I had just finished a brachioplasty with the plastic surgeon (as a surgical nurse) when I was called into his office. Long story short, surgery is booked for October 18.

My first reaction was obviously excitement. There may have been a point where I was jumping up and down… and clapping.

Of course, on this day, my mother was meeting my new boyfriend for the first time. Do I tell her? Do I tell my dad? Do I tell my boyfriend’s parents who have probably already read about it on facebook? Honestly, I’ve actually never questioned telling anybody anything I do (although, in hindsight I’ve questioned whether or not it was always appropriate); it was a really odd feeling! I figure, I’m a terrible liar, so I might as well just say it like it is:

“Mom, I’m getting a boob job.”

Things don’t really faze my mother at this point. There was a moment of déjà vu back to the night before my 18th birthday, when I told her I was getting a tattoo.

“How big?” she asked.

“Proportional” I answered. (I gave the wrong answer when I was 18, and I am fortunately not the owner of a GINORMOUS back tattoo, THANK GOD for my mother telling me to make it small!).

“It’s your body, whatever makes you happy.” Aw, mom!

It’s Your Body

Making the decision to undergo plastic surgery should never be anyone’s decision but your own. It should never be for a guy or under peer pressure of a friend. It is a major decision, and as with any surgery, it has risks. I’ve wanted to do this for years, but either I haven’t had the time or I haven’t had the money!

I want to be more proportional. I want my clothes to look good on (or off). And I don’t want to dread bathing suit season!

My reasons for doing this are healthy, and I am very happy with my decision.

August 9,2012 – My Consultation

Choosing size, shape, and style

There are a lot of options to consider when deciding on implants! The first question many ask is: “how big?” expecting an answer in cup size, I guess. But implants don’t come in cup size. They come in cc’s (cubic centimeters). In order to determine the size, shape, and style of implants that are best suitable, there are several things to consider:

  • Symmetry of your breasts
  • The width of your breasts in proportion to the chest wall
  • The characteristics of your breast tissue – how much tissue do you have? How much stretch do you have in your breast tissue?
  • Your goals and expectations for surgery
  • The location of the incision and the implant placement

The Age Old Question: Saline vs. Silicone

Saline

Silicone

Contents

Filled with sterile salt water.

Filled with soft, elastic gel.

May be pre-filled to a predetermined size, or filled at the time of surgery to allow for minor modifications in implant size (good for asymmetrical breasts).

Pre-filled and may require a longer incision for implant placement.

Consistency

Amount of fill affects the shape, firmness, and feel.

Feels and moves like natural tissue.

Risks

scar tissue, breast pain, infection, changes in nipple sensation, implant leakage or rupture.

same as saline.

Rippling

More likely

Less likely

Cost

Less expensive

More expensive

I chose silicone, because it is more natural looking and feeling.

Under the Muscle or Over?


The implant is placed in a pocket either directly behind the breast tissue (right) or underneath the pectoral muscle which is located between the breast tissue and chest wall.

I chose under the muscle.

Incisions, Incisions, Incisions?


An incision can be made either underneath the breast, just above the crease, around the lower edge of the areola or within the armpit.

One of the advantages of a saline-filled implant is that, because it is filled with saltwater after being inserted, only a small incision is needed. Often, an incision of less than one inch is made underneath the breast, just above the crease, where it is usually quite inconspicuous.

Another possible location for the incision is around the lower edge of the areola. A third alternative is to make a small incision within the armpit.

Once the incision is made, the surgeon creates a pocket into which the implant will be inserted, either under or over the muscle as previously discussed.

Smooth or Textured

The surface of the implant can be smooth or contoured. The contoured implants have little bumps on them (like gripping). They are teeny tiny. It’s hard to describe and the pictured don’t really help. But anyways, this keeps the implant exactly where it is placed.


smooth, round

textured, round

I choose textured.

Round or Oval Base

The base of the implant (or the back I guess you would call it when it’s inserted) can come in round or oval.

round

oval base (see how it’s wider)

We are still deciding this one. Leaning towards oval base.

Projection

The amount the implant sticks can be determined by the base to width ratio of the implant.

High Profile Implants

Have more projection per measurement of base diameter than a moderate profile breast implant. An added benefit of the high profile breast augmentation is that in order to create the profile, the side wall of the implant has more height, which may reduce visible rippling. These high profile breast implants will provide more anterior projection (front projection).

Moderate Profile (regular / standard)

These are the standard, creating a ‘normal’ profile. With a full and rounded look, this moderate profile breast implant adds a significant amount of dimension and volume to a woman’s breast. This could create a wider chest appearance, which would benefit those with a narrow chest.

Low Profile Implants

These breast implants have less projection per measurement of base diameter than a moderate profile breast implant.


Example:

200cc High Profile Implant (top in picture) is 9.8cm wide and 9.8cm tall. The projection is 4.9cm

210cc Moderate Profile Implant (bottom in picture) is 10cm wide and 11cm tall. The projection is 3.8cm.

Drawing not to scale. Sorry!

I chose moderate profile, again, because I want the most natural look.

Round or Contoured Implant Projection

Prior to Sientra’s new implant (more on Sientra below) the contoured implant eventually became more round due to the body’s muscle pulling on the silicone gel. The new “gummy bear” implant will keep it’s shape.

round shape

contoured

We are still discussing this as well, but we are probably going with contoured.

Breast Implant Manufacturers

Currently there are 3 companies that manufacture breast implants in the U.S. As of recent, a cohesive silicone gel implant manufactured by Sientra was approved by the FDA (after 8 years of clinical trials). I had heard of this hot new option in New Beauty Magazine (best magazine ever) a year or so ago. They have been nicknamed “gummy bear implants” because, like the candy, the implant has a rubbery consistency that holds its form well over time. This product is the most natural-looking breast shape, and lasts for many years.

The Sientra Implant has the lowest leak rate of all the implants currently approved. Even if the outer shell is ruptured, the silicone gel in the implant remains cohesive and doesn’t migrate to other parts of the body. (I would have tested this theory, but I’m not allowed to cut the implants in half at the office…)

The implant is the most natural looking. Because silicone gel is more cohesive, the risk of shell collapse producing a rippling effect seems to be lower. The implant is also fit to the person’s size and body type.

Less scar tissue
forms with this implant type. Capsular contracture is the medical term for scar tissue buildup and hardening around the implants – a condition that can be painful, and in severe cases, require surgery. The rate of scar tissue buildup appears to be much less with gummy bear implants.

I’ve basically been looking at breasts and reading about breast implants since the middle of August. (Is this what it feels like to think like a man?) Here are some sites I found interesting about Sientra’s new silicone implant (the second two are video’s).

http://www.sientra.com/

http://abcnews.go.com/Health/gummy-bear-breast-implants-future-breast-augmentation-surgery/story?id=16370362#.UEiTF2Hh-pg

http://www.huffingtonpost.com/2012/04/09/gummy-bear-breast-implants_n_1413122.html

My Consultation Sizing


Before

492cc Implant

Before

492cc Implant


Why I Chose To Have an Eyelid Lift

28 Aug

A Note from Me:

The following is a note from a patient about their experience with blepharoplasty, or an eyelid lift. The patient has been a client and friend of mine for years, and had started doing Botox to lift her eyelids, although ultimately, she wanted surgery. I encouraged my client to talk to a plastic surgeon, just to get an idea of what the surgery was like, and when would be the best time for her to undergo this procedure. The patient decided to book surgery after her consultation.

I was able to assist in the procedure at the Newton Surgical Center location. Because the patient was also a friend of mine, we had previously arranged for me to take care of her post-op as well. The surgery itself was only about 2 hours start to finish. The patient stayed home for the next few days, but had very little pain or swelling. The best advice we can give: keep frozen peas in plastic baggies in the freezer and switch them out every 20-30 minutes. Ice decreases swelling, and the peas are light weight and mold to the shape of the eye. I knew there was some use for those things (I am not a fan of peas!).

I would like to thank this client for sharing her story!

(Do you like my shirt? I thought the eyes were appropriate for this post! Wow… I officially have started matching my outfits to my blog posts… maybe I’m becoming more like my mother (the kindergarten teacher) who has a festive turtleneck for every holiday of the year. I did match my diva weave to the Fourth of July this year…)

  • LK

Blepharoplasty (Eyelid Lift)


Blepharoplasty, or “Bleph,” is a surgical modification of the eyelid. Bleph’s are performed both for functional and cosmetic reasons. Cosmetically, the heavy, drooping eyelid gives the illusion of a tired appearance. The lower eyelid bleph is almost always done for cosmetic reasons, to improve the appearance of “bags” and puffiness. (In my experience, eyes are the most concerning feature for women in regards to aging.)

In severe cases, where vision is compromised, everyday tasks (such as driving) can be hazardous. An eyelid lift gives the patient a more awake, alert and youthful appearance and increases the field of vision.

Source: Center for Advanced Facial Plastic Surgery


Whether one is looking to treat their upper lid, lower lid, or both, this procedure is generally the same.  Blepharoplasty is usually performed under local anesthesia in an office or hospital setting.  I’ve assisted in many bleph’s (Observing Surgery: Blepharoplasty).

A crescent shaped incision is made either in the upper eyelid fold or next to the lash line on the lower lid.  Excess skin and fat are removed and small, inconspicuous sutures are left behind.

    


After surgery is complete the eye area can bruise and swell.  Cold compresses (or peas!) can be applied gently to minimize these effects. Antibiotic ointment also needs to be applied for the first couple of days to prevent infection.  Patients will return to for a follow up a week after surgery monitor the healing progress and most return to work soon after that.  The incision lines will fade after approximately two months, but are barely visible.

A Note from a Patient:

I can remember as far back as 6th grade having heavy eyelids. I am almost – and I say almost – 60 years old. For the past 10 years or so, I found myself constantly raising

my eyebrows in hopes that it would raise my eyelids. It became just so natural for me to do that – hence – wrinkles. Can’t win!!

Then I met Laura. Here I am – Miss Deathly Scared of Needles – and I had no qualms about getting shot up with Botox. Instantly there was an amazing difference. She was able to raise my brows so that it took an edge off of my drooping.

As a couple of years went by, I just got to the point where it just wasn’t enough for me. Hey, I am approaching 60, how long am I going to wait to become 40 again. Laura talked to me about seeing a doctor to get my eyes done. He was running a special time of the year sale and who doesn’t like a sale?? But seriously, I made the appointment and met the Dr. I felt so comfortable with his approach and what he had to say.

Originally, I had only wanted to get my top lids done. I had been so focused on them for so long that I didn’t even think about underneath the eyes. The doctor explained the full procedure to me (both top and bottom) and recommended I do both lids. He showed me the excess skin I had, and suggested once I did the tops, I would definitely want to do the bottoms (they were pretty saggy as well!). He said it didn’t make sense to do surgery twice. I was very happy with what he told me and made the appointment.

I was more excited than I was nervous on the day of my surgery AND lucky. I had my own private nurse. Laura picked me up and brought me in for the surgery. She actually stayed and watched the surgery for more of that unstoppable knowledge that she craves. I wasn’t totally knocked out, so I have very faint bits of hearing some things. Apparently, I wanted to get up and help. How thoughtful of me!! When I was done, Laura took me home and took care of me (as much as I can remember). Thank goodness for peas, the best home remedy in the world.

My recovery was so fast. I didn’t have any problems at all. It was amazing. I chose to stay in the house for almost a week just because I am so vain and it forced me to stay home and work. From being so healthy and constant peas on my eyes, my lids started healing over the stitches so they took them out early. Four of my friends came over to see me one day to bring lunch. I think I was in the very purple stage. No one wanted to say anything. My cousin told me later that she was scared to death looking at me. I knew how bad I looked. Now they all can’t believe how amazing my eyes look. I absolutely love them. AND the funny thing is that with all the focus on the lids, the best thing I did was underneath the eye. I would do it all over again in a heartbeat.

Other patient experiences:

Why I Chose to Have a Tummy Tuck.

Why I Chose to Have a Tummy Tuck

10 Jun

The following was written by a patient who had undergone abdominoplasty. She is 40 years old, and had extreme weight loss resulting in extra skin. I think it’s also an important point to mention that she is recently divorced (which is stressful for anyone), and has been thinking about dating again (which is stressful for EVERYONE!). I am very thankful for her to share her story. There are tons of women who want to know more about this procedure.

Abdominoplasty

AKA “Tummy Tuck” is a surgical procedure used to make the abdomen more firm by removing excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia of the abdominal wall. The wall is then stitched together making the abdomen more “tight” in appearance. This procedure is great for women who have had kids (they say you never can get your body back after children—”they” clearly haven’t heard of a good surgeon!) and for individuals who have lots of sagging, excess skin after major weight loss.


This procedure is sometimes also done in conjunction with liposuction of the abdomen. But not always. J

Why I chose to have a tummy tuck

I first considered getting a tummy tuck 2 years ago when I was going through a tough time in my life, thinking it might boost my spirits.  My weight had gone up and down for about 20 years and I had maintained a pretty substantial amount of weight for the latter part of those years.  I had just started to lose some weight due to stress and had talked casually to a surgeon about having it done.  He recommended I have a consult and that was as far as I got with it at the time.   

I thought I had made up my mind when I overheard a friend tell another friend that I was planning surgery for all the wrong reasons.  Something in me snapped and I decided against surgery.  I contacted a personal trainer and started on a plan to lose weight and get in shape.  It was not easy.  I had never been one to exercise and it took me a long time to start choosing the right foods.  The same patterns continued where I would lose some weight, but then put it back on.  I was getting frustrated and knew I had no one to blame but myself.  I continued to work out and eat better but I just couldn’t seem to move forward.

A few months ago I saw the same surgeon who told me I should have the tummy tuck.  He knew I had been working out and eating better and I didn’t look much different.  I took his advice this time and had a consult.  What I learned was that I had loose skin that was never going to get smaller with diet and exercise.  On the contrary, the more weight I lost the more loose skin I had.  It got to the point where I felt like it was both mentally and physically holding me back.  I decided to do the surgery.  The hardest part of my decision was telling my personal trainer.  I was afraid he would think I was taking the easy way out and I respect his opinion.  He was great!  He didn’t realize I was dealing with excess skin and he was very supportive.  He asked me a lot of thought provoking questions to verify that I was doing it for the right reasons and he gave me his blessing.  I thanked him and told him I would see him 6 weeks after surgery.

A week before surgery I had a pre-op where they took photos and went over my health history.  Other than the excess weight I was extremely healthy and a good candidate for surgery.  I was a little nervous, but mostly about the recovery.  I wasn’t nervous about the surgery, just about how I would feel afterward.

The morning of surgery I got up early and went to the hospital.  I was greeted by the wonderful nursing staff and then by my surgeon.  Lastly, I was introduced to my anesthesiologist, and that’s where it all becomes fuzzy.  The next thing I know I was waking up and the nurse said hello to me.  My response: Am I skinny now?  She laughed and told me I was.  I was in the recovery room for a short period of time and then two nurses wheeled me to my room.  My only discomfort at this point was bladder pressure (they adjusted my catheter and all was fine) and my back was sore.  Once I was able to adjust myself on the bed I had no discomfort. 

I opted to stay overnight in the hospital and I am glad that I did.  The nursing staff made sure I got meds on a regular schedule and I felt comfortable knowing I had round the clock care.  I had a few visitors who came and made sure I ate and that I was recovering well.  When the nurse came to give me pain meds I asked for Motrin instead.  I had zero pain, which was unexpected, so I didn’t feel the need to take narcotics.  I spent exactly 24 hours in my hospital bed and barely moved a muscle.  I wasn’t sure what to expect with movement so I decided to wait until the next day to move around.

The next morning the nursing staff asked me if I wanted to get out of bed and walk around.  I had them remove my catheter but told them I wanted to wait to get out of bed.  As soon as they left I got up on my own.  I don’t know why.  I think maybe I wanted to know I could do it on my own.  I walked to the bathroom and washed my face and brushed my teeth.  I walked back to the bed for a half hour and then got back up to get dressed in anticipation of going home.  Imagine the surprise the nurses experienced when thy came to check on me and I was dressed and ready to go!  No discomfort!  My only thought was to stay hunched so I wouldn’t compromise my stitches.

My friend, coincidentally a nurse, came to pick me up around noon.  They wheeled me in a wheelchair to the car and I very carefully climbed in.  I was tired but otherwise felt good.  The ride home was uneventful.  I got home and slowly walked upstairs to my bedroom, knowing I would be staying there for a few days while I recovered.  The doctor had told me to get up and walk around a little bit, but only as needed.  I had 2 drains that would let him know if I did too much activity.  I had another nurse friend stay with me the first night home but after that I felt like I could manage on my own.

I was a pretty good patient, or so I thought.  I felt great so I ended up walking around more than I was supposed to.  I washed my hair every day and fed my cats.  When I went for my post op appointment 6 days after surgery I got bad news.  My drains were pulling in too much fluid which meant I couldn’t have them removed.  I was put on bed rest and told to come back in 2 days.  Lesson learned.  I stayed in bed for the full 2 days, only getting up to go to the bathroom.  It worked.  I had my drains removed 2 days later and went back to work 3 days after that.  The removal of the drains was a source of anxiety for me but I barely felt them being removed. 

For 6 weeks I kept my activity to a minimum and followed all my surgeon’s instructions.  I asked the surgeon why I had such a great experience and he said it was probably because I was in shape from working out so much.  My recovery was not exactly typical.  I was a bit tired from the anesthesia but otherwise I felt pretty good.  Physically, I looked a bit out of proportion as I had a lot of swelling but over time everything evened out.  I am now 3 1/2 months post surgery and I couldn’t be happier with my decision.  I am back to the gym and I am now focusing on other areas of my body that need attention.  It’s been a long road but a trip worth taking.


Before and After

Also, check out how hot those panties are!


Before


After

A Note from Me

Sometimes I wonder if people understand that not all plastic surgery is done by super vain and “plastic” looking people. There are many different types of people who undergo the knife each year for reconstructive purposes and to fix something that has affected their self image. Case studies are the best! You should always talk to people who have done the procedure before (unfortunately most people who are elated with results from plastic surgery aren’t usually telling the world their secrets) so here’s some advice from Joan Rivers, Do Whatever You Want, If It Makes You Happy. But First Take This Quiz..

On a serious note, surgery IS serious and if you’re  Thinking about a NoseJob/Breast Aug/Lipo/Tummy Tuck? … Butt Implants?. you should have the list of questions printed from the blog entry to ask your doctor.

I would also like to remind patients NOT to get out of bed without assistance post-procedures. If you are on narcotics (which you probably still have in your system post-op) you are more likely to fall. And then the nurses have to fill out paperwork and it’s REALLY time consuming. Also, if you ever stand up and you feel dizzy, do NOT look down. Those are my words of wisdom for today.

Thanks!

-LK


Hey, You Look Just Like Me!

25 Dec

Let’s Face it (a little pun for you!), the generic face is not attractive.  Beauty should be individualized.  It includes style and personality.  That’s what sets you apart from being just “another pretty face.” Beauty Defined.

Devan (the girl I live with on the North Shore 2 days a week), turned to me the other day and said, “we look like sisters.”  Well… we certainly did not start out that way.  I’m Boston Bred and Russian/Polish by descent.  She’s from Virginia and sports some very fair skin (more Eastern European).  Several spray tans, a couple of boxes of Juvederm, some cheek augmentation, and a splash of bleach later… and we look like sisters.  Either she’s blind… or we both have the same idea of beauty.

One thing that certainly sets us apart is our noses.  I’m of Jewish descent, and my nose isn’t small.  But it does fit my face.  And I would never change it!  I like classic beauty, and looking youthful… but generic is one thing I could NEVER be on the inside, and my idea of beauty will NEVER reflect that on the outside.

Do I love my nose? Eh.  But it’s me.  I feel like a lot of women complain about their noses.  This is usually because it throws off the balance of someone’s face if it’s not in symmetry or proportion to other features (Proportion: The Rule of Thirds and Fifths).

If it’s broke, let’s fix it, and if it’s not broke… Let’s fix it!

Aside from correcting breathing problems, I rarely recommend rhinoplasty (nnnnnoseeee jobs).  I have seen so many bad nose jobs.  A lot of surgeon’s just have this generic nose that they put on every face… and then your stuck with it.  Like tattooing your eyeliner… it’s forever.  And it’s maximally invasive!  And super expensive!

If only there were some alternatives…………

Oh, but there are!  Depending on what your issues are, there are several less invasive and cheaper options for you to change your nose to be more aesthetically fitting to your face.

Contour with Make-up (cost < $100)

Check out this site.  I think it shows a pretty good tutorial on contouring.  Also, check out YouTube!

http://makeupforlife.net/2011/07/makeup-tutorial-how-to-contour-your-nose.html

For a special event, or a night out, contouring is a cheap, easy way to make your nose appear more aesthetically pleasing.

Lip Augmentation (cost $700)

I have a few clients who have large eyes, large noses, and a wide face… with small lips.  This makes the face look unbalanced and makes the nose look bigger.  By correcting the volume/size of the mouth, the face is put more into proportion.  I have found lip augmentation to balance my facial features, and I am very happy with this option.  My nose is symmetrical, straight, and I have no trouble breathing (i.e. a deviated septum).  Remember, augmentation DOESN’T mean you will look like a duck.  Discuss with your Nurse or Doctor what you find attractive.  (I’ll have to take pics of this. Inbox me if you feel like this would be good for you!)

Liquid Nose Job ($700+)

I have been recommending this to a lot of people lately.   This minimally invasive technique is performed using Botox and Fillers to correct any parts of the nose which are a-symmetric, can raise the tip of the nose, and fix some crooked features.

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Non Surgical Nasal Augmentation

Nothing Replaces… Traditional Plastic Surgery ($$$)

If you have a deviated septum, and have difficulty breathing, or if you have a bump that really needs to be shaved… this might be the best option for you.  If you decide to go under the knife, I have a few suggestions.

Tip #1 : Ask to see LOTS of before and afters. 

It’s hard to get clients to agree to be a “before and after” example when it comes to your nose… because you really need to show the whole face.  And we all want to be “naturally” beautiful.  But your Board Certified PLASTIC Surgeon (see tip below).  A lot of surgeon’s will have a signature style.  If you see all the noses look EXACTLY the same RUN.  You don’t want to look like Michael Jackson.  A generic nose is NOT attractive.  Sometimes the signature style will be shaving too much off the bridge, or making the tip turned up (i.e. the Prince of Pop).  Look very closely at the pics, and if you do see something that resembles a personal “style” of the surgeon, think to yourself: does this fit my face?  my style?

Tip #2: Certifications

Never, ever, ever ever ever see a general surgeon for a plastic procedure.  They are NOT even remotely qualified.  Do you want someone who wears a bow-tie, can’t dress themselves, and doesn’t know the first thing about make-up to be working on your FACE?  Well… when I put it that way, I hope you say no.

Look into what those letters stand for.  Anyone can throw a bunch of letters on a page and make themselves look qualified.  I’m a Latisse Lash Expert (brush my shoulder off!) – this took me twenty minutes of watching a tutorial (ok, I fast-forwarded the whole thing and just took the quiz at the end).  But it sounds cool, doesn’t it!?!

Tip #3: Don’t Cheap Out

Dr. A will do a nose job for $2,500 and Dr. B will do it for $10,000.  Financially, seems like a no-brainer.  Realistically, Dr. A is probably not a Board Certified Plastic Surgeon (or a Doctor at all for that matter) and your procedure will be done in a basement under local anesthesia smuggled in from Brazil. And please stay out of Brazil.  When you get your surgery botched (which you will) insurance will not fix it.

If you’re going to opt for surgery, let’s be real.  It’s expensive.  It lasts forever.  In this case, it’s your FACE.  Real Surgeon’s know what they’re worth and they are NOT cheap.

In the same respect, if the price is outrageous… you’re a sucker.  Which leads us to Tip 4.

Tip #4: STAY AWAY FROM NEWBURY STREET

You’ll be overcharged for a generic “masterpiece.”  Actually, stay off of Newbury for any type of beauty service.  I’ve heard more horror stories from that street than ANYWHERE.  (I will name no names).  Even for hair… I’m not impressed.  And fashion… Charles Street Hands Down!  (I digress).

Tip #5:  Have a consultation.  Ask the right questions.

Check out this post if you’re Thinking about a NoseJob/Breast Aug/Lipo/Tummy Tuck? … Butt Implants?.

There are always alternatives, and remember to always put safety first!

Happy Holidays Y’All

I think I’ve been hanging out with Devan too much!
 

Thinking about a NoseJob/Breast Aug/Lipo/Tummy Tuck? … Butt Implants?

15 Dec

I go with a lot of my clients to their consultations and watch a lot of procedures with a plastic surgeon.  My wonderful friend called me at 8 this morning to ask me what she should ask at her consult (apparently she forgot I am NOT a morning person).  I jumped out of bed though, because I remembered I had a lists!  I love lists ALMOST as much as I love white boards!

I know Plastic Surgery isn’t for everyone, but I think if you are contemplating it, you should be prepared from the beginning; starting with the right surgeon can make all the difference in the world!

Plastic Surgery:  Making the Best Decision

Brief important plastic surgeon qualifications

Please check out www.plasticsurgery.org to see if your surgeon is ASPS accredited.  If they are ASPS accredited you are in good hands.

Each ASPS member must meet the following:

  • At least five years of surgical training and a minimum of two years of plastic surgery training.
  • Board certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.
  • Trained and experienced in all plastic surgery procedures, including breast, body, face and reconstruction.
  • Peer-reviewed for safety and ethical standards prior to attaining the honor of active membership.
  • Only operates in accredited facilities.

When making the choice:

  • Use your head not your heart in making the selection.
  • Bring before and after photos, if possible, to show what you want.
  • Research the doctor, call other patients for recommendations.
  • Get a recommendation from your bariatric surgeon.
  • Meet the doctor and get to know him or her; you trust yourself to his or her care, so you need to feel comfortable with the person.
  • Use the term “reconstructive surgery” with your insurance company, since “plastic surgery” is often considered to be “cosmetic” or “elective” and hence is not covered.

Questions to ask:

1.  Are you an ASPS member surgeon? If he or she answers “yes” you can rest assured that your surgeon is board certified in plastic surgery, has hospital privileges and only performs surgery in accredited facilities.
2.  Are you board certified by the American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada?
3.  Do you have hospital privileges to perform this procedure?   If so, at what hospital? Is the surgical facility accredited?
4.  Am I a good candidate for this procedure?
5.  What will be expected of me to get optimal results?
6.  What are the risks involved with my procedure?
7.  Will I need to take time off work?  If so, how long?

What you should ask about the procedure

8.  What is the simplest and safest surgery to help me achieve my goals?
9.  How is the surgery performed?
10.  What is the expected length of operation?
11.  Are other options available?
12.  What results can I expect, and how long do the typical results last?
13.  Where will scars be located, and how noticeable will they be?

What you should ask about your surgeon’s experience

14.  How many times has the surgeon performed this procedure?
15.  How long has the surgeon been performing this procedure?
16.  How many times per year does the surgeon perform the procedure?
17.  How many patients have required re-operation or touch-ups?
18.  What complications may occur?
19.  How frequently do these complications occur?

What you should ask about logistical matters

20.  What preparation is required the day before and morning of surgery?
21.  Should my regular medications be taken on the morning of surgery?
22.  What time should I arrive at the surgery location?
23.  Should someone drive me?
24.  Should someone wait at the surgery location or come back later?

 

What should you ask about emergency plans

25.  What emergency plan and equipment are in place to provide for my needs in the event of an emergency?
26.  Are the surgeon and staff certified in Advances Cardiac Life Support? (ACLS)?
27.  Does the surgeon have admitting privileges at a local hospital should problems arise during my office surgery? (Call the hospital to confirm)
28.  How would I be transported to this facility?
29.  Has an adverse event ever occurred in the past?

What should you ask about the recovery process

30.  What kind of care will I require?
31.  When will I be able to go home? Is an overnight stay required, or is one available if I prefer?
32.  Who will attend me in the case of an overnight stay?
33.  Will I need someone to drive me home?
34.  If a problem arises after I go home, who answers calls after hours and on weekends?
35.  If I need to be seen after hours, where will this occur?

36.  If I need help in my home, is a private duty nurse available?  At what cost?

37.  Are any special garments, medications, or diets required during the recovery period?
38.  How much pain/swelling/bruising is to be expected? How long are these likely to last?
39.  How long does the entire healing process last?
40.  How many follow-up visits are necessary?
41.  Who performs the skin care/post-operative follow-up/suture removal?
42.  When can I wear makeup?
43.  When may I return to exercise/bathing/driving/normal activities/work?
44.  At what point will I feel comfortable in a social setting?
45.  What if I am dissatisfied with the results or with the degree of changes achieved?
46.  If touch-ups are necessary when would that be performed?

What about fees

47.  Does the cost depend on where my surgery is performed?
48.   Will I need to see another physician prior to surgery for examination or testing because of a preexisting medical condition?

49.  Who pays this cost? Will my regular family doctor suffice?
50.  If a complication causes me to be transported to a hospital or stay overnight, who pays for this additional cost?
51.  If I request multiple procedures, can they be performed at the same time? What are the cost savings?

52.  What options are available for payment?

53.  Does the office accept credit cards?
54.  Is a payment plan available to patients?
55.  What is the refund policy should I change my mind after paying in full?
56.  Is my surgery covered by my insurance plan?

After discussing all of the factors involved with your proposed procedure with the surgeon, you should have a sense of whether or not the surgeon is right to you.  Take note of and consider whether the surgeon:

  • Listen and understand your priorities, opinions, and requests?
  • Communicate concern, compassion, request and honesty?
  • Instill confidence in you?
  • Display confidence in his or her ability to care for you?
  • Seem distracted, or come across as arrogant or curt?
  • Seem patient and willing to spend time to answer all your questions and discuses your concerns?
  • Condescend; talk down or under estimate your intelligence?
  • Make eye contact or continually jot down notes in the chart as you spoke?
  • Display positive body language?
  • Confuse you or offer clear explanations?
  • Appear to be selling you the procedure?
  • Adequately discuss any preexisting medical conditions you might have?
  • Encourage your family to participate in the consultation and decision-making process?

Do you:

  • Feel that you have established forthright communication and a positive rapport with the surgeon?
  • Trust your life to this surgeon?
  • Feel the Surgeon is acting in your best interest?
Remember, Aesthetic Augmentation is no one’s decision but yours. 
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