Secondary Plastic Surgery- What to do When you are Unhappy with the Results

As much as plastic surgeons try, some patients do not get the results that they had hoped for.  It can be due to a complication, such as infection or bleeding.  Not following your doctor’s instructions can result in a poor outcome as well.  Even if the surgeon does everything properly, and you take perfect care of yourself, you can still scar noticeably or react poorly to an implant or suture material due to genetics. 

So what do you do?  My advice is if you like and trust your plastic surgeon, let him/her know that you are disappointed, and ask about what can be done to improve the results.  As long as you are respectful and reasonable, a good doctor will do what he/she can to work with you.   You can ask why it happened, and the answer might be helpful in explaining the possible remedies.  Many times, no fee is charged.  If he/she gets offended, or tries to blame you for the problem, definitely seek another opinion.  This usually is a defense mechanism to try to avoid blame.

If you do not like or trust your surgeon, or cannot return due to distance, it is often helpful to seek a second opinion from a board certified plastic surgeon in your area with a good reputation.  They can evaluate you, let you know their thoughts on your complaints, and might offer to treat you with injections, medications, or surgery if needed.  Of course, you have to pay for these services.

Helpful things to bring are your medical records or a treatment summary from the first doctor, which they are required by law to provide for you.  This lets the doctor know what exactly was done, and if you have any implants, the size and type they are.  If the second opinion plastic surgeon says things like “Who did that to you?”, or “Your doctor did not know what he was doing”, also beware.  A good surgeon will try to figure out what happened, and help you fix it.  He/she cannot make judgments without first  seeing your records and knowing exactly what happened after surgery.  The primary concern should be on your happiness.

Also be open to the possibility that the first plastic surgeon might have done everything right, and that your expectations might be unreasonable.  As well trained as we are, we do have limitations as to what we can deliver.


What is Different about Hispanic Plastic Surgery?

Although it may be politically incorrect to say, all people are not created equal- not in appearance, cultural beauty ideals, or desires. Because of this, each woman who wants a breast augmentation has more than one choice of implant type, size, shape, texture, and insertion technique. But are Hispanic women different? In my experience of having consulted on over 23,000 of them, I would have to say they are, and are proud of it.
Although the term Hispanic or Latin encompasses a very wide group of people of varying countries, colors, and body types, I can make some broad distinctions that apply to the majority. Some are physical, some genetic, and some cultural.

Hispanic skin is certainly different, and responds to surgery and inflammation in a manner unlike Caucasian or African-American skin. If you are not very white or very black, the body’s response to surgery is much more unpredictable, and conditions like PIH (a darkening of the skin after inflammation) and abnormal scarring can occur. Knowing how to inform the patients of this, and having techniques available to reduce the risk, as well as treat the result, is something only a large experience with Hispanic patients can teach.
The Latin beauty ideal is also different. A fuller hip and buttocks is almost a universal Hispanic desire, as well as noticeable curves. Some countries like a fuller breast, some a smaller firm breast. You must speak to each patient to understand individual desires.
Hispanic music and fashion also play a role, as wearing form fitting clothing does not allow for bulges or “chichos”. Dancing requires contact with the waist and back, so the firmer and flatter the better. Women cannot always get away with a girdle.
It is your right to know the experience of your plastic surgeon, so ask. What percentage of his/her patients are Hispanic, make sure he/she speaks your language so you can communicate directly, and make sure the staff and patients look like you!


The Best Reason to Have Cosmetic Plastic Surgery

Most plastic surgeons are happy to have patients come to see them for cosmetic plastic surgery, and focus on the physical attributes only. What I have learned is that the motivation behind wanting the surgery is the best predictor of patient satisfaction.
Seeking cosmetic surgery means that there is something about your appearance that you do not like, and that in itself is fine. But sometimes, the real motivator has nothing to do with a patient’s body image.
I have patients who seek breast implants or liposuction because there husband or boyfriend is losing interest or cheating on them. Rather than believe it is a relationship issue, they feel by looking better they can stop this behavior. In my experience, this is very rarely the case.
Some women and men feel they are passed over for promotions because the younger or more attractive coworkers have an unfair advantage, and if they can look refreshed or sexier, they will be rewarded. Unfortunately, it is usually job performance that is to blame.
While I have seen people with low self esteem blossom into more confident , happier people as a result of plastic surgery, it is when friends and family are there to encourage and support them. A jealous or mean spirited spouse or “friend” can shatter the confidence of even fairly well adjusted people.
If you are considering cosmetic plastic surgery, think about your reasons first. The best reason to have cosmetic plastic surgery is that you are happy in your relationships, have a good network of supportive people, and you are doing it to improve an area of your appearance that bothers you, not anyone else. Operating on unhappy people only makes better looking unhappy people.


Does Post Operative Massage Really Improve Surgical Results?

Although I am extremely well educated (The Johns Hopkins University, Columbia University College of Physicians and Surgeons, Columbia Presbyterian Medical Center), and Board Certified by the American Board of Plastic Surgery, I was taught nothing about post operative massage. The Chairman of Plastic Surgery at Columbia scoffed at the idea, and not a single attending physician offered this therapy to there patients.

When I opened Yager Esthetics in 1997, I naturally did not believe that this therapy was necessary, or even worked. In 1999, I had a patient on whom I performed a liposculpture and removed a significant amount of fat. She came back for her 6 month visit and looked incredible. When I asked what she had done, she told me that she was back home in Colombia, and had lymphatic drainage massage at a local clinic. The skin texture, smoothness, and completely natural look left me amazed even though I had performed nearly 1000 liposuctions by that point.

While little scientific evidence exists in the literature to even look at the effects, I did my research and was stunned by the results. Nearly 100% of my patients who did post operative massage were very satisfied with the improvement.
Not every massage is equal, and you have to be careful to select a well experienced therapist to ensure the best results. Not every spa is appropriate for the immediate post surgical patient, and you need to ask your surgeon if it is ok. Starting early(within a few weeks) makes a huge difference as well. In general, the therapy should be a little uncomfortable if it is effective. Gently touching the skin as in a relaxation massage feels nice, but will not get you the results you need.
In my opinion, post operative massage therapy greatly enhances the results of liposuction, as well as other plastic surgical procedures. I have 3 very tired massage therapists that can attest to this as well.


Better Bodies after Babies- The Mommy Makeover

After the joys of pregnancy and childbirth often come the sorrows of altered body shapes. Having children, especially with significant weight gain, can change not only your stomach, but your breasts, back, skin, buttocks, and thighs. This is not news to many of you moms out there.

What you may not know, and what your Ob/Gyn may not tell you, is that there are things that you can do to repair the damage. The combination of several of these procedures at once is often known as a Mommy Makeover. I perform these procedures every week, and it is gratifying to know that it not only fixes physical issues, but can elevate your self esteem and outlook on life.

When considering a combined plastic surgical procedure, it is important to be honest about any health problems you may have. Sometimes it is safer to do each separately, and safety should be your primary concern. Your weight and age also have to be considered.

In my practice, the most popular combinations are abdominoplasty (tummy tuck) with liposuction and/or fat transfer to buttocks, or abdominoplasty with breast surgery. The results can be quite dramatic, as our photo gallery can show you.

I do more mommy makeovers and combined cases now than 10 years ago, as my surgical times have gotten shorter from experience, and risks can therefore be reduced. The results are better than ever. I do not perform surgery that takes longer than 3 hours, as risks from anesthesia and being immobile increase. If more is desired, I break it up into 2 sessions to enhance patient safety.

If you are healthy, are done having children, and want your prebaby body back, think about the mommy makeover. It can change the clothes you wear, increase your confidence and self esteem, and make your after child years the best of your life.