Great Expectations- A Plastic Surgery Story

When many of my patients at Yager Esthetics come for consultation for cosmetic plastic surgery, they expect miracles. No scars or marks, no time off from work needed, no discomfort or swelling, no bruising. Instant gratification is what it’s all about. They hear stories from my former patients who are thrilled with their results and forget the recovery process. These patients need a reality check.

When I consult with prospective patients, I make sure to give a realistic idea of what to expect in terms of a result, the recovery process, time off from work or exercise, and the potential complications that may occur. I show before and after pictures of my actual patients with no retouching, and not just the best result I have obtained.

But I find I have great expectations as well. Although my patients are very happy with the changes that I make in their bodies and faces, I expect perfection every time, even when it is impossible. I am too hard on myself, and I am never 100% happy. This is bad for me, but great for my patients. To achieve the incredible, you have to attempt the impossible.

I think the happy medium for 2012 is for my patients to expect the very best results that can be achieved in plastic surgery at Yager Esthetics, and for me to be satisfied with delivering the best results possible as well. Perfection does not exist in our world, but I will continue to chase it.


When Faster is Better

As I went through my training at Columbia Presbyterian Medical Center, the plastic surgery attending physicians always asked for my help on cases.  It was not just my ability to do excellent work, but also my capacity for being efficient that made the case go more quickly.  While the number one goal in cosmetic plastic surgery is safety, number two is to achieve or exceed a patient’s expectations with superb results.  Sometimes the two goals are at cross purposes.

I happen to perform my surgeries quite quickly in comparison to some other plastic surgeons.  I feel that I deliver at least the same if not better quality results while enhancing your safety.  The longer a procedure takes, the more risk you have of something going wrong.  A longer time under anesthesia sometimes means that a light sedation won’t work, and a general anesthetic is needed.  This can lead to more nausea and vomiting, as well as the additional time under anesthesia increasing risks of blood clots.  In addition, for longer surgeries, indwelling catheters are needed which can lead to urinary retention and urinary tract infections.  There are more fluid shifts, and if the wound is open for longer periods of time, wound infections are more likely.

It is important to note that I do not advocate rushing a surgery or leaving out steps.  I simply stay 100% focused on my patient, and do not waste time under anesthesia.  In my experience at Yager Esthetics since 1997, I have performed a tremendous volume of surgery.  As with any skill, the more you do, the better you become.  Every plastic surgeon, anesthesiologist, and nurse who visits is uniformly amazed that an abdominoplasty (tummy tuck) can be done in less than one hour with exceptional results.

Just because a doctor says he spends 3 ½ hours doing the same operation does not mean you are getting more surgery or a better result.  In many instances, you are putting yourself at additional risk for a less well performed outcome.  Be careful.


December at Yager Esthetics

As December rolls around, everyone is getting ready for the holidays and New Years.  What that means for my practice is a lot of spa and injectable treatments, such as botox, Radiesse, Juvederm, Xeomin (a new botox alternative) Silkpeels, and chemical peels.  All of my patients want to look their best for the family and corporate gatherings without the downtime of surgery.

This year, we have a much larger Yspa staff to help meet the demand, and a new Nurse Practitioner to increase the flexibility of having your injectables from Monday through Saturday.  She is extremely well experienced and I trust her 100%.  To prove it, we have an injectable promotion until the end of 2011.  Call for details, or friend us on Facebook (Yager Esthetics)  and follow us on Twitter (@yageresthetics).

What I like to do is to look at the before and after photos for the year, and try to pick out what is working best and to try and find some small area to improve.  Although I am confident in all of the techniques I offer, I always feel that you need to strive to do better or there is no hope of improvement.  My abdominoplasty of 1997 is no where near as satisfying as the 2011 version.  This does not mean 1997 results were inferior, but the steps and time to achieve the results and the recovery process are are far easier now.

I would encourage all of you to reflect on your job performance from this past year, and honestly assess the areas in which you might improve.  It will make you a better employee, employer, or stay at home mom.  When you stop caring about job performance, or feel you can no longer improve, that is when bad things happen.  Even the best can get better, and that is what I try to do even after 15 years at Yager Esthetics.

Happy holidays to all.


Nurse Practitioners and Plastic Surgeons

After practicing plastic surgery solo for 15 years, I have recently hired a Nurse Practitioner.  This was a necessary step for me to continue giving the highest standards of care to my patients, as well as to expand the services that Yager Esthetics offers.

A Nurse Practitioner, or NP, is a Registered Nurse who has gone on to obtain an advanced degree in patient care so that they can actually take care of patients and do many of the things that MD’s can do.  The key for me was to find someone with the experience in cosmetic plastic surgery who was bilingual who I trust to help me expand the care I offer my patients.

I have been very fortunate to grow my practice over the years to the point where I actually have to set limits to the amount of surgery that I feel I can perform so as to be able to give each patient the time they require before and after the procedure.  When I am in surgery, I cannot see patients, and this limits the times that I am available.  My NP can take care of the basic procedures of suture removal and answer 99% of patient questions, thereby  allowing my patient more options for follow up care.

My NP also is an expert in Botox, laser treatments, and injectable fillers, and treats spider veins as well.  This enables me to offer these services with safety and confidence to my practice and a more flexible schedule.  This offers a higher level of training to my patients than many offices who have medical assistants and cosmetologists doing some of these treatments.

I encourage you to visit us at Yager Esthetics to meet her, and learn how an NP can help enhance your experience in our office.