For any of you who follow me on twitter (@drjyager) or are a regular reader of my blog, you know that I love music. I listen to music during surgery, so about 20 hours a week. A little over 2 years ago, a friend of mine asked if I played an instrument. I told him about my brief drumming career 30 years ago, and he convinced me to try it again. Along with another guy, we formed a group which has evolved into Used Karmas.
We played a few small venues as we wrote our own music, and have finally completed recording of our first album, Certified Preowned. I will post more details about our Album Release Party and how to get a copy very soon. The process has changed me in ways I never imagined.
Visually, I can look at a body and instantly see the potential within for improving curves and balance, and cosmetic plastic surgery comes very naturally. I have been in private practice since 1997, and still enjoy it.
With music, I have a good feel. I can tell if it is well done or interesting almost immediately, and can listen to a wide variety of styles. All of these influences come together when writing a song, from the hook to the lyrics to the arrangement.
Cosmetic plastic surgery is like making music. I instantly know when it will be amazing, if it is a “hit”, and how to arrange things so they work well together. The preoperative visit, the consult, the post op care are so similar to the pre and post production and engineering, as they all have a direct impact on the final product.
When I evaluate patients now, as well as when I do surgery, I hear music. My goal is to create megahits for decades to come.
I recently had a very frustrating day of cosmetic plastic surgery. It wasn’t that the cases were difficult, or that it was too many hours of surgery, it was a patient and her attitude. Unfortunately, this is not the first time that this has happened.
I do many surgeries in a single day, so only one patient gets to be first. Not everyone can get here at 6:45 am, and so I always ask patients what their time preference is. I have learned to beware of the patient who insists on being the first case. They often think they are entitled to extra privileges.
I am in the OR at 6:30 am, getting ready. At 7:10, still no patient. We call, she answers calmly that she is still a distance away. When asked if she knew she was supposed to be in the office at 6:45, she said she did. No apology.
We called in the second patient to come early and proceeded after losing over an hour of time. For that hour, I have to pay anesthesia, 3 in or personnel, and 2 recovery room people. No one is reimbursing me for that.
My special patient comes in at 8:45, a full 2 hours late. She is told she must wait. I call in the third patient, who was on time, and the first patient gets upset that she is going before her, as she got there first. We explained that her time has passed, that it is unfair to make an on time patient wait because she was late. She sat there with a frown. No remorse.
Finally, she went fourth. I asked what happened, she said she came from Long Island and there was traffic. I told her my anesthesiologist lived in the same place, and he was there on time. No apologies. She had her procedure, recovered, and was discharged. Five minutes after leaving (she had been in the office for 8 hours) she calls the office and says she lost her prescriptions and needs new ones. She said she could not turn around, and we should call them in to her pharmacy.
Isn’t she special?
The words of the title of this blog were spoken by famed Brazilian Plastic Surgeon Ivo Pitanguy many years ago. It does not mean that everyone who seeks cosmetic surgery is crazy, it implies that the reasons and expectations for the operations is of vital importance.
When I meet some patients, I can tell just by the way they fill out the forms for my office that they are a bit strange. Others, after a few minutes of general conversation, can be found to have unrealistic expectations or traits of personality disorders that make them poor candidates for surgery. These are the easy ones.
Some patients can function well in the world, even over long periods of time, if the conversation is specific and focused over short periods of individual encounters. Sometimes they are delightful with the doctor, and things slip when they are with other staff. These are the dangerous ones.
Once you operate on a patient, they are yours. I can deal with a patient who is unhappy over something tangible, such as a scar that is dark, or a minor imperfection. What is impossible is the patient who has a spectacular result who feels they have been wronged.
The best scenario is to avoid operating on these people, but that is not always easy. The next step is to review photos in a logical manner. If they refuse to see reality, I try having them bring a family member or friend to see if reason may prevail. Failing this, I have referred patients to Psychologists and Psychiatrists. This almost never goes over well.
My advice is, if you are in an unhappy relationship, if you expect perfection and nothing less, if you are an angry person, please do not seek Plastic Surgery. Happiness will not come from the scalpel for you.
Puede sonar extraño, pero lo último que trato de lograr en la cirugía plástica cosmética es la perfección. Como residente en formación, nos enseñaron, “El enemigo de lo bueno es lo perfecto.”
¿Qué significa eso?
Nadiees simétrico.Un ojoes más grande, uno inferior, las fosas nasales son diferentes, ninguna mujer tiene2senos que sonexactamente iguales.Curiosamente, nuestroscerebrosestán entrenados paranonotar estos detalles.
Estoyconstantemente sorprendidocuandoseñaloenormesdiferencias alos pacientes, que a menudono tenían ni idea. Todaslas partes del cuerpotienenque estar enarmonía unos con otroscon el fin deparecer natural. Si usted tieneuna caraasimétricacon una narizperfecta,sólo se ve mal.
Una gran cirugía plástica nunca luce como una cirugía. Es el arte de equilibrar las pequeñas cosas que te hacen único, y la mejora de ellos sin perder su carácter. He estado en mi práctica privada en Yager Estética durante 18 años, he realizado más de 5.000 cirugías cosméticas, y todavía tienen que alcanzar la perfección. Tengo, por otra parte, que hice más del 99% de estas personas muy felices. Mi consejo es que siempre sea usted, es lo mejor que puedes ser. Nadie es perfecto.
It may sound strange, but the last thing I try to achieve in cosmetic plastic surgery is perfection. As a Resident in training, we were taught, “The enemy of good is perfect.” What does that mean?
Nobody is symmetrical. One eye is bigger, one lower, nostrils are different, no woman has 2 breasts that are exactly alike. Interestingly, our brains are trained to not notice these details. I am constantly amazed when I point out tremendous differences to patients, they often had no idea.
All of your body parts have to be in harmony with each other in order to look natural. If you have an asymmetrical face with a perfect nose, it just looks wrong. Great plastic surgery never looks like surgery. It is the art of balancing the little things that make you unique, and enhancing them without losing your character.
I have been in my private practice at Yager Esthetics for 18 years, have performed well over 5000 cosmetic surgeries, and have yet to achieve perfection. I have, on the other hand, made over 99% of these people quite happy.
My advice is to always be you, but the best you you can be. Nobody’s perfect.