Archive for the ‘Consultation’ Category
On Sunday, September 30, my family and I participated in the FACES event to raise awareness of cancer in the Hispanic community. As the motto of Yager Esthetics is “In the community, for the community”, how could we not participate?
I brought my 3 year old and 6 year old daughters, as community service and Hispanic heritage are important for them to learn. They helped set up the booth, hand out educational materials, and test all of the playground areas in Fort Tryon Park just to make sure they were fun.
Hundreds of people turned out for a moving and impactful day. The stories of loved ones lost, survivors, and community leaders were emotionally powerful. Many tears were shed.
As someone who is a doctor, I shared my personal stories of family tragedy caused by cancer and the failure to seek early help. Prevention and screening were the messages I delivered to the people in attendance.
While patients come to Yager Esthetics to look better, I am still a physician who looks out for health first. We have discovered serious medical problems and have even found very early cancers through our preoperative testing program.
I urge all who read this to do annual exams, do colonoscopies and mammograms, and know your family history so we can prevent cancer from taking lives.
Before undergoing cosmetic plastic surgery, my patients need to get ready. They come to Yager Esthetics for a consultation, we discuss what they want to change, and we do a physical evaluation to see if it is possible. We make sure that they are mentally prepared and understand the risks and potential complications, and have reasonable expectations. We make sure they are financially ready, and have their financing or payments coordinated. We make sure they are medically ready, and have all of their preoperative testing done and a note from their general doctor as needed to insure safety. But what happens when you get home from your procedure? Is your home ready to receive a Plastic Surgery patient?
First, you have to fix the social and family issues. Large dogs that jump on you, children who want to be carried, and people who rely on you for day to day care must be taken care of. Whether it is mom coming to stay with you are sending your kids away, arrangements must be made.
Next, is the house physically ready? If you live in a fifth floor walk up, it is not a good idea to stay there right after an abdominoplasty (tummy tuck). Make sure you have enough pillows, and that your bed is not too high or too low to get in and out of. Make sure it is clean before you come for surgery.
Have you prepared everything you could have? Do you have your medications, has food been cooked according to any restrictions of firmness (for facial surgery), and is someone around to help you especially the first few nights? Remember, the better you plan, the easier the recovery.
Finally, did you fill your house with positive energy? What I mean is that some people are negative about things, or jealous, or resentful. These people need to be removed from the house and replaced with the good attitude supportive friends and family that make your postop period a pleasure.
I often see patients in consult for cosmetic plastic surgery who are crippled by low self esteem. They can barely look me in the eye, are timid, and are embarrassed to even let me look at them for the purpose of a physical examination. My heart breaks for these women, and I work extremely hard to make the experience at Yager Esthetics one of healing and support.
The reasons for low self esteem rarely stem from the actual physical defects that they have or perceive. It comes from a childhood of being emotionally and psychologically abused, and sometimes even physical or sexual abuse. This leads to a feeling of shame and low self worth. These unhealthy feelings attract the wrong kind of people, and a thoughtless or abusive spouse or partner feeds off of this negativity to further cripple the person.
I am very clear with my patients that I am there to help them correct the physical defects that they possess, and offer support and encouragement to show them that they are worthwhile people. I also tell them that surgery is not the answer to fixing a cheating spouse, or improving their social life. It will not get them a better job, or make their family dynamic change.
I am encouraged by the many cases I have where the physical improvement has indeed changed the way in which the patient views herself, and has lead to them breaking unhealthy patterns in their lives. They carry themselves differently, dress differently, and are suddenly empowered to remove the negative influences from their lives.
In some cases, I decline to operate until they see a counselor or other professional to make sure that they are safe and in a proper state to undergo surgery. It is unfortunately not the usual patient who agrees, but some do. The improvement in the emotional well being of the patient sometimes overrides the need for plastic surgery, which does not bother me at all. Being a Plastic Surgeon to me is all about helping people look and feel their best, and if I can do it without surgery, then I have really made a difference.
As a Board Certified Plastic Surgeon in NYC, I do a tremendous number of breast implant surgeries. I order 50 implants at a time, and put in hundreds every year. I take pride in trying to select the perfect size and shape to produce a natural and balanced result. There is an art to it, and I want to give my future patients a few types on how to decide.
Do not pick an implant size and style because you like the way a picture on a doctor’s website looks and that is the implant he/she used. Every woman’s body is a little different in width, height and bone structure. The same size implant will look very different in a taller or narrower frame. Also, the amount of breast tissue and the shape and symmetry of your breasts before surgery play an important role in the final result.
Do not say that you want a B or a C, as this is very inaccurate. If you tried 10 different c cup bras from different manufacturers, each would fit differently. Cup size is not an exact measure, it is a difference in circumference from your chest wall to the measure around the center of the breast.
Do not tell me your sister had the surgery, and she had 375cc and you want the same. Your sister may have a very different body shape or breast shape, unless she is your identical TWIN.
So, what should you do? Seek out a Board Certified Plastic Surgeon, make sure he/she does at least 100 augmentations each year, and that you feel comfortable with him/her. Have them show you women with similar heights and breast tissue amounts to you, and tell them which after picture looks good to you. Say to them if you want a little more or less, if you like fullness at the top or a more natural slope, and be specific. You can also bring photos of what you like and don’t like as a guide. An experienced surgeon can then look at you and select the perfect size and shape.
To me, bra size doesn’t matter, it is the way your breasts look to you when you look in the mirror. If you are pleased, forget about what the tag in your bra says and enjoy.
Let me first start by saying that this is my personal and professional opinion as a Board Certified Plastic Surgeon, and it comes from both my training at Columbia Presbyterian and from my private practice in NYC, Yager Esthetics. Although I do not know any Board Certified Plastic Surgeons who do the procedure in the US, and to my interpretation of the legal guidelines it is not FDA approved even as an off label use as this type of silicone has no approvals, I am sure it happens.
Despite the increasing number of horror stories reported in the news in both Spanish and English, I was still asked this week by a friend what I thought about her undergoing the silicone injection in a woman’s apartment for $1500 a session. She had no idea it was illegal or unsafe.
Virtually every week, I get calls from women and men who have had silicone placed in their bodies who are having problems. Some have open wounds and nasty infections, others have lumps, darkening of the skin, migration of the product to other body areas, redness, heat and pain. This can happen immediately, or many years later. In large quantities, I feel that liquid silicone is a ticking time bomb.
I have patients flying in from other countries, Florida, and states up and down the Eastern Seaboard for me to try and remove the silicone, and help them with these often life altering complications. While I do not enjoy these procedures, I do them because they are necessary and patients do not have many places to turn as most doctors will not even try to help.
I plead with you to not inject silicone in your body. Let us work to educate our friends and families so that no more deaths and disfigurements come from a lack of awareness.