Income Tax and Plastic Surgery

Today, your taxes are due. Mine as well. Nobody seems to enjoy this day unless a refund is due them. That has unfortunately never happened to me.

Income tax refunds are used by many of my patients for plastic surgery. A check comes in that you are not expecting and you start to think of what fun things you can do with it. After a few years, you plan on it being there. I have always found this fascinating.

As income tax loan advancements became more popular, the surge in plastic surgery came a bit earlier. Now in late January to February, the dates are being filled up. Couple that with the Spring Break holidays and April is insane.

This is my 19th tax season at Yager Esthetics, and it always keeps me busy. Earning the money I need to pay my taxes works out well. In reality, the government is receiving a loan from the people who overpay all year long and then giving it back. After this, the people give it to me, and I send it back to the government. The circle of life!

I love it when tax season brings happiness to others. It is otherwise sad for me.


Pain

Today would have been the 47th birthday of an old friend.  He was a remarkably bright presence, and his smile made the world a better place. I miss him.

I met him when he was starting college at Columbia University and I was starting Medical School there. He had a back issue he had been dealing with, and it seemed odd to me.  I sent him to a Neurologist who found a spinal cord tumor.

He underwent surgery and radiation therapy which stabilized the mass.  He went on to finish his degree, get married, and have children. The one thing he could not control was the pain.

Narcotics, Toradol, spinal stimulators, medical marijuana, and all other attempts were not met with success.  Still, he lived with a smile on his face and was there for all.

Finally, after 25 years of suffering, he ended his life.  He had a party to celebrate the 25 years, it turned out it was just to say goodbye. I was not there.

The point of the story is that pain cannot be ignored or disregarded, be it temporary or chronic.  Take it seriously, and save the medications for when you need them.


Last Blog of 2016

Another year of blogging is now complete. I hope to those who read it, it has provided some valuable information, some amusement, and a little insight into what makes me who I am. Intentionally, and often unintentionally, my personality will leak out in my writing.

Even if no one ever read these pages, it was still worth it to me writing. It is an excellent exercise in thought. Each blog takes me about 10 minutes to complete. I sit down with no topic or notes and then just flow with an idea of the moment. I do no drafts or revisions. I have no editor or assistant. It is often fascinating where my mind decides to go.

2017 will be a year of major changes at Yager Esthetics. Our nonsurgical services are booming, and more technology is on the way. Stay tuned here for what is next. At least 2 will launch in January. Both are long overdue and will be much in demand.

We are going full electronic records and eliminating paper. Get ready for iPads and laptops, as well as a video revamp of the website. Technology cannot be stopped. We will continue to set the bar for plastic surgery in the Hispanic community.

I wish you all a very happy and Healthy 2017. Thank you to all who have supported me over these 20 years, and know I will continue to support you for as long as you will have me.


A December to Remember

It is already the last month of 2016- where did the year go? The older I get, the faster time seems to speed by. Yager Esthetics is charging ahead in our 20th year as the Latina beauty experts. With all of the imitators popping up, we are certainly flattered, but be sure to be safe and do your homework.

December is a funny month, in that we tend to hold a few extra surgery days aside for the “last minute shoppers” of our practice. All of a sudden, people start realizing the holidays are coming, and there is time off from school and work. Gift money comes in, and all of a sudden they want to finally have that cosmetic plastic surgery procedure they have been thinking of.

If that is you, realize that surgery should not be rushed. Testing needs to be done beforehand to insure you are healthy and safe. Implants, girdles, and special order items need to be secured ahead of time, and all of the preop and postop visits need to be coordinated. You need to think about child care, who will pick you up from surgery and care for you, and who will cover you at work.

Of course we offer nonsurgical treatments and injections, such as Botox, fillers, skin tightening, laser hair removal, Silk Peel and skin care, for those who can’t quite get a surgery together. The results are amazing and can get you ready for a holiday party, family gathering, or New Year’s Eve celebration.

If you want this to be your December to remember, be efficient, make an appointment with your general medical doctor for right after your visit with me so testing will not be delayed. Patients aren’t the only ones who take off time around the holidays, doctors do as well. Except for me- I am here to serve you.


Thanksgiving 2016

I can’t believe Thanksgiving has passed already! It is my most favorite holiday, as all Americans can celebrate together. It is a wonderful reminder to all of us as to how lucky we are to live in this great country.

One tradition I have in my life is to have a Thanksgiving dinner for all of my staff, where we can enjoy food from everyone’s traditions and share a moment without working. It is important to realize that we are all people, and have personalities and lives outside of work. Getting to know each other in a more personal context is fantastic.

At my home, I make it a point to insure that everyone we know has a place to go for dinner. Even if it is a new neighbor, classmate of a child, friend of a friend, we try to open our house to at least one new person a year to make it a welcoming holiday. It is about sharing and caring.

I would also like to thank my Hispanic community for welcoming my practice for 20 years. It has been my pleasure serving, and I hope for at least 20 years more.


May You Live in Interesting Times

There is an ancient Chinese curse, “May you live in interesting times.” I think with the results of the United States Presidential election last week, these times would surely qualify. Donald Trump, a billionaire with zero political experience and a decidedly not political way of expressing himself, went from an outsider with a 1% chance of winning last year to the office of Washington and Lincoln.

I am not here to express a political view, but rather to step back and consider what this means in general terms. I try to take inspiration and find the good in everything, and there is a lot of both in this result.

To those of you who think that no one can make a difference in politics, it has just been shown that even if no other politician likes or supports you, it is the American people who get to choose. Put your message out there, and if it resonates with the public, you can win. Trump was outspent and did not have the full support of his supposed party behind him, yet he won.

Many people voted for the first time, or the first time in a while. While I feel the campaigns and the process in 2016 were ugly and a poor example to the world of a civil democratic process, this has certainly sparked an interest in the millenials in voting.

I am hopeful that all politicians take notice and realize that they serve at the will of the people. Maybe they can pull together and actually get things done so that service to their constituents and to this great nation I love will come before party and politics. G-d bless America.


Back to School 2016

As the kids return to school, and teachers begin to work again, the beginning of September is a great time for me to work on learning.  After four years of college, four years of medical school, and 5 years of training in Plastic Surgery, even starting my 20th year of private practice does not mean I know it all.

Every 3 years, I must complete 150 credits of continuing medical education just to maintain my license.  In addition, to remain a Board Certified Plastic Surgeon, I have to do a Maintenance of Certification program in 10 year cycles.  This involves courses, certifications and an exam.

Next year is my exam year, and I will be doing the Cosmetic Plastic Surgery module, as that has been my sole focus for my career.  While I still remain competent in all areas of Plastic and Reconstructive Surgery, I have not performed many of the procedures in decades.

This year, I am on a mission to explore new areas of practice, as well as critically assess what I do best and where I can improve.  I have never seen a perfect result in plastic surgery, be it my own work or others.  I do not think it is impossible, but I like the challenge of getting as close as humanly possible while remaining safe.

I invite you to assess your own work, whatever it may be.  I am sure there are courses or videos that might expand your abilities, as there are for me.  Let us all return to school and learn for a lifetime.  School is definitely in session.


Labor Day 2016

It is Labor Day! Enjoy your day of rest and relaxation. This means that tomorrow, all the kids go back to school, and my teachers have to return to work after a summer of vacation.  The rush of plastic surgeries for the teachers is over, and now they start coming to book for Thanksgiving and Winter Break.

The first weeks of September are usually quieter for most people in my field, and an excellent time for vacation for me. I usually work hardest when most people are on vacation.  Although I am a professional and highly educated, I am a servant to the needs of the public, and therefore must make myself available at their convenience.

The side benefit of this strategy is that when I take vacation, most people are working.  This means the vacation spots are less crowded, and sometimes even less expensive.  You have to look on the bright side of things, as every seeming negative usually has a positive hiding somewhere.

The year has been quite rewarding for the first 2/3. I have a solid and stable staff, we just refreshed the entire Surgery Center OR and Recovery areas, and are getting ready to launch our new website design.  Our transition to electronic medical records continues, and we hope to be paperless by the end of the year.

Please keep reading weekly, as some exciting news will be revealed over the next months.  I will share details as they become finalized.  Enjoy the last day of Summer (unofficial), and get ready for an end of year to remember.


Is it Okay to Visit Cuba?

I was speaking to a patient the other day who was about to travel to Cuba. She is of Cuban descent, and she was born here in the US. She had mixed feelings about the trip, and would never have done it while her Cuban father was alive. He absolutely refused to return until the country was free.

I have other Cuban friends and patients, and the dividing line seems to be similar. The older generation wants nothing to do with the Castro government and is resentful of what they endured. The children are a bit unsure, but most want to see the island firsthand.

My patient told me that her children wanted to see where they were from, the places in the stories that there grandfather told them. The house where he was born, the building that he owned that is now home to 20 families. Even though he still has the deeds, there is virtually no hope of reclaiming it.

I understand both sides, and do not want to help a regime that has oppressed its people for so long unless my visit can somehow improve the quality of life of the people of the island. But how can I do that?

For now, I will wait and see what the future brings. There is no right answer, only what each person feels.


Aug August

It is August already, and as Summer marches on, I am reminded of the Summer of 1998.  It was my second year in practice, and I was not as well known as I am now.  For some strange reason, I got an influx of patients for breast implant surgery.

I was so excited that my practice was growing, and that I was making it happen for myself.  With no real money and a lot of school loans, I had managed to survive a whole year as a solo plastic surgeon in Manhattan.  I could feed myself and afford rent on a one bedroom apartment outside the city.  Sadly, this was similar to when I was a resident in terms of my disposable income.

I had always been very good at selecting breast implant sizes, even as a student.  Spatially, I could see a woman and a photo of what she wanted in terms of breast size, and instantly know the implant size required.  I never use sizers during surgery, nor do I order multiple sizes for a single patient.  I had been fortunate to have a patient or two who didn’t mind sharing the fact that they had surgery with me.

It came to pass that in that month, I had a string of days where nearly all the cases were breast augmentations.  At that time, it was far and away a record for most implants in a single month.  We called it “Aug August.”

Now, I sometimes do that many implant cases in a week.  Don’t worry, the breast is yet to come.