What’s in a Name

When I was constructing my office expansion, I thought it was the best time to consider a name for the practice. Yager Plastic Surgery was working, but now we were doing so much more than Plastic Surgery. I wanted the name to include all of what we offered- the ySpa, spider vein treatments, injectable fillers and skin care, as well as laser and advanced scar therapies.Being that my practice was focused on the Hispanic population, I wanted a name that would appeal to a Spanish speaking patient. I tried all sorts of clever names before I settled on Yager Esthetics/Estetica. The reason was that I felt the best indicator of quality, trust, and dedication to the community was my name- Yager.

Yager is not a Spanish word. In fact, it is Austrian. Jaeger, the German version, means hunter. When my Great Grandparents came to the US over 100 years ago, the spelling was changed. They came to Washington Heights, and opened a candy store. My Grandfather opened a Pharmacy in the Bronx, and my Father was a Podiatrist in Manhattan. I came back to my roots in Washington Heights.

Treating patients well is of the utmost importance to me. I try to insure a first class experience from the time they make an appointment, to the way they are treated in a world class facility, to the consult experience and on through surgery and recovery. This is what I do.

I recently had a patient who was not happy due to an issue beyond my control. Even though it was not my fault, it was hurtful for me. I insured her, as I do all of my patients, that I would do everything possible to make her satisfied.

When you come to Yager Esthetics/Estetica, the name means everything. I will continue my mission to provide the highest quality of care to my patients and my community. In the community, for the community is not just a slogan, it is my reputation. If anyone is dissatisfied, please let me know how I can remedy the situation. I am here for you.


Is Your Home Ready for a Plastic Surgery Recovery?

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.


Self Esteem and Plastic Surgery

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.


Don’t get Sliced by the Cutting Edge

I love technology.  The advancements in Plastic Surgery and nonsurgical treatments have been tremendous over the last 20 years that I have been following it.  I love to learn about it and study it, but have a problem with using it as a marketing tool before safety and the realistic results can be determined.

We all think about the magic of microdermabrasion, the many uses of laser treatments, and the injectable products we think of as routine now. What a step forward in the ability to achieve better cosmetic results.  What the public, and some of my colleagues, forget is the hyped treatments that did not pan out.

Just because something is new and exciting and promises great things does not make it true.  Experience using new devices takes time, and if someone wants to be the first one on the block to advertise it, it does not mean that they are well trained or capable of giving you what they promise.  With the competitive marketplace for your esthetic dollars, many of the early advertisers are not Board Certified Plastic Surgeons at all.

If you hear about a new device or procedure, do your homework.  Find out what the ABMS specialty of the doctor is, how long he/she has been in training and their Board Certification, and how many of these treatments they have done. Make sure you see pictures of their own work, not photos supplied by the device company (just ask if the photos are patients that they themselves treated personally).  You can also go on the internet and see what the public experience with the treatments is.

Do not take this to mean I am antitechnology.  I love anything that safely improves my patients’ appearance.  What I won’t do is experiment on the people who trust me to be their Plastic Surgeon.


Cuando y Cuanto

Even after 15 years in private practice, as a Board Certified Plastic Surgeon I am still honored that patients seek me out for consultation.  I make sure to educate them properly regarding the procedures they seek, and go over a great deal of information to help them make an informed decision.  Unfortunately, not all patients want to be informed.  I call them the Cuando y Cuanto patients.  This, for those of you who do not speak Spanish, means “how much and when”.

Of course, the price of the procedure lets you know if you can afford it, and allows you to compare other doctors and the fees they charge.  This is not the most important factor.  You do not go looking for a car and ask the price before you know what make, model, year, and the history.  You look at the car, research, ask questions, and see if you are interested.  If it excites you, then you find out the cost.

When I do a consult, I first find out what bothers you about your appearance, then let you know the options to best correct the issue.  Sometimes you come thinking you need one thing, but a different procedure is more appropriate.  You learn about my training, experience, see the office, the place the procedure will be done, meet the anesthesiologist, and get several examples of my work on similar patients.  Then, we talk about fees.

As for Cuando, yes you have an idea of when a good time is for you.  Most good plastic surgeons are booked out in advance.  You should not expect to have a procedure a week or 2 after your consult.  Plan to consult as far in advance as possible, about 2-3 months before so that you will not be disappointed.  Never plan your vacation and hope to book your surgery, book your procedure and then ask for the days off.  Make sure you pick the right doctor, even if you have to wait.

As you seek out the realization of your cosmetic surgery dreams, make sure you feel comfortable with the doctor, the staff, the office and how you are treated.  Make sure you see before and after photos similar to you that you like.  Make sure the procedure takes place in an accredited surgical facility with a Board Certified Anesthesiologist as well, and that testing is done.  Cost and timing are important, but not as important as making sure you make the right decision.


The Best Facelift Compliment I Have Ever Received

As a Board Certified Plastic Surgeon, I try very hard to make each patient happy with their result.  I also try to make myself feel proud of the work I have done.  In all cosmetic plastic surgery, but in facial surgery in particular, you must make sure to achieve a great result without it looking fake or overdone.  I will share with you a favorite patient story.

I had the pleasure of taking care of a lovely Cuban woman in her early sixties.  She was happy in life, always smiling and vibrant.  She wanted to have a facelift in order to look her best for her son’s wedding.  It was to be 3 months later in Miami, and she had not seen him for nearly 10 years due to Castro.

I performed the operation, and healing was uneventful. We were both happy with the results, and off she went to Florida with the promise of returning with photos of the event.  I eagerly awaited her return (and the reviews from her family).

She came to see me at Yager Esthetics 2 weeks after the event with the pictures in hand and a smile across her face.  After listening to the story about the trip and the service and the family, I had to ask what her son thought.

She grinned, and told me that her son was so thrilled to see her.  He hugged her, cried, stepped back and stared at her in amazement.  He then said “Mom, you look the same as you did ten years ago.  You just never change.”

A better compliment than that, I can not receive.


Sweating the Small Stuff

I always liked the saying, “Don’t sweat the small stuff”.  It was a good way to put things in perspective, and not get hung up on things that are really not that important in the big picture. Since I became a plastic surgeon, especially a cosmetic plastic surgeon, my views have been altered.

Everything I do is about small stuff.  Every fraction of a millimeter, every fat cell, each hair follicle  is important in making my patients 100% happy.  I can remove 5000 cc of fat from someone, and drop them 6 dress sizes, and they would be dissatisfied if their pants fit differently on one side then the other, even if it had nothing to do with my surgery.  It could drive you insane.

Now, I think only of the after results, not what they looked like before.  Everyone seeks perfection, and they do not care about how much of a change was made if the reflection in the mirror is not the ideal.  I have found a way to deal with it to make myself and my patients happy.

I have decided to only focus on 100% satisfaction of my patients, no matter if the criticism is fair or not.  If I see something that can be done to improve the results safely, even if the procedure was done perfectly, I just offer to do it.  While it might be small stuff to a surgeon, it is majorly important to the patient.

So at Yager Esthetics, I will sweat the small stuff for my patients so that they don’t have to.


Does Plastic Surgery Leave Scars?

One of the most common questions I get is “Am I going to have a scar after surgery?” The answer is, of course! Every time you cut the skin beyond a certain depth, the body repairs the damage by forming a scar. This is to create strength in the damaged area so as to prevent further injury.

The art of cosmetic plastic surgery is to try and minimize and hide the scar in a way that it is the least visible. In many cases, even the trained eye cannot find the mark. We use many tricks, such as hiding it in natural creases such as the fold of the eyelid or curve of the ear, and using the change in color from dark to light, such as in the edge of the areola in breast augmentation.

The healing process often takes about a year before the scar matures, and it can go through some red and firm stages before the process is complete. I see my patients very often after surgery to insure healing is proceeding in the ideal manner. If the scar looks dark,red, wide, or thick, I can usually recommend medications, tapes, and sometimes injections to improve the final result. If a patient comes back after 6 months or longer, it is often too late to help with these small interventions, and sometimes surgery is needed to correct the scar.

Let me also clear up 2 common misconceptions- lasers and keloids. If you do surgery where you are cutting, a laser is just as likely to leave a scar as a scalpel. It is just a different way to cut. Some lasers can help after a scar is established to help flatten or fade a mark, but do not be fooled into thinking that a laser tummytuck, laser breast lift or laser facial surgery is in any way better than traditional surgery. It is often just hype to sell you a service that is most often no better result wise, and in inexperienced hands can have significantly more complications.

Every ugly or visible scar is not necessarily a keloid. Keloids are a type of abnormal scar that rises off the surface of your skin, and grows beyond the border of the scar onto normal skin. It is often treated with steroid injections and radiation therapy in addition to surgery. They are often resistant to correction.

So, if a plastic surgeon tells you that a surgery in which your skin is cut leaves no scar, be very skeptical. No one can promise you an invisible scar, as even the best surgical technique coupled with perfect patient care afterwards cannot overcome genetics. Do know that the overwhelming majority of scars heal extremely well with time, and this should not deter you from seeking out cosmetic plastic surgery if it is right for you.