Your Plastic Surgeon is not your Parent

Many patients visit me at Yager Esthetics looking for answers to their cosmetic  concerns.  They want to look better, have heard good things about my office from friends, family, other doctors, or on television, and they see me for a consultation.  What surprises some is that I do not make any of the decisions, I leave them to the patient.

To clarify, this does not mean I do what the patient asks of me regardless of what it is.  It is my job to educate you, give you the benefit of my experience, and review the risk and benefits of your options with you. I will let you know if I disagree with your choice, and explain why it may not be your best option as well.  I am not your parent, I am your experienced guide and teacher, a partner in care who will help you decide what the best choice may be.

I hear stories of consultations in other offices where the doctor pops in, looks at the patient, and tells them what they need, and leaves it to his staff to answer questions and try to make you commit to surgery.  I do not think this is adequate.  Each patient is unique, and just because you plastic surgeon is partial to a c-cup, this might be either too big or small for your taste.  One size does NOT fit all.

I encourage you to come to my office for an education on your safe options for improving your appearance.  I will do my best to guide you through the process so that we may come to a mutually agreeable decision as to how to realize your esthetic dreams.


Smarter Liposuction

As I mentioned in a prior blog, “Is Smart Lipo Smart for You?”, the use of laser assisted liposuction has many potential problems for my latin patients.  Darkening of the skin, burns, the inability to use this fat for Brazilian Butt Lifts, and the higher cost without any real scientific evidence of better results are among the most concerning of these issues.

 Not to mention the fact that a large number of the providers advertising Smart Lipo and other laser assisted devices are not Board Certified Plastic Surgeons, but Ob/Gyn’s, Anesthesiologists, Family Practitioners, and other MD’s with no formal training in plastic surgery other than the company sending them to watch another doctor do the procedure a few times.

Does Smart Lipo really tighten the skin as they claim?  I have yet to see convincing long term scientific studies to back up these assertions.  I will say that after liposuction, loose skin can be a problem in certain cases.  While I am a Board Certified Plastic Surgeon with experience with thousands of cases of liposuction, there are some cases in which a little skin tightening would improve the results. 

Now we have a safe skin tightening laser specifically designed for Hispanic skin.  My technique, Smarter Lipo, involves careful liposculpture so that the complications of laser assisted liposuction can be avoided, followed by lymphatic drainage massage and then external laser skin tightening as needed.  It provides an even result, and you only pay for the laser you need if you need it at all.

We invite you to come in and see for yourself.


The World’s Greatest Tummy Tuck

I have had the good fortune to do an incredible number of abdominoplasties (tummy tucks) in my career as a board certified plastic surgeon so far.  I passed 1000 tummy tucks done as an outpatient in my private offices at Yager Esthetics, with 119 in 2010.  As I reflect on my experience and all that I have learned, I wanted to share with you what makes for the world’s best tummy tuck.

Most of my tummy tuck patients have had children, and desire to correct the loose skin, stretch marks, and lax muscle left behind.  More than half also elect to do liposuction of the back as well.  Other popular combinations usually involve breast surgery.  Others come after gastric bypass and massive weight loss.  But what makes some results better than others?

I find that the best results have 4 common factors, and I try to put them together as often as possible.  They are the result of careful study, and not all are in the surgeon’s control.

First is that after surgery, you should not look like you had a tummy tuck, you should simply look great.  The signs of an obvious surgery are upper abdominal fullness and a flat area below the belly button, a flat stomach with a fat back, no curve to the waist, and an unnatural looking belly button.  While the belly button is a tiny fraction of the work, it is what generates most complaints after an abdominoplasty if it is not done right.  I always tell patients about potential unnatural results on there consult, such as the need for back liposuction, umbilical hernias, or if weight loss is needed.

Next is a scar that is too high or that sticks out of the underwear.  I always mark my tummy tucks with the patient wearing the style of panty they want to wear after surgery to insure it is well hidden in case the scar does not completely fade.

Thirdly, patients who have a good support system of positive friends and family around them.  The recovery takes time, and doubts creep in.  Having someone tell you you look great really helps.  A jealous spouse or a mean spirited friend can ruin even the best surgical results by insensitive comments.  If you have negative people in your life, you are better off without them.

Lastly, as a plastic surgeon, I have to be there for each patient to support them, listen to them, and do everything possible to make the tummy tuck experience a positive one.  It is an honor to be chosen to reconstruct the human body, with all the hopes and dreams of my patients riding on the result. 

I wish to thank the 1000 plus tummy tuck patients I have taken care of for their confidence, and hope to see the next 1000 at Yager Esthetics soon.


The Plastic Surgery Diet

At Yager Esthetics, patients often ask me if there is a special diet they should follow after liposuction or tummy tuck surgery.  While the short answer is that they can eat what they want, a sensible and healthy approach to diet and portion control is essential to maintaining the best shape.

While I do not claim to be a nutritionist or registered dietician, I thought I would pass along some healthy eating guidelines to lose or maintain your weight.  I do not endorse any particular diet plan, and favor learning how to eat regular food both at home and in a restaurant so you can follow these principals forever.

To increase your body’s metabolism, you have to keep it working all day long.  Skipping meals is the worst thing to do, as your body just slows down thinking it may never be fed again.  I recommend eating every three to four hours in a sensible way.

In the morning you need a sensible breakfast, such as Special K with fruit, an egg white omelette with veggies, or a whole grain toast with preserves and coffee or tea.  In between breakfast and lunch, have a low fat yogurt with 100 or less calories and a piece of fruit and space them out.

For lunch, I prefer a protein the size and thickness of my palm with a starch (rice, potato, etc)  the size of my fist without a thumb.  I can have as much veggies as I want, like a salad, but very little dressing on the side.

In between lunch and dinner, another yogurt and fruit.  Dinner is the same guideline as lunch.  After dinner, 2-3 hours later, I allow myself a dessert of 100 calories or less of any type.  I often find it difficult to eat so much in a day.  At work, sometimes frozen food are convenient if you read the labels, keep fat calories to 25% or less, and keep it under 500 calories.

Throw in a little exercise 2 to 3 times a week, and you are well on your way to a healthier new you!  If you need more help, call us and we will recommend a nutritionist or weight loss doctor to help you.


Plastic Surgery in Latin Men

While the overwhelming majority of my patients are still Latin women, the number of men seeking cosmetic plastic surgery is definitely on the rise.  In fact, it is one of the fastest growing segments of my practice in 2011 so far. 

The most common procedures for men are liposuction of the love handles and lower abdomen, as well as the chest.  These are the most frequent patterns of male fat deposits.  With the advances in liposculpture and the minimal downtime, it appeals to more men.  Who doesn’t want to look better at the beach?

The other frequently performed procedures on men are nose reshaping (rhinoplasty), eyelids, and face and neck. As we live longer, and have to work more years, a youthful appearance is associated with more energy.  Not to mention, the pursuit of women sometimes changes a man’s perspective on plastic surgery.

Skin care, wrinkle injections such as botox and fillers, as well as peels are also on the rise in Hispanic men. Little or no downtime from work and instant results are an easy sell.

So, if you are a Hispanic man, it is time to consider the benefits that cosmetic surgery has to offer.  If you are a the wife or girlfriend of a Hispanic man, and feel there is room for improvement, give him the support he needs to come in.


Is Smart Lipo smart for you?

For the last year, there has been a lot of hype surrounding Smart Lipo, a laser assisted liposuction technique that has since had other companies produce machines like Slim Lipo among others. The marketing plan of the company is certainly smart, promising direct advertising to the public and referrals to all the doctors who buy the machine from them. Because they sell them all over the country, they can afford a national ad campaign, and it results in patients for anyone who has the machine. The real question is does it offer benefits for you the patient?

As of my writing of the blog today, I am not aware of any convincing long term study that shows improved results over traditional liposuction. I am aware of many cases of skin burns and permanent contour irregularities as a result of inexperienced doctors performing Smart Lipo. Let me explain why.

The company that sells the machine wants to sell as many machines as possible. They will sell to any doctor, regardless of his/her training or certification. That means your ob/gyn, family practitioner, or internist who wants to make money can buy the machine and get the referrals as a Smart Lipo expert. The only training they get is to watch a doctor do it in his office before doing it on their own. Additionally, laser assisted liposuction has a much higher complication rate of burns and fluid collections.

This is not to say that the procedure is bad- the major problems are with the doctors. As in my prior blog entry “Is your cosmetic surgeon a plastic surgeon?”, never assume just because a doctor does cosmetic surgery that he is a board certified plastic surgeon. Ask “Are you certified by the American Board of Plastic Surgery?” if you want to be sure.

In my opinion, Smart Lipo is smart for the doctor, not the patient. You pay more for a riskier procedure that is possibly done by a less well trained physician with no benefit of better results. Just because something is new and well advertised does not make it better. Be a smart consumer and do your homework.