Happy Ending Story – Breast Cancer

During my training in Plastic Surgery and General Surgery at Columbia Presbyterian Medical Center, I was involved in many cases of breast cancer and the reconstruction of breasts. It was some of the most important and memorable training I had, and I very nearly went into practice for breast reconstruction.

When I was a General Surgery resident, I had a patient with recurrent breast cancer who needed a very big surgery, a radical mastectomy, where we remove not only the breast, but the chest muscles and extensive lymph nodes as well. The surgery went well, and she was free of cancer.

Several years later, when I was Chief Resident in Plastic Surgery, I had the pleasure of performing breast reconstruction on her. She looked and felt whole again, and I was very gratified to know that I helped save her life and restore her form.

I finished training and went into private practice in cosmetic Plastic Surgery here in NYC. One year later, she came to see me and ended up doing a cosmetic facial procedure. Just recently, nearly 20 years after her cancer surgery, she was back for cosmetic services and in perfect health.

While I am a cosmetic plastic surgeon, I salute all of my colleagues who dedicate themselves to the noble battle against breast cancer.


The Debate and Plastic Surgery

Everyone has been getting all excited about the presidential debates this month. Each side is trying to sound better, inspire confidence, which are good things. Unfortunately, they also bend the truth to fit their agendas, and try to make the other side look bad instead of presenting the positive side of themselves.

It struck me that this is similar to the Plastic Surgery community in New York. When patients go on consults, the doctor should be trying to highlight the positives of his practice. Things like being Board Certified by the American Board of Plastic Surgery, the number of years in practice, how many cases similar to yours he has done this year and overall, using Board Certified anesthesiologists and Accredited Surgery Centers. Showing Before and After pictures of his work and educating you on the risks and benefits of the proposed procedures let you know that he has your best interests at heart. That is how we treat patients at Yager Esthetics.

There are other centers, however, that take the negative side. Just like in the debates, I wish there was a Truth Squad to let patients know when they are being misled. Most doctors in cosmetic surgery who are not plastic surgeons will not tell you things that make them look bad. Nobody will say “I am not a Plastic Surgeon” or “I have never done that procedure before.” You have to be a good moderator and ask the right questions.

Please ask the following- Are you certified by the American Board of Plastic Surgery?
​​​How long have you been in private practice?
​​​Will you or someone else be performing my surgery?
​​​Will it be done in an Accredited facility?
​​​Will a Board Certified Anesthesiologist be giving my Anesthesia?
​​​How many of my procedure have you done THIS year?
​​​What are the risks and alternatives?
​​​What results can I expect?
​​​Can I see at least 3 before and after pictures that you have done?

If a doctor is bad mouthing another doctor, or you get an uneasy feeling, run away. About this there should be no debate.


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.


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.


Top Ten Things To Do To Make Your Plastic Surgeon Happy on Surgery Day

Everyone wants the best possible result from a cosmetic Plastic Surgery. At Yager Esthetics, we give you a list of Preoperative Instructions, and discuss the does and don’ts of the period before your procedure. Unfortunately, few people actually listen or read the papers. Listed below, you will find a few tips to make everything go as smoothly as possible.
1. Do not eat or drink anything after midnight the night before your procedure. No water, coffee, gum, cigarettes- nothing. I cancelled a surgery once because a patient was eating 1 gummy bear. It makes the surgery riskier for life threatening pulmonary complications. The only exception is if your doctor wants you to take any medications with a small sip of water.
2. Do not put on any body creams. We do not mind if you are ashy. It makes it impossible to draw on you and make the marks needed for an accurate surgery.
3. Make sure you have at least one finger nail that is of normal length with no red or reddish color on it. We need to monitor your oxygen, and a finger probe is used.
4. Remove all jewelry and piercings. They can get lost, and cannot be worn during a procedure because they could conduct electricity and burn you.
5. Remove contact lenses and false eyelashes. The lenses can scratch you under anesthesia, and the lashes can be damaged by the tape we use to shut your eyes during surgery.
6. Remove any removable teeth, as they can be dislodged and swallowed on intubation.
7. Stop all aspirin containing medications 8 days before surgery. A whole list is given to you at your peop visit. Please read it.
8. Stop smoking 3 weeks in advance. This will lower the risk of wound healing complications.
9. Stop birth control pills and patches 2 weeks in advance. This will reduce your risk of blood clots.
10. Smile, be excited, and be on time!

Have a great surgery.


Is Plastic Surgery a Good Investment?

With tax season upon us, and many of my patients receiving refund checks, the question arises as to how best to spend the money.  Obviously, family and financial needs must first be met.  But what if there is a little bit more that you could use?  Is plastic surgery a good investment?

I am a Board Certified Plastic Surgeon, not a financial planner or a business person, so my observations are from my 15 years at Yager Esthetics.  I will lay out for you the potential benefits, and you can decide whether it makes sense to you.

Plastic surgery can boost your self esteem and enhance the way you feel about your body and your sexuality.  The confidence it brings can change the clothing choices you make, the activities you will participate in, and even the way you interact with others both socially and in business.

A refreshed appearance can make you look younger, more energetic, and less tired to potential romantic interests as well as potential employers.  It can also help those who feel young on the inside feel better about looking in the mirror and seeing what they want to see.

Cosmetic Plastic Surgery can be empowering, especially to women after having had children or massive weight loss.  It can  be a fresh start to a healthier lifestyle, as when you look better, you tend to take better care of yourself through improved diet and exercise.

All of these benefits are enjoyed every hour of every day no matter where you are or what time it is.  Yes it is a “me” thing, but if you have worked hard you deserve to do something for yourself.

If the numbers add up for you, it may turn out to be the best money you have ever spent.


Black Friday and Yager Esthetics

Black Friday, the day after Thanksgiving, has become a major event in the United States over the last few years as the official start to the holiday buying season.  This year, 2011, some retailers have moved the clock up to start Thanksgiving night.  In my opinion, this has to stop.

Thanksgiving commemorates the working together and peace of the pilgrims and native Americans at the start of the colonization of America, before greed and prejudice eroded the trust in this country.  We now use it as a day for the family to come together and give thanks for the blessings we have.  And then, we race to the stores, trample over people, and even pepper spray them to get a good price on an X-Box?  Ridiculous!

I understand the idea of creating buzz for the retail industry, and jump starting sales, but the timing couldn’t be more inappropriate, and the method is dangerous.  Let families enjoy the holiday together and not think of materialistic things.

I used to operate on Thanksgiving morning, and make sure the staff left by noon, thinking nothing happens before then on the holiday anyway, and that many people found it a convenient time to take off from work.  Then I stopped operating that day, but was open Friday and Saturday as normal.  I stopped that as well a few years ago so that my employees could have more family time.

I guess the purpose of this blog is to remember that no matter how cheap a deal is on an ipad or plasma tv, it is meaningless compared to value of family time.  If you are lucky enough to have the Friday off, enjoy the precious gifts that money can not buy.


Plastic Surgery Commercials on Radio and Television

There are more and more advertisements for plastic surgery on television and the radio.  As with any commercial, the effectiveness comes from hearing it over and over, and from the feeling of the listener or viewer that if it is on tv or the radio, it must be good.  These are dangerous assumptions.

I have advertised on the television and radio in the past to attempt to let more patients know about Yager Esthetics.  You can see my commercial on youtube if you look.  It worked pretty well, and my approach was to just let actual patients talk about their experience with my office.  It was tasteful, and I feel good about it.  So why did I stop after a few months?

For the most part, the other commercials I saw and heard were from less than professional offices.  Many were misleading as to the qualifications of the doctors, and some were unethical.  I did not want to be associated with that group of doctors. Advertising is a paid attempt to sell goods or services, and is not truly regulated.  Many are not Board Certified by the American Board of Plastic Surgery- some are Facial Plastic Surgeons (ENT) with no formal training in surgery of the breast and body, others Board Certified Surgeons ( some Ob Gyn) who fancy themselves qualified.

Being a recognized expert in plastic surgery for the Hispanic community, I am interviewed a lot on television and in magazines and newspapers (see the clips on our homepage).   I am answering the questions of the public, and commenting on stories of the day.  It is educational for the audience, and not trying to sell anything.

I am flattered every time someone takes their time to visit me at Yager Esthetics, and honored when they choose me to perform their procedures.  I feel good knowing that they are here for me, I have used no slick or misleading words to fool anyone as to my training, and that I have earned the trust of my community to be the choice for so many women and men.


Why are Hispanic Noses Different?

While I believe that all people are created equally, the anatomic differences among the races cannot be ignored.  As a plastic surgeon who specializes in Hispanic beauty, I am keenly aware of the unique challenges that these variables create.

I have seen very poor results in rhinoplasty of the latin patient done by very competent board certified plastic surgeons.  Why?  Because they do the same surgery they are used to doing in the Caucasian population.  This does not always work for my patients.

Let me qualify this discussion by stating that the Hispanic population is tremendously diverse, from the lightest thinnest skin to the darkest and thickest.  My observations are generalities, and each patient needs an individual analysis by a board certified plastic surgeon who specializes in Hispanic noses.  Below you will find my most important tips for success.

  1. The nose has to match the face.  You can have a perfect nose, but if it does not match the face in both size and ethnic features, it will look strange.  Make sure your doctor has computer imaging to show you how the nose you like will look on your face.  At Yager Esthetics, we do this for every nasal consult.
  2. It is better to do too little than too much.  Obviously, I try to do the perfect amount every time, and my revision rate for rhinoplasty is 5%.  Once you have an overoperated nose, especially if the nostrils are too narrow, it is nearly impossible to restore a natural appearance. 
  3.  Internal support is essential for breathing.  If you remove too much structure in an attempt to get a smaller nose, it usually fails due to skin thickness.  Once support is gone, you risk a nose that cannot breathe.                                                                                                                                                                                                                                                                                                                                                   

Good luck in your quest to improve your appearance.  We look forward to seeing you  and offering a safe and beautiful solution.