Casanova and Yager Esthetics

As I write these words, Yager Esthetics is being turned into a set for an autograph session for Project Runway All Star Casanova. As a grateful and happy patient, he wanted to share his experience with his fans and the media in the heart of the Hispanic community.

The theme of the night is From Design to Plastic Surgery- an evening with Casanova. He and I are two sides of the same coin, and both of us helping women improve their self esteem and feel more beautiful. Casanova is Hispanic and achieved his success through the exposure of the English speaking media. I am American and achieved my fame in the Spanish speaking world. We are both creative artists, he with fabric and I with skin. We are both dedicated to improving the lives of Hispanic women and men.

I was a little uncomfortable with a patient sharing their experience with a plastic surgery procedure with the media to promote me. I do not seek attention or fame, I just appreciate the media as a tool to help educate my community. As I see the opportunity to reach more patients and perhaps have the chance to give them the tools to make good decisions about their appearance, I am grateful to Casanova and all of my patients.

Let us support Casanova in his quest to make his Latin fans proud with a long and successful career in fashion. Thank you for your wonderful gift!


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.


Great Expectations

When a patient consults with me at Yager Esthetics, they usually come as a result of knowing or seeing a patient of mine who is extremely happy with their result.   I had a woman show me on her phone that in her contacts, I am listed as “Miracle Doctor,” for the transformation she underwent after her procedures.

After 15 years and over 30,000 different patient consults, I have also established what I consider the premier practice in Cosmetic Plastic Surgery in the Hispanic community of the New York region.  The center looks a certain way, the staff is trained just so, even the website and patient education materials show an incredible dedication to detail.

I have also become a frequent resource for the media in Spanish to speak on topics related to my field.  I had a patient see me last week who said “Tiene tanta fama que sale en mi sopa.” (You are so famous that I even see you in my soup).  All of this together means that when patients arrive for their consult, my reputation is such that great expectations are placed on my work.  This is both good and bad.

I am a Board Certified Plastic Surgeon, and I am very confident in the way I operate and manage patients.  My results are generally excellent, and 99% of my patients are extremely pleased with their outcomes.  The overwhelming majority of dissatisfaction comes from patients who expect more than quality plastic surgery can realistically deliver.

I try very hard to give a true picture of the surgical and post operative periods, and to point out the limitations of what I can do.  I even show patients the things on their own bodies that I can not fix.  The problem is when patients think that despite what I say, perfection is guaranteed.

After hearing the wonderful experiences of my former patients, seeing me on television, and going through the consultation and office tour, the bar is set quite high.  I always do my best, and can say I can not recall a single case in which my effort was lacking.  My advice to any patient coming to Yager Esthetics or any other office is to listen carefully to what your doctor says, read all the consent and instruction forms thoroughly,  and be clear in expressing your expectations before electing to have surgery.  If all of this is accomplished, satisfaction is nearly always achieved.


30,000 Appointments

As I was seeing patients this past Saturday, I noticed the first patient with a medical record number over 30,000. This was amazing to me. As I finish my 15th year in private practice at Yager Esthetics, this means that on average, over 2000 different people a year wanted to see me. That is about forty new potential patients every week.

When I opened Yager Plastic Surgery in 1997, I certainly was not seeing that many patients. I was somewhat naïve to think that I could just hang up a sign, and magically people would find me. I knew nothing about marketing, budgeting, hiring and firing or advertising. I just wanted to see patients and help the Hispanic community.

Each year, the word got out more and more. I advertised in a local paper, then made a website. Eventually, the news media sought me out for my expertise on cosmetic plastic surgery in the latin population. Now, we have a waiting list for appointments.

Do not let me be misleading- not all 30,000 patients have actually come to see me. Some have not shown up, others have cancelled. Many other inquiries do not result in appointments. My staff handles all of these calls, as well as taking care of my returning patients for their postoperative course and new procedures as well.

I am humbled and grateful for the outpouring of support and love from the Hispanic community, and look forward to the next 30,000.


Always Wear Clean Underwear

I remember growing up and hearing my mother say “Always wear clean underwear.”  It was meant so that if you should have an accident, and have to go to a hospital, you wouldn’t embarrass your family by having holey or dirty underwear.  Be prepared, so to speak.

Thinking about this brought up a new concept-maybe it means to always be prepared to make a good impression.  You never know when you might meet that special someone or impress that new business opportunity.  Make sure you look your best and behave professionally at all times.

At Yager Esthetics, that is basically our philosophy.  Our office is always spotless and ready for a television interview, as we are often called upon to do when a plastic surgery story breaks in the Hispanic community.  My staff is always professional and well prepared to handle any phone call or person who may stop in to inquire.  My AAAASF certified outpatient Surgery Center is always fully stocked and inspected to insure safety.

I always keep an extra suit, shirt and tie in the office as a backup, and have second and third machines to replace my surgical equipment in case of malfunction, and even have a generator in case electricity fails and I need to complete my surgery.

These are all good reasons to feel safe with Yager Esthetics, but it is also a good philosophy for any successful business or approach to life.  Clean underwear.  Mom was right.


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.