Independence Day

As July 4th approaches, we all think of Independence Day, when America decided it wanted to be free from England and establish its own government. By that same spirit, let this year be your time to be who you want to be.

After 18 years plus here at Yager Esthetics, I have seen tens of thousands of patients. Not all of them follow through with surgery or treatments, which is appropriate. The ones that stick out are the ones that have used the benefit of plastic surgery to better their lives.

One patient in particular comes to mind. She came with her husband who spoke for her and belittled her intelligence. Her head was down, and she did not say a word during the consult. I confirmed with her that she really did want the procedure, and was aware of all the risks.

After her surgery, when the dressings came off, she looked fantastic. She started to make eye contact, came without her spouse, smiled, and started wearing makeup. It was a different person in my office.

I received a frantic visit from the husband 2 months later, asking me for a copy of her record and her bill. She was divorcing him, and he wanted to show how much he paid. I told him that it was her record, and only she could authorize its release.

She still comes in, has had more done, and is one of the happiest people you will meet.

Ladies- do not let anyone make you feel helpless, stupid, or ashamed.

Gentlemen- treat your women well, or somebody else will!

Recovering at Home

Most people take care in selecting the right Board Certified Plastic Surgeon. Some even check out the operating facility. Fewer still ask about the Anesthesiologist. One of the most overlooked areas is the patients’ own home.

Outpatient, or ambulatory surgery are the norm today with regards to most cosmetic plastic surgeries. That means you go home a few hours after the procedure. How is your home set up for you?

Physically, it is important to consider if there are stairs, if you live in a building with an elevator, and where in the house you will recover. Talk about this with your surgeon before the day of surgery, as sometimes you need to stay with a friend or relative, or even in a hotel if your space is unfit.

How far do you live, and is it wiser to stay close the first night, or week, or 2 weeks for optimal recovery? Long drives can sometimes increase the risks of complications such as DVT, and if you have an emergency, it might not be safe to drive for hours to return to the clinic.

Who is in the house to help you? You often are limited in what you can do physically, and things like cooking, cleaning, and child care need to be taken care of by someone. Is there food prepared, are you alone or is someone there for emergencies?

Also, if you are around negative people, who for jealous reasons or other bad intentions, will whisper bad things in your ear, make sure to remove them from your life, at least during the healing process. You need the positivity when you are the most vulnerable.

I will make sure we do everything needed to prepare Yager Esthetics for your procedure, you need to get your own house in order!

How to Fix a Tummy Tuck

In my 18 years of private practice plastic surgery. I have now done over 2000 abdominoplasties. Very few, if any, plastic surgeons have done more in an entire career. Amongst them, I have done over 100 tummy tucks on women who have had the surgery before.

When evaluating a patient for a tummy tuck, you have to look at the skin, fat, and muscle, as well as the proportion to the surrounding anatomy and prior scars. After an abdominoplasty, you also have to consider what happened to leave the patient dissatisfied.

Sometimes, the problem is that the woman had a pregnancy after, creating the same problems as before. Sometimes, there has been another big swing in weight, either up or down, to create more laxity. In the rest, the surgery just wasn’t done optimally.

In certain cases of weight gain, a liposuction is all that is needed. In other cases, a full abdominoplasty needs to be repeated. The in between cases are the most challenging, and I believe I have solved many of them.

The modified abdominoplasty is a technique that leaves the belly button attached to the skin, and allows muscle tightening and skin and fat removal. When the initial scar is too high, and the belly button is high as well, both problems are corrected easily. The patient is flat, the high scar is lowered, and the umbilicus sits in the proper place.

While some plastic surgeons refuse to see other doctors’ unhappy patients, I do not. My basic instinct is to help, even if it means dealing with unhappy people. There is often, but not always, hope. I love tummy tucks, and I love my patients. What could be better?

1001 Albums for the Operating Room

A few years ago, I received a book entitled “1001 Albums You Must Hear Before You Die.” I have since acquired them all, and have listened to most. Since I spend 20 hrs a week in the OR, I thought it would be fun to listen to them alphabetically, all the way through. This will take nearly an entire year, as some are double and triple discs.

We started the week of Memorial Day, with ABBA, ABC, David Ackles, Adam and the Ants and Barry Adamson. I got mixed reviews from my OR staff, but they were interested in the project. Most of the music came out before they were born, which is unsettling to me.

My process in the OR is to be efficient and orderly, reducing extra movements and maximizing safety. I thrive on challenging cases, but prefer that there is no excitement in the operating room. If well planned, surgery should be smooth and relaxed. Music helps me to that end- it keeps me locked in and focused.

My life has been a series of goals set and achieved. This is a pleasant task I am happy to undertake. The musical journey of 1001 cd’s begins with just one album!

June is Busting out Allover

With the month of June comes warmer weather and the opening of the beaches. As school ends, all of the teachers, school staff, and college students turn their thoughts to looking good and enjoying the Summer. That means it is a busy time at Yager Esthetics.

I have been doing a tremendous amount of breast and body surgery, and expect that to keep booming this season. I am all about the Hispanic community, and my patients want curves. Sometimes it is removing fat, sometimes injecting fat, and often involves a reshaping and/or resizing of the breasts.

One of my changes in thought has been the use of breast implants in breast reductions in younger patients who want a perkier look. I was taught that this was crazy 20 years ago, but have come to realize that while volume determines size, it is the position of the volume that is the most important for a more youthful appearance. The technique needs to be modified to insure good blood supply to the nipple, but my patients seem very pleased so far.

Fat transfer to the buttocks is also very popular. Called a Brasilian Butt Lift, or BBL by my patients, it can make a nice change in body fat distribution. If we could only pick where the fat would go without surgery! Unfortunately, some patients do not have enough fat to make the change they would like, and no one can guarantee how much fat will survive. Satisfaction rates are still very high.

I also like the Summer because when my patients visit, you can tell how confident they are with their new look by the clothing choices they make. To see someone wear a tanktop for the first time ever, or to use a short skirt, is very satisfying.

When people look better, they usually feel better. I will try to keep up with the demand.