Be Beautiful Boca

This blog is moving to our new and improved website!

2012-02-09T11:17:00.001-05:00

Hello Everyone,

As of today this blog is moving to our new and improved website www.drberman.com. You can view all the latest current trends in the plastic/cosmetic surgery field on our website. We also have an informative question and answer page listed on the site so you can get as much insightful information to make an informed decision about your possible upcoming surgery.

The office of Dr. Jonathan R. Berman

Underwire Bras after Breast Surgery

2011-11-03T16:28:00.001-04:00

Breast surgery in my practice varies greatlyfrom augmentations, to reductions, to lifts and reconstructions, as well as acombination of all of these. All of mysurgery patients are seen at least twice in consultation before surgery, toinsure that they fully understand everything that will be taking placepreoperatively, operatively and postoperatively, and to insure compliance withinstructions. My philosophy is that a patient who has a globalunderstanding of what is taking place, is one who will be more compliant and ismore apt to heal without complications.

I recommend not wearing an underwire bra after surgery. I am not a big fan of underwire brasfollowing breast surgery for the first 6 months. Whatever the breastsurgery, the inframammary fold is affected, and there are incisions that may be at the bottom of the breast, which can beirritated by the wire and delay healing.

Eventhough I have instructed patients not towear an underwire bra immediately after surgery, some patients have ignoredthis and then complain of the wire hurting their breasts, unlike before thesurgery. I suspect that this is because there is inflammation in thisarea which then causes discomfort due tothe wire.

Thus, I advise all of my breast patients to wear either jogging/athletic brasor support bras which do not have wires. Stay comfortable, follow instructionsand do no harm to your recovering breasts.

The Best Breast Size

2011-10-31T10:18:00.004-04:00

How big is big?? One of the most difficult questions for my patients undergoing breastaugmentation is deciding their new breast size.

There’s a great deal to consider. What look does the patient want? What is safe for them? What willoffer the most natural results? How muchcleavage?

The best breast size is the size that best fitsyour body. I also take intoaccount body image, as each woman has their own unique image.

Regardless of your cup size or the shape of yourbreasts, I need to determine the best size and shape for you, and what you arecomfortable with. During breastaugmentation consultations, I discuss this at length with my patients and askthem to try different sizes in a joggingbra,

At least two weeks prior to the surgery, I layout several sizes of implants and have the patient put on a jogging bra andtogether we select the best implant size. The patient is not told the volume of the implant at that time,and only comments on whether or not shelikes or dislikes the look with the implant under the jogging bra.

It’s vitally important that patients arecomfortable and happy with this longterm decision.

Does Immediate Laser Treatment Minimize Scarring?

2011-10-28T15:58:00.001-04:00

A recent Reuters Health reports states that“treating the edges of a surgical wound with a fractional carbon laserimmediately before closing the wound — rather than the more traditional methodof waiting months to resurface surgical scars — will minimize scarring later.”

Peopleneed to be wary of studies quoted to support absolute statements. There are fewreal absolutes in science and far more in advertising. The study quoted reflects the interpretation of ten patientphotographs after skin procedures performed by dermatologists in which half awound was treated with laser.

Theconclusion that immediate fractional carbon laser treatment will make scarsless appreciable later is premature, to say the least. The second supposition, that using a laser months after an operationfor scar treatment is standard, isspurious as well.

Whatdoes the study prove?

Furtherstudy is indicated to determine whether or not patients who have procedures bydermatologists might benefit by laser treatment. With a small sampling of justten patients, no other conclusions are reasonable. Making a broad-based absoluteconclusion based on this very small study is not good science.

Problems?

(1) Scarformation varies greatly, depending on the area of the body, type of skin, ageof the patient, and surgery performed.

(2) Asa general rule, health insurance companies will not pay for laser procedures totreat scarring, and costs vary, greatly depending on the type of laser usedand the size of the area to be lasered.

FDA officially approves Restylane.

2011-10-24T16:49:00.001-04:00

TheU.S. Food and Drug Administration (FDA) has approved another use for RestylaneInjectable Gel: this week the agency gave its official blessing to use thefiller for lip augmentation.

Restylane was previously approved to treat facial wrinkles. While we have longused it for lip augmentation, this was known as an unofficial or"off-label" use. Restylane is the first filler to get the FDA'sapproval for this particular use.

In the multi-center study that Medicis, the makers of Restylane, presented tothe FDA, Restylane was found to be highly effective for lip augmentation, forup to 6 months. It did not have any serious side effects. About 80% of patientsliked the results so much that they signed up for a second treatment after 6months.

This is certainly our experience at my practice: both restylane andjuvederm work very nicely to shape and fill the lips in a pleasing andnatural-looking way. Patients love it!

The Waiting Game After Breast Augmentation.

2011-10-20T11:07:00.001-04:00

It is very important that you build a solid rapport with your surgeon, and it’s paramount to develop an open line of communication him/her and with the entire staff. After the initial consultation, and once a patient has scheduled surgery, we see the patient twice prior to the procedure, and ask each patient to write down questions and bring the list into the office, or call if there are any immediate concerns. The most frequently asked questions are, “How long after surgery can I return to work?” “How long before I can begin to work out and engage in other sport activities?”

Return to work after Breast Augmentation

Most of my patients can comfortably return to sedentary desk jobs within a week of their breast augmentation surgery. Patients having breast implants placed above the muscle tend to be a little less sore than patients who have the implants placed beneath the muscle. Generally, by the beginning of the third week following breast augmentation, I will encourage the patient to start light exercise. Full activity is generally the rule by week four.

Sports activity following Breast Augmentation

I encourage playing "couch potato" for two weeks! Clean out the DVR, tackle the Netflix queue. You should be able to escalate to gentle activity by the beginning of the third week and full activity by the fourth week. There are exceptions to every rule, of course. So please speak with your surgeon; they will know what’s best for their patient!

Be safe, and if ever in doubt contact your surgeon’s office with any post op concerns and questions. I see each patient postoperatively numerous times during the healing period, and either myself or a member of my staff is on the phone daily for at least the first 7 postop days.

I cannot stress strongly enough the importance of asking questions, as a fully informed and compliant patient will generally recuperate much better.

What you need to know about DIY Botox

2011-10-17T15:02:00.004-04:00

DIY Botox first gainedpopularity in late 2008. Today, if onewere to initiate a Google search, thereare over 2 million results. Among themyou would even find a step-by-steptutorial on YouTube. Do-it-yourselfBotox and other dermal filler kits are becoming prevalentinternationally, but is it safe?

The dangers are countless,and I’ll enumerate a few of them:

DIY Botox is not legal. The Botox and other dermal fillers I use inmy practice are approved for use by theFDA by physicians and nurse practitioners under the direction of a physicianonly, in a clinical setting.

Injectables which arereadily available to the public, on-line or otherwise, have not been approvedby the FDA, and are not monitored. These fillers and other injectables are not subject to safety measures, andmyriad complications may ensue. Thesenon-FDA approved products may be even more potent than licensed Botox. The consequences couldbe fatal, or result in short-termor permanent paralysis.

DIY Botox is not sterile.

Prescription Botox ispackaged in a sterile environment, using sterile equipment. Botox purchased through a non-FDA approved source isoften not prepared under sterile conditions, may contain other toxins, and the risk factors are vastlygreater for complications.

As with any sterileprocedure, whether it’s in the operating room or the examining room, provenmethods of sterile technique are adhered to, and this also applies to the useof Botox and filler injections.

Counterfeit Botox andJuvederm has not been approved by the FDA and is not legal in the UnitedStates. Patients subjecting themselvesto injections of these substances by non-professionals using illegal substanceswill not be saving money in the long-term, as the risk of infection,disfigurement, abscess and even death is high.

It's a Bird...It's a Plane...It's Superman?

2011-10-14T20:48:00.000-04:00

When Clark Kent wanted to transform into his heroic alter-ego, Superman, all it took was a quick whizz round inside a phone box. In real life, things are rarely so easy as I read on an ABC news article! A 35-year-old man has had extensive cosmetic surgery to make him look more like the comic book character.

Herbert Chavez, from the Philippines, has dramatically altered his appearance to look more like the famed Man of Steel. In his quest to emulate his favorite superhero, he has undergone a variety of procedures ranging from chin augmentation to thigh implants.

Mr Chavez, whose profession is given as 'pageant trainer', has been going under the knife since 1995 to achieve the transformation. So far Mr Chavez has admitted to having a chin augmentation to give him Superman's iconic cleft; Rhinoplasty to transform his Asian nose into one more closely resembling Superman actor Christopher Reeves; silicone injections to his lips to make them fuller and thicker; and thigh implants to make his legs appear more muscular.

Based on the before and after photos, I would also suspect eye surgery, cheek augmentation and a jaw augmentation. His look appears to be an amalgamation of all the actors who have played Superman, as well as comic book depictions of the fantasy character. Surely an interesting yet extreme look at what plastic surgery can do. Although I wouldn’t necessarily advocate plastic surgery to become your favorite super hero.

Can lipo make you healthier?

2011-10-10T12:40:00.000-04:00

Ontoday’s blog I wanted discuss a new study recently presented at this years theannual conference of the AmericanSociety of Plastic Surgeons has found that liposuction can notonly make you thinner, but could possibly simultaneously decrease thetriglyceride content in your blood.

Accordingto ABCNews:

Researchersstudied levels of cholesterol and “bad” fats called triglycerides in the bloodof more than 300 patients who were undergoing liposuction. Patients who hadelevated triglyceride levels before the procedure showed an average 43 percentreduction in their triglyceride levels after they had liposuction.

Thepatients showed no changes in their cholesterol levels, but researchers didfind a post-liposuction reduction in counts of white blood cells, which areassociated with heart attacks, obesity, strokes and high blood pressure.

Thisis the first study that has shown any beneficial health effects ofliposuction removing subcutaneous. However, I would still say it’s a stretch to say that lipo alone willmake you healthier. There are fatsthat cannot be removed via liposuction such a visceral or intra-abdominal fat. Unfortunately, these carry with them a higherrisk of heart disease, unlike subcutaneous fat.

Thereis a place for liposuction. But itwon’t be a substitute for a good dietand regular exercise. It’s purpose is to treat stubborn areas of fat inpeople who have a healthy body weight.

Beauty sleep is not a myth

2011-10-03T11:06:00.000-04:00

Want a free a simple idea to improve your appearance? My answer: Get at least 8 hours of sleep a night. The idea of people needing "beauty sleep" has acquired some scientific backing, according to a Swedish study.

The study, led by John Axelsson of Sweden's Karolinska Institute, was published Dec. 14 in BMJ, a British medical journal. It set out to explore the effect that sleep has on how one is perceived, specifically on others' judgments of an individual's attractiveness and health.

People deprived of sleep for long periods appear less attractive and more unhealthy than those who are well rested, say researchers. Volunteers were photographed after eight hours sleep and again after being kept awake for 31 hours.Observers scored the sleep-deprived participants as less healthy and less attractive, the BMJ reports.

The concept of beauty sleep is well known. But, according to researchers at the Karolinska Institute in Stockholm, it has lacked scientific support. The team asked untrained observers to rate the faces of 23 young men and women who had been photographed after a normal night's sleep and then after a night of sleep deprivation. The photographs were standardized so that people were the same distance from the camera, wore no make-up and used the same expression.

The authors wrote in their paper published in the British Medical Journal: "Sleep deprived people are perceived as less attractive, less healthy and more tired compared with when they are well rested." They say the results may be useful in a medical setting, helping doctors to pick up signs of ill-health in their patients.

Commenting on the study, Derk-Jan Dijk, Professor of Sleep and Physiology at the Surrey Sleep Research Centre, said the effects of sleep loss on beauty may be even more dramatic than the photographs show. He said: "The photographs were taken during the daytime when the biological clock promotes wakefulness. Can you imagine how sleep loss makes you look at night or early in the morning when the circadian clock (body clock) promotes sleep?"

Findings showed that sleep-deprived people appear less healthy, less attractive and more tired compared with when they are well rested," wrote the researchers. This suggests that humans are sensitive to sleep-related facial cues.

While the long-term effects of poor sleep on overall health have been widely researched, this is the first study to provide evidence that in the short term, sleep deprivation does in fact show up as a discernible change in facial appearance.

So, get some sleep and go from rough to ravishing!

Should you Combine Plastic Surgery Procedures?

2011-09-29T11:09:00.000-04:00

One of the questions I’m most often asked by patients: “Is it possible to have more than one surgery at the same time?” This has been a particularly growing trend in the past few years. Over the last several years more and more patients come to the office wanting to address more than one problem area at the same time.

For many years plastic surgeons have been combining facial rejuvenation surgical procedures because as we all know, humans don’t age one facial part at a time. We commonly perform eyelid surgery and facelifts surgery simultaneously They are even combined with other rejuvenation surgical procedures because they can be done so safely. Patients are recovering at one time, and they end up with a more harmonious result.

As long as sound judgment and safety are the primary focus of all consideration, then even larger operations on the body can be accomplished in one operative visit. Preoperative screening should always be completed prior to an operation of larger magnitude or other longer and delicate procedures. The pre-op assessment will be a good indicator of what the patient will be able to safely handle. It is also important to make sure that you are choosing a plastic surgeon with proper credentials and plenty of experience as well as one that performs their surgeries in a certified operating facility.

As a double board certified surgeon, I say safety first!

Breast Reduction

2011-09-26T11:14:00.000-04:00

Breastreduction is often misunderstood online. The operation is defined as thereduction and lifting of breasts. This is not the same as removing or reducingthe size of breast implants in a woman’s breasts. That is called an implantexchange.

Implantsare not usually involved especially when an insurance company is scheduled topay for it with the possible exception of surgery to reconstruct a woman’sbreasts after breast cancer surgery.

Itis difficult enough to get most insurers to pay for “clear cut”medically-necessary plastic surgery. Breast reduction surgery is the reductionof naturally enlarged breasts and that is all.

Breastreduction used to be one of the more common insurance-covered procedures. Withthe economy as of late, insurers are not always so quick to approve them, butfor the right patient they are still do-able.

Usuallywe see our patients for a consultation and then apply to their insurers forpre-approval if the case seems reasonable by insurance company standards. We don’t make the rules on approval, but wedo know the game. Appeals are not uncommon.

Thesedays, insurers are looking for a certain amount of breast gland to be removedin a certain sized woman in order to allow coverage. In addition they like tosee documentation of things like bra strap furrows, the “dents” some largerbreasted women get in their shoulders from breasts weighing against them throughoutthe day. Insurers don’t tend to like claims where liposuction has beeninvolved. This can trigger denials on cosmetic grounds at the time of billing.

Insurancepre-approval usually covers surgery for a 90 day period. The exact nature ofthat coverage varies by the plan. Besure to talk to your surgeon about what your options are and what the best planof action is for you.

What to do when finding a surgeon.

2011-09-19T22:23:00.003-04:00

As a plastic surgeon, people often share their fears of surgery. Sadly, they also frequently share horror stories of botched surgeries, terrible results, and even the death of someone they knew. Some of these fears were captured by a US Today article I read recently that showcases the story of the Howards, local to our very own South Florida.

It would be irresponsible of me to say that there aren’t risks in plastic/cosmetic surgery. There are risks involved every time you go under the knife for sure. However that doesn’t mean you should allow that to scare you from looking into the surgeries you would like performed to achieve the results that you desire. Unfortunately, you only hear about the bad or “horror” stories. There are plenty of plastic surgery “wows” that are unseen because the patients look so good. They look so natural, no one would know anything was ever done.

There is plenty that you can do to put yourself in the best possible hands to ensure not only your safety, but results you’ll be happy with.

I feel that the most important thing you can do is to do you homework. First, think long and hard about exactly what you want improved or what you’d be interested in. Then form an idea of the results you’re expecting. Once you’ve done this, find a few surgeons via credible recommendations. Please do yourself a favor and check the surgeon’s web presence. Do you like the feel you get when you see the website? How glitzy? What’s the environment like? Can you see that Doctor treating you? Next, schedule your consultation. Don’t be afraid to ask the doctor about their experience, ask to see testimonials. Most importantly ask questions. What are your different options? What exactly will happen during the surgery? What can you expect during your recovery time? It is paramount that you do your due diligence and stay safe while seeking out the new you!

Safety is job one!

Insurance Dollars for Rhinoseptoplasty

2011-09-14T13:28:00.000-04:00

In recent years many celebrities have explained going under the knife for a nose job by stating it was a performed for medical purposes. So it’s no surprise that I have been asked various times by patients about the likelihood that their insurance plan would cover the surgery.

It has been my experience that it behooves the surgeon to obtain pre-authorization for the surgery from the specific insurance company as they all have varying policies. The third party will usually pay for medically necessary surgery, provided that the appropriate medical documentation to support necessity of the proposed surgery is available. If there is associated trauma to the nose, the third party will often pay for reduction of a nasal fracture more readily than pay for a rhinoplasty. Third parties typically deem rhinoplasty a cosmetic surgery. They regard septoplasty and turbinectomy as medically appropriate surgeries performed for medical necessity.

Septoplasty and turbinectomy procedures are performed to improve breathing; therefore third parties tend to pay for these procedures. However, if a rhinoplasty is performed at the same time, the third party will deny payment for the cosmetic portion of the surgery---- the rhinoplasty, including anesthesia and operating room fees incurred during the cosmetic portion.

There are always exceptions to the rule, but it is better to expect that there is a very small likelihood that your insurance will cover your rhinoplasty. The best course of action is to talk to your surgeon about what your options are and what payment alternatives exist.

Does Obama look 50?

2011-09-12T09:59:00.000-04:00

I shared earlier how I felt that fifty was the new thirty. Baby boomers today are more active, vital and involved with their health and fitness than their parents were. A great example of this is our very own president. President Obama is making the headlines not only in the political arena, but also among those of us in the plastic surgery field. I read an interesting article by the American Society for Aesthetic Plastic Surgery blog that talks about how the President’s recent 50^th birthday has brought to the forefront what a fifty year old should look like.

They mention the “’holy trinity’ of aging: (1) wrinkles, age spots and other superficial changes exacerbated by too much sun and smoking; (2) loss of facial volume, which highlights under eye bags and, finally, (3) drooping of the eyelids, nose, corners of the mouth and jaw.”

If we consider this trifecta in reference to President Obama we can see that he doesn’t exactly fit the mold. The biggest reason is the president’s race. His skin better protects form the harmful UV rays of the sun. It’s also not only thicker, but oilier too. A combination that save guards against the proclivity to wrinkle of paler skin.

Also helping the President’s appearances are the balance of exercise as an avid ball player and the healthy diet provided by the presidential chefs. You can also not discount his cool as a cucumber attitude. A relaxed personality avoids not only frowns but age lines. The president is a great example of how we can all feel and look better with age. After all, remember, 50 is the new 30!

Preventing stitches from popping after surgery.

2011-09-08T10:50:00.000-04:00

I love when patients have a lot of questions during their consultations. I think it’s an important part of the process, and insures the best results for the patient. A question I’m often asked by patients looking to have a tummy tuck is: In What Percentage of Tummy Tuck Cases Do MR Stitches Pop?

That’s a very good question. Sure, some sutures may "pop" or break. But the better question is why did one pop? Was it poor technique? Was it deficient diet and nutrition? Or was it a lack in patient compliance with post-operative instructions? All things being equal, I am always concerned about this possibility. The major control I have in prevention of this occurring is performing safe surgery techniques, giving appropriate post-operative instructions, and advising the patients to eat properly. However, I cannot control patients who exercise or exert themselves prematurely compromising their surgical result.

At surgery, I approximate the muscles with interrupted permanent sutures rather than one long running suture. If the one long running suture breaks then the suture has the potential to unravel. This could effect the result of the tummy tuck. I believe that over time, some of these sutures may not hold as true as they did when they were originally placed. Scar tissue grows in, among, around the placed sutures. This increases the strength of the closure. Certainly, this strength increases with time after the surgery. The repair is the "weakest" in the early 2-3 weeks after the surgery. This is one of the reasons my patients are advised to refrain from vigorous activity in the early post-operative period.

There are many tummy tucks done each year. Few have popped sutures requiring re-operation. As a double board certified surgeon, I take every possible precaution so that my patients don’t have a “popped” suture as part of their tummy recovery experience.

Feel free to ask me about tummy tucks or other plastic and cosmetic surgery procedures.

Rhinoplasty : Shaping your nose

2011-09-02T11:33:00.004-04:00

A nose job or rhinoplasty (Greek: ῥίς rhis, nose + πλάσσειν plassin, to shape), is a delicate work of art that requires clear communication of desired results and a solid pre-operative strategy to achieve the best results. Rhinoplasty is an operation that is a sum of its parts. The various parts of the nose need to be brought to a perfect harmony. Should tip work be performed, then in all likelihood that the nasal dorsum needs to be recontoured to properly align with the newly created tip. The width of the nasal bones will probably need attention as well. Welcome to delicate balance that is Rhinoplasty!

Patients often present with large bulbous tips for rhinoplasty. Rhinoplasty can change the shape of the nose by removing/adding structural elements. There is some skin retraction following rhinoplasty. After all, once a bump is taken down or a tip cartilage removed, where does the extra skin go?

Often, the patient who has a big nasal tip has thick skin. The rhinoplasty surgery does not really address this issue. Excess skin/tip width can often reduced by reducing the alar base width which is removing part of the nostril.

We still do not have the ability to decrease large excess and thickness of skin on the nose without causing severe changes to the nose. There are surgeries to help but it is difficult to control scar formation and further thickening of the skin.

By changing the structure of the nose by altering its cartilaginous or bony framework will make a smaller nose, but still a thick nose.

There are patients where "most" of the work needs to be addressed at the tip. Those patients require more tip work than others but still often need surgical refinement of their nasal dorsum, nasal bones, etc.

I have been performing Rhinoplasty for more than 20 years. It is a procedure that you continue to learn to perform better. If you want to learn more I invite you to leave a comment and contact my office.

Breast Enhancement that fits your Lifestyle

2011-09-01T10:38:00.000-04:00

Breast enhancement surgeries are is one of the most sought after cosmetic surgery procedures performed today. I’d like to outline some of the various types of these procedures to help women decide which is best of them. Ultimately, the goal is for my patients to achieve the shape, volume and size of their breasts that best matches their unique goals and physique.

Breast Implants

Breast implants are used to increase the size and fullness of a woman’s breasts. Breast implants are filled with either silicone gel or a saline solution, and can be found in variety of sizes and textures. Each offering different aesthetic effects. Typically, implants are inserted into a pocket created beneath the breast or behind the pectoralis muscle. However, the implant may be inserted through the areola, the armpit, the belly button, or at the breast crease for better results for certain patients..

There are many benefits to breast implants. Most notable, most women report a greater self-confidence, and happily report that they are able to expand their wardrobes to include styles of clothing that they couldn’t wear before.

Breast Lift

Breast lift surgery (mastopexy) is used to treat breast sagging – the natural loss of elasticity, firmness and shape caused by pregnancy, nursing, excessive weight loss and aging. A breast lift typically consists of the removal of excess skin, tightening the skin and, in some cases; it is combined with breast augmentation in order to restore shape and volume.

Breast lifts result in “perkier” breasts and a more youthful overall look. Because of this, breast lifts are a popular component of the “Mommy Makeover,” a series of cosmetic procedures that is designed to reverse the effects of childbirth and nursing.

Breast Reduction

Excessively large breasts can cause neck, back and shoulder pain, which can lead to chronic health complications. Breast reduction surgery helps correct this issue by removing fatty tissue, glandular tissue and excess skin so that your breasts better match your frame size and become smaller.

Breast reduction helps alleviate strain on your neck and back and makes it easier to shop for clothing and exercise. Because of the long-term health benefits of breast reduction, these procedures are sometimes covered by insurance.

If you’d like to find out more and further discuss what breast enhancement procedure fits your lifestyle contact my office or leave a comment!

Fighting Acne and Aging?

2011-08-26T10:21:00.000-04:00

At the Skin Care Center at Berman Plastic Surgery, I’m often asked if a single product can fight pimples and attempt to beat wrinkles?

There was an interesting article in a recent issue of The Wall Street Journal about products targeted at adults suffering with acne. I’m sure you have seen a number of products being marketed as having both an anti-aging benefit as helping get rid of acne.

It appears to me that the cosmetics industry realizes that they can broaden the appeal of a single product by targeting both the young and old. Resulting in an interesting dichotomy for their products: Younger clientele get a cure for their acne, while older clients get the wrinkle prevention they desire..

The article points out that the combination skin care products can contain antibacterial, anti-acne ingredients, such as benzoyl peroxide; as well as salicylic acid, which helps clear the pores. These medicines are tried and true — they work. Regardless of age, it is clogged pores that cause acne. Think of each acne spot is a mini-infection.

The other components of the dual-mission products are often moisturizers and clarifying cleansers. The purpose of these is to improve the skin’s appearance, and, hopefully, slow the aging process. Retinol is the most commonly used ingredient in the form of retinoic acid (Retin-A.)

My best advice is that you read the labels, study the components, and then make an educated decision. Most importantly, you do not have to spend a fortune on these products. More often than not, the higher cost items are paying for brand awareness and other cost accrued by the cosmetic company. Also remember everyone’s skin is different so it’s best to discuss with you skin professional what products are best for you.

If you have any more questions about skin care, I invite you to check out the Skin Care Center at Berman Plastic Surgery.

50 is the new 30!

2011-08-23T10:11:00.001-04:00

I read an article last week in the New York Times about the elderly population wanting and having cosmetic surgery. In the past, more often than not, we would not perform cosmetic surgery on patients older than 70. It is a different time now than it was 10 years ago. I have performed cosmetic surgery on 65, 75 and 80 year olds. I am doing a facelift this week on a 78 year old woman who is super fit!

Baby boomers like me are now getting into their fifties. They are successful, sophisticated, upwardly mobile and want to continue their youthful life. We want to age as gracefully and slowly as possible. We are entering our 50's and we don’t feel old. We accept the maturity of aging but not the biological fact that we are older. Coming out of our 40’s is like leaving our 20’s, and therefore turning 50 is like turning 30. We understand that we are aging, but feel more like we are entering our 30’s rather than 50’s.

Baby boomers are more active, vital and involved with their health and fitness than their parents were. The boomers are cycling, running marathons, taking spin classes, hiring trainers, running triathalons, swimming, exercising like gym rats....all to keep looking young and fit. All to turn back the clock and trying to stop father time from marching on. Think about what my generation is eating: Whole foods, organic meats and vegetables, all believing that these are healthier and better. How many people my age are Vegans? Vegetarians? Fruitarian? Pescatarians? Yes the 60's saw a break from traditional values, yet those that are now 60-70 are not as active in their 50's as those in their 50’s today; the later baby boomers.

So....

Did I ever think in a million years I would take a spinning class? I was clearly not the only 50 year old in the class. There were mostly women ages 25-45. But a few men like me were in their 50’s.

See the attached photos. Me, yes me, in a spin class(I loved it!) and a friend of mine who is 51 wearing a “30” jersey. I think I heard him first say it…“50 is the new 30!”

What to Ask Before Your Breast Augmentation

2011-08-17T11:26:00.000-04:00

So, you are considering a breast augmentation. What’s next for you now? The most important thing is to do your research so you know what to expect and select the perfect surgeon for you. We’d like to suggest some key questions you can ask to help you make the best decisions for the details of your operation. Often times we clam up when we get to the doctor. Many patients are often surprised by the choices and considerations they’re faced with when considering a breast augmentation.

Looking at your breasts the way a doctor does can be an emotional event full of new information which may be hard to process, but it is essential that you and your doctor are ‘on the same page’ regarding the type of implant and surgical approach that will be used.

Here are a few questions you should discuss and answer prior to having your breast augmentation procedure:

Saline or silicone? 

The two most commonly used types of implants are: saline and silicone. Saline implants are silicone shells that are inserted empty and then filled with sterile saline after they’re placed into your breasts.

Silicone implants are inserted into the breasts in full gel form. Most patients choose silicon implants since they definitely have a more natural feel. However, if a patient is going to have breast lift in conjunction with, silicone implants are recommended over saline.

What size implant? 

This is perhaps the biggest consideration in the minds of most women. Breast size after surgery will be dependent on how big your breast were prior to surgery and the final volume of the implant that is inserted.

Breast implant volume is measured in CC’s (30cc = 1oz). The most popular implant size is 300cc’s. To give you an idea of what 300cc’s might look like, fill a freezer bag with 10 ounces of water. Then place that in the lower part of your bra. During your consultation, your plastic surgeon should let you try on actual implants by placing them inside your bra. We suggest that you two different types of tops (perhaps a blouse and a tank top.) This will help you make a better decision about what the right size is for you.

High profile or low profile? 

Although implant volume is very important, the shape of the implant is an equally significant consideration. Most women want to be sure their breast augmentation procedures leaves them looking proportionate. A good proportion is not only determined by the breast implant size, but also by the shape of the implant as compared to the size and shape of her chest wall and torso. The choice of moderate vs. low profile has a lot to do with your anatomical chest frame dimensions. For example, if you have a really narrow chest, the round low profile implants may have too big of a diameter for your chest wall. Therefore, you may need to consider going with the high profile shape, which has a narrower diameter but more projection(taller).

In comparing implants of the same size, a low profile breast implant has a wider, rounder base when viewed from the top. A high profile implant has a smaller base. Therefore, when viewed from the side, the high profile implant has more projection. The high profile gives more projection and more fullness near the top. The choice of implant will also affect the resulting cleavage from the procedure. These days more women tend to prefer the high profile implants.

Textured or smooth implants? 

Some implants have a textured surface while others have a smooth surface. A smooth implant is softer and able to move more freely than a textured implant. The past ten years have send trend favoring smooth implants.

Under or over the muscle? 

Breast implants can be placed over the muscle or under the muscle. Below the muscle, as it is commonly referred to, is actually a partial insertion of the top part of the implant under the pectoralis major muscle. The most common medical recommendation is under the muscle because it gives the most natural look and the best long term result. There is however a downside, which is that your recovery may be a couple of days longer since the procedure is more involved to get the implant placed under the muscle

If your surgeon suggests ‘over the muscle’ be sure that he has a very good reason for that choice, as inevitably the result does not hold up well over time. Knowing the location of your implants is important to understanding exactly what the plastic surgeon has planned.

Where to have the incision? 

Most patients with a preference have based their opinion on the experience of someone they know having had that type of incision and the way that looks. There are several types of breast augmentation incisions used by plastic surgeons including the inframammary incision, the circumareolar incision, the axillary incision and even the TUBA incision. The truth is every type of incision has its pros and cons. There is not one best incision for all breast augmentations. Every case is individualized based on the patient’s specific choices and objectives.

With or without a breast lift? 

If you have sagging breasts and a loss of fullness in the top portion of your breasts, you may benefit from having a breast lift in conjunction with your breast augmentation. Often, with age and particularly after pregnancy, the breast skin is stretched or the nipple begins pointing downward. For those patients, who wish to achieve the fuller appearance with better cleavage, I recommend getting breast augmentation with a breast lift.

If you’re planning a breast augmentation procedure, consider these variants be sure to discuss them with your surgeon. Be sure to try implants on for size.

Implant size and profile, incision placement, and implant types are not things you want to go into blindly! It’s important that you discuss them with your board certified plastic surgeon during your initial consult so that you can get the results and look you want and deserve.

Technology and your recovery period.

2011-08-15T11:31:00.000-04:00

While much of our website is dedicated to better inform you about cosmetic surgery and helping prepare you for your upcoming procedure, we would like to talk about the recovery period following any cosmetic surgery procedure.

During your pre-op appointment, the Surgical Coordinator will review your post op instructions. This appointment normally occurs a few weeks before surgery so you have some time to review. They will give you a description of what you should expect following your cosmetic surgery.

Topics usually discussed include:

• how long to wear the garment

• when you can shower

• when you can drive

• drains- when do drains come out

• pain pumps and pain control

• swelling and bruising

• when to contact the office

Perhaps the most reassuring post-op instruction is that we encourage you to call if you have any questions or concerns.

But in today’s day and age, cell phones can do a lot more than place a phone call! These days most patients have smart phones, or phones that can take pictures, send e-mails, and text. You may have questions about redness and swelling following your cosmetic surgery procedure. All surgeries involve some amount of redness , swelling, and discomfort. However, some complications will start to present themselves with an unusual amount of swelling and or redness. Whenever we suspect such a situation we will always insist on the patient coming into the office to be examined, no matter what time or day of the week it is.

However, sometimes the patient is vague about the symptoms and it may be hard for to judge over the phone whether you should come in sooner than your next scheduled appointment. In these instances, when a patient calls with a question or description of a particular problem they are having, it may be a good idea for the patient to send a photo of the operative site to him by e-mail or text.

In most instances a photo will tell whether you need to be seen in the office right away. This is a great tool for both doctors and the patient, as it often times will save everybody an unnecessary extra trip to the office!

A picture says a thousand words, and technology is wonderful. But when ever in doubt, call the office and come in. It’s better to be safe than sorry.

Liposculpture or Liposuction: Twenty five cents or a quarter? Kleenex or Facial Tissue?

2011-08-12T21:33:00.000-04:00

Liposuction of often thought of by women as a way to look slimmer. Most plastic surgeons agree. They use liposuction as a way to shave off pockets of fat where needed. However, as the technology and views of beauty have progressed curbs and form are now equally as important. It is not only important to remove the fat in areas of concern, but also to add where necessary.

But the truth of the matter is that liposculpture and liposuction are interchangeable. Patients who undergo liposculpture have liposuction. Fat is removed by different techniques: LASER, suction, ultrasound, etc. The inventors of the various forms of the removal claim their form of fat removal is less "stressful" to the tissue, less "traumatic" and ensures less downtime and more rapid healing.

Consider this: the less surgery you have performed, the less healing that has to occur, and thus allowing you a faster the return to daily activities. Therefore the more surgery you undergo, as well as the more invasive surgery that is performed is, there more noticeable result.

Whatever form of surgery that is performed creates local tissue injury. The local tissue injury results in immediate post-operative swelling. The swelling is to be expected and is a normal part of the healing process. It takes time to resolve. It is not uncommon for patients immediately post-op to have less swelling than they do one week after surgery. For the most part, patients who undergo liposuction need to wear post-operative girdles and garments to help control the post-operative edema and swelling to facilitate more rapid and controlled healing.

For more information about your liposuction, contact Dr. Berman’s office.

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2011-08-08T21:54:00.001-04:00

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Will Fat Grafting to the Breast Affect Mammograms?

2011-08-08T09:37:00.003-04:00

Fat Grafting, also known as fattransfers or fat injections, is a plastic surgery procedure which removes fatfrom unwanted areas of your body, it is then methodically processed, once it’sready, it is reinjected to the particular adipose fat tissue where more volumeis desired. Fat injections are commonly used as a rejuvenation agent for theface, buttocks, hands, or breasts. There has also been in increase in the useof fat injections in reconstructive breast surgery. The advantages being thatfat grafting will restore volume to the breast and can be performed with orwithout the need of an implant.

Being that the procedure is fairlynew, there have been some concerns expressed about how the fat injectionsaffect the results and efficacy of mammograms. We would like to share a few varying perspectives on the matter

Lately we have seen some plasticsurgery blogs expressing concern regarding how fat injections to the breastaffect mammograms. We feel that both sides of the story are not being told, sowe would like to address that here. Theheated debate hit the The Plasticand Reconstructive Surgery Journal, a journal of peer reviewedstudies from the plastic surgery community, recently published several papersthat come to different conclusions about whether fat injections to the breastcan interfere with cancer screening.

Let’s explore these publicationsto review the various findings.

TheChinese Study

April 2011, Plastic and Reconstructive Surgery

“Clinical Analyses of ClusteredMicrocalcifications after Autologous Fat Injection for Breast Augmentation”

Therecently released paper, published in the April 2011 issue, put fat injectionsto the breast in a negative light. The study was conducted by Chinese plasticsurgeons at Meitan General Hospital and Peking Union Medical College Hospitalin Beijing, China. The Chinese study concluded that fat injections createissues with mammograms used to detect cancer in the breast. Based on thesefindings, the study recommended prohibiting all fat injections to the breast.

This study analyzed ‘digitized mammographic films’from 48 patients who had received fat injections to the breast from July 1999to December 2009.

The studyfocused on calcifications which occur after fat grafting is performed.

When a fatinjection does not take well, the fat cells can die (fat necrosis), and take onthe appearance of a calcification. The Chinese study concluded that mammogramscannot distinguish between calcifications formed from fat or calcificationsthat may be cancerous. The study’s abstract conclusion states “clusteredmicrocalcifications found after autologous fat injection for breastaugmentation, cannot be distinguished from malignancy.”

Eventhough all calcifications were biopsied to be non-malignant, the study alsoreached a grandiose conclusion that fat injections to the breast “should beprohibited.”

So–should fat injections to thebreast be outlawed? Or is there another side to the story? If so, what is it?The heart of the matter is whether radiologists can distinguish ifcalcifications seen on mammograms are due to dead fat cells, or from malignantcancer cells. First of all, not all fat grafting produces calcifications.If a fat graft takes well, there will be fewer dead fat cells, or fat necrosis,thus resulting in fewer or no calcifications. However, a poorly performed fatgraft will likely have lots of dead fat cells, likely resulting in morecalcifications.

Let’s look at other recentarticles that were published on the topic of fat injections and mammograms, allwithin the last month.

TheDiscussion Article about the Chinese Study

April 2011, Plastic and Reconstructive Surgery

Daniel DelVecchio, M.D.

The sameApril 2011 Plastic Surgery Journal issue included a ‘Discussion’ article aboutthe Chinese study. If you had a hard copy of April’s journal, you would simplyturn from the last page of the Chinese publication to read the ‘Discussion’section that immediately follows written by Plastic Surgeon, Dr. DanielDelVecchio. Dr. DelVecchio was an early adapter of fat grafting to the breastand has been published frequently in the Plastic Surgery literature.

Dr.DelVecchio brought up several excellent points as to why the Chinesepublication conclusion was without merit. One point addressed concerned theissue of the resolution quality of the mammograms. What type of mammography didthe Chinese use? The Chinese publications stated that they used ‘digitizedmammographic films.’

Accordingto DelVecchio, this would imply that plain screen film mammograms wereinitially imaged, and later digitized. Per DelVecchio: “the quality ofdigitized screen film mammogram is only as good as the quality of the originalmammogram, and it is common industry knowledge that screen film mammograms areinferior to direct digital mammograms.”

In otherwords–did the Chinese study simply digitize mammogram films with inferiorresolution?

Dr.DelVecchio pointed to the work of other fat grafting pioneers, such as Dr.Emmanuel Delay, who have described the ability to distinguish between benignand malignant findings on post fat grafting mammograms. DelVecchio cited theradiologic literature which supported the general concept that calcifications and fat necrosis can bedistinguished from the malignant signs of irregularly shaped, high-opacitymicrocalcifications when supplemental imaging modalities are considered.

Othernotable points made by Dr. DelVecchio included the need for standardization offat injection procedures in order to minimize fat necrosis, which result incalcifications. Deviation from ideal fat grafting techniques result in poor fattake because some of the fat dies. It is these dead fat cells that can resultin calcifications. As standards emerge for the best fat grafting techniques,there will be less fat necrosis and calcifications to show up on mammograms asa result of fat injections to the breast.

InDelVecchio’s opinion, modern mammography techniques can distinguish betweenmalignancy and benign fat deposits found on mammograms.

TheFrench Study

March 2011, Plastic and Reconstructive Surgery

“Radiographic Findings after BreastAugmentation by Autologous Fat Transfer”

Exactlyone month prior to the Chinese article publication, a group of French surgeonspublished an article in the March 2011 issue of Plastic Surgery Journal. Thestudy compared mammograms pre and post operative mammograms on 20 patients whounderwent fat grafting to the breast. The study’s goal was to determine whetherthe transfer of fat to the native breast hampers breast imaging.

Usingguidelines stabled by the American College of Radiology classification, thestudy concluded that radiographicfollow up of breast treated with fat grafting is not problematic and should notbe a hindrance to the procedures. However, the study did recommendthat techniques used for fat injection patients should become standardized, sothat reproducibility could be insured.

OurSummary:

As more and more radiographersbecome more familiar with fat grafting and how it may skew results, we expectthis mammogram issue to diminish, as was seen when breast implants gainedpopularity

Perhaps the more significant factto report yet is that of the thousands of fat graphs to the breast completed todate, there has not been a single case of cancer missed by a mammogram thatcould be attributed to a fat graft procedure.

Get the 411 on Liposuction

2011-07-17T19:20:00.002-04:00

What is Liposuction?

Despite the fact many people diet and exercise religiously, sometimes it's physically impossible to get rid of fat deposits in certain areas of the body such as the abdomen, thighs, arms or butt.

As a result, literally hundreds of thousands of people undergo liposuction surgery each year. According to the American Society for Aesthetic Plastic Surgery, lipoplasty has even been the top overall surgical procedure since the Society started collecting nationwide procedural statistics in 1997.

In short, liposuction is the removal of fat deposits in the body through suction.

A conventional liposuction procedure involves four basic steps:

1. Application of either a local or general anesthetic, depending on the number/area of your procedure(s).

2. An incision or incisions is made near the selected area and a thin "cannula", or tube is inserted through the skin and muscle.

3. A small amount of anesthetic is injected into the area to break up the fat deposits and the fat is removed through suction via the cannula.

4. Once the fat is removed, the incisions are closed and padding is applied to reduce bleeding and allow the incisions to heal.

No shortcut to weight loss

It's extremely important to remember however that liposuction isn't a shortcut to weight loss, and it's recommended primarily for healthy adults within 10-20 pounds of their ideal weight looking to remove stubborn pockets of fat and shape and contour their body.

Liposuction (technical term lipoplasty) is a surgical procedure that removes fat deposits from designated areas of the body. Several techniques can be used during liposuction surgery, but, generally speaking, the plastic surgeon uses a probe that is inserted into the patient’s body through a small incision. The surgeon then breaks up the fatty cells and extracts them from the targeted area of the body.

Common Types of Liposuction

Liposuction (technical term lipoplasty) is a surgical procedure that removes fat deposits from designated areas of the body. Several techniques can be used but, generally speaking, the plastic surgeon uses a probe that is inserted into the patient’s body through a small incision.

Lipoplasty surgery has become one of the fastest, most effective and safest cosmetic surgery procedures available today, and much of that is due to the technological advancement of both the techniques and the equipment

The following are the four most common liposuction techniques.

1. Tumescent Liposuction

Tumescent liposuction is the most common type of liposuction.

The basic process is your surgeon will insert the cannula through the incision and inject lidocaine and epinephrine into the fatty tissue, causing it to becomes swollen and firm, or "tumescent."

This helps break up the fat deposits for easier suctioning, and it also reduces bleeding.

Ultrasonic Liposuction

Vaser liposuction is an increasingly popular alternative to traditional liposuction. Contour Genesis is another ultrasonic liposuction solution. It has been available for the past seven years. Using this solution has been very successful in our practice.

Ultrasonic lipo technology involves using ultrasonic sound waves to gently loosen the fat for easier removal.

Tumescent liquid is still injected into the body, but instead of the cannula ultrasonic probes use vibration to break the fat cells apart.

Once the fat is emulsified, asmall cannula is used to suction out the fat cells. Some of the local anesthetic remains in the tissue and that helps to reduce post-procedural pain.

Vaser liposuction is considered gentler on the body and the remaining cells in the treatment area than more conventional liposuction methods.

2. Smart (Laser) Liposuction

Smart Lipo is essentially the earliest version of laser liposuction.

Few Plastic surgeons use this as an alternative form of liposuction. The costs of this technology far outweigh the benefits of this solution. The ability to use light energy for liposuction has not shown been shown to be clinically better. A small cannula is still inserted through an incision or incisions, but instead of sound or liquid an intensified laser is used to break down the fat deposits.

Water Jet Liposuction

3. Water jet liposuction uses a pressurized stream of saline to simultaneously break down the fat and help remove the cells.

Basically the water jet loosens the fat cells, and while it still uses tumescent fluid the cannula both irrigates and suctions the loosened fat cell from the body.

There is very little bruising or swelling with water jet liposuction and, because of the water, there is also much less trauma to the surrounding tissues.

Am I a Good Candidate for Liposuction Surgery?

Good candidates for liposuction surgery are in good health, both mentally and physically, have realistic expectations for their surgery, and have healthy skin with good elasticity.

Lipoplasty may be the perfect solution for you if you have a fatty pocket that just doesn't respond to diet and exercise.

Costs of Liposuction Surgery

Liposuction cost can vary depending on the number of procedures, where you live in the country, and the extent of your surgery.

If you are considering liposuction, please visit the website of double board-certified plastic surgeon Dr. Jonathan Berman for more information.

Everything you wanted to know about Injectables and Fillers!

2011-07-12T21:52:00.001-04:00

General Information on Injectables & Fillers

Generally performed as outpatientprocedures, cosmetic filler injections are extremely safe and effective forfilling in wrinkles and scars, removing frown lines or rejuvenating saggingskin.

The key is making sure you get theproper filler for your specific needs―and that you have reasonableexpectations.

Some fillers are primarily usedfor shallow surface flaws while others are injected deeper under the skin tofill in more substantial folds or depressions. Some fillers can also be used toincrease the fullness of the lips or cheeks.

The newer dermal fillers on themarket even assist in stimulating creating new collagen growth to preventfuture flaws.

Whatever the procedure, there’s aproduct out there for it these days, although the most common areas treated arestill smile lines around the nose and mouth, fine lines above the mouth, frownlines between the eyes, and acne scars.

Dermal Fillers

The materials used in dermalfillers vary from basic human fat and animal-based collagens to hyaluronic acidand enhanced microsphere-added hydroxylapatite.

Different materials inducedifferent reactions within the body, so the amount of time the injections last,potential side effects, recovery times and how often you’ll have to return fortreatments will also vary.

Dermal fillers also come in avariety of thicknesses and brand names, with some more suited for certain partsof the face or body than others. In general, dermal fillers fall into threecategories:

• Fat/Collagen Fillers

• Hyaluronic Acid Fillers

• Hydroxylapatite microsphere-enhanced fillers

As a rule, the thicker the filler,the deeper it’s injected under the skin and the larger the folds it is meant tofill.

There are also two generalclassifications for the duration of dermal fillers, temporary or permanent.

For the sake of this page though,we’ll stick to the temporary facial fillers which require repeated injections(some less than others) to maintain.

Botox and Dysport

For those interested in Botox (andits counterpart Dysport), it’s important to note these are not technically“fillers” but more muscle paralyzers or “wrinkle-freezers.”

“Wrinkle-freezers” are made up ofprimarily of Botulinum Toxin A, a substance that essentially paralyzes themuscles around the injection point to decrease the amount of current wrinklesand prevent further wrinkles.

Botox is the best known of the twohaving been around longer, and is primarily used between the eyebrows or on thecrow’s feet around the eyes.

Dysport is Botox’s newestcompetitor, only recently approved by the FDA. Like Botox, it has botulinumtoxin A as its primary ingredient.

The main difference is Dysporttakes affect a little bit quicker (1-2 days instead of 3-7), is slightlycheaper overall and spreads out a little bit further than Botox.

Both last about the same time -three to four months.

For more on Botox and Dysport, visitour Botox page here.

Ifyou have any questions about Botox injections or would like a free consultationwith a Botox specialist in your area, fill in the form on the right-hand sideof this page and one of our experts will contact you!

Facial Fillers

Fat Transfers

Fat transfers were one of thefirst dermal filler techniques and have been used for well over 100 years tofill in various forms of facial lines and folds.

Today, though, fat transfer is notas common for the face as newer products have superseded it in terms ofduration and quality.

Successful fat transfer is alsovery dependent on the technique of the surgeon to ensure as many fat cellssurvive as possible, making results for many people very inconsistent.

Still, in certain cases fattransfer from other parts of the body can be used to fill in some facial linesand folds and add fullness.

Fat injections had been commonlyused to rejuvenate the lips, for bags under the eyes, to lessen the linesaround the mouth or fill out the cheeks or chin.

CollagenFillers

Collagen Fillers come in two basicforms, bovine and human. They fell outof favor with the introduction of the hyaluronic acid fillers. Few plastic surgeons use these fillers todaysince there are better options available.

Bovine (cow) collagen was one ofthe first forms of collagen to be used for dermal fillers. Bovine collagen is anaturally occurring protein that is found in the skin, bones and muscles ofcows.

This collagen is so similar tohuman collagen it can be used fairly seamlessly (although with some treatmentbeforehand naturally) to fill in fine lines and correct scars.

Zyderm and Zyplast are the mostcommon brand names for bovine collagen fillers.

Zyderm I is used for the treatmentof fine lines and lesser scars, while Zyderm II is meant for longer, deeperscars. Zyplast is used to get longer-lasting results for more damaged skin.

Since bovine collagen is aprotein, it will break down in the body over time. Generally, the results lastfrom 3-6 months. Once the collagen fades, the treatment can be repeated.

There are a few instances ofallergic reactions to bovine collagen injections. Those reactions can includeredness at the injection site, hives, and chest pain.

During the consultation process,your doctor will recommend you do a skin test to see if you are allergic beforeproceeding with a bovine collagen injection.

Human Collagen

Created from real human collagen,this filler is a normal part of all skin and is naturally absorbed by the humanbody.

Human collagen is best used forfine wrinkles, especially those found around the mouth, and it typically lasts3 – 4 months. For continued effects, repeated treatments are necessary. Theeffects are immediate in onset however. Like Bovine collagen, these fillers are not used as frequently as thehyaluronic acid fillers.

Cosmoplast, Cosmoderm, Cymetra,Fascian and Autologen are the most common human collagen products on themarket.

HyaluronicAcid Fillers

Hyaluronic acid is part of theconnective tissue of all human skin and several dermal fillers have beendeveloped over the years with hyaluronic acid as their base.

These fillers also stimulatecollagen production in the skin, allowing for better, longer-lasting resultsand a longer period of time between injections.

Hyaluronic acid fillers areexcellent for plumping up lines and wrinkles because they attract water and areideal in correcting nasolabial folds, thin lips, wrinkles (especially above thelips), reducing under-eye circles and filling out the chin or cheeks.

The most common brand names forhyaluronic acid fillers are Juvederm, Perlane and Restylane.

Restylane andJuvederm

Both Restylane and Juvederm arepopular hyaluronic acid fillers. The difference between the two is theconsistency of the gel, and preference depends on both the patient and thedoctor.

Perlane

Perlane is a"mid-dermal" hyaluronic acid filler product. As a sister product toRestylane, Perlane is designed for more pronounced facial folds and wrinklessuch as those on the sides of the mouth.

The duration of effect averagesbetween 6 – 9 months for Restylane and Juvederm and 9-12 months for Perlane andJuvederm Ultra.

For continued effect, repeatedtreatments are also necessary with Perlane.

Macrolane

Another hyaluronic acid derivativeused mainly for breast augmentation procedures is called Macrolane. Because italso absorbs into the body like other fillers, Macrolane is an alternative tochemical implants.

Hydroxylapatitemicrospheres

Radiesse

Marketed under the brand nameRadiesse, calcium hydroxylapatite is physically larger in particle size thanother dermal fillers.

Basically, tiny calcium-basedmicrospheres form a “scaffold” to support and stimulate the growth of collagen.Over time, the microspheres gradually break down and are safely and naturallyabsorbed by the body.

Radiesse does more thantemporarily fill-in facial folds and wrinkles and can be used to restore facialvolume for a more youthful look.

Radiesse also works to stimulatenew collagen production while adding volume and lift. It’s best used formoderate to severe wrinkles, nasolabial lines, facial fat loss and volume lossin the cheeks.

Duration of effect is usually12-15 months in most patients.

Ifyou are considering facial fillers and injections, please visit the website ofdouble board-certified plastic surgeon Dr. Jonathan Berman for more information.

Does the patient always come first?

2011-06-06T15:21:00.000-04:00

Why you should choose a board certified physician.

We’ve all heard the expression “The patient always comes first.” There is a lot that goes into choosing a doctor, but one of the first things to consider is their experience and proven record of success and safety. One sure fire way to be confident about these factors is to choose a board certified surgeon, or a double board certified surgeon like myself.

Why choose a board certified surgeon? Many patients do not know, that in most states, a licensed physician may perform plastic surgery without being board-certified in plastic surgery.

Many physicians (and sometimes even non-physicians) call themselves “plastic surgeons”. American Board of Plastic Surgery is one of the 24 specialty boards recognized by the American Board of Medical Specialties (ABMS). It is the only ABMS Board which certifies in the full spectrum of the entire specialty of plastic surgery.

By choosing a plastic surgeon who is certified by the American Board of Plastic Surgery, Inc., you can be assured that the doctor has graduated from an accredited medical school and has completed at least five years of additional training as a resident surgeon. To become certified, the doctor then must successfully complete comprehensive written and oral exams. Board Certification is a voluntary process.

To become a member of the American Society of Plastic Surgeons, the world’s premier organization representing plastic surgery, the surgeon has to be board certified, practice for a certain period of time (candidate period), regularly attend medical education courses, and adhere to a strict code of ethics. Membership in the ASPS is symbolized by the “circle of excellence”:

Recently, I had a 71 year old patient who was in for surgery. Everything that morning began as expected . The patient was checked in, the scrub nurse was ready to assist and the anesthesiologist was ready anesthetize the patient. As we were going to proceed with the surgery, the patient’s blood pressure sky rocketed. After careful consideration, I made the decision the surgery would just not be safe for my patient. I put her first. We woke her up, and more than likely saved her life. Now I ask you, would your doctor put you first?

Get your body ready for the summer!

2011-06-01T14:10:00.000-04:00

The scoop of breast augmentation.

Women who are considering breast surgery generally want their new shape to be ready for summer. Understandably, they look forward to taking full advantage of all the clothing and fashion they've been unable (or hesitant) to enjoy in the past.

In order to allow for plenty of healing time, breast augmentation candidates should plan to have their procedure completed in the winter or early spring months. With people's busy holiday schedules behind them, and colder weather keeping everyone indoors, these months are an ideal time to rest up and to recover from breast augmentation surgery.

Breast augmentation is not only sought out by individuals dissatisfied with their breast size. Other patients look to breast augmentation to help correct asymmetrical breasts, or to restore volume that was lost because of breastfeeding, childbirth, or weight loss.

Thanks to modern techniques and materials, breast augmentation has become safer and more accessible than ever, making it an ideal solution for women who have always felt the need to hide their figure due to asymmetry or insufficient size. Consulting with a skilled, board-certified breast surgeon can help you determine a treatment plan that will give you a naturalistic, evenly-proportioned look that you can take confidence in.

One reason you want to allow for plenty of recovery time between your breast augmentation surgery and the summer fashion season is because you may be swollen for up to three or four months after surgery. While drinking water and engaging in light exercise can help reduce this swelling, you want to give your body the downtime it needs for proper healing to take place.

During recovery, it is important to keep your incision dry. Do not use lotions or creams on the incision, as they can cause inflammation. Complete the course of antibiotics your breast surgeon has prescribed to avoid infection.

Pain medication can help during this time, although it should not contain aspirin or ibuprofen until your surgeon says otherwise; early on, these medications can cause excessive bleeding.

If you had a breast lift combined with your breast augmentation surgery, this will lengthen your overall recovery time.

For the first few days and weeks following your surgery, your breasts may be firmer than you're used to, sitting higher up on your chest. Over time, they will soften and drop into a more natural position. Don't worry if your breasts seem a bit "off" at first in either position or shape; they will normalize over the next few weeks and months.

If you are considering breast augmentation, please visit the website of double board-certified plastic surgeon Dr. Jonathan Berman for more information.

The Facts About the Tummy Tuck Surgery!

2011-04-06T09:15:00.016-04:00

Tummy tuck is a surgical surgery also known as, Abdominoplasty or Panniculectomy is a surgical procedure that includes the removal of excess skin and fat from the waist, which cannot be shifted by diet and exercise alone. This type of surgery is mainly meant for people who suffer with loose tissues after pregnancy or individuals with sagging after major weight loss. Skin that contains stretch marks on the lower abdomen may be removed as well. Many people had a wrong concept that Tummy tuck surgery is only meant as a method for weight loss and it is not recommended for extremely overweight individuals.

Abdominoplasty Surgery Boca Raton

Before you go for the tummy tuck surgery, it is very important to know some facts about it. Thus help in reducing the risks during surgery since a tummy tuck surgery is done under general anesthesia:

1. Many people had confusion about the tummy tuck surgery. This procedure mainly helps to change the shape of the body and that it does not result in weight loss. In other words, tummy tuck procedures are performed to enhance body shape, not create a perfect body.

2. To get fast recovery and avoid risks of complications, it is recommended to quit smoking at least 2 weeks prior to surgery. As Smoking prolongs recovery and increases the risks of complications.

3. When tummy tuck is combined with liposuction, it might bring out desired results but before going for it, it is better to consult Your plastic surgeon that whether combining liposuction with tummy tuck is right for your needs or not.

4. Tummy tuck results can last a long time if you stay active and eat right. Excessive weight gain after the procedure can cause your skin tissues to stretch and create bulges.

Dr. Jonathan Ross Berman is Certified by both the American Board of Plastic Surgery and the American Board of Otolaryngology / Head and Neck Surgery. This double certification adds an extra dimension to Dr. Berman's specialized care in facial cosmetic surgery, including eyes, ears, nose, cheeks, chin, neck and lips.

Enhancing your Appearance with Nose Plastic Surgery (Rhinoplasty), or “Nose Job” can Enhance Facial Harmony & Self Confidence

2011-04-05T09:55:00.003-04:00

Rhinoplasty or nose surgery, sometimes referred to as “nose reshaping” or a “nose job,” improves the appearance and proportion of your nose, enhancing facial harmony and self confidence. Surgery of the nose may also correct impaired breathing caused by structural abnormalities in the nose.

Rhinoplasty Surgery Boca Raton

Enhancing your appearance with nose plastic surgery

While the shape of your nose is usually the result of heredity, the appearance may have been altered in an injury or during prior surgery.

What can surgery of the nose accomplish?

Rhinoplasty surgery can change:

Nose size, in relation to the other facial structures
Nose width, at the bridge
Nose profile, with visible humps or depressions on the bridge
Nasal tip, that is large or bulbous, drooping, or too upturned
Nostrils that are large, wide or upturned
Nasal asymmetry and deviation

Is it right for me?

Nose cosmetic surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.

Your facial growth is complete and you are 13 years of age or older

You are physically healthy

You do not smoke

You have specific, but realistic goals in mind for the improvement of your appearance

My nose surgery recovery

After your procedure is completed, packing will likely be placed inside your nose and a splint or bandages placed on the outside to support and protect the new structures during initial healing.

You will be given specific instructions to follow during your recovery from rhinoplasty: How to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon.

What you can expect during your individual recovery:

After your surgery is completed you will be taken to the recovery suite.
You will be given a prescription for antibiotics and pain.
Stitches are removed one week after surgery.
You may resume normal activity and exercise two to three weeks post surgery depending on how you heal.
You will return for follow-up care the following day after surgery

If You are Bothered by Signs of Aging in Your Face, Facelift Surgery May be Right for You

2011-04-04T09:35:00.002-04:00

If you are bothered by signs of aging in your face, Facelift Surgery may be right for you. Technically known as rhytidectomy, a facelift is a surgical procedure to improve visible signs of aging in the face and neck, such as:

Sagging in the mid-face
Deep creases below the lower eyelids
Deep creases along the nose extending to the corner of the mouth
Fat that has fallen or is displaced
Loss of muscle tone in the lower face may create jowls
Loose skin and excess fatty deposits under the chin and jaw can make even a person of normal weight appear to have a double chin

Rejuvenation procedures typically performed in conjunction with a facelift are brow lift, to correct a sagging or deeply furrowed brow, and eyelid surgery to rejuvenate aging eyes.

Face Lift Surgery Boca Raton

What Facelifts Won't Do:

As a restorative surgery, a facelift does not change your fundamental appearance and cannot stop the aging process.

Is a Facelift Right For Me?

A facelift can only be performed surgically; non-surgical rejuvenation treatments cannot achieve the same results, but may help delay the time at which a facelift becomes appropriate and complement the results of surgery. Facelift surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires to try to fit any sort of ideal image.
Facelift surgery is a good option for you if:

You are physically healthy
You do not smoke
You have a positive outlook and specific, but realistic goals in mind for the improvement of your appearance

My Facelift Recovery

When your procedure is completed, a bandage could gently be placed around your face to minimize post facelift swelling and bruising. A thin tube may be present to drain any excess blood or fluid that may collect under the skin.

how to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in overall health, and when to follow up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.

After your surgery is complete you will be taken to the recovery suite.
You will be prescribed antibiotics and medication for pain.
You will have dressings and bandages.
You may resume normal activity and exercise two to three weeks post surgery depending on how you heal.
You will return for follow-up care the following day after surgery.

You Will Be Given Specific Instructions That May Include: