Category: Uncategorized

Three Reasons Why There Are More Male Plastic Surgeons Than Female

Plastic Surgery is a specialty that is aimed at wellness and wholeness.  Feeling comfortable in one’s own body is a critical part of holistic health. Women (and men) seek plastic surgery because they are unhappy with some aspect of their physical self. For many women, a female insight into how one relates to one’s own physical presence can improve the chances of achieving confidence with her body.  It is possible that women (not all women) may have an edge on men (not all men) on how this psychology operates, and hence might be better equipped to address the wanted change.  It is surprising how the numbers of female plastic surgeons lag behind, when the great majority of people seeking plastic surgery are female. Here are some stats:

  • 90% of plastic surgery patients are women, according to the American Society of Plastic Surgeons.
  • 50% of medical school graduates are female.
  • The American Society of Plastic Surgery has 758 female members and 4742 male members.  That is a shocking 14%.

So why are there so few women among the graduating medical classes that choose plastic surgery for their career?

  1. First, it’s only been in the last 10-15 years that women have consistently represented half of medical students. Training to become a plastic surgeon is a minimum of six years after four years of medical school so even if half the class is female it is ten years before those women are even able to enter the field of plastic surgery, and another two years to become board certified.
  2. Work-life balance issues are prominent. The hours per week and years of training cut pretty heavily into time for family, friends, and outside interests. If having children is a high priority a choice must be made for women in surgical specialties between hours spent become a skilled specialist or hours spent on maternity leave.
  3. Plastic Surgery is also such a male dominated specialty that many women simply do not want to put up with the sexist subtleties of training. The battle of the sexes is old news, and though there is change that occurs very slowly in women’s position in the workplace, many will pick a different front to address the issues and show their full strength. In other words, they choose a career where the leadership makes them feel entirely welcome, rather than having to struggle with cultural sexism to establishing their worth

The good news is that the women who have chosen the career path to becoming highly trained, skilled, and  certified  by the American Board of Plastic Surgery  are a dedicated and talented bunch!


The New Breed of Holistic Workout

HealthClubTreadmillsArianna Huffington recently wrote a great article on how exercising (at American health clubs in particular) has become something to dread. Gyms have become a place we drag ourselves to, pay a hefty monthly fee for, and stare at a TV as we clock the obligatory 30-60 minutes/day.

She writes,

“The benefits of making our bodies fitter are deeply connected to the fitness of our inner selves, but gyms make it hard to feel that connection. They don’t allow for the kind of solitude and mindfulness that we can get communing with nature on an outdoor run. And, overly muscled pickups aside, they aren’t very conducive to making any real social connection. A person watching her own screen while walking on a treadmill next to another person watching another screen while walking on a treadmill is like a metaphor for our modern life. It’s what we do at work, at home and at the gym.”

I too find the gym is not conducive to mindfulness, and am more and more conscious that what I am motivated by most, is working out in a social context-with friends or family or the people I work with. I’d rather take a class, or go for a bike ride or a hike and share the endorphin rush with great people, than spend spare hours I don’t have on a treadmill.

Ariana references The Guardian‘s Nicole Mowbray, who wrote recently about the growing trend of the “calm workout,” or “a new breed of holistic workout that promises to care for your head as well as your heart” as she describes it. For example, there’s Psycle, which offers spinning classes in rooms with low lights and calming music and features a “free time” break during the class. 

“The philosophy is supposedly inspired by the belief that ‘your state of mind is key to how often and how hard you exercise.’ There’s also CardioLates, which combines spin and Pilates; Third Space, which offers the services of ‘wellness doctors’; and Spynga, which is part spin, part yoga.

These workouts are part of a trend driven by the understanding that getting fit doesn’t have to be so unpleasant. And it’s pretty simple to see that if we make exercise a more inviting and more rewarding experience, we’ll do it more often. If we’re going to redefine success to include well-being, we also need to redefine getting in shape to include mental and soul fitness.”

View Huffington link

Anti-aging, Exercise, Personal Fitness, Uncategorized, Weight loss

Plastic Surgery After the Weight Loss: Completing the Process

Massive Weight Loss procedures

The February 2014 edition of the Aesthetic Surgery Journal provides of survey of post weight loss patients, asking which patients were most likely to have plastic surgery to correct the surplus skin issues and which surgeries they preferred to have.

Here are some of their findings:

  1. The majority of patients wanted to have body contouring procedures for both functional reasons and improved body confidence.
  2. People with a weight loss of more than 50kg (110lb) showed a stronger desire for body contouring than those with less than 20 kg(44 lb).
  3. Women were more likely to desire body contouring than men.
  4. Younger age groups had a stronger desire for post bariatric body contouring.

The areas that people most wanted improvement in were:

  • 62.2%. Abdomen
  • 37.6% Upper Arms
  • 28.3% Breast or Chest
  • 35.6% Rear or Buttocks

Only 15.5% did not wish any post weight loss plastic surgery. Most respondents to the survey thought that dealing with the extra skin was an important part of achieving their health goals.

Read more in:
Aesthetic Surgery Journal 2014,Vol 34 (1) 118-132, p. 96.



“BRAVE DAY” March 21, 2014

iStock_000012759589SmallBreast Reconstruction Advocacy Education, sponsored by the Pink Lemonade Project

Breast cancer is an all too common disease. One in eight women will be diagnosed breast cancer. An organization known as “Pink Lemonade” is dedicated to increasing education for women about what their options are for fighting the cancer.

March 21, 2014, BRAVE DAY, has been designated as a day of national awareness of women’s “rights” when it comes to diagnosis and treatment of breast cancer. The Pink Lemonade has declared a Bill of Rights for U.S. Women. It includes:

  1. If you have a family history of breast cancer, insurance companies may provide early screening and preventative measures starting at age 35.
  2. If you notice a lump in your breast, insurance companies will provide access to screening at any age after puberty.
  3. Your first screening mammogram should be at age 40.
  4. If your breasts are found to be dense on a mammogram, your insurance company provides approval for additional diagnostic testing and referral to a specialist to discuss treatment options.
  5. If you have inherited the BRCA gene that puts you at high risk for breast cancer, insurance may provide coverage for preventative treatment.
  6. Insurance covers reconstruction of a breast after either a lumpectomy (partial mastectomy) or mastectomy. 
  7. State and Federal laws require insurance companies to cover reconstruction of the breast affected by cancer as well as a matching surgery for the opposite breast. (Women’s Health And Cancer Rights Act of 1998).

For more information check out


Identical Twin Studies Demonstrate Smoking’s Contribution to Facial Aging

Smoking Twin

The twin on the right smoked 14 years longer than his brother.

Twinsburg, Ohio is the site of the annual Twins Days Festival. The gathering is always a fascinating comparison of “NATURE V. NURTURE”.

The subject of the effect of SMOKING on FACIAL AGING was studied by a group of plastic surgeons who report their findings in the November 2013 issue of Plastic and Reconstructive Surgery.

79 pairs of twins were identified where one was a smoker and the other tobacco free. Over a three year period, standard facial photographs were taken and analyzed by judges that did not know which person was the smoker. Age related facial features and wrinkles were compared and scored.

Those who had smoked more than 5 years had worse scores than their twins in the following ways:

  1. More upper eyelid skin excess
  2. Larger lower lid bags
  3. Large cheek bags, below the eyelid
  4. More upper lip wrinkles
  5. More dark circles on lower lids
  6. Deeper nasolabial folds (the parentheses around the mouth)

The smoke related changes seemed to be worse in the middle and lower face.

Conclusion: A five year difference in smoking can make noticeable difference in features of facial aging.

Are there any good reasons to smoke? 

More than 150 news outlets covered this story including:,, WebMD, Reuters, Huffington Post



WomanSaladXSmallcropStrong for Surgery is Washington state initiative aimed at preparing patients for their surgery. Health habits can make a big difference in how well your procedure turns out. Thus, you the patient can maximize your chances for a smooth post-operative course.

SCOAP, Surgical Care Outcomes Assessment Program, is a non-profit foundation dedicated to improving healthcare quality. The program has been successfully launched in more than 60 clinics and hospitals in Washington State. Here are four health changes that can be used to prepare for an upcoming surgery.

  1. Stop smoking.
    Nicotine causes small blood vessels to go into spasm. This decreases blood flow to healing areas that need it most. Smokers also have a six fold increase in pulmonary complications following surgery. They also have poor healing and an increased infection rate.
  2. Eat well.
    If your nutritional status is suboptimal, it is difficult to heal wounds and fight infection. This is especially true for those who have recently lost weight, or tend to stay underweight. 
  3. Control your blood sugar.
    An elevated blood sugar can contribute to problems with healing or infection after surgery. It is important to know if you have any tendency towards diabetes and manage your blood sugar in advance.
  4. Use your medications as intended.
    It is important to tell your surgeon ALL medications and health food supplements you are using, so your providers can coordinate choices for anesthesia and recovery.

Keeping up your level of fitness and being in a good psychological state of mind will also help you to your best recovery. 

Our team can help you check these four health measures and evaluate any other medical issue that might be important for your speedy recovery. We look forward to discussing this at your consultation.


Plastic Surgery after Bariatric Surgery Shown to Improve Long Term Weight Control

Weight lossBeing massively overweight is associated with poor body image, low self-esteem and reduced health related quality of life. In the United States, over 100,000 bariatric surgeries are performed annually to address these health concerns. Gastric bypass, the most frequently performed weight loss procedure, allows rapid weight loss in the first 18 months. However, half of these people gradually regain 10-15 % of the lost weight over the next 10 years. Those regained pounds undo some of the improvements the bariatric surgery brought. A new study reported out of Geneva Switzerland shows that those who have body contouring plastic surgery for the excess skin after massive weight loss are more successful at keeping the weight off for the long haul.

A group of patients who had undergone gastric bypass surgery between the years of 1999 and 2007 were compared for their ability to keep the weight off. Average weight loss was an impressive 99 lb. With a follow up of seven years, the 102 people who had not chosen to have plastic surgery to get rid of the deflated skin had regained an average of 50 lb. However the 98 people who chose body contouring plastic surgery to complete the process after their bariatric surgery only regained an average of 13 lb. over the seven year period.

The authors conclude that bariatric plastic surgery is crucial for successful treatment of morbid obesity. The plastic surgery improves psychosocial functioning and strengthens long term weight loss maintenance., October 2013

Anti-aging, Body Contouring, Doctor-Patient Relationship, Mommy Makeover, Nutrition, Personal Fitness, Uncategorized, Weight loss

After the Weight Loss

scaleOne of the good things about our nation’s obesity epidemic is that there are so many people affected by it learning to reverse the weight gain. I often ask people what made them ready for change.  In my practice about half of the massive weight loss patients I see had bariatric surgery and half used diet and exercise alone. Make no mistake. Both are hard work.

The US population has obesity levels that are sky rocketing compared to our parent’s generation.  Theories abound about the cause of this unprecedented rise, but there is no doubt that it has become a serious public health problem. Health benefits of massive weight loss are large, but people often endure aesthetic and functional impairments that do not go away with weight loss alone.

Studies show that people are pleased with the changes in their appearance after massive weight loss, but their body image satisfaction decreases after 2-3 years.

The change comes from quality of life limitations created by the deflated hanging skin. They experience functional impairments including limited mobility from excess inner thigh skin, postural instability from abdominal skin excess, and increased hygiene demands from areas where the overhanging skin rubs.  16% report sores, rash and skin breakdown. 60% are dissatisfied with the appearance of their thighs.  Many continue to feel uncomfortable about their appearance which can have an impact on sexual and social interactions. The removal of excess skin by body contouring plastic surgery can contribute to better, physical, psychological, and social function. 

Studies have shown that 75-85% of those who have sustained massive weight loss desire body contouring surgery. The desire for plastic surgery after weight loss is twice as frequent in women and inversely related to age.

For more information refer to the December 2012 issue of Annals of Plastic Surgery.

Beauty, Body Contouring, Breast Augmentation, Breast health, Breast Implants, Breast Reduction, Cellulite, Mommy Makeover, Uncategorized, Weight loss

Plastic Surgery Linked to Positive Self Reported Outcomes in Quality of Life

Blonde-w-boardThe Association of Psychological Science reported on a controlled study that compared psychological outcomes of a group of people that chose to have cosmetic plastic surgery compared to a group that was considering it, but did not have the aesthetic surgery. Positive results were self-reported in the following areas:

  • Decreased anxiety
  • Decreased social phobias
  • Less depression
  • Less body dysphoria
  • Better goal attainment
  • Better quality of life
  • Better life satisfaction
  • Greater sense of attractiveness
  • Better mental and physical health
  • Greater sense of self efficacy
  • Greater self esteem

This study out of Bochum, Germany followed participants at 3, 6, and 12 months. See the full report in Clinical Psychological Science 1 (3) 239-252,

There are now an estimated 1.5 million aesthetic surgeries annually performed in the United States and 8.5 million worldwide. For those that report dissatisfaction with a particular physical feature, plastic surgery appears to result in self-reported positive change.


Asian Eyelid Surgery

AsianWomancropSeattle has a large Asian population of varying ethnicities. I find they express different preferences for beauty in the upper eyelid. Those from Chinese, Japanese or Korean heritage more often favor a narrow crease above the eyelashes. Filipinos, Taiwanese, Malaysians and Indonesians prefer a wider fold. Population genetics show that the narrow or no crease peoples were originally from Northern Mongolia in prehistoric times. The Southern Mongolians evolved different facial features including deep set eyes and a wider crease. Most people want to retain a natural look that is true to their familial background.

The “classic” Asian eye

  1. Slants upward on the outer corner
  2. Has an absent lid crease,
  3. Has a fold of skin that lies over the inner corner, referred to as an epicanthal fold

In reality, the Asian eyelid has a large range of individual variation, including the height of the crease, the width of the eyelid opening, the amount of fat around the lids, and the shape of the eye.

It is possible to vary the blepharoplasty procedure according to each person’s preferences, especially when it comes to the desired fold height. You will want to talk about that when you come in for a consultation. You can make aesthetic changes without  erasing your heritage. A “natural” look is better than a “westernized” look. 

Anti-aging, Beauty, Blepharoplasty, Fat Transfer / Fat Grafting, Skin Care, Uncategorized

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