Want To Be a Better Version of You?

Accept the Challenge in 2014 

Walk ParkWonder diets and quick weight loss plans get a lot of attention with the start of each New Year. I suggest skipping extreme solutions. Dropping 20 lb. and gaining it right back is not success. The real path to your best health, vitality and weight control requires commitment to a lifestyle that is practical. Here are a few practical suggestions for sustainable health and fitness improvements:

  1. Diet without counting calories. It is too much trouble to weigh and measure every bite of food you put in your mouth. Use portion control and avoid calorie dense foods.
  2. Hit your goal 80% of the time. If you are a perfectionist you will be disabled by your disappointment. Perfect is definitely not practical. So allow yourself some margin.
  3. Keep a journal so you are accountable and honest with yourself.
  4. Drink 11-12 glasses of water a day to combat hunger and fill your stomach.
  5. Keep moving!! You have to move to lose weight and exercise is a good to fight anxiety and depression. 
  6. Weigh weekly to avoid weight drift.
  7. Your weekly exercise routine should include 30 minutes of cardio a least 3 times and resistance training 2-3 times. Find exercise you like doing. Make your exercise social. Exercise with a friend to accomplish two important functions at once.

A sound body requires a sound mind. Learning methods for managing stress and building resilience are important for the sustainability of your challenge. Most women are so accustomed to being caretakers, they neglect their own needs, both physical and psychological. Make time for your mental and physical well being.   

Announcements, Anti-aging, Body Contouring, Doctor-Patient Relationship, Exercise, Nutrition, Personal Fitness, Weight loss


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.


Combining an International “Vacation” with Plastic Surgery: Is Price More Important than Quality?

Womaninhammock“Medical tourism” is a modern reality. It is estimated that there may be as many as 15 million Americans a year receiving some form of care outside of the country. Those that are seeking plastic surgery are lured by combining their desire for cosmetic improvement with their desire for a vacation abroad. The consumer that puts a premium on cost over quality may not be aware of what they are giving up.

Here are some points to consider before booking the trip:

  1. What are the qualifications of the person performing your surgery abroad?  Does the country have any regulation of who is allowed to perform cosmetic surgery?
  2. Will a language barrier make it difficult to communicate with your caregivers, about your medical history, your informed consent, and your after care instructions? Will they know all they need to know about you and will you learn what you need to know from them?
  3. How can you verify the safety and sterility of the operating room where your surgery will take place? The United States has high, likely the strictest standards, for accrediting its medical facilities.
  4. Recovery from surgery is usually a time where rest is needed to heal. Fatigue is likely to interfere with the “vacation” part of the trip.
  5. Who will take care of potential complications? What if you need care beyond the time allotted for the trip?
  6. If the result is unsatisfactory who will revise your surgery? Will you have any follow up?

The American Society for Aesthetic Plastic Surgery has a set of guidelines for those consider international plastic surgery. You can access this checklist here.

Anti-aging, Beauty, Body Contouring, Breast Augmentation, Breast Implants, Discount cosmetic surgery, Doctor-Patient Relationship, Mommy Makeover

South Korea: The World’s Capital for Plastic Surgery

Korean Plastic Surgery FaceI  just returned from a week in Seoul S. Korea, visiting with a manufacturer of US medical devices. This first time visit to Korea was eye opening. My pre-conceived images of Korea, probably formed by watching re-runs of MASH, were of a struggling people recovering from the ravages of Japanese occupation and the Korean Civil War. They have reversed the sufferings of the last century. Seoul is now a sophisticated metropolis, ringing with commerce and populated with meticulously dressed urbanites, rushing from offices, restaurants, karaoke bars, health clubs and university classrooms. South Korea has made an astonishing move from shanty-town poverty into a modern high rise industrialized economy in a span of 50 years. 

Of particular interest to me was the Korean attention to beauty. They dress stylishly, pay careful attention to grooming and consider looks to be an important element to success. This value allows them to be very open to plastic surgery as a means of achieving their ideals.

South Korea has the world’s highest per capita rate of cosmetic plastic surgery, according to the 2009 and 2011 statistics of the International Society of  Aesthetic Plastic Surgeons. 

For Korean college graduates seeking employment, 27.4% get plastic surgery to fare better in the hyper-competitive job market. Every year 74 out of every 10,000 people undergo cosmetic surgery, a rate 1.8 times the United States. One in five women between the ages of 20 and 45 is reported to have cosmetic surgery. 

Korea is followed by Greece, Italy and the United States in the per capita rate of choosing plastic surgery. The people of Brazil and Taiwan also value and utilize plastic surgery with a high degree of frequency.

The Asian specialized procedures that are performed frequently in Korea include the double eyelid surgery to make the eyes appear larger, cheek implants to create an “apple” shape, jaw contouring to decrease the width of the face and rhinoplasty to raise the height of the nose.  Forehead shaping with fat grafts, liposuction and breast implants are also popular. 

For more information consult:

International Society for Aesthetic Plastic Surgeons,

Anti-aging, Beauty, Blepharoplasty, Doctor-Patient Relationship, Fat Transfer / Fat Grafting, Rhinoplasty, Skin Care

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


Jewel-Kilcher---Performing-in-Lancaster--09National Breast Reconstruction Awareness Day

October is Breast Cancer Awareness Month, a  campaign to  educate women  about this all too common disease. Though the disease is common, the treatment can vary widely  and decisions for therapy need to be individualized. For the second year in a row, the American Society of Plastic Surgeons has sponsored Breast Reconstruction Awareness Day, or BRA DAY as part of the October campaign.  

This year’s spoke’s person for BRA Day is singer/songwriter Jewel, who has composed a song The song is entitle “Flower” and can be downloaded on I Tunes to benefit breast reconstruction patients.

Here are a few facts about public awareness of breast reconstructive options:

  1. Only 19% of women understand that the timing of their treatment for breast cancer and the timing of their decision to undergo reconstruction greatly impacts their options and results.
  2. Only 23% of women know that there are a range of options available for breast reconstruction.
  3. Only 22% are familiar with the quality of outcomes that are possible.
  4. 89% of women express the desire to know more about results of breast reconstruction prior to undergoing treatment for breast cancer.

The American Society of Plastic Surgeons urges women to make sure a plastic surgeon is part of their treatment team as they select options for treatment.  Here are a few online resources for breast reconstruction information.

American Society of Plastic Surgery

American Cancer Society


Breast health, Doctor-Patient Relationship, Mommy Makeover, Tubular Breasts

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


Washington-Health-Plan-FinderThere is a lot of change occurring in healthcare currently. One of the best changes is that health insurance will be available to many who were previously ineligible. “Coverage is here” is Washington state’s slogan to educate the public about the new state health benefit exchange. The federal Affordable Care Act has a mandate to increase the number of people covered by health insurance. Enrollment is beginning now for plans that go into effect January 1, 2014. There are 46 health insurance plans participating in the new system. Here are some common questions about the new health benefit exchange:

  1. Who is eligible for these plans?
    Individuals, families and small businesses can purchase insurance through these new plans.
  2. How much will it cost? 
    The cost will vary by how much coverage you choose and whether or not you are eligible for any fee reductions, based on your income.
  3. Will I be able to see my own doctor on the new plan?
    Each insurance plan will have its own panel of doctors.  You may be able to find the plan that your doctor works on before you purchase.
  4. If I have insurance through my employer will I have to go through the state healthcare exchange?
    Most individuals will be able to stay on their company’s plan.

 For more information go to

Announcements, Breast health, Doctor-Patient Relationship, Personal Fitness

Easing Recovery After Breast Augmentation

Most women that choose breast implant surgery have been considering it for a long time and are highly motivated. They are happy about their anticipated body change. As the day approaches, it is not uncommon to have concerns about putting up with post-operative discomfort. Here are a few of the ways that postoperative pain can be lessened and use of narcotics can be decreased:

  1. Nerve Blocks Just like the dentist injects the nerves to your teeth to make a procedure comfortable, it is possible to block nerves to the chest wall before breast augmentation. The nerves that bring sensation to the breast area run just below each rib on the chest wall. Injecting these nerves with a long acting local anesthetic, blocks painful impulses. I like to place a lot of local anesthetic in the tissues at the beginning of the procedure. I use “intercostal nerve blocks,” and I put additional local around the incision, beneath the muscle and along the breast fold to get the areas as pain free as possible. If the pain is blocked early in recovery the overall pain response appears to be diminished. These local anesthetic blocks do not eliminate the need for pain pills, but they do reduce the amount of narcotic that is required during recovery. 
  2. on-Q_pump“Pain Pump” Most women find their post augmentation discomfort is manageable, but for those that are particularly worried about dealing with it, I use a device called the On Q Pain Buster. This pain pump technology is an elastic ball filled with local anesthetic that continually delivers the medication to the surgical site through two tiny catheters. It provides good pain relief for three days following the procedure. For more information on the Pain Buster go to
  3. Exparel Exparel is a new formulation of an old local anesthetic. The medication bupivacaine has long been used for long acting block of pain impulses. It has been created in a slow release form by wrapping the medication in a “liposome.” A liposome is a fat coating that allows a 72 hour sustained release. This medication adds expense comparable to the pain pump, but it can be placed in the surgical area to help numb the discomfort. It provides one more tool to make recovery manageable. Basic information about Exparel can be found on

I am happy to discuss these options with you when you come in for a consultation about breast enlargement to make your recovery as comfortable as possible.



Breast Augmentation, Breast health, Breast Implants, Doctor-Patient Relationship, Mommy Makeover

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.


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