Kavali Plastic Surgery in Atlanta, GA

Update on Implant Problems in Europe!

2012-01-19T05:23:00.000-08:00

Dear Dr. Kavali, I've recently heard from a good friend that the French want to remove all silicone implants from patients who had breast augmentations there. I also heard the same thing is happening in the UK. I have Silicone implants myself and this concerns me for obvious reasons. Am I safe? Do I need to have my silicone implants removed immediately?

Not to worry! This problem belongs overseas, not here in the states. A French breast implant manufacturer named Poly Implant Prothèse supplied silicone implants to patients all over Europe. It’s recently reported that about 1,000 of the women who have undergone breast augmentation with these implants have experienced rupturing (out of 30,000 patients). A major concern is how the body will react to the industrial grade silicone, and most have reported burning, soreness, and pain. This prompted French officials to recommend that women with these implants have them removed as soon as possible. Again, for women who had their breast augmentation procedures done by us in our Atlanta plastic surgery office, it’s not a problem. We buy French Fries and French wine but we don’t buy French breast implants!

Thanks for asking!

To your health & beauty,

Carmen Kavali, MD

A Skin Lightening Procedure NOT For You!

2011-09-13T12:00:00.000-07:00

Usually it’s tanning beds and sun bathing that cause obsession within our society. Everyone wants that sun kissed look, even if they have to burn to a crisp, or up their risk for skin cancer. But then there are those that want the opposite, a more lighter look.

Most skin whitening treatments use a combination of topical lotions or gels containing melanin-inhibiting ingredients. Combined with sunscreen and a prescription retinoid or RetinA derivative, plus some possible chemical peels, a procedure my practice provides, you could be on your way to lighter skin.

However, the Phillippines FDA has issued an advisory on a different form of skin whitening due to its serious health risks. Recently it has become popular to inject glutathione, a liver-generated compound that plays a role in antioxidant defense, metabolism and regulation, into the veins to cause skin whitening. It is believed that glutathione inactivates the enzyme tyroninase. This particular enzyme helps produce melanin, which, when inactive, could cause the pigment to become the lighter pheomelanin.

The risks, however, don’t seem to be worth the end result. Patients receiving twice-weekly glutathione injections into the vein are experiencing:

Stevens-Johnson syndrome
Toxic epidermal necrolysis
Thyroid function derangement
Kidney dysfunction, potentially leading to kidney failure
Severe abdominal pains
Overload in renal circulation

Not one of these side-effects is worth the injections. If you are seriously considering a skin whitening procedure, bear in mind the other options; options that will not harm you the way this procedure can.

To your health and beauty,

Dr. Carmen Kavali

Discovery Links Progeria to Normal Aging

2011-09-06T19:33:00.000-07:00

There are many ways to fight aging, especially on the face. At my Atlanta plastic surgery practice I provide Botox, dermal fillers, Sculptra, chemical peels, and microdermabrasion among other treatments. I also provide surgical procedures such as a forehead lift and face lift. There are so many options that one is bound to suit your aging face’s needs. Of course, these treatments and procedures are only skin deep. We can’t truly turn back the clock, but we can continue to try and understand why we age.

Prior to new findings, it was thought that the body aged due to our cells gradually wearing out. However, new findings show that there is a link between normal aging, and the age-related disease Progeria, which causes children to age at seven times the normal rate.

Progeria is caused by a mutation in a gene called LMNA that makes the toxic protein known as progerin. The protein is what causes the children to begin aging so quickly. However, new studies have found the same toxic protein in perfectly healthy human beings, but it much lower amounts. Therefore, it could actually be this toxic protein causing all aging; the less progerin, the slower the aging process.

Why is this a huge discovery? It means that aging isn’t what we thought it was. If progerin is the reason why we age, aging is actually a biological mechanism programmed into our cells from birth; a mechanism that is tweaked when it comes to age-related diseases. This not only allows us to understand the aging process, it opens up an understanding towards these diseases as well.

To your health and beauty,

Carmen Kavali

Botox Lasts Longer That You Think

2011-09-01T17:19:00.000-07:00

Botox is the most popular non-invasive cosmetic procedure done each year. I administer Botox injections quite frequently at my Atlanta plastic surgery practice. Many patients go for this treatment because it takes only fifteen minutes four times a year for best results. Yet, some patients considering Botox are not ready, or sometimes can’t afford, four treatments a year. However, research shows that four treatments a year is no longer needed for great Botox results.

A new study treated fifty women between the ages of 30 and 50, the recommended age bracket to start Botox, for two years only to find that Botox can reduce wrinkles with half as many visits as previously thought. The study found that if patients receive Botox every four months for two years, treatment can be reduced to every six months. This is a long way from a consistent Botox treatment of every three months indefinitely.

It’s true that patients that stick to treatment every three months will most likely have better results, but the study showed that treatment every four to six months produced comparable wrinkle reducing results. With these new findings there are only more reasons for patients to undergo Botox now. Not only is it even quicker and easier to keep up results, it is now more affordable. Patients who were once on the fence about Botox are more likely to reconsider due to these new findings.

Will you consider Botox now that treatments don’t have to be as often?

To your health and beauty,

Dr. Carmen Kavali

The Skinny on Your Body Fat

2011-08-23T12:12:00.000-07:00

When people think of fat, many people picture an abundance of fat that they would rather live without. People will picture someone unhealthy. But, fat actually has some very healthy qualities. It stores energy, influences our ability to fight infections, regulates our blood pressure, and affects the way our blood forms clots. Therefore, too little fat could be just as unhealthy as too much. What we need to find is a healthy balance, not to mention that we should pay close attention to our visceral fat.

Our bodies store two types of fat: subcutaneous and visceral. Subcutaneous fat is the kind of fat my Atlanta plastic surgery practice can help you with. Because it resides right beneath your skin, I can easily perform liposuction on it. My practice also provides laser-assisted liposuction. Watch as your thighs, love handles and belly pouch shrink to give you the contoured look you’ve always wanted.

However, when it comes to visceral fat, you are on your own. This fat settles in your abdominal cavity and cannot be surgically removed. Lipo does not penetrate that deeply. The more visceral fat you have, the more at risk you are. It has been known to have a hand in diabetes, cardiac disease, high cholesterol, hypertension, and other health issues.

How do we get such high amounts?

Our heredity does have a hand in how much visceral fat we store. But habits like not exercising and eating junk food are the main reasons. It’s why even people within, or close to, their healthy weight can have high amounts of this fat. How many times have you seen a fairly skinny person except for their bulbous belly? Men, especially, sport beer bellies, but may be perfectly proportioned in every other aspect.

So how do we get rid of visceral fat or avoid it altogether?

Since lack of activity and unhealthy eating habits are the cause, the best options are to start exercising daily and cutting back on the junk. Think walking or running every day with less potato chips, beer and ice cream. In fact, unless you suffer from obesity, which can qualify you for Barriatric surgery or oral medication to curb your appetite, these are your only options for ridding your body of visceral fat. And though it may not be as easy as gaining it, losing the unhealthy fat can be done if you are committed and focused.

To your health and beauty,

Dr. Carmen Kavali

Restylane For Your Lips

2011-08-16T11:06:00.000-07:00

In Atlanta, dermal fillers are a popular treatment with my patients. Aging causes the fullness in our hands and face to deplete, causing deep lines, hollowed looking eyes, and an overall older appearance. Dermal fillers, such as Restylane, can temporarily rectify these issues for up to a year, or even longer if you return for a touch up. Even better is the fact that a treatment such as this works instantly!

But were you aware that Restylane is good for other things too?

At my Atlanta plastic surgery practice, I use Restylane for lip augmentations with great results. The results are smooth and can last up to a year. Restylane is also great to use as a “lip liner” to plump the lip margins, which prevents lipstick-bleed. What woman wouldn’t want that? To put it simply, Restylane as a lip plumper is great for overall volume.

As of right now, Restylane is the only FDA approved dermal filler for a lip augmentation. No others can do what Restylane has been shown to do. Aside from some redness and minor swelling at the injection site within the first few days, patients that opt for this treatment are very happy with their new plump lips. So don’t just stick out those lips in hopes that you will appear pouty and sexy. Instead, get yourself a real pout in a matter of minutes.

To your health and beauty,

Dr. Carmen Kavali

What Traffic Does To Your Skin

2011-08-09T13:36:00.000-07:00

In Atlanta, plastic surgery is very popular, especially with patients seeking to reduce wrinkles or skin spots. I frequently treat patients with Botox or dermal fillers to get rid of wrinkles. Other patients opt for laser skin resurfacing or microdermabrasion. Of course, some patients choose to undergo a face lift or forehead lift. All will give a patient a more youthful appearance.

But what if I told you that part of the reason you could be aging is due to traffic-related airborne particles? Particles such as this have already been found to be harmful to your lungs, and have also been linked to an increased risk for type 2 diabetes as well as cognitive failure in the elderly. Studies are also trying to find a link between Alzheimer’s and traffic-related airborne particles.

But new studies are now linking these particles to early skin aging too. After studying a group of people who lived in a heavily industrialized area, as well as a group in a rural area for twenty years, a strong association has been established between residing near areas with heavy traffic and increased wrinkling and pigment spots. The association was so strong that traffic-related airborne particles is now ranked third, underneath UV radiation and tobacco smoke, as the most potentially modifiable major factor in early skin aging.

Perhaps it’s time to cut back on the all the cars and buses after so much evidence has shown its harmful effects to not only the environment but to us also.

To your health and beauty,

Dr. Carmen Kavali

Does The Fat Come Back?

2011-08-04T19:52:00.000-07:00

In Atlanta, liposuction, whether it be traditional or laser-assisted lipo, is one of the most common procedures I perform. Many of the patients that come into my Atlanta, Georgia plastic surgery practice have worked really hard to reach a healthy weight but have one or a few areas of fat they can’t seem to shake. Due to liposuction being a body contouring procedure, these patients are ideal candidates and can easily obtain the body they’ve been working towards. It also helps to be as close to your goal weight as possible because new studies show that fat has a tendency to return within one year of a liposuction procedure.

Don’t just write off liposuction just yet. In fact, fat has shown to be quite adamant in returning after dieting and exercising as well. However, whereas fat usually returns to the same spots after diet and exercise, the fat will not settle back into any areas that have previously been liposuctioned. Meaning, your sexy shape will still be retained.

But why is fat so adamant on returning no matter what we do? Scientists believe that the brain, or possibly some other part of the body, is trying to regulate the body after weight loss, which could cause the body to gain back any poundage that has been lost. If scientists are able to prove this, it means that maintaining a healthy body weight from the start is more important than ever. It definitely is worth considering before you reach for the chips over whole wheat crackers to give to your children.

The bottom line is that a healthy lifestyle should be maintained no matter what. Liposuction is a great tool to help with any problem areas, but it is not a weight loss procedure. Even afterwards, it’s important to continue a healthy diet and to exercise daily in order to combat the fat that will try and return.

To your health and beauty,

Dr. Carmen Kavali

The Next "Botox" is Almost Here....

2011-08-03T09:39:00.000-07:00

Xeomin (pronounced "Zee-o-men") has just been FDA-approved for use here in the States. Xeomin is a new botulinum toxin from Merz, the company that makes Radiesse (a collagen-stimulator, wrinkle filler) and Asclara (for spider veins).

We don't know exactly how Xeomin will stack up against Botox and Dysport, but we do know that Xeomin is supposed to be a "purer" form of the botulinum toxin protein, and we know it doesn't have to be refrigerated, so it has a longer shelf-life. We don't yet know if it will last longer than Botox or Dysport, or how it will work for areas other than the "11s" between the brows, which is presently the only area it's FDA-approved to treat. And we don't yet know about it's cost.

As with many products, Europe has been using Xeomin for awhile now, even though it just became available here in the States. In Europe, it's called Bocouture....which brings me to the issue of names for these wrinkle-reducers.

Why are all the names so unappealing?? "Botox" sounds like a poison. "Dysport" sounds dys-functional. Xeomin, well, I had to figure out how to pronounce it! Europe got the good name for Dysport (it's Reloxin over there", and they got the good name for Xeomin (Bocouture). Not sure why we're getting all the bad names over here.

What do you think--will you try Xeomin as soon as it's available, or will you wait until it's more "tried and true" here?

Could I Have Body Dysmorphic Disorder?

2011-07-14T13:06:00.000-07:00

With cosmetic enhancements becoming more widely accepted in today’s culture, it’s only natural for more people to want them. Just like the rest of America, in Atlanta, cosmetic surgery is certainly no longer just for the rich and famous. And in a society that values beauty and youth, more and more people decide to utilize a plastic surgeon’s talents. Can cosmetic enhancement ever become too much of a good thing?

In fact, yes, it can, for those who have one procedure after another, but are never satisfied with the way they look. Those folks may have a psychological condition called “Body Dysmorphic Disorder” in which the affected person is excessively preoccupied by a perceived defect in his or her physical features. Similar to individuals suffering from a disorder like bulimia, who never see themselves as thin enough, those with BDD never see themselves as physically “perfect” enough.

Of course, it’s common for us to be critical of ourselves, especially when it comes to appearance. Simply thinking someone’s breasts are better than yours doesn’t mean you suffer from BDD. Patients who come to our Atlanta plastic surgery office for a breast augmentation, and later on (or even at the same time) they decide to have a liposuction procedure doesn’t mean they have BDD. Maybe they just have a few things on a list that they’d like to change about themselves. So, how can you tell when you, or someone you care about, might have a problem with Body Dysmorphic Disorder?

Here are some symptoms of Body Dysmorphic Disorder:

Preoccupation with physical appearance, ie, beyond that of most other people.
Strong belief that they have an abnormality or defect in their appearance that makes them ugly. One wrinkle can turn them into a tailspin.
Frequent examination in the mirror or, conversely, avoidance of mirrors altogether.
Belief that others view their appearance in a negative way.
Constantly seeking reassurance about their appearance from others.
Frequent cosmetic procedures but little satisfaction with the results.
Unusual body habits, such as hair plucking, picking at their skin, etc.
Extreme self-consciousness.
Refusal to appear in pictures.
Always comparing their appearance with that of others.
Avoidance of social situations.
The need to wear excessive makeup or clothing to camouflage perceived flaws.
Obsessing over specific parts of their body, such as breasts, abdomen, and/or face.

OK now, don’t get worked up if a few of these apply to you. In fact, several of these are fairly natural and occur in almost everyone to a degree. The warning lights should go off, however, when these minor symptoms occur so frequently and they are combined with other unusual behaviors such as refusing to appear in pictures or frequent cosmetic surgery without satisfaction. When that happens, it could be time to talk to a professional. Through therapy, those with BDD can learn to view both their inner and outer beauty in its fullest.

Do you ever worry that you, or someone you care about, might have Body Dysmorphic Disorder?

To your health & beauty,

Dr. Carmen Kavali

Bristol Palin's Plastic Surgery: Necessity or Narcissism?

2011-07-01T18:37:00.000-07:00

By now everybody knows that Bristol Palin, famous teen mother of presidential hopeful, Sarah Palin, AKA former Governor of Alaska, has visited a plastic surgeon. Atlanta folks, along with everybody else, have been told that it was for “health reasons” as a plastic surgeon, I’m not so sure. What did she have and was it done well?

First of all, it appears that she’s had a mandibular advancement to move her lower jaw forward. She may also have had some liposuction of her neck (under her chin). Her brows are thinner and more arched, which could mean a good waxing artist, or could indicate Botox usage.

Although I fully agree with jaw surgery in young people for functional improvement, I wouldn't necessarily use Botox in a 20-year old. Regardless, I do think she looks better.

What do you think about Bristol Palin’s plastic surgery? Would you be willing to allow your 20-year-old to have this kind of surgery? Why or why not?

Can't wait to hear your opinion!

Carmen Kavali, MD

Botox results for less $$?? Who wouldn't want that?!

2011-06-24T07:43:00.000-07:00

A new study has confirmed what we've long-suspected in my practice: people who use Botox regularly can eventually use it LESS often and still get the same great results! So if you've been wanting to try Botox, but have been worried about needing to do it every 3 months to keep up your results, this is great news!

The study found that women aged 30-50 who have Botox every 3 months for about 2 years can then start using it only twice a year (every 6 months) and see no change in their lines and wrinkles.

Have a great weekend!

To Your Health and Beauty,
Dr. Carmen Kavali

Stem Cells--Aesthetic Miracle?

2011-05-27T11:59:00.000-07:00

Have you seen advertisements that “stem cells” are used in all kinds of aesthetic procedures, such as breast augmentation, face lifts and wrinkle treatments? Before we all jump on the bandwagon, I’d like to share some cautionary information—not to put a damper on the exciting potential of stem cell usage, but to balance the excitement with some facts.

First, what are stem cells?

Stem cells are “undifferentiated” cells. That means that they have the potential to become any other cell type, such as skin cells, muscle cells, bone cells—you get the idea.

Where do stem cells come from?

So far, stem cells have come from one of two sources:

· Embryos

· Adults

Embryonic Stem Cells:

Embryonic stem cells come from labs that create embryos for in vitro fertilization. Multiple embryos are created, but only one embryo is inserted during each in-vitro cycle. What to do with the others? Throw them away? Keep them? Use them for research? There’s been an ongoing ethical debate with persuasive opinions on all sides. Fortunately, we have another source now: adult stem cells.

Adult Stem Cells:

After we’re born, we retain stem cells in the tissues of our brains, liver, blood & blood vessels, skeletal muscles, skin and liver. These stem cells are your body’s National Guard. They show up when you need them, but otherwise, they wait. If they are “activated” by disease or injury, they divide and conquer. For example, if you cut your finger while chopping onions, your stem cells get a message to get busy and repair the tissue and skin that was damaged.

Originally, scientists thought that stem cells from the liver would only make liver cells and stem cells in bones would only make bone cells, etc, but recent studies show that most stem cells can “differentiate” to make other cell types. This is great news because everybody has stem cells, compared with the limited availability of embryonic cells, not to mention the ethical debate about using embryonic stem cells.

Stem Cell Usage in Aesthetic Medicine

There are ads all over the Internet, in magazines and newspapers and on radio & TV that you can get larger breasts through stem-cell injections instead of a breast implant; that it lasts a lifetime, is less expensive and has an easy recovery. Some doctors and centers advertise that they can plump your lips or fill your wrinkles with stem cell enriched fat instead of fillers and that it’s permanent, ie, you’ll never need to come back for a refill like you do with Juvederm.

Sounds great! So what’s the problem?

This is the problem: the marketing of stem cell treatments is way ahead of the proven safety of stem cell treatments. That creates risk for everyone who is exposed to their use before safety has been absolutely proven.

Remember what I said about stem cells’ ability to become other types of cells? Can injected stem cells become cancer cells? Can they can create a new disease? Nobody is certain yet. Scientific studies are performed over the course of several years and the scientific community simply hasn’t had those years of study to be absolutely certain whether there are side-effects of stem cell injections and if so, what those side effects might be.

What This Means To You As My Patient

I am a member of a professional association composed only of board-certified plastic surgeons: ASPS (American Society of Plastic Surgeons). The ASPS and ASAPS (American Society of Aesthetic Plastic Surgeon, also all board-certified surgeons) put together a task force to study the issue of stem cell procedures. Because both groups are committed to the highest standards of ethics and safety in plastic surgery, they are very concerned that physicians—primarily those on the “fringe” of plastic surgery, like dentists injecting Botox, OB’s doing breast augmentations—you get the idea—are pitching “the miracles” of stem cells long before their safety is confirmed.

Led by plastic surgeon and stem cell expert J. Peter Rubin, M.D., the task force poured over every study and report they could get their hands on about stem cells and cosmetic usage. They realized this: the scientific information available right now doesn’t support the marketing claims targeted to consumers seeking aesthetic procedures and treatments. It’s just too soon to know if stem cell injections are safe. Maybe they are, but what if they aren’t?

The task force position is: until it’s proven to be safe, members of the ASPS and ASAPS are asked not to inject stem cells into their patients.

I am an aesthetic surgeon but, first and foremost, I am a doctor who, like all MD’s, took the Hippocratic oath that includes these words: “I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.” I only deliver treatments to my patients that are proven to be safe and effective. You are not my guinea pig, and you shouldn’t be a guinea pig for another physician either. The phrase, “Buyer Beware” should apply to used cars, not to human health.

For safety’s sake, please forward this blog post to everyone you know who is currently involved with, or considering, cosmetic enhancements.

To your health & beauty,

Carmen Kavali, MD

Spring Cleaning for Your Face?

2011-04-25T06:48:00.000-07:00

Spring has sprung and while some of you are spring-cleaning your homes, many of you are coming into our Atlanta plastic surgery and skin renewal practice to spring-clean your skin, too! The dry winter weather, stress or sun damage could be to blame but as seen on The Doctors, 3 non-invasive facial rejuvenation procedures can clear the cobwebs, and buff and shine your face for a fresh, spring look.

Laser The Cobwebs (Spider Veins) Away

Facial spider veins aren’t painful but they certainly are embarrassing. Damage from the sun can cause the tiny facial blood vessels to dilate, as can aging. Spider veins can appear on any skin type but they tend to be more visible on fair-complected people. Covering them with makeup works for a few hours, but longer-term results can be gained over your lunch break with little or no downtime. Both the IPL (photo-facial) and the Alexandrite/YAG laser can be used to be treat most skin types, as they target the red blood cells, causing the vessels to collapse, shrink and in most cases, disappear. If more appear later on (a common occurrence), another treatment can zap them away!

Buff Away Dead Skin

We have lots of great chemical peels to refresh the skin: Skin Medica's Vitalize Peel, for instance. This peel addresses several skin conditions, such as hyperpigmentation, melasma and sun damage. After only one treatment you’ll see visible improvement. After a series, you’ll see more significant results. Little or no downtime is the norm with the Vitalize Peel, so come in during lunch for your peel!

Need some skin tightening? Known as “the lift without a knife,” Refirme lasering results in immediate lifting and firming of facial skin through a combination of radiofrequency waves with infrared light. The Refirme laser has become a favorite of our Atlanta patients who want tighter and firmer skin on the spot, without visible post-treatment marks.

The Matrix IR is a diode laser for facial lines. By heating up the deeper layers of your skin (while protecting your surface skin), it signals collagen to rebuild. It’s great for nasolabial folds, marionette lines, crow’s feet, forehead lines and those little wrinkles around the eyes. Since its energy is fractionated, more intense light energy can be placed, which means it’s highly effective.

Time To Add Some Shine

The last and final step of the spring-cleaning facial rejuvenation is laser skin rejuvenation with our eMatrix (fractionated RF) Laser. This laser treats superficial skin lesions, acne scarring and wrinkles while improving both the texture and tone of your skin. The 3 settings allow for superficial, mid-level and deep skin correction, so it’s easy to tailor for your specific needs. A series of treatments can reveal the beauty and shine that you love!

You can have any of these procedures done during lunch and return to work, looking refreshed and ready for spring!

To your health & beauty,

Dr. Carmen Kavali

Study Says: Men Paying More Attention to their Appearance

2011-04-14T16:30:00.000-07:00

Say, how's your man looking these day? If he's considering cosmetic enhancements, he might be part of the increase in aesthetic treatments by American males. According to the latest study by the American Society of Plastic Surgeons, men are lining up for face lifts, Botox, nose jobs and liposuction. Cosmetic procedures among men accounted for over 1.1 million cosmetic procedures in 2010, including both non-invasive and surgical procedures.

Treatments for gynecomastia (man boobs) increased by 6% in 2010 over 2009. Men are more aware of their chests than previously and are embarrassed to be seen sporting the equivalent of a B or C cup. The majority of men having male breast reduction were under the age of 30, however, although breast enlargement can happen to men of any age, and is most common during puberty and after the age of 50.

Men in their 50’s and 60’s are apparently more interested in face lifts, with an increase of 14% from 09 to 10. As Baby Boomers, looking young while feeling young has become imperative, especially for men who are still involved in their careers. As a group, Boomers have always been interested in looking young and have no intention of growing old gracefully!

Non-surgical treatments such as dermabrasion increased by 4% while Botox injections went up by 9% among men between the years 2009 and 2010. Liposuction went up 7% and ear surgeries 11%.

The report revealed that the most popular surgical procedures for men are nose reshaping, eyelid surgery, liposuction, breast reduction and hair transplantation.

Although Botox tops the most-wanted list of minimally invasive procedures, it was followed by laser hair removal, microdermabrasion, chemical peels and wrinkle fillers.

Which brings me to a question for my readers: What's your man up to? Do you think he needs a bit of help in the appearance department? If you could wave a magic wand, what's the first thing you'd want him to have done?

To your health and beauty,

Dr. Carmen Kavali

The real price of cheap cosmetic surgery...

2011-01-23T17:47:00.000-08:00

See?! It's not just me going on about non-plastic surgeons "learning" to do plastic surgery procedures in weekend courses, then calling themselves "cosmetic surgeons"! Self Magazine, in its January 2011 issue, ran a great article about the real price of cheap cosmetic surgery. Highlights from the story:

Cosmetic surgeons are NOT plastic surgeons. They may have taken some weekend courses, but haven't done nearly the 4-6 years of training that a true board-certified plastic surgeon has done.
Hospital privileges matter. A hospital would never take on the liability of allowing a "cosmetic surgeon" to perform procedures in the hospital facility. The hospitals recognize that the training is not the same as it is for a board-certified plastic surgeon.
"Awake" surgery doesn't mean safer surgery. And it may mean the doctor doesn't have any other options than to do your surgery in his office.

Buyer beware, and be educated.

Death During Liposuction

2010-11-11T22:21:00.000-08:00

As if you needed any more reasons to choose a surgeon who is certified by the American Board of Plastic Surgery for your plastic surgery procedures, along comes this story:

I want to emphasize that I reviewed the medical records in this case, and my opinion in this video is not one given lightly.

Every physician has had complications and unfortunate outcomes, even in situations when everything was seemingly done right. So I'm not quick to "point fingers". But this was not a case when things were done right from the start.

I still don't understand why anyone would ever choose a non-plastic surgeon to do their plastic surgery. These "cosmetic surgeons" are NOT plastic surgeons! They are doctors in other specialties (family practice, internal medicine, anesthesiology, OB/GYN, etc) who have decided to take some weekend courses so they can start doing cosmetic procedures in their offices. Would you think it was okay if I started doing PAP smears or delivering babies (I mean, I did both of those things in med school, and I'm a doctor, so surely I'm qualified, right)? The medical board ALLOWS any physician to do anything they want--buyer beware.

Now in Atlanta: Liposuction clinic with a (not-so-great) record

2010-08-29T12:40:00.000-07:00

Sono Bello is now in Atlanta, apparently. Wow. This is the same outfit that had a death after liposuction not too long ago. Here's the article about the young woman who underwent "micro-cannula" liposuction with one of Sono Bello's "board-certified doctors" (NOT the same thing as a "board-certified plastic surgeon", mind you).

The worst part of this whole thing is that I completely recognize the pattern: some investors (not medical personnel) own these centers and are most concerned about the bottom line. They hire doctors to perform the procedures, effectively turning the doctor into a technician, rather than the professional clinician he/she should be, and they use non-clinical staff to "educate" patients (ie, SELL) about the procedures.

The most telling part of the article about that poor woman's death in Bellevue is what happened when a reporter went back to that same center months later, and was told there had never been a serious complication from their liposuction procedures:

In late October, KING TV sent a producer into Sono Bello in Bellevue, which is where Aura had her liposuction done. The producer asked the patient care consultant, "Have you had serious complications?" The consultant replied, "no, no, no, not here."
This was five months after Aura Javellana died.

Here's a link to more online reveiws of Sono Bello. And another link to a site called complaintsboard.com with lots of information about Sono Bello.

I'm concerned about a public who still doesn't get the difference between a board-certified doctor and a board-certified plastic surgeon or the difference between a plastic surgeon and a cosmetic surgeon. I'm concerned about the commercialization of the practice of medicine. And I'm concerned when patients aren't properly educated (and are even misled) prior to undergoing a surgical procedure.

Heidi: She now wants smaller breast implants--or maybe just more press

2010-08-25T18:36:00.000-07:00

Well, it seems that those G-cups Heidi Montag chose to have implanted less than a year ago have outlived their usefulness for her. I thought I read somewhere shortly after her initial 10 surgeries (!) that she really wanted her breasts to be even larger, but a G cup was the best she could do at the moment. Now, she's telling Life and Style magazine that those big breasts are causing her back pain and making it difficult to exercise---is she really surprised?! Women with truly natural G-cup breasts typically see me for breast REDUCTIONS.

Oh, and the real drama now is that her plastic surgeon, Dr. Frank Ryan, died in a tragic auto accident recently. I'm certainly saddened for his family, but there is definitely no plastic-surgeon shortage in California, and I think it should be pretty easy for Heidi to find someone capable of handling her revision surgery. I guess this was the latest angle she had to extend her 15 minutes.

Botox as "Push Present"?

2010-06-19T06:02:00.000-07:00

Apparently, Push Presents have become all the rage over the past few years: a present a new Dad gives a New Mom around the time of the baby's birth. I think it's a sweet idea, something to make Mom feel honored, respected, and maybe even a little glamorous after all she's been through during pregnancy and childbirth.

There are plenty of opinions regarding Push Presents: some people think the baby is present enough, and others think it's just a sweet gesture. And there are plenty of ideas for Push Presents--of course the jewelry industry hopes Dad will choose a true bauble for Mom. Fortunoff even has a Push Present registry!

But I just had an expectant mom tell me that she wants Botox and some Fotofacial skin care treatments as her Push Present! Nothing like a little wrinkle reduction and skin smoothing to make a mom feel a little more confident and gorgeous, I say. And, you know, if Mama's happy....

Building a New Breast: You Know We Can Do That, Right?

2010-05-12T07:10:00.000-07:00

Breast reconstruction is a gratifying procedure, creating "something from nothing", almost literally. The idea of waking up after breast cancer surgery with two breasts still on her chest is a calming idea to many women.

It amazes me, though, that only about 20% of women who have a mastectomy go through with reconstruction. An article in Cosmetic Surgery Times gives more details. The main barrier to breast reconstruction seems to be AWARENESS! In this age of instant information and constant contact, I find this saddening.

I rarely see a breast cancer patient prior to her diagnosis, so the women I see already know that breast reconstruction is an option. It's the women who never get to the office of a plastic surgeon that we need to reach. I don't think there are any easy answers, but maybe if more people know about this, more people will talk about it.

Thanks for stopping by here!

No Bones About It: Why Many Facelifts Look Unnatural

2010-04-19T11:38:00.000-07:00

So have you ever wondered why most facelifts look like, well, facelifts?? Why Joan Rivers looks like she's been caught in a wind-tunnel? It's because most facelifts address loose skin, but do nothing to fill the hollows in the face. It's like making a bed by pulling the comforter tight, but leaving the sheets rumpled beneath it.

You probably already know that you lose fat in your face as you age (and tend to find it in your thighs!). But you also lose BONE as you age--the bones in your face literally become thinner, making eyes look more hollow, jawlines look more loose, and cheeks look more flat. A great article from NPR goes into more detail.

In the world of plastic surgery, there has been a lot of attention given to "volumizing" faces. You may have heard about "liquid facelifts". Or lots of different fillers to fix hollows in the face: Sculptra, Restylane, Radiesse, Juvederm, or even your own fat.

To fix an aging face, you have to treat it like a home renovation: address the foundation first (fill the hollows), then spackle and paint (remove loose skin, sculpt the jawline, and start a good skin care routine).

Thanks for stopping by here!

Fighting Gravity, Two Breasts at a Time

2010-03-10T17:56:00.000-08:00

We all know that gravity is not our friend. Nobody likes sagging or drooping. I had the great pleasure of connecting with some dynamic women to talk about breast health: breast cancer screening, breast surgery, and great bra support.

So who were these dynamic women? Susan Nethero and the ladies of Intimacy the Bra Fit Specialists and Karyn Greer from WXIA 11 Alive! You can see the final edit tomorrow night (March 11) on 11 Alive news at 11p and again Friday morning (March 12).

Thanks for stopping by here.

Recession-proof procedures!

2010-03-09T09:55:00.000-08:00

The recession may have hit most of us pretty hard, but the 2009 ASAPS cosmetic surgery stats reveal that we still value our appearances. Cosmetic procedures in 2009 were only down about 2%! Of course, the more pricey surgical procedures were down about 17%, which isn't surprising at all. But nonsurgical cosmetic procedures increased by about 1%--that may not sound like much, but when you consider that over 2.5 MILLION Botox procedures were done in 2009, 1% doesn't seem insignificant.

So what were the most common plastic surgeries in 2009? For women, it was breast augmentation, liposuction, eyelid surgery, rhinoplasty, and abdominoplasty.

For men, the most common plastic surgeries in 2009 were liposuction, rhinoplasty, eyelid surgery, gynecomastia treatment (male breast reduction), and hair transplants.

The most common nonsurgical procedures in 2009 were Botox, fillers, laser hair removal, microdermabrasion, and chemical peels.

Thanks for stopping by!

The End of the Man-Boob

2010-02-01T13:45:00.000-08:00

Women are the greatest consumers of plastic surgery procedures, comprising about 85% of my practice. I think there are many reasons for that, including childbearing, age discrimination, and others that could be a topic for another blog.

Men come, generally, to have a few things touched up. They come for Botox when their scowls make them look "too mean" to make a sale. They come for liposuction when they can't get a handle on their love-handles. They come to have their heavy eyelids removed, so they don't look so tired. And, more often than ever now, they come to get rid of their man-boobs. Our professional term for "man-boobs" is "gynecomastia.

There are a few ways to get rid of man-boobs, including laser-assisted liposuction and direct excision (cutting out the extra tissue). The scars are minimal and so is the down-time.

In fact, the procedure can often be done in the office under local anesthesia. Southside Steve, one of The Regular Guys from Rock 100.5, had his procedure done in my office a few months ago and took the time to create a YouTube video about it. My disclaimer here is that I had no editorial control over the video and it probably won't appeal to all of you. View at your own risk.

Fox News ran a story today about man-boobs and the trend of getting rid of them. Thought you might be interested.

Thanks for stopping by here!

2010-01-24T08:05:00.000-08:00

Are you ready for a turnaround for your skin,

a reversal of aging,

a perfect winter wake-up,

an about-face for your face?

Join us on
Tuesday, February 2
for an
All-Day Skin and Makeup Makeover Event

RSVP 404-250-3333 to reserve your time

The Perfect Winter Wake-up:

Fotofacial treatments are only $125 on Event Day Only
Microdermabrasion is only $75 on Event Day Only

If you're already thinking about more long-term maintenance,

Try a Package of 3 Fotofacials for only $700
or a Package of 3 Fotofacials and 3 Renewal Peels for only $1000
Packages may be purchased at these special prices anytime during the month of February.

The Turnaround:

Once your skin is prepped from your Fotofacial or Microdermabrasion, see Mark Lares for a Complimentary Glo-Minerals Makeup Makeover.

Mark is a hair and makeup expert, and we are excited to have him with us for this event.

Whether you need a fresh basic look or a new glamorous look for an upcoming event (Valentine's Day, anyone?), Mark's got you covered. And we've got very special pricing on all Glo-Minerals products--you don't want to miss this one!

The About-Face for Your Face:

Renew and Maintain your skin with SkinMedica products.
Event Day-Only Specials:

SkinMedica Illuminating Eye Cream and TNS Line Refine for only $100
SkinMedica TNS Recovery Complex: Buy Two, Get One Free
Buy one TNS Essential Serum and Get TNS Illuminating Eye Cream FREE
10% off All SkinMedica products

Juvederm Special, good anytime through February 14: Get a FREE Vivite Defining Lip Plumper with every 1 cc syringe of Juvederm. (mail-in offer)

Octomom--My apologies for extending her 15 minutes

2010-01-23T18:30:00.000-08:00

The same woman who denied ever having her lips plumped is now saying her flat tummy (after 14 kids!) is just from diet and exercise. I'm not buying it. Her bellybutton looks like an operated one, and, even if she didn't have a tummy tuck, air-brushing can work miracles!

Now can we all quit talking about her so she'll just go away?

Jumping on the Heidi Bandwagon

2010-01-23T17:37:00.000-08:00

I was as stunned as anyone to see the latest Heidi Montag photos in People magazine (and everywhere else!). She looks like an older, plastic version of herself. Or, as a friend of mine said, "She looks like an old porn star."

Now, I'm obviously a fan of plastic surgery. But, as with most things, plastic surgery is better in moderation. And it's better when the procedures are actually correcting a problem, not just tweaking things that are just fine. I'm not sure how any 23 year old could really need 10 cosmetic procedures.

Here's my take on what she had done:

1. Botox: at age 23, likely not needed. But not bad maintenance and prevention, so I can't really knock it, even though her brow position now makes her look a bit evil.

2. Mini-browlift: I'm not even sure what this procedure is exactly. You either do a browlift, or you don't. Meanwhile, it's clear from her "before" photos that she didn't need anything done to her brows.

3. Chin reduction: Ok, I see the difference, but, again, not necessary.

4. Revision of breast augmentation: Obviously to go even larger. All I can say is this: the bigger they are, the harder they fall. She may regret this later.

5. Liposuction: I can see this difference, too, in her hips and waist. Many otherwise thin women do come for contouring of areas that they consider to be their "problem areas", and I think that's not entirely unreasonable. I'm not sure Heidi has done anything to take care of problem areas, though. It seems to me that she's had all this work done, and had People magazine following her every step of the way, just to get more press for the launch of her pop album.

6. Fat grafting to the cheeks: completely unnecessary in a 23 year old

7. Lip augmentation: Not bad

8. Buttocks Augmentation (presumably with fat): I can't really tell a difference here, nor can I see that she needed this procedure done.

9. Revision rhinoplasty (nose-job): She may be on the Michael Jackson path here. Her nose looked just fine before this second surgery.

10. Otoplasty (ear pinning): I don't recall noticing her ears being prominent prior to her surgery, so I can't really say if this made sense. It wouldn't be unreasonable if they did stick out quite a bit before.

I just hope that Heidi doesn't have as many fans as she seems to think she has, so there won't be be hordes of young women following her lead. And I hope she gets the help she needs for her obviously impaired self-esteem. And I hope her 15 minutes are over soon.

Our January Event!

2010-01-08T07:55:00.000-08:00

Want to learn more about the NEWEST nonsurgical cosmetic procedure approved by the FDA?

Please join me for a
Lunch and Learn
and find out more about the exciting new wrinkle remover, Sculptra Aesthetic!

Tuesday, January 26, 2010
Drop in between the hours of 11:30am – 1:30pm
Lunch will be provided for those attending.

Why should you care about Sculptra Aesthetic? Well, if you've been waiting for a great solution for those lines and hollows in your face, Sculptra just might be right for you!

Sculptra Aesthetic isn't a "filler"--it's a collagen-stimulator! The results are literally YOU, just better!
Sculptra Aesthetic works gradually over time, so there are no "instant" changes that are obvious to everyone around you.
Sculptra Aesthetic lasts 2-3 years! You'll save money in the long run by investing in Sculptra now.

You can visit the Sculptra Aesthetic website and watch the clip of Sculptra Aesthetic featured on the popular morning show, The Doctors, to better familiarize yourself with this amazing new injectable that lasts 2-3 years.

If you're ready to learn even more, give us a call to reserve your space at our Lunch and Learn Event.

***EVENT ATTENDEES WILL RECEIVE $100 OFF EACH VIAL OF SCULPTRA PURCHASED***

***Can't make it to the event, but think you're ready to try Sculptra? Call us on January 26 to book your future Sculptra Aesthetic procedure, and you'll enjoy the same savings! ($100 off each vial)

RSVP: 404-250-3333

Ding dong, the Botax is dead! (for now)

2009-12-20T19:25:00.000-08:00

THANK YOU to all of you who picked up the phone, emailed, or wrote letters to your Senators! I guess grass-roots democracy still works some of the time. The proposed 5% tax on all cosmetic procedures is being withdrawn tonight as part of Senator Reid's "manager's amendments" to the healthcare bill currently being debated in the Senate. That means the final Senate version of the bill will not include this onerous tax on middle-class women.

We need to keep our eyes peeled, though, as there will be ample opportunity in the coming weeks for it to be reintroduced.

Thanks for stopping by here.

Avoiding a plastic surgery tragedy: What Miss Argentina needed to know

2009-12-10T17:56:00.000-08:00

My heart just breaks when I hear stories like the one of the beautiful former Miss Argentina. You probably already heard about her death. It was initially reported that she died after having plastic surgery to enhance her buttocks. (Here's the original story.)

Well, more details have emerged, and it appears that Miss Argentina wasn't actually having "plastic surgery". In fact, an Argentinian plastic surgeon refused to do the procedure she requested! So she went to someone who isn't a plastic surgeon at all and was willing to inject her buttocks with liquid silicone--something not approved in Argentina or here in the States. She died, reportedly, from a pulmonary embolus (a clot in the lungs).

There is an educational opportunity in this tragedy. In fact, this article from CNN.com does a great job of breaking down some of the questions you should ask before undergoing any cosmetic procedure. Of the questions that CNN suggested, these are the ones I think are MOST critical:

"Doctor, are you board certified?

You want a doctor who's certified by the American Board of Plastic Surgery. "

Doctor, do you have privileges at a hospital to perform this procedure?

Even though you likely won't be in the hospital, you want to know if a hospital has deemed your doctor skilled enough to perform the procedure in their facility.

"The hospital is the judge of the physician's abilities," Haeck said. "If a surgeon says he doesn't have privileges at a local hospital to do the procedure, that should be a red flag."

If the surgeon says he does have privileges, call the hospital and double-check."

Dentist = Plastic Surgeon? I don't think so!

2009-12-06T15:37:00.001-08:00

There's a story out today about a dentist who performed breast reduction and liposuction on a 15-year-old! Here's the link to the full story. Now, I've got a couple of issues with this.

First, what's a dentist doing working below the neck? This guy did go to medical school as well as dental school, but that doesn't make him a plastic surgeon. He never did an accredited residency or fellowship in plastic surgery, so, in my opinion, he shouldn't be venturing too far from the face!

Unfortunately, there are no laws against ANY kind of doctor performing ANY kind of surgery he/she wants, so long as they can do it in their own office! That's because no hospital would allow them to do those surgeries in their facilities--the hospitals don't consider them to be adequately trained to do such surgeries. If I wanted to really be reckless, and if I could find someone willing, I could do brain surgery in my office. I guess I could take some weekend courses before-hand, so I'd be "qualified".

Second, who does liposuction on a 15-year-old?! There was another story a few years ago about a 12-year-old who had liposuction, but that was a very unusual case, and there certainly is no accepted established precedent for such surgery. There is sometimes good reason to do breast reduction surgery at that age, but it's not common. There is, in my opinion, no good reason for liposuction on someone that age--that poor girl should have been encouraged to diet and exercise some more.

So, buyer beware: a "cosmetic" surgeon is often NOT a surgeon at all. Most ABPS-Certified plastic surgeons don't call themselves cosmetic surgeons because we're aware of all the non-plastic surgeons using that name.

How do you know if your cosmetic/plastic surgeon is legit? Check out your surgeon here. You'll find out if he/she is Certified by the American Board of Plastic Surgery. Can't find your surgeon there? Check him/her out here. You'll see exactly what specialty their board-certification is in (internal medicine, plastic surgery, emergency medicine, etc). And, check out your surgeon here, too. If they're an ASPS member, they have to be an ABPS-Certified plastic surgeon.

Getting Back Your Body After Baby: Mommy Makeovers in Atlanta, GA

2009-12-05T16:17:00.000-08:00

What's a busy Mom to do when the family is complete, but all the diet and exercise in the world aren't working to give her back her pre-baby body? Seek out a Mommy Makeover! The trend isn't new, but it's certainly picked up steam in recent years. Both celebrities and soccer moms have these procedures.

Mommy Makeovers are designed to take care of the problem areas that most women have after pregnancy. Now, every Mom is different, but the most common procedures in a Mommy Makeover are tummy tucks, breast lifts, and liposuction.

When you're ready for your Mommy Makeover, come see me at Kavali Plastic Surgery. As a Mommy myself, I can understand what you're going through.