Screen Shot 2015-09-23 at 9.41.47 AM


I’m not saying your trainer is a liar or a bad person. It’s just that when it comes to certain issues about how diet and exercise actually affect the human body on a cellular level, many personal trainers don’t know exactly what they’re talking about. Or they do know what they’re talking about, and they continue to talk and take your money.

So before you take everything your trainer says at face value, and feel ashamed that no matter how hard you work out, your body isn’t turning into what your trainer promised you it would, ask yourself these three questions:

1) Does your trainer happen to have a PhD, Master’s, or at least a Bachelor’s degree in Biology that includes courses in Human Physiology?

2) Can your trainer talk to you in detail about the process of aging at a cellular level, especially about what’s happening to the skin on your arms and above your knees?

3) Does your trainer know how and where in the digestive system fat/protein/carbohydrates are absorbed and what happens to them once they hit the bloodstream?

I would bet not.

As someone who was FORCED to spend SIX painful years STUDYING and RELEARNING and MEMORIZING the basic science of the human body (all of my colleagues out there who made it through a pyramidal general surgery program and had to obtain high scores on the “In-Service Exam” to keep their jobs feel my pain), I am fully prepared to go head to head with your trainer who shames you by telling you that if you just keep doing the workouts they prescribe, and eat the way you’re supposed to, they can fix those things about your body that you hate.

So below are the five most common myths that every patient of mine with a trainer has been shamed into believing. I am sick of hearing them and I am here to set the record straight:


  • “If I just keep working out, this will go away.”

If you’re generally overweight, yes. Fat will burn off in general and you will get thinner. But if you are at a reasonable weight for your height and build, and you are working out and taking care of yourself, and there is muffin top/bra fat/saddle bags/inner thighs that you’ve had your whole life or developed after pregnancy or menopause and just won’t budge, IT WILL NEVER GO AWAY. Unless you are twenty pounds underweight. And who has time for that?

Because while you can tone designated muscles, you cannot spot reduce your body with exercise. (ie) Running isn’t going to necessarily get rid of fat from your legs. Rowing is not necessarily going to get rid of fat from your arms.

Fat is simply a form of energy storage. Elements of Carbon, Oxygen and Hydrogen (yeah, remember that periodic table from eleventh grade chemistry?) are broken down from the food you eat and bonded together into lipids (the building blocks of fat.) Lipids are stored in fat cells. The thing is that you don’t get to pick which cells will be used for storage. When your body needs energy, it breaks those bonds and releases the energy (like gasoline in a car) from wherever it is programmed to do so. Not necessarily the part of the body you are exercising. If you want to target an area of fat, that’s a lipo, possibly a Coolsculpt, or at least a Vixen.

So for example, if you lose ten pounds, your body could use the stored fat in your face and breasts, and you could wind up with deflated boobs and a sunken, older-looking face and still have thick arms. In fact, if you’ve had thick arms your whole life, I can almost guarantee that they will stay thick.


  • “If I work out my legs it will tighten the skin.”

The skin is a waterproof covering of your body. It is made of collagen and elastin and other building blocks whose names are too technical to get into here.

The main thing to understand is that the skin does not participate in your exercise regimen. It can tighten as a healing response to direct injury from things like lasers and peels. It can look better after treatment with non-invasive “skin tightening” machines like Velashape and Exilis, though long term results are still questionable.

So, contrary to popular belief, the skin does not tighten with exercise.


  • “Well, then I can build up my muscle and fill out the loose skin.”

That might be true if you started taking steroids. Take a look at the skin you want to fill out and how much you have to pull it to make it look tight. Do you really want your muscles that big? And chances are, you wouldn’t be able to get them big enough without taking some questionable supplements.

In most situations where skin is really sagging, a skin excision procedure (tummy tuck, thigh lift, arm lift) is necessary to get the result you want. For the abdomen, a tummy tuck can be a good option if you are okay with the scar hidden beneath your underwear line, as the tradeoff for having tighter skin.

On an arm or leg, the scar would be hidden in most positions, but still present. So, unless you have had massive weight loss, and can’t live with the extra skin anymore, I am not recommending thigh lifts and arm lifts.

As we age, our skin just gets crappier. Childbearing also takes a toll. No matter what we do, it loses elasticity that we cannot get back.

If you stayed out of the sun when you were younger, you’re ahead of the game. But chances are, unless you are fortunate enough to have amazing genetics (which really plays the biggest role in having “tight skin”) after your mid-forties you are probably constantly bemoaning the skin on your body.

My personal solution: Spray tans

If you really have money to burn, you could do weekly Velashape treatments for the rest of your life.

But for most of us, (myself definitely included) when it comes to the skin on our bodies, in general, we have to GET OVER OURSELVES. And do the best we can. Look the best we can for our age.

We need to accept that our days parading around in a tiny bikini and getting checked out by every guy at the hotel pool may be over. That’s okay. Hopefully by now we have other, more important things going on.

Because really, besides feeding our egos, what did getting superficial attention from a bunch of strangers actually do for us, anyway?

Moving on.

  • “If I keep working out my core, my abdomen will be flatter, and I’ll get a six pack.”

 I’m talking about that situation that we all have after a certain age—that your abdomen is flat in the morning but as soon as you eat or drink something, it starts sticking out.

Even if you haven’t had kids, as we age, our abdominal walls become looser. It’s not the muscle, it’s the tissue around the muscles and holding everything together (the fascia) that is loosening. Again—loss of tissue elasticity. Like your skin, your fascia does not participate in pilates.

You can definitely make your abs muscles stronger, and you can learn to keep them tight and held in, but the fascia can’t tighten itself. And sit-ups do not flatten your abdomen.

So if you’re really doing everything you can to be fit and healthy, and your abs muscles won’t get flatter, and you still can’t see them, the answer is one of two things:

A tummy tuck with plication of the deep abdominal wall (permanent suturing inside like an internal corset)


Liposuction to get the fat off your abdomen so you can uncover the muscles underneath that you’ve been working so hard on. Remember, you cannot spot reduce fat (see myth #1)


  • “If I cut down on the carbs I will lose weight.”

 Weight loss is not rocket science. It’s first grade math. Although these days, kids are probably doing this kind of math before they hit kindergarten. Energy in, Energy out. All food gets broken down to simple sugars, amino acids and lipids—that’s sugar, protein, and fat. Calories are a measurement of energy in the food that you eat. Like money—it doesn’t matter how you get it, green is green. Whether it comes from sugar, fat or protein, a Calorie is a Calorie.

So don’t get caught up in the good carb/bad carb thing. All carbs get broken down to the same basic simple sugars by the time they hit your bloodstream.

If you are trying to lose weight, you need to have your energy intake be less than what you are expending.

It’s not WHAT you’re eating, it’s HOW MUCH of it.

Most of us are not completely honest with ourselves about how much we are eating. Especially if we go out to a lot of dinner meetings. Those appetizers sitting there…and it seems like you’re not eating that much because there’s still so much food left on the table.

Unfortunately, it is much easier to put energy into your body than it is to get rid of it. Running four miles barely burns off a bagel. So, unless you are a professional athlete training for the Olympics, or Natalie Portman preparing for Black Swan, most weight loss has to do with HOW MUCH YOU ARE EATING—not necessarily WHAT you are eating—and not how much you’re working out.

If you feel that you are dieting and exercising and not losing the weight that you want to, the best way to get a handle on it is to start recording into your phone notepad whatever you eat throughout the day. It sucks, but things add up quickly.


So those are the main self-deprecating quotes I hear from women who can’t seem to meet their workout goals. Whether it’s a trainer telling them, or they are telling themselves these things, they are inaccurate.

To be clear, I am not advocating body contouring or skin tightening procedures as a replacement for working out and keeping a healthy diet. Addressing resistant areas of fat is a supplement to–and should only be performed–in conjunction with a healthy lifestyle.

If you are already taking care of yourself, having a procedure that targets a certain area might even give you a kick-start if you are stuck at a plateau.

For instance, wouldn’t you be more motivated to work out and eat less if your thighs didn’t rub together while you’re on the treadmill, or you didn’t have to keep re-arranging your LuLu Lemons to keep your muffin top or post-baby sagging abdominal wall skin from getting exposed? Those are legitimate concerns.


Just saying.




Screen Shot 2015-08-16 at 5.05.09 PM

At least twice a day someone asks me this question, and since I’m a surgeon, I used to just blow it off with the answer: “Oh, that doesn’t really work. To get the stubborn fat pockets off that won’t go away with diet and exercise, you need to have a lipo.”

I am not retracting my answer, but I would like to clarify.

For the wish lists of nearly all of my patients, this is true. This non-invasive/no-downtime fat reduction procedure cannot take the place of a lipo. Usually. It does not work like a lipo, and will never replace what a liposuction surgeon can do it. But it does do something.

I would put it this way: Compared to doing nothing, it works. Compared to doing lipo, it works a little.

Unfortunately, there is a lot of deceptive advertising of the “fat freezing” procedure—I don’t know about other cities, but here in Los Angeles the billboards make it look like if you sign up, you will be one fat freeze away from having the body of a supermodel. This is NOT the case. Unless you are one of those absurd people who already have that body.

I have yet to come across an objective guide to “fat freezing” by an expert for the consumer, so I decided to create one myself, with the help of my friends at Ava MD who always have the latest and greatest lasers, and are honest about all of them.

“Five things to know about Cool Sculpt”

      1)  “Cool Sculpt” is the brand-name for the fat freezing machine made by the company Zeltique. It works by killing fat cells by freezing them, and then over time your body eliminates the fat, meaning you pee it out. The traditional machine has a “clamp” that is really good only for the love handles and abdomen. If it is used anywhere else on the body, it can make a dent. It can still make a dent regardless if not done properly. There is a new machine that has a flat plate and that can be used for other problem areas like saddlebags, knees, and inner thighs, or other areas that are not “pinchable.”

2)  It is a painless procedure that takes an hour per area. (ie) ONE love handle (flank) is ONE area. So YES–to do BOTH sides, that’s TWO HOURS sitting there, if the place you go to only has one machine. There can be some bruising and soreness, and a “pulling” sensation, but it doesn’t require taking pain medication and you can go on about your regular routine afterwards.

3)  Each area usually has to be done at least twice, and should not be done closer than three months apart. It takes several months to see a result, so you will not see an automatic body sculpting like you do with liposuction. So results might not be visible for six to nine months. This system cannot give you liposculpture results. The system is supposed to kill up to 30% of the fat cells in an area, but the result is never guaranteed. I know some people that have had a great result with it, and some that saw no difference. The ones that saw no difference probably needed more treatments.

4)  Okay, so this is the kicker: COST.  At a reputable place, it will usually cost approximately $800/area. That’s EACH SIDE.

So to do both love handles, that’s $1600, and most likely it has to be done more than once to be effective, so that’s $3200 over a period of six months to see the difference. The average cost for a lipo of that area—that is going to GUARANTEE a result immediately– is usually not much more than that. So It’s not as inexpensive as it first sounds.

5)  If you ARE going to do it, and you are in the L.A. area, go see my girls at AVA MD. They have been doing it for a long time and will be honest with you about your expectations. They also do give discounts when you buy packages.

  • ***Note: Remember–with a fat freezing procedure, your fat cannot be used for cosmetic enhancement of your face, breasts or buttocks—a procedure that starts to sound like a really good idea when you get older.

Hope that was helpful! I’m warning you—if anyone starts asking me about “that fat freezing thing,” I’m going to direct you  to here. J



So, If you’re not helping in the kitchen, it could be starting to feel like that time of day…presents have been opened and put away, you’ve run out of things to talk about with relatives you barely know, and if you have to listen to “Jingle Bell Rock” or even look at a single frame of “A Christmas Story” one more time you’re going to lose it. What is a girl to do in this digital age, when we’ve become so lazy we can’t entertain ourselves without a screen in front of us, yet today is one day that we can’t find anything appropriate that we haven’t already seen a million times before? Besides spiking the egg nog (see previous Christmas Eve post), why not put on a Chick Flick masquerading as a Family Friendly holiday movie? Netflix has at least a few that you’ve probably never even heard of before. As a Chick Flick Guru, I’m shocked that these got past me. So if you’re running dry on novel audio/visual stimulation today, try checking these out:


12 Dates of Chirstmas


“The 12 Dates of Christmas”

This sounds like “Groundhog Day” with Amy Smart instead of Bill Murray and obviously takes place on Christmas Eve instead of the actual Groundhog Day. I’m not saying there’s not potential there.




Christmas Cupid 2


“Christmas Cupid”

An updated Ebeneezer Scrooge tale about a workaholic career woman/Los Angeles Publicist who is visited by the spirits of “Ex-Mas” Past, Present and Future. I predict that by the end she will no longer be a calculating, self-absorbed go-getter who puts work before family. But then how in the world is she going to survive in L.A.?



Holiday in Handcuffs 2


“Holiday in Handcuffs.”

This sounds like “The Proposal,” set over Christmas, starring Melissa Joan Hart and Mario Lopez. Clearly Mario Lopez is the one in handcuffs. What could be better?



Mistle Tones 1

“The Mistle-Tones”

A sing-off movie a la “Pitch Perfect” but with rivals Tia Mowry-Hardrict and Tori Spelling. You decide.

In no way should my notes here be construed as reviews, as I have not seen any of these movies. These descriptions are simply for identification purposes, so you don’t “accidently” choose something with a similar title that has profanity and nudity, and blame me. To eliminate confusion, these are all ABC Family made-for-TV movies.

With or without these fabulous films, I hope you and your family are having a wonderful Christmas!






I loved the taste of eggnog before I knew it was supposed to have liquor in it. Now that I know, the low fat recipe below is an attempt at balancing out the added calories of alcohol:

Eggnog 1


Prep Time: 20 min

Yield: 6 servings

Level: Easy



2 cups nonfat milk

2 large strips orange and/or lemon zest (the “Zest” is the very thin outer colored part of the peel—it can be collected with a grater, vegetable peeler or a knife. Make sure to wash the orange or lemon first and don’t get an of the deeper white part of the peel because that gives a bitter taste.)

1 vanilla bean

2 large eggs plus 1 egg yolk

1/3 cup sugar

1 teaspoon cornstarch

White rum or bourbon (optional)

Freshly grated nutmeg and cinnamon stick for garnish



Combine 1 1/2 cups milk and the citrus zest in a medium saucepan. Split the vanilla bean lengthwise and scrape out the seeds; add the seeds and pod to the saucepan and bring to a simmer over medium heat. For those of you like myself, I’ll save you the Google. The “Pod” is the shell of the bean and the “seeds” are the inside.


If you can’t get your hands on a true vanilla bean, you can use 2 teaspoons of PURE vanilla extract instead.


1 (1 inch) vanilla bean = 1 tsp vanilla extract


Meanwhile, whisk the eggs, egg yolk, sugar and cornstarch in a medium bowl until light yellow.

Gradually pour the hot milk mixture into the egg mixture, whisking constantly, then pour back into the pan. Place over medium heat and stir constantly with a wooden spoon in a figure-eight motion until the eggnog begins to thicken, about 8 minutes. Remove from the heat and immediately stir in the remaining 1/2 cup milk to stop the cooking. Transfer the eggnog to a large bowl and place over a larger bowl of ice to cool, then chill until ready to serve.

Remove the zest and vanilla pod. Spike the eggnog with liquor, if desired, and garnish with nutmeg and/or cinnamon stick.

Per serving (1/2 cup): Calories 90; Fat 2 g (Saturated 1 g); Cholesterol 96 mg; Sodium 59 mg; Carbohydrate 13 g; Fiber 0 g; Protein 5 g

Recipe courtesy of Food Network Magazine

Read more at:


Happy Christmas Eve!



Screen Shot 2014-12-14 at 11.34.00 AM

Screen Shot 2014-12-15 at 6.55.34 AM

Above pic courtesy of award-winning baking blog With Love and Confection

Those who know me know that I DO NOT COOK. Simply put, as a surgeon I consider using my hands in the kitchen an occupational hazard. That’s my story and I’m sticking to it. But gingerbread–my absolute favorite–is something I would be willing to dabble in, as there are not really any knives involved. However, with everyone at some level of gluten-free these days, is anyone else having anxiety about showing up at a party with your slaved-over baked goods that nobody will eat? Below are some politically–if not “socially” correct–gingerbread options for ringing in the 2015 new year with your gluten-free friends:


1 cup superfine brown rice flour (source link below)

  • 1 cup arrowroot starch
  • 2 teaspoons ground ginger (use 1 teaspoon if you don’t like a heavy ginger taste)
  • 1 teaspoon cinnamon
  • 1/2 teaspoon nutmeg
  • 1/2 teaspoon salt
  • 1/2 teaspoon baking soda
  • 1/2 teaspoons guar gum
  • 1/2 cup dark, unsulfered molasses
  • 1/4 cup confectioner’s sugar
  • 1/4 cup softened butter (1/2 stick)
  • 1 teaspoon vanilla extract
  • Extra rice flour for dusting when rolling and cutting out cookies
  • 1 recipe for Royal Icing
  • 1 recipe for Chocolate Buttercream Frosting
  • Prep Time: 30 minutes
  • Total Time: 30 minutes


Preheat oven to 350 F degrees

Line 2 large baking sheets with parchment paper or lightly grease

  • Sift all dry ingredients together and set aside.
  • Cream butter and sugar, beating on high speed for 3-5 minutes until light and fluffy.
  • Add molasses and vanilla and beat until combined.
  • Slowly add dry, sifted ingredients to butter mixture and beat just until a stiff dough forms.
  • Place dough between 2 sheets of plastic wrap lightly dusted with sweet rice flour. Roll out to 1/8 inch thick.
  • Dip gingerbread cookie cutter in sweet rice flour and cut out gingerbread men. Use a flour-dusted spatula to transfer cookies to baking sheet. If the dough should get too soft while you are working with it, just place it in the freezer for about 5 minutes.
  • Bake for 10 minutes in preheated oven, or until cookies are firm to the touch. Cool and decorate with Royal Icing and Chocolate Buttercream Frosting.

Yield- About 20 medium cookies. Depends on the size of your gingerbread cookie cutter.

Reminder: Always make sure your work surfaces, utensils, pans and tools are free of gluten. Always read product labels. Manufacturers can change product formulations without notice. When in doubt, do not buy or use a product before contacting the manufacturer for verification that the product is free of gluten.

For more great gluten free recipes like this one check out

Another healthy and easy-to-make option is to use gluten-free graham crackers. This is less messy and great for kids:

Screen Shot 2014-12-15 at 7.41.56 AM

More info about this one at:

And for my VERY FAVORITE gingerbread loaf, King Arthur Flour has a great option:

Screen Shot 2014-12-15 at 7.45.58 AM


  • 1 box King Arthur Gluten-Free Yellow Cake Mix
  • 1 tablespoon ground ginger
  • 1 teaspoon ground cinnamon
  • 1/4 teaspoon each ground cloves and ground nutmeg
  • 1/4 teaspoon baking soda
  • 6 tablespoons unsalted butter, at room temperature
  • 1/3 cup molasses
  • 1 tablespoon vinegar
  • 4 large eggs
  • 2/3 cup buttermilk or 1/2 cup liquid whey (the liquid drained from yogurt)


1) Preheat the oven to 350°F. Grease and flour a 9″ x 13″ pan.

2) Whisk together the cake mix, spices, and baking soda.

3) In a separate bowl, beat the butter with half the cake mix/spices.

4) Beat in the molasses, vinegar, and one of the eggs.

5) Add the remaining eggs one at a time, beating well after each addition.

6) Add the buttermilk alternately with the remaining dry mix, one-third of each at a time. Beat until smooth, scraping the bowl after each addition.

7) Pour the batter into the prepared pan.

8) Bake the gingerbread for 40 to 45 minutes, until it’s brown and firm on top. Its internal temperature should be between 210°F and 212°F.

9) Remove the cake from the oven, and cool it on a rack for 15 minutes before slicing.

Yield: one 9″ by 13″ cake.

Happy Baking! Let me know how it goes…;)




Check out my new You Tube video below, basically a recap of my consistently number one post, “Is it possible to have fuller lips without coming out looking like a duck?” (02/02/2012)




Happy Monday!



I know I’ve gotten busy/lazy about posting, but this is one I need to share this month :)

This is a shout-out to all of the incredible women that I have worked with over the past decade to help match their outer beauty to their inner beauty. You all need to know how fortunate I feel to have been a part of your lives.

Thank you for giving me the privilege of being your surgeon. For trusting me, for traveling far distances and fighting the 405 freeway to see me, for waiting in my office (but at least we have those good trashy tabloids, right?), for not giving up even when it seemed like you were never going to “get back to normal.”

We are all familiar with the variables that put us at an increased risk for breast cancer…age, family history, hormone use, smoking…but one thing I’ve learned is that, at the end of the day, it’s kind of a moot point.

Most of the women I’ve helped to treat have had no more risk factors than me. Many have been younger than me. When it comes to breast cancer, there is no “us” and “them.” Every year after my mammogram I say to myself , “Okay, I don’t have breast cancer this year.” Like my patients who had no risk factors, next year could be different.

None of us are “safe” from this crappy disease. But fortunately, with the therapeutic and surgical advances that are being made every year, breast cancer has become something that many women are able to live with and beyond.

Special thanks to those of you who were able to send us recent pics. It’s so nice for others dealing with the same “journey” to see how radiant you all are since you’ve left breast cancer behind.

So check out the cute photos of our “Lipo Queen Family” below :) We love you all!




If you follow her on Facebook, you would know that Rita is always on the go, enjoying herself with friends and family. She’s on a retreat right now with bad reception but still took time to send us a pic! Congratulations Rita! Her son is in his second year of college. :)


 Betty Ann


Congratulations, Betty Ann! You did it! Betty Ann finished her degree, took the LSATS, and is on her way to law school…


vegas 2013 kev car

…but she still makes time for her favorite way to spend the weekend :)




Jenna has a full work and social schedule…


…yet still has time with her family…


…and sometimes even plays a real fairy princess at Disneyland :)




Mary is back in action, and we congratulate not only her but her son who graduated from college and landed a coveted job at one of the biggest talent agencies in L.A.




We’ve haven’t seen Elizabeth in a while because she’s too busy with her work and family. We miss seeing you, but we understand that you and your sisters have better things to do than hang out in our office reading tabloids so…thanks for the pic–you look fabulous!





Jennifer and her boyfriend, who has been around for the duration…the smile says it all. :)




Elegant Irina–back playing violin professionally as soon as we let her






Chardelle, we know you’re busy with work and family–congrats btw! ;)–so thanks for stopping by for a visit for this hot pic with our beloved Ady, office manager/patient care coordinator, and medical assistant extraordinaire




Gigi, (and daughter Jordan) we have no words…you’ve been our family member forever :) and we so appreciate all your support with our Vixen launch and promotion and your comic relief. ;) Congratulations on your new career and all the successes of your beautiful children!





Tracey, you gorgeous girl, now WHAT would we do without YOU? ;) Tracey pays us a visit every once in a while, but usually she’s too busy with her work and family. How is it possible that this hot chick is a Glam-Ma to five???



Marcie is an actress who was on some of your favorite shows back in the '80's--Facts of Life, anyone :) --and is still acting today!

Marcie is an actress who was on some of your favorite shows back in the ’80’s–Facts of Life, anyone? :) –and is still acting today. And as a sit-com veteran, also provides us appropriate comic relief whenever she’s around.




So good to see you smiling, Carmelita! (but then it’s hard not to smile while getting your picture taken with Ryan, right?) :)


Leigh Ann

This post is dedicated to Leigh Ann Zeinali, truly one of the most remarkable women I have ever known. Always with a positive attitude and a sense of humor, always getting everything she could out of life, even though it was all taken from her way too early. She still has an account on facebook where her friends and family can help keep her memory alive. We miss you Leigh Ann and think of you all the time. Thank you so much Gina Lorenzo for sharing with us one of the most awesome BFF pics ever! (though I would have loved to see those cartoons!) ;)








Get every new post delivered to your Inbox.

Join 439 other followers