Archive

Face Lift

 

 

 

Screen Shot 2015-10-28 at 11.25.59 AM

You’ve heard of it. And you’ve probably been like, “What the fu$k is that?”

Well, if you feel like the skin on your face and neck is looking weathered and crepey and like you were a previous sun-worshipper/smoker and overall older than you want it to, this is the procedure for you. It is my number one go-to now for skin rejuvenation. INSTEAD of any laser.

So what is it exactly?

It is an in-office procedure that takes about an hour.

  • We draw a tube of your blood (Hence the term “vampire”) and spin it down in a centrifuge in a special tube that separates out the red blood cells and the liquid–the “plasma,” which is yellow and clear. This is what is known as “Platelet Rich Plasma” or “PRP.” It is chock full of growth factors. Think of growth factors as workmen coming in to rebuild your skin. It stimulates collagen production and whatever else has to happen to make your skin thicker/newer/better. We use it in reconstructive surgeries for wound healing as well.
  • We put numbing cream on your face (and neck if you want it there. Like me, if you need it on your face you probably need it on your neck).
  • We microneedle your face and neck with a Dermapen. Think dermabrasion with actual almost microscopic needles that do not leave marks. This microneedling can be a stand-alone treatment for facial rejuvenation by stimulating collagen production and rebuilding your skin, but it is even MORE effective when combined with the PRP. This part is not uncomfortable when you have had the numbing cream on for at least twenty minutes.
  • We inject the PRP directly under your skin, concentrating in the areas that need rejuvenation the most. This part can burn. You can have a pain pill and Uber home.

What’s the Downtime?

There is no pain afterwards. If you do the microneedling alone there is almost no downtime—you look a little sunburned for a day.

If you do the entire Vampire Face Lift, there is some swelling in the areas of injection, and some bruising that can last a few days. If you are not going to an event where people are going to look closely at you, you can really go on with your regular routine, put makeup on immediately, and nobody will notice. Just apply the ointment we give you, and try to stay out of the sun. I went to dinner the next night and nobody at the table noticed. But if you are going to be in settings that will make you self-conscious, give yourself a week. But it’s not a week of looking like a lobster or a Smurf. You can still do regular errands like going to the grocery store/driving kids to soccer and lacrosse/watching soccer and lacrosse, etc.

Or there’s still time to have it done before Halloween and make it part of your costume 😉

When will you see a result?

At about five days afterwards is what we have heard from our patients, and I can testify myself that it is now five days since the procedure and I see the difference. My skin is dewier and younger-looking. So it’s not one of those things that you have to do a bunch of times over months to see a difference. YOU WILL SEE RESULTS AFTER ONE TREATMENT.

In short, this is the skin rejuvenation of the future.

The Cost: $1500/treatment at our office. You will find this to be an incredibly reasonable price if you start shopping around.

Here’s an action photo:

IMG_5363

 

You’ll have to come visit to see the after. Or check out the latest post on our instagram @lipoqueen.com

And you never know. YOUR after photo could look like this:

Screen Shot 2015-10-28 at 11.30.53 AM

😉

 

Happy Halloween!

XO

LQ

 

 

Okay, you guys know I’ll somehow tie this together at the end, so just stay with me.

First of all, the question that I get before every procedure–“when will I look normal again?”—needs to be defined. Are you talking “normal” enough to drive to a Whole Foods in a different neighborhood to pick up more Arnica and a few pre-cooked meals, wearing a scarf, hat and sunglasses so that everyone  thinks you’re trying to look like an incognito movie star but the woman standing next to you on the check-out line can see the bruises under your eyes and thinks, “Oh, yeah, she had something done,” but you don’t care because you’ll never see her again?

Or are you talking about an impromptu reunion with the hottest guy from your Med School class who you haven’t seen for over a decade but just happens to be in town for a meeting and wants to catch up over drinks two weeks after you just had a brow lift and your lower lids done?

Speaking from personal experience, I can answer both questions.

Shortly after opening my practice in Beverly Hills, I had an endoscopic brow lift (with tiny incisions in the hairline ) and fat transposition of my lower eyelids (see earlier post “What can I do about the bags under my eyes?”)

To those of you who don’t live here in La La Land, I know this sounds like a lot of surgery for someone who’s still relatively “young” but really, this wasn’t me being crazy because I’d just moved to Beverly Hills. It was a procedure I’d been thinking about for years (and had been told by several colleagues–not so tactfully–that I could really use.)  Sometimes you look at your parents and the writing’s just on the wall. It’s not aging, it’s genetics and you shouldn’t have to apologize for wanting to fix it. In my case it was those fat bulges under my eyes, and the constant creases across my forehead from trying to keep my eyebrows off my upper lids. The upside was that I saved a lot of money on make-up because there was nowhere to put eyeshadow. Too much Botox in this situation–to get rid of transverse forehead creases on someone who has a short forehead and a low brow–risks making you looking like a Neanderthal:

So I had the procedure done. I had the best doctor in town—Dr. Andrew Frankel, at the Lasky Clinic in Beverly Hills—and I would recommend him to anyone in a second. And everything went swimmingly, except…I am a bruiser. I don’t know if it was the lower lids or the brow lift, but I was scary swollen and bruised for about a month. Like blue-black, can’t-cover-with-professional-makeup bruised. Even with all of the Arnica and Bromelein and Hyperbaric Oxygen Treatments in town.

I believe that for most people, it would be reasonable to expect this kind of swelling and bruising for a week. But everyone responds differently and after my experience, I have to say that if you have an event that you really care about, give yourself at least a month to six weeks after this kind of surgery.

Okay, let’s define “care about”:

I was able to drive and go back to work three days later. Swollen and bruised and looking scary, but my patients were all so intrigued, and full of questions, and I didn’t mind telling them about it because you have to practice what you preach, right?

Don’t care.

One week post-op, while picking up dry cleaning I heard some teenage girls on skateboards say (not even whisper) as I passed them, “That lady had plastic surgery.” I was more upset that they had referred to me as a “lady” than the fact that they had called me out on my surgery.

But, never going to see them again and I don’t know their mothers. So, still don’t care.

Ten days post-op a colleague takes me to a big party for a Craniofacial Surgery Society. For this one I got professional makeup done because I wasn’t really looking forward to sporting my still-very- obvious cosmetic surgery bruises in a room full of male plastic surgeons. I thought the professional makeup was doing the trick, until a couple of hours into it, I caught a glimpse of myself in a mirror and realized that the packed-on concealer under my eyes was there no longer and the bruises were as dark and obvious as ever, and I wasn’t fooling anyone.

Oh, well. They’re not my crowd anyway. Still don’t care.

But then….two and a half weeks after my surgery…pretty much back to my normal routine…My browlift is looking amazing, and the bruising and swelling under my eyes is slowly getting better but still extremely obvious but, what the hell…at this point I’ve given up trying to hide it…and anyway, we’re in Beverly Hills, I’m wearing it all like a badge of honor…and then one day my office manager rips one of those phone message things from the book and hands me my copy and says, “Oh, this Doctor C.M. is coming into town for a meeting this weekend. He said to call him, maybe you guys can get together.”

At this point I am a successful Board-Certified Plastic Surgeon in Beverly Hills. I’ve got it going on. People respect and like me. My patients love me. I’m an accomplished adult.

And yet my first thought is: OMG!!! C.M.? C.M. was by far the cutest guy in my Med school class. I had not seen or spoken to C.M. for fourteen years. I didn’t think he even knew who I was. How did he find me? And did he mean to find me? I had never had another “Suzanne” in a class with me my entire life, until Med school where there were three of us. And as luck would have it, the other two were: 1) a beauty pageant queen from Maryland and 2) a cute-as-a-button girl who went by “Suzie.” Surely C.M. was confused. Surely he thought he was calling one of them.

Then there was the issue of my face. Even after I moved into the Hyperbaric Oxygen chamber for the next two days and tried the professional makeup again, there was no way my face was ready for a reunion with C.M.

He was staying two blocks away, at the Century Plaza Hyatt. I called him and we had a nice chat. We confirmed that he knew exactly which Suzanne he was talking to—that I was not the ex “Miss Maryland” or the darling five-foot-one girl that everyone was always giving piggy back rides to. He’d heard from a friend that I was in L.A. and he didn’t know anyone here and was hoping we could get together. During this conversation I tried to convey how improved I was since Med School. I was a Beverly Hills Plastic Surgeon. I had cool friends and I myself was incredibly cool, so much cooler and improved than when he knew me in fact, that I was not going to be able to meet him this weekend because in a few hours I was leaving to go snowboarding in Mammoth.

To have to lie like that was pure agony. But there was no way I was going to meet C.M. after fourteen years looking like Frankenstein.

My patients and I share stories like this all the time and when I tell this one–even to the women who are settled and married and out of the dating world (as am I!)—they feel my pain as if it were their own. Because no matter what we do as women professionally, when it comes to dating, for some reason the playing field is completely leveled out and when we get really excited about someone, we start acting like we’re in high school again.

On that note, as much as I generally dislike medical TV shows, I can’t help noticing that there are a couple of new ones this fall that resonate with me–“The Mindy Project” on Fox and “Emily Owens, MD” on the CW–about young Bridget-Jonesy female physicians failing miserably in their personal lives despite their successful careers. While the main character in my book, Lipo Queen isn’t bumbling around the hospital, mooning after her colleagues in between saving lives, what makes her interesting is her confidence in the workplace, and lack thereof around men. So I’m curious to tune in, particularly to “Emily Owens, MD,” which has the tag-line “High school in the hospital.” However, I don’t think doctors, with their stunted social development, are the only ones who tend to behave like high schoolers in the workplace. I’m guessing that behind closed doors, the big law firms and business offices are not very different.

If you don’t have a reason to watch it, I’ll give you one:

My husband can make fun of me all he wants, but he’s the one watching Vampire Diaries and asking, “Honey, why aren’t these girls taking their clothes off?” and I have to tell him, “They’re underage, and you’re on the wrong network.”

The show premieres October 16th on the CW, but the pilot is available online. Here’s a link to watch it: http://www.cwtv.com/shows/emily-owens-md 

Check it out! It looks like fun, and a dichotomy (big word for me, I know) that most women can relate to!  But please remember, no matter what those TV doctors say—not all of us plastic surgeons are mean girls. 😉

XO

LQ

We’ve all heard about stem cells. They’re like the millenium’s new “black.” But why, again?

Stem cells are progenitor cells. Think of them as generic cells that can morph into whatever type of cell that surrounds them, as well as enhance the existing cells with extra hormone-type substances—called “growth factors”—that they secrete. There is promising research being done right now that gives us hope that one day adult human stem cells will be used to restore injured tissue after heart attacks, or even spinal cord injuries.

So how did plastic surgeons get involved with something that started out as a potential “magic cure” for heart failure and paralysis?

One of the most exciting discoveries has been that the same fat we’ve been discarding in the hazardous waste containers after liposuction cases (and no, it’s not Fight Club and we don’t make soap with it, as every guy seems to think is the most hilarious question to ask me) is chock full of stem cells. And most of us have at least some of that to spare.

So what does it mean when your surgery is enhanced with your stem cells?

Usually it is a procedure that already involves fat injection. Then it means that your plastic surgeon is additionally using an expensive machine to isolate out an even more concentrated number of stem cells from the fat, and injecting it all back in together wherever the fat is going—usually the face, breasts or buttocks. It also means that you are probably paying extra because the plastic surgeon has to pay off the loan on the machine, and for whatever expensive Google marketing they’re doing to sell their “stem cell” surgeries.

So is it worth the extra money?

There has been promising data regarding the positive effects of fat injection. I have seen it firsthand not only in my “natural breast augmentation” patients, but in cases where it has softened radiated tissue and improved pain and sensation in my breast reconstruction patients. And the science points toward the stem cells and their growth factors as the main reason for this success. However, there is no hard data to prove that isolating out some of the stem cells and then mixing it up with the fat to give you “supercharged stem cell” fat injections is superior to just injecting the fat with its regular stem cell concentration. But the term “Stem Cell” has become as much of a marketing buzz-word as SmartLipo™” did four years ago (See my Smart Lipo post) and this is where it gets confusing.

My main concern has always been whether or not the additional stem cells are helpful in the “take” of the fat in a natural breast augmentation, as this is a procedure that has become a big part of my practice. I have taken an informal poll of the experts at the meetings, and I have found that it is basically a split camp. In general, many of the plastic surgeons in Japan and the ones here in the U.S. who have stock in the stem cell companies like Cytori are huge stem cell advocates. However, I’ve spoken personally with fat-grafting pioneers such as Dr. Gino Rigotti, Dr. Mel Bircoll and Dr. Roger Khouri, all who disagree.

So far I am personally getting great long-term results in my natural breast augmentation patients without supercharging the fat with more stem cells. In fact, one of my first “guinea pigs”  just emailed me some pictures, bragging about how much appreciation her breasts were getting. I believe the direct quote was: “Oh my God, Boobs are so great! They do all the work for you—I don’t even have to open my mouth anymore! I wish I’d done this sooner. When I was younger I used to feel sorry for the girls who had to show off their boobs to get attention, but let me tell you—they were onto something!”

I also did spend a spa day with another one of my first volunteers and although there were no pictures allowed–I can only tell you that she is thrilled and looks amazing; she still weighs 106 pounds and wears a size zero, but she gained two pounds over the holidays and it all went to her boobs.

So could they be better if I used the stem cell machine? Maybe. I have access to stem cell-enhancing technology if the patients want to pay for it, but I don’t feel comfortable pushing it as a “superior” method.

I am a member of both The American Society of Plastic Surgery and The American Society of Aesthetic Plastic Surgeons and the two groups just issued a joint statement, essentially saying that there is not yet any scientific evidence that this expensive extra step of stem-cell enhancement is beneficial.

So what is the take-home message?

If you have been sold a “Stem Cell” procedure, you should understand that what you are getting is fat grafting and while the “stem cell enhancement” may help, there is no proven benefit to the use of additional stem cells in fat transfer. As of now, it is really more a “throwing everything into the pot” approach to getting the fat to take.

XO

LQ

In case you are interested, I have copied and pasted the points made in the ASPS/ASAPS January 2012 advisory statement on “stem cell” surgeries:

“…growing concerns have emerged regarding advertising claims and/or clinical practices using stem cells that have not been substantiated by scientific evidence. These concerns include:

* Use of the term “stem cell” in aesthetic surgery procedures, such as the “stem cell face lift,” with the implication of improved results.

* Claims that skin quality can be improved from stem cell treatments, and that outcomes from fat grafting can be improved with stem cell therapy.

* Widespread marketing, evidenced by a Google web search using the search terms “stem cell face lift” yielding 197,000 results and “stem cell breast augmentation yielding 302,000 results, respectively.

* A lack of consistency in how these procedures are performed and how stem cells are incorporated into the procedures.

* Instructional courses, some “for profit,” that have emerged which are designed to teach methods of stem cell extraction for aesthetic procedures.

* Many procedures being advertised by practitioners who are not board certified plastic surgeons or members of other core specialties with formal training in aesthetic procedures. Such “noncore” practitioners have not been trained in an approved residency program designed to teach the physician safe and careful evaluation of cosmetic patients or a working knowledge of the full range of aesthetic procedures.

* Specialized equipment being marketed to physicians for use in “stem cell procedures.”

* Specialized equipment to extract stem cells, including devices, may fall under FDA regulations. Some devices, including automated machines to separate fat stem cells from fat tissues, are not yet approved for human use in the United States.

* Claims of purifying or activating stem cells through techniques that have not been fully verified and tested for safety and efficacy in current, peer-reviewed medical journals, or claims of improved outcomes as a result of these therapies…”

For the full statement you can go to:

http://www.surgery.org/media/news-releases/asaps-and-asps-issue-joint-position-statement-on-stem-cells-and-fat-grafting