How does the saying go...Imitation is the greatest form of flattery. Well, I guess so.
My office is proud to have been the first in Louisville to introduce lots of things. Here's a partial list:
Plastic Surgery office-based prescription skin care
Computer Imaging
Sciton Contour Profile Laser for facial rejuvenation
Shaped, anatomical tear-drop saline breast implants
"Quick Recovery" Breast Augmentation technique
VASER ultrasonic liposuction
VASER 2.0 High-Definition Liposuction with Fat Transfer
VASER Shape
High-Lateral Tension Abdominoplasty with Circumferential Liposuction
Style 410 form-stable, fully cohesive silicone gel breast implants (Gummi Bear implants)
Sculptra Aesthetic
Extended Deep-plane SMAS facelift
It's a great list, and it speaks to the breadth and scope of practice that my office strives to offer cosmetically inclined patients in our community. I am pleased that as leaders in the field, other offices have watched what we do, and have decided to add many of these facets to their cosmetic practices as well.
When it comes to being the first to offer something meaningful in clinical practice, nothing takes the place of having a thorough understanding of the patients we serve and for truly understanding their needs... for that is what really allows visionaries to provide the products and services of tomorrow that will have lasting relevance in plastic surgery. It's also just as important to be able to weed out the new techniques and technology that just don't stack up, and to vow to offer only new technology - or to stick to the tried and true over what may be newer - because it's the best option for patients.
You can follow trends...or you can set them. I'll bet you can guess which I prefer.
J.
Monday, October 1, 2012
Tuesday, September 18, 2012
VASER Shape Clinical Study...College Road Trips
Summer is over...
School is well underway...
My girls are riding their hearts out...Kaitlyn won 8th place out of a very large division of qualified riders at the American Eventing Championships in Atlanta last weekend, winning 8th place out of over 80 riders from across the country...Go Kaitlyn and Buck! A year and a half ago, her father, trainer and I all offered to trade Buck in on a newer, more forgiving version of horseflesh, but Kaitlyn convinced us there was a "winner in there", and she was determined to get it to come out...so we persisted. Sometimes our kids do have the answers (or maybe it's blind faith), and if we can allow ourselves to follow their wisdom and instinctual desire every now and then, that willingness to let nature take its course (btw...when, in our formative years, do we "learn" to become such control freaks?), sometimes things just seem to work out. Anyway, Buck certainly found his way into just the right teenager's heart...I still think he could easily have ended up in the circus...
Kaitlyn's twin sister Lexie is transitioning toward a higher level eventing horse, and while lovingly finding the will to part with her first "dream horse", is showing us a level of maturity and patience that we hadn't realized she'd even learned.
Even though their father and I have had a full 16 years to prepare for this time...thinking about careers and colleges is here. I love to say it is the time I've been "dreading" since they were born...the day they will leave...but do kids EVER really leave anymore? Anyway, it is an exciting time too, and they are so excited about what lies ahead, so I am trying to get into it as well. Every weekend we go somewhere really cool to think about whether we could really be happy students there and achieve the best we can be, we investigate the "fit", and then we come home again and wonder if it will really all be okay. The family is supposedly coming up with a plan for mom's survival when the girls leave home together...I hope it involves more horsey time for me...
And here in the office we are preparing to begin the first clinical VASER Shape study. The study will begin at the end of October and will hopefully provide more definitive data regarding how the technology works so well, and at the same time, shed new light perhaps on upcoming innovative design change which would further improve results. Many of you may have seen the article in the fall issue of Her Scene this month comparing VASER Shape with CoolSculpting. The reader can form their own opinion, but having had both treatments myself, I can tell you that we are very pleased with our decision to incorporate VASER Shape into our body sculpting options and would make the same decision now regarding which technology to choose...a full 24 months following our original selection date...VASER Shape is still the best noninvasive body contouring technology...results are achieved faster and with fewer treatments (and more comfortably) than any other noninvasive technology. This will be born out by the clinical study, and we hope to have results to share soon. We are still accepting study pateints at this time, so if you know of interested patients, tell them to call us to be included in an upcoming evening informational seminar about study participation.
The office surgical menu is expanding once again...many of you may know that the office has acquired the new VASER 2.0 device, which incorporates improved internal ultrasonic capabilities for liposuction, comfortably performed here in the office setting, while also simultaneously allowing the fat harvested to be immediately available in injectable form to enhance areas such as the face, lips or other muscle groups for enhanced definition (High Def Lipo with fat injection). We also continue to offer eyelid lifts (blepharoplasty) to pateints who would like the convenience and cost savings of having surgery outside the surgery center setting. Inquire about an office consultation if you are interested in our office surgery offerings to see if you would be a candidate!
We are also planning a Holiday Open House for Wednesday December 5th, so stay tuned for more details about that or call Cynthia to be placed on the guest list. We will be showcasing surgical and nonsurgical options for facial rejuvenation, and breast and body contouring enhancement techniques, as well as live demonstrations of popular procedures, including VASER Shape. There will be skin care and injectable product vendors on site, and lots of door prizes and festive refreshments!
Laters followers!
Julene
School is well underway...
My girls are riding their hearts out...Kaitlyn won 8th place out of a very large division of qualified riders at the American Eventing Championships in Atlanta last weekend, winning 8th place out of over 80 riders from across the country...Go Kaitlyn and Buck! A year and a half ago, her father, trainer and I all offered to trade Buck in on a newer, more forgiving version of horseflesh, but Kaitlyn convinced us there was a "winner in there", and she was determined to get it to come out...so we persisted. Sometimes our kids do have the answers (or maybe it's blind faith), and if we can allow ourselves to follow their wisdom and instinctual desire every now and then, that willingness to let nature take its course (btw...when, in our formative years, do we "learn" to become such control freaks?), sometimes things just seem to work out. Anyway, Buck certainly found his way into just the right teenager's heart...I still think he could easily have ended up in the circus...
Kaitlyn's twin sister Lexie is transitioning toward a higher level eventing horse, and while lovingly finding the will to part with her first "dream horse", is showing us a level of maturity and patience that we hadn't realized she'd even learned.
Even though their father and I have had a full 16 years to prepare for this time...thinking about careers and colleges is here. I love to say it is the time I've been "dreading" since they were born...the day they will leave...but do kids EVER really leave anymore? Anyway, it is an exciting time too, and they are so excited about what lies ahead, so I am trying to get into it as well. Every weekend we go somewhere really cool to think about whether we could really be happy students there and achieve the best we can be, we investigate the "fit", and then we come home again and wonder if it will really all be okay. The family is supposedly coming up with a plan for mom's survival when the girls leave home together...I hope it involves more horsey time for me...
And here in the office we are preparing to begin the first clinical VASER Shape study. The study will begin at the end of October and will hopefully provide more definitive data regarding how the technology works so well, and at the same time, shed new light perhaps on upcoming innovative design change which would further improve results. Many of you may have seen the article in the fall issue of Her Scene this month comparing VASER Shape with CoolSculpting. The reader can form their own opinion, but having had both treatments myself, I can tell you that we are very pleased with our decision to incorporate VASER Shape into our body sculpting options and would make the same decision now regarding which technology to choose...a full 24 months following our original selection date...VASER Shape is still the best noninvasive body contouring technology...results are achieved faster and with fewer treatments (and more comfortably) than any other noninvasive technology. This will be born out by the clinical study, and we hope to have results to share soon. We are still accepting study pateints at this time, so if you know of interested patients, tell them to call us to be included in an upcoming evening informational seminar about study participation.
The office surgical menu is expanding once again...many of you may know that the office has acquired the new VASER 2.0 device, which incorporates improved internal ultrasonic capabilities for liposuction, comfortably performed here in the office setting, while also simultaneously allowing the fat harvested to be immediately available in injectable form to enhance areas such as the face, lips or other muscle groups for enhanced definition (High Def Lipo with fat injection). We also continue to offer eyelid lifts (blepharoplasty) to pateints who would like the convenience and cost savings of having surgery outside the surgery center setting. Inquire about an office consultation if you are interested in our office surgery offerings to see if you would be a candidate!
We are also planning a Holiday Open House for Wednesday December 5th, so stay tuned for more details about that or call Cynthia to be placed on the guest list. We will be showcasing surgical and nonsurgical options for facial rejuvenation, and breast and body contouring enhancement techniques, as well as live demonstrations of popular procedures, including VASER Shape. There will be skin care and injectable product vendors on site, and lots of door prizes and festive refreshments!
Laters followers!
Julene
Wednesday, February 1, 2012
Do You Have Cowgirl Smarts? ... Then exercise them!
Hi everyone! I just had a birthday, and a special gift that I received from my dad was a little book called, "Cowgirl Smarts...How to Rope a Kick-Ass Life". I was told by my mother that in a rare "together shopping moment", my dad encouraged my mom to "get this book for Julene", which, mostly to shut him up, my mother did! As fate would have it, this little book of course, turned out to be one of my favorite birthday presents. I haven't had the chance yet to sit down with my sweet father and ask him exactly why it occurred to him that his oldest daughter should have a copy of this book, but I am hoping that, and until I can ask him for clarification I will go on assuming that maybe the reason is that he thinks I might have "cowgirl smarts"...of course, the other alternative is that he thinks I might NEED more "cowgirl smarts"!
This little gem of a book is about Life Lessons obtained from cowgirls who tamed the West, and when you think about it, some of those women had to have been pretty tough and potentially gutsy role models for many generations of women to come. My parents and schoolteachers taught me and inspired me from a young age to believe that I could become whatever I wanted to be in life. They inspired in me a sense of self-confidence that was genderless.
So, for years I believed I could easily become anything or anyone I wanted to be, but as I looked toward the top surgical residencies after medical school, and then for Plastic Surgical residencies after General Surgery residency, I realized that in the "real world" of the career I had chosen, there were not hundreds of women who had gone before me. Where were my female role models? I had chosen a career that, throughout most of my training, was not totally devoid of female physician/surgeon role models, but there were few. I then chose a surgical specialty and residency where I was the 11th female Plastic Surgery resident to complete the program. When I finished Plastic Surgery residency, women represented less than 5 % of practicing board-certified plastic surgeons.
Now, I have never been a true feminist in every respect, but I do think, and as I read this little book I came to wish, that all girls everywhere could make decisions like a cowgirl, and set big goals for themselves like a cowgirl. This little book helps women realize, by reading chapter after chapter, how they might aspire in their lives to find their cowgirl spirit and use it to exercise their sense of freedom and independence in their everyday lives, whether it is spent on the golf course, running for a political office or volunteering for the Peace Corps. The little book documents characteristics in cowgirls of the Wild West by telling stories about the lives of true cowgirls. The author has summarized some of these cowgirl characteristics into a set of unwritten rules that cowgirls lived by for over 100 years, and she calls it The Cowgirl Creed. Here it is...
The Cowgirl Creed
1. Dare to be a cowgirl
2. Buck the rules
3. Stay balanced in the saddle
4. Ride the trail of adventure
5. Dream as big as Texas
6. Be tough, but be feminine
7. Attack life like it's a 1000 lb. steer
8. Saddle your own horse
9. Rein in your fears
10. Dress for success - the cowgirl way
11. Ride high in the saddle
12. Ride high, but stay grounded
13. Give others a leg up
14. Always get back on the horse
15. Ride beside your man
16. Recharge your cowgirl spirit
17. Die with your boots on
I hope you find a way to lasso your cowgirl spirit and think outside the ranch! Like a plaque I have in my kitchen reminds me everyday...Here's to a good woman...may we know them...may we be them...may we raise them.
Happy trails to you, until we meet again!
Julene
This little gem of a book is about Life Lessons obtained from cowgirls who tamed the West, and when you think about it, some of those women had to have been pretty tough and potentially gutsy role models for many generations of women to come. My parents and schoolteachers taught me and inspired me from a young age to believe that I could become whatever I wanted to be in life. They inspired in me a sense of self-confidence that was genderless.
So, for years I believed I could easily become anything or anyone I wanted to be, but as I looked toward the top surgical residencies after medical school, and then for Plastic Surgical residencies after General Surgery residency, I realized that in the "real world" of the career I had chosen, there were not hundreds of women who had gone before me. Where were my female role models? I had chosen a career that, throughout most of my training, was not totally devoid of female physician/surgeon role models, but there were few. I then chose a surgical specialty and residency where I was the 11th female Plastic Surgery resident to complete the program. When I finished Plastic Surgery residency, women represented less than 5 % of practicing board-certified plastic surgeons.
Now, I have never been a true feminist in every respect, but I do think, and as I read this little book I came to wish, that all girls everywhere could make decisions like a cowgirl, and set big goals for themselves like a cowgirl. This little book helps women realize, by reading chapter after chapter, how they might aspire in their lives to find their cowgirl spirit and use it to exercise their sense of freedom and independence in their everyday lives, whether it is spent on the golf course, running for a political office or volunteering for the Peace Corps. The little book documents characteristics in cowgirls of the Wild West by telling stories about the lives of true cowgirls. The author has summarized some of these cowgirl characteristics into a set of unwritten rules that cowgirls lived by for over 100 years, and she calls it The Cowgirl Creed. Here it is...
The Cowgirl Creed
1. Dare to be a cowgirl
2. Buck the rules
3. Stay balanced in the saddle
4. Ride the trail of adventure
5. Dream as big as Texas
6. Be tough, but be feminine
7. Attack life like it's a 1000 lb. steer
8. Saddle your own horse
9. Rein in your fears
10. Dress for success - the cowgirl way
11. Ride high in the saddle
12. Ride high, but stay grounded
13. Give others a leg up
14. Always get back on the horse
15. Ride beside your man
16. Recharge your cowgirl spirit
17. Die with your boots on
I hope you find a way to lasso your cowgirl spirit and think outside the ranch! Like a plaque I have in my kitchen reminds me everyday...Here's to a good woman...may we know them...may we be them...may we raise them.
Happy trails to you, until we meet again!
Julene
Tuesday, December 20, 2011
Here's to Excellent Holidays!
"We are what we repeatedly do. Excellence, therefore, is not an act but a habit."
The Holiday Season is upon us...Happy Hanukah, Merry Christmas and Happy New Year to all of you loyal Sculpt followers! I hope that you all have an excellent holiday season, and enjoy a happy and prosperous New Year. When I was the age my children are now, I think I thought I'd be living in space by the year 2012, or at least travelling there regularly, but here I am still in Kentucky. But it is the holiday season, and I am pretty sure it's no easier to be ready for these holidays on the Moon than it is here on Planet Earth...I'd still have a "List", which is actually how you know I'm really frazzled, as I don't make a List any other time of the year.
Since my List is pretty long, I'll have to keep the Blog short this time, and wish only to make sure everyone knows that I truly appreciate the friendship and loyalty shown by you to myself and my staff this year, and I hope we will see you often in the coming New Year! Thank you for all the cards and gifts this holiday season (especially the chocolate ones), but thank you mostly for the gifts of your friendship and loyalty. I hope we have enriched your lives just a little this year, and we hope that in addition to wonderful time spent with family and friends, that you will find warmth and enjoyment in some of life's "liitle" pleasures this holiday, since it can be a rather hectic time of year. These are a few of the tiny pleasures I enjoyed just this week...
the smile and friendly greeting of a total stranger
the door being held open for me by a handsome young man when he encounterd me...the Bag Lady... dropping it all
Kevin at Tassels who gave my Christmas tree mouth to mouth and a new beginning
a bright starry evening over the horses playing in the pasture
a morning run...rare these days...compliments...Cynthia
the horses looking up and trotting over to me at my first hello
Kona (my horse) really just needed to pass gas and didn't really have colic
Lexie asking for her Mommy upon waking up without wisdom teeth
the smiles on the faces of my beautiful staff at a Christmas dinner in front of the fireplace at Harmony Landing Country Club...their wonderful gifts to me and the girls
lovely cards from friends and family in the mail
the $10 I found in my old jeans (that got a little LOOSER!...compliments Sound Surgical Technologies and VASER Shape)
Kaitlyn's goodnight kiss
my mom and dad's phone calls literally every night this week calling to check on us in a busy week
a random text from my mother in law telling me The Coconut Cake is baked
a lovely dinner evening with my awesomely interesting neighbors
a heartfelt thank you from a patient who could NOT have been feeling very well, but loves me anyway
a friend's email sharing a Bible secret I never knew existed
the pleasure of meeting a delightfully friendly elderly lady who backed up into my front fender in the drive-thru at Wendy's but magically hurt neither of our cars or herself
...and these are just a few!
May you also find excellence all around you this holiday season!
Blessings,
Julene
The Holiday Season is upon us...Happy Hanukah, Merry Christmas and Happy New Year to all of you loyal Sculpt followers! I hope that you all have an excellent holiday season, and enjoy a happy and prosperous New Year. When I was the age my children are now, I think I thought I'd be living in space by the year 2012, or at least travelling there regularly, but here I am still in Kentucky. But it is the holiday season, and I am pretty sure it's no easier to be ready for these holidays on the Moon than it is here on Planet Earth...I'd still have a "List", which is actually how you know I'm really frazzled, as I don't make a List any other time of the year.
Since my List is pretty long, I'll have to keep the Blog short this time, and wish only to make sure everyone knows that I truly appreciate the friendship and loyalty shown by you to myself and my staff this year, and I hope we will see you often in the coming New Year! Thank you for all the cards and gifts this holiday season (especially the chocolate ones), but thank you mostly for the gifts of your friendship and loyalty. I hope we have enriched your lives just a little this year, and we hope that in addition to wonderful time spent with family and friends, that you will find warmth and enjoyment in some of life's "liitle" pleasures this holiday, since it can be a rather hectic time of year. These are a few of the tiny pleasures I enjoyed just this week...
the smile and friendly greeting of a total stranger
the door being held open for me by a handsome young man when he encounterd me...the Bag Lady... dropping it all
Kevin at Tassels who gave my Christmas tree mouth to mouth and a new beginning
a bright starry evening over the horses playing in the pasture
a morning run...rare these days...compliments...Cynthia
the horses looking up and trotting over to me at my first hello
Kona (my horse) really just needed to pass gas and didn't really have colic
Lexie asking for her Mommy upon waking up without wisdom teeth
the smiles on the faces of my beautiful staff at a Christmas dinner in front of the fireplace at Harmony Landing Country Club...their wonderful gifts to me and the girls
lovely cards from friends and family in the mail
the $10 I found in my old jeans (that got a little LOOSER!...compliments Sound Surgical Technologies and VASER Shape)
Kaitlyn's goodnight kiss
my mom and dad's phone calls literally every night this week calling to check on us in a busy week
a random text from my mother in law telling me The Coconut Cake is baked
a lovely dinner evening with my awesomely interesting neighbors
a heartfelt thank you from a patient who could NOT have been feeling very well, but loves me anyway
a friend's email sharing a Bible secret I never knew existed
the pleasure of meeting a delightfully friendly elderly lady who backed up into my front fender in the drive-thru at Wendy's but magically hurt neither of our cars or herself
...and these are just a few!
May you also find excellence all around you this holiday season!
Blessings,
Julene
Monday, October 24, 2011
Imagine...
"Your imagination is your preview of life's coming attractions."
We're blessed to be able to enjoy four really beautiful changes of season here in Kentucky! I sometimes have to stop and remind myself not to let each one pass me by without my taking the time to notice and to enjoy all that an approaching new season has to offer. Each new season is a time of change...change in the landscape and in the nature that surrounds us...changes in the number of daylight hours we have to spend outside...shifting our lives to more time spent indoors...changes in the lives of our loved ones and families...it's a constantly changing world.
My family spent last weekend readying our neighbors' barn and pastures for the arrival of two of our horses for a new winter home, and I realized the change in our lives that this will bring...more early mornings for the girls who will be responsible for the morning feedings now...the beauty we will behold as we watch our beloved boys playing in our neighbors' beautiful pastures through the winter...our children are getting older and learning more responsibilities, and with this will come new challenges and changes for us. (Tom, you're still teaching them to drive, right?)
I personally LOVE change, which may come as a surprise to those who believe that doctors are creatures of habit and hate change. I certainly like the stability of tried and true techniques which lead to predictability of results, and following routines in clinical practice that leave very little room for error or surprises for patients, but when it comes to being creative... for always striving to deliver an even better patient experience...we absolutely MUST leave our minds and hearts open to change. We need to look for ways to answer more of our patients' common needs...deliver better quality of care in more comfortable or affordable ways. This is certainly something I spend considerable time and effort in thinking about, and I enjoy the opportunity to share these ideas with more new patients every week...as well as with many of our older, more established patients in the practice...and I hope that I get the chance to continue to do this for many more years.
Changes we plan for the practice coming up really soon include evolution to electronic records systems, the addition of new non-invasive treatments for rejuvenation of the problematic face and neck, and a new location for the practice next year. We are also hoping to explore new ways of interacting with you to learn more about what issues our patients are facing, and how we might help. Please feel free to contact me or my staff through our website, by calling the office to chat with us, or by suggesting new ideas for the Blog or for upcoming activities you'd like to see us offer!
Please join us this Friday, October 28th for a day of Fall Specials, including 30% off skin care, Botox and Juvederm, 40% off laser procedures, and some fun door prizes and appetizers.
Our Holiday Open House is scheduled for Thursday, December 1, 2011 from 10AM to 4PM and will feature VASER Shape demo's, special holiday discounts on skin care, laser procedures and injectables, and festive appetizers and beverages. Bring a friend!
Hope to see you soon!
Julene
We're blessed to be able to enjoy four really beautiful changes of season here in Kentucky! I sometimes have to stop and remind myself not to let each one pass me by without my taking the time to notice and to enjoy all that an approaching new season has to offer. Each new season is a time of change...change in the landscape and in the nature that surrounds us...changes in the number of daylight hours we have to spend outside...shifting our lives to more time spent indoors...changes in the lives of our loved ones and families...it's a constantly changing world.
My family spent last weekend readying our neighbors' barn and pastures for the arrival of two of our horses for a new winter home, and I realized the change in our lives that this will bring...more early mornings for the girls who will be responsible for the morning feedings now...the beauty we will behold as we watch our beloved boys playing in our neighbors' beautiful pastures through the winter...our children are getting older and learning more responsibilities, and with this will come new challenges and changes for us. (Tom, you're still teaching them to drive, right?)
I personally LOVE change, which may come as a surprise to those who believe that doctors are creatures of habit and hate change. I certainly like the stability of tried and true techniques which lead to predictability of results, and following routines in clinical practice that leave very little room for error or surprises for patients, but when it comes to being creative... for always striving to deliver an even better patient experience...we absolutely MUST leave our minds and hearts open to change. We need to look for ways to answer more of our patients' common needs...deliver better quality of care in more comfortable or affordable ways. This is certainly something I spend considerable time and effort in thinking about, and I enjoy the opportunity to share these ideas with more new patients every week...as well as with many of our older, more established patients in the practice...and I hope that I get the chance to continue to do this for many more years.
Changes we plan for the practice coming up really soon include evolution to electronic records systems, the addition of new non-invasive treatments for rejuvenation of the problematic face and neck, and a new location for the practice next year. We are also hoping to explore new ways of interacting with you to learn more about what issues our patients are facing, and how we might help. Please feel free to contact me or my staff through our website, by calling the office to chat with us, or by suggesting new ideas for the Blog or for upcoming activities you'd like to see us offer!
Please join us this Friday, October 28th for a day of Fall Specials, including 30% off skin care, Botox and Juvederm, 40% off laser procedures, and some fun door prizes and appetizers.
Our Holiday Open House is scheduled for Thursday, December 1, 2011 from 10AM to 4PM and will feature VASER Shape demo's, special holiday discounts on skin care, laser procedures and injectables, and festive appetizers and beverages. Bring a friend!
Hope to see you soon!
Julene
Saturday, September 17, 2011
Fall Specials
Hello to all!
Fall is here, and with it a whole new reason to enjoy some pampering! Now that all of our offspring are back in school, you may have found yourself with just a little extra time for you. Just in case back to school hurt your pocketbook, we have some fall specials to share with you! Check our website for special pricing on skin care, lasers, and injectables...I'm sure your favorites are on the list of things we want you to enjoy this fall.
Not sure about you, but after a summer in the sun, one of my favorite things to catch up on is the BBL and Skin Tyte laser combination to fade sun spots and tighten skin of the face, eyes and neck. This is really one of my all-time favorite treatments because there is no downtime, and no pain. A series of 6 treatments will leave your skin tone more blended and tighter...LOVE IT for the eyes and neck!
I personally use the fall also to do a microlaser peel or ProFractional treatment for smoothing, tightening and fine line control, and will add a hydroquinone product to my nighttime favorite Essential Serum for improving tone, texture, and pigmentation of face and neck. The Holidays are just around the corner, as well as class reunions! Can't be showing up all haggard and worn for events like that, now can we?
For a limited time only, we are including Sculptra on our list of discounted injectables. Sculptra is a fabulous product that creates a tighter look to the face, brows, and jowls. It addresses very well the other part of the facial aging problem (besides laxity due to gravity), and that is restoration of volume lost due to aging. A series of 2 to 3 injections stimulates your body's own collagen deposition to create a tighter look that can last up to 2 years. Check our website for photo results and use the special link to get more information. Call my office, and we will send you a complimentary DVD that fully explains why there is so much "buzz" going on right now about this product!
In addition to the annual fall specials, which are designed to reward our patients for their support throughout the year, we welcome new friends and referrals, so please ask any of my great staff about our patient referral program... and a new VIP Program you will hear more about real soon to reward our most loyal patients.
Lastly, a thought for fall...that season of introspection before winter comes...
"Think of something that would be wonderful, if it were only possible.
Then set out to make it possible."
Armand Hammer
Have a great Fall season!
Julene
Fall is here, and with it a whole new reason to enjoy some pampering! Now that all of our offspring are back in school, you may have found yourself with just a little extra time for you. Just in case back to school hurt your pocketbook, we have some fall specials to share with you! Check our website for special pricing on skin care, lasers, and injectables...I'm sure your favorites are on the list of things we want you to enjoy this fall.
Not sure about you, but after a summer in the sun, one of my favorite things to catch up on is the BBL and Skin Tyte laser combination to fade sun spots and tighten skin of the face, eyes and neck. This is really one of my all-time favorite treatments because there is no downtime, and no pain. A series of 6 treatments will leave your skin tone more blended and tighter...LOVE IT for the eyes and neck!
I personally use the fall also to do a microlaser peel or ProFractional treatment for smoothing, tightening and fine line control, and will add a hydroquinone product to my nighttime favorite Essential Serum for improving tone, texture, and pigmentation of face and neck. The Holidays are just around the corner, as well as class reunions! Can't be showing up all haggard and worn for events like that, now can we?
For a limited time only, we are including Sculptra on our list of discounted injectables. Sculptra is a fabulous product that creates a tighter look to the face, brows, and jowls. It addresses very well the other part of the facial aging problem (besides laxity due to gravity), and that is restoration of volume lost due to aging. A series of 2 to 3 injections stimulates your body's own collagen deposition to create a tighter look that can last up to 2 years. Check our website for photo results and use the special link to get more information. Call my office, and we will send you a complimentary DVD that fully explains why there is so much "buzz" going on right now about this product!
In addition to the annual fall specials, which are designed to reward our patients for their support throughout the year, we welcome new friends and referrals, so please ask any of my great staff about our patient referral program... and a new VIP Program you will hear more about real soon to reward our most loyal patients.
Lastly, a thought for fall...that season of introspection before winter comes...
"Think of something that would be wonderful, if it were only possible.
Then set out to make it possible."
Armand Hammer
Have a great Fall season!
Julene
Wednesday, August 17, 2011
Back to School...and Martha's Vineyard...
Hello all,
A short entry this week to let you in on a secret or two...and I won't make you wait until I get back from Martha's Vineyard to learn of it...(haha)...no, I'm not going to Martha's Vineyard either...the only vineyard I'll be frequenting this month is one that grows in a tall, skinny glass bottle with a cork stuck in it...
This will be an interactive blog, so read on for contest rules!!!
Secret #1: There is a great SCULPTRA special going on in my office right now. Each vial of Sculptra is on sale for a limited time only for $775. each (regularly $900.). See my website or previous blogs regarding Sculptra and why it is clearly my favorite "liquid facelift" option. There is a lot of info on my website and a great link to the Sculptra Aesthetic website for viewing before and after photo's of results. Our office has the most experience in the region using this facial rejuvenative option, so you should call us and inquire. Limited time only on the special pricing!
Secret #2: VASER Shape results are continuing to amaze us and our patients! I just reviewed photo's of our last 20 patients and am truly amazed by these results! Guess I'll be Vasing my thighs again this weekend...there are also some new, very enticing pricing options for patients interested in trying VASER Shape. Call Cynthia, Mindy or Terry in my office for more information, as we are always trying to help patients afford to try this new, non-invasive method of body contouring. It really does a much better job than any other method I've investigated and well worth the money. We are looking forward to some one-on-one time with the chief technological engineer for Sound Surgical Technologies who is coming for a short visit to the Bluegrass state, all the way from Denver, to spend some time with us and a few of our patients, and to discuss with us a new tool that may help to optimize treatment settings for faster results. Stay tuned!
Secret #3: There is a factoid embedded in our new breast augmentation microsite (accessed by going to breastaugmentationky.com) that could win you and your BFF a free VASER Shape treatment. This is a contest, and the first person to email the correct response to Part 1 of the question to me will win a free VASER Shape treatment for themselves. If they also get Part 2 of the question correct, they'll aslo win a free VASER Shape treatment for their BFF! You need to email me with the correct responses before my next blog in order to win!!! So...are you quite ready??? Here's the two part question...
1) What are the manufacturer incentives for patients interested in silicone breast augmentation right now? (BTW, this is the absolute BEST time to have that breast augmentation at Eastpoint Surgery Center...go find the clues...)
2) Which are the most interesting pages on this site: racingpaparazzi.smugmug.com? HINT #1: my girls and I competed in the family division of the Long Run Hounds Club Hunter Pace last weekend, and are very proud of our first place blue ribbon on August 13th! HINT #2: There are 2 pages to peruse the most carefully...
Thanks for being a follower, and have a great Back to School season!
Julene
A short entry this week to let you in on a secret or two...and I won't make you wait until I get back from Martha's Vineyard to learn of it...(haha)...no, I'm not going to Martha's Vineyard either...the only vineyard I'll be frequenting this month is one that grows in a tall, skinny glass bottle with a cork stuck in it...
This will be an interactive blog, so read on for contest rules!!!
Secret #1: There is a great SCULPTRA special going on in my office right now. Each vial of Sculptra is on sale for a limited time only for $775. each (regularly $900.). See my website or previous blogs regarding Sculptra and why it is clearly my favorite "liquid facelift" option. There is a lot of info on my website and a great link to the Sculptra Aesthetic website for viewing before and after photo's of results. Our office has the most experience in the region using this facial rejuvenative option, so you should call us and inquire. Limited time only on the special pricing!
Secret #2: VASER Shape results are continuing to amaze us and our patients! I just reviewed photo's of our last 20 patients and am truly amazed by these results! Guess I'll be Vasing my thighs again this weekend...there are also some new, very enticing pricing options for patients interested in trying VASER Shape. Call Cynthia, Mindy or Terry in my office for more information, as we are always trying to help patients afford to try this new, non-invasive method of body contouring. It really does a much better job than any other method I've investigated and well worth the money. We are looking forward to some one-on-one time with the chief technological engineer for Sound Surgical Technologies who is coming for a short visit to the Bluegrass state, all the way from Denver, to spend some time with us and a few of our patients, and to discuss with us a new tool that may help to optimize treatment settings for faster results. Stay tuned!
Secret #3: There is a factoid embedded in our new breast augmentation microsite (accessed by going to breastaugmentationky.com) that could win you and your BFF a free VASER Shape treatment. This is a contest, and the first person to email the correct response to Part 1 of the question to me will win a free VASER Shape treatment for themselves. If they also get Part 2 of the question correct, they'll aslo win a free VASER Shape treatment for their BFF! You need to email me with the correct responses before my next blog in order to win!!! So...are you quite ready??? Here's the two part question...
1) What are the manufacturer incentives for patients interested in silicone breast augmentation right now? (BTW, this is the absolute BEST time to have that breast augmentation at Eastpoint Surgery Center...go find the clues...)
2) Which are the most interesting pages on this site: racingpaparazzi.smugmug.com? HINT #1: my girls and I competed in the family division of the Long Run Hounds Club Hunter Pace last weekend, and are very proud of our first place blue ribbon on August 13th! HINT #2: There are 2 pages to peruse the most carefully...
Thanks for being a follower, and have a great Back to School season!
Julene
Friday, July 8, 2011
Christmas (for your body)... in JULY!
This is a series of events you don't want to miss! We receive many calls every day regarding VASER Shape...what does it feel like...what can be accomplished with this exciting new technology...how do I find out more about it...to name just a few of the questions my staff field every day. We have begun to offer VASER Shape treatments at a special introductory price of $2600. for four treatments, because we really do believe that the individual's best result with any non-invasive body contouring device is to commit to a series of uniquely designed treatments over time...after all, it's not SURGERY! No non-invasive body shaping technology is able to deliver quite the "one and done" result that surgery typically delivers, but because we do see very nice single treatment results, we have agreed to offer (on a limited basis) introductory small areas of single treatments at the special price of $150.00 for 20 minutes. Although this will not fully contour any single area, we would like for the prospective patient to see the immediate skin tightening we can achieve, and begin to see shrinkage of those problem areas. Most patients will lose one half to one inch after a one hour treatment, and see immediate results in terms of skin tightening, but enter the VASER Shape treatment a bit worried or concerned about how the treatment will feel.
The events we have planned for July 18th and July 20th, here in our office, are designed to share this exciting new technology with our prospective new VASER Shape patients in a friendly, informative and relaxing environment...starting small...gaining knowledge and information...and then proceeding with full treatment packages as a better informed patient.
So call and schedule your appointment for a complimentary VASER Shape consultation and short 20 minute introductory treatment and begin your journey toward a tighter, flatter tummy, or begin to see thighs lose that look of cellulite...ICK!
YES...IT'S REALLY CHRISTMAS IN JULY AT OUR OFFICE!
We will have light appetizers and drinks, and are accepting appointments now for July 18th and 20th. Or, if you are unable to join us this time, ask us for additional dates in August, and we'll add you to the list of upcoming VASER Shape offerings.
Ho Ho Ho, and best regards!
Julene
Friday, June 24, 2011
The "Hidden Costs" of Procedures
This week I have been struck by the growing number of patients who seek my services because of poor surgical results achieved elsewhere. With each passing year, I see a growing number of patients referred to me for revisionary surgery, and the single largest revision procedure requested is breast surgery...augmentations, lifts and reductions. When the need for revision is continued aging of the breast, weight fluctuation, device malfunction, or the patient changed her mind...I understand these as valid reasons for revision...but, when the reason is a poorly planned or executed initial surgical procedure...I fail to understand so well. There was a recent FDA report in Medscape that cited the all-too-true 20 % revision rate seen with breast implant procedures.
Now, let's think about that a moment. There is absolutely no way to prevent the need for SOME breast implant revisions...those revisions due to continued aging of the patient's breasts (these may require reshaping, resizing, or re-lifting), those revisions due to device failures (they are man-made devices), those revisions due to the changing desires of the female patient, those revisions due to the small, unexpected chance of infection or bleeding, and those revisions due to newer, better breast implants that may become available after initial implantation. I get all of those reasons for revision. What I don't get, is the fact that those revisions probably account for less than 5% of all breast implant revisions. The remainder seem to be revisions necessitated due to poor planning of the originating breast implant procedure, poor execution of the surgery, or poor communication with the female patient regarding the intended result. These latter reasons for revision of the original result are to me, the preventable, avoidable reasons for revision, and therefore represent, the "hidden costs" of surgery.
In each and every visit my staff and I have with a future breast implant patient, we touch on the reasons that some patients will have to have their breast surgery revised. In my practice, the revision rate for preventable complications (actually, allcomers) is less than 5%. Yes, we are very proud of that statistic, but it is heartbreaking for us to continue to meet more new patients each year who have NEVER achieved their intended or wished for result after their first breast implant surgery. The costs of the revision surgery plus the original surgery far exceed the cost of a nicely performed single breast augmentation surgery...one that allows the appropriate time for control of surgical factors that, if performed, reduce the need for future revisions. (See a previous blog entry on the "No-Touch Technique of Breast Augmentation")
I have been in a successful breast, face and body contouring practice for 16 years now, and with a strong reputation in this community, I expect to see a certain percentage of revisionary surgical procedures, but the number of revisionary procedures I am now asked to perform has exceeded 30%. This is an astounding statistic to me. I very much enjoy a challenging case, and the results delivered to a patient who feels so appreciative at the conclusion is a great thing to participate in certainly, but it does sadden me when I feel that it wasn't done right to begin with, and that the patient and I should have been able to meet under better cirumstances (perhaps a second plastic surgical cosmetic procedure sought because the first one was so enjoyable!).
My message to any patient seeking a cosmetic procedure - not even just a breast procedure - is do your homework and don't settle for merely the cheapest price...you might actually get what you pay for. A common denominator then, among many of the revision procedures I do is, the patient chose the surgeon based on lowest price, believing all surgical techniques are largely the same. There are so many differences in the way surgeons perform all surgical procedures that I couldn't possible enumerate even some of them here, but with respect to breast augmentation specifically, there are several that bear mentioning. (Again, these are more completely summarized in the blog mentioned above, the "no touch technique" of breast augmentation, which reduce revision rates, but also importantly, reduce recovery times after breast implant surgery). Here are just a few of the most commonly seen errors: implants that are too large for the patient; pockets for the implants that are poorly made; poor choice of device; sloppy, hastily made breast implant pockets; poor attention to sterile technique or control of oozing; poorly chosen surgical facilities that don't lend themselves to a sterile environment, which is so important when placing a prosthetic device; poor communication between surgeon and patient, so that intended results are inadequately discussed and agreed upon; poor attention to detail in the early post-operative period; infrequent patient follow-up, which is necessary to recognize early, fixable problems or asymmetries...and many more.
And it's not just breast augmentation that lends itself to unnecessary revisions...it's also the $9.00/unit Botox, and the steeply discounted fillers and laser procedures. We do occasionally reward our loyal customers in my practice with periodic discounts, but we do so specifically because we recognize that this a tough economy, and we want to make it easier to remain loyal to this practice, and we refuse to sacrifice the quality of the procedure when we discount things. Remember, the only way a practitioner can make up these drastically discounted profits when they are constantly being offered, is via increasing volumes...and when that is the primary reason for ongoing, less periodic, discount rewards, then there can be only less time spent concentrating on the quality measures that reduce revision rates. Hence, the poor result.
Bottom line...be a wise consumer...insist on quality of care...and when you find an office committed to the highest quality that also cosistently exceeds the patient's expectations...STAY THERE!
Have a great summer!
Julene
Now, let's think about that a moment. There is absolutely no way to prevent the need for SOME breast implant revisions...those revisions due to continued aging of the patient's breasts (these may require reshaping, resizing, or re-lifting), those revisions due to device failures (they are man-made devices), those revisions due to the changing desires of the female patient, those revisions due to the small, unexpected chance of infection or bleeding, and those revisions due to newer, better breast implants that may become available after initial implantation. I get all of those reasons for revision. What I don't get, is the fact that those revisions probably account for less than 5% of all breast implant revisions. The remainder seem to be revisions necessitated due to poor planning of the originating breast implant procedure, poor execution of the surgery, or poor communication with the female patient regarding the intended result. These latter reasons for revision of the original result are to me, the preventable, avoidable reasons for revision, and therefore represent, the "hidden costs" of surgery.
In each and every visit my staff and I have with a future breast implant patient, we touch on the reasons that some patients will have to have their breast surgery revised. In my practice, the revision rate for preventable complications (actually, allcomers) is less than 5%. Yes, we are very proud of that statistic, but it is heartbreaking for us to continue to meet more new patients each year who have NEVER achieved their intended or wished for result after their first breast implant surgery. The costs of the revision surgery plus the original surgery far exceed the cost of a nicely performed single breast augmentation surgery...one that allows the appropriate time for control of surgical factors that, if performed, reduce the need for future revisions. (See a previous blog entry on the "No-Touch Technique of Breast Augmentation")
I have been in a successful breast, face and body contouring practice for 16 years now, and with a strong reputation in this community, I expect to see a certain percentage of revisionary surgical procedures, but the number of revisionary procedures I am now asked to perform has exceeded 30%. This is an astounding statistic to me. I very much enjoy a challenging case, and the results delivered to a patient who feels so appreciative at the conclusion is a great thing to participate in certainly, but it does sadden me when I feel that it wasn't done right to begin with, and that the patient and I should have been able to meet under better cirumstances (perhaps a second plastic surgical cosmetic procedure sought because the first one was so enjoyable!).
My message to any patient seeking a cosmetic procedure - not even just a breast procedure - is do your homework and don't settle for merely the cheapest price...you might actually get what you pay for. A common denominator then, among many of the revision procedures I do is, the patient chose the surgeon based on lowest price, believing all surgical techniques are largely the same. There are so many differences in the way surgeons perform all surgical procedures that I couldn't possible enumerate even some of them here, but with respect to breast augmentation specifically, there are several that bear mentioning. (Again, these are more completely summarized in the blog mentioned above, the "no touch technique" of breast augmentation, which reduce revision rates, but also importantly, reduce recovery times after breast implant surgery). Here are just a few of the most commonly seen errors: implants that are too large for the patient; pockets for the implants that are poorly made; poor choice of device; sloppy, hastily made breast implant pockets; poor attention to sterile technique or control of oozing; poorly chosen surgical facilities that don't lend themselves to a sterile environment, which is so important when placing a prosthetic device; poor communication between surgeon and patient, so that intended results are inadequately discussed and agreed upon; poor attention to detail in the early post-operative period; infrequent patient follow-up, which is necessary to recognize early, fixable problems or asymmetries...and many more.
And it's not just breast augmentation that lends itself to unnecessary revisions...it's also the $9.00/unit Botox, and the steeply discounted fillers and laser procedures. We do occasionally reward our loyal customers in my practice with periodic discounts, but we do so specifically because we recognize that this a tough economy, and we want to make it easier to remain loyal to this practice, and we refuse to sacrifice the quality of the procedure when we discount things. Remember, the only way a practitioner can make up these drastically discounted profits when they are constantly being offered, is via increasing volumes...and when that is the primary reason for ongoing, less periodic, discount rewards, then there can be only less time spent concentrating on the quality measures that reduce revision rates. Hence, the poor result.
Bottom line...be a wise consumer...insist on quality of care...and when you find an office committed to the highest quality that also cosistently exceeds the patient's expectations...STAY THERE!
Have a great summer!
Julene
Monday, May 16, 2011
ASAPS in Boston
Hello Friends,
It's spring in Kentucky...or so they tell me...Derby fever has passed, and we're left with rain and allergy season. Post-Derby blues are common around here, so resolve to lift your spirits by getting ready for a new you for summer! A couple of news items first...
ASAPS (The American Society of Aesthetic Plastic Surgeons) convened last week in Boston. The society is composed of approximately 2800 board certified plastic surgeons who primarily perform cosmetic surgery of the face, breast and body in our specialty. The hot topics seemed to be fat transfer and stem cell technology, cosmetic laser facial rejuvenation and fillers, as well as the new non-invasive body contouring devices. As many of you now know, my office was the first to offer the Sciton Contour Profile cosmetic laser for facial rejuvenation and resurfacing, and I have posted a recent blog summarizing the benefits of becoming familiar with our laser menu of options for facial rejuvenation. I also recently blogged about facial injectables, and there are links on my website for viewing patient results with Juvederm, Botox, and Sculptra.
I have recently become very interested in non-invasive body contouring as well, and offered the first such system here in Louisville as of September 2010, Vaser Shape. I think the timing for a non-invasive device in this economy couldn't be better, and non-invasive devices certainly add to excellent treatment options already available in a busy body contouring practice such as mine. However, discerning products that truly work versus those that represent true sales hype is an ongoing challenge for the consumer (and physician consumer too, I might add!). After extensive research regarding other competitive technologies, and after seeing some of the early clinical results presented in Boston, I remain firm in my conviction that ultrasound technology remains the clinical leader at this point...for its versatility, cost effectiveness, deep (as well as skin level) effect and safety. I have contributed to several journals regarding the use of non-focused ultrasound in this respect, as well as have agreed to author several publications which are pending regarding clinical results to date. There is ongoing clinical and animal research, but preliminary results are very promising, and these corroborate the results we are currently seeing in our patients. I am hosting a webinar next month specifically designed for our existing Vaser Shape physician users, so that we may all continue to collaborate to see that our patients are beneficiaries of the ongoing, developing fund of knowledge regarding early treatment parameters.
Additionally, I am happy to inform our patients that we are forming a new partnership with select local businesses... the first to be announced is an upcoming special evening we are hosting with Glasscock Boutique. The event will take place at Glasscock on Thursday May 26, 2011 from 4PM to 8PM, with a portion of the proceeds to benefit The Derby Museum. The evening will offer Botox and Juvederm at special savings, as well as selected skin care products from several lines, and a trunk showing from a selected designer. If you would like to be included on our guest list, just call the office and let one of my staff know.
Stay in touch, and we hope to see you this spring!
Many thanks,
Julene
It's spring in Kentucky...or so they tell me...Derby fever has passed, and we're left with rain and allergy season. Post-Derby blues are common around here, so resolve to lift your spirits by getting ready for a new you for summer! A couple of news items first...
ASAPS (The American Society of Aesthetic Plastic Surgeons) convened last week in Boston. The society is composed of approximately 2800 board certified plastic surgeons who primarily perform cosmetic surgery of the face, breast and body in our specialty. The hot topics seemed to be fat transfer and stem cell technology, cosmetic laser facial rejuvenation and fillers, as well as the new non-invasive body contouring devices. As many of you now know, my office was the first to offer the Sciton Contour Profile cosmetic laser for facial rejuvenation and resurfacing, and I have posted a recent blog summarizing the benefits of becoming familiar with our laser menu of options for facial rejuvenation. I also recently blogged about facial injectables, and there are links on my website for viewing patient results with Juvederm, Botox, and Sculptra.
I have recently become very interested in non-invasive body contouring as well, and offered the first such system here in Louisville as of September 2010, Vaser Shape. I think the timing for a non-invasive device in this economy couldn't be better, and non-invasive devices certainly add to excellent treatment options already available in a busy body contouring practice such as mine. However, discerning products that truly work versus those that represent true sales hype is an ongoing challenge for the consumer (and physician consumer too, I might add!). After extensive research regarding other competitive technologies, and after seeing some of the early clinical results presented in Boston, I remain firm in my conviction that ultrasound technology remains the clinical leader at this point...for its versatility, cost effectiveness, deep (as well as skin level) effect and safety. I have contributed to several journals regarding the use of non-focused ultrasound in this respect, as well as have agreed to author several publications which are pending regarding clinical results to date. There is ongoing clinical and animal research, but preliminary results are very promising, and these corroborate the results we are currently seeing in our patients. I am hosting a webinar next month specifically designed for our existing Vaser Shape physician users, so that we may all continue to collaborate to see that our patients are beneficiaries of the ongoing, developing fund of knowledge regarding early treatment parameters.
Additionally, I am happy to inform our patients that we are forming a new partnership with select local businesses... the first to be announced is an upcoming special evening we are hosting with Glasscock Boutique. The event will take place at Glasscock on Thursday May 26, 2011 from 4PM to 8PM, with a portion of the proceeds to benefit The Derby Museum. The evening will offer Botox and Juvederm at special savings, as well as selected skin care products from several lines, and a trunk showing from a selected designer. If you would like to be included on our guest list, just call the office and let one of my staff know.
Stay in touch, and we hope to see you this spring!
Many thanks,
Julene
Wednesday, March 30, 2011
Vaser Shape in Sydney, Australia
Good da' mate! If you have listed Australia on your bucket list of places to visit...I highly suggest you wait no longer! Thank you to all of the new friends I met during my recent visit...it was a great meeting and a wonderful way to share the US experience with Vaser Shape (Med Contour in other countries) with our Australian colleagues. Bella Media Services (thank you so much Gemma and Michelle!) did an excellent job of coordinating my visit with the Australian fashion and beauty magazine editors (Madison magazine, Cleo, Shop til You Drop, the plasticdiariesblog, thebeauty directory.com, Bella Beauty Magazine and The Plastic Surgery Magazine, Better Homes and Gardens, and Vogue magazine...did I forget anyone?). It was such an enjoyable experience, and an extra big thank you to Donna and Louis from Australian Medical Aesthetics...THE source for Med Contour in Australia. I hope that everyone enjoyed the complimentary treatments, and it was great to meet you all and share our US experience with you. We will look forward to reading the many editorials we know will follow the trip. It is the beginning of autumn in Australia, and I loved the welcoming nature of Australians...the country is absolutely lovely, and Sydney so centralized to the beautiful Blue Mountains, coast, harbor, and all the culture and cuisine offered by a large coastal city. I only wish Cynthia could have allowed me to stay longer, and that my whole family could have joined me. Next time I WILL be found touring the wine country or Gold Coast, surfing on Manley or Bondi beach, and riding horses on Cox's River in the Blue Mountains...as weather and time did not permit those activities this time! During my trip I did find that the clinics I visited, and the results that are being achieved by Donna McNeill, the Australian trainer, are very reflective of the great results we are experiencing here in the US...Med Contour/Vaser Shape really works!!! During my visit, I was able to share our favorite US treatment settings with our Australian colleagues, and we all learned from one another. All of the fashion and beauty magazine editors were very pleased with the immediate results of their treatments, and thought Med Contour was far superior to competitive technologies. I am pleased to report also that more information will be forthcoming regarding further reports on results of the initial 3000 patient treatments from the first 11 Vaser Shape clinical sites here in the US, as I have agreed to serve as lead author on the publication of those results in an upcoming publication. So far, I can tell you this...we are on average, after 4 to 6 treatments in most patients, seeing a loss of 0.5 to 1 inch in the first and each of subsequest treatments, an average of 2 to 4 or more inches lost after 4 treatments, skin tightening in all treated areas by IR imaging, and fat cell contents in the lymphatic system. I have also used Vaser Shape now in several pre-liposuction situations (the fat seems to be more easily mobilized and removed at surgery), as well as in several post-operative patients (tummy tuck and liposuction patients), and find Vaser Shape to be a nice complement to surgery when necessary. Thanks for being a friend to the practice, and stay tuned for more updates. Join us for our next Cocktails and Consults, featuring not only Vaser Shape demonstrations, but also our favorite Sciton Laser facial combinations, and our favorite facial injectables...Juvederm and Sculptra! Join us on April 28th from 4PM to 7PM for this event...RSVP please. Best always, Julene
Tuesday, February 22, 2011
Part III: Winter Skin Tips...Laser Options and Vaser Shape Update
Hello everyone!
It's certainly been a BUSY winter here in our practice! Seems like more than just a few people have taken Part I and Part II of my blog to heart and gotten busy skimming inches off their bellies and thighs with Vaser Shape and Vaser Lipo! (That was Part I of my last blog). Just as an update...we now make HcG injections part of our menu of options for those hoping to trim down before spring and summer. Call my office for more information on this, as we have diet and exercise advice to add to the traditional HcG diet popularized by Dr. Simeon's in the 1950's. For many patients, the metabolic boost provided by HcG injections makes following the diet so much easier...quite simply, I know of no other quicker or safer ways to lose unwanted poundage! (Like many of our patients, surgeons are notoriously interested in quick and immediate results!)
To update our Vaser Shape followers...we have now completed our initial series of 70 patients with at least 4 Vaser Shape treatments each, and Melanie, Rita, Terry and I continue to hone our skills in achieving at least one or two inches of lost circumferential measurement in ALL patients! Most patients are losing an average of 2 to 4 inches in a month without dietary intervention. Some of our patients are using HcG in addition, and although we do not enter their data into our research protocols, they are pleased as they can be!
There are now some exciting results coming in from animal studies which are delineating how well the Vaser Shape non-invasive ultrasound is working to create both skin tightening as well as fat reduction, and I have just submitted some of our patient data for the first publications on Vaser Shape, and will be doing some international speaking regarding results and treatment protocols being developed. I will be hosting a workshop in Sydney, Australia next month, so will hopefully be able to collaborate with other practitioners who are finding clinical success with Vaser Shape around the globe! As always, we are happy to meet with prospective patients either one on one or in group consultation for a discussion of the best Body Contouring options...Vaser Shape or traditional liposuction/tummy tuck via Vaser Lipo. Also, join us for our next Cocktails and Consults, March 3rd from 4PM to 7PM on Vaser Shape and Vaser Lipo. We will have a great local food sponsor, drinks, and our local celebrity patient, Linda Lambert from 102.3 The Max radio station! Other Vaser Shape and Vaser Lipo patients will be there as well, both devices will be on hand, and Chuck Wright, our Sound Surgical representative, will be joining us. During the evening, I will give a presentation followed by live patient Vaser Shape demo's! Call to RSVP!
Now on to Part III of our winter skin tips...
Last blog we covered our favorite skin care products, and each of our staff weighed in with their "must-have" products. This week I wanted to touch on some of our favorite laser procedures for the face, neck, chest and decollatage areas. As many of you know, we own the Sciton Contour Profile laser system which is a uniquely designed device. We designed the laser specs for a device that has the flexibility to treat many skin problems within a single laser system. Since I was the first physician to bring this technology to the Louisville area, my nurses and myself now have over 6 years of experience in skin peels, ProFractional skin tightening, Broadband light treatments for sun damage and brown spots, treatment of visible facial and leg blood vessels and rosacea, and non-invasive skin tightening of the face and neck. I employ two registered nurses to assist with and perform laser treatments every day. We are happy to meet with prospective patients in one on one consultations to design a comprehensive treatment program of laser and skin care products that work together. There is still time before spring and summer to really work on your skin.
One of my favorite no downtime procedures to do all year is a combination Skin Tyte and BBL treatment for sun damage. I am outside all year long riding horses and running and love the pigment control and tightening I receive with a single ST/BBL laser treatment. I recommend a series of 6 treatments a year for patients who want the convenience of a no recovery procedure and who are trying their hardest to either put off the facelift, or who are trying to maintain the results of a facelift. As the laser gently heats the deeper layer of skin (the dermis or collagen layer), it thickens the skin, which makes it tighter and smoother.
For patients who can afford 3 to 5 days of mild swelling and bruising, and who want more visible tightening in a single session, I recommend ProFractional. We can vary the depth of treatment to control both the amount of tightening as well as the recovery period. Since all of these treatments are performed right here in our office, there is no anesthesia or facility fee.
For patients who desire skin smoothing, we like the laser peels. We can do a light or superficial peel or we can do a deeper treatment, depending upon how much recovery time a patient can allow, or how much smoothing they desire in a single treatment. The look of the skin after a peel is either similar to a mild sunburn or, for a deeper treatment, perhaps like a sunburn when the blister has come off. Again, no anesthesia or facility fee. Recovery times are 3 to 7 days, depending upon depth of the peel. This is the treatment we recommend the most frequently for acne scar patients or patients with deeper wrinkles. We can really do a lot of smoothing in a series of 1 to 3 peels for large pores, deep wrinkles or acne scars.
Probably the laser procedure I love the most is the combination laser peel plus ProFractional. Rita and Melanie are way skilled in making patients comfortable for this combination laser treatment, in which we can combine the peel for skin smoothing, and the ProFractional for skin tightening...a winning combination for wrinkles, large pores, pigment problems, and skin that is beginning to become lax or saggy. The face and neck are done together, and again, depth is decided upon after considering what the patient needs, as well as how long they can allow for recovery, usually only slightly longer than each treatment performed alone (ie, days to a week).
Since the Sciton laser uses evaporative/ablative wavelengths of light to effect the magical changes seen in our skin smoothing treatments like the peels, there is no heat involved in a typical peel, and therefore the healing times are much quicker and more comfortable. It is really the heat incorporated in other laser resurfacing treatments which hurts, and creates the significant downtimes with respect to skin redness following the treatments. In certain patients who desire more of a deep treatment, we can provide a bit of oral sedation and do a much deeper treatment, or in select cases (deepest acne scars or wrinkles), we might elect to go to an outpatient surgical facility such as our Eastpoint Surgery Center, to do a deeper laser resurfacing peel under anesthesia. However, most patients prefer to do moderately deeper peels right here in our office, and can do a series of even 3 deep "doctor peels" with me, and still not spend as much money as one deeper operating room peel, and with less recovery time.
So you really can use these bleak winter months to make significant improvements in the quality of your skin! Look over our Blogs, find out what your "hot topics" are, and schedule an appointment to come in and let me, Rita or Melanie put together a treatment package just for you. You might also want to call us or go online and see what "Spring Break specials" Cynthia is putting together right now. Be sure you have an updated email address for us to use to stay connected with the latest our office has to offer! Join us on Facebook or our website for new postings to Blogspot, and contact me personally to suggest new topics for our blog, Sculpt. I will discuss my favorite injectable treatments in an upcoming post.
Here's to a great-looking face for 2011!
Best to you,
Julene
It's certainly been a BUSY winter here in our practice! Seems like more than just a few people have taken Part I and Part II of my blog to heart and gotten busy skimming inches off their bellies and thighs with Vaser Shape and Vaser Lipo! (That was Part I of my last blog). Just as an update...we now make HcG injections part of our menu of options for those hoping to trim down before spring and summer. Call my office for more information on this, as we have diet and exercise advice to add to the traditional HcG diet popularized by Dr. Simeon's in the 1950's. For many patients, the metabolic boost provided by HcG injections makes following the diet so much easier...quite simply, I know of no other quicker or safer ways to lose unwanted poundage! (Like many of our patients, surgeons are notoriously interested in quick and immediate results!)
To update our Vaser Shape followers...we have now completed our initial series of 70 patients with at least 4 Vaser Shape treatments each, and Melanie, Rita, Terry and I continue to hone our skills in achieving at least one or two inches of lost circumferential measurement in ALL patients! Most patients are losing an average of 2 to 4 inches in a month without dietary intervention. Some of our patients are using HcG in addition, and although we do not enter their data into our research protocols, they are pleased as they can be!
There are now some exciting results coming in from animal studies which are delineating how well the Vaser Shape non-invasive ultrasound is working to create both skin tightening as well as fat reduction, and I have just submitted some of our patient data for the first publications on Vaser Shape, and will be doing some international speaking regarding results and treatment protocols being developed. I will be hosting a workshop in Sydney, Australia next month, so will hopefully be able to collaborate with other practitioners who are finding clinical success with Vaser Shape around the globe! As always, we are happy to meet with prospective patients either one on one or in group consultation for a discussion of the best Body Contouring options...Vaser Shape or traditional liposuction/tummy tuck via Vaser Lipo. Also, join us for our next Cocktails and Consults, March 3rd from 4PM to 7PM on Vaser Shape and Vaser Lipo. We will have a great local food sponsor, drinks, and our local celebrity patient, Linda Lambert from 102.3 The Max radio station! Other Vaser Shape and Vaser Lipo patients will be there as well, both devices will be on hand, and Chuck Wright, our Sound Surgical representative, will be joining us. During the evening, I will give a presentation followed by live patient Vaser Shape demo's! Call to RSVP!
Now on to Part III of our winter skin tips...
Last blog we covered our favorite skin care products, and each of our staff weighed in with their "must-have" products. This week I wanted to touch on some of our favorite laser procedures for the face, neck, chest and decollatage areas. As many of you know, we own the Sciton Contour Profile laser system which is a uniquely designed device. We designed the laser specs for a device that has the flexibility to treat many skin problems within a single laser system. Since I was the first physician to bring this technology to the Louisville area, my nurses and myself now have over 6 years of experience in skin peels, ProFractional skin tightening, Broadband light treatments for sun damage and brown spots, treatment of visible facial and leg blood vessels and rosacea, and non-invasive skin tightening of the face and neck. I employ two registered nurses to assist with and perform laser treatments every day. We are happy to meet with prospective patients in one on one consultations to design a comprehensive treatment program of laser and skin care products that work together. There is still time before spring and summer to really work on your skin.
One of my favorite no downtime procedures to do all year is a combination Skin Tyte and BBL treatment for sun damage. I am outside all year long riding horses and running and love the pigment control and tightening I receive with a single ST/BBL laser treatment. I recommend a series of 6 treatments a year for patients who want the convenience of a no recovery procedure and who are trying their hardest to either put off the facelift, or who are trying to maintain the results of a facelift. As the laser gently heats the deeper layer of skin (the dermis or collagen layer), it thickens the skin, which makes it tighter and smoother.
For patients who can afford 3 to 5 days of mild swelling and bruising, and who want more visible tightening in a single session, I recommend ProFractional. We can vary the depth of treatment to control both the amount of tightening as well as the recovery period. Since all of these treatments are performed right here in our office, there is no anesthesia or facility fee.
For patients who desire skin smoothing, we like the laser peels. We can do a light or superficial peel or we can do a deeper treatment, depending upon how much recovery time a patient can allow, or how much smoothing they desire in a single treatment. The look of the skin after a peel is either similar to a mild sunburn or, for a deeper treatment, perhaps like a sunburn when the blister has come off. Again, no anesthesia or facility fee. Recovery times are 3 to 7 days, depending upon depth of the peel. This is the treatment we recommend the most frequently for acne scar patients or patients with deeper wrinkles. We can really do a lot of smoothing in a series of 1 to 3 peels for large pores, deep wrinkles or acne scars.
Probably the laser procedure I love the most is the combination laser peel plus ProFractional. Rita and Melanie are way skilled in making patients comfortable for this combination laser treatment, in which we can combine the peel for skin smoothing, and the ProFractional for skin tightening...a winning combination for wrinkles, large pores, pigment problems, and skin that is beginning to become lax or saggy. The face and neck are done together, and again, depth is decided upon after considering what the patient needs, as well as how long they can allow for recovery, usually only slightly longer than each treatment performed alone (ie, days to a week).
Since the Sciton laser uses evaporative/ablative wavelengths of light to effect the magical changes seen in our skin smoothing treatments like the peels, there is no heat involved in a typical peel, and therefore the healing times are much quicker and more comfortable. It is really the heat incorporated in other laser resurfacing treatments which hurts, and creates the significant downtimes with respect to skin redness following the treatments. In certain patients who desire more of a deep treatment, we can provide a bit of oral sedation and do a much deeper treatment, or in select cases (deepest acne scars or wrinkles), we might elect to go to an outpatient surgical facility such as our Eastpoint Surgery Center, to do a deeper laser resurfacing peel under anesthesia. However, most patients prefer to do moderately deeper peels right here in our office, and can do a series of even 3 deep "doctor peels" with me, and still not spend as much money as one deeper operating room peel, and with less recovery time.
So you really can use these bleak winter months to make significant improvements in the quality of your skin! Look over our Blogs, find out what your "hot topics" are, and schedule an appointment to come in and let me, Rita or Melanie put together a treatment package just for you. You might also want to call us or go online and see what "Spring Break specials" Cynthia is putting together right now. Be sure you have an updated email address for us to use to stay connected with the latest our office has to offer! Join us on Facebook or our website for new postings to Blogspot, and contact me personally to suggest new topics for our blog, Sculpt. I will discuss my favorite injectable treatments in an upcoming post.
Here's to a great-looking face for 2011!
Best to you,
Julene
Sunday, December 19, 2010
Winter Skin Survival Guide
Hi friends!
By now, your skin has started to reflect the harshness of the change in climate, and once the bit of color from summer fades, we sometimes see all kinds of "badness". Even those of us who try our best to protect our faces from summer's rays, know that we have a bit of a glow after summer's end that can hide some common skin problems. Plus, the naturally paler color of winter skin can expose common pigmentary problems, large pores and fine lines. Our skin is drier due to less humidity in the air and the colder air and winds of winter. Bottom line...winter is typically the perfect time to correct hyperpigmentation, provide hydration and smoothing, and to more deeply correct the signs of aging, which are all more noticeable during the winter.
I have asked my wonderful staff to list some of their favorite skin care products, and they are found below..."Staff picks"!!! Enjoy the list, and as always feel free to ask us about any skin care advice specific to your needs.
CLEANSERS:
CYNTHIA...lists Dermesse Sugar Scrub among her favorite cleansers. She uses it every day, and who wouldn't want skin like hers...porcelain, I call it! For face, she likes Dermesse Creme Cleanser, especially after laser or chemical peels.
MELANIE, JULENE AND RITA...like Dermesse Cleanser Gel for the refreshing feel it gives oily skin.
TONERS:
CYNTHIA...likes SkinCeutical's Revitalizing Toner for its nice cucumber extract scent (which is a natural emollient with calming, soothing agents - maybe that's why she is so unflappable), as well as its lavendar oil (which is anti-inflammatory, antiseptic, and anti-bacterial). She says, "it also contains horsetail, which speeds connective tissue repair...hee haw!" (never mind that's a noise a donkey makes, not a beautiful horse, Cynthia)
MELANIE, JULENE AND RITA...seem to be in agreement again, that we like Dermesse Toner. It leaves a refreshed feel to the skin and is carefully pH-balanced with the cleanser to set the stage for easier absorption of the corrective products apllied later. It also closes pores to prevent some of the day's damage and helps to control breakouts.
BLEACHING AGENT:
CYNTHIA, JULENE, MELANIE AND RITA...we all apparently agree, hands down, that Neocutis' product for hyperpigmentation, Blanche, is the best. It works to fade brown spots, hyperpigmentation and melasma from a unique combination of ingredients, including 4% Hydroquinone and Melaplex. Also, as Cynthia points out...it is formulated with anti-oxidants and hydrates the skin with shea butter and jojoba oil, is steroid free, fragrance free, and non-comedogenic. If you have an intolerance to hydroquinone, like I do, then Kojic acid is a great substitute and can be found in SkinCeuticals' Phyto Plus. OR...the alternative to a topical for hyperpigmentation is of course to use the laser (Sciton, of course)- for this we would recommend a series of treatments with BBL (broadband light).
EXFOLIATING AGENTS:
CYNTHIA and JULENE...SkinCeuticals' Retexturizing Activator, used morning and night, improves texture and tone by stimulating enzymes that promote desquamation while hydrating the skin via hyaluronic acid and Kombuchka (say THAT 3 times after a Cocktails and Consults evening) to promote its natural barrier functions. It basically smoothes, resurfaces and moisturizes skin, all at the same time! Cynthia says, "This product is UNBELIEVABLE, and I like to use it every day as well as right before a laser or chemical peel."
MELANIE and JULENE...Dermesse Exfoliator, which contains a unique blend of alpha-hydroxy acids, gently smoothes skin and is available in 2 strengths.
RITA...likes Dermesse Sugar Scrub for body, and the Dermesse Exfoliator for face.
SKIN SMOOTHING AGENTS:
CYNTHIA...likes NIA 24's Skin Strengthening Complex Repair Cream, because it has the Pro-Niacin to strengthen the barrier function of skin, as well as vit A to improve texture and elasticity, anti-oxidants green tea and rosemary, and ceramides, evening primrose and wheat germ oil to moisturize the skin. Phew. CYNTHIA and JULENE like SkinCeuticals' A.G.E. Interruptor and A.G.E. Eye Cream (at night only) due to their ability to improve the creping and thinning of our "mature" skin due to an aging process in older skin called glycation, when excess glucose molecules cause collagen and elastin fibers to stick together leading to the formation of Advanced Glycation End-products (A.G.E.) ie, bad things, which cause wrinkles, ick. Also, we both like Neocutis' product Lumiere for eyes, which contains Swiss technology growth factors and proteins specifically well-suited for smoothing the delicate eye area. It also contains hyaluronic acid, which is a natural hydrating agent.
YOUNG MELANIE...thinks her skin never looks smoother and pores smaller than when she uses a combination of Dermesse Cleanser Gel, Toner and Exfoliator!
RITA and JULENE...say "Retin A baby!!!" A longtime favorite skin smoothing agent is good old retin A. Many patients find its precursor, retinol, available in different strengths, to be easier and less drying to use, but you can't argue either's effects of deep penetration to the dermal layer where wrinkles begin.
***special note to self...for the fastest skin smoothing known in these parts, the Sciton laser is a quick way to smoothe skin utilizing laser peels and profractional treatments, alone or in combination! (Stay tuned for my next blog)
SUN DAMAGE AND DNA REPAIR:
CYNTHIA, JULENE, MELANIE and RITA...we all seem to agree on this one, Nia 24 Sun Damage Repair is a nutrient-rich cream that delivers intense moisture while it improves the appearance of photo-damage on the decolletage, shoulders and hands. As Rita says, results are seen very quickly and within 6 weeks! This product works very well in combination with our laser packages to visibly add to results (when used between laser treatments).
***special note to self...one of the nicest things to add to a good home skin care program, is to work in a couple laser resurfacing treatments a year to slowly eliminate the sun damaged layers
SUNPROTECTION AND SUNBLOCKS:
CYNTHIA...likes CE Ferulic Serum in conjunction with either Dermesse or Nia 24's Mineral Sunscreens.
JULENE...likes Dermesse Sunblock SPF 30.
MELANIE...likes SkinCeuticals' SPF 50.
RITA...likes Nia 24 also, because it is not oily and it absorbs instantly.
MOISTURIZERS:
CYNTHIA and JULENE...love the combination of SkinCeuticals' Hydrating B5 Gel and masque, because they contain hyaluronic acid, the body's natural hydrator, to bind moisture to the skin. It is often used along with vit C treatments, and is oil-free.
***note to self...if one can improve the overall health of the skin over time, it really will need less topical moisturization, so most moisturizers will only need to be used in the dead of winter when nature's elements are most harsh!
There you have it! The experts have spoken! But, always after that ONE FAVORITE recommendation, for those of us on a budget who want just a few really good products, I asked each of my staff what single product for each area would they go back into a burning building to save (if they knew they could still get out alive, and the family and household pet were already safe!), and here is what it distilled down to...
for FACE:
CYNTHIA...Phloretin CF is her all-time favorite because it is a serum, it is both preventive as well as corrective, and as an anti-oxidant, it helps to prevent and correct the aging process by supporting elastin and collagen synthesis, while increasing cell turnover, thus giving her skin its radiance and firmness (did you know she's really 75?) Cynthia uses it at night, and notes that it also contains vit C to help with inflammation and in prevention of skin cancer.
JULENE...realizes that although it is expensive, like Loreal says, "it's worth it!" I absolutely LOVE Skin Medica's TNS Essential Serum. I can tell the next morning if I've used it or not, because of the smooth, glowing look it gives my skin. Really. It contains the renowned growth factor formula TNS Recovery Complex in one chamber and APS Corrective Complex (a potent mixture of anti-oxidants and peptides) in the other. The combination - and it comes out together in one expensive little clump of liquid gold - has been clinically proven to improve tone, texture and elasticity, and to work on brown spots and wrinkles, as well as to tighten skin and help it regenerate and protect itself. What else is left to fix? Although this is my all-time favorite single nighttime product, I love mixing it up and using a good serum or cream several nights a week, like Neocutis Bio-Gel, Bio-Serum, or Hyalis, or SkinCeuticals' A.G.E. Inrerrupter. And yes, my cosmetics closet looks like a pharmacy lab.
MELANIE...is a big fan of Dermesse Exfoliator, and says she has man-eating pores the night after she forgets to use it!
RITA...stands by A.G.E. She likes the A.G.E. Interrupter, A.G.E. Retexturizing Activator, and A.G.E. Eye Cream the best.
for the EYES:
CYNTHIA ...A.G.E. Eye Cream AM and PM. She likes the fact that it is good for menopausal skin and that it contains blueberry extract to help prevent future wrinkles in the very thin eyelid skin. (But won't we sell less Botox Cynthia? How can that be good?)
JULENE...likes a serum under make-up for daytime use and a cream at night for extra moisturization, so I like Skin Medica's Uplifting Eye Serum in the morning. RITA likes this too, because it is not oily, and because one tiny drop will take care of both under eye areas, so it lasts a long time. I like either Neocutis' Lumiere at night or SkinCeuticals' A.G.E. Eye Cream.
MELANIE...likes Skin Medica's Eye Repair Cream the best, because it begins to work immediately, and she sees fewer fine lines as early as the next day.
for the NECK:
CYNTHIA...likes Neocutis' Bio-restorative Hydrogel with PSP (processed skin proteins), or Bio-Gel, because it restores a refreshed appearance to aged, stressed skin.
JULENE...likes Neocutis' Bio-restorative Skin Cream (Bio-Cream)) with PSP, for the same reasons, but I just like a cream on the neck rather than a gel, because I think it hydrates better, and lasts longer.
MELANIE...likes SkinCeuticals' A.G.E. Interrupter, because it is not oily and feels like silk! It works very well to diminish fine lines and wrinkles.
RITA...likes
A.G.E. Interrupter. (She didn't say why, so I guess you'll just have to ask her. She is a woman of few words SOMEtimes.)
A.G.E. Interrupter. (She didn't say why, so I guess you'll just have to ask her. She is a woman of few words SOMEtimes.) Lastly, I asked the girls to comment on any category I forgot, and Cynthia mentioned the wisdom of a good old skin peel periodically. I think this is a very good alternative for those who do not desire the downtime of a facial laser procedure, or the cost. Although the laser procedures go deeper, the 3 minute Skin Medica Peel is great. It can be modified to be either an Illuminize Peel, a Vitalize Peel, or a Rejuvenize Peel, depending upon the strength of the acid chosen and the depth of penetration. A peel can be formulated to produce varying degrees of exfoliation based on each patient's individual needs, but works on tone, texture, acne, hyperpigmentation, melasma, large pores, fine lines and wrinkles.
Call us with questions!
Ho Ho Ho and Fa La La! Have a wonderful holiday season full of blessings everyone!
Julene, Cynthia, Melanie and Rita
Tuesday, November 23, 2010
Tips for Surviving the Holidays (and that dreaded "Winter Skin")
Happy Thanksgiving everyone!
I am beginning Part I (of III) today... we will have a discussion involving my personal tips for surviving the holidays (how to improve our bodies and weight management tips), and then I also plan to provide tips on how to use the winter months to work on problem skin, to treat existing problems, but also tips on how to take a more proactive stance on anti-aging. I do not have all the answers, mind you, but I certainly have opinions, and isn't that what blogging is all about Tommy, honey? I get to express my opinions to whoever wants to listen!
As always, feel free to call us for some personal recommendations on anything that suits your fancy. We are hosting another "Cocktails and Consults" here at the office on Friday December 10th, from 10AM to 6PM, during which a portion of our proceeds on services rendered or purchased that day will go to Support The Boys' Haven. Join us for drinks, appetizers and some live talks and demonstrations on Botox, Juvederm, Sculptra and Vaser Shape. We will have special pricing that day on skin care and injectable products, as well as laser services... and it will help a really good cause. Angela Ariatti is helping us to organize the day's events, and is our Boys' Haven sponsor. (She is also Lexie and Kaitlyn's riding instructor and incredible female role model/mentor, ie., "life coach").
The most important things to remember when re-evaluating body proportion and "problem areas", is to do your best to be patient with yourself, and to be realistic as you reset your goals. We can all make some level of improvement in our physical fitness, but a balanced program is required. Diet, exercise, reasonable goals and a real commitment (and sometimes, intervention, surgical or otherwise) are necessary. I am a physician and a plastic surgeon, not a dietician, nutritionist or fitness instructor. I do however, care about my fitness , have done a fair bit of reading and research over the years with respect to diets and exercise disciplines, and have a large experience with different techniques myself on a personal level, and consider my medical background and training to be a sound base for the evaluation and interpretation of various methods of staying fit. Coupled with the fact that I have a significant surgical experience in treating and caring for patients - men and women - who care about their physiques as they age, I think I am at least able to render some sound advice on this subject. So...here are my thoughts, for what they are worth...
After menopause, or even in the pre-menopause or "perimenopausal years", there is no doubt about it...hormonal fluctuation and decreased metabolic rate are all contributing factors to the slow, steady weight gain many women experience, so that despite sometimes our best attempts to stay lean, we are undone. Finding an exercise program that is truly enjoyable to you is often the key to the next challenge, which is finding the time to work it into a busy schedule. I like to run and bike and ride horses...all of which I like (or must) do outdoors. Although I have a treadmill and elliptical trainer, I much prefer to be outside, so I use these devices mostly in the winter months. Although I think the commitment provided by working out with a trainer is wonderful, motivational and ensures that the proper change and flexibility of varying a workout routine is adhered to, I simply find my schedule too restrictive and inflexible to allow me the luxury of a regular workout with a trainer. (Not to mention the cost involved with finding a good trainer and the typical gym membership.) In recent years, my husband and I have just found it more time-efficient and doable for our schedules to buy a bit of workout equipment to keep at home so that we can work out whenever we want. In addition to our treadmill, elliptical and bike trainer, we have some free weights, and I recently purchased the P90X DVDs to firm up "softer" :-) areas this winter. Basically, any regimen that incorporates some aerobic conditioning and training with resistance training using weights or bands will work, and you don't have to spend a lot of money on a home gym. Aerobic training that is consistent and maintained at a certain heart rate level for a sustained 30 to 45 minutes 4 to 5 days a week will improve fitness. Much less than that will probably only help you maintain a certain fitness level, rather than improve fitness.
In addition to the proper work out plan, of course one must add a smart diet. Having read all of the diets my patients routinely ask me about, like...The South Beach Diet, Sugar Busters, The Zone, Atkins, etc...I think of things rather simplistically as follows: If calories taken in exceeds calories out, those extra calories will be stored as fat. If we eat the wrong kinds of carbs, they work just like sugar. Most women are fairly protein-deficient and need to eat more lean meat. The best proportion of food calories consumed is about 30% fat, 40% carbohydrate, and 30% protein. When you eat (in relation to the calories you burn that day) is as important as what you eat. Certain types of work out or training periods may change the recommendation of the above things a bit, but in general, these seem to be sound principles. So what I try to do is eat small frequent meals (around 450 cal per snack or meal 6 times a day, or a larger meal earlier in the day with fewer snacks) so that I can burn more easily the calories consumed, try to eat more lean meat and "good carb" vegies, limit sugary foods, consider the rule of portion size (palm of hand size), and not eat after 8PM. I love what is taught in The Zone...that food really is a "drug" that we put in our systems every day, that the food we eat regulates the hormones insulin and glucagon to regulate glucose metabolism and fat storage, and that if we want to better utilize (rather than store as fat) the calories we consume, we must eat to stay in "the zone", where our body's glucose levels stay fairly constant, we are utilizing the calories we are consuming, there are not large rises and falls in sugar levels which then cause us to store the excess glucose as fat, and we maintain a stable glucagon and insulin milieu (and therefore, stabilize weight). If it is weight loss we are after, then we MUST consume fewer calories than we utilize, and to avoid muscle loss, that means combining calorie restriction with exercise. Although I learned this from every trainer I have ever known, and I still believe this to be the best way to achieve longterm successful weight loss and improved fitness, I would also say that I now believe that sometimes (especially after the onset of those menopauseal years), that I do see the value of jump-starting one's slowing metabolism, via alternative means.
We have recently begun to offer short courses of metabolic supplements to some of our surgical and nonsurgical body contouring patients who are trying to achieve timely weight loss in order to enhance results seen with both Vaser Shape, a nonsurgical method of body contouring now available in my office (see my website or previous Blogs) and Vaser Lipo (operative liposuction). We would be happy to evaluate anyone who wants to hear more about HcG injections or sublingual drops in this context. I do believe that patients who can "reset" their metabolic rates with these supplements will be more likely to maintain results they achieve with (Vaser Lipo) or without surgery (Vaser Shape).
The bottom line is that it is really exciting to get to assist patients with their body change goals in a very holistic manner, because as a woman who is also a plastic surgeon, I can help my patients with diet and exercise recommendations, with metabolic supplements and weight management tips, as well as meaningful interventional techniques, ie, Vaser Shape (non-surgical ultrasound body contouring), and Vaser Lipo (surgical liposuction, with or without tummy tucks or lifts).
As always, we welcome the opportunity to design a plan specific to each patient's needs.
Happy Thanksgiving! (eat more turkey than mashed potatoes)
Julene
I am beginning Part I (of III) today... we will have a discussion involving my personal tips for surviving the holidays (how to improve our bodies and weight management tips), and then I also plan to provide tips on how to use the winter months to work on problem skin, to treat existing problems, but also tips on how to take a more proactive stance on anti-aging. I do not have all the answers, mind you, but I certainly have opinions, and isn't that what blogging is all about Tommy, honey? I get to express my opinions to whoever wants to listen!
As always, feel free to call us for some personal recommendations on anything that suits your fancy. We are hosting another "Cocktails and Consults" here at the office on Friday December 10th, from 10AM to 6PM, during which a portion of our proceeds on services rendered or purchased that day will go to Support The Boys' Haven. Join us for drinks, appetizers and some live talks and demonstrations on Botox, Juvederm, Sculptra and Vaser Shape. We will have special pricing that day on skin care and injectable products, as well as laser services... and it will help a really good cause. Angela Ariatti is helping us to organize the day's events, and is our Boys' Haven sponsor. (She is also Lexie and Kaitlyn's riding instructor and incredible female role model/mentor, ie., "life coach").
The most important things to remember when re-evaluating body proportion and "problem areas", is to do your best to be patient with yourself, and to be realistic as you reset your goals. We can all make some level of improvement in our physical fitness, but a balanced program is required. Diet, exercise, reasonable goals and a real commitment (and sometimes, intervention, surgical or otherwise) are necessary. I am a physician and a plastic surgeon, not a dietician, nutritionist or fitness instructor. I do however, care about my fitness , have done a fair bit of reading and research over the years with respect to diets and exercise disciplines, and have a large experience with different techniques myself on a personal level, and consider my medical background and training to be a sound base for the evaluation and interpretation of various methods of staying fit. Coupled with the fact that I have a significant surgical experience in treating and caring for patients - men and women - who care about their physiques as they age, I think I am at least able to render some sound advice on this subject. So...here are my thoughts, for what they are worth...
After menopause, or even in the pre-menopause or "perimenopausal years", there is no doubt about it...hormonal fluctuation and decreased metabolic rate are all contributing factors to the slow, steady weight gain many women experience, so that despite sometimes our best attempts to stay lean, we are undone. Finding an exercise program that is truly enjoyable to you is often the key to the next challenge, which is finding the time to work it into a busy schedule. I like to run and bike and ride horses...all of which I like (or must) do outdoors. Although I have a treadmill and elliptical trainer, I much prefer to be outside, so I use these devices mostly in the winter months. Although I think the commitment provided by working out with a trainer is wonderful, motivational and ensures that the proper change and flexibility of varying a workout routine is adhered to, I simply find my schedule too restrictive and inflexible to allow me the luxury of a regular workout with a trainer. (Not to mention the cost involved with finding a good trainer and the typical gym membership.) In recent years, my husband and I have just found it more time-efficient and doable for our schedules to buy a bit of workout equipment to keep at home so that we can work out whenever we want. In addition to our treadmill, elliptical and bike trainer, we have some free weights, and I recently purchased the P90X DVDs to firm up "softer" :-) areas this winter. Basically, any regimen that incorporates some aerobic conditioning and training with resistance training using weights or bands will work, and you don't have to spend a lot of money on a home gym. Aerobic training that is consistent and maintained at a certain heart rate level for a sustained 30 to 45 minutes 4 to 5 days a week will improve fitness. Much less than that will probably only help you maintain a certain fitness level, rather than improve fitness.
In addition to the proper work out plan, of course one must add a smart diet. Having read all of the diets my patients routinely ask me about, like...The South Beach Diet, Sugar Busters, The Zone, Atkins, etc...I think of things rather simplistically as follows: If calories taken in exceeds calories out, those extra calories will be stored as fat. If we eat the wrong kinds of carbs, they work just like sugar. Most women are fairly protein-deficient and need to eat more lean meat. The best proportion of food calories consumed is about 30% fat, 40% carbohydrate, and 30% protein. When you eat (in relation to the calories you burn that day) is as important as what you eat. Certain types of work out or training periods may change the recommendation of the above things a bit, but in general, these seem to be sound principles. So what I try to do is eat small frequent meals (around 450 cal per snack or meal 6 times a day, or a larger meal earlier in the day with fewer snacks) so that I can burn more easily the calories consumed, try to eat more lean meat and "good carb" vegies, limit sugary foods, consider the rule of portion size (palm of hand size), and not eat after 8PM. I love what is taught in The Zone...that food really is a "drug" that we put in our systems every day, that the food we eat regulates the hormones insulin and glucagon to regulate glucose metabolism and fat storage, and that if we want to better utilize (rather than store as fat) the calories we consume, we must eat to stay in "the zone", where our body's glucose levels stay fairly constant, we are utilizing the calories we are consuming, there are not large rises and falls in sugar levels which then cause us to store the excess glucose as fat, and we maintain a stable glucagon and insulin milieu (and therefore, stabilize weight). If it is weight loss we are after, then we MUST consume fewer calories than we utilize, and to avoid muscle loss, that means combining calorie restriction with exercise. Although I learned this from every trainer I have ever known, and I still believe this to be the best way to achieve longterm successful weight loss and improved fitness, I would also say that I now believe that sometimes (especially after the onset of those menopauseal years), that I do see the value of jump-starting one's slowing metabolism, via alternative means.
We have recently begun to offer short courses of metabolic supplements to some of our surgical and nonsurgical body contouring patients who are trying to achieve timely weight loss in order to enhance results seen with both Vaser Shape, a nonsurgical method of body contouring now available in my office (see my website or previous Blogs) and Vaser Lipo (operative liposuction). We would be happy to evaluate anyone who wants to hear more about HcG injections or sublingual drops in this context. I do believe that patients who can "reset" their metabolic rates with these supplements will be more likely to maintain results they achieve with (Vaser Lipo) or without surgery (Vaser Shape).
The bottom line is that it is really exciting to get to assist patients with their body change goals in a very holistic manner, because as a woman who is also a plastic surgeon, I can help my patients with diet and exercise recommendations, with metabolic supplements and weight management tips, as well as meaningful interventional techniques, ie, Vaser Shape (non-surgical ultrasound body contouring), and Vaser Lipo (surgical liposuction, with or without tummy tucks or lifts).
As always, we welcome the opportunity to design a plan specific to each patient's needs.
Happy Thanksgiving! (eat more turkey than mashed potatoes)
Julene
Tuesday, November 9, 2010
Perseverance...
I took my twins to a 3 day horse trial last weekend outside of Knoxville in the Smoky Mountains. They both compete in the sport of "eventing", which is a 2 or 3 day horse trial encompassing the elements of dressage, stadium jumping and cross-country jumping. All 3 phases of riding are scored, and the order of finishing places is determined by the lowest penalty scores after all 3 phases of riding are completed. Usually, 2 of the 3 phases of the riding are accomplished in the first day of the horse trial, with the other element finished the final day of the horse trial. The kids may walk the jumping courses with their trainer prior to that phase of the competition, but the horse is not allowed to school either the stadium jumping course or the cross-country course prior to the actual riding of the courses. Dressage is a practiced, coordinated and very controlled test of horse and rider communication, where form and style over the various gaits are judged in a small arena. Stadium jumping is a timed ride over a variety of jumps in an arena, and cross-country jumping is a timed ride over jumps in open fields over several miles of a cross-country course.
The kids on our "recognized" eventing team are trained by Angela Ariatti in Goshen, KY, and range in ages from 12 to 17. They travel the country competing in horse trials that are recognized by the USEA (United States Eventing Association), and accumulate points over the course of a calendar year, culminating in their qualification (or not) for the AEC's (the American Eventing Championships) year-end competition. This is a competition entered by riders, both amateur and professional, from all over the country, and it serves as a chance for our young riders to associate with and observe high level competitors, many of whom are top-ranked riders in eventing, and even international or Olympic level, competitors.
Angela took 4 of our team members (including my Lexie and Kaitlyn) to River Glen last weekend, a beautiful equestrian park in Tennessee along the banks of the French Broad River. I was so proud of all of the girls, and it was a very mixed weekend of results. We had a rider fall during stadium jumping, which is an automatic elimination from the competition. We had a 6th place finish in the Open Novice division (Lexie), and 2 fourth place finishes, Kaitlyn in Open Beginner Novice, and another in the Open Training division.
All of the kids amaze me over the course of these competitions, because in order to be successful, they learn that all 3 phases of the competition are important, and they all 3 matter. They learn that they must remain focused and competitively optimistic as all 3 phases of the riding progress, and that it is a cumulative score they are seeking. They learn to emphasize their own strengths as well as the strengths of their mounts in order to optimize scores in each of the riding phases, and they learn to persevere on to the next phase of the competition even when one element may not go as well as they'd hoped. They learn to persevere. Can you think of a more valuable lesson in life?
The team member who fell off her horse at stadium stayed to cheer on and support her fellow team-mates even after her own elimination from the competition. Kaitlyn persevered in order to move up consistently through all 3 phases of the competition, from 12th after dressage, to 7th after stadium, to an ultimate 4th after cross-country, behind riders who were all her senior in age grouping and experience.
As the weekend progressed, and as an adult, I thought about how the kids handle the challenge of a 3 day competition, how they handle the nerves and the stess in order to do their best in all 3 phases of the riding. I watch them learn how to watch the mistakes others make and to learn from them, how to plan with Angela their best course of action, and I watch them swallow the hard lumps as they make their own mistakes and learn to go on to the best of their abilities. In the end, Angela only expects them to do the best that they are capable of, and they know this, but it is truly amazing to observe this learning process, for it is a journey they each make.
Achieving goals in life is all about having the courage to dream of the goal, consistently working hard toward that goal, and persevering to never lose sight of the goal...individuals who can do this oftentimes exceed the expectations or achievements of others. And they amaze and inspire us all.
Congratulations girls.
The kids on our "recognized" eventing team are trained by Angela Ariatti in Goshen, KY, and range in ages from 12 to 17. They travel the country competing in horse trials that are recognized by the USEA (United States Eventing Association), and accumulate points over the course of a calendar year, culminating in their qualification (or not) for the AEC's (the American Eventing Championships) year-end competition. This is a competition entered by riders, both amateur and professional, from all over the country, and it serves as a chance for our young riders to associate with and observe high level competitors, many of whom are top-ranked riders in eventing, and even international or Olympic level, competitors.
Angela took 4 of our team members (including my Lexie and Kaitlyn) to River Glen last weekend, a beautiful equestrian park in Tennessee along the banks of the French Broad River. I was so proud of all of the girls, and it was a very mixed weekend of results. We had a rider fall during stadium jumping, which is an automatic elimination from the competition. We had a 6th place finish in the Open Novice division (Lexie), and 2 fourth place finishes, Kaitlyn in Open Beginner Novice, and another in the Open Training division.
All of the kids amaze me over the course of these competitions, because in order to be successful, they learn that all 3 phases of the competition are important, and they all 3 matter. They learn that they must remain focused and competitively optimistic as all 3 phases of the riding progress, and that it is a cumulative score they are seeking. They learn to emphasize their own strengths as well as the strengths of their mounts in order to optimize scores in each of the riding phases, and they learn to persevere on to the next phase of the competition even when one element may not go as well as they'd hoped. They learn to persevere. Can you think of a more valuable lesson in life?
The team member who fell off her horse at stadium stayed to cheer on and support her fellow team-mates even after her own elimination from the competition. Kaitlyn persevered in order to move up consistently through all 3 phases of the competition, from 12th after dressage, to 7th after stadium, to an ultimate 4th after cross-country, behind riders who were all her senior in age grouping and experience.
As the weekend progressed, and as an adult, I thought about how the kids handle the challenge of a 3 day competition, how they handle the nerves and the stess in order to do their best in all 3 phases of the riding. I watch them learn how to watch the mistakes others make and to learn from them, how to plan with Angela their best course of action, and I watch them swallow the hard lumps as they make their own mistakes and learn to go on to the best of their abilities. In the end, Angela only expects them to do the best that they are capable of, and they know this, but it is truly amazing to observe this learning process, for it is a journey they each make.
Achieving goals in life is all about having the courage to dream of the goal, consistently working hard toward that goal, and persevering to never lose sight of the goal...individuals who can do this oftentimes exceed the expectations or achievements of others. And they amaze and inspire us all.
Congratulations girls.
Wednesday, November 3, 2010
Watch a Vaser Shape treatment and talk to the patient!
This week's update on our Vaser Shape experience is very special...we will be featured on the evening news Thursday at 5PM on WAVE 3. Health reporter, Lori Lyle, was in the office last week to tape an actual patient having the procedure performed. Lori interviewed Tracy, who was gracious enough (and pleased enough with her results) to also allow taping of her actual Vaser Shape treatment. This was Tracy's second treatment with Vaser Shape of the tummy and hips, and her measurement change so far is an unbelievable 2 inches lost above the belly button and over 4 inches at the hips!!! I know what you're thinking...I thought the same thing...this is really too good to be true. So, I measured again, and again...
So, tune in Thursday, and see for yourself! Tracy talks about her goals for the treatment, how it feels, and I speak to its place in our body contouring armamentarium. Lori asks great questions about the evolution of this technology, and results we are seeing in all patients.
One of the best ways to receive more information about Vaser Shape is to join us here in the office for a group or individual consultation. We will outline the technique and its applications in an informal setting with a powerpoint presentation, and then provide one-on-one consultation about who and what areas might be good candidates for treatment with Vaser Shape.
Another way to find out if Vaser Shape is right for you and to view current patient results, is to join us Friday, November 19th, here in the office for our next "Cocktails and Consults", where we will be doing a live demonstration of Vaser Shape. The theme for this evening of cocktails and information gathering will be Mexican...so bring a friend and come and have a margarita with us!
We hope to see you soon!
Best,
Julene
So, tune in Thursday, and see for yourself! Tracy talks about her goals for the treatment, how it feels, and I speak to its place in our body contouring armamentarium. Lori asks great questions about the evolution of this technology, and results we are seeing in all patients.
One of the best ways to receive more information about Vaser Shape is to join us here in the office for a group or individual consultation. We will outline the technique and its applications in an informal setting with a powerpoint presentation, and then provide one-on-one consultation about who and what areas might be good candidates for treatment with Vaser Shape.
Another way to find out if Vaser Shape is right for you and to view current patient results, is to join us Friday, November 19th, here in the office for our next "Cocktails and Consults", where we will be doing a live demonstration of Vaser Shape. The theme for this evening of cocktails and information gathering will be Mexican...so bring a friend and come and have a margarita with us!
We hope to see you soon!
Best,
Julene
Tuesday, October 26, 2010
Weekly update on Vaser Shape...
Hi guys! For those of you who may be watching and waiting to hear more about Vaser Shape, I thought I would begin a weekly post to update our followers on what we are seeing as we treat our first patients, the overall experiences we are having, and I would also invite any questions you may have, group chats, etc. This is very exciting and brand new technology, so we will have lots to pass on as the weeks go by.
We completed our training several weeks ago, and were fortunate enough to be one of only a few sites in the US to receive a visit and second round of training from Benedetta Baciucco, the Italian trainer for Sound Surgical Technologies and Vaser Shape, from Florence, Italy. We videotaped some footage of Benedetta's visit, which you can see on Facebook or on our website.
To date, we have treated about 25 patients and/or ourselves : ) - What woman doesn't have a little, eensy, weensy bit of fat she'd like to get rid of? We have not disappointed anyone, and I am pleased to report that we have seen the loss of 1 to 3 inches on average in 1 to 2 treatments, depending upon the size of the area to begin with and the skin tone at the outset. We are measuring and weighing everyone before and after each treatment, so Vaser Shape is not for the light of heart. We are after thorough and honest treatment results! I AM a surgeon after all, so if I don't see results, I can of course still recommend surgery.
I want to say at the outset, that I do not consider the Vaser Shape a "replacement" for surgery, but quite literally, an awesome complement to the sculpting we can achieve with Vaser in the operating room. I also firmly believe it is an alternative for patients who either cannot or will not consider surgical fat reduction.
Another interesting "side effect" is skin tightening, and we are seeing evidence of this phenomenon on the table after just a single treatment. There are a whole bunch of women (and men, I always forget them), myself included, who would like more skin tightening than even fat reduction. Do you know how many women I see each year who ask me what can I do about the loose skin of their knees, arms or inner thighs? It's like the bacteria in a urine sample from a patient with a urinary tract infection..."TNTC", or "too numerous to count"! I used to say, with much true compassion, "not very much", now I may use the Vaser Shape for some of these areas. (Okay, I confess, I did my inner thighs last Friday...and, yes, they are tighter).
We are going to make some noise about the Vaser Shape, look for our ad in The Voice this week, and for upcoming news segments on WAVE3 with Lori Lyle. We can't keep this a secret for long...
And of course, follow us here for updates!
Best to you, and so long fat rolls!
Julene
We completed our training several weeks ago, and were fortunate enough to be one of only a few sites in the US to receive a visit and second round of training from Benedetta Baciucco, the Italian trainer for Sound Surgical Technologies and Vaser Shape, from Florence, Italy. We videotaped some footage of Benedetta's visit, which you can see on Facebook or on our website.
To date, we have treated about 25 patients and/or ourselves : ) - What woman doesn't have a little, eensy, weensy bit of fat she'd like to get rid of? We have not disappointed anyone, and I am pleased to report that we have seen the loss of 1 to 3 inches on average in 1 to 2 treatments, depending upon the size of the area to begin with and the skin tone at the outset. We are measuring and weighing everyone before and after each treatment, so Vaser Shape is not for the light of heart. We are after thorough and honest treatment results! I AM a surgeon after all, so if I don't see results, I can of course still recommend surgery.
I want to say at the outset, that I do not consider the Vaser Shape a "replacement" for surgery, but quite literally, an awesome complement to the sculpting we can achieve with Vaser in the operating room. I also firmly believe it is an alternative for patients who either cannot or will not consider surgical fat reduction.
Another interesting "side effect" is skin tightening, and we are seeing evidence of this phenomenon on the table after just a single treatment. There are a whole bunch of women (and men, I always forget them), myself included, who would like more skin tightening than even fat reduction. Do you know how many women I see each year who ask me what can I do about the loose skin of their knees, arms or inner thighs? It's like the bacteria in a urine sample from a patient with a urinary tract infection..."TNTC", or "too numerous to count"! I used to say, with much true compassion, "not very much", now I may use the Vaser Shape for some of these areas. (Okay, I confess, I did my inner thighs last Friday...and, yes, they are tighter).
We are going to make some noise about the Vaser Shape, look for our ad in The Voice this week, and for upcoming news segments on WAVE3 with Lori Lyle. We can't keep this a secret for long...
And of course, follow us here for updates!
Best to you, and so long fat rolls!
Julene
Wednesday, October 13, 2010
The "No Down-time Breast Augmentation"
I was visiting another plastic surgery colleague in another state recently, and after learning where I had trained, he told me he had visited one of the surgeons who trained me during my residency. It turns out, the surgeon has been in practice longer than me and does a fair number of breast surgeries, but had always told his patients that they would need significant time off work and daily activities, and that they would require a lot of pain medication during their recovery period. He mentioned this "no-touch technique" and how it so drastically reduces recovery periods to mere days, and I guess I got a pretty quizzical look on my face - I usually try to be more subtle - and he then asked me if I use that technique (especially important when placing the implant under the chest muscle, or pectoralis). I said, "well, yes!" (Again, Ms. Subtle). I put that information away to think about later, as more and more surgeons are using their new-found information about this technique as a marketing tool, and it wasn't until today, when one of my own happy breast augmentation patients said the following (she was here for some October "Boo-tox" and happily telling me of a friend she is referring to me for breast augmentation), "When was the last time one of your breast augmentation patients went to Red Lobster the night of her surgery - you know I did!" I decided right then and there that although I am happy to learn that knowledge of the technique is spreading, because patients will be the huge beneficiaries if their surgeons use this technique, I decided that I must be guilty of not emphasizing the difference this technique can make to my very own patients enough. We do tell patients that we will give them pain meds and muscle relaxants, but most tell us they didn't need them, they take Tylenol and go to back to work in 2 to 3 days. There is virtually no bruising or swelling, and this is true even when we place the implant under the muscle.
The "no-touch technique" is really the use of a very light general anesthetic, so that the chest muscle can be fully relaxed while a pocket is made under it to hold the implant. Traditionally, most surgeons are taught to fairly bluntly pull the muscle up, and although this is moments faster, it allows too much oozing into the submuscular pocket. This blood will usually be absorbed by the body slowly, but leads to much more discomfort, which is the most common cause of post-operative nausea and vomiting. The leftover blood can also stimulate a higher risk of capsular contracture (scar tissue), or if it is enough bleeding, can cause an unexpected trip back to the OR for evacuation of the hematoma. Additionally, post-op asymmetries are more common when more bleeding is allowed to occur.
Instead of this rather brutane method of pocket creation, advocates of the "no-touch" technique utilize a special hand-held cautery device that works much like a laser to control bleeding before it starts. Therefore, the pocket for the implant is very dry and controlled, minimizing down-time, helping to "control" the symmetry of the result, reducing the risk of hematoma or capsular contracture, and most importantly...reducing the risks of revisionary surgery, which I believe is the true "hidden cost" of all surgical procedures...ie, how many times does the surgeon have to operate to get it right? Additional nuances of the technique involve irrigating the pocket once it is made with antibiotic solutions, changing gloves after making the pocket, using talc-free gloves before touching the implant, opening it only when ready for insertion into the pocket, and limiting touching of the implant to the surgeon only. I am also a big believer in offering selected patients intra-operative sizing with temporary, single use sizers if there is asymmetry or uncertainty about ultimate size desired, and sitting all patients up in surgery to assess the final result before leaving the OR. All of these manuevers add seconds to the actual surgery time (still only a little over an hour or 80 minutes if sizing is performed), but drastically reduce the risk of revision or the "post-operative surprise"!
The use of the "no-touch technique" is even more important when I am using the investigational "Gummi bear" device, because this device mandates a tight seal between the implant and the capsule which forms arouond all implants. This device is currently investigational for certain patient indications (revision patients right now), and I am happy to be one of only a very limited surgeons in the U.S. invited to finish the clinical trials for Allergan. It's advantages are a tear-drop anatomic shape, very soft feel, no liquid nature to the filler (fully cohesive silicone gel), low risk of capsular contracture, and low risk of spread of silicone if the device should rupture.
The "no-touch technique" is really the use of a very light general anesthetic, so that the chest muscle can be fully relaxed while a pocket is made under it to hold the implant. Traditionally, most surgeons are taught to fairly bluntly pull the muscle up, and although this is moments faster, it allows too much oozing into the submuscular pocket. This blood will usually be absorbed by the body slowly, but leads to much more discomfort, which is the most common cause of post-operative nausea and vomiting. The leftover blood can also stimulate a higher risk of capsular contracture (scar tissue), or if it is enough bleeding, can cause an unexpected trip back to the OR for evacuation of the hematoma. Additionally, post-op asymmetries are more common when more bleeding is allowed to occur.
Instead of this rather brutane method of pocket creation, advocates of the "no-touch" technique utilize a special hand-held cautery device that works much like a laser to control bleeding before it starts. Therefore, the pocket for the implant is very dry and controlled, minimizing down-time, helping to "control" the symmetry of the result, reducing the risk of hematoma or capsular contracture, and most importantly...reducing the risks of revisionary surgery, which I believe is the true "hidden cost" of all surgical procedures...ie, how many times does the surgeon have to operate to get it right? Additional nuances of the technique involve irrigating the pocket once it is made with antibiotic solutions, changing gloves after making the pocket, using talc-free gloves before touching the implant, opening it only when ready for insertion into the pocket, and limiting touching of the implant to the surgeon only. I am also a big believer in offering selected patients intra-operative sizing with temporary, single use sizers if there is asymmetry or uncertainty about ultimate size desired, and sitting all patients up in surgery to assess the final result before leaving the OR. All of these manuevers add seconds to the actual surgery time (still only a little over an hour or 80 minutes if sizing is performed), but drastically reduce the risk of revision or the "post-operative surprise"!
The use of the "no-touch technique" is even more important when I am using the investigational "Gummi bear" device, because this device mandates a tight seal between the implant and the capsule which forms arouond all implants. This device is currently investigational for certain patient indications (revision patients right now), and I am happy to be one of only a very limited surgeons in the U.S. invited to finish the clinical trials for Allergan. It's advantages are a tear-drop anatomic shape, very soft feel, no liquid nature to the filler (fully cohesive silicone gel), low risk of capsular contracture, and low risk of spread of silicone if the device should rupture.
Monday, October 11, 2010
How the Sciton Contour Profile laser can clean up the summer's damage!
I'll share a secret with you...I can't always follow my own advice...after a summer of fun in the sun running, swimming, biking, riding horses and chasing after my girls in the hot sun at various eventing horse trials, the good doctor does enjoy lying down for a series of awesome laser treatments by Melanie or Rita designed specifically to reduce the appearance of sun spots, wrinkles and even laxity of the skin.
I do religiously use my own skin care products...the same ones I recommend for my patients...virtually year-round, but there is really nothing as effective as the laser to provide more aggressive and rapid correction of these common skin problems. Although I have tested every cosmetic laser on the market, the Sciton Profile is quite simply the best.
I use Dermesse cleanser gel and toner morning and night, uplifting eye serum in the morning under my make-up, Latisse lash enhancement at night, and Lumiere eye cream at night. To sleep in for the rest of the face, I alternate using Essential Serum by Skin Medica with Hyalis or Biogel. Every night and every morning I use Biocream on my neck. I know this may sound like a lot of product, but when I told Christa Ritchie of the Courier Journal recently my age, I thought she was going to fall off my couch (God love her!) In addition to these topical products, I never let my Botox fully wear off, and I love Juvederm and Sculptra for filling and tightening between laser treatments.
Despite these truly revolutionary skin care products, I am a big believer in the laser for deeper treatments. I like the combination BBL and Skin Tyte treatments for brown spots and visible vessels, as well as for tightening of the skin of the face and neck. There is absolutely NO down time, no discomfort, and immediate results. The best results are seen with a series of 6 to 12 treatments.
Another favorite combination is ProFractional for skin tightening and MicroLaserPeel for skin smoothing. These treatments can be performed individually or together for even more dramatic results. The downtime is variable, and dependent upon the depth of the treatment that is desired by the patient. The depth of the treatment is chosen by the patient and the nurse or myself prior to the treatment. No anesthesia is required, and the skin is numbed and chilled for comfort.
Come in for a complimentary consultation just for mentioning this blog, and "fall" into a more beautiful Fall 2010!!! Better yet, join us on November 19th for our next "Cocktails and Consults" from 4 to 6PM...our next themed cocktail evening will be all Mexican! Bring a friend and receive special discounts on our favorite skin care products and laser treatments, or even a free texturizing facial peel.
See you soon!
Julene
I do religiously use my own skin care products...the same ones I recommend for my patients...virtually year-round, but there is really nothing as effective as the laser to provide more aggressive and rapid correction of these common skin problems. Although I have tested every cosmetic laser on the market, the Sciton Profile is quite simply the best.
I use Dermesse cleanser gel and toner morning and night, uplifting eye serum in the morning under my make-up, Latisse lash enhancement at night, and Lumiere eye cream at night. To sleep in for the rest of the face, I alternate using Essential Serum by Skin Medica with Hyalis or Biogel. Every night and every morning I use Biocream on my neck. I know this may sound like a lot of product, but when I told Christa Ritchie of the Courier Journal recently my age, I thought she was going to fall off my couch (God love her!) In addition to these topical products, I never let my Botox fully wear off, and I love Juvederm and Sculptra for filling and tightening between laser treatments.
Despite these truly revolutionary skin care products, I am a big believer in the laser for deeper treatments. I like the combination BBL and Skin Tyte treatments for brown spots and visible vessels, as well as for tightening of the skin of the face and neck. There is absolutely NO down time, no discomfort, and immediate results. The best results are seen with a series of 6 to 12 treatments.
Another favorite combination is ProFractional for skin tightening and MicroLaserPeel for skin smoothing. These treatments can be performed individually or together for even more dramatic results. The downtime is variable, and dependent upon the depth of the treatment that is desired by the patient. The depth of the treatment is chosen by the patient and the nurse or myself prior to the treatment. No anesthesia is required, and the skin is numbed and chilled for comfort.
Come in for a complimentary consultation just for mentioning this blog, and "fall" into a more beautiful Fall 2010!!! Better yet, join us on November 19th for our next "Cocktails and Consults" from 4 to 6PM...our next themed cocktail evening will be all Mexican! Bring a friend and receive special discounts on our favorite skin care products and laser treatments, or even a free texturizing facial peel.
See you soon!
Julene
Friday, October 8, 2010
Join us for our next "Cocktails and Consults" Evening!
Thanks to all of you who joined us tonight for our first "Cocktails and Consults" evening! It was fun to see those of you who could join us, and to celebrate the arrival of fall! Cynthia brewed up a great witch's brew (or two), and everyone enjoyed it. Patricia Young of "Creative Crystals" joined us and brought some of her beautiful Swarovsky crystal jewelry pieces.
We had great appetizers and even pumpkin pie! (Saved some for Kaitlyn and Lexie of course). Dan (Cynthia's cute husband) coined the term "Julene's Juice" for Cynthia's special concoction of Skyy passion fruit vodka, sparkling apple cider and cranberry juice/pineapple juice/ginger ale, a clinically proven recipe for a beautiful complexion, and we all had at least one cup (Melanie took home a cauldron). Even Rita's nose stopped running after 10 cups (or so).
We all gazed at the Vaser Shape box...it will be birthed next week. At this point, Cynthia and I at least think we should name it. Of course, it is a girl...our training is all set up for next Friday, October 15th. A couple months of melting fat and none of my staff will be recognizable, right?
We offered many specials tonight, including 40% off Juvederm, $9.00/unit "Bootox", 50% off laser procedures over $400, and discounts on many of our favorite skin care products.
For those of you who couldn't make it tonight, we are planning another "C & C" for Friday November 19th from 4PM to 6PM. We will likely choose a whole new group of specials, so be sure and call the office to check with us and reserve a space for you...and a friend...which is the only ticket you need for admission! I think we may also demo the new Vaser Shape for fat reduction (see last blog entry). If you'd like to be the evening's model patient for Vaser Shape, let someone in my office know.
Have a great weekend!
Julene
We had great appetizers and even pumpkin pie! (Saved some for Kaitlyn and Lexie of course). Dan (Cynthia's cute husband) coined the term "Julene's Juice" for Cynthia's special concoction of Skyy passion fruit vodka, sparkling apple cider and cranberry juice/pineapple juice/ginger ale, a clinically proven recipe for a beautiful complexion, and we all had at least one cup (Melanie took home a cauldron). Even Rita's nose stopped running after 10 cups (or so).
We all gazed at the Vaser Shape box...it will be birthed next week. At this point, Cynthia and I at least think we should name it. Of course, it is a girl...our training is all set up for next Friday, October 15th. A couple months of melting fat and none of my staff will be recognizable, right?
We offered many specials tonight, including 40% off Juvederm, $9.00/unit "Bootox", 50% off laser procedures over $400, and discounts on many of our favorite skin care products.
For those of you who couldn't make it tonight, we are planning another "C & C" for Friday November 19th from 4PM to 6PM. We will likely choose a whole new group of specials, so be sure and call the office to check with us and reserve a space for you...and a friend...which is the only ticket you need for admission! I think we may also demo the new Vaser Shape for fat reduction (see last blog entry). If you'd like to be the evening's model patient for Vaser Shape, let someone in my office know.
Have a great weekend!
Julene
Subscribe to:
Posts (Atom)