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Beyond Beauty Blog: The Surgeon's Secrets

Vocal Aesthetics & the Male Magnet

p1Mufasa of The Lion King. Darth Vader of Star Wars. Lt. Zogg of Dr. Strangelove. James Earl Jones’s famously low, chest resonating rumbles are undoubtedly memorable.  But, it’s now been clinically proven that women tend to remember things better when they’re spoken by deep male voices.  Dr. Yagoda calls this phenomenon the male magnet principle and believes there are strong implications about the role of the voice in attractiveness–or vocal aesthetics.The phrase “vocal aesthetics” might be puzzling to you. After all, we can’t see the voice. But it’s human nature to talk to others, and the sound of your voice can definitely effect the way that others perceive you. Imagine a telephone conversation, for example. The way that the person on the other end of the line speaks allows you to form an image of that person in your mind, which is purely based on his or her voice.

In fact, as it turns out, the pitch of your voice can actually make you more or less attractive to others. The new study, published in the journal Memory & Cognition, suggests that women prefer the sound of a deep male voice more than a higher-pitched voice. In fact, test results show that women are more likely to remember the name of an object when it was spoken by a lower-pitched male voice. So, ladies– when you find yourself irresistibly drawn to a magnetic, deep voice, you’ll know why!

Medical Tourism

The concept of medical tourism is not a new one, but dates back thousands of years to when Greek pilgrims traveled from all over the Mediterranean to the small territory in the Saronic Gulf called Epidauria, the territory of the healing god Asklepios. Epidauria became the original travel destination for medical tourism.  Subsequently, spa towns and sanitariums emerged.  

Medical Tourism

A large draw to current medical travel is accessibility, convenience, affordability and ease of international travel. In 2009, an estimated 600,000 Americans traveled abroad for plastic surgery.   Popular cosmetic surgery travel destinations include: Argentina, Bolivia, Brazil, Colombia, Costa Rica, Cuba, Mexico and Turkey.  Not surprisingly, the United States heads the list of popular sites for health tourism, and generates $5.5 billion annually.  Brazil is in second position. Europe as a whole, is listed third.  Dr. Orhan Murat Özdemir, a plastic surgeon in Turkey states that “Nearly 350,000 people visit Turkey annually to receive treatment and spend nearly $20 million dollars. In Turkey, dental aesthetics in particular, bring a consumer cost advantage in excess of 50% savings over the US and the rest of Europe.”

But, medical tourism carries several risks.  Infectious disease may be acquired when there is exposure to pathogens without having built up natural immunity.  In addition, misdiagnoses in the homeland may be frequent because diseases acquired on foreign soil are perceived to be “rare.” Hospitals and doctors may not be accredited to US, UK or Canadian standards. Long distance travel home soon after surgery can increase the risk of complications as can vacation activities such as strenuous exercise, sun exposure, alcohol consumption and lifting heavy luggage.  Surgical complications may not be adequately addressed in countries with unfamiliar legal systems and hospitals and/or doctors may be unable to pay for financial damages.  In an extreme situation, the cost of a medical air “ambulance” home can cost more than the list price of a new car.  So, consumer beware of a false surgical economy!  You may be lucky to get what you pay for!

When traveling abroad, consider purchasing medical travel insurance from MedJet Assist and “take trips, not chances”.  1.800.527.7478

Identifying Body Dysmorphic Disorder: Who “Nose”?

Rhinoplasty or nose job surgery is not only one of the most difficult facial plastic surgeries to perform, but the results can also change a person’s appearance the most drastically. Of course, many who seek this plastic surgery procedure desire exactly that–but a new study reveals that 33% of patients considering cosmetic nose job surgery show symptoms of a chronic condition called body dysmorphic disorder (BDD).

p4BDD is a type of mental illness in which negative thoughts of body image overwhelm someone to the point that it negatively affects his or her life, getting in the way of healthy relationships, careers, and socializing. The disorder can lead to suicidal thoughts, eating disorders, depression, anxiety and — as seen in this study — unnecessary cosmetic surgery.

Because the rate of BDD is so high in rhinoplasty patients (and even higher in those patients who have already had a nose job previously),  it is especially important for the doctor to take a detailed psychological evaluation during the consultation to make sure that the patient is mentally healthy before authorizing this plastic surgery procedure. Rhinoplasty is a team approach: you, the patient, have to come in with realistic expectations and sound motivation, and I, the facial plastic surgeon, will provide noticeable and natural results.

The Best 4 Places to Live for Fabulous Skin and Great Hair

According to an article in, where you live can affect how you look!  The authors suggest that hair typically looks best in locations with low humidity, minimal pollution, little rainfall, reduced wind speed, soft water and a high concentration of hair salons!  They also note that skin typically looks best in cities with minimal pollution, reduced sunshine, sparse tanning salons, moderate humidity, low number of smokers and little stress.  Here are their top ten lists by category:

For Best SkinHand-colored Map of the USA
1. Anchorage, Alaska – no pollution, only 41% of days are sunny, moderate humidity and low rates of skin cancer
2. Bismark, North Dakota
3. Honolulu, Hawaii – pollution free, few tanning salons, moderate humidity, consistent weather
4. Flagstaff, Arizona
5. Billings, Montana
6. New York – minimal tanning salons, 58% of days are sunny, average humidity, low skin cancer rates
7. San Antonio, Texas
8. Washington, D.C.
9. San Francisco, California – little sunshine, sparse tanning beds, consistent weather, lowest smoking rates
10. Cheyenne, Wyoming

For Best Hair
1. Santa Barbara, California
2. Honolulu, Hawaii – clear air, soft water, lots of salons, consistent weather
3. San Diego, California
4. Anchorage, Alaska – lack of pollution, minimal wind, soft water
5. San Francisco, California – most consistent weather, soft water, minimal wind, high concentration of salons
6. New York – perfect water for hair, most salons per zip code in the country
7. Miami, Florida
8. Los Angeles, California
9. Denver, Colorado
10. Boston, Massachusetts

Based on the data from, you should live in Anchorage, Honolulu, New York or San Francisco, if you, your skin and hair want the external, environmental factors in your favor.   But don’t forget….beauty is an external reflection of internal health and wellness too!  Eat a healthy diet, get plenty of sleep, control your stress, stimulate your mind, surround yourself with positive relationships….and when all else fails, you’ve got BeautyScoop, injectables and plastic surgery to offer a helping hand!

Lash Extensions: Q & A

1. What kinds of lash extensions are available? There are a few different lash enhancement options available, each with their own risks and benefits.

Strip Lashes-

They can be made from synthetic or human hair. They are useful when used as a temporary solution and for very short term wear. There is an unnatural heavy feeling on the lids. These are placed against the upper lash line as close to your natural lashes as possible. Applying a strip of lashes can be a daunting task. It requires a great deal of practice and patience. Even well applied lash strips can cause embarrassing situations as the temporary adhesive used to apply the lash strip can come loose due to heat and perspiration.

From a “lash health” perspective there are a few concerns. There is an increased risk of allergic reaction since there is a direct contact of the adhesive with the skin. Long term use of lash strips can occlude the lash line and block the hair follicle resulting in increased potential for permanent lash baldness. There is also an increased risk of infection. Care must be taken when removing the lash strips as to not pull out natural lashes while removing.

“Clusters” or “Flare” type Lashes-Lash Extensions

These types of lashes have a slightly more natural look since they are bundles of three to eight blunt tipped lashes held together by a little knot. They are typically placed on top, in between, or underneath the natural lash line.

Similarly to strip lashes, flares or clusters are attached using an adhesive which comes in contact with skin, and they pose the same risks of allergic reactions, damage to the hair follicle, and risk of infection. If a temporary adhesive is used, they can come off due to heat and perspiration. Many salons offer these types of “lash extensions” with a stronger more permanent adhesive. This type of eyelash extension can cause permanent damage to the hair follicle with repeated use. Since they are placed on top or under the natural lashes, they are attached to a few or your own natural hairs. When it is time for your natural to shed (all of our natural lashes are at a different growth stage), the cluster will also remove other lashes that are still intact. This can result in bald patches in your lash line. Everyone’s threshold for lash regrowth is different. Repeated injury to the lash line can cause permanent damage.  Because of the method of application, they can also be quite uncomfortable and cause pain. You still feel the “knot” of the cluster as well as the pain associated with the cluster pulling the hairs from the root.

Semi Permanent Eyelash Extensions-

Semi permanent eyelash extensions are made to mimic natural lashes. They are placed one by one to your natural eyelashes. A single extension is bonded to a single natural lash. These types of lash extensions are the least damaging to your natural eyelashes. They are light, natural looking and natural feeling. A medical grade adhesive is used to bond each lash individually. The adhesive does not come in contact with skin and is only placed on the eyelash.

2. What are the risks of extensions?

Risks of wearing extensions vary with the type of extension used. Strips, clusters, and flares carry an increased risk of allergic reaction and infection due to the contact with skin and potential for the occlusion of the follicle. There is also a risk for permanent damage to the follicle from lashes being pulled from the root prematurely.

Poorly applied semi permanent eyelash extensions can also carry the same risks as flares and clusters. Technique is very important. The stylist must be precise with application, not connect the extension to your skin, and be sure t only apply a single extension to a single eyelash as well as choosing appropriate size and thickness of the extension. It is important that your natural lash can support the weight of the extension and not place stress on the natural eyelash follicle.

3. Which treatment do you recommend and why?

I prefer and recommend semi permanent lash extensions. While they are the most expensive option, they carry the least risk and are the most natural looking and feeling. They also involve the least amount of maintenance. I do not offer any other type of lash enhancement due to the risks involved. Properly applied and maintained eyelash extensions do not damage your natural lashes.

I also love the ability to contour the lashes to enhance our most noticed feature- our eyes. Semi permanent lash extensions can make you feel younger, fresher, and more polished.

4. What is the maintenance required?

Since our natural lashes shed at different rates, touch-up appointments are necessary to attach an extension to the new growth. The majority of my clients come in every three to four weeks for a one-hour maintenance visit. They are actually quite simple to take care of and every client loves the ability to wake up feeling beautiful without the hassles (and clumpiness) of mascara.

5. Beauty Scoop is called the edible beauty accessory. Do you believe that it can help your eyelashes and your overall beauty?

I definitely believe Beauty Scoop can help your eyelashes and overall beauty. Nurturing and nourishing your beauty from within and promoting hair growth can positively affect overall “lash health.”

Do You Know If Your Healthcare Provider Is Actually a Doctor?

Do you know if your Botox is given by a nurse practitioner, an aesthetician (illegal!), an OB/GYN, a dermatologist, or plastic surgeon? Does it even matter? It’s easy to get confused when you’re having a procedure. In fact, if you’re confused about who is really a doctor, you’re not the only one. I hear questions like these  every day:

  •  “Do you have to be an MD to apply peels and do laser?” (No.)
  •  “Is an otolaryngologist really an MD?” (Yes.)
  •  “Can my cosmetic dentist really do facelift surgery?” (I suppose, if you are willing to let him/her.)
  •  “Do I need to see an audiologist or an otolaryngologist for my allergies, and which one is really a doctor?” (The ENT is the MD in this case.)

You, too, may be unsure of who’s an MD and who’s not, and why it matters. According to a 2010 Pew Internet and AmeCaduceusrican Life Project, 83% of internet users are searching for medical information on-line and 59% of all US adults have looked on-line for health information.  Despite this, there is significant documentation to show that patients are confused about who is providing their health care.

In fact, according to a telephone survey of 852 adults conducted by the Global Strategy Group, 51% of those interviewed believed that it is not “…easy to identify who is a licensed medical doctor and who is not.”  For example, only 32% of those surveyed thought an Otolaryngologist is a medical doctor (I am!), yet 33% believed that an audiologist is a medical doctor (she/he is NOT)!  Similar confusion surrounded many other areas, including whether podiatrists and psychologists  were MDs.

This widespread confusion and public ignorance may well be the result of the managed care companies’ ubiquitous and interchangeable use of the term “provider.”  It leads to the public’s mistrust of the medical establishment and inhibits the public’s ability to make informed choices about their healthcare.

Knowing your provider’s background, training, experience, and expertise can help you become more comfortable and certain of your choice of medical expert. You wouldn’t want to end up with a C-section instead of a facelift!

Don’t be shy…if you’re not sure, be sure to ask. Don’t let the healthcare insurers confuse you. Get the right information and be empowered with knowledge!

Facial Gymnastics

Body muscles have to be exercised. We all know that.  And most of us even belong to a gym.  It should come as no surprise that the fifty or so muscles in the face need some regular toning too.  Simply put, facial work-outs have the same effect on your face as crunches have on your abs.  And they’re free!  No gym membership, no personal trainer, no sign-up lists, and no limited hours.  Just you, a few spare moments (two, to be exact) and the bathroom mirror.  It’s really quite easy—but it sure does take an iron will.

The principle is that you identify the specific muscle and work it, first by itself and later with your fingers to create resistance.  The problem is that some muscle areas are difficult to work, and the movements may be exceptionally subtle.  Ideally, an expert should supervise your technique, but (due to popular request) here are some beginner exercises for the determined:

Eye Muscles – (Smile Lines/Crow’s Feet)

Young Woman Touching Forehead, Eyes Closed
Keeping the eyelids closed, cross your eyes, i.e., look inward toward your nose.  Then squint your eyelids and hold for a few seconds.  Finally, open your eyes very widely and stare at a fixed point some distance away.  HINT:  when you squint, don’t scrunch up your entire face – just the eye area.  To relax, quickly blink the eyelids several times, then gently close.

Cheek/Chewing Muscles

These muscles shape the lower face.  First, open your mouth widely, lowering the bottom jaw as far as possible, then place your index finger firmly across the bottom row of teeth.  Next, try to close the mouth and clench the teeth together.  CAUTION: don’t actually bite your finger; just bring the teeth down to it and hold while feeling the pressure in the chin. To relax, bend the head slightly forward, open the mouth a little, and slowly move the head from left to right (as if in the manner of saying no.)


The first one is simple. Lift the eyebrows, open the eyes widely and stare at a fixed point.  For the second exercise, smooth the forehead by placing the left hand palm side down on the scalp with the fifth (pinky) finger parallel to the front hairline.  With the right hand, place the index finger over the center portion of the right eyebrow, and the third finger over the center portion of the left eyebrow, and “fix” them in place.  Raise the eyebrows against this “fixed” position and use your finger to prevent upward movement of the eyebrows.  That’s it.  To relax, place the fingertips on the muscles of the forehead and apply light pressure.  Shake the head gently from side to side.

Mouth and Chin

To improve the tone of the mouth and chin, open the lips while clenching the teeth, then pull the sides of the mouth sideways with your index fingers to make the bottom teeth fully visible.  Press upward with the index fingers and try to pull the corners of the mouth down against the resistance of the fingers.  Hold for a few seconds.  To relax, close your mouth lightly and go “brrr”, vibrating your lips like you are shivering.

Remember, facial exercises are an adjunct, not a replacement to facial surgery in the same way that liposuction and exercise go hand-in-hand.

Learn more:

Why Your Face is Now Part of Your Workout – The New York Times – August 25, 2015

Kate Middleton’s Hair vs. The Heir’s

According to the UK’s Glamour Beauty, Kate Middleton’s hair is “bouncy, shiny [and] basically perfect”. Prince William, on the other hand, could use some hair….err…help! While many people consider hair loss to be a “male” issue, it commonly affects women as well. In fact, excessive hair loss affects more than 30 million women, or 15% of all women in the US alone. The good news is that in women, hair loss may be related to hormonal or medical causes that can be reversible. On the contrary, [poor William!] men’s hair loss is typically genetic. or hereditary and irreversible. Patterns of hair loss in men and women differ as well. While men’s hair loss is typically localized to the temple, the crown or the “bald spot” on the top of the head, in women there is more often a diffuse thinning throughout the scalp, or a high hairline.

The most common medical problem causing p2thinning and balding in women is related to excess male hormone (androgen) and is called androgenic alopecia. It may come as a surprise to some, but male hormone is typically present in women, albeit in small quantities. When those levels rise abnormally, the hair growth cycle will be adversely affected: the hair follicle will shrink over time and die, or become incapable of producing and maintaining healthy hair growth.

Alopecia areata is another common medical cause of hair loss in women. It is an autoimmune issue characterized by patches of hair loss, but often successfully treated with steroids. Hormonal fluctuations with pregnancy, post-pregnancy and menopause, as well as those hormonal changes associated with medications like the oral contraceptive, can contribute to hair thinning and balding as well. These and other medical causes like anemia, thyroid problems. physical or mental stress and crash or poor diets can lead to an insufficient quantity of the building blocks necessary for the growth and maintenance of healthy hair. Non-medical factors causing excessive hair loss are a growing concern. Hair straightening procedures like the Brazilian Blow-Out or Japanese Straightening can cause thinning and balding. Overstyling with frequent blow-drying, hair coloring, perming or processing be problematic, as can hair extensions, tight ponytails, braids and corn rows that can lead to tension alopecia with premature breakage and tearing of the hair from its follicle.

Plastic Surgery to PREVENT Bullying?

Think plastic surgery to prevent bullying is all just media hype? Don’t be so quick to judge a book by its cover, or a child by his mother! Well-meaning, psychologically aware parents have been choosing plastic surgery for their children to help maintain self-confidence and prevent bullying for decades… D-E-C-A-D-E-S! It is nothing new. Sometimes, starlets’ plastic surgery can seem self-indulgent or vain, a purely cosmetic tool. It’s important to remember, though, that much of plastic surgery focuses on reconstruction. No one questions the “necessity” of plastic surgery for those with burns, clefts, and scars left from cancers–and for good reason. But the cosmetic benefits of these procedures are undeniable.

Plastic Surgery to prevent bullyingTake, for example, a child with protruding ears. Ear pinning (otoplasty) can restore the ear size, shape, and position to normalcy. After the age of six, otoplasty is safe, fast, and virtually painless. So why subject a child to a lifetime of “Dumbo” jokes? An otoplasty in an otherwise physically, emotionally, and socially healthy child can be a surefire way to prevent bullying. The same is true of exaggerated nasal features. Oversized, crooked, or oddly shaped noses are often a source of relentless teasing among children. Surgery that restores normal nasal structure and function has long been accepted by well-adjusted teens, their parents, and doctors, so why stand by and watch a child experience a painful loss of confidence? While surgeries to improve the appearance of a child’s ears or nose have long been popular, a newer cosmetic procedure is also on the rise. Those who suffer from unwanted hair, such as girls with upper lip hair or thick sideburns, may want a lasting solution to avoid being taunted by their peers. Laser hair removal is now becoming a more common alternative to waxing, depilation creams, and the dreadful shaving.

External beauty is first and foremost a reflection of inner health and wellness. But when physical appearance does not reflect the inner self, surgery is the necessary option for improvement. In fact, it can strengthen self-confidence and prevent bullying. Young skin is quite elastic. It is quite forgiving, and it heals quickly. Emotional scars from bullying make their mark for life.

What do Joaquin Phoenix and King Tut have in common?

Both the Oscar-nominated actor and the Egyptian child king were born with clefts. A cleft is an opening or gap in the bone and/or soft tissue of the nose, mouth, and palate, typically formed before birth. They are more common than you might think: approximately 1 in 700 newborns have a cleft lip and/or palate. In fact, football player Peyton Manning, NBC Nightly News anchor Tom Brokaw, and the Reverend Jesse Jackson were all born with clefts too! In addition to the cosmetic concerns that may leave a psychological impact on young kids vulnerable to bullying, a cleft lip and/or palate also presents a number of functional difficulties. These can include difficulty feeding, susceptibility to inner ear infections, delayed or impaired speech function, and abnormal dental development. Some children born with clefts also have associated nasal malformations. To avoid or lessen the above risks, it’s important to close the cleft within the first 2-3 months following birth. Generally this closure happens surgically. The surgeon attaches the muscles of the lip, then attempts to hide thep1 scar in the natural lines of the upper lip.

Because the surgery happens at such an early age, the baby’s young, elastic skin tends to heal quickly and be more forgiving than more mature skin. Scars of childhood often heal faster and more invisibly that scars in adults. In spite of this, many adults find the scars from their cleft palate and lip repair to be fairly obvious. Revision surgery can be not only traumatic and inexact, but unpredictable and expensive. Dr. Yagoda offers an accurate, non-surgical option to fine-tune cleft lip and nose asymmetries with injectable fillers. Fillers can achieve the look of a polished, closed cleft without the downtime, potential scarring, and cost of a surgical repair.