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Category Archives: Facial Plastics

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.

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!

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.