Patients often ask, "I have somewhat a large hump on my nose, I want it reduced but only by a millimeter or less because I don't want it removed, just a slight reduction so I can keep my ethnic feature. Is this possible to do where only a millimeter or less is shaved?"
It is possible to perform minimal hump removal in an ethnic nose. I find that computer imaging helps both my patients and me as a surgeon in being able to predict if the Subtle Rhinoplasty will fit the individual. The key to the computer imaging is creating a profile that the surgeon can realistically replicate in the operating room. The patient and surgeon must then be happy and satisfied with the predicted result.
The Subtle Rhinoplasty has become very popular in my practice. Patients have very little bruising or swelling, packing is usually unnecessary, and the results are most satisfying for both patient and surgeon.
There are many people who have thought about a subtle change in their nose for many years, but have not considered rhinoplasty as a reality because they have been petrified that they will have too much of a change, and ruin their appearance.
They don't want to look like "everyone else who has had a nose job"; they still want to look like themselves, just without the bump (of less of it). They want to look natural after surgery; they want a nose that looks like they were "born with", not like every other patient in the surgeon's waiting room. They don't want to have to re-introduce themselves when they bump into old friends after their surgery (as Jennifer Grey found herself doing).
With a conservative, Subtle Rhinoplasty the risks are low, and the benefits are high. It is always much easier to go back and remove more in the rare case than it is to go back and add tissue to a nose where too much has been removed.
The Subtle Rhinoplasty will become very popular in the future as more patients achieve their desired results in the hands of properly selected experienced surgeons. Select your surgeon most carefully.
Huntington Beach, California Police reported that the "Big Bust Bandit" turned herself (and her pair of 400 cc implants) in yesterday. With the Beach Boys, "I Wish They All Could Be California Girls" playing in the background, police in Huntington Beach say the clinic staffers used a photo lineup to identify the Big-Bust Bandit as Yvonne Pampellonne, 30, of Laguna Niguel (pictured on her MySpace page if you wish to see that it was very difficult for the bandit to hide the incriminating, mountains of evidence). She allegedly used a stolen identity to open a line of credit that she used to get $12,000 of breast implants and liposuction from Pacific Center for Plastic Surgery in Huntington Beach. She is charged with commercial burglary, grand theft and identity theft. For the complete report go to the Orange County online article at http://inyourface.freedomblogging.com/2009/03/24/4-botox-bandits-busted-big-bust-bandit-still-at-large/4569/ In related crime news, beware, there are many "Botox Bandits" out there, but many have been busted having forgotten that they had posed for "before" photos in the physicians office. Once again, remember, crime doesn't pay. What I would give to see Peter Falk as "Columbo" to have "busted" her.
Despite being misspelled in the title, and a few other "Freshman Year Dumb-bell English" mistakes, Beverly Hills residents were treated to the "Next Big Thing" in facial plastic surgery in the BH Courier. Here it is:
Flaxel Re:Pair–A Fast, Painless New Method To Erase A Decade
Published 03/20/2009 - 10:31 a.m.
By Marta Waller
Tucked away, seemingly, in every medical building in Beverly Hills is a plastic surgeon offering the fountain of youth at the end of a scalpel. Call it what you will, a facelift is a facelift and there will be telltale signs that you’ve had “something done” no matter how good your surgeon. But imagine erasing a decade, and maybe more, without a scalpel, a stitch, or a scar. It’s also about a third the cost of a traditional facelift.
Very few physicians have this state-of-the-art laser available to patients. Plastic surgeon Michael A. Persky, M.D. is one such physician who believes this is the future. He was the first to offer the Fraxel re:pair to his patients.
Says Dr. Persky, “I like the Fraxel re:pair because results are much more subtle and natural than a traditional facelift, which pulls the skin, but doesn’t address damaged skin that appears old. Fraxel re:pair is all about tightening the skin and improving the tone, texture, and color along with restoring a natural, more youthful shape.”
Dr. Persky explains the one-hour treatment that’s practically painless and shows results almost immediately works:
“During the treatment there’s vaporization, or removal, of skin which causes tightening immediately. Then the skin adjacent to the vaporized skin remaining has been heated up to a 1.5mm depth, stimulating new collagen formation over the next four to nine months, resulting in continuing improvement.”
To assure his patients receive the best treatment possible, Dr. Persky performs all Fraxel re:pair treatments himself. He says this is a powerful laser and should be used only by highly experienced, trained experts.
Fraxel repair has FDA approval for improvement of wrinkles, irregular texture of skin, age spots, sunspots and sun induced redness, among others.
Treatment with the Fraxel re:pair laser takes about an hour for the entire face and requires only one treatment. Recovery is two to four weeks, with patients returning to daily activities within the first week.
Persky, maintains a private practice in Encino. He was raised in L.A., graduating from Hamilton High School (class of ‘71) and UCLA before attending Emory University Medical School in Atlanta. He completed his training at County-USC Medical Center.
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Deborah Crowe interviews Dr. Persky in the recent issue of The Los Angeles Business Journal (Vol.31, Number 11; March 16-22) in an article entitled "Putting a Good Face on it". Dr. Persky addresses the current recession and the effect that it is having on facial plastic surgery. There has been a marked decrease in surgical procedures, while Fraxel laser skin rejuvenation, fillers, and Botox have increased in demand. To read the full article link to http://67.59.172.92/article.cfm?articleID=64657. The article makes for good reading for the 80% or so of Dr. Persky's patients who while in his treatment chair ask, "So Doc, how's the economy affecting your practice?" For a related philosophical take on the subject, see the blog entry in this section entitled, "Facial Plastic Surgery and the Economy".
Fraxel re:pair is highlighted in the current edition of Vogue Magazine (page 146 in the newsstand copy, and in the “men’s” section of subscription copies…for those of you who cringe as I do at trying to find the table of contents in the heavy jungle of advertisements). The well written article by Catherine Piercy explains the emergence of fractionated carbon dioxide (CO2) laser skin rejuvenation as "the Next Big Thing" in dermatology. "The spot-eradicating, line-smoothing results are good enough "to turn a prune-face" (who’s she talkin’ about?) back into a taut, juicy plum, and they (fractionated CO2 lasers) have the most conservative dermatologists feeling giddy with excitement". New York City dermatologists are featured in the review. Deborah Sarnoff, MD and David Goldberg, MD are quoted referring to the fractionated CO2 lasers generically. Fredric Brandt, MD has the Lumenis Active FX (a superficial laser); Patricia Wexler,MD is not using fractionated CO2 but using non-ablative Fraxel re:store and is quoted anyway; Roy Geronemus, MD is using Fraxel re:pair around some patients eyes as "a substitute for surgery...for a fraction of what you'd pay for an eye-lift"; and Macrene Alexiades, MD is conducting FDA trials for Deka's Dot Therapy device. Not mentioned in the article, but an excellent NYC dermatologist using the technology is Doris Day, MD who is getting great results with Lumenis Total FX (deep and superficial treatment). The article is accompanied by Roy Lichtenstein's "Thunderbolt (1966) which has many "dots" similar to the pattern of pixilated dots that the fractionated CO2 lasers deliver. I think that Lichtenstein’s “Girl Looking in a Mirror” might have been a good choice for the article as well. I have been using Fraxel re:pair for the past year. This Vogue article is the first of many to come in the next few years on The Next Big Thing in facial cosmetic skin rejuvenation. The technology is very exciting, safe, and effective when used properly in trained and experienced hands. It is very powerful, when used improperly the potential for complications is real. Therefore please do your homework and choose your treating physician most carefully. Be well.
One of the most frequently asked questions today is, "So Doc, how is the economy affecting your practice?” Fortunately I am busy, spending office hours taking care of patients, preparing a presentation for Facial Cosmetic Surgery 2009, and answering many patient questions online. The Los Angeles Business Journal will be running a story in the next week or so in which I am interviewed about facial plastic surgery and the economy. I left out a few points in the interview that I wish to share with you now.
This economy has been, is, and likely will be for some time very bad for all of us. Too many of us judge our "self" worth based upon our "net" worth, but the two are independent. We may have lost some of our "net" worth in the recent economy (just ask Bill Gates or Warren Buffet, Mr. Gates went from being the 3'rd wealthiest to 1'st this year by losing $25 billion last year), but we never need lose our "self" worth. Our self worth is not related to money, portfolios, or property values, but to how we treat each other, as in "love your neighbor as yourself", the title of the latest book by Rabbi Joseph Telushkin. We may lose some money, but no matter what else is taken away from us, no one can take away our ability to help one another, our ability to nice to each other. Acts of kindness and charity that are given during this down time will be magnified, appreciated, and remembered for a lifetime by needy recipients; much more so than in otherwise "comfortable" times. It costs nothing to be kind. So how is this economy affecting my practice? It has given me an increased sense of the needs and plights of others, an opportunity to help with kindness, and a greater incentive to support charitable causes. Be well.
Fraxel repair skin rejuvenation is a premiere fractionated carbon dioxide (CO2) laser treatment. I have now treated 100 patients. My experience has confirmed that the treatment is safe and effective when performed properly using meticulous technique. The treatment results in patients looking years younger, rested, healthy, and importantly a natural version of themselves. The true downtime after an aggressive treatment is 7 days, granted that patients look as if they forgot to use their sun block after a day on Santa Monica Beach by the 7’Th day. With the application of a skin tinted sun block, my patients are back to work after a week. It then takes from 2 to 3 additional weeks for the skin color to return to normal. There has been no hypo- or hyper-pigmentation of the skin. The post-treatment recovery period has been very smooth without pain or allergic reactions in the last 50 patients. Patients are now seen in the office after about one week instead of every few days. The most consistent findings have been tightening of neck skin laxity (which improves over time); lifting of the mid-face cheek both posterior-superiorly, as well as anteriorly giving the appearance of increased facial volume; "wow" improvement of eye lid skin redundancy (upper folds and lower lid skin crepe-ness) resulting in "fresh, rested" eyes; improvement of the contour of the jaw line (it will not "remove" jowls); the improvement of acne scars and skin irregularities; and improvement of skin red and brown discolorations. If patients desire further rejuvenation, another treatment may be performed any time after the first 4 to 6 months. Patients may have a "Lite" procedure at very low settings which acts as a booster effect of the initial treatment, or they may elect to have another "full" treatment. I have treated two patients aggressively twice, and they both have had amazing results. Fraxel re:pair is a rejuvenative tool that is ahead of its time. To insure maximum benefits from the treatment, I encourage all of my patients to live a healthy lifestyle, exercise, diet, and use good skin care products before and after their treatment. Beauty never goes out of style, and the best item that a person can wear is their own face. Many patients are finding that for a few thousand dollars, the "bang for their buck" is well worth the years removed from their aging face, neck, and chest. With the ability to communicate via the internet, digital photographs, and the telephone we are able to treat patients from all over the world. Recent patients have been from Dubai, London, Hong Kong, New York City, Charlotte, San Diego, and San Francisco. I will be presenting the findings of our first 100 Fraxel repair patients at Facial Cosmetic Surgery 2009, a multi-disciplinary scientific medical meeting in Las Vegas this June, and possibly at The American Academy of Facial Plastic and Reconstructive Surgery meetings in San Diego this September.
"Trust Your Face to a Facial Plastic Surgeon" is the slogan of The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS).
The Academy has put out a video to help patients with the task of choosing their facial cosmetic physician (http://www.youtube.com/watch?v=CYAx4vcCRzI).
Donn Chatham, MD, current President of AAFPRS, is featured commenting in the video. Dr. Chatham is not only a great facial plastic surgeon, but believe it or not after watching the video; he has the best sense of humor of any physician I have ever known. Choose your facial cosmetic physician most carefully.
Seth Godin, author of many books including "The Dip" has a daily blog with valuable information. Internet communication is here to stay until the next quantum leap in communication. Mr. Godin's daily blog addresses this along with other valuable bits of information each day. A recent example may help how we treat each other better in the age of Google (http://sethgodin.typepad.com/seths_blog/2009/02/personal-branding-in-the-age-of-google.html). You may subscribe to his blog at no cost by copying and pasting the above link. Be well.
The "Rock", starring in "Return to Witch Mountain" is not the only LA resident with a big premiere on 3/13/09. Michael Persky, MD, FACS will appear on TLC (The Learning Channel) where Host Kyan Douglas and his ``glam squad,'' hairstylist Anthony Morrison, stylist Andy Paige and make-up artist Jeannie Mai, try to shave 10 years off their subject's apparent age via a makeover. After spending the past decade taking care of her family, Stephanie undergoes a professional makeover before beginning a new job, including Fraxel re:pair laser skin rejuvenation by Dr. Persky. The episode is entitled "Back to Work" and airs on TLC Fri 3/13/09 @ 10am or 1 pm PST depending on your local provider. Set your Tivo's and DVR's. Be well.
