Probably no one watching me now hasn’t heard of Botox. Botox is a purified protein that we use to weaken muscles in the face, and usually these are muscles that are causing frown lines or other deep lines such as crow’s feet lines around the eyes. I’m on the national education faculty for Botox and have been using it for about 8 years. Botox actually has been used in the United States for over 20 years, and was first used for some complex eyelid twitching that patients may have had. Now we use it for cosmetic purposes to give a more refreshed, relaxed look. And when a patient comes in to discuss Botox with me I will usually show them a video and then explain to them which muscles we’re going to be treating. And I do it very conservatively, especially the first time I see a patient, because I don’t want an overly frozen type of look. We want that natural appearance, much more fresh, without lines, and then I see the patients back in a couple of weeks when the Botox has really taken effect nicely. And if I need to do a little dose adjustment at that time we’ll do it, and then we set that dosage for the patient so that on subsequent visits we know exactly what they’re gonna need.
My staff has been with me for an average of almost 10 years. We start with Mary Lynn who is my nurse. She is the one that directs my operating room. She meets with our patients before and after and does all of our scheduling and makes sure everything is set for their surgery.
Karen who is my patient care coordinator meets with patients beforehand and also helps in their education, and she’s been with me 7-8 years.
My administrative assistant Margie has been here for 14 years. She’ll help you on the phone, take care of you while you’re here in the office, and really has a great commitment to my patients.
Jansee who is my Spanish-speaking employee helps tremendously with our Spanish population and also is very knowledgeable about plastic surgery.
In addition I have the radiant skincare staff. Lisa has been with me, she’s actually my longest employee, has been here 15 years and has been taking care of my patients both before surgery, after surgery, and also incorporates facials and skincares in some of my non-surgery patients.
Stephanie now directs our skincare center and has been with me almost 5 years. And in addition I have part time staff that works with me in the operating room, recovery room, and in the general office setting.
Liposuction is one of the procedures that we do a fair amount of here and usually we do it in our accredited operating room. I do both tumescent liposuction and vaser liposuction. Vaser liposuction is a type of ultrasonic liposuction where we get better results in certain areas, faster healing, less bruising. Other times tumescent liposuction may be the most appropriate way to go. It’s a procedure that I’ve been performing since 1983 and I’ve actually used all of the different modalities of liposuction for my patients. And it is very common that one patient may have two or three different liposuction modalities depending upon the area that is being treated.
Liposuction can be used in a lot of different areas. In the face I usually only use it in the neck but it gives excellent results for contour. In men liposuction’s most often used in the chest for gynecomastia and in the love handle areas. For women the most common areas are the abdomen and the thighs. It can also be used around the knees and to contour the calves. And one of the other common places is in the arms. Especially women in their mid 30s to 40s, of course seeing a little bit of hanging but still have good skin quality.
Tummy tuck or abdominoplasty is a procedure to remove the excess skin and fat from the lower abdomen. At the same time we usually repair the muscles that may have been stretched during pregnancy as this procedure is most common in women after they’ve had children. The other time we may use it is in people that have lost a fair amount of weight either through diet and exercise or with bariatric surgery. The recovery may be a little bit longer than many of the other procedures, but I think the results are definitely worth it for a nice flat abdomen that allows you to wear clothes that you could otherwise not be able to wear.
While it’s great to have children it does impact on your body in many ways, so a mommy makeover is a group of procedures. May involve breast augmentation or breast lift or sometimes a breast reduction and lift. At the same time we do abdominoplasty or tummy tuck along with liposuction or liposuction alone. So we combine these procedures in a personal plan for each patient to really get them back to their pre-baby state or sometimes even better than their pre-baby state.
Breast augmentation is a procedure that I really specialize in. I’ve used silicone gel implants and saline implants for over 25 years. I pride myself on natural-looking results, so women can really expect their breasts to be larger but still appear very natural. Sometimes it’s combined with a breast lift when necessary. And it gives the woman a much fuller contour where she can wear different kinds of clothes that she might not have been able to wear otherwise. But my commitment really to women is that they have a natural result so that most people wouldn’t know that they had a breast augmentation in New Jersey.
You know it’s great that silicone implants are now back on the market because it gives women a choice. Silicone implants were taken off the market with some allegations that over the last 14 years have not proved to be true. There really is no greater risk to women with silicone implants than there is to saline implants, but there are some differences. Saline implants, if they rupture, you would know it because one breast would deflate. Whereas with a silicone implant we may have a silent rupture and it may not be detectable except by MRI or perhaps physical examination by the plastic surgeon.
Some women still are uncomfortable with silicone implants and that’s fine and I still use saline implants for those women. Other women have actually waited until silicone gel implants were available because they do have a little more natural feel, especially in women with very small breasts to begin with.
I have a lot of things on my website and I spend a lot of time speaking with patients when they come into the office about breast augmentation, about the differences between saline and silicone. And I’m not one that tries to push you to one implant or the other. I really look at myself as a resource. I want you to do so me research on your own and them I’m here to help you make that final decision.
Breast lift is really for women who either have sagging breasts naturally or it’s happened after childbirth or breastfeeding. It entails lifting the nipple to the more normal position, sometimes removing skin, and sometimes involves breast augmentation as well if the person so desires. There are different types of breast lifts so that we may just take out some skin around the areole, we may reduce the areole as part of the procedure which is what a lot of women want. It may also entail a vertical mastopexy which means that there’s an incision that goes vertically from the areole to the crease underneath the breast. Or in some cases it involves a full anchor incision, although that’s an incision that I’ve tried to get away from, and really with newer techniques we can usually accomplish that.
A breast lift will elevate the breast to its more normal position, which may be a position that it was at when you were younger. It may also increase the size of the breast by adding an implant and it gives a much more natural contour to the breast, something much more youthful and perky.
Breast reduction surgery is surgery that I very often will do in the hospital because it’s usually covered by insurance. It’s for women that have very large breasts. They may have back pain, neck pain. They may have a lot of trouble wearing normal clothes. And very often it’s women that just can’t exercise because of the weight and the pain in their breasts. We work with women very carefully to get it covered by insurance most of the time, but at the same time there are women with slightly smaller breasts that wouldn’t be eligible for insurance coverage. And in those women we may operate on them in our accredited facility in the office where a smaller operation is necessary and they’re able to go home the same evening.
Gynocomastia is a condition in men where they actually develop breast tissue. All men have breast tissue naturally but it doesn’t develop. When it develops it may either be fat or it may be glandular. When it’s just fatty tissue I use vaser liposuction in order to remove that fat through very small incisions usually in the arm pit. This gives a much better contour to the chest and allows men to be able to take of their shirt, wear different clothes, and really enhance their appearance. At times when breast tissue needs to be removed I make a small incision half way around the nipple which is hidden right at the border of the nipple and the normal colored skin. That way through a very small incision I can remove the gland and achieve that nice contour to the chest. And often it’s combined with liposuction in the love handle area because that’s the other most common region that men require or want liposuction.
