How do you judge a good nose job?  A good plastic surgery procedure is one that provides not only an improved appearance but one in which the rest of the world wouldn’t be able to tell that anything had been done. The surgeon that can provide this has to be a good artistic plastic surgeon and not merely a plastic technician. It upsets me when I walk through a grocery aisle and see the tabloid magazines pointing out how this celebrity or that celebrity had a bad cosmetic procedure- as if all plastic surgical procedures turn out badly. The way I respond to my patients is that the vast majority of procedures turn out fine, that they would be surprised how many of their neighbors have had procedures, but they might never know it because they turned out well.

A good example of what I am talking about is Ashlee Simpson. Simpson reportedly had a nose job in April 2006. When asked about it in an interview in May, Simpson neither confirmed nor denied it. In the May 2007 issue of Harper’s Bazaar, she said that she was not insecure about her appearance and had not been beforehand. She later stated that “as long as people have two eyes” they could determine for themselves whether she had a nose job.

Ashlee Simpson- Before and After

See My Before and After Pictures at :  http://fairfaxplasticsurgeon.com/rhinoplasty.htm

Here is a celebrity starlet who underwent the procedure for her own reasons… probably because she didn’t like the appearance of her nose. And regardless of the reasons for her procedure, some people needed to speculate whether she had the procedure at all. And finally, there is no doubt that the appearance of her “new” nose is attractive, natural, and improves her overall appearance. Kudos to her plastic surgeon.
Rhinoplasty procedures can be one of the most satisfying and life-changing procedures in cosmetic surgery. I have patients that range from 17 years old to 70 years old who come in with complaints about the appearance of the nose. The nose is after all, the central feature of your face.  Rhinoplasty procedures are becoming one of the most common procedures performed by plastic surgeons.  Typical complaints include:

• my nose is too large
• my nose is too small
• my nose has a bump
• my nose has a drooping tip
• my nose has a big tip
• my nose is too large
• my nose is crooked

What most people don’t realize without coming in for a consultation is that not all of these procedures require a surgical nose job.  Some of these issues can be addressed non-surgically.  I was one of the first plastic surgeons according to one of my filler representatives to use cosmetic fillers such as Radiesse, Juvederm, and Restylane to address the cosmetic appearance of the nose.  To some degree, all the complaints can be addressed with one of these fillers, without surgery, and no need for recovery.  Radiesse lasts between 1 and 2 years.  Juvederm and Restylane can last up to 1 year.

 At least half of my patients benefit more from a Surgical Nose Job.  The goals, of course are to provide an improvement that appears natural.   If you look at my before and after pictures on my web site ( www.GoToBeauty.com or www.fairfaxplasticsurgeon.com ), you will see that I attempt to provide my patients with an attractive appearance and an appearance of never having had a rhinoplasty.  I spend a lot of time performing revision rhinoplasties on patients from other offices where the results are not as natural.

 The first step is an initial consultation which is complementary.  During your consultation, we will discuss your image with some digital imaging software.  We will discuss your complaints and desires come up with a plan that fits your desired image and lifestyle.  Sometimes this means a non-surgical option, and sometimes it means a surgical rhinoplasty.

Blog by Dr. Phillip Chang, M.D. :  Board Certified Plastic Surgeon with Offices in Loudoun and Fairfax, Virginia.

Attached is an article excerpted from the American Society of Plastic Surgery. The finding point out that the use of nonsurgical methods of cosmetic improvement such as the use of Botox and facial fillers has become mainstream.

NEW YORK, NY (June 1, 2009) — Despite what some may think, people aren’t hiding their use of BOTOX® Cosmetic and hyaluronic acid dermal fillers. In fact, according to survey statistics released today by The Aesthetic Surgery Education & Research Foundation (ASERF), the research arm of the American Society for Aesthetic Plastic Surgery (ASAPS), nearly nine out of 10 respondents (87 percent) openly discuss their BOTOX® Cosmetic and hyaluronic acid dermal filler treatments with others, with seven out of ten (70 percent) receiving support from the people they told.

“In a similar survey issued four years ago, we dispelled the myth that Hollywood and corporate wives were the typical BOTOX® Cosmetic patient,” says ASERF President Laurie Casas, MD, a plastic surgeon practicing in suburban Chicago. “Now, demographic and perception data trends show us that aesthetic injectable treatments have continued to evolve into mainstream and accepted options for the everyday woman.”

• 90 percent of patients who get botox openly discuss it
• Typical recipient is a working mother 41-55 years old of modest incomes
• Younger patients are beginning to have treatments with botox to mantain their appearances of youth
• Patients are treating their “angry lines” and “worry lines” with botox and their “parenthesis lines” around their mouths

Survey results found that the typical aesthetic injectable patient is a married, working mother between 41-55 years of age with a household income of under $100,000. The survey also found that women receiving aesthetic injectable treatments are health-conscious and philanthropy minded, with the majority incorporating exercise (95 percent) and healthy eating habits (78 percent) into their lives, and many volunteering with charitable organizations that matter to them (32 percent). In addition, nearly seven out of 10 respondents believe that BOTOX® Cosmetic (72 percent) and hyaluronic acid dermal fillers (65 percent) are important parts of their aesthetic routine.

“Interestingly, among BOTOX® Cosmetic patients, nearly seven out of 10 respondents also received treatment with hyaluronic acid fillers,” says Dr. Casas. “Most people have great success with BOTOX® Cosmetic and dermal fillers; however, we need to make patients aware that even though injectables are not ‘surgery,’ their administration is a medical procedure with risks that depend on the training and experience of the clinician, the clinical setting and the technique used.”

Additional findings of the survey found that 72 percent of respondents received BOTOX® Cosmetic injections to treat their glabellar lines – also referred to the “11” – the frown lines in between the brows, while 63 percent of those surveyed received hyaluronic acid dermal filler injections to treat their nasolabial folds – also known as the “parentheses” – the lines around the nose and mouth. A few of the most frequently cited reasons to receive treatment with BOTOX® Cosmetic was “to look more relaxed, less stressed” while patients reported choosing treatment with hyaluronic acid dermal fillers to “look more rejuvenated.”

Based on its annual survey of U.S. physicians performing cosmetic procedures, ASAPS recently reported that BOTOX® Cosmetic injections have remained the most frequently performed procedure since FDA approval of the product in 2002. Hyaluronic acid dermal fillers ranked as the third most popular procedure performed last year. ASERF conducted this follow-up survey to quantify the characteristics and opinions of the patients who receive the treatment to help its members and the public obtain a better understanding of these important modalities.

Blog by Phillip Chang MD ( Aesthetica Cosmetic Surgery and Laser Center )  serving Loudoun and Fairfax in Northern Virginia

According to a new survey by the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery, attitudes about self-image and the desire to improve self image through cosmetic surgery change depending on your age and stage in life. Visitors were asked “What aspect of physical beauty do you find most appealing in another person?”

Interestingly, most younger patients ( 20s through 40s ) valued the appearance of their bodies over the appearance of their face. As they got older ( 50s through 60s ), the feelings of body image evolved. These patients came to value the appearance of their faces more than their bodies.

· Respondants in their 20s through 40s responded that they valued a fit well proportioned body the most

· Respondants in their 50s and 60s responded that they valued youthful skin the most

These finding reflect what happens in my practice.  I have offices in Loudoun, Winchester, and Fairfax, Virginia.  This is one reason why my “Mommy Makeover” procedure has become so popular. Women in their 20s through their 40s value the appearance of their bodies in when they are in their 20s as they search for potential partners. These same patients, however, once they have a partner and begin to have children struggle with their body image because of how having children change the appearance of their bodies. The mommy makeover procedure usually addresses the changes to their breast ( through an augmentation and/or a lift ) and their belly ( through a tummy tuck and/or liposuction ).

As a woman approaches their 40s and 50s, these patients begin to focus more on their face and skin. This makes sense as our facial features begin to change around this time. The skin loses elasticity, and years of sun damage begin to take its toll on skin quality. These are the patients make up a large part of my practice. In general, these patients come in for:

· Mini Facelift to address laxity in the skin and jowls

· Facial fillers ( Juvederm, Radiesse, or Restylane ) to improve the appearance of deep facial lines such as the “ parenthesis “ line around the mouth and to fill in the loss of facial volume in the lips and cheeks

· IPL ( Photofacial ) to treat sun damage and dark spots

· Botox to treat the lines of the forehead, glabella, and crows feet.

Finally the respondants were asked why they would have cosmetic surgery? The most common answer was to boost self-confidance. To boost self-confidence was the top choice for all decades. The second place answers depended on the patient’s age.

1. 20s- To attract potential partners

2. 30s- Increase professional opportunities

3. 40s- Increase professional opportunities

4. 50-60s To help make friends

It is always important to understand what our patients are most concerned about at different stages of their lives. We want to be equipped to help our patients make the right decisions to maintain their beauty at every age—no matter which type of cosmetic medical procedure they are interested in.

Another question asked members to contemplate “The most important factor in maintaining beauty.” While adherence to a healthy diet, regular exercise and skin care were popular choices, approximately one in five members felt that a cosmetic medical procedure was most important in the 50s and 60s.

Blog by Phillip Chang MD:  Board Certified Plastic Surgeon with Offices in Loudoun, Winchester, and Fairfax Virginia

It appears that during the later years of his life Michael Jackson may have worn a prosthetic nose.

Michael Jackson wore a prosthetic nose, according a report — and it was missing from his surgically mangled face as he lay in an LA morgue.
Left behind was a small, dark hole surrounded by bits of cartilage, Rolling Stone magazine said, citing witnesses who saw the King of Pop’s body on the autopsy table.
Jackson, who was notoriously shy about his appearance, wore the prosthetic to mask the effects of decades of plastic surgery, according to the magazine.

Most people acknowledge at this point that Michael Jackson despite his musical brilliance was deeply troubled.  This fact is evident in almost every aspect of his life outside of music.  For most plastic surgeons, Michael Jackson’s pathologic obsession with plastic surgery was very evident.  What is sad is the lack of restraint that his plastic surgeons posessed when presented with his desires.  Most people recognized that at the very least, Michael Jackson had multiple nose jobs, a cheek implant, a chin implant, bleaching of his skin, and wore wigs.  There was not much else to change.  And what was most sad, was that none of these procedures enhanced his appearance.  In the end, Michael Jackson lay on an autopsy table with an empty space where he typically wore a prosthetic nose.

Lifestyle Lift Slammed for Deceptive and Illegal Posting

Earlier today, the New York state Attorney General announced it fined Lifestyle Lift, the “facial-firming” mini-lift company, $300,000 for posting fake consumer reviews on the Internet.

The Attorney General accused Lifestyle Lift of tricking consumers “into believing that satisfied customers were posting their own stories” about the product. This deception, said the AG, constituted “deceptive commercial practices, false advertising, and fraudulent and illegal conduct” under New York and federal laws.

The news out of New York today is thought to be the first case in the US combating “astroturfing” — the practice of employees of a company posing on the Internet as unaffiliated or independent consumers to praise a product or attack detractors. In media reports, Lifestyle Lift did not immediately respond to requests for comment. 

Lifestyle Lift is a nationally advertised company which provides significantly discounted mini-facelift procedures which they claim are faster and get patients back to work in only a few days.

I frequently tell my patients that you get what you pay for.  Make sure you see before and after procedures that are performed by the surgeon; not by other doctors in the company.  Also make sure the surgeon is a Board Certified Plastic Surgeon.  Many doctors are really trained as ENT doctors, Oral Surgeons, or Dermatologists.  They are, in my opinion not properly trained to work on your face and body.

Addendum:

To be fair, I have received a letter from the Executive Vice President of the American Academy of Facial Plastic and Reconstructive Surgery stating that their membership of otolaryngologists are trained in the field of  Facial plastic and reconstructive surgery.  This additional training requires a competative one year accredited  fellowship incorporating facial plastic and reconstructive surgery.   I have many friends who have completed this fellowship and are excellent surgeons.  None of these friends, however, stray from the face to operating on the breast and or body.

To my knowledge, this still does not include the body ( breast augmentation, tummy tucks, body liposuction ).

Blog by Phillip Chang, MD ( Aesthetica Cosmetic Surgery and Laser Cener ) Offices in Loudoun and Fairfax, Virginia.

IPL or Intense Pulse Light Laser should not be used as a treatment for suspected skin cancers.  While IPL is an excellent method to treat skin discolorations, brown spots, and age spots, IPL can not and should not be used to treat skin cancers.  The reason is the IPL is not an ablative or destructive laser.  It does not eliminate or “destroy” skin.  This is why you can actually have an IPL treatment and go back to work the same day ( with make-up of course ).  Another reason, is skin cancers can be deep; and the IPL laser does not penetrate to the deeper layers of the Dermis.  Finally, skin cancers are cancers.  Although most skin cancers are slow growing, they can be very destructive if not addressed properly by a plastic surgeon or dermatologist.  Call for a consultation and be evaluated.

Blog by:  Phillip Chang, MD ( Aesthetica Cosmetic Surgery and Laser Center)

NATRELLE® is offering great savings with the purchase of their pre-consultation kit. For just $39.95, receive $170 in rebates, including:

• $50 towards the price of NATRELLE® gel implants surgery
• $50 off BOTOX®
• $50 off JUVÉDERM®
• $20 off LATISSE®

http://www.natrelle.com/kit2.html

One of the most frequent questions I am asked is what is a Mommy Makeover. Other ways that this question might be posed is, “I just had a baby… I love him/her to death but now my breasts aren’t as full and perky as they used to be; and my belly is stretched to the point where I sometimes still look pregnant… what can you do to make me look better.” Most of these women don’t want to be Barbie dolls. They don’t particularly want to be unrealistic. They really just want to resemble as closely as possible what they might have looked like before having children.

According to the American Society of Plastic Surgery (ASPS), breast augmentations increased by 55% between 2000 and 2006. Breast lifts increased by 96%. While tummy tucks jumped by a whopping 4000%. That is not a typo; you read it right. There was a 4000 percent increase in tummy tucks between 2000 and 2006.

These figures reflect what women are asking me about in my own practice. My practice generally sees patients from Loudoun and Fairfax Virginia, but I have a strong contingent of patients from Winchester and other parts of Northern Virginia. The vast majority of these patients are moms who are trying to reverse the effects of motherhood on their bodies. Therefore, the typical “Mommy Makeover” includes a breast augmentation and/or a breast lift, or a tummy tuck with localized areas of liposuction.

These patients can be seen in the before and after section.

http://www.webmd.com/skin-beauty/features/mommy-makeover-a-plastic-surgery-trend

The following video, produced by WUSA9 in Washington DC, highlights the offer by Dr. Chang’s “Radiance Salon & Spa” to give free hair cuts to individuals in need of a job or morale boost.

With an eye toward creating natural-looking results, Dr. Phillip Chang has created the Aesthetica Cosmetic Surgery and Laser Center, a full-service plastic surgery practice with offices located in Loudoun and Fairfax counties, Virginia. He offers an array of facial, breast, and body-contouring ‘mommy makeover” procedures which emphasize natural results with less recovery times such as the minimal scar mini-facelift and breast augmentation procedures.