Laser for Varicose Veins

Image result for Varicose Vein Anatomy

Just as with Dermabrasion and similar treatments, laser works by damaging the vein which, in turn, initiates new growth of tissue. This new tissue is not the vein but a form of scar tissue, which closes up the vein. The vein loses blood source and dies, and gradually (over a year or two) disappears.

Laser treatment is never a single treatment but a series of many gradual “assaults” which take effect only slowly. You cannot expect miracles but, with patience and determination, you will get there.

Spider veins are small veins ousting from the larger veins. It is the larger veins that must be “attacked” with laser. So-called “endovenous” laser treatment is applied. A laser fiber is passed through a thin tube (catheter) into the vein. While doing this, the doctor watches the vein on a duplex ultrasound screen. Only local anesthesia is required.

You should wear compression stockings for one week or more after endovenous laser treatment and avoid any strenuous lower extremities activity (such as jogging).

Burning, changes in color, small clotting may accompany this treatment but should not last for more than a few days. If it does, consult your physician and discontinue the treatment.

Plastic Surgery Trends in 2016

In 2016, we’ll see a rise in liposuction and Botox procedures. Breast augmentation is in steady demand, although women do not desire overly voluptuous figures. “Modern Family” actress Ariel Winter, who had breast reduction surgery this year, is also reported to have influenced this “smaller breasts” trend.

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Unorthodox buttocks surgeries are on the rise, mainly due to their importation from and popularity in Brazil. They continue to pose risks and are not recommended by top experts in the field. Some “bottom-heavy” trends among the “stars” have also influenced the market (Kardashian). As politeness turns into political correctness, one ceases to be “fat” and is to be defined as “more shapely.”

Kardashian

Smaller enhancements are more in fashion than multiple surgeries, mainly due to the steady bombardment of the market by companies promising “painless and fast” fat loss, skin improvement etc. What they often omit to say is that such “fast losses” just as quickly vanish. An average non-surgical treatment of an “area” will last 1-2 years before it has to be repeated.

In 2015, we have already marked a steady increase in face and neck lift surgeries, approximately 25% more compared to 2014. “People take ‘selfies’ and that’s what they see,” Dr. Fisher says. “Camera resolution, instant availability, online presence… people are more self-critical. That is where we, experts in body-sculpting, can truly make a difference.”

DCIS

Ductal carcinoma in situ (DCIS) is the most common type of non-invasive breast cancer. Ductal means that the cancer starts inside the milk ducts, carcinoma refers to any cancer that begins in the skin or other tissues (including breast tissue) that cover or line the internal organs, and in situ means “in its original place.” DCIS is called “non-invasive” because it hasn’t spread beyond the milk duct into any normal surrounding breast tissue. DCIS isn’t life-threatening, but having DCIS can increase the risk of developing an invasive breast cancer later on.

When you have had DCIS, you are at higher risk for the cancer coming back or for developing a new breast cancer than a person who has never had breast cancer before. Most recurrences happen within the 5 to 10 years after initial diagnosis. The chances of a recurrence are under 30%.

Women who have breast-conserving surgery (lumpectomy) for DCIS without radiation therapy have about a 25% to 30% chance of having a recurrence at some point in the future. Including radiation therapy in the treatment plan after surgery drops the risk of recurrence to about 15%. Learn what additional steps you can take to lower your risk of a new breast cancer diagnosis or a recurrence in the Lower Your Risk section. If breast cancer does come back after earlier DCIS treatment, the recurrence is non-invasive (DCIS again) about half the time and invasive about half the time. (DCIS itself is NOT invasive.)

Here is an actual case:

43 year old with palpable breast mass biopsied in 2006 with results showing fibroadenoma. The mass has grown (now 3cm) and she is having a gyne surgery and wants the mass removed while in OR.

1st step: excisional biopsy, do pathology, send it out

2nd step: atypical fibroepithelial lesion with 2.5mm focus of DCIS? Margins negative for DCIS but positive for atypical cells? Do an MRI. Any enhancement pattern surrounding complete lumpectomy cavity consistent with atypia or DCIS?

3rd step: re-excision margins where atypical cells show, further excision to clear the margin, then XRT

4th step: no further radiotherapy, possible chemo

Diet after Liposuction

Sarah Condor-Fisher, Ph.D. is an expert legal contributor to Rick Amato show, broadcast on Sirius XM, Breibart.com, and http://amatotalk.com/podcasts/

Cosmetic Surgery and Laser Center of Cerritos

Obviously, what you eat after liposuction is crucial. Do not go to any extreme diet right away. Changes should be gradual but should accommodate your new self. You have taken the first step to your happiness. Eliminate sugar. Sugar is a disaccharide which contributes to your weight nothing but empty calories. Before sugar became widely spread, during the 18th and 19th century, people used only honey to sweeten their food and drinks. There were fewer obese people and fewer heart attacks. People died of other causes, for most of which we have cures today. If you need a sweetener, use the artificial one, but also with discretion. Remember that sweetness (the taste buds on your tongue and in your mouth) recedes relatively quickly. If you eliminate all sweet food from your diet for 4-6 weeks, the “sweet tooth” cravings will go away.

Meat can be just as dangerous…

View original post 213 more words

Diet after Liposuction

Obviously, what you eat after liposuction is crucial. Do not go to any extreme diet right away. Changes should be gradual but should accommodate your new self. You have taken the first step to your happiness. Eliminate sugar. Sugar is a disaccharide which contributes to your weight nothing but empty calories. Before sugar became widely spread, during the 18th and 19th century, people used only honey to sweeten their food and drinks. There were fewer obese people and fewer heart attacks. People died of other causes, for most of which we have cures today. If you need a sweetener, use the artificial one, but also with discretion. Remember that sweetness (the taste buds on your tongue and in your mouth) recedes relatively quickly. If you eliminate all sweet food from your diet for 4-6 weeks, the “sweet tooth” cravings will go away.

Meat can be just as dangerous as sugar when used without discretion. The diets rich in protein, which are so common today, are misguided to the extent to which they are based on exceptionally healthy and fit individuals who exercise and need increased protein consumption. If you are not one of these individuals, stop worrying about protein in your diet. Eliminate red meat, save for an occasional steak or “pleasure meal” and focus on white meat and eggs. No, you need not worry about cholesterols either. If you do not supply them to your body in the diet, the body will manufacture them, because it needs to have some.

Finally, avoid fat in all forms. Do not add fat on your salads, do not think that you should add extra olive oil because it is healthy, and do not – ever! – mix carbohydrates and fat, such as fried potatoes or cakes where flour is mixed with butter… Substitute water, vinegar, lemon juice, if you must have that cake. Use Teflon pans, cook your potatoes or better still, have a bowl of rice.

(This advice comes to you from Miss World and Miss USA in Natural Bodybuilding – Physique, INBA/PNBA professional natural athlete, Sarah Condor-Fisher, Ph.D. For more, see her book on nutrition on Amazon and Barnes and Noble.)

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Troubled by Lines?

For your forehead, Botox and Dysport would be your first choice. Dysport is a possible alternative to Botox. It works in a similar way, keeps muscles relaxed and does not cause wrinkles. Dermal fillers (Juvederm and Radiesse) will be used when minor filling is necessary (e.g. lines on your forehead). Lasers apply heat energy to help create new collagen fibers and may also be used.

Lines between the brows are created by the procerus and corrugator muscles. In severe cases, these muscles can be removed by a procedure involving an upper eyelid incision. This procedure may be a viable long-lasting alternative for those who have had poor results from Botox and are reluctant to try it again (all fillers have to be re-applied).

Breast Cancer – BRCA 2

BRCA 2 is a DNA repair mutation, which prevents (other) DNA mutations which might effectively prevent cancer. Survival rate does not depend on your age, but on the progress of this malignancy. BRCA is more dangerous in that it prevents DNA repair and thus precludes or minimizes the efficiency of chemotherapy. Prophylactic mastectomy is to a greater benefit in BRCA patients, provided that they survive the primary treatment, because the systemic risk of the initial malignancy will not be altered. If the malignancy has been characterized as “node-negative,” it is also a good sign.

Plastic Surgery Success Is Yours

Women that underwent facial rejuvenation surgery (facelift) are perceived as more attractive and more likeable, which reflects in their everyday life and employment. JAMA plastic surgery journal last week reported this saying that it illustrates a phenomenon known as “facial profiling,” an assemblage of cues we gather about other people from visual contact, in particular their facial expressions.

“This is part and parcel of our evolutionary makeup,” says Dr. Gregory Fisher, the expert plastic surgeon at Cosmetic Surgery and Laser Center of Cerritos. “We use it to assess the danger as well as likelihood of success in our daily interactions.” Dr. Fisher wrote extensively on body image and our perception of our selves. “This is another aspect of the same issue,” he told our interviewer, “we tend to approximate not only likenesses and dislikes to the dynamic facial expressions of others, but we also compare those and subliminally turn them inside-out, so as to align them with ours where possible and reject them if we find no likeness or similarity. Then there are what you may call ‘standard features’ of sadness, anger, etc. These  were first described in the book entitled  Mécanisme de la Physionomie Humaine by Guillaume Duchenne who used electric stimulation to determine which muscles were responsible for different facial expressions. Charles Darwin subsequently used Duchenne’s research in his work on the subject. Darwin famously  compared facial expressions in humans to those in animals: whether the cheeks were full and high, thus showing happiness, etc..”

We all know that we judge people’s appearance, thus making our own deductions about their character. Such a judgment is often made within seconds of seeing the stranger’s face for the first time. Judgments about generic characteristics tend to be the same (e.g. perception of threat or welcome in someone’s eyes, their smile etc.). As the new JAMA study shows, these perceptions can be manipulated by plastic surgery, which changes the appearance of a person’s resting facial expression.

For the small study, the researchers took before-and-after photos of 30 white women who had recently undergone various facial plastic surgery procedures, including face-lift, eyebrow lift, neck lift, eyelid surgery and/or chin implant surgery. Then, each individual photograph was rated by dozens of study participants for six personality traits: aggressiveness, extroversion, likeability, trustworthiness, risk-seeking and social skills.

They found that the women’s post-operative photos were rated as being more likeable, higher in social skills, more feminine and more attractive. There was no significant change, however, in perceived trustworthiness, risk-seeking, extroversion or aggressiveness.

Why? “I made similar conclusions twenty years ago,” Dr. Fisher comments. “Face-lifts and lower eyelid procedures are the most telling here. These surgeries can easily increase the curvature of the lips, mouth, stretch the skin an increase the freshness around the eyes. Some of it can even be achieved non-surgically but, of course, the surgery will have more lasting result and a more radical and immediate positive impact on person’s life.”

Do Not Go To Brazil for Cosmetic Surgery!

A model whose bottom came second in Brazil’s Miss BumBum beauty contest has revealed the terrible harm plastic surgery wreaked on her body.

Andressa Urach, 27, spent a month in intensive care and feared she would lose her leg after fillers ‘rotted’ her muscles and had to be removed, triggering a life-threatening infection.

These photos show the shocking extent of the damage to one of the most controversial TV presenters in Brazil – a nation which has overtaken the U.S. to become the cosmetic surgery capital of the world.

WARNING GRAPHIC CONTENT 

Terrible toll: Brazilian TV presenter Andressa Urach, a runner up in Brazil's Miss BumBum competition, has revealed the terrible damage wreaked on her body by plastic surgery after wounds in her thigh were infected

Terrible toll: Brazilian TV presenter Andressa Urach, a runner up in Brazil’s Miss BumBum competition, has revealed the terrible damage wreaked on her body by plastic surgery after wounds in her thigh were infected

Taped up: The presenter spent a month in intensive care and reportedly feared she would lose her leg

Miss Urach, who once made hotly-contested claims that she slept with footballer Cristiano Ronaldo, has reportedly undergone at least nine cosmetic procedures in the past five years.

They were said to have included a nose job, a bioplasty facial ‘correction’, jaw reduction, breast enlargement, liposuction and even vaginal lip reduction.

Homemade Plastic Surgery

One of the most famous cases of awful plastic surgery gone wrong: Hang Moiku. This 48 year-old lady from South Korea, became so addicted to plastic surgery that she was left unrecognizable after her obsession led her to inject cooking oil into her face. She had her first plastic surgery procedure when she was 28. Following operation after operation, her face was eventually left enlarged and disfigured, and the surgeons she visited refused to carry out any more work on her and one suggested that her obsession could be a sign of a psychological disorder. So Hang resorted to injecting cooking oil into her face. It became so grotesquely large that she was called “standing fan” by children in her neighborhood – due to her large face and small body.

As Hang’s notoriety spread she was featured on Korean TV, viewers seeing the report took mercy on her and sent in enough donations to enable her to have surgery to reduce the size of her face. During the first procedure surgeons removed 60g of foreign substance from Hang’s face and 200g from her neck. After several other sessions her face was left greatly reduced but still scarred and disfigured, a true challenge for Korean plastic surgery.

Join Us for New Beauty Night

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Call our offices at 562-865-9600 to find out more. Meet with our staff of professionals.

Visit our Facebook account and leave a note with your review and wishes at the front desk computer system.

Liposuction vs. Tummy Tuck

The amount of loose skin is the deciding factor. After a dramatic weight gain-and-loss (pregnancy), tummy tuck will be the only way to rid you off the loose skin in your abdomen. Liposuction is only for fat loss and will not do much to the skin in terms of aesthetic improvement. In fact, if you already have loose skin, it might even exacerbate the condition, because lipo-suction is the suction of fat, the skin will remain and may overhand even more.

lipo beforelipo after

Tummy tuck is a more complicated surgical procedure than liposuction. In liposuction a thin, hollow tube (cannula) is inserted into the body, and fat is “sucked out.” This leaves minimal scarring and recovery is very fast. With tummy tuck, a larger incision is necessary, in order to expose the abdominal wall and remove fat. Abdominal muscles may need to be sutured together after the surgery, which may require complete quiet and prolonged healing. Anything like extending your arms or undergoing even light exercise within 4-6 weeks after a tummy tuck is guaranteed to cause complications and is therefore against Dr.Fisher’s strict directive.

COST: Depending on the extent and area, the cost of liposuction is from $3,500-7,000 and more. The average cost of a tummy tuck is about twice as much, simply because a tummy tuck is more complicated, requires more surgical expertise and also entails a higher risk of complications, for which you are paying.

EXPERIENCE is crucial and you need a surgeon with 20+ years of experience in the field to do the job really well. Do not hesitate to ask about the physician’s experience and expertise.

 

Join Us for Beauty Night

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Once again, we will be offering special products for special prices to special customers. There are new sales but also new products for very special prices only on this Beauty Night. More importantly, you can become acquainted with our staff of expert nurses and assistants and ask questions about you particular condition without waiting or hesitation.

 

Join Us for BEAUTY NIGHT

Join Us for BEAUTY NIGHT

Special Prices, Sales on Selected Items, free Information about Surgery, Laser Procedures and All Cosmetics Available!!! Do Not Hesitate – Places Are Limited! Come and Celebrate July 4th with US by Becoming MORE BEAUTIFUL! Make Yourself Happy! Make It Happen NOW!

Beauty Night Again!

Beauty Night Again!

Come and get the best deals. A brand new laser, state-of-the-art technology available! Special deals on selected items. Do not hesitate and call our office for more information.

This entry was posted on May 14, 2014. 1 Comment

Contamination and Healing

ImageAntibiotic prophylaxis of clean surgical procedures (e.g., elective operations on skin and soft tissue) is controversial based on a single randomized trial that showed benefit in breast and groin hernia surgery. The controversy persists because the incidence of superficial surgical site infection was so high (4%, versus an expected incidence of about 1%) in the placebo group. Evidence that antibiotic prophylaxis is indicated for soft tissue procedures of other types is lacking entirely, and prophylaxis cannot be recommended. If administered, antibiotic prophylaxis should be given before the skin incision is made, and only as a single dose. Additional doses are not beneficial because surgical hemostasis renders wound edges ischemic by definition until neovascularization occurs, and antibiotics cannot reach the edges of the incision for at least the first 24 hours. Not only is there lack of benefit, prolonged antibiotic prophylaxis actually increases the risk of postoperative infection. Increasingly in the practice of plastic surgery, there is a tendency to leave closed-suction drains in place for prolonged periods in the erroneous belief that the incidence of wound complications is reduced by prolonged drainage. Nothing could be further from the truth. Data indicate that the presence of a drain for more than 24 hours increases the risk of postoperative surgical site infection with MRSA. Closed suction drains must be removed as soon as possible, ideally within 24 hours. Prolonged antibiotic prophylaxis is often administered to “cover” a drain left in place for a prolonged period. This is a prime example of error compounding error, and is a practice that must be abandoned.

Fibromyalgia

Fibromyalgia is a common health problem that causes widespread pain and tenderness (sensitive to touch). The pain and tenderness tend to come and go, and move about the body. Most often, people with this chronic (long-term) illness are fatigued (very tired) and have sleep problems. It can be hard to diagnose fibromyalgia.

Fibromyalgia affects two to four percent of people, mostly women. Doctors diagnose fibromyalgia based on all the patient’s relevant symptoms (what you feel), no longer just on the number of tender points.

There is no test to detect this disease, but you may need lab tests or X-rays to rule out other health problems. Though there is no cure, medications can relieve symptoms. Patients also may feel better with proper self-care, such as exercise and getting enough sleep.

 Fibromyalgia is a chronic health problem that causes pain all over the body and other symptoms. Other symptoms that patients most often have are:

  • Tenderness to touch or pressure affecting joints and muscles
  • Fatigue
  • Sleep problems (waking up unrefreshed)
  • Problems with memory or thinking clearly

Some patients also may have:

  • Depression or anxiety
  • Migraine or tension headaches
  • Digestive problems: irritable bowel syndrome (commonly called IBS) or gastroesophageal reflux disease (often referred to as GERD)
  • Irritable or overactive bladder
  • Pelvic pain
  • Temporomandibular disorder—often called TMJ (a set of symptoms including face or jaw pain, jaw clicking and ringing in the ears).

What causes fibromyalgia?

There is most often some triggering factor that sets off fibromyalgia. It may be spine problems, arthritis, injury, or other type of physical stress. Emotional stress also may trigger this illness. The result is a change in the way the body “talks” with the spinal cord and brain. Levels of brain chemicals and proteins may change. For the person with fibromyalgia, it is as though the “volume control” is turned up too high in the brain’s pain processing centers.

Criteria Needed for a Fibromyalgia Diagnosis

  1. Pain and symptoms over the past week, based on the total of:
  2. Number of painful areas out of 19 parts of the body
  3. Plus level of severity of these symptoms:
  • a. Fatigue
  • b. Waking unrefreshed
  • c. Cognitive (memory or thought) problems

Plus number of other general physical symptoms

  • Symptoms lasting at least three months at a similar level
  • No other health problem that would explain the pain and other symptoms

 

(Source: American College of Rheumatology)

Join Us for Beauty Night

Join Us for Beauty Night

If you have been to our Beauty Night previously, you probably know that this is a one-of-a-kind event, where you can get all the mentioned cosmetic improvements fast, efficiently, at better costs, while also consulting with our staff of expert nurses and professionals who administer Restylene, Dysport, ViPeel, Latisse, Perlane and other cosmetic enhancements in their everyday practice.

Our Public Reviews

  • Lizete B.
  • Irvine, CA

7/13/2013

The staff is amazing… very friendly.  Dr. Fisher did everything I asked for and more.   After procedure staff and Doctor constantly called to assure everything was going well.  

I have done my research for over 5 years and Dr.Fisher’s name kept coming up.  I finally decided after speaking with several of my friends with their experiences with procedures, only to find out they all had done procedures with Dr. Fisher.  That was it. There is no better recommendation than word of mouth and even better from those closest to you.

I’m not one to take the time to go online and write a review or even the person to brag about what I’ve done, but the staff and doctor honestly did an amazing job.  I will continue coming here, I will continue recommending, and so far I have 3 of my friends lined up to do procedures themselves.

The best part about the office is they are professional, but yet give it a twist to make it fun.  They have Beauty Nights where you and a group of friends can come and get really good discounts on procedures.

 

  • Janet O.
  • Lakewood, CA

7/11/2013

I had a wonderful experience. I highly recommend paying Dr. Fisher a visit. He does not charge for appointments. The offices are located within the Cerritos Towne Center, where the Cerritos Sheraton is along with all the numerous office buildings.  When you walk into the office, the waiting room is clean, staff is very helpful. Dr. Fisher was recommended to me by my sister. My sister had an amazing surgical care, both pre and postop and the results are great. She is very satisfied – and so am I.

More Reviews

    • Wendy O.
    • Baldwin Park, CA
    • 3 friends
    • 3 reviews

    I would definitely recommend Dr. Fisher to anyone I know that’s considering having laser hair removal or plastic sugary, the nurses are very friendly and helpful and I’m very pleased with the work I had done. If I ever decide to have anything else done I will definitely be going back.

  • Carol W.
    • Carol W.
    • Fawnskin, CA
    • 0 friends
    • 8 reviews10/16/2013

    After 19 months, I decided to have another Thermage procedure yesterday.
    Since 2003, I have had at least three Thermage procedures, I decided this time to have my chest and arms done. In the past I had my face and neck only.
    Thanks to Dr. Fisher’s excellent staff, I am thrilled with the results. I woke up this morning and my arms look awesome! I am 66 years old and have had years in the sun swimming, kayaking and boating. With Thermage, my arms look so great, especially my upper arms. I  am also happy that my face nor neck is swollen-maybe a little on the neck. I also had laser on my psoriasis on my left side of my face.
    I am so convinced that Dr. Fisher and his staff work together as a team. Thank you from the bottom of my heart for such excellent service. I am two months away from taking Embrel due to Dr. Fisher and his staff!
    Again, thank you so much for your excellent care. I really appreciate that Sarah, Nancy and Dr. Fisher met with me before the procedure and stayed with me until it was over!
    You are such of an awesome team!!!

Our Internet Reviews

As public internet sites are often unfairly and unjustifiably censored, we offer a few direct reviews from our actual patients on this site:

Janet O. from Lakewood, CA, says:

I had a wonderful experience with the entire staff. I highly recommend paying Dr. Fisher a visit, it is very easy to obtain an appointment free of cost.  It’s located within the Cerritos Towne Center, where the Cerritos Sheraton is along with all the numerous office buildings.  When you walk into the office, the waiting room is clean, staff is very helpful. Accreditation on the wall. I was recommended by my sister. My sister had an amazing care. I had a great care during my breast augmentation very satisfied with my results.

Hair laser removal: also an amazing experience. It was easy, painless, and in minutes I was out the door. Nurses made me feel very comfortable. Overall, I thought the whole staff was professional and friendly. I would definitely recommend this surgical center to a friend.

Thank you, Janet. It was our pleasure to help you and your sister and make you both happy.

Gummy Bear Implants

ImageGummy bear implants are made of a highly cohesive, form-stable silicone gel. Compared with other types of silicone gel implants, the silicone particles in the gummy bear implants are more cross-linked, so the material bands together more closely. This “form-stable” quality is where some of the advantages of gummy bear implants come into play.

One of these advantages is the feel — gummy bear implants have the feel of natural breast tissue.Image

There are also safety pluses. Namely, if you cut a gummy bear implant in half, the gel stays put. As a result, there is minimal risk of gel migration if the implant shell ruptures (and they can). This puts them on par with saline breast implants, which (upon rupture) release only salt water into the body. And gummy bear implants feel more natural than saline gel implants.

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In contrast, with other types of silicone gel implants, errant gel can migrate and may cause local problems such as scarring and granulomas (small areas of inflammation in tissue).

According to some experts, the new cohesive gel implants may also pose a lower risk of capsular contracture  (scar tissue around the breast implant). Exactly why this occurs, and if it proves to be true in the long run, is unknown, but it may be a result of how firm the new implants are.

There are some downsides to the newest player in breast enhancement. The “form-stable” attribute means that they must be inserted through a larger incision, since their shape can’t be altered. The incision length may be up to 5.5 centimeters, depending upon the size of the implant. Smaller incisions are used for today’s silicone gel and saline-filled breast implants.

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Finally, form-stable breast implants cost more than other types of silicone-gel implants. Discuss the cost with your surgeon during your breast implant consultation. Beware, some outpatient centers do not include the implant cost into surgery, so you may end up paying much more than your initially telephone inquiry indicated. This never happens with Cosmetic Surgery Laser Center of Cerritos, where you are given the total cost of your procedure after you meet with the surgeon and determine the type of surgery you want.

Laser Treatment for Dark Spots and Skin Blemishes

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Darkened regions of the skin occur as a result of abnormal tanning. Human skin is sensitive to sunlight. Several diseases and many drugs can occasionally cause photosensitivity.

Dark spots can appear in a variety of ways, like freckles, brown patches (blotchiness), and moles. Any dark spot that is either new or changing should be evaluated by a professional.

At Cosmetic Surgery and Laser Center, we offer a range of laser treatments for different skin spots. Cosmetic Laser treatments are non-invasive procedures that use pulses of visible light to improve the appearance of aging or pockmarked skin. It is most often performed on the face, neck, chest, and hands to erase these spots and any signs of aging.

Among these signs of aging are fine lines, red blemishes, mottled coloration, broken blood vessels, pigment discoloration such as freckles and age spots, enlarged pores, coarse or rough skin, loss of skin tone and elasticity, and general sun damage. A series of laser treatments bring a more youthful, smooth and revitalized skin appearance, with no downtime.

Laser treatments are clinically shown to reduce wrinkles and improve the tone of the skin by non-invasively stimulating new collagen production.

The type of response heard from patients after having the treatments done is that they feel like their skin is lifted. There is a decrease in pore size, their skin feels tighter, and there is a reduction in fine lines and wrinkles.

What are the benefits?

–          Improve appearance of aging or sun damage skin (fine wrinkles, freckles, pigmentation

–          Smoothen skin and reduce pore size

–          Improve skin tone or tightness

–          Reduce redness, flushing or Rosacea

–          No recovery time

 

Am I a candidate for Laser treatment?

The Best Candidates for Laser treatment are:

• People with early skin aging changes and sun damage who desire healthier more youthful skin
• People who suffer from Rosacea and experience flushing and redness of their skin
• People who don’t want to take time off to heal from laser resurfacing or chemical peels
• Active people who want to improve their skin, but do not want to interfere with social or outdoor activities.

 

 

How does Laser work?

Specialized lasers specific to your skin condition area selected to deliver a series of pulses of light to the skin using settings that are customized to skin type and skin color. You may need one or more ( a series) of treatments, performed at intervals of a few weeks to months. The benefits of Laser treatments are consistent, visible changes from the first session, with little discomfort and minimal risk. Red blemishes from broken blood vessels and brown spots of pigment from sun damage respond and skin quality respond to the Laser energy.  Visible result can be seen after treatments.

What areas can be treated with Laser?

Laser can be used on any part of the skin. It is especially effective for improving the appearance of the face, neck, and chest and hands.

What results can I expect from Laser treatments?

The effects Laser treatments are cumulative. People with visible aging skin from the sun can expect to see smoother skin with a decrease in fine wrinkles, reduction in pore size and fading of sun spots. Others can expect to see a gradual decrease in overall redness, flushing and dilated capillaries. Many people with Rosacea can see improvement in the number of breakouts and are able to decrease or discontinue their medications.

Why are multiple treatments of Laser necessary?

Depending on the number of conditions you are treating, and the severity of the individual problems, a series of five or more treatments of Laser, spaced three weeks apart, is our standard recommendation. You can return to work the same day and resume all regular activities. By dividing the full program into several treatments, the procedure provides gradual improvement with very low risk – and, it preserves the wonderful “no downtime” feature people appreciate so much.

Are there any side effects resulting from Laser treatments?

Immediately following the procedure you may experience some redness and/or a slight darkening of pigmented areas. The redness usually dissipates within 24 hours; however, darkened pigmentation may persist and peel lightly for up to two week. Makeup can be applied to the treated area immediately, if necessary. Additionally, tattoos may be lightened and hair growth may be impaired in the treated area, although it is not the intended purpose of this particular treatment. It is extremely important to wear sun block and avoid sun exposure on a daily basis to reduce any potential side effects.

 

What are the Laser treatments like?

Each Laser treatment takes approximately 15 to 30 minutes. People with more sensitive skin may prefer to use a topical anesthetic cream applied 30-60 minutes before the treatment. After treatment, there is no discomfort – you can return to your normal routines and activities immediately. Occasionally, there may be signs of treatment such as redness or blotchiness that last for a few hours. You will see gradual improvement from each session, resulting in a dramatic improvement by the end of your treatment program. Results are long-lasting, usually a year or longer.

I’m interested – What do I do next?

Call us at 562-865-9600 to schedule an appointment to discuss your concerns with our knowledgeable staff of expert nurses and Dr. Gregory T. Fisher, MD, F.A.C.S., who has years of experience in treating skin disorders.

 

Breast Capsulectomy Surgery

 

When a breast implant is performed on a patient, the body may in certain instances “wall it off” and form a capsule that surrounds the implant. This capsule can vary in thickness from patient to patient. Patients with capsules that contain muscle cells have the ability to contract and misshape the breast altogether. This contraction is called a capsule contraction. It may cause pain, break, rupture, and deform the shape of the breast altogether. The removal of this capsule is done through breast capsulectomy surgery.

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(Pre- and post-capsulectomy surgery)

 

Capsulectomy will involve total or partial removal of the capsule and will usually involve the replacement of the implants. The goal in this surgery is to allow the body to form a more favorable capsule and to place a breast implant that will last longer than the previous one.

The method of inserting and positioning your implants depends on your anatomy and your surgeon’s opinion. Normally, implants are inserted through an incision in the natural crease under the breast. Other methods of insertion are through an incision in the armpit or around the areola. These incisions are closed using fine dissolving sutures. They are also taped to provide better support during the healing process.

Breast capsulectomy surgery will take around one and a half hours to complete. General anaesthesia is used and you may be required to stay overnight, attended to by expert nurses from the Cerritos Cosmetic Surgery and Laser Center. There are some cases where patients may go home on the same day.

You must have realistic expectations from breast capsulectomy surgery. You will feel more confident with your appearance and will be overall more self-confident.

Caldwell-Luc Procedure

As a maxiofacial surgeon, Dr. Fisher is an expert in performing the Caldwell-Luc procedure, also known as a radical antrum operation. This surgical procedure is indicated in chronic maxillary sinusitis, i.e. the obstruction and inflammation of the maxillary sinuses. It is sometimes performed to obtain tissue for biopsy of a tumor located in the area below the eyes.

The maxillary sinuses are hollow air spaces located on both sides of the nose, just beneath the cheeks. Maxillary sinusitis can be caused by allergies, nasal polyps or direct trauma to the face. Symptoms include fever, clogged nose, facial pain, runny rose and sometimes a toothache.

The Caldwell-Luc procedure is indicated after all conservative treatment options have been exhausted. A small incision is then made between the gum and the upper lip, and a small portion of the maxillary bone is usually removed. The sinus opening leading to the nose is often made larger. This usually results in improved drainage of natural secretions.

Some side effects may arise after the procedure. The most common is swelling of the face, which resolves after a few days. Other side effects are bruises on the neck, numbness of the upper lip and cheeks, pain while eating or chewing, facial pain and sometimes teeth discoloration. There are usually no visible scars after the operation, as the incision is made under the upper lip.

Advances in Plastic Surgery

Plastic surgery is one of the most advanced surgeries in the field of medicine. People with accidental abnormalities as well as people who are dissatisfied with their current personalities prefer to have a plastic surgery, not only to improve their appearance but all facets of their personal and professional lives as well. Plastic surgery does wonders to personalities of individuals whether it is through liposuction, facelift, facial implants, skin resurfacing, tummy tuck, or any other procedure.

The first most important thing to consider while planning a plastic surgery is the surgeon itself. A number of surgeons claim to be the best. However, thanks to advances in the field of Plastic surgery, one can now authenticate the credentials of every doctor. Surgeons, such as Dr.Fisher, who are certified by the American Board of Plastic surgery are the ones to go for. Additionally, you may want to check the surgeon’s past record on the Board site, his or her previous derelictions and actions against them. Unlike some less reputable sites, which require no authentication and people can post on them anonymously (e.g. Yelp), the Medical Board site will always tell you the truth about the surgeon and his or her record.

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Over the years, there have been many advances in this field. The technology is becoming more and more sophisticated with the passage of time. New techniques have been introduced, which have helped achieve better results and shorten recovery time.

One of the latest techniques, is the ultrasound assisted lipoplasty, applicable pre, during or after liposuction. This technique accompanied with the tumescent technique, and super-wet technique has changed the way things have been done in liposuction. Now surgeons can gain precise results in little time.

Another advancement in this field is the transconjunctival blepharoplasty, which is a technique used in eye-lid surgery. As opposed to traditional surgery, this kind of surgery is used with minimal incision. A very tiny incision is made in the lower eyelid. Fine forceps are used to remove the fats and dissolvable sutures are used to close the incision. This way, perfect eye shape is obtained with minimal incision and scarring.

Whatever, procedure you plan to undergo, you need to understand that plastic surgery is a very complex field. Gain a level of satisfaction by communicating your concerns and expectations with your doctor, have basic knowledge and understanding of the surgical procedure and the technology being used, and do not be afraid to ask sensible questions. Read all materials presented to you and pay the down payment only after you make the decision to undergo a specific procedure.

However, also prepare yourself for the unexpected. Things can go wrong in any surgery, and complications may occur. Plastic surgery is medicine-science wedded with art. You need a good surgeon who is also a great artist. Therefore, learn about the complexity of your desired physician, weigh the benefits over the risks, and then go for it.

Liposuction

Liposuction is one of the most traditional forms of cosmetic surgery and it is still one of the favorites. For those who struggle to lose those extra pounds this is the simplest way to get looking the way you want to without having to sweat for it. This is a procedure overwhelmingly favored by women and the price tag of over $1,000 per area may well put many off. However, as public research indicates, the money is well worth it – 85% of all those who have undergone plastic surgery retain the weight loss. This is partly due to the fact that plastic surgery actually takes away your fat cells. Interestingly, you only have a certain number of fat cells and the number is given to you genetically. The fat cells may grow or increase but they do not “multiply.” Thus, once taken away, your fat loss is going to be permanent – unless, of course, you “stretch out” the capacity of the remaining fat cells by overeating.

It is also interesting to note that Dr. Fisher has the experience, ability and skill to execute several procedures in one operation, thus your liposuction can be tied in with breast augmentation (or reduction, as you desire) at a minimized cost. Of course, the total cost depends on how extensive the procedure is and how time consuming it is going to be for the staff and the surgeon. Thus, unless you visit Cosmetic Surgery and Laser Center in person for a personalized examination with the surgeon, you will not be given any definite price tag on your surgery.

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Mentor Memory Shape Breast Implants

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Featuring a natural look and youthful firmness, these teardrop shaped implants have been used for over a decade and in over 70 countries. They’re now FDA approved and a beautiful option for you and your surgeon to consider.

MENTOR® MemoryShape Breast Implants are the latest innovation in breast implants. The implants are filled with a highly cohesive gel and have a unique, tapered appearance. Unlike round breast implants, MENTOR® MemoryShape Breast Implants are teardrop shaped, meaning they’re thinner at the top and gently slope to a fuller projection point near the implant’s bottom to mimic the silhouette of a natural breast. Each MemoryShape Implant features SILTEX® Texture, a gentle imprinting process designed to help keep your implants in place.

MENTOR® MemoryShape Breast Implants are indicated for breast augmentation in women at least 22 years old, or for breast reconstruction. Breast implant surgery should not be performed in women with active infection anywhere in their body, with existing cancer or pre-cancer of their breast, who have not received adequate treatment for those conditions, or who are pregnant or nursing.

There are risks associated with breast implant surgery. Breast implants are not lifetime devices and breast implantation may not be a one-time surgery. You may need additional unplanned surgeries on your breasts because of complications or unacceptable cosmetic outcomes. Many of the changes to your breast following implantation are irreversible (cannot be undone) and breast implants may affect your ability to breastfeed, either by reducing or eliminating milk production. The most common complications with MENTOR® MemoryShape Breast Implants include reoperation for any reason, implant removal with or without replacement, and ptosis. A lower risk of complication is rupture, which is most often silent (meaning neither you nor your doctor will know you have a rupture) and can only be detected by appropriate imaging techniques such as MRI. The health consequences of a ruptured silicone gel breast implant have not been fully established. MRI screenings are recommended three years after initial implant surgery and then every two years after to detect silent rupture.

Healty Mind in a Healthy Body

Breast augmentation surgery produces measurable improvements in several important areas of health and quality of life. Interestingly, the official medical journal of the American Society of Plastic Surgeons (ASPS, August issue) also reported that so does breast reduction. A “Breast-Q” questionnaire, a well-validated survey instrument by the ASPS, documented both physical and psychosocial health benefits of breast reduction surgery.

“These results confirm my study from Columbia,” says Dr. Fisher, “that all is a matter of proportion. We all have unique requirements. Listen to your patient, I often tell my younger colleagues. You simply cannot approach surgery with a universal volume or implant in sight.”

The ASPS study was designed to evaluate and confirm the benefits of breast surgery for the purposes of insurance coverage. Previous studies have found similar benefits and it is only up to the insurance companies to realize the implications. “In the long run, the entire society benefits from plastic-cosmetic surgery performed on an individual whose psychological and psychosocial makeup is thereby improved,” says Dr. Gregory T. Fisher, P.C., F.A.C.S., of Cerritos Laser and Cosmetic Surgery Center.

In the latest BREAST-Q questionnaire, the only questionnaire used to assess breast reduction outcomes that meets international and federal standards for questionnaire development, out of a series of 49 patients who had undergone breast reduction, 78 percent anonymously completed the BREAST-Q before and/or after surgery. The results showed significant improvement in all four areas evaluated on both the before and after questionnaires: satisfaction with the appearance of the breasts and psychosocial, sexual and physical well-being. On a 100-point scale, satisfaction with breast appearance increased from about 20 before surgery to more than 80 afterward.

There were also large improvements in scores for psychosocial well-being: from 41 to 84, sexual well-being: from 40 to 78, and physical well-being: from 43 to 81. As reported in previous studies, the procedure relieved pain in the breast, neck, back and shoulders.

“This is nothing new,” concludes Dr. Fisher, “only, in the past, most of such studies have been performed with breast augmentation patients, with similar results.”

 

Surgery vs. Botox

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Botox, fillers and chemical peels were among the most popular cosmetic treatments in the United States and fueled growth in the plastic surgery industry for the third consecutive year. The American Society of Plastic Surgeons quotes 14.6 million procedures were performed in 2012, an increase of 5 percent from 2011. “The growth in cosmetic surgery continues to be driven by a significant rise in minimally invasive procedures,” Dr. Gregory Fisher says. “However, many people do not realize that you get what you pay for, and apart from not being perfect, the non-invasive results do not last forever.”

Botox treatments rose 8 percent last year to 6.1 million procedures, along with the skin-smoothing treatment microdermabrasion. Demand for fillers to smooth out wrinkles jumped 5 percent, while laser hair removal treatments rose 4 percent and chemical peels jumped 2 percent. Overall, minimally invasive treatments accounted for 13 million procedures in 2012, while surgery such as breast enlargements and facelifts dropped 2 percent to 1.6 million.

“Female cosmetic breast surgeries such as breast augmentation, as well as body contouring procedures like tummy tucks, were still the most popular procedures I performed in 2012,” says Dr. Fisher, “although they too saw a decline in popularity.”

Although breast enlargement surgery dropped 7 percent from the previous year, it was still the most popular surgical cosmetic treatment with 286,000 procedures, followed by nose reshaping, liposuction, eyelid surgery and facelifts.

Reconstructive plastic surgery, which improves function or abnormal appearance, was also up slightly last year with tumor removal the top surgery.

Average Liposuction Fee

LIPOSUCTION*
Cost Range:
$2,000-$10,000

Cost Range by specific area:

Abdomen, upper & lower: $3,800 – 8,700 Chin, Cheeks, Jowls, Neck $2,500 – 5,000
Abdomen, lower: $2,500 – 5,500 Flanks, male $2,500 – 5,500
Arms $2,000 – 5,500 Anterior Thighs & Knees $2,800 – 5,800
Back $2,000 – 4,500 Inner Thighs & Knees $2,800 – 5,800
Breasts $3,500 – 8,000 Hips/Waist $2,100 – 5,500
Buttocks $2,000 – 5,000 Outer Thighs $2,100 – 5,500

Average Total Cost:
One Area: $3,500

Surgeons fee: $2,000
Anesthesiologist: $500
Facility fee: $700

Three Areas: $6,800

Surgeons fee: $5,000
Anesthesiologist: $800
Facility fee: $1,000


Five Areas: $9,700

Surgeons fee: $7,000
Anesthesiologist: $1,000
Facility fee: $1,200
Hospital Fee: $500

RELATED FEES**

 
Buttock lift $4,878
Cellulite massage treatment $223
Laser treatment of leg veins $407
Liposuction (suction-assisted) $2,697
Liposuction (ultrasound-assisted) $2,979
Lower body lift $7,810
Sclerotherapy $326
Thigh lift $4,653
Tummy tuck $5,232
Upper arm lift $3,610

MemoryShape TM

The Food and Drug Administration (FDA) on June 14 approved MemoryShapeTM breast implant, an anatomically shaped, highly cohesive silicone-gel implant manufactured by Mentor Worldwide LLC, and which is indicated for breast reconstruction as well as breast augmentation in women at least age 22.

“Breast augmentation continues to be the most popular cosmetic surgery across the United States, so these exciting advances in implant devices mean that women have more choices for a natural result,” says ASPS President Gregory R.D. Evans, MD. “FDA approval of this implant signifies that board-certified plastic surgeons now have another safe, new choice to offer women.

“Research shows that patient satisfaction with breast augmentation is an impressive 98 percent, and we will undoubtedly continue to see extraordinary satisfaction rates with these new implant options,” Dr. Evans adds. “There are many considerations to discuss when choosing breast implants, and ASPS Member Surgeons have the certification and aesthetic expertise to guide patients through this process.”

The FDA requires that Mentor conduct a series of post-approval studies to assess long-term safety and effectiveness outcomes, and the risks of rare disease. Lessons learned from previous post-approval studies on silicone gel-filled breast implants informed the design of post-approval studies for Mentor’s MemoryShape breast implant.

As a condition of approval for the MemoryShape breast implants, Mentor must:

  • Continue to follow 955 women who received the MemoryShape breast implants as part of the pre-market core study that provided safety and effectiveness data for the device approval. These patients will be followed until they have completed their 10-year evaluations for long-term device performance;
  • Continue to follow approximately 350 subjects who were implanted with the MemoryShape Medium Height Moderate Profile (CPG Style 321) breast implants as part of a pre-market continued-access study (not part of the pre-market core study). The patients will be followed until they have completed their five-year evaluations;
  • Conduct a new study of approximately 2,500 women receiving MemoryShape breast implants to collect information on long-term local complications (e.g., capsular contracture, re-operation, removal of implant, implant rupture) and less-common potential disease outcomes (e.g., rheumatoid arthritis, breast and lung cancer, reproductive complications). These patients will be followed for 10 years;  
  • Conduct five case control studies by enrolling 10,750 women, to evaluate the potential association between any silicone gel-filled breast implant (including MemoryShape breast implants) and five rare diseases: rare connective tissue disease, neurological disease, brain cancer, cervical/vulvar cancer and lymphoma;
  • Evaluate women’s perceptions of the patient labeling; and
  • Analyze the MemoryShape breast implants that are removed from patients and returned to the manufacturer.

In addition to the Society’s work with the FDA to establish the PROFILE Study to track cases of ALCL in women with breast implants, the FDA and ASPS are also partnering to establish a National Breast Implant Registry (NBIR). The primary goal of the NBIR will be to create a device surveillance registry for persons with breast implants in the United States. The Registry will focus on collecting information on short- and long-term safety outcomes associated with all types of breast implants.

“In the process of launching PROFILE, it became apparent that the development of a National Breast Implant Registry would be beneficial to monitor the safety and efficacy of these devices in the patients who have used them,” says The PSF President Charles Verheyden, MD, PhD. “A cooperative research and development agreement (CRADA) has since been signed with the FDA and weekly progress is being made in reviewing historical data, validating questions, and discussing the mechanics of harvesting and utilizing data.”

The FDA’s approval is based on six years of data from 955 women demonstrating that there’s a reasonable assurance of safety and effectiveness for this implant. Mentor’s MemoryShape breast implant showed similar rates of complications and outcomes as previously approved breast implants.

“It’s important to remember that breast implants are not lifetime devices. Women should fully understand the risks associated with breast implants before considering augmentation or reconstruction surgery, and they should recognize that long-term monitoring is essential,” says Jeffrey Shuren, MD, director of the FDA’s Center for Devices and Radiological Health.

“The data we reviewed showed a reasonable assurance of safety and effectiveness,” says Dr. Shuren. “We will be looking at the results from post-approval studies that will focus on their long-term safety and effectiveness.”

The silicone gel in the MemoryShape breast implant contains more cross-linking compared to the silicone gel used in Mentor’s previously approved implant. Cross-linking refers to the bonds that link one silicone chain to another. This increased cross-linking results in a silicone gel that is firmer. The clinical significance of this type of silicone gel is not known. 

This approval makes the Mentor MemoryShape implant the fifth FDA-approved silicone gel-filled breast implant available in the United States.

For more information, go to www.fda.gov/breastimplants.

Dry Skin and Diet

Ordinary dry skin (xerosis) is not a serious problem, but it can be uncomfortable, unsightly and itchy, turning plump healthy appearing cells into shriveled and dehydrated looking ones and thus creating fine lines and wrinkles. More serious dry skin conditions, such as the inherited group of disorders called ichthyosis, can sometimes be disfiguring enough to cause psychological distress.

Fortunately, most dry skin results from environmental factors that can be wholly or partially controlled. These include exposure to hot or cold weather with low humidity levels, long-term use of air conditioning or central heating, and excessive bathing, using soap and shampoos.

Chronic or severe dry skin problems may require a dermatologist’s evaluation. However, you can do a lot on your own to improve your skin, including using moisturizers, bathing less and avoiding harsh, drying soaps and wear protective coverings in harsher climates.

The cause of dry skin may be both genetic and environmental, but the common physiochemical basis is a disrupted epidermal barrier function. The skin is not producing the structural lipids responsible for preventing water loss and protecting skin from foreign substances.

Symptoms

The feeling of tightness, especially after showering, bathing or swimming is usually a sign of excessive dryness. Skin that feels and looks rough rather than smooth, is itchy (pruritus), flakes or if you notice scaling or peeling, fine lines or cracks, also redness and, in advanced stages, deep fissures which may even bleed.

Dry Skin vs. Eczema

Atopic dermatitis, also known as eczema, is an allergic skin condition. It is hereditary and is often associated with food allergies, asthma and/or allergic rhinitis. Eczema can affect all age groups, but is most often seen in young children. In young children, it looks like a red, itchy, scaly rash. It is patchy and starts out as flaky or scaly dry skin on top of reddened, inflamed skin. The rash will itch or burn. If it is scratched, it may ooze and become crusty, especially in young children. Painful cracks can develop over time.

The rash most often affects the face, wrists, inside of the elbows, on the backs of the knees and outer thighs, usually where bends in the extremities occur. The severity of the disease can vary from person to person. In mild forms the skin is dry, hot and itchy, while in more severe forms the skin can become broken, raw and bleeding. Although it can sometimes look unpleasant, eczema is not contagious.

Key Ingredients in Skin Products

Key ingredients include those which mimic the structural epidermal barrier lipids such as ceramides, cholesterol, essential fatty acids (linolenic and linoleic acids). This lipids help reduce trans-epidermal water loss, which is the leading cause of skin dryness. Further, ingredients that attract water to the skin (humectants) especially under high relative humidity, i.e. glycerin, hyaluronic acid, sodium PCA and panthenol (vitamin B5) are extremely helpful at alleviating skin dryness.

SPF

Utra-Violet Rays (“UVRs”) are present throughout the year, irrespective of the season. For every 1000 feet increase in elevation, UVRs’ intensity increases approximately by 5%. UVRs are reflected and magnified by snow and other smooth surfaces, therefore one must take extra precaution during winter trips to ski resorts.

UVA is also present throughout the year and day. UVA is the longest wavelength of URV and can easily penetrate clouds, lighter color and loosely woven fabrics. The UVA wavelength is primarily responsible for collagen and elastin damage (photodamage) in the deeper dermal tissue. Therefore it is critical to apply at least SPF 30 broad spectrum UVA-UVB sunscreen daily and throughout the year.

Exfoliation

Over exfoliation can cause more barrier disruption, which will exacerbate dry skin. The upper layer of skin cells (corneocytes of the stratum corneum) help to keep water within the superficial and deeper skin layers and also keep foreign substances from getting into the skin.

Diet

Water is essential for proper body function. Drinking eight glasses a day is recommended as guidance for most healthy individuals. Listen to your body. If you are thirsty, drink.

Dry skin is caused, in part by epidermal barrier disruption. Fat soluble vitamins, especially A, E and D groups, preserve your skin. However, be careful not to overdose – usually 2-3 times a week a small capsule is more than enough, especially if you do not suffer from malnutrition and have diet rich enough in vegetables.

Finally, prefer water-rich fruit and vegetables to water-based juices and lemonades. Water from fruit and vegetables absorbs into the body slowly, keeping you – and your skin – fresh for much longer than a drink ever could.

 

New Trends in Plastic Surgery

Plastic surgery is practically a rite of passage for many modern people, because it cures the psyche and helps deep-seated insecurities. In recent years, however, plastic surgery has expanded beyond the traditional nose job or face lift. Here are four of the more questionable and painful-sounding plastic surgery “trends” of recent memory:

1.      Arms like Michelle Obama

The first lady has put a spotlight on toned triceps, and a new report from the American Society of Plastic Surgeons claims that more and more Americans are opting for the “upper arm-lift.” In 2012, more than 15,000 patients (98 percent women) spent a mind-blowing $61 million to have the fat from their arms liposuctioned. The Los Angeles Times notes that the procedure — termed a brachioplasty — “involves making an incision from the armpit to the elbow, usually along the back of the arm, to remove excess skin.” In other words, it’s the perfect quick-fix. However, Dr. Fisher points out, you can preserve the long-term results only with slight dumbbells, cardio, and eating a healthy diet.

2.      Artificial limb-lengthening

Who doesn’t dream of being taller? That’s why a few masochists — mostly men — are going to extreme, painful lengths to add two to three precious inches to their frames. The grotesque procedure requires a doctor to break a patient’s shin bone and insert a telescoping rod. The rod pulls the bone apart at the rate of about 1 millimeter a day for three months straight. This adds height to the legs while bone, nerves, arteries, and potentially infectious bacteria slowly fill in the gaps. One man, who went from 5-foot-6 to 5-foot-9, described the excruciating ordeal as “the worst decision I made in my life.” All yours for $85,000 and at least six months of immobility.

3.      Chinplants

If buff arms and long legs aren’t your thing, how about a more pronounced jawline? In 2011, the ASPS claimed that the procedure du jour was the “chinplant,” the popularity of which skyrocketed by 71 percent from the previous year for reasons science will never quite figure out. For ca. $5,000, the surgeon will take a scalpel to your lower lip or chin, and insert an implant into the soft tissue to create a more authoritative jaw. While it probably won’t make you the CEO of a Fortune 500 company, the idea is that at least you’ll kind of look like one from your neck to your lower lip.

4.      Toe-besity

Summer’s almost here, which means it’s time to dig out the flip-flops. And if you consider your toes fat, ugly, or otherwise imperfect, please don’t be one of the hundreds of Americans who are opting to have their toes to a more eye-pleasing standard. The procedure has introduced a new term to the English language – “toebesity.” You can have yours done for $2,500+ in Hollywood. Dr. Fisher reserves his judgment on this procedure. However, you may always call in and consult with this experienced Columbia and Harvard University surgeon about why you should or should not undergo a surgery.

 

 

Liposuction Cost

LIPOSUCTION*
Cost Range:
$2,000-$10,000

Cost Range by specific area:

Abdomen, upper & lower: $3,800 – 8,700 Chin, Cheeks, Jowls, Neck $2,500 – 5,000
Abdomen, lower: $2,500 – 5,500 Flanks, male $2,500 – 5,500
Arms $2,000 – 5,500 Anterior Thighs & Knees $2,800 – 5,800
Back $2,000 – 4,500 Inner Thighs & Knees $2,800 – 5,800
Breasts $3,500 – 8,000 Hips/Waist $2,100 – 5,500
Buttocks $2,000 – 5,000 Outer Thighs $2,100 – 5,500

Average Total Cost:
One Area: $3,500

Surgeons fee: $2,000
Anesthesiologist: $500
Facility fee: $700

Three Areas: $6,800

Surgeons fee: $5,000
Anesthesiologist: $800
Facility fee: $1,000

Five Areas: $9,700

Surgeons fee: $7,000
Anesthesiologist: $1,000
Facility fee: $1,200
Hospital Fee: $500

RELATED FEES**

 
Buttock lift $4,878
Cellulite massage treatment $223
Laser treatment of leg veins $407
Liposuction (suction-assisted) $2,697
Liposuction (ultrasound-assisted) $2,979
Lower body lift $7,810
Sclerotherapy $326
Thigh lift $4,653
Tummy tuck $5,232
Upper arm lift $3,610

* Fees vary according to region of country and patient needs.
**These fees are averages only. Fees do not include anesthesia, operating room facilities, or other related expenses.

Liposuction

Liposuction, commonly known as liposculpture, involves removing unwanted subcutaneous fat while simultaneously recontouring to create a more aesthetically appealing body. While not a treatment for obesity, liposuction- liposculpture selectively removes persistent and unwanted subcutaneous fat.

Bothersome fatty deposits are found in areas that are resistant to diet and exercise, such as the face, neck, breast, abdomen, upper arm, hips, thighs, knees, and ankles. Liposuction-liposculpture can be performed on multiple areas at one time – Dr. Fisher will follow accepted guidelines regarding safe volumes which may be removed in one session. Loss of 15-30 pounds in one procedure is common.

Goals include size improvement and weight loss. However, final results may not be evident for 6 months following your procedure. During this time your body balances fluids and the skin and remodels underlying tissues. Final results also depend on proper nutrition, exercise and decreasing your caloric intake.

Small incisions are made in hair bearing areas or natural skin folds. A special tumescent solution is next placed within the fatty areas to be removed. This solution provides anesthesia to the areas, while limiting the usual blood loss. Fat is then carefully removed from the areas of concern to the patient using a surgical instrument called a cannula, which is attached with tubing to a suction machine.

The time for completion of the procedure depends upon the total amount of fatty tissue removed. At the end of the procedure, the skin openings may be sutured or left open to heal, depending on the size of the openings. The patient may be placed in a compression garment that is worn for certain amount of time afterwards.

While recovery is easy, you should expect some initial drainage along with swelling, bruising and discomfort. Your compression garment will minimize the swelling, bruising, discomfort and assist in the retraction of any loose skin.

While some results are noted immediately, your final shape and form will continue to improve as your swelling subsides. You will be encouraged to be up and about the night of your surgery and progressively increase your activities. Usually light work duties may be resumed within three to five days and vigorous exercise within two to four weeks.

Who Is A Candidate?

  • Women and men desiring an improved facial, neck, breast, body or leg shape.
  • Patients of most ages who are healthy.
  • Patients who realize that this is not a weight loss procedure.

Procedure Description

  • Liposuction-liposculpture is usually performed under local or conscious sedation, in an approved outpatient facility.
  • The incisions are small and heal with minimal scars.
  • Patients may be placed in a special support (compression) garment at the end of the procedure.

Recuperation And Healing

  • You will be discharged home to the care of a responsible adult.
  • You are encouraged to be up and about the first night.
  • Some blood tinged drainage is expected for usually the first several days.
  • Light household duties may be resumed in several days.
  • Most patients resume standard pre-operative activities with 2 to 4 weeks after their surgery.

 

Other Options

  • Laser assisted liposcuction-liposculpture.
  • Vaser and ultrasonic assisted liposcuction-liposculpture.
  • Cool Sculpturing.

Neither of these last stated alternative options yield satisfactory results and Dr. Fisher does not perform them.

 

 

Notes

  • The specific risks and suitability of this procedure for a given individual can only be fully determined at the time of consultation with Dr. Fisher. All surgical procedures have some degree of risk. Minor complications which do not affect the overall cosmetic results occur occasionally. Major complications are rare.

 

Bunion

Many foot issues that are not curable dermatologically can be treated by a skilled plastic surgeon. A bunion or as medically called Hallux Abductovalgus develops when the big toe points toward the second toe, forming a bump on the inside edge of the foot. The bump is made of extra bone which the body forms in a defensive mode. The bump is formed because the big toe is not pointing ahead and throws off the alignment of the bones. Bunions do not happen overnight but gradually: as the big toe points toward the second toe, the angle of the bones slowly change throughout the years, causing a bump.

Bunions are so frequent as to afflict 30% of the entire population in the United States. Naturally, your mobility and quality of your life decreases as a bunion worsens, and the big toe pain causes major dissatisfaction with physical, psychological and social appearance.

Certain flawed structures of the foot are inherited. Bunions themselves are not inherited. Wearing shoes that crowd the toes such as narrow shoes or high heels can cause symptoms leading to a bunion. Wearing high heel shoes which place the feet in a more pronatory position will also lead or worsen a bunion. In fact, it is thought that for this very reason women have a higher prevalence of bunions than men. Women are 10 times more likely than men to have bunions. The National American Orthopaedic Foot and Ankle Society conducted a study that should that in the US, 88% percent of women wear shoes that are too small and 55% of women have bunions. Many women with bunions fear wearing open-toe shoes as aside from being uncomfortable, want to hide the appearance of their feet.

At the site of the bunion, the patient may feel pain, a burning sensation, or even numbness. There may be inflammation, as well. Bunions are usually visually apparent. However, x-rays are also taken to fully assess the condition. This can determine to what degree the bones are unaligned. Furthermore, bunions are progressive in that they usually worsen over time without the proper treatment. Individuals who have Rheumatoid Arthritis or some other joint problems will have more odds of getting a bunion.

Treatment is available with or without surgery. After an initial consultation and a review of the patient’s x-rays, the proper route can be determined. Most non-surgical treatments are early therapies for reducing pain, but not to get rid of the bunion. Some of these treatments include changing the type of shoe the patient wears to wider shoes, applying ice to lessen the inflammation, inserting padding in the shoes, avoiding activity that makes the patient stand for long periods of time along with other methods that can be discussed with Dr. Fisher.

There are many, many surgical procedures to fix bunion and most of these are modifications of each other. Some of these procedures involve removing the bump while others involve correcting the structure of the bone where the problem lies. The procedure that Dr. Fisher utilizes is truly revolutionary, because most patients are able to bear weight almost immediately after the procedure. Another benefit that Dr. Fisher provides his patients is that he performs the procedure in such an expert fashion and manner that no-one can tell that the patient had foot surgery.

BDD – Rhinoplasty of the Mind

Dr. Gregory Fisher, FACS, is the expert on body image. Among his numerous publications and articles, he focuses on the correlation of rhinoplasty and decrease of the symptoms of body dysmorphic disorder (BDD). BDD is the result of misperceived proportion among various parts of the body. This can occur with hands and the torso, feet or – the nose.

“The most frequent requests for ‘adjustment’,” says Dr. Fisher, “concern the face. The face is the most obvious, always visible, part of the body, which communicates our feelings and sensations. People with larger noses may appear unnecessarily ‘pushy’ or self-assertive.” This perception is then reflected in their own conduct and they may become what (they thing) corresponds to their appearance.

Many people with BDD have “unrealistic expectations,” says Dr. Fisher. They will never be satisfied and the most perfect result will fall short of the “ideal” they want to achieve. Unfortunately, this “ideal” is just as unreal in the person’s mind as it is in reality. Dr. Fisher suggests pre-operative computer imaging or portrait imposition may assist prior to surgery, in order to realize where to go and what to avoid.

However, Dr. Gregory T. Fisher, M.D., F.A.C.S. is also an expert in psychology and psychiatry. He can help such patients in other ways… “If only the patient will listen,” says Dr. Fisher, “I cannot perform miracles, but my team and I, we come very very close to it.”

A recent study published in Plastic and Reconstructive Surgery® (http://tinyurl.com/c2gqube), the journal of the American Society of Plastic Surgeons® (ASPS), parallels Dr. Fisher’s observations. The study concludes that rhinoplasty patients with BDD may be more likely to be disappointed with their results. People with BDD perceive one or more of their features as a defect. According to the ASPS (http://tinyurl.com/clc3bc8), BDD is “the only psychiatric diagnosis that directly considers body image concerns.”

“As a physician,” says Dr. Fisher, “I must consider primarily the patient’s long-term health. – As a plastic surgeon,” emphasizes Dr. Fisher, “I must always weigh their psychology and mental health. People who approach me for plastic surgery here in Los Angeles will obviously have some aesthetic concerns, but they need to understand what aesthetic medicine can and cannot fix.”

“Moreover,” adds Dr. Fisher, “one cannot consider a bodypart-at-a-time so to speak. For instance rhinoplasty is as much about the rest of the face as it is about the nose. I can change the shape of your nose to best balance with the chin and cheekbones, but balance is an uneasy concept for anyone with BDD, because BDD is all about balance and the inability to balance.”

Chocolate News

Image

Researchers at University of Warwick have come up with a new way through which they can cut down the fat content in chocolates by as much as half without changing how it feels in your mouth.

Presenting their study at an American Chemical Society meeting, the researchers revealed that one can create tiny ‘sponges’ in chocolate with the help of gelling agent agar, which can displace fat.

The researchers added that these sponges could be filled up with anything from water, juice or even alcohol.

Lead researcher Stefan Bon said that while their findings can be used to create ‘unhealthy’ chocolates by filling them up with alcohol, it can also be used to create chocolates with significantly lower fat content. “You can stick to your fruit juice if you want, but you can also make a vodka-based chocolate bar, which is exciting – obviously not very healthy, but exciting. It opens the route to different types of confectionery candy that can be placed on the shelf next to everything else that’s out there already”, he said.

 

 

Corrective Breast Surgery

 

Corrective breast surgery refers to several types of cosmetic breast correction, such as breast implant revision and inverted nipple correction. Dr. Gregory Thomas Fisher performs these procedures with utmost kill, specifically tailored to your conditions. It is therefore impossible to inform you in particular.

Generally speaking, however, there are many types of complaints patients come to us with desire to revise their previous breast augmentation. Breast augmentation is a very popular procedure. Among the many women who undergo breast augmentation, a relatively small number of them do not achieve their desired outcome. If you have undergone breast augmentation surgery and are not satisfied with the result, you can choose to have a breast implant revision at the Cosmetic Surgery and Laser Center in Cerritos Towne Center.

 

What Does Breast Implant Revision Correct?

Even if Dr. Fisher did not perform your original breast augmentation, he can help you improve your results through breast implant revision. Dr. Fisher performs breast implant revision in order to:

  • Change the size of your implants,
  • Improve breast symmetry
  • Replace a ruptured implant
  • Correct symmastia or treat capsular contracture.

In most cases, patients only undergo a revision procedure if they have completely healed from breast augmentation.

 

How Is Breast Implant Revision Performed?

Implant revision surgery is similar to your original augmentation surgery. Dr. Fisher will make incisions, typically in the same location as the first operation. These allow Dr. Fisher to reposition your implants or replace a ruptured implant. Your recovery will be very similar to your original breast augmentation recovery. You should rest, wear your supportive bra, and avoid lifting heavy objects. Dr. Fisher and his staff will provide specific instructions after the surgery. IT IS IMPERATIVE THAT YOU FOLLOW DR.FISHER’S POST OPERATIVE INSTRUCTIONS, because any complications caused by your negligence in not following Dr.Fisher’s instructions will result in another corrective surgery, which is not a part of your first or second procedure.

 

Inverted Nipple Correction (For Inverted or Prominent Nipples)

Nipples may be naturally flat or indented, and not project to the desired position. You may choose to undergo an inverted nipple correction procedure in order to improve the appearance of your breasts.

Pregnancy and breast-feeding can create prominent nipples and make nipples long, wide, and droopy. Prominent nipples can overshadow the youthful look of a breast enhancement. Correction of the nipple can complement breast augmentation or breast lift.

You can undergo inverted nipple correction in order to gain:

  • a more beautiful and proportioned contour,
  • an improved breast appearance,
  • breasts that appear more youthful.

How Is Inverted Nipple Correction Performed?

To correct an inverted nipple, small incisions are made near the nipple to allow access to the underlying structure. Tissues in the nipple are spread (inverted nipples) or contracted (prominent nipples), and dissolvable sutures are placed in the nipple.

A special stent may be placed for 1-3 days to ensure that your nipple is held in the correct position as it heals. The sutures in your nipple dissolve in several weeks. Inverted nipples are corrected with great care to preserve the milk ducts.

If you are interested in a corrective breast procedure, such as implant revision or inverted nipple correction, contact Dr. Fisher’s office at 562 865 9600 for a confidential consultation.

 

Tumescent Liposuction

The tumescent technique of liposuction consist of the following: Dr. Fisher distends the fat and soft tissues with local anesthesia, adrenaline, and salt water. In so doing, the blood loss has decreased to levels that are acceptable in an outpatient surgery setting without the need for post-operative transfusion. Further, more fat tissue may be safely aspirated at one sitting, frequently without the necessity of hospitalization or even general anesthesia. Currently, experimental procedures involving ultrasound and liposuction are being perfected which will hopefully improve techniques further. However, there is no substitute for the gentle hands of a skilled surgeon, who like a sculptor approaches the body to accomplish the perfection machinery can never master.

Regardless of the technique, liposuction is still not a treatment for generalized obesity, but rather for treatment of localized fat excess and disproportion.

Saline Breast Implants

About Saline Breast Implants

Saline implants are the most frequently used implants in the U.S. They vary in shell surface (i.e. smooth or textured), volume, shell thickness, profile, shape (round or anatomical), as well as expandable implants. Most saline implants are single lumen, and are filled at the time of surgery. There are prefilled saline implants, which are filled by the implant manufacturer. However, there are no prefilled saline implants with FDA approval at this time.

The shell consists of a strong, silicone elastomer shell, and is filled with a sterile saline solution at the time of surgery. Should these implants rupture, the body will absorb the saline, much like drinking a glass of water. The sterile saline solution, used as the implant filler, should conform to the USP (United States Pharmacopeia) of Normal Physiological Saline (injection grade), which has a concentration of 0.15M and a pH of 7.2-7.4.

Saline Breast Implant Sizes

Saline implant sizes range from 120cc to 960cc. A patient wanting implants larger than 850cc will need custom implants. Currently, the only implants available for use in the United States are those manufactured by Mentor Corp. and Allergan.

Saline Breast Implants Valves

All inflatable implants have valves. There are a few types of valves: the leaf valve, the kink valve, and the diaphragm valve. The diaphragm valve is like a snap, like in clothing. The male portion at the end of the tubing snaps into the female receptor hole, incorporated into the implant shell.

The leaf valve was a flat sleeve (about 1.5″ long) that a stylet (metal catheter) threaded through it. When the stylet was removed the sleeve would go flat, sealing the valve. The leaf valve had a higher degree of user trauma. If the stylet was forced hastily into the sleeve, damage could occur to the valve, thus causing leakage. Mentor and McGhan no longer use the leaf valve. Most valves are located on the anterior, or front, of the breast implant.

Spectrum Expandable Saline Breast Implants

The Spectrum Expandable saline implant, invented by Dr. Hilton Becker, in conjunction with Mentor Corp. can be used as a permanent expander, or as a “regular” breast implant for breast augmentation in general. This implant has the Becker valve, fill tube, and reservoir system. For use as a “regular” implant, the fill port and tube is removed at the time of surgery, sealing the valve. Once the fill tube is removed, you can no longer add or remove saline from this implant, as you can from most other saline implants.

For use as an expandable implant, the fill tube is left in place. A special fill port is attached to the tube, through which saline can be added or removed. Saline is usually added in 50cc increments. Once the desired size has been achieved, a minor surgical procedure is performed in your surgeon’s office, during which the fill port and tube are removed. This closes the valve, sealing the implant. In the event of a redo, the incision will need to be a little longer, because the implant will have to be removed in tact, since the valve cannot be re-opened.

The Spectrum Expandables come in smooth round, textured round, and contour profile, with the valve located on the posterior surface of the implant. The Spectrum valve has 3 sealing mechanisms. As the fill tube is removed the kink valve, leaf valve and the plug offer triple protection against valve failure.

Prefilled Saline Breast Implants

PIP USA (Poly Implant Prosthesis) manufactured prefilled saline breast implants, which are breast implants filled by the manufacturer and sealed with a patch on the back. Pre-filled saline breast implants are said to be comparable to the look and feel of silicone implants, softer than “regular” saline implants, and according to many, appear to give the same, or similar, aesthetic results. This is thought to be due to the thinner shell of the PIP.

As of May 15, 2000, implants by PIP USA can no longer be purchased from the manufacturer. The FDA did not approve the PMA (pre-market application) for these implants due to the limited follow-up data available from the USDPS (U.S. Discretionary Postmarket Surveillance Study). The two major factors in the FDA panel’s recommendations were that the pre-clinical and clinical data were not complete.

Clover Leaf Products produce a prefilled saline breast implant, also manufacture prefilled hydrogel breast implants, as well as cohesive gel breast implants. These implants are not available in the United States.

Hand Surgery Expert

Not many people are aware that Dr.Gregory Thomas Fisher is one of the foremost American surgeons who stood at the cradle of the hand surgery. His incredible knowledge, skill, and acumen now serves his colleagues in court. Please visit www.hand-surgery-expert.com for more.

Double Bubble

 

double bubble

“Double Bubble” is a chewing gum brand, not a surgical problem. If you have suffered an unsettled inframammary fold as a result of breast augmentation and are not satisfied with the results, you should not refer to it as “double bubble.” You probably told your surgeon that you did not want “any scars,” which is the first problem. Trying to comply with your demands, the surgeon attempted to lift your breast by means of the implant itself. You should never immediately rush from surgery to surgery, expecting instant reparation and results. It is not uncommon for the breast tissue to “settle” after 6-12 months, even two years.  Changing your diet and slimming also helps because breast tissue is simply fat, which decreases in volume and gives way to the implant. Other than that, if you have had a result similar to this picture, and you have detected no noticeable changes for the better in more than one year after the surgery, please contact Dr. Gregory T. Fisher, PC, F.A.C.S. and visit Cosmetic Surgery and Laser Center for consultation.

double bubble x

Surgery After Weight Loss

Obesity has been said to be a major health problem in the United States, and seems to be getting worse. Fortunately, methods have been devised to help patients lose excessive weight by limiting the size of the stomach and the amount of food they can ingest, giving them a sensation of being full after a smaller meal, which leads to weight loss of 50-75, even 100 and more pounds.

Such weight loss leaves the patients with skin which has been overstretched from the days when they were obese. It will not shrink to the new framework they have obtained. A proper plastic surgery by a board certified plastic suregon with experience in weight loss surgery reconstruction is essential to obtaining optimal results for these patients.

The areas of chin and neck, the breasts, arms, back, abdomen, inner and outer thighs and buttocks, as well as paragenital areas, may be particularly disconcerting to the successful weight loss patients. These patients often look in the mirror and feel they have traded one deformity for another – and they may be right.

Reconstructing these patients is complicated by the fact that the skin covers areas of the body that are moving, such as elbow joints, shoulders, writsts, legs, hips, knees, as well as important esthetic areas, such as the breasts, the pubis, the inner thighs and the paragenital area… and if not properly performed, limitations of motion in these critical junctures may be a complication of surgery by the ill-trained.

Much of the ability to correctly reconstruct these patients comes to the plastic-reconstructive surgeon, such as Gregory T. Fisher, MD, FACS, through the experience obtained in caring for burn patients. Dr.Gregory T. Fisher of American Burn Association carries out, and has taught his peers to perform, many reconstructive surgeries on burn patients, fully restoring the motion of the joints and overcoming the resistance of the skin, which is no longer pliable. In weight loss surgery, we apply many of the same techniques as in burns surgery, although the problems may be opposite, i.e. not insufficient elasticity but too much elasticity.

Without these essential professional skills gained in peforming burn and other reconstructive surgery, it is hazardous for the patient to undergo any other surgery, including reconstructive surgery by a bariatric surgeon.

Reassurances are no substitute for thorough training, experience, and proven success!

 

Purchasing Surgery

“Purchasing a surgery” is really the wrong term to use. Many people approach the surgeon trying to barter for a “deal” on surgery. Several points must be stated in this regard. First, your body is unlike any other body. Thus, what your friend told you about her having surgery for this much and what-a-deal-that-was! – does not apply to you. Second, the body can only survive a limited amount of surgical trauma before the risks of serious surgical complications increase dramatically. Therefore, do not “barter” and then “chop and change” for another “deal.” The likelihood of successful removal, once you decide for your breast augmentation, is smaller than the likelihood of success in the augmentation itself. The skin may have problems shrinking, you may have more visible scars, or, rather, your scars may become more visible, and your mental state may be detrimentally affected. Lastly, only a skilled surgeon with years of experience can tell you instantly what is enough and what is too much. Remember – experience in the field comes from years and years of practice, not reading books or investing into a posh Beverly Hills location. Prestige and skill, unfortunately, are not identical.

Therefore, do not “purchase a surgery” but purchase happiness, purchase a gift to yourself, not to your husband. If you are doing something with your body, do it for yourself, not for your husband, your friends, your parents – do it because you are worthy and deserving. That way, you will not be disappointed.

General Anesthesia

General anesthesia (also “systemic anesthesia”) is applied for three main reasons: first, it permits the surgeon to extend the volume of fat extracted by liposuction, second, it enables the surgeon to combine procedures to your best benefit, thus minimize the total volume of pain and discomfort, lastly, it is to your economic benefit because you pay less for the operating room and related expenses (i.e. less than if you underwent the procedures one-at-a-time).

Dr. Gregory T. Fisher, F.A.C.S. of Cerritos Surgery and Laser Center has more than 35 years of experience and best education the United States can provide – Columbia and Harvard Medical Schools. Unlike some unscrupulous Beverly Hills surgeons, he does not overcharge and does not promise you blue from the sky just to get you in the OR. If it can be done, it can be done – if it cannot be done, then there are several ways of how to split the procedures.

What many patients do not know is that to have a good, experienced anesthesiologist is nearly as important as a good surgeon – they must be a team. You may want to ask how long has the surgeon you are intending to choose for your particular procedure retained their anesthesiologist – in years or months? This gives you a picture of the internal surgical “unit” and its functioning.

There are two types of anesthesia: local and systemic. Systemic anesthesia includes general anesthesia given by inhalation of anesthetic gases such as halothane or isoflurane, intravenous (IV) drugs injected into a vein such as propofol (Diprivan), midazolam (Versed), ketamine (Ketalar) and narcotics such as meperidine (Demerol), or fentanyl (Sublimaze). All of these drugs are commonly used to achieve general anesthesia. Obviously, dangers are greatest in young, inexperienced or inattentive anesthesiologists.

Always weigh safety over volume, quality over quantity. Our patients are pleasantly surprised when they find out that Dr. Fisher operates a small family clinic where the anesthetist, Sarah Collins, CRNA, is an experienced professional nurse with exclusive skills and education, who has been on his team for the past twenty-five years! With forty years of experience, she has not had a single “anesthesia gone wrong” case in her entire career! She wakes the patients up with a gentle, soothing voice and attends to their well-being in the adjacent Sheraton Hotel where a room is always reserved for them.

As a professional technical writer, who has undergone general systemic anesthesia performed by Sarah Collins, CRNA, three times, I can but stand in awe and admiration of her skills and acumen. I have visited some of the much acclaimed Beverly Hills surgeons, most of them of foreign extraction and education too. In the end, all I can say is: go with quality, not quantity. I did and I am happy for it.

3D Imaging

Do not be misled by the surgeons offering some “super new” technologies, such as a 3D imaging. Your surgery will only be as successful as your surgeon’s experience warrants. No “super device” will help an unskilled hand achieve exceptional results. Of course, it may increase what you pay for surgery, as many of our patients tell us when they return from a Hollywood Top Clinic with a poor result, which is “nothing like the 3D image.”

“It can be helpful where the patient cannot decide about the size or shape,” says Dr. Gregory T. Fisher of Cerritos Cosmetic and Laser Surgery Center. “However, such cases are rare, as most women simply want to keep their natural shape and either enlarge or reduce the size. I have tried all modern devices as soon as they hit the market. I want to know whether they work and if so, how. In the end, I always have to rely on my own skill and experience. I have seen thousands of breasts in my career, both as a professor of surgery and a director at Kaiser Permanente. To evaluate all parameters that I factor in, you would need a NASA computer!” Dr. Fisher smiles and leaves me in the waiting room, full of women who have come for a free consultation.

I peruse the wall posters which show Dr. Fisher’s work. I have seen his work on the internet, but it is not the same. Dr. Fisher is kind, amiable and mature, and – those results!

This entry was posted on August 9, 2012. 1 Comment

Botox for Incontinence!

U.S. Food and Drug Administration (FDA) recently approved using the botox injections to help patients with neurological conditions who suffer from incontinence, or an overactive bladder. How? Botox injections paralyze the bladder muscle to prevent contractions that cause urgency to urinate or leak. Although medications and behavioral modifications are treatment options, many patients, especially the elderly, do not respond to these methods and need a more aggressive approach. In particular, in cases of neurological conditions, such as spinal cord injuries, Parkinson’s disease and multiple sclerosis, improvement is particularly rapid – within a week – and lasting up to nine months or even a year.

Botox for Incontinence!

U.S. Food and Drug Administration (FDA) recently approved using the botox injections to help patients with neurological conditions who suffer from incontinence, or an overactive bladder. How? Botox injections paralyze the bladder muscle to prevent contractions that cause urgency to urinate or leak. Although medications and behavioral modifications are treatment options, many patients, especially the elderly, do not respond to these methods and need a more aggressive approach. In particular, in cases of neurological conditions, such as spinal cord injuries, Parkinson’s disease and multiple sclerosis, improvement is particularly rapid – within a week – and lasting up to nine months or even a year.

Otoplasty etc.

 

First of all, let us remind the readers that all the operations Nadia underwent are performed by Dr. Fisher at one-third of the cost. Nadia Ilse is now looking forward to the new school year, when she will no longer be called “Dumbo” by her peers for her “elephant ears.”

To ward off school bullies who began taunting her in the first grade for her ears, Nadia begged her mother at the age of 10 for an otoplasty — an operation to pin her ears back.

The teen, now 14, was recently granted her wish by the Little Baby Face Foundation, a charity that provides free corrective surgery to children born with facial deformities.

Nadia told CNN that the bullying turned her talkative self into a withdrawn, antisocial girl. The taunting “hurt so much,”

When the Little Baby Face Foundation was contacted by Nadia’s mother, the organization brought the duo to New York City from Georgia and did more than just pin her ears back. The organization’s founder, Dr. Thomas Romo, III. also performed reduction rhinoplasty, reducing the size of the nose, and mentoplasty, altering the chin.

The foundation covered the estimated $40,000 cost of surgery.

Avoiding school bullying by going under the knife is on the rise among American teens. In 2007 alone, about 90,000 youth underwent cosmetic surgery — though not all cases were the result of teasing.

While Nadia says she knows she should have been accepted as she was before the surgery, she also knew the bullying wouldn’t end and has no regrets following the procedure.

“I look beautiful, this is exactly what I wanted, I love it,” she said.

Nadia must still start counseling as part of her treatment to overcome the years of psychological distress from bullying, but Little Baby Face board member Don Moriarity told MailOnline that Nadia’s new outlook demonstrates the group’s mission.

“We like to say that Baby Face transforms the lives of these children and gives them newfound confidence,” Moriarity said.

Nadia’s story emerges months after 13-year-old Nicolette Taylor was featured on ABC’s Nightline for her nose surgery to overcome online harassment and name-calling at school. There was also global outcry when 7-year-old Samantha Shaw had her ears pinned back to escape name-calling and harassment last year.

So through all this, what advice would you give parents? Gupta asked Nadia.

“Give your children a lot of love and affection and tell them that they’re beautiful every single day,” she said.

Most states now have bullying laws that require schools to adopt bullying policies, and efforts to combat school bullying have escalated over the last decade, according to a report released in December by the U.S. Department of Education.

Between 1999 and 2010, more than 120 bills were adopted by state legislatures to introduce or amend legislation that address bullying, harassment or similar behavior in schools. By the time of the Education Department study’s conclusion, there were 46 states with enacted anti-bullying laws, 36 with regulations that work against cyberbullying and 13 that give schools the authority to monitor and address bullying behavior even when it occurs off school grounds.

 

This entry was posted on July 28, 2012. 2 Comments

How Long Will My Implants Last?

The life-span of breast implants used to be advertised as ten to fifteen years. However, the quality of the implants has improved considerably in the last decade. Dr.Fisher provides the best quality implants current market can offer. Their lifespan is 20-30 years. One of the most common reasons that women have their breast implants replaced is because of rupture, which can occur because of hazardous and risk-entailing physical activities. More active women who undertake a lot of physical activity in the chest area are more likely to need replacement due to rupture. Also any kind of trauma to the chest could cause rupture. Sometimes the woman will decide to have the breast implants replaced or removed for cosmetic reasons. The surgery may have not turned out that way they had been expecting and they may feel that the implants are too small or too large. Some women may choose to have them removed altogether.

Dr.Fisher is often asked “what if my implants leak?” If your implants leak, this is not yet a disaster. What matters is the extent of the leak and the reason for it. Implants filled with saline that leaks will shrink slowly and the saline can be absorbed into the body harmlessly. As they shrink the woman will then become aware of the rupture and seek further advice. However, silicone implants will not shrink when they rupture and women with silicone implants are advised to have them checked on a regular basis.

Finally, breast augmentation is a cosmetic procedure. Your body alters with age and lifetime, and what was proper when you were thirty may not be so when you are fifty. It is your personal decision to have the implants replaced or removed, which need not be based on medical or health factors.

 

How Long Will My Implants Last?

The life-span of breast implants used to be advertised as ten to fifteen years. However, the quality of the implants has improved considerably in the last decade. Dr.Fisher provides the best quality implants current market can offer. Their lifespan is 20-30 years. One of the most common reasons that women have their breast implants replaced is because of rupture, which can occur because of hazardous and risk-entailing physical activities. More active women who undertake a lot of physical activity in the chest area are more likely to need replacement due to rupture. Also any kind of trauma to the chest could cause rupture. Sometimes the woman will decide to have the breast implants replaced or removed for cosmetic reasons. The surgery may have not turned out that way they had been expecting and they may feel that the implants are too small or too large. Some women may choose to have them removed altogether.

Dr.Fisher is often asked “what if my implants leak?” If your implants leak, this is not yet a disaster. What matters is the extent of the leak and the reason for it. Implants filled with saline that leaks will shrink slowly and the saline can be absorbed into the body harmlessly. As they shrink the woman will then become aware of the rupture and seek further advice. However, silicone implants will not shrink when they rupture and women with silicone implants are advised to have them checked on a regular basis.

Finally, breast augmentation is a cosmetic procedure. Your body alters with age and lifetime, and what was proper when you were thirty may not be so when you are fifty. It is your personal decision to have the implants replaced or removed, which need not be based on medical or health factors.

 

How Long Will My Implants Last?

The life-span of breast implants used to be advertised as ten to fifteen years. However, the quality of the implants has improved considerably in the last decade. Dr.Fisher provides the best quality implants current market can offer. Their lifespan is 20-30 years. One of the most common reasons that women have their breast implants replaced is because of rupture, which can occur because of hazardous and risk-entailing physical activities. More active women who undertake a lot of physical activity in the chest area are more likely to need replacement due to rupture. Also any kind of trauma to the chest could cause rupture. Sometimes the woman will decide to have the breast implants replaced or removed for cosmetic reasons. The surgery may have not turned out that way they had been expecting and they may feel that the implants are too small or too large. Some women may choose to have them removed altogether.
Dr.Fisher is often asked “what if my implants leak?” If your implants leak, this is not yet a disaster. What matters is the extent of the leak and the reason for it. Implants filled with saline that leaks will shrink slowly and the saline can be absorbed into the body harmlessly. As they shrink the woman will then become aware of the rupture and seek further advice. However, silicone implants will not shrink when they rupture and women with silicone implants are advised to have them checked on a regular basis.
Finally, breast augmentation is a cosmetic procedure. Your body alters with age and lifetime, and what was proper when you were thirty may not be so when you are fifty. It is your personal decision to have the implants replaced or removed, which need not be based on medical or health factors.

Autologous Fat Grafting

Grafting of “autologous” fat (bodyfat) into the breast remains controversial. Dr. Fisher radically opposes this technique because of the risk of infection and complications, but also because it cannot be effectively contoured as standard breast implants can. It may be safe in correcting minor deformities but Dr. Fisher radically opposes its use for common breast augmentation.

Surgeons experimenting with this technique argue that fat injection offers “controlled reshaping of the breast.” However, Dr. Fisher argues that from his very earliest years, as someone who stood at the cradle of breast implant surgery in the 1980s in St. Luke’s Hospital in New York, and has specialized in the field in the past more than thirty years, the “modified” injection is a minor corrective, which begs more questions than it answers.

 

The fat placement with respect to both level and quadrant of delivery cannot be thoroughly documented, as this would require ongoing supervision, if not hospitalization. Certain three-dimensional structural fat grafting approach, in which small aliquots of fat are placed diffusely, largely into the pectoral-retromammary space (the pectoralis major muscle and the retropectoral and prepectoral spaces) for augmentation, as well as more superficially into the subcutaneous space for shaping, are potentially without risk and effective, but rarely show any radical changes.

Further, in most cases, fat is not grafted into the parenchyma, but placement deep to the areola, in order to increase projection. The fat transfer is usually done through only four incision sites, although an additional site in the axilla may be used in reconstruction cases. Thus, it is of little help in “lifting” the breast or in  improving a “baggy” condition.

Since the autologous fat injection requires that cannulas of 9 cm or 15 cm in length be used, the procedure is not painless either. For further information, please visit Dr. Gregory Fisher in his office hours.

Autologous Fat Grafting

Grafting of “autologous” fat (bodyfat) into the breast remains controversial. Dr. Fisher radically opposes this technique because of the risk of infection and complications, but also because it cannot be effectively contoured as standard breast implants can. It may be safe in correcting minor deformities but Dr. Fisher radically opposes its use for common breast augmentation.

Surgeons experimenting with this technique argue that fat injection offers “controlled reshaping of the breast.” However, Dr. Fisher argues that from his very earliest years, as someone who stood at the cradle of breast implant surgery in the 1980s in St. Luke’s Hospital in New York, and has specialized in the field in the past more than thirty years, the “modified” injection is a minor corrective, which begs more questions than it answers.

 

The fat placement with respect to both level and quadrant of delivery cannot be thoroughly documented, as this would require ongoing supervision, if not hospitalization. Certain three-dimensional structural fat grafting approach, in which small aliquots of fat are placed diffusely, largely into the pectoral-retromammary space (the pectoralis major muscle and the retropectoral and prepectoral spaces) for augmentation, as well as more superficially into the subcutaneous space for shaping, are potentially without risk and effective, but rarely show any radical changes.

Further, in most cases, fat is not grafted into the parenchyma, but placement deep to the areola, in order to increase projection. The fat transfer is usually done through only four incision sites, although an additional site in the axilla may be used in reconstruction cases. Thus, it is of little help in “lifting” the breast or in  improving a “baggy” condition.

Since the autologous fat injection requires that cannulas of 9 cm or 15 cm in length be used, the procedure is not painless either. For further information, please visit Dr. Gregory Fisher in his office hours.

Laser Scar Treatment

Any wound causes inflammation. The word “inflammation” is derived from Latin inflammo, which means what it says: something is enflamed, hot and swollen, red and painful (the four basic symptoms) because such is the natural reaction to pathogens, damaged cells and irritants.  Scarring is the result of healing. Its extent depends on the gravity of the wound, age and the individual characteristics of the patient.

The progress  to tissue formation is initiated by the inflammatory reaction that is a result of the trauma, which has occurred. Collagen is the main building block of skin, cartilage and blood vessels.

Today, laser scar removal can reduce the appearance of several types of scars. First, keloid scarring, which are firm, raised and reddish-purple scars that extend beyond the initial wound area and build over time. Second, hypertrophic scars, which are firm, raised and pink scars that remain within the initial wound area and may fade over time. Third, atrophic scars, which are depressed pin-like pockets in the skin that can result from skin conditions or diseases such as acne.

People with skin disorders may not be ideal candidates for laser treatment, but even so, in some cases, considerable improvement may be obtained. Lasers can greatly improve the appearance of acne scars. It is important that you make an individual appointment with Dr. Fisher to discuss your specific case and the method in which modern technology used by Dr. Fisher and the Cerritos Laser and Surgery Center can benefit you.

How does laser scar treatment work? During scar treatment, the laser vaporizes or removes a layer of skin and penetrates the underlying dermis causing a reorganization of the interlocking collagen molecules, thus minimizing scar appearance. Such treatment will also stimulate new collagen growth and correct scars from the inside out.

LifeCell

Since 1994, LifeCell has been a pioneer in the science of regenerative medicine. Our flagship product, AlloDerm® Regenerative Tissue Matrix, has been used successfully in more than one million grafts and implants to date. AlloDerm® Tissue Matrix and our next generation soft-tissue repair product, Strattice™ Reconstructive Tissue Matrix, are being used by an increasing number of surgeons for a range of surgical applications including hernia repair, breast reconstruction postmastectomy, breast plastic surgery (breast augmentation revisions) and other reconstructive applications.

LifeCell™ Tissue Matrix products are manufactured with proprietary processes that remove cells which can lead to tissue rejection and graft failure. Laboratory studies show that they support tissue regeneration by promoting rapid revascularization, white cell migration and cell repopulation – ultimately transforming into host tissue for a strong, natural repair.

LifeCell’s innovative technologies have been developed through extensive research and testing.  Our products allow surgeons to restore many types of tissue damaged through injury, surgery, or disease – using the body’s innate regenerative power.

After more than fifteen years of successful use, LifeCell’s patented tissue matrix technology remains “first in class” – making LifeCell the leader in tissue regeneration. To learn more about LifeCell, you may visit their site, but you may also call Dr.Fisher for an appointment to determine whether the particular product would be the best solution and/or what would resolve your skin issues.

Tummy Tuck

 Dr.Fisher recommends that you start your new year on the lean side, albeit not “skinny”- certainly Self-Confident!!!

Do not hesitate, for you live only once –

Start a new romance – with yourself

Give yourself a chance!

A chance? To a new romance?

And if not, make it Health!

Do it in the open, do it in stealth

Just do it! There’s nothing to it!

You’ll never regret –

getting rid of that fat!

Symmastia

Symmastia is a term for touching breasts. It is a genetic malformation, which may occur after breast implant surgery, for various reasons. It may for instance happen during the breast augmentation when the pectoral muscle is cut or detached. Often, this situation improves as the body heals itself. Sometimes, it does not.

It is somewhat of a paradox because closely positioned breasts are actually very attractive and many women intentionally push the breasts together. Symmastia, however, may pose a problem and the patient will need a reconstructive surgery, which is not without risk. Since the “capsule” has to be re-formed by the surgeon, there is a risk of asymmetry in suturing the pectoral muscle (none of us has perfectly symmetrical muscles) and also possible capsulectomy, which may result in the intended separation of the breasts, but not equal visual perfection.

Symmastia has a high rate of recurrence, and Dr.Fisher only treats patients who present their complete medical history and who realize that one treatment/operation may not suffice.

How You Look Is How You Feel

According to the American Society of Plastic Surgeons, over  200,000 people in the United States underwent cosmetic eye surgery in 2010. The demand for blepharoplasty surpasses facelift, rhinoplasty, facial implants, and forehead lift. The eyelid and potential fat pockets around and under the eyes may distort the person’s natural expression and contribute to their psychological state of depression. If the lids grow droopy or bulging, the face may project an inappropriate look of fatigue and lack of vigor despite adequate rest and good health. This not only misleads others, but has a detrimental effect on the person thus suffering. Blepharoplasty will definitely help you. However, once the eyes are “hollowed” and “tightened” your face might appear unnatural simply because your sagging jaw or neckline begin to suddenly stand out.

Dr.Fisher therefore recommends undertaking several procedures together, which is also cheaper for you, because the Operating Room does not have to be cleared and sterilized for one brief surgery (such as only blepharoplasty) but for several surgeries (neck-lift, face-lift, and blepharoplasty, and/or rhinoplasty) at the same time, only once. Since a significant item on your surgery bill is the payment for the OR, oxygen, anesthesia etc… Your overall price for several surgeries, which may cost over $5,000 individually, will be lowered to almost one-half.

Eye Circles III

Under eye circles may also be caused
by a thinning of the skin only. This is due to the unique anatomy of the area
which leaves a thin layer of skin over the muscles surrounding the eye with no
fat layer in between. The color of blood flow in the muscle permeates through
the skin. This is not treatable. Teamine or Hylexin or some other topical agent
might be applied but no lasting solution exists.

Today: more about under eye circles…

Under eye circles can also be caused
by volume loss. This means a thinning of the skin and loss of fat in the area
that leaves the inferior orbital rim (lower portion of the eye socket bone) in
a shadow. Your skin may be contracted but sometimes the pigment is just not the
issue one needs to focus on. Here, a skilled surgeon like Dr.Fisher recommends
augmentation of the tear trough and infra-orbital rim area. This is done
using fillers like hyaluronic acid and can be done without any incisions during
your first visit in our office.

Eye Circles?

Many modern trends in plastic
surgery trend to cure the effects without searching for the causes. Some causes
can be genetic and can appear relatively early in your life. Circles under the
eyes are often caused by volume loss and thinning of the fatty tissue in the
area (which is also why many people look younger when they have more
subcutaneous fat while stringent dieting makes you look older). However, such
changes can be postponed and for many years altogether avoided. Dr.Fisher has
extensive experience in this area and impeccable results. However, prior to the
operation, he always focuses on the causes and circumstantial factors: age,
environment, stress… For instance many women (and men) suffer from loose lower
eyelids due to increased concentration of melanin in the dermis (skin
pigmentation) which causes “dark spots” under the eyes earlier than in people
who do not have increased levels of melanin. It is therefore important to avoid
stress, supplement surgical treatment with vitamins (retinol, A-D, C and E) and
avoid direct sunshine whenever possible.

voting

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Conquer Your Depression by What You Eat

Sweet foods worsen depression, so avoid them when you
feel depressed. The only exception is perhaps dark chocolate with high
percentage of cocoa – over 60 per-cent. Chocolate contains: sugar (which,
again, should be avoided), fat, caffeine, phenyl ethylamine, flavonoids, bromine
and tryptophan. Beetroot is a
vegetable rich in uredines, which are not commonly found in other kind of food.
It is best to eat fresh, although supplements derived from beet, containing beta
carotene, calcium and iron, are assimilated by the body faster. Many women in
particular favor soy because its
amino acids are assimilated better by the female body. It contains no
cholesterol and works well as a prophylactic to depression. Soy cheese, however,
is also good for men because it prevents prostate cancer, atherosclerosis and
osteoporosis. Of couser, milk products such
as different kinds of cheese, yoghurt and cheese contain more calcium than soy
and should never be eliminated from your diet. Absence of calcium from your
diet contributes to depression. Likewise, there should be calcium-magnesium
balance, so, just to make sure, purchase a supplement and take it after your
last meal (for the night). Many people today do eat plenty of fish, so it is
not necessary to use cod liver oil or omega-3
supplements. If you have vegetables, mix the colors and eat them before your
meal or at the same time, not after your meal. Finally, coffee has a protective effect, similar to dark chocolate. It likewise
reduces prostate cancer as well as the risk of Alzeheimer’s, Parkinson’s disease,
and diabetes. It stimulates the brain and purportedly prevents dementia, which is
debatable. However, it does
increase the acidity of the stomach, which is why many people drink it after
the meal…

Manuka Honey

Dr.Fisher recommends Manuka honey products to increase recuperation after surgery. Manuka honey is a monofloral honey made by bees in New Zealand that pollinate the manuka bush, Leptospermum scoparium. It has strong antibacterial properties because of its methylglyoxal content. Manuka honey is typically dark in colour with a strong flavour.

For manuka products, you may wish to visit: http://www.manukahoneyus.com/product.html

Manuka products from New Zealand are certified “USDA Organic.” We have experienced excellent results in improving post-operative healing, prevention of scarring, and even combating infection acquired as a result of not following Dr.Fisher’s advice with respect to post-op hygiene (e.g. showering).

The application is easy. After you clean the area (with e.g. Hydrogen Peroxide) apply the honey on the area. Do not touch. Then cover wound with pre-soaked gauze pad. Finally, use some waterproof dressing (Telfa-style) so as to prevent soiling of your clothes/bedding. Be careful not to use any dressing/adhesives that might irritate your skin. Always ask our staff before you decide to “experiment” on your own!

This entry was posted on May 30, 2011. 1 Comment

Applied Psychology?

As we have previously emphasized, cosmetic surgery is the art of applied science – science, which cannot be separated from art. No doubt we should give credit to those surgeons who venture into the unknown for scientific purposes, to advance humanity, devoid of selfish motives and pecuniary gain. Such a risk may entail the opprobrium of their peers and even public at large, although the fruit of victory oftentimes tastes sweeter than the sour grapes of defeat… However, cosmetic surgery is not a heal-all for someone who has underlying psychological problems. The late report http://www.sfgate.com/cgi-bin/blogs/sfmoms/detail?entry_id=85855  seems to indicate that either peer pressure or low self-esteem may have been the motive force for the incriminating decision. Dr.Fisher is an expert psychologist, with life-long professional experience. Please do not hesitate to contact him if you are uncertain whether cosmetic surgery or any cosmetic procedure is good for you.

This entry was posted on May 14, 2011. 1 Comment

Beware of Promises!

Many patients expect results overnight. Many doctors – unwisely – promise results overnight. It is important for everyone to realize that great things do not happen overnight, and a good cosmetic surgery is a great thing – it ultimately saves you much effort and struggle fighting your weight or your social stigma, be it small bosom or unsightly nose. We all have ours…

No-one put on 20 pounds of fat overnight and it is unrealistic to expect such a loss overnight. Wise surgeons will not exceed 4 pounds on liposuction. Sometimes 6, in rare cases 8 pounds of fat can be “sucked” during one surgery. However, to be on the safe side, even the healthiest individuals should not undergo any drastic procedures. Every procedure involves loss of blood, which naturally increases with extensive performance. Some surgeons even recommend transfusions before the actual surgery, in order to facilitate recovery.

In Dr.Fisher’s opinion, all this is unnecessary. “Michelangelo did not create David overnight,” says Dr.Fisher. “If you come to me for excellent results, you must be patient – not so much with me as with yourself. Some of the most successful results took 3-4 liposuction procedures or tummy tucks over a period of 2-3 years. Of course, it may be more expensive, but, in the long run, it is your investment into your own health and happiness.”

We therefore recommend that you stay realistic and eschew “dreamland surgeons” who promise you that you will look like a movie star overnight. Dr.Fisher will never promise the impossible, but, as it happens, often achieves what you might think was impossible anyway. “It is in the nature of a great plastic surgeon,” says Dr.Fisher, “to be also a great artist; and the human body is like a block of marble, a canvass for a great artist. Of course, once you let a novice mar it, it is more difficult, if not impossible, to repair. However, in the hands of a great artist, nothing is truly impossible…”

What is Ultrasonic Assisted lipoplasty?

Ultrasonic assisted lipoplasty (UAL) is the application of ultrasonic waves on fat tissue. Similarly as we have reported formerly on ice technologies, the goal is here to “liquefy” fat. However, fat does not entirely disappear. UAL is a precondition for subsequent use of low vacuum suction. This use in cosmetic surgery is not unique. You may have heard of lithotripsy, which is the same procedure, i.e. using the ultrasonic waves to destroy unwanted or undesirable tissue – only lithotripsy is done on patients suffering from kidney stones while UAL found its use in cosmetic surgery. In either of these methods, the ultrasonic waves do not actually destroy or eradicate the tissue completely. Ultrasound-assisted liposuction has been attempted to “liquefy fat,” which should result in minimal incisions in subsequent operation. UAL begins injections of saline solution, which facilitates fat suction. Small incisions are made, wherein a tube is inserted, which produces ultrasonic waves, thus hitting a specific problem area. The fat is then removed with mild suction of the saline solution. UAL is a gentle technique, which is more expensive than ordinary liposuction but should result in minimal bruising, blood loss and swelling. It may be used after liposuction, as a contouring procedure.

This entry was posted on April 20, 2011. 2 Comments

Minimally Invasive Procedures

 

Several subsequent articles this week will be dedicated to minimally invasive cosmetic procedures, because these non-surgical treatments used to reduce the appearance of facial lines, remove unwanted hair, and even out skin pigmentation, are increasing in popularity every day. Although minimally invasive procedures such as botulinum toxin  injections, microdermabrasion, chemical skin peels, and dermal fillers do not involve surgery, they are not without risk. It is important that you visit the office/hospital and ascertain the conditions, such as the overall demeanor of the personnel, cleanliness and hospitableness of the place. The first impression should be guiding to what comes next. Look around, and do not neglect to notice how modern the equipment is, how embellished and friendly the waiting room and the office itself appears. Usually, this is most telling of the precision and preparation of the surgeon himself.

 

Part I – Botulinum Toxin

 

Adults are living longer than ever before. We feel vital, we’re active and we want our bodies to mirror youthful minds and hearts. Enter botulinum toxin, one of the most important substances to hit the field of facial rejuvenation. Short of a surgical facelift, this substance is the most popular way to reduce facial wrinkles. Botulinum toxin can be used as a wrinkle treatment to smooth:

Frown lines
• Crows feet
Forehead furrows
• Skin bands on the neck

Smiling, frowning, squinting and even chewing – basically any facial movement can eventually lead to one of the most common signs of aging: wrinkles. They can make you appear tired or even angry when you are not. One of the quickest and safest remedies to remove wrinkles is an injection of botulinum toxin.

Botulinum toxin type A and botulinum toxin type B are both purified substances, derived from a bacteria. Injections of this substance blocks muscular nerve signals, which then weakens the muscle so that it can’t contract and diminishes your unwanted facial wrinkles.

Botulinum toxin can be combined with other cosmetic skin procedures such as chemical peels, dermal fillers or microdermabrasion to further improve your results. This combination of therapies can even help to prevent the formation of new lines and wrinkles.

Dr.Fisher’s Surgery and Laser Center of Cerritos Towne Center offers a gamut of modern procedures, and botulinum rejuvenation is one of the most frequently desired non-invasive procedures.

Bra to Bear III

According to a research conducted in 2007, 85% of women wear incorrect bra size. Your size can be measured as follows: (viz. Michael Rabinowitz in The Handbook of Style (Quirk Books, 2007)

 

Step One: Measure Band Size

  1. Measure yourself while wearing an unlined or thinly lined bra.

  2. Using a soft measuring tape measure around your rib cage in inches – just beneath the bust. Ensure that the tape is snug, smooth, and level in the front and back.

  3. If your measurement is even, add four inches to this number to get your band size; if your measurement is odd, add 5 inches to this number to get your band size. Fuller figured women with rib cage measurements of more than 36 inches may only need to add 1 or 3 inches to get to the next even numbered band size.

 

Step Two: Measure Cup Size

  1. Keeping the measuring tape straight and snug, measure around the fullest part of your bust.

  2. Subtract this measurement from your rib cage measurement.

  3. The difference is the basis for your cup size; each inch of difference is equal to one cup size.

You can look up your cup size here:

  • less than 1 inch = AA cup

  • 1 inch = A cup

  • 2 inches = B cup

  • 3 inches = C cup

  • 4 inches = D cup

  • 5 inches = DD cup (E)

  • 6 inches = DDD cup (F)

  • 7 inches = DDDD cup (G)

 

Get Fitted for a Bra

Dr.Fisher’s staff is best equipped to provide you with a complimentary bra fitting consultation. In addition to measuring you for your accurate size, the staff will also be prepared to help you find bra styles for specific outfits or occasions.

Further, just because you have a bra fitting once doesn’t mean you’re finished. No, the experts at La Senza say that women’s bra sizes change up to six times during their lives. The lingerie retailer’s national online survey results revealed that 45 percent of women surveyed have never had a professional bra fitting and 64 percent of respondents have been wearing the same bra size for up to five years.

Puberty, pregnancy, breastfeeding, weight gain, weight loss, menopause, and variations in fit between different brands and styles… there are many reasons why you should regularly go for a bra fitting to ensure proper fit and comfort throughout your life.

Bra to Bear II

In order to correctly wear your bra, you must understand the basic features of your anatomy. Your bra should be aligned with your breastbone and the underwire should not be pulled down so as to bring to bear full functionality of the support. This is important in particular after breast augmentation when you do not at first realize that support can be beneficial to you. Even though your post-operative results are to a large extent self-supporting, this support must still be increased by a firm bra in order to make it last.

Relaxed underwire may be caused by either laxity in the shoulder straps or the size of the band. On the other hand, if you tighten the straps too much, the back support will slide up your back. This may happen because the bra is too large and in trying to make it fit you are basically compensating for the front fit by the back misfit. If you feel the back band sliding up, you need a smaller size bra. Now, smaller size does not necessarily mean a smaller cup. Post-augmentation, it is preferable to have a slightly larger cup (up to +2 sizes) until you mentally, psychologically and physically adjust to your new size breasts. Many women injudiciously trade-in only to find out that what they needed was a soft-cup, larger-size temporary bra.

 

Bra to Bear – Part One

Before bras, there were corsets, whose function was to lift and shape breasts upward. In the past, women did not move as much, did not jog, did not commute, and consequently there was little need for this type of undergarment. The modern bra with its two separate cups was gradually developed from the corset in the early 20th century.

Generally, the bigger the breasts, the more support you need. Women with small-to-medium size breasts, if they are used to wearing bras, probably feel a little uncomfortable without them. However, this is more a psychological issue and a question of habit: women tend to feel awkward or less self-conscious without bras if they are used to wearing them. In fact, you become used to automatically wearing bras, it is possible to not even notice or pay any attention to the slight discomfort from bras. So much the more important it is to ascertain the correct size and make certain it fits.

Although credible studies have not been conducted in this field, for obvious difficulties of arriving at objective statistical results, it is a common knowledge that tighter bras may have some link to breast cancer… In the field of plastic surgery, the surgeon is actually the best person to consult on the size, shape and aperture of the bra, because he knows your anatomy better than you. Dr.Fisher will provide you not only with advice, but also with the correct bra you should wear for 3-6 months after the operation.

Dr.Fisher’s general (non post-operative) advice:

1. Adjust the straps to the maximum length.

2. Lean forward into the cups and rest your breasts into the supports.

3. Reach behind to hook the bra on the middle hooks of the closure.

4. Put the straps on your shoulders.

5. Position your breast in the cup by slipping a hand into the cup and lifting the breast while aligning the underwire on your ribcage along the natural crease of your breast to prevent pinching of the breast tissue.

6. Tighten the straps so that they support the breasts lightly without cutting into the skin or putting too much strain on the shoulders.

7. Adjust the straps every time you put on a bra.

Further, while bras do give breasts support, they do not ultimately prevent sagging. Gravity will eventually take its effect. However, fortunately, you can visit Dr.Fisher – the Expert in combating this type of gravity!

More about Nipple Reconstruction

Historically, nipple-areola complex reconstruction has been considered a secondary procedure to the more important breast mound reconstruction. To optimize positioning of the nipple, surgeons generally recommend waiting until complete settling of the reconstructed breast before performing nipple reconstruction. However, when nipple reconstruction is delayed for months to years, final reconstruction is often never completed, as patients often opt to minimize their exposure to further surgical procedures. Most recently, some have advocated immediate nipple reconstruction in free TRAM flap reconstructions to minimize operative procedures and to achieve earlier completion of the breast reconstruction.

Nipple reconstruction techniques have evolved significantly over the years. From simple tattooing to the more technologically advanced, although rarely available, tissue engineering. Dr.Fisher uses techniques, which provide long-lasting, satisfactory reconstruction with minimal morbidity. While not recommended in breast augmentation, this procedure is inevitable in certain types of reconstructive surgery. (viz. our previous article)

Nipple-areola reconstruction represents the completion of the breast restorative process and has significant psychological implications for women who undergo mastectomy. Nipple size, position, projection, and color are determining factors in the aesthetic symmetry of the reconstruction, qualifying an otherwise nondescript flesh mound as the new breast. Complete nipple-areola reconstruction with tattoo can visually draw attention away from the scars on the reconstructed breast mound. In addition, autologous flap breast reconstruction following skin-sparing mastectomy can usually be designed so that the entire flap skin paddle, along with the scar, is tattooed as an areola.
The benefit of nipple-areola reconstruction is supported by the findings of a retrospective psychological survey comparing the level of satisfaction of women who underwent breast reconstruction with or without nipple-areola reconstruction; a highly significant correlation was seen between level of satisfaction and presence of the nipple-areola complex. Artists and anatomists consider the nipple-areola complex an essential and defining component of the breast aesthetic unit, and the physical characteristics of the nipple gain importance as the breast mound decreases in size. Reconstruction of position, size, shape, and color of the native nipple-areola complex currently are attainable goals; functional restoration of erectile ability and erogenous sensation can be restored by Dr.Fisher.

 

Nipple Surgery?

Breast augmentation ought to be conducted safely, using well established methods. Nipple surgery, although simple to a lay person, entails many more risks and long-term consequences than any other type of breast augmentation.

Substantial nerve connections can be severed, you may never feel anything, never be able to breast-feed… It is also very obvious that you have had the areola reconstructed, so in any sexual contact, you may instantly be questioned – not to mention the fact that although not visible from afar, the nipple is one part of your body, which really stands out, especially after breast augmentation. Do you really want to undergo surgery via the nipple?

In that case, you should address the Expert in the Field, Dr. Gregory Thomas Fisher, who has had years and years of experience, and has seen it all – bad, not so bad, and tolerable. Successful?

“I would not do a nipple surgery unless it is for some reason medically indicated,” states Dr.Fisher. “For instance, we do so following mastectomy, because the overall benefit is psychological and not merely esthetic. Even there, because the reconstructed nipple is not easily moved, nipple reconstruction is usually reserved as the final step in breast reconstruction and is critical for providing an aesthetically pleasing breast. Once disturbed, the nipple area can literally psychologically disable the woman’s well-being – even a small malformation or disparate distance or height is very perceptible to every woman and she may feel extremely uncomfortable…”

“For instance, patients with loss of the nipple and areola from cancer excision, trauma, or congenital absence continue to experience psychological distress even long after breast mound reconstruction has taken place. Studies have shown that recreation of the nipple-areola complex has a high correlation with overall patient satisfaction and acceptance of body image.”

“Obviously, completion of the breast reconstruction by creating a nipple-areola complex that matches the contralateral nipple in terms of size, shape, projection, and position adds significantly to the reconstructive result. Once the surgeon disturbs one nipple, there is no way back!”

Numerous techniques have been developed to reconstruct the nipple following mastectomy. These include intradermal tattooing, variations of local tissue flaps, skin grafts, cartilage grafts, tissue-engineered structures, and nipple-sharing techniques. The most common problem following nipple reconstruction is a decrease in projection, or nipple flattening. Thus, methods of secondary nipple reconstruction as well as restoration of nipple projection have been reported.

Therefore, DO NOT UNDERGO NIPPLE SURGERY UNLESS YOU HAVE TO – as part of your mastectomy or other treatment. THE RISKS ARE TOO HIGH!

Contact Dr. Fisher for further consultation. www.DrFisher.com

This entry was posted on January 18, 2011. 1 Comment

Research

Pursuant to our internal research conducted from January 1, 2010 to January 1, 2011, out of 512 patients who chose to answer our questionnaire, over 400 came upon their friends’ recommendations. All the respondents looked up our website prior to visiting us. 170 came for a major procedure, 186 for a minor surgery. Almost one half of the patients stated that they prefered complete anesthesia, while the other half did not have any preference in this regard. More than 360 patients have stated that they will “definitely recommend” Dr.Fisher’s services to their friends. The rest simply stated that they would recommend us, without qualifications. All the patients regarded our staff as professional and kind, in all cases (that is 100 per-cent !) answering the patients’ questions;  but at the same time gave more weight to the doctor’s attitude and experience. 92% of the respondents stated that being able to trust Dr.Fisher was the most important reason for their coming to us, sometimes repeatedly, for advice and help. 85% stated that they did not find anyone within 25 miles with equal experience and skill. 63% of responding patients came to us because we had “very competitive prices.” Of course no-one would want to associate the adjective “cheap” with anything that they might receive in/on/for the benefit of their body. The body is just as important as the mind, and no-one wants to be “cheap” when their body/mind is concerned. Thus, we purposefully and intentionally completely omitted this word from our questionnaire.

Dr.Fisher Will Never Let You Down!

Many women fail to do their homework and throw themselves hopelessly after the Hollywood glitz and sparkle. It is the unique understanding of how the body works with the experience wedded in the hands of an artist, which provides Dr.Fisher with such acumen and wise distance when assessing his would-like-to-be competition.

A recent study showed that almost 15% of plastic surgeons in the United States are misleading their patients about saline implants. In some geographic locations, this number can be much larger.

Saline implants are little more than round bags of salt water. As any skilled environmentalist would tell you, such a round bag can last for centuries in the harshest weather conditions without significantly decomposing or malfunctioning. In the safe environment of the human body? “Well, it will last you a lifetime,” as Dr.Fisher says.

Compared to cohesive silicone gel implants, saline implants are somewhat more prominent and sturdy. That is why the popular sex symbols you often seen on magazine covers and the T.V. screens have opted for saline, not silicone. In the latter, the filler material is silicone gel, which is adapted to mimic the consistency of natural breast tissue, and retain its natural shape.

Silicone gel implants cost $1000-$1,500 more than their saline counterparts. This may be the reason for their lasting popularity. However, you should not think of your wallet but your welfare when you come and see Dr.Fisher in Cerritos Towne Center.

“I am very comfortable with all varieties of silicone as well as saline. I mostly use saline implants though, because there is a higher demand for them,” states Dr.Fisher. “I make a tiny incission, not more than an inch-and-a-half, which is completely imperceptible when healed… True, some of the proponents of the saline implants,” says Dr.Fisher, “argue that the silicone gel implant is too complicated. Too complicated? They mean the operation… Nothing is too complicated if you know what you are doing!” responds Dr.Fisher with a smile. “There have also been those who voiced objections based on their bad memories of the flawed liquid-silicone implants popular in the ‘80s… These have long since been made illegal in this country. Of course, you can go to Mexico or Venezuela or wherever these hopeless souls go, trying to save. You never know what you are getting there…”

There are many more types of implants. Do not listen to your girlfriend, because your body may not well accommodate to – or may even reject – the type she has. Modern implants, both saline and gel, are safe, but only a board certified plastic surgeon with experience and unsurpassed artistic acumen, such as Dr.Fisher, can determine which type is best-suited for a you, based on a number of factors.

Therefore, come to us with an open mind and never hesitate to ask; for Dr.Fisher will never experiment with your health. Your safety comes first. He may even postpone your operation or even ask you for a secondary medical exam. Do not be surprised.

Dr.Fisher will never let you down. Your Happiness is His Goal!