Which is better; surgery in a private center or a large outpatient surgery center like the Ronald Reagan Medical Center at UCLA
It is hard to improve on the staff and resources available at the UCLA Outpatient Surgery Center at the Ronald Reagan Medical Center at UCLA. UCLA is consistently rated the top medical center in the Western United States and one of the top five medical centers in the country.
Private surgery centers
Accredited surgery centers run by your surgeon’s office are generally safe, but Dr. Steinsapir believes there is inherent security offered by major medical centers that is difficult to duplicate in small surgery centers. Dr. Steinsapir notes that, while it is certainly more profitable and convenient for a surgeon to run his or her own surgery center, patient safety is a central focus of major medical centers, and therefore they are often a safer option for the patient. One of the great advantages of a major medical center is increased peer scrutiny and clinical resources. There are simply more people looking over the surgeon’s shoulder. At a private operating room, there is a single anesthesiologist and perhaps two nurses, or a nurse and a nurse anesthetist working with your surgeon. There is a very low incidence of issues in operating rooms, however, if an issue does arise, the available staff members and attending physicians are limited. Who is around to assist your surgeon and their anesthesiologist?
UCLA Surgery Center
The UCLA Surgery Center is not only staffed with numerous anesthesiologists, nurse anesthetists, respiratory therapists, and critical care nurses, but all staff members are up-to-date on the latest techniques. The anesthesiologists are not community-based. UCLA Surgery Center anesthesiologists are also academic faculty members actively involved in the latest developments in anesthesia as well as teachers of the next generation of anesthesiologists; they know their business. The surgery center is on the campus of the Ronald Reagan Medical Center with all the resources that modern medicine has to offer. You might inquire if your surgeon’s office-based operating room has a plan should something go wrong, but at UCLA you know you are in good hands.
Cost benefits of UCLA Surgery Center
Your surgeon’s private surgery center offers a convenience if your surgeon is local, but UCLA Surgery Center offers remarkably competitive facility and anesthesiology fees. In many cases, the rates are lower than those of many private surgery centers (in some cases, much lower). It is comforting to know that the safety of the UCLA Medical Center is within financial reach for your cosmetic surgery.
About Dr. Steinsapir
Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.
Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.
I have mild myasthenia gravis. Is it okay for me to have cosmetic Xeomin treatment?
Xeomin® (incobotulinumtoxinA) is FDA approved and being distributed for use in the United States. However, the current FDA-approvals for this product only extend to two medical conditions: blepharospasm and cervical dystonia. Xeomin is is not currently FDA approved for cosmetic procedures.
Xeomin and FDA approval for cosmetic use
Merz, the company that developed Xeomin, reports that clinical studies for cosmetic applications are underway. Doctors are able to use this product in what is referred to as “off-label” manner, meaning that your doctor can prescribe Xeomin at doses and for procedures other than those recommended by the FDA, however in these situations, you are using the product at your own risk. It is possible to obtain treatment for cosmetic indications with Xeomin. Just note that such uses have not been tested rigorously and may pose higher risk than being treated with drugs that are formally approved for treating cosmetic issues such as BOTOX® and Dysport®. Based on studies so far and the use of Xeomin in Europe – where it is available for cosmetic purposes – doctors anticipate that Xeomin will work very much like BOTOX for cosmetic applications.
Xeomin and myasthenia gravis
Regardless of FDA approvals, Xeomin, or any other clinical botulinum toxin, should not be used on individuals with myasthenia gravis. If you have myasthenia gravis, you have antibodies that attack the neuromuscular junctions causing weakness. You are especially susceptible to the effects of botulinum toxin. Even relatively low-dose treatments can be associated with unwanted systemic effects including unpleasant or even life-threatening effects on the muscles responsible for swallowing and breathing. Individuals with neuromuscular junctional disorders like myasthenia gravis or Lambert-Eaton syndrome, treated for blepharospasm are at increased risk of complications due to reduced blink function including dry eye, corneal exposure, and even corneal ulceration. For these reason avoid botulinum toxin injections for cosmetic purposes and carefully monitor treatments if you are receiving them for medical reasons.
About Dr. Steinsapir
Dr. Steinsapir is a much sought after oculofacial surgeon. He is an innovator in minimally invasive cosmetic and reconstructive procedures and has invented new methods for treating with BOTOX, Fillers and cutting edge reconstructive eyelid and midface surgery. He specializes in high precision eyelid surgery and is a leader in correcting prior facial and eyelid surgery, including multiple revised cosmetic eyelid reconstructions. He attended medical school at the UCLA and completed ophthalmology residency at The University of Chicago. He is multiple fellowship trained including three years of fellowship training in oculofacial plastic surgery at UCLA, and a two-year cosmetic surgery fellowship in Rancho Mirage. He is widely published and lectures to other surgeons nationally and internationally. He is an associate clinical professor of Ophthalmic Plastic and Reconstructive Surgery at the Jules Stein Eye Institute at UCLA. His private practice is located in West Los Angeles, immediately serving the Los Angeles and Bevery Hills communities. Additionally, individuals from all over the country and the world regularly come to Los Angeles for this expert care.
To learn more about Dr. Steinsapir’s specialization in botulinum toxin treatments, please contact us today.
Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.
What is the Zerona Laser Treatment?
Zerona® Laser Treatment is intended to be a non-invasive alternative to liposuction. The promotional material describing the Zerona Laser Treatment suggests that shining a low-energy laser on the skin causes damage to the fat cells below the surface of the skin. Specifically, these promotional materials suggest that the cell walls become “porous” after being exposed to the Zerona Laser Treatment causing the fat stored within them to be excreted. Over the two-week treatment period, consisting of six, forty-minute sessions, the fat cells in the target areas allegedly become smaller and flatter. However, there is no scientific evidence to suggest that this method of body sculpting is effective. The company touts FDA approval for the device. However this only means that it is safe to expose the skin to the laser light from the device. It does not also mean that the treatment does what the manufacture claims.
Safe, Non-invasive, Effectiveness Questionable
Despite the testimonials of allegedly satisfied patients who have had Zerona Laser Treatment, there is no independent, peer reviewed studies showing that this treatment is effective. Individuals reporting on RealSelf.com have raised significant questions regarding the effectiveness of this treatment. Interestingly, the Zerona Laser Treatment protocols also call for altering your diet. Any calorie restriction that is severe enough is likely to cause weight loss. This does not mean that also shining a laser at your body further enhances the body contouring simply caused by a calorie restriction. It is unclear if the Zerona Laser is more effective than shining a laser pointer at your body. What does appear accurate is that this treatment is probably completely safe. However, if you spent thousands of dollars for a treatment that is supposed to contour your body and are disappointed, this may be of little solace.
Zerona vs. Laser Liposuction
Zerona Laser is not surgery or liposuction. It is simply a fancy low energy laser shined on the skin. The treatment is a bit of a light show so one might have the impression that it is actually doing more than it is. However, it is not a surgery or invasive procedure. In contrast, Smartlipo™, or laser liposuction uses a small cannula assisted with a laser. The aspect of the surgery that seems to please most patients is that their liposuction is performed under local anesthesia with a mild oral sedative. Like tumescent liposuction, the down time for laser liposuction is minimal under local anesthesia. The results are comparable to what can be accomplished with other methods of performing liposuction under local anesthesia.
Unlike Zerona Laser Treatment, laser liposuction is similar to tumescent liposuction in that local or general anesthesia is administered and the procedure is invasive. Laser liposuction yields visible and proven results only because it is essentially tumescent liposuction ― the laser has no scientifically-proven impact on the procedure.
Why all the hype?
Marketing people understand that the public is fascinated by lasers and is under the impression that any treatment with laser must be better. However, due to a loophole in how the FDA approved devices, manufactures only need to show that these devices are safe. This is a much less rigorous standard that drugs are held to. Drugs must be proven both safe and effective. So when a company reports that their device is FDA approved, the public may think that devices also must meet the safe and effective standard; is not the case. Consequently, device manufactures have more leeway in marketing their devices compared to drug manufactures. Care is therefore needed in assessing device claims.
About Dr. Steinsapir
Dr. Steinsapir is an expert cosmetic surgeon who has skillfully handled liposuction procedures in Los Angeles and Beverly Hills for over 20 years. He only performs tumescent liposuction under local anesthesia because of its superior results and fast, comfortable recovery time. He is a board certified opthalmologist and fellowship trained in oculoplastic surgery and cosmetic surgery in Southern California where he specializes in cosmetic surgery with an emphasis on minimally invasive techniques and surgery, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert provider of liposuction.
Should I get a Deep Plane Facelift?
There are so many different types of facelifts that you may be confused as to which might be the most appropriate treatment for your particular needs. A great facelift is not characterized by type, but by customization. The best way to get disappointing results is by looking for a cookie-cutter procedure. A skilled surgeon can produce amazing results with almost any method if he or she customizes the procedure to your individual circumstances.
The Risks of Deep Plane Facelifts
The deep plane facelift carries with it a risk of facial nerve injury even in the best of hands. This is because the nerves are exposed during the process of dissection. It is not possible to have a great facelift result if part of your face does not move correctly after surgery due to a facial nerve injury. This small risk might be justifiable if the deep plane facelift led to a much better result or a more long lasting procedure. The reality is, after six months it is impossible for experts to tell what technique was used in a particular facelift. So it makes no sense to perform high-risk maneuvers under the facial flaps.
Most any type of facelift can procure excellent results if customized by an experienced facial cosmetic surgeon. The deep plane facelift can be as effective as other methods, but it’s a riskier procedure and the benefits usually aren’t worth the risk when there are other options available. With the deep plane facelift, there is an increased chance of injury to a facial nerve that can even happen in the best of hands. The chance of these facelift complications are small but if it happens to you, the damages could be irreparable; some of your facial muscles will cease to work properly. Since properly functioning facial muscles are essential to your appearance, your results will not be good. Since there is no clear advantage to the deep plane facelift, why take the risk, even if it’s small? If you are set on receiving this method, you will probably find someone who will perform it for you if you knock on enough doors and have enough money, but may end up regretting your inflexibility.
About Dr. Steinsapir
Dr. Steinsapir is a board certified ophthalmologist (eye surgeon) and fellowship trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert provider of BOTOX, which can be a vital part of your evidence-based treatment plan
How do I avoid the BOTOX® “frozen forehead”?
The frozen forehead, or “BOTOX® freeze,” leaves you with a forehead that is glass smooth, without a line in sight. But the aesthetic costs of this effect are significant; it causes the eyebrows to fall and the eyes look small and closed in, an effect seen in many well-known models and actresses. These types of results are undesirable, but with proper placement of the BOTOX they are also completely avoidable.
Dr. Steinsapir has a solution
Dr. Steinsapir is the inventor of the newly patented Microdroplet™ botulinum toxin (BOTOX, Dysport®, Xeomin®) method. The Microdroplet method of administering cosmetic botulinum toxin is a breakthrough invention that revolutionizes the way we think about BOTOX treatments. The Microdroplet BOTOX treatment is applied less densely in the ‘worry line’ area to maintain the ability to furrow. The Microdroplet BOTOX treatment along the eyebrows and crow’s feet is very natural and does not interfere with the activity of the forehead. There is absolutely no reason to have a frozen forehead with this new technology.
To achieve natural results without the “forehead freeze” sometimes associated with BOTOX, Microdroplet BOTOX relies on highly controlled placement of tiny microdroplets of botulinum toxin to balance out the give-and-take of the muscles pulling around the eyebrows and causing the all too familiar pinching and frown lines.
The benefits of Microdroplet BOTOX
The result of the precise and balanced placement of your Microdroplet BOTOX treatment is that you can attain natural-looking results that balance your facial features while avoiding the side effects that you see with traditional BOTOX treatments. While there is a chance with any cosmetic procedure that you will not be completely satisfied with your results, Microdroplet BOTOX can maximize your chances for a natural outcome by relaxing overactive facial muscles and emphasizing features that make a face look more youthful.
Who is a candidate for Microdroplet BOTOX?
Microdroplet BOTOX is recommended for high-profile professionals such as executives, actors, and other individuals who seek an improved aesthetic appearance. Microdroplet BOTOX preserves natural forehead movement and expression without the all-to-familiar frozen appearance that has become the hallmark of getting treatment with BOTOX using traditional injection methods. The relaxed and lifted eyebrows with preservation of forehead movement sets this treatment apart from other off-label methods. Those who wish for a younger look with reduced wrinkles, frown lines, and crows feet will want to checkout Microdroplet BOTOX.
About Dr. Steinsapir
Dr. Steinsapir trained alongside the inventor of BOTOX and has performed thousands of BOTOX treatments in Los Angeles since 1988 and recently patented his Microdroplet BOTOX technique. He is a board certified eye surgeon and fellowship trained in oculoplastic surgery and cosmetic surgery in Southern California where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert provider of BOTOX.
Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.
Who can inject BOTOX®?
The short answer to the question of who can inject BOTOX® is: any licensed medical doctor or any nurse under the direct supervision of a licensed medical doctor. The exact details of the required qualifications vary by State so it’s important to research the individual you wish to perform the injection to ensure he or she is qualified. However, just because your doctor or nurse is minimally qualified to perform the injection does not necessarily indicate he or she is the ideal candidate for the procedure. As with many other medical procedures, ideal results require a certain level of qualification, skill and experience; these concerns are perhaps even more important when considering modifications to your physical appearance.
Nurses
Most States do not allow the independent practice of nurses performing BOTOX injections. The presence of a “Medical Director,” in name only, is no substitute for a personal examination by a supervising physician on the premises when you are treated by a nurse. It has become common to see nurses injecting clients at beauty salons. They might also suggest that they are supervised by a “medical director.” In the State of California for example, registered nurses are only permitted to inject under the immediate supervision of a licensed physician. The physician needs to have performed an examination and be physically present in the same office where the treatment is taking place.
When seeking a professional for this procedure, talk to the doctor to determine who will perform the procedure, what their qualifications are, if they have undergone specialized training, and how much experience they have performing the injections. If you don’t feel comfortable with the prospect of the nurse or the doctor performing the injections, it’s time to look for someone new.
Dr. Steinsapir never uses nurses or “physician extenders” to treat you. He personally performs all treatment himself. Don’t be fooled into thinking that cosmetic treatments are simple enough to be performed by an assistant under supervision. Dr. Steinsapir, like all reputable surgeons, makes sure that he is available to answer your questions in person and address your concerns individually, rather than directing you to a receptionist or simply brushing you off. He can individualize your treatment plan to help you meet your personal goals. Have treatment at the time of your consultation if it is right for you.
Dentists
Most States do not permit general dentists to inject cosmetic BOTOX. However, dentists who hold a dual, MD and DMD degree sometimes perform cosmetic BOTOX injections. These individuals are often highly trained Maxillofacial surgeons with residency training in Maxillofacial surgery. It is misleading to simply describe these individuals as “dentists.” Check with the licensing board for your State to learn what is, or is not permitted. When it doubt, remember, that there is no substitute for experience in performing these treatments.
The right doctor for the job
When seeking a medical professional for BOTOX injections, board certification in one of the four core aesthetic specialties is usually a good place to start: Dermatology, General Plastic Surgery, Facial Plastic Surgery, and Oculoplastic Surgery. Board certified professionals in one of these four specialties undergo rigorous and extensive training and have a wealth of experience working with BOTOX. Especially when seeking cosmetic injections in the facial regions, look for someone who understands the importance of adapting treatment for a given face.
Beginning your search with board certified professionals will greatly reduce the number of unqualified professionals you interview. Look for someone with the skills and experience to provide satisfactory results that make you happy.
About Dr. Steinsapir
Dr. Steinsapir trained alongside the inventor of BOTOX® and has performed thousands of BOTOX® treatments in Los Angeles since 1988. He is a board certified eye surgeon and fellowship trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert provider of BOTOX, which can be a vital part of your evidence-based treatment plan.
I’m unhappy with my eyelid surgery, and my surgeon doesn’t understand why
Yes, we are well into the new millennium, yet some surgeons are still performing surgery like it is 1970. Surgery based on out-dated concepts and techniques result in what Dr. Steinsapir calls “standard result.” Your surgeon is frustrated with your unhappiness because he or she achieved everything they were looking for with the surgery, so what’s the problem? The problem is, instead of looking natural, wonderful, and like a better you, you look like someone performed surgery on your eyelids!
Experience has nothing to do with these “standard results.” These surgeons are missing an understanding of the aesthetics required to achieve a completely natural appearance. Dr Steinsapir consults with three to four new patients per week who are disappointed with their first eyelid surgeon. Dr. Steinsapir believes that as many as 40 percent of these surgeries are associated with disappointing results that may benefit from revisional surgery.
The problem
The problem is that the patient and the surgeon have very different expectations. However, the fault rests with the surgeon who does not understand the craft and does not understand how the patient desires to differ from the results of standard surgical procedures. Creating natural results that don’t suggest surgery requires experience, finesse and an advanced knowledge of anatomy and the limitations of surgery. No one elects to undergo surgery with the goal of looking like they had surgery. Yet this is a common outcome because this is the result of applying standard surgical methods without understanding what makes an eyelid look beautiful. It is controlling the details of eyelid surgery that achieves a natural result including understanding how the eyelid fold interacts with the eyebrow position; how to preserve upper eyelid fold fullness; how to control the break of the upper eyelid fold to expose just the right amount of the upper eyelid platform, where to place the upper eyelid crease; and how to trim the eyelid platform skin and re-suspend it to the levator aponeurosis to support the eyelashes and snug the eyelid platform skin. These are the critical details that should go into each and every upper eyelid blepharoplasty. These are the essential steps that Dr. Steinsapir takes to customize and achieve a great eyelid surgery result.
Finding the right surgeon
Dr. Steinsapir often works with people who have had disappointing surgery by well meaning surgeons who achieve what can only be described as standard results. Fortunately almost all surgeries can be improved and revised to achieve a more harmonious result. As an oculoplastic surgeon, Dr. Steinsapir has a wealth of experience performing eyelid reconstruction. He has developed and advocates conservative surgical methods that help to preserve the integrity of the eyelids and spare eyelid tissue whenever possible. By combining this approach with the most innovative thinking and techniques, dramatic yet highly natural eyelid surgery results are possible with a minimum of down time.
Open communication between the surgeon and their patient is an important part of any surgical experience. Dr. Steinsapir strongly believes in establishing a relationship of trust by working with you to learn what you want the finished results to be and educating you in the process
About Dr. Steinsapir
Dr. Steinsapir is board certified in Ophthalmology and has completed numerous fellowships, including three years of Orbit and Eyelid fellowships at the prestigious Jules Stein Eye Institute at the David Geffen School of Medicine at UCLA and a separate two year cosmetic surgery fellowship under the auspices of the American Board of Cosmetic Surgery. He is widely respected for his work and has published over thirty scientific papers and eight book chapters. He is a true innovator, having developed Microdroplet™ BOTOX®, a unique patented method for injecting BOTOX®, and Deepfill™ under-eye Restylane® treatment to address the dark circle and under-eye hollow . Dr. Steinsapir is one of the foremost eyelid surgeons in the world. He is on staff at the UCLA Ronald Regan Hospital and Medical Center where he is an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute. He is also on staff at Harbor/UCLA Medical Center where he serves as an attending surgeon. He is in practice in West Los Angeles and is in high demand by discerning individuals from Los Angeles, Beverly Hills, and Southern California. Many of his patients also come to see him from around the country and the world. Very few doctors offer the level of skill and expertise he brings to cosmetic surgery and aesthetic restorative surgery to address prior unsatisfactory eyelid surgery. Please contact us today to learn more about evidence-based treatment options with Dr. Steinsapir for proven results.
