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November 1, 2011

Even the Wall Street Journal fails to understand how cosmetic surgeons are trained!

Filed under: Cosmetic Surgery,Dr. Steinsapir,facial cosmetic surgery,safe cosmetic surgery — Tags: , , , , , — admin @ 1:53 pm

The message that one should only go to a board certified plastic surgeon is the public relations message of general plastic surgeons.  While there are many excellent skills that general plastic surgeons offer, it is essential to understand that very few of these surgeons were trained to perform cosmetic surgery in their plastic surgery residency.  Additionally numerous surgical subspecialties offer high quality cosmetic surgery and were very extensively trained in these procedures in residency and fellowship programs.  In many cases, the subspecialist cosmetic surgeon offers a level of service that is better than what can be obtained from the majority of general plastic surgeons.  It is my opinion that general plastic surgeons betrayed their public trust by not doing more to bring up the standard of care in cosmetic surgery and for so long failing to properly train their resident surgeons to properly perform cosmetic surgery.  For this reason, the public is often much safer getting their cosmetic surgical care from the subspeciality cosmetic surgeon and not a general plastic surgeon.  The Wall Street Journal just published an article that completely ignored this issue.  Here is the letter I sent to the Wall Street Journal.

Dear Editor:

I read Robert Johnson’s article “A Nip and a Tuck” about cosmetic surgery for the 65-plus crowd that appeared in the October 31, 2011 WSJ.  The article only mentions a single specialty that offers cosmetic surgery: general plastic surgeons certified by the American Board of Plastic Surgery.  Either general plastic surgeons are very good at public relations (they are), or the author was unmotivated to provide readers with a balanced perspective.  General plastic surgeons are not the only board certified surgeons who offer safe, high quality cosmetic surgery.

For years general plastic surgeons failed to train their residents for cosmetic surgery. General plastic surgery residency instead focused on broad training in reconstructive general plastic surgery.  Despite claims to the contrary, treating a burn is not the same as performing liposuction, a facelift, or an eyelid surgery.  This lack of leadership has resulted in a less than ideal standard of care for these elective cosmetic surgeries.

Over the past 40 years, otolaryngologists, ophthalmologists and dermatologists have built excellent fellowship training programs in facial plastic surgery, oculofacial plastic surgery, and dermatologic surgery that provide in-depth training in cosmetic surgery to allow these surgeons to offer cosmetic surgery to the American public that is arguably safer and of better quality than that offered by general plastic surgeons.   The American Board of Cosmetic Surgery, a non-ACGME board, accredits high quality cosmetic surgery fellowships that are open to a number of surgical specialties including general surgeons, gynecologists, oral maxillofacial surgeons, as well as general plastic surgeons. These highly trained specialists provide a quality alternative to board certified general plastic surgeons who lack formal training in cosmetic surgery.  It is now well accepted that fellowship trained dermatologists practicing liposuction are much less likely to be sued for liposuction malpractice than general plastic surgeons to cite just one example.

It is not controversial to state that general plastic surgery residencies do not provide adequate training in cosmetic surgery.   Fortunately the field of general plastic surgery has recognized this and now offers a growing number of fellowships in aesthetic surgery for board eligible general plastic surgeons.  However, compared to fellowship trained specialists in facial plastic surgery, oculoplastic surgery, dermatologic surgery, and cosmetic surgery; general plastic surgeons still have a ways to go before the public trust in this specialty is truly deserved. Unfortunately readers of Mr. Johnson’s article were left unenlightened about these issues.

Sincerely,

Kenneth D. Steinsapir, M.D., Los Angeles, Ca.

Associate Clinical Professor

Division of Orbital and Ophthalmic Plastic Surgery

Jules Stein Eye Institute

David Geffen School of Medicine at UCLA

 

September 5, 2011

What should I expect with my facelift surgery?

Filed under: beverly hills facelift,Cosmetic Surgery,facelift,facelift los angeles,facial cosmetic surgery,Ronald Reagan Medical Center at UCLA,safe cosmetic surgery — Tags: , , , , , , , , — admin @ 3:13 pm

Facelift surgery is the most powerful of facial cosmetic surgeries you can undergo.  Although we say it in practically every blog entry, in this instance it is more true than ever; choose a doctor who is experienced, up-to-date on the latest techniques, and skilled at performing facelifts.  The procedure for facelift has changed significantly in recent years.  What is clear is that there is not added benefit for the higher risk, deep plane facelift.

When it comes to choosing the best facelift for you, there is no right answer as to which method is the most effective, natural looking, or successful.  A customized treatment plan, established by you and your doctor and based on your features and desires will significantly influence the outcome of your procedure.   A facelift will always be a procedure of intelligent choices.

Where is surgery commonly performed and what type of anesthesia?

Typically facelift surgery is an outpatient procedure, but overnight stays may be recommended after deep sedation or general anesthesia.  For certain individuals, your doctor can perform your facelift in the office, while you are awake and under local anesthesia.  But for most, general anesthesia or deep sedation is the best choice.  For cases requiring deep sedation and general anesthesia, Dr. Steinsapir performs surgery at the UCLA Ronald Reagan Medical Center and usually recommends an overnight stay at the surgery center.

Recovery and physical restrictions

A facelift takes approximately four hours. Usually there is minimal discomfort afterward; managed with either over-the-counter or prescription pain medications.  You may experience moderate swelling around the eyelids and other areas of the face, but this is normal and is not cause for concern.  Most find taking 7-10 days off from work about right.   This time frame can depend on the precise nature of you work.

Common complications after surgery

Facelift surgeries performed by a skilled and experienced surgeon rarely have complications.  The deep plane facelift mobilizes the tissue under the facial muscles and can injure these motor nerves causing facial weakness. The incidence is small but not zero.  The risk amounts to only a very small percentage of individuals who receive this treatment experiencing this complication, but there is just no reason to risk this nerve damage when other methods of facelifts are available.  In fact, there is essentially no cosmetic benefit to the deep plane facelift compared to other lifting methods. Other complications can include significant bruising and very rarely infection.

The time frame before full recovery

Recovery periods for facelift procedures vary greatly depending on the type of facelift surgery your physician and you decide on.  Typically however, you can expect to return to work after 6 to 10 days.  After 2-3 weeks, others are unlikely to detect that you just had surgery.  Facelifts are not considered fully healed until about 6 months after.  Once you have recovered fully, the results of surgery are very long term.

About Dr. Steinsapir

Dr. Steinsapir is on active staff at the UCLA Hospital and Medical Center at the David Geffen School of Medicine as an associate clinical professor of Ophthalmology in the Division of Orbital and Ophthalmic Plastic Surgery. UCLA is consistently rated the best hospital in the West and ranked at the top with a handful of medical centers in the United States. Many surgeries are performed on an outpatient basis at the Surgery Center at the UCLA Medical Center.  Dr. Steinsapir addresses a broad array of oculofacial reconstructive concerns.  Contact us today to schedule a personal consultation with Dr. Steinsapir.

August 6, 2011

Can I visit the United States for Reconstructive Surgery?

Filed under: blepharoplasty,cosmetic eyelid surgery,Cosmetic Surgery,Dr. Steinsapir,eyelid cancer reconstruction,eyelid reconstructive surgery,facial cosmetic surgery,fixing eyelid surgery,oculoplastic surgeon,oculoplastic surgery — Tags: , , , , , , — admin @ 9:32 am

When it comes to reconstructive facial surgery, Dr. Steinsapir has extensive experience with eyelid, midface, and orbital reconstruction including repair of prior unsatisfactory eyelid surgery, removing unsatisfactory facial implants, correcting eye changes associated with thyroid eye disease, orbital and tear duct surgery, and repair of the eyelid after skin cancer removal or trauma.

Many people travel from across the United States as well as internationally to have surgery with Dr. Steinsapir.  He is world-renowned for his leadership in facial cosmetic surgery.  If you are considering traveling to have reconstructive surgery or other cosmetic treatment with Dr. Steinsapir, here are some important considerations that will help you have the best experience possible.

Consult First

Many people who travel for cosmetic treatment feel they should be able to have surgery at the time of their initial consultation.  They want to take care of everything in just one trip, so they may fly or make a long drive to Los Angeles, have their consultation, and have surgery all during the same trip.  This idea may seem appealing because you only have to book a flight and pack your suitcase once, and you may even save a little money—but please reconsider this approach.  Dr. Steinsapir doesn’t believe in performing an initial consultation and surgery at the same time.  Even if you save a few dollars in airfare, in the end this amounts to hasty and high-pressure decisions.  Your choice to move forward in having surgery with the right doctor is important, and it’s not a good idea to cut corners here.

Reconstructive surgery should be something you and your surgeon approach calmly, thoughtfully, and with confidence.  Instead of too much pressure, Dr. Steinsapir strongly advises and encourages you to take the time to make sure you have found the right doctor and right treatment approach.  He wants you to have time to think about the options and be completely comfortable with the proposed surgical plan.

Take Time to Reflect

Consulting now and having surgery later is a sound approach for anyone seeking the right cosmetic treatment with any doctor.  Although admittedly not convenient, slowing down, thinking about your choices and being fully comfortable ensures that you can make a fully informed choice without the pressure of time.  When you consult with Dr. Steinsapir, he won’t pressure you into committing to surgery.  It is better for everyone if you have the opportunity to meet with the surgeon, then have time to think about the issues discussed well before undergoing reconstructive surgery.

Make Thoughtful Decisions

Even if you’re traveling from very far, Dr. Steinsapir will not perform surgery at the time of your initial consultation.  The best surgery is always performed with the utmost of care, consideration, research, and planning.  You should go into surgery comfortable and confident that you have made the right decision.

About Dr. Steinsapir

Dr. Steinsapir is on active staff at the UCLA Hospital and Medical Center at the David Geffen School of Medicine as an associate clinical professor of Ophthalmology in the Division of Orbital and Ophthalmic Plastic Surgery. UCLA is consistently rated the best hospital in the West and ranked third among all medical centers in the United States. Many surgeries are performed on an outpatient basis at the Surgery Center at the UCLA Medical Center. Larger procedures may also be performed on an inpatient basis at the Jules Stein Eye Institute. Dr. Steinsapir addresses a broad array of oculofacial reconstructive concerns.  Contact us today to schedule a consultation, followed by a brief consideration of the more common reconstructive issues that bring people to see Dr. Steinsapir.

July 8, 2011

How Do I Know if I’m Ready for Cosmetic Surgery?

Filed under: best cosmetic surgeons,Cosmetic Surgery,Dr. Steinsapir,facial cosmetic surgery,safe cosmetic surgery — Tags: , , , , , — admin @ 11:38 am

Dr. Steinsapir typically does not recommend surgery until you have some issue that can’t be addressed or rectified with non-surgical means, or if the economics of surgery outweigh the non-surgical treatments and the risks of the two approaches are appropriately balanced.  Practically speaking, if you look long enough, you will almost always find a surgeon willing to perform surgery.  This means that it’s especially important for you to research the different treatment options available, talk to a number of specialists and, if surgery is the best course of action, discuss the pros and cons with your chosen surgeon.  An ethical surgeon will examine your condition and make a recommendation based on your goals and needs, rather than their pocket book.

Consider the impact of surgery

While television programs are full of stories about how plastic surgery transformed the lives of the patients, these grand results are much less common than the TV might lead you to believe. An improved upper eyelid won’t suddenly transform your life by helping you to get a better job, end conflict with your spouse, or make you an instant celebrity.  A realistic goal is that you will be pleased with the improvement and happy that you had surgery.  However, it is unrealistic to expect the surgery will help you land that promotion and help you pay off the cost of surgery. Don’t opt for surgery if it is a choice between basic necessities and having surgery.  Paying rent and health insurance is more important than elective cosmetic surgery.  These are personal choices, but cosmetic surgery is a luxury and not a necessity.  Make sure you aren’t over committing yourself financially in deciding to have surgery.

Consider your motivations

Before deciding to undergo cosmetic surgery, ask yourself “why.”  The first step to understanding if you are ready for surgery is to understand your motivations.  Do you want surgery to please yourself, or to please someone else?  There is no right answer, but if you want surgery to please someone else, ask yourself if the surgical outcomes are something you also want.  Do you find yourself preoccupied with thoughts of a particular surgery?  Do you avoid social situations because you are concerned that people are staring or whispering about you?  Do you spend hours every day repeatedly thinking about an issue that your friends have trouble seeing?  These may be signs of a condition called body dysmorphic disorder.  Body dysmorphic disorder is an obsessive thought pattern characterized by focusing on a slight or nonexistant flaw. Unfortunately, it is difficult to fix subtle or nonexistent issues surgically.  Occasionally this leads to a flat out misunderstanding between surgeon and patient, and even more trouble after surgery.  Dr. Steinsapir find that it is best to air these issues openly and if necessary involve a psychotherapist to help the individual better understand their motivation to have surgery.

Consider your support system

One last series of questions you should ask yourself is about support from family and friends.  Are others around you supportive of you having cosmetic surgery?  Keep in mind that a negative environment can be harmful to your healing process following surgery.  It is so important to make sure those you love are supportive of your decision before you undergo cosmetic surgery.  Don’t try to hide the fact that you are undergoing cosmetic surgery; be open about your plans and find support from those around you.

About Dr. Steinsapir

Dr. Steinsapir is a board certified ophthalmologist 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 cosmetic surgery.

May 24, 2011

How good are the cosmetic surgeries advertised on television?

Filed under: best cosmetic surgeons,Cosmetic Surgery,Dr. Steinsapir,Ronald Reagan Medical Center at UCLA,safe cosmetic surgery — Tags: , , , — admin @ 2:33 pm

Advertisements on television offer compelling bi-lines and a lot of hype about cosmetic surgery procedures.  In today’s media-driven world where television personalities and movie stars seem to be always under the knife, it’s easy to become carried away with the notion that cosmetic surgery is simple, painless, and as easy as walking into the nearest cosmetic surgeon’s office and walking out with a new look.  In reality, television greatly skews our understanding of what it means to undergo a facelift, lid lift, or even a BOTOX® injection.  In truth, satisfactory cosmetic surgery results do not come from the best price, the flashiest advertisement, or the most recently famous surgeon; they come from a dedicated surgeon who is an expert in his or her field who will listen carefully to your needs and offer you the safest and most effective treatment plan for you.

Reality vs. Reality Television

When it comes to cosmetic surgery reality shows, the term “reality” becomes a very loose term.  These programs have ridden (some would say helped to stimulate) the wave of interest in cosmetic surgery, yet they provide only a very distorted view of the practice of cosmetic surgery. The consultation becomes a sound bite and in the process minimizes the risks and appropriate concerns that must be addressed.  So many procedures are performed on some of these shows at one time that the surgery becomes unnecessarily life threatening.  No one should be placed in a position of choosing between their beauty and their health.  Of course there are risks with any surgery and anesthesia.  However, these risks can be managed and reduced by using the most appropriate anesthesia, operating in the proper setting, and limiting the amount of surgery performed at a given time.

Choosing the right doctor

By playing on your desire for a “quick fix,” advertisers are reinforcing the misconception that cosmetic surgery is just another quick trip to the doctor’s office; like receiving a flu shot.  But just as a flu shot comes with risks, so too does cosmetic surgery.  Although there are risks with any surgeon and procedure, an expert surgeon will guide you through these risks helping you to make an informed decision.  Offices that gloss over these concerns are trying to take advantage of your lack of expert knowledge.  It is the job of the surgeon and their staff to educate you and help you make the right decision, not hustle you into having surgery.  At the end of the day it is essential that you trust your doctor.  It goes without saying that your doctor should make sense, listen to you, and treat you with respect and dignity.  The office staff should also listen to your concerns and treat you with respect. Don’t be intimidated by the doctor’s reputation.  That reputation is meaningless if the doctor doesn’t treat you like a human being.  Before and after pictures are also extremely important. This is generally a doctor’s best work. If you don’t like what you are seeing, it is a mistake to think your results with that particular doctor will be better than what you are being shown.

Consultation is key

Whether you decide to seek help from a clinic advertised on TV, or to take the recommendations of a friend or family member, it’s important to first attend a consultation with your chosen physician.  That consultation should also include meaningful time with the surgeon who will be doing your surgery.  If the surgeon is not detailed during your consultation, is it reasonable to assume they will be detailed in performing your surgery?  To get the most from a consultation, do your homework. Have a good idea of what you are trying to accomplish. Be open to an approach that is different from what you thought you needed.  Choose your surgeon based on his or her expertise, not based on media hype or discounts.  If you don’t like what you are being told, don’t try to convince the surgeon to do something they have just advised you to avoid.  Instead, consider seeking a second opinion to ensure your surgeon is giving you the options that he or she is most comfortable with and the safest possible plan-of-action.  The good news is that in most cities, there are lots of options for cosmetic surgery care. No one person has all the answers.  If all the other doctors you have seen recommend against a particular course, think long and hard about allowing that surgeon to perform your surgery.

About Dr. Steinsapir

Dr. Steinsapir is a board certified ophthalmologist 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, DYSPORT, Restylane and Perlane, and advanced eyelid and facial surgery, which can be a vital part of your evidence-based treatment plan.

May 13, 2011

Which is better; surgery in a private center or a large outpatient surgery center like the Ronald Reagan Medical Center at UCLA

Filed under: best cosmetic surgeons,Cosmetic Surgery,Dr. Steinsapir,Ronald Reagan Medical Center at UCLA,safe cosmetic surgery — Tags: , , , , , , , — admin @ 1:58 pm

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.

April 7, 2011

Should I get a Deep Plane Facelift?

Filed under: beverly hills facelift,Cosmetic Surgery,facelift,facelift los angeles,facial cosmetic surgery — Tags: , , , — admin @ 7:14 pm

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

March 19, 2011

Who can inject BOTOX®?

Filed under: Beverly Hills BOTOX,Botox,Botox Los Angeles,Cosmetic Surgery,Dr. Steinsapir,Microdroplet BOTOX,oculoplastic surgeon,oculoplastic surgery — Tags: , , , , , , — admin @ 8:32 pm

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.

March 8, 2011

How long should I wait before having my eyelid surgery revised?

Filed under: blepharoplasty,eyelid reconstructive surgery,Eyelid Surgery — Tags: , , , , — admin @ 8:47 pm

Deciding to undergo reconstructive blepharoplasty is not a decision that should be taken lightly.  However, living with surgery results that make you unhappy with your appearance is not something you should have to do either.  It’s important to consider which symptoms are part of the healing process and which are cause for concern.  Minor bruising and swelling can make it difficult to tell if your surgery has provided the results you were hoping for so it’s important to talk with your surgeon about your concerns as well as what to look for if, by some small chance, something does go wrong.  Complications can occur even at the hands of the very best surgeon and although they’re rare, emergencies happen and it’s important to know the signs.

Common side effects of surgery

Many people become concerned when swelling in the eyelid persists for several weeks after surgery; some amount of bruising is also common following surgery, but neither bruising nor swelling are cause for concern unless they are excessive.  Remember that that it does take time to heal and many issues resolve with time.  For this reason, it is best to give the eyelid plenty of time before considering revisions to your surgery, especially if the issue is mild ptosis.  Dr. Steinsapir usually recommends six to twelve months before considering revisions.  There can be pressing reasons to operate earlier.

Certain lower eyelid surgeries (primarily transcutaneous lower blepharoplasty) have a finite risk of damaging the lower eyelid.  These issues can be complex.  It is often true that when something is not right several months after eyelid surgery, the problem was evident very soon after surgery.  Because many things will show improvement over time, a period of healing is often recommended, even if reconstructive surgery will be necessary.  Treatment with medication such as steroids and simple mechanical treatment such as finger winking can help with the ultimate lower eyelid position.  In this situation especially, it’s important to wait and allow time to heal before deciding on reconstructive surgery.

Causes for concern

There are occasions when immediate action is necessary to correct a problem that may result in a much more complex reconstructive surgery down the road or immediate damage to the cornea.  These situations are unusual.  Worrisome issues that occur within the first 24 hours of surgery include bleeding, bruising that rapidly expands across the eyelid, loss of vision, or persistent or severe pain.  These types of issues should prompt an immediate call to your surgeon.  If you are not able to reach your surgeon, consider calling 911 .  It is better to be seen for something that turns out to be nothing serious than to miss something truly important.  Other issues are much less urgent and may not make themselves clear for several days or weeks after surgery.  Even when it is clear that the issue does not require immediate attention, call your surgeon and discuss the situation with the office.  Most often the surgeon will want to assess you personally and assure themselves of what is going on.

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®, Deepfill™ under-eye Restylane® treatment to address the dark circle and under-eye hollow for up to a year without the need for retreatment.  Dr. Steinsapir is one of the foremost eyelid surgeons in the world.  He is on staff at the UCLA 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.

February 27, 2011

Can I exercise my facial muscle for an improved tone?

Filed under: Beverly Hills BOTOX,beverly hills facelift,Beverly Hills Restylane,Botox,Botox Los Angeles,Cosmetic Facial Fillers,Cosmetic Surgery,Dr. Steinsapir,facelift alternative,facial cosmetic surgery,forehead lift,midface lift,Restylane,safe cosmetic surgery — Tags: , , , , , , , , , , , — admin @ 8:48 pm

Exercise and diet are essential for a healthy lifestyle, but it’s important to recognize their limitations.  Not every condition can be cured by exercise, vitamin supplements or fad diets, especially when the problem is not a result of poor nutrition or inactivity.  We absolutely encourage you to exercise moderately and eat well, but we admit to being skeptical of the arising claim that exercising facial muscles can restore youth and beauty to one’s face.  This is an unproven method, and when one considers that they are likely still using their facial muscles just as much as they were ten years ago, it becomes apparent that their aging looks are unlikely due to facial inactivity.

It’s appealing to believe that we can resolve all of our concerns through exercise, and while research shows that exercise does benefit our health in many ways, it also shows that further medical treatment is required for many conditions.  Just as someone with presbyopia cannot exercise to regain the ability to focus for reading vision, it’s not likely that you’ll be able to reverse the effects of age, time, gravity, and stress by wiggling your face or by having electrical currents stimulate your facial muscle to contract.

There are many types of facial cosmetic surgery and other treatment that can help you obtain the result you need if your doctor determines that you are a suitable candidate.  These range from minimally invasive treatments with little-to-no downtime like BOTOX and undereye Restylane to surgeries like the facelift and plastic eyelid surgery including eyelid reconstruction, which give dramatic yet natural results to individuals with far-reaching concerns.  While it is impossible to know which treatment, if any, is most suitable for you before a private consultation with the best facial cosmetic surgeon for you, you can be confident that there are a wide range of treatments that an expert can custom-tailor to meet your needs.

As a specialist in facial cosmetic treatments, Dr. Steinsapir has treated many individuals who first explored a variety of “natural solutions” for their aesthetic facial concerns.  Frustrated when they saw no results, they eventually consulted with Dr. Steinsapir and opted for proven treatment methods that provide dramatic yet natural results.  This human tendency to pursue unproven treatments is not a fault; it is normal to want to independently resolve a problem using the least invasive and most economical method possible.

Dr. Steinsapir is focused on your personal goals and comfort level.  Dr. Steinsapir always asks you questions about your specific goals, individual situation, and preferences so that he can plan a solution that is aligned what you want, so you can feel comfortable knowing that you are ultimately in control of your treatment plan.  Dr. Steinsapir very much believes in using the least invasive method for accomplishing a particular goal; for example, he does not recommend a forehead lift when a BOTOX treatment for wrinkles will will meet your goals – and he is a leader in his field of minimally invasive solutions.

If you are seeking a proven treatment with an experienced facial plastic surgeon with extensive training in oculofacial plastic surgery, we invite you to a personal consultation with Dr. Steinsapir today.  Dr. Steinsapir is honest, friendly, and can talk to you about customized treatments that give you the results you seek by addressing your specific needs and unique facial features.  Please call us today to schedule a time when you can speak with Dr. Steinsapir.

About Dr. Steinsapir

Dr. Steinsapir is a board certified cosmetic surgeon and oculoplastic surgeon 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 patients at UCLA, where he is an assistant
clinical professor. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert provider of facial cosmetic surgery and eyelid reconstruction, which can be a vital part of your evidence-based treatment plan.

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