Berman Blog - Why Our SculpSure Pricing is So Much Lower than Other Providers

Why Our SculpSure Pricing is So Much Lower than Other Providers

Most places are charging between $1,500-2,000 per session for SculpSure fat melting sessions, while my office only charges $1,000/session. Why? Because you truly need 2 seasons to get the best results, ideally spaced 6 weeks apart. I find that many providers push clients to purchase one session only, at that higher rate. However, I feel that everyone should plan on 2 sessions to maximize your success.

It is important to know that you can do multiple sessions in different areas of the body, one after another, since each session is only 25 minutes and you are not sore after the treatment. I have had patients complete a session on their abdomen and immediately afterwards, move the 4 paddles to their love-handles, then to their bra fat and then to their thighs. I insist patients purchase a minimum of 2 sessions to see a noticeable reduction in body fat. Studies done by Cynosure have demonstrated an average reduction of fat of 24% when done on the abdomen or flanks. However, the paddles for Sculpsure can be placed almost anywhere on the body including: thighs, upper arms, knees, bra fat, male breasts,etc. If you are on the fuller side, you should consider doing 3-4 sessions per area.

I also offer Smartlipo, Bodytite and Facetite, as other options, in addition to the Sculpsure. However, Sculpsure is the only one that offers fat reduction with NO incision – meaning, NO DOWNTIME for you.

Have questions about SculpSure? Please call my office at 703-406-2444 to schedule a complimentary consultation with me.

 

Dr. David Berman -Board Certified Plastic Surgeon

Do I ever Recommend Against Plastic Surgery?

The quick answer is quite often. There can be countless reasons for this, but they can probably best be grouped into two main categories:

  1. Risk outweighs benefits
  2. Unrealistic expectations.

Exploring the first option, “risk outweighs benefits,” there are endless possibilities here. Someone in less than good health should not be receiving elective cosmetic, plastic surgery in my opinion. Fortunately, almost all of the patients that I see are in good health. However, every once in while, someone comes to me with a load of medical issues and I will tell them that they should not be getting these procedures. I am also quick to point out that I don’t make any money by sending them away and that if they shop around, someone will probably perform their surgery, but I have to share my honest medical opinion. Of course, there are many procedures that can performed in the office with just local anesthetic – meaning they involve less risk. However, this does not mean that everyone is a candidate for a particular procedure. There are still risks. Sometimes it is obvious that someone should not be doing a procedure. Other times, it takes surgical judgement and experience to know this.

With regards to the second category, “unrealistic expectations,” I sometimes find that while the procedure can be carried out safely, there is a reasonably high possibility that even if the procedure goes as planned, the expectation of the patient is greater than what I can achieve on average. This is why the initial consultation is so important. It lets the surgeon explain what he/she can achieve on average and to confirm that this is commensurate with what the patient is expecting. Even if the patient gets the best result that has ever been obtained, if they wanted even more, they will be dissatisfied.

Along the same lines, it is important to discover if there are secondary, hidden goals. As an example, a woman came to me many years ago for a breast augmentation (BA). It became clear to me during the consultation that she was satisfied with her breast size and shape. What truly brought her was that her husband was having an affair and she hoped that the augmentation would solve her marriage issue. I don’t think she was aware of this at the time of her consult. I told her that I would not perform the procedure on her because what she really wanted was a repaired marriage and that was NOT going to be fixed by altering her breasts. She would inevitably been dissatisfied with the results of her surgery since it would not have achieved what she wanted from the procedure. Sometimes, patients are aware of these hidden goals and sometimes not.  We have to discern them from our consultation.

If you’d like to discuss any concerns you have, please do contact my office to schedule a private consultation with me.

Who is a Good Candidate for Male Breast Reduction

Those who are not affected by having “man boobs” (larger breasts than typically), do not realize how much emotional distress this can cause a man. Most of the men that I see in my office for this reason refuse to take off their shirts in public, even when they are at the pool or beach. I am a sun-loving plastic surgeon, so I can certainly imagine how miserable this could be!

Most of the men that I see for this procedure have fullness in their breast area, but overall their breast shape is good. It is just larger and fuller than they desire. For these men, I can do their male breast reduction in the operating room with just an incision that only goes along the bottom half of their areola. They go home the same day and can usually return to work in 4-5 days. They can shower the very next day. I usually place drains in the area for excess fluid, which will be removed in my office 5-7 days later.

If there is mostly fatty tissue, rather than fibrous tissue, as well as a good shape, I can perform either SculpSure or SmartLipo to decrease the fat in the chest area instead of a traditional gynecomastia procedure. This has the advantage of no incisions with Sculpsure (and only very tiny incisions with SmartLipo) and a return to work either the same day (with SculpSure) or the next day (with SmartLipo).

Men who have lost a great deal of weight sometimes have large hanging breasts, and their surgical repair is more complicated and involves larger incisions.  These are more challenging cases, but the men that feel they need this surgery are usually more than willing to accept the greater scarring involved in order to get a better breast shape.

Ultimately, a good candidate for a male breast reduction is a man who is realistic in his expectations and is troubled by the appearance of his breasts.

Laser Hair Removal for Asian and Olive Skin

When it comes to laser hair removal and skin color, not all lasers are created equally. Someone with white or Caucasian skin has much less to  worry about when it comes to getting a burn from laser hair removal.

The lasers work for hair removal because the laser light gets selectively absorbed by the hair, compared to the surrounding skin. This is why laser hair removal systems do not work on white or grey hair. This lighter colored hair cannot absorb the laser energy.

With skin that is darker, including olive skin or that of those of Asian descent, it can absorb too much of the laser energy and thus sustain a burn. The YAG laser is much safer for those with non-white skin. This is a 1064 wavelength laser, in contrast to the Alexandrite laser, which is a 755 wavelength. The YAG laser has a different absorption frequency, providing a safer laser experience (though the skin should still not be tanned when getting a treatment). For those with light olive skin, the Alexandrite laser can likely still be used. But again, the skin should be very light in color.

We can increase the energy setting with the YAG laser and still get an effective permanent hair removal. However, it may require a few more treatments than with the Alexandrite laser. It is also less uncomfortable for most people, because the skin absorbs less of the energy. I still recommend that you apply the numbing cream 45-60 minutes before and cover with Saran wrap. We  always use the cooler during the treatment, which helps to make it more comfortable.

The advantage of our Cynosure Elite Laser is that it is actually an Alexandrite and also a Yag laser, housed in the same unit. With the push of we can switch from YAG to Alexandrite.

Berman Cosmetic Surgery - Can you remove fat without surgery

Can You Remove Fat Without Surgery?

The short answer is YES, you can remove fat without surgery.

SculpSure is the newest and best way to remove permanently subcutaneous fat (the fat under the skin) – though it will not attack the internal or visceral fat deep (deep within your belly, as an example).

I have been really impressed with the SculpSure laser, and my patients have seen really great results. And what’s also great is that SculpSure is a quick 25 minute treatment. Four  paddles are placed anywhere on your body that has pinchable fat (not the face or neck), which then conduct a laser beam which travels through your skin and melts the underlying fat. This laser is safe for all skin tones, by the way. Your body then breaks down the fat gradually over 3 months, and it is metabolized away. I recommend that patients plan two treatments, spaced 6  weeks apart – though they can be done at 4 weeks intervals as well. You will continue to improve for 3 months after the second session. According to Cynosure, patients can see up to a  24% reduction in fat in the areas targeted. After a session, you can do whatever you want. I went directly to the gym immediately after both of my sessions for a workout!

This is a far superior to Coolsculpt, which has greater name recognition because they were the first one to the market with a non-invasive fat reduction system by about six years. That time, however, allowed Cynosure to learn from their shortcomings and design a better system. From what I have seen, Coolsculpt has a lower patient satisfaction rate, takes longer, is more painful, has occasional issues with unevenness, and in a small percentage of patients, there has been reports of long term nerve pain. We have not seen this with SculpSure.

Of course, modifying your diet and getting rid of junk food, processed foods and soft drinks, cutting your carbs and incorporating more exercise are  excellent ways to reduce your overall body fat – as well as improve your health.

Berman Blog - Breast Augmentation or Breast Lift: Which One is Right for Me

Breast Augmentation or Breast Lift: Which One is Right for Me?

This is an extremely common question and a good one. The answer really depends on where your nipple-areolar complex (NAC) lies relative to where your breast meets the chest wall when viewed from the side (lateral view).

If your nipple is positioned at or above the crease, when viewed from both the front and side, then you probably do not need any type of lift.
If it is just at the crease, then you may need a lift in order to achieve your desired result.

If the nipple is at the bottom of your breast and it points to the floor, you’ll likely want a breast lift for a more balanced shape.

The question of whether or not get an augmentation is really a question of, “do you want more volume, i.e. larger breasts?” For the most part, a beast augmentation makes the breasts larger, but does not really change the position of the NAC on the breast. The lift alters the position of the NAC, but does not change the volume – though it is true that a lift can sometimes make the breast look larger since it is less droopy.

Of course, many women want and need both an augmentation and a lift to get their desired look, and these can be done at the same time. It is important to note that it is always a more predictable outcome for the final shape if a woman only requires a straightforward augmentation, than when we perform a combination of an augmentation and a lift. This is especially true for one of the more complicated lifts, such as a vertical mastopexy.

Have additional questions? Please do not hesitate to schedule a complimentary, private consultation with me to discuss your individual needs.

Dr. David Berman -Board Certified Plastic Surgeon

Why You Should Insist on a Board Certified Plastic Surgeon

I’ll be honest, the fact that this is even a question is bewildering to me. But it also brings to light for me that people may not understand what it means to be a Board certified plastic surgeon. Simply put, having this designation means that we have complete a full residency (special training) for at least 5 years following medical school and passed rigorous written and oral exams in order to become a member of the American Board of Plastic Surgeons. Why anyone would want less from someone performing surgery on them is beyond me.

Perhaps one of my biggest pet peeves is the title “cosmetic surgeon” or “certified cosmetic surgeon.” This is not a legitimate title. There is no Board of cosmetic surgery. This is a group of doctors (yes, they are doctors) who do not complete a residency in plastic surgery. They simply give themselves this title because the general public  does not understand that they are NOT plastic surgeons.

Another title to watch out for is Facial Plastic Surgeon. A facial plastic surgeon is an Ear, Nose and Throat (hence ENT) surgeon who calls himself a facial plastic surgeon. In fairness, many are in fact trained to perform some facial plastic surgery procedures, such as facelifts, nose jobs and eyelid lifts. However, it drives me nuts when they perform procedures below the neck, where they have no training. They have no business doing liposuction below the neck (if even there since they really should not be performing liposuction).

What are dermatologists? They are board certified in internal medicine (not surgery) and have a good understanding of the skin from a medical perspective. They, along with plastic surgeons, were the first to perform Botox and fillers. However, they are not trained in surgery, beyond just a small biopsy. Most of them do stay away from surgery. However, there are some who perform blepharoplasties (eyelid lifts), liposuction and even labiaplasties. Perhaps it will not be too long before we can take our cars in for a tune-up and get liposuction or a breast augmentation while we wait?

In this crazy world of ours, we now have family doctors performing liposuction and Smartlipo. Even though these require only small incisions, you need to know what you are doing – and many performing these procedures have no formal training in this area. I often think about the case of a hairdresser performing butt injections… and yes, the client died. And there have been several similar cases reported in the U.S.! L

We also have dentists giving Botox injections – and there is even a dentist in Richmond, Virginia performing facelifts. Heck, why not have your plumber do your colonoscopy – all plumbing is all the same, right?!

I am also not a huge fan of the medispas which have an almost non-existent doctor and often, just have someone on their staff doing the Botox injections and fillers.

My point is this: Can other specialists and non-specialists do what plastic surgeons do? The answer is yes. However, would you insist on a fully-trained pilot, who has passed all their tests, flying your plane? Or would you be satisfied with someone who has watched a few YouTube videos and has had a chance to fly their uncle’s plane on occasion? A Board-certified plastic surgeon is typically not more expensive, either. But even if they were, would it not be worth your health?

Berman Cosmetic Surgery & Skincare Center - Reversing Facial Fillers - Blog

Reversing Facial Fillers: Where, How and How Often?

There are a large number of facial fillers on the market and they are becoming immensely popular. Although, not quite as popular as Botox, they are quickly becoming the “next biggest thing.” Although there are millions of women and men doing this, for those that are newer to this, you are probably wondering the following:

Should I do do this? Who should I let do the injection? What are the risks? And if I hate it, can I reverse it?

Let me preface my comments by saying that I have always done all of my own injections for fillers and Botox for my patients. I know many places use estheticians and other doctors that are not plastic surgeons (even dentists). Most of the time, this is probably fine but there is a lot to be said for having an experienced plastic surgeon do your injections. But ultimately, that is your decision, based on your comfort level.

Not all facial fillers are reversible. Only those that are made from hyaluronic acid can be reversed. The good news is that all the facial fillers that I use are made from hyaluronic acid: namely Juvaderm and Voluma, and their associated families of products. This also applies to Restylane and Perlane and that entire family of fillers. This does not apply to Radiesse or Sculptra, which are made from a completely different material.

When a filler is injected, I always tell my patients to massage any firm areas that they may notice during the first week. You can certainly ice an area after an injection, but it is not required. Also, if you are happy with the look after the injection, it will almost certainly stay that way. Everyone gets some water absorption and slight swelling after the filler is injected. I strongly advise everyone to wait 2 weeks after the filler before considering making any changes. Since people sometimes examine the area injected very critically, it is important to realize that there may be subtle differences between the areas injected and along the areas injected (eg the two sides of the lip) that may be noticeable to you at day 2 or 3, but will be fine by day 14. The important thing to note here is to not be in a rush to make changes in the first two weeks!

I believe the main advantage of knowing that your filler is reversible is having peace of mind that you are not “stuck” for many months or years with the filler if you end up not really liking it. The practical side is that you are very unlikely to even need it reversed. You should also know that if you inject the reversing agent, it may dissolve ALL of the filler injected into that area, which you may not want. It is not an exact science and we cannot control exactly how much of the filler will melt away with the reversing agent.

Berman Cosmetic Surgery - 3 Summer Must Haves for your Skin

3 Summer Must Haves for your Skin

Written by Jacqueline Seabra, Master Esthetician

Summer is that time of the year when sweat glands and sebaceous glands are more active – meaning the skin clogs more easily. You need a good regimen to maintain your skin and keep it free of blemishes, while protecting it from harmful UV rays.

Seeing a need for a great skincare solution for our clients is what prompted Dr. Berman to create his own line of skincare products. As a master esthetician, I cannot say enough about our 3-step plan for gorgeous skin, which consists of a daily scrub, Vitamin C serum, and tinted moisturizer.

These 3 products are all you need to set the stage for beautiful summer skin: 

  • CLARIFYING BRIGHTENING POLISH
    This mild brightening scrub is environment friendly with micro-beads to gently and effectively polish the skin by removing excess oil, residues and impurities. As a brightening agent, it contains Arbutin, a natural brightener that inhibits melanin production, Glycolic and Salicylic Acids to assist with cell renewal, and Vitamins A, C, and E, which work as powerful antioxidants.
  • VITAMIN C SERUM
    This unique serum delivers the most stable form of ascorbic acid to the skin using a special liposome-encapsulated phyto stem cell and peptide delivery system. This powerful antioxidant can be applied both morning and night to combat free radicals.
  • PERFECT TINT -SPF 50 

    This luxurious tinted moisturizer, enhanced with green tea extract, is the perfect combination of an antioxidant moisturizer and sun protection, made with 16.2% Zinc Oxide. It will also block both UVA and UVB rays. Its’ unique Universal Pigment Technology provides a sheer, healthy touch of color for all skin tones.

In addition to these 3 must-haves, our Berman Cosmetic Surgery skincare line has everything else you need to customize your skincare regimen according to your individualized needs and concerns. View the complete line >

Great skin is just part of your skin care regime. If you have more serious concerns you’d like to address, including hyper pigmentation, acne scars and fine lines,  you may want to consider our Picosure laser facial, which gives great results with NO downtime, or one of our popular skin care facials or chemical peels.

If you have questions or need help finding the perfect skincare regime, please call us at 703-406-244 to schedule a complimentary consultation with me. Here’s to healthy, glowing summer skin! 

Berman Cosmetic Surgery - How to Improve your Results after a Tummy Tuck, SmartLipo or Sculpsure - Blog

How to Improve your Results after a Tummy Tuck, SmartLipo or Sculpsure

Whether it’s a tummy tuck, SmartLipo or SculpSure, you have invested considerable time, money and effort into your body contouring procedure and you surely want to get the maximum results. There are several things I recommend my patients do to optimize their procedure.

Almost of the people doing these body contouring procedures are trying to reduce fat in specific areas. Sometimes there is one area which has been treated, but more often, several areas have been treated. In a minority of the tummy tucks that I have performed, there was no extra fat at all – it was entirely a loose skin problem. If you have a bit more fat than is ideal, you can definitely enhance your results by decreasing your total body fat. I am decreasing fat in specific areas but if in addition to that, you can decrease your total body fat everywhere, you will look even more amazing.

There is no magic here. Modifying your diet is extremely helpful.It is almost impossible to out-exercise a poor diet. I believe that following a Paleo or Paleo-like diet works the best. It’s for that reason that I do offer my favorite Paleo meal replacement through my office. This makes it very easy to follow the Paleo diet if you can simply replace your regular breakfast and/or lunch with the powder. I realize that there are many different diets that can work. I am, however, not a fan of diet pills or anything artificial.

Maintaining or increasing your activity level is also key. More and more evidence is confirming that some variation of a high intensity workout done a few times per week gives you the greatest return on your time. Most gyms offer this and there are countless free videos on Youtube that you can do in the comfort of your own home with no equipment. I have a lot of opinions on exercising, and will be blogging about those in the future, but in short, it is my strong belief  that everyone should be doing core exercises as part of their routine. As we get older, this is even more important. For women especially, strength training for the upper body in women is critical.

Regarding the scarring from a tummy tuck or the small scars from Smartlipo (there are NO scars from SculpSure), we sell a scar cream that should help the scar fade and mature more quickly. I have many years experience and some people’s scars fade much quicker than others and this has little to do with the surgeon’s skills. Virtually every scar will continue to fade with time, but it should be noted that they will never completely disappear. They’ll be visible if you look hard enough for them! I have seen some women get tattoos over they TT scars and this does a great job hiding them. But of course this won’t be a desirable option for everyone.

It is important to recognize that there is plenty you can do to help you look and feel better overall. A tummy tuck, SmartLipo or SculpSure can help to eliminate fat and loose skin, but proper attention to your overall health, fitness and nutrition will help your skin look it’s absolute best.