Why PicoSure is So Popular in Asia

Most women over the age of 35 years old have some level of irregular pigmentation on their face. Those who do not likely have amazing genetics or little sun exposure to thank. As we age, the irregular pigmentation spreads from the face and forehead to the neck, chest and hands. It is an even greater concern in the Far East due to cultural reasons and because it seems to be even more noticeable and harder to hide with makeup.

The Picosure laser has become incredibly popular in the Far East – the biggest reason being that Asian skin is prone to hyperpigmentation from unsuccessful treatment attempts. Just yesterday, I saw a woman from Laos who has significant hyperpigmentation. She tried the Fraxel laser last summer and it the hyper pigmentation even worse. It has not improved, despite a plethora of skin care products. The reason for this is because most lasers create an inflammatory response and this leads to further increased pigmentation. The skin is essentially saying, “I have been injured” – and responds by healing the area with too much inflammation, leading to hyperpigmentation.

The Picosure laser fires 1,000 times faster than other lasers. It is so quick that there is very little inflammation, little to no downtime and much less risk (nothing has no risk) of responsive hyperpigmentation.

Women should plan on 3-6 treatments, each spaced a month apart. It is a good idea to pre-treat with 4% hydroquinone products (HQ), which we carry, to decrease the risk of hyperpigmentation. Any active agents, such as HQ or Retin-A or glycolic/lactic acid etc, should be stopped 3 days before treatments and can be resumed the following day. A great sunblock is imperative. Hormone treatments, such as birth control pills, should be avoided.

Want to discuss PicoSure and what it can do for your skin? Call my office at 703-406-2444 to schedule a private, complimentary consultation.

When Should You Consider Plastic Surgery - Berman Cosmetic Surgery Blog

When Should You Consider Plastic Surgery?

There are, as you can imagine, numerous considerations to take into account when deciding if you are ready for plastic surgery.

Check out my video below for the questions I always ask my patients before considering plastic surgery. It needs to feel right for you. If you’d like to chat in greater detail, please do not hesitate to schedule a complimentary, private consultation with me calling our office at 703-406-2444.

Which is Better: SmartLipo or Liposuction - Berman Cosmetic Surgery Blog

Which is Better: SmartLipo or Liposuction?

This is a very common question that I often get asked.

SmartLipo is actually a form of liposuction, but it includes the additional step of using a fiberoptic laser to melt the fat and cause some skin tightening

How Does Liposuction Work?
With regular liposuction there are basically two steps. After you have the areas for liposuction marked, the surgeon will numb up a few small areas for the incisions. He will then infiltrate local anesthetic into those areas. After a few minutes to let it work, he will then carry out liposuction, often under general anesthesia.

How is SmartLipo different?
Smartlipo is always done by me in my office under local anesthetic, frequently with oral sedation. The main difference is that after the area has been made numb but before the liposuction is carried out, I insert a small fiberoptic laser fiber into the subcutaneous fat. Every time I step on the peddle, 2 laser beams are emitted into the fat and this both melts the fat and also gives heat to the skin, to cause it to tighten. After this middle step is done, then the melted fat is liposuctioned away.

Which one is more highly recommended? 
I believe Smartlipo allows more to remove more fat. In addition, there are going to be fat cells that do not immediately get melted and which come out in the liposuction but these fat cells will later die from the effect of the heat and your body will resorb them. This means the effect of the Smartlipo will be greater than what is initially removed. In addition, the laser creates small tracts throughout the fat, which will over the next 2 months, get healed with newly formed collagen. After 2 months, this collagen will mature and start to tighten and contract, making the area tighter.

With Smartlipo, you will continue to improve for 6 months after the procedure.

With all liposuction procedures, you can enhance the final result by also working on your dieting and exercising to decrease your total body fat.

Check our my video below for additional considerations. If you’d like to talk more about SmartLipo or liposuction, please do not hesitate to schedule a complimentary, private consultation with me calling our office at 703-406-2444.

Recovery from Botox and Expected Results - Berman Cosmetic Surgery Blog

Recovery from Botox and Expected Results

In this video, I discuss what results you can expect following Botox injections, as well as what recovery looks like. I always like to share that I perform Botox injections in our office myself – it is quite rare to receive injections from a Board Certified plastic surgeon!

If you’d like to talk more about Botox, please do not hesitate to schedule a complimentary, private consultation with me calling our office at 703-406-2444.

Kybella Right Option for your Neck and Chin - Berman Cosmetic Surgery Blog

Is Kybella the Right Option for Concerns about your Neck and Chin?

In this video, I discuss Kybella and how to determine if it is the best solution for you to address concerns with the profile of your chin and neck.

Kybella is the only FDA-approved injectable treatment that destroys fat cells under the chin to improve your profile, and address concerns with what many refer to as a “double chin” or extra fullness in the neck. Check out my video below for other alternatives to Kybella, including SmartLipo.

If you’d like to talk more about Kybella or SmartLipo, please do not hesitate to schedule a complimentary, private consultation with me calling our office at 703-406-2444.

Price of Beauty: Botox and Fillers - Berman Cosmetic Surgery Blog

Price of Beauty: Botox and Fillers

People still sometimes get confused about the difference between Botox and fillers. Botox works through muscle paralysis  to decrease facial motion and help eliminate fine lines. Fillers represent a wide range of products used to enhance facial volume.

What is Botox?
Botox, like Dysport and Xeomin, are neurotoxins, which means they are injected in order to weaken the muscle contracting. The most common place they are used is the glabellar area which is the area between the eyebrows – the famous “11’s”. The next most common area is the crow’s feet, which is the area lateral (to the side of) of the eyes. The third most common site is the forehead. This has the risk/benefit of altering the eyebrow position – either raising or lowering them or not changing them, depending on how much is injected and where. Less common areas to inject these are the chin and upper lip. They are also injected into the axillary region (armpits) to stop sweating (often lasts 6 months in this area). These agents take 4-10 days to work and last about 4 months, when used in the face.

How much does Botox cost?
There is some variation in the prices for Botox to be injected. Everyone is using the same Botox (or Dysport or Xeomin), with just  3 companies controlling the entire market. It is much more expensive for physicians to buy these from the company that makes them than people realize. Some places will charge by the area (eg injecting the glabellar area) but most places charge by the unit.

Factors that may affect the price:

  1. Who is doing the injecting and what is their experience doing this?  Is it a plastic surgeon? A doctor – family doctor or other doctor? A nurse? An Esthetician? A Medispa?I personally do all of my own injections and I always have. I presently charge $12 per unit. You certainly can find it for slightly less but if you pay less, you almost certainly will not be getting a board certified plastic surgeon doing your injection himself. The highest I have come across in the Northern Va area is $19/unit. The average cost seems to be about $15/unit.
  2. Geographic area: You will almost certainly pay more in certain areas such as Bethesda, McLean or Tysons Corner than you will pay in Sterling, Virginia (where my office is location). This is just a function of the rents being higher in those areas.
  3. Groupon and other deal websites: If you get your Botox through Groupon, you may be able to pay less. However, be wary since you have no control over who is injecting you. Frequently, the places offering Groupon for Botox are not making any money on their Botox, after they pay off Groupon.

How much do fillers cost? 
The same discussion above also pertains to fillers. We are all getting our fillers from the same major companies. They are ready to inject straight out of the box. No one can make the fillers, last a longer or shorter time. Depending on the filler, they will last in general from 1-2 years with the more dense fillers lasting longer (eg Voluma – closer to 2 years) and the thinner fillers (as used in the lips or under the eyes – eg Volbella) lasting more like 1 year.

There is skill in how they are placed by the injector -both the location and the comfort. The same concerns I expressed above – who is injecting your Botox, also applies to your fillers.

The cost of the fillers are going to depend on 4 things:

  1. Which filler is being used?
    Some fillers cost more for us to buy and this is being passed on to the patient
  2. The size of the syringe:
    Is it 0.5cc or 1.0cc or 2.0cc. Of course, the more filler being injected into you, the more it will cost.
  3. Who is injecting? Is is a plastic surgeon or dermatologist or personnel at a medispa or traditional spa? As with Botox, I do own injections! Once again, this is very uncommon for a plastic surgeon to do his own injections.
  4. Geographic area:
    Once again, you are going to pay more in Bethesda, McLean or Tyson’s Corner.

Pricing will vary as per above but for most 1 cc fillers, you should expect to pay between $600-900 per cc. Volbella, which comes as 0.55 cc will be about $375-550.

 

Have questions about Botox or facial fillers? Please call my office at 703-406-2444 to schedule a complimentary, private consultation.

How Much Does SculpSure Cost?

In this video, I discuss our Sculpsure pricing – and why our pricing is so much lower than our competitors. 

As you may know, Sculpsure is the latest innovation in non-invasive fat reduction. This means that there are no incisions. The laser energy travels through the skin (it is safe for all skin types) and heats and kills the underlying subcutaneous fat. Cynosure’s studies have shown up to a 24% reduction of fat – though it is important to remember that some people will get more and some will get less.

If you’d like to talk more about Sculpsure, please do not hesitate to schedule a complimentary, private consultation with me calling our office at 703-406-2444.

Advantages of Sculpsure over Liposuction or a Tummy Tuck - Berman Cosmetic Surgery Blog

Advantages of Sculpsure over Liposuction or a Tummy Tuck

There are several of advantages to getting a SculpSure treatment over Smartlipo (which I love), liposuction or more invasive surgery such as a tummy tuck or arm lift. This popular procedure melts up to 24% of stubborn fat with highly advanced laser technology.No Downtime:
The biggest advantage with Sculpsure is that it is totally non-invasive. There are absolutely no incisions or downtime. I had my love-handles treated twice, and both times, I went immediately to the gym from my office. SculpSure is so convenient you can do it on your lunch break or on your way home for dinner. Treating an area only takes 25 minutes and you can treat several areas, one right after another.Low on Risk & Side Effects:
There are very few risks and side-effects from the treatment. The laser light can travel through any skin color and only penetrates into the subcutaneous fat. It is safe to use even if you have had a hip replacement (as I have) or abdominal surgery (we don’t, however, want to place the paddles directly over scar tissue). I do tell all of my patients to make sure they eat something and drink lots of water before they do their treatment.

Sculpsure is a great addition to your diet and workouts to maximize your chance of improvement. I always stress to my patients, that there are no magic treatments. If you want maximum improvement, you will want to increase your exercise and improve your eating.

Sculpsure has been shown to decrease your truncal fat up to 24% (this result will vary from person to person) but this still means you will have 76% of your fat left behind. Sculpsure is a great start and a great addition to a workout routine. Combining this with your new diet makes it more likely that you will see results sooner.

It is important to know that doing Sculpsure now does not prevent you from doing more invasive procedures, such as a Smartlipo (laser lipo) or a tummy tuck later on if you feel you need a more invasive procedure to get your desired look.

Questions about SculpSure? Please call my office at 703-406-2444 to schedule a private, complimentary consultation.

w Soon After a Breast Augmentation Can You Work Out - Berman Cosmetic Surgery Blog

How Soon After a Breast Augmentation Can You Work Out?

This is a great question and one that comes up very, very frequently. It comes up a lot because many of the women that I perform a breast augmentation (BA) on exercise regularly and want as little interruption as possible.

In general, I am more progressive than most other surgeons in that I allow my post BA patients to get back to exercising sooner . I do ask that they don’t significantly elevate their heart rate for prolonged periods of time for the first week. A suggestion here is going for long walks, at a comfortable pace, but nothing more strenuous than that.

After the first week, they can do things like take a spin class or use the elliptical machine  essentially, anything that will elevate their heart rate but without a lot of bouncing movement. The elliptical or spin bike provide a much more comfortable experience than trying to jog, as an example. They can also begin strength training for their lower body, as well as for biceps and triceps. At this stage, they should avoid chest exercises or difficult back exercises. I believe gentle stretching is very helpful from the beginning, and should become easier after the first week.

Most of my hard core runner patients will start running after 2.5-3 weeks. I always advise starting easier (shorter distance and shorter time) for the first few times out running.

Chest exercises such as push ups should be held off until  4 to 6 weeks post-surgery. Start lighter and go easier during the first few sessions. When you are contracting your pectoral muscles, it is very normal for your breast implants to be displaced upwards, while the muscle is contracting. They will return to normal immediately, and it does not do any harm.

Two of my most notable patient stories on the topic – and these women certainly represent the exception, not the rule!

  •  I performed a breast augmentation on a very close friend of mine. She and her husband were the couple that got me into doing triathlons and Ironmans. I did a BA on her before she moved to Florida. She did a half Ironman (1.3 mile swim, 56 mile bike ride and 13 mile run) after only 5-6 weeks from her BA. She is the exception, not the rule!
  • A number of years ago, I performed a breast augmentation on a woman who clearly did a lot of weight lifting. I saw her a week after her BA and she mentioned that she never stopped doing her pull ups after surgery. I have never had a patient do this before. She did no harm, so this does show you that it is hard to really hurt things. She did run the risk of increased bleeding or bruising, but she experienced no problems, despite her pull-up regime.

Have questions about this procedure? Please call my office at 703-406-2444 to schedule a private, complimentary consultation with me

Berman Cosmetic Surgery & Skin Care Center - Body Surgical Procedures

How much does Sculpsure cost?

As you may know, Sculpsure is the latest innovation in non-invasive fat reduction. This means that there are no incisions. The laser energy travels through the skin (it is safe for all skin types) and heats and kills the underlying subcutaneous fat. Cynosure’s studies have shown up to a 24% reduction of fat – though it is important to remember that some people will get more and some will get less.

Generally, Sculpsure will cost $1,500 for a session. However, we are only charging $1,000 because we want to make this is more easily affordable to more people (and yes, we do offer financing).

How Does it Work?
A treatment consists of 4 paddles, which are about the size of a small cell phone. The entire session only takes 25 minutes. You can treat multiple areas, one after another, in the same visit.  To explain, you can put 4 paddles along your lower abdomen and after this immediately, place the 4 paddles on the outside of your hips, or the inside of your hips or knees or bra line or love-handles, etc.

No Downtime:
One of the best things about this treatment is that there is no downtime associated with it. I have actually treated my own love handles with SculpSure and after each of my two sessions, I immediately went to the gym.

How Many Treatments Will You Need?
I tell my patients that they should plan on treating each area twice, with 4-6 weeks between each session, to get the best results. You can certainly do more than two sessions per area, but the minimum you should plan on is two sessions. There are no hidden costs with this treatment, as it does not require any medication or an operating room.

Why You Should Consult with a Plastic Surgeon if Considering SculpSure:
The most important reason to see a plastic surgeon when inquiring about SculpSure is because a plastic surgeon is in the best position to explain whether you will be best served with SculpSure or Smartlipo (laser liposuction) or some type of excisional surgery. It is important to know whether your expectations are realistic for the given procedure, especially given the financial investment you are making. A plastic surgeon can also give you a good sense of the pros and cons of each option to help you make the right choice for you. In my office, your treatment will be carried out by an esthetician specially trained in the art of SculpSure. We will do our very best to make sure that your treatment is as comfortable and specific to your needs and body goals.

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