Is Snapchat Causing Image Dysmorphia?

This new “condition” has recently been brought to my attention. It is when a patient shows up for a consult and has brought along a picture of themselves that has been altered with a Snapchat filter or altered in some specific way with Photoshop-style editing.

The situation has to be assessed on its individual merits .If someone (usually a woman) comes into my office with a picture showing her lips slightly fuller, what do I think? I have resisted the marketing tool which allows the surgeon to computer program the final result of the patient. The reason that I have strongly resisted this marketing tool is because surgery and cosmetic changes are not an exact science and not 100% totally predictable. I feel that if I give or show the patient a photograph of the final result — even if I tell them that this is just an educated guess — then any shortcoming from that final result will greatly distress the patient, even if they get a very good final result.

The exception to this rule is if someone comes in with a before picture of what their breasts look like now, and also brings along a final result, which states the implant size. This is very helpful, since if I just copy the implant size, the patient should get almost the same result.

However, with facial procedures – whether it is surgery or fillers and Botox – it really depends on the degree of changes they are expecting and how realistic their expectations are. Fillers allow us to build up definite areas of the face. This can also give some tightening to the face (example placing fillers along the zygomatic arch/cheekbone can help minimize the nasolabial folds) or help improve depressed areas or make areas that are too prominent be less prominent, if the areas around them are filled in.

What I look at are the degree of changes the person wants and the intensity of what they want. It is also important to try and discern their motivation for wanting the changes. Sometimes, patients will be quite open with a bit of questioning (my life coaching background is helpful here), that they expect these changes to get their previous boyfriend or girlfriend back or will make them popular, etc. Someone who has seen and been treated by numerous specialists and feels they all have done a poor job is unlikely to be happy with me. Of course, if there are questionable cases, it is best to turn them down or perhaps, refer them to a mental health professional.

In general, I think the Snapchat generation tends to be much too focused on what they want and are owed and much less focused on service and responsibility – but perhaps I am just showing my age!


Have other questions about your cosmetic procedure? Call us at 703-406-2444 to schedule your complimentary, private consultation with me. I’d be happy to answer any questions you may have!

What Can Growth Factors Do For Your Skin?

In case you didn’t know, growth factors are the next big thing in the skincare industry and they are taking anti-aging products to a whole new level. Growth factors occur in our body naturally but as we age, we start to decrease our production of growth factors.

But not to worry, there are now products available that will help replenish growth factors. They are one of the best active ingredients you can add to your skincare routine for total skin rejuvenation because they promote collagen and elastin growth at the cellular level. They take care of all your skin care concerns at once, from fine lines and wrinkles, to lack of firmness and pigmentation. You can add growth factors to any skin care routine and really boost your results. Plus, they are great for all skin types!

Since they are working with your cells to create more collagen and elastin, they help to maintain and enhance your results from any cosmetic procedures you may have done and keep your skin smooth and firm. If you want a healthy, youthful complexion don’t wait and start adding growth factors into your regimen!

One of our favorite skincare products with growth factors is the TNS Recovery Complex from SkinMedica. It has the highest concentration of a patented growth factor blend, with over 380 growth factors and is also formulated with antioxidants, soluble collagen, cytokines and matrix proteins.

We also offer the HydraFacial at our office which has different booster options depending on your skin care concerns including the CTGF (Connective Tissue Growth Factor) booster that we can add to any of our treatments. The unique tips on the HydraFacial allows the serums to penetrate deeper into your skin. You will leave the office glowing – trust us!

Have other questions about your skincare routine? Call us at 703-406-2444 to schedule your complimentary, private consultation with our estheticians. We’d be happy to answer any questions you may have!

VI Peel Combination Therapies - Berman Cosmetic Surgery

VI Peel Combination Therapies

Written by Nicole Hackett, Master Esthetician


VI Peel is an excellent chemical peel that is suitable for ALL skin types! Many people fear chemical peels because of how painful they think it might be… however, the VI Peel is virtually pain free because it has powerful numbing agents in the solution. These are specifically designed treatments to target concerns including anti-aging, hyperpigmentation, acne prone skin and acne scarring. After you receive your VI Peel, we give you detailed at-home care instructions — and you will see your results in as little as 7 days!

How and when should  you incorporate VI Peel with other skin care treatments?

  • Botox: you can get your Botox the day after you get your VI Peel
  • Fillers: you can get dermal fillers the same day as the VI Peel just be sure to get the fillers first
  • Mega Peel Microdermabrasion: same day beforeyour VI Peel
  • HydraFacial: 1-2 weeks before or after your VI Peel
  • SkinPen Microneedling: 2-4 weeks before or after your VI Peel
  • PicoSure Laser Facial: 4-8 weeks afteryour VI Peel (FYI- a VI Peel prior to your PicoSure treatment preps your skin to get you the best results)

Now that Fall is around the corner, it’s a great time to start booking your appointments and get your peel on!

If you have any questions regarding your skin concerns or you’re not sure what route you should go, call us at 703-406-2444 to schedule your complimentary, private consultation with one of our Master Estheticians!

Can I Fly After Surgery?

This is a question I receive from a number of patients. Unfortunately, my answer is not going to be an answer that applies to every surgery. There are really two categories of surgery – general and local surgery with oral sedation. The latter category would include procedures such as Smartlipo and  Blepharoplasty. I believe it is fine to fly the next day after Smartlipo, but I would want you to remain in the area for 3 days, generally, after a blepharoplasty.

  • For general anesthesia cases, I believe it is fine to fly out 48-72 hours after a straightforward Breast Augmentation (BA). Of course, it would be nice if you could stay longer, but I don’t think this is absolutely necessary.
  • If there was a vertical lift performed with the BA, I would want you stick around in the area closer to 5-7 days.
  • After a Breast Reduction, it would be best to stay in the area for 5 days or more, but again, there could be reasons to leave earlier.
  • For a Tummy Tuck, it would be best to stay in the area for 10-14 days, but again, depending on circumstances, this could change.
  • For a Gynecomastia surgery, it would be best to remain in the area for a week.
  • For a Facelift, 10-14 days.

These are, of course, just rough guidelines and each case would be individually determined. If your surgery lasted more than 3 hours, and your flight is more than a few hours, I may recommend that you take a baby aspirin before you fly.

Have other questions about your cosmetic procedure? Call us at 703-406-2444 to schedule your complimentary, private consultation with me. I’d be happy to answer any questions you may have!

More on Intermittent Fasting, Ketogenic Supplements and the Ketogenic Diet - Berman Cosmetic Surgery - Blog

More on Intermittent Fasting, Ketogenic Supplements and the Ketogenic Diet

As most of you know, I have been very enthusiastic these past 4 months about combining 2 concepts into one diet plan. The first concept is intermittent fasting and the second concept is ketogenic diets and supplements. You’ve surely seen quite a bit about these topics on the news and in social media. Many celebrities are touting these dieting strategies, including Halle Berry and Jenna Jameson.

These have both become very hot topics in 2018. I get Google articles on my phone about both of these daily. I just read a blog by a Dr. Pedre who has “created” what I have already been advocating for months – his “Cyclitarian Diet”. This is my intermittent fasting combined with being ketogenic. The only difference is that I did not give my diet a name!

Let’s explore the logic behind my diet. There are a huge number of benefits to intermittent fasting. Intermittent fasting basically means no food or calories for between 12 and 18 hours.

What are the benefits of intermittent fasting?

  • Burn fat
  • Live longer
  • Increased brain health
  • Reverse Type 2 diabetes and restore insulin sensitivity.
  • Decreased side effects from chemotherapy

And the benefits of a Ketogenic diet?

The list keeps growing and there is good scientific evidence to support all of these claims. By the way, I recommend the Ketogenic Bible, which you can buy through Amazon, if you want to read a great book on this topic. I read it and I learned a great deal. It is scientific but very easy to read.

  • Increased brain function – increased memory, cognition, clarity, better seizure control, fewer migraines
  • Possibly fights some cancers – brain cancers namely
  • Prevent heart disease – decreased blood pressure, lower TG, better cholesterol profiles (increased HDL
  • Also changes your LDL cholesterol from small (which is the bad form) to large LDL (which is benign). I personally would suggest that it is better to try and get more of your healthy proteins and fats from plant sources and wild caught fish eg salmon, rather than animal sources.
  • Improved acne, arthritis, psoriasis, eczema, IBS, etc
  • Increased energy and sleep
  • Decreased uric acid levels – helps gouts and kidney function
  • Better GI and gallbladder health
  • Helps with a large number of neurologic diseases eg seizures and also metabolic disorders
  • Stabilizes hormones for women and increased fertility.
  • Helps prevent cataracts
  • Increased muscle and better endurance
  • Increased insulin sensitivity, decreased and potentially curing type 2 diabetes, helps with Type 1 diabetes control
  • Increase fat burning especially visceral fat. So weight loss due to fat loss and muscle preservation
  • Decreased appetite

Why the ketogenic supplements?

Simply put, they allow you to enter ketosis immediately, without having to do a ketogenic diet for the 4-5 days normally required to enter ketosis. The ketogenic supplements immediately put ketone bodies into your bloodstream.

My diet essentials:

  • A 12-16 hour fast (drink water or herbal tea or coffee, no sugars added)
  • Take a ketone supplement after you wake up and then ideally another ketone supplement 3-5 hours later, if your budget and personal plan allows
  • Eat your first meal and stay ketogenic at least until dinner. At dinner, eat healthy and try and be as close to ketogenic as you can. You don’t have to be perfect every meal. The amount of weight you want to lose will determine how strict you need to be.
  • When you take a leniency from the diet, use common sense. It is one thing to occasionally have some sushi with rice or a whole wheat roll. It is quite another thing to have a high sugar dessert like donuts etc, which you should try hard to avoid, at least most of the time.
  • One final word of caution: all “diet sodas” are terrible for you so avoid them even though they have no carbs or calories!
  • Exercise, specifically high intensity exercise, will increase your state of ketosis and your fat loss.

To find out what ketone supplement I am using for myself click here.


Want to discuss the Ketogenic diet in greater detail or other available options for decreasing body fat? Call us at 703-406-2444 to schedule your complimentary, private consultation with me. I’d be happy to help you find the right solution for you!

Dr. Berman and the Bobbitt Case: 25 Years Later - Berman Blog

Dr. Berman and the Bobbitt Case: 25 Years Later

I often get asked about the infamous Bobbitt case that I took on in 1993. As most of you remember, John Bobbitt was that famous case where his wife decided she was upset with him and cut off his penis (at the base) and then threw it out of her car window into a field. I achieved significant fame from being the plastic surgeon who reattached it with microsurgery.

With the 25 year anniversary of this case that made national headlines, I was interviewed by Washingtonian magazine.

Read complete article


Malia - Berman Cosmetic Surgery & Skin Care Center Blog

What Is Milia?

Written by Nicole Hackett, Master Esthetician

Do you have little white bumps on your face that look like whiteheads, but nothing comes out when you try to pop them? If that is the case, you probably have Milia. These tiny white or yellow cysts occur when keratin becomes trapped beneath the surface of the skin and then hardens.

Milia is not painful and doesn’t cause any long-term damage. However, Milia cannot be popped and you should see your esthetician to have them extracted. If you are experiencing Milia around your eyes, you may be using a cream or lotion that is too heavy for your skin, which is causing sebum and dead skin to get trapped under the skin.

As we age our skin starts to lose its natural ability to exfoliate. In order to prevent Milia from forming, you should regularly exfoliate your skin and use a retinol serum. A chemical exfoliant will help to remove dead skin from the surface and retinol will encourage your cell turnover rate and bring new skin to the surface.

If you have questions or need your Milia extracted, call us at 703-406-2444 to schedule your complimentary, private consultation with one of our Master Estheticians! 

Podcast: The Truth Beneath the Surface - Berman Cosmetic Surgery Blog

Podcast: The Truth Beneath the Surface

As I hope my patients all know, I consider my business to be less about plastic surgery and more about “improving people’s lives.” I have even been known to refuse surgery requests if I believe a procedure will negatively impact a patient’s self-esteem. I recently spoke to Northern VA Advice Givers about my practice, what I attribute my success to, the psychiatry of plastic surgery and what’s on the horizon for aestheticians.

If you are considering a cosmetic procedure, I am happy to talk with you about your goals and possible ways to achieve them. Please call my office at 703-406-2444 to schedule a complimentary, private consultation with me.

Skin Necrosis after a Tummy Tuck (TT)

I answer a lot of questions on and a question I have seen many times concerns skin necrosis, the dying of live skin cells, following a tummy tuck. It is very important to know that this complication occurs occasionally to every plastic surgeon, no matter how careful he is. As I was once taught and it is very true: the only surgeons who do not get complications with this don’t operate or they lie (courtesy of Dr. John Guy, one of the better surgeons that I trained with many years ago).


First of all, why do some patients get skin necrosis after a TT ?

This is always due to an insufficient blood supply. It is much more common in smokers or nicotine users. I insist all of my patients refrain from all nicotine products (including cigarettes, patches, gum etc) for 3 weeks before and after surgery. Diabetics are also more likely to have decreased circulation after a TT to the distal flaps of tissue. An extremely tight garment that interferes with the blood supply can contribute to this.

However, most of the time when it occurs, it just happens, and there is no obvious reason. I had a female patients many years ago who placed a very hot pad on her abdomen for menstrual cramps and gave herself a 3rd degree burn, which caused skin loss – but this is a very unusual case.


Where does the skin loss occur?

Almost always, the skin loss occurs at the farthest point of the flap, where the blood supply is the weakest. This is at the lower abdominal incision, usually close to the middle of the incision or at the T-junction if there is a small vertical part of the scar.


What is the treatment for skin necrosis?

This will depend on the size of the area and how it looks. This will require frequent visits to the plastic surgeon or a wound healing center. If the area is fairly small, local wound care is usually all that is needed, plus lots of patience. The area will usually go black, lift off and then heal fine. Sometimes the scar will need to be revised in the office at a much later date. The final result is usually excellent but you need to have a lot of patience since you cannot rush the process.

In some cases, you may need to pack the wound or use special vacuum suction to speed up the healing.


Have more questions or concerns about the tummy tuck procedure? Please call my office at 703-406-2444 to schedule a complimentary, private consultation with me.

How to Take Care of Your Skin After a Facial

Written by Nicole Hackett, Master Esthetician

Maintenance and consistency are critical after you get a facial, or any other treatment for your skin such as lasers, peels, microneedling, Botox, fillers, etc. If you truly want to be preventative and have good skin health, you need to have a good at-home regimen. One facial a year is just not going to cut it. You can have great products, but to see results you need to use them on a regular basis. Miracles don’t happen overnight. Getting on a good skincare routine can be hard at first, but it’s important to make time and add it into your daily routine. Once you get in the swing of things, it just becomes habit.

These are the essentials that I believe everyone should be using:

  • First, you want to be using a good cleanser and ideally not something you can find at the drugstore. You want something with high-quality ingredients that is going to clean your skin, get rid of makeup/dirt and not strip your skin – which can make it dry and flaky. You should be cleaning you face 2x day, but if that’s too much for you, then I recommend cleansing at night.
  • Second, I recommend exfoliating at least 1-3x week. There are different ways to exfoliate the skin, either mechanical exfoliation or chemical exfoliation. Exfoliating your skin is going to remove the dead skin cells on the surface of your skin and help to increase your cell turnover rate, which slows down the older we get. It will help prevent fine lines and wrinkles from forming and help to control blackheads.
  • In addition, everyone can benefit from a good quality vitamin C serum. Vitamin C helps to lighten and brighten your skin tone, it also helps to protect skin from the visible impacts of pollution, promotes collagen production, improves hydration and keeps your skin looking younger, longer!
  • Keeping your skin moisturized is very important for anti-aging, as the drier our skin is, the more noticeable fine lines and wrinkles are. There are tons of different moisturizers out there, but hyaluronic acid is an ingredient that all skin types can benefit from. Hyaluronic acid is extremely moisturizing, holding 1000 x its weight in water and locking in moisture from the air. It is best used after you apply your serums because it is made with larger molecules and it will help to penetrate your serums deeper into your skin.
  • Now the number one anti-aging product you should be using is SPF, and you should be using it EVERYDAY, even if its cloudy and rainy outside. The sun is the number one cause of aging and we are constantly being exposed to UVB and UVA rays. Even indoors, the fluorescent lights are emitting rays and when we are driving the rays are penetrating even stronger through the glass. If you are going to be outdoors for long periods of time it is important to reapply every two hours. Use a good sun screen with SPF 30 or higher and make sure it says broad spectrum.

To maximize your results from skin care treatments, it is vital to be using good skin care products at home and that you use them consistently.

Want to chat more about our options for healthy, glowing skin? Call us at 703-406-2444 to schedule your complimentary, private consultation with one of our Master Estheticians – we’d be happy to help you find the right products for your skin!