How to Maintain your Results after SmartLipo or Liposuction

This is a very easy question to answer. The most important thing you can do to maintain your results from Smartlipo is not to put on weight. Many of my patients have read online that you cannot gain fat after doing liposuction. This is patently untrue! There are plenty of misleading articles online suggesting this, but the truth is that there are fat cells left behind after any type of liposuction. If you put weight on, those fat cells can swell and make you look larger in the treated area. It is possible that with less fat cells in the area (since fat cells are destroyed by the laser in Smartlipo) that you may not enlarge in the treated area, but there is no guarantee of this.

You can absolutely enhance your results by dropping your total body fat through better eating (see our Paleo meal replacement planLose Weight with our Paleo Meal Replacement Program for a simple way to do so). Smartlipo reduces fat in the treated areas, but because is also part of your total body fat, it is helpful to work to further reduce total body fat. Exercising allows you to both decrease your body fat and tones your body. There are of course a multitude of health benefits to exercising as well.

Want to further discuss SmartLipo and what results you can expect from this procedure? Please call my office at 703-406-2444 to schedule a complimentary, private consultation with me.



What Kind of Results Can One Expect from SmartLipo?

I often spend time answering answering questions on RealSelf from users considering plastic surgery, or recent surgery patients sharing their results on the website. I do this for several reasons. Obviously, it’s a great way to connect with potential patients. It has also helped me to stay connected to what people’s biggest concerns are, the results they’re seeking and what they are wanting from their experience.

I recently came across a post from a woman who felt that her surgeon was “cold” when she discussed not feeling she had experienced much of a change after her SmartLipo treatment, and I feel compelled to share my response here for those considering SmartLipo:

“It is important to understand that almost certainly your doctor is not trying to be cold. He is just not sure what to say. On your front view, it does appear that you have improved. The side view seems to show less change. You note that two liters came out – which is a lot. I do feel that many patients are very focused on how much comes out, but there are other factors to consider, such as how much is left behind and how many pulses were given to an area, since this will melt fat that may not get sucked out immediately. Some doctors put in a lot of fluid, which means that they will remove far more fluid but that does not mean you will get a better result.

All doctors want to do a good job. He did remove fat but he cannot control how much that will impact your looks and appearance. You could ask him to do some of those areas again, but you should expect to pay and not expect it to be free. Many plastic surgeons, myself included, would give you a discount. There is significant cost to the surgeon each time we perform SmartLipo. The fibers are not reusable, so a new one has to be used for each case and they are expensive.

He, no doubt, does feel bad and wishes you had a more dramatic change. He just does not know the right words.

All of us who perform a lot of Smartlipo treatments have had this experience. I warn all of my patients that I will be taking out fat, but it is impossible to predict how much improvement you will get. The best analogy I use is: you can lose 4 lbs and still feel fat and feel your clothes are still tight. You can then lose 0.5-1.0 lb more and all of a sudden, your clothes fit better. It is not that the first 4 lbs did not do anything, but it did not reach that “tipping point” (to borrow a phrase from Malcolm Gladwell) to make your fat loss visible. Any surgeon who says all of his patients are thrilled with his results is simply not being honest or does very, very few cases.

We try our best for every patient, but some patients will always get better results than others.”


Have questions about SmartLipo? Please do not hesitate to contact my office at 703-406-2444 to schedule a private, complimentary consultation.


Top Cosmetic Treatment for Gorgeous Skin

There is no doubt that the honor for the top cosmetic treatment for gorgeous skin goes to the Picosure laser.

Why? It’s simple. There is no other laser, chemical peel or skin care product that can eliminate irregular pigmentation and melasma from your face, neck, chest and hands with virtually no downtime. PicoSure is safe on skin types 1-4 and it is immensely popular in Asia. For many skin types,  treatments such as CO2 and Fraxel run a high risk of leading to hyperpigmentation which would make things worse, not better. Strong chemical peels also have the same risk and cause a great deal of redness. Milder peels will not be as effective as the PicoSure laser facial.

The Picosure laser will also stimulate your own collagen and elastic fiber production so that it will help with fine lines and even acne scarring. You should plan at least 3 sessions, spaced a month apart. My wife is having her 4th session next week and she has treated her face, neck, chest and hands.

You can increase results with a great skin care regime following treatment. We carry a premiere medical skin care line that is only available in our office that has helped our patients yield even faster results and glowing skin.

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

How Much Does a PicoSure Laser Facial Cost?

We have just reduced the pricing of our Picosure Laser Facial to just $1,500 for 3 Laser Facial treatments. We have been so incredibly impressed with the great results that we want to make it even more affordable for everyone to complete the series.

You are probably wondering what makes the Picosure Laser Facial so special? It allows you to dramatically improve melasma and irregular pigmentation on your face, neck, chest and hands. Almost all women over the age of 35 will have irregular pigmentation on their face – and as they age, this will affect their the above areas.

Picosure can resurface the skin with virtually no downtime. You can apply your makeup after a treatment and return to work or play. It will also stimulate your collagen and elastic fiber production, so it will help with your fine lines. You should stop any active skin care products 3 days before. You should not be tanned in the area being treated – meaning Fall and Winter are the perfect time to get these facials. Many of my staff have had the Picosure laser and my wife is getting her 4th Picosure laser treatment next week! She has seen an amazing improvement in her skin.

This laser is exceptional popular in the Far East, where hyperpigmentation is even more noticeable and the Asian skin type is prone to hyperpigmenting, if the wrong laser is used. We have had very good results treating Asian skin with the Picosure Laser.

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

A Great Gift Idea: Berman Cosmetic Gift Certificates!

In gift giving, we know it’s the “thought that counts,” but typically, a less than ideal gift is selected. A tie a man does not need, another perfume that a woman hates or a ring she isn’t crazy about. Why not let the person buy a gift they truly want for themselves? Most women, certainly those over the age of 35, will find a service or product they truly desire in our office, making a gift certificate a really perfect (and easy!) gift.

In our society, almost everyone women will feel that either her body or her face is not perfect. If she is older than 35 years old, she will almost certainly have areas on her face (and neck and chest) that have irregular pigmentation (melasma or sun damage or simply aging), that she tries to cover up with makeup. Picosure is the world’s best laser for doing an incredible job for improving this. The reason for this is because the Picosure fires 1,000 faster than any other laser. It can succeed in situations where other lasers, such as CO2, Fraxel or IPL will only make things worse. There is little to no downtime with the Picosure laser and most women will have huge improvements with only 3 treatments, spaced a month apart.

If they are happy with their faces, then almost certainly there will be some areas on their body that has a bit more fat than they’d prefer. SculpSure is a way of melting the fat through the skin so that no incisions are required. Each session only takes 25 minutes and multiple areas can be treated in one office visit. Every person should treat each area, at least twice, spaced 4-6 weeks apart. As we like to say, “Treat until complete.” You can immediately return to work or play afterwards. This makes for a great gift for men, since almost all of us men, even if we exercise a ton, will still have love handles. I have treated mine twice with a nice improvement (my wife noticed the improvement even before I did).

Of course, these gift certificates can be used for other things such as laser hair removal, fillers and Botox and even towards surgery such as Smartlipo or a Breast Augmentation.

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.