The Transformative Aspects of Plastic Surgery

It is the transformative aspect of plastic surgery where its greatest benefit occurs. I divide this into two main groups. As some of you may know, I also am a fully-trained life coach, having spent a year getting certified with CTI. I explore this in greater detail with patients who I take on as clients for life coaching.

The first aspect is how much better a person feels about themselves following plastic surgery. We are all familiar with the experience that if we feel better about ourselves, our entire attitude changes towards others and the world around us. We are physical and spiritual beings. If we feel more attractive and good about ourselves, this more upbeat attitude will be reflected on our mood towards others. We are likely to treat our partners, family members and co-workers better. We are less likely to be sensitive about small things. There are endless quotes and truths about life being a mirror. If we smile out to the world, the world smiles back at us. It becomes a self-fulfilling prophecy as well. Each day that is good tends to lead to expectations that the next day will be good and so on.

There is a second aspect of plastic surgery that I emphasize a great deal. I do a lot of body reshaping procedures, especially Smartlipo and Sculpture, but also tummy tucks and breast augmentations, breast lifts, and so on. I always stress to my patients that I can definitely improve their bodies. However, there is NO magic. Almost everyone will get a better final result if they can decrease their body fat. Everyone knows that we are experiencing an epidemic of obesity in the Western World. I personally believe (as do many other functional doctors) that our diets play a huge role in all diseases including cancer and heart disease. If I can assist and encourage my patients to eat significantly less processed food, stop all sodas and diet drinks, to eat more vegetables and decrease their carb intake (I firmly believe taking my Ketone Supplements makes this easier), they will be far healthier and will decrease their total body fat.

We are all familiar with situation where a diet is started, but after 4-6 weeks, where there is little change, we give up. However, if someone gets Smartlipo or Sculpsure, this gives them a much greater and quicker change than diet alone would do. It also gives them greater motivation to stick with a better diet and exercise program since they have put in the money and effort to get a procedure done with me. This will lead to long-term life changes both in looking much more toned but also feeling much better. As above, if you feel better about yourself and you also have better health, life will almost certainly find life better for you, and you will make life better for those around you. This will be a change that will last your entire lifetime.

Want to discuss available options for decreasing body fat or cosmetic procedures in general? 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!

Now’s the Time to Plan your End-of-Year Surgeries!

It won’t be long before Christmas is over and we will be into a new year. Many people elect to have their plastic  surgery completed during this time, as their jobs are typically less busy and offices are frequently closed. This can be an excellent time to get your more involved surgeries done, for many reasons.

Although the recovery from procedures like a breast augmentation are not too significant (4-5 days off of work) and a tummy tuck (about 10 days off of work, and 10-14 days if you get a breast augmentation/reduction along with a tummy tuck), using this holiday time is a great way to sneak off from work, with people just assuming you are going on a vacation. This also means they will be less likely to ask questions. You’ll still be able to hit the pre-Christmas parties, and have time to complete your  surgery and recovery after the parties are done.

Of course, if you are trying to look your best for those New Year’s parties, then you should get moving on having your breast augmentation, tummy tuck or Smartlipo now or in the near future. These surgeries take time to get your best look (you’ll continue improving post-surgery) and you’ll also want to allow some time between the surgery and showing your results off.

Want to discuss available options for your end-of-the-year procedures? 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!

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!

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!

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.

Dr. David Berman -Board Certified Plastic Surgeon

What to Look for in a Plastic Surgeon

The absolute most important thing to look for in a plastic surgeon is whether he or she is actually a Board certified plastic surgeon. There is nothing that upsets a board certified plastic surgeon more than other doctors who seek to confuse the public into thinking they are board certified plastic surgeons.

To illustrate: there is no such thing as a Board-certified “cosmetic surgeon.” It is NOT a real certification given by the American Board of Surgeons! Any doctor can call themselves a “Cosmetic Surgeon” – they don’t even have to be a surgeons! This is a scary scenario that is becoming far too common.

Another confusing title is “Facial Plastic Surgeon.” This is someone who has done ENT training (Ear, Nose and Throat), who likely things it sounds more like a plastic surgeon to call himself a facial plastic surgeon. These doctors can be well trained in surgery at the neck and above, but often go far beyond their specialty training by performing liposuction and breast surgery, etc. This goes for obstetricians and gynecologists as well, who perform liposuction and Botox. This is not part of their training. Even more inappropriate are oral surgeons – and even dentists – who are performing Botox and fillers – and sometimes cosmetic surgery. I don’t understand why someone would choose a non-plastic surgeon to do fulfill their plastic surgery needs.

Next, I would recommend that you select someone with at least a few years of experience.

It is also incredibly important to choose a plastic surgeon that you have a good rapport with. This is not something concrete that you can objectify, but rather a feeling. I strive for a natural look and this will appeal to many. However, there will be some patients who like that overdone, way overfilled look that Hollywood is famous for. These select patients will have a better rapport with someone other than me. I am also quite down to earth and enjoy hearing about my patient’s lives. Some doctors are more paternalistic, which will appeal to a different set of patients.

I always give my cell phone to all of my post-operative patients. This will be ideal for most patients, but there will be some patients that may prefer to only go through an answering service.

Lastly, I do all of my own injections for Botox and fillers. If you prefer that the plastic surgeon do your injections, you should find out ahead of time who is actually doing your injections.

If you have any questions, or want to chat about potential procedures, please do not hesitate to call my office at 703-406-2444 to schedule a private, complimentary consultation with me.

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

Common Non-Invasive Cosmetic Procedures: How They Work and How Long They Last

There are now some great non-invasive procedures available these days, providing long-lasting results with minimally discomfort or downtime. Below are a few of my favorites:


  1. FOR THE FACE: My favorite by far, is the Picosure laser. This laser is a true game changer. It is not super well known, because it is a very expensive laser for the doctor to purchase and therefore is not in a lot of physician offices. You are not likely to find this in a medispa either.What makes this Picosure Laser so special is that because it fires 1,000 faster than other lasers, it can do a facial resurfacing with NO DOWNTIME. This means that you can significantly improve the irregular coloration in your face, neck, chest and hands, with just 3 treatments, spaced a month apart. And again, with absolutely no downtime. .Also, because the Picosure fires so quickly, there is little inflammation – meaning it can be used in skin types 1-4 with little risk of hyper-pigmentation. It will also stimulate your own collagen and elastic production, which will help diminish fine lines and wrinkles.

    How long do results last? This will vary from person to person. The most important thing is to use a good sun block (which we offer in the office) and good skin care after your treatment (also offered in our office). Good skin care that is pharmaceutical grade and can only be found in a doctor’s office, will continue with minor exfoliation and collagen stimulation. It can last a year or several years, depending on your genetics and how well you care for your skin.

  2. FOR THE BODY: Sculpsure is the most popular (and its competitor Coolsculpt) for spot reductions of fat in a completely non-invasive way.  Both of these techniques will destroy fat cells (Sculpsure through heat and Coolsculpt from freezing, which I feel has more complications) and these fat cells are permanently destroyed. They will not come back. However, it is important to work on better dieting and exercising to decrease your overall body fat. If, on the other hand, you eat poorly and put on fat, those remaining fat cells will expand in size and you will look larger. Thus, the total number of fat cells is reduced forever, however, there is no “free lunch” and you still have to look after yourself.
  3. LASER TATTOO REMOVAL: The Picosure laser is the very best tattoo removal laser that exists. It fires 1,000 faster than other lasers to vibrate away the tattoo pigment. You will need half the number of treatments with the Picosure laser than you will need with other lasers. I have seen pure black tattoos disappear after only 3 treatments. This laser rarely causes ghosting. It is also the only laser that removes blue pigments.
  4. LASER HAIR REMOVAL: With our Cynosure Elite laser, hair removal is permanent, unlike the less expensive lasers frequently found in medispas. However, when your hormone environment changes such as with pregnancy or menopause, you can get stimulation of dormant hair follicles. Most people will need 5-9 treatments to eliminate most or all of their hair. It should be noted that no laser treatments will work on white or blond hair or very fair hair.

Why More Men are Getting Cosmetic Procedures – and What They’re Having Done

There are a lot of reasons more men are getting cosmetic procedures. Probably the largest reason is cultural. It is simply more culturally acceptable for men to do things to improve their appearance these days, other than just going to the gym to exercise. In addition, as techniques become less invasive, it makes it much more possible for them to do procedures that no one will know about. As a society, we are also blurring the boundaries more and more around what is strictly female and strictly male behavior. Cosmetic procedures are a natural extension from this blurring of the lines.

What are the top male cosmetic procedures?

  • Generally speaking, the most common procedure done on men parallels what is most common for women, namely Botox and fillers. The difference is that men frequently need to get more units of Botox into the glabellar area (between the eyebrows) and crow’s feet. I prefer to put a total of 25 units often in men’s glabellar areas. In women, I usually put in 20 units. Also in the crow’s feet, men usually need a total of 25 units total on both crow’s feet, rather than the usual 20  units that women usually receive. Men frequently don’t want brow elevation in the lateral third as women do since men natural have a more horizontal eyebrow appearance.
  • Men of course also see me for tattoo removal (we have the very best tattoo removal laser – the Picosure laser) and laser hair removal – especially on their backs and chest (I use the Cynosure Elite laser).
  • More men are getting laser facials and regular facials to keep their facial skin looking shiny and healthy.
  • Also laser treatment for the spider veins on their faces is also quite common.
  • Sculpsure (non-invasive way to reduce fat, which is better than Coolsculpt) is very popular for both men and women since both sexes want to reduce fat in a select area. The areas will be different typically for men versus women. Men tend to want fat reduced in their abdomen, love-handles (flanks) and sometimes chest area, whereas women will also do thighs, bra fat, knees and upper arms. The other option is using Smartlipo to treat these areas. Not surprisingly, I have a number of both men and women who are using my Paleo Meal Replacement to help them lose weight.
  • A nice option for men who do not want to have a facelift is a neck z-plasty. These scars tend to fade well and are less invasive and less expensive than a facelift, when the main problem is loose neck skin.

The most common surgical procedures in my practice are Smartlipo (laser liposuction) and male breast reduction (gynecomastia). Less common for men in my practice are tummy tucks for those with undesirable loose skin. For those concerned with excess skin or fat in the neck area, I feel that I can deliver the best results using Smartlipo over Kybella or Sculpsure.

Have questions about cosmetic procedures for men? Please call my office at 703-406-2444 to schedule a private, complimentary consultation with me.


How Young Is Too Young for Plastic Surgery - Berman Cosmetic Surgery

How Young Is Too Young for Plastic Surgery?

It is important to point out that much of plastic surgery is not cosmetic surgery, but rather, reconstructive surgery. For example, children born with cleft lip and palates, and fingers that are joined together (syndactyly). No one would argue that these surgeries should be postponed until much later in life. So the question is really, when is cosmetic surgery appropriate? As is true with all good questions, there is often no simple answer. There is no magic age, but many considerations to take into account for various procedures.

One of the more common plastic surgery procedures done for children is otoplasty. This in simple terms means that the child’s ears stick out and the otoplasty corrects this problem. Everyone knows that children can be cruel and be mean. I have had young children brought to me by their parents, wanting to know when they should have the surgery. What I tell the parents is the following: “I would wait until the child begs for the surgery.” Many times when I ask the child, they are not concerned. It is the parents who worry about the possibility of their child being teased. It is my personal belief that if the surgery is done before any teasing begins, the child will be given the impression that there is something wrong with them, that the parents are forcing them to correct. Clearly, this is not an ideal situation. I explain to the parents that their child may never encounter any problems from their ears, in which case, there is no reason to undergo the surgery. It is best to wait until the child requests it to begin the consultation process.

Breast Reduction:
Most professionals would agree the young woman’s breasts should have stopped increasing in size for at least six months before considering options. The youngest woman I have completed a breast reduction for was 17 years old, but I had been in discussion with her and her parents for over a year. As a surgeon, I want to make sure that the patient fully understands and has the maturity to deal with the surgery and the potential scarring, etc.

Breast Augmentation:
I have completed breast augmentation on several young women who were graduating high school, who had their parents’ full support. Currently, the FDA has only approved silicone breast augmentation for women over 22 years of age. Thus, I use saline implants only for these young women. There clearly has to be a maturity level and emotional stability for these young women, but I personally think it is fine for them to have this procedure when they are graduating from high school.

I don’t believe there is a magic age for this surgery. It would really depend on the level of anxiety one’s labial appearance is causing them, how realistic their expectations are for the surgery and a gut feeling about her reasons for the surgery. Years ago, I saw a young woman in her very early 20’s who wanted a labiaplasty. After talking with her, she told me that she had been sexually assaulted and her labia reminded her of the incident. I strongly encouraged her to get counseling and she agreed. She has never returned for surgery which tells me that the solution was likely therapy and not surgery. In general, I think most women should be at least in their 20’s.

SmartLipo & Lid Blepharoplasty:
I have seen a few women in their early 20’s who have had congenital fullness in the neck area, who did great after I did Smartlipo on her neck. I have also had a young woman in her early 20’s who congenial bags under her lower lids that did very well with the lower lid blepharoplasty that I did for her.

Botox & Fillers:
There is absolutely no role for putting in Botox and fillers in advance of needing them. It is extremely unlikely that a woman in her teens would need these, and I’d say the same for those  in their early 20’s. I have put lip fillers (Volbella is a one) in women in their 20’s. I believe this should be done gradually, and the goal should be a natural look. I always caution these young women, and older woman too, to go gradual and aim for a natural look – and not to emulate some of the Hollywood stars, who I feel have gone way overboard.

I think that in the society we live in, there will be a push for teenagers to have more and more cosmetic surgery, earlier and earlier, which I personally do not think will be a good thing. There should always be careful consideration given to cosmetic procedures.

If you have questions about any procedures you are considering, please call my office at 703-406-2444 to schedule a private, complimentary consultation with me.