Best Ways to Replenish Your Skin

Written by Sophia Seligmann and Nicole Hackett

We all know that using good quality skin care products is important to keep your skin healthy and hydrated, and to slow down the aging process. It’s important to have the right products for your skin type, be consistent, and of course use them properly. Our favorite ingredient to help get that glow back is Hylauronic acid. It’s certainly a game changer, and  great for all skin types. We repeat – ALL skin types! It is water-based so it won’t clog pores and it locks in the moisture in your skin. I promise you will wake up and your skin will be looking and feeling amazing, super soft and hydrated. You can use it 1-2 times/day – or more, if you have very dry or dehydrated skin and it just needs that extra quench. Dr. Berman has his very own skincare line and sells a pure Hylauronic serum called “ultra hydrating serum.” This product is excellent for hydrating and bringing your skin’s moisture barrier back to health. It nourishes and quenches dehydrated skin to impart a supple, smooth complexion and instant correction. This universal booster provides all day moisture retention and visibly reduces the signs of aging with a nourishing blend of antioxidants and humectants. With each drop, skin appears brighter, firmer and rejuvenated.

It’s important to note that skin care products can only penetrate so deep into your skin. It’s also very important to have healthy skin at a cellular level, improving it from the inside out. Having a healthy diet and lifestyle will help your skin tremendously. Drinking plenty of water, eating your fruits and veggies and staying active are a few ways to achieve that.
Be sure to add these fruits and veggies to your diet to get the benefits:
  • Avocados can help reduce redness in the skin; grapefruits, oranges, and mangos are all packed with powerful antioxidants that help protect against UV rays, improve blood circulation and distribute nutrients and oxygen to the skin and help protect the collagen in the skin.
  • Kale is an extremely nutrient dense food and is amazing for your skin. It’s the ultimate skin replenisher, it encourages healthy cell growth producing collagen, and helps keep your skin firm and radiant.

A few extra tips for amazing skin:

  • We recommend cutting back on your alcohol intake, as alcohol dehydrates your skin and deprives it of vital vitamins and nutrients and causes your face to look bloated and puffy.
  • You also want to make sure that you are getting your beauty rest. Getting a sufficient amount of sleep is essential for healthy skin. It’s recommended to get 6-8 hours of sleep, so aim for 8 hours so you can look and feel great the next day.
  • Studies have shown that high stress levels can be detrimental for your overall health, including that of your skin. People who have high stress levels tend to produce more oil, causing bad breakouts – and no one wants a big zit, especially when they have a special event to attend. Try meditating, doing yoga daily, listen to relaxing music or sounds (which will also help you have a better nights sleep; there are free apps on your phones available).

These are just a few recommendations to help you replenish your skin and get it looking better than ever. If you can make these changes to your lifestyle, along with proper skin care products and treatments, your skin will truly thank you for it! Trust us.

If you have any questions regarding your skin concerns, call us at 703-406-2444 to schedule your complimentary, private consultation with one of our Master Estheticians!

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.

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.

Non-Surgical Mommy Makeover Options - Berman Cosmetic Surgery Blog

Non-Surgical Mommy Makeover Options

What is a “Non-surgical mommy makeover”? Although there is no dictionary definition, I define this as methods used to help restore mothers to their pre-child state, using either non-invasive or minimally invasive techniques. Most women, I’d imagine, are expecting this to be done in an office setting, without general anesthesia. It is important to be realistic (your plastic surgeon can guide you on this) in your expectations. Some women can get closer than others to their pre-pregnancy state.

For most women who come in for a consultation with me after having children, their focus is on their abdomen, flanks, bra fat, breasts and thighs. this is going to generally mean decreasing fat and possibly tightening the skin or improving the cellulite.

What are your options?
For starters to reduce fat, the completely non-invasive procedures available are Sculpsure (which is newer technology, faster, more comfortable and I believe more effective) and Coolsculpt (which has been around for more than 6 years). Both techniques are done in the office without any anesthesia, which means you can do the procedure and then return to the office or go out for dinner. Both techniques should be done at least twice for best results. There are no incisions and you can expect some definite improvement in most cases (but people will respond differently). These techniques reduce fat in the treated area and multiple areas can be treated in one session. If you want the maximum improvement, you are going to want to decrease your overall body fat, as well as have specific  sites treated. Diet is even more important than exercise, but ideally both should be focused on. There are a lot of healthy diets which share similar concepts such as eliminating processed foods, all sodas (including diet sodas) and refined sugars. My patients have had very good success with our Paleo Meal Replacement, which emphasizes reducing carbs.

For those willing to have a very small incisions, Smartlipo, which can done in the office with 2-3 mm incisions, for most women, is going to be more aggressive than Sculpsure and certainly more than Coolsculpt. It is also only done once. For most women, I prefer to give some oral sedation which means a driver is required. However, you can return to work the very next day.

For those women with cellulite, there are two generally helpful options: Cellulaze (which I offer) and Cellfina. Certainly there are presently no creams or massages or wraps or fascia blasters that I believe really work. You also get some skin tightening with Cellulaze but neither technique can totally eliminate cellulite. The key is to focus on improvement, not near perfection.

Many women develop hyperpigmentation or melasma on their face after their pregnancy (many women just develop this with natural aging). The Picosure laser with no downtime, has really revolutionized the treatment for this common problem. You should plan 3 treatments, each done one month apart. You can return to work or social activities the same day as your treatment. Facials and skin creams can be helpful after treatment, to prevent the hyperpigmentation from returning. Sunblocks are crucial if you are out in the bright sun. Older techniques such as Fraxel and CO2 lasers can be effective but cause a lot of redness. They can also make the problem worse on those women who are not Caucasian. The Picosure laser is safe on skin types 1-4.

Other changes in the face can include a loss of fat and thinning of the lips and lipstick bleed lines. These can be effectively improved by many of the fillers on the market and in select cases with fat transfers.

If you’d like to discuss non-surgical mommy makeover options, please contact 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.

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?

Bridal Makeover: Plastic Surgery for the Bride-to-Be

It is almost universal that a woman would like to look her very best on her wedding day. However, from a plastic surgeon’s perspective, it takes careful planning. I’ve seen women who have requested fillers and Botox within a few days of their wedding. I’ve even seen women who have requested an upper lid blepharoplasty within 2 weeks of their wedding. And ditto for a breast augmentation. Quite frankly, all of these are terrible ideas. This topic covers a broad age group: many women are having their first marriages in their 20’s and 30’s and oftentimes a second or third in their 50’s. I’m also discussing others in the wedding party in the information below.  

Of course, each woman and her wedding situation can be different. However, I think as a general principle you should ideally do fillers and Botox six weeks before your wedding. I am being conservative here… 3-4 weeks before is probably fine, but I would lean towards six weeks to be certain. This allows any bruising that may occur to completely resolve and for any fine tuning that needs to be done. Even if you “never bruise,” there is always a first time, so I recommend allowing time for that possibility. A more minor point is to be careful using Botox on your forehead before your wedding. Although getting rid of all lines and wrinkles on your forehead is appealing, those same muscles allow your brow to elevate. Anyone who has Botox injected in their forehead (this does NOT include the glabella area or crows feet), can experience eyebrow descent. This is only correctable with time!

I personally would not do a breast augmentation closer than 4-6 weeks before a wedding, and perhaps much longer if a complicated lift is required at the same time. Three months before the wedding is a better timeframe. As I said previously, I have had women request a breast augmentation the week before their wedding. I’ve told them to enjoy their wedding and honeymoon and then get their augmentation. Remember it takes up to three months for your implants to drop fully into position – and sometimes longer with a vertical mastopexy. I would recommend the same minimum three-month timeframe for a tummy tuck as well. 

SmartLipo is fine three weeks before their wedding, though the more time in advance, the better, as improvements continue to take place over a six month time frame.  

Remember, you are likely your own worst critic. While the thought of looking your very best for your big day is appealing, you want to be sure you allow plenty of time to prevent having any issues or complications on your wedding day. 

Should I Have a Tummy Tuck Before Having Kids?


A high percentage of tummy tucks performed are after a woman is done having children. They often aren’t happy with the stretched out look that bearing children has created on their abdomen. There may be loose skin, stretch marks, and decreased muscle and fascial tone, causing the abdomen to bow outwards.

But what about those women who have not yet had children, but feel they could benefit aesthetically from having a tummy tuck? I often see patients who have experienced significant weight loss and have the same concerns that moms may have, with stretched out skin.

This definitely comes up in my practice from time to time. It is really not a problem. They can have a tummy tuck without issue, but if I know that they will likely have children,  I just avoid tightening their fascia, the the thin layer that overlies the abdominal muscle and helps to keep it flat. This allows me to excise the extra skin and fat and give them a tighter look. When and if they get pregnant, the skin and muscle will stretch. How it will look after their pregnancy is impossible to predict, but oftentimes it will be much better than if they did not have the tummy tuck, especially if they are careful to eat in a healthy, controlled fashion and maintain their workouts. I can, of course, still do liposuction to their flanks (love-handles) to help give them a more contoured look. Of course, if they know they are going to have a child soon (in the next 2 years or so), then it makes more sense to wait until after the pregnancy.

What happens to those women who think they will have no more children and have a TT and then find themselves pregnant? Ultimately, the child always wins. The abdominal wall will stretch and the internal sutures will stretch or break. This has obviously happened to women on numerous occasions. However, if i know of these plans in advance, I would simply not tighten the fascia for this reason.

A Day in the Life of a Plastic Surgeon


One of the better things about being a plastic surgeon is that no two days are ever alike.

I thought it would be fun to share with you what a day in my life looks like. May 10, 2017 began off with a SmartLipo case for a female client from Baltimore. She had previously came in for a complimentary consultation with her sister. Like many couples who come in to my office for a similar treatment, one will complete theirs first so the other can hear how easy or tough it was. Of course my hope is that they always think of it as easy! As is the case with almost all of my SmartLipo cases, she took some Ativan beforehand to help her feel more relaxed and comfortable (and open). Although some plastic surgeons may be bored while performing SmartLipo, since it is repetitive motions, I really enjoy doing these cases. For me, it is a great chance to chat with my patients and learn about their lives. I have heard incredible stories, both disheartening (sexual abuse, financially helping their families even when they had little money of their own, and so on), as well as truly inspiring (coming to the U.S. with less than $50 in their pockets and succeeding). Whatever the subject matter, it is truly a privilege to be able to connect to people in this way. We are all so busy in this hectic world that this is truly committed time to talk with another person (neither one of us can leave!)

I worked on two of her areas of concern. She currently does not exercise and I had a chance to stress the importance of healthy eating and also exercising. I personally like the Paleo meal replacement product that I currently sell in my office, as it takes most of the planning and thinking out of following a strict diet – and it definitely does work. I also stressed that everyone will get a more dramatic change from SmartLipo if they decrease their total body fat. With both SmartLipo and SculpSure, spot areas of fat are being reduced, but it is still important to decrease the total body fat.

I actually had a second Smartlipo case immediately following this one. This time, it was a former professional athlete who over the last year had found himself super busy with work – to the point where he had stopped all exercising and his diet had gotten worse. The two places guys tend to get fat is in the lower abdomen and flanks. He had already turned around his diet and was starting to exercise. The SmartLipo was to get him jumpstarted so that he could see changes more quickly. He was very, very committed to this and I know he will be successful and will get buff again. It is definitely taking a toll psychologically on him to go from a super-cut 6 pack to his self-proclaimed “doughboy” status.

I followed these procedures with several Botox patients. I like my Botox patients to come back in every 3.5 months. Unlike most plastic surgeons, I do my own injections – and enjoy it! I particularly enjoy hearing if they have any new vacation plans coming up and what is new in their lives. I often have known these patients for years. Some days, I only have a couple of minutes to catch up and other times, I have more time to get into the details – but it is always great to see them again. Two of the women on this day were over 40 years old. It was also an opportunity to tell them about the new Picosure laser that I had just recently purchased for my practice. It is truly an amazing laser, as it allows women to dramatically even out the coloration of their skin and eliminate brown spots and pigmentation on their face, neck, chest and hands – with no downtime. They need to do at least 3 treatments about 1 month apart. We are all amazed by how much improvement the patients are getting already. We are just starting to post some of our results online.

Next up were a few patients wanting fillers. The fillers usually last 12-18 months, so I don’t see them quite as often. However, many of the filler patients also get Botox. Today, as is often the case, I saw a woman who I told should hold off on fillers as she looked great, and that perhaps we should re-evaluate in 4-6 months. Sadly, many doctors will always do something if they can. However, I prefer a more natural look and also personally do not want to encourage treatments that aren’t necessary in my professional opinion.

I then saw a few follow-up patients: a Smartlipo case, a labiaplasty case (done with her breast augmentation) and a breast augmentation case. It is nice to see how they are progressing, and with each visit ,getting a more natural and improved look. After most cosmetic procedures, with time, things look better and better.

I then had a SculpSure consult. I have known this woman for several years, and she has been troubled by stubborn fat that just won’t go away. I was able to offer her insight on both SculpSure and SmartLipo, as they would both be helpful to her. SculpSure is a new laser that I recently purchased which will melt up to 24% of the fat in an area, with no incisions and just 4 small paddles applied to the skin. The treatment only takes 25 minutes, and there is absolutely no downtime. You must do two treatments 4-6 weeks apart to get the best results. It is the only treatment that I have ever had done to myself – so I can tell you with 100% absolute certainty that the results are amazing and what the actual procedure feels like) After explaining both procedures to her and giving her the prices, she left to think about which one makes the most sense for her right now.

My last consult of the day was a woman who wanted a tummy tuck. However, in her case I thought that while a tummy tuck could be beneficial, her skin tone was good enough that if she would work on losing a bit of weight, she would probably do fine with a less invasive procedure such as SmartLipo.

It was a busy day. I never schedule a lunch break. However, I always find time to grab some food that I brought from home between patients and to drink lots of water.

Tomorrow, I will be going the surgicenter to exchange breast implants in a woman who received saline implants over 15 years ago and who now wants to go larger and have silicone implants placed.

Every day brings new patients and former patients back into my world. And every day, i get an opportunity to help boost someone’s self esteem both by what I can do for them and also what I can say to them. If we feel good about ourselves, and feel empowered, then almost anything is possible.

Experience SculpSure


Many people are not familiar with SculpSure, but I am sure over the next few months, they will become much more aware of this exciting new laser. This is a new laser and a new concept. Cynosure, the number one laser company in America and who is also the manufacturers almost all of the lasers that I have in my office, developed this and is promoting it heavily in magazines, TV and the internet.

It is a revolutionary laser that in just 25 quick minutes, through the transfer of heat through your skin, kills fat cells below the skin. The science behind this is based on the fact that fat, has a poor blood supply (compared to muscle) and is very sensitive to heat. If fat is heated to 47 degrees, many of the fat cells will die. Using a specialized laser, heat is able to be transferred through the skin, without burning it, to kill the underlying fat cells. Approximately 20-25% of the fat cells under the skin, will be killed. Most people will require two treatments spaced about 6 weeks apart. Larger patient and many patients may want to do additional treatments. You will continue to improve for 3 months after the last treatment, so you need to be patient.

before and after sculpsure

Of course, if you lose additional weight on your own (eg with our Paleo protein program), you will get an even better result.

Does it hurt? I did the treatment on my love handles and every one of my staff has done the treatment. It definitely gets very warm but it is very tolerable. For the first 5 minutes, it is just warming up. Then it gets quite warm for the next 5 minutes or so and then after that, you get distracted watching TV or playing on your phone and it is quickly over. You can do this if you are diabetic or have a hip replacement (like I do)

Does it hurt afterward? No. Immediately afterward, I went to the gym and exercised with no problems. I had no tenderness the next day, though some patients may be a bit tender. You can return to work or do whatever you want after a treatment.

Come Experience SculpSure – Office Event

We are having an “office party” on November 10 from 5:30 to 7 pm to show off our new machine. We will be doing 1-2 live demos. Plus we will have special pricing that evening only. All of your questions can be answered then. We won’t do your treatment that evening, but we will allow you to reserve future treatments at that price.

Please RSVP to the office by calling 703-406-2444 and please bring along friends.