aesthetic plastic surgery procedures

Tips for Surviving the Holidays (and that dreaded “Winter Skin”)

Posted on November 23rd, 2010
Posted by Julene

Happy Thanksgiving everyone!

I am beginning Part I (of III) today… we will have a discussion involving my personal tips for surviving the holidays (how to improve our bodies and weight management tips), and then I also plan to provide tips on how to use the winter months to work on problem skin, to treat existing problems, but also tips on how to take a more proactive stance on anti-aging. I do not have all the answers, mind you, but I certainly have opinions, and isn’t that what blogging is all about Tommy, honey? I get to express my opinions to whoever wants to listen!

As always, feel free to call us for some personal recommendations on anything that suits your fancy. We are hosting another “Cocktails and Consults” here at the office on Friday December 10th, from 10AM to 6PM, during which a portion of our proceeds on services rendered or purchased that day will go to Support The Boys’ Haven. Join us for drinks, appetizers and some live talks and demonstrations on Botox, Juvederm, Sculptra and Vaser Shape. We will have special pricing that day on skin care and injectable products, as well as laser services… and it will help a really good cause. Angela Ariatti is helping us to organize the day’s events, and is our Boys’ Haven sponsor. (She is also Lexie and Kaitlyn’s riding instructor and incredible female role model/mentor, ie., “life coach”).

The most important things to remember when re-evaluating body proportion and “problem areas”, is to do your best to be patient with yourself, and to be realistic as you reset your goals. We can all make some level of improvement in our physical fitness, but a balanced program is required. Diet, exercise, reasonable goals and a real commitment (and sometimes, intervention, surgical or otherwise) are necessary. I am a physician and a plastic surgeon, not a dietician, nutritionist or fitness instructor. I do however, care about my fitness , have done a fair bit of reading and research over the years with respect to diets and exercise disciplines, and have a large experience with different techniques myself on a personal level, and consider my medical background and training to be a sound base for the evaluation and interpretation of various methods of staying fit. Coupled with the fact that I have a significant surgical experience in treating and caring for patients – men and women – who care about their physiques as they age, I think I am at least able to render some sound advice on this subject. So…here are my thoughts, for what they are worth…

After menopause, or even in the pre-menopause or “perimenopausal years”, there is no doubt about it…hormonal fluctuation and decreased metabolic rate are all contributing factors to the slow, steady weight gain many women experience, so that despite sometimes our best attempts to stay lean, we are undone. Finding an exercise program that is truly enjoyable to you is often the key to the next challenge, which is finding the time to work it into a busy schedule. I like to run and bike and ride horses…all of which I like (or must) do outdoors. Although I have a treadmill and elliptical trainer, I much prefer to be outside, so I use these devices mostly in the winter months. Although I think the commitment provided by working out with a trainer is wonderful, motivational and ensures that the proper change and flexibility of varying a workout routine is adhered to, I simply find my schedule too restrictive and inflexible to allow me the luxury of a regular workout with a trainer. (Not to mention the cost involved with finding a good trainer and the typical gym membership.) In recent years, my husband and I have just found it more time-efficient and doable for our schedules to buy a bit of workout equipment to keep at home so that we can work out whenever we want. In addition to our treadmill, elliptical and bike trainer, we have some free weights, and I recently purchased the P90X DVDs to firm up “softer” :-) areas this winter. Basically, any regimen that incorporates some aerobic conditioning and training with resistance training using weights or bands will work, and you don’t have to spend a lot of money on a home gym. Aerobic training that is consistent and maintained at a certain heart rate level for a sustained 30 to 45 minutes 4 to 5 days a week will improve fitness. Much less than that will probably only help you maintain a certain fitness level, rather than improve fitness.

In addition to the proper work out plan, of course one must add a smart diet. Having read all of the diets my patients routinely ask me about, like…The South Beach Diet, Sugar Busters, The Zone, Atkins, etc…I think of things rather simplistically as follows: If calories taken in exceeds calories out, those extra calories will be stored as fat. If we eat the wrong kinds of carbs, they work just like sugar. Most women are fairly protein-deficient and need to eat more lean meat. The best proportion of food calories consumed is about 30% fat, 40% carbohydrate, and 30% protein. When you eat (in relation to the calories you burn that day) is as important as what you eat. Certain types of work out or training periods may change the recommendation of the above things a bit, but in general, these seem to be sound principles. So what I try to do is eat small frequent meals (around 450 cal per snack or meal 6 times a day, or a larger meal earlier in the day with fewer snacks) so that I can burn more easily the calories consumed, try to eat more lean meat and “good carb” vegies, limit sugary foods, consider the rule of portion size (palm of hand size), and not eat after 8PM. I love what is taught in The Zone…that food really is a “drug” that we put in our systems every day, that the food we eat regulates the hormones insulin and glucagon to regulate glucose metabolism and fat storage, and that if we want to better utilize (rather than store as fat) the calories we consume, we must eat to stay in “the zone”, where our body’s glucose levels stay fairly constant, we are utilizing the calories we are consuming, there are not large rises and falls in sugar levels which then cause us to store the excess glucose as fat, and we maintain a stable glucagon and insulin milieu (and therefore, stabilize weight). If it is weight loss we are after, then we MUST consume fewer calories than we utilize, and to avoid muscle loss, that means combining calorie restriction with exercise. Although I learned this from every trainer I have ever known, and I still believe this to be the best way to achieve longterm successful weight loss and improved fitness, I would also say that I now believe that sometimes (especially after the onset of those menopauseal years), that I do see the value of jump-starting one’s slowing metabolism, via alternative means.

We have recently begun to offer short courses of metabolic supplements to some of our surgical and nonsurgical body contouring patients who are trying to achieve timely weight loss in order to enhance results seen with both Vaser Shape, a nonsurgical method of body contouring now available in my office (see my website or previous Blogs) and Vaser Lipo (operative liposuction). We would be happy to evaluate anyone who wants to hear more about HcG injections or sublingual drops in this context. I do believe that patients who can “reset” their metabolic rates with these supplements will be more likely to maintain results they achieve with (Vaser Lipo) or without surgery (Vaser Shape).

The bottom line is that it is really exciting to get to assist patients with their body change goals in a very holistic manner, because as a woman who is also a plastic surgeon, I can help my patients with diet and exercise recommendations, with metabolic supplements and weight management tips, as well as meaningful interventional techniques, ie, Vaser Shape (non-surgical ultrasound body contouring), and Vaser Lipo (surgical liposuction, with or without tummy tucks or lifts).

As always, we welcome the opportunity to design a plan specific to each patient’s needs.

Happy Thanksgiving! (eat more turkey than mashed potatoes)



Posted on November 10th, 2010
Posted by Julene

I took my twins to a 3 day horse trial last weekend outside of Knoxville in the Smoky Mountains. They both compete in the sport of “eventing”, which is a 2 or 3 day horse trial encompassing the elements of dressage, stadium jumping and cross-country jumping. All 3 phases of riding are scored, and the order of finishing places is determined by the lowest penalty scores after all 3 phases of riding are completed. Usually, 2 of the 3 phases of the riding are accomplished in the first day of the horse trial, with the other element finished the final day of the horse trial. The kids may walk the jumping courses with their trainer prior to that phase of the competition, but the horse is not allowed to school either the stadium jumping course or the cross-country course prior to the actual riding of the courses. Dressage is a practiced, coordinated and very controlled test of horse and rider communication, where form and style over the various gaits are judged in a small arena. Stadium jumping is a timed ride over a variety of jumps in an arena, and cross-country jumping is a timed ride over jumps in open fields over several miles of a cross-country course.

The kids on our “recognized” eventing team are trained by Angela Ariatti in Goshen, KY, and range in ages from 12 to 17. They travel the country competing in horse trials that are recognized by the USEA (United States Eventing Association), and accumulate points over the course of a calendar year, culminating in their qualification (or not) for the AEC’s (the American Eventing Championships) year-end competition. This is a competition entered by riders, both amateur and professional, from all over the country, and it serves as a chance for our young riders to associate with and observe high level competitors, many of whom are top-ranked riders in eventing, and even international or Olympic level, competitors.

Angela took 4 of our team members (including my Lexie and Kaitlyn) to River Glen last weekend, a beautiful equestrian park in Tennessee along the banks of the French Broad River. I was so proud of all of the girls, and it was a very mixed weekend of results. We had a rider fall during stadium jumping, which is an automatic elimination from the competition. We had a 6th place finish in the Open Novice division (Lexie), and 2 fourth place finishes, Kaitlyn in Open Beginner Novice, and another in the Open Training division.

All of the kids amaze me over the course of these competitions, because in order to be successful, they learn that all 3 phases of the competition are important, and they all 3 matter. They learn that they must remain focused and competitively optimistic as all 3 phases of the riding progress, and that it is a cumulative score they are seeking. They learn to emphasize their own strengths as well as the strengths of their mounts in order to optimize scores in each of the riding phases, and they learn to persevere on to the next phase of the competition even when one element may not go as well as they’d hoped. They learn to persevere. Can you think of a more valuable lesson in life?

The team member who fell off her horse at stadium stayed to cheer on and support her fellow team-mates even after her own elimination from the competition. Kaitlyn persevered in order to move up consistently through all 3 phases of the competition, from 12th after dressage, to 7th after stadium, to an ultimate 4th after cross-country, behind riders who were all her senior in age grouping and experience.

As the weekend progressed, and as an adult, I thought about how the kids handle the challenge of a 3 day competition, how they handle the nerves and the stess in order to do their best in all 3 phases of the riding. I watch them learn how to watch the mistakes others make and to learn from them, how to plan with Angela their best course of action, and I watch them swallow the hard lumps as they make their own mistakes and learn to go on to the best of their abilities. In the end, Angela only expects them to do the best that they are capable of, and they know this, but it is truly amazing to observe this learning process, for it is a journey they each make.

Achieving goals in life is all about having the courage to dream of the goal, consistently working hard toward that goal, and persevering to never lose sight of the goal…individuals who can do this oftentimes exceed the expectations or achievements of others. And they amaze and inspire us all.

Congratulations girls.

Watch a Vaser Shape treatment and talk to the patient!

Posted on November 3rd, 2010
Posted by Julene

This week’s update on our Vaser Shape experience is very special…we will be featured on the evening news Thursday at 5PM on WAVE 3. Health reporter, Lori Lyle, was in the office last week to tape an actual patient having the procedure performed. Lori interviewed Tracy, who was gracious enough (and pleased enough with her results) to also allow taping of her actual Vaser Shape treatment. This was Tracy’s second treatment with Vaser Shape of the tummy and hips, and her measurement change so far is an unbelievable 2 inches lost above the belly button and over 4 inches at the hips!!! I know what you’re thinking…I thought the same thing…this is really too good to be true. So, I measured again, and again…

So, tune in Thursday, and see for yourself! Tracy talks about her goals for the treatment, how it feels, and I speak to its place in our body contouring armamentarium. Lori asks great questions about the evolution of this technology, and results we are seeing in all patients.

One of the best ways to receive more information about Vaser Shape is to join us here in the office for a group or individual consultation. We will outline the technique and its applications in an informal setting with a powerpoint presentation, and then provide one-on-one consultation about who and what areas might be good candidates for treatment with Vaser Shape.

Another way to find out if Vaser Shape is right for you and to view current patient results, is to join us Friday, November 19th, here in the office for our next “Cocktails and Consults”, where we will be doing a live demonstration of Vaser Shape. The theme for this evening of cocktails and information gathering will be Mexican…so bring a friend and come and have a margarita with us!

We hope to see you soon!