aesthetic plastic surgery procedures

Christmas (for your body)… in JULY!

Posted on July 8th, 2011
Posted by Julene

This is a series of events you don’t want to miss! We receive many calls every day regarding VASER Shape…what does it feel like…what can be accomplished with this exciting new technology…how do I find out more about it…to name just a few of the questions my staff field every day. We have begun to offer VASER Shape treatments at a special introductory price of $2600. for four treatments, because we really do believe that the individual’s best result with any non-invasive body contouring device is to commit to a series of uniquely designed treatments over time…after all, it’s not SURGERY! No non-invasive body shaping technology is able to deliver quite the “one and done” result that surgery typically delivers, but because we do see very nice single treatment results, we have agreed to offer (on a limited basis) introductory small areas of single treatments at the special price of $150.00 for 20 minutes. Although this will not fully contour any single area, we would like for the prospective patient to see the immediate skin tightening we can achieve, and begin to see shrinkage of those problem areas. Most patients will lose one half to one inch after a one hour treatment, and see immediate results in terms of skin tightening, but enter the VASER Shape treatment a bit worried or concerned about how the treatment will feel.
The events we have planned for July 18th and July 20th, here in our office, are designed to share this exciting new technology with our prospective new VASER Shape patients in a friendly, informative and relaxing environment…starting small…gaining knowledge and information…and then proceeding with full treatment packages as a better informed patient.

So call and schedule your appointment for a complimentary VASER Shape consultation and short 20 minute introductory treatment and begin your journey toward a tighter, flatter tummy, or begin to see thighs lose that look of cellulite…ICK!


We will have light appetizers and drinks, and are accepting appointments now for July 18th and 20th. Or, if you are unable to join us this time, ask us for additional dates in August, and we’ll add you to the list of upcoming VASER Shape offerings.

Ho Ho Ho, and best regards!


The “Hidden Costs” of Procedures

Posted on June 24th, 2011
Posted by Julene

This week I have been struck by the growing number of patients who seek my services because of poor surgical results achieved elsewhere. With each passing year, I see a growing number of patients referred to me for revisionary surgery, and the single largest revision procedure requested is breast surgery…augmentations, lifts and reductions. When the need for revision is continued aging of the breast, weight fluctuation, device malfunction, or the patient changed her mind…I understand these as valid reasons for revision…but, when the reason is a poorly planned or executed initial surgical procedure…I fail to understand so well. There was a recent FDA report in Medscape that cited the all-too-true 20 % revision rate seen with breast implant procedures.

Now, let’s think about that a moment. There is absolutely no way to prevent the need for SOME breast implant revisions…those revisions due to continued aging of the patient’s breasts (these may require reshaping, resizing, or re-lifting), those revisions due to device failures (they are man-made devices), those revisions due to the changing desires of the female patient, those revisions due to the small, unexpected chance of infection or bleeding, and those revisions due to newer, better breast implants that may become available after initial implantation. I get all of those reasons for revision. What I don’t get, is the fact that those revisions probably account for less than 5% of all breast implant revisions. The remainder seem to be revisions necessitated due to poor planning of the originating breast implant procedure, poor execution of the surgery, or poor communication with the female patient regarding the intended result. These latter reasons for revision of the original result are to me, the preventable, avoidable reasons for revision, and therefore represent, the “hidden costs” of surgery.

In each and every visit my staff and I have with a future breast implant patient, we touch on the reasons that some patients will have to have their breast surgery revised. In my practice, the revision rate for preventable complications (actually, allcomers) is less than 5%. Yes, we are very proud of that statistic, but it is heartbreaking for us to continue to meet more new patients each year who have NEVER achieved their intended or wished for result after their first breast implant surgery. The costs of the revision surgery plus the original surgery far exceed the cost of a nicely performed single breast augmentation surgery…one that allows the appropriate time for control of surgical factors that, if performed, reduce the need for future revisions. (See a previous blog entry on the “No-Touch Technique of Breast Augmentation”)

I have been in a successful breast, face and body contouring practice for 16 years now, and with a strong reputation in this community, I expect to see a certain percentage of revisionary surgical procedures, but the number of revisionary procedures I am now asked to perform has exceeded 30%. This is an astounding statistic to me. I very much enjoy a challenging case, and the results delivered to a patient who feels so appreciative at the conclusion is a great thing to participate in certainly, but it does sadden me when I feel that it wasn’t done right to begin with, and that the patient and I should have been able to meet under better cirumstances (perhaps a second plastic surgical cosmetic procedure sought because the first one was so enjoyable!).

My message to any patient seeking a cosmetic procedure – not even just a breast procedure – is do your homework and don’t settle for merely the cheapest price…you might actually get what you pay for. A common denominator then, among many of the revision procedures I do is, the patient chose the surgeon based on lowest price, believing all surgical techniques are largely the same. There are so many differences in the way surgeons perform all surgical procedures that I couldn’t possible enumerate even some of them here, but with respect to breast augmentation specifically, there are several that bear mentioning. (Again, these are more completely summarized in the blog mentioned above, the “no touch technique” of breast augmentation, which reduce revision rates, but also importantly, reduce recovery times after breast implant surgery). Here are just a few of the most commonly seen errors: implants that are too large for the patient; pockets for the implants that are poorly made; poor choice of device; sloppy, hastily made breast implant pockets; poor attention to sterile technique or control of oozing; poorly chosen surgical facilities that don’t lend themselves to a sterile environment, which is so important when placing a prosthetic device; poor communication between surgeon and patient, so that intended results are inadequately discussed and agreed upon; poor attention to detail in the early post-operative period; infrequent patient follow-up, which is necessary to recognize early, fixable problems or asymmetries…and many more.

And it’s not just breast augmentation that lends itself to unnecessary revisions…it’s also the $9.00/unit Botox, and the steeply discounted fillers and laser procedures. We do occasionally reward our loyal customers in my practice with periodic discounts, but we do so specifically because we recognize that this a tough economy, and we want to make it easier to remain loyal to this practice, and we refuse to sacrifice the quality of the procedure when we discount things. Remember, the only way a practitioner can make up these drastically discounted profits when they are constantly being offered, is via increasing volumes…and when that is the primary reason for ongoing, less periodic, discount rewards, then there can be only less time spent concentrating on the quality measures that reduce revision rates. Hence, the poor result.

Bottom line…be a wise consumer…insist on quality of care…and when you find an office committed to the highest quality that also cosistently exceeds the patient’s expectations…STAY THERE!

Have a great summer!

ASAPS in Boston

Posted on May 17th, 2011
Posted by Julene

Hello Friends,
It’s spring in Kentucky…or so they tell me…Derby fever has passed, and we’re left with rain and allergy season. Post-Derby blues are common around here, so resolve to lift your spirits by getting ready for a new you for summer! A couple of news items first…

ASAPS (The American Society of Aesthetic Plastic Surgeons) convened last week in Boston. The society is composed of approximately 2800 board certified plastic surgeons who primarily perform cosmetic surgery of the face, breast and body in our specialty. The hot topics seemed to be fat transfer and stem cell technology, cosmetic laser facial rejuvenation and fillers, as well as the new non-invasive body contouring devices. As many of you now know, my office was the first to offer the Sciton Contour Profile cosmetic laser for facial rejuvenation and resurfacing, and I have posted a recent blog summarizing the benefits of becoming familiar with our laser menu of options for facial rejuvenation. I also recently blogged about facial injectables, and there are links on my website for viewing patient results with Juvederm, Botox, and Sculptra.

I have recently become very interested in non-invasive body contouring as well, and offered the first such system here in Louisville as of September 2010, Vaser Shape. I think the timing for a non-invasive device in this economy couldn’t be better, and non-invasive devices certainly add to excellent treatment options already available in a busy body contouring practice such as mine. However, discerning products that truly work versus those that represent true sales hype is an ongoing challenge for the consumer (and physician consumer too, I might add!). After extensive research regarding other competitive technologies, and after seeing some of the early clinical results presented in Boston, I remain firm in my conviction that ultrasound technology remains the clinical leader at this point…for its versatility, cost effectiveness, deep (as well as skin level) effect and safety. I have contributed to several journals regarding the use of non-focused ultrasound in this respect, as well as have agreed to author several publications which are pending regarding clinical results to date. There is ongoing clinical and animal research, but preliminary results are very promising, and these corroborate the results we are currently seeing in our patients. I am hosting a webinar next month specifically designed for our existing Vaser Shape physician users, so that we may all continue to collaborate to see that our patients are beneficiaries of the ongoing, developing fund of knowledge regarding early treatment parameters.

Additionally, I am happy to inform our patients that we are forming a new partnership with select local businesses… the first to be announced is an upcoming special evening we are hosting with Glasscock Boutique. The event will take place at Glasscock on Thursday May 26, 2011 from 4PM to 8PM, with a portion of the proceeds to benefit The Derby Museum. The evening will offer Botox and Juvederm at special savings, as well as selected skin care products from several lines, and a trunk showing from a selected designer. If you would like to be included on our guest list, just call the office and let one of my staff know.

Stay in touch, and we hope to see you this spring!

Many thanks,

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