No surprise here, but achieving taut and toned muscles isn't easy to do. While you don't necessarily need to train like an Olympic athlete to get sculpted, it's still difficult for many of us to get rid of those small pockets of fat—especially on the abdomen—that seems to be more stubborn than a toddler entering their "terrible twos."
Luckily, there's a new in-office treatment called Emsculpt NEO to pick up where your endless crunches have left off. While you may have heard of the original Emsculpt device, this new version has just recently launched, and unsurprisingly, it has experts beyond excited.
"Emsculpt NEO is a true technological innovation," says San Diego dermatologist Melanie Palm, MD. "It combines two technologies delivered simultaneously to target both muscle toning and fat loss."
"I call this my 'holy grail' device because everything it can do simultaneously is new to the market," adds Louisville, KY plastic surgeon Julene Samuels, MD.
Although panedemics have played a role in shaping human history throughout the ages, few people reading this today will remember outbreaks on the scale of COVID-19. There are, of course, some historical examples, such as SARS, "swine flu", Spanish flu, even HIV. We have emerged from all of them by developing vaccines and effective medical treatments where a vaccine may not yet be available (HIV). We did this by way of surveillance, the isolation of those who contracted the virus, and strict quarantine measures. Even if traditionl public health measures are not able to fully contain the outbreak of COVID-19, they have been effective in reducing peak incidence and global deaths. Pandemics do end, and fortunately, we now know some things about COVID-19 that we didn't know just a couple short months ago.
As of May 21st, the CDC reports that the current global estimate of the mortality rate of COVID-19 is around 0.4%, but that beats the original estimate of 3% by a lot. The U.S. as a whole has a mortality rate of 0.167%, while most states report rates of less than 0.1% to 0.3% (Kentucky stands at 0.21%). The pandemic has been devastating in terms of loss of life and economic prosperity, however, measures we have put into place have flattened the curve. We are moving toward effective treatments and prevention, and we have much to be thankful for.
As I prepare to enter the 26th year of my surgical practice, I think back upon circumstances and events that have had the most impact in "shaping" my career as a cosmetic plastic surgeon...fitting that this month's TOPS is devoted to "Shaping Louisville."
I feel lucky to have chosen a career that combines both art and science, so that I can use whatever surgical talent and insight I may have to positively impact the lives of others. I hope I have done this through the years with style and a flare that is all my own, shaped as it has been by my mentors and past patients.
Ever felt like you needed a "new you," this just might be the place. From the newly designed offices, to the nation's latest techniques and services, JBSMD has everything you will need at their new location.
In a wonderful new place they call home, you'll find the offices of Dr. Julene B. Samuels MD, FACS. Located in the vibrant Towne Square of Norton Commons, alongside over 70 other businesses, this bustling residential and commercial destination offers convenient walkability, ample parking, and lots of community support.
"We are so excited because we love the space, but most importantly we love what it means for our patients," states Dr. Samuels. "We have expanded our in-office surgery and medspa facilities and created a patient aesthetic that you really have to see. It's gorgeous and functional, it flows well, and it feels just perfect."
We're four weeks out from Derby and that means the race to primp and prep is on. Here, local cosmetic surgeons share the quick fixes that can make you walk into the track looking like a winner.
Since the first Derby was run in 1875, it has been an opportunity for attendees to dress up and look their best. Today the tradition of dressing to impress at the track carries on with a modern, scientific twist: Derby primping now often begins with a little high-tech help from local cosmetic surgeons. Whether they're filling fine lines, plumping lips or smoothing bumps and eliminationg the need for Spanx, our local medical experts have a whole spectrum of quick fixes that can guarantee a beauty triumph at the track.
FOUR WEEKS OUT:
Micro-needling with radiofrequency retexurizes and smooths both facial and body skin with little downtime. Fractora is a collagen pen that is a great one. Profound is another device she uses but it has much more heat, takes longer to do, and is more expensive than Fractora.
THREE WEEKS OUT:
Injectables as a fast filler, long-lasting collagen stimulating injectables, injectables for acne scar filling, neurotoxins, and facials that vary in simple subtle ways to a chemical peel or alpha-hydroxy acid facial for a quick complexion fix.
TWO WEEKS OUT:
Peels and fillers.
Don't forget to stop taking medications that can cause bruising if you're getting injectables and plan at least a week or two ahead for skin smoothing and resurfacing treatments to give yourself healing time and realize that your full results can take weeks or months for some of the treatments.
The world of health and beauty revolves around an endless race towards some antidote to the less desirable symptoms of aging. It is the continual push to revolutionize the anti-aging battle and discover the mysterious fountain of youth. From consmetics to topical creams to lasers to vitamins to surgeries, there are so may options to consider at each stage and age.
Every year yields new discoveries to be deciphered and decoded. To streamline that process, we have highlighted some of the most exciting new cosmetic procedures and products for 2018. Here, you'll find a list of safe solutions that will reverse or improve those signs of unwanted external changes-those that can maintain, enhance, sustain, or regain the healthful appearance of the past, for our body's future.
Dr. Julene Samuels is a double board-certified surgeon with extensive, specialized training in cosmetic surgery of the face, breast and body. She believes the best results are maintained over time through the use of specific surgical techniques, coupled with additional state-of-the-art nonsurgical or minimally invasive rejuvenative options. For each patient, she outlines a plan that is customized specifically to age-related concerns, lifestyle, budget and recovery needs. "I love making patients happy and treating them over time. The rewards of this continuity of care from patients who place their utmost trust in me is a real pleasure and a labor of love," she says.
The past five years have witnessed a surge of interest in female wellness and specifically, vaginal rejuvenation, both surgical and nonsurgical. The American Society for Aesthetic Plastic Surgery (ASAPS) procedural statistics report an increase of 23% in surgical labiaplasty procedures performed in 2016 by plastic surgeons in the United States, compared to 2015 (the first year for which statistics were available).
It is estimated that 35% of plastic surgeons now offer surgical labiaplasty and performed over 10,000 procedures last year. Along with this newer area of surgical interest, there has also developed a rapid growth in the number of treatment options for nonsurgical vulvovaginal
rejuvenation. For both cosmetic and functional reasons, increasing numbers of women have sought alternatives to traditional options (vaginal lubricants, topical or oral estrogen products, and hormone replacement therapy) for dealing with unwelcome vaginal changes of menopause and childbirth, by choosing among a host of energy-based treatment devices that have emerged.
Most of us spend a lot of energy and money focusing on above-the-neck anti-aging measures, while what's below the wrist can give us away. "A woman can look ten or fifteen years younger than her age and then you look at her hands," says Dr. Julene Samuels, a cosmetic surgeon in St. Matthews. "Age spots, visible veins and rough texture add those years back. And they're so easy to treat."
To the rescue: Laser treatments that can zap both bulging veins and discoloration, typically in a single treatment. "The Sciton BBL laser is incredibly effective at removing brown spots and smoothing texture," says Dr. Samuels. "And the Sciton vascular laser can treat vessels in one to three treatments."
She didn't tell her co-workers and she won't use her last name, but twenty-one-year-old Erin is one of over 12,000 women who had cosxmetic surgery last year to reduce and reshape their labia. And she can't wait to talk about it.
"I would do it a million times again," says Erin, a twenty-one-year-old local woman who had a labiaplasty performed by Dr. Jule Samuels, a St. Matthews cosmetic surgeon, last October. "It first became a problem in fifth grade," she says. "My doctor referred me to a gynecologist because I had enlarged labia that might have been the side effect of a medication. No one could ever do anything for me."
You don't need surgery to firm your face and body. Dr. Julene Samuels shares the new, non-surgical procedures that are making taut skin a possibility without significant side effects or down time.
As a surgeon, I am a professed "anatomist." As a plastic surgeon I appreciate form and function. I have dedicated my practice to the art of sculpting the human body in ways that help my patients achieve the best physical versions of thermselves.
It's no wonder Julene Samuels is so excited to have a barn— and her two thoroughbreds and a quarter horse - right across the street. As a solo practitioner in a thriving cosmetic surgery practice, her days routinely start before 8:00 a.m. and end twelve to fourteen hours later: "It’s often dark when I get up and getting dark when I drive home," she laughs. Add to that the travel she does as an educator and consultant for several medical device companies and as a clinical investigator for Allergan, Syneron Candela, BTL and InMode and her enthusiasm over having daily access to her horses makes sense. "I still remember how excited I was when we fi rst moved out here and I could get up in the morning, walk across the street and feed the horses," she says. "There's something magical about mornings in a barn.... It makes the balance of my life work."
The Fastest-Growing Rejuvenation Procedure That No One Is Talking About
From TOPS Louisville Magazine
What's trending in the art and medicine of female intimate wellness? Dr. Julene Samuels shares the latest news that you might not have heard, yet.
It may come as a surprise to you, but one of the hottest trends in plastic surgery right now is labiaplasty, a surgical procedure used to trim excessive labia minora (the "inner lips" of the female vulva), labia majora (the "outer lips"), and labial "puff" procedures in which the loose or saggy tissue of the labia majora is filled or lifted. Nonsurgical vaginal rejuvenation technologies now also exist that help women deal with unwelcome internal vaginal canal changes that occur with childbirth, aging, and menopause. While these are common problems, well over half of women may be unaware of current options available to them, but that’s changing rapidly.
According to the latest statistics from the American Society for Aesthetic Plastic Surgeons (ASAPS), labiaplasty procedures spiked 49% between 2013 and 2016, and this trend is continuing, with more than 12,000 procedures performed by ASAPS members just last year. The increase in interest stems from both aesthetics and function. For instance, the internet is full of what constitutes a "desirable" appearance of the vaginal area implying a "new norm" of more petite appearing labia minora and full, tight labia majora. Due to the popularity of Brazilian waxing, the female anatomy is now more commonly totally visible. A common complaint of patients is excessive redundancy, deflation and hyperpigmentation of the external tissues, which is both a cosmetic concern and a functional problem for women of all ages. Young adolescents feel "abnormal" if the labia minora hang too much or are asymmetric, post-partum women experience changes of laxity and sometimes sexual dysfunction after child birth or weight loss, and¬ menopausal women can experience dryness, tightness, itching and painful sex after aging and hormonal loss. Women’s clothing has expanded to include form-fitting streetwear like yoga pants, exercise clothing and leggings, and excessive tissues can cause rubbing, chafing, irritation, dryness, and fullness that is uncomfortable during exercises like running, biking, horseback riding or even during intimacy.
With this cultural shift and increased media representation, the good news is that board certified and well trained plastic surgeons have fine-tuned surgical techniques that offer safe, effective and aesthetic results while also correcting functional issues for female patients bothered by true symptoms down below. The bad news is that with rapidly increased demand, accompanied by a lack of mandated training for the great numbers and types of practitioners offering treatments, many women fall prey to "botched" surgeries or spend boo-coos of money on ineffective therapies. Good plastic surgical techniques for labia reduction and even clitoral hood reduction yield very high patient satisfaction results and can make all the difference between a life of chronic anxiety and doubt and one of pleasure and self confidence.
Meaningful nonsurgical options using CO2 laser technology now exist to most effectively offer treatment of the functional conditions such as loose vaginal canal (Vaginal Relaxation Syndrome) after childbirth or weight loss, and dryness, itching, vaginitis, tightness, urinary leakage (Genitourinary Syndrome of Menopause) caused by declining estrogen levels in menopausal women or those denied estrogen as after hormonally treated cancers. These lasers can also be used to cosmetically treat the atrophic, loose or hyperpigmented external vulvar skin that occurs with pregnancy and aging, in some cases even eliminating the need for surgical labiaplasty. And finally, these lasers can help treat sexual dysfunction including painful intercourse due to internal vaginal dryness or tightness, laxity due to relaxation, and orgasmic dysfunction.
In a clinical trial that I conducted last year on the use of the CO2RE Intima laser for 40 menopausal women, results showed an astounding 90% patient response rate after just two laser treatments, and a 100% response rate after the recommended three monthly treatments on symptoms of dryness, itching, painful intercourse and urinary leakage. Several of the female patient groups who can be dramatically improved with these treatments are breast cancer and hormonally treated cancer patients who may enter menopause at an earlier age and for whom hormone replacement therapy is not advised, patients with radiation induced dryness, and patients suffering from urinary incontinence or pelvic organ prolapse. Again, not all practitioners offering treatments for these cosmetic and functional issues are necessarily surgically trained or laser experts, so as always, patients should research credentials, board certification, experience and recognition in the field before selecting a provider to ensure the best outcome.
Dr Julene Samuels featured Presenter at ASLMS 2017 Conference in San Diego
Fractional CO2 Laser Treatment of the Vaginal Canal and External Labia for Symptoms of Vulvo-Vaginal Atrophy in Postmenopausal Women
New applications of laser in genito-urinary syndrome of menopause (GSM), stress urinary
incontinence (SUI), and lower female genital tract.
Gynecologists, Urologists, and other health care professionals who are interested in menopausal
medicine (such as endotrinologists, G.P., internal medicine, physiotherapists, nurses and professionals interested in women's health issues. Scientists/engineers with special interest in the design of laser delivery systems.
Physicians, nurses, engineers, writers/journalists (the media) with special interest in
Women's Health issues.
Instructional Content/Expected Learning Objectives:
It is expected that participants will receive scientific information on cutting edge technologies to treat age related female lower genital tract issues. These new technologies replace controversial hormonal treatments and other related solutions.
Eight Ways to Get Your Derby Shine On by: Susan Gosselin
You’ve bought the dress. You’ve bought the hat. And you’ve even got matching shoes. But have you stopped to think about what your skin is going to look like in your Derby finest? With a just a few weeks left to go, experts on beauty treatments and medical procedures say there’s still plenty of time to get your Derby shine on. The secret is to start thinking about your options now.
Here are the strategies and procedures they recommend before the big day.
"People are often afraid to book an appointmentwith a plastic surgeon, especially
if they aren’t interested in surgery. But in my practice, we work with a lot with patients to help them develop a plan that works for them—their skin, their goals and their budget. For some patients, that is just using the right skin care products. For others, it could be fillers, peels, non-invasivelaser treatments, or surgery."
Study Shows CO2RE Intima Improves Vaginal Health with High Patient Satisfaction by: Kevin A. Wilson
Adding versatility and value to the CO2RE laser system for aesthetic rejuvenation and wrinkle reduction, the new CO2RE Intima module from Syneron Candela (Irvine, Calif.) provides physicians with a top tier technology for non-invasive vaginal tissue remodeling that's both patient and user-friendly, meeting a growing need in the field of women's intimate health and wellness. With the CO2RE Intima module physicians can remodel and restore the tissue of the vaginal wall and vulvar to improve not only the aesthetic appearance of women's external genitalia (including vulvar dystrophy and dyschromia), but overall functional vaginal health as well, providing a relatively inexpensive treatment with appeal for women of all ages.
"All women experience these changes at some point, and the previous treatment offerings do not compare with CO2RE Intima in terms of risk, downtime, side effects, compliance, safety or results."
Talking Turkey About Profound (Or How To Get Rid Of Your Dreaded Turkey Neck)
November 01, 2016
From Tab's View
“Turkey neck”… that age-old cosmetic problem both men and women hate, a problem which has defied most nonsurgical treatment options, has finally met its match: Profound. In a single, simple in-office treatment, Profound is a reliable, predictable, scientifically proven way to nonsurgically improve skin quality of the face and neck, as well as truly contour away unwanted fat of the jowls and neck! Unlike other nonsurgical options such as Kybella, Venus Freeze, Exilis or CoolMini, Profound is a single in-office treatment with great results seen as soon as four weeks (although optimal results usually are seen at three to six months post-treatment).
Patient response really is close to 100 percent, as reported by Syneron Candela’s clinical trial, in which histological results confirmed that Profound induced the formation of new collagen, new hyaluronic acid (the substance injected in most facial “fillers”), and most importantly, new elastin in treated skin. Profound is essentially “Fractional Radiofrequency,” in which heat is delivered via tiny pairs of microneedles to the deep layer of skin called the dermis, or in the fatty tissue below the skin.
After comfortably numbing the skin with cream and local anesthetic, patients can opt to have the treatment performed to the full face and neck, or to smaller regional areas like the lower face and neck. The heat delivered by the shorter needles available causes improved skin texture, skin tightening, thickening and smoothing, as well as increased volume in areas where injectable fillers would be placed.
In addition, there are now longer needles available which can reach the fat of the jowls and neck (that “turkey waddle” we hate under the chin) to truly contour these areas much like liposuction of the face and neck. In contrast to the single-treatment option with a one-week recovery process Profound offers, Kybella neck injections must be performed as a two- or three-treatment series over six-week intervals, with several weeks of pretty significant swelling with each injection.
Kybella and other non-surgical device treatments not only require more time to result, due to higher total numbers of treatments required, but also end up being usually more expensive when compared to Profound’s single treatment cost of $2,800 to $4,800, depending on size of the treatment area. If you compare this cost with the cost of the traditional surgical facelift/necklift — which can run anywhere from $12,000 to $15,000 — you can see why this makes patients smile.
Even though a surgical remedy for the neck remains the longest-lasting treatment option for facial and neck aging and will always be the gold standard, not everyone wants surgery. We also don’t recommend having too many facelifts in one’s lifetime in order to avoid that “over-operated look.” The fact is the neck is frequently the problem area which makes patients “pull the trigger” toward finally having facelift surgery, since I am able to keep them happy longer in the face with facial volumizing and laser treatments, which don’t typically help the neck. I am now using Profound to help patients put off the age at which they finally have that surgical lift, as well as to maintain it longer non-surgically.
Since I am actually improving the quality of the skin with Profound, even when the patient finally has that face/necklift, the lift lasts longer due to having “youthenized” the skin quality by previous Profound treatments, hopefully allowing even the surgical facelift patient fewer surgical revisions over time. Finally, facelift surgery doesn’t improve the actual quality of the skin itself, and is rather like “making up the bed with the same bedspread” over time. Profound is as corrective as it as pre-emptive in its effects on skin quality and contouring of the face and neck.
Here is a typical before and after Profound result to consider. The patient is shown pre-treatment, at two months, and at six months. Note the improved skin tone and texture, increased volume in the cheeks and nasolabial folds outside the mouth, reduced fat of the jowls and neck, and overall skin tightening. Recovery is limited to one week of swelling, mild bruising and tiny bumps on the skin’s surface from the needles, which quickly resolve with skin moisturization. I also have been using various growth factors and PRP in the immediate post-treatment period to assist with an improved drug delivery system for these products through the needle holes, as well as to hasten healing from Profound.
And finally, the longer needles are now our favorite single-treatment option for nonsurgical correction of nonfacial skin laxity and cellulite…the topic of a future story to watch for here as we get ready for spring…
GOBBLE ON, but go light on the gravy!!!
Drilling Down To The CO2RE
With Dr. Julene Samuels
October 26, 2016
From Tab's View
On a cool Tuesday autumn afternoon, Tab’s View attended an open house at the office of Dr. Julene Samuels in St. Matthews to learn more about some of the procedures and services available at her office.
The main attraction to the open house — aside from the discounts on services and products — was the Syneron Candela CO2RE Intima vaginal rejuvenation medical laser. The CO2RE Intima uses medical laser technology to address several issues related to vaginal care, from dryness and looseness, to tightness, itching and pain. Dr. Samuels explained it best in her piece about the Intima:
This laser is a fractional CO2 laser which delivers laser energy to cause a natural thickening of the vaginal skin, restoring a more youthful quality to the skin, along with a return of natural lubrication, the formation of new collagen, and the rejuvenation of natural elasticity lost amid declining estrogen levels during menopause or hormonal treatment of breast cancer.
Tab’s View also learned about Sculptra Aesthetic, an injectable poly-L-lactic acid used to restore a youthful appearance in one’s face. The injectable is also used on those suffering from the effects of AIDS and medications aimed at treating the disease, bringing fullness taken away by the disease and treatments back to the face.
Later on, we caught a tech demo featuring another Syneron Candela product, UltraShape. This device uses ultrasound technology to reduce fat without pain or the scalpel. Instead, UltraShape causes the walls of fat cells to collapse, liberating the contents as triglycerides while slimming down one’s appearance.
Aside from tech demos and discounts, the open house had plenty of snacks and beverages for both current and future patients to enjoy. And of course, what would an open house be without a prize giveaway or two? Guests could enter a drawing for a free peel by filling out a slip with their name and contact info, then folding it up and dropping into a fishbowl.
Tab’s View had a wonderful time at Dr. Samuels’s office, and look forward to the next open house.
Intimacy After Breast Cancer
October 04, 2016
From Tab's View
October is Breast Cancer Awareness Month. While we celebrate the many breast cancer survivors and the advances in the diagnosis and treatment options which now happily exist for breast cancer, I want to talk about a topic of which many breast cancer patients may be unaware.
There are changes in a woman’s body which occur during or months after hormonal treatments for breast cancer, particularly vulvovaginal atrophy (VVA). Many of the symptoms of VVA occur naturally with menopause, are made worse if a woman is given anti-estrogen hormonal therapies in treatment of breast cancer. It’s the topic which often doesn’t come up in the exam room, or if it does, treatment options to offer patients have been limited.
While hormone replacement therapy is an option for menopausal women dealing with symptoms of hot flashes, vaginal dryness, itching and atrophy, painful intercourse, and frequent vaginal infection or stress urinary symptoms, these same hormonal therapies are not options for breast cancer patients. Now, with recent advances in laser technology, there is a safe, non-hormonal option…Laser Vaginal Rejuvenation.
A laser used for many years for facial skin rejuvenation has now been modified with a handpiece to work on vaginal epithelium in much the same way as it works to rejuvenate facial skin: CO2RE Intima. This laser is a fractional CO2 laser which delivers laser energy to cause a natural thickening of the vaginal skin, restoring a more youthful quality to the skin, along with a return of natural lubrication, the formation of new collagen, and the rejuvenation of natural elasticity lost amid declining estrogen levels during menopause or hormonal treatment of breast cancer. The treatment requires three 15-minute, non-painful, in-office laser treatments performed at one-month intervals. Symptoms begin to improve as soon as days after the first treatment, and a single annual re-treatment is usually required to maintain results in the face of continued declining estrogen levels. This laser also works to tighten a loose vaginal vault in the post-partum woman after pregnancy-induced changes – or after weight loss – and is part of the new “Mommy Makeover” revolution!
Here is a short video clip that shows how the laser is placed very comfortably within the vaginal canal. No anesthesia is needed, the treatments are very comfortable and quick, and there is no recovery time. Laxity and hyperpigmentation of the external labial skin can also be improved.
I recently conducted one of the first clinical trials in the U.S. with this revolutionary laser, and our results showed a 97% response rate and symptom reduction. Our patients call it a “life-changing” treatment that they didn’t dream could so effectively restore a sense of self-confidence and feminine well-being. One of our study patients, Rosie, said, “I didn’t even tell my husband I was going to have the laser, and he noticed the tightening and better lubrication the first time we were intimate again after only my second treatment. I was so much more interested in sex and so much more comfortable, and he noticed we didn’t need to use a lubricant. So I told him what I had chosen to do. Everything is different now. I hadn’t realized how much this had affected our relationship in a negative way.” Another of our study patients is a breast cancer survivor who was diagnosed and treated while in her 30’s. She had experienced decades of menopausal symptoms when she presented to me for the CO2RE Intima study complaining of vaginal dryness, irritation and terrible urinary leakage requiring the use of multiple pads daily. Cathy explained, “After one treatment, I stopped using pads altogether, and the increased vaginal lubrication is nothing short of a miracle!”
I have spent my career trying to help women experience their best selves by removing physical sources of concern for them and thereby restoring a better sense of “self” for them in safe and affordable ways, whether this is done with surgery or meaningful non-surgical options. The CO2RE Intima is truly an extension of the surgical labiaplasty option I have long offered women to improve their feminine wellness and to restore vitality to this very important area lost due to childbirth, weight loss, aging, menopause or illness. As a woman, I have always been bothered by what my female patients feel they can’t freely discuss. For too long women have been told there are no viable treatment options for these concerns and that these unwelcome changes are just part of the aging process. This is not true. Finally, women have a source for open and honest dialog and can expect some real help.
If you are a breast cancer survivor or know of a woman who would benefit from learning more about CO2RE Intima treatments to restore intimacy and feminine well-being, call us for more information. During the month of October, we are happy to offer a three treatment laser series for the price of two treatments. You pay for two and get the third treatment for free.
Act Now…There’s Never Been a Better Time to Restore Your Intimate Health!
Surgical vs. Nonsurgical Cosmetic Options:
Five Things to Consider
September 09, 2016
From Tab's View<
When considering your plastic surgery and cosmetic treatments, the options available sometimes are overwhelming. Are surgical procedures, such as a tummy tuck, facelift, breast augmentation or liposuction, right for you? Perhaps the subtle results achieved with innovative nonsurgical treatments, like Profound, UltraShape Power, CO2RE or injectables, are your best choice.
“As a cosmetic plastic surgeon, I help patients navigate this important question every day,” said Julene Samuels, M.D., a plastic surgeon in Louisville, Ky. “Even though I am a surgeon and I love to operate, I realize the limitations of even well-performed plastic surgery. Surgery isn’t always the right choice, and sometimes it’s just too much.”
“Surgery also may not address all of a patient’s concerns in a given area, and may require nonsurgical adjuncts to deliver the optimum result, or to maintain a surgical result over time. Furthermore, since entering private practice in 1994, there are now many more truly meaningful nonsurgical options that are very worthy of consideration than there used to be.”
Here is a list of things to consider as you try to determine if surgery or a nonsurgical option is right for you…
How dramatic of a change do you want? Do you want an instant “Wow!” result — like breast implants which will be noticed immediately — or would you prefer a subtle change or improvement over time?
Are you okay with multiple treatments to achieve results, or do you prefer a “one and done” approach? Do you have the ability to return for multiple treatments in a nonsurgical series to achieve results?
Are you a good medical risk patient for a surgical procedure? Are you opposed to anesthesia (even intravenous sedation), or would you rather avoid it?
How much do you want to invest in your procedure? Plastic surgery has become more affordable over the years, but surgical procedures do require more of an investment than nonsurgical options.
What about recovery time? Do you have the time to recover from a surgical procedure, or would a nonsurgical treatment with minimal recovery time best suit your schedule?
The discussion surrounding any cosmetic concern should involve a discussion of appropriate surgical as well as nonsurgical options with a board-certified and knowledgeable physician who actually offers both surgical and nonsurgical options. Have you ever heard the phrase, “If all you have is a hammer, the whole world is a nail”?
“There is a line that is written in all my patient charts that goes like this: Risks, benefits, options and alternatives, limitations and revisions outlined,” added Dr. Samuels. “A thorough discussion of the surgical options and alternatives to surgery is the only true route to informed patient consent. Every surgical patient who comes to see us hears about the best nonsurgical options for care of their particular concern first, and then we focus on the surgical options next. That way, my staff and I can help patients figure out whether it is surgery they desire or something else.”
Many times, patients may not be aware good nonsurgical options for their concern exist. Conversely, understanding the limitations of a nonsurgical procedure might mean a change of course to a surgical approach instead.
Per Dr. Samuels: “All patients deserve to hear both nonsurgical and surgical options, the intended results of each, what the anticipated process of each will involve, and then the right choice between surgery or non-surgery can be made.”
There are also many instances where a patient may combine nonsurgical and surgical approaches. Staging results or improving one’s candidacy for surgery may make starting out with a nonsurgical approach the best option, delaying surgery.
It is also common for many patients to choose a more thorough correction via surgery initially, then utilize nonsurgical procedures to maintain surgical results without the need for further surgery or surgical revision.
According to Dr. Samuels, there is definitely a place for nonsurgical treatments in the armamentarium of ways to proactively thwart the aging process. It is often possible now to utilize meaningful nonsurgical treatments at earlier ages to slow the aging process, and to delay the age at which patients present for more aggressive management.
“As a plastic surgeon, I am often asked, ‘Have you had any surgery yet?’ My answer: No, but I will when I run out of good nonsurgical options that make me happy!
“Don’t get me wrong. Sometimes surgery really is the only option. But the real key to cosmetic surgery success is to choose age-appropriate interventions (surgical or nonsurgical), to operate only when necessary.
“And when there is no good or equivalent nonsurgical alternative, [the key is] to choose the right surgical techniques when you do choose surgery; to try to avoid too many surgeries over one’s lifetime; and to use nonsurgical alternatives where appropriate in a proactive manner, or for nonsurgical maintenance.
“In the end, it’s good to have options.”
To learn more about innovative surgical and nonsurgical options contact Dr. Samuels at 502-897-9411.
Behind the Botox
From HerScene Magazine
Their names are in the contact lists of those friends who keep looking better every year. Here, three different types of medical experts talk about what it's like to guide other women through the anti-aging maze.
What are the biggest misconceptions patients have about anti-aging treatments?
Most patients undervalue starting early with an anti-aging program and think they need to wait until the signs of the aging process are more significant. However, there are many age-appropriate noninvasive steps a woman can take that make a great difference if practiced regularly, even starting in her twenties and thirties. Doing small but meaningful things daily can help women avoid premature aging and can definitely help women put off the age at which they may require more aggressive intervention.
What's the smallest step that can make the biggest difference in how youthful you look?
A healthy lifestyle including a proper diet, exercise, rest, hydration; daily prescription skin care and avoidance of as many harmful environmental influences as possible-- like unprotected sun exposure and smoking.
What is the best reaction you've ever had to a treatment you've provided?
A patient who came to me after extreme weight loss to deal with too much loose skin on her face, breasts, tummy, thighs and arms. Slowly, and in steps of combination procedures, we did the various face and body lifts to correct all of the skin laxity that had resulted from the weight loss of 180 pounds. The patient cried at the end of three major combination surgeries and told me that even though she knew she had drastically improved her health with the weight loss, that, for a long time, she had become sorry she had lost the weight due to the residual excess skin. It wasn't until after the last surgery that she actually stopped seeing herself as a permanently overweight woman.
We keep a lot of Kleenex in the office for these occasions, and go through it so fast that, one time, after a trip to Sam’s Club, my own husband asked me why we seem to go through so much Kleenex in a plastic surgery office!
Which treatments are you most excited about?
I am a surgeon, and while I love the surgical results I can achieve for women, I fully understand the limitations of surgery, as well as the fact that not all women desire surgical intervention.
I am most excited about new nonsurgical methods of tightening skin, especially in the lower face and neck. For so long, the neck has been the "missing piece of the puzzle." Women hate their aging necks and surgery used to be the only option to really tighten the neck in a meaningful way, since lasers cannot be used as aggressively on the neck as on the face. For skin tightening of the face and neck (and also nonfacial areas), the single greatest new tool is microneedling with audiofrequency. Some of our before and after's almost look like a facelift or neck lift or neck liposuction was done.
Are there any anti-aging cosmetic mistakes that you commonly see?
I am appalled at how often even simple treatments – usually fillers - are overdone. Cosmetic "enhancements" should enhance the positive while de-emphasizing the negative, and restore anatomic elements and tissues to a more youthful, balanced, proportional and naturally beautiful state.
Minimally Invasive Profound
Recreates the Building Blocks of Skin
From The Aesthetic Guide - by Kevin A. Wilson
With its precise, temperature-controlled fractional radiofrequency (RF) delivery system, the Profound platform from Syneron Candela (Irvine, Calif.) revitalizes skin by uniquely stimulating the production of new collagen, elastin and hyaluronic acid. The addition of the new SubQ handpiece adds versatility and value to an already impressive device that demonstrated a 100% response rate for wrinkles and 95% response rate for skin laxity in a 2013 clinical trial.1
"By delivering RF energy in a fractional manner directly into the reticular dermis using an array of paired microneedle electrodes, we are without a doubt hitting the exact target region," said Julene Samuels, M.D., a plastic surgeon in Louisville, Ky. "The real time in-tissue temperature feedback allows us to quickly and safely reach the clinically proven ideal temperature targets and maintain them for the scientifically determined timeframe for best results."
As David Kent, M.D., a dermatologist and medical director of Dermatologic Surgery Specialists in Macon, Ga. expressed, "Profound is vastly different from ablative fractional laser resurfacing or other RF devices. It is the only RF fractional microneedling device proven to create elastin. Additionally, unlike lasers and other RF devices that create a primarily catabolic injury, which first breaks down collagen, Profound fractional RF causes an anabolic wound healing response, which is like a slowly building fire that stimulates the neocollagenesis, neoelastinogenesis and the production of hyaluronic acid. I’ve been very pleased with it and my patients have been, too."
According to Dr. Samuels, the feedback mechanism features both temperature and impedance monitoring; readings are taken ten times per second within tissue at the treatment site rather than from external monitoring or other means. "We want to control heat to achieve and maintain the maximum safe temperature targets, but also the electrical current flow, which depends on impedance of local tissue," she explained. "Different tissue types have varying impedance, so by sensing changes the current flow between electrode pairs is as consistent as can be. This allows precision in the physical location as well as consistency of energy delivery, temperature of tissue, and the time we maintain therapeutically relevant temperature levels."
With the new SubQ handpiece this same powerful and precise fractional RF delivery mechanism is employed for subcutaneous fat, especially on the neck or jowls, to further craft a more youthful visage. Dr. Kent was involved in clinical trials with the SubQ handpiece. As he explained, "The needles enter the skin at a 75° angle, rather than the 25° angle of the dermal handpiece, and penetrate to the adipose tissue. Precise, controlled energy deposition causes the anabolic wound healing response that seems to persist for quite some time, so as with the dermal handpiece the onset of outcomes takes time. Patients may not easily discern their result because it is so gradual, but when we show them comparison pictures their jaws drop. This new handpiece is very operator friendly, the anesthetic technique is very simple, treatment duration is short, and therapy is quite tolerable. There is no post-procedure pain with only minimal swelling and rapid return to normal activity."
1. Alexiades-Armenakas M, Newman J, Willey A, Kilmer S, et al. Prospective multicenter clinical trial of a minimally invasive temperature-controlled bipolar fractional radiofrequency system for rhytids and laxity treatment. Dermatol Surg 2013;39 (2):263-73.
Hands of a Healer, Eyes of an Artist
June 9, 2016
From the Voice Tribune - Wes Kerrick
You'll never meet a condescending glance. The moment never comes when you need to worry about the doctor's decisions.
It's a straightforward place.
On the third floor of The Springs Medical Center on Dutchmans Parkway, Samuels treats her patients with "a skillful, caring approach, with a woman's touch."
The aesthetic plastic surgeon has a gift for putting people at ease. She attributes that gift to the fact that she is a woman practicing in a field where most patients are also women. She gets them.
"It's the demeanor as well," she says, "not wanting to appear like I'm superior to them in any way."
Samuels typically spends an hour to an hour and a half with patients on their first visit. Men, who still account for a small minority of her patients, are turning out in ever-increasing numbers.
"If you sit down on your stool and you just have a friendly conversation with somebody and, in the appropriate places, let them get to know you – whether it's through humor or just honesty – people really appreciate that."
Having practiced cosmetic surgery since 1994, Samuels has seen aesthetic treatments by other practitioners come and go. Some of them have left patients disappointed.
A part-time clinical faculty member at UofL, Samuels stresses the importance of knowing your doctor's credentials. Looking at the wall in her office, it's clear she isn't lacking.
Certified by the American Board of Plastic Surgery. Certified by the American Board of Surgery. Awarded Fellowship in the American College of Surgeons. Member of the American Society of Plastic Surgeons. Member of the American Society for Aesthetic Plastic Surgery.
The list goes on.
Samuels begins by asking patients what aspect of their body they see as a flaw. She asks them to describe the look they'd like instead.
And she listens.
Then she explains all the options. Instead of just telling them what she thinks they should do, she gives them enough information to make their own decisions.
"They have to know the ins and outs or they're not a partner in the proposition," she says. "And I am responsible for the result, but if a patient has weighed in on the decision about what the aesthetic goal is, then we're partners in that decision."
Samuels says the objective of any good aesthetic surgeon is to improve people's looks while maintaining all the natural characteristics that make them uniquely beautiful. She always goes for timeless beauty, not just what happens to be trendy.
"Helping somebody look – in their eyes – better, but not too different, is a goal."
Over the years, as her practice has grown, Samuels has been careful to continue giving every patient her full attention.
"They want my time, and I respect that because their time is as valuable as mine," she says. "Our goal is to have people think they're the only one we're taking care of right now."
With expertise and attentiveness, Samuels always aims to create a "boutique" experience that she hopes will exceed her patients' expectations.
"It becomes, then, more like a calling than just a job," she says. "And that’s the difference – because people can go anywhere and get a filler. They can go anywhere and get a breast implant. They can go to a multitude of offices and get Botox. But at the end of every knife and at the end of every needle is the artist."
Indeed, Samuels likens her work to painting a canvas. It was the synthesis of art and science that attracted her to cosmetic surgery in the first place.
"It doesn’t matter if it’s just a filler or Botox. The artistic sense of the person doing that procedure is paramount in terms of the result." VT
Today's Woman Magazine - Most Admired woman
June 1, 2016
Julene B. Samuels: M.D., Owner of A Woman's Touch
Originally from Danville, Kentucky, Julene did her medical residency in Dallas, then moved to Louisville with her husband Tom to be closer to their Kentucky family. After living in the Highlands for many years, they built a new home in Prospect. They have 19-year-old twin daughters, Lexie and Kaitlyn, who are students at the University of Kentucky.
UP FOR THE CHALLENGE
Taking the easy path has never been Julene's style. "I've always been pretty focused," she says. "If someone said, 'This is really hard,' I'd say, 'Sign me up!'" She decided early on in high school that she wanted to be a doctor because it was so difficult. " I did try to talk myslef out of it for a time. I thought, 'I don't know if I want to do all that training.' so I did pharmacy as an undergrad. But I couldn't get it out of my system and went on to medical school."
FINDING HER CALLING
Julene planned to specialize in general surgery and trauma, but as her training progressed, she started to question how she would manage the demanding schedule while raising a family with her husband. The answer came in the fourth year of her residency program when she began a plastic surgery rotation and found it to be the perfect fit. "I love taking care of women -- not that men don't do it, but plastic surgery patients are mostly female -- and I don't miss the addrenaline of the trauma because plastic surgery is so challenging. It's detail-oriented and precise, requires a really good anatomic knowledge of the entire body, and there are always new techniques and technologies to learn. And while there's certainly trauma in plastic surgery as well, for the most part, it's happy surgery. It's making a difference in women's lives."
A WOMAN'S TOUCH
In her solo private practice, Julene values the opportunity to take care of patients and their families over time. "A woman might first come to me for a breast augmentation, then return for body contouring or a tummy tuck after having children, and come back for a facelift later on, " she says. "Or I'll do a procedure on a patient and she'll bring her mother in for something, too. It's kind of like being a family physician. And it's rewarding having people come with an issue that is a big deal for them and being able to offer a solution that just takes it off their plate. Sometimes people don't realize how much negative energy they spend obsessing about something that can be easily and safely changed."
BEAUTY ON THE INSIDE
People are often surprised to find out that Julene leaves her plastic surgeon's eye at the office. "I'm a very observant person, but when I'm out in public or at a social venue, I don't look at people and think about what they can do to 'look better.' I try to focus on a person's positives and feel that what makes people beautiful or attractive comes from inside. I do, however, notice poor plastic surgery work that leads to distortion. That jumps right out at me."
One thing Julene struggles with is not letting her professional perfectionism seep into her personl life. "I have to have control when it comes to surgical results or bad things can happen. So, I'm always thinking ahead about possible outcomes and planning what I will do. But in my private life, I can't control everything. I have to let people be imperfect and let circumstances lead to inefficiency. And that's hard for me."
Julene is an avid equestrian. She rode horses growing up, and she bought a Thoroughbred when she moved back to Kentucky. "My girls ride, too -- they compete -- and it's been something we do together," she says. "We now have six horses between us. I try to ride several times a week, and I also like to fox hunt when I get the chance." With three of their horses kept on the property, Julene spends a lot of her free time at the barn. "I go out first thing in the morning to clean their stalls and get everytig ready for the day then come home after work and do it again. It's a lot of physical labor, but I love everything about being with the horses."
HIT THE ROAD
When she needs to relax, Julene gets moving. She's competed in several marathons and half-marathons, but now that she's older, she prefers to just run recreationally. "I'll do an occasional 10K with one of my daughters who has taken up running, but I don't want to do marathons anymore," she says. She also bikes to keep up her fitness. "I love to travel while I'm exercising. I have a group of girlfriends who are really good bikers, and we ride together in Louisville and sometimes in Indiana. I would love to do some long-distance biking, like one of those really cool trips where you stay in a five-star place but you're biking all day."
Not Your Mother's Facelift
February 29, 2016
The ProfoundLift procedure is making the news accross the country -
(BPT) Are you looking for younger, fuller and firmer skin? Maybe you've got some wrinkles and sagging cheeks you would like to see disappear. Minamally invasive nonsurgical treatments are trending, and may even be replacing traditional facelifts in some cases.
One of the latest antiaging breakthroughs -- dubbed "the injectable laser" -- takes on fine lines, wrinkles and skin laxity in just one session. "The energy based treatment, known as Profound, can produce lifted, smoothed, contoured skin without scars or surgery," says Louisville, Kentucky plastic surgeon, Dr. Julene Samuels.
Profound delivers radiofrequency energy beneath the skin through tiny microneedles to add volume and resiliency to the jawline, neck, jowls, nose-to-mouth folds and cheeks. Other energy based technologies help with skin laxity or wrinkles, but not both.
"The ProfoundLift procedure is a win win, and it may help give traditional facelifts a run for their money," says Chicago plastic surgeon, Dr. Steven Bloch, "When used at the optimal settings, Profound may produce up to 89 percent of the improvement seen with a facelift, according to reasearch plublished in Dermatologic Surgery Journal."
Here's how it works. The jowling and laxity is the result of our dwindling suppy of collagen, elastin and hyaluronic acid -- the building blocks of supple skin that snaps back into place. With Profound, the energy is sent directly into the skin's deeper levels to boost all three. It also takes on the lines and wrinkles, without injections. The ProfoundLift fills them naturally from the inside out.
Results don't scream plastic surgery
Unlike other systems that require multiple treatments, Profound is a one and done treatment. "Most people need three days to a week for recovery, and you can wear makeup in a day or two," says Dr. Bloch.
The improvements from a ProfoundLift are gradual and begin to show at one month and continue over the next few months. "Your friends and family will notice you look better, firmer, and brighter, but they won't be able to put a finger on why," adds Dr. Samuels.
To contact Dr. Samuels, call 502-897-9411 or visit www.awomanstouchmed.com for more information about Profound and to schedule a consultation.
Profound Voted Biggest Breakthrough in 2015
December 7, 2015
Profound earns top honors froom both Plastic Surgery Practice and Yahoo Beauty! According to PSP's "Hot Stuff" Highlights the Hottest Launches in 2015: Profound came out of the gates in 2015, and quickly developed a loyal fan base of dermatologists and cosmetic surgeons. The system delivers radiofrequency energy through needles to boost collagen, elastin, and Hyaluronic acid from the inside out. It can lift sagging jowls, define the jawline, tighten other areas of loose skin, and add volume to marionette lines. Profound can also enhance delivery of topical agents.
Some research suggests it can achieve close to 89% of what a traditional facelift can when the temperatures are optimized.
"The concept of microneedling - either with a handheld device, motorized pen, or by radiofrequency energy, is one of the hottest trends in medical aesthetics," says PSP contributing editor Wendy Lewis.
"Profound® is the first system that has been clinically proven to stimulate new collagen, elastin, and Hyaluronic acid - the three essential elements of youthful skin, which elevates the treatment to a new level for nonsurgical systems," Lewis adds. - dlm
Yahoo Beauty named Profound one of the "Seven Biggest Beauty Breakthroughs of 2015"
Profound is a needle-based radio frequency treatment that creates new elastin, collagen, and hyaluronic acid and has the ability to lift and contour sagging jawlines. On the face, it can smooth out wrinkles and restore volume to skin. "It's a whole new chapter in lasers," explains Alexiades-Armenakas. "It's the closest we have gotten to a surgical facelift, nonsurgically"
Dr. Julene Samuels, a world renowned cosmetic surgeon, introduced Profound to the Louisville area.
Dr. Julene B. Samuels, MD Aesthetic Plastic Surgeon is introducing a new treatment to her practice. It's getting tons of press - Harper's Bazaar thought it warranted a full page in their February issue, New Beauty Magazine announced that it is the best body contouring device around, The Doctors have showcased it on their show and the list goes on. If you want to see what all the buzz is about, give her a call 897-9411.