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Category: News & Events

Considering Breast Implant Augmentation?

Breast enlargement or enhancement by implants, and more recently fat grafting, is the most popular of all cosmetic surgical procedures.  Last year over 300,000 women in the U.S. had breast implant surgery, and the procedure has nearly tripled in popularity since the year 2000.  The reasons for this dramatic increase are many but improvements in implant biomaterial, advances in operative and anesthesia techniques, and overall patient comfort and safety have resulted in more natural and balanced results with long-term patient safety and high satisfaction levels.

The good news is that when performed by an appropriately-trained and credentialed plastic surgeon in a regulated operative facility, the high patient satisfaction rates and safety have proven in clinical studies to significantly improve patient self-confidence and quality of life.   Unfortunately, when the above criteria and considerations are not followed, complications and costly long-term problems can occur which may not be entirely correctable.  At evolv Plastic Surgery, Dr. Frank Barone and Dr. Peter Koltz believe strongly in the benefits and safety of comprehensive patient education and the importance of making informed choices when it comes to any cosmetic or plastic surgical or non-surgical procedure.  The fact is that the most informed patients generally make the best choices.  https://www.plasticsurgery.org/cosmetic-procedures/breast-augmentation/questions

Because there are so many choices in any elective aesthetic or cosmetic procedure, and especially in breast implant augmentation, we believe it is critical for any woman contemplating breast implant surgery to carefully review the following fundamental considerations.

Goals and Benefits

The goals of breast implant augmentation are consistent with the goals of every properly performed cosmetic or aesthetic procedure – to safely enhance or improve body contour and restore natural youthful features in order to increase self-confidence, enhance self-image and subsequently improve overall quality of life for each patient.  Each patient’s motivation may vary but improving self-image and confidence is not simple vanity but is connected to our evolution and the human desire to improve appearance for ‘survival’ benefits.  Like it or not, appearances matter, and multiple studies have consistently proven that naturally-appearing and enhanced, youthful features provide distinct advantages to quality of life.

Properly done aesthetic procedures should be balanced, safe and natural-appearing, but we have all seen poorly done cosmetic surgery in the news, that is far from ’natural appearing.’  This is especially true with breast augmentation.  Patients and providers who do not respect this fundamental concept will often have unnatural and negative outcomes with the risks of increased complications, additional costs and detrimental long-term results.

What Breast Augmentation Can and Can’t Do

Breast implant augmentation can:

  • safely improve fullness and projection to benefit overall female contour and balance
  • help restore areas, such as the upper pole of the breast, that may have lost fullness after pregnancies or aging
  • help correct imbalance or congenital and developmental asymmetries of the breasts
  • help improve self-image and self-confidence when done properly and for the right reasons in each patient

Breast Augmentation cannot correct significant sagging or laxity of the breasts that may have occurred from weight loss, multiple pregnancies or aging.  In these situations, a breast lift or mastopexy with or without implant or fat graft augmentation may be suggested by your plastic surgeon.

Costs – Price Shoppers Beware

The price of breast implant augmentation can vary widely depending upon:

  • training, qualifications and experience of the surgeon
  • location of the surgery (accredited outpatient facility vs doctor’s office operating room or clinic)
  • type of anesthesia and qualifications of anesthesia provider (certified anesthesiologist vs less experienced staff)
  • experience, training and qualifications of ancillary staff
  • manufacturer, type and quality of breast implant

Surgery is expensive and affordability is a key concern for patients contemplating breast implant surgery; however, ‘price shopping’ can be very dangerous for many reasons including all the above considerations.  The most proven and important consideration is the training and qualifications of the surgeon.  Many consumers do not realize that any physician with a medical license can legally perform breast implant surgery, as well as any cosmetic surgical procedure, in their own clinic or office even if they have not had credentialed training in that surgery or specialty.  Savvy marketing and advertising or attention grabbing ‘deals’ can be difficult to resist for many patients who have limited resources to afford the procedure.  When these ‘bargains’ are carefully analyzed, there is always a reason why the price is considerably lower, and it is no coincidence that these are the situations where more complications and re-operations occur.  It can be very costly to repair complications, and often results are compromised.  In the words of the world’s greatest investor Warren Buffet, ‘Price is what you pay….value is what you get.’

Implant Options

A variety of implant styles, shapes and types are available.  The quality, safety and performance of breast implants has dramatically improved in recent years as have patient outcomes.  All breast implants in the United States must undergo long term and rigorous testing as well as clinical studies to obtain FDA approval, and constant monitoring is done annually.  Some of the considerations in implant choices are:

Fill – Implants may either be filled with either sterile saline (salt water) or silicone gel.  Both have been thoroughly studied and fully approved by the FDA.  Gel is more popular due to its natural ’tissue like’ feel, but a discussion with your plastic surgeon will help determine which option is best for each patient’s goals and concerns.  Recently a form stable gel, often referred to as the ‘gummy bear’ implant, has been approved and has the advantage of holding its shape in anatomic or ’tear drop’ styles and avoiding the chance of leakage.

Shape – Breast implants are available in a round or anatomic (tear drop) shape. Each has a particular advantage, and these options should be reviewed with your surgeon.  Many choices in implant dimensions such as width, heath and projection are also important features in choosing the most appropriate device for each patient’s anatomy, goals and lifestyle.

Surface – Breast implant shells may be smooth or textured, and each choice has a potential advantage depending on the patient’s goals and interests.  Textured surfaces may reduce the possibility of capsular contracture or excessive firmness of the tissue around the implant.  A rare form of lymphoma called implant associated ALCL (anaplastic large cell lymphoma) has been recently reported in approximately 1:50,000 patients with textured implants.  ALCL is usually cured by removal of the implant and the surrounding capsule, but this issue should be discussed with your surgeon if a textured device is preferred.

https://www.plasticsurgery.org/cosmetic-procedures/breast-augmentation/implants

Risks and Safety

When performed by an experienced, board certified plastic surgeon in a properly credentialed facility, breast implant surgery has a very high (greater than 96%) satisfaction rate and is also safe and effective.  But any procedure has risks, and these should be completely reviewed with the patient in the preoperative examination.  A thorough physical examination and complete medical history are also an essential component of reducing risks and complications. Openly defining risks and benefits along with a comprehensive medical assessment and photographic documentation/imaging are important and integral parts of properly planned aesthetic surgery.

Procedure Steps

Being well informed and prepared for surgery will reduce anxiety and improve the overall experience.  For the breast augmentation procedure, the plastic surgeon will discuss recommended anesthesia options, choice of incision location, location of implant placement (either below or above the chest wall muscle), implant type, volume and dimension, and expected post-operative course and recovery.  At evolv Plastic Surgery, Dr. Barone and Dr. Koltz often utilize the Vectra 3-D, a 3-dimensional imaging system to help predict implant choices and results specific to each patient’s own anatomy and goals.  The implant surgery typically takes less than 2 hours in the operating room.

Recovery and Down Time

After surgery is completed, patients are dressed in a custom post-operative bra and taken to the recovery room.  Because the anesthetic is light, recovery room time is usually less than one hour for most patients.  Patient comfort is a priority at evolv Plastic Surgery and precise and less traumatic dissection techniques, headlight illumination, prevention of bleeding and long acting nerve blocks (Exparel) and post-operative lymphatic massage all play an integral part in minimizing discomfort and downtime and improving the overall experience for our patients.  Each patient will be given specific instructions and advice on resuming activities and return to work.

The Most Important Decision – Choosing a Plastic Surgeon

Breast Augmentation surgery involves many choices.  Studies confirm that the first and most important choice is selecting a qualified plastic surgeon that you can trust and who is a member of the American Society of Plastic Surgery as well as board certified in Plastic Surgery by the American College of Surgeons.  As members, these surgeons must meet the following rigorous standards:

  • Board certification by the American Board of Plastic Surgery (ABPS) or in Canada by the Royal College of Physicians and Surgeons of Canada
  • Complete at least six years of surgical training following medical school, with a minimum of three years of plastic surgery residency training
  • Pass comprehensive oral and written exams
  • Graduate from an accredited medical school
  • Complete continuing medical education, including patient safety, each year
  • Perform surgery in accredited, state-licensed or Medicare-certified surgical facilities

Be wary and cautious of other ‘official’ sounding boards and certifications or by the term ‘board certified’ if it is in another specialty.

https://www.plasticsurgery.org/cosmetic-procedures/breast-augmentation/surgeon

Conclusion

The decision to have breast augmentation surgery is a highly personal one, as is any aesthetic surgery or procedure.  Any woman considering breast implant surgery should carefully evaluate their options, take appropriate time to learn as much as possible from reliable sources, and take their time in making a well-informed decision.  The most important decision is choosing an experienced and board-certified plastic surgeon.  Despite the excellent safety and high satisfaction rates in breast implant procedures, it is still a significant surgical procedure and one that can have higher risks and complications if done by a less experienced or non-specialty trained physician in an unregulated clinic or office procedure room.  Aggressive internet marketing and advertising that attracts patient candidates with considerably lower price offers and unrealistic outcomes are not only unethical but dangerous.

Trust is the most important criteria in the doctor-patient relationship and must be earned with honest communication, transparency and dedication to specialty training and ongoing education.  If you are interested in more information or would like to learn more about the many facets and options in breast implant augmentation, please contact Dr Barone or Dr Koltz at evolv Plastic Surgery and Medical Aesthetics.

Thank you for your attention and interest!

The Newest Board-Certified Member- Dr. Koltz

Recently our trusted, reliable, and caring practitioner, Dr. Koltz has been certified by The American Board of Plastic Surgery. This is a huge accomplishment for Dr. Koltz. Over his career, Dr. Koltz has worked very hard for this certification. Starting from obtaining his training in plastic surgery in New York, then going to the University of Pennsylvania for a fellowship in Reconstructive Microsurgery. Dr. Koltz is well-renowned, and often reviews several publications and textbooks, while also traveling all over to present his own research at different meetings around the world.

Getting Board Certified

Getting certified by The American Board of Plastic Surgery is well-renowned and not an easy thing to accomplish. The American Board of Plastic Surgery was founded in 1931 and represents around 93% of all board-certified plastic surgeons. They wish to advance the quality of care by setting high standards for their doctors as well as furthering their education. In order to become board certified, doctors have to go through extensive training into the field of plastic surgery as well as complete exams for the board certification. Members of The American Board of Plastic Surgery must meet standards set by the foundation of their facility, patient care, and education.

Training

Dr. Koltz has worked very hard for this moment. Training in plastic surgery is a long process, taking years and years of practice. First, going to medical school, then completing a residency in general surgery at an accredited practice. After those basic steps, you can apply for a certified plastic surgery residency. Overall, the complete training takes eight to ten years. Dr. Koltz has gone above and beyond that, by taking extra years for research in breast implant-related scar formation, body contouring, congenital craniofacial malformations, breast rejuvenation, hernias, and pain control options. He not only wants to better his education, but he wants to better the education of all future generations of plastic surgeons. He also completed a year of fellowship training at the University of Pennsylvania in reconstructive microsurgery. All of his hard work over the years has led him to become officially board certified.

His Memberships

Dr. Koltz has long-standing memberships with many different accredited groups such as the American Society of Reconstructive Microsurgery, American Burn Association, and the Northeast Society of Plastic Surgeons, as well as many more. He has received many different awards and recognition for his hard work such as The Joseph M. Serletti, MD Resident Award for Excellence in Academic Plastic Surgery, University of Rochester Plastic Surgery- Top Gun Award for Highest Plastic Surgery In-Service Examination Score and University of Rochester Medical Center – Strong Star for Excellence in Patient Care, Patient Nominated. His patients and our team here at evolv Medical Aesthetics know that he is reliable and delivers amazing results.

Meet Dr. Koltz Today

By going above and beyond in his career, Dr. Koltz has received this great honor to be board certified. The team at evolv Medical Aesthetics is thrilled for him, and his patients are as well. If you wish to be treated by Dr. Koltz then contact our office today.

What is a ‘Real Plastic Surgeon’?

Cosmetic (also called ‘aesthetic’) plastic surgery is more popular than ever these days.

Nearly 18 million cosmetic procedures, both surgical and non-surgical, were performed in the United States last year which is a 200% increase since the year 2000!  There are a variety of reasons for this increase including improved and more natural appearing results, better products and technology, and an increase in lifespan and work years.  Despite the dramatic increase in demand, there remains a significant deficiency of adequately trained and appropriately credentialed physicians and licensed professional providers.  Considering these trends, it is not surprising that the number of complications and unfavorable or unnatural results, most of them preventable or unnecessary, have also significantly increased.  Most of these complications or unnatural appearing results are often associated with inadequately trained or inexperienced providers, as well as treatments performed in non-certified or non-credentialed medical spas, private clinics or physician offices….and sometimes unfortunately hotel rooms!

While it has become easier and more commonplace to obtain cosmetic plastic surgery and aesthetic procedures, it also has become exceedingly more challenging and confusing for the consumer to find a qualified plastic surgeon and especially a trained professional provider that they can trust.  With the internet and rapid dissemination of marketing disguised as ‘education,’ finding fair, accurate and unbiased information in order to make such an important decision has become an increasing challenge even for the most educated of consumers.

To illustrate this growing concern, let’s see how your general plastic surgery IQ relates to some of the more common questions or assumptions that face the average consumer considering a plastic surgical or aesthetic procedure.  Answers can be found below the test.

All answers are either true or false.

1) Only a credentialed and board-certified plastic surgeon can legally perform cosmetic surgical procedures in the U.S. such as breast implants, tummy tucks, facelifts, liposuction, etc.

2) Any medical doctor (M.D.) can advertise, promote and legally perform any cosmetic surgical or non-surgical treatment even if they have never completed a credentialed surgical training program or validated training in the specialty involving the cosmetic procedure they are promoting.

3) A doctor who is ‘Board Certified in Cosmetic Surgery’ is also considered a plastic surgeon.

4) A ‘Board Certified Facial Plastic Surgeon’ is also considered a plastic surgeon.

5) The training and experience of a plastic surgeon in cosmetic surgery and non-surgical aesthetic procedures can vary significantly even for board certified plastic surgeons.

6) Traveling outside the United States to have plastic surgery in order to reduce costs can be safe and effective if the medical clinic and treating physician have proper credentials and certification.

7) Potential complications and risks in cosmetic surgery and non-surgical cosmetic procedures are unavoidable, infrequent and usually not life threatening.

8) State Medical Boards will not allow a physician (M.D.) who has not had credentialed surgical training to advertise, market and perform plastic surgical procedures on patients in the United States.

9) Non-surgical cosmetic treatments such as Botox or filler (Restylane, Juvéderm, fat grafting) injections, fat reduction, cosmetic laser treatments, etc., can be legally performed in the United States by dentists, registered nurses, healthcare professionals or any medical doctor. 

10) The cost for cosmetic surgery procedures such as breast implants or liposuction, as well as non-surgical aesthetic treatments such as Botox and filler injections, can vary significantly between different physicians, but the surgery or treatment and the results are essentially the same.

 Answers 

1)False

Any physician with a M.D. degree can perform plastic surgical procedures legally in the U.S.  These will usually be done in the doctor’s office or a ‘medical clinic’ associated with the physician because hospitals or accredited surgical facilities will require appropriate surgical training or verified board certification in plastic surgery in their credentialing process.

2) True

A medical license (M.D.) in the U.S. allows the physician the option or legal right to perform any medical or surgical procedure in their office or clinic even if they have not completed a validated training program in surgery or accredited residency in that treatment or specialty.  Most states allow any physician to advertise or promote cosmetic surgical and non-surgical treatments even if they trained in a residency or specialty that is unrelated to the services and procedures they are promoting.  Recently, however, the Medical Board of California did place some restrictions on these misleading advertising practices (see answer #3  and link below).

3) False

The only official accrediting body for medical specialties is the American Board of Medical Specialties (ABMS), and ‘plastic surgery’ is one of the 24 recognized specialties.  There is no board certification or specialty of ‘Cosmetic Surgery’ recognized by the ABMS.  There is an American Board of Cosmetic Surgery which is an organization created more recently by non-plastic surgeon physicians, but it is not recognized by the ABMS.  These physicians are not trained in a plastic surgical residency but can take one year of cosmetic surgical training to qualify for the American Board of Cosmetic Surgery and call themselves ‘board certified in cosmetic surgery.’  Recently, the Medical Board of California denied the request of the American Board of Cosmetic Surgery (ABCS) that its members be allowed to advertise themselves as ‘board certified cosmetic surgeons’ because it is so misleading to consumers and that the ABCS is not a recognized board. https://www.plasticsurgery.org/for-medical-professionals/resources-and-education/publications/psn-extra/news/medical-board-of-california-abcs-is-not-equivalent-to-abms-board  Board certification in plastic surgery requires a minimum of 6 or 7 years of surgical and plastic surgical specialty training from an accredited residency program, as well as passing a rigorous written and then oral examination.

4) False

A ‘board certified facial plastic surgeon’ is typically a physician trained in otolaryngology or ENT who then goes on to take additional training in cosmetic facial surgery to qualify.  A ‘board certified plastic surgeon’ has typically completed 4 or 5 years of general surgery training from an approved residency, an additional 2-3 years in an ABMS approved plastic surgery program, and then passed both the written and oral examinations administered by the American Board of Plastic Surgery.

5) True

Even among board certified plastic surgeons, training and experience in the many different cosmetic surgical procedures and non-surgical aesthetic treatments may vary significantly from program to program.  Some plastic surgeons will elect to take an optional additional year or more of specialty training in cosmetic surgery and or reconstructive surgery with an accredited program and a recognized expert plastic surgeon. This additional training is called a post graduate fellowship.  Dr. Barone completed post graduate fellowships in aesthetic and reconstructive breast surgery, cosmetic surgery, and facial reconstruction.  Dr. Koltz completed a post graduate fellowship in microvascular breast surgery and reconstruction.  The American Society of Aesthetic Plastic Surgeons is a prestigious organization that admits only board-certified plastic surgeons that have documented and proven experience and expertise in cosmetic surgery and aesthetic procedures.

6) False

Many patients are lured to travel outside the U.S. by significantly lowered pricing and other incentives to have cosmetic procedures.  Although there are many well trained and board-certified plastic surgeons in other countries, it is very difficult for a ‘medical tourist’ to verify the training and credentials of physicians offering these ‘deals’ in other countries.  The facilities or ‘specialty clinics’ where they are performed also have little to no ongoing regulation and validation for training, sterile technique and anesthesia safety, and the results can be disastrous.  In addition, air travel after surgical procedures can be especially risky because of the potential for the development of blood clots and pulmonary embolism after surgery.  Repairing complications or unfavorable results can be far more expensive and less effective than doing the procedure properly in the right facility and with a qualified plastic surgeon.

7) False

While any procedure, surgical or non-surgical, may have the risk of a complication, seeking out an experienced board-certified plastic surgeon who performs elective surgery in an accredited, outpatient operating room facility will reduce the chance of complications.   In addition, utilizing an experienced anesthesiologist, as well as appropriately trained nurses and professional staff, will minimize any risks and increase the likelihood of a safe and natural-appearing outcome.  It’s important to remember that the decision to have a cosmetic procedure is highly personal and impactful and can have lifelong consequences.  https://www.nbclosangeles.com/news/local/Warning-Plastic-Surgeries-in-Tijuana-504213161.html

8) False

Most states do not prevent physicians from advertising or marketing plastic surgery or cosmetic procedures even if they have not had accredited training in that specialty.  Because this is so misleading to even the most educated consumers, the Medical Board of California recently changed their state law and ruled that in order to advertise for a plastic surgery procedure, the physician must be trained and credentialed by the American Board of Medical Specialties which is the only recognized body for medical/surgical specialties.  https://www.plasticsurgery.org/for-medical-professionals/resources-and-education/publications/psn-extra/news/medical-board-of-california-abcs-is-not-equivalent-to-abms-board  There is no recognized ‘board of cosmetic surgery’ and no valid ‘board certified cosmetic surgeon’ specialty.

9)True

The legal right to perform non-surgical procedures such as Botox and filler injections, cosmetic laser treatment, and fat reduction are often regulated by state medical boards and can vary significantly in each state.    Appropriately trained and certified physician assistants, nurse practitioners, registered nurses and other licensed professionals can be accredited for performing these aesthetic treatments and some have excellent training and experience, but this can vary significantly.  It is critical that prospective patients do their homework on the provider and the facility before considering any aesthetic procedure.

10) False

Costs for cosmetic surgery or non-surgical aesthetic treatments may vary significantly but so can the results, safety and risks!   While more cost or expense does not guarantee a better outcome, many factors involved in the total treatment can have a considerable impact on quality, risk and results.  Even though the name of procedures such as breast augmentation, liposuction, facelift, and Botox injection may sound the same, quality and results can be impacted by many significant factors.  Physician training and experience, technique of the surgery, quality of implants, concentration of Botox, qualifications of the treatment facility, anesthesia methods and anesthesiologist experience, pain control, nursing staff experience, training, and other factors can all have an impact on total procedure cost.  The old adage ‘You get what you pay for’ may not always be true, but it is a famous and time-tested quote for a reason!

How to Find a Real Plastic Surgeon

When performed by a qualified plastic surgeon or credentialed and supervised aesthetic provider, cosmetic surgery and aesthetic procedures are not only life changing for patients, but also consistently safe and natural appearing.  Natural and balanced cosmetic treatments can significantly improve self-confidence and quality of life for the appropriate patient.

But how does an interested consumer go about finding the right physician or practice from the often-dizzying array and Google lists of surgeon candidates?  One helpful consideration is to organize a solid set of minimal criteria to help you with your search.  The following suggestions and checklist are based on real data and outcomes and can be a helpful starting point in vetting potential surgeon and aesthetic provider candidates:

– Appropriate Board Certification

Look for an experienced surgeon who is trained in the specialty that you are considering and is certified by the American Board of Plastic Surgery, https://www.abplasticsurgery.org/public/verify-certification/ModDefault.aspx?section=SurgeonSearch which is the only plastic surgery board recognized by the American Board of Medical Specialties.

– Proven experience and natural appearing results with before and after photos only of their own patients.

– Verified and credible reviews by real patients

– Strict adherence to safety standards for the practice and all staff

– Access to a fully accredited and/or state licensed surgical facility

– Proven dedication to ongoing continuing education and training by doctor and staff

– Thorough and comprehensive patient consultations

– A personal rapport, communication and trust with the physician and staff

The decision to have a cosmetic procedure is a critically important and personal one and can have lifelong consequences.  The challenge of finding the right plastic surgeon can be made easier with the assistance of the criteria listed above, professional standards and personal preferences.  Patients can feel much more confident about achieving the optimal result with safety and natural and balanced outcomes when they can find a plastic surgeon that has the experience, qualifications and compassion that they can trust.

Frank Barone MD FACS

Attitude, Gratitude, Happiness and our Well Being

Welcome to the Holiday Season from all of us at evolv!

The Thanksgiving through Christmas Holiday season has always been my favorite time of year for many reasons.  Growing up in a large Italian family in the 60’s meant lots of family traditions, celebration, anticipation and best of all…..Rosie’s (my Mom) food!

This is a time of year that just about everyone can appreciate.  Who among us wouldn’t benefit from a little more gratitude in their lives?  A little less taken for granted; a little more time to stop and smell the roses.  Even though this season can be the ‘best of times’ for many, it can also be one of the most stressful and challenging as well.

Evolutionary scientists believe there may be a negativity bias built in to the human brain……it’s easier to survive threats and danger if you are constantly on guard, suspicious or worried.  Unfortunately, it just may be a human nature survival instinct to dwell too much on what’s wrong rather than appreciate what’s right.  Have you ever noticed that after you’ve had a backache, you are grateful when it goes away?  But how many of us woke up this morning and were thankful for not having a backache?

Science has also taught us that chronic stress, anxiety and worry can also make us physically ill and shorten our lives.  Conversely, studies also prove that the practice of developing a more positive attitude, and being grateful and appreciative, can also improve our health, well-being and longevity.

What if this year we could truly take stock of the good and get some balance to correct the bias of negativity that is hardwired into our ‘survival human brains?’  What if we could find an ‘attitude of gratitude?’  Here are three suggestions on how to do it:

1) ‘Accounting of the Soul’ 

In his ‘Nightly Gratitude Meditation,’ Jeff Warren recommends that every evening we just think of a single thing or event from the day that was good or positive in our life.  It’s not complicated or difficult…..just a single thing that matters and is positive.  You could appreciate someone in your family, a friend, your work, your health, anything…..there’s a lot of good out there if only you could just stop for a moment and listen.

2) Share your Feelings

This season provides a great opportunity to open up and share your feelings.  Feelings and emotions are a very powerful force in our lives, and sharing them with family or friends can reduce stress and be a very healthy mental exercise.  Just letting those you work or live with know how much you appreciate them can bring happiness and peace of mind not only to others, but also to ourselves.

3) Consider the Present Moment and Then Let Go

The realization and acceptance that nearly all worry and anxiety and tension are rooted in thoughts of the past or future is the basis of meditation practice. Perhaps that is why meditation philosophy focuses on releasing all of the constant ‘chatter’ in our heads, to let go of worries of the future or thoughts of the past, and just sit back and observe the moment,  just hang out.

The spiritual teacher Eckhart Tolle said ‘turn your entire attention to the now, and tell me what your problem is.’  This may sound naive, impractical or unrealistic because the ‘present moment’ is not the whole story and we do indeed have problems in this world.  But although it may take a little effort and consistency, it is possible to stop for a moment, to practice mindfulness, and learn how to let go of thoughts of the past or future, just for a moment, to rest.

I can personally support the benefits of this practice.  I lost my mother of 98 years after a wonderful, lifelong relationship, earlier this year. Rosie was a selfless and special woman who touched so many lives.  As I sat at her bedside overwhelmed with thoughts of sadness and worry and struggle, I found a moment when I just let it all go.  And then I noticed the snow softly falling on the trees, there was a beauty in her face, there was love all around, there was continuity….and that is when I found peace, with all of it.

Thanksgiving and the Holiday Season are a once a year opportunity for ‘gratitude practice.’  And it is that ‘attitude of gratitude’ that can provide a wonderful possibility to be ‘calm in your heart’ and to find peace….right there in the midst of all the anxiety, noise and trouble of a crazy and beautiful life!

All of us at evolv are thankful and appreciate you and the belief and trust that you have placed in us for you care.

Happy Holidays and Blessings to all of you and your families!

CHANGING THE BREAST CANCER EXPERIENCE

Even though it was over 30 years ago, I will never forget her face.

She was a young mother and school teacher with 2 small children and I was a first year plastic surgery resident.  She had a mastectomy for breast cancer and was left with a large and painful tight scar.  The implant that had been placed by my instructor under the scar was hard, unnatural and uncomfortable…..at that time in the mid 1980’s there just were not many options or choices. She looked at me and I did not know what to say to comfort her.  That was the day I decided to seek post graduate training in breast reconstruction and that young mother, with the eyes I cannot forget, changed my life forever.

This year an estimated 230,000 women in the U.S. will be diagnosed with breast cancer but less than 25% of those women will be aware of their reconstructive options before treatment.  The breast cancer experience touches not only those women but also their spouses, their children, their families and their lives for years.  The breast cancer experience involves much more than just removing a tumor or having a mastectomy, it is a journey that can involve medical and other post-operative treatments as well as impact a women’s personal life and self-confidence and relationships at every level.  In short it will someday effect all of us and someone we love.

The really exciting news is that the breast cancer experience is changing significantly for the better for a variety of reasons:

Education and Patient Awareness – public awareness and educational efforts by a number of professional     organizations have resulted in women being more informed and aware of their options.  The American Cancer Society, the American Society of Plastic Surgery, the Susan G. Komen Foundation, The Victory Center and many others are doing an incredible job of communicating useful information to patients and their families.  The best informed patients make the best choices!

Identifying Risks and Cancer Prevention – the most effective way to fight cancer is prevention.  New research on nutrition and life style as well as genetic testing to quantify risk factors have actually made a substantial difference in breast cancer incidence.  Advances in genetic mapping have made great progress and resulted in improved options and treatment outcomes for patients at risk.  Prophylactic mastectomy or removing the breast tissue to prevent cancer in high risk individuals, as popularized by actress Angelina Jolie, can reduce cancer risk by 90-95% in appropriate patients and result in excellent aesthetic outcomes.  We encourage everyone to learn more about these exciting advances in order to protect themselves and their families.

– Early Detection – After prevention, the next most effective way to impact breast cancer is early diagnosis.  Improved patient education and self-exam, consistent doctor’s visits, advances in imaging techniques such as mammography, ultrasound, MRI and other scans have resulted in earlier detection of breast cancer and breast ‘pre-cancers’ which will improve the overall patient experience and outcomes as well as reduce breast cancer morbidity.

– Improved Surgical and Reconstructive Techniques – Significant advances in biomaterials for breast implants and implantable materials (acellular dermal matrix) to help shape breast reconstruction procedures, have resulted in much more natural breast shapes as well as improved safety and less recovery.  Earlier detection and research on tumor biology have resulted in less invasive resection procedures (lumpectomy and mastectomy) and options such as sparing the breast skin and nipple in appropriate patients.  Placement of implants above the chest wall muscle (pre-pectoral reconstruction) and advances in tissue flap surgery reduce recovery time and have improved results for patients dramatically.  Our very own Dr. Peter Koltz, an associate with Dr. Barone at evolv Plastic Surgery, completed advanced training in tissue flap surgery for breast reconstruction last year and has been offering these options for patients in the Toledo area.

Post Treatment Quality of Life Improvementthe consequences of breast cancer treatment do not stop after the procedures have ended.  Many patients taking  estrogen blocking medication or other targeted chemotherapy or radiation deal with side effects such as bone and heart health, hair loss, premature skin aging, tissue dryness and laxity, post-menopausal vaginal dryness and urinary incontinence.  This often results in femininity and intimacy challenges, sexual difficulties and overall loss of self-confidence and intimacy.  New advances in clinically proven topicals, non-estrogen growth factors and other therapies can reduce symptoms and help restore confidence and vitality.  Regenerative treatments with platelet rich plasma (PRP) and other stem cell growth factors as well as collagen stimulating noninvasive technologies have given many patients much improvement in these issues and a better quality of life.

October is Breast Cancer Awareness month and October 17th is Breast Cancer Awareness Day (or ‘BRA Day’).  Please support these worthwhile programs and help bring more awareness, education and encouragement for the many women, men and their families that are dealing with this life changing issue.  We invite you to join myself, Dr. Peter Koltz and the evolv staff at Rosie’s on Wednesday, October 17th to support BRA DAY and spread the word on the improving awareness and quality of life for breast cancer patients and families.  

Yes the breast cancer experience is changing for the better and helping improve the quality of life for many.  Advances in clinical research, cancer biology, genetic testing, surgical and reconstructive option have transformed the breast cancer experience in such positive way.  The quality and safety of new reconstruction choices and postoperative treatment options can restore a patient’s self-confidence and lifestyle. As plastic surgeons we now may often hear a post reconstructive patient say, “Doctor, I sometimes forget I had a mastectomy!”

And I am forever grateful to that young mother and cancer survivor that inspired me with her courage so many years ago.

How to Earn More BD Points!

Just as evolv keeps on evolving – Brilliant Distinctions® by Allergan has released some important product rule changes and new opportunities to earn more Brilliant Distinction Points!

Brilliant Distinctions – Botox Points

New changes in product rules include:

  • Members can earn a maximum of 200 points per 90 days, regardless of the treatment area.
  • Patients can still receive treatments in various areas within a 90-day period (following safety requirements), but will not earn points on those treatments.
  • Rebates and rewards can still be redeemed on eligible Botox® treatments within a 90-day period, however, points will not be earned on those treatments that are within 90 days.

How to Earn More BD Points

Watch videos on the BD website and mobile app!

This is an exciting new way and opportunity for you to earn points, while you learn more about what treatments you’re receiving and explore BD’s program benefits and functionalities. Here are some tips on how to make the best of your BD points!

  • Members must be logged in to earn points when watching videos
  • Members can earn 20 points per unique video watched and up to 60 points (3 videos) every rolling 12 months
  • Points earned from watching videos are non-tier qualifying, but watching videos extends points expiration

Become a Brilliant Distinctions Member

Do you want to become a BD Member? It’s simple to sign up. Click here to get started.

If you have any questions on how to become a Brilliant Distinctions Member or how to maximize the benefits, don’t hesitate to contact our office today for more information!

May…a month filled with great news!

May is an especially busy time here at evolv Plastic Surgery & Medical Aesthetics.  Like all of you, we are anxiously awaiting the return of the sun and warm weather, but in the meantime, here’s what’s happening this month at evolv:

  • Many of our staff will be attending the annual American Society of Aesthetics Plastic Surgery Annual Meeting in New York City. This is the premier educational event in aesthetics and plastic surgery bringing together the leading authorities, researchers, companies and products in the world of aesthetic surgery, medicine and skin care.  We will be returning with lots of exciting information for our surgical, cosmetic medicine and skin care patients on the latest, state-of-the-art treatments and products so please stop by to learn more.
  • We are proud to announce that our very own evolv licensed aesthetician, Lindsay Cole, has been appointed to the Board of the Society of Plastic Skin Care Specialists which is the leading national organization for licensed aestheticians specializing in advanced medical skin care. Congratulations Lindsay on this special honor and achievement!
  • Peter Koltz, our evolv associate and board eligible plastic surgeon, has recently published two research articles in the Journal of Plastic Surgery, the leading publication for Plastic Surgeons worldwide. Dr. Koltz is a fellowship-trained plastic surgeon with special expertise in breast reconstruction and microsurgical tissue flap reconstruction.  https://www.ncbi.nlm.nih.gov/pubmed/?term=koltz+p
  • Frank Barone recently returned from Los Angeles where he was personally invited by Dr. Zein Obagi, world-renowned dermatologist, researcher and developer of ZO Skin Health. Dr. Obagi presented an advanced workshop in medical skin care and services that was filmed for physician training seminars.  Dr. Barone is a faculty member for ZO Skin Health and physician instructor.
  • Last month, we gave you a ‘Hint’ about evolv’s announcement of a revolutionary new aesthetic membership program. We are excited to announce that next month we plan to open the ‘enso club’ at evolv!  We realize that you are busy, and we get it.  Let us help!  evolv’s enso club is an exclusive VIP membership program that is dedicated to helping our patients achieve their best results and outcomes consistently and at the best price possible.  What is an ‘enso’ anyways?  Remember to ask the next time you are in the office to learn more about a membership.  And remember, Aging Beautifully …Is Up to You!

  • Mother’s Day is coming soon, Sunday, May 13th. We have some exciting options for our special Moms.  Check out our website’s exclusive offers page to make your Mother’s Day gift this year the best yet! http://evolvmedicalaesthetics.com/patient-resources/exclusive-offers/  Let us help you celebrate the wonderful mothers, special women and role models in your life this year!

All of us at evolv would like to honor and congratulate all of the beautiful and life changing mothers that make this world a better place.  Wishing all a very Happy Mother’s Day!

-Frank Barone, MD, FACS

Skin Peels of the Future

Spring is coming … Finally!

Spring is a season of renewal, and this April evolv Plastic Surgery and Medical Aesthetics would like to focus on the importance of medical skin peels to renew and rejuvenate the skin.

Like so many areas of aesthetics, skin resurfacing by medical peels has evolved significantly.  The peels of the future are now available and this new generation of clinical peel offers some very significant advantages for patients of all ages and all skin types including:

  • Stimulation of deep dermal collagen and elastin to restore youthful skin tone
  • Improved absorption and efficacy of skin care products
  • Reduction of fine lines and ‘age spots’ or hyperpigmentation
  • Removal of aged or damaged outer skin cells for a younger looking complexion
  • Specialized peels that are proven to reduce skin cancer risk
  • Reduced or no ‘down-time’ peels

The natural aging process, menopause, stress and excessive sun damage can all drastically slow down the process of natural exfoliation, or loss of outer surface cells, as well as new collagen production.  The result is dry, pigmented, thin and wrinkled skin that is prematurely aged and a significant increase in skin cancer risk.

The new generation of chemical peels from ZO Skin Health Research provides the unique benefits of gentle removal of aged, outer cells and unique deep tissue stimulation which results in replacement and rejuvenation of the skin.  Another key benefit is a reduction in skin cancer risk and the restoration of optimal skin health and youthfulness.  Many of the fundamental health benefits that we are so passionate about for our patients and families here at evolv can be more effectively achieved with proper skin peels in a medical skin care comprehensive plan.

Because of these fundamental benefits of clinical peeling, for the month of April at evolv we will be featuring all three of our ZO peels as our spotlighted treatments. Not only are there chemical peels promotions this month, but we also have some great value on laser hair removal treatments too!

Interested in learning more about the details of these promotions? Please click on this link http://evolvmedicalaesthetics.com/patient-resources/exclusive-offers/ and learn all about the details and added value we are offering this month to kick off Spring!

A ‘Hint’ of What’s Coming – March 2018 Newsletter

At evolv Plastic Surgery and Medical Aesthetics, we believe in balanced, personalized and comprehensive plans to provide the most natural and long-lasting results for our patients at any age.

But despite the many obvious benefits of personalized treatment plans, compliance and consistency can be challenging because of costs and the fact that everyone seems so busy these days.  Balanced and natural results require an individualized skin care program and often non-surgical and possibly surgical procedures to achieve optimal and lasting outcomes.  And with all the many options in products, services and new technology, choices can be confusing and staying consistent with a regimen very challenging.

For all of the above reasons, we are very excited at evolv to introduce to you a new program that will hopefully begin in May that will offer more affordable and feasible treatment plans for every patient.  This new membership and VIP loyalty program will customize every patient’s treatment plan with improved value into one easy payment that can fit each individual lifestyle.  The program can be customized and also incorporate all of our aesthetic partners along with their services and products without any restrictions.

The focus is to provide a balanced and personalized program for each patient’s needs and goals that is affordable and encourages consistency.

Please stop by if you would like to learn more.  For now, all we can say is that we will give you a ‘HINT’…. so stay tuned!

evolv Plastic Surgery & Medical Aesthetics is beyond excited and proud to announce that two of our licensed aestheticians, Lindsay and Mervat, have been chosen by ZO Skin Health by Zein Obagi, MD to be official members of the National 2018 #ZO Crew!  The ZO Crew is composed of medical aestheticians with a proven commitment toward educating their patients about the latest products and services for optimal skin health.  We are also proud to announce that evolv Medical Aesthetics is the only skincare practice nationally to have two aestheticians chosen!  We want to recognize all our aestheticians, nurses and staff who collaborate and work together to make these events possible.

In honor of their achievements, both Lindsay and Mervat will be flown to Beverly Hills to meet and train with the renowned Dr. Obagi, and they also will be appointed to the ZO skincare specialist advisory board!  Only 20 winners from across the U.S. were selected to be part of #ZOCrew, which makes this truly a tremendous honor!

ZO® & HydraFacial™ Join Forces

Your favorite medical-grade skin care company has partnered up with one of your favorite refreshing treatments!

The superior ZO® Skin Health meets HydraFacial™ technology to bring the HydraFacial Brightalive® Booster. This serum is scientifically designed to brighten your skin and improve the appearance of discoloration, resulting in an instantly glowing complexion.

With the in-office treatment and at-home skincare products, you can have and maintain healthier, smoother skin.

Here at evolv, we believe in everlasting scientifically proven skincare that will leave you looking and feeling younger! With this news, we will be holding an event at our office for a limited amount of patients.

ZO HydraFacial Tuesday

Tuesday, February 6th from 12:00pm – 6:00pm

Schedule a NEW ZO HydraFacial treatment for only $200 SAVE $100 on Tuesday, February 6th and you’ll receive even MORE:

  • Receive a complimentary Deluxe Mini ZO® Ossential C-Bright Serum AND be entered to win a prize valued over $1,000
  • Have access to exclusive Xeomin offer (Only 20 available)
    • Buy one area already $50 off and receive one area FREE

Purchase a package of ZO HydraFacial treatments on February 6th and receive EVEN MORE

  • Package of 3 – Valued at $1,080 for ONLY $700 SAVE $380
    • Includes:
      • Full-Size ZO® Pore Refiner
      • 3 Complimentary CooLifting sessions
  • Package of 6 – Valued at $2,150 for ONLY $1,325 SAVE $825
    • Includes:
      • Full-Size ZO® Pore Refiner
      • $50 Gift Card towards Skincare Products
      • 6 complimentary CooLifting sessions

Must pay a non-refundable $75 deposit in order to reserve your spot. Space is limited, so schedule your ZO HydraFacial treatment now!