Up In Arms

Today people are dropping pounds by the dozens. Super sized fast food meals are being replaced by healthier portions. People are trying to exercise and get into better shape. Some are helping the process along with bariatric surgery procedures like the lap band, gastric sleeve and gastric bypass. With all these pounds being shed many people are finding they have another new problem to deal with – unwanted excess skin. One of the most troubling areas for people that have lost weight is the upper arms.

Whether you call it a fat pad, arm waddle or bat wings, having floppy excess skin in the upper arms is no fun. Thankfully there is hope. Brachioplasty can remove the excess skin and remaining excess fat leaving a trim and slim upper arm. Using a procedure that takes just a few hours more and more patients are getting closer to their ideal shape. In fact, in the last 15 years the number of brachioplasty procedures being performed has jumped an astounding 777%. And the rise in popularity seems to be continuing.

Despite sometimes losing well in excess of 100 pounds many of my patients need to wear shirts that are one or two sizes larger than they need for their body just to be able to fit their arms in their sleeves. For many, the embarrassment of short sleeve shirts or tank tops is too much to bear. And most don’t even consider sleeveless tops for a moment. After brachioplasty these patients have renewed confidence and comfort with the appearance of their arms (and upper body as a whole). Tanks and sleeveless tops are suddenly an option. Using the most modern technique the thin scars are placed in discreet locations, hardly seen in most positions.

For me, the best part of performing brachioplasty procedures is the next morning when we take down the dressing from surgery. At that moment my patients see their new arms for the first time. In many cases they see a new shape in the mirror they may have never seen their entire lives. It is a very powerful moment and frequently leads to tears of joy – from both my patients and myself. It’s truly a life changing procedure.

So if aging and or weight loss has left you with unwanted excess skin and fat in the upper arms consider brachioplasty. With one procedure the arms that are getting you down can quickly be raised up with confidence.

Here is a story that CBS4 in Miami did about brachioplasty:

Cosmetic Surgery is Not A Sweater

Everyone is always looking for the best deal. Whether you’re buying a house, a new car, a great meal or a sweater, we’re always looking for the best price. It makes sense, why pay more for the same thing? The thing is, what if “the same thing” isn’t really the same thing? In the case of cosmetic surgery it’s impossible to find a true apples to apples comparison.

If you’re buying your favorite skin care system you might go online and shop around. You could look for the lowest price since the products are the same no matter where you get them. For cosmetic procedures that’s not the case. Having an injection like Botox or filler is not the same in one doctor’s office as it is in another’s. Even more so, your experience with cosmetic surgery and surgical procedures can be VERY different depending upon where you choose to receive your care. Obviously the price needs to be affordable or you couldn’t choose to have any procedure at all. But be careful about finding the lowest price in town for your breast augmentation, liposuction, tummy tuck or facelift. As I’ve written about before, if you look for the biggest bargain you may end up with more than you bargained for!

More and more I’m seeing patients with complications from some bargain basement practices and centers. Some patients saw a discount deal and jumped in without really checking out the doctor because the price was so good. Others figured that getting a breast augmentation for half the price made sense, until they had a complication. And I’ve seen more than a few that got lured in by a center that “specializes” in cheap facelifts, only to have a painful procedure, mediocre results and disappointment when the deal that was too good to be true, really was too good to be true.

There’s nothing wrong with looking for a good value. That doesn’t always mean the lowest price. Check out the doctor that is going to perform your injections or surgery. Make sure he/she is really a plastic surgeon and not someone who might not even be trained in surgery of any kind. Choose a board certified plastic surgeon that you feel comfortable with that has the experience to keep you safe and give you good results. It’s probably worth paying a little more for that piece of mind. You can start your search at SmartBeautyGuide.com where every doctor is a board certified plastic surgeon and a member of ASAPS (the American Society for Aesthetic Plastic Surgery). Experience matters. You wouldn’t want to fly to your vacation on a plane piloted by an amateur weekend pilot. You’ll pay the airline a fair price to get you there safely with a properly trained and experienced pilot – no mater how cheap the other flight might be. So if you’re shopping for a sweater the discount store might do just fine; but always remember that cosmetic surgery is not a sweater.

Aging and The Sexes: Get The Specific Treatment You Need

When it comes to being with the one you love, you have visions of growing older together. However, in your visions, the two of you start dealing with wrinkles, sagging skin and gray hair at the same time – but research shows that couples start aging at different times.

Men and women may love the idea of aging together, but it’s important to note that the sexes age differently. While genetics can play a critical role in how men and women age, studies have shown that the genders start to experience the aging process in different areas of the face. Therefore, it’s important for men and women to seek out different plastic surgery treatments based on these critical aging differences.

Just take a look at some of the differences that men and women often experience during the aging process:

Women typically notice wrinkles around their eyes (also known as crow’s feet or laugh lines). In addition to these wrinkles, women often experience sagging skin around the neck, which is unfortunately referred to as “turkey neck.” As a consolation prize, women don’t typically see a change in the shape of their jaw lines.

Men typically begin to see wrinkles in the forehead area, which can be more pronounced than the laugh lines women start to develop. Men are also more likely than women to experience a diminished chin, which can have an overall impact on the appearance of the jaw line.

At Dr. Rubinstein’s cosmetic surgery practice in Miami, Florida, men and women will experience truly specialized anti-aging treatments that take age, genetics, and lifestyle into account. As a highly respected and board recognized plastic surgeon, Dr. Rubinstein works with his patients to determine which anti-aging treatment will be the most effective.

For wrinkles, Dr. Rubinstein typically uses Botox or another type of filler to help ease and smooth over fine lines, crow’s feet, and deep-set wrinkles. To help combat turkey necks, Dr. Rubinstein performs both traditional and non-invasive neck lifts. Dr. Rubinstein also offers chin implants for men who want to maintain a strong jawline.

Dr. Rubinstein also offers couples’ plastic surgery, as many couples find it more enjoyable, relaxing, and calming to seek out treatments together. However, couples should expect to undergo individual consultations, as plastic surgery procedures need to be customized for each person.

For a better plastic surgery experience –with or without your partner – visit Dr. Rubinstein’s cosmetic surgery practice in Miami, Florida.

Strax Rejuvenation Deaths: The Death of Strax Rejuvenation?

It seems that news of a death related to Strax Rejuvenation in south Florida is not surprising news. The most recent happenings, though, are quite surprising. Even for someone very familiar with the very sketchy track record of Strax Rejuvenation when it comes to patient safety and patient deaths. Diana Gonzalez, health reporter for NBC6 in south Florida, reported one of the most recent deaths of a patient related to Strax Rejuvenation. Here is a link to the story:


Given the history of the last few years, another death of this nature is not altogether surprising. What is surprising, even shocking, is that this death is only one out of three that have occurred in the last few weeks. That’s three deaths of patients associated with Strax Rejuvenation in the last few weeks. Almost as shocking is that only the story of Idell Frazer made the news. The tragic loss of Ms. Frazer was well covered by Diana Gonzalez, however, nothing has been reported on the other two deaths. How is it that the two other souls were not worthy of coverage? And how many more Strax related deaths have there been over the years that were never made known to the public.

One answer is that not all Strax related deaths happen on their premises. It is probably easier to keep such a tragic event quiet and out of the news if they don’t have to call an ambulance to the center itself. If a patient dies in the immediate post-operative period (the first few weeks after surgery) it is considered a complication of surgery. When calculating mortality rates these deaths would be included, even if they never made the news. And even if they didn’t actually happen during surgery or inside the walls of Strax Rejuvenation.

If you are a regular reader of my blog you will be familiar with my two previous articles about Strax Rejuvenation and their death rates. Here are the links to those stories:



As you can see, giving Strax Rejuvenation tremendous benefit of doubt still arrives at a shocking mortality rate. If we re-examine the death rates including the most recent additions the numbers get even more alarming. Another year has passed so the total number of procedures will be higher. If we use Strax Rejuvenation’s own numbers, 29,000 procedures performed over eight years, that would add up to exactly 14,500 procedures performed over four years. I am aware of eight patient deaths related to Strax Rejuvenation in the last four years. That adds up to a death rate of 1 in 1813 cases. That’s shockingly TWENTY EIGHT TIMES the published mortality rate of 1 in 51,459 cases (American Society for Aesthetic Plastic Surgery, ASAPS). That means that in the time it would take to have a single death in a surgery center with the numbers published by ASAPS, twenty eight people would have died at Strax Rejuevantion.

If you have a friend that has been involved in eight car accidents in the last four years, how would you feel about letting that person drive your children around? Probably not too comfortable. Now imagine that all of those accidents included a fatality. You would probably sooner have your kids walk than ride in that car. The risk of a day to day car ride is much lower than having surgery. How many more deaths will it take to make everyone think twice about having surgery at Strax Rejuvenation? I would hope the answer is zero. Maybe the next death won’t be a patient, maybe it will be the death of Strax Rejuvenation.

Dr. Adam Rubinstein being interviewed at the 2013 iGuide Luminaries Conference in Beverly Hills, CA

Check out Dr. Adam Rubinstein being interviewed at the 2013 iGuide Luminaries Conference in Beverly Hills, CA. He discusses the latest in non-invasive neck lift treatments from iGuide. This procedure is great for younger patients who are not quite ready for a full neck lift. People who don’t have a lot of skin hanging from their neck, but still a little something.

The consultation is very important because that’s where we learn what our patients are looking for, where they’re starting from, and what they hope to achieve. They key is education. Once patients know what their options are, many of them opt for the non-invasive solution.

Check out the interview below to see Dr. Rubinstein speak about the procedure.

Discover A New Mommy Makeover

Whether you’ve just had your first child or your fourth, you deserve a little rest, relaxation, and celebration. After all, you’ve just brought a little bundle of joy into the world – and you deserve to look as exhilarated and excited as you feel.

Once of the biggest concerns that new mothers have is that they’re worried their bodies won’t bounce back after giving birth. While mothers should give themselves plenty of time to get back into shape, there’s no denying that you may want a helping hand. After all, you don’t have all the time in the world to spend on diet and exercise – and you need to find a mom-friendly shortcut.

If that’s the case, it’s time to discover a mommy makeover at Dr. Rubinstein’s cosmetic surgery practice in Miami, Florida. As a highly respected and recognized board certified plastic surgeon, Dr. Rubinstein prides himself on providing new mothers with the confidence boost they may need after childbirth.

The Three Mommy Makeover Procedures

A mommy makeover consists of three of the most popular plastic surgery procedures in the country for women: breast augmentation, tummy tucks, and liposuction, especially for the lower body. Together, these three procedures can help mothers get their bodies back into shape even after diet and exercise. After all, pregnancy can permanently change your body – and sometimes a healthy diet and regular exercise routine won’t cut it.

A mommy makeover might seem like a hefty expense, especially after bringing a new life into the world (a life that needs a LOT of diapers). However, it’s important not to reduce your self-confidence down to dollars and dimes. Mommy makeovers can help make you feel comfortable in your body, which is essential for feeling content and happy. And there’s no denying that a happy mom is critical for bringing up a happy baby.

Supplement Your Mommy Makeover Procedure

At Dr. Rubinstein’s practice in Miami, Florida, he offers the traditional Mommy Makeover procedures; however, you can opt to supplement your mommy makeover with additional procedures. For example, vaginal rejuvenations have skyrocketed in the past year, with many practices seeing as much as a 64% increase.

The point of the Mommy Makeover isn’t just to get your best body back; it’s to make you feel comfortable and happy in your own skin. After all, when it comes to raising your little bundle of joy, you want to feel as confident and comfortable as possible. Visit Dr. Rubinstein at his practice in Miami, Florida to discover a new Mommy Makeover.

Are Gummy Bears Always a Sweet Deal?

Breast implants that is…

If you have heard any news at all about breast implants in the last few years the term “gummy bear” has probably been associated with them. These gummy bear implants are all the rage. They promise to revolutionize breast augmentation with safer breast implants that won’t leak if they break. But what exactly IS a gummy bear breast implant? It can be confusing. Lets take a look at the history of breast implants and the latest trends.

When breast augmentation started a wide variety of materials were used while doctors were searching for the best choice. Solid silicone, soft sponges, and other materials were tried with limited success. In fact, the very first breast augmentation ever done used a fatty tumor that had been removed from another area on the same patient. Then Dr. Cronin and Dr. Gerow in Houston, TX came up with the idea of liquid silicone in a plastic silicone bag. And the rest is history. Hundreds of thousands of women have had breast augmentation performed with silicone filled implants since that fateful day. But the implants have been updated over time.

In total there have been five generations of breast implants. The first implants used a very thin shell and thin liquid silicone. As the newer generations have been introduced the shell has gotten thicker and the silicone gel has gotten thicker as well. Today’s silicone gel implants have the thickest silicone gel ever used in breast implants. The gel is so thick that if you cut the implants completely in half they retain their shape. The silicone gel will very, very slowly run out of the shell. The newest implants available would hold their shape nearly forever. So, they are kind of like a gummy bear in that when you cut a gummy bear in half the two pieces keep their shape; and the gummy bear when whole is kind of spongy to feel like a breast implamt. So when the newest generation of implants were being introduced someone described them like gummy bears. And the name stuck.

Here’s the thing, while an implant that doesn’t leak if it breaks sounds like a good idea (and it is to some extent), it’s not the best idea for every patient. The newest breast implants that have the thickest gel do not flow as naturally as the softer implants. The do hold their shape better, which is good for some patients, but not for all patients. Sometimes the gummy bear implants are a little too firm and don’t give as natural an appearance and/or as natural a feel. The moral of the story is to be sure you discuss your options with your board certified plastic surgeon. He/she can help you learn about the choices available and help you pick the best breast implant to achieve your goals while taking into account your body and breast type. Remember, the gummy bear implants might be the best choice for you, but sometimes they’re not such a sweet deal.

Lifestyle Lift, One Size Never Fits All

You’ve probably heard the radio ads or seen the TV commercials for the Lifestyle Lift. I’ve seen them myself – ads promising a revolutionary one hour procedure that is done under local anesthesia and gets you back to work as soon as the next day. You know the old adage, “if it sounds too good to be true, it probably is”. Well, from the ads I’ve seen it sounds really good, but some of the claims are simply not true. In fact, a lot of things surrounding what you may have heard about the lifestyle lift are not what they seem.

Let’s begin with the name itself. To my knowledge there has never been a paper describing the Lifestyle Lift published in any plastic surgery journal. I am not aware of any technique that is called a Lifestyle Lift. As best as I can tell, a Lifestyle Lift is some kind of variation on a mini-facelift. In fact, one of the medical directors for Lifestyle Lift recently explained in a trade magazine that the technique used by Lifestyle Lift is largely left to the surgeon operating that day. So, it seems to me that there really isn’t a special or “revolutionary” procedure called a Lifestyle Lift. If you sign up for a Lifestyle Lift it doesn’t seem like there is a procedure or technique called a Lifestyle Lift to have. And if that’s the case, what are they selling when you go for a consultation at Lifestyle Lift?

What they are selling is some kind of facial rejuvenation procedure that is likely to include a variation of a mini-facelift. Figuratively, what they are selling is what every patient wants to hear: short operative time, local anesthesia, quick return to work, and a cheap price. The advertising is very catchy and draws a lot of interest and attention. But the reality is often not as nice as the advertising might make it sound. The procedure takes longer than an hour. Actually, that’s just fine because if I’m the patient I want my doctor doing the best job possible and not trying to meet a promised one hour deadline. And the procedure in nearly all cases requires some amount of sedation along with local anesthesia. In most cases patients take sedation pills and pain pills before the procedure begins. The problem with that (other than not really being completely under local anesthesia) is when the sedation and pain medicine wears off, you’re stuck with only local anesthesia if the procedure is still ongoing. And if the pills you took to start the procedure are not enough, you’re out of luck as well. If you had an anesthesiologist keeping you comfortable (which is generally NOT the case with Lifestyle Lift) everything could be adjusted all the time to keep you completely comfortable and safe.

I always talk about looking out for bargains that end up being more that you bargained for. This one appears to end up that way all too often. The web is riddled with bad reviews from patients that have had surgery by Lifestyle Lift doctors. Of course, not all reviews have been bad, but when there are so many less than happy reviews (and many that are shockingly angry) you should take notice. You wouldn’t buy a one size fits all wardrobe of clothing, especially if there were a lot of bad reviews out there, no matter how cheap the price might be. Give your face, and your health, the same consideration. Because the truth is, one size never fits all.

Can Chin Ups Really Lift Your Chin?

You spare no expense in buying the latest anti-aging creams and undergoing a variety of treatments. You love staying up-to-date on the latest anti-aging innovations, and there’s nothing you wouldn’t do to shave five or even ten years off your look.

But will facial muscle exercises really make you look younger? Facial muscle exercises were really popular in the late eighties; and there seems to be a trend towards bringing them back in a big way. Face and neck exercises are becoming popular with trendy gyms, and you only need to stop at your local exercise store to find facial exercise DVDs.

But are facial exercises actually working to reduce the appearance of wrinkles, fine lines, and other tell-tale signs of aging? To put it simply, no. Don’t get lured in to the idea that making some funny faces and tensing your neck on a regular basis will rejuvenate your face and neck. In fact, the truth is that these exercises show little benefits in terms of eliminating wrinkles and getting rid of fine lines.

So what makes facial muscles so different from other muscles within the body, which end up looking sleeker and stronger when you work them out? You use your facial muscles constantly, all day long. That means that you’re not in danger of suffering from sagging or weakening muscles. While your body muscles often become weaker with lack of use, facial muscles are used to help you smile, laugh, talk, and even blink. Therefore, your facial muscles don’t need additional exercise to stay healthy. Actually, repeating some kinds of muscle movements can even cause wrinkles and fine lines to get worse – and that’s exactly the opposite of what you want!

If you have some loose or hanging skin in your face or neck don’t count on a trendy facial exercise regimen to make things better. You may want to consider some of the many options we offer in the office that can help turn the clock back. There are lots of non-surgical techniques to keep you looking young. And if you’re looking for a little more oomph you can consider some more advanced options. Either way, discuss your goals with a board certified plastic surgeon and don’t rely upon making funny faces to turn the clock back.

Jewel Plants a Flower for Breast Cancer Awareness

In a couple days I will be attending the national meeting of the American Society for Plastic Surgeons (ASPS). While there a special fundraising event will be held featuring the recording artist, Jewel. You may know that October is breast cancer awareness month. The idea is to raise awareness of the seriousness of the problem that breast cancer poses and make women aware that there is great hope for a good recovery. Part of that recovery can include breast reconstruction. Jewel has recorded a song entitled, “Flower”, that she will perform live at the meeting to benefit breast cancer awareness.

One in eight American women will suffer breast cancer in their lifetime. That is a shockingly high number. Every woman should be aware of that possibility and take steps to help themselves stay healthy. Regular mammograms and self exams play a big part. Women requiring treatment for breast cancer should be aware that there are many options for reconstruction of their breasts that can often be started right away, the same day as any cancer procedure they may need. Jewel will perform “Flower” at the ASPS meeting on Breast Reconstruction Awareness day to help women know that they have options when going through cancer surgery that may change their breasts. Attached is a clip that tells more of that story:

I hope you never need to consider breast reconstruction and stay cancer free throughout your life. If you do find that you need treatment for breast cancer always remember that you have options for recreating your breasts after cancer treatment. Seek out the opinion of board certified plastic surgeons and together develop a plan that is right for you.