Adam J. Rubinstein, MD, FACS
Adam J. Rubinstein, MD, FACS
Adam J. Rubinstein, MD, FACS

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.

Fade to Brown: Hyperpigmentation

Here in Miami the sun is one of our best assets. Warm weather, bright sunny days, year round tans… But it’s also one of the biggest threats to skin health. Besides causing sun burns, those golden rays are responsible for unwanted dark spots and patches Brown spots, or hyperpigmentation, are becoming the latest skin woe. In Elle’s September 2012 issue, beauty experts commented that the purchase of treatments to fade color in the skin is steadily rising.  With more and more spas and plastic surgeons offering diverse options for fading stubborn brown spots, it’s becoming increasingly clear that people are determined to achieve perfect skin by tackling their hyperpigmentation head on. So what exactly is hyperpigmentation – and what can you expect from your treatment? Hyperpigemntation in simple terms just means too much pigment. It can be small spots or broad patches of skin. While most hyperpigmentation is related to sun exposure there are other causes. Trauma to the skin can create areas with too much pigmentation.  In this case, inflamed and damaged skin takes on a scar-like appearance, which changes the pigmentation of the injured area, usually darkening it.  This is called post-inflammatory hyperpigmentation. This is sometimes seen after some treatments, such as laser resurfacing. Another common cause is the influence of hormones. In fact, some hyperpigmentation can be caused by pregnancy, which is commonly referred to as melasma. Melasma can be found in people that have never been pregnant but patchy brown discoloration can be common as a result of hormones during pregnancy. Whatever the cause, hyperpigmentation is no fun. The good news is that there are a host of options for treating hyperpigmentation. From a daily skin care regimen, to medications designed to decreas the color, to light and laser treatments, you have many choices to help blend your skin tone. If you have pigmentation that you want to fade, with the right regimen you too could say (in the words of Shakespeare), “out dammed spot”! Visit Dr. Rubinstein and get ready to kiss those brown spots good-bye! To schedule your consultation simply leave us a note here or call 305-792-7575.

Russian Roulette? Strax Rejuvenation

Patients seeking bargain pricing for their plastic surgery have been going to Strax Rejuvenation for years as the cheapest option in town. Strax commonly advertises very low prices to lure patients for their procedures. Recently, patients are learning that the lowest price is often not the best value. There has been another death at Strax Rejuvenation. That makes 5 known deaths in less than three years. Last Thursday I received information about a patient that died while undergoing a procedure at Strax Rejuvenation. The patient went to Strax for fat transfer to the buttocks. During the procedure her blood oxygen levels began to drop and she could not be resuscitated. She died in the operating room at Strax Rejuvenation. I have written about the deaths at Strax Rejuvenation in the past: /blog/bargain-price/ In that post I analyzed recent deaths at Strax and calculated their mortality rate. Based upon my review, giving Strax Rejuvenation a huge benefit of the doubt, their mortality rate is alarmingly high. In fact, it was seven times higher than a published acceptable rate from the American Society for Aesthetic Plastic Surgery. When last Thursday’s tragedy is added to the analysis the numbers get much worse. My original review of the Strax Rejuvenation death rate was based upon 4 deaths in two years time. That was less than one year ago. Let’s look at an analysis that includes this most recent death. Strax Rejuvenation currently has 12 doctors on staff. Only 10 perform aesthetic procedures. We could assume that every one of them operates every day of the week, never takes a vacation, and never sees patients for consultations nor follow up visits. Clearly that is not the case, but let’s give them the benefit of the doubt. Also assume that each doctor performs 4 procedures everyday. That would calculate to  31,200 procedures in a three year period. If that were true the death rate at Strax Rejuvenation would be 1 in 6240 cases. But it’s actually worse than that. Strax Rejuvenation has six operating rooms. It would not be possible for all 10 surgeons to perform procedures all day, everyday. Only six cases can go on at the same time. So now let’s assume that each of the six operating rooms are fully occupied 12 hours a day, 5 days a week, 52 weeks a year, for three years. That would add up to a total of about 19,000 cases which would make the death rate at Strax Rejuvenation 1 in 3800 cases. That’s more than THIRTEEN TIMES the mortality rate published by the American Society for Aesthetic Plastic Surgery (ASAPS). If we use Strax Rejuvenation’s own numbers it is even more grave. They boast having performed 29,000 procedures. Strax was founded in 2004 which gives it an eight year history. If the cases are evenly distributed over the eight years that would come out to just under 11,000 cases in three years. That means the death rate at Strax Rejuvenation over the last three years using their own numbers is 1 in 2175 cases. That is shockingly over TWENTY THREE TIMES  the published mortality rate. When compared to having your procedure performed by a board certified plastic surgeon in their own private practice, having surgery at Strax Rejuvenation sure does seem like making a riskier choice to me. Maybe not quite like Russian roulette, but definitely not the bargain most patients think they are getting.

Tips on Switching Your Aesthetic Routine, Courtesy of Allergan Inc.

Juvederm is one of the most popular wrinkle fillers available today. Here in Aventura, Florida, Dr. Rubinstein frequently uses Juvederm on patients who want to reduce the appearance of the nasolabial folds, the “smile lines” that travel from the nose to each side of the mouth. Juvederm is made by Allergan Inc, the company behind Botox and Latisse. Together with television personality Dayna Davon, Allergan has launched the Juvederm Switch Up Campaign, an effort that uses social media to educate women about non-surgical cosmetic enhancements and how to “switch up” their aesthetic routine. To receive beauty and lifestyle tips from Juvederm spokesperson Dayna Devon, just become a fan of Juvederm on Facebook.com

Non-Surgical Treatments Rise in 2009 Despite Economy

According to figures from the annual survey conducted by the American Society for ASAPS-logoAesthetic Plastic Surgery, non-surgical procedures are still on the rise despite the uncertain economy of 2009. Treatment with Botulinum Toxin type A  – commonly known as Botox Cosmetic or Dysport – was the most frequently performed non-surgical procedure in 2009.  Close behind were injections of hyaluronic acid wrinkle fillers such as Restylane, Juvederm, Hydrelle and Prevelle Silk. Although the growth seen in these procedures was relatively low, the figures are a reason to remain optimistic.  Aesthetic Society President Renato Saltz said the reason for modest growth in the number of non-surgical enhancements was likely repeat patients and those postponing cosmetic surgery. 2009 Statistics from the ASAPS – the Top 5 Non-Surgical Treatments
  1. Botox – 2,557,068 procedures
  2. HA Wrinkle Fillers – 1,313,038 procedures
  3. Laser Hair Removal – 1,280,031 procedures
  4. Microdermabrasion – 621,943 procedures
  5. Chemical Peels – 529,285 procedures

Mini-facelift or full Facelift: Make the right choice!

Mini-facelifts have grown popular due to a lot of advertising by some of the franchise facelift businesses. There are lots of different types of these operations, but they’re all variations of the same basic principle. The most well known example is the Lifestyle Lift. The goal is to improve the area between your lower eyelids to the jaw line. The most improvement is usually seen along the nasolabial folds which are the lines from the corner of your nose to the corner of your mouth. If you have the right set of concerns/problems a mini-facelift could be a great operation for you. Too many people, however, choose to have a mini-facelift for the wrong reasons. Some for cheaper cost, others for the idea of a shorter scar or shorter operation time. Mini-facelifts are not one size fits all. If you have any issues in your neck (for example) the mini-facelift will not improve them at all. A lot of people get enamored with the idea of a mini-facelift and end up choosing the wrong operation for their anatomy and concerns. If you have a mini problem, the mini-facelift can be great. If you have a bigger issue, you probably need the full facelift. Be very careful when choosing a procedure to improve the appearance of your face. There is a lot of hype and many promises made that may not be delivered. I encourage you to listen to a two part radio show that highlights some shocking details surrounding the Lifestyle Lift (links below). http://www.voiceamerica.com/episode/57040/special-encore-presentation-lifestyle-lift-a-real-lift-or-a-letdown-part-1 http://www.voiceamerica.com/episode/57210/special-encore-presentation-lifestyle-lift-a-real-lift-or-a-letdown-part-2 I recommend that you visit with a few plastic surgeons certified by the American Board of Plastic Surgery. get a few opinions and a lot of information. Then choose your procedure together. That’s a good way to get a great result! I hope this info helps!

Help for PIP Implant Victims

The scandal surrounding PIP implants has become a top story worldwide. Since the news broke about substandard industrial silicone being used in PIP implants there has been a cascade of reactions from governments around the world. Some countries are providing free procedures to remove the tainted implants. Others are offering some form of support falling short of free procedures to remove PIP implants. While free surgery is very helpful for the estimated 300,000 women around the world with PIP implants in place, it is not the best solution for many PIP victims. There is no question that PIP implants should be removed. The question then, is what to do once the implants are removed. Some patients may choose to simply remove the PIP implants and remain without any implants moving forward. Most patients will likely prefer to have safe, American made implants inserted to replace the PIP implants being removed. The catch is that while the surgery to remove the implants is free in many places, having new implants placed is not covered. This will leave thousands of women left to pay the associated fees to keep the look they desire. Mentor, one of the only two FDA approved American implant companies, has announced a program to assist in the replacement of PIP implants. The program provides for a $250 American Express gift card for all patients having PIP implants replaced with Mentor implants. While it hardly covers the cost of surgery to replace PIP implants, it is a very nice gesture. Receiving $250 dollars is better than nothing. I expect Allergan, the other FDA approved American implant company, to follow suit and announce a similar program soon. In an effort to help patients with PIP implants that wish to have them removed I am offering my services at greatly reduced fees. The total cost to have PIP implants removed is $2500 including all costs. For patients choosing to have PIP implants replaced the total cost is $3750. Though the American government does not offer any benefits for PIP implant victims (PIP implants were never approved in the USA) I feel a personal commitment to help those patients in need. If you or someone you know has PIP implants simply make an appointment for a free consultation and mention this blog. There is no expiration date for this offer. It will always be honored as my commitment to aid in this PIP implant tragedy.

Silicone injections – Don’t make a fatal mistake!

Buttock augmentation is very popular in the United States and throughout the world. There is probably no place where butt augmentation is more popular than in Miami. Butt augmentation is something that a lot of patients come to my office to discuss. I perform these kind of augmentations on a regular basis. But there are some dangers that patients need to know about. There are basically two ways to augment the buttocks. They can be made larger by using implants, or by injecting something to increase the volume of the buttocks. Implants are riddled with problems including malposition, infection, extrusion (popping out through the scar), causing pain, and a few others. Suffice to say that butt implants are not a great choice. The problem is that injections can be even more dangerous. I regularly perform butt augmentation using fat injections. This is a procedure that takes fat from areas with too much of it and places the fat into the butt. The fat is removed with liposuction and then injected back into the buttocks. The result is a really soft and natural butt augmentation and a sleeker body contour after the liposuction. Results can be terrific. The procedure is not inexpensive costing anywhere from $7000 up to $15,000 depending upon the surgeon and the amount of work being done. Patients often prefer cheaper alternatives but don’t know that making that choice comes with high risks. Some patients try to save some money and have other artificial materials injected into their buttocks. Silicone is often the choice. Silicone butt injections can cause tremendous problems and possibly lead to death. There are many stories in the news about patients trying to have a cheap procedure and ending up dead. Most recently some patients flew to Pennsylvania from England to have this procedure done. One died shortly thereafter in a local hospital. Her injections were done by a non-medical person in a hotel room. Other similar stories are found in New York City and Los Angeles. Always a non-medical person, sometimes in a spa, most of the time in a hotel room, and all ending in death of a patient. Tomorrow I will broadcast my live radio show talking about plastic surgery disasters. We will spend a good amount of time discussing these tragedies. Tune in (or listen to the archived show) and you might learn something that could save your life. If you’re thinking about having buttock augmentation I strongly recommend fat transfer as a safe choice when performed by a qualified and board certified plastic surgeon. If you try to find a bargain you will probably get more than you bargained for!

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