The Debate and Plastic Surgery

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Everyone has been getting all excited about the presidential debates this month. Each side is trying to sound better, inspire confidence, which are good things. Unfortunately, they also bend the truth to fit their agendas, and try to make the other side look bad instead of presenting the positive side of themselves.

It struck me that this is similar to the Plastic Surgery community in New York. When patients go on consults, the doctor should be trying to highlight the positives of his practice. Things like being Board Certified by the American Board of Plastic Surgery, the number of years in practice, how many cases similar to yours he has done this year and overall, using Board Certified anesthesiologists and Accredited Surgery Centers. Showing Before and After pictures of his work and educating you on the risks and benefits of the proposed procedures let you know that he has your best interests at heart. That is how we treat patients at Yager Esthetics.

There are other centers, however, that take the negative side. Just like in the debates, I wish there was a Truth Squad to let patients know when they are being misled. Most doctors in cosmetic surgery who are not plastic surgeons will not tell you things that make them look bad. Nobody will say “I am not a Plastic Surgeon” or “I have never done that procedure before.” You have to be a good moderator and ask the right questions.

Please ask the following- Are you certified by the American Board of Plastic Surgery?
​​​How long have you been in private practice?
​​​Will you or someone else be performing my surgery?
​​​Will it be done in an Accredited facility?
​​​Will a Board Certified Anesthesiologist be giving my Anesthesia?
​​​How many of my procedure have you done THIS year?
​​​What are the risks and alternatives?
​​​What results can I expect?
​​​Can I see at least 3 before and after pictures that you have done?

If a doctor is bad mouthing another doctor, or you get an uneasy feeling, run away. About this there should be no debate.

BMI and Plastic Surgery

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There are some patients who seek out plastic surgery as a desperate attempt to look better without having to address the fact that they need to lose weight. While I do not believe that you need to be at your ideal weight for a cosmetic procedure, you do need to be reasonably close to it.

Not everyone wants to be skinny, and in fact the height and weight charts that are out there are often unrealistic and difficult to apply to everyone. Some people are naturally thicker, and look well at higher weights. My general rule of thumb is that if you are within 20lbs of your desired weight, it is reasonable to consider plastic surgery. There are, however, limits.

The BMI, or Body Mass Index, is a quick calculation based upon your height and weight ((weight in pounds / height in inches x height in inches)x 703). In my office, we do not offer surgery if your BMI is over 35. This is due to an increased risk of complications from surgery at this higher number, as well as a less than optimal cosmetic result.
Patients are often disappointed when I tell them to lose weight before plastic surgery. When I explain to them that it is for their own safety and long term cosmetic benefit, some of them realize that I am trying to help. I obviously do not make money by saying no. Unfortunately, some doctors here, and many overseas, do not care about your weight and will do whatever you like if you have the money. I urge you to not let this happen. Please ask them if your weight adds any additional risk, or if losing weight after surgery will alter your result. If they say no, run.

If you are convinced that you want to have this surgery then you need to take into account your fitness and weight levels. If your weight is high and you need to lose some to accomplish the optimum size for surgery like this, there are ways this can be achieved. More and more people are turning to such things as fitness trackers like Fitbit’s to help them monitor their progress. You can go onto sites such as Mobile Mob and see offers on accessories for your Fitbit to make it work for you, and to make you feel positive about getting this done, so you can go into your surgery knowing you did your best.

The Importance of Anesthesia in Plastic Surgery

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As a Board Certified Plastic Surgeon, my practice at Yager Esthetics is mainly one of surgery. In order to keep my patients safe and pain free, I need to provide anesthesia. This is a topic even the most educated patients neglect to ask about.

Some patients do have strong feelings about the type of anesthesia used, and if they have had bad experiences in the past, will prefer not to use the same technique. General anesthesia, monitored sedation, regional anesthesia, and local anesthesia are all used in my AAAASF accredited outpatient surgery center.

General is a type of anesthesia where the patient is totally unconscious and usually requires a breathing tube. Monitored sedation is a technique where IV medicines put you in a twilight sleep where you do not see, feel, or hear anything. Regional is most commonly epidural in my practice, where the lower half of the body is numbed with an injection in the back (as in c-sections and labor).
Local is when you are awake, and an injection numbs the area, like at the dentist.
But who is giving the anesthesia? Anesthesia is the most important thing for safety, and in my practice it is only given by a Board Certified Anesthesiologist. I am a Plastic Surgeon, and for me to supervise a Nurse Anesthetist is not the safest thing for my patients. I have to concentrate on surgery and beautiful results, not worry about blood pressure and heart rhythms. That is why I pay much more for a doctor to do that for my patients.

So when you go on consults for plastic surgery, after you know that your surgeon is certified by the American Board of Plastic Surgery, find out where the procedure is done, make sure it is an accredited facility, and that a Board Certified Anesthesiologist will be there 100% of the time.

FACES Walk to Raise Awareness of Cancer for the Latin Community

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On Sunday, September 30, my family and I participated in the FACES event to raise awareness of cancer in the Hispanic community. As the motto of Yager Esthetics is “In the community, for the community”, how could we not participate?

I brought my 3 year old and 6 year old daughters, as community service and Hispanic heritage are important for them to learn. They helped set up the booth, hand out educational materials, and test all of the playground areas in Fort Tryon Park just to make sure they were fun.

Hundreds of people turned out for a moving and impactful day. The stories of loved ones lost, survivors, and community leaders were emotionally powerful. Many tears were shed.

As someone who is a doctor, I shared my personal stories of family tragedy caused by cancer and the failure to seek early help. Prevention and screening were the messages I delivered to the people in attendance.

While patients come to Yager Esthetics to look better, I am still a physician who looks out for health first. We have discovered serious medical problems and have even found very early cancers through our preoperative testing program.

I urge all who read this to do annual exams, do colonoscopies and mammograms, and know your family history so we can prevent cancer from taking lives.

What’s in a Name

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When I was constructing my office expansion, I thought it was the best time to consider a name for the practice. Yager Plastic Surgery was working, but now we were doing so much more than Plastic Surgery. I wanted the name to include all of what we offered- the ySpa, spider vein treatments, injectable fillers and skin care, as well as laser and advanced scar therapies.Being that my practice was focused on the Hispanic population, I wanted a name that would appeal to a Spanish speaking patient. I tried all sorts of clever names before I settled on Yager Esthetics/Estetica. The reason was that I felt the best indicator of quality, trust, and dedication to the community was my name- Yager.

Yager is not a Spanish word. In fact, it is Austrian. Jaeger, the German version, means hunter. When my Great Grandparents came to the US over 100 years ago, the spelling was changed. They came to Washington Heights, and opened a candy store. My Grandfather opened a Pharmacy in the Bronx, and my Father was a Podiatrist in Manhattan. I came back to my roots in Washington Heights.

Treating patients well is of the utmost importance to me. I try to insure a first class experience from the time they make an appointment, to the way they are treated in a world class facility, to the consult experience and on through surgery and recovery. This is what I do.

I recently had a patient who was not happy due to an issue beyond my control. Even though it was not my fault, it was hurtful for me. I insured her, as I do all of my patients, that I would do everything possible to make her satisfied.

When you come to Yager Esthetics/Estetica, the name means everything. I will continue my mission to provide the highest quality of care to my patients and my community. In the community, for the community is not just a slogan, it is my reputation. If anyone is dissatisfied, please let me know how I can remedy the situation. I am here for you.