Physician, Magician, or Beautician?

People, especially in this age of Social Media, expect a lot out of Plastic Surgery and cosmetic treatments.  Reality television shows a world in which everyone is perfect looking, or has someone fix it if it is not.  That sets a standard that is nearly impossible to meet.

Some people think Plastic Surgeons are Beauticians.  You tell them what you want, and they do what you ask.  They will switch it around countless times until you are happy.  This is dangerous, as although we are partners with our patients, we are not equal partners.  I (hopefully) have more experience and training in the field, and can use my knowledge to help steer you away from foolish choices.

Others think we are Magicians.  They do not care about the before pictures.  They want a miracle,  don’t care what is involved, and do not understand the limitations that they each bring to the table.  The after picture depends entirely on what we are working with.

Plastic Surgeons are actually physicians first. We take an oath to first do no harm, and consider your well being.  If we are talented, and you are willing, we can work together to make you the best version you can be safely, and understanding the risks.

Before you consider Cosmetic Plastic Surgery, really think about your expectations and the role your Plastic Surgeon plays.

Start Thinking About June

I am always amazed when patients come in and expect that they can have surgery in a few days after their consult, or are shocked that the most popular vacation times are already taken.  Well regarded Plastic Surgeons are busy, and it takes proper planning to insure you get the time you need.

It is important to have your consult as early as possible, to make sure you are happy with your surgeon, that the price is affordable, and that you know how much time off of your particular work you will need, and what the recovery will be like.  Arranging childcare, maintenance of the household, vacation time for you and sometimes your spouse as well, all take time.  Even after this is sorted, your Plastic Surgeon has to have the date available.

Unfortunately, many of my teachers could not be accommodated during Spring Break, as there are only so many hours I can operate and give the best level of care.  I hate disappointing people, especially teachers, but they need to have a plan well in advance .

This is my wake up call for all of you who want to look better this Summer.  When school is out, the rush is on.  Call us if you do not want to miss June as a possibility.  I already have many of the days filled, and my next available is in June already.

Even if I am not your Plastic Surgeon, you still should plan for whomever you choose.  If he/she is a talented Board Certified Plastic Surgeon, space will be hard to come by.

I Finished My First CD!


For any of you long term Blog readers or my followers on Twitter (@drjyager), you are most likely aware that I am not only a huge music fan, but I am also a member of a band.  Used Karmas, a three man group, has been together for about 3 years now, and has been dedicated to creating meaningful and original music.  We have written, practiced, recorded, mixed, and mastered a full album entitled “Certified Pre-Owned”, a collection of 11 tracks of which we are all proud.

Finding the times in our busy lives to do this was difficult, but we spent late nights and off hours making it happen.  The process was fascinating, and has made me not only a better musician and vocalist, but has allowed me to more freely access my creative energies.  This makes even my cosmetic plastic surgery better!

It is very hard to describe the Used Karmas sound.  It has been influenced by 60’s and 70’s rock, like The Rolling Stones, The Who, The Doors and Pink Floyd.  There is some Van Morrison and Lou Reed mixed in, as well as modern alternative rock.  The thing that I am most proud of is the construction of the story each song tells.  It is not just catchy hooks and beats, the lyrics truly tell an important story.

The CD will be release on April 23, 2015, and will be found on, as well as on iTunes.  Our website,, will be functional by that date as well for info on the band and where we can be seen live.

It is Hard to Say No to a Patient


I am by nature an optimist.  I believe in the goodness of people, and my first instinct is to help. This has gotten me in to trouble several times in my life, but I would rather be taken advantage of than refuse to assist someone in true need.

As a Plastic Surgeon, there are patients who come in looking to make trouble.  They have been to other doctors and have been, in their words, “butchered”, and need someone to fix the mistakes.  I am willing to listen, but most of the time, the doctor has done a reasonably good job, but the patient is expecting more than is humanly possible.  If you then do a nice improvement, you may become the next in a line of “butchers”, with the patient threatening to ruin your reputation if you do not refund them or “pay them off.”

Some patients are very nice, but have health concerns or weight issues that make elective surgery riskier than usual.  While I have supreme confidence in my ability to perform the procedure to the highest standards, I cannot predict how the patient will heal or if they may develop issues unrelated to the surgery.  It is hard to say no to them if you can technically perform the surgery well, even if their doctor clears them for the operation.  I have learned I must.

Some patients have psych issues that make them unsuitable.  No matter how delicately you phrase it, patients do not like to be told they are unfit for elective cosmetic surgery.  You cannot argue with crazy.  You do not want them in your practice.

After 18 years at Yager Esthetics, I like to think I am still an optimist.  I just have become a more savvy optimist.