Dr. David P. Rapaport
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About My Practice
How would you summarize your philosophy?
I am extremely detail-oriented and emphatic that the work I do appears natural. I’m a big believer in really listening to my patients to determine what will make them happy. If I do not feel that surgery is the preferred way to address patients’ aesthetic concerns, I opt not to operate.
What type of anesthesia do you provide?
I am a proponent of monitored sedation or 'twilight anesthesia.' Many of the procedures i perform, like liposuction and even facelifts, do not require general anesthesia.
What new noninvasive procedures are you offering?
I am proud to be the founder and medical director of Coolspa, which is dedicated to noninvasive body contouring using CoolSculpting, as well as other cool treatments that actually work! Coolspa is New York’s leading provider of CoolSculpting*. And, with our new CoolSmooth applicator, we are now able to permanently reduce fat on the outer thighs and hips with no needles, anesthesia or downtime.
Where do you perform your surgeries?
With patient safety always paramount, I perform most procedures at my accredited, on-site surgical facility, attended by a handpicked team of anesthesiologists. I am a proponent of “twilight anesthesia” and many of the procedures I perform, such as liposuction or even facelifts, do not require general anesthesia.
What new treatments are you excited about?
CoolSculpting is, I believe, the biggest noninvasive breakthrough treatment in aesthetic body contouring in the last decade. With our new CoolSmooth applicators, we can now reduce “non-pinchable” bulges, including outer thighs and hips, all without needles, anesthesia or downtime.
What is your practice philosophy?
The simple phrase, “Listen to your patient,” that I learned 28 years ago from my chief of surgery at Harvard, Bill Silen, still rings true today. The art of listening, and truly understanding my patients, and conversely, communicating to them what they really need to know, is crucial to ensuring their satisfaction and our long-term relationship and trust.
What are some of your hobbies?
I like playing seasonal sports with our four sons, traveling, fishing and skiing.
When did your love for medicine begin?I remember seeing my father a holocaust survivor who became a dentist in scrubs, and I knew that when I grew up I wanted to be in the medical profession like him. My induction into the medical field was only natural.
What is the best advice you've received?
When you think about a patient or problem, think about it thoroughly and always plan ahead.
What are some of your hobbies?
I like to travel with my wife and four sons and play seasonal sports, ski and fish.
What is your favorite part of your job?
I love the craft of plastic surgery.
What is the best advice you've received?When you think about a patient or problem, think about it thoroughly and always plan ahead.
Where do you go to escape the office?
I ride my bike through Central Park; I love New York.
What is your favorite part of your job?I love the craft of plastic surgery.
A Minute With
My happiest professional momentThere is nothing more gratifying than receiving a thank-you note from a patient years after treating them—knowing I made a difference makes me feel that it was all worthwhile
What sets my practice apartHighly individualized and informational consultations and treatments geared to the personality and body of each patient
My dream innovationRegeneration of skin and limbs
Career-defining procedureCoolSculpting, which led to my founding of Coolspa, one of New York’s leading CoolSculpting providers, changed my career by offering a noninvasive treatment that really works, finally
My mentorMy late father, a Holocaust survivor, who became a dentist after the war, was a source of inspirational grace and dignity
My mottoGive more to the world than you take
- Facelift / Necklift
- Liposuction / Fat Transfer
- Breast Augmentation
- IDEAL IMPLANT®
- Breast Lift / Reduction
- Revisional Breast / Liposuction Procedures
- Chin Enhancement
- CoolSculpting® / SculpSure®
- CoolMini™ / Kybella®
- Surgical Chin Enhancement
- Nonsurgical Rhinoplasty
- Cellfina™ Cellulite Reduction
- Juvéderm® Fillers
- Botox® Cosmetic / Dysport®
- NeoGraft® Hair Restoration
- AccuTite / BodyTite™ / FaceTite™
- Platelet-Rich Plasma (PRP) Therapy
- Removal (Moles / Birthmarks Skin Tags / Lesions)
- Scar Revision
- Earlobe Repair
- Facial / Skin Rejuvenation
- Radiesse® / Sculptra®
- Advanced Microneedling
- Restylane® Fillers
- Stem Cell Banking
How do I decide if I want my breast implants over or under the muscle?What our experts say:
Especially if a woman is quite lean, when you go over the muscle, you can more distinctly see the edges of the implant, making the breasts look more round or fake. What I tell my patients is to imagine a beach ball on your bed. Now imagine that same beach ball with your comforter over it. When you have the comforter, that’s like the muscle covering the implant. You don’t see the edges and it has a more natural slope. Even with silicone, if someone has little breast tissue, then there is the potential to see subtle ripples beneath the skin. The muscle helps camouflage that. Additionally placing the implant under the muscle allows for better mammograms in the future. All of the data we have looking backward will tell us that the rate of capsular contracture is lower when we do it this way too.
What amount of fat is safe to remove during liposuction done in an office setting?What our experts say:
It's important to remember that liposuction is a contouring procedure and not a weight-loss procedure. You don’t judge the result by how many pounds you lost, you judge the result by how you look in the mirror. If someone is excessively overweight there is very little that liposuction can do. A liposuction that is more than 5 liters, is considered a large liposuction. The good news it that you don’t need enormous amounts of fat removal in order to improve someone’s contours.
Can I enlarge my breasts without scars on them?What our experts say:
The answer is yes for many women. The primary option for enlarging the breasts if one doesn’t want a scar on the breast is to go through the armpit. However, no one can guarantee how a scar is going to look and the phrase “invisible scar” is an unrealistic concept. Almost all scars on the body are forever visible. They may not be obvious but you can expect at minimum a pink line for a few months that will change to a white line forever.
Can I get silicone breast implants with an incision in the underarm?What our experts say:
Absolutely. The underarm scar for saline implants measures about a ¾ inch long and it’s typically in a skin crease. Silicone, because it’s already filled, is bigger. That scar will be about an inch and a half in length.
Is the recovery the same for the different breast augmentation incision options?What our experts say:
Regardless of the incision placement, whether it’s areola, underarm or under the breast, one incision does not have more pain than another. The post-operative discomfort from breast augmentation deals more with how tight you’re filling the skin and whether or not you placed the implants under the muscle. The underarm incision does not limit movement more than any other scar. There is not any additional pain or a higher risk of numbness. It’s more a matter of where you would rather have that pink line.
How do you know what size and shape and of breast implant is the right one?What our experts say:
The primary method at my practice is to let patients try on implants. We have all kinds of sizers including shaped sizers that better imitate what the shape will look like in addition to the size. I don’t think any woman should ask the doctor to make that choice. This isn’t about the doctor’s tastes, it about the patient’s tastes. Trying on the implant is key, but the other thing that I do often is use a 3-D system called Axis 3. It takes six photographs of a woman’s chest and puts them together so we can look at them on a computer screen and simulate different sized implants so the patient can get an idea of what they will look like. It allows you to see different angles, which is really helpful when dealing with cases of asymmetry.
Can you treat asymmetry in the breasts with augmentation alone?What our experts say:
It depends on the case, but we’re very forgiving when it comes to asymmetry. In general, our brains forgive asymmetry unless it’s severe because everyone has it. Asymmetry can be more complicated in that it may have to do with the way the chest wall is built so that the ribs may be more prominent on one side than the other. Very frequently the patient isn’t even aware of it. In the vast majority of patients, asymmetry can be greatly reduced by using different sized implants, but what is important for patients to realize is that we are reducing the asymmetry, not perfecting it. While our goal is perfection, that’s not really achievable.
What is the recovery like after liposuction?What our experts say:
The majority of patients are going to be able to have liposuction on Friday and be at work on Monday. Now there is going to be bruising that will probably be there for about three weeks or maybe four weeks. You are walking around slowly and feeling soreness. Patients report soreness rather than the word pain. So it’s not a very big deal and you can go back to normal activity. You can be back at the gym within five to seven days after liposuction. I wouldn’t recommend anything like swimming in the ocean because you still have tiny fresh scars, but in terms of exercise and recreation you have a lot of freedom.
Can I eliminate stubborn fat without surgery?What our experts say:
Liposuction is the gold standard of body contouring, but some people don't want surgery of any kind. Now there is a technology that I’ve been using for over a year and a half called CoolSculpting that is an alternative for many patients. It is definitely a more subtle change than liposuction. What CoolSculpting does is use a principle called cryolipolysis, which relies on the finding that when exposed to a controlled cold environment fat cells are damaged before other cells. You’ll get about 20 to 25 percent reduction in the treated areas as long as it can be pulled into the hand piece, which suctions it and holds it for an hour. It’s a useful technique that is truly noninvasive and requires no anesthesia.
Which areas respond best to CoolSculpting?What our experts say:
In my experience the areas that have responded well are the abdomen, love handles, bra fat, inner thighs, arms and male breast tissue.
I'm interested in breast augmentation at age 49. Is age a factor?What our experts say:
Breast augmentation of women in their late 40s or older is not at all uncommon. Many women who have had children with subsequent loss of breast volume are interested in breast enhancement at this age. It is very important that you be be properly screened for breast cancer prior to enhancement surgery, generally with mammography with ultrasound added as needed.
Can you tell me the effectiveness of i-lipo for treating small pockets of fat on inner and outer thighs.What our experts say:
I consider I-lipo to be very similar to Zerona. While I must make it clear that I have no personal experience using either of these technologies, I must say that I have consistently heard only disappointment in terms of their results. Specifically, it seems that while they may make fat cells "leaky" and therefore may lead to some local reduction, the fat can easily come back to the same area. I personally find CoolSculpting by Zeltiq to be consistently effective as a non-invasive, no downtime, FDA-cleared alternative to liposuction.
considering sculptraWhat our experts say:
Sculptra may be an excellent choice to improve the sunken appearance of your cheeks and nasal-labial folds. It is extremely common to lose fat in this area as part of the normal aging process. Sculptra is often called a volumizer rather than a simple filler. That is because it actually stimulates your body to produce its own collagen with results typically lasting one or even two years. However, unlike fillers such as Restylane, results are not immediate and take three to six months to be fully seen. Typically, Sculptra is injected in more than one session separated by four to eight weeks. Fillers such as Restylane can also be used for the same purpose and create an immediate improvement. They typically last nine to twelve months in these areas.
Can liposuction be redone on an area to fix problems with the original procedure?What our experts say:
I probably perform secondary (revisional) liposuction once or twice in any given week. Sometimes, fat can be grafted at the same time to areas that may have been overdone in a past procedure. You would need to be examined to determine whether additional liposuction and/or fat grafting could benefit you. Using newer technologies is really much less important than being properly assessed and treated by someone with a lot of experience in cases such as yours.