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About My Practice
What does a consultation with you entail?
After listening carefully and examining the patient thoroughly, appropriate options are discussed and a recommendation for treatment is made. In some cases, modern imaging techniques are used to enhance communication between patient and surgeon. If the patient feels that the image conveys their desired appearance and I believe I can deliver the look, we’re good to go!
Where do you perform surgical procedures?
Surgical procedures are performed at the Encino Surgicenter, a state-of-the-art, medicare- and AAAASF-approved freestanding center, located adjacent to my office.
What is the recovery like after a macs-lift?
Since a MACS-Lift can be performed under local anesthesia and without post-surgical drains, the recovery tends to be less difficult. Patients may go directly home after surgery and may resume normal activities after one and a half weeks and light exercise by two weeks.
How would you describe your approach to patient care?
I've found, in my 27 years of experience, that the best approach is one that integrates the diligent pursuit of surgical excellence with understanding, sensitivity and kindness.
What qualities, in your opinion, distinguish a doctor?
Selflessness, honesty and integrity. The person should also have the impression that they are called to the profession as opposed to seeing it as a pathway to prestige and riches. Its richest rewards come in the form of expressions of gratitude and thank you letters from patients.
Is there a treatment that fades scars from cosmetic surgery procedures?
Time fades scars. Minimizing stretch on the scars also helps and can be done by the wear of paper or silicone tape, avoiding excessive tension on the scars during surgery. Lasers will sometimes be used to try to shrink the collagen that is forming the scar. Pressure on the scar also helps and can be applied by specially fabricated splints.
How do you treat gynecomastia?
Medication is not usually of value in the cases I see. Surgical removal by excision using a cartilage shaver or directly excising the gynecomastia is usually required. If there is fat present, liposuction also plays a role.
Can you combine several cosmetic surgery procedures at once? If so, how many?
One can combine several procedures if the health of the patient is sufficiently good and if the procedures are not too large. There is no simple answer to this question, but frequently we do combine procedures as long as the total operative time is under 6 or 7 hours.
What alternative occupation would you choose?
Philanthropy has always appealed to me. I also believe I would enjoy being a college professor! When I began college I wanted to be a high school science teacher, but the fact that there were over 100 PhD candidates for a single science teaching position made medical school seem like an easier path to follow. I’m glad I took that route!
Why did you become a plastic surgeon?
As a medical student I was attracted to psychiatry and the concept of changing a person’s self-image. When I was exposed to plastic surgery, I realized that this was a pathway to improving self-image in a matter of hours instead of the years required by psychiatry.
Do you have any hobbies?
I particularly like horseback riding, skiing, golf, travel and church activities.
Do I need implants with a breast lift?
Often you will if you want fullness in the upper part of the breast. A lift alone does not do a particularly good job of giving upper breast fullness by itself.
American Board of Plastic Surgery
Affiliation:American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
A Minute With
What sets my practice apart
A truly diverse offering of facelift techniques to meet virtually any situation
What i love most about my profession
That patients like to see me for my services
High-tech, but with a high touch
The future of my field
3-D tissue modeling, stem-cell therapy
Three words that best describe me
Disciplined, fun, hardworking
The most outrageous medical myth i’ve heard
That it’s easy to get a great result
My happiest professional moment
Every time a patient’s expectations are exceeded
Most memorable patient reactions
Patients have made cakes displaying the part of their anatomy that was improved with surgery
My greatest achievement
To have lived a life that was balanced between family, my practice and service at my church
My operating room playlist
Smooth jazz or ’70s folk rock
Which new services are you excited to offer?
We have recently opened Silk, an
on-site medspa where we provide
fillers, injectables and noninvasive
treatments in a spacious, relaxing
environment with a spectacular
view. Our hours include evenings
and weekends to accommodate
- Short-Scar Facelift
- Facial Cosmetic Procedures
- Endoscopic Facial Surgery
- Rapid Recovery Facial Laser
- Breast Augmentation
- Cosmetic Breast Surgery
- Tummy Tuck
- Skin Treatments
What is a Botox browlift?What our experts say:
You use Botox to block the downward pull of the orbicularis ocularis muscle that encircles the eye and pulls the outer part of the brow down.
What is the best way to rejuvenate the face? Surgically? Non-surgically?What our experts say:
There is no best way. It depends on what the problem is – skin aging, loss of volume, drooping tissue, etc.
How do you make a facelift undetectable?What our experts say:
With proper direction of lift, attention to detail in the suturing, and by avoiding too tight of a pull.
What is the difference between a MACS-Lift and a traditional facelift?What our experts say:
The MACS-Lift involves less skin lifting and involves a great deal of deep lifting. It is a less-involved surgery with less expense and a shorter recovery. It is best for those women without a great deal of neck problems and good skin quality.
How do I add more volume to my face?What our experts say:
You can do so by repositioning drooping fat or by adding volume in the form of fat or “off the shelf” injectables like Juvederm, Sculptra, Radiesse, etc.
How do I get fuller lips?What our experts say:
Typically you add volume. This can be done by injecting things or by adding implants. Currently my favorite is PermaLip which is a permanent silastic implant – it’s very natural, well-tolerated, easily removed, and not associated with loss of feeling or undue firmness.
Why would one need a bone or cartilage graft to fix their nose?What our experts say:
If structural support was required or an addition of volume required, these would be the graft materials of choice.
How do I know if I need a browlift?What our experts say:
If your brows are at the level of the supraorbital rim or below. The supraorbital rim is the bony prominence located above the upper eyelid.
What is a Circle Breast Lift?What our experts say:
It is a breast lift that removes a “donut” of skin from around the areola and then pulls the remaining skin down to the areola with a permanent internal stitch that both tightens and lifts the breast skin, lifts the areola up, and decreases the areolar diameter.
What is the “dual plane” technique of breast augmentation and why is better than other methods?What our experts say:
“Dual Plane” refers to placing a breast implant beneath the upper part of the pectoralis muscle and in front of the lower part of the muscle. It allows the lower part of the implant to fill out the lower part of the breast and gives a more natural look and it is a far less painful operation.
What causes capsular contracture? How can I avoid it after breast augmentation surgery?What our experts say:
Capsular contracture is not completely understood. It is apparently caused in some cases by a small amount of bacteria that become attached to the outer part of a breast implant in what is called a “biofilm.” These bacteria stimulate an inflammatory reaction in the scar tissue that surrounds the implant, causing it to contract. In other cases, blood in contact with the implant can lead to contracture. X-Ray therapy can also cause contracture. Avoiding capsular contracture is done by minimizing any bacterial contamination of the implant by careful surgical technique and avoiding blood collections around the implant. Placing the implant behind the muscle also helps as does postoperative massage of the implant.
What is Microliposuction and where is it used?What our experts say:
Microliposuction refers to 2 to 3 millimeter diameter cannulas that remove the fat. It can be used in virtually all cases and is free of some of the risks associated with laser and ultrasonic techniques. Microliposuction is done in conjunction with injection of a large amount of local anesthetic solution to minimize bleeding and maximize fat removal.
What is a pain pump and when is it used? When and how is it removed?What our experts say:
I use pain pumps in tummy tucks. This is a device that pumps in local anesthetic where the abdominal muscles have been tightened. It markedly reduces pain after surgery and is removed several days later much as one takes out an IV – painless and quick.
What is a “drainless tummy tuck”? Why is a drain normally used?What our experts say:
Drainless tummy tucks are those done without resorting to a drain after surgery. Usually a drain is required to remove blood and fluid from beneath the skin. If one sutures the skin down to the underlying muscle, this may allow one to get away without a drain. This allows for a more comfortable recovery.
How do you augment the buttocks?What our experts say:
Usually with fat. Implants have too many complications in that area for me to use them.
What is the recovery like after a thigh lift? Where are the scars?What our experts say:
There are inner and outer thigh lifts and there are several types of each of those. Typically an inner thigh lift requires a scar in the crease between the upper thigh and the perineum or a scar running down the inner thigh to the knee. The latter is reserved for more extreme cases of inner thigh drooping. An outer thigh lift typically requires a scar that runs from the low abdomen to the mid-back and that is hidden by undergarments.
Where are the incisions placed in an arm lift?What our experts say:
They run from the underarm region to the elbow. If only a limited lift is required, the scar may be totally confined to the armpit.
What type of implant placement will yield the most natural results?What our experts say:
The best answer is that, "It depends!" For most patients, a properly done submuscular dual plane placement of a silicone gel implant gives the most natural result. If a patient has large breasts or a great deal of fatty tissue, either in front or behind the muscle looks about the same since the implant is "hidden" by the tissue. If the patient is a body builder, preference may need to be given to an implant placement in front of the muscle to avoid the unattractive movement of the implant that may occur with pectoralis major muscle contraction. If the patient is extremely thin, it may be better to avoid the dual plane position since unnatural rippling of the muscle may occur in the lower part of the breast.
In general I prefer to place the implants behind, as opposed to in front of, the muscle since there is less rippling of the implant that can be seen or felt, there is a more natural slope to the upper part of the breast, mammographic interpretation is better, and there is a lesser chance of capsular contracture (hardness) of the implant. The dual plane position refers to the implant being behind the muscle in the upper 2/3 of the breast and in front of the muscle in the lower 1/3. This position has a number of advantages over the "completely behind the muscle" position such as a lesser chance of forming a "double bubble", less implant movement with muscle contraction, and less discomfort after surgery.
I had saline breast implants done 17 years ago, and they are beginning to sag. What is the average cost to have new implants done, and will I also need a breast lift done at the same time?What our experts say:
Although a consultation with a board-certified plastic surgeon is required for a proper answer to your question, here are a few general thoughts. You may wish to consider silicone implants as they have some advantages over saline. The average cost depends on many factors, but something in the neighborhood of $8,100 for new silicone implants plus an additional $1,500 - 2,500 for a breast lift, depending on the type of lift needed. For saline implants, subtract $500 from the price.
How to correct dimpling skin (abdomen and lower back) after liposuction procedureWhat our experts say:If the dimpling is due to loose skin, removal of the skin by means of a tummy tuck and a flank lift would be appropriate. If the dimpling is due to scarring and/or irregular thickness of the fatty layer, it may not be possible to fully correct the issue. A combination of judicious liposuction and fat grafting will usually help.
What is your favorite style of facelift?What our experts say:
Although I have used many techniques throughout my career, my favorite is the MACS-Lift because of its low risk and superb results. If a patient needs a greater degree of improvement in the neck than a basic MACS-Lift allows, I can modify the procedure to accomplish their desired result. For those patients needing additional lifting of the cheeks, an Extended MACS-Lift procedure can be the solution.
How is breast augmentation a better procedure today than it was years ago?What our experts say:
Not only are the implants far sturdier and less prone to leakage, but we also have a much better understanding of how to minimize complications from surgery.