Board Certified
Plastic Surgeon
Since 1989

Diet, Exercise and Weight Loss | Plastic Surgery Consultations

Plastic surgery consultations extend beyond the cosmetic to overall health and wellness of patients. Plastic surgery is often seen as a shortcut to achieving a better body, but embarking on the path to a new look begins with a new approach to diet, exercise and weight loss. In this interview, Doctor Widder the “D.C. Butt Doctor” discusses his approach to overall health and wellness as well as the book “Sugar Busters” by H. Leighton Steward, Morrison Bethea, Sam Andrews and Luis A. Balart.

Q: When people come in for liposuction or tummy tuck, do you also talk with them directly about diet, exercise, weight loss, or overall health issues?

Healthy Eating and Surgery

Yes, I do talk about health in general.  If someone smokes, I try to convince them to stop that bad habit.  If they are overweight, I usually recommend a book for them called Sugar Busters that talks about choosing low glycemic index foods.  I don’t believe in diets.  Diets are temporary. Most people can’t really maintain a certain diet over a long period of time, because it’s difficult.  But if you make lifestyle changes, it’s easier to maintain it over the long haul.

When I give patients the book Sugar Busters, it helps to explain to them the physiology of how the body makes fat.  For example, it is ok to eat pasta, but whole wheat pasta.  If they eat white pasta – refined flour pasta – that’s no good. That is a high glycemic food, which causes insulin surges and winds up damaging the body. You can eat rice, but brown rice. If you eat white rice, again, it is a food that is causing the release of insulin and too much insulin is the enemy. You want to reduce the release of insulin as much as you can.  All of this is discussed in the book quite extensively.  Sugar Busters, for me, is the food lifestyle Bible.  I always have copies of this book in my office and I give them to my patients free of charge to educate them on how to eat correctly.

Sugar Busters

Q: Do you find that most people who come to you are interested mainly in appearance or are they also interested in improving health?

Well, the majority of patients are probably interested in improving their looks and they’re looking for the easy way – a shortcut.  That’s reality because we’re humans.  To do it in the other way is very difficult.  People are busy and have so little time. They don’t have the energy required for intense exercise.  If you want to lose weight by exercise, you really have to do it in a very dramatic way, for hours.  There was an article in the Washington Post two years ago that talked about how many hours you have to exercise according to your age. In your 20’s, you can exercise only half an hour a day and still maintain your healthy Body Mass Index (BMI). When you get to your 30’s, you’ll need an hour for the same result.  In your 40’s, it’s an hour and a half.  By the time you’re in your 50’s, who can do two hours of exercise a day?  It’s very difficult.  So instead, people are coming to my office to make those changes through liposuction or tummy tuck.  Other patients are working very hard in the gym and just can’t develop calf muscles, pec muscles, or buttock muscles.  So they come into the office to get implants that give them the look they want.

Some people will consider a change in lifestyle.  I give them the book and a few of them make those changes, but the majority want to make life easy. When people improve their looks, their confidence goes up and the attention of the people around them or the people they’re interested improves.  They find immediate gratification from the procedures I provide.

Q: Is there anything else you’d like to share about using Sugar Busters to help your patients?

The original book came out in the 1980s.  Since then there have been a few editions with updates.  But the principle has always been the same – becoming aware of low glycemic index foods and insulin levels.  That’s what they base the whole theory on and it works. I personally followed the book and lost 28 pounds in six weeks.  Sugar Busters is an easy read and you can also apply it very easily.  It just takes a little bit of will.  It takes will because you do have to give up on a few things that are very tasty.  Overall, it’s important to help people find a realistic approach so that it is something they’ll stick with.  Most people aren’t going to give up their staple foods, but substitutions can help.  Instead of white potatoes, try sweet potatoes, or brown rice instead of white rice. I tell my patients: Even if you don’t apply all of the principles, if you can do only 80%, you will see significant, positive changes.

Do you have any questions about healthy eating, exercise or diet following plastic surgery? Contact Widder Cosmetic and Plastic Surgery in Northern Virginia for a free consultation: http://www.widderplasticsurgery.com/contact.php. Or call: (703) 506-0300

 

Trends and Motivations for Plastic Surgery for 20/30 Year Olds

Trends and motivations for plastic surgery vary from person to person, but younger people often have similar interests in specific procedures. Celebrities also have an impact on ones motivation to improve a particular aspect of the body. Dr. Widder explains some of the motivations he hears in his consultations that profoundly impact his patients decisions.

trends and motivations in plastic surgery

Q: Which plastic surgery procedures are the most popular for people in their 20’s and 30’s?

Breast implants and butt implants are very popular for patients in their 20’s and 30’s.

Q: What do you hear from your patients about why they choose buttock enhancement surgery and breast implants?

The reasons vary.  Everybody brings their own histories and their own aspirations for what they want to look like. Some do it for a functional reason, such as they would simply like their clothing to fit better.  Others are interested in clothes as well, but from a different perspective.  They may just want to look good in the latest fashions.  What many younger patients want most is a sexier, more attractive appearance in order to feel better about themselvs and possibly garner more attention.  Some also want to emulate celebrities like Kim Kardashian and J Lo.

Not long ago I had a patient who came in for a consultation for buttock enhancement surgery.  “Is it gonna look like J Lo?” she asked me.  I showed her pictures of a before and after case that seemed along the lines of what she was seeking and I challenged her to decide for herself: “Does this look like J Lo?”  The photo I presented showed a very, very nice result.  In my opinion, the shape of the buttocks was reminiscent of Jennifer Lopez’ figure.  I gave the patient time to compare shapes and sizes until we found the right celebrity look for her.

Q: Even though prospective patients mention various reasons, do you think enhancing sexual attractiveness is really the main goal?

Well, it is true that patients are concerned with the butt and the breasts because they are sexual targets. When you are young that is very important.  It’s also important for older people, but it is often not as intense an issue in later years because hormones levels tend to be a bit lower.  Cosmetic surgery can improve upon parts of the body and it can help make a person look and feel much more attractive.   I appreciate being able to do that for a person.  The enhancements are very exciting for younger individuals.  It can absolutely bring about advantages in one’s personal life, especially in the sexual realm.  Enhancing attractiveness can also cultivate advantages in other areas, such as in the workplace.

Whatever the reason, the forces that encourage people to have cosmetic surgery are incredibly powerful.  I respect the fact that patients choose to go through the discomfort and the inconvenience in order to improve on those areas they feel are deficient or less than optimal.  It is a big decision.  I take the decision-making period very seriously; I do my best to listen, provide guidance, and respect each patient’s needs and wishes.  As long as I feel that I can deliver what the patient is looking for, we move ahead with the procedure.

Q: What signs do you see or hear from your breast and butt implant patients that indicate how they feel before and after their procedures?

Afterward, you can see a new sparkle in their eyes.  They walk differently.  They have confidence.  When they come in for a consultation before surgery they have often heard good things about me, but I can see that they feel a bit unsure and they have concerns.  It looks to me as if they are thinking, “Am I going to have this surgery or not?  Will I be happy?”

Once they have it done, they are extremely happy.  You can see it in their eyes.  In my experience, eyes are the #1 indicator.  Try taking a look at pictures of before and after surgery and notice the eyes.  You’ll see that before surgery, many of them look dull and depressed.  Afterward, you can see a new energy projected from the eyes.  They’re brighter. It’s like there is a new confidence and a readiness to take on the world.

Feel free to contact our office to discuss your own motivations for considering plastic surgery or visit the office to take a look at our extensive portfolio of before and after pictures. 703-506-0300

Plastic Surgery and Older Adults

Some of the most common procedures for older adults include the facelift and tummy tuck. Dr. Widder describes his experience with this population and their motivations for cosmetic changes.

plastic surgery for older adults

Q: Some say “60 is the new 40.”  How does your work help your older patients keep up with that concept?

Cosmetic surgery is definitely part of the story.  Overall, people are taking better care of themselves today than in the past.  Medical care is better.  People are eating better and exercising more.  People are just in better shape.  Plastic surgery helps a great deal when attention to health and fitness doesn’t achieve everything a patient desires.

A woman who is 68 came to my center a while ago.  She is dating a fellow in his 40’s.  He thinks she’s got the nicest butt in Washington, D.C. and he doesn’t even know she’s had a butt implant.  I worked with another woman who had multiple procedures including a face lift and tummy tuck.  She’s in her 70’s and nobody is able to guess her age.

It’s not unusual in my practice to find women in their 60’s who date men in their 40’s.  Better overall health is part of the equation, and plastic surgery can work wonders as well.  Looking younger after cosmetic surgery can be a huge emotional boost.

Q: What are the main reasons sited by older people for coming in for a cosmetic surgery consultation?

A few of them will tell me they feel a disadvantage in the workforce.  Younger people are being hired and they feel they are treated differently as older employees.  Others tell me they still feel very energetic but when they look in the mirror, they see their mothers.  They want to look the way they feel.  Those are the most common reasons people are looking for surgery.

Q: Which procedures do the most to boost confidence in your older patients?

The tummy tuck and the face lift are the most popular.  A tummy tuck makes patients feel younger and a face lift makes them look younger.  Those are great confidence boosters.

Some patients start out by sticking their toes in the water, so to speak, and won’t go for a full face lift at first.  They’ll go for the eyelids and will wait to see how that works out for them.  Once they have the eyelids done and the results are satisfactory, they will go for something more.  Those patients are the minority, however; the majority of patients come in with the pre-made decision and they go for it.

Recently, a patient in her 60’s came in after three or four consultations with other doctors.  There were three reasons for her  decision to have the surgery with me.  One was that I took the time to give her the common sense explanations of why I do the face lift procedure the way I do.  This was something she didn’t get from other doctors.  Another factor was that I showed her extensive before and after examples.  She saw that what I was talking about really occurs in actual patients.  Finally, I was able to demonstrate how the technique I have been using for the past 10 years is quicker, less risky, and less expensive.  For her and her husband, it was a ‘no-brainer’.  Her surgery is scheduled for the beginning of next month.

Q: What are the main questions and concerns for older patients? 

I noticed that my older patients almost exclusively come to me through word of mouth.  If an older patient is referred, it’s much simpler for them to talk with me and  trust me.  Everyone, at first, is worried about surgery risks, but if they have been referred by someone else who had surgery in my center, they feel more at ease.

Another common concern is about the outcome of the procedure.  Since an older person was most likely referred by someone they know and have seen my work on their friends or family members, they usually feel confidence and comfort relatively quickly.  Knowing that the surgry center where they are having the surgery is accredited and that they will have a board certified surgeon and anesthesiologist is also very helpful and comforting to them.

It is very beneficial to older patients to see and speak with our office staff.  We have a woman in her 60’s who works in our office and she’s had multiple surgeries.  The staff sees what is going on in the surgery center.  Patients realize that if staff members thought that there was a surgical risk with the surgeon or the anesthesiologist, they wouldn’t be willing to have their own surgeries there.  In our case, older patients can see and speak with a woman on staff who has had five or more operations.  She looks terrific.  That makes it easier for potential new patients to make the decision.

If you would like to learn more about plastic surgery options, costs and considerations give us a call or fill out our online inquiry form. 703-506-0300

Health Risk Misconceptions in Plastic Surgery

Health risk misconceptions are often fueled by limited information on the web and anecdotal information by persons who have experienced or heard, negative outcomes in surgery. In this interview Dr. Widder guides patients to seek complete information from their doctor as well as the American Society of Plastic Surgeons who can explain that risks in cosmetic plastic surgery are no greater than other forms of surgery.

shlomo widder

Q: As the “DC Butt Doctor,” do you receive many questions about the safety of cosmetic surgery procedures?

I actually get questions of this nature often.  Sometimes patients come to my office and have heard rumors about cosmetic surgery health risks.  They may be very eager, for example, to undergo surgery for buttock enhancement or some other procedure, but are hesitant because of complications they’ve only heard about.

Q: How do you respond to these questions and concerns?

I try to ease their minds by letting them know that there is no exceptional danger associated with cosmetic surgery.  As with all surgeries, there are risks, but that is not increased in the case of cosmetic enhancements.  I direct those who are still unsure to take a look at what the American Society of Plastic Surgeons has to say about preparing for a safe plastic surgery experience.  The recommendations are remarkably similar to prepping for any kind of surgery.

Q: Is the extra concern about cosmetic surgery due to the idea that it involves elective rather than necessary procedures?

Yes, I think that is what people believe sometimes.  But the truth is that plastic surgery is not always done for vanity’s sake, and can sometimes actually improve health.  Sometimes health issues require the help of a cosmetic surgeon.  For example, rhinoplasty can greatly improve the life of someone who finds breathing difficult because of obstructed nasal passages or breast reduction can alleviate back pain etc.  Even when surgery is for purposes of appearance, the risks are still not greater than when there is a medical objective As long as it is being done in an accredited surgery center by a board-certified plastic surgeon.  I encourage potential patients to learn all the facts about the procedure that is of interest.  Fear, especially without facts, is not helpful in making a good, confident decision.

Q: What is your general advice for those beginning to think about cosmetic surgery?

Always have the surgery in a surgery center accredited by a reputable organization like the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF).  Make sure your surgeon is board certified.  Finally, it is very, very important to make sure to disclose any and all existing health conditions you may have and get cleared by your internist for any medical issue or if you are over age 45.  Anyone interested in more information about safety and preparing for a procedure can find it on my website and also at the site of the American Society of Plastic Surgeons.

Dr. Shlomo Widder, the “D.C. Butt Doctor,” offers premium services to fit every cosmetic surgery need in Northern Virginia, the Washington, D.C. metropolitan area, and beyond.  As the only plastic surgery center in the area offering buttock implants, other services include rhinoplasty, facelift, facial implants, otoplasty ear tuck, Botox and facial fillers, cheek, chin, and eyelids surgery, liposuction, breast lift, breast augmentation, breast reduction, gynecomastia surgery, pectoral implants, and calf implants.  Consultations are free of charge.

To find out more about the Widder Cosmetic & Plastic Surgery Center, stop by during office hours: 9 – 5 pm, Mon – Fri, or visit our website at: www.widderplasticsurgery.com.

Plastic Surgery and Self-Esteem

 

Plastic surgery and high self-esteem are directly linked. Dr. Widder discusses a recent study by European researchers from Researchers from Ruhr Universität and the University of Basel that confirms the vast numbers of anecdotal evidence seen in patients across the country following cosmetic surgery procedures.

Q: You have used your talent and skill to sculpt some of the D.C. area’s nicest looking bodies.  What do you think is the relationship between plastic surgery and self-esteem?

In my experience, the effect of plastic surgery on self-esteem is very positive.  I see it all the time with my patients.   I often receive thanks from patients and they tell me how much of a difference the physical changes have made in their lives.  They feel good about themselves and have more confidence.  A recent study has talked about this.  Plastic surgery can definitely improve self-esteem.

Q: Would you talk more about the study? 

Yes. The study showed that a better self-image and overall happiness is a common result of plastic surgery procedures.  It even goes on to explain that when many of the patients experience high self-esteem, their overall enjoyment of life increases as well.  The people in the survey weren’t out to transform their lives, but only to enhance a particular body part, so it is exciting to me that overall life improvement is also a common result.

More specifically, the study looked at people who had opted for surgery as opposed to those who didn’t.  Greater feelings of health and self-esteem were noted in the surgery recipients, as well as fewer feelings of anxiety.  They also felt more attractive, not only with respect to the body part that was enhanced, but overall.  No adverse effects were observed, so that is very good news.

Q: If someone is considering plastic surgery, are there any times in life you feel are best to make those changes?

Anytime it suits the individual is the best time, but it is often a good thing to do when one is at a crossroads in life.  It might be a divorce, a midlife crisis, career change or even after a bout of unemployment.  It is spring now, and that can be great timing.  Spring is a time of energetic rebirth, so it can be perfect occasion for stepping out, being bold, and discovering plastic surgery as a way to enhance life and getting ready for the summer.

Dr. Shlomo Widder, the “D.C. Butt Doctor,” offers premium services to fit every cosmetic surgery need in Northern Virginia, the Washington, D.C. metropolitan area, and beyond. To find out more about the WidderCosmetic & Plastic SurgeryCenter, stop by during office hours: 9 – 5pm, Mon – Fri, or visit our website at: www.widderplasticsurgery.com.

Multiple Plastic Surgery Experience and Outcomes

Multiple plastic surgeries is not an uncommon experience for people who are very satisfied with their initial outcomes. Stories and experiences of plastic surgery patients in Northern Virginia, D.C. and Maryland are shared in this most recent interview with Doctor Widder of Widder Cosmetic and Plastic Surgery Center in Vienna, VA.

multiple plastic surgeries

Q: How common is it in your practice for patients to request multiple plastic surgeries?

 Lots of people do it. Many people lose a lot of weight as a result of gastric bypass surgery.  One of the consequences is a lot of loose skin.  Sometimes after gastric bypass, people are interested in further surgeries for the abdomen and the breasts.  Then they may want me to take care of the arms, the thighs, and sometimes the face and the neck.  I always remember one particular patient who had gastric bypass surgery.  I gave her a tummy tuck after the gastric bypass surgery.  The tummy tuck went well, so she did breast augmentation with a lift after that. She was so happy with that surgery that she sent me a picture – the picture was of her breasts and on it, she wrote: “Thank you, Dr. Widder!”  That’s a funny one.

Q: After the tummy tuck, why did she choose breast augmentation?

When women who have gastric bypass and/or a tummy tuck and lose a great deal of weight, the breast size goes down.   The breasts are made of breast tissue and fatty tissue.  The breast tissue doesn’t change after those operations, but the fatty tissue does.  The breast can become deflated – It will appear as loose skin without a significant amount of volume.  You can take care of it with just the lift procedure. I usually use the keyhole mastopexy.  It will improve the shape of the breast, but then she’ll have about an A cup.  For some women, an A cup is ok.  I had a largely breasted patient who wanted to be an A cup, so I gave her a breast reduction. But the majority of women want to be in the C range.  Maybe a small C or full B if they are athletic, or a full C to small D if they aren’t athletic and just want to look good in their clothes and bathing suit.  I had a woman patient who had an A cup size breasts before surgery, so she requested the implant and I combined it with the mastopexy or keyhole lift.  It’s called the keyhole lift because the incisions take the shape of a keyhole: there is around incision around the areola,  a vertical incision, and a horizontal incision at the crease area.  With that technique, you remove all the excess skin and achieve a very nice shape. You get a perky, beautiful breast.  To add the volume, I use the implants.  So her situation was a common one; it is very rare that a patient with such small breasts will go for just a lift.  Most of them do also want implants.

Q: Since you specialize in buttock augmentation, would you say there is an additional operation that tends to go with that?

Well, the butt augmentation can go very naturally with liposuction to enhance its shape.  Liposuction is more common with the fat injection procedure. Unfortunately, the fat injection to the butt does not last beyond 6-12 months.  With the butt implants, the change stays intact, so those patients look very good permanently.  As a result, I don’t do as many liposuctions associated with butt implants.

I do sometimes see patients that have me redo a procedure they already had done by someone else previously.  One woman came in for a redo tummy tuck and breast augmentation with a lift.  You can imagine how unhappy she must have been if I had to redo the surgery, because the tummy tuck surgery, in particular, isn’t a walk in the garden.   Yet, she was motivated to go through it again.  She was very, very happy with those procedures, so next, we moved on to liposuction of the thighs.  She was so pleased with the liposuction that the week after next we were doing the butt implants. The whole sequence has been at a very fast pace, all done in only six or eight months.  After the butt implants, she wants to do liposuction of the hips and waists.  She seems ecstatic with the changes – you can hear it in her voice.

Q: Do you have any other memorable stories about two or more surgeries?

 Yes. There is a woman who works in my office – she’s on my staff.  She has had multiple surgeries and looks phenomenal.  She’s a 65-year-old African-American woman, and she’s beautiful.  She looks like she’s 40.  I’ve done her tummy tuck, breast lift, eyelids, chin augmentation, liposuction in multiple areas, and calf implants.

Q: Which one started her journey with plastic surgery?

She started with the tummy tuck.  She just came in as a patient.  She had a very nice result and we at the practice thought she had a nice personality, so we offered her a position in the office.  Once she joined the team, we continued with the process of improvement.  After the tummy tuck, I gave her the calf implants.  Her breasts were a nice size naturally though droopy, she chose to go for a breast lift next.  These were followed by eyelids surgery,  chin implants, then liposuction of the abdomen, hips and waist, and finally liposuction of the thighs.  I think we did 8 or 9 surgeries in all.  She looks fantastic.

Widder Cosmetic & Plastic Surgery Center provides multiple plastic surgery options as well as single procedures for those looking to improve their appearance in one area. Stop by during office hours: 9 – 5pm, Mon – Fri, or visit our website at: www.widderplasticsurgery.com. Office Phone: 703.506.0300.

What is Botox and How Does Botox Work?

Botox is a very popular cosmetic procedure and is often mentioned in the media as a quick way to remove the signs of aging. Everyday people, as well as celebrities, have benefited from Botox.  In this interview, Doctor Widder describes what Botox is and how Botox works. Botox safety and its effects are also described in easy to understand terms.

Q: What is Botox?

Botox Virginia

Botox is the commercial name for the Botulinum toxin. It is a medication that basically paralyzes muscle.  We use it in very small amounts and it doesn’t have any systemic side effects.  The most common area of use for Botox are the glabella area, between the eyes (the frown lines), along the lateral canthal area (crow’s feet), and the forehead.  Some people use it to raise the corner of the mouth to improve the smile.  I don’t do this because it’s a little risky.  Around the mouth, it is possible to get asymmetries, so I like to play it safe and use it only around the eyes, the forehead, and sometimes the platysma band of the neck.

It is really a miracle drug because without surgery you get very nice rejuvenation.  The use of Botox involves interactions between muscles.  When you use it around the eyes, for example, you can literally raise the eyebrow.  There are muscles that are depressors that pull down, and there are muscles that are elevators and lift the face up.  So if you want to get a lift, you disable the depressor and the elevator lifts up.  The brows can go up 2 or 3 millimeters, which is significant.

Those are the cosmetic uses but there are others as well.  Some doctors use it to reduce sweat production in the armpit.  Neurologists are using it to relax the muscles for people who have spasms.  It’s being used for some people who have lost their voices – by injecting Botox with a very specialized skill, doctors can reduce the muscle tension that caused the loss of voice and people are able to talk again.

Q: How was Botox discovered?

 For quite a few years before it was used for cosmetic purposes, Botox was used for ophthalmological conditions like lazy eye.  Then there was a married couple from Canada – one was a dermatologist and one was an ophthalmologist.  They discussed the issue and the dermatologist decided to try Botox for facial expression.  They used it around the eye for frown lines.  That was probably some 20 years ago; I don’t remember the exact date.  The success rate was so impressive that they kept finding more uses for it.  Now Botox is probably the most popular nonsurgical procedure used for cosmetic purposes.

Q: How long does Botox last?   

 It really varies between people.  Everyone’s body reacts differently to different drugs.  On average it lasts 3-4 months, but I’ve had patients for whom it lasted 8 months.  It depends on metabolism.  Some people break down the Botox faster, and some slower.  Ideally, one should consider doing it continuously every 3 months so that the muscle doesn’t recover.  If it’s being done in that way for about 2 years, then the muscle will become so weak that the need to inject the Botox goes down to once every 10 months or even once a year.

Q: What causes the “too much Botox” look? 

The smart usage of Botox creates a beneficial interplay between the muscles.  If you use too much, you get an exaggerated result.  When a doctor injects the forehead to eliminate wrinkles and goes too low, all the forehead muscles can become paralyzed and droopiness of the brow is the result. That is what they call the overdone look.  What happens is that gravity can take the Botox down.  When you do the injection, there is a little trauma and a bit of fluid is released from the injury site.  The weight of the fluid with the Botox will carry it down because of gravity.  I don’t want to mention a famous politician, but it happened during one of the debates – his brows were very low.  But it also happens in everyday life.

It happened to me at the beginning of my practice.  I knew I had to stay above a certain level, but didn’t really know by how much.  I started with one inch and it wasn’t quite enough. Now I usually leave about 1 ¼ – 1 ½ inch of muscle and inject the Botox only above that level.  Even if it is pulled down a little, that still leaves enough muscle to elevate the brows so they don’t get that tired look or interfere with vision.  There is another possible complication where the Botox paralyzes the levator of the eyelid so that you get droopiness of the eyelid.  That usually goes away in 2 -3 weeks because the amount of Botox that goes into that area is not significant.  Most of it stays outside the orbit, so the effect is short-lived.

Q: Who can get Botox?

Those with the symptoms like wrinkles, hyperactive muscles, droopy brow, or crow’s feet are clear candidates for Botox.  You can also use it as a preventative treatment.  This is because as the facial muscles contract, it is like bending an iron wire – after a while, it breaks.  It’s the same with the collagen fiber in our skin.  It is hard to imagine how many times we use our facial expressions each day, but after 20-30 years, it is probably in the millions.  Those contractions will eventually break the collagen fibers and you’ll get wrinkles.  So if you use Botox at a young age, you’ll prevent the contractions and you’ll prevent wrinkles.  That’s one of the things I talk to my patients about.  Whatever they have now are conditions they’ll continue to have, but if they use Botox continuously, they’ll prevent it from deteriorating.  That is useful, not much talked about, but there is room for this use in young people.

People who want to make good first impressions may consider eliminating frown lines.  Frown lines reflect unpleasantness like anger and stress, so if one wants to avoid that, Botox can help. It is of social benefit to present a pleasant facial expression rather than an unpleasant one.

Q: How safe are these procedures?

The lethal amount of Botox is 5000 units.  The average cosmetic procedure uses no more than 100 units.  So, the safety margin is very, very high.  People shouldn’t worry at all about that.

If have any questions about Botox procedures or costs contact Widder Cosmetic and Plastic Surgery located in the Vienna, VA area for a free consultation: http://www.widderplasticsurgery.com/contact.php. Or call: (703) 506-0300

How to Choose a Surgery Center

how-to-choose-surgery-center

Choosing a cosmetic and plastic surgery center is often a new experience for patients. Dr. Widder discusses what to look for when choosing a plastic surgery center in Northern Virginia, D.C. and beyond.

Q: What are the important factors for potential patients to look for in a plastic surgery center?

Safety is always a #1 issue.  So is the quality of the work done, of course?  Plastic surgery has become more and more available, and that means there are a lot of options out there for patients. Researching the facility and the surgeon is incredibly important before choosing a date for any procedure.

Q: Can you list the main things someone should look for when making a plastic surgery decision?

Yes, there are definitely four main things to look for if you’re thinking of having plastic surgery:

  1. Will the surgery be done by a Board Certified plastic surgeon and anesthesiologist in an accredited surgery center?
  2. Can you find positive Testimonials from satisfied patients?
  3. Are you sure your Privacy will be respected?
  4. Are the Location and the business hours suitable for your needs?

I’ve offered plastic surgery in the DC Metro region for more than 25 years, so I have a sense of what patients are seeking and what is important for them before, during, and after a procedure.

Q: What more can you share about your practice in relation to each of these points?

My surgery center, Widder Cosmetic, and Plastic Surgery Center are accredited by the American Association for Accreditation of Ambulatory Surgery Facilities and I am certified by the American Board of Plastic Surgery.  Anesthesia is only given by our board-certified anesthesiologist who has specialized in this work for over 30 years.  Our focus truly is on safety for the patient and the quality of the work.

People should realize that different surgeons use different methods and produce different results. Reviewing recent testimonials will give a potential patient a good sense of the surgeon’s work. At Widder Cosmetic and Plastic Surgery Center, we also offer a review of before and after pictures of previous clients.  Potential clients can see the results we achieved for others who had a procedure similar to what they are considering so they can make an informed decision.

Patients’ privacy is paramount in my center. We even have a private waiting room. Larger surgery centers and hospitals don’t afford their patients that level of privacy and discretion.

Finally, Widder Cosmetic and Plastic Surgery Center is right in the heart of Tyson’s Corner in Northern Virginia.  It is only 10 to 15 minutes from two major airports and is convenient to people in the Washington D.C. metropolitan area, Baltimore, and beyond. Our easy driving distance from many locations, indoor covered parking, and convenient hours make the center a good choice when looking for the right facility.

To find out more about the Widder Cosmetic & Plastic Surgery Center stop by during office hours: 9 – 5pm, Mon – Fri, or contact us today!

Plastic Surgery Preparation – The Do’s and Don’t

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This interview provides an overview of the standard preparations required before and after plastic surgery.  Many patients are unaware of the basic standards of care required for a successful outcome to their surgery. Let the negative outcomes of others serve as a warning to heed your surgeon’s advice! If you find this information useful, subscribe to our blog for weekly insights and feel free to suggest topics or questions you would like answered!

Q: What are some of the Dos and Don’ts that you give people in preparation for surgery?

I give them instructions that are true for any surgery, not necessarily specific to cosmetic surgery. All patients receive a form with the type of foods and medications they’re not supposed to have before surgery.  About ten days to two weeks before surgery, they have to stop taking any Advil or aspirin for example, which are blood thinners.  The same goes for tomatoes – they have salicylic acid which is also a blood thinner.   A patient shouldn’t drink coffee or tea or any caffeinated beverage the night before surgery or right after surgery because they can increase blood pressure. There are certain herbs and over-the-counter supplements that are also prohibited because they can interfere with anesthesia. Diet pills are an example of that.

 Q: What are your general recommendations for after-surgery care?

 For buttock augmentation, my recommendations are no physical activity, no heavy lifting, and no sex for one month.  When sitting, the patient should sit leaning forward so there’s no pressure on the incision. They can lie only on their stomach or their sides. Lying on the back is not allowed because that can put pressure on the incision and disrupt the wound.  Patients can walk and sit as long as they lean forward. You can drive, but you’ve got to drive cautiously and not wind up in an emergency situation.  If you drive, drive slowly. Be sure you’re in control and aware of your position, so that you’re less likely to lean back and hurt your incision.

Q: In addition to those recommendations, should patients simply stop any activity that makes them feel tender or painful?

Well, you want to be one step ahead. You have to be thoughtful and use common sense in a way that will prevent you from even feeling pain.  If there is already pain, you may have already broken the incision.  Right after butt augmentation, you should just lie in bed on your stomach, in the following days avoid any excessive or strenuous physical activity, and lean forward in your seat.  If you do that, you’ll be fine.

Q: One of the important things after breast augmentation surgery is for the patient to do breast massage to avoid hardening of the breasts. Are there similar things that should be done to improve outcomes after other surgeries?

With buttock augmentation, I don’t usually recommend massage – only in specific situations. In other surgeries like pectoral or calf augmentation, I recommend the same as with breast augmentation.  I teach them how to massage the implant in order to loosen up the scar so you don’t get what is called capsule contracture.  Capsule contracture is the condition where the scar tightens around the implant and can deform the implant or change its position.

Q: What can go wrong when patients don’t follow instructions?

I once had a patient who had calf augmentation surgery.  He walked half a mile from the parking lot to his house.  Obviously, he bled.  He called me at 2 o’clock in the morning and I had to take him to the OR to evacuate the hematoma.  Another patient who received buttock implants ended up with complications because she had sex shortly after surgery.  Someone else who had buttock implants went to a party.  She admired so much the results that she wanted to show it off, so she danced and moved and broke the sutures.  Yet another patient hurt herself by jumping out of a truck. Even sitting in a deep couch can cause problems by straining the incision.  So I tell people that they have to follow up and heed my instructions.  The recommendation come from doing surgery for a long time and having a lot of experience.

Do most people pay attention and take care of themselves?

The majority of patients listen, but there is always an exception to the rule.  I’d say that about 5% are not attentive and don’t do what I instruct them, then they have complications.  The most common complication is wound disruption. Once it happens, it just takes time for it to heal.  It is best when the patient just allows the body to take its time and gives it the opportunity to heal.  After one month, they can do whatever they want; there are no limitations.  If they want to climb the Himalayas, they can be my guests.

To find out more about the Widder Cosmetic & Plastic Surgery Center stop by during office hours: 9 – 5pm, Mon – Fri, or contact us today!

How Does the Plastic Surgery Conversation Begin and What is the Initial Consultation Like?

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The following interview features Dr. Widder’s experience and insights directly with men and women who are considering plastic surgery for the first time or are looking to explore a higher level of care and quality results. Subscribe to our blog for weekly insights and feel free to suggest topics or questions you would like answered!

Q: What are the main questions you and a patient go through together to plan a course of action for surgery? How does the conversation start?

Well, when a patient comes to my office, I ask them “How did you hear about me? Did you visit the website?” Then I ask them “What brought you to the office today?” and “What can I do to help?” After that, they usually feel comfortable speaking about whatever is on their mind and any problem they have. Initially I just listen to what they say. Next, I ask to see the condition. If it’s a face, naturally, I see it immediately and I ask them what they would like to change. I show them manually how things would change with the procedure they are asking about. After that, I take them to the computer and we look at before and after pictures.

If it is a body issue, I ask them to show me the area of concern and we discuss whatever is bothering them – whatever can be improved. I show them what can be done, be it a breast or a tummy, the buttocks, the calf, or what have you. Suppose someone comes in interested in breast reduction. If it’s a man, this would be the pecs. When men talk about the chest, they usually have gynecomastia, or fat deposits on the chest. In this case, we consider a gynecomastectomy, which means I remove fat and breast tissue. With women, it will be a breast reduction – removing from the breast tissue and contouring the breast through tightening the skin envelope, creating a kind of biological bra.

So it’s up to the patient. It depends on the different issues that come up. I am quite thorough about the different options. I give them a few options – whatever they feel is most appropriate. Sometimes one option is more expensive than another and we’ll go for the other option, as long as it’s appropriate.

Q: Say someone did come in and wanted a breast reduction. What are the options?

Breast reduction is for a very large breast. Anything over a full C or D cup is a candidate for breast reduction if it’s bothering them – if they have the symptoms like shoulder pain, neck pain, limitation in exercise, in running, or if they have any intertrigo –irritation under the breast. So if they have those symptoms, I would offer them the procedure that I do. I will tell them that there are different techniques, but I’ve done the one that works for me for 25 years. I’ll show them the before and after pictures of the technique that I use. They are free to use somebody else if they prefer a different technique.

My technique is called The Keyhole. The Keyhole Technique is where you make an incision around the nipple, then vertically down the lower part of the breast, and then a horizontal incision in the crease under the breast. The other technique where the incision is only vertical results in a lot of redundancy, or loose skin. It takes a long time for the redundancy in the crease area to dissipate. Another method uses an incision just around the aereola and in the crease, but then again, I don’t like the results because they’re missing one dimension. They end up with a round breast instead of an oval, which I think is a nice breast.

There can be a lot of extra, loose skin because you either take the skin through the method I use, The Keyhole, or you leave it at the crease. With time it stretches, but it takes months and months to occur. I don’t think my patients will accept months of loose skin under the breast. If you use my technique, the breast is pretty almost from the start. Now, you have a scar, but if you are meticulous in your repair, the scar heals very, very nicely. Occasionally you have a challenge like a keloid scar, and if that is the case, I treat it with steroids. I inject with cortisone and that reduces the amount of scar formation.

When I was in training, they taught me to do the tummy tuck. They would make a very short scar, but end up with big “dog ears” – a bulge on both sides – after the tummy tuck. The reason they’d say that was the right way to do it was that the patient hates scars. What I learned through my experience is that patients don’t really care about scars as long as the procedure gives them a nice shape – as long as you hide the scar in a place where it doesn’t bother them that much. They hate the “dog ears” or bulges more, or in the case of the breasts, the laxity that causes rippled skin that ends up in the crease area. For me, the scar is a nonissue. Now, if the surgeon is not competent enough to make a nice scar, that’s a concern. My scars are very nice. It’s not that patients love my scars, but they prefer the nice results with the scar than the other way around.

Q: I imagine people ask you about safety issues. What are the things you tell people as they are considering a procedure?

If a patient comes to me referred by another patient of mine, then the issue is moot. They trust me, they know that I’m safe and reasonable and caring. They just talk about the procedure. In that case, they are interested in two things – the cost and the date. But if I have a new patient that came to me through the Internet or other printed media, they are interested in asking about safety. First of all, I tell them I am a board certified plastic surgeon. My office is accredited by the “AAAASF,” or the American Association of Accreditation of Ambulatory Surgery Facilities, which has very strict guidelines about safety. I have a board certified anesthesiologist who’s been in practice for over 30 years. So safety is really my utmost concern, and obviously I combine that with results. On my website there is a logo that says “Quality is our Niche.” Really, “Safety and Quality” is our niche.

Now I do tell them that no surgery is 100% free of any complication. They get written material about the procedure and any possible complications that can happen. Even in the best of circumstances, you can have complications for different reasons, especially if the patient is not compliant with my instructions. So all those issues are discussed in detail and they all promise that they’ll do their best. Most of them do.

Q: How long does your initial consultation take?

I have consultations that take 10-15 minutes. They know what to expect because they saw my work. Their friends had the surgery. I have many patients who do breast augmentation. It is very common in the Asian community. They see their friends and family members, and come in and say “Ok, let’s do it. Let’s do it tomorrow. Let’s do it next week.” Other patients are more detailed. It may take me half an hour, 45 minutes, or even an hour. With some patients, it will take me one meeting, with others two, three, or even four. It depends on the people, their level of anxiety, and their level of comfort with me. Some have never met me and really want to hear from me, but with the majority of patients, it is a really quick process. 10, 15, 20 minutes, and we go ahead with scheduling.

To find out more about the Widder Cosmetic & Plastic Surgery Center stop by during office hours: 9 – 5pm, Mon – Fri, or visit our website at: www.widderplasticsurgery.com.

*Individual results are not guaranteed and may vary from person to person. Images may contain models.