Keep reading if you’ve experienced something similar, or you’re simply interested in starting Latisse!

Lash growth update

Top: Before Latisse, Middle: 6 weeks after, Bottom: 6 months after

This is what you came for. As evidenced in the photos above, my lashes have improved in both length and thickness after 6 months of use.

The good, the bad, the ugly

While I do miss the glam of lash extensions, I’m excited to finally have lashes that can take a curl and mascara.

The hard part is you must stay consistent. It takes at least 16 weeks to see the full results of Latisse¹. Moreover,  Latisse works by increasing the duration of the hair growth phase², meaning that continued use is required to maintain results. If you discontinue use, your lashes will return to their previous length and volume.

But I have heard on the grapevine that after the initial 16-week growth period, some users are able to maintain them even with pairing down use to every other day.

One last thing worth mentioning is that throughout this lash journey, I experienced common side effects – skin darkening, irritation, and redness¹. The skin darkening is minimal and can be covered by makeup, so that slight drawback is negligible in my case. Thankfully, I only experienced intermittent irritation and redness, which is typically resolved by skipping a day or two of application.

My two cents!

Considering that my biggest gripes are being consistent with daily use and the mild side effects, using Latisse is a breeze! My final verdict is that the benefits of having longer, fuller lashes is worth maintaining Latisse use – so I will!

Starting your own Latisse journey? Learn more here or purchase online here!

1. https://www.latisse.com/WhatToExpect.aspx
2. https://www.rxabbvie.com/pdf/latisse_pi.pdf

Click here for the original blog post written by Leslie Payne for BuildMyHealth.

The post Life After Lash Extensions: 6 month update first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Hear from one of our beloved patients:

“I’m so impressed and excited about the work that you are doing with the Weight Management program. Not discounting the incredible work that Dr. Bae and the team do in the surgery center, I credit a good portion of my recovery, results and current lifestyle to the weight loss and exercise that I did prior to any of my surgeries. Above all, I had the opportunity to create healthy habits that I’ve been able to stick to post-surgery, which took the burden of undoing any surgery off the table (no pun intended ).

None of this is easy – changing habits, weight loss, exercise, surgery, recovery, etc – but the support that you and the team have provided me throughout my journey is unmatched. Investing in my health has been the most rewarding and humbling experience and I never could have done it without y’all! Thank you for empowering me to find me .”

The proof is in the pudding:

Let’s talk about the elephant in the room

Lots of patients ask if they should lose weight before surgery… Or even if they should gain weight before their Brazilian Butt Lift! Instead, consider being in a healthy weight range (or close to it!) at the time you schedule your procedure. If you need diet and exercise to get there, putting in the work before the procedure contributes to better outcomes and patient satisfaction.

But that doesn’t mean that you need do it alone. Exercise with friends. Make diet changes with your whole family. Get some fresh air and enjoy more time outdoors. Join a club. Dance!

Shout out to the Bae Lounge

If you still need more guidance and motivation, consider joining a Medical Weight Management Program like the one offered at Dr. Bae’s Health and Wellness Lounge. The program combines medications with lifestyle coaching to give patients the tools to set exercise goals, make healthy food choices, and keep the weight off.

Keep it going

As our patient can attest, the healthy habits instilled before going under the knife translates to better surgical outcomes. There are so many benefits to being in good physical condition prior to surgery, including:

• A healthy BMI decreases the risk of complications with anesthesia and intubation
• Patients who are obese are at greater risk for surgical site infection and slower healing because of reduced blood flow in fat tissue. This impacts every incision, as well as fat transfers such as Brazilian Butt Lifts
• High blood pressure and high blood sugar are more easily controlled
• The fat removal maximum for liposuction is 5L, so being close to your goal weight will maximize your results
• Patients tend to be happier with their results, because they’re often more noticeable when at a healthy BMI
• Recovery is typically faster and easier for patients in good physical condition
• The ability to maintain your post-operative results is easier, since you have already established a health-centric lifestyle

The post Get Those Coveted Mommy Makeover Results… and Keep Them! first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

My story

In an attempt to have fuller, longer lashes, I wore lash extensions for 3+ years. While I hated the upkeep, I loved the results. Waking up feeling pretty and ready to walk out the door was well worth the bi-monthly refill appointments, the meticulous care to keep them clean, and the noticeable dent it made in my wallet. Until I developed an allergy – a bad one.

Feast your eyes on this monstrosity:

It started out subtle. Some irritation and redness around my lids that resolved in a couple days with ice. My lash artist (love you, Winnie) confirmed that she had not switched any products. No new glue, no new anything. However, over the course of a few months, my allergy progressively worsened: major swelling, redness, and irritation that did not resolve, even after hydrocortisone, ice, and antihistamines.

From lash extensions to Latisse

I made the difficult decision to say goodbye to lash extensions forever. Until I relapsed, thinking that a “break” would eradiate my allergic symptoms. Big mistake – still allergic.

I needed a solution. I had tried Latisse in the past, but I didn’t stay consistent. I typically stopped after the first bottle and just resorted to extensions. Now that extensions are no longer an option for me, I decided to give it another shot.

I have been using Latisse for the past 6 weeks now. Although I don’t quite have the look of extensions yet (apparently 16 weeks is when you’ll get the full effect of Latisse¹), I’m optimistic! I’ve already noticed some improvement with the length and thickness of my lashes. I’m dedicated to staying the course for the full 16 weeks to determine if I can achieve the eyelash extension look without suffering through my allergic symptoms.

Slightly longer and darker, don’t you think?

Check back later to see the final results!

If you’re interested in starting Latisse, learn more here or purchase online here!

*Pro tip: Try applying Latisse in the morning vs at night! One of the side effects I’ve experienced is redness around my eyes. No irritation, just pigmentation. However, when I started using Latisse in the daytime, I noticed that I had less “spread” and less redness. Good luck, folks!

1. https://www.latisse.com/FAQs.aspx

Click here for the original blog post written by Leslie Payne for BuildMyHealth.

The post Life After Lash Extensions: What I did after developing an allergy first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

My experience with cosmetic procedures

When I was about 13 years old, my grandfather suggested that I get a rhinoplasty (nose job). I have a “flat” nose and he thought a bridge would make my face appear more attractive. As a quick disclaimer, I know that he loves me and does not think I am ugly. It was just the norm in the world he lived in. In fact, he performed my grandmother’s rhinoplasty! Therefore, trust, access, and finances were not the issue. But I declined the surgery because my nose did not bother me, and it was not my priority.

A few years later, I decided to “fix” my teeth. There was nothing wrong with it’s functionality or health, but some areas were not aligned, and some were naturally small compared to my jaw size and other teeth.

You could argue that this process was much more involved than a rhinoplasty. Typically, a rhinoplasty is a 2-3 hour procedure with 4-6 weeks of healing time. My teeth took 9 months of braces with regular appointments and painful adjustments. The braces caused swelling of my gums, which required an even more painful gum resection procedure to improve the appearance of my smile. I then had to get scans to send to the lab who made my veneers that the dentist attached to my “little” teeth. Let’s not forget the cost! Orthodontic work and cosmetic dentistry are not cheap! But it was important to me and I had it done!

Fast forward almost 20 years…

I didn’t think twice about my teeth until about a month ago when one of my veneers broke off. After it happened, I was distraught and self-conscious. I didn’t like any of my pictures, I was hesitant to smile or open my mouth in public, and I was even reluctant to go on a fun trip with my little sister because I didn’t want our photos ruined by my tooth. And while my self-acclaimed “flaw” is something most people probably would not even notice, getting my tooth reconstructed again boosted my confidence and overall mood.

My tentative smiles are long gone, and I don’t cringe at my pictures. I feel ready to tackle any challenges that come my way and chores that I have been putting off. Once again, I am open to trying new things and being social. I feel motivated to exercise. I feel outgoing, cheerful, and optimistic.

Here’s my two cents!

So, if you’re reading this and considering cosmetic work, I say go for it! Whether it’s cosmetic dentistry, botox, fillers, plastic surgery, a trip to the salon – you’ll never feel more like your true, jovial self!

And if your loved one is considering cosmetic work and talks to you about it, support them! It’s not just superficial. They will feel happy and confident. I’ll even bet that all the things you already love about them will shine through for the rest of the world to see!

Click here for the original blog post written by Jan Ramiro for BuildMyHealth.

The post Why cosmetic procedures aren’t just for the shallow at heart! first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

The speed of vaccination development and rollout is also its greatest drawback. Distrust in the “newness” of the vaccine. But it wasn’t new. Research and development of mRNA vaccines have been in the works for the last 30 years.

Now a year and half into the pandemic, I’m done with the fear. We’ve incorporated social distancing, hand washing, testing, mask wearing and vaccination into our daily lives. Some of us have natural immunity through previous infection. Overall, we’ve been as responsible or irresponsible as we could be. Sure we could benefit from more Americans with immunity through either infection or vaccination. But with vaccine hesitancy – stupidity masked as self-determination and self-righteousness – apparently this is as good as it gets. Time to move on and live with it.

How pandemics end

There are two ways pandemics end: 1) Immunity through vaccination or infection and 2) apathy. I got vaccinated. Now I’ve reached the point of apathy. What else can we do? If there’s another surge, are our health departments going to shut down businesses again? Will the public really tolerate that? In my opinion, they won’t.

I don’t believe I’m the only one that feels this way. We’ve restricted our movements, our children’s education, our commerce and our relationships. At some point we have to collectively realize that we’ve done what we can to mitigate the risks of the pandemic and move on with our lives.

Just get the vaccine

If you’re not vaccinated, just do it. There’s enough data to prove the safety and effectiveness of these vaccines. In fact, the vaccines that you and your children willingly accept, like polio and the flu vaccine, weren’t tested on nearly as many people as have undergone testing with the COVID vaccine prior to FDA approval.

Feel like it hasn’t been around long enough or worried about the new technology associated with an mRNA vaccine? Until you know what m-R-N-A stands for, your opinion regarding virology, vaccinology and epidemiology may not be relevant. Don’t trust researchers and doctors who developed the vaccine but trust them enough when you’re sick as hell and seeking treatment at the hospital? Why the trust after sickness but not before?

The pandemic is over

From an epidemiological perspective, the pandemic may not be over. There will be more surges, more infections, more death. I hope I’m not one of those. I hope you and your family members are not in that number. Avoid high risk situations and get the vaccine. Other than that, apathy is what will ultimately end this pandemic.

The post The pandemic is over… time to move on first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr. Bae:
Thanks so much, Greg. Good to see you.

Greg:
Did I embarrass you? I hope not.

Dr. Bae:
I’m getting red, getting red.

Greg:
Your hair’s getting longer, by the way, again. Are you doing the COVID thing and not cutting it again, or what’s going on over there?

Dr. Bae:
Yeah, letting it grow out. According to my wife and the person who cuts my hair, Kristin at Monument Salon, shout out to Kristin, they both like my hair a little long, kind of like Oscar Isaac. That was actually the actor that they said they wanted my hair to look like.

Greg:
Hey listen, first of all, the two people you should be listening to in life, your wife, number one, and the person that does your hair, number two. So good choice.

Dr. Bae:
Thanks.

Why Dr. Bae cancelled his trip to Hawaii

Greg:
But the reason I bring it up is, we were kind of full steam, speed ahead, taking our masks off, going out, doing all these things because we kind of thought we had this COVID thing beat, but the Delta variant has thrown a little bit of a curve ball at us, and we’re all kind of coming back. I know me, I washed all my masks, got them in my car, got them in my backpack again. And then I know you just made a major decision about traveling. You were about to take a big trip to Hawaii and you’ve made a decision to not go?

Dr. Bae:
Yeah, if y’all remember, on Big Bay Mornings, I actually invited everybody to come join us in Hawaii and Maui at the end of August, and-

Greg:
I was going to be your nanny. I was going to take care of the baby and then y’all could hang out.

Dr. Bae:
Exactly. Well, yeah, we were excited to have you as our nanny, but we decided to not go because… And I want to make it clear to everybody that we’re making decisions based on specific situation in our life that this doesn’t necessarily mean everybody else has to do the same. But if it was just me and Kelsey, two adults that were vaccinated, I would’ve still gone to Hawaii at the end of the month. No question about it. Even with the Delta variant, even though it’s more infectious and things like that. We would’ve been vaccinated, we would’ve worn N95 masks on the plane. I felt like we would’ve been pretty safe.

Kids under 12 unvaccinated

Dr. Bae:
But because we were going to be traveling with a six and a half month old, or a seven month old by that time, who’s not eligible for the vaccine, who wouldn’t be vaccinated by then, we felt like we needed to cancel the trip. And we reached out to the hotel and just said, “You know what? We’re coming there, we promise. Keep our money, we’re not asking for a refund. Hopefully we’ll be there within the next six months.” And so yeah, we canceled the trip to Hawaii and we’ll just do a little staycation here. But I think the issue was just that, because Emilio isn’t vaccinated yet and being in closed quarters for a five-hour flight, it was just too much anxiety. Because the truth is, he’s a perfectly healthy little boy, and if he got sick, and I know it’s rare that kids get really sick from COVID, but… It’s rare, that doesn’t mean it’s zero. And if he did actually get sick-

Greg:
Yeah. Well, and a baby can’t even wear a mask, right?

Dr. Bae:
That’s the whole thing, yeah, they talk about… Well, the baby’s not required to wear a mask, but I think it’d be pretty tough and maybe a little scary if it-

Greg:
I mean, how would you put a… Yeah, I don’t even know how you would do it.

Dr. Bae:
Yeah, and you’d be afraid that it would smother the baby. Yeah, that’d be a bad scene. So we just didn’t want to take the chance of this perfectly healthy little boy getting potentially sick and getting a rare, serious case of COVID. So yeah, we canceled the trip. We’ll hang out here. We’ll be able to travel there again. We’re just going to stay home, stay healthy. And since we’re requiring all of our patients coming into the office now to be vaccinated, we’re hopefully going to keep the Delta variant at bay, keep our own little herd immunity here in the office and that way I won’t take it-

Greg:
At bay. At Bae.

Dr. Bae:
Oh yeah, at Bae. Yeah, there you go, B-A-E.

Greg:
Hey, even though you did cancel your trip and you did it because of your baby, but you said you would’ve gone had-

Dr. Bae:
I would’ve.

How to travel safely

Greg:
… you weren’t taking the baby. You do still think there are safe ways people can travel, but you would definitely recommend, I mean, maybe the best mask possible. What is that, the N95?

Dr. Bae:
Yeah, I don’t know if it’s… Nothing’s going to be a hundred percent safe. It’s about risk mitigation, risk reduction. And I think that if you’re traveling by car to someplace up in Napa and you’re going to be at a hotel that’s got, basically outdoor, that you don’t have to go into a lobby to go into your room, that you have a direct entrance into your room, if there’s little bungalows and things, I think that’s super safe to do that. I think you’re outdoors, you’re not going into a crowded area. If you’re able to eat outdoors, I think that’s as safe as you can be without completely shutting everything down. And yeah, N95 masks definitely are going to be better than just a regular cloth mask. So I think there’s definitely safer ways to travel and that’s what I would encourage people to do, and that’s what we’re… We’re following my own advice.

Greg:
Awesome. Well, I mean, listen, we’ve got to live life, but we also can make smart decisions and smart choices to keep ourselves safe and everybody else safe.

Dr. Bae:
Right. We want to live life, but we want to be alive to live life.

Greg:
There you go.

Dr. Bae:
Yeah, so make some good choices. There you go.

How to find Dr. Bae

Greg:
That’s great advice. And if you need any other advice from Dr. Bae, whether it’s about COVID, or maybe you want to book a plastic surgery appointment, or maybe you need a consultation for something and just want to ask him a question, he will answer anything that you want to ask at…

Dr. Bae:
Realdrbae, R-E-A-L-D-R-B-A-E on Snapchat, TikTok and Instagram. You can direct message us on any of those. You can watch us operate on social media, and you can also check pricing on our website at realdrbae.com. Always available.

Greg:
Great to see you, Dr. Bae.

Dr. Bae:
Great to see you, Greg.

The post Why I canceled my trip to Hawaii [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr. Bae:
I’m great, Greg. Good to see you.

Greg:
It is good to see you too, especially now. I mean, have you noticed the weather’s getting a little bit better? We’re finally seeing the sun again. It was a bleak summer for a while.

Dr. Bae:
July. Yeah, we got out of July and it’s beautiful again.

Greg:
Yeah. July was pretty bad. Speaking of pretty bad, this new COVID variant, this Delta and Delta Plus I guess, is in the mix again. I mean, what is happening with the new variant and what can we expect over the next couple of months?

The Delta Variant

Dr. Bae:
Yeah, the Delta variant is… What they’ve said is about a thousand times more infectious than the original Wuhan variant, and what that means is that there’s just so many more viral copies of the virus that build up in your respiratory tract, specifically in your nose. And so that, back before you weren’t putting out as many viral particles, maybe you’d have to be in consistent contact with somebody for 15 minutes indoors to pass it along. Now you could be outdoors potentially and have just a passing interface with somebody. And because there’s more viruses that you’re expelling.

Greg:
Masks again, right? Pull out the masks again.

Dr. Bae:
Masks again for sure. And you know, some people are saying N95s, particularly in a close quarters, like an airplane. So yeah, we are going backwards. It’s very frustrating. And it’s because not everybody’s getting vaccinated. We’re allowing this new Delta variant to get a foothold on all of the unvaccinated people. Yes, there are some breakthrough cases of people who’ve been vaccinated getting the new Delta variant, but it’s definitely significantly fewer vaccinated people are getting sick compared to the unvaccinated people and more critically important as the unvaccinated people are getting seriously ill, more likely to be admitted to the hospital, more likely to die.

Dr. Bae:
Whereas the vaccinated people are less sick. And maybe after a 24 hours or 48 hours of feeling like you have the cold, those people get better that are vaccinated without having to go to the hospital. So obviously [inaudible 00:02:08]… I don’t think I have to say it again, but I will that it would be beneficial if you go get vaccinated, whatever data you’re reading out there that the vaccination is unsafe or something like that. I don’t know how many hundreds of millions of people you have to have entered into a study, getting a vaccine and obviously a huge majority of them, over 99% of them are doing fine with the vaccine. It’s going to convince you.

Long term immunization and boosters

Greg:
Well, let me say this. Yeah. Even though that is kind of the bad news that we’re getting right now and the Delta thing is going on, I do think there’s been two pieces of good news that have come out recently. Number one, we just found out that Moderna said that, I think, even after six months, that vaccine is still 93% effective. So that is great news to know that we now have that study. And of course my girl, Dolly Parton, she funded that one. So of course that one works.

Dr. Bae:
Of course, of course. Yeah. No, a lot of good studies coming out of Israel also, cause they’ve done a lot of the studies with Pfizer showing that, the more antibodies you have that the more protection you have. And so that’s why they’re talking about maybe getting a booster, which isn’t unusual. Because that’s what you do with the regular flu vaccine every year is you’re essentially getting a booster of the new variants that are coming out every year. So to some extent, this Delta variant is no different than… I mean it’s much more serious and obviously… But as far as getting the vaccine, it’s no different than what you would typically get annually for the flu vaccine.

Greg:
Because flu strains change, right? I mean they change every year.

Dr. Bae:
Every year. Exactly right.

Greg:
It’s not the same flu last year that it was this year. And so they change the vaccine every year a little bit.

Annual flu shot will include protection against COVID variants

Dr. Bae:
Exactly. And people think that this is a new thing just because it’s always in the news and you’re hearing about it more, but it’s just obviously rising to our top of mind because of the pandemic and everything. But yes, that is going to be a pretty typical thing I think is that maybe even the annual flu vaccine will include some aspects of the COVID virus in the future, moving forward as that variant changes. So, I think what I’ve read before is that the typical flu vaccine is trivalent, meaning it’s effective against three strains. Now it’s going to be four strains, five strains, but including these different COVID strains, it’s going to be a much bigger needle next year, probably.

Greg:
Yeah, well the other piece of good news is that with the Delta variant, which is not the good news, more people are getting vaccinated. I think people have kind of wised up to the fact that, okay, this is really serious. So we’ve seen numbers, I think going about the 50% range to going over 70% with people at least have one shot.

Herd immunity

Dr. Bae:
Correct. And I think what they were talking about with the original Wuhan strain, that if they got to 70% vaccination rate, that that would give us herd immunity. Now with this more infectious Delta variant, that has got to be closer to 90%, but yeah, we’re definitely moving in the right direction. I think people are getting scared now, they’re realizing, oh wow, this is actually happening to people I know. And so, yes, you’re right. I agree with you. More people are getting vaccinated. And I think just seeing those numbers from the hospital where a huge majority of the people admitted to the hospital are unvaccinated. So people are starting to realize that’s the way to go.

What if the Delta variant was around before the vaccine?!

Dr. Bae:
Something I’ve said before, that blows me away though, is that how many people are getting admitted to the hospital right now in Florida, Louisiana that are overwhelming those systems like no previous surge was overwhelming them. Keep in mind that with this Delta variant, that not everybody’s going to the hospital because we have the vaccine right now. But think about back in March of 2020, if we didn’t have any protection, no vaccine, if the Delta variant was the original strain back in March of 2020, how much more infectious it would have been, how much more sick everybody would have been, how many more people had been going to the hospital, it would have really been like Armageddon. It would have been unbelievable experience. Like we think this was bad. It would have been even worse.

Go get vaccinated!

Greg:
It could have been worse, but you know what, here’s the deal. I’ll make it easy for you. It is… So we were all begging to try to get the vaccine back in the day, right. A year ago, or whenever we started doing it, six months ago, it is so easy. The Safeway across from where I work out, you could walk in, it’s free. You don’t need an appointment. It takes under five minutes. I’ve seen people do it when I’m in there shopping. It is so easy to get vaccinated and it is free. So if you’re not… Go in and do it and you will feel so much better I think.

Dr. Bae:
It’s so true. Do you remember the days where people were getting up early in the morning to log in on multiple websites, trying to find an appointment? And now, the Walgreens in our building, they say walk-ins welcome, walking [crosstalk 00:06:46] available. [crosstalk 00:06:46].

Greg:
Absolutely. And we are lucky again. I know everybody knows this. We’re lucky to live in this country. I was just in Puerto Vallarta a couple of months ago for my birthday. Did you send me… You sent me an email, but where’s my card Dr. Bae? Anyway, there were people, 300 deep, around a building in sweltering heat, just waiting to get the vaccine. So we’re so lucky to be able to just walk into a Safeway. So please do that. And if you have any questions, Dr. Bae can answer them or get you to somebody. If he doesn’t know the answer, he’ll get the answer for you. You’re so good about answering everything on your social media. So can you tell people how to ask you anything really, right?

Where to find Dr. Bae

Dr. Bae:
Absolutely. Anybody can get in touch with us at Real Dr. Bae, R-E-A-L-D-R-B-A-E on Instagram, Snapchat, TikTok and just direct messages. And then you can also come to our website and message us through our contact page, or even schedule a consult, well for cosmetic things, obviously, but if you have questions about COVID and the vaccine just absolutely go through our contact submission form at realdrbae.com, R-E-A-L-D-R-B-A-E.com.

Greg:
Great information. Great to see you again, Dr. Bae.

Dr. Bae:
Great to see you, Greg. Thanks for having me.

The post Bae Break with Greg: What is breakthrough COVID? [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr. Bae:
I’m good ,Greg. I’m thankfully healthy. No signs of COVID, doing well.

New vaccine mandate

Greg:
That is good. Well, that leads me into my next topic, because I know that coming into your office, if you want a consultation, or if you’re going to get surgery with you, you have a new vaccine mandate. Is that correct?

Dr. Bae:
That is correct. Throughout this entire pandemic, we’ve been requiring patients to at least test negative in the community. And then when they come in the morning of surgery, we do get an antibody test on them. But now with this delta variant being a thousand times more infectious than the original Wuhan variant, we just had to get serious about it and our employees have always been vaccinated. That wasn’t a mandate. They just wanted to go out and get vaccinated because they’re into science and things.

Greg:
Oh my God, imagine that, being into science.

Dr. Bae:
Right, right. And being in healthcare and being into science. Right. And so that we’ve decided that we’re going to require all patients coming in for consults, for injectables, for surgery, that they have to be vaccinated. It’s no longer good enough just to have a negative test. You’ve got to be vaccinated, to at least minimize the chance of you getting breakthrough COVID, excuse me, a breakthrough COVID infection.

Free coffee for everyone… who is vaccinated

Dr. Bae:
The way it all started though, is kind of funny. It started out funny at least, that we got this new latte machine that had latte art on it, which we actually posted a photo of you yesterday on our latte.

Greg:
I saw you-

Dr. Bae:
And everybody’s asking for a sip of it.

Greg:
You can make my face on… no, you’re actually making my face on your latte machine.

Dr. Bae:
Right. We can upload your photo. We upload our logos, things like that. And then the machine prints out your face on top of the latte.

Greg:
I can’t wait to send this to my mom. I mean, she’s going to be like, “You finally made it.”

Latte art promotion

Dr. Bae:
Ginger will love it. Ginger will love it. And so what we said is like, oh, we should have people come in and get free coffee and then we’ll put our logo on the latte art. And then if people tag us on social media, they’ll get 10% off the surgeon’s fees for injectables or for surgery. And then we were like, you know what? If we’re offering all these people to come in for free so that they’ll tag us on social media, then we need to make sure that they’re all vaccinated. We don’t want to be bringing a bunch of delta variants into the office. And then we started thinking, well, if we’re going to require everybody to be vaccinated to get coffee, well, maybe we should be requiring everybody to get vaccinated who’s going to be having surgery. Because if you have COVID and you get surgery, you’re going to have the increased risk of getting infections or having post-op complications associated with your surgery.

Dr. Bae:
So that’s how it all started. And then we’ve said, okay, that’s what we’re going to do. So it’s been a few weeks now that we have a vaccine mandate for all patients coming into the office. Even if you were a previous surgical patient and you’re coming back to get another operation, you’ve got to be vaccinated now.

Pushback to our vaccine mandate

Dr. Bae:
And we have had some pushback. But so far… I mean pushback on social media, people saying, “Oh, this is like Nazi Germany.” Everybody always loves to use Nazi Germany as their excuse for anything. And they always think that they automatically win an argument if they compare you to Nazis. They don’t realize that you automatically lose an argument when you compare something to Nazi Germany. But we’ve had some people say, “Oh yeah, you’re forcing us to do this.” It’s like, not forcing you to do anything. You can choose not to get vaccinated. And I can choose not to have you in the office at the increased risk of getting-

Greg:
It’s really about keeping everybody safe, though.

Dr. Bae:
Exactly.

Greg:
It’s not just about forcing people into vaccinations. It’s about keeping your staff safe, you safe, and the patients safe.

Dr. Bae:
And also not bringing home the delta variant to Emilio, our six and a half month old who’s not eligible for vaccine yet.

Greg:
You have a baby to think about now. It changes everything.

Dr. Bae:
I have to. Just like I care about other people’s babies staying healthy, then you should care about my baby staying healthy and that’s why you should come in vaccinated now.

Why you should get vaccinated

Dr. Bae:
The thing that I don’t understand is, I know everybody’s got their different viewpoints on the science and they feel like this is this or that, but just with the data coming out with all of these people who are being hospitalized, that overwhelmingly the people that are being hospitalized are unvaccinated people and to a much lesser degree, it’s vaccinated people. And then to a greater degree, the people that are vaccinated are staying out of the hospital. They’re not getting serious illness. They’re kind of having a cold. And so just the numbers seem so obvious to me that if you’re unvaccinated, you’re at much higher risk of being admitted to the hospital, dying and things like that.

Dr. Bae:
The thing that blows me away is, think about this. Think about if this delta variant, which is a thousand times more infectious than the original Wuhan variant, think about if we had this variant at the beginning of the pandemic in March of 2020-

Greg:
Oh my God.

Dr. Bae:
when there was no protection against it, there was no vaccine. It would be Armageddon. Everybody would be getting admitted to the hospital. It would’ve been really horrible.

Greg:
Well, we definitely would have been in our bunkers then. Yeah, we would have been hiding.

Dr. Bae:
For sure. If we think it’s bad now, it would have been way worse if we had no protection against something that was that infectious and that serious. So because of all that, that’s why we are requiring people to get vaccinated. And you know what? Get vaccinated, come in, get some free coffee, tag us on social media, get 10% off surgery. How can you go wrong with that?

How to learn more

Greg:
And you know what? You don’t even have to get any kind of procedure, or ever even think about getting any kind of procedure-

Dr. Bae:
That’s true.

Greg:
of course we would love for you to, to get that free coffee.

Dr. Bae:
Right. That is true.

Greg:
How do we get the free coffee, Dr. Bae? If we’re vaccinated, we can reach out to you.

Dr. Bae:
That is a really good point. You do not have to be a patient or get a procedure just to get the free coffee. You can just come in, be vaccinated and get it. So the way to do it is you actually go to our website, realdrBae.com, R-E-A-L-D-R-B-A-E.com, and you’ll see a link to put a pre-order in for your latte.

Greg:
Oh wow.

Dr. Bae:
And you just book your coffee right there and you come in and we will give you a coffee with our logo on it.

Greg:
No, my face.

Dr. Bae:
And you can choose to tag us on social media or not.

Greg:
My face. Ask for my face.

Dr. Bae:
You get a choice, either Greg’s face or our logo.

Greg:
Perfect.

Dr. Bae:
But we also can put your post-op photos on the latte art. We have a booty shot on the latte now.

Greg:
Wow.

Dr. Bae:
Yeah, yeah. Check out your e-blast. You’re in there. We sent out an email newsletter this morning. You’re in there.

Greg:
Oh, Lord. I hope it’s not my booty.

Dr. Bae:
But it’s pretty funny. It’s amazing. What you can do with latte art now is limitless.

Greg:
All right. Well, we’ll see you soon, Dr. Bae.

Dr. Bae:
Thanks so much, Greg.

The post Bae Break with Greg: Vaccine mandate for patients first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr. Bae:
Hey, Greg.

Greg:
What’s going on?

Dr. Bae:
Things are good. We are seeing patients regularly, busy. Everybody’s like kind of getting their COVID face on. They’re ready to get back out into the world, getting recovered so they can enjoy the summer.

Medical Tourism

Greg:
That’s true, absolutely. People are getting out and about and people want to look better. And that’s one reason to go see Dr. Bae. I have a friend and she just did one of your favorite procedures or one of your expertise procedures, the mommy makeover. But when she told me she was doing it, I was a little concerned because she went to a foreign country, medical tourism. I won’t say where. But she went to another country. It was a whole process when she was explaining it to me. She’s going to be down there for a couple of weeks and they’re moving her to another facility after. I mean, I’m concerned and I just wanted to talk to you about… Yeah, it’s cheaper, right? It’s cheaper maybe to go to another country. But what are the risks and how do you figure out? How to get a good person if you’re going to do that? And can somebody talk to you before they make a bad decision?

Don’t just focus on cost

Dr. Bae:
Absolutely. Unfortunately, people are really just focused on the cost. And of course, cost is a big part of everything, I know. We provide pricing on our website, so people can check pricing before they come in for a consultation. But you don’t want to boil everything down to cost. It’s like the ultimate decision. But you have to keep in mind that, yes, you’re going to save some money if you go to another country. And I’m not going to make a blanket statement that all surgeons in other countries are bad surgeons. But the thing that you have to realize is whether it’s a good surgeon or a bad surgeon, whether it’s in this country or out of this country, there’s always the risk of complications. And just because its cosmetic surgery doesn’t mean it’s not real surgery.

Dr. Bae:
So if you come to me and unfortunately you might have a complication like the wound doesn’t heal right, or the breast implant gets infect, or something like that, at least I’m here locally to take care of you and it won’t cost you anything else for me to take care of that complication or at least I’ll do everything I can to make sure it doesn’t cost you anything. Whereas if you get that procedure done in another country and then you come back home and then you start looking around for a doctor to help you when you’re having this complication, they’re going to charge you. That’s not your… They’re not your original doctor. You’re not their original patient. That’s what they do. They have to charge you to provide those services and it’s going to get really expensive. So whatever money you may have saved by going out of the country, you’re going to spend twice that treating a complication because you’re working with the doctor that’s not your original doctor.

Hope for the best, prepare for the worst

Dr. Bae:
So, I get it that you want to save some money. But for the peace of mind, and just put it out of your mind first of all that you might not get a complication, that certainly you have to go into it kind of preparing for the worst. I mean, that’s just kind of a good way to look at it because hopefully everything will be great. And yeah, so if you have a problem, you’re going to want to have your doctor there locally because you’re probably not going to be able to go back across the country even if it’s in the United States or go outside of the country to get that complication treated.

Greg:
Well. And of course, whatever decision anybody makes, it’s always so smart to do your research. But do realize if you go out of the country and you have a health problem and you’re having it there, it’s going to be difficult because you’re not at home with your insurance and stuff. And then again, it’s going to be hard if you have an issue with that doctor and you’re back here, what can you really do about it there?

Dr. Bae:
Another interesting thing is a lot of people will tell me like, oh, but when you go to another country, because it’s less expensive, you get more for your money. You get the operation that you’re going to get here. And you can then stay there and recover for two to three weeks or a month even. [crosstalk 00:03:49] hotel.

Greg:
Which is what my friend is doing. Yeah. She stayed in a hotel for two weeks.

Benefits of getting home as soon as possible

Dr. Bae:
And so you’re thinking, oh, that’s great. I get so much for my money. But the thing is, after you do your operation with us here in office operating room, you go home. And that’s, I don’t think there’s any better place to recover than at home. And if you’re staying at these hotels or these post recovery centers for an extended period of time, other patients are staying there also. So just like, there’s a risk of getting an infection from somebody else at a hospital, there’s a risk of getting infection in these long-term facilities and other places in other countries. So, it’s not so great that you have a place to stay for a long period of time. It actually increases your risk of infection potentially. So, that would be my opinion is get home as quickly as possible. And if you want a home health nurse to help you out, sure, no problem.

Dr. Bae:
But most of the things you’re going to be dealing with after your surgery, you don’t really need a nurse. You just need a family member that’s there available to help you. You don’t really need somebody that’s got additional degrees. Because even if you get a home health nurse, they maybe mostly a cardiology nurse. They’re not necessarily a post-op cosmetic surgery recovery nurse. And that’s a big difference. Just like, you don’t come to me for your diabetes management, you don’t go to a internal medicine doctor for plastic surgery. So, same thing. Nurses are sort of specialized as well. So, they might not necessarily be perfectly suited to take care of you in your recovery. So, get home as soon as possible after your surgery. Try to avoid being around other people or other institutions where you could get additional infections. And so, that would be my argument why you should stay in the country.

How to get more information from Dr. Bae

Greg:
Well, whatever you decide, just make sure you do your research. Take your time. Don’t rush into anything. And if you have questions you want to reach out, you want to ask anything, you can always go to Dr. Bae social media. Ask him anything. And it is?

Dr. Bae:
@realdrbae, R-E-A-L-D-R-B-A-E, not B-A-Y, and realdrbae.com. You can always reach me there through website, social media. I’m always available to answer questions through direct messages.

Greg:
I’m going to test you now. I’m going to send you a message. See how long it takes you to answer me.

Dr. Bae:
Hopefully not asking me what’s the capital of North Dakota or something.

Greg:
You could look that up. All right. We’ll see you next time, Dr. Bae.

Dr. Bae:
Thank you so much, Greg.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Beware of Medical Tourism [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Anaplastic large cell lymphoma (ALCL) vs Breast implant associated illness (BIAI)

Compared to BIAI, it’s “easier” to determine if someone has ALCL. They’ll present with a late onset fluid collection or seroma around their breast implants (most typically textured implants), 1 to 20 years after surgery. And when sent to the lab, that fluid collection will test positive for the CD30 protein or negative for the anaplastic lymphoma kinase (ALK) protein. ALCL is treatable, and cure is possible, with removal of the implant and surrounding scar tissue when performed early. Again, the most encouraging aspect of ALCL is that it is diagnosable and treatable.

While BIAI and ALCL are similar in that they both seem to affect patients with textured implants, they are very different in other ways. For example, BIAI has many vague symptoms also associated with other disease processes, including those not involving breast implants. Symptoms that women commonly report are fatigue, anxiety, foggy thinking, memory loss, headaches, muscle pains and even hair loss and skin rashes. A caring sympathetic doctor would not dispute that a patient is feeling these symptoms. But this is not enough to make the diagnosis of BIAI.

BIAI is difficult to diagnose for two reasons. First, there’s not always a physical symptom like seroma formation. And secondly, there’s currently no diagnostic lab test, as in the case of ALCL. However, in an exceptional case, I had a patient with BIAI that actually had physical symptoms and a positive lab test. But a word of caution. The lab tests referenced here are not specific to BIAI and are certainly not diagnostic of BIAI in the same way CD30 is diagnostic of a symptomatic patient with ALCL.

A BIAI patient with symptoms and lab abnormalities

A previously healthy, thin, fit, female patient of mine had breast augmentation with 320cc round-base, shaped, textured implants in April of 2016. Approximately 6 months after surgery, she started to experience rashes (see photo), extremely high blood pressure (168/110) and numerous food allergies (gluten, dairy, alcohol, coffee) which would lead to more rashes.

Her hands would turn white and purple, a sign of Raynaud’s disease (see photo) – changes she never experienced prior to breast augmentation. Soon after, she started to experience muscle weakness and a sensation that her legs were very heavy. Upon going to the ER, her lab tests showed very high levels of creatine kinase (CK). This is an enzymatic protein found in the heart, brain, skeletal muscle, and other tissues. It is released into the bloodstream when there is damage to those tissues. Measuring high levels of CK is  a common test for someone actively experiencing a heart attack. CK levels are high when there is damage to the heart muscle because coronary arteries are clogged and the heart isn’t receiving enough oxygen.

Despite a high CK level, there was no reason to suspect she was having a heart attack. She was young, had no chest pain and no changes on EKG. But they were concerned that elevated CK levels, whatever their cause, could damage the kidneys, as is possible in rhabdomyolysis. Rhabdo, for short, is the rapid breakdown of muscle tissue and release of proteins into the bloodstream. The large amount of proteins can damage the kidneys and cause acute renal failure.

While the doctors had not yet diagnosed the cause of the elevated CK protein in the blood, they worried about its effect on the kidneys. In an overabundance of caution, she remained in the hospital for 3 nights with IV fluids to help flush out the CK protein before it could damage the kidneys, which was successful.

Unsure of the cause of her full body symptoms, she dramatically shifted her lifestyle. This included alcohol cessation, which she already used in moderation beforehand, and avoidance of foods that could cause any bodily inflammation.

After another admission to the hospital in July of 2019 (3 years after surgery) because of weakness, muscle wasting and an elevated creatine kinase level of 411 U/L (normal is 24-173 U/L), she decided the implants were the underlying cause of these symptoms and made the decision to remove them.

In November of 2019 (3+ years after implantation), I removed the implants and the surrounding scar tissue (capsulectomy). Since then, her rashes, Raynaud’s and all other symptoms have disappeared. As of January 2020, 2 months after implant removal, her creatine kinase level returned to the normal range.

So what does it all mean?

This represents one of the few examples in the literature when demonstrable physical symptoms (rash and Raynaud’s disease) in combination with a lab test, both had resolution after removal of implants. And while resolution of elevated lab tests and symptoms should be seen as a success after implant removal in patients experiencing BIAI, the true success remains elusive.

What we need is a preoperative antigen test that can predict, with a high degree of certainty, that if someone gets implants, their body may react to the implants and enter a sustained, chronic phase of inflammation. And if the patient is found to be “reactive” to such a test, they wouldn’t get implants.

Testing like this is not unheard of within aesthetic medicine. For example, one component of the dermal filler Bellafill is bovine collagen. Because some patients can have a reaction to bovine collagen, they receive a skin test one month before Bellafill treatment. If they have a skin reaction, they are not a candidate for this long-lasting dermal filler. Similarly, if someone would have a reaction to some future “breast implant antigen” test, they would not be a candidate for breast augmentation.

Conclusion

For those who believe no one should get breast augmentation until the development of such a test, that is an unreasonable approach. There are millions of women around the world who currently have breast implants and over 400,000 undergoing the procedure for cosmetic or reconstructive reasons each year.  And with a relatively small percentage experiencing ALCL or BIAI, the benefits of breast augmentation greatly outweighs the risks. While continuing to provide this service to women for cosmetic reasons or for reconstruction after mastectomy, we should also continue to develop prognostic techniques to avoid augmentation in the few patients that will have very real adverse reactions.

And for those few patients that do have symptoms after implantation, luckily there’s treatment. They can be potentially cured with explantation (implant removal) and capsulectomy.

Dr. Jonathan Kaplan is a board-certified plastic surgeon based in San Francisco, CA and founder/CEO of BuildMyBod Health, a price transparency-lead generation platform. You can watch him operate and educate @realdrbae on Instagram, Snapchat and TikTok.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post The difficulty in diagnosing Breast Implant Associated Illness (BIAI) first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

COVID cases increase

But telling schools, sports (without spectators), salons and other indoor businesses to remain suspended isn’t a long term plan. Sure you can attempt to mitigate the spread by not participating in large crowds like protests, enclosed bars and restaurants. You can wear a mask around others, social distance and wash your hands. But despite these measures, the rate of infections will continue to ebb and flow.

What we have to understand is this is a pandemic that is here to stay. Everyone is quick to mention the end of the pandemic will arrive when a vaccine is available. But even if a vaccine is approved, we have to hope it’s effective against all strains of this novel coronavirus.

There’s also the issue of distributing the vaccine. What makes you think you’ll be the first to get it? It’s almost certainly going to the elderly and institutionalized first. Your cohort, whomever you may be, is probably third or fourth in line!

So we need to prepare for the long haul here. We will continue to see surges come and go across the country and around the globe. Often revisiting locales that already experienced surges before. And that means the public has to avoid the temptation of demanding that everything, including schools or sports, shut down the moment one person, or three, get infected. This situation demands tolerance when members of our community test positive, because that is an inevitability. Remember, the realistic goal we set for ourselves from the outset was to flatten the curve, not eliminate it.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post As COVID cases increase, so too must the public’s tolerance for them first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Early on in this pandemic, the recommendations from the CDC and state authorities were pretty clear when it came to mass gatherings: don’t have them. In fact, the CDC reiterates this guidance in an update from July 7th, 2020. The highest risk of spread of the coronavirus comes from “large in-person gatherings where it is difficult for individuals to remain spaced at least 6 feet apart and attendees travel from outside the local area.”

What constitutes a mass gathering?

In other words, congregating in large groups can lead to a surge in infection, like the surge we currently find ourselves in. So what qualifies as a mass gathering? If you sample articles like here, here and here, you would think mass gatherings only apply to debaucherous events such as partying during Memorial Day or July 4th weekends. In the articles above, the banner image is often that of folks partying on inner tubes, bars or beaches.

Noticeably absent in the national conversation about this surge are the largest mass gatherings over the last 6 weeks: protests. If your only source of the world around you was traditional media, you would think protests are exempt from the definition of mass gatherings.

Why is that? Why do political protests against police brutality (an obviously worthy cause), get a “pass” when it comes to assigning responsibility for a surge? It’s as if we’re afraid to recognize the role of the recent protests in the current surge. Are linking protesting and surges somehow politically incorrect? Is there really no scientific basis to state this simple fact: mass gatherings of any kind, including protests and parades (as in the case of a war bonds parade in Philadelphia during the 1918 influenza pandemic), increase the spread of the disease.

Here’s a quote from an article about Pittsburgh, Pennsylvania’s recent surge that epitomizes this ongoing journalistic dishonesty and total lack of recognition about the role protests play in spreading the coronavirus:

“The main source of the current outbreak is largely undisputed. People who had been cooped up for months flocked to the city’s bars and clubs, crowding shoulder-to-shoulder like old times on East Carson Street.”

No mention of the protests occurring in Pittsburg throughout the month of June. No mention of thousands of protesters with and without masks, yelling, chanting and spreading droplets of virus amongst other protesters.

Evidence that the current surge is due in part to the protests

If you question the validity that protests are potential super spreader events, this map of the more than 2000 protests that took place across the US should make you reconsider.

Based on research from the Pew Research Center, the majority of protesters were ages 18-49. This corresponds with the same age group that is contracting the virus during this surge.

The same Pew research also points out that Black and Hispanic communities were overly represented at the protests. While Blacks only account for 11% of the US population, 17% of the protesters were Black. Hispanics account for 15% of the US population but were 22% of the protesters. Sadly, these same communities are also disproportionately affected by the coronavirus.

While the media is hesitant to blame the thousands of protests that took place across the country in June, they’re quick to blame a single pro-Trump rally for a recent surge in Tulsa, Oklahoma. Keep in mind that the media initially reported a “disappointing” low turnout for the Trump rally but then weeks later determined there indeed were enough people attending the rally that it was responsible for the subsequent surge in Tulsa.

It’s interesting to see how the media has twisted the words of the local public health official in Tulsa. The official referred to an increase in cases after “several large events” including protests and the Trump rally. Notice that the public health official recognized it was all mass gatherings that led to the surge, but the media assigned the blame to the Trump rally only.

Why it is important to admit the role protests have in the current surge

All of this is to point out two realities: 1) surges are not political phenomena and 2) not recognizing the role of protests in the current surge diminishes the credibility of our news media and public health officials.

Surges are epidemiological realities of mass gatherings. It’s immaterial as to whether you’re a Democrat or Republican, or whether you agree with the social justice issue at hand. Protesters need to recognize that while they are fighting for a worthy cause, they’re endangering the same minority communities they’re trying to help. And how worthy a cause may be, is irrelevant to the transmission of viral genetic material.

Understandably, stopping a protest because of concerns about the spread of the coronavirus is impractical. Nothing is stopping the rage and anger leading to these protests. But when there is a surge, the media should recognize it for the epidemiological inevitability that it is, rather than avoiding the reality because it may be politically incorrect. Admitting to and recognizing problems and how best to deal with them doesn’t just apply to social justice. It also applies to pandemics.

Protesters need to recognize that while they are fighting for a worthy cause, they’re endangering the same minority communities they’re trying to help.

Despite the overwhelmingly skewed coverage of the surge, this article attempts an honest look at protests as an example of mass gatherings that are leading to the surge across America. The article interviews and highlights the hypocrisy of public health officials that essentially say mass gatherings in a pandemic are ok if you agree with the context of the protest. And these opinions are being promoted by people supposedly motivated by science and not politics.

The ignorance of these public health officials further reaffirms the erroneous belief held by members of society that this “pandemic” is a hoax. That segment of society is hearing that it’s not ok to socially distance in a church, but it is ok to be in a protest where protesters are shoulder to shoulder, potentially coughing and wheezing from tear gas. Is it any wonder that Americans are disillusioned with our elected and appointed leaders who issue directives and edicts about social distancing?

Bottom line: if you must protest, first, recognize that you are contributing to the spread of a virus that is not a hoax, and affects the young and the old alike. Second, consider the safest form of protesting: a caravan protest.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

Dr. Jonathan Kaplan is a board-certified plastic surgeon based in San Francisco, CA and founder/CEO of BuildMyBod Health, a price transparency-lead generation platform. 

The post So we’re to believe some mass gatherings are ok during a pandemic? first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.