• Reduce body fat
• Increase lean muscle mass, bone density, and energy levels
• Enhance the immune system
• Strengthen the heart
• Improve sleep quality by promoting non-REM slow wave sleep.

Please take a moment to review some more information about Semorelin Nasal Spray below and call/text our office at (415) 923-3005 or email us at frontdesk@pacificheightsplasticsurgery.com for assistance. You could also click here to complete our intake paperwork and get started now, or just purchase online here! While you can purchase online now, we’ll still require paperwork before shipping to you.

What is Sermorelin?

Sermorelin is a synthetic peptide that stimulates the pituitary gland to produce more natural growth hormone (GH). Growth hormone plays a critical role in maintaining several functions in the body, including energy levels, muscle growth, fat metabolism, and cognitive function. Sermorelin helps replenish growth hormone levels, which naturally decline as we age.

How Does Sermorelin Work?

Sermorelin works by stimulating your body’s natural production of growth hormone. Instead of directly introducing synthetic growth hormone, Sermorelin encourages your pituitary gland to secrete more of it on its own, which can lead to better, more sustainable results over time.

As we age, the body’s natural growth hormone production decreases, leading to symptoms such as muscle loss, decreased energy, increased fat storage, and cognitive decline. By restoring healthy growth hormone levels, Sermorelin helps combat these issues, promoting overall vitality and wellness.

What are the potential side effects?

At Pacific Heights Plastic Surgery, we’re committed to providing safe and effective treatments. Sermorelin is generally well-tolerated, but some potential side effects may include:

• Mild headache
• Fatigue
• Joint pain
• Dizziness or nausea 
• Brief burning sensation or irritation in the nose

These side effects are typically temporary and should subside after a short time. If you experience any lasting discomfort, don’t hesitate to contact our office at (415) 923-3005 for guidance and support.

Frequently Asked Questions (FAQs):

• Q: How is Sermorelin administered?

• • • A: We provide sermorelin as a nasal spray to be administered once a day (ideally at night) through one nostril. You have the option of a daily intramuscular injection which may burn, which is why we prefer the daily nasal spray.

• Q: Will I need a new consultation or lab work?

• • • A: No, you will only pay for the Sermorelin Nasal Spray subscription at $200/28 days but we do require intake paperwork which can be found here.

• Q: How long does it take to see results?

• • • A: Results can vary, but most patients begin to notice improvements in energy, sleep, and overall wellness within a few weeks.

• Q: What if I don’t feel the results right away?

• • • A: Sermorelin may take some time to work depending on your body’s current hormone levels. However, if you feel the treatment isn’t working for you, please reach out, and we can adjust your plan.

• Q: Can I pick up my medications in person?

• • • A: Yes! Please give us a heads-up in advance so we can prepare your medication. 

• Q: Can I cancel my subscription?

• • • A: Yes! Our program is flexible, so you can opt in or out as needed. There are no additional cancellation fees.

• Q: What if I have more questions?

• • A: We’re here to help! Please call our office at (415) 923-3005 or email us directly at frontdesk@pacificheightsplasticsurgery.com. Our team is available Monday through Friday, from 8 AM to 4:30 PM.

What next? You can:

• Call/text our office at (415) 923-3005 with any additional questions
• Email us at frontdesk@pacificheightsplasticsurgery.com
• Click here to complete our expedited consultation paperwork and get access,
• Or just purchase online here! While you can purchase online now, we’ll still require paperwork before shipping to you.

The post Sermorelin Nasal Spray first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

• Boost energy levels

• Enhance mental clarity and focus

• Support cellular health and repair

• Improve mood and stress

Please take a moment to review some more information about NAD+ injections below and call/text our office at (415) 923-3005 or email us at frontdesk@pacificheightsplasticsurgery.com or click here to complete our intake paperwork to get started, or just purchase online here! While you can purchase online now, we’ll still require paperwork before shipping to you.

What is NAD+?

NAD+ stands for Nicotinamide Adenine Dinucleotide. It’s a coenzyme that’s naturally present in   your body and plays a crucial role in many of your body’s key processes. Essentially, NAD+ helps your cells produce energy, repair damage, and regulate your metabolism.

Why is NAD+ important?

NAD+ is involved in several vital processes, including:

• Energy Production: NAD+ helps convert the food you eat into energy that your cells can use. It plays a key role in the function of your mitochondria, which are responsible for producing energy.

• Cell Repair: As you age or experience environmental stress, your cells undergo damage. NAD+ helps repair damaged DNA, supporting your body’s natural healing processes.

• Metabolism Regulation: NAD+ helps regulate your body’s metabolism, including the way you process fats, proteins, and sugars. It also helps with balancing blood sugar levels.

• Healthy Aging: Higher levels of NAD+ are associated with longevity and age-related health. As we get older, NAD+ levels naturally decline, which can contribute to the aging process and reduced energy. By boosting NAD+, some believe we may be able to counteract some of the effects of aging.

How Does NAD+ Decline with Age?
As we age, NAD+ levels in our bodies naturally decrease. This reduction can lead to lower energy levels, slower recovery from exercise, impaired cognitive function, and other age-related issues. Factors like stress, poor diet, alcohol use, and lack of sleep can also accelerate the decline in NAD+.

What are the potential side effects?  At Pacific Heights Plastic Surgery, we pride ourselves on providing accessible symptom management for all our patients. Potential side effects after taking NAD+ injections are temporary but may include nausea, dizziness, stomach cramping, or tenderness at the injection site. Please call our office at (415) 923-3005 so we may provide support if you experience any discomfort.

Frequently Asked Questions (FAQs):

            • Q: Will I need a new consult or labwork?

                        • A: No, you will only pay for the NAD+ subscription at $399/28 days but we do require intake paperwork which can be found here.

            • Q: Will symptom management be included in my subscription costs?

                        • A: Absolutely! We are able to call in a prescription, set up a meeting with any of our providers, or offer guidance with no additional cost.

• Q: Will my medication dose increase?

                        • A: No, unlike GLP-1 medications we keep the dose of NAD+ injections consistent. 100mg subcutaneous injection every week. If 200mg/mL concentration vial, 50 units each week. If 100mg/mL concentration vial, 100 units each week.

            • Q: Can I pick up my medications in person?

                        • A: Yes! Please give the office a heads up in advance so we know to expect you. Otherwise, we are happy to ship local to California or all across the country because we are licensed in most states, including about 99% of the US population!

            • Q: Can I cancel my enrollment?

                        • A: Yes! Our program is opt-in/opt-out, so if the medication isn’t working for you, let us know! There is no additional fee to cancel or re-start the program. You’re never locked in other than the month you already paid for and received medication for.

            • Q: What if I have more questions?

                        • A: Please give our staff a call at (415) 923- 3005 or email us directly at frontdesk@pacificheightsplasticsurgery.com! Our hours of operation are 8 AM-4:30 PM Monday through Friday.

What next? You can:

• Call/text our office at (415) 923-3005 with any additional questions
• Email us at frontdesk@pacificheightsplasticsurgery.com
• Click here to complete our expedited consultation paperwork and get access,
• Or just purchase online here! While you can purchase online now, we’ll still require paperwork before shipping to you.

The post NAD+ Injections first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Once you’ve watched the video above, you can move forward with either our coaching program here or non-coaching program here.

We’ll be notified of your choice and will follow up immediately with a link for online paperwork completion. Once that’s complete, we’ll place an order for lab work so you can go into any LabCorp and get your blood drawn for no additional out of pocket cost.

Once the lab work is reviewed, we’ll send you a link to sign up for your medication subscription. Either semaglutide here or tirzepatide here.

If you already have lab work within the last 3-6 months that includes a CBC, CMP, HbA1c and TSH, feel free to email those results to frontdesk@ph-ps.com so we don’t have to unnecessarily repeat lab work.

The post Recording of our recent Shared Virtual Consultation first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Background on Ozempic and Wegovy

Not since Viagra or Botox, has a class of medications garnered as much attention as Ozempic, Wegovy and Mounjaro. These glucagon-like peptide (GLP-1) receptor agonists mimic naturally occurring gastrointestinal hormones to help suppress appetite and enhance insulin secretion from the pancreas, one of the reasons these medications were first approved for treatment of type 2 diabetes.

During approval studies and real-world treatment with this class of medication, patients with type 2 diabetes were also losing significant amounts of weight. So much so that NovoNordisk, the manufacturer of Ozempic, remarketed the exact same active ingredient, semaglutide, as a chronic weight management medication under the name Wegovy.

Not to be outdone, Eli Lilly, the manufacturer of the type 2 diabetes medication Mounjaro (which mimics both GLP-1 as well the GI hormone gastric inhibitory peptide (GIP)), is in the final stretch of FDA-approval of its active ingredient, tirzepatide, as a weight management medication as well.

The verdict is in. These medications work. Well. Sure there are potential side effects on the gastrointestinal tract such as nausea, vomiting, constipation and diarrhea. But they don’t occur in a majority of patients and they often dissipate with ongoing use. Despite side effects, they’re unquestionably safer than all weight loss drugs that came before. Remember Dexatrim from the ’80’s? Ingredients included the amphetamine-like compound, ephedra. Fen-Phen? Taken off the market in combination due to cardiac issues.

And yes, GLP-1’s have been associated with medullary thyroid cancer in rats but even some of the rats in those early studies that were taking the placebo (inactive medication) as part of the control group developed thyroid cancer. So the association isn’t clear. Additionally, the FDA admits the significance in humans isn’t evident either considering that the incidence of medullary thyroid cancer in humans has been rare and stable for over 30 years while this class of medication has been available for human use for over 20 years. It’s so rare that your risk of dying from medullary thyroid cancer by taking the medication pales in comparison to your risk of dying from heart disease and obesity by not taking the medication.

Medication Shortage

The problem now with such a successful medication on the market is its rampant shortage around the country. Because of that shortage, Ozempic and Wegovy, along with Mounjaro, are on the FDA shortage list. In the case of a shortage, FDA regulations allow compounding pharmacies to make duplicates of these commercially available drugs without fear of patent infringement.

Compounding pharmacies, in contrast to traditional pharmacies, get their materials from FDA-approved manufacturers that follow current Good Manufacturing Practices (cGMP) and customize them for customers. For example, compounding pharmacies can remove a dye from a commercially available drug for someone who is allergic to it. Hospitals have compounding pharmacies that mix specialized medications for patients. And this past winter, compounding pharmacies were encouraged by the FDA to make the liquid form of acetaminophen, the active ingredient in Tylenol, due to a shortage during the recent tripledemic of kids suffering from RSV, flu and COVID in the US.

Similarly, because of the shortage of Ozempic and Wegovy, compounding pharmacies are making a duplicate of the active ingredient, semaglutide. However, semaglutide can come in two forms, the pure base or the salt version (which includes an additional sodium ion attached to the semaglutide amino acid sequence). Because the FDA allows a duplicate of medications on the shortage list, the duplicate must truly be a duplicate of the semaglutide found in Ozempic and Wegovy. NovoNordisk’s original formulation is a semaglutide base, not semaglutide salt. While several compounding pharmacies I spoke with state that the difference between the base and salt form are negligible, the salt form is technically not a duplicate. Regardless, the semaglutide base is being manufactured by FDA-approved manufacturers and is available to compounding pharmacies.

What did the Board of Pharmacy ban in Mississippi and West Virginia?

Rather than the Mississippi and West Virginia Boards of Pharmacy (BOP) ban the use of semaglutide salt, they banned all forms of semaglutide, even the base version that is the active ingredient in the FDA-approved Ozempic and Wegovy.

But this suggests these Boards are incapable of differentiating between a compounding pharmacy using the semaglutide base or salt version of the compound. When inspecting and licensing a compounding pharmacy in their state, all raw ingredients are evaluated by the respective BOP and a Certificate of Analysis (CoA) confirms the makeup of the raw ingredients the compounding pharmacy sources from their FDA-approved manufacturer.

For example, the CoA below was provided to me by our compounding pharmacy on behalf of the manufacturer that provided them with the semaglutide base. If this was the salt version, an ‘Na’ would follow the sequence at the top of the document. So if I am able to attain this CoA for my weight management program, you would think a state Board of Pharmacy would be able to do the same and ban only semaglutide salt and not the approved base.

The result: by banning all semaglutide, including the true duplicate of the active ingredient found in Ozempic and Wegovy, a less expensive, more affordable alternative is unavailable for the poor, obese citizens of Mississippi and West Virginia.

But why wouldn’t these Boards perform their due diligence and limit the ban to only semaglutide salt? The most plausible answer is NovoNordisk, despite their admission they can’t meet demand, must be behind this campaign. Consider the fact that the letters issued by West Virginia and North Carolina banning all forms of semaglutide are strangely identical. Is NovoNordisk providing templates for pharmacies to ban all versions of the drug leaving a void in the market while they ramp up production?

No comment from NovoNordisk at this time.

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

The post Shame on you Mississippi and West Virginia first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Incretin mimetics

Ozempic, Wegovy and Mounjaro are all part of the same class of drugs that have been available for human use for over 20 years – incretin mimetics. These drugs mimic the effects of naturally occurring gastrointestinal hormones like glucagon-like peptide (GLP-1) and gastric inhibitory peptide (GIP).

What do these naturally occurring hormones do in the body? They suppress your appetite after eating so you feel full and they stimulate the pancreas to produce  insulin, which shifts sugar from the blood stream into the tissues for use as energy.

As the class name suggests, these drugs ‘mimic’ the effects of these hormones. For example, Ozempic and Wegovy stimulate the same receptors that glucagon-like peptide (GLP-1) stimulates in the body to suppress appetite, slow gastric emptying (food moves more slowing from the stomach to the intestine so you feel more full and eat less) and release insulin from the pancreas.

The Twincretin!

Mounjaro acts by mimicking two hormones, in other words it’s a “twincretin!” It acts on the GLP-1 receptors like Ozempic and Wegovy but also acts on the same receptors that GIP acts on, stimulating the gastric inhibitory peptide effects, further suppressing appetite.

Type 2 Diabetes Treatment

As you might have guessed (or not), Ozempic and Mounjaro, by acting on the pancreas to produce insulin, were first approved for the treatment of type 2 diabetes, the version of diabetes that’s most associated with obesity. [Type 1 diabetes is very different from type 2 diabetes. In type 1 diabetes, there’s a genetic or autoimmune reason for the insulin-producing cells in the pancreas to no longer produce any insulin. In this case, type 1 diabetics need insulin injections to live. This is very different from the cause of type 2 diabetes and how its treatment.] Leading up to obesity, people eat more food than their body needs, and that high sugar/carbohydrate diet is converted to and stored as fat, resulting in obesity.

And each time they eat, their pancreas is stimulated to produce insulin. After many insulin spikes over years of overeating, the pancreas becomes “burned out” and doesn’t produce enough insulin. So sugar in the blood isn’t shifted into the tissues for energy, leading to the body’s inability to get enough energy for critical functions like ensuring the brain and other organs work properly.

Weight Loss Approval

These medications were originally approved by the FDA to treat type 2 diabetes by enhancing the seretion of insulin from the pancreas. During the course of the drug approval study process, incretin mimetics were found to produce significant weight loss. So NovoNordisk, the maker of Ozempic, submitted the same active ingredient in Ozempic, semaglutide (an incretin mimetic) for approval as a weight loss drug, ie Wegovy. Therefore Ozempic and Wegovy are the same medication but for different indications/treatments.

Similarly, Mounjaro was approved for type 2 diabetes and was also found to have significant weight loss effects. Eli Lilly, the maker of Mounjaro is currently going through the FDA approval process to get the same active ingredient, tirzepatide, approved for obesity treatment.

Ozempic/Wegovy vs Mounjaro

How do these medications compare? Let’s focus on their weight loss results rather than their effectiveness for treatment of type 2 diabetes.

Both are once per week injections.

Dosages for Ozempic (approved for type 2 diabetes) are 0.25mg, 0.5mg, 1mg, 1.7mg and 2.0mg.

Dosages for Wegovy (approved for obesity) are 0.25mg, 0.5mg, 1mg, 1.7mg, 2.0mg and 2.4mg.

Dosages for Mounjaro (currently only approved for type 2 diabetes but already being used off-label for obesity) are 2.5mg, 5mg, 7.5mg, 10mg, 12.5mg and 15mg.

In the paperwork for the FDA approval of Mounjaro, there’s a helpful table comparing weight loss in Mounjaro and 1mg of semaglutide (the active ingredient in Ozempic and Wegovy) in patients with type 2 diabetes after 40 weeks of treatment.

The patients on semaglutide lost 5.7 kg (12.5 lbs). Patients on a relatively higher dose of Mounjaro (10mg), lost 19.3 kg (20.5 lbs), ie more than those on semaglutide, the active ingredient in Ozempic and Wegovy.

This is one reason many believe that Mounjaro, as a twincretin, will eventually have greater weight loss results than Ozempic/Wegovy. Some are predicting consistent bariatric surgery weight loss without the bariatric surgery when taking Mounjaro (tirzepatide)!

The other data point in Mounjaro’s favor is its safety profile. Whereas Ozempic/Wegovy led to nausea in 44% of patients, three studies show that the risk of nausea with Mounjaro ranges from 12-18%. Keep in mind that with Wegovy, the nausea was only bad enough to force 1.8% of patients to quit. The others found the benefits outweighed the downsides.

Risk vs Benefits

And that’s a common theme with these medications. Each person must weigh the pros and cons for themselves. If you’re morbidly obese and need to lose 100 pounds, you may be willing to accept the risk of nausea, especially when you can take other medication (Zofran) to alleviate those symptoms.

Many often ask about the risk of medullary thyroid cancer seen in some rats during studies with incretin mimetics. Some rats exposed to these medications in the lab developed medullary thyroid cancer but so did some of the rats that were taking a placebo (not the medication) as part of the control group.

Additionally, the FDA has not been able to determine if this is significant in the development of medullary thyroid cancer in humans. The incidence of medullary thyroid cancer in humans has been rare and stable in humans for over 30 years even though this class of medications has been used in humans for over 20 years. So no increased incidence. But if you’re still worried about getting thyroid cancer with these medications, then I would argue that your risk of dying from heart disease and diabetes by not taking these medications is significantly higher than the risk of dying from a rare form of thyroid cancer by taking these medications.

Wanna learn more? Read this post here, here and here. And if you’re ready to schedule a consultation, it’s easiest to pay for the consult here and receive priority scheduling. After the consult and reviewing your labs, you’ll have the choice, semaglutide ($500 per month) vs tirzepatide ($600 per month).

The post Ozempic and Wegovy vs Mounjaro first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Rather than making you wait for the next available individual consultation, we’re starting Shared Consultations via ZOOM Webinar so that multiple patients can have a virtual consultation ASAP. And before you ask, because we’re setting this up as a webinar, your name and face will not be seen by others attending the shared consultation.

Benefits include:

• A free weight management program consultation (normally $100)
• An earlier appointment vs waiting for an individual consultation when time allows
• Receiving the same information you’d learn in a regular individual consultation
• The ability to ask questions via the chat feature so you’ll get your questions answered
• Hearing answers to questions someone else asks that you may not think of yourself

At the end of the consultation, a link will be shared in the chatbot on ZOOM so you can 1) pay online to start the program and 2) begin the process of signing up for a semaglutide monthly subscription where you’ll receive a shipment of 4 prefilled syringes every 28 days for your once-weekly injections.

We’ll review all of this during the shared consultation. Next step is registering for one of the 3 shared consultation options below:

Shared Consultation on Wednesday, March 15th at 9am PST

Shared Consultation on Wednesday, March 15th at 12 noon PST

Shared Consultation on Thursday, March 16th at 9:30am PST

The post Shared Online Consultations for Ozempic/Wegovy Weight Management Program first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

I did write about this topic, albeit tangentially, in this silly article when Kylie Jenner was rumored to be pregnant with her first child!

Botox in pregnancy

While no doctor will encourage you to get botox injections for cosmetic reasons while pregnant, it doesn’t mean you can’t or you shouldn’t. Simply put, there isn’t a large randomized controlled study comparing women getting botox while pregnant vs women not getting botox while pregnant.

Yes, a large study of this type would answer the question of whether botox was safe in pregnancy. But it will never happen. For obvious reasons, no one would conduct or fund a study that could potentially affect a baby. So we’re left to extrapolate from this retrospective study (studying patients after the fact), animal studies or personal stories of patients that have gotten botox during pregnancy.

As a plastic surgeon, I have injected patients with BOTOX® or XEOMIN® when they didn’t realize they were pregnant. And the patient and their baby turned out fine. So while there’s no evidence of a problem in being injected with these products while pregnant, it’s impossible to say they’re safe beyond a doubt. But there’s no evidence of birth defects associated with cosmetic botox injections that exceeds the risk in the general population. It’s a calculated risk similar to the risks we take walking across the street, not wearing a mask outside or speeding on the highway.

Botox while breastfeeding

This one is a little easier. Based on the LactMed database that evaluates medications and their presence in breast milk or their affect on the child, the evidence is quite clear:

“No data exist on the medical use of onabotulinumtoxinA [BOTOX®] during breastfeeding. However, it is not detectable systemically after intramuscular use, thus excretion into breast milk is considered unlikely. Breastfeeding appears to protect infants against botulism.”

In other words, botox isn’t detectable in breast milk. To further drive home the point, even in a patient that became ill after ingesting botulinum from tainted food (not cosmetic botox injections), she didn’t pass the toxin along to her fetus. So even if it’s present in high concentrations systemically during an active infection and still doesn’t reach the breast milk, then it’s even less likely to reach breast milk when present in lower concentrations associated with cosmetic, localized injections.

As an aside, botulism from tainted food is the same reason you don’t feed honey to a baby before the age of one because of the presence of the botulinum bacteria. After age one, children are better equipped to ward off the infection.

There you have it. The data. And now you can make an informed decision based on that.

Click here to check pricing from Dr. Kaplan!

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

The post Botox, Xeomin or Jeuveau during pregnancy and breast feeding 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.

Why BMI isn’t enough

Sure BMI is better than looking at weight alone. Because even if a person weighs a lot, they may be very tall. And in that case, they would not be considered overweight.

However, BMI doesn’t take all nuances of body shape into account. For example, in the video below, the patient had a BMI of greater than 30. She would be considered obese. But there were several reasons she was a great candidate for a tummy tuck. First, she was healthy. No high blood pressure or diabetes. Second, her weight was concentrated in her thighs, not her abdomen.

So while her BMI was high, it didn’t accurately reflect the operation she wanted – skin removal from her abdomen. If most of her weight was in her abdomen, then it would be more appropriate for her to lose weight first since skin removal would not address the excess fat around her intestines (visceral fat). In her case, she her torso and abdomen were amenable to a tummy tuck and she had a great result.

If a patient is considered obese, they can still be offered a procedure. As long as no more than 5 liters of fat is removed in an operation, the patient can go home. With that limitation, they may have to come back in stages for surgery. But when patients undergo a cosmetic procedure that’s not medically necessary, there’s no reason to take unnecessary risks.

Video on Body Mass Index

Click here to check pricing on a procedure from Dr. Kaplan.

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

The post There’s more to it than BMI! [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

BuildMyBod Health: A primer

BuildMyBod Health allows consumers to check pricing on healthcare services that are typically paid out of pocket. They are paid out of pocket because 1) you haven’t met your deductible for a medically necessary service (think colonoscopy, lab test or X-ray) or 2) because the procedure is considered cosmetic and insurance doesn’t cover it anyway. Consumers interested in pricing can visit BuildMyBod.com or download the BuildMyBod iPhone app. Even more user friendly, consumers can utilize the BuildMyBod Price Estimator on a doctor’s website.

Regardless of how you find the doctor, you add procedures or services of interest to your “wishlist.” Then submit your wishlist along with your contact info. After that, you’ll instantly get an email with a breakdown of the costs and the doctor’s contact info. The doctor’s office will also receive your contact info for follow up. Better yet, they can help you navigate through the healthcare process.

What presentations are on tap?!

On Thursday, Dr. Kaplan will speak on filling your sales funnel with leads that become patients during the Certified Aesthetic Consultant course. While not every lead will become a patient, you have to start somewhere. And the best way to generate a lead is to offer pricing information in exchange for contact info. This increases the likelihood that every visitor becomes a potential lead. Otherwise you just have visitors clicking on your website and you can’t follow a click!

On Friday, as part of the Advanced Techniques for Practice Success, the topic is weeding out price shoppers and finding serious patients in the process. This too highlights the usefulness and importance of price transparency in today’s healthcare setting. Sunday he’ll take his message of lead generation and show attendees how to monetize their social media following.

To check pricing on healthcare services through the BuildMyBod Health platform from Dr. Kaplan, click here. Or to sign up as a provider and offer pricing information to consumers in an automated way and generate leads, click here.

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

The post Dr. Kaplan speaking at THE Aesthetic Show 2018 first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Responsive websites

That means having a thoroughly accessible and educational website that looks good on both desktop and mobile devices. Often times this may be the consumer’s first experience with your brand. So you have to make sure your site is easy to navigate and actually works. There’s nothing more frustrating to the consumer than seeing a heading for the procedure they’re interested in but unable to click through on their phone or similar mobile device because the mobile version of your site isn’t optimized.

Unfortunately that means you have to spend money on a responsive site. That’s a website that looks good on any device. Words like “responsive” and “mobile optimization” aren’t buzzwords you typically associate with customer service. But don’t kid yourself, they’re all ingredients in the same recipe!

They wanna know the cost!

While cost isn’t the only pain point, it is the ultimate pain point! That’s to say that yes, board certification and experience are important, but ultimately the patient is going to need to know, and want to know, their out of pocket cost. And, remember, giving the customer what they want is an example of good customer service. So why not make it easy for them to determine cost and generate a lead in the process?!

That’s why a Price Estimator on your website is so great. It allows the consumer to check pricing in an automated way but only after they provide their contact info. That information is passed along to the doctor as a lead and the patient gets the immediate gratification of pricing data. But what do you do with that lead?

Follow up quickly and mention accolades

There are multiple sources that suggest there’s a better chance a lead will turn into an actual patient if the office follows up on the lead within 5 minutes. So if the office staff receives a lead through a Price Estimator on their website, they should follow up ASAP. Or if someone calls asking about price, then the office staff should use the accompanying Price Estimator app to provide pricing over the phone.

All of these leads can also be added to a database for future email marketing. If the office has a monthly email newsletter, this will allow for 12 additional touchpoints throughout the year.

This is all in an effort to provide good customer service veiled as price transparency. But it’s also a great opportunity to tell the potential patient why they’ll get great value for that cost. If there are any accolades the office or doctor has recently received to support that value, this is the time to tell the caller. For example, Dr. Kaplan of Pacific Heights Plastic Surgery was recently named Best Cosmetic Surgeon by SF Weekly, a local tabloid. But it’s more than a reflection of him.

Even if the doctor was the greatest on earth, that wouldn’t make up for incompetent staff. So when community members vote on “the best of,” they’re not thinking only of the doctor. They’re thinking of their entire personal experience with the office or what they’ve heard secondhand. And that requires great customer service by the entire staff, not just the doctor, to generate that sort of buzz.

Again, once you have the consumer on the phone, this is the office staff’s chance to educate the patient about a procedure-of-interest, the price and the value behind that price.

Education can also come in the form of social media.

Education comes in many forms now and social media is a growing source of potentially very good, very raw education. Social media offers live or almost-live recordings of surgery. If the patient is watching surgery on Snapchat and/or Instagram Stories, they can actually ask questions during the procedure! But even by osmosis, they’re learning a great deal. And hopefully, this will result in a consultation.

Day of the consult

When the patient arrives, quickly offer them something to drink (water, tea or coffee). Of course any visit to the doctor requires the completion of intake paperwork. Always attempt to send the patient their paperwork via email beforehand and they can complete, email  or bring it in at the time consult. This shortens their in-office wait time significantly.

Then it’s up to the doctor to avoid making the patient wait. The consult should be thorough, stopping frequently to ensure the patient has a chance to answer questions.

When it comes to injectables like fillers, offer the patient a dental block to minimize their pain. If they are receiving non-surgical treatments that day, consider charging the patient in the exam room with a mobile payment processor after their procedure. This is for privacy reasons so the patient doesn’t have to pay at the front desk with other patients listening in the waiting room.

If they are considering a surgical procedure, bring the patient to a separate part of the office to meet with a patient care coordinator. This gives the patient the opportunity to ask difficult questions without the doctor present. Hopefully this will lead to the patient booking surgery.

Day of surgery and post-op communication

While not every doctor has access to their own in-office operating room, this does elevate the surgical experience to a VIP experience. Studies also show that patients that undergo surgery from a doctor that operates with the same staff have fewer postop complications. And if avoiding postop complications isn’t considered good customer service, I don’t know what is!

Another huge patient satisfier after surgery is providing them with all of the medications they need. That doesn’t mean all of the prescriptions they need but all of the actual medications. Depending on the state, it’s ok to provide the patient with filled prescriptions for pain, anti-nausea and any scar creams. This can be included in the cost of the procedure. The value here is the ability for the patient to go home directly after surgery because they have their meds and don’t have to stop at the pharmacy.

Last, but not least, one of the best examples of customer service is for the doctor to call surgical patients at home the evening following the procedure. Not only does this give the doctor the opportunity to check on the patient’s well-being, but also allows the patient to ask additional questions. Now that the patient has the doctor’s phone number, they can text or call the doctor with any follow up concerns so they don’t go looking for answers online or at an ER.

Customer service is a never-ending task but well worth happy patients and thank you cards like the ones above.

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

The post What it takes to provide great customer service first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

If you’re looking for a quick synopsis of prominent ear surgery, you’ve come to the right place! Broadly speaking, there are two different causes of prominent ears. In one type, the ear bends outwards because of a lack of normal architecture within the visible part of the ear. In the second type, the cartilage that connects the ear to the side of the head is too prominent. This is due to a deep “conchal bowl” – the type of correction described in the video below.

These two different causes can occur alone or in combination to create a prominent ear. Surgery differs based on the underlying cause.

Prominent ear surgery

In the first type, an incision is made behind the ear. Stitches are then placed behind the ear to bend the ear backwards to create the folds that should naturally appear within the ear. The main fold is referred to as the antihelix. By using stitches to bend the ear backwards, the fold is created and this also brings the ear into a more appropriate position.

In the second type, the excess cartilage that connects the base of the ear to the side of the head (the conchal bowl) must be reduced. To do this, an incision is made behind the ear similar to the incision used in the first type of prominent ear correction. A wedge of cartilage is removed from the conchal bowl. This reduces the prominence of the ear. But stitches again are used to secure the newly reduced ear to the side of the head.

Even if the description above isn’t totally clear, the video below will help.

Video of prominent ear surgery

To check pricing on prominent ear surgery from Dr. Kaplan, click here.

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

The post Prominent ear surgery [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.