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.

During plastic surgery, one of the biggest concerns patients and their surgeon’s have is the potential for the development of blood clots in the patient’s legs. These are referred to as a DVT or Deep Vein Thrombosis. The pathophysiology, or the reason these clots develop, has to do with three possible factors. 1) Stasis, or lack of movement of blood in the legs during surgery, 2) Hypercoagulability, increased clotting in the blood which could be due to genetic disorders, or 3) Injury to the blood vessels themselves.

Under normal circumstances, when a patient is not under anesthesia, their calf muscles act as a pump to keep blood moving. But during general anesthesia, the “calf pump” doesn’t function to the same degree. So blood pools in the deep veins of the leg, leading to an increased risk of the blood developing into a blood clot. By itself, the development of the clot isn’t deadly. But that clot could subsequently travel to the heart and lungs in what’s referred to as a pulmonary embolism. A “small” pulmonary embolism (ie a small clot traveling to the heart/lungs), could lead to mild shortness of breath that passes with time. On the other end of the spectrum, a pulmonary embolism consisting of a large clot could lead to sudden death. This is why DVT’s and pulmonary embolisms are of such great concern for the surgeon and their patient.

How do you reduce DVT’s in surgery?

This is a controversial question. For almost two decades, one option was to give patients chemoprophylaxis, or medications like blood thinners, to reduce the risk of forming a DVT in the leg. However, these medications are not without risks. In an amazing book chapter on the subject by Dr. Eric Swanson, he explains why blood thinners aren’t the answer. The annual risk of an adult having a DVT is 0.1-0.3%. But the risk of having a major bleeding complication (hematoma) from a blood thinner is 3% annually. So the risk of having a hematoma is higher than the risk of having a DVT.

You might think, well if it reduces my risk of a DVT to any extent during surgery, maybe it’s worth the risk? Despite conventional wisdom, there’s very little evidence that these blood thinners actually reduce the risk of DVT during surgery. So do you just accept the risk of a DVT by avoiding blood thinners because you don’t want a hematoma?

The alternative to blood thinners

Luckily there are alternative methods to reduce your risk of a DVT and ultimately, pulmonary embolisms. Dr. Swanson describes SAFE anesthesia. This is an acronym for Spontaneous breathing, Avoid inhalation gases, Face up and Extremities mobile.

Spontaneous breathing – avoidance of paralyzing the patient during surgery with medications called paralytics. If paralyzed during surgery, the patient is dependent on the ventilator to breathe. Paralyzing a patient for general anesthesia can also reduce blood pressure. If the anesthesiologist avoids paralytics, then the patient can spontaneously breathe on their own, blood pressure doesn’t drop and the calf muscle pump continues to work, thereby reducing stasis and DVT formation.

Avoid inhalation gases – think stronger versions of laughing gas. By using propofol (yes, the Michael Jackson drug) instead of gas to keep the patient asleep, the risk of DVT is lower.

Face up when possible, meaning keeping the patient on their back with their face up. This is obviously difficult in situations where the surgeon needs to operate on the patients back wherein they’re laying face down. But switching the patient from side to side, to always avoid being face down is one option.

Extremities mobile. Moving the limbs at some point during surgery, either by turning the patient, or repeated checking of limb position, can reduce stasis and DVT’s forming.

Checking for DVT’s preoperatively

Many offices, including ours, utilizes Doppler ultrasound surveillance to determine if someone has a deep venous thromboses before surgery. By knowing the patient doesn’t have a DVT ahead of time, they’re that much safer going into surgery.

What about those squeezers?!

SCDs (sequential compression devices) are the “squeezers” doctors use to reduce DVT formation in the legs. Some patients even rent or purchase these machines after surgery for home use. All in an effort to reduce the formation of a DVT and thereby a pulmonary embolus.

In truth, there is no evidence that sequential compression devices affect the frequency of deep venous thromboses in plastic surgery patients.

It may not be profound, and certainly not technically advanced, but the best way to avoid DVTs after surgery is to get up and walk around. In our office, we recommend showering hours after the procedure to force the patient to get up out of bed and take a walk to the bathroom.

Concerned about too much activity? Our mantra is, “If it hurts, stop doing it. If it doesn’t hurt, you can do it!” Listen to your body so you don’t overdo it. Don’t push through the pain. But stay out of bed as much as possible and get back to regular activity. The muscles in the calves were designed to reduce the risk of blood clots. So let them do their job but getting up and walking around rather than depending on devices like SCDs that are not proven to work.

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

The post Avoiding blood clots in the legs during and after surgery first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr. Bae:
I’m very official. I don’t just play a doctor on the radio.

Greg:
No, leave that to me. I will play a doctor on the radio. I do get a lot of questions from people. Some of them, thanks to you, I can actually answer. I can actually answer a lot of lipo questions now, because I’ve asked you so many questions about lipo in the past. But we need you here to really give us the professional’s opinion.

Breast augmentation

Greg:
And what I have been wondering is a lot of women, when they get breast augmentation… Generally, if they’re doing that, they’re wanting to go bigger, right? How do you help them decide which implants to get, how big to go, what’s right for your body? Because I think a lot of people may have one thought in their head, and maybe you see it a different way.

Dr. Bae:
Yeah. I try to break it down to make it as easy as possible and to give them… Basically, I tell them that you have five decisions to make when they come in for a breast augmentation consult. So five decisions. What are those five decisions? One is whether you want saline or silicone. The next is whether you want round or shaped. Third, where you want the incision. Around the edge of the areola, through the armpit, or under the breast? Fourth, whether you want it on top of the muscle or under the muscle. And fifth, what size you want.

Saline vs Silicone

Dr. Bae:
And so, after I tell them, those are the decisions, then we go through and explain each one. So starting off with saline versus silicone, I just tell them the pros and cons. Silicone feels more natural, looks more natural. That is what most people are getting. Saline is less expensive, but it does look more like a balloon and feels a little more firm, whereas silicone, like I said, just feels more natural.

Dr. Bae:
There’s also something with rippling. If you look on the side of the breast of somebody that has a saline implant, you can see this rippling in the skin a little bit more with a saline implant versus a silicone implant. And then, the other thing is that, if you get a hole in the implant, a silicone implant, they’re more of a gel. So even if you get a hole in the shell of it, it can actually keep its shape because it’s a gel. It’s not a liquid. It doesn’t just spill out. Whereas, with a saline implant that gets a hole in it, that’s a liquid, obviously. And that just spills out, and it deflates completely. And then you have to get it replaced, whereas with a silicon-

Greg:
You’ll have a deflated breast.

Dr. Bae:
You’ll have a deflated breast. Whereas, with a silicone implant, because it’s a gel, it keeps it shape. And that capsule or scar tissue that naturally forms around the implant can actually keep it self-contained, so it doesn’t spill all over your body, like the way you’ve heard those kinds of things happening back in the nineties and things like that.

Shaped vs Round

Dr. Bae:
So, that’s the first thing. Second one… And by the way, there’s no right answer to any of these. I just give them the facts, and then they can make the decision. The second one is round versus shaped. So a round implant is kind of what you think. It’s round, where it gives a more fullness up top, which patients really like that, versus a shaped implant. And a shaped implant? It’s got more fullness at the bottom and less fullness up top. So it doesn’t give them that fullness up top. So it looks more natural. Not having a lot of fullness up at the top of your breast is more natural, but patients don’t really want that. They say they want natural, but then, when you get down to the nitty gritty of it, they really want that kind of buxom look up top.

Greg:
Yeah, I’ve noticed. I watch a lot of reality TV, and I noticed a lot of the breasts. They want them here. They want this spilling out.

Dr. Bae:
Up close to their neck, even though they say they don’t.

Greg:
Yes. Yes. They do.

Location of the incision

Dr. Bae:
But anyway, so I give them the option. So, round is more fullness up top. Shaped, less fullness, more natural looking. Then the third option is the incision. And that really kind of depends on a few things. As far as the incision, people talk about going through the nipple. Nobody really goes through the nipple. It’s an incision along the edge of the areola, which actually can be really well hidden between that junction of your natural skin tone and that darker reddish pigment of the areola. And so, you can hide in an incision well, within that.

Dr. Bae:
You can make an incision underneath the breast, which most people do. And there’s the incision through the armpit, which people like because that’s well hidden. The thing people have to understand is that going through the areola, going through the armpit, that even though we prep everything with betadine, make it as sterile as possible, there’s still bacteria down in your sweat glands in your armpit. There’s still bacteria down in the milk ducks of the nipple.

Dr. Bae:
So even though we clean all that up, that bacteria can still get on the implant and possibly cause an infection but more likely cause something called capsular contracture, which is that natural scar tissue that forms around the implant, totally normal on all types of implants. But if it gets too much bacteria there, called colonization, it can make that scar tissue get thick and distort the breast. And that’s called capsular contracture. So that’s less likely if you make an incision under the breast.

Dr. Bae:
But then the downside, potentially, of making an incision under the breast is you could have the implant bottom out. So lots of pros and cons with all these things because, if there was one right way, then everybody would just do it that way.

Over or under the muscle

Dr. Bae:
Then the fourth decision is on top of or under the muscle. And one of the things about going under the muscle, it helps camouflage the implant. So it makes it a little more natural-looking. But the other thing is that thing I was talking about, capsular contracture, where the scar tissue gets really thick and distorts the breast? There’s some suggestion that, by putting the implant under the muscle, it reduces that risk of capsular contracture. So I tend to put implants under the muscle. And it also depends on if the patient has enough breast tissue to begin with, because if they don’t have that much breast tissue to begin with, you probably don’t want to put it on top of the muscle because there’s not a whole lot of skin to camouflage it, and it looks more like a water balloon.

What size implant should I get

Dr. Bae:
And then, lastly, what size? And we just have people try on implants in the office. They bring a sports bra. We have them put in all of the sample implants we have in the office and try them on and see what size they like best. And we go with that. And we usually have a range of options in the operating room the day of, to make sure we have whatever eventuality comes up of what they’re looking for. So that’s the buffet of decision-making and answers and suggestions that I make to them, recommendations. And then, they go from there.

Greg:
You know what? The main key here, again, as we always talk about, especially if you’re doing something like this, research, research, research. Talk to your doctor and then make the best decision for you and your body.

Dr. Bae:
That’s right. That’s right. Thanks for always promoting board-certified plastic surgeons. That’s probably the person you want to go to. They have a lot of experience. They do a lot of training, too. You know, it’s one thing. Anybody can put in an implant, but it’s knowing how to put in the implant, when to put an implant, and what other kind of surrounding issues are involved to make sure you’re making the right decision because, quite frankly, the biggest thing with breast augmentation is the pre-planning, the decisions made before the operation, not the actual operation.

Greg:
And not anybody can put in an implant. A lot of plastic surgeons and a lot of other surgeons can, but not anybody. So that’s why we have you here. And we are grateful for it. Thank you so much, Dr. Bae. Give out all your information, social media.

Dr. Bae:
Yeah. I appreciate the faith you have in me, but yeah. Check me out. Real Dr. Bae. R-E-A-L-D-R-B-A-E, not B-A-Y, on Instagram, Snapchat, and TikToK, and realdrbae.com. Check pricing on there and watch us on social media when we operate, so you kind of know what to expect when you come in for your operation.

Greg:
Absolutely. We’ll see you next time.

Dr. Bae:
Thanks a lot, Greg.

Greg:
Thank you.

The post The 5 decisions of breast augmentation first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr. Bae:
That’s right. That was a lot of tests, oral and written tests, and a lot of exams in school to become board certified, so thanks for not forgetting it.

Greg:
And I see you want to fight with me today. You got your college hat on, LSU. It’s close to mine, but I know you went to the University of Texas for a short time, didn’t you?

Dr. Bae:
No, no. I went to UT Austin, correct, but not for a short time. I went for all four years.

Greg:
Okay.

Dr. Bae:
I think I’ve told you this before. I didn’t technically graduate. I didn’t get enough credits to graduate, but I did all the stuff you have to do to be able to get into medical school, like MCAT and everything. But then I went to LSU for medical school and general surgery residency. I grew up in Louisiana, so that’s the LSU hat. I might just got out of an arm liposuction case.

Greg:
Can you at least get a UT hat the next time I see you? I mean, you went there. You could wear a UT hat for me.

Dr. Bae:
That would be totally legitimate. You are right. Out of respect to you, you’re right. I should wear a UT scrub cap next time I see you. Okay. Fair enough.

Liposuction vs Tummy Tuck

Greg:
Thank you. Now, I have a real question for you, Dr. Bae. A lot of people want to lose weight, whether it’s after having a couple of kids or maybe they feel like they can’t lose it on their own, and they’ve just gained so much weight in COVID. Is there one thing that fits everybody? Is it liposuction or how do we do this?

Dr. Bae:
Well, you just basically look at your body and if you can just pinch the skin and you pinch it and you feel like there’s fat in there, maybe you would think, oh, maybe I’m a candidate for liposuction, but then you also have to look at how much excess skin do you have? Do you have a lot of hanging skin or excess skin or wrinkly skin or stretch marks?

Dr. Bae:
The other thing you have to look at is how much of an abdominal bulge you have, like the upper part of your abdomen, and that could be a sign of a rectus diastasis, which is something when your abdominal wall stretches out because of having kids. You take those things into account, a stretched out abdominal wall, excess skin, excess fat. If it’s just excess fat, no hanging skin, no abdominal bulge, you could just do liposuction. That’d be fine.

Dr. Bae:
Then, the other option is if there is excess skin, then you would consider doing a tummy tuck. If you have an abdominal bulge, maybe that’s the only thing you have is the abdominal bulge after having kids, then you would still probably need a tummy tuck because the only way to fix the abdominal bulge is to go through a big, lower abdominal incision, like you would with a tummy tuck.

Different types of tummy tucks

Greg:
Well, what’s involved in a tummy tuck?

Dr. Bae:
A tummy tuck is, typically there’s a few different kinds. There’s a mini tummy tuck, traditional tummy tuck, extended tummy tuck. I guess some doctors will have different definitions, but in general, a mini tummy tuck is just when you’re removing the excess skin at the lower part of the abdomen. And so that means you have a nice flat tummy, otherwise just a little excess skin at the bottom. Maybe you don’t have a whole lot of excess fat. The only people I’ve found that really fit within that category of a mini tummy tuck with just that excess skin are marathon runners, who’ve had a kid. So they’ve had the kid, they still have a nice flat abdomen for whatever reason, genetically, they didn’t get stretched out abdomen.

Greg:
That’s very specific, by the way.

Dr. Bae:
That’s very specific and that’s really the truth. So they’ve worked off all the fat because they’re a marathon runner and they just have this excess skin. What we do is we make a lower abdominal incision, well below the panty line, so at least it’s hidden and they can still wear bikini bottoms and things like that. And so we just remove a strip of skin. That’s a mini tummy tuck.

Skin removal and diastasis repair

Dr. Bae:
If they’ve got more skin that’s hanging, if they’ve got stretch marks they want to get rid of, if they’ve got that abdominal bulge, then we have to make an incision along the lower part of the abdomen, still low enough that it can be hidden, just a little bit longer than a mini tummy tuck, that gives us the ability to remove excess skin, gives us access to go up underneath the upper abdominal wall to tighten that up and to do liposuction at the same time.

Extended tummy tuck

Dr. Bae:
And then if you have excess skin that wraps around the sides of your body towards the back, then that would be more like an extended tummy tuck. That’s kind of the upshot of it all is just notice whether you have excess fat, excess skin and abdominal bulge. That’ll give you an idea whether you need to do liposuction or a tummy tuck. Then depending on how much excess skin you have, how much stretch marks, how much that skin wraps around, that will help you determine what type of tummy tuck you get. I think that pretty much puts it all in a nutshell.

How to find Dr. Bae

Greg:
Yeah, that covers it. They’re truly answers for everybody. You just need a good consultation with a board certified plastic surgeon. Dr. Bae, how do they find you?

Dr. Bae:
They can find me on Snapchat, Instagram, Tik Tok at RealDrBae, R-E-A-L D-R B-A-E, not B-A-Y, and then you can check out our website, RealDrBae.com and they can check pricing on there for all those procedures, mini tummy tuck, full tummy tuck, extended tummy tuck. We got all that information on there, so that by the time you come in, you have a pretty good idea what you need and you have a good idea of how much it costs.

Greg:
Awesome. We’ll see you next time.

Dr. Bae:
Thanks so much, Greg.

Greg:
Hook ’em horns.

Dr. Bae:
Go Tigers.

The post Which type of tummy tuck is right for you? first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr. Bae:
Hey Greg. Thanks for joining me.

Greg:
Absolutely. It’s always great to be here, especially, from month to month when we do these, I compile a list of questions that my friends ask me. They sort of think because I know you, I know all of the things that you know, which is not necessarily true.

Dr. Bae:
Yeah, you’re a plastic surgeon adjacent. You just skipped the whole med school thing.

Breast lift without an implant?

Greg:
Exactly. I had a pride party a few weeks ago and a question. One of my friends who just turned 50 was there and she wanted to actually talk to you. She wants her breasts perkier, but she does not want her breasts larger and she didn’t know, would she have to get some kind of implant to make them perk up or is there a way to do a lift without… She really doesn’t want to go bigger.

Dr. Bae:
Right. So, absolutely. There’s definitely a way to be perkier without going bigger. And so instead of getting breast implants, you would get a breast lift, but it’s not just straightforward. Like what type of breast lift? Everybody’s a little bit different. And some people think that we just decide, okay, we’re going to do this type of breast lift on you just like how we feel that day. We’re going to do that type or that type. But it really is how droopy the breasts are and if you’ve had kids and your breasts are pendulous, my favorite word, after breastfeeding, that can make them a little bit droopier. And so it really just all depends on how droopy they are and basically where the nipple is in comparison to that fold onto the breast. It’s called the inframammary fold.

Where’s the nipple?!

Dr. Bae:
So, basically if the nipple is just below the inframammary fold, then maybe just have a little bit of droop and so that would be one type of breast lift. If it’s further below the fold, then that’s a different type of breast lift. We have to remove more skin to get them back up to where they need to be. And if they’re pointing down and really droopy, then that means we have to remove even more skin, which means we have to make even more incisions. So, that brings me to the different types of breast lifts. One is the one that needs the least amount of lift is maybe you just need a little crescent of skin taken off the top of the areola and that can help just reposition the nipple a little bit. So that’s really just, you want the nipple to be in a better position, but your breasts look fine otherwise.

Dr. Bae:
Now, if you have a little bit more droop, then you have to remove more skin. You can also take skin from around the areola and just basically take a donut of skin and that’s why we call it a donut lift. And that helps tighten up the breast skin and brings up the breast and the nipple at the same time. If you have a little bit more droop, then we’ll do what’s called a lollipop incision where we make an incision around the areola and then up and down and that’s just to take out more skin to give you more of a lift. And if it’s as droopy as you’re worried it is, then we would do an anchor lift where we make an incision around the areola, a vertical incision, and then an incision under the breast. And by removing all of that extra skin, we can bring the breast back up to where it is. And remember, we’re not reducing anything we’re not taking on any breast tissue. We’re just tightening up the skin envelope to give them that perkier breast that they’re looking for without fat injections, without an implant if they choose.

Greg:
So you’re able to keep all of their breast tissue that they naturally have and you’re just able to bring it up into a position where it was when they were 22, rather than my friend, she’s 50. Okay, that makes sense to me, but I’m glad I did not try to explain this to her at my pride party. It would have been very strange.

Dr. Bae:
Especially since there might have been alcohol involved at the pride party.

Greg:
Might have.

Dr. Bae:
So you might not have gotten all that clear. Might have.

Greg:
No, there for sure was.

Breast lift vs Breast reduction

Dr. Bae:
But that’s actually, you bring up a good point. So if they are looking to get a breast reduction, it’s actually the same types of incisions and so the only additional thing you’re doing is you’re taking out breast tissue in addition to doing the lift. So a breast reduction includes a lift, a lift doesn’t necessarily have to be a breast reduction. So very, very key point a lot of patients don’t understand before they come in to see me.

Greg:
Awesome. Well, tell my friend and everybody out there watching these videos how they can communicate with you the best and get in and see you.

Dr. Bae:
They can easily just text us at the office. They can text our office number (415) 923-3005. They can call that number too. They can also direct message us through Instagram @realdrbae. And of course, they can always watch us on social media, realdrbae, Instagram, Snapchat, TikTok, and check pricing at realdrbae.com/pricing. We’re very easy to get ahold of.

Greg:
Awesome. Thanks so much, Dr. Bae.

Dr. Bae:
Thank you, Greg.

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

The post What kind of breast lift do you need? first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr. Bae:
Hey, Greg.

Greg:
I was thinking about you the other day. I was driving through your neighborhood. I was like, “Where is he? Maybe I can find him in this coffee shop and he can buy me some coffee.”

Dr. Bae:
Shoutout to Wrecking Ball!

Neuromodulators

Greg:
Absolutely. It’s good to see you. I wanted to start with this question. Now, it’s commonly now referred to as getting Botox, if you get an injectable to stop the lines and the wrinkles. However, Botox is actually a brand name. There are many different types of injectables that do the same thing as Botox. So how do we pick the right one?

Dr. Bae:
Exactly right. The idea is that Kleenex or Puffs are a type of tissue paper, and Botox has just been used just the way everybody says, “I’ll give you some Kleenex.” It’s that generic term. Or, get me some Coke to drink. The same thing is happening with Botox. It’s just that term that’s become the generic form of what is actually called a neuromodulator. So you have facial tissues-

Greg:
A what?

Dr. Bae:
Neuromodulator, N-E-U-R-O-M-O-D-U-L-A-T-O-R. If we’re taking the SAT and we’re talking about those analogies, we’re going to be thinking of, tissue paper is to Kleenex as neuromodulator is to Botox. Botox is the brand. There are other brands. Aside from Botox, there is Jeuveau, which is a newer one on the market. They go by #newtox on social media. There’s Dysport and Xeomin, X-E-O-M-I-N. These are all versions of neuromodulators. They’re also just basically called botulinum toxins. The toxin that’s made that you’re not supposed to have kids… No children under six months are supposed to eat honey, because it could have botulinum toxin in it, which could cause botulism. But if you do it the right way, you inject it in your face and it’s fine.

Treatment areas

Dr. Bae:
You’re essentially injecting poison in your face. But whatever product you’re using, Botox, Jeuveau, Xeomin, Dysport, the idea is you inject it into the elevens here or into the forehead, the crow’s feet, you can even do in the upper lip to treat a gummy smile or down here to help with, if you have a bitchy resting face, it can help the corners of your mouth go up.

Greg:
I want to keep mine. I’m not changing that. I’m keeping my bitch resting face.

Dr. Bae:
But the way it works is, you inject into those muscles in those areas and it relaxes those muscles. That makes those wrinkles go away that are caused by those overactive muscles. So again, the elevens, the forehead, crow’s feet, upper lip, along the jaw line. People sometimes think, “Oh, well, you can use Botox for these lines here, the parentheses lines.” That doesn’t work, because these parentheses lines aren’t caused by overactive muscles, so Botox won’t work there. That’s caused by loss of collagen and that’s where you would use fillers.

Greg:
Then how do you find the right brand for you? Are they all basically the same and go with whatever’s on sale?

Is one brand better than another?

Dr. Bae:
Well, every company will tell you that they’re the best for one reason or another. Well, first off, just so you know, right off the top, is that I am a speaker, a paid spokesperson, for Xeomin. A company, Merz, makes Xeomin. It’s a company based in Germany. But they have a North American unit here and that’s where the Xeomin comes from. But I feel they’re all pretty much the same. I would treat all of these on my family members. I think they all have essentially the same result. The only one I don’t use is Dysport and not because there’s anything wrong with the product. It’s because they use a different gradation or measurement technique as far as how much you inject somebody with. But Botox, Jeuveau, Xeomin, you basically can treat 20 units to this area in the forehead, 20 units to the eyes, so it’s all pretty much the same.

How do you choose one brand over another?

Dr. Bae:
But the thing that’s interesting is whenever a new company comes out, they don’t necessarily just come out right and say, “We’re better than Botox.” Because you would think if a car dealer comes out with a new car, a new model, a car company comes out with a new model, they’ll say, “Oh, this car is better than that Ford truck,” or, “This Chevy truck is better than that Ford truck.” What I find with the neuromodulators is they just say, “We’re the same as Botox.” They don’t necessarily say they’re better. They just say, “We’re the same,” because they know that’s the benchmark. They say, “Well, we’re as good as it gets. We’re the same as everybody else. So you can utilize us.” The thing that may make a difference is that some of them have loyalty rewards programs that are different. Maybe you get more points and more freebies, depending on which company you go with.

Greg:
Oh, my God, it’s like every thing else. It’s like choosing an airline or whatever. You choose the one where you can get the most advantages, points, maybe a sale, something from them. Okay, so-

Dr. Bae:
Credit cards.

How to see Dr. Bae

Greg:
Yeah. They’re basically all the same. They’re all safe. And, of course, you can always be educated in Dr. Bae’s office about these types of things. Tell them how to find you and how to book an appointment.

Dr. Bae:
You can always find us, if you’re watching this, you’re already probably on our website at realdrbae.com, R-E-A-L-D-R-B-A-E, not B-A-Y. Or you can watch us on social media, TikTok, Snapchat, Instagram at realdrbae. You can watch us operate. You can actually watch us do injectables on patients that are okay with us showing them on social media. Because it’s different, when we’re doing operations, the patients are covered up. You never see their face. But when you’re doing injectables, the patients are a little bit more reticent to be shown on social media, because you’re actually injecting their face. It’s hard to hide their face, even though sometimes we’ll try and zoom in really well, or we’ll put an emoji over part of their face. You can watch us do those types of injectables with neuromodulators, i.e., Botox, Xeomin, Jeuveau or Dysport in our office, anytime on any social media.

Dr. Bae:
And you can check pricing on all of these injectables on realdrbae.com/pricing. You can even purchase non-surgical services through our website. So you can actually pay for it online and come in and get the treatment and just walk out as though it was free. You didn’t have to pay for it. You [crosstalk 00:06:10].

Greg:
Perfect. And you can show my photos there. I’m such a big boy. I hardly even grimace when the needle goes in.

Dr. Bae:
Thanks. That’s good to know. Thank you.

The post All about Botox, Xeomin, Dysport and Jeuveau first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr. Bae:
I’m good. I’m good. All is well, all is well.

The big news on textured breast implants

Greg:
Well, I’m happy to hear that. I’ve been seeing a little bit in the news lately, these textured silicone breast implants that I think were done, you can correct me if I’m wrong, done years ago. I don’t know that they do them anymore. Maybe they do, but there is some concern about them and a lot of people who have those are wondering, do I need to go and get those replaced? Or, what do I do, because everybody wants to stay as healthy as they possibly can.

Dr. Bae:
Right. Well, I’m glad you asked me about that, because I just happened to have some breasts implants with me right here.

Greg:
Oh, wow. Look at that, props.

Why textured breast implants are textured

Dr. Bae:
What are the chances? So I guess the first thing we should talk about is just kind of some baseline knowledge, fundamental knowledge that there’s the difference between round implants, which are kind of the typical round silicone implants you always think of, versus these teardrop or shaped implants. You can see it’s fuller at the bottom. And so, when you have a round implant, if it spins in the breast tissue, like in the breast pocket, inside the patient’s breast, if it spins, no problem. It’s still a round implant. But if this spins, then you’ve got sort of a sideways boob. So what they do is, they now texture-

Greg:
Nobody wants a sideways boob, Dr. Bae.

Dr. Bae:
I think a lot of people gave that up for their New Year’s resolution, right? So the thing is, the reason they texture these implants, as opposed to being smooth like the other implant I showed you, they texture these-

Greg:
So they don’t move.
Dr. Bae:

So they don’t move, exactly. So, what the … you’re pretty smart. Producer, check out the big brain on Greg.

Greg:
Maybe I’ll go to medical school.

Dr. Bae:
Maybe so, and I’ll go back to being … I’ll be a radio host.

Greg:
We better keep what we’re doing.

Dr. Bae:
So, the thing is, that texturing has become an issue over the last couple years, that people have noticed an issue with it. And what it is, is that there’s something called anaplastic large cell lymphoma, which is kind of like cancer, but not really. And what it is, is that after a few years, two years to 28 years they found, after getting textured implants, what they found is that the scar tissue that naturally forms around breast implants, whether they’re saline, silicone, round, shaped, your body naturally formed scar tissue. But in some cases, specifically with a certain type of textured implant, that scar tissue could get really thick and starts secreting some fluid. And the patients would have this huge seroma or fluid collection that would form around their breast implant. Like I said, two years or 28 years after.

Anaplastic large cell lymphoma (ALCL)

Dr. Bae:
And that was caused by this lymphoma, or this thickened scar tissue. So the way to treat it is you go in, you take out the breast implant, you take out the scar tissue and typically a hundred percent of the time people would be cured if you found that early enough. So that’s anaplastic large cell lymphoma, ALCL, that’s associated with textured implants. But not just any textured implant, specifically one that was made by Allergan, and that one’s been taken off the market. So statistically speaking, is a very low risk for people to get this problem if they have textured implants. If you have smooth implants, there’s really been no evidence that smooth implants cause that problem. And the reason it’s been in the news lately, and also which, I should say, the reason I’ve been thinking about this lately because it’s been in the news, I’ve had patients reach out to me saying, “Hey, I’ve got this brand of a MENTOR silicone textured implant. Does that mean I need to come back in?”

Dr. Bae:
And the FDA says, just like I told this patient, that because they took the main offender off the market and because the risk is so low, that if you have textured implants and it’s not that Allergan product, if it’s MENTOR or Sientra and you’re not having any problems, your breast isn’t blowing up with a bunch of fluid, if you’re not having problems, you don’t have to do anything. You don’t have to go in and get them changed out. So just FYI, the more you know, public service announcement, that if you’re happy with your breast implants, you don’t need to do anything with them. You don’t have to get them taken out every 10 years like some people mistakenly think. So again, just keep going, get your mammograms, get your checkups from your doctor. And as long as you’re happy with your breast implants, you don’t have to do anything else about them.

Greg:
But, if somebody has a question, if somebody has a question about their implants, or if they just want you to examine their breasts and check out where they are, they can reach out to you on social media.

Dr. Bae:
Absolutely. They can reach out to us. Instagram, TikTok, Snapchat @realdrbae. R-E-A-L-D-R-B-A-E, not B-A-Y. And check us out on our website, realdrbae.com, where they can check pricing, all that good stuff. But yeah, people message us all the time. All my surgical patients, they always have my email address and my phone number. So they’re able to reach out to me afterwards if they’re worried. So, there’s no excuse. You can absolutely get in touch with this doctor.

Greg:
And if you’re not a previous patient of Dr. Bae’s, and you’ve never even spoken to him before, if you Instagram him with a question, DM, he will answer you. Right, Dr. Bae?

Dr. Bae:
That’s absolutely true. Yeah. As long as you’re not saying anything mean, I will respond to you.

Greg:
That’s my policy on social media, too. All right. Well, thanks Dr. Bae. Appreciate it.

Dr. Bae:
My pleasure. My pleasure.

The post What you need to know about textured breast implants [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr. Bae:
Hey Greg. Thanks for having me.

Greg:
How have you been?

Dr. Bae:
I’ve been good. I’m good. I’m better now that they’ve stopped making us wear masks outdoors, and maybe even indoors in certain situations. But of course they stay consistent with whatever your local guidelines and rules are, but it’s still, it’s showing signs of progress. That’s all, that’s the main focus.

Is Botox a gateway drug?!

Greg:
Yeah. We’re getting back to normal and feeling good. Hey, and I’ve got a question for you. Botox, it seems kind of the entry level thing that people do when they-

Dr. Bae:
Gateway drug. Yeah.

Greg:
Yeah, absolutely. And in the beginning it was to treat wrinkles mostly on the forehead, around the eyes, stuff like that. But there are so many more uses for Botox, even helping with migraine headaches these days.

Dr. Bae:
Right.

How young is too young?

Greg:
But how young is too young and how do you help determine with a patient whether they really need it and if the time is right for Botox?

Dr. Bae:
I think it would be simple enough to say, oh, if you’re 18 years old or older, the age of consent, that’s when you can start doing Botox. But even people would think, oh, that’s too young. And it’s easy to get real judgemental of people. Like a 25-year-old shouldn’t be using Botox. Wrinkles on our forehead are normal. But people should step back and realize that whatever may be appropriate for you may not be necessarily appropriate for other people. And it’s, so one of the things I would tell people is caution, caution them to not get too critical because different situations apply to different people. Specifically, I think of a girl that was, I think she was 14-years-old that called the office, scheduled a consult, said she was coming in with her mom and she wanted Botox. She actually said she wanted fillers to her lips. And so I’m thinking, okay, this is someone that’s been watching Kylie Jenner.

Greg:
I was about to say, Kylie Jenner. This Kylie Jenner.

Dr. Bae:
Exactly. It’s Kylie Jenner’s fault. And I’m thinking, all right, I’m going to have to talk this girl down. It’s like, I can’t give you fillers. You’re 14 years old.

Greg:
Yeah.

Understand what the patient wants

Dr. Bae:
And even I was being not, I wouldn’t say judgemental, but I was already coming up with reasons to not do this treatment for her. And when she got here, she came in with her mom. They obviously had a good relationship and like yeah, my daughter thinks she wants fillers. And I’ll say, “Well, so what’s your concern?” She’s like, “Well, whenever I smile, my lip gets really thin and it shows my gums and that makes me uncomfortable.” And I was like, “Well, actually, now that I better understand your situation, you don’t really need fillers.” Because fillers obviously can plump up your lips. But the thing is, if you plump up your lips so that when you smile, because it’s natural for your lip to thin out when you smile, that happens to everybody.

Dr. Bae:
So if you plump up your lips to make them fuller when you smile, that means that when you’re not smiling, your lips are going to look even more full. Like might even look a little bit weird. You’ll have this big, full upper lip when you’re not smiling.

Greg:
Yeah.

Dr. Bae:
And when you smile, it might thin out.

Greg:
Rubber ducky lips.

Dr. Bae:
Exactly, exactly. So I was like the most appropriate thing for you to treat that thinning upper lip, the gummy smile, if it’s really bothering you, if it makes you feel uncomfortable at school, which it’s kind of hard to tell somebody, don’t … Buck up. Don’t feel weird at school.

Greg:
Yeah.

Upper lip botox for this patient

Dr. Bae:
Don’t give into peer pressure. It’s just ridiculous. So one of the things that’s most appropriate for her is something we’ve talked about before is Botox to the upper lip so that when you smile, it relaxes the muscles in the upper lip. So when you smile, your upper lip doesn’t go up as high. So it doesn’t show up as much of your gums. And also because it doesn’t lift up as much, it stays fuller, doesn’t then out as much. So it ‘kills’ a couple birds with one stone that Botox, not fillers, was really the most appropriate thing for her. And because she was there with her mom, and even though she was 14, I did Botox to her upper lip and she was really happy.

Dr. Bae:
And her mom and she had reached out to me since then and thanked me for it. And it’s like how much more comfortable she is. And maybe we should get to the point where she is still so comfortable in her own skin that she won’t feel like she needs to keep coming in for it, and her face will change. But it was a really nice experience for me, a learning experience for me to just don’t be judgy, listen to what the person’s concerns are and see if there’s maybe a really less invasive way to treat them, to make them more comfortable in their own skin.

Greg:
The two important things there, if you are younger, younger than 19, obviously you need to consult your parent, bring your parent with you.

Dr. Bae:
Right.

Greg:
But also really important to just make sure you’re finding a Board Certified plastic surgeon who can give you a good consultation and is really going to do or not do what is in your best interest.

Dr. Bae:
Yeah. It’s true. And it doesn’t necessarily have to be a Board Certified plastic surgeon to do your Botox. You could go see a Board Certified dermatologist. They’re trained in all that. But it is really-

Greg:
But you want somebody who’s got your best interest at heart.

Dr. Bae:
You want somebody that’s as smart and as experienced as me. That’s what you’re really trying to say.

Greg:
There you go. And me.

Dr. Bae:
That’s why I’m here.

Greg:
And me too. All right.

Dr. Bae:
Of course.

Greg:
See more of Dr. Bae’s work, check out pricing, all that stuff. Reach out to him on his social media. He loves to interact.

Dr. Bae:
That’s right. @realdrbae, r-e-a-l-d-r-b-a-e. Not b-a-y, and realdrbae.com.

Greg:
All right. Thanks everybody.

Dr. Bae:
Thank you.

The post How young is too young for cosmetic procedures? first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr. Bae:
Hey, Greg.

Greg:
How’s the baby?

Dr. Bae:
Baby’s good. Baby’s sleeping through the night. I think slept seven hours last night. So the patients-

Greg:
Wow.

Dr. Bae:
… that see me on social media, when I come in the morning to pre-op them for surgery, they know that I’ve gotten a good night’s sleep now.

Greg:
Well, that’s funny you mentioned sleeping through the night. That’s a thing that a lot of people are having trouble during the pandemic doing. More anxiety causing more stress. And another thing coming with that, people are kind of grinding their teeth, and clenching their jaw. And that affects some issues in your cheeks and the way your jaw looks. And I know that you have some methods to maybe helping people if they have that issue.

TMJ and teeth grinding

Dr. Bae:
Yeah. Jaw clenching, or TMJ, which is the temporomandibular joint. That’s what people referred to TMJ when they have that pain right here. And that can be caused by congenital issues with the cartilages and the bone in that area. But it can also be just stress and grinding your teeth, and grinding your teeth at night when you’re sleeping, you don’t even realize it just from stress or whatever. And so people do come in asking for treatment for that. They’re trying to do a couple of things. One is if there’s a non-surgical way to do it, that’s what they’re interested in. And they want to do something that will help them to not clench their teeth as much. But also one of the things that they’re noticing is when they’re clenching their teeth, it’s making these muscles right here, called the masseter muscles, it’s making those kind of bulk up.

Dr. Bae:
Because in a way you’re kind of working out those muscles by grinding your teeth, and these muscles buck up. So they’re looking for a way to one, minimize the tension and the grinding in their teeth. And then also minimize those muscles. And one of the ways you can do that really simply is Botox. You can inject Botox right here into those muscles, masseter muscles. You ask the patient to clench down. And I feel where the peak of that muscle’s coming in. And then I just inject a … I usually start with 10 to 15 units per side, just one injection.

Botox for grinding teeth and TMJ

Dr. Bae:
And after one to three days, it starts to kick in. And then they can let me know, give me some feedback. Is it working for you? Is it working as effectively as you want? And they may need more in the future. But the idea is it really reduces the bulkiness of that muscle. And it actually gives them a nice heart shaped face. I notice a lot of Asian women come in for that, because they feel like they have a very square jaw line. And they come in and they get Botox here. They’re not even having grinding issues or TMJ issues. We just do the Botox right here, it reduces the size of that muscle. It gives them a nice heart shaped face. Pretty effective.

Greg:
Well, that’s so interesting you say that. Because I do have that issue. I’m grinding a lot more at night. I thought the only solution really was to get a mouth guard. And those can just be … It’s not sexy, number one, when you’re going to bed with your partner. Number two, it’s all the saliva. And it’s just kind of uncomfortable, and the grossness of it. So I think this is a really great alternative where you’re not, [inaudible 00:03:02], in the middle of the night.

Are you a candidate?

Dr. Bae:
Right. Right. And obviously I can’t guarantee it’s going to work for everybody. Just like people talk about getting Botox for migraines. Not everybody’s necessarily a candidate. It won’t necessarily work for them. But same thing here with clenching of the teeth, it’s certainly a reasonable thing. If you’ve tried the mouth guard and you don’t really like the way that looks, that headgear look that you might’ve had when you had braces when you were a kid. If you want to try another option, then yeah, Botox right here. And you don’t lose anything. If it doesn’t work, it doesn’t work. It’s fine. You don’t burn any bridges in the process.

Greg:
Yeah. And it’s an affordable way to go about it.

Dr. Bae:
Correct.

Greg:
Even if it doesn’t end up working for you.

Dr. Bae:
Right. What I just described would probably be about $300 to $450 to do that injection. Which I mean, I’m not saying it’s no money. But it’s not as maybe as expensive as some other options out there.

Greg:
Oh my God.

Dr. Bae:
And certainly-

Greg:
And I mean, listen-

Dr. Bae:
… it’s not surgical.

Greg:
Listen, look at the people’s Amazon accounts. That’s nothing with what they’re buying.

Dr. Bae:
Exactly.

Greg:
I mean, how many times have you really used that Jimmy Buffett margarita machine you bought during the pandemic? Not that many. So this is a great option, an affordable option for you. So if you’ve got questions about that or other things, you can always reach out to Dr. Bae on his social media, which is-

Dr. Bae:
@realdrbae, R-E-A-L-B-A-E. Not B-A-Y on TikTok, Snapchat, Instagram, and realdrbae.com. You know where to find me.

Greg:
All right. Thanks. Good to see you Dr. Bae.

Dr. Bae:
Thank you. Great seeing you, Greg. Thank you.

The post Treatment options for TMJ and teeth grinding first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr. Bae:
Doing great, Greg. Thanks for having me.

Greg:
Well, I am having you today because I have a personal question. This is all me.

Dr. Bae:
It’s not for a friend?

Greg:
Well, it’s for everybody, but I have a question about if you could help me with something. Now look, I’m near perfect, but not completely. When I smile, this has always bothered me. When I smile for photos, my eyes sort of disappear. So they go from open to almost closed. I mean, really, in a lot of photos, my cheeks are so full they come up. And my mother also has the same issue and she can’t stand to have her photo taken and she won’t smile in any photos. And I’ve noticed that literally, my eyes will go away. So a lot of times what I do is wear sunglasses in my photos, because I just don’t like the way it looks. Is there anything that can be done to help me out to where I actually have eyes when I smile?

Dr. Bae:
Absolutely. And the thing is, if you want to do something to address that we can, but you also don’t want to take away all your facial expressions. That’s when you start to look like a real housewife or something.

Greg:
Well, hey, that’s my dream, so don’t knock it. I want to be a real housewife.

Dr. Bae:
So I think the easiest way to address those issues is something called a neuromodulator, which is just the fancy term for Botox or Xeomin or Dysport or Jeuveau, any of these products you’ve heard.

Greg:
Oh, that sounded like a neuromodulator, it sounded like you’re going to put a mask on my face and pull it like this. So you mean it’s just Botox.

Dr. Bae:
Yeah, we can do that too. Just neuromodulator makes me sound smarter. But there’s a couple of different ways you can address that. So one is when you smile really big, you see these crow’s feet here. And so you can inject Botox there, that will relax the muscles. And so for those people that don’t know about Botox, it’s again, neuromodulator, you inject it under the skin, into the muscle. It relaxes the muscle so that when you smile, the muscles aren’t as activated and you don’t have those wrinkles and you won’t close your eyes as much. The other thing you can do is you can put Botox in the forehead. And a lot of doctors will do Botox all the way across the forehead, which will get rid of those forehead lines, but you don’t want to take away all the muscle tone from the forehead, because the muscles in your forehead also keep your eyebrows in a good position.

Dr. Bae:
So if you do Botox all the way across the forehead, it can take away all the muscle tone and your eyebrows can droop, which obviously not a good look, not one that people want. So what I do is I do Botox in a V pattern. I start in between the eyebrows and I go up onto the forehead in this V pattern, and that helps treat these lines. But since I don’t inject the muscles way out here, these muscles keep working. So when you smile or regardless, if you’re not smiling, you’re just in repose, these muscles keep working and they can keep your eyebrows lifted. Not like a Spock look that’s scary, but it can lift the outer part of the eyebrows. So between Botox in the eyes, Botox to the forehead in the way I described, can give you a little brow lift and that can also keep your eyes open when you smile really big. So it’s pretty cool that there is definitely a way to treat that and still maintain your facial expressions so people will know if you’re happy or sad. You won’t be just totally frozen.

Greg:
People know I’m always mad. But Dr. Bae, this reminds me, this is sort of a similar treatment you’ve talked about in the past that you had a client come in, was bothered, some people are bothered they expose too much gum when they smile maybe. And you said it’s a similar treatment for that. You don’t need major surgery. It’s Botox so your lip doesn’t come up as far, right?

Dr. Bae:
Right. So some people do have a lot of gummy show and one of the more permanent ways to treat that is to get a jaw surgery where they break the bone of the upper part of the jaw. I know everybody thinks of this as the jaw, this is the upper jaw where you break that bone and you can shorten that area and so it doesn’t have as much gum showing. Obviously, most people aren’t going to do that. There’s a much easier way to handle that. And what you can do is inject a very small amount of Botox into the upper lip. People do different areas depending on the doctor, but it’s all reasonable ways of treating it. But you inject Botox into the upper lip so that when you smile, the muscles are relaxed. And so the lip doesn’t go up as high when you smile.

Dr. Bae:
And because it doesn’t go up as high, it doesn’t show as much of the gum, so that fixes your gummy smile. The other thing that’s really cool about it is because your upper lip isn’t going up as high, it shows more of your lip. More of your lip rolls out, and that’s what people are talking about when they’re talking about the lip flip is just doing Botox here, treat your gummy smile. It makes your lip look fuller. Even though you didn’t get fillers, it looks like you got filler. There’s a photo I have on my Instagram page where this patient has a really thin lip when she’s smiling really big, and then she has a really full lip when she’s not smiling as big. It’s not because we put filler in her lips. It’s because we did Botox, did that lip flip, showed more of her lip. It’s a very cool photo. It looks really, really effective.

Greg:
This is why we love you, Dr. Bae. You give us the least expensive way to get what we’re looking for and the least invasive way to get what we’re looking for. So you’re not trying to get us for all we got. You’re trying to help us look our best, the easiest way possible.

Dr. Bae:
That’s right. I don’t get referrals by taking as much money and screwing people over. That’s not how it works.

Greg:
Well, good. We’re glad about that, and we do appreciate it. If you want to check out pricing for any procedure, make an appointment, or just get a consultation and go see Dr. Bae, you of course can do it right here on the website where you’re watching this video, or Dr. Bae is a crazy mad social media guru. He’s doing dances on TikTok. He’s all over Instagram. What’s your handle, Dr. Bae?

Dr. Bae:
It’s real Dr. Bae, R-E-A-L-D-R-B-A-E, not B-A-Y. Yeah, very easy to reach out on social media to find us or check out our website, realdrbae.com.

Greg:
Thanks, Dr. Bae. We’ll talk to you next time.

Dr. Bae:
Look forward to it.

The post Keeping your eyes open while smiling first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr. Bae:
Doing great, Greg. Thanks for having me.

Greg:
Hey, I had a question. So I had a friend who went in for a consultation for some work, let’s just say, recently. And she went in thinking she needed one thing and the doctor told her she needed something completely different to help with her issue that she was having. So how often does that happen, and how do you guide patients into the right direction?

Dr. Bae:
Right. Usually when patients come in, they have an idea of what they want, and you might need to tweak that expectation. Maybe they’re coming in, they want a breast augmentation and they want really big implants. And maybe you need to tweak that and say, “Well, you know what? You’ve already got a lot of breast tissue. Just because you saw somebody on Instagram that had 500cc implants and you liked the way they look, maybe they didn’t have any breast tissue to begin with so they needed all 500ccs.

Dr. Bae:
But if you’ve got it, you got some breast tissue, maybe you only need 300ccs. So we’re not totally changing them from what they want in general, maybe just trying to give them a little nuance to what their expectations are. The one time that I find that I’m completely telling people a completely different operation than what they’re expecting, it ends up typically involving the neck or the jawline or the chin. And what I mean by that is that patients will come in and say, “You know what? I think I need a bigger chin,” or, “I need a more streamlined jawline.” And what it really is is they have a very full neck that’s enveloping their jawline and their chin. And so I’ll show them-

Greg:
Is that like the turkey neck or the overgrown thing?

Dr. Bae:
Exactly. They just have… The muscle that’s in the neck is called the platysma, P-L-A-T-Y-S-M-A. And it’s like this hammock across the neck, and it just kind of holds everything in.

Greg:
I love when you use big words like that.

Dr. Bae:
And sometimes the platysma… At least I’m spelling them for you. You can go back and check my spelling. But yeah, that hammock of muscle, the platysma, sometimes it’s really lax and it could cause the neck to look really full. And like I said, it just engulfs and swallows up the jawline and the chin. And they’re thinking, “Oh, I need a bigger chin. And like, “No, you really need a smaller neck.” Of course, I say it more polite and more diplomatic than that.

Greg:
You say it nicely.

Dr. Bae:
Exactly. But that’s one of the things that we’ll talk about, like doing the different neck procedures. Maybe they just need neck liposuction, or maybe they need that SIMI neck lift that I do, the single incision, minimally invasive neck-lift. Or maybe they even need a full neck-lift. But by contouring their neck, it shows their jawline better. It shows their chin. And I’m able to show them other photos of patients that I’ve operated on, where before, they looked like they had a really small chin, and that you would think, “Yes, they need a chin implant.”

Dr. Bae:
But that’s why you go to somebody that’s been doing this a while is that when I show them the after photo, they can see that the chin looks bigger, the jawline looks more refined. But I didn’t do anything to the chin. I didn’t do anything to the jawline. I just took care of the neck. So it’s really interesting to see when they come in thinking one thing. And I’m just glad that I have photos to show them to prove to them that I’m not making this up, that, “No, you really don’t need a chin implant,” which is nice if you can avoid certain types of implants, if you can just do some natural contouring to the body.

Greg:
Well, I can speak from experience because one of my friends flew from Texas to get this SIMI neck lift with you, Dr. Bae. And she always thought maybe she needed liposuction there, which I know you can do. Or she needed another procedure, because she was always worried she looked, she said, like a bullfrog. And she had a small frame, but big here, which made her look big and round. And since she’s had that procedure, she really has just slimmed up. She has a neck, she has a profile, she has a chin. So it’s a really amazing transformation. And she’s so happy.

Dr. Bae:
Yeah, no, no. I’m glad to hear that. Thanks for the feedback. I appreciate it. One other example of people coming in and thinking they want one thing and that they really maybe just need another is when it comes to fillers, this might be more applicable to more of the audience, is that people think, “Oh, I have these deep grooves in my face right here, the parentheses lines. And I need fillers there.”

Dr. Bae:
Well, that was one of the ways… It still is one of the ways to treat it. But there are other ways to treat that now. What you can actually do is kill two birds with one stone, is that you can actually give them a little bit more cheekbone fullness here by doing fillers to the cheekbones. And by volumizing the cheekbones, not making them look like a balloon face or anything, but by volumizing the cheekbones, you can actually lift the face and it makes these parentheses lines less deep.

Dr. Bae:
So instead of them having these deep lines, you lift the cheeks, and you can actually see in the video, how I’m making my parentheses lines look less deep by volumizing here. So now what you’re doing is, like I said, killing two birds with one stone. You’re volumizing the cheekbones, which is a nice look, if not overdone. And it can lessen the depth of these creases here without also putting in filler there.

Dr. Bae:
So pretty nice what we’ve learned over the years, techniques that have improved, and steering the patient towards the right thing, not necessarily what I want them to do or what they want to do, but just steering them to the right thing that’s best for them.

Greg:
All right. Well, if you’re watching this video, you’re already on the website, right? So-

Dr. Bae:
Correct.

Greg:
… check pricing right here. Use the price estimator. Also, you can book your appointment right here, or you can always book and ask questions on Dr. Bae’s Instagram, which is…

Dr. Bae:
Real Dr. Bae, R-E-A-L-D-R-B-A-E, not B-A-Y.

Greg:
All right. Thanks, Dr. Bae.

Dr. Bae:
Always a pleasure, Greg.

The post Are you getting the right procedure?! first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr. Bae:
Hey Greg, how you doing?

Greg:
I am amazing Dr. Bae. Hey, I wanted to talk to you about this, you are very transparent with your pricing. You have a pricing tool right here on the website that people can find out how much something cost. Not everybody can pay for everything right upfront I mean, you’re not going to sit here and tell people, “Yeah I can do this for next to nothing.” And I don’t want my surgeon saying that by the way.

Dr. Bae:
Right. Cheap plastic surgery isn’t good and good plastic surgery isn’t cheap.

Greg:
No. So tell me some options that people have, maybe I can’t roll out five, six, seven, $10,000 just right off the bat but I want to get a procedure done that cost that.

Dr. Bae:
Yeah. So it’s a tough question because we don’t want people overextending themselves but there are definitely ways of financing these operations through different services. We don’t actually do any in… people ask all the time, do we do in-house financing? We don’t do in-house financing meaning that we won’t do your operation for nothing upfront and then you pay us back over time. We don’t do that but we do use some finance… You’d be surprised how many people ask that-

Greg:
Well, and by the way, I don’t do that for the radio station either. I don’t say, “I’ll work for a couple of months and you pay me later.” So I get that. I don’t do that either Dr. Bae.

Dr. Bae:
So that’s what I’m hoping is once the utility company says, “Oh, we’ll just give you the electricity [crosstalk 00:01:35] and you can pay us next year.” That’s when I’ll start doing. But for now what we do is that we use some third-party financing companies. We use CareCredit which a lot of people use, not just for cosmetic procedures but if you have a high deductible health plan and you got to pay out of pocket for medically necessary services, people use CareCredit for that, they use it for dental work. So we use CareCredit, We use another company called Alphaeon Credit, there’s Prosper Healthcare Lending. There’s several of them out there and they do things different ways as far as how they pay but the idea is that we get paid upfront for the service from that company and then the patient pays them back.

Dr. Bae:
So like CareCredit for example, they will pay the pers… pay the CareCredit back. The consumer will pay CareCredit back monthly for a certain period of time. And the thing people need to keep in mind there are options. There are some options like you can do six months no interest where CareCredit pays us everything and then if you pay CareCredit back within that six month period, you have to pay them the full amount but no interest that’s pretty awesome. But just to be sure-

Greg:
That is awesome, that’s like cash, yeah.

Dr. Bae:
It’s like cash but just be sure that you’re going to be able to pay it back within that six months because if not, then they are going to start to add interest and the interest is like 26%. It’s very high. Now-

Greg:
Oh, I see you do financial advice to Dr. Bay. So you are a financial advisor and… Yeah I mean, [crosstalk 00:02:55] don’t understand the interest rates and stuff like that so you have to do your research.

Dr. Bae:
Right. And that you got to keep in mind, how do these companies make money? They don’t make money by paying… people paying them back interest free in six months, they make money by people not being able to pay them back in six months interest free and then they have to pay a 7th and 8th month and the 9th month with that 20% interest rate. So of course, whatever advice I’m providing make sure you clear with an accountant first or your tax advisor. But the other thing to keep in mind is like, okay, well still you’re thinking, “Okay. You know what? I can’t afford it six months. I can’t pay it all off in six months so I don’t want us to be stuck paying some usury interest rate for that after those six months.” So the other option you might think is like, “I’ll pay it off over five years or I’ll pay it off over six years.”

Dr. Bae:
And they do have plans like that but keep in mind, those interest rates are pretty high too. Maybe they’re not as high as 26%, but they are may be like 14% or something like that. So they do get kind of high if you’re not going to pay them off within a year or two. So just keep that in mind, be safe, read the fine print. The fine print is there. They’re not trying to hide it from you. They have actually, I think by law had to made the fine print bigger. It can’t be as fine has to be bigger and easier to read. The other thing the state of California has done is that we can’t sign you up for CareCredit. That’d would be the way it could be done in the past and we could be done honestly where we would sign the patient up for CareCredit.

Dr. Bae:
They would give us their information and we would physically sign them up online. Now we no longer can do that. They have to physically log in and sign up for themselves because obviously some doctors may be or some institutions were signing people up without their knowledge so that’s why you can’t do that anymore. We never did that of course but anyway, read the print, know what you’re getting yourself into. And a lot of people you’d be surprised I mean, even if your credit score is not awesome, people are still getting approved by these different companies and they’re getting their procedure and hopefully paying back the company to keep the company whole so they don’t turn them over to collections.

Greg:
All right. And what about crypto coin? Do you take crypto coin? That’s a big thing-

Dr. Bae:
We do actually. You got to-

Greg:
What?

Dr. Bae:
Yeah you got to stay up with all the time. So yeah, we take Bitcoin, Ethereum, Litecoin, Dozer Coin. We [crosstalk 00:05:08]. I don’t know that we can take XRP right now. I think that’s tied up in litigation the SEC or whatever but yeah, we do take crypto coin if people are interested in paying that way. The trick is to get paid by that crypto coin and then cash it out immediately because the price fluctuates [crosstalk 00:05:28]. Yeah somebody can pay you when it’s $10,000 and then when you’re cashing in it’s $8,000, you just lost $2,000 on the operation but-

Greg:
There you go. [crosstalk 00:05:36] got to work out your finances on your end too.

Dr. Bae:
Exactly. That is true.

Greg:
All right. Well thanks Dr. Bay. And if you want pricing, it’s right here on the website, everything is transparent. You can book appointments, you can call to ask questions. You can email to ask questions or probably the easiest way is to reach out on social media.

Dr. Bae:
Yeah, you can reach us on TiTok, Snapchat, Instagram @realdrbae R-E-A-L-D-R-B-A-E. You’re a great spokesperson Greg, I might pay you to do this.

Greg:
Oh, you should in crypto. I’ll take Bitcoin.

Dr. Bae:
Fair enough.

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

The post Financing your medical or cosmetic procedure first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.