When world famous sculptor Rodin molded a piece of clay, he magically transformed it into a thing of beauty. Dr. Samuel Rosenthal likens his work in the field of plastic surgery to the art of Rodin.
“Rodin’s medium was clay. My medium is human flesh,” says Rosenthal, who has been enhancing the facial features and bodies of patients for over thirty years. “Unlike other modalities in medicine, plastic surgery is actually an art form,” he says, “and it’s a gratifying field of medicine because the patients not only feel better — they look better. Very often it changes their whole life.”
Rosenthal’s favorite area for surgery is the nose. “It’s a coffee break operation for me,” he says, “and in that short time, I can make a plain girl pretty.” Noting that as we age, the nose tends to droop, Rosenthal often tells patients who come in for other facial procedures that he is going to “tip” their nose while he’s at it. After performing thousands of nose jobs over the years, Rosenthal points out that the best result is one that is not obvious, but looks perfectly natural.
“Amazingly enough, people really don’t remember what you looked like before,” he says, giving the example of a local surgeon with a large nose who came in for surgery. “I told him ‘No one will know you had a nose job.’” “People thought he’d shaved his mustache,” laughs Rosenthal. “Only he never had a mustache.”
“As with all surgeries, there are risks involved. Choosing the right surgeon is crucial,” says Dr. A. H. Nezami, who, like Rosenthal, is board certified by the American Society of Plastic Surgery. “Many physicians say that they are board certified, but patients need to explore further and find out what board they are certified by and if it is a recognized board.” With the internet as a tool, Nezami notes that women are now better informed about the procedures available to them and the doctors who are qualified to perform those procedures.
Elizabeth, 38, used the internet extensively in making her decision to have a breast augmentation. “I’m not a risk taker,” she says, “and I was hesitant to take this step, but after nursing my baby, I noticed that I’d lost a lot of volume in my breasts.” In addition to researching on the internet, Elizabeth talked to several friends before deciding to go ahead with the procedure.
“Dr. Nezami had done a total breast reconstruction for a friend of mine,” Elizabeth recalls, “so I had my first consultation with him. He struck me as very conservative, and he was completely up front about everything, including the risks. He warned me about possible leakage, the fact that they don’t last forever and that I’d probably face surgery again in my lifetime. I told him I just wanted to go up one cup size — from a B to a C — and he said, ‘Smart girl.’” Today Elizabeth is a satisfied patient of Nezami’s. She had surgery on a Wednesday and went back to work the following Monday.
As important as choosing the right physician, choosing patients carefully is important to Dr. Nezami. During the initial office visit, he spends a good deal of time trying to discern what is really bothering the patient. “I ask them what it is they are trying to accomplish and why,” says Nezami.
Does the patient want to look like a star? Is there a particular flaw that the patient wants corrected? For example, if someone comes in with a huge nose and shows Nezami a photo of a tiny, cute nose, the transformation from one to the other may not be advisable or even possible. “Much depends on the anatomy of the patient,” says Nezami. “Realistic expectations are important.” Once both the doctor and patient understand each other, Dr. Nezami also discusses the cost of the procedure. “Then it is their decision,” he says, “and mine.”
In most cases, plastic surgery is elective, expensive and is not covered by health insurance. Financing is available with many plastic surgeons, as well as through websites such as PlasticSurgeryFinancing.com, where costs for cosmetic/plastic surgeries are mapped by listing the procedure, price range, monthly payments and length of procedure. For instance, the website lists the cost of a major face lift as ranging from $6500 to $8500, with monthly payments of anywhere from $195 to $425. The procedure takes around two to four hours. Liposuction takes about one to three hours and costs from $2300 to $7000.
The following are some of the most common plastic and cosmetic surgeries are:
• Face Lift – tightens loose skin and removes bulges
• Brow Lift – opens up hooded eyebrows and lifts
• Laser Resurfacing – minimizes fine lines and removes skin blemishes
• Nasal-Cosmetic (Rhinoplasty) – corrects external or internal defects
• Nasal-Functional (Septo/Turbinectomy) – corrects external or internal defects
• Nasal Implant – builds and extends bridge of nose
• Eyelid – removes excess tissue and fat – reduces bags
• Ear Surgery – places ears flatter to head
• Chin Augmentation – corrects weak or inset chin, balancing to face
• Liposuction – removes hard to lose pockets of fat
• Tummy Tuck – removes excess skin and fat
• Breast Augmentation – enlarges small breasts
• Breast Lift – removes excess skin and lifts breasts
• Breast Reduction – removes excess skin and tissue, reducing breast size
Currently many non-surgical procedures have gained popularity due to reduced complexity and cost. With the recent FDA approval of Botox injections, there are actually Botox parties (akin to TupperWare and Pampered Chef home parties) in which Botox injections are given by a cosmetic surgeon as guests drink wine and sample dainty appetizers. Containing a small amount of toxin that works to paralyze the facial muscles, thus reducing the deep wrinkles of crow’s feet, frown lines and forehead creases, the injection is quick, nearly painless and effective. Downsides to Botox are that it may limit facial expression and it is a temporary fix, lasting only a few months.
Other non-surgical procedures include collagen injections, dermabrasion, chemical peels and permanent makeup. Dr. Loren Z. Clayman often gives his patients a permanent eyelinen, tattoo while they are undergoing a facelift. “I put it on while they’re asleep and when they wake up, they have an eye-enhancer that highlights what they have and does it all day long,” says Clayman.
Dr. Clayman’s philosophy, after more than a quarter century of plastic surgery, is to recommend an early approach to face surgery. “If a woman has an early partial face-lift in her forties, she just doesn’t age,” he says. Illustrating his point, Clayman talks about a “girl” who came into his office recently. “I gave her a partial face-lift 22 years ago,” he says. “She’s 75 and has hardly aged at all.”
In addition to early face-lifts, Dr. Clayman recommends using the best skin products available and sticking with a daily regimen of skin care. “If you’ve been out in the sun for thirty years, you’re not going to completely smooth out your skin,” he says, pointing out that laser surgery for sun-damaged skin has its drawbacks. “Going back out in the sun or to a tanning bed after laser surgery can result in pigment like a spotted owl — and that can be devastating for a woman.”
Graceful jaw lines and “swan necks” can be dramatically achieved through face lifts, but plastic surgeons are in agreement that modest rather than dramatic improvements are what patients should expect. “Women bring in Vogue magazines and want to look exactly like the models,” says Dr. Clayman. “I tell them you have to work with what you have — this is not Houdini surgery.”
Citing Michael Jackson as a perfect example of a plastic surgery junkie looking for extremes, Clayman says he wants his patients to be comfortable about their appearance. He also advises that follow-up care after surgery is important in maintaining their new look. For instance, young women who have had breast augmentations need to wear a bra to sleep in order to protect their breasts during the changes brought on by pregnancy.
“I find reconstructive surgery after mastectomy to be most rewarding,” says Clayman. “In the old days women lived in a little shell following mastectomies — but now they are not afraid to seek reconstruction.” He advises women to wait two to three months to heal from the mastectomy before reconstruction.
Dr. J. Felipe Garcia, M.D. of Ponte Vedra Beach specializes in facial plastic surgery. “I’ve studied the face for years,” he says, “and when a woman comes in for the first consultation, I feel it is very important to study not only her face, but her reasons for being there. When a woman thinks that by looking younger she can save her marriage or get a job promotion, she is seeking surgery for the wrong reasons. There is no guarantee.”
Most of Dr. Garcia’s patients request “Aging-Face Surgery.” “Women in their forties and fifties tell me they work out and jog every day and watch their diets in order to maintain youthful bodies, but when they look in the mirror, they don’t see the person they think they should see. They ask me to make them look as young as they feel. If I can turn back the clock ten or fifteen years, I’ve done my job well.”
Often women come in complaining of double chins. For that problem Dr. Garcia’s remedy is liposuction under the chin and a neck lift, which elevates the tissues of the neck. “The results of a necklift are pretty dramatic,” he says, “but with most facial surgery, the goal is reached when the change is not obvious — when friends make comments like ‘There’s something different about you… did you change your hair, lose weight?’
Cosmetic procedures are generally done in the plastic surgeon’s office, with the exception of breast reduction, which is done in the hospital. In selecting a plastic surgeon, it is important to find out about their hospital affiliations as well as their board certifications, in case of complications. There are several factors which may affect your recovery from plastic surgery procedures, such as smoking or drinking habits, the nature of your job, diseases, medications you are using and lifestyle. These are important matters to discuss with your plastic surgeon during the initial consultation.
“I love my nose,” says Colleen Goff of Ponte Vedra Beach, who took her nose job and turned it into a new career. “Dr. Rosenthal did my nose fifteen years ago. I had fragile features and a big nose. He gave me a nose that fits my face.” Since her nose job, Colleen has become an expert on plastic surgery, especially the recovery phase. A certified nurse’s assistant, Colleen says she bridges the gap between the cosmetic surgeon and the patient with a service called “Confidential Care.”
“It’s a privacy issue, often,” says Colleen. “People don’t want neighbors or family to know they’ve undergone a procedure, and there is a crucial recovery period involved. I take them home, bandaged and under the influence of drugs, and stay with them as long as necessary. Sometimes I spend the night. Since I’ve been through a procedure myself and done volumes of research, I can identify with them and answer the questions they forgot to ask. They are in a vulnerable state and I’m their protector — a cut above the neighbor next door.”
From “miracle” skin products to complex reconstructive surgery, the modern woman has an array of choices available for preserving youth and enhancing her appearance. The First Coast has become a mecca for cosmetic procedures.