Surgeries Sculpting The Future


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, 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.

Fitness Fun Factor


For some women, fitness fun may sound like an oxymoron. Where is the pleasure in logging miles on a treadmill? What’s exciting about crunches and lunges?

Unfortunately, without finding a way to enjoy working out, the odds of sticking to an exercise regimen are low.
According to the U.S. Department of Health and Human Services, adults should get at least two and a half hours of moderate physical activity a week. Before you start grumbling, read the fine print in the agency’s 2008 Physical Activity Guidelines for Americans: “Physical activity is any form of exercise or movement of the body that uses energy.” No treadmills or health club memberships required! That means you can get physical doing activities you actually like.

“Enjoying your fitness routine is vital to long-term success and maintenance,” says Melissa Arnold, a personal trainer and programs director at The High Intensity Training (HIT) Centers. ”When we are enjoying an activity we are more likely to make it part of our lifestyle routine than a part of our To Do list.”

There are countless ways to create a more vigorous lifestyle. Jazz things up with a new piece of equipment, sign up for a new class, join a team or indulge in one of many outdoor activities.

The latest and greatest in exercise gear

In 2002, more than $4 billion was spent on home fitness equipment. As companies develop new products to tap into this market, the boon for consumers is a constant stream of new and exciting gear.

Topping the list of innovative fitness products is technology-based “exergaming.” Exergames are video games that incorporate exercise, such as Konami’s Dance Dance Revolution and Nintendo Wii Fit. The Wii Fit monitors body statistics while offering yoga, balance, strengthening and aerobic games such as slalom skiing and hula hoop.

Other fitness products are designed to enhance traditional exercise like aerobic dance, calisthenics and weight lifting such as the dome-shaped BOSU® Balance Trainer, oval polymer gliding discs and cast iron cannon-shaped kettlebells.

Technology is making workouts more fun. Waterproof cases and headphones make it possible to listen to iPods while swimming or surfing, and one company even manufactures an underwater MP3 player. For runners, Nike+ is fast becoming the leading trend in high-tech gadgetry. The Nike+ sensor, which fits into a special slot in the bottom of certain Nike running shoes, communicates with a computer-compatible reader or an iPod Nano, allowing individuals to upload distance, pace, time and calories burned.

A new class of fitness

Gyms and fitness instructors know that diversity and novelty are two ways to keep clients coming back. They also know that group settings offer a supportive environment and an opportunity to meet new friends. Most facilities continually expand and change their lineup of classes.
There are several trends popping up in fitness classes around the nation, including group personal training, different types of yoga, circuit training, boot camps, cycling and active aging exercise. Choreography has been popular for years, ranging from hip hop to belly dancing.


“Dance brings an element that’s so exciting,” says Beth Handline, a fitness instructor and co-owner of Dance Trance Fitness. “Fitness becomes a side element.”

Dance prevents boredom by challenging participants to learn new steps. It is socially rewarding, and it provides an outlet for creativity and personal expression, Handline says. Many women also find it to be a great stress reliever, as focusing on the music and movement chases away thoughts of work, family and other responsibilities.

Zumba is the latest dance craze. These routines feature interval training sessions with fast and slow Latin rhythms. Developed by celebrity fitness trainer Beto Perez in the mid-1990s, Zumba blends toning and sculpting with the fat-burning efficiency of aerobics. According to, there are almost 200 Zumba classes within 25 miles of Jacksonville.

The team mentality of fitness

Many a woman recollects the pride and camaraderie of participating in organized sports as a youth or teen. Whether it was tennis, bowling, basketball, softball, soccer or golf, team sports are still a great option for getting out there and having fun.

“It pushes you to your personal limits in a fun, competitive way,” says personal trainer Melissa Arnold. “The team environment is also another positive component of sport: You are not doing it alone, which keeps you accountable, and it is motivating and fun.”

Terri Wright, 45, of Fernandina Beach, became an avid golfer about two years ago when a career change afforded time for lessons and league play. Three times a week she is on the greens. She says the physical activity of the game has improved her muscle tone, agility, flexibility and weight management. “I’m not a person who likes to work out,” Wright says. “Someone can call me and within the hour I’ll be ready to walk six miles on the golf course, but the treadmill is torture.”

Swimming is another athletic activity with wide appeal. “Everyone can swim, no matter their fitness level,” says Joani Maskell, swimming instructor and owner of Swimming Safari Swim School. “It can make you feel like you can really move. You can do a lot more in the water than you can on land.”

Swimming isn’t limited to doing laps. For something different, try water aerobics, walking in water, water polo, diving, synchronized swimming or adding props such as foam noodles, kick boards, ankle and wrist weights, steps or balls.

Maskell adds that the tactile experience of being in water helps women to connect with their bodies, building self-confidence and helping them feel more comfortable within their own skins.

Fun under the Jacksonville sun

Living in Florida provides year-round access to water and land-based activities. Jacksonville’s Riverwalk, along the north and south banks of the St. Johns River, provides an urban setting for walkers, runners and bikers. For nature enthusiasts, there are a number of local parks with paved and unpaved trails including Little and Big Talbot Island State Parks, Crystal Springs Road Park, Fort Caroline National Memorial and Tree Hill Nature Center.


If your fitness routine is usually based indoors, take your workout to the waterfront. A number of businesses rent bicycles and other water equipment like surfboards, boogie boards, snorkel sets and kayaks. For novice water sport fans, tour guides and instruction are also available.

Jody Hetchka, co-owner of Kayak Amelia, has been teaching the basics of kayaking for more than thirteen years. “It’s like any new sport,” she says. “You’re not going to be perfect the first time. There’s a technique to doing it the right way.” An afternoon spent on the water will work out abdominal and lateral muscles, as well as arms and shoulders. Serious fitness buffs who want more of a challenge can surf the ocean waves or paddle against the current. Either way, it’s a definite change of pace from the treadmill.

Today’s woman has many demands on her time and energy, so any activity she doesn’t enjoy is likely to get pushed to the bottom of her list. By exploring ways to make fitness fun, you are more likely to get active and stay active. And that feels good.

Find Your Fitness Fun Factor

“If you go out with the attitude that all exercise does is help you lose or control your weight, then the actual therapeutic value of exercise is lost,” says Melissa Arnold, a personal trainer and programs director at The High Intensity Training (HIT) Center. “Making working out fun requires something different for everyone.”

Try these suggestions to transform your fitness routine from a work-out to a fun time out.

Create short-term, manageable goals that focus on the process, not the outcome. Instead of aiming to lose twenty pounds, strive to get outdoors three times a week or learn a new skill like kayaking.
Move with meaning: Get involved with a 5K fundraiser or charity bowl-a-thon.
Spend some time analyzing what types of activities you enjoy. If you like socializing and making new friends, a class or group setting might be a good choice. If you’re competitive and athletic, join a team or league. If your life is hectic and busy, a solitary walk or meditative yoga might appeal.
Buddy up. Working out with a friend provides encouragement and accountability.
Commit to trying one new activity each month.

If you need just one more reason to get active, consider these facts:

By age 65, people who have not engaged in regular exercise may lose up to eighty percent of their muscle strength.
If you are 25 pounds overweight, you have almost 5,000 extra miles of blood vessels through which your heart must pump blood.
Research shows that regular exercise can improve your mood and enhance your overall sense of well being.
Experts report that working out in increments as brief as ten minutes can pay off. Logging thirty minutes of moderate activity five days a week can help you look and feel better as well as cutting your risk of cancer, diabetes, heart disease and stroke.

The top recreational activities for women are walking, aerobics, exercise, biking, jogging, basketball, lifting weights, golf, swimming and tennis.

The Fine Art of Social, Courtship, and Seductive Flirting to Get the Best Things in Life by Ronda Rich


Consider the following scenarios.

You are a manager in a successful company. You need to get a last minute assignment from your boss, and you ask your assistant to stay late to help you. She already has plans for the evening. You tell her that it is her job to help you so she cancels her plans. While the two of you are working, you continually remind her of the urgency of the project and of the details that must be taken care of. And you mention that the last time a similar project was done, she made mistakes. After the project is complete, you send her home with a quick “thanks” and say nothing more about her working late. A few weeks later she tells you she got an offer from another company and is leaving in two weeks.


You need your assistant to stay late you help you, but she already has plans. You tell her what a good worker she is and say that you don’t know how you will get the project done without her. You ask her about her plans, and she tells you she is going to see her sick mother. You ask about her mother, and relate a story about how bad you felt when you were sick recently and say that her mother is very lucky to have her. You assistant says she will call her mother and tell her she will be a little late. While the two of you are working, you praise your assistant’s dedication and thank her profusely for helping.

When she leaves, you smile graciously and say you couldn’t have done it without her. Then you prepare a handwritten thank-you note and leave it on her desk; the next day you take her out to lunch. The following week, when the district manager is in the office, your assistant tells him how wonderful you are to work with; he then compliments you on running the office well and gives you a raise.

It’s Saturday and you want your husband to go to a movie with you, but he says he has plans with his buddies. You begin to whine and complain about how he never spends any time with you. The two of you argue, and he leaves to spend the afternoon with his friends.

When you suggest going to a movie on Saturday, your husband says he has plans to go fishing with his buddies. You tell him how much you will miss him and that the movie just won’t be the same without him to laugh with. Then you ask him about his fishing trip, listening attentively when he tells you the details about putting the worms on the hook and telling him how great a fisherman he is. You say you will go to the movies by yourself and hope that he has fun. You get dressed, putting on a sexy top and making sure your hair is perfectly styled and your perfume is in just the right places. Before you walk out the door, you kiss him and tell him you will see him later. He then follows you to the door and says he is kind of tired of listening to Bubba’s same old jokes and the movie does sound like fun.

What Southern Women Know about Flirting by Ronda Rich is about how being nice or “flirting” can make life more pleasant for everyone. As the title of the book indicates, Rich uses her southern heritage as a basis to show how people respond to thoughtfulness, kindness and friendliness. Though her examples often come from Southern traditions, her message is relevant to everyone.


Rich explains, “Flirting is simply the art of being real nice which, in turn, makes others feel good about themselves and about you.” She says, “We [Southern women] make no apology for the potency of our charming, darling ways, for we long ago discovered that we could practice the ancient arts of femininity while proclaiming a strong-willed independence.”

To be an accomplished flirt, you must possess self confidence. An outer appearance directly influences how you feel about your inner self. Rich stresses the importance of enhancing one’s feminine attributes. Clothes, hair, and makeup should show that you care about yourself. Rich also advises, “Stay away from others who chip away at your self-confidence.” And look for the positive in others, as well, refraining from giving negative comments, even if you are “just kidding.” Also important in flirting are humor, genuine interest, goodwill, knowledge and, very importantly, gifts. Sending a written note of thanks is an invaluable gesture in today’s world of email, and giving a present (flowers, a gift certificate, or a specially chosen item) will make another feel good about herself, and thus make her feel good towards you.


Rich defines three types of flirting: social, courtship and seductive. Social flirting is appropriate in any situation. Among Rich’s various examples of successful social flirting is her story about getting a seat on a fully booked flight. By “flirting” with the ticket agent and then the pilot, whom she happened to meet in the waiting room, she was allowed to move ahead of the other passengers on the waiting list. Another success occurred when she was checking into a hotel. She complimented the desk clerk on her lovely hair; the women was flattered and responded in a friendly manner. Then Rich asked if it were possible to get an upgrade on her room—to a river view. The women didn’t say anything else, but when Rich went to her room, she found not only an upgrade to a river view, but also a master suite. She immediately called the woman downstairs and gushed her thanks, and when she checked out, she filled out a compliment card, praising the employee. So both people prospered from a little social flirting.

Courtship flirting, according to Rich, “is the demure, feminine science of sweetly attracting a man until he falls madly and inescapably in love,” and seductive flirting is what keeps the relationship alive. If your husband wants a peanut butter sandwich, Rich says, you should get up off of the couch and get him one. On the other hand, she also stresses that he should dote on you as well. “If a man is taking you for granted or bruising your esteem, put on your highest heels and click away as fast as possible,” she says. “I prefer being alone than being neglected.”

Rich’s many references to the South will delight readers, especially the southern ones. Flirting, says Rich, “spreads a feeling of goodwill and good humor as steadily as kudzu spreads on a warm summer’s day.” Rich tells how southern traditions play a great role in courtship and seductive flirting. For example, cooking is very important, as “men feel nurtured by women who cook for them.” “Rule the roost, but pamper the rooster,” Rich states, and she describes a needy woman as “a chigger burrowing into a man’s flesh. It will bite the heck outta you and just keep biting until it dies.”


The author concludes her discussion by listing the top rules for flirting, must haves for a modern flirting girl, top places to meet guys, secret weapons and flirting girl don’ts.

Rich’s says, “People become too serious-minded about life and forget to have fun while accomplishing goals and winning hearts.” What Southern Women Know about Flirting contains practical ideas to make life more fun.