August 25, 2015

How to get a gorgeous smile: An invited article by Irina Starik, DMD

August 25, 2015

I'm pleased to introduce Dr. Irina Starik, a fabulous dentist on the Upper East Side whom I have trusted with my own teeth. Read her article on what you can do to maintain and achieve a beautiful smile and great teeth, below.

How to Get a Gorgeous Smile by Irina Starik, DMD

Guest Blog Post for Lara Devgan, MD, MPH

"The world is like a mirror, if you smile it smiles back, and vice-versa."

- Ras Obenn

A recent study conducted by the Max Planck Institute in Germany concluded that smiling can make you appear younger. The question then becomes, how do we keep this healthy smile throughout our life?

As we age so do our teeth and gums. Enamel (the outside layer of teeth) changes color, wear over the years shortens the length of the actual tooth, the gum line begins to recede and our teeth move and become misaligned.

Oral Hygiene

The first line of defense is oral hygiene. This includes brushing and flossing your teeth every day as well as regular checkups by your dentist semi-annually. The best time to brush your teeth is after breakfast and after you have had your last meal at night. Flossing should be done every night prior to brushing and incorporating mouthwash helps reduce the bacteria count in your mouth. Seeing your dentist regularly will ensure that any problems that develop are treated right away and that your daily oral hygiene technique gets the professional stamp of approval!

Whitening Your Teeth

However with time and aging other factors start to affect your smile. As you age, it becomes vital to understand how food and drinks affect your teeth. Coffee and wine stains the teeth and other foods such as sugars and citrus fruit even break down your enamel. Whitening your teeth professionally is the best way to restore what time has diminished and monitoring your diet will help slow the wear of your teeth.

Teeth Grinding

One of the biggest obstacle to a healthy smile early on is smoking and teeth grinding. Symptoms of grinding include excessive wear of the teeth, increased sensitivity, and jaw pain. The best way to treat this is to have a night guard made by your dentist. Recently there have been new treatments developed, including Botox therapy of the specific muscles (masseter and temporalis) that control closing and clenching of the jaw.

Invisalign

With age, teeth also begin to shift and change position, even if you have had orthodontics (braces) in the past. The best and least invasive way to realign your teeth is through Invisalign treatment. This is a modern approach to braces that uses virtually invisible retainers that gently re-position your teeth.

Lip Fillers

Facial aesthetics also have a direct affect on the beauty of your smile. Enhancements such as lip fillers will help hide receding gums. Other ways to improve your smile is to use these fillers in your gums to help plump and lower them.

There are many ways to help you maintain your youthful smile, ask your dentist about other specific options that you may have!

Click to learn more about the author of this post, dentist Irina Starik, DMD — Click to learn more about the author of this post, dentist Irina Starik, DMD

Lara Devgan, MD

August 19, 2015

Revision rhinoplasty: what to do when you are unhappy with your first nose job

Lara Devgan, MD

August 19, 2015

Actual patient of Dr. Devgan, before and 11 days after revision (tertiary) rhinoplasty. The first two operations were performed by another surgeon.

Rhinoplasty (nosejob surgery) is one of the most complex and detailed operations in plastic surgery. For this reason, it is not uncommon for me to encouter patients who have previously had a rhinoplasty done by another surgeon who are not happy with their results. Either they don't breathe well, they don't look good, or some combination of those things.

Gunter diagram for analyzing the components of the nose, for rhinoplasty and septoplasty surgery.

Revision rhinoplasty is called secondary rhinoplasty the 2nd time around or tertiary rhinoplasty the 3rd time around. In these situations, attention to detail, anatomy, and sound surgical principles is incredibly important.

Intraoperative view of nasal anatomy during a complex revision rhinoplasty operation.

My philosophy with rhinoplasty is to achieve a patient's desires by making subtle, incremental changes that preserve the unique beauty and characteristics of his or her face. This is especially important in ethnic rhinoplasty (rhinoplasty in patients of Asian, Indian, Middle Eastern, African, Jewish, or mixed heritage), as an overly anglicized nose can look artificial and incongruous.

A good rhinoplasty and/or septoplasty operation will allow you to look good and breathe well. It will make your nose less of a focal point and allow observers to appreciate your other facial features, such as your eyes, lips, and cheekbones.

If you would like to speak with Dr. Devgan about revision rhinoplasty, or if you are not happy with a rhinoplasty that has been done by another surgeon, please call (212) 452-2400 or email info@LaraDevganMD.com to set up a consultation appointment.

Lara Devgan, MD

August 17, 2015

Alar Base Reduction Rhinoplasty

Lara Devgan, MD

August 17, 2015

Actual patient of Dr. Devgan, before and 3 weeks after alar base reduction rhinoplasty

One of the most aesthetically important parts of the nose is its width at the base. It can be distracting and overpowering for your other facial features if your nose that is too wide for your face, or if your nostrils are disproportionately large compared to the bony structure of your nose.

How do you know if your nose is too wide for your face?

According to ideal facial proportions, your nose should be approximately as wide as each eye, and no wider than the space between the eyes. When the face is divided into fifths vertically, as above, the ideal aesthetic relationship becomes clear.

Of course, there is no one-size-fits-all approach to facial features. Nasal width reflects heritage and ethnicity as well, and some people prefer a nose that is either wider or narrower than the above diagram indicates. Your nose is too wide for your face only if you feel that it is too wide.

What can be done for a wide nose or wide nostrils?

A traditional rhinoplasty takes apart and rebuilds the nose completely, but if your only concern is a wide base of your nose, you might be a candidate for a smaller procedure called an "alar base reduction rhinoplasty" or "Weir excision rhinoplasty."

An alar base reduction rhinoplasty narrows your nose in a short operation that takes under an hour. This operation can be done with local anesthesia only, meaning that it is a painless and awake procedure. Not only does eliminate the risks of sedation and general anesthesia, but it also means that you are able to return to your normal life (including work and school) the next day.

The incisions for an alar base reduction rhinoplasty are tiny and hidden in the crease between your nose and your cheeks. When stitches are removed one week after surgery and healing becomes more complete, they are barely noticeable-- even in people with dark complexions.

What is the next step?

If you are interested in nose reshaping surgery, including alar base reduction rhinoplasty, please email info@LaraDevganMD.com or call (212) 452-2400 to set up a consultation appointment.

Verified rhinoplasty patient review from RateMDs.com

Lara Devgan, MD

August 10, 2015

Nipple Reconstruction After Breast Cancer

Lara Devgan, MD

August 10, 2015

Primary (first time) nipple reconstruction. Actual patient of Dr. Devgan.

Secondary (second time) nipple reconstruction, 10 years after the initial reconstruction. Actual patient of Dr. Devgan.

Breast reconstruction after breast cancer can be a long, multi-stage journey. However, technology for breast reconstruction has improved dramatically in the past decade, and results are better and more beautiful than ever.

The initial stages of breast reconstruction involve creating a breast mound (the soft round form on the chest that mimics the female breast). This can either be done with a breast implant or with your own tissue (usually fat from the belly).

The final stage of breast reconstruction is often the reconstruction of the nipple (or nipple areolar complex). This procedure is more minor and can be done while you are awake, using only local anesthesia. However, it is a very gratifying operation, as the breast looks much more realistic when a nipple has been created. A reconstructed nipple is generally very durable. However, some women note that their reconstructed nipple tends to sink down and become more flat after several years have passed. In these women, we perform a secondary or revision nipple reconstruction.

Once the nipple has been made, most women choose to undergo areolar tattooing by a qualified tattoo artist. This is a final finishing touch that gives the reconstructed breast a beautiful, natural appearance.

For more information about breast or nipple reconstruction after breast cancer, please set up a consultation appointment with Dr. Devgan by calling (212) 452-2400.

Lara Devgan, MD

August 7, 2015

Pediatric Plastic Surgery

Lara Devgan, MD

August 7, 2015

Actual patient of Dr. Devgan, before and after repair of facial laceration.

As the mother of three young children, taking care of kids who require plastic and reconstructive surgery is a great joy of my job. Not only do I appreciate the gentle and delicate way kids relate to adults (especially scary doctors), but I also understand the things that can help keep them at ease.

Singing Wheels on the Bus, watching Peppa Pig, giving out stickers and band-aids, sharing (sugar free) candies, and playing doctor to stuffed animals-- these are all part of my routine when helping kids through their tough times.

Whether your little one has a facial laceration from a fall on the playground, a hand injury from a mishap at home, a congential anomaly, a suspicious mole, or anything else, please do not hesitate to reach out to me if I may be of help. I take care of pediatric patients ranging in age from birth through the teenage years and beyond. I address concerns such as teenage breast reduction, teenage rhinoplasty (or nose job surgery), teenage torn earlobes from ear piercings, dog bites, cat scratches, and conditions that your child may have been born with such as cleft lip and palate.

You may call my office 24-7 at (212) 452-2400 for either routine or emergency concerns, and you may always reach out to me via email at info@LaraDevganMD.com.