Safety in Plastic Surgery

My foremost concern as a plastic surgeon is the health and safety of my patients. Helping my patients look and feel their best is of course the heart of what I do, but safety always comes first. When becoming a physician, I swore to the Hippocratic Oath, to "first do no harm," and I live by that in my practice.

To that end, I have designed my New York City plastic surgery practice to be a safe, high-quality concierge experience for everyone involved. 

My office is a modern, state-of-the-art facility with a comfortable ambiance and sterile patient care areas. My operating room is nationally accredited and fully certified by the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF), with all of the safety features, medications, and life-support found in a hospital. The entire operating facility is powered by a backup power generator.

All of my nursing staff is trained, accredited, and certified in Advanced Cardiac Life Support and extremely familiar with the protocols involved in elective plastic surgery.

I only use a board-certified anesthesiologist to monitor my patients, never a nurse anesthetist, and never sedation performed by a less qualified individual.

Every patient receives a personal call from me the night after surgery. In addition, each surgical patient receives my personal cell phone number for direct access to me 24/7.

All of my patients' post-operative care is included in their surgical fees, and I am committed to ensuring that each person will receive the type of special attention that I myself would want if in their shoes.

While it may sound financially appealing to have plastic surgery abroad or in a cut-rate environment, it is not without serious risks. Though it is important to take into consideration what any procedure is going to cost, it is more important to know the safety policies of a surgeon and his or her clinic. Unfortunately, not all cosmetic clinics abroad adhere to the same firm safety standards as required in the United States, and not every plastic surgeon has the same dedication to safety above all else.

RESEARCH & QUESTIONS

When researching a plastic surgeon, ask the following questions:

• Is the surgeon board certified?
• Is the medical practice accredited or state licensed?
• How frequently does the surgeon perform the procedure(s) you want?
•  Are there before and after photos of this surgery done by the doctor you could see?
•  What are the possible risks and complications for this surgery?
•  How are these risks and complications resolved?
• What are your options for anesthesia and who will provide the anesthesia? Are they board certified as well?
• What is the recovery process?
•  How many appointments will you have post-surgery?
• What is the cost of the surgery? How does this cost compare to other equally qualified surgeons in your geographical area?

Please feel free to call my patient coordinator, Erica, at 212-452-2400, or email her at erica@LaraDevganMD.com for more information about me and my practice.

Non-surgical eye rejuvenation

Actual patient of Dr. Devgan, before (above) and after (below) Botox injection for crows feet and Juvederm filler injection for tear troughs (under eye dark circles).

This actual patient of mine is pictured before and after Botox to smooth out her crows feet and Juvederm to lessen the dark circles and tear troughs under her eyes. With this 10-minute non-surgical procedure, she looks younger, fresher, and more alert. 

Blepharoplasty (eye lift surgery) is actually the gold standard approach to rejuvenation of the eyes-- but this patient is young with good tissue elasticity and preferred a quicker fix. In older patients with less elastic skin, surgery is definitely the way to go.

To get an unbiased recommendation tailored to your unique anatomy, seek a practitioner who is capable of performing the full spectrum of plastic surgical and dermatological procedures. If you go to someone who only knows how to do injections, they won't have an incentive to tell you honestly when you would benefit from surgery. 

For a comprehensive evaluation of everything from skin care to peels to injectables to surgery, call my New York City private plastic surgery practice at (212) 452-2400 or email office@LaraDevganMD.com.

Dr. Devgan featured on Inspiring Women in Surgery: Faces of Surgery

Click to view Dr. Devgan's feature on Inspiring Women In Surgery.

I am honored to be featured on Inspiring Women in Surgery: Faces of Surgery, an online platform dedicated to motivating women to succeed in the male-dominated profession of surgery.

For years during my education and training, I wished that I had more female surgery mentors to model myself after. Now, I am trying to BE the role model I always wanted. Thank you Inspiring Women in Surgery for showing the next generation examples of how surgery is an equal opportunity field where the only thing that matters is being a good person who is good at your job.

I encourage you to look at this interesting page (linked above, by clicking on my photo) and read the stories of dozens of amazing women who work in all aspects of the field of surgery. There are many ways to contribute to the science and humanity of surgery, and the women featured on this page provide rich examples for anyone needing a bit of motivation and inspiration.

Gummy bear breast implants vs silicone implants: What do women in NYC prefer?

Actual patient of Dr. Devgan, before and after breast augmentation with highly cohesive gel silicone implants.

One of the big decisions with breast implants is what type of implants you will get. In this day and age, over 90% of the patients in my New York City private practice opt for silicone implants. This is because silicone implants tend to look and feel more natural than saline implants. In addition, in thinner women, silicone implants are less likely to demonstrate visible wrinkles or folds.

Within the category of silicone implants, women have the option of choosing "gummy bear" silicone or traditional highly cohesive gel silicone implants. Both types of implants have their advantages, and I am happy to accommodate my patients' preferences about implant type. However, overall, most women in New York City tend to prefer traditional highly cohesive silicone gel implants over gummy bear implants.

Gummy Bear Breast Implants

Gummy bear breast implants are form stable, meaning that, much like a gummy bear, if they are cut in half, they will keep their shape. Gummy bear implants can be round or shaped like a teardrop. They tend to be firmer and harder than traditional silicone implants. 

Traditional Highly Cohesive Gel Silicone Implants

Highly cohesive gel silicone implants also maintain their shape if cut in half, however, they are softer and more bouncy feeling than gummy bear implants. Women who have traditional silicone implants report that they feel like a soft, natural breast at a higher rate than women who have gummy bear implants.

Gummy bear implants versus silicone implants

Think of a gummy bear implant like a jelly bean and a traditional silicone implant like a cube of Jell-o. Both are soft. Both are form stable. Both will maintain their shape if cut in half. But a gummy bear implant will feel firmer and be less squeezable, while a traditional silicone implant will be softer and more pliant.

For this reason, most women in my practice (and most women surveyed overall) report a preference for traditional silicone implants.

If you have questions about breast augmentation surgery, including silicone, saline, or gummy bear implants, please feel free to contact my office on the Upper East Side of Manhattan at (212) 452-2400 or office@LaraDevganMD.com.

Actual patient of Dr. Devgan, before and after breast augmentation with highly cohesive gel silicone implants.

Actual patient of Dr. Devgan, before and after breast augmentation with highly cohesive gel silicone implants.

Actual patient of Dr. Devgan, before and after breast augmentation with highly cohesive gel silicone implants.

Actual patient of Dr. Devgan, before and after breast augmentation with highly cohesive gel silicone implants.

What age is the right time for Plastic Surgery?

Patients are often curious when they should have a plastic surgical procedure. There is no magic time frame that is right for everyone, and there is no correct answer to that question. Plastic surgery is highly individualized and depends on a variety of factors, including physical maturity, emotional maturity, readiness, and optimization of overall health.

There is a wide age range for people who undergo elective plastic surgery. From teens who are growing into their bodies to seniors who want to reverse signs of aging, plastic surgery has varying prevalence across age groups. Though many procedures can be performed at any age after puberty, data published by the American Society of Plastic Surgeons reports the following plastic surgery trends by age group:

• Rhinoplasty – ages 13 to 19

• Breast Augmentation – ages 20 to 29

• Liposuction/body sculpting procedures – ages 30 to 39

• Eyelid (blepharoplasty)/eyebrow lift – ages 40 to 45

• Facelift and necklift – age 55 and older

What does this say about your age group?

RHINOPLASTY (ages 13–19): The nose changes the least out of all of the facial features, and it is often a cause for concern starting in one's teens. I advise patients to wait until the craniofacial skeleton has finished growing (typically around age 15 in girls and age 17 in boys) before thinking about rhinoplasty or nose job surgery. This allows your surgical result to match your facial features without causing any disturbances in facial growth. Surgery in minors always requires the consent of a parent or guardian.

BREAST AUGMENTATION (ages 20-29): Once puberty is complete, a woman can assume her breasts are fully formed. While I have performed breast augmentations in teens as well as women in their 70s, the twenties and thirties seem to be the most popular time for first exploring this procedure.

LIPOSUCTION/ BODY SCULPTING (ages 30-39): Usually by the time both women and men are in their thirties they have begun to go through metabolic changes. When exercise and a healthy diet no longer suffice in getting rid of stubborn body fat, people begin turning to different forms of liposuction and body sculpting techniques. These surgical procedures have proven to safely and successfully remove fat.

EYELID SURGERY/ EYEBROW LIFT (ages 35 to 45): Men and women’s eyes typically begin to show signs of aging in their thirties and forties. The periorbital skin is the thinnest on the body, and genetics, sun damage, time, and stress can reveal themselves in the form of wrinkled skin, excess tissue, puffy bags under the eyes, and dark undereye circles. A subtle way to give aging eyes a renewed look is upper and lower blepharoplasty (eyelid surgery). Blepharoplasty is one of my favorite, signature procedures, and one of the most popular cosmetic surgeries in America.

When skin around the eyes and on the forehead begins to sag, it can also cause eyebrows to droop. Depending on each person’s unique anatomic characteristics as well as their desired look, either a non-surgical or surgical option can be offered to give eyebrows a refined raise.

FACELIFT/ NECKLIFT (ages 50 +): From the forties, fifties, and onward, many people realize that parts of their face and neck are not exactly how they remember them. Sagging skin can cause more prominent nasolabial folds, loss of definition in the jaw line, and loose, hanging skin on the neck. When done correctly, a facelift and necklift are incredibly subtle operations that can have significant and dramatic effects in improving a person's overall appearance.

So what is the best time for plastic surgery?

In my New York City practice, I see patients at all points on the age spectrum, from childhood to older ages. The right time to have surgery is different for every person, and there is no single cookie-cutter mold for every single patient. If you are physically healthy, emotionally stable, and concerned about a particular feature of your face or body, seek the opinion of a board-certified plastic surgeon to learn more about your options and the best time for your potential procedures.

For more information about a given procedure, or the correct timing for you, please call my office at 212-452-2400 or email office@LaraDevganMD.com.

Reference: Malek, Marc. "Some Things Never Change: Popular Plastic Surgery Procedures by Age." Some Things Never Change: Popular Plastic Surgery Procedures by Age. N.p., Web. 29 June 2016