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Los Angeles Times Article

By Dr. Richard Fleming This is a very interesting and well-written article from the Los Angeles Times, which discusses the popularity of rhinoplasty for Iranian women. In our practice at the Beverly Hills institute, we have been privileged to perform rhinoplasty surgery on many Iranian women patients, and our experience has been quite similar to that described in the Times article. That is, almost all of these patients seem to feel that their “quality of life” has been greatly improved by this procedure. Thus, it is a “win-win” situation ( for both the patient and the surgeon) in that it is truly gratifying for our surgeons to have these patients, in their “follow up” visits with us, express their enthusiasm and satisfaction with their surgical results. (On a side note, we should observe that an additional “bonus” for we surgeons is that these Iranian women are generally so pleasant and so interesting –and fun–to work with, that this in some way also contributes to the success of these surgeries.) — Dr. Richard Fleming

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Social Media’s Influence on Plastic Surgery

By Devin Swift The number of requests for plastic surgery is increasing year after year, and one primary reason is the growth of social media. A poll conducted by the American Academy of Facial and Reconstructive Surgery shows surgeons are seeing more than a 30 percent increase in the number of patients interested in plastic surgery to improve their image on social media. Social media, particularly the “selfie”, has dramatically increased self-awareness translating into more patients seeking to improve their appearance. This trend was first documented in 2013 but continued into 2014 and by all accounts will increase throughout 2015. The advent of a device called the “selfie stick” – an extendable metal rod that attaches to a smartphone and allows for a wider variety of selfie shots – has only further promoted the self-awareness that leads to more plastic surgery requests. Another new wave of technology having an impact on plastic surgery trends are smartphone apps that can be used to alter images to create a different appearance. These apps can be as simple as a filter that changes the shading on an image, or they can apply artificial makeup and remove wrinkles. The plastic surgery procedures so far seeing the largest increase in numbers attributed to the selfie craze include rhinoplasty, hair transplants and eyelid surgery. Each of these procedures and many more are capable of providing a rejuvenated appearance and even addressing very specific cosmetic concerns. However, it is important to remember that plastic surgery isn’t right

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Obsession with Celebrities Physical Features

By Devin Swift An increasingly large number of people seeking plastic surgery are doing so in an attempt to mimic the appearance of celebrities. In 2014, 13 percent of surgeons surveyed by the American Academy of Facial Plastic and Reconstructive Surgery reported an increase in requests for celebrity procedures, up from three percent in 2013 and seven percent in 2012. The increase isn’t much of a surprise considering how much media exposure for celebrities in general has grown in recent years. Social media and expanded television coverage gives people more opportunities to see the celebrities they hope to emulate in appearance and more examples to request from their surgeons. In 2014, the most commonly requested celebrity features included Angelina Jolie’s lips and cheekbones, Beyoncé’s facial structure, Kim Kardashain’s eyes and jawline, Brad Pitt’s nose and Natalie Portman’s nose. Other celebrities rumored to have commonly requested features are Jennifer Lawrence and Julia Roberts. Lawrence for her nose and Roberts for her grin. Celebrity features are commonly requested in Beverly Hills plastic surgery offices, but the request for a celebrity feature is less common than a patient requesting a specific alteration to their appearance. It’s also important to remember that simply changing the appearance of one part of the face or body to resemble another person’s will not provide the same level of recognition. It’s fairly common for Beverly Hills plastic surgery patients to reference a certain image of a celebrity for an idea of what they would like from their procedure

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Plastic Surgery Trends for 2014

By Devin Swift The plastic surgery industry is always changing. New procedures are developed, old procedures fall out of favor, and celebrities push trends in new directions. There was a general increase in requests for plastic surgery in 2013 and a study formulated by the American Academy of Facial Plastic and Reconstructive Surgery suggest the surge in requests continued in 2014. One primary reason for the increase in plastic surgery requests is the advent of the “selfie”, which has people thinking more about their appearance than ever before. It’s extremely likely the increase in plastic surgery requests seen over the past two years will continue into 2015 and beyond, largely attributed to “selfie” culture. Another form of media influencing plastic surgery statistics is video clips, which according to Cisco will account for 80 percent of all consumer Internet traffic by 2018. Video impacts plastic surgery requests in that videos cannot be retouched or altered as easily as images. According to the American Academy of Facial Plastic and Reconstructive Surgery, this is leading consumers to seek neuromodulator injections to improve their appearance in videos. The statistics reflected an increase in neuromodulator injections in 2014 and all signs point to a further increase in 2015. Of all plastic surgery procedures performed in 2014, roughly 80 percent of them were minimally invasive, almost half of which were Botox injections. Additionally, the survey shows that 71 percent of surgeons saw an increase in combined non-surgical treatments. Procedures potentially included in a combined non-surgical procedure

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Holy Peptide!

Peptides are composed of different combinations of amino acid cha Five or ten years ago, the use of peptides was all the buzz and any product that contained one seemed worth a try. It was the next big thing since alpha-hydroxy acids and then antioxidants. By now in 2013, there are hundred if not thousands of different peptide-based skin care products available. You can choose from a $2.99 bottle of cream advertised on Amazon as an “Antioxidant-Peptide Complex” or a pair of “Private Reserve” neuorpeptide serums retailing at Nordstrom for $475. How to choose? We will stick to the basics and discuss two “workhorse” peptides that have appeared in many different formulations for over five years. Matrixyl (different from Matrixyl-3000) is a tradename for the palmitoyl pentapeptide-4 anti-aging ingredient. In short, it helps your skin build collagen so it diminishes wrinkles and improves elasticity. In fact a 2013 study by researchers at University of Reading concluded it has potential to nearly double the amount of collagen you produce and also stimulate your own hyaluronic acid production. Cosmetic studies for products which include the peptide report that people see improvements in wrinkle reduction and hydration. This ingredient seems to be very beneficial without sideeffects and suitable for any skin type – so the only question being how much are you willing to pay to get a higher percentage of this particular peptide in your product! Argireline (the trademark name for Acetyl Hexapeptide-8) is a peptide that is also in widespread use

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When You Want Plastic Surgery — But The Doctor Refuses

By Devin Swift I AM OFTEN ASKED HOW MICHAEL JACKSON LOOKED THE WAY HE DID PRIOR TO HIS DEATH. I answer that by saying he had unrealistic expectations and found a surgeon who told him what he wanted to hear. There you have the makings of a disaster! Last week I saw a patient from the East Coast who exemplifies this issue. Let’s call her Mary. She looked like Jennifer Lawrence, who is someone I would not operate on because she doesn’t need anything done. Mary was an attractive woman who was of normal weight, size and pretty. She had had her nose done as well as her cheeks and upper lip. When I asked her what bothered her she said she thought her nose could be further refined and thought she DEFINITELY needed a mini facelift. She is 22 years old. I explained to her that her nose did not need any further surgery since it looked great and the risk outweighed the gain. Furthermore, that she had NO excess skin to be removed and this would only leave her with wide scars since her skin was too tight at 22 years of age. She absolutely disagreed with me pulling back the skin on her cheeks to show me what she wanted done and how “simple” this would be. I then explained to her that I only make money when I operate on people, so she should understand this if nothing else. Furthermore, I told her that she could

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Rhinoplasty Surgeons Get Better With Age

By Devin Swift Rhinoplasty surgeons should have a great deal of experience. They call it the “practice” of medicine for a reason. Rhinoplasty is probably the most difficult cosmetic procedure since it takes 1 year to see the final result of your work.There have been many surgeons who do outstanding work into their 80’s. It is not the hands that deteriorate with advanced age it would be the mind. If the surgeon is excellent he will keep this—if he doesn’t know who u r the day of surgery, u might want a different surgeon–just kidding!

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Improving the Fiveheads

In this forum we frequently talk about beauty and facial proportions first described by Da Vinci. The frontal hairline, which helps to frame the face in both men and women, will influence facial balance. In men we are all aware of the common problem of male pattern baldness and the medical and surgical alternatives to treat this condition. The majority of women have normal forehead height which is 1/3rd of the face. If that is a normal forehead, many years ago the term “fivehead” was coined to describe a bigger forehead. I’ve not heard that term for a long time but recently I’ve seen it twice; tmz.com had a piece on this last month and Tyra Banks is producing an autobiographical comedy called Fiveheads.There are many examples of beautiful women with fiveheads such as Beyonce, Vanessa Williams, and Angelina Jolie but many women do not like this feature which is distracting and will limit their hair styles. That is why we continue to see women from all over the world to have our hairline lowering procedure, which we described many years ago. In this technique we lower the hairline and shorten the forehead , bury hair follicles which produce hair that will grow through and in front of the incision so it will not be seen after healing is complete. We thank TMZ and Tyra Banks for reminding us about this innovative description of the unwanted physical characteristic of a “Fivehead” which can be eliminated.

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16th Annual Hollywood’s Hottest Looks Survey

With the evolution of techniques in aesthetic surgery some things are constant. Patients still look to Hollywood for standards of beauty. Over the years we have kept track of the celebrities patients reference when they describe physical features they admire. The results of our 16th Annual Hollywood’s Hottest Looks Survey will be released this week. You can participate in the survey by going to our Hollywood’s Hottest Looks Survey.

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Why do most surgeons have dissatisfied patients?

The best rhinoplasty surgeons have few if any “bad results”. Rather, they are results that the patient may feel are not “perfect”. In 35 years of performing rhinoplasty, I have found that many patients who I could only get “good” results on were happier than some patients that got a fabulous result. Beauty is in the eye of the beholder, and the objective of the best surgeons is to try to find out what the PATIENT wants and not necessarily what the surgeon wants.

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Oxygen Treatments and Healing Skin

Oxygen is central to life, health, and beauty. The element has been a mainstay of skin care for ages – whether it is being harnessed in Benzoyl Peroxide formulation to target p. acne bacteria or carried internally to nourish cells by stimulating the skin via massage, peels, or exfoliants. Healthy skin depends on it. Oxygen machines harness these benefits and multiply them exponentially. The machines concentrate oxygen in the air to very high levels, and then push it deep into the skin. This nourishes the tissue immensely. Vitamins, minerals, and enzymes – or even light peeling chemicals – are added into the pressurized air flow to deliver powerful stuff into active layers of the skin. Oxygen facial treatments boast instant plumping and stimulating effects, because they fill the skin “to max capacicty” with healthy hydrators and antioxidants. Their real power is in accelerating the road to new, healthy skin. This makes them a perfect finish to dermaplanes, microdermabrasions and peels – guaratneeing fast, flawless healing.

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Thinning Eyebrows? Try Eyebrow Hair Transplantation Instead of Permanent Makeup

Patients and surgeons have been aware of the importance of eyebrow position for many years. That is why we developed the Trichophytic Hairline Browlift to elevate low brows and preserve or improve the patient’s hairline location. For men and women the eyes are a strong focal point in facial beauty and attractiveness. The brows are an important part of this aesthetic unit because they frame the eyebrow-eyelid complex. Only recently have we focused on the thickness and continuity of hair within the brows. In patients who want fuller and thicker brows, techniques such as tattooing provide less than ideal temporary improvement. Hair transplants placed in the brows achieve a permanent, natural result. Hair transplants are done to improve the appearance of the eyebrows in patients who have: 1) lost hair secondary to aggressive plucking of the brows, 2) congenital absence of hair, 3) thin or low density brows, 4) lost hair secondary to scarring following trauma or a direct browlift, and 5) lost hair secondary to infection, hormonal imbalance, or diseases such as alopecia areata,. These transplants can improve brow location, contour, and density. One hair micrografts are taken from specific areas of the scalp to match the caliper of the existing brow hair. The number of grafts will depend on the needs of each individual patient. Because the grafts are taken from the scalp the hair must be occasionally trimmed. While hair transplantation is a relatively easy procedure this is a technically and aesthetically demanding operation. Surgery to enhance

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Why Do You Cleanse your Face?

There is a basic formula to choosing the right cleanser Taking care of your skin is very complicated these days. “Basic” care includes juggling complicated home regimens and frequent visits to a specialist. Do you ever get so confused that you don’t even know where to begin? At our practice, we are finding many people aren’t even sure how to cleanse anymore – the very first step!   Let’s break it down. Cleansers are used to 1) take off makeup 2) lightly exfoliate surface dead skin cells 3) remove excessive buildup of dirt, oil, sweat 4) remove bacteria.   Depending on your lifestyle some or all may apply, but everybody will benefit by cleansing at least once a day in the evening. 1) If you use a cleanser to remove makeup, choose an oil or cream. These cut through makeup. Dry skin will be soothed by the texture. If you have oily skin or larger pores, finish with a balanced toner or gel cleanser to guarantee residue won’t remain on the skin to clog later. 3) If you’ve cleaned a kitchen, you probably know that “oil cleans oil”. For this reason, many people like to use oil-based cleansers to clean the skin of grease and dirt. Modern surfactants in gels and foams also do the job, though maybe not as quickly. Either is suitable, but finish with a toner for oily skin with larger pores.2) Nowadays there are designated exfoliants (from surface to aggressive) appropriate for every skin type to

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Rejuvenating the Upper-Third of the Face in Aging Patients.

1. REMOVING THE EXCESS SAGGING SKIN 2. CUTTING THE WRINKLE MUSCLES TO PREVENT AND LESSEN WRINKLES WITHOUT BOTOX–The muscles are carefully divided at the same surgery. 3. FOREHEAD LIFTING WITH THE IRREGULAR TRICHOPHYTIC FOREHEAD LIFT–This is a procedure that we developed to raise the brows and feminize and make a younger look WITHOUT removing any hair. The hair grows thru, not behind, the scar. 4l HAIRLINE LOWERING— The hairline can be lowered at the same time depending on the looseness of the scalp. If the scalp is tight, we use the Fleming-Mayer Tissue Expander to lower it up to 1-2 inches. 5. BALDING TREATMENT — men or women with frontal balding can have the Fleming-Mayer Flap to give natural density without texture change to give a full head of hair. We create a natural, youthful look to a previous sad, tired and angry face. Look at the photos and videos of patients done this way. Schedule a Consultation today to see if any of these procedure might be right for you.

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How to Fight Cellulite

Endermologie is the only FDA-approved, non-invasive treatment for cellulite. Though the technology is always advancing, the method is based on classic principles – rollers and suction maneuvers are used to offer deep massage and stretching to connective fibers and tissue in problem areas. The increased circulation expels excess water and toxins and transports healthy blood and oxygen to the stagnated area. The 35-minute biweekly sessions are invigorating for the client. One feels tension melt as the machine’s rollers lift, stretch, and mobilize the tissue and skin. The calm and refreshed feeling is only a side benefit to the real achievement – significant reduction of cellulite, a sculpted look, and tighter skin. Benefits are often visible after only a few sessions, but typically 12-20 sessions are recommended to achieve desired results. Patient participation is key to the process – and lifestyle changes required for the program can lead to years of improved health. Eating healthy, ample hydration and light exercise are all paramount to great results with the treatment process. Whether its for beauty, health, or both – endermologie is a favorite procedure among patients of all ages and demographics. Schedule a consult with Brandy at The Beverly Hills Institute and take the first step towards your goals!

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What Should I Expect at My Rhinoplasty Consultation?

Take full advantage of your Rhinoplasty consultation to answer all your questions and discuss your goals and expectations. Plan ahead. Make a list of your questions and explain what you don’t like and what changes you want. The following is a list of questions most often asked by patients and advice on how to have a profitable meeting with your surgeon. What is your training and board certification (if this has not been checked before the consultation)? What is your experience with Rhinoplasty surgery? How long have you been doing the operation and how many do you perform each month? What percentage of your practice is Rhinoplasty surgery? What is the most common operation you do? Where do you perform the surgery? If not in a hospital, is the facility fully accredited? How often do you revise your own Rhinoplasty work? Is there an additional charge for your revision surgery? What percentage of your Rhinoplasty practice is devoted to revisions of other surgeon’s work? What would you do to improve my nose? What changes will you make? What kind of anesthesia do you use? Will you use the open or closed technique? If grafts are necessary, where are they harvested? Do you use my own tissue for grafts or synthetic material? How long will my surgery take? Will you pack my nose after surgery, for how long, and with what? Where do I stay the night after surgery? How long is my recovery? Please describe. Will my nasal breathing be better, worse or the

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Not all Vitamin C is Created Equal

Well, we’re not sure if that goes for the stuff in nature, but when it comes to anti-aging skincare ingredients – it’s the truth! L-ascorbic acid is the scientific name for the molecule we call Vitamin C. It is abundant in fruits and vegetables and great for its antioxidant and immune-boosting properties. It is also essential to the collagen-building process in the skin. It allows you to get the plumping and firming benefits from all the microdermabrasions, peels, and at-home exfoliants that stimulate the collagen rebuild effect. Feed the skin l-ascorbic acid, and watch the years melt away. Great… so why haven’t Beverly Hills women started adding bricks of ascorbic acid to their swimming pools? Well, there’s one complication – pure vitamin C is not stable in oxygen or water. As it oxidizes it takes on a yellow and eventually orange color. That’s bad news. Why? For one thing, because you’ve probably spent a lot of money on Vitamin C skin serums at the drug store, the department store, the health food store, even the spa. The “vitamin C” in them most likely did nothing for your skin. It probably wasn’t even vitamin C anymore – it had oxidized. Two others forms of Vitamin C worth mentioning hit the mark too. Ascorbyl palmitate is a widely used in skin care. It is not so effective at collagen-building but it does provide great antioxidant benefit to your skin and to other ingredients in the product. Magnesium ascorbyl phosphate is also very

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How do I stop aging?

We are always asked, “What can I do to not age?” While stopping the signs of aging from appearing completely is impossible, there are steps that each one of us can take to reduce the signs of aging and maintain a healthy appearance. Signs of aging appear due to a number of environmental causes including gravity and direct sun exposure. While we can’t control the effects that gravity may have on the face, sun damage can be prevented and can have a profound effect on the overall appearance of the skin and face. The photo below from the New England Journal of Medicine shows a trucker who worked for 26 years. Spending a great deal of time in his truck, he assumed he would be sheltered from direct sunlight and chose not to protect his skin from UV rays. As you can see in the photo below, the side of his face that has been left dramatically sun damaged is the side that faced an open driver’s side window. This is an excellent demonstration of a simple task that we can all do to reduce the visible signs of aging. Protecting our skin from harmful UV rays can have a profound effect on the facial appearance and should not be ignored. While there are plastic surgery procedures and less-invasive skin treatments that can work to correct the damage that has been done over the past 26 years, a bottle of sunscreen in the cab of his truck would have solved this problem

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Evolution of Modern Natural Rhinoplasty

Rhinoplasty surgery, the most common cosmetic operation in the world, has changed dramatically over the past 35+ years. Previously, the main goal was to reduce the size of the large nose which frequently resulted in the scooped out profile and a pinched, turned up tip.. As patients we should demand and expect more than this surgical appearance. After surgery, nobody should know that you had an operation. Fortunately, nasal aesthetics have been refined while we preserve normal anatomy and function. There has been a concerted effort to improve results. Today we understand the anatomy and complexity of the nose. Every change we make in one part will affect other structures and the whole nose. Function, including breathing and humidification of the air, is now an important consideration. Aesthetic tastes have changed; in one word we can describe the ideal result – it must be natural. We strive for a strong well defined nose that is proportional to the surrounding facial features. There is no such thing as a standard procedure. Every nose is done differently; we individualize every rhinoplasty operation. For example a nose is very different in a small, thin, 5’ tall lady than it is in a tall, statuesque woman with stronger physical features. While technical skills are important, aesthetic judgment is critical. The most important work is done preoperatively; that is, the planning of the operation. Make sure that your surgeon shares your aesthetic tastes and you understand exactly what will be changed during your surgery. With the improvement

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The Eyes Have It – Caring for This Very Delicate Skin

Careful treatment around the eye area gives beautiful results Reversing age and sun damage in the eye area requires good habits and a little help from the experts. This skin is some of the most delicate on the body. It is completely unable to withstand facial products, polishes, and full-strength tretinoin creams that we use at home to keep the rest of our skin fresh and beautiful. On the other hand, it shows the effects of age and environmental stress faster than any other part of our face! Here is a five step regimen to restore youth to the eye area. Schedule light treatments for the eyes every 3 months as part of your in-office skin care routine. An esthetician with specific training in chemical peels and eye area treatment can choose the right treatment or home care to improve the area incrementally. Remove milia, but never by yourself. See an esthetician or dermatologist about removing milia (small, pearly bumps) that are commonly seen around the perioribital area. These usually do not resolve without extraction by a trained professional. Be healthy. Sleeplessness, fatigue, heavy salt intake, sugar intake, allergies, and stress make an indelible mark on this ultra thin skin. Love your eye products. Be sure to include a treatment product daily for the eyes. A retinol product designed specifically for this area is best for sun-damaged skin. A vitamin C treatment is great to protect and address less advanced concerns. Pair with a great eye cream in the AM.

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