Up close and personal with Dr. Elsa Raskin*, an exclusive Q & A

We are wondering if you are as confused as we are. Plastic surgery? Botox? Fillers? Are you dizzy as well?  No doubt the answer is probably yes…so we thought it would be prudent to look to our expert in this field to dispel and provide useful information on these cosmetic procedures.  Dr. Elsa Raskin, www.elsaraskinmd.com, a specialist in the field of women’s cosmetic and reconstructive surgery, gives us the inside scoop on topics we know are frequently asked.

GPL: First and foremost Dr. Raskin, what are the most important considerations and aspects in choosing a plastic surgeon? And when do you know that plastic surgery is a viable choice?

Dr. Raskin: Choose a plastic surgeon that is Board certified by the American Society of Plastic Surgeons. Web site: ASPS.org. Also look up his or her hospital affiliation. It ensures that you are picking a surgeon who went through a rigorous process before joining the hospital. Chances are an established plastic surgeon should have a web site that is professional looking but does not promise you the impossible.

Plastic surgery is most often a personal choice when an individual wants to improve their personal appearance. Your plastic surgeon should discuss whether your personal goals are realistic and attainable as well as discuss other options and explain clearly why and when surgery will work better.  For instance, there is no better option then a lift for a sagging breast. A well-done plastic surgery should enhance yourself but be realistic and still look like the old you. Plastic surgery is the choice when you have physically identified something on your person that really bothers you and there is no other solution, i.e, nothing will lift a saggy breast but a mastopexy.  A plastic surgeon should have the ability to discuss all options and explain clearly why and when surgery will work better.

GPL: Now let’s talk about the many facets of plastic surgery-

What do you recommend for the over 50 crowd?  What is the proper age to consider facial plastic surgery and why?

Dr. Raskin: Face fillers and Botox will do the trick until your early 50’s, but after a while when you are not getting much of an improvement, you should consider a more specific procedure, i.e. eyes or a facelift. When well done, a face-lift should not be noticeable; the scars are camouflaged into the hair and behind the ears.  It is easier to deliver a great result in the late 50s and early 60s then later when the aging process further thins the skin.

GPL: What about downtime for recovery?  Just how important is the healing process?

Dr. Raskin: On average downtime is about two weeks for a facelift and one week for eyes only. It is extremely important to schedule downtime to have an optimal recovery. Healing is equally as important as the surgery itself. One should have time set aside to have a quiet and uneventful recovery. Also if available, help at home for cooking, cleaning etc. Preparation is key, I tell all my patients to avoid any alcohol and all over-the counter medications starting with A, such as Aspirin or Advil three weeks before sugery. And of course, no surgery is performed on smokers. Other supplements taken in the peri-operative period such as Arnica Montana, Bromelain and Vitamin C will minimize the bruising.

GPL: Speaking of the facial aspect now with all the fillers, can you give us some insight about just that, i.e. all the fillers and injectables on the market?

Dr. Raskin: Most products such as Restylane, Juvederm and Voluma, just to name a few, are derivatives of hyaluronic acid, a natural product that we all have in our joints. Their degree of cross-linking determines their thickness and longevity. If overdone, these products can be easily dissolved by an enzyme. Another filler Radiesse is calcium hydroxylapatite, which gives wonderful volume for the cheek area or restores the lost volume to aging hands. Then of course we are all familiar with Botox, which can minimize the wrinkles in the upper face and neck.

GPL: When should someone use that avenue, (fillers & injectables) and yet when should someone consider more invasive procedures such as facial surgery?

Dr.Raskin: When one does not see an optimal result with fillers, it is time to consider other options.

GPL: Please explain why it is better to see a carefully trained plastic surgeon to administer these procedures rather than say the local ENT or Dentist or Vet?

Dr. Raskin: Some ENT surgeons are trained in facial plastic surgery and are very capable facial plastic surgeons; they do not perform surgery on the rest of the body. Dermatologists perform injection and lasers. A trained plastic surgeon goes through on average 7 to 10 years of training twice the length of a dermatologist. Plastic surgeons have been specifically trained in cosmetic and reconstructive surgery; other specialties often take a weekend course on fillers and start injecting.

GPL: Let’s talk about all the other great aspects on the market for plastic surgery to correct scarring, lipo, or tummy tucks?  What are age appropriate, safe, and a consideration?

Dr.Raskin: When choosing between an abdominoplasty (tummy tuck) or liposuction, the patients’ weight and skin condition are the major determinants. Patients with small amounts of fat deposits will do best with liposuction. In my office I use Smartlipo under IV sedation (twilight). It is a day procedure and patients have minimal pain. Patients lose easily an inch or two inches in their waist and have minimal downtime. There is a lot of publicity about Coolsculpt (an external device that melts the fat without surgery). I see a lot of patients who had it done elsewhere and come to me because they don’t see a significant improvement. Smartlipo is more predictable and is done through 3mm incisions, which are barely detectable after one year.

GPL: What would you like readers to know about all aspects of plastic surgery?  What myths do you feel should be dispelled and what truths do you want to share with our readers?

Dr.Raskin: The biggest myth promoted by laser companies is that lasers such as Ultherapy or Fraxel can replace a facelift. It is disheartening to see patients spend resources on lasers that do not work simply because they have been brainwashed by the media. Fraxel will improve the skin texture and appearance but will not improve the overall laxity. Of course surgery carries risks, but also so do the lasers; you can get burns, scarring etc. If you select a good plastic surgeon, a facelift will be a much better investment in the long term.

GPL: Many people financially can’t approach the surgery, but are genuinely interested in corrections or improvements to themselves- what are your suggestions?

Dr.Raskin: Many offices around the nation utilize Care Credit, a financial company that can assist with upfront payment for surgery. The payments will then pay Care Credit in monthly installments.

GPL: Is there anything of special interest you would like to share with us that we have not covered?

Dr.Raskin: I take special pride in giving a woman’s breasts their best possible shape by using small implants, or fat and the smallest possible scars. Fat grafting is the new frontier of plastic surgery.

*Questions? Dr. Raskin welcomes your correspondence!

You may reach her via email: emraskindmd@gmail.com

And you may visit her web site: www.elsaraskinmd.com