By

Lois W. Stern
Several months ago I read an article about some new options for reconstructive breast surgery. What was most startling to me about this article was the fact that although several new breast reconstruction options exist, patients are rarely told about them. One reason for this nondisclosure is that many plastic surgeons have not been trained in these latest breast reconstruction procedures. Another is pure economics. Whereas implant surgery is rather straightforward, some of these other surgical techniques are quite complex and can be far less profitable.  

Typically a Manhattan surgeon bills an insurance company about $7,000 for a one-hour implant reconstruction, while some of the newer flap procedures require six to twelve hours of surgery, with an insurance reimbursement of $15,500. Based on an income/time expenditure ratio, there is little economic incentive for the surgeon to pursue these more complex procedures.

Breast implants are the most popular method of reconstruction in the United States. Often performed immediately after a mastectomy, a temporary balloon-like device called an expander is inserted under the skin to stretch it enough to accommodate the implant. It is a relatively simple procedure and the one with the shortest recovery time. But implants come with the potential for future operations because reconstructive patients are more likely to develop complications after implant surgery than cosmetic patients with healthy breast tissue. Clinical studies show that within four years, more than one third of reconstruction patients with implants had undergone a second operation, primarily to fix problems like ruptures and infections. Although complication rates for the newer flap procedures have not been well studied, many surgeons believe they are less likely to require follow-up operations.

Some of the newer, more complex breast reconstruction procedures are variations of flap techniques. The TRAM flap cuts away a portion of abdominal fat as well as underlying muscle containing blood vessels and then uses that tissue to rebuild a breast. The vessels provide a blood supply for the new breast mound. The procedure promises a more lifelike look and feel. The downside to the TRAM procedure is the risk of a weakened abdominal wall and possible hernia. Another flap method, the DIEP free flap, is the newest and most intricate. It involves moving abdominal fat and blood vessels, but because no muscle is moved, it is thought to reduce the likelihood of abdominal wall weakness. Not enough research has yet been done to evaluate the long-term efficacy of these flap techniques.

According to the American Society of Plastic Surgeons (ASPS), approximately 57,000 women in the United States had reconstructive breast surgery last year. Although it’s a safe bet to say that none of them chose their breast cancer diagnosis, they certainly have the right to informed consent in selecting their choice of reconstructive technique, if in fact they decide to undergo breast reconstruction.  www.breastcancer.org is an excellent source for further information.

Lois Stern is the author of two books: Sex, Lies and Cosmetic Surgery , which has just been republished with an interactive CD and Tick Tock, Stop the Clock , as well as a number of magazine articles. She publishes a free monthly Health and Beauty Newsletter. You can sign up at:
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Fast track to beauty?  Fasting.

I used to think fasting meant I had to seclude myself into a spa or getaway and fanatically remove myself from 'real life' until it was over. As a former Yoga instructor, I'd hear of other teachers and students whose willpower was simply amazing. They'd easily be able to head into a week-long fast and exclaim the virtues and victorious sensations they'd feel.

Last year I interviewed wonderful Ryan www.HumbleBeeHealth.com whose Master Cleanse is renowned for its rejuvenating and healing promises. He's not only terrific he's so helpful and kind and knows his stuff! I recommend Ryan and his site if you think you'd like to learn more about fasting, especially the Master Cleanse.

This time I'm eesy-weensy fasting.  Not fasting for 10 days as suggested; that would feel like a triathlon to me! I'm fasting for 24 hours. That seems do-able. After all, a cup of coffee is my first nectar of each day. I'm renewed with my latte each morning. What's a coffee girl to do? A gladd of spring water first thing tomorrow.  

I'm not sure I can do it but I'm going to give it my best. Being understanding to myself is the first rule. Being patient the second. No pressure to perform.

I used to be able to fast for 24 hours often and it seemed like I just felt better. So tonight's dinner is my last food.  I'll not eat until tomorrow night @ the same time, 8 pm or maybe I’ll even sleep it off 'till Tuesday morning if I can. Warm lemon water will start my day tomorrow. Herbal tea in the afternoon if I need something more. I'll take it easier tomorrow, take deep breaths, relax, and meditate in between working. I'll proceed with calm and reassess my life during breaks. What'll I think of? My thoughts over these difficult times.  My blessings. My dreams. My hunger pangs. My appreciation for all that I have. My friends and family and loved ones.

So what does fasting have to do with beauty?

Outer beauty is fun and fabulous, but I hold a deep personal conviction that inner beauty and elegant grace are the traits I am attracted to and reflect real beauty. Traits like inner health, wellness, and a solemn calm offer something a surgeon just can't infuse into a woman's face. To me it shows when a woman is a person of peace, a person of grace, one who knows her own beauty and spiritual worth. It far surpasses all the nips and tucks of a surgeon. It's a quiet self-confidence that needs no shouting, needs no proving to others, but exudes through the very pores of her face. It's happiness with an added elegance, not flashy, not chatty, not smackin' of Valley talk, but confident vocals and the kindest of eyes. I notice it in fewer women these days. I guess I long for it to be a part of my own self. I think I’ve burned the candle too long and need a rest and a return to a better me. And just ‘cause I like it does not mean it’s for others. I just like me more when I move through my life with that certain-ness. I am more in touch with myself - my intuition and my own heart and mind.

Fasting will cleanse and flush my body of internal toxins and give my digestive system a nice rest. It'll calm my nerves and create a sense of strength and stamina within me. It'll foster an appreciation for whatever food I have that follows my fast. Fasting is mentioned in the Bible almost 100 times and it represents self respect and reverence for a Higher power.  

If I falter, I'll just restart and do it the next day.  

Breaking a fast carefully and correctly is important. Fruit juice is ok. Lite salad or vegetables are ok also. Little bit at a time. Think water based foods and think lite.

If you every attempt your own fast, be sure and check with your doctor first. Don't flirt with any medical conditions that are best discussed first with your physician.

I plan to be thinking of all the women at Fab40n also. We women have so many things we can do for one another and web portals like Fab40 are helping us connect and learn and share. And those are all actions that are also quite healing and invigorating and fun.

And isn't Life better when it's fun?

Patty Kovacs
www.wsRadio.com/HealthandBeautyRevolution

BETTER SEX AFTER THE KNIFE
By

Lois W. Stern
At one time I would have laughed with amusement at the mere suggestion that cosmetic surgery and sexuality were so inextricably intertwined, answered with a vehement "NO WAY", if asked my opinion. But now I know differently.

It didn't take long after my surgery before Aphrodite, that Greek goddess of love and desire, to invade my life - an interesting side effect to my surgery. I questioned whether I was unique or if cosmetic surgery impacted similarly upon the lives of other women. Did many experience a resurgence of sexuality? If so, did they dare reveal those feelings to themselves? Would they be willing to share such intimate details of their personal lives with a total stranger? I wondered how I could get those answers.

I began my investigation very tentatively, but all that changed the day I spotted a most attractive ad in New York Magazine placed by a Manhattan-based Cosmetic Surgery Consultant. On a whim, I called her. Would she be willing to let me interview her? She was most gracious and agreed. (Because that one interview extended to a series of many, her pithy wisdom punctuates many chapters of my book, Sex, Lies and Cosmetic Surgery .) During one of those interviews, I asked her if she ever gets feedback from her women clients about after effects to their surgeries. Aside from increased self-esteem, were there other ways it impacted their lives? She spoke about career boosts, more positive attention and notice, improved social status, boosts to their social lives . . . and then threw out an interesting statement: "Women in their fifties and sixties tell me details of how their sex lives have improved." She talked openly about several of her clients while concealing their true identities. One story she shared was about Cindy, a fifty-two year old woman who said that before her cosmetic surgery she used to bury her face during sex because she felt so unattractive, but how that changed after her surgery:

"Since my facelift, I'm no longer afraid to let my husband see that look of ecstasy that comes across my face while we're intimate. I feel so good about the way I look that now I want to peer deep into his eyes instead of into his armpit."

Feeling a bit amazed by the intimacy of this woman's revelation, I blurted out: "Women actually tell you these things?" Her simple answer: "Of course. This is all about sexuality," was my moment of awakening. I knew I needed to explore this unspoken relationship between cosmetic surgery and sexuality. Based both on book sales and e-mail messages from all parts of the USA and beyond, I knew that readers identified. Then, just before the first edition of Sex, Lies and Cosmetic Surgery went to press, an interesting thing occurred. My eyes pooped open as I read the following headline on the ASAPS (American Society for Aesthetic Plastic Surgery) website:

"Women's Self-Image and Sexual Satisfaction Increase
After Cosmetic Surgery"
Based on a study of seventy women who completed a survey about their post-operative psycho-sexual life, the ASAPS publicly recognized a reality that has not been addressed until now.  

In their study, they had sent an anonymous questionnaire regarding preoperative versus postoperative psychosexual health and sexual behaviors to three hundred and thirty male and female patients who had undergone a major aesthetic procedure.  (i.e. breast augmentation and/or mastopexy; facial aesthetic surgery, including face lift, brow lift, and rhinoplasty; and body contouring procedures, including abdominoplasty with or without lipoplasty, or lipoplasty alone.) Seventy completed surveys were returned, all of whom were women.  

Study Results:
More than ninety-five percent of respondents reported improvements in body image. Eighty percent of breast augmentation respondents and fifty percent of body surgery respondents declared improvements in sexual satisfaction. Fifty percent of breast and sixty percent of body respondents had changed to more provocative attire. Approximately seventy percent of the breast and body group testified that their partner’s sex life had been enhanced. More than thirty percent of breast patients and fifty percent of body patients reported an enhanced ability to achieve orgasm. When body and breast respondents were compared with face surgery respondents, statistical significance (P < .01) was found among most psychosexual variables investigated.

Conclusions: The results of this study affirm that cosmetic surgery patients overwhelmingly tend to feel better about their body after surgery. The sex lives of both patients and their sexual partners can be strikingly enhanced after elective cosmetic surgery, particularly if the surgery is focused on the breasts, abdomen, and thighs.

Interesting Aside:
While still working on Sex, Lies and Cosmetic Surgery ,  I had an opportunity to interview a prominent plastic surgeon from Pittsburgh, Pa. His credentials include Board Member of the ASAPS, Clinical Assistant Professor of Plastic Surgery at the University of Pittsburgh School of Medicine, Plastic Surgery Consultant to the Pittsburgh Steelers . . .  to name a few.  Although the goal of my interview was to gather information for a magazine article assignment, he was so warm, informative and conversational that at the end of our interview I told him I was writing a book about women and cosmetic surgery. As we spoke, he became intrigued and told me he would be very interested in reading my manuscript when I felt ready to share. His comment: "I always was aware that cosmetic surgery could be a very emotional experience for women. I would like to understand it better," reveals much about his open-minded approach. I sent him my manuscript, he read it with much interest and his wonderful blurb is one that now sports the back cover of Sex, Lies and Cosmetic Surgery .

The Most Interesting Part to This Story: The study I cited above came out of Pittsburgh, Pa., the very city where the plastic surgeon I interviewed resides and works. I can't help wondering if the women's experiences detailed in my book were the inspiration for this study. I certainly hope so!
No matter how it came to be, it is gratifying to learn that the validity of the work I began several years earlier is now being officially confirmed.

Living Without Exercise Is Like Smoking a Pack of Cigarettes a Day

By Patty Kovacs

Over the years I've focused on various ways to improve my facial and body appearance. God knows I could use weekly spa facials to erase these signs of aging, but can't afford it in time or money.  

Having been a yoga instructor for many years, I switched careers a while back so to write and promote for a living. As part of that career change, I sit in a chair with radio headphones on my head every Monday and tap away at my computer all week for too many hours. Waking and working at my computer has become a way of life.

Then I found a new habit: don't exercise. Veg out. Stay informed by television, internet, and print. Drink up information, not an energy smoothie. It became my habit of choice to stay in my head as exercise became a pest. You know, no time for it, too busy. What an absurdly unbalanced life I developed.  

Was I depressed like Oprah is now confessing? I would never had declared it. Not me. Divorced with no support from a multi-millionaire husband of 20 years, I had a family to raise (Ann Coulter would say I was a disgraceful single mother) and I had beautiful mouths to fee and big bills to pay. So I worked and ‘chose’ ? note my choice, ‘chose’ ? not to exercise.

The habit became my pattern. Yep, exercise became a dusty memory. Oh, I'd walk occasionally. A good walker I was, but I had no regular pattern to it. I’d call my walking more a hobby. My golf clubs had intricate spiderwebs on them and my tennis racket was now a decorative fixture hanging on my garage walls. A National Tennis Champion, over-35, 1998, I knew the discipline of exercise and focused athletics, but my racket now served as a symbol of a time called ‘then’ when I exercised. I got a harsh reminder each time I drove my car into the garage from a long day of working.

Along came October, 2008: the financial downturn of America. The world as we knew it would forever change in America.  Heading up my own business, I had let my own body crush with stress. After all, I assumed exercise, a treat, not a necessity.

I take no drugs whatsoever. I eat nutritionally sound food, often organic. I pray. I love. But in this frightening economic downward spiral came other surprises and I was forced to stop long enough to take a hard look at my life and my body. Mirror, mirror, on the wall, who’s the liar of us all?

In yoga, the body is the temple of the soul. My temple looked more like a tent. I'd wear carefully chosen clothes to hide it but even the attire couldn’t fix the problem. And my face, well, the prize of stress and no exercise reared its ugly face on my face. A roadmap of wrinkles and dark under eye circles were my un-athletic trophies. Evidence of no exercising was now so apparent not even La Mer moisturizers could make it all disappear. The more makeup I'd apply, the more my secret of not exercising showed.

There's a cool saying, " Living Without Exercise is Like Smoking a Pack of Cigarettes a Day."  Nails it. Particularly if you're over 40. Over 50 and it’s a mantra.

So I started moving my body. Daily I'd do a little stretching and yoga. Free weights while I watched the news. Bands while I watched the ladies of The View on my self-imposed break. I picked up golf again. Exercise, though somewhat an annoyance from my workaholic addiction, became my newest friend. Not one I totally trusted. After all, I was really a workaholic. Fear based but also dedicated to doing the right thing for my family. No matter what the cost to me.

But slowly I noticed, the more I exercised, the better I felt. What was happening? The body fluff was melting. Slowly, but ever so surely. I was beginning to feel I deserved this time. I started to hear my mother's favorite reminder, "Nobody is gonna love you more than you love yourself." I started to love loving myself again. My body, my mind, my soul, my spirit, my all of me.

Mornings now consist of a cup of coffee (yes, the docs I've interviewed and respect say a cup ‘o jo is ok so that habit still stays in a singular form), and the computer slowly has become something I’ve had to 'Just Say No'  to until I've honored my body with focused movement and stretches.

I can't overstate the importance of exercise now. Maintaining a fit body after 40 is a necessity. After 50, it's life or death. During this period of life, peri-menopause and menopause come to nest and soon try to take ownership of our bodies. I perfer to own my body.

What happens when we exercise? Exercise relieves stress and activates the parasympathetic nervous system which sends blood flow to the genitals (translation: better sex). The sympathetic system, which gets our body ready for flight or fight, directs the blood flow to our legs, allowing us to walk or run faster, more assuredly. When we're in flight or fight mode, we're thinking of survival, not sex. Cortisol overflows like a broken pipe inside us if we don't exercise. When we move about and push the body, healthy endorphins come out to party in our brain. We start to feel g-o-o-d. Endorphins are feel-good brain hormones that contribute to an overall feeling of well-being. So we need to get this party started and exercise!

Did I mention that my waistline is a bit trimmer? Yep. Hips are wide but not wider. Love handles are no longer looking like handles. Buttock muscles are screaming that they don't want to lift up but I'm gonna win. The pear-shaped body nature gave me to birth children is getting a boot camp makeover.  

I'm feeling so incredibly much happier, better, 'gooder.'

So if you have the habit like I did of over-working, over-worrying, visualize that image of smoking a pack of cigarettes a day. It's ugly. So is a body that’s not exercising. Join me to make our lives healthy, wealthy, wise, and pretty, inside and out. Eat, pray, love and exercise. Every. Single. Beautiful. Day.

Hoo-Ahh!

Patty Kovacs
www.wsRadio.com/HealthandBeautyRevolution
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Crystal Ball Time for Cosmetic Surgery
By
Lois W. Stern  

The editors of Consumer Guide to Plastic Surgery predict that less will be more in 2009 as consumers consider cosmetic enhancements. The reason for this shift takes little pondering. Our current economic recession is already forcing us to make lifestyle changes. Many consumers are going to select less costly procedures such as injectables (muscle relaxers and fillers) in place of more costly and more invasive surgeries. Competition for the provision of these services will grow, inducing some of those less skilled, inexperienced and even unqualified providers to cut prices in order to lure new patients. Buyer beware: Always consider qualifications, professional training and experience before price.  

The Consumer Guide suggests that fat freezing (or cryolipolysis) may give liposuction a run for its money in the near future. This technology works by freezing fat cells and in turn breaking them down. It's in clinical trials now, and results look promising. This is one On the Horizon  technology that we should watch with interest. A second is a wrinkle relaxer cream - Botox in a new form that can be topically applied without needles. Third on their list is Latise, a topically applied drug for eyelash lengthening, approved by the FDA in December 2008 to promote longer, thicker and darker lashes.  

Let's continue with some breast enhancements. Next on their list are fat injections for breast augmentation . In 1982, the American Society for Plastic Surgery spoke against the use of fat injections for breast enhancement, but now they are reevaluating their prior stand. In 2008, a task force found that reshaping the breasts by injecting a woman's own fat works well for touch-ups after breast reconstruction, but it is not yet proven effective for cosmetic breast enhancement. Refinements to this technique are likely to continue in 2009.  

Cohesive gel breast implants, sometimes referred to as 'gummy-bear breast implants' are another innovation we are likely to hear more about in the future. Filled with cohesive silicone gel, these leak-resistant implants are used in Europe and Brazil and are being studied in the United States. Gummy bear implants have all the positive attributes of silicone gel, without the potential for gel migration in the event that the shell should weaken.

Lipodissolve is an experimental "fat-melting" technology that is being described as a non-surgical alternative to liposuction. Also called mesotherapy, lipodissolve involves a series of medicated injections that may melt away unwanted small, localized areas of fat. To test these claims further, the American Society for Aesthetic Plastic Surgery has begun a scientific study of mesotherapy using standardized ingredients, to examine its safety and effectiveness in a controlled setting. Some results may be available in 2009.

This is just a sampling of cutting edge beauty enhancements for today with a few prediction for tomorrow. If you are curious and can't wait to learn more, be one of the first to read my newest book, Tick Tock, Stop the Clock: Getting Pretty on Your Lunch Hour.
www.ticktockstoptheclock.com

Also the author of Sex, Lies and Cosmetic Surgery: Things You'll Never Learn From Your Plastic Surgeon  

Last week I had the pleasure of interviewing Dr. Amy Wechsler, one of only 2 doctors in the country Board Certified in both Dermatology and Psychiatry, and author of the fabulous new book from the Real Age experts, The Mind-Beauty Connection, 9 Days to Reverse Stress Aging and Reveal More Youthful, Beautiful Skin.

Dr. Wechsler beautifully ties together how important it is that we take care of not only our aging skin, but also our body, our mind, and our soul, that we fill our lives with meaning and purpose, that we see the beauty in each precious moment of life, whenever possible.  

And Dr. Wechsler gives us a delicious amount of beauty secrets from a no-nonsense, medical approach to  removing the glitz we see in packaging that promises youth but delivers a hugely unnecessary dent in our wallet.  

Repeat after me, "Beauty doesn't necessarily have to cost a lot of money, but neglecting ourselves will cost us a bundle."

I ask myself these days, how much does every new wrinkle actually cost me?  As I've watched my nasal pores grow to the size of moon craters, I quiver. Time to tighten, lighten, brighten, firm, and re-hydrate and my face alarm siren is going off.

Dr. Wechsler reminds us that Retin-A, retinol, topical C, all are our friends. Lasers are cool tools available today as never before? oh, and we can significantly improve our facial skin by applying the alphabet daily: A, C, D, and E. (Having had squamos and basal cell carcinomas, I take 800mg Vitamin D daily).

My skin feels like a baby's bum now. Dr. Wechsler's suggestion that I apply Safflower Oil has softened not only my facial skin but also my attitude. Right out of the pantry. Safflower oil. Go figure. It definitely provides a more youthful glow. Not to forget,  I added more fruits, green veggies, legumes, nuts, grains, and calcium-rich foods to my diet. Remember when mom soapboxed us telling us the virtues of such basic foods? That very advice is now rich with beauty secrets.

Today I had the delight to meet Dr. Travis Stork, host of The Doctors, the newest superb television show that's sweeping the nation and providing viewers with a remarkable amount of valuable, actually priceless, medical information on various topics of interest to any person over the age of 15. In today's world, finding highly credible information is basically easy with the internet, but adding the beauty of visual ? i.e., , with highly credentialed physicians, surgeons, etc. and you have this great TV show that can answer a lot of questions for a lot of us ? ACTURATELY. Remember my mantra, always check the credentials of any medical expert before you consider his or her advice, ever.

My connection with The Doctors?  In October, 2008, I interviewed Dr. Andrew Ordon, the head plastic surgeon starring on The Doctors and found him spot on with his delivery of the latest in plastic surgery information.  

Incorrectly associating?I interviewed Jen from The Bachelor, and from her other television show, The Bachelorette,  but realized today that it was Sarah who was Travis' love when he starred in The Bachelor.

What information do I really have to share this time? We best serve Life by making healthy living and choosing to live a beautiful life to be our personal daily commitment. And we best act with kindness to expect kindness in return. And in living in a state of happiness, we find true beauty and true radiance that emanates from within.  

Patty Kovacs
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