When I was a medical student doing my surgery rotation in 1991, I encountered what I thought was a very unusual patient. She looked normal from her chest up, but her belly and her legs were severely swollen and purple. She looked like Violet from Willy Wonka!
The chief resident explained to me that this patient had just had liposuction. She would remain in the hospital for about a week so that we could monitor her blood count and fluid status. At the time, liposuction was considered a radical surgery. “Why would anyone put themselves through such an ordeal?” I thought. In the end the results were not even that impressive. She was lumpy and the fat reduction was modest at best. This was not a procedure that I had thought I would ever recommend for a patient. The last thing I would have predicted at the time was that out patient liposuction would be my favorite procedure to perform.
In 2006 an invention called “SmartLipo®” was approved by the FDA to use laser energy to assist with liposuction. This device allowed surgeons to “pre-melt” the fat with a laser under the skin. When combined with a technique called “tumescent anesthesia”, liposuction could now be performed without the bleeding and painful recovery that were previously associated with traditional liposuction. By melting the fat before sucking it out, surgeons were able to insert much smaller, blunt cannulas into the targeted area and suck out the liquified fat. The laser would coagulate blood vessels so there was almost no bleeding. In addition, the heat would cause the skin to retract so that there was less risk of loose, hanging skin remaining after the fat was removed.
This invention was truly revolutionary. Since the patient did not have to be put under general anesthesia and the blood loss was minimal, the procedure became very safe. It allowed non-plastic surgeons like myself to perform liposuction outside of the hospital setting.
When I started performing liposuction in 2011, I knew that some of the best plastic surgeons in the world are right here in the New York metropolitan area. I would have to have the best technology and the best technique to compete with the these celebrity doctors, so I invested in the SmartLipo® laser. This laser definitely gave me an edge over the surgeons who were performing traditional liposuction. Patients were thrilled that they did not need to stay overnight in a hospital, they could resume normal activities the day after having liposuction with me. It was not long before the other surgeons caught on and soon everybody had the Smartlipo® laser, so I had to find a way to stay one step ahead.
Now that liposuction had become a routine outpatient procedure, patients had plenty of choices of where they could go for their liposuction. Not only were they looking for doctors who could perform the procedure safely, they were looking for the best results and the best value. They would not settle for just a fat reduction, they wanted better skin tightening and they also wanted body sculpting.
Fast forward to the age of social media, and the expectations from liposuction had gone through the roof! Nobody is happy with just reducing the fat anymore. If you just want to make your bulges look a little smaller, you can do that with non-invasive procedures like CoolSculpting®. But if a patient is doing liposuction these days, they want to be able to show off their bodies in a bikini and they want six pack abs. Not only do the surgeon need to have the best tools and skills, we need to be amazing artists.
There are many doctors who perform liposuction. I have worked with some of the most renowned liposuction surgeons in the country, but there are only a handful in the world who can truly sculpt the body. Arguably, the greatest body sculptor in the world is a man named Dr. Alfredo Hoyos who has a clinic in Bogota Colombia. I had followed his work for years and recently, had the privilege to spend a week with him in Bogota. Sharing ideas and techniques with colleagues like Dr. Hoyos and others around the world is an important aspect to mastering the art of lipo sculpting, one often overlooked by doctors who continue to practice doing the same things they learned in residency.
Liposuction is no longer about just debulking fat. We can now shape, sculpt and define. Our tools and our techniques have evolved making the procedure safer and better than it ever was. There is no hospital stays involved and the patients are back on their feet the same day. I no longer use the SmartLipo® machine. What was considered cutting edge technology less than ten years ago is now obsolete because we have even better tools. My go to devices are now Renuvion® Vaser® and Microaire®, but that may change as new innovations are introduced.
If you are thinking about having a body sculpting procedure, you have lots of options. Non-invasive treatments such as CoolSculpting® are very popular but in light of possible complications that have surfaced, I have been recommending out patient liposuction over the non-invasive options because the results are so much better and, when done correctly, liposuction may even be safer and more cost effective. A small area liposuction can be performed in one hour, about the same time as a session of CoolSculpting®
RF Microneedling A Paradigm Shift in Aesthetics -H. William Song, MD
One of the top Aesthetic trends in last year was Radiofrequency Microneedling. This is not a new technology, but the new generation machines introduced in recent years, and one in particular has been a game changer for medical beauty treatments. You may have heard of some of these Brands: Morpheus8®, Secret®, Vivacie® and the SylfirmX®. There are other brands but these are the major players and I will tell you which one is my favorite, but before we do that, allow me to share what I have learned about radiofrequency over the years.
Nicola Tesla first noted around 1891, the ability of high-frequency currents to produce heat in the body and suggested it’s use in medicine. Since then, RF energy has been used in medical applications in everything from medical imaging to cancer treatment. In the field of aesthetics, RF is most noted for its ability to tighten skin.
RF works by an alternating electrical current going between two points. As the energy goes back and forth, it causes the oxygen in the water molecule to line up in one direction as the energy flows one way and then quickly line up in another direction as the energy flows back in the other direction. This rapid and continuous flipping of the water molecules creates friction and thus causes heat in the same way that your hands get warm when you rub them together.
The heat causes collagen to remodel and stimulates the production of new collagen and elastin. It may also help with mitochondrial function and aids in healing and new blood vessel formation. There are other ways to create heat, but unlike lasers, RF is safe for all skin types and there is much less down time with minimal risk of burns, hyperpigmentation or hypopigmentation.
The first radiofrequency device I worked with back in 2007 was called the Accent® by Alma lasers. I liked the Accent® because it was a nice alternative to the other popular RF device at the time called Thermage®. The Thermage was effective but very painful, so the Accent® offered a pain free way to tighten skin. I later upgraded to a similar device called the Forma® then upgraded again to another device called Thermismooth 250®. These devices are nice because they deliver the RF energy non-invasively through the skin and they have zero down time. If you do a series of treatments followed by regular maintenance, these treatments are a great way to keep boosting the collagen in the deeper layers of your skin where topical products cannot reach.
For even better results, we can use little needles to penetrate the skin to deliver higher energy under the skin. The Fractora® was the first RF microneedling device that I worked with. It offered insulated needles that exposed only the tip of the needle so that we can crank up the energy deeper in the skin while protecting the surface from burns. This treatment was great for tightening the jaw line, loose skin under the eyes and lifting the skin above the eyes. The big drawback was that it was quite painful. Just like all the other RF microneedling devices that were available at the time, patients had a hard time tolerating the treatments. I was almost ready to give up on this technology when I was asked by a company called Refine USA to develop protocols for a new RF microneedling device called the Rejuvamatrix®. The Rejuvamatrix® was an elegant machine with a smooth mechanical injection of the neeedles that made the treatment much more tolerable than the older RF microneedling devices. I loved working with this machine and the results were unbelievable! We were weeks away from getting the final FDA clearance when the shocking news came. One of the big aesthetic device companies had acquired a patent on the RF microneedling technology and served all the other companies with a cease and desist notice. The project fell dead in it’s tracks. The decision was made by the president of Refine to quash the project rather than pay exorbitant royalties to the patent holder. I had to return the protocol Rejuvamatrix® device. None of the existing or new RF microneedling devices that made it to the market were very impressive to me. I went back to using my Fractora® but I knew something better had to come along, and it did.
I was introduced to a new device called the SylfirmX® that was about to launch in the United States by a California company called Benev. I met with the CEO and with Dr. JongJu Na, the inventor of the SylfirmX. Although Benev is a US based company, these men are both from my native South Korea so we hit it off right away. I was blown away to learn that Not only did Dr. Na invent the SylfirmX, he is the inventor of RF microneedling itself! Because Dr. Na’s original patents supersede the patents that derailed the Rejuvamatrix® and others RF microneedling devices, the SylfirmX® is immune to the patent lawsuits. They asked me to be one of their key opinion leaders and I was all in!
I thought I was the expert on aesthetic uses of radiofrequency energy, but after speaking with Dr. Na, I realized how much more there was to the RF technology. More importantly, I realized how little most people in the industry actually know about it. Dr. Na showed me that the insulated needles that all the other companies were basing their technology around was irrelevant because of what he has coined “the Na Effect”: If you deliver the precise amount of energy for the optimal duration with the electrodes placed at the exact distance to uniformly transfer the energy, the zone of tissue effected can be controlled. You don’t need to insulate part of the needle to prevent complications because all the safety stops are already built in to the machine.
When I started using the SylfirmX® with the non-insulated needles, I felt like a kid who just learned how to swim. I didn’t have to wear those floaty things around my arms anymore! The SylfirmX® is so elegantly designed that it did not cause burns, even at the highest settings. I was concerned that the results would not be as good since the energy was lower, but to my delight, the results were better. Significantly better! With much less discomfort and almost no down time. The SylfirmX® treatment does require multiple sessions and it takes time to see the results but within a few week, you can start seeing smoother texture, smaller pore size, less wrinkles, tighter skin and evening out of the pigment. All that with almost no down time. This is why I am naming SylfirmX® as my favorite aesthetic device for 2021.
"My doctor said I was a walking Tim bomb... 12 weeks later I was competing in the Tough Mudder!"
It was supposed to be a routine test to check the arteries in my heart, so imagine my shock when I was told that I needed an emergency procedure to clear a severe blockage. My doctor said I was a “walking time bomb”! As a cosmetic surgeon, I take great pride in helping other people look their best. Although I kept myself looking good on the outside, I wasn’t taking very good care of myself on the inside. Like most people my age, my diet was not the greatest and my exercise routine was shamefully inconsistent. Having to get an angioplasty procedure at age 55 was a huge wake up call. I decided then and there that I needed to turn my health around, so I took some massive action. Twelve weeks later, I was looking like I had been training my whole life and I found myself competing in the Tough Mudder with my teenage sons. The best part is that I seem to be inspiring people all around me to do the same, just by telling them what I did...
My Triglyceride levels had been elevated for years but I felt fine, so I did what I could. I didn’t eat fast food, I limited sugary beverages and got on the treadmill every once in a while. I would have kept going like this oblivious to the fact that my coronary arteries were building up with plaque. Then on Memorial day weekend, my mother had a heart attack. She recovered, but this was her second one even though her diet was better than mine. This was a reality check because I had somehow convinced myself that I was invincible. I was in better shape than most of my peers and aside from some episodic bouts of gout, I had never been sick, taken any medications or even missed a day of work. A few years ago I did a screening test where they did ultrasound scans of my aorta and carotid arteries. They said that my arteries were squeaky clean. This fed into my fantasy that I was in perfect health despite my high cholesterol. But given my family history, I decided to get some more tests to help me decide whether or not I should go on cholesterol medications.
I decided to get a test called a calcium score. This is a simple test that takes about 15 minutes. They do a CT scan of your heart and based on how much calcium they see around your heart, they can give you a score to gauge how likely you are to have blockages. My score was 400, which put me at high risk. I was stunned. I did not expect to have a high calcium score, but I knew that this test is not very specific. There could be other causes for the high score, so I asked my doctor to order a CT angiogram. This is a high resolution CT scan that takes images of your heart after injecting dye into your veins. With this test, you can actually see the outline of the dye filling the arteries that bring blood to your heart.
Because I was not having any symptoms like chest pains, my health insurance refused to cover the test. I asked my doctor to order it anyway. It costs about $1000 out of pocket but I decided it was worth it to know. I was beginning to accept the possibility that I had some plaques forming in my arteries and it was better to have a baseline so that I could see where I was at. I blocked out a Friday morning from my busy schedule to have this test done. I didn’t even tell anyone I was going because I expected to be back at work that afternoon. In fact my schedule was packed!
The test went smoothly and I was getting dressed to leave when the technician asked me to wait a minute because the radiologist wanted to talk to me. “Why would the radiologist want to talk to me?” I wondered. Radiologist do not like to talk to patients, so if the radiologist wants to talk to me, “that’s not good,” I thought. Then I took a breath and decided, “maybe the radiologist saw that I am a doctor and just wants to say hello”.
The technician started to wheel me to the radiology reading room in a wheelchair. I offered to walk myself, but she said she wasn’t allowed to let me walk. I felt guilty using up a wheelchair when there were probably real sick people who were waiting for transportation.
The radiologist said his name was Dr. Gupta but I had never met him before. This was definitely not a social call. He was looking at somebody’s CT scan on his screen and looked surprised when he saw me. “oh you’re young” he said. “I have already notified the cardiac surgeons and I am trying to contact an interventional cardiologist. In the meantime, we need to take you to the emergency room. Are you having chest pains right now?”
“What chest pain? What is going on?” I asked, totally confused. Dr. Gupta pointed to the CT scan on his screen and started talking really fast. “You have a near total occlusion of your LAD. There is almost no blood flow, if this closes off, you are going to have a massive heart attack. They are all tied up in procedures right now. I am going to get somebody. You are a walking time bomb!” At that instant his cell phone rang and he said. “Oh thank goodness, here he is.”
I could hear someone on the other end of the phone. “Yes, I saw the CT scan, let me talk to the patient.” Dr. Gupta handed his cell phone over to me and the doctor on the other end introduced himself to me as Dr. Tayal an interventional cardiologist at Valley Hospital. I explained to Dr. Tayal that I was having no symptoms whatsoever and that I was just there to do a routine screening. I tried to explain to him that they must be looking at someone else’s CT scan.
Dr. Gupta was shaking his head. “You are the first patient. There is no other patient who had a CT angiogram today.” He explained. “This is definitely you.”
Dr. Tayal seemed much calmer. He explained that I will need a cardiac catheterization to see if they could pass a wire through the artery and place a stent. He said there was a possibility that I would need bypass surgery if they could not get a wire through. This would have to be done as soon as possible. They scheduled my procedure for the following Tuesday.
I couldn’t believe that this was happening. No one even knew that I was here. I had patients waiting for me at the office. I quickly got dressed and walked to my car in the parking lot. I sat down and the reality of what was happening hit me like a brick wall. I sat there in my thoughts for about ten minutes trying to wrap everything in my head. I called my wife to tell her what was happening and she thought I was joking. When she realized that I wasn’t, she wanted me to go back to the hospital but I told her that since I wasn’t havening any symptoms they told me I could go home and I needed to avoid any strenuous activities. Next, I called Michelle, my office manager, and told her what was going on. I told her to cancel all my patients that day and for the rest of next week. She too was shocked. “What should I tell the patients? What should I tell the staff?” She asked.
“What WAS I going to tell everybody?” I wondered. I was supposed to be the one telling my patients how to be healthy and fixing them so that they looked young and fit. I was embarrassed. I felt like a fraud for giving out advice that I was not following myself. I decided then and there that I needed to take some massive action. I put the phone to my mouth and said “Michelle, let’s tell them the truth!”
My weakness had always been meat. That sizzle and smell of a nice juicy steak was too irresistible. I loved getting together with the guys and going out for steak. We did this on a semi-regular basis and I would eat until my stomach hurt. I knew this was not healthy so I kept telling myself that I should eat better. I had watched the Netflix documentary “The Game Changers” several times and had been inspired to go on a plant based diet, but it never lasted more than a week. After a few days, I would give in to my intense cravings for meat. I never found salad to be very satisfying.
Not everybody gets a second and third chance like my mother did. In fact, for many people, especially men, the first symptom of coronary artery disease is sudden death. The realization that this could actually happen to me is what changed my mindset. I made a decision that I was never going to eat meat again. And for good measure, I decided to give up sugar, bread, dairy and gluten as well.
I went in for my procedure that Tuesday. The plan was to pass a catheter from the femoral artery in my groin up to my heart and into the coronary arteries that bring blood to the muscles of the heart. Once they got into the artery, they would put a stent into the lumen to keep the artery open. Hopefully, when I woke up, I would either have stents in my heart or if it was too severe, I would have to go for cardiac bypass surgery.
I had heard about some anecdotal cases of people being diagnosed with coronary artery disease and actually reversing it by going on a very strict diet but there is very little in the medical literature to confirm that. To get actual evidence of this happening, you would have to do a cardiac catheterization procedure to document the presence and degree of plaques, not do any intervention, and put the subject on the diet and then go back in and do another catheterization to document regression of the plaque. Cardiac catheterization is an invasive procedure so this would not be a very practical study. As fate would have it, I was given the opportunity to become that experiment.
The plan was to place some stents in the areas of blockage so that the arteries would stay open for the blood to flow through. With the right medications and some modest lifestyle changes, it would typically take about ten years for the plaque to build back up and they can go back in and place some more stents or do a bypass surgery. This trajectory did not sound very appealing to me. In my mind, I’m still young and healthy. I did not want to be that guy with the heart condition!
I was determined to make some drastic changes and I needed to do it for the rest of my life no matter what the outcome of this procedure. I went into the cath lab praying for some kind of miracle. I asked God to give me a way to stay committed. That miracle came in an odd way.
I woke up from the procedure to find out that although they managed to open up the blockages by doing a balloon angioplasty, they did not place the permanent stents. There were multiple areas of blockage that they worked on and they had to inject a considerable amount of dye into my system. They were able to open up the significant blockages but there was one small area that they were not able to get to because they did not want to exceed the safe amount of dye they could inject in one setting. The doctor was almost apologetic when he told me that they did not place the stents because, they would eventually have to go back in to get to the last small blockage, but the stents could possibly get in the way. They wanted to wait about eight weeks and do some more angioplasty on that last portion of blockage and they would place the stents at that time. In the mean time, if I stayed on the medications and watched my diet, I would be fine.
I went into the procedure hoping that this would be the end of my ordeal but I was actually glad that this happened. If I can stay committed to my diet and lifestyle changes for eight weeks, when they go back in, we can actually see the changes, if any, that my diet will have on the plaques. I was excited! My one person experiment could possibly provide evidence for doctors to be much more aggressive in recommending diet and lifestyle changes to their patients rather than just pushing drugs and procedures. This could be a gamechanger. My prayer had been answered. I now had the motivation to do this!
I initially went on a cleansing diet. I stopped all animal protein including eggs and dairy. I cut out all added sugar and salt and I went gluten free. I did this for three weeks and it was really hard. I was searching and experimenting with different vegan meals and I was spending a lot of money at Whole Foods buying strange food that I ended up throwing away because they were just plain gross. It seemed almost impossible to find anything to satiate me and I was feeling weak. My exercise tolerance, however, was improving daily. After only two weeks, I found myself keeping up with my wife and teenage boys on the vigorous hikes instead of lagging behind like I usually did. Something was happening. I could feel it. I could see it too, my body was changing. My stomach was flattening and my skin was glowing. My efforts were paying off and now I was motivated to keep it going.
I started to increase my speed and duration on the elliptical machine and I started lifting weights and doing sit-ups. Some of the younger guys in my men’s group at church were talking about competing in something called the “Tough Mudder.” Anthony, the fittest member of the group explained to me that this was actually not a race, but it was an insane obstacle course where you had to perform feats of strength and endurance crawling, swimming and climbing through mud. It was not timed but the goal was to finish the course and do as many of the obstacles as you could. This sounded like exactly what I needed to do! I convinced my teenage sons Eric and Matthew to do it too and the other guys recruited their wives and teenagers as well. The average age of our team was now half my age but that was ok. I told Anthony, “I’m in! 100%.”
In order to do this safely, I needed to make sure that I was in great shape. This was my motivation to keep going with my diet and exercise. I knew I could do it because I was feeling so much more energetic after only a few weeks of my new diet and exercise. After the third week, my cravings for meat and sugar were gone. I had discovered that Costco has a huge selection of organic and vegan foods that you can purchase in bulk. Most restaurants in our area have incredible vegetarian dishes so I could go out with my friends and not feel deprived. The amazing thing was that I can now watch someone eating a big juicy steak right across from me and I would be lying if I said I didn’t feel a craving but it would only last about a minute and then I passes. I can enjoy my vegetable meal and not feel sorry for myself. I just think about my absent gut protrusion and know that it’s worth it. I was amazed at how fast my belly went away. For the first time in decades, I now had a flat stomach and I could even see some definition. Was it possible to get the washboard abs that had eluded me all my life at age 55? I wanted to find out. We have this machine at the office called the Trusculpt Flex®. This is a higher powered version of the popular Emsculpt® treatment that helps define muscles. We had been using this machine and we were getting some incredible muscle definition in younger people after liposuction or CoolSculpting® and I had always wanted to do this on myself so I went for it. I started a series of Trusculpt Flex® treatments and sure enough, I am now seeing a washboard pattern emerging from my abdominal muscles!
I would have never thought that at age 55 I would be in the best shape of my life. Everyone is commenting at how great I look and ask me what I am doing. I do not hesitate to tell my story everyone who cares to listen. I am now discovering that I am actually inspiring people all around me. I had to cancel a dentist appointment when I went in for my angioplasty and I told my dentist what happened to me. When I went back for my rescheduled appointment, my dentist was looking visibly slimmer and he told me he went plant based after talking to me. Some of my staff members and dozens of my patients have also changed their diets after hearing my story. I became a doctor because, to me, it is the greatest feeling in the world to help other people change their lives for the better. I just coulldn’t imagine that I could change lives just by telling people about what I was doing.
I did manage to do the Tough Mudder and complete every obstacle. What and incredible experience. I got to get down in the mud with all these incredibly fit people who were half my age and I got to show off my new abs! I am now in the maintenance phase of my program. I do not eat any red meat or chicken, but I do eat some fish, mostly wild caught to avoid the hormones fed to farmed animals. My protein comes in the form of vegan shakes, beans, nuts, tofu and protein bars. I exercise at least three times a week by doing weights and getting my heart rate up to my target of 65 (220 minus my age). I will also periodically get on our Trusculpt Flex machine to maintain my abs. I never thought I would be saying this but "love my abs!"
Click Here to learn more about non-invasive and minimally invasive body contouring treatments at Omni Aesthetics.
One of the first things I learned in CoolSculpting University was to help people set realistic expectations. So when an exceptionally large woman came to me for a consultation, my first instinct was to try to steer her towards liposuction or even bariatric surgery. Janet (not her real name) came to us because of our reputation for being honest and for our unparalleled CoolSculpting® results. I did not want to betray her trust, so I was very straight forward with her. I explained to Janet that Coolsculpting is a great treatment for shrinking stubborn areas of fat to help people look better in their clothes, but it might not be right for her. However, she insisted that this is exactly what she wanted. Her second son was getting married and she wanted to wear the same dress she wore to her first son’s wedding 10 years ago. Looking at her current body compared to the photographs she showed me, I knew this would be a huge undertaking. I was honest, and I told her she would need a lot of cycles. Liposuction would probably cost her less and she would get faster and better results. Janet was denitely not interested in liposuction, even though I explained to her how our minimally invasive Vaser® liposuction was nothing like the old liposuctions that required months of recovery. She could be back on her feet the next day. In the end, she still decided to go ahead with CoolSculpting®. The wedding was in six months!
I have been performing CoolSculpting treatments at Omni Aesthetics since 2014 so I know that there is definitely an art to getting the best results. Most people think that just freezing the area with the machine is how the fat is removed, but that is just part of the process. Once we successfully freeze the adipose tissue under the skin, we have to pulverize the frozen cells by vigorously massaging it, otherwise the fat cells can come back to life and grow bigger than they were before the treatment (this is a rare phenomenon called "Paradoxical Adipose Hyperplasia" or PAH). I learned the proper massage techniques in CoolSculpting school but then Dr. Song showed me how I can really destroy the frozen fat using our shock wave machine. With the tools and the training that I had, I felt confident that I could help Janet achieve her goal. Back then, we only had one CoolSculpting machine, so each cycle took 45 minutes to do. We did 20 cycles over a period of several weeks. Once Janet started to see the inches coming off, she became really motivated and started also losing some weight on her own, the old fashioned way with diet and exercise. By the time the wedding day came, she had to actually have the dress taken in a couple of inches! This is just one of so many life altering stories that I have had the privilege of being a part of and this is why I am so passionate about what I do.
Fast forward to 2021. We are now up to the third generation of CoolSculpting machines called "CoolSculpting Elite®" and we have two of them with a total of four applicators. That means we can potentially treat four people at the same time or put all four applicators on one person to do the treatments in 1/4 of the time. I now also have two assistant CoolSculpting technician who are going through the same training that I did. I consider it a true honor to personally mentor the next generation to help them master the art of body contouring.
When I went for a routine dental visit in July of 2019, I could never have imagined what I would have to go through for the next year. The X-rays revealed a rare tumor that would keep growing if it was not immediately addressed.
The treatment required removal of half of my upper jaw and extensive reconstructive surgery. After a ten hour surgery and seven days in the ICU, I was told that they had removed all of the tumor! I was beyond thankful that I was alive, yet looking in the mirror, I was terrified. Would my life ever be the same again?
Candidly, 2020 was the most difficult year of my life, as it has been for so many of you. I had to really lean on my faith, pray and trust. The team of doctors at Mt Sinai Hospital were excellent. Despite several setbacks, including two more surgeries, and countless in-office procedures, they were able to make me look normal again. I had some of the best reconstructive surgeons in the world work on my face and they did an amazing job. The small irregularity that still remained was hardly noticeable. However, I was painfully self-conscious of the asymmetry that persisted. I was losing confidence in myself. I dreaded the thought of returning to the workplace. Then, as if in answer to my prayers, in 2021 I met Dr. Song and the team at Omni Aesthetics.
Dr. Song told me about his technique of performing a facial fat transfer. He can use fat harvested from anywhere on my body and transfer it to specific areas on my face where I needed extra volume. There was a visible deficit in my left lower face where the tumor was removed and he told me that he can fill that with fillers, but using my own fat would be a much better option. Fat is more permanent and would look more natural. An added benefit would be that the regenerative effects of the fat could help to soften and heal the scar tissue that had formed as a result of my operations.
The fat transfer had been offered to me before, but I was given the impression that it would require another operation, which I was not interested in. Dr. Song told me that his technique did not require going under anesthesia. He could do it under local anesthesia and there would be no cutting! I was intrigued.
When he asked me where I would want the fat to be harvested from, I jokingly pointed to the flabby fat on my upper arms and I was shocked when he said “sure, we can take it from there.” He said I would see a noticeable reduction just from the harvest and that he would do both arms. I was sold!
I decided to do the fat transfer to my whole face to touch up the hollowness under my eyes and temples. I also had him put some in my cheeks and lips. The changes were instant and other than some swelling and a small amount of bruising, I had very little down time. I did not have to hide out like I did with my other surgeries. I had a touch up a few months later, which was not a big deal since I did not have to risk general anesthesia. Now, not only is my face much more symmetrical, I actually look ten years younger!
It is now mid 2021 exactly two years since my ordeal began and I feel that I have come out from the worst year of my life better and stronger than before. My faith is stronger, my attitude is better and my face actually looks younger!
“As I Lay on My Driveway, I Watched My Car Roll Over My Right Leg”
It was a dark night in December 2019, before COVID came along to disrupt our lives. I had left work after a late meeting at Omni Aesthetics with Dr. Song and Michelle. During the short 5-minute ride to my home, I must have been distracted by the exciting new laser we were discussing because the next thing I knew, my own car was rolling over my leg.
I stepped out of the car—and then I was on the ground. Screaming, as my car tire made its way over my right thigh in slow-motion. How could this be happening??
I’ve always driven stick shift cars. (The guys at the gas station called me a “Badass!” for driving a stick) Normally, I would put it in gear, pull up the handbrake, and get out. As the Registered Nurse for the practice, I develop procedures and train our staff to always use systems to check and double check for safety, wear their laser googles, follow infection control measures… Pause and be mindful about their next step. How could I forget to do this essential safety measure with my car?
After rolling right over my leg, the car kept going, stopping only when its trajectory was stopped by one of the evergreens along the edge of our driveway. I worried that our neighbor’s fence might be damaged. Nobody heard my screams. My husband and our dog, who usually signals my arrival by barking at the window, apparently went to bed early. They didn’t hear me either. I laid on my driveway in a state of shock. I was all alone.
In my trance-like state, I did not think to use my phone to call my husband, call the police, or summon an ambulance. No. I got up, and somehow walked up the stairs, down the hallway, and opened our bedroom door. “My car just rolled over me!” I exclaimed to my husband. We both stared at the tire tracks by my knee. It was now really starting to hurt.
Wow, apparently I’m not the only one who has been run over by their own car. The ER doctor told me of two other cases in the past year alone.
From the hospital, I called Dr. Song to let him know what happened and texted Michele. “Wait. What?!? “Your car ran over you?” They were both a bit shocked! I hadn’t wanted to bother them, but I thought they should know that I wouldn’t be into work the next day, which actually ended up being 6 days. You’ve got to have a sense of humor about things. Michele informed the team, “Well, Beth wanted to take a few days off, so she ran herself over with her car.”
As I waited on my gurney, while being rolled and parked around the hospital hallways to get multiple X-Rays, CT and MRI scans, and doppler ultrasound to see if I had any blood clots blocking my blood vessels, I had time to think. This was scary. The car could have rolled over my pelvis, my ribcage, even my head! I could have been dead. I was sent home in ace bandages. All my tests were negative, not a broken bone, no damaged blood vessels. A couple of large hematomas (bruises) within my right thigh, but these would resolve on their own over time. I did develop a tiny fracture in a non-weightbearing bone near my knee, detected several weeks later at a follow-up visit with the orthopedist, which didn’t require any treatment. Must have been my mother’s “milk with meals rule” that kept my femur from fracturing.
I thought about why I didn’t just pull up the brake and place my car in gear, something I’ve done countless times over more than 40 years of driving. I realized, “My car didn’t run me over. I ran MYSELF over.” By not following my own advice to use mindfulness, ‘practice the pause’, breathe for a moment, follow the steps, I had caused this unnecessary accident to happen.
What happened to the car, you might wonder? Not a scratch on it. But I turned it in for one with an automatic shift, newer version. I figured it can’t hurt to be too safe. What did Dr. Song have to say about the new car? “Well, you didn’t have to give up being a “badass”. I’m sure you would never have gotten out of your car again without putting it in gear and engaging the handbrake.” Very funny.
Beth Tansey Peller, RN is a registered nurse at Omni Aesthetics. She is a faculty trainer for the Advanced Aesthetics Education Group and a certified Well Coaches wellness coach.
“As a cosmetic surgeon, I was seriously questioning my ability to keep my COVID19 patient alive.”
65 is way too young to die! The typical 65 year olds I see in my practice look younger than most 40 year olds and are all living full, active, vibrant lives. Our motto after all, is "age backwards".
So, when 65 year old George with COVID pneumonia dropped his oxygen level down to 89%, I was not ready to put him on a ventilator and send him off to the ICU where he only had a 50% chance of survival.
On a wickedly cold night in April 2020. I was the physician on duty at one of the makeshift COVID Field Hospitals set up by the National Guard. I had accepted George’s transfer from the hospital earlier that day. His oxygen saturation was at a steady 96% when he arrived. He had been considered stable enough to leave the real hospital where the ventilators were, but he was not well enough to go home because patients with COVID pneumonia could rapidly turn and deteriorate at any minute as too many of them did. George was just one of many who came to the field hospital that day.
Amy was the nurse who noticed his oxygen levels dropping as he started to have an ominous coughing fit. She quickly alerted the rapid response team which I was heading. We jumped to action, and turned up his oxygen flow. The protocol at the time dictated that when a patient started deteriorating this fast, we insert a breathing tube down his throat and send him back to the hospital so that he could be placed on a ventilator. Looking back, it turns out that we probably saved his life by doing exactly the opposite of what we were trained to do… (continued)
Fiona Regan, L.E.
Staring back at me from my mirror was someone I could not even recognize. Almost overnight, my face had blown up like a balloon and I was terrified that it would stay like this forever. Now I know why they call it a “Moon Face”!
It was the summer of 2019 and I was having the time of my life. I had graduated from cosmetology school and my aesthetician license was on the way. I started a new job working exactly where I wanted to be, at Omni Aesthetics, using my skills and helping people feel good about themselves. I was going to parties, the beach, vacation, having fun, and then—out of nowhere, I hit a wall. I woke up one day and I couldn’t move. I don’t even remember the day I went to the hospital. My sister was going to drive me to the Emergency Room, but I couldn’t get up. Apparently, the ambulance squad brought a chair up to my room and carried me down.
In the ER, I told the doctors I had the worst headache ever. Before I knew it, I was in a room, receiving a blood transfusion. For two weeks, I was in and out of the hospital. I even had to receive a transfusion just to go to my best friend’s graduation party. Then back in for more. A total of 14 transfusions. They finally figured out that my own immune system was attacking my red blood cells. They immediately started me on high dose steroids and after four months of treatment, my face began to grow…
My blood count eventually returned to normal and my illness went away as mysteriously as it came, but my face, remained swollen! A known side effect of high doses of steroids. There’s even a name for it: “moon face.” I felt much better, but I was extremely anxious about facing my friends and co-workers with my moon face.
Back at work, I was happily doing HydraFacials and learning to perform advanced treatments like micro needling and Venus Viva. I loved it, but I felt so self-conscious when I greeted my clients. I wondered what they were thinking about my moon face. My cheeks were so swollen, and my lips made me look like a puffer fish. This was before COVID, so I couldn’t even hide behind a mask. But as time went on and I was able to wean from the steroids, my face returned to its natural state and I started to feel like myself again.
I wouldn’t wish the experience I had on anyone. I may never find out why this happened to me. But, as scary as it was, I learned something from it. As an aesthetician who wants everyone to feel good about their natural beauty, I hadn’t fully appreciated my own. The face I had before I developed this crazy illness. The one I missed so much when steroids made me look like someone else. The face I have back now. This has really helped me help my clients accept and appreciate their own unique features and embrace them. I can really appreciate that Dr. Song’s approach is to restore our patients’ natural beauty rather than making them look like a caricature.