Photo Credit: amronmd.com
Beverly Hills dermatologic surgeon David Amron is on a mission. Dubbed a “liposuction expert,” from his enclave in Beverly Hills, Amron performs body contouring procedures with a keen aesthetic eye and superb level of care. Amron is the Founder of Spalding Drive Cosmetic Surgery and Dermatology, as well as Beverly Hills Doctors Surgery Center. He specializes in non-surgical facial rejuvenation and is recognized internationally for his unique approach to artfully sculpting and shaping the body for women and men. As a pioneer in the field, he offers multiple types of body sculpting and fat removal procedures that can be done individually or combined, depending on the patient, for a truly customized experience and outcome. Another thing that stands out about Amron is that he is not the typical “Beverly Hills cosmetic surgeon.” His well heeled international clientele tout his caring beside manner and the special interest he takes in all of his patients, not only the ones you see on the big screen.
Lipedema is an often-misdiagnosed fat storage condition affecting millions of our national and global population. It primarily occurs in the legs, specifically the anterior thighs, knees, and ankles. Often, it will also appear in the upper arms in later stages. It develops the appearance of tree-like, column-like legs, with disproportionate fat storage and a lot of non-pitting edema, or excess swelling. A lot of times there’s a cuff around the ankles in lipedema patients. It’s different from obesity and fat legs. Obesity is being overweight, and fat legs may just be a part of genetic disproportion, but with lipedema, there’s also prominence of swelling, and again, that sort of column-like look to the leg. Commonly there’s a genetic inheritance component to lipedema. It occurs almost exclusively in women, and usually appears after puberty and progressively gets worse. It affects approximately 11 percent of the female population — 17 million women in the U.S. and 370 million women worldwide. For the most part, lipedema is resistant to diet and exercise.
Various medical treatments have been met with limited success, and the only real possible cures are tumescent lymphatic sparing liposuction (which many surgeons are reluctant to perform) and water-assisted liposuction (WAL). There are a number of things that have been done, but nothing with the same results. One of the main treatment therapies is Manual Lymphatic Drainage (MLD). It does seem to significantly help with the swelling that comes with lipedema, however, there’s a lot of maintenance involved, and it doesn’t really seem to make a difference in terms of the disease itself. There are several doctors and healthcare providers around the country who are treating lipedema medically. The medical treatment primarily revolves around the use of medicines such as Cimetidine and supplements such as Selenium, as well as others, to reduce the inflammation and swelling. The role of decongestive therapy also involves MLD, leg elevation, and compression is used to reduce swelling.
Lipedema is a very under-recognized condition, especially in the United States, and I’m one of the few doctors with experience in surgically treating lipedema patients. I want to further advance both the knowledge and awareness of lipedema among the medical community, as well as within the general public. There are many treatment centers in Europe, especially Germany, a country at the forefront of initial research and treatment for lipedema patients. Unfortunately, there are very few treatment centers in the nation, but I’m currently in the process of advancing my practice to treat more and more lipedema patients around the world. I’m also setting up an extensive protocol, both pre- and post-surgically, to treat these patients in a comprehensive fashion. Along with that, I am aligning myself with many medical experts around the country, including Dr. Karen Hebrst, who is a worldwide expert in fat disorders, such as lipedema. We’re working together to establish protocols, and also collaborating on studies among lipedema patients to not only advance therapies, but also to increase awareness, so that possibly one day, lipedema might be more recognized by insurance companies in terms of coverage. Lipedema patients are not only suffering from the aesthetic effects of the disease, which creates emphasis on disproportionate areas, but they also suffer in terms of their lifestyles. As lipedema progresses, patients experience a series of symptoms including: discomfort, pain, numbness, and often immobility. Patients begin to experience a viscous cycle of worsening swelling and pain, such that they can’t properly exercise, which certainly makes the condition worse.
I’ve been an expert in liposuction surgery for the past two decades, and in recent years, there’s absolutely been an exciting area of advancement in regards to noninvasively targeting fat. I’ve been observing this area very carefully, and there are several devices that work well. Some are better than others, but UltraShape is the most specific, noninvasive device that exists, and it represents the next generation of approaching fat non-surgically. It’s much more customized and focused on how it works, versus other, more nonspecific modalities. As a key opinion leader for Syneron, the developer of UltraShape, I’m one of the first few surgeons in the nation to offer the treatment. Before UltraShape was released to other surgeons, I already made the decision to incorporate it into my practice as a great alternative for patients who do not want surgery.
It’s important that patients do their research to select a surgeon they trust — they shouldn’t be quick to make a decision, or fall prey to some price-driven marketing campaign. The patients I see have taken the time to learn and understand the procedure, and they come to me as an expert in the area. I am really here for guidance, and to help patients determine what the best course of action may be, whether it’s surgical or nonsurgical. Patients want a procedure that will deliver the best results, and one that doesn’t involve a lot of recovery time. That’s one of the advantages to some of the noninvasive techniques that are now entering the marketplace. UltraShape is entirely painless and works very, very quickly. In as little as two weeks, patients already start to see improvements in their bodies. In regards to traditional liposuction, when patients understand my approach, which uses local anesthesia as to general anesthesia, they’re often impressed by how little downtime they experience. Patients will leave my office half an hour after their surgeries, and are able to go home and walk around. The next day, patients are usually up and going, and in as little as two days, most are back at work and doing their daily routines, including light exercise.
If patients have reasonable expectations, and are evaluated properly, noninvasive treatments provide a great alternative for someone who wants to avoid surgery. Noninvasive approaches are an area of significant growth in the industry, because now, we have the ability to remove and destroy fat tissue. This area is getting better and better, not only in terms of non-surgically removing fat, but also in terms of tightening up the skin. I use a variety of technologies, and we’re seeing fantastic improvements in cellulite in ways we wouldn’t have seen years ago. I’m currently developing a new approach, Integrative Body Contouring, which provides the patient with a more comprehensive treatment. The approach is now more holistic, and instead of doing a liposuction procedure to simply remove fat, Integrative Body Contouring will address the role of many different facets – how overweight the person is, his or her ability to lose weight, as well as the role of exercise and muscle tone. Additionally, proper hormonal balance is critical, so we’re incorporating anti-aging medicine into the treatment, addressing patients who are hormonally challenged and adding corresponding therapy as part of their overall procedure. I’ve always been a purest in terms of all of the new improvements that have entered the marketplace. I always return to the most important factor, which is the trust a patient places in his or her surgeon. I’m very excited about all of the recent technological advances, but again, the most important factor to me will always be selecting the right doctor.
Photo Credit: bravottv.com
Popular RHOBH star Kyle Richards, the 45-year-old mom of four and wife of real estate titan Mauricio Umansky, is also aunt to Paris and Nicky Hilton and author of Life Is Not a Reality Show. The actress and entrepreneur has also had many high-octane, on camera blow-outs with her sister Kim Richards as well as cast mate Lisa Vanderpump. And she is back for season five. The new season, which premieres Tuesday, Nov. 18 at 9 p.m. on Bravo, includes the addition of two new housewives — soap opera stars Lisa Rinna and Eileen Davidson — and is poised to be explosive.
The raven-haired beauty talked to us about what’s to come in 90210 this season, her personal beauty secrets, as well as her recent diagnosis of chronic dry eye.
Will Season five really be “drama-free” as has been alleged?
NO!!! This was a very intense season with way TOO MUCH drama. We just finished shooting and I am happy because I want to have peace in my life right now. Until it airs!
What is one beauty product that you can’t live without?
The one beauty product I swear by is Benefit’s they’re real! mascara. Also, theBalm Hot Mama shadow/blush. And of course lip gloss. I never leave home without that.
Any other beauty secrets to share?
My beauty secret is exfoliating. I do a scrub on my face twice a week, as well as microdermabrasion once a month. I use a Clarisonic to keep my skin clean and get rid of dead skin cells. I also like to use a heavy moisturizer with Vitamin C to help reduce spots and improve appearance of fine lines without having to layer on ten different products.
Tell us about your chronic dry eye diagnosis.
Around the time of the first season of Housewives, I began to notice that my eyes were bothering me throughout the day. At first, I thought I just might be getting dehydrated, so I would drink more water. When that didn’t work, I noticed that I was using artificial tears several times a day, like when I was watching movies with my family or out to lunch with friends. So I kept a bottle of artificial tears stashed wherever I might need them — in my purse and different areas of my house. The condition seemed to worsen over time, so, eight months ago, I finally decided to see my eye doctor about this. After asking me questions and examining my eyes, he told me that I had Chronic Dry Eye disease, a condition that can be caused by decreased tear production due to inflammation. I was surprised because, although I had heard the term Chronic Dry Eye from seeing TV commercials about RESTASIS®, I didn’t make the association with what I was experiencing.
How has treatment made a difference in your quality of life?
Within the first six months of using RESTASIS®, I noticed that I was making more of my own tears. While this was my personal experience, other people should check with their doctor since individual results can vary. If you think you have Chronic Dry Eye, I encourage you to talk with an eye doctor, get diagnosed and see if RESTASIS® might be right for you. You can find an eye doctor in your area, as well as more information about Chronic Dry Eye disease, RESTASIS® and questions to ask your doctor at www.RESTASIS.com.
Photo Credit: drmezrow.com
Board certified plastic surgeon Craig Mezrow’s career is impressive. He received a B.S. and M.S. from Emory University in Atlanta, and an M.D. from The Mount Sinai School of Medicine in New York City. He initially entered the field of cardiothoracic surgery, but after a decade, he found his true calling and trained for five years in plastic and reconstructive surgery at the Medical College of Wisconsin. Mezrow went on for additional training in Cosmetic Surgery at the prestigious Manhattan Eye, Ear & Throat Hospital in New York City. He is now in private practice in Bala Cynwyd, located on Philadelphia’s posh Main Line.
Along with breast enhancement, tummy tucks, and liposuction, Mezrow offers a comprehensive nonsurgical menu of BOTOX, fillers, skincare, Intense Pulsed Light (IPL), and lasers. He was one of the first plastic surgeons in the U.S. to offer the UltraShape focused ultrasound device for body shaping, and is also a big proponent of VelaShape to target cellulite and dimples.
He talked to Beauty in the Bag about his love for lasers and light-based devices, the body contouring revolution and where he thinks this field is headed. Here’s what he had to say:
As a board certified plastic surgeon, how and why have you embraced lasers in your practice?
I believe that lasers as well as radiofrequency and ultrasound devices are becoming essential tools in an aesthetic surgical practice. To illustrate this, consider the face and neck lift patient, whom not only has hanging jowls and loose neck skin but also has wrinkles and sun damaged skin. To only perform a face and neck lift without addressing the wrinkles and/or skin dyschromia (pigment discoloration) would be incomplete. Only with a comprehensive approach using light and/or energy-based devices can a complete rejuvenation be achieved. On the other hand, some patients do not wish to have any surgery but instead desire non-invasive treatments to improve their skin color, texture, firming and possibly even reduce regions of excess fat. We now have the ability to address their concerns without employing invasive treatments.
What is new and exciting in the world of body contouring?
Each year, hundreds of the thousands of patients undergo surgical body contouring procedures such as abdominoplasty and/or liposuction. Many desire additional refinements such as reduction of fat deposits without further surgery. For the aforementioned and for those patients who won’t consider surgical modalities, we now have non-invasive treatments. During the last decade, multiple non-invasive fat reduction therapies have been introduced into the United States. Some of these technologies include radiofrequency heating devices such as VelaShape, Venus Freeze, Venus Concept Legacy, and Vanquish. Other devices “freeze” the fat such as Coolsculpting by Zeltiq. Lastly, there are devices that employ ultrasound to destroy fat such as the Liposonix device and the most recently FDA-approved UltraShape device, which is the only non-thermal device in the U.S. market place.
I am very excited about the introduction of UltraShape to the U.S. because this technology uses pulsed, focused ultrasound that is not “cold” or “hot” to selectively destroy fat cells without injuring nerves, blood vessels, muscle, and surrounding tissues. The area to be treated can be individualized, customized, designed to each patients needs. UltraShape is comfortable since it is non-thermal thus not requiring any type of anesthesia. It has no down time, as there is no swelling, bruising, induration, or soreness. With a series of three abdominal treatments performed every other week, a three to six centimeter circumferential reduction can be achieved with visible results as early as two weeks. I also expect to use UltraShape in the near future to treat fatty arms, necks, thighs, etc.
What do you use as your ‘go to’ techniques for turning the clock back?
The most important is the patient’s concerns. After a complete history and examination, we have a discussion about whether the patient desires a combination approach of surgery and nonsurgical modalities or only desires non-invasive treatments. Significant non-invasive rejuvenation and patient satisfaction can be achieved when a combination of treatments are employed using multiple modalities. The treatments may incorporate a combination of lasers, IPL, radiofrequency, and ultrasound devices to achieve aesthetic goals. It would not be uncommon for non-invasive facial and body procedures to be performed on the same day in conjunction with injections of hyaluronic acid-based fillers, polylactic acid and/or botulinum toxins.
Does anything work well for acne scars, stretch marks, and cellulite?
When treating acne scarring, it is imperative to first evaluate the degree of scarring, the patient’s skin type, and the patient’s desires of a single treatment with significant downtime or multiple treatment sessions with little or no downtime. If the patient has a lighter skin type (Fitzpatrick I-III), and accepts downtime, I will perform a single treatment of fractional CO2 laser resurfacing. I have obtained excellent results with Syneron Candela’s CORE CO2 laser. I am very fond of this system because I can perform full ablation and/or fractional ablation with varying settings without changing the hand piece. Full ablation is the complete removal of the skin’s top layers, while fractional ablation involves a controlled wound healing process. The laser places tiny holes or micro channels in the skin which cover a fraction of the total treatment area. This activates the body’s wound healing response, and stimulates the production of new collagen.
For the patients whom do not want significant downtime, I have been extremely pleased with fractional radiofrequency Sublative treatments using Syneron’s Matrix RF. What’s fabulous about this system is the rapid healing, minimal downtime, and the fact that it can be performed on all patient skin types including African American patients. The treatments to improve stretch marks are more complex. It is important to assess if the stretch marks are red, immature scars as compared to lighter, mature scars. While in my opinion, there are currently no reliable treatment options, I have had success using fractional radiofrequency Sublative treatments.
Cellulite continues to be concerning for millions of women. My view is that the technology is improving and hopefully one day, we will have a permanent treatment modality. Syneron’s VelaShape technology has had the longest track record, totaling nearly a decade with four generation of machines to decrease cellulite. Their latest model is the 150 watt VelaShape III, that now has a three treatment regimen protocol. That is reduced from their earlier 20 watt machines requiring sixteen treatments. Another promising newcomer to the marketplace is the Venus Concept Legacy that combines multipolar radiofrequency with electromagnetic energy.
What are your East Coast patients looking for most often and how has that changed in the past decade?
What has changed the most in the aesthetic industry over the last decade is the patient demand, desiring non-invasive, nonsurgical options without downtime for facial rejuvenation and body contouring.
In your view, what is the future of aesthetic surgery?
My opinion of the future of the aesthetic industry is going to be the obvious future demand of non-invasive, nonsurgical, no downtime treatments. I also believe that more physicians are going to incorporate non-surgical modalities with their surgical aesthetic practices.