Photo Credit: beautyinthebag.com
Dr. Kamakshi Zeidler is a board certified plastic surgeon in San Jose and greater South Bay Area. She has authored numerous medical journal articles and lectured nationwide. She is one of very few women surgeons in the Bay Area formally trained in microsurgical breast reconstruction; her specialty is aesthetic plastic surgery of the face and body. Dr. Zeidler’s philosophy is to create a fantastic but natural appearing final result.
Dr. Zeidler sat down with BITB to discuss her passions, top trends in cosmetic surgery and her predictions for the future of surgical and non-surgical treatments for the face and body.
1. Can you tell us about your passion for your career?
Plastic surgery is my absolute greatest passion. There are so many aspects that make this profession rewarding that it’s hard to narrow down, but first and foremost, the rewards come from being able to take care of patients. Being a physician is an incredible responsibility, but being a surgeon is a very intimate relationship. Patients have to trust that you understand what they need, and in the case of plastic surgery – what they want. They have to trust that you will take good care of them throughout the process and ultimately provide them with their desired end result.
The patient/surgeon relationship takes a lot of trust and it is a relationship that I don’t take lightly. I work very hard to understand my patients, their needs and desires, and work hard to arm them with information so we can make good decisions together, and I can also put them at ease about the process. I feel this provides the best outcomes and the happiest patients.
My favorite days at work (other than actually doing surgery) are days when a patient comes in thrilled with their result and we both look back on the journey together. Many patients tell me they were scared and very emotional about the process and thank me for getting them through it. Knowing that I helped them get through the journey is what I live for!
Every patient is looking for something special and an ideal result that fits their unique lifestyle. Each patient also has a different level of willingness of what they want to go through to achieve an ideal result. I love being able to draw from the wealth of experience I have to then tailor a specific procedure to achieve that result. Nothing is better than being in the operating room and actually making it happen, and then being able to look in the mirror with my patients after surgery and see the smile on their face once they see the results.
Beyond the intense patient bonds this profession gives me – I love the work itself. I absolutely love surgery. Patients ask me what my hobby is and it’s funny because I always say “surgery, of course!” When I was a young child, I loved arts and crafts, and as I grew older I developed a passion for art in the form of sculpture and eventually fashion. I spent lots of time creating things with my hands. Performing surgery now is an extension of similar interests I had early on.
Another passion for my career is the evolving technology and innovation. I never want to stop learning and growing. As such, I have naturally been drawn to a variety of companies that are making innovative products for plastic surgery – whether it is a new type of breast implant, a new type of liposuction, or a new way to process fat for fat transfer. I specifically seek out new products and techniques that I think will benefit my patients, and I participate in research and development of these new technologies so that I can lend my expertise and be as involved in the process as possible. I am on the front lines and know what patients truly want, so this allows me to be their voice and let companies know what is really needed in this market.
Finally, I have a special affinity for performing breast surgery. Some of this stems from my family having the breast cancer gene which makes this very close to home for me. I have gone through extensive training to learn advanced techniques for creating natural looking breasts after patients have gone through a mastectomy. The breast is a part of the body that is very tied to femininity and personal self-expression, both with personal style and intimacy. There is such a unique perspective from each patient on what the ideal shape and size is which makes planning surgery very unique. We do lifts, reductions, augmentations, and sometimes we combine the techniques. Both breasts need to look the same – which always brings a challenge of creatively determining what method and technique is going to achieve the perfect and symmetric result.
2. Please tell us about the top trends in cosmetic surgery of the moment? What do you see trending, and what are patients asking for most frequently?
The biggest trend is towards achieving a natural result. Patients these days want to look their best, but want it to be a secret. I see this trend taking hold in every aspect of what I do. Certainly, when it comes to breast augmentation in the United States, we are becoming a little more like Europe and South America where the average size of a breast implant has gone down and the number of women choosing an anatomically shaped, or teardrop shaped implant is more popular.
When it comes to the face, patients want fillers and Botox to be unnoticeable and want procedures like rhinoplasty and facelifts to give real results that don’t give away the procedure and this requires very careful planning and an extreme attention to detail in terms of how the tissues are rearranged and how scars are hidden. It’s the reason we use the tagline in our office ‘You. Only better.’ Patients want to look like themselves, just better.
Other procedures that are trending include the latest in breast augmentation options.
We now have anatomically shaped implants for extremely natural looking results which women want especially when wearing a bathing suit or sports bra.
We also now have a way of removing breast implants and replacing them with fat. I think this trend is on the upswing as patients learn that their own body fat can be repurposed. A growing number of women who are dissatisfied with breast implants that were placed over a decade ago [and look fake] are turning towards this procedure as an option to update their look. The wonderful thing about fat transfer is that it “kills two birds with one stone” allowing liposuction to other parts of the body and then reusing this fat to make the breasts look beautiful.
Some women are even avoiding implants altogether and augmenting with fat alone.
In terms of trends with the nose and face, it’s similar in that people just want refined looks with natural results.
Fat transfer doesn’t just apply to the breasts. Whether it’s a middle-aged patient looking for rejuvenation or a patient in their 20s looking for some refreshing, fat transfer to the face is an extremely popular and permanent alternative to fillers. The cheeks and under eye region, as well as the lips, are very popular places to have this done.
Now let’s look at trends when it comes to the buttock as this is definitely a trend in plastic surgery that is more recent. The last few years have seen huge growths in the number of patients wanting buttock augmentation and reshaping. Dubbed the “Brazilian butt lift,” a fat transfer to the butt originated in Brazil, a country that’s aesthetic revolves around the buttocks more than any other body part. Superstars like Beyoncé and Jennifer Lopez, as well as reality TV stars like the Kardashians, have also influenced some people’s view that fuller buttocks is an aesthetic ideal.
The growing number of men opting for aesthetic procedures and plastic surgery is also on the upswing whether it’s botox or breast reduction surgery, we are seeing more and more men having procedures. Especially in California’s Silicon Valley where I have my practice, patients are looking to stay young and fresh, and men, like women, are not holding back as they try to keep up with the fast tech startup world.
We are also seeing younger patients – Millennials – coming in for non-surgical treatments, such as lip augmentation with dermal fillers. There are so many new technologies that help achieve results without the need for surgery, which is why we are seeing more young patients or those with very busy lifestyles coming in to get these types of procedures. Other examples of quick office visit procedures that are trending include Coolsculpting to reduce fat in areas like the abdomen, and Miradry to permanently eliminate underarm sweating.
3. What are your predictions for the future of surgical and non-surgical treatments for the face and body? What is coming next, what has lost popularity? Also, what would you like to see more pronounced in the world of plastic surgery?
Fat transfer is going to continue trending in a major way. As plastic surgeons we are seeing a shift to looking at the overall balance of the body as a whole, so we are seeing patients who want to remove fat from one area in order to build up another area. Recent American Society of Plastic Surgeons national data shows this is trending with large increases in fat grafting to the face, the breasts and buttocks
In terms of predictions, I believe that surgery will always be a staple. There is never a way to win the war against time and gravity, and the biggest changes and most dramatic results will always come from surgery. That said, the increasing availability of good nonsurgical treatments will certainly open the door for smaller nips and tucks that are more attainable and appealing to the masses.
What’s coming next? Better breast implants! I was just in Barcelona for the annual Breast Meeting and the rest of the world has so many amazing options that we haven’t had access to in the U.S. since the FDA here is very strict. But this is a good thing and should give us comfort in knowing that what we do have available is very safe. The U.S. will catch up though as new companies invest in research in order to bring new technologies to market, such as better materials that are longer lasting, lighter implants and implants that feel more and more like natural breasts.
What’s losing popularity? Hands down – the ‘done’ or ‘fake’ look especially when it comes to breast augmentation. Women today prefer having more of a fit yoga and natural look.
Another thing losing popularity is the removal of fat from the face, especially when it comes to the eyes and cheeks. Blepharoplasties or “eyelid lifts” used to include a large amount of fat removal, but now we are taking the lead from looking at young faces that are plump and full. Instead of removing fat, we are now turning back the hands of time with fat injections around the eyes and cheeks to give the face a more youthful roundness. I have patients bring in pictures of themselves from their 20s so that I can see where fat has been lost as a guide for exactly where to restore it.
Thankfully, long recoveries are also a thing of the past. In our office, for example, we have a state of the art private surgery and recovery suite which enables patients to go home the same day within about an hour of surgery. One simple way in which recovery is sped up includes providing special cooling masks to limit swelling. This is something we routinely offer for facial procedures. When it comes to surgeries like rhinoplasty, our office is unique in that we use small electric tools instead of a hammer and chisel to make the surgery less painful and this cuts the recovery time in half! In all facial surgeries, we use platelet rich plasma which jump-starts the healing process and limits bruising. In breast surgery, we use Exparel which is a pain medication injection that lasts for a few days. Lastly, in tummy tuck surgery we use implantable pain-reducing pumps that give constant medication deep into the surgical area – over the course of a week, which makes the pain of a tummy tuck minimal. All of this makes the recovery process easy!
What I would like to see more pronounced in the future? I want access to more breast implant options. I am envious of surgeons around the world who have special types of implant texturing, as well as implants that are strategically designed to weigh less. I am also looking for the perfect tissue matrix. Tissue matrix is the term I use for all of our biological scaffolds that act as reinforcement to what we do in surgery. You can think of it as an implanted surgical bra that becomes a part of you and provides unbelievably long lasting results. These matrices are made out of a variety of materials including biologic plastic to human and animal skin and can be very expensive. The perfect matrix would be one that is cost effective so more patients have this as an attainable option and one that has all the ideal characteristics in one single option. The best matrices have good biocompatibility – rapid integration into the body and long-term strength to hold the results in a permanent way. I recently have found a matrix that might fit the bill and may be working with the company to develop its use for breast surgery.
I would also like to see fat transfer become a more standardized process so that all patients can get highly predictable results. I also look forward to patients being able to give a small sample of fat cells and be able to order as much fat needed to fill out breasts and buttocks for those who don’t want or need liposuction as a donor source. This is an area where I think we are really close to making this available.
Most of all, I am looking forward to a future of continuing to help patients with their goals and leading a practice that continues to offer the best and latest technologies to achieve the most beautiful long lasting and natural results.