Askanesthetician's Blog

An esthetician explores skincare issues and concerns

Don’t Neglect Your Skin! Start Early, See the Results Later March 8, 2012

I work for a plastic surgeon and there is a phenomena that I see here at our office again and again.  Women in their late 40s and their 50s come into the office because they suddenly feel that they look old.  It is as if overnight they aged.  Just think – you wait until your late 40s or 50s to invest in your appearance you will end up having to spend a lot of time and money trying to recapture your youth.  Instead – invest in your appearance early on in order to look your best as you age.

Let me be clear that I am not advocating trying to look like you are 20 when you are 40.  I believe in looking both great and appropriate for your age.  Two of examples for what I mean by this are Glenn Close and Meryl Streep (and that is why I used their images in this post.  Also notice how natural, yet flattering both of their make-up is).  I am all for some filler, Botox, laser treatments, and even cosmetic surgery if you feel that you need it, but if you develop good skin habits early then you can actually save yourself the time and expense of having to invest in lots of treatments later on.

Keep a few things in mind – we have a tremendous amount of control over how our skin ages.  About 20% of skin aging is genetic and the rest is caused by the environment – sun, stress, pollution, disease, medication, our overall health, etc.  Following smart skincare steps like protecting your skin from the sun on a daily basis, keeping your skin barrier intact in order to prevent skin disease and chronic inflammation to the skin, eating a diet rich in antioxidants, and not smoking will all help keep your skin looking good.  If you follow all these steps does that mean your skin will never sag or wrinkle?  Of course not, but if you follow a few simple steps everyday you can definitely help maintain your youthful glow and edge for longer.  So keep in mind that when you use your Vitamin C serum every morning you are preserving your skin for the long run – building collagen and fighting inflammation in order to prevent the aging effects of chronic inflammation.  Just because you don’t see a big payoff immediately with how your skin looks after applying Vitamin C doesn’t mean that you aren’t protecting your skin for the future.  Keep the big picture in mind when caring for your skin so that you don’t have to pursue invasive treatments in the future in order to have your outside reflect how you feel inside.

Lastly, remember the following in mind – it takes hundreds of dollars to prevent but thousands of dollars to fix.  So consider investing in your skin as a “must have” and not a “maybe”.


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Image of Glenn Close from and image of Meryl Streep from


To Inject or Not to Inject, To Avoid the Knife or Not – That is the Question June 9, 2011

Dominique Browning wrote an article in The New York Times called The Case for Laugh Lines which makes well quite the case that women should accept their bodies, mostly their faces, as they age instead of getting injections and plastic surgery.  Though she admits that a little work isn’t bad Browning writes that she is upset and sick of seeing friends completely change their appearance with injections and plastic surgery until they also get rid of all of their ability to express any emotion.

Browning writes in her essay:

We’ve gone too far. I’m becoming very, very scared.

We’ve reached a stage where cosmetic surgery is so readily available that in certain circles it is expected of women and men to avail themselves of these age-deniers. (You cannot call them youth-enhancers when you are no longer young.) If you choose not to partake of the benefits of needle and knife, you are judged to be making a statement. You are taking a position against the current standards of beauty.

We have triggered a weird, collective, late-onset body dysmorphia. What’s worse is that our anxieties about aging have trickled into our children’s generation, so that the mantra about cosmetic procedures even among some 30-year-olds is “intervention early and often.”   …

Too many people have had procedures that have gone awry. They look strange, and tragic. Is this inevitable? You do one thing, the effects begin to fade, you do another, and so on. You get puffy. You get rigid. Or you slide. And I wonder. Has no one said “stop”? Has no one, particularly the one wielding the needle, gently advised against further work? It used to be an unusual sight to spot cosmetic surgery addicts, but it has become astonishingly common.  …

Many people assume that in saying no to knife and needle, you are making a feminist statement; such is the lackluster aura that hangs over that label. Feminism has nothing to do with it. Feminists worry why women still make only 77 cents to every dollar a man makes, not whether women are going broke on Botox.

Though least you assume that Browning wants everyone to embrace a natural look completely she explains:

This is not an essay about why I am categorically against cosmetic surgeries. I am as supportive as the next gal if a certain someone feels so bad about her neck that she won’t leave home, or if another is so heavy-lidded that every time he blinks he misses half the picture. Plastic surgeons have done wondrous things.

As for the proliferation of smaller cosmetic procedures? The ones your dentist offers to do while he’s in the vicinity of your mouth anyway? The injections of fillers to plump up lips, smooth wrinkles, pad out laugh lines? At this point, it’s a wonder that the salesclerk at Barneys isn’t offering to shoot up your face while you’re trying on hats.

Again, I’m not against it. Well, maybe Botox. I’m the one to call for a rant when my friends are teetering at the brink of succumbing to the needle. I mean, who wants to inject a poison so lethal that it paralyzes nerves, sending tiny muscles to atrophy?


I work for a plastic surgeon so I would be a huge hypocrite to say that I don’t think women should get plastic surgery or have injections, but I completely agree with Browning about how and how much of that work should be done.  I liked when Browning wrote the following:

My current rule of thumb, when confronted with an enhanced face, is that if I find myself vaguely wondering whether there was work, the alteration was well done.

I completely agree with Browning’s statement above.  I truly believe in plastic surgery and facial injections if they make you feel better about yourself and help you look like a more refreshed version of yourself.  There is no need to freeze your face, just like there is no need to turn yourself into someone else.  As plastic surgery and injections become more and more easily available and affordable are we all going to end up looking like The Real Housewives of Orange County?  I certainly hope not.  (Also check out the latest issue of New Beauty to see the scary photos of over-injected celebrities)

 In my opinion it never hurts to get a little cosmetic help from a doctor in order to look and thus feel your best.  But avoid going overboard – there is nothing wrong with still being able to show your emotions!

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Cosmetic Procedures and Practices to Avoid February 21, 2011

Recently I read with horror the story of a young woman who died following a botched cosmetic procedure performed in a hotel room in the Philadelphia area.   There were numerous disturbing things about this tragic story but far and away one of the most upsetting aspect was the idea that someone would go to a hotel room to have what was obviously an unsafe cosmetic procedure.  Reading a story like this makes made me wonder what the thought process one would have behind making such a decision in the first place, let alone going through with it.

Needless to say this tragedy was quite avoidable which makes it even more upsetting.  So that begs the question – how can you be sure that the cosmetic procedure you are getting is safe?  And moreover how can you be sure that the person doing the procedure is legit?

There are a lot of procedures being offered by medical spas that are actually quite controversial and it is best to educate yourself before paying any money let alone proceeding with surgery.  Take for instance a procedure called Lipodissolve which promises to remove small pockets of fat through injections.  Sounds great, right?  Well actually it sounds great only on paper.  In reality the procedure is controversial enough that the FDA is cracking down on medspas that advertise that they perform this procedure.  Not only is the procedure not FDA approved, there is no evidence that it actually works. 

So once again, how do you protect yourself both financially and health-wise when you want to get a cosmetic procedure done?  When selecting a plastic surgeon make sure that they are board certified in plastic surgery and work in an accredited facility.  Ask a lot of questions during your consultation.  And it goes without saying that you should do a consult before any procedure.  If  some place wants you to go ahead with a procedure without a consult with a doctor (not a sales person but a doctor) definitely stay away!  Not only should you feel comfortable to ask about all aspects of a procedure during a consult, but any good doctor shouldn’t give you trouble when you ask about their credentials and experience.  You can quickly figure out if the doctor you’ve consulted with is board certified by logging to the American Board of Medical Specialties and looking up the doctor.  Educate yourself!  There even good resources online like The American Society of Plastic Surgeons website and New Beauty can give you details about popular cosmetic procedures.

Above all use your common sense – if your gut feeling tells you that things don’t feel right – stay away.  If someone offers to do your surgery for a cut-rate price there is usually a reason for that, a bad reason – stay away.  Legitimate places can offer discounts on surgery but if you are quoted a price that is way below the going rate there is probably a bad reason for that.  While the results of cosmetic surgery can be life changing and life enhancing do make sure that you proceed with caution and feel good about your decision before going through with anything.


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