Posted on by

LASIK isn’t as straight-forward as it may seem. There are several practices out there that offer all sorts of deals. The bottom line is that you don’t want to bargain with your vision. Furthermore, $299 an eye usually turns into much more. Most of these offers are for a very small population of patients, and it’s NEVER for laser-based surgery. It’s a bait-and-switch technique of marketing that gets our bargain driven society in the door. And once you’re there, supposing you’re a candidate for LASIK surgery (with a blade), the sales associates will push for an up-sale to IntraLase (laser) surgery, hereafter “iLASIK,” because of the extreme amount of complications associated with using a blade on the eye. Remember the discussion of “halos” from the 90’s? You get what you pay for.

Dr. C at machine

Dr. Coad with an iLASIK Patient

In reality, you’re not likely to get iLASIK anywhere for cheap. It’s going to run anywhere from $3500 to $5500. The money you spend directly relates to the expertise and individual attention you will receive from your Ophthalmologist. With lower-end pricing, it’s very possible that you’ll be receiving your operation from someone very inexperienced. There are some places that will offer iLASIK with an experienced surgeon in the mid-range pricing, but much of the time you probably won’t get to meet that person for more than a few minutes right before the procedure. Before that point, you’re likely to talk to at least one Sales Coordinator, one Surgical Coordinator, and one Optometrist – none of whom are likely to have anything to do with your procedure. It’s scary to entrust the only two eyes you have to such a changing cast of characters. In many of these cases, it’s also very hard to get someone on the phone if you’re running into any difficulties after the procedure (or just have a simple question), and it’s unlikely that you’ll be able to talk to the doctor that worked on your eyes.

It’s really not that much more of an investment to go ahead and spend the money to put yourself in the right hands. We do our best to cater to our patients’ pocketbooks; however, it is important to keep in mind that with a half-million dollar machine, the price point is going to be high. We have the most up-to-date technology, and you meet with the two people who are going to see you through treatment from beginning to end. I have been performing LASIK since its inception and am well versed in all of the latest technology and techniques. Christine is a Certified Ophthalmic Assistant, who has been in the field for the last fifteen years. We both see patients along every step of the way.

We offer CustomVue with all laser eye surgeries. That means that every procedure is customized to use your own eye scan to correct your prescription and address your unique imperfections. Some other practices will offer this service for an add-on fee; however, laser eye surgery is not one-size-fits-all, and we would never bargain with your vision. We also give the same attention to PRK patients who are not candidates for iLASIK (if their corneas are too thin). There is a much longer recovery period for PRK, and you deserve to have your doctor available at every step along the way.

We also give a full examination at your first complimentary consultation. It’s important for someone to be a very good candidate. That’s our main concern. We want to have happy patients. A good candidate is someone that has good corneal thickness, good surface maps of the eye, no real dryness, and is correctable to 20/20 in both eyes. All of this is determined on the first day at Chelsea Eye.

Some other practices do not perform a full evaluation the first day, so patients may not find out until their second or third visit if they are good candidates for LASIK. By then, they’ve likely already paid money down on a procedure that they may never get back. Additionally, they may need a different procedure such as Visian ICL, in which a lens is implanted into the eye to correct vision. That’s a much higher price point. What’s worse is that sometimes patients are never told if they’re not good candidates for LASIK. Some people are not correctable to 20/20 in both eyes. There may be a problem with their eye health that gets in the way. Too frequently, we hear stories that someone didn’t know that they’d only be able to get to 20/30 in one eye.

It’s important for us to be up front and to set realistic expectations with our patients. I should also note that there has been some recent talk about a new approach called “SMILE LASIK,” especially in Europe, but it’s not yet been sufficiently tested and is not FDA Approved. We would never gamble with a patient’s vision. We only perform the best procedures and only do our best work. LASIK is still the best investment you can make in yourself – as long as you choose wisely.

- Christopher Coad, MD, FACS, Surgical Director of Eye Care at Chelsea Eye

Posted on by

Growing Your Biceps, Triceps, & Buttocks

Traditionally, there have been no good body fillers. Butt implants, calf implants, and bicep implants look unnatural and require major surgery. They almost always have to be removed, get encapsulated or infected, are very expensive, and tend to look overly dramatic (much like with facial implants). Growing Biceps

That’s why I found it necessary to pioneer this “off-label” usage of Sculptra, which is different because is based on the material used for medical sutures that trigger a healing response when they dissolve. During the initial FDA Clinical trials 15 years ago, doctors found that this material could be used to create volume in the face by stimulating collagen to treat Facial Wasting in AIDS patients.  Unlike silicone (which lasts permanently), the actual Sculptra product is absorbed by the body. In addition, because it’s your own collagen that is grown, it’s totally natural, and diminishes slowly over time. Treatment is considered to be “semi-permanent”. To maintain the results, usually a yearly treatment is required because it doesn’t stop the aging process. Maintenance can be accomplished with Sculptra or with other products; Sculptra doesn’t preclude the use of any other fillers or devices if you desire a greater change or require other treatments moving forward.

As our techniques have been refined, Sculptra has proven very useful. It can be used to lift, shape, and volumize the face, to improve skin tone and texture, to smooth fine wrinkles, to create a tightening effect, and even to address bone loss from the aging process. That’s what makes it such a top product. All of these things can be achieved with other products, but usually only in combination: a laser to tighten, a filler to give volume, and surgery to lift. Here, in one product and with the right technique, we’re often able to accomplish things that may otherwise require several different procedures to accomplish.

When we started using Sculptra in the face, one limiting factor to using it elsewhere was the high cost of product. I had always thought that in the buttocks you would need a lot of product to get it to work. What we learned in the face, though, was that the location of injection really can maximize the results. With the buttocks, we don’t really need to inject the entire area because the aging process creates a drooping effect, rather than a smaller booty. We can do what we do in the face, which is to inject the upper part to lift and shape the buttocks. This makes it affordable for the patient. So, in the face where you might standardly use two vials for a treatment, in the buttocks we use three or four vials – but because the buttocks treatment technique is faster and less complicated, the cost can be the same for the patient. Less product is usually needed for arms, biceps, calves, and other areas.

The important thing to keep in mind is that this treatment isn’t designed for emaciated or overweight people. It’s for the in-betweeners that have good body shape already but want a little help. You need the underlying muscle to augment in order to get a nice aesthetic result. It’s difficult to take a flabby arm and create a bicep. This treatment is for people who have some definition, but have thin arms or legs and want bigger muscles. It’s also for people who are getting older, whose pants are starting to sag, and who want a little bit of a lift and that appearance of a “shelf.” If you really want a big butt and you have no butt, you need a butt implant or you need fat transfer. If you are overweight, you need liposuction or abdominoplasty. It’s for everyday people who want to cheat the gym a bit yet want that sexy body without all the effort.

Posted on by

Plastic surgery has changed immensely over the last two decades from new surgical techniques to non-surgical options that reduce the need for surgery.  Once thought of as the surgery for socialites (mainly women), today, men are increasingly undergoing cosmetic procedures to enhance appearance, combat the effects of aging and improve chances for employment in competitive job markets.  As 50 becomes the new 40 (and 40 becomes the new 30), men are living longer, exercising more,  eating healthier and starting early with minimally invasive procedures.  Instead of the extreme facelifts of the 80s, men are opting for a more natural, youthful appearance.  Now, the idea is to avoid surgery.  Over the last ten years, cosmetic treatments have become increasingly more affordable with the popularity of procedures that do not require anesthesia or lengthy hospital stays.  Downtime and time off from work has also decreased considerably.

Joker-Jack-NicholsonWhen it comes to facial treatments, non-surgical options have really come into their own in the last decade. Botox and Dysport are now indispensable tools in a cosmetic surgeon’s arsenal when it comes to rejuvenating the upper faces without lifting a scalpel. Dermal fillers like Restylane, Juvederm, Radiesse, and Sculptra work anti-aging wonders, lifting the face, filling in fine lines and wrinkles and giving the face volume while still preserving a natural look.

Devices represent another area of aesthetic medicine that has advanced by leaps and bounds. While CO2 lasers were the gold standard, fractionated lasers, IPL (intense pulse light therapy), ultrasound, and Radiofrequency technologies have now developed to the point where many are effective at skin tightening and lifting with less downtime than aggressive surface (laser) treatments.

Now and going forward, more advanced surgeons will use their training in anatomy, their understanding of the aging process and facial beauty, and their technical skills to perform less surgery and more minimally-invasive procedures and combination treatments. We are becoming “wellness doctors” who partner with our patients so that they look good at every age.

Posted on by

More and more people are starting earlier to have treatments. Part of it has to do with the entire society being more youth-driven. A recent article in The New York Times and Worth Magazine cited a big spike in men’s cosmetic procedures in Silicon Valley and in places with several high-tech businesses. This is particularly true of men in their 30s and 40s (and sometimes even 20s), who are have procedures in order to look young and be more competitive in the workforce. The New Businessmen

There is a definite feeling that young people in the tech industry are sharper, brighter, more creative, and think outside the box. People who are older find it professionally necessary to hide their ages as a way to keep people thinking that they are young and fresh. This is one of the most interesting trends in the last couple of years, and certainly we’ve seen it in our practice especially in tech, but also in the stock market and other areas of business.

There’s also much more of a trend for all people to start early. We know that Botox relaxes and retrains muscle, preventing wrinkles. More and more people are interested not only in preventative health care in terms of medical issues, but also in preventing the signs of aging. Many people are starting earlier, when for example their eyes are just starting to look tired. Much of the time, they don’t want or need to look younger. A little filler under their eyes can help them to look fresh, healthy, and on their game.

Cosmetic Procedures have long been par for the course with socialites, women, and even gay men in theatre, media, and fashion, but straight men are quickly catching up. Many of the patients I see are less concerned about beauty, but more concerned about competitiveness and vitality. It’s not uncommon for someone to tell me that they never thought they would be doing something cosmetic or vain, but that they are starting to see these treatments as more similar to going to the gym. They are maintaining their bodies, their health, and their appearance. Starting early and taking preventative measures means that they’ll never need to do anything drastic to themselves like surgery.

Posted on by

Thanks for visiting. I know there are a lot of questions out there about ThermiRF,  the latest micro-invasive technology that uses Radio Frequency energy to treat skin laxity, tighten soft tissue, and melt fat in all areas of the body. It can also be used to treat fine lines, wrinkles, and even hyperhidrosis! The results are especially dramatic in the neck and jawline. Please check out our recent video that explains this cutting-edge procedure, now being offered at Chelsea Cosmetic!

 Click here to schedule your free consultation today!

 

ThermiTight is the first aesthetic procedure, which delivers controlled thermal energy under the skin to reverse the effects of aging. ThermiTight is FDA approved and is ideal for patients who want more results than non-invasive procedures can deliver and DO NOT want surgery. It’s great for problem areas of the face, neck, tummy and thighs. Patients should expect to come in for a treatment on Thursday and return to work on Monday. Results can be seen in as little as 1 month and should continue to improve for 6-8 months. Great for non-invasive neck and jawline lift!

ThermiSmooth is an FDA approved, non-invasive procedure for improving the appearance of aging skin through tightening and increasing collagen production over a period of time. It uses a unique hand piece to deliver targeted heating to the surface of the skin. There is little to no downtime. Patients can expect to see results in as little as 1 month and should continue to improve for 6-8 months. Most patients require 3-6 treatments to achieve significant reduction of lines and skin tightening. ThermiSmooth is most effective for treating the area around the eyes, crow’s feet, and crepey skin under the eyes. We also use it to tighten skin in the upper eyelid for patients who don’t need or want surgery. It also works well for fine lines around the mouth. Great for non-invasive upper-eyelid skin tightening!

ThermiRase is the newest FDA approved advancement in tissue tightening through nerve ablation. This device targets areas with precision and with safety with less adverse effects or complications than Botox or Dysport. Only local anesthesia is required for most people. This technique is used to treat glabellar frown lines and have lasting results of 18-24 months. Patients should expect to see immediate results. This is for patients who want some of the results of Botox without the toxin.

ThermiDry uses the same technology as ThermiRase to address hyperhidrosis. This procedure is perfect for those suffering from embarrassing excessive armpit sweating and want a toxin-free, minimally-invasive alternative to Botox or Dysport. Results are immediate and can last anywhere from 18-24 months. Patients have been thrilled with this treatment.

 Click here to schedule your free consultation today!

Posted on by

Ten years ago, I was a principal investigator in FDA clinical trials for both Radiesse and Sculptra to treat patients with facial lipoatrophy, related to HIV and AIDS medications. Many of these patients were doing well, but they had wasted and sagging faces that made them look like they were on Death’s door. Treating these patients was the most gratifying part of my day. We were able to turn around their lives. Today, most of them are still in my care, now working, raising families, in love with others, with themselves, and with life itself.

This experience made me want to take this idea to the next level and create “Lives Fulfilled”: a program that will target a variety of patients with medical conditions that might benefit from improving the way they look. Most of these people cannot afford cosmetic treatment, so it’s a way for me to give back and help out in that way with something that I enjoy doing – rather than just writing a check.

Recently, we’ve partnered with Merz Aesthetics and Victim2Vixen to help cancer survivors get back on their feet, so that they can get back to work and socialize again. Our first patient was Victim2Vixen founder, Anne Dragovcic. Please take a minute to check out her transformational video.

Posted on by

DrEviatarConsult3

I’m seeing exciting changes in the world of facial rejuvenation. Surgery is just too simplified to address all of the issues that are involved in aging. Contrary to popular belief, skin isn’t the only thing that shows our age. In order to get a true fresh look, the soft tissue and bone structure also need to be addressed. Furthermore, we don’t have time or money to deal a week-long recovery period – and no one wants to look like they’ve had something “done”.

What I do now is largely non-surgical, thanks to advances in technology and the development of injectable fillers, muscle-relaxers, and devices. I pride myself in taking the time to customize treatments for each patient, using a mix of products to achieve the best results. This is an important shift in the way we view Aesthetic Medicine and Procedures.

Ultimately, there is no cookie-cutter usage for cosmetic products or procedures – though many doctors will do whatever their patients ask for (regardless of whether the results are lasting and natural-looking). There are lots of bargain treatments out there that may not be the safest. Unfortunately, these issues come up far too frequently. In this constantly evolving market, patients need a place to educate themselves.

This blog will introduce a few concepts, such as:

  • Why Many People Start Early to Look Better, Not Just Younger
  • How Our Youth and Beauty Oriented Culture Affects Aesthetic Medicine
  • Cost Benefits of Non-Invasive Treatments – and Why Some Cost More than Others
  • What Fillers, Muscle-Relaxers, Laser Treatments, and Devices Actually Do – and their Differences
  • Wading Through Product Advertisements to Find the Right Doctor and Treatment
  • How to Maintain Results to Keep You Looking Your Best

This site is a place where people can come to see other people dealing with similar things and relate. I plan to highlight different body areas and cosmetic concerns, giving examples of how we treat patients with various issues. Perhaps that will take some of the fear and mystery out of cosmetic procedures. But primarily, this blog is dedicated to providing real information so patients can ask the right questions and make better decisions.