-  Do you see more patients for reconstructive purposes such as birth defects, car accidents, burns, and animal bites, etc. Or do you deal more with Aesthetic plastic surgery such as breast implants, liposuction, so on and so forth.

 At the beginning of my career, my exposure to plastic surgery was almost totally reconstructive in nature, but as the years have gone along, I’ve moved into an almost exclusively aesthetic practice – a normal transition for many plastic surgeons who begin their careers in teaching situations.   Early on I worked in teaching institutions and that’s not the type of environment where many patients come for aesthetic surgery.    Conversely, not many patients with complex birth defects, cancers or trauma come to private practices because for many of these cases, a team approach spreading across many specialties provides the most appropriate care.   Also, the more complex reconstructive cases require a hospital setting and 24/7 patient observation – something that‘s doable with a team of residents but difficult for a single individual who has to spend time in an office.  Most private practice, aesthetic surgeons do most of their surgery in a surgery center. 

-  Does the age of patients vary? Do you happen to see more adult patients or teenage patients.

We see and treat newborns to folks well into their 90’s, albeit for different things (and for some similar things, like lacerations).    We see males and females of all ages, but the bulk of my aesthetic practice consists of middle aged women.

-  is there a sense of emotional maturity required in your opinion before being able to take part in such a procedure? 

This is definitely the case with aesthetic surgery.   I never do an aesthetic procedure on someone not mature enough to understand what is transpiring, or on someone who cannot fully consent to the procedure.  For example, we’ll get many parents bringing in a little infant with protruding ears, asking that they be fixed before the child realizes that their ears are not normal or before people start teasing them.   But protruding ears are on the bell curve as  a normal variant and do not have to be fixed – there are many adults with protruding ears not bothered by the deformity and feeling no need to pin their ears back.    Thus, we wait until the child is old enough to be bothered by the condition, until the child tells us that he/she’d like the ears fixed.    This never happens before the child is kindergarten age, but some are not bothered by their ears until they reach teen years or even adulthood – and then that becomes the time to make the correction.   For reconstructive problems like cleft lips and other birth defects, the parent makes the decision and we’ll do the surgery even if the child does not understand or give their approval.   But for aesthetic cases, we only operate on volunteers!

Here’s an example with a 7 year old girl before and a year after I pinned her ears back.  This took attention away from her ears and increased her self confidence.

-  when reshaping and reforming human tissue is necessary, is it important to take proper care of yourself after your surgery to ensure the upmost sucess?

The main thing we make sure all patients do prior to an elective procedure is to avoid aspirin and Advil for a few weeks before surgery because anti inflammatories interfere with the clotting mechanism and more bleeding/bruising would result after their use.  Of course we expect people to be off diet pills and other street drugs, to be sober, and to rest & to follow instructions after surgery.   I don’t think that in generally healthy, North American patients there is any proven benefit to taking additional vitamins or other supplements prior to a procedure.

-   In a society where surgery is very common do you feel that surgery is less of a risk than it used to be?

 Risks decreases with time because doctors become better trained, drugs become safer, monitoring becomes more complex and thorough, and procedures become better with more complex equipment.   But the risk will never be reduced to zero and we make sure all patients have a very good idea of potential risks during the informed consent procedure.  

 -  have you ever had a consultation with a patient, whose condition was so extensive that even surgery could not help? if so what was the condition and why were you unable to operate?

 Just yesterday a patient of mine brought in her 8 mo old son with questions about his skull.   I’m fairly certain he has craniosynostosis but did not see any point in ordering extensive test because craniofacial surgery is not something that should be considered in a private office setting.     I referred the child to a colleague at the UCLA craniofacial service where the child will be evaluated by a team of plastic/neuro/ENT surgeons and a treatment plan devised.  

 -  Has your outlook on what you do changed since you began in your profession?

 As I’ve mentioned, I do different type of work now than I did at the beginning of my career.    Private patients tend to be more grateful and to follow instructions more than some of the folks I saw in a university setting.   But I cannot say that my outlook has changed – I always have done my very best to give patients as good a result as is humanly possible.    And the one thing that has never wavered is my love for my profession.    I consider myself a very lucky person because I’m able to come in every day and do something incredibly intellectually stimulating and just plain fun to do!  I have always loved, and continue to love my job!

 -  Did you become a surgeon to help people deal with serious birth defects or did you come into it thinking you were going to help people who didnt feel comfortable in their own bodies?

The answer to this question is “Neither, really!”    I was never exposed to a plastic surgeon or a plastic surgery rotation during my medical school years at the University of Toronto.    From medical school, I went on to Columbia University to study general surgery for five years (and became Board Certified in general surgery).   During my stay at Columbia, I did get exposed to plastic surgery and plastic surgeons, attended my first postgraduate plastic surgery medical meeting at the University of Michigan at Ann Arbor and decided that plastic surgery was going to become my life’s passion and work.   What really caught my attention, and the part I loved the most about plastic surgery was the head and neck cancer cases I saw – there were a lot more smokers in those days and it was common to see massive resections of the head and neck including tongues, lips, cheeks, jaws, wind and food pipes, along with radical dissections of lymph nodes in the neck.    These procedures were about as complex as one could find in surgery and they fascinated me, as did the reconstructions.   I looked for a program that did many of these types of cases and decided to apply to Harvard University.   Not only did they do many such cases but this program was also a leader in doing very complex, craniofacial cases.    The program director, Professor Joseph Murray was one of the few surgeons in the world to have won a Nobel Prize!   I was very lucky to get accepted into this program because they only took one resident a year!    Well, needless to say, I was in heaven in Boston and when I finished, took a similar job at the University of California San Francisco School of Medicine, teaching and doing similar reconstructive work as a full time faculty member.  As you can see in my resume, I did a lot of research and published a lot of scientific articles and book chapters on reconstructive topics.  I did some aesthetic cases along the way but prior to going into private practice in 1983, my life centered on reconstructive surgery.   

-  have you noticed as time passes different “trends” so to speak on what surgery is the newest best one to have?

Of course!    Just as with clothing, styles change.   Values change.   For example, 20 years ago every question I heard about a buttocks was related to making it smaller – today, with Jennifer Lopez’s influence, some folks actually are interested in making their buttocks larger!    Similarly, new procedures become popular based on technology, the introduction of new equipment and publicity.    As difficult as it is for someone your age to imagine, in 1980 there were no DVD players, lap tops, smart phones, flat screen TV’s – or liposuction!    Liposuction was introduced in the USA in 1981, the technique was not that difficult to master, the equipment was relatively inexpensive – you can imagine the public’s thirst for information about liposuction and the explosion of requests for fat removal.

-  what precautions do you take before you begin on a procedure with a child 18 or younger as opposed to an adult.

A child in their teens is pretty well similar to an adult.    But patients who are very young or very old are frailer and more challenging to the surgeon and anesthesiologist.   With the very old you can imagine that a major concern is the condition of vital organs such as the heart, lungs, kidneys and the liver.    With the very young the main issues are a very small airway and a much smaller total blood volume.   Operating on an average adult, there is little harm from a blood loss of a pint or two.   But a 3 week old with a birth defect cannot lose much more than a few tablespoons before getting into trouble.    Infants with life threatening conditions must be operated upon, preferably at a university or CHOC type of setting.   Whenever the condition is not life threatening and it’s possible to wait, we’d prefer to wait until the child is at least a year old before embarking on elective surgery.

-  do you recommend patients are fully grown before attempting to alter their physical appearances?

The answer to this question depends on the deformity one is trying to correct.   Birth defects such as cleft lips are usually corrected any time after a month of age, cleft palates at a year of age, protruding ears after age five or six, enormously large breasts can be reduced in a girl as young as twelve, large noses after the mid teen years.   But I would never do an elective breast augmentation or liposuction on a girl who has not reached 18, or preferably 20 years of age. 

Infant with cleft lip and a week later – repairing this is reconstructive but you are not going to make the child wait for a repair as sucking and good nourishment is difficult.

Previously we outlined why the face sags as we age – a hereditary process caused by a muscle sagging and dragging the overlying skin downward with it!    Then we discussed what we can do surgically to slow down or reverse these common signs of aging.   Today will be a shorter discussion regarding timing of facial rejuvenation surgery.

When is it appropriate to do something to slow down the aging process?     It is appropriate to do something very important to slow down future aging even during infancy and childhood –that’s something we should be encouraging our children and grandchildren to do, USE SUN BLOCK!    Yes, we should be using sun block as well, even if we personally would never consider surgical rejuvenation, as this decreases our chance of getting skin cancers andslows down the signs of skin aging.   In our opinion, the best sun protection around is afforded by using MD Sun Protection by MD Performance® – call our office if you would like to order some.    Next, it is important, whether or not you decide surgical intervention is in the works for you, to being gentle with your skin (by using one of the MD Performance® cleansers), hydrating your skin with a superb moisturizer and using a high performance product to slow down the aging process (again, we’d recommend our MD Performance® skin care line).   The next step entails using neurotoxins like Botox® and fillers like Juvederm® to minimize facial lines, fill lips and so forth.    Minor peels and laser or intense pulse light (IPL) treatments will probably come next.   But when jowls start becoming visible and the neck starts to sag, the only thing that will improve this situation is a surgical lift!   The question remains, when is it appropriate to do such a lift?    I have two criteria for agreeing to helping a patient surgically, and what surprises many folks is that neither of them has anything to do with the absolute age of a patient.   First and foremost, the patient has to have a desire for improvement and agrees to go ahead with the procedure.    Secondly, the patient has to have enough laxity for me to agree that a surgical procedure will give them enough of an improvement to justify going through the procedure and recovery phase!    I see so many patients, some in their late 30’s, some in their 40’s and even some in their 50’s who show me a little neck laxity when they drop their chin, but don’t have any laxity when their jaws are held straight ahead.  A lift at this point will not give enough improvement to warrant a surgical procedure.   I explain the aging process to these folks and ask them to see me again in a year!    Now let’s say you have sufficient neck laxity and jowl formation to do a procedure now – patients will ask me if they should go ahead or wait a few more years, but I cannot answer that question for them.    The answer all depends on how much the laxity bothers the patient now – if not too much, by all means wait…………but if you are bothered by a correctible deformity, why wait?    Go ahead and do yourself a favor, let yourself look more like you feel!

I’ll give you one final update on Deb next week – but if you are at all interested in facial rejuvenation and would like to see someone in the second week after surgery, do stop by and see her for yourself!

Deobrah 5 days after facelift

In the last two articles I showed photos of Deborah taken on Tuesday, the day prior to her surgery.  Here she is on Monday, March 5th, on the 5th day after her surgery – on the day that she returned to work!      Yes, a little neck bruising but overall, good to go!      

If any questions or would like to explore improving your appearance, please contact the office at 949-888-9700 to set up a complimentary consultation!

Yesterday we outlined why the face sags as we age – a hereditary process caused by a muscle sagging and dragging the overlying skin downward with it!    Today we will discuss what we can do to slow down or reverse these common signs of aging.

Surgical corrections of the aging face/neck can be divided into two basic methods, and in each, there are many variations.   But in general, we can divide these procedures into mini lifts and more traditional lifts.   The minilift category is very popular in these difficult economic times, but unfortunately, the results do not last long.   In this minilift category are many of the light lifts, Life Style lifts and so forth in which, under local anesthesia, frequently performed by a non surgeon in a doctors’ office, the skin is elevated for an inch or so around the ears, the skin pulled back and the excess excised.   There will be a definite improvement, just as you can see an improvement if you put your fingers down by the jaw line and pull backwards (if you have an excess as I do!) – but this approach does not address the problem, the sagging muscles, and unfortunately, within a year, these folks will look very nearly the same as they did before surgery, as the skin sags again due to the downward pull of the muscles!   I cannot tell you how many people we see in our office each week who had one of the minilifts performed very recently, with no perceptible improvement, and now the patients are preparing for a true lift!   In the more traditional lift, the same skin incisions are made but the skin is undermined all the way to the nose, and all the way across in the neck, to give excellent exposure of the underlying muscle.   The muscles are then lifted to where they used to be in your 30’s and the skin is redraped, the excess excised but no tension is placed on the skin closure to make sure we do not leave you with a fake, pulled look!    We’ll show you a few examples in the weeks to follow, after Deborah is healed.   

So by now we’ve covered the problem and the possible solutions – next week we’ll go over when it’s appropriate to do something surgical to slow down the aging process.  

DEBORAH PRE FACELIFT

DEBPRAH 2 DAYS AFTER FACELIFT

Here is a photo of Deborah taken on Tuesday, the day prior to her surgery and Friday, on the second day after her surgery!    Check out that jaw line!    

Don’t forget our seminar, here in our office the evening of March 7th.    We have many of the top medical professionals in Rancho Santa Margarita as speakers, and of course, our spinning wheel and will be giving away many gifts.    We expect this event to fill up quickly.  Deborah will be there, exactly a week after her facelift and you’ll be able to see her in person.    If you’d like to come to the seminar, hopefully with a few friends, or if you have any other questions, please contact the office at 949-888-9700.

Those of you who know Deb will know that she’s a beautiful lady and may wonder why she decided to do this.   This brings up three questions:   why do we show signs of aging, what can we do to slow or reverse these signs of aging, and when should these signs of aging be addressed.   I’ll answer the first question now and the other two in subsequent days as I share more follow up photos of Deborah.

There are two parallel paths that contribute to aging, the first we have control over and the other is totally hereditary.   The skin is an organ and has to be cared for as much as our other organs requre care – if you want nice skin, provide it with good nutrition, don’t smoke or drink to excess, use sun block, don’t stretch the heck out of your skin by gaining too much weight and so forth.    The hereditary part is just that, hereditary, and we cannot do anything to alter that part of the aging process.   As we age, we all tend to resemble one or both of our parents from years earlier.    What causes the hereditary signs of aging in the face is namely a muscle that loses its tone and droops, dragging the overlying skin with it.   This muscle sheet, called a SMAS in the cheek area and the platysma in the neck, is different than any other muscle in our body in that it does not cross a joint and no longer serves a useful function.    Because this muscle is no longer attached to bone, it cannot be exercised into shape.   When it relaxes and starts to droop, it creates very similar signs of aging in all of us, male or female, tall or short, white or black, fat or skinny – but to varying degrees and at different ages.     A youthful person has full upper cheeks and the face slopes downward and inward towards the jaw line.   As the tissues under the skin start to descend, the lower face becomes fuller than the upper part – instead of our face looking pyramid, fullest part facing up, the pyramid wtih age reverses itself and the fullest part now appears at the jaw line and the neck becomes lax.    So this is the nature of the problem – tomorrow we will show you Deborah’s current photos and address the options for slowing down the aging process.    

                                                                                                                                                                                      Here is a photo of Deborah taken on Tuesday, the day prior to her surgery.   Note the loose ning muscle bands in her neck and the fullness in the jowl area.

  Here’s Deb today, 24 hours after her surgery, just as the dressing came off, before we removed the drains (i.e. you can see the ridges under her skin where the drains lie) or even cleaned her up yet.    Deborah had a face and midface lift on Wednesday, February 29th, 2012.

We are having an event in our office the evening of March 7th.    We have as speakers many of the top medical professionals in Rancho Santa Margarita.    We expect this event to fill up quickly.  Deborah will be there, exactly a week after her facelift and you’ll be able to see her in person.    If you’d like to come to the seminar, hopefully with a few friends, or if you have any other questions, please contact the office at 949-888-9700.

Water Boosting Foam Cleanser is appropriate for all skin types

-          Deeply cleans pores, leaving skin fresh and comfortable

-          Luxuriously rich, soap-free gel containing Panthenol (a moisture-protecting skin hydrator) and Allantoin (a soothing agent originally derived from the comfrey root)

A New Year’s resolution is a goal to be reached that year, a commitment a person makes to one or more lasting personal goals, projects, or to drop a bad habit.   To be effective, this goal should become a blueprint for your actions in the coming year.   Much research has been done on New Year’s resolutions and here are the top ten that people strive for, year after year:

1)      Weight loss!   Some 60% of US adults are overweight and losing weight is the number one resolution that people make, year after year.  Do something about it this year – come and hear how Lindora can help!

2)      Improve fitness levels, improve overall health and look fabulous.   This is where your gym, Orange County Plastic Surgery and Unique Tans can help you – come and learn more!

3)      To drink less alcohol or, for the sake of one’s health, to stop drinking completely.   Alcohol has been with mankind since the beginning of time.  A glass of wine with dinner will certainly not hurt anyone, but if you’re drinking more, maybe you should revisit this habit.

4)      To spend more time with family and friends.   Isn’t it amazing how quickly the children grew up to become fine young adults?   Seeing them just on holidays is not enough!

5)      To enjoy life more – to slow down, to smell the roses.  As we get older, we realize how quickly life is passing us by.  Are we enjoying the privilege of being on this earth to its fullest?

6)      To learn something new – how about learning a new language at Saddleback College or getting a pilot’s license? 

7)      To get out of debt – certainly something desirable that this last economic downturn taught many of us!

8)      Help others more.   We are so proud of our friends, Megan Lazar and Steve Jarman, who collect clothes and blankets all year and donate them to the homeless in Santa Ana each Christmas, a charity they started and maintain themselves!   How about helping them out, or starting your own version of a charity?

9)      Get better organized.    This was a more common desire before personal computers.  But definitely worth being more organized, especially as tax time approaches.

10)  Stop smoking!   A large percentage of smokers who quit every year begin their conquest of this bad habit on New Year’s Eve – go for it and do your health a big favor!

Lindora is considered America’s leading medical weight management provider.    I am certain that Lindora’s Chairwoman, Cynthia Stamper Graff, author of the best seller “Lean for Life”, will have a few copies of her book to give away!   This will be your first chance to come and hear about Lindora’s fabulous programs during one of our events.   Sherry Meredith from Unique Tans will also be present and show you how you can get that tanned look without using harmful UV rays – and Sherry usually gives away a few of her spray on tans as well.  Anne Floerchinger, our talented medical aesthetician, will be giving an overview of our MD Performance Professional Skin Care® line of products.   Tracey Prescott, our brilliant injection and laser specialist will be going over her contributions to our practice and let you know what you can do to improve your appearance in a minimally invasive way.   And of course, I’ll go over the newest and the greatest in plastic surgery.   

 The Fairmont always puts on a very nice dinner for us and the staff is very accommodating – we are looking forward to seeing you at our first special event of 2012.    Make your New Year’s resolution to look and feel better and to be healthier!    We expect this event to fill up quickly.    If you’d like to come to the seminar, hopefully with a few friends, or if you have any other questions, please contact the office at 949-888-9700.

I Googled the first ten pages for the search term “PIP implants USA” and read through numerous articles outlining the problems with PIP implants, which I’ll summarize in the next paragraph, and blogs and articles stating problems abroad but claiming that PIP implants were not sold in the United States! On page 7 there was an article on a site called Ripoff Review, Report: #57145, dated May 15, 2003 in which a lady from Texas complained that her saline implant ruptured 18 months after insertion and that PIP had not honored the warranty because they were no longer around. But surprisingly, there was no other mention of PIP’s being sold in the USA, just article after article about PIP implant troubles in other countries in the world – 30,000 women in France have PIP implants in place, 50,000 in the UK, 25,000 in Columbia, similar numbers in Venezuela, Germany and Australia, 4,300 pairs in Italy, and so forth, 400,000 women overall, but nowhere could I find a reference to how many were inserted in the United States.

What’s the issue with PIP implants? Reuter’s news agency has quoted the PIP lawyer, Yves Haddad, earlier this month as admitting that most of the prostheses sold by PIP since 1991 were produced using an industrial grade silicone that was not approved by health authorities, a silicone that was not intended for implantation – a silicone that was designed for use in mattresses! And this was done by the company founder for financial reasons, industrial grade silicone costs about a fifth as much as medical grade silicone! Haddad stated that PIP did manufacture a “high end”, medical grade silicone implant for use “by higher end clients” but nowhere could I find which of these implants was sold in the USA. The French government has come out and stated that there is no higher risk of developing breast cancer in women with PIP implants, but did say that the industrial grade silicone was more irritating to tissues once the implants ruptured and have recommended that all women with such implants have them replaced with current, approved implants. France is covering the cost of removing such implants but the patients will be responsible for replacement costs if they chose to have another implant inserted. Italy and Venezuela have offered similar plans to remove the implants at the government health care system’s expense, while not paying for replacement surgery. Germany and the UK have suggested that patients with PIP implants see their surgeons and make an individual decision regarding the advisability of removing and replacing the implants but will not cover costs through insurance or government health plans.

So what does Orange County Plastic Surgery recommend? First of all, all implant patients should replace their implants if they are 20 years old. The inside of the scar tissue surrounding a breast implant will calcify over time. These calcifications not only make cancer detection more difficult, but the roughened surface invariably cause the implant shell to rupture with time! For your peace of mind, a ruptured implant containing medical grade silicone has not been shown to lead to any increased incidence of any diseases but the liquid silicone can cause a local tissue reaction and the creation of a mass that, by mammogram or physical exam, cannot be differentiated from a cancer (without removing the lump and having a pathologist examine it). We should note that the implants we use today have a cohesive gel, the consistency of a gummy bear candy, and this gel will not run or leak after a rupture, a big advance over any kind of gel implants from the 80’s or 90’s. We recommend any patient who knows that they have a PIP implant in place replace it as soon as convenient. Reports I read online suggest that the industrial grade silicone is very irritating to local tissues and a massive inflammatory reaction, formation of many masses, and so forth can result! So if you have a PIP implant from that era, or are not sure of your implant manufacturer and your implants were inserted during the 1990’s or early 2000’s, may I suggest that you get the implants replaced. We do not have the resources that France has but I would like to help the unfortunate ladies who may have a PIP implant in place and for the next three months, will offer to remove any patient’s breast implants from that era without charging our usual professional fee! As in France and other places that insurance or the government is covering the cost of the removal, you will have to pay for insertion of new implants if you chose to do so. You will also be responsible for the cost of lab work, the surgery center and the anesthesiologist’s fees, things that are independent of our office and not under our control. So if you have any concerns about your implants, do call to set up a complimentary consultation (949-888-9700 or toll free 888-822-6277).

Photo above shows a ruptured implant from the above mentioned era being removed – note the liquid gel exuding from an opening in the scar tissue surrounding the ruptured implant.  The next photo is of the same scar tissue, turned inside out, after the implant was removed and the liquid silicone washed off.  Note the sharp calcifications along the upper third of the capsular lining – this 20+ year old implant did not have a chance of not rupturing.

This is a time of giving and, often, overindulging! Whether we are talking about drinking alcohol, eating rich foods or buying presents, the best advice I can give you is to do everything in moderation! Make some good New Year’s resolutions to eat well, exercise, enjoy and show love to your families and your friends. About a year ago, Anne Floerchinger, our fabulous Orange County Plastic Surgery medical aesthetician, made a pledge to improve her health and this decision has resulted in a tremendous success story that could serve as motivation to some of you! I’d like to share Anne’s story with you.

Anne was born in England. Anne attended London’s prestigious Barrett College for two years, studying skin care. At age 21 she move to the United States and continued what has turned out to be a 50+ year dedication to skin care. She served as Helena Rubinstein’s training director for beauty consultants in the United States. She studied skin care at Purdue University in Indiana for four additional years. She served on the Education and Cancer Committees for the state of Indiana and spent many years training aestheticians. 15 years ago, when husband Gary retired, they decided to move to Orange County to be closer to her daughter’s family. She worked in Rancho Santa Margarita at Skintique for a number of years. I first met Anne ten years ago. Anne came to us for a facelift/brow lift/blepharoplasty – this is Anne’s photo at age 62 before she had her lift and the second photo was taken 8 years later when she turned 70! Needless to say, doing a facelift on someone heavy, with a lot of stretched skin, is a technical challenge. But Anne did look better after her lift and was pleased with her results.

Shortly after I did Anne’s facelift, we had an opening at our office and I offered Anne the position of our medical aesthetician. For the past ten years, we have been blessed to have Anne’s knowledge and skillful hands available for our patients. But this is where the story gets really good! Anne knew that she was overweight and not doing her overall health any favors. A year ago, Anne made a commitment to improving her health! She knew from past experiences how difficult loosing weight could be and decided to seek professional help. After much research, she found this help at the local Lindora office. Lindora is a controlled weight loss program run by medical professionals. The nurses at Lindora taught Anne to count her carbs and to limit carbohydrate intake. She checked in at Lindora weekly for an initial 10 week program, was weighed and counseled. Her ketones were checked to make sure she was in a fat burning mode. She received B6 and B12 shots from the nurses at Lindora. She started going to a gym once a week and walked 20 min daily. Nothing dramatic at first but Anne did lose 35 pounds in those initial 10 weeks! Instead of calling it quits, Ann signed up for another 10 week program and has kept working with Lindora – to the point where today she has shed a total of 75 pounds! But as with all significant weight loss, loose skin is left as a reminder of the prior self! Anne is on the schedule for a little tightening here and there in 2012! Congratulations, Anne for sharing your success story.

Since seeing Anne succeed so amazingly in such a short time, I decided to explore more about Lindora. Lindora is considered America’s leading medical weight management provider. Lindora is a local company with headquarters in Costa Mesa. I have spoken to the Lindora Chairwoman, Cynthia Stamper Graff, author of the best seller “Lean for Life”, and am pleased to announce that we have decided to participate together in our first event of 2012 together at the Fairmont Hotel in Newport Beach on January 26th. As usual, we will have a number of talented speakers and give away many fabulous prizes, including Sherry Meredith from Unique Tans. This will be your first chance to come and hear about Lindora’s fabulous programs during one of our events. The Fairmont always puts on a very nice dinner for us and the staff is very accommodating – we are looking forward to seeing you at our first special event of 2012. Make your New Year’s resolution to look and feel better and to be healthier! We expect this event to fill up quickly. If you’d like to come to the seminar, or if you have any other questions, please contact the office at 949-888-9700.

During this past year, my lovely wife, Tina, launched a new company and a new skin care line, MD Performance Professional Skin Care®. It has been pleasing to watch the line grow, to see sales increase and now, the last few months, to see our line featured in a number of magazines (like the November 2011 issue of Dermascope!) It has taken forever and a day to get our brochures done but they are now completed and look great! Hopefully, the MD Performance web site will be finished before the Christmas Holiday! 2012 promises to bring us much more interesting and good news about MD Performance®, so stay tuned!

This has been an interesting year for me. About a year ago, I received a phone call, asking me if I would consider becoming the Honorary Consul for the Republic of Latvia here in the Southwest. I consented, made a trip to the embassy in Washington right after Thanksgiving and to Riga, Latvia in March to visit the foreign ministry. While in Riga, I spent a few days teaching at the main medical school, Stradins Medical School. This was followed by a visit to Orange County by the Prime Minister of Latvia with a large delegation in July, the official opening of the consulate there, and a whirl wind few days spent with diplomats, politicians and the Secret Service! Since that time, I have been amazed by how many calls and letters I get as the Consul, and how many events we get invited to attend! In the last week alone, we have been to the Japanese Consulate in Los Angeles for the inauguration of a new consul and to celebrate the Emperor’s Birthday, to San Diego to celebrate the 60th anniversary of the founding of the Latvian Lutheran Congregation there as well as Independence Day, and in Los Angeles to celebrate Latvia’s Independence Day! I did say “we” because my wife Tina comes to all consular events with me – does that make the long drives to LA or San Diego more pleasant! Next July, we will be traveling to Riga and bringing a trade delegation from the United States…………..so it never seems to end!

On a personal note, all four of our children are employed, all four of our elderly parents as well as all of our brothers and sisters were able to make it down for our son, Justin’s wedding this fall. We all thank God for our good health and our families! We look forward to a good year and wish all of you the same!

It’s never to late to start to plan for the Christmas Holidays – our annual Christmas Soirée will take place here at the RSM office on December 6th and we hope you can make it.

I hope you are all enjoying a great summer!

I will keep this one very brief.

A friend of mine, movie producer Robert Kline, is organizing the West Coast Film Festival in San Juan Capistrano this month, in conjunction with Warner Bros Studios and Lionsgate. On his behalf, I’d like to invite you to enjoy this So Cal gem and attend the festival. The August 21st opening night film is Casablanca–a legendary love story with themes of patriotism and heroism against oppressive forces. It is the face of Warner Bros. and is being presented by Warner’s for the premiere. We would appreciate it very much if you would attend and support the presentation of this iconic classic film. Below you will find West Coast Film Festival’s one sheet for an introductory overview. Please visit www.westcoastfilmfest.com for a complete picture and regencymovies.com to purchase tickets online at San Juan Capistrano Regency Theatre or at the box office. Hurray, tickets won’t last! The San Juan Capistrano Theatre with Rick’s Cafe upstairs depicts the film, Casablanca’s Rick’s Cafe. We would greatly appreciate your support for the inaugural West Coast Film Festival from August 21-25, 2011.

My wife Tina and I will be there, see you there!

Our line includes four different cleansers for different skin types, four different high performance moisturizers, eight different high performance anti-aging products, a product to help control acne, a silicone based scar formula, a high performance sun block and three prescription only products.   A number of the products are also packaged in 1 ounce (30 ml) travel sizes which can be brought aboard airplanes in carryon luggage.   We are currently working on a men’s line and hope to come out with those products by the end of this year.     In subsequent articles, I will describe each of the products in detail.

In February of this year, the company MD Performance Inc. was born and the first products arrived.   The products were initially sold through our practice, Orange County Plastic Surgery, and were very well received!    We are now branching out, selling our products at various spas, though independent sales representatives and even exploring opportunities abroad.   Angela O’Mara and Giles Raines have been chosen to handle the domestic sales representative – anyone interested in this business opportunity should contact Angela or Giles directly at (949) 760-1522.

Our web site, www.mdperformance.com is currently under construction but will contain a wealth of information about our products and company – and training videos for the sales representatives.  Learn more about Orange County Plastic Surgery and our skin care line, MD Performance Professional Skin Care ™ by following us on Facebook or Twitter.

www.facebook.com/OCPlasticSurgery

www.facebook.com/mdperformance   

www.twitter.com/OCPS