My Resolution of Self-Acceptance

My Resolution of Self-Acceptance


Thanks to all of you who expressed missing my blog and where did I go? Some of you know that I’m working on a major writing project that takes up much of my precious writing time. But, I am appreciative to those of you asking me to resume my blog, so here we go. Well, it’s another new year and time for resolutions.  I have a suggestion: how about a resolution of self-acceptance and, here we go, self-love.

Resolutions come from a place within us that awakens our inner critic. We’re too fat because we don’t eat right or exercise. We are morons who can’t spend our money correctly. We can’t succeed at x because we are not y. Get my point? Especially, the more “Type A” we are the more geared we are to critique those around us, and, most all, ourselves.  Also, these are downer times where many people are feeling anxiety and uncertainty about the future.

We all have our chosen successes and failures in our lives. Whether it’s a daily routine or a goal that we feel we must achieve but haven’t, we tend to focus on “failures” hence our society’s omnipotent and highly popular resolution concept. Sometimes failures are highlighted because people around us love to focus on and gossip about these things……especially, in the competitive milieu. What self-acceptance/self-love do is not make us lazy and say to hell with it, this is the way it is. Rather, instead of negative thoughts, self-acceptance brings on the energy of focusing on the good about ourselves and then, if there’s something we want to change approach our inner critic with the “ by the way, there’s something I’d like to improve upon and let’s give it a whirl” attitude. My best example that I can think of comes from sports. We all have favorite teams and athletes. There are times, for example, that I watch Derrick Rose (Chicago Bulls MVPx3) who is amazing most of the time. However, even Derrick misses a key lay up or free throw that costs the team a game. I’m sure he, his teammates and coach (Oh! And let’s not forget the people who bet on the game, the team owner and manager and the whole state of IL) slam him.  Outside of his not playing a game this season because of his ACL issue, does he throw in the towel? NO!!!! He knows he’s good, we know he’s good and he just goes back and tries his best.

My closing thought to you is to be kind to yourself. Life is hard, but guess what? We’re all in this together and if we’re kind to self and accept self, collectively, we’re kind and accept each other


The Meaning of a Scar: Part II

…, just in brief review from where I left you last week, a scar is a braid-like protein (put on you 3-D glasses) that actively remodels itself during the healing process. The first couple of months this process is extremely active, for six months active and then for the first year still can change. Often tie, during the first two months, scar gets raised and pink-red because of normal biology, but after a few months the scar softens, flattens and fades whether or not you do anything. Over a year to two-year time frame, scar continues to fade, etc.

There are several modalities that you can use to minimize or even help the scarring process. These suggestions are mine and are based on science, research and practical experience from patient interaction and productive feedback. And, I like to keep things simple because simple works.

  1. Massage. Love massage and here’s where I get the two-thumbs up from my OT/PT friends. Remember the braid-like structure that continually remodels itself? Massage with even pressure over the scar breaks-up the braid and softens not only the exterior but also the bump or knot under the scar. You have seen pressure reducing tactics for scar reduction in burn patients where those individuals are fitted with special pressurized garments to keep scars flat. Though these are garments or devices, massage works as a pressurized gradient to soften scar.
  2. Oils or Lotions. For me, these serve as lubricants for intervention #1. Remember, I am not a commercial but I’ll give you some brief notes. Vitamin E oil got some bad press but I must say that many patients that “pop” the shell of a Vitamin E capsule to use the oil have some great looking scars. If one has redness or bumps from the Vitamin E then one is sensitive or allergic to that substance….so don’t use it. Mederma’s active ingredient is an onion extract. Its main action is to exfoliate, and, yes, I do think it helps. Because of its popularity, people use it even if they or their child develop redness, bumps or wound breakdown. Just as with Vitamin E oil, this type of reaction is an allergic or sensitivity reaction… don’t use it. People want Mederma to work so much to erase the scar that these symptoms are ignored and scar worsens. An allergic reaction is an allergic reaction and can be seen with any skin preparation.
  3. Scar Sheets. There are some that work and some that don’t. Silicone sheeting has been around for a long time, and the theory is that it changes the environment of collagen cross-linking. I do recommend certain types. Most of the OT/PT grades are phenomenal.
  4. YOU MUST WEAR YOUR SUNSCREEN SPF25 or higher and reapply it even if it says waterproof or sweat proof. Not only can the sun aesthetically affect the scar, but also can burn the scar and surrounding tissue since these are zones of inflammation and healing.

Scars symbolize an event, issue or, you might even call it, an imperfection. I was going to get more philosophical but I’m already over 500 words…maybe another time. For me, when I look at my scar, I am reminded of my mother’s unconditional love and a love that only a mother can possess and understand. Though my father is gone, his handiwork remains on my forehead, and I see his beautiful face smiling down at me with love and concern. None of us get through life without scars. What people may call imperfection; I call life and treat it with care, just like a scar. That’s what makes us human.


What exactly is cellulite? Cellulite is that dimpled skin look often seen on thighs, hips, buttocks and abdomen. Rather than smooth skin or even skin laxity, the skin appears irregular with an “orange peel” look. You can see cellulite on under perfect, or overweight bodies. Think layers as I take you simplified anatomy. From superficial to deep, there’s skin, subcutaneous fat, fascia, muscle, and bone. The skin, itself, ha two layers: epidermis and dermis. Epidermis is seen as the outer layer of your skin, and dermis is the underlying white layer seen when you get a deep cut. Running throughout these layers are connective tissue fibers, blood vessels, lymphatics and nerves. If we didn’t have the connective tissue component, our skin and underlying structures would move at different times rather than the nice, coordinated movement that we, for the most part, witness. Cellulite occurs with subcutaneous fat herniation (def.poking through where it shouldn’t)through the small connective tissue fibers attaching to the skins under-surface. Fat attached to the dermis pulling it into the dimple configuration. This can be a little difficult to conceptualize, and, frankly speaking, if I didn’t cut through these layers as many times as I have, I would have trouble picturing cellulite vs. non-cellulite. So, go easy on yourself if you have to read this a few times…put your mind’s eye on 3-D mode. Most of us plastic surgeons who perform a lot of bodywork can readily picture this deformity, as we call it in our lingo (certainly does not mean you are deformed) because we cut through these layers and see it. Interestingly enough, which goes with my recurring point that we are living creatures, cellulite is hard to see in cadavers because it happens in living tissue.

There are many theories concerning the cause of cellulite but genetics, hormones, diet and even tight garments are common culprits. Activities that increase blood flow to these areas improve the condition. Exercise, yoga, or walking instead of taking the elevator is such activity. Massage works by not only increasing blood flow but also by detaching the adhered fat from the dermis. Lymphatic massage, as well, stimulates lymphatic flow ridding the body of toxins. There are a vast collection of lasers and gadgets that generally work by the same mechanism of inducing vasodilation. They can do this either through heat production or mechanical stimulation. The appearance of cellulite may improve but it really depends on the severity of cellulite, number of treatments, and mode of delivery. Usually, none of these treatments leads to a permanent change. Regular use of lotions or creams always helps skin, if anything, improve overall appearance. Whether the active ingredient actually results in decreased cellulite content is a good question. I, personally, have not seen any NIH study that proves cause and effect with any cellulite combating chemical. And, then there is always what I call the looking good basics…..eating nutritious food, drinking lots of water and remembering to breathe. All good, inexpensive ways to rid our body of harmful toxins.

I Love My Pregnant Breasts

“I loved my breasts during pregnancy and want them back to that size and look. You know, full and perky.” First, before, I address this issue, I just want to say that, yes, breasts are the fixation of us women. Men like them, but we are obsessed with those body parts.

During pregnancy, breasts serve to nourish the life soon to be born, and the body gets them ready for that function. Hormones during pregnancy not only support the uterus for the growing baby but also get breasts ready for this important function. Breast ducts enlarge for milk production, blood supply increases because of this food preparation, and the nipple areolar complex re-adjusts so baby can extract food. That, in short, is why breasts enlarge and look nice, shiny and plump. Whether you are able or not to breast feed, the body still prepares breasts for this function. Eventually, hormones revert to the non-pregnant levels, and breasts lose that look. In other words, the volume, fullness, glowing, plump, and perky look goes bye-bye. Often times what remains is what we call in plastic surgery a “deflated” look or loss of upper pole fullness. Because the support structures are no longer held under tension, nipple position may change…..a plastic surgery term that we call ptosis.

All of these considerations are important to address for ladies desiring breast surgery with a mental picture goal of acquiring that “look at my pregnant breasts” look. Remember, however, that we are living creatures and not a slab of marble. After pregnancy, circulating hormones and chemicals are different as well as skin elasticity. Breast implants, saline or silicone, do a very nice job replacing volume. However, in addition to replacing volume, there are many other considerations that we, as plastic surgeons, must take into consideration like chest wall issues, breast asymmetry, skin quality and nipple position. Breast surgery after pregnancy varies with each person which is why your procedure may be different from your friend’s surgery. It may be more involved than you think. And, of course, there’s the healing factor and how your body takes to surgical recovery.

Along the lines of health remember that October is Breast Cancer Awareness Month. BREAST CANCER HAPPENS IN 1 out of 8 WOMEN AND MEN GET IT, TOO. For both genders, do your monthly breast self-exam. Ladies get your mammograms; I don’t care how much it hurts—it saves lives. We all can get breast cancer, and if cancer is caught early, there are reconstructive options…..if even needed. Life is precious, and, again, the breast thing is our fixation. With or without them, we are still beautiful and so is life. Treat it with care.

Wrinkles and 9/11

Other than obnoxious, what exactly are wrinkles? Wrinkles are lines, folds and crease that form on our skin for many reasons. With age skin just plain changes losing elasticity, thinning out, and reflecting sun damage or toxins from prior years. Not only is skin the largest organ of the body but also is constructed of many different cell types from oil glands to pigment forming cells to hair follicles…to name a few. Have you ever wondered why we just can’t blow-dry our wrinkles away every morning the way we dry our hair?

Skin care is a daily ritual and first step to aesthetic care, so to speak. Even with the best and perfect plastic surgery, if your skin is not in good shape, the result will not last. In addition to basic skin care, skin reflects our general health as well, because we are dynamic human beings…. Our skin reflects our basic metabolism and body function. Skin also drapes over muscle and fat so that if the aforementioned are not in good shape, we put some of the blame on bad skin. Many corrective products exist on the market from cleansers, fillers, lasers and neurotoxins. In the ensuing blogs, I’ll address different corrective measures. But for now, I want to stress that there isn’t one great miracle treatment. There are certainly some nice lasers and products out there, but each one has its limitations. Again, I will demystify and simplify treatments in future blogs. For now I feel compelled to spend the rest of this blog to discuss 9/11.

To shift gears, my blog would not be complete if I did not mention 9/11. I was living in Chicago the time completing my plastic surgery training. I’ll never forget watching on TV at Cook County Hospital those towers collapsing turning a vibrant city into what appeared to be a war zone. Areas that were so familiar to me were now gone or covered with rubble. Prior to living in Chicago, my life in NYC was coupled with my surgical residency in Brooklyn and a post-doctoral fellowship at the Rockefeller University and New York Hospital. One of my projects involved the burn unit allowing me to attend the New York Hospital burn unit Christmas party in 1995. I was so impressed by how much the firefighters viewed their job with enthusiasm and excitement. They related stories of the day giving each other high-fives. They were all gentlemen. In the after-shock days of 9/11 all I could picture were those firefighters of Christmas 1995 and wonder if they were all now with God. To this day, I pray for them and all the brave firefighter souls that work so hard to ensure our safety. God Bless.


So, I just ate three slices of pizza, looked in the mirror and swear that my face looks fatter. I know that sounds ridiculous but many of us do what I did and think that fat is that easily mobilized, gained or lost. Because of that mentality, TV, print and radio is and flooded with devices promising to melt, freeze or blast away fat without surgery. Fat is gone and, poof! We look like a Sports Illustrated swimsuit model. Trust me, if a machine like that existed, I would be the first to buy it and hook myself up.

We have fat everywhere in our body and the stuff does become a part of our body chemistry. Fat is pinch-able. It’s around our inside organs (know as visceral fat). It is biologically active just like skin, liver, kidney, heart etc. in that it participates in our body function. That’s why the slow, regulated way of losing weight is not only safest but also long-lasting. What happens as we age is that our bodies obtain more fat …both men and women!!…our hormones and chemistry change, and we lose muscle mass which slows our metabolism as well. Working out is fun in our 20’s, a good thing to do in our 30’s, a MUST in our 40’s+++.

Let’s get back to talking about these miracle machines. Most of you know that I own a smart-lipo MPX device. It’s a wonderful and strong laser that specifically targets the fat cell and shrinks the skin. However, after melting the fat it must be removed with a liposuction cannula….literally, removing the fat from the body. The laser is an in-between step that provides for a more specific and gentle procedure that yields much better contouring than the old-fashioned liposuction that you have seen and been grossed out by on You-Tube or TV. The indications are still the same as with traditional liposuction in that you should be on a good diet and exercise program but have persistent areas where the fat just doesn’t go away. None of the machines out there serve as a miracle wand that permanently removes fat. After all, we are not a bar of soap. We are active, ALIVE, creatures and there is not substitute to a healthy lifestyle.

Understanding Plastic Surgery and Your Body

You, too, can understand your body. You, too, can understand plastic surgery. And, yes, you can and will be able to understand the flood of information that assaults you from TV, internet or advertisements. In fact, when I talk to friends and patients that is the number one, recurring comment to me, “Melody, there is so much information out there and so many products. How do I make the right decision?”

Well, thank you to my friends and patients (or both) who inspired me with this blog idea so that I can communicate, educate and hopefully inspire you. That being said, Topic #1 is….. I feel fat. When we feel fat, we think we look fat. What makes us feel this way? Are we truly fat? Did we eat too much? Or do we have issues in this anorexia-based society? Stay tuned to next week’s blog.