Interviewer: “Who are the best candidates for Cosmetic and Plastic Surgery?”

Dr. Choucair: “ An ideal Cosmetic and Plastic Surgery candidate is a person who desires to make a change in their physical appearance but are motivated internally and not by an external reason such as obtaining a raise, keeping a marriage together, etc. These individuals are self-motivated to increase their self-esteem. Medically speaking, a perfect candidate would be an individual who is in generally good health and not compromised by untreated conditions. Additionally, the candidate is not on blood thinners or other medications that would inhibit the healing process. A person in good health, motivated for the “right” reasons is an excellent cosmetic and plastic surgery candidate. 

Interviewer: “What do you recommend as the best strategy for “youth preservation” or age maintenance? And is it ever too late to try and take 5 to 10 years off of your appearance with a face lift and other cosmetically enhancing procedures?”

Dr. Choucair: “For people who would like to stave off the aging process, there are a growing number of minor procedures and new technologies that allow for early subtle adjustments to the aging process. There has been an explosion of change in this arena with the introduction of the “injectables” such as Botox^® , Restylane^® and fat transfer as well as new laser treatments for the skin where non-ablative lasers are used to encourage cellular regeneration.  Additionally, doctor prescribed skin care products are an excellent way to renew the skin by sloughing dead skin cells as well as evening out skin tone, removing discolorations, etc. There are several cosmetic and surgical procedures that may be done prior to considering a full facelift. They include surgery of the nose, eyelid lift, cheek implants, and limited incision facelifts where there is less trauma and little downtime. It is important to ask your plastic surgeon what the right approach may be for you, because he/she will take into consideration your age, bone structure, skin tone, general health and what kind of results you desire. And, is it ever too late? Not anymore with the latest technologies of skin resurfacing, “filling the face” as well as less invasive ways to perform plastic surgery procedures, it is safe to say that it is never too late. 

Interviewer: “What do you think about the new “lunch time” face lifts? Is there an upside? Downside?” 

Dr. Choucair: “ These newer “fast” face lifts are basically done by a technique called “threading”, where an actual wire thread, with barbs attached, is threaded under the skin near the hair line. These small barbs grab the flesh from the inside and then the skin is pulled taut by these threads and secured in place. This type of face-lift is less expensive and takes less time, however, results are clearly not as optimal as a more traditional “lift”. My honest opinion on these types of procedures are that they create minimum enhancement, so taking into consideration of what type of results you desire, is it worth it to you, to take less down time for less money for a lunch time face lift which may or may not make any lasting improvement in your appearance.

Interviewer: “Let’s talk about Botox^®, Restylane^® and the other “injectables”.  Can you prolong the length of time of the “need” to have a facelift by using these new antiwrinkle alternatives?

Dr. Choucair: “The popularity of using Botox^® Injections as well as injectables such as Restalyane^® , fat, and others has grown by leaps and bounds. The trend in cosmetic and plastic surgery has moved toward incorporating “filling” of the deflated tissue in addition to the traditional face lifts where the skin is pulled taut. If you notice in a young child or young adult, their faces reflect youth with dewy skin, full face volume, fleshy mouths with little or no lines and wrinkles. To regain a more youthful appearance, cosmetic and plastic surgeons have recognized how important it is to not just pull the skin tight but to also fill in the hollows, lines, depressions, etc with substances such as Restylane^® or fat, giving the face a fuller, more youthful appearance. Restylane^® and fat injections are also used to plump up lips that are thin or 
that have become thinner with age. These injectables assist in making the face  more youthful looking. Botox^® Injections work in another way…they are simply  injected into areas where the muscles contract causing lines and wrinkles. Once the injection of the Botox^® “settles in”, sometimes taking up to two weeks for it to fully take effect, the muscles are paralyzed, preventing the movement that was causing deep furrows, wrinkles around the mouth as well as the eyes. Once this occurs, wrinkles become much less noticeable. Cosmetic and Plastic Surgeons may use injectables such as Restylane^® and Botox^® to delay surgical options such as a face-lift, in some cases for up to 5 to 7 years. Then, once surgical options such as rejuvenation surgery is recommended i.e. a brow lift, facelift, etc, these injectables are often used to enhance the final results of a cosmetic facial plastic surgery procedure. 

Interviewer: “Body Contouring, if done properly, can have wonderful results. What methods do you use for optimal results?

Dr. Choucair: “Body contouring surgery or liposuction surgery is considered to be one of the safest and most effective cosmetic and plastic surgery procedures available today. However, I must mention that it is extremely important that you choose a surgeon who is board certified by The American Board of Plastic Surgery and performs the procedure in an appropriate facility. Liposuction surgery was invented by Dr. Georgio Fischer of Europe, in 1974. As compared to many advances in technology in other areas of plastic surgery, a few have been made in the arena of liposuction. In the 1980’s U.S doctors introduced the use of tumescent fluids along with liposuction surgery to decreases risks as well as allow for greater ease and access to fatty tissue. In the 1990’s the use of ultrasound, which uses sound vibration to liquefy fat, has been found to be highly effective in preparing fatty deposits for extraction. And in 2000, power liposuction made fat removal even easier. The actual liposuction procedure is typically done by using a small wand or canula to suction fat. I use a newer, smaller diameter canula rather than the larger, original tool developed for liposuction surgery. A smaller diameter canula may take a bit longer to use to extract fat and “sculpt” the body, however there is less trauma to tissues, resulting in less bruising and discomfort following surgery which is extremely important for optimal healing. It is gratifying to see dramatic results, removing fatty tissue, which may have been close to impossible for the patient to get rid of even with a balanced diet and exercise regime. Liposuction works because your body contains a finite number of fat cells and liposuction permanently removes fat cells. This may be a real blessing, especially if Mother Nature, with or without your “help” decided to bestow you with a bit more than you would like. 

Interviewer: How much of your business is dedicated to assisting individuals who have had less than optimal results from previous cosmetic and plastic surgery procedures?

Dr. Choucair: “Well, I often evaluate patients who have had previous surgery that did not meet their expectations. It really does take a leap of faith in trusting a new surgeon after a patient has had suboptimal results with another plastic surgeon. We strongly encourage patients who have had unfavorable results to consult with us, to give them options to restore their confidence and appearance. My background in reconstructive surgery is of great benefit to me in situations such as these due to the fact that my experience and preparation in training is second. When patients come to me to help repair what they feel is less than ideal, they are trusting in my surgical and aesthetic judgment, seeking a solution to their problem. My work is highly gratifying in these situations, where I am able to come up with a creative and sophisticated approach to surgical restoration and follow through with an optimal outcome. 

Interviewer: What is coming up on the horizon in the field of cosmetic and plastic surgery? Are there any new procedures or products to watch out for?

Dr. Choucair: “For skin resurfacing and rejuvenation, there are new non-invasive laser technologies, such as the Fraxel Laser. In the future, look for refinement of these procedures to continue. Also, technology is constantly being developed for patients to have less “down time” post surgery. Basically, it just keeps getting better and better.”



Interviewer: You see many plastic surgeons’ offices promoting patient education with “patient educators” on staff. How important is this aspect to patients?

Dr. Choucair: “Patient Education benefits all parties involved. If a patient is armed with knowledge of what questions to ask as well as what the answers should be, they become more empowered to make the right choice as to what cosmetic and plastic surgeon they choose. My “Twenty Questions You Should Always Ask Your Cosmetic and Plastic Surgeon” is something we developed to ensure our patients become more educated before they have their procedure. 

These questions cover all of the bases, including the most important question regarding a potential surgeon is board-certified by The American Board of Plastic Surgery. Also, when a new patient comes to our office, I meet with them personally, speaking to them at length about what procedures I recommend as well as educating them after they decide to move forward. It is my priority to take great care of my patients and to gain their trust and as well as my peers in the medical community. So, yes, patient education is a very important part of the process..the good news with my practice is that I personally become your instructor.