Leonard M. Hochstein, MD - Miami Plastic Surgeon

Other Official Donation Sites for the Haiti Relief

2010-01-18T09:57:00.001-05:00

Other Official Donation Sites

On January 12, a series of earthquakes with magnitudes ranging from 6.5 to 7.3 devastated Haiti. The American Red Cross is working with its partners in the global Red Cross and Red Crescent network, including the Haitian Red Cross, and other partners to assist those affected by this disaster.

Your gift to the American Red Cross will support emergency relief and recovery efforts to help those people affected by the earthquake in Haiti. Assistance provided by the American Red Cross may include deploying personnel, sending relief supplies, and providing financial resources.

Dr. Leonard Hochstein/ Halloween fundraiser

2009-10-06T09:58:00.005-05:00

Every fall, Dr. Leonard Hochstein and his wife Lisa Hochstein host a Halloween fundraising event that has become one of Miami's most notable charity functions. Each year the Hochstein's alternate on raising funds to help either the Human Society or Make A Wish Foundation. This year the money will go to the Human Society. If you would like to donate please contact:

Summer Miller
Special Events Manager
Humane Society of Greater Miami Adopt-A-Pet
Soffer and Fine Adoption Center
16101 West Dixie Highway, North Miami Beach, FL 33160
www.humanesocietymiami.org

Rhinoplasty by Dr. Leonard Hochstein

2009-07-07T14:20:00.000-05:00

Over the years Dr. Hochstein has become well known for his specialty with Rhinoplasty (Nose job). Patients come from all over the word to have their Rhinoplasty done here in Miami Florida. Although Dr. Hochstein is recognized for his breast augmentations world wide he is also gaining a great reputation for the beautiful work he achieves with Rhinoplasty.

Rhinoplasty is the most commonly performed facial plastic surgery today but also one of the most difficult because the doctor performs the Rhinoplasty mainly by feel and experience alone. For the reason it is very important to do you home work on the doctor and see a lot of before and after photos of the doctor’s work before you chose a surgeon. If a doctor chooses to use computer imaging, be very careful because this is not a representations of the doctor’s work it is a computer imagine that can be gained by anyone that is efficient in a PhotoShop program. Dr. Hochstein will need to consider you entire face when planning your operation. Some patients may need to have a chin implant (chin augmentation) to achieve balance, Dr. Hochstein will discuss this with you during consultation.

Features can be changed to improve the over all shape, size and angle of the nose through plastic surgery here at Dr. Hochstein office located in Aventura Florida. Rhinoplasty can be perform after the complete growth on a child, ages 15-16 for a woman and 16-17 for a man. The ideal outcome that Dr. H is trying to achieve with a Rhinoplasty is a natural appearing nose with balance and harmony, enhancing the beauty of the lips and eyes.

There are two main options when it comes to Rhinoplasty surgery: Closed Rhinoplasty and opened Rhinoplasty (Dr. Hochstein prefers the Closed Rhinoplasty). Closed Rhinoplasty incision are confined to the inside of the nose and not visible after surgery. With Open Rhinoplasty you will see a small incision between the nostrils, in addition to incisions on the inside of the nose.

Surgery lasts about 1-2 hours and will usually be performed under general anesthesia.

During recovery you will want to sleep with you head elevated for the following week to minimize swelling. Dr. H will need to see you the next day to remove the packing and then again one week later to remove the split. Bruising and swelling will last anywhere from 1-6 weeks for initial healing. After this the final result will be apparent but you may continue to see small changes for up to 3 months to 2 years. The final outcome will depend on your age, skin type and ability to heal. Most patient talk about numbness after Rhinoplasty (nose job), this usually lasts for several weeks just at the tip.

When considering a Rhinoplasty, it is very important to find a Qualified Board Certified Plastic Surgeon, Diplomat of the American Board of Plastic Surgery, who has successfully completed the prerequisites and knowledge and have the experience to perform this operation safely. There are no substitutes. Some doctors are using false Boards so it is important that you do your home work before you make any decisions. Start by going to www.flhealthsource.com . You can also call the Agency for Health Care Administration (AHCA), Consumer Services at: 1 (888) 419-3456 or the Florida Board of Medicine: 1 (850) 245-4131

Help Stop Puppy Mills

2009-04-16T13:47:00.004-05:00

I know this is not about plastic surgery but here at Dr. Hochstein's office we are trying to make a differance in the lives of so many amimals that need our help.

Puppy mills are breeding facilities that mass-produce puppies for sale in pet stores, over the Internet, and directly to the public. Dogs are stacked in filthy wire cages, often with no veterinary care or human interaction, and they are treated not like pets but like a cash crop. Mother dogs are constantly bred and kept in continuous confinement.

After their fertility wanes, breeding animals are commonly killed, abandoned or sold to another mill. Puppy mills will go out of business when people stop buying the puppies.

Puppy mill puppies are sold even in the swankiest of pet stores and through the most picturesque of web sites. The truth is, unless you personally visit the place where your puppy was born and raised, you have no real way of knowing whether you're supporting a puppy mill. Please visit After their fertility wanes, breeding animals are commonly killed, abandoned or sold to another mill.

Please visit http://humanesociety.org/puppymills learn more and discover how you can help put an end to this cruel and inhumane practice.

Botched Plastic Surgery Revisions!

2008-07-17T16:03:00.003-05:00

There are a lot of helpful articles on how to pick a plastic sergeon but few patients seem to ask the right questions! I work for one of the top plastic surgeons in the country and I find that a lot of patients do not really look into a doctor's background before having surgery! Often times it still comes down to price. And with the way the economy is going this is getting a little scary!! There are unfortunate a lot of doctors willing to do just about anything to make money! The thing patients fail to understand is once you have one bad surgery it can be a downward slide. The patient may even find themselves in the position where the doctor that performed the botched surgery will not fix it without you paying for a whole other surgery again and if you seek out another doctor he will most likely ask for way more due to the fact that you have now become a revision. The one thing that patients never seem to ask before surgery is "what is your revision police". If I were a patient I would get it writing no matter what. Here at Dr. Hochstein's office we have one that states that in the event of a revision that requires general anesthesia the patient will pay for the OR and anesthesia costs and that's it. All doctor’s costs will be waived. If it is done under local, all costs will be waived.

By Michelle Heavens

How Men Really Feel About Beast Implants

2008-06-17T15:17:00.003-05:00

HOW MEN REALLY FEEL ABOUT BREAST IMPLANTS
by Tom Chiarella

Fake is a beautifully complicated word. It starts softly, in almost a whisper, then quickly gathers strength on the way to its harsh, nasty terminus. It's employed with equal authority by schoolchildren and accountants, jewelers and philosophers. And it's rife with contradiction.

In sports a fake is a move, a tool, a device. In art it is corruption. A fake either works so perfectly that the fact of the counterfeit goes unnoticed, or it is so poorly executed that it fools no one and does not work at all. Noun. Verb. Adjective. The word has range.

I always laugh when people use the word fake when discussing breast augmentation. They say it as if the breasts themselves were lies, forgeries, as if someone were being hoodwinked. Yet there is very little deception in the matter of implants, since most of the time the whole story is right there for you to look at. In point of fact, you're supposed to look. For men that's the best part. Most men have lived some portion of their lives surreptitiously regarding cleavage, stealing glances from across the 10th-grade-English classroom, from behind a magazine, from the end of the bar. I don't know a single heterosexual guy who doesn't rubberneck when it comes to this part of a woman's body. I've seen preachers, therapists, pharmacists, and university presidents eyeball a woman with great cleavage, often cleavage obviously built on the back of great implants. You don't have to be an evolutionary biologist to know that men are visually stimulated. So the tacit invitation to have a look at a woman's breasts is, in itself, a wonderful thing. And whether what one is looking at is a miracle of technology or the real deal seems less than the point.

The compact is clear: A woman with breast augmentation asks to be regarded. It really isn't about size; it's about attitude. Her attitude. That's a provocation most men welcome.

Tummy Tuck

2008-06-17T10:08:00.004-05:00

A Tummy Tuck (Abdominoplasty) that is performed with or without a breast lift (Mastopexy or Bennelli) has become one of the most popular surgeries performed by myself and for very good reasons. When properly done, there is no surgery, which can alter the post pregnancy body more other than perhaps breast augmentation / breast lift. Every anatomical change cannot only be corrected but even brought back to a better than before pregnancy state. A True Mommy Makeover!

There are several changes that occur to the female body during the pregnancy. The most visible change is the stretching of the skin with the possibility of developing stretch marks. There is also a fat redistribution with the fat being centered in the hips and abdomen area. There is also a significant muscle separation creating an out pouching of the abdomen. All of these are addressed by the modern abdominoplasty (Tummy Tuck).

The first issue to be addressed is a skin stretching. The skin from the supra pubic area to the level of the umbilicus is usually removed and the upper skin is stretched down to the lower portion, which also results in a lifting/tightening of the external genitalia. Sometimes stretch marks are streak and developed. Depending upon their position most can be removed or at least brought to a much lower location. When healed, the scar should be thin and located in a low enough position so that a bikini would completely cover it. I have seen abdominoplasty scars, which seem to go very high as the incision goes outward. This is a worse situation possible when it comes to hiding the scar and makes it impossible to lower or otherwise hide.

The next problem, which is addressed, is the fat layer. The lower abdominal fat is addressed by excision along with the overlying skin in one piece. There is additional shaping performed in the hips and back using lipo sculpting. I prefer to use the power-assisted techniques to remove these fat deposits to create a narrow waist. Recently, ultrasonic or smart lipo gained some popularity but I have seen some very irregular and poor results using this technique.

The last issue is the muscle stretching or separation. This is what creates...
Read Complete Article

Saline vs. Silicone Breast Implants

2008-06-11T15:45:00.004-05:00

Saline vs. Silicone Breast Implants
In recent years there has been some debate as to which breast implants are better and what kind of maintenance or replacement is necessary. The FDA ruling to allow the use of silicone again has certainly raised the popularity of these implants and I have seen a greater demand in my own practice in Miami. So what are the differences? Breast implants are composed of a shell and a filling. The shell consists of solid silicone. In saline filled implants there is a valve through which saline is added. The Silicone implants come pre-filled so there is no valve present but instead there surface is completely smooth. The main difference of course, is the filling. Saline implants are filled with salt water and silicone is filled with silicone gel.

The surgery of implant placement also differs. Because saline implants are empty they require a smaller incision for their placement and they are filled and positioned in the pocket. Because silicone is pre-filled this incision has to be larger (generally about half an inch more). For this reason, some surgeons have used the lower fold incision for placement which I consider a cosmetically inferior choice. I have preferred to extend the areola (nipple) incision rather than using the lower fold. The wound closure is identical when I used absolvable sutures which do not need to be removed and do no leave a mark. Postoperative care is also identical.

Now that the implants are in how do they differ in look, feel and durability? From across the...
Read Complete Article

Face Lift

2008-06-05T16:07:00.003-05:00

When to do a face lift is a very hard decision to make for any woman. Choosing to do them younger even more. The age old question is : When do you decide to trade lose saggy skin for scars? Even though a really good doctor hides his scars well at best you will still have to deal with at least six months to a year with some form of evidence. Because of this, some women put off having face lifts until it is too late to have any chances of looking natural. Every year that goes by we lose more fat and elasticity and these are exact things that make a face look youthfull. We have all seen the wind blown look where a woman's face looks like it has been pulled too tight and her ears are wrapped around her head. This is not always the doctor's fault, not to say that a good doctor is not worth its weight in gold when it comes to face lifts, but the older and more worn out from aging, sun damage and smoking, the harder it is to achieve fantastic results. All these things cause skin to become like paper instead of the bouncy supple skin of a 20-30 year old woman.

If you read about the way we age, after 30 is when our skin cell rejuvenation starts to slow down. And although this is a fact most women can still get away with a quick trip to the dermatologist to get a little filler, botox or peels. All these things can usually hold you off until your forties or fifties. After your forties / fifties and for the very few lucky sixties, you will see a great disconnect between your friends and family. Some will still be looking quite fabulous and while others look like they have been left out in the desert for years without any sunblock.

Some people are opting for string lifts, thread lift, weekend lifts and mini lifts where the surgeron is just either cutting the excess skin away and tacking it to the ears instead of a true face lift where the surgeon reinforces and redistributes your fat to give the face a more youthfull appearance. The dead give away of these quick fix face liftsis usually bad scarring because all the weight and tension that is put upon the ears resulting in the Mr. Potato Head Look; because the ears are being dragged down and the face was not properly done. A good surgeon spends hours re-attaching and redistributing the skin to your face.
The worst part is that these face lifts only last usually one to two years and cost approximately half the price of a full face lift. Now I know that all the women that thought about getting a face lift would love to think a thread lift is a perfect solution to having no scars but these lifts have been largely discredited by sucessfull prominent doctors due to the fact that you can't control how long each string will hold and how normal of an appearance is achievable. And then, when you finally decide that a full face lift is inevitable, the strings can be hard for your surgeon to remove. Over the years Dr. Hochstein has watched these trendy quick fixes come and go but still no one has come up with a better alternative. We are all waiting for the day when a face lift will not be needed due to stem cell rejuvenation.

So what is a girl to do when fillers and creams are no longer providing the youthfull appearance we desire to see when we look on the mirror? You either go to counceling and try to find acceptance from within or you go to counceling and go find a plastic surgeon (LOL) because you may indeed need both.

Michelle Heavens

Tummy Tuck Miami, Florida

2008-05-16T13:38:00.005-05:00

Dr. Hochstein is well known throughout the world for his Breast Augmentations, Breast Lifts, Breast Reductions and Breast Revisions. What most people do not know is that his second most popular surgery is the Tummy Tuck, this is partially due to the fact that women that come into Dr. H's office seeking Breast Lifts due to pregnancy or weight loss will usually need a tummy tuck as well. A breast lift combined with a tummy tuck is an amazing transformation! Patients are usually very satisfied with the joint procedure because it delivers results that could not be achieved by dieting and exercising alone.

Tummy tucks, out of all the procedures performed by a plastic surgeon, can be one of the hardest ones to recover from. This is due the fact that it affects mobility and the amount of time that will take to recover and the post operative care that it demands.

Because abdominoplasty involves the removal of extra abdominal skin and usually the tightening of abdominal muscles you will experience some difficulty standing up straight for a few weeks which can cause strain on the lower back and compromise daily activities, like getting out of bed and going to the bathroom. The tightness will gradually disappear as you heal and progressively use your body muscles for activities to daily living. It is important to make no special attempt to stretch or pull the abdominal strengh during the two first weeks of healing, but it is very important to change your position and walk around the house every few hours to reduce the chance of blood cloths. Dr. Hochstein places one or two drains into the surgical area at the time of surgery, these drains evacuate the fluid that accumulates after surgery and enable you to heal faster. Because you must keep your body at a bent position for the first couple of weeks, sleeping can become difficult at best! We recommend if possible the use of a recliner which can make it not only easier to fall asleep in a V position, but facilitate getting up and down. At our office all details about post operative care are given in written in a pre / post care packet and explained by a registered nurse the day of surgery.

With breast augmentation and other procedures mobility is not so compromised. To make this process easier for the patient, Dr. Hoschstein uses a pain pump to control pain. The pain pump is very effective in reducing the initial pain in the surgical site. Most of our patients are very surprised to find out they have little to no pain coming from the tummy area. The pain pump has an uninterrupted flow of analgesia for up to 6 days, which can greatly reduce the intake of narcotics.

Although the tummy tuck may take a little more time to heal, it is by far the most gratifying procedure. When patients come to this office they know this is a last resort. They have usually tried working out and dieting and are now left with stretched out saggy stomachs that can only be improved by the skillful hands of a plastic surgeon.

Michelle Heavens

What is Malignant Hyperthermia!

2008-04-03T12:39:00.002-05:00

MH is a genetic inherited disease which causes in body temp. and severe muscle contractions when the person receives certain forms of general anesthesia. Most instances occur in children and has been estimated to be present in about one case per 15000 surgeries. It is less frequent in adults.

MH is a dominant trait. This means that only one parent has to have the disease to pass it on to their child. It may also be associated with other musculoskeletal diseases. There is usually a history of an MH episode or an unexplained death as a result of anesthesia in a patient's family history. In case of a non specific history or a history of high body temperature after general anesthesia a muscle biopsy may be obtained to confirm the diagnosis.

The signs of MH attacks are generally rapid onset in nature and occur within the first hour of anesthesia. There is a rapid rise in body temperature up to 113 degrees. There is also a rise in heart rate, respiratory rate and blood pressure. There is onset of muscle contraction or rigidity. There is also the possibility of dark brown urine formation.

Treating MH is geared toward reducing body temperature and ceasing the cascade. All triggering agents are immediately stopped and respiratory rate is increased with the administration of oxygen to remove excess CO2 from the system. Packing the patient in ice as well as irrigating the stomach and bladder with cold solution are important. Maintaining intravenous fluids is also crucial to avoid kidney damage. The key drug to administer is dantrolene which has significantly improved the outcome of MH. This drug relaxes the muscles and stops the contractions.

MH can lead to respiratory or cardiac arrest, brain damage, or organ failure. When the disease was first diagnosed nearly 50 years ago it was associated with a survival of only 20%. Today, due to earlier diagnosis and dantrolene treatment there is a survival of greater than 90%.

Anesthesiologists can prevent the onset of MH by avoiding its triggers. These triggers include a paralytic(paralyzing) agent called succinylcholine and inhalational agents(gases) during general anesthesia. General anesthesia can be performed safely in the MH individual if precautions are taken.

MH, as well as all disease processes, are taken very seriously at my surgical center. In patients who have had uneventful general anesthesia in the past we are able to perform traditional anesthesia. In those patients who have not had anesthesia in the past we perform an intravenous anesthesia only. This also holds true for anyone with a questionable history. In these situations intravenous anesthesia only is administered.

For more information about MH there is a hotline: 800 644 9737
Or you can go to: the MH Muscle Biopsy Centers

By Dr. Leonard M. Hochstein, M.D., P.A.

2008 Comeback Stories: Silicone is back in

2008-03-03T10:15:00.002-05:00

They're Ba-a-ack!
Once hot, then not ... we round up the people, products and things that are returning to the spotlight in 2008. Click through our gallery and find out what you'll be seeing a lot more of this year -- and why.

2008 Comeback Stories: Silicone is back in

by Tracy Coenen Mar 4th 2008 @ 4:15PM
This post is part of our series on people, places and things that have found new life in 2008.
Silicone breast implants, after falling into disfavor in the early 90's on claims that they caused various diseases including cancer, are back. In their latest incarnation, a safer fourth-generation "gummybear' silicon material, they are expected to grow to a $620 million product by 2012.Plastic surgery has never been more popular, thanks to television shows like Extreme Makeover and Dr. 90210. Led by the creepy Dr. Robert Rey, the show Dr. 90210 shows young men and women that they can look however they want with just a cut of the knife and a few nauseating comments from the doctor about how gorgeous their boobs are.One of the most popular plastic surgery procedures is undoubtedly breast implants. In late 2006, the Food and Drug Administration approved silicone gel implants, deeming them safe and effective. Although silicone had been accused of causing certain medical problems/symptoms in the past, doctors using the implants now say that they are safe. Women who get silicone breast implants no longer just get an increased size. They get a product that now feels more natural than ever. And silicone implants aren't just for your boobs anymore. They can be used all over your body: from cheeks to lips to butts. Depending upon which body part the implant is used for, its consistency may be a little different to give it the most natural look possible. Aren't you glad that you can now sculpt your body using silicone practically anywhere? You can have the body you always wanted without any hard work... if you're willing to go under the knife.

Tracy L. Coenen, CPA, MBA, CFE performs fraud examinations and financial investigations for her company Sequence Inc. Forensic Accounting,and is the author of Essentials of Corporate Fraud.

The Beauty of the Silicone Breast Implant

2008-02-29T15:20:00.002-05:00

Dr. Hochstein has been on the Silicone Study for the past 5 years. The Study had many restrictions and patients had to be closely monitored. Since the approval from the FDA in 2007 we have seen a tremendous increase in our office for the demand of silicone. FDA determined that there was adequate data to support Mentor's implants as safe and effective.

Silicone is actually found in many household products such as sun tan lotions, hand lotions, soaps, processed foods and chewing gum! Silicone is derived from Silicon a semi-metallic or metal like element which in nature combines with oxygen to form silicon dioxide, or Silica. Silica is the most common substance in the Earth. Heating Silica with carbon at a high temperature produces silicone.

Many questions have been asked by our patients and this blog entry is an attempt o address a few of them.

Let's talk about safety. One very frequent question asked is "Do implants influence the occurrence of breast cancer?" All the reports have indicated that patients with breast implants are not at a higher risk than those without the silicone implants for developing breast cancer. However more x-ray views will be necessary when doing routine mammograms for women with breast implants.

It is important to realize that the shells of both silicone and saline implants are made with silicone. So if you are opting for saline thinking you are actually escaping silicone, do consider that the shells will still be made of the same material.

The beauty of the new silicone implant is that they are solid all the way through which means you will not have to worry about leakage. What this means is that if you cut it in half one implant you would see the implant staying together pretty much like jello instead of spreading out like liquid. If your implants would ever implode due to trauma caused by immense impact, the implant could rupture, causing breakage to the shell, however the memory gel fill will always stay intact. This is why they are called "memory gels" .

When a saline implant deflates, its deflation is visible and usually noticed either right away or within a few weeks, letting you know there is a problem. With silicone, the deflation can only be detected with an MRI.

The good news is that since 1995 their shells have had a tremendous upgrade. They are now three times thicker and they can no longer leak. They also carry a lifetime warranty which guarantees replacement.

All this aside, the reason why they have become so popular is because of their natural shape and feel! If you happen to be someone who was blessed with absolute no breast tissue, and had saline implants you were guaranteed to encounter rippling. Not only that but you may have experienced that ever not so attractive round "balloony" shape! Also people complained about feeling the water movement and a cold sensation due to their saline implants. Some even worse, have reported they could hear the water jiggling. These saline implants did not produce a natural feel and look unless you had a B or bigger cup to begin with. This is due to the fact that when the implants go under the muscle and breast tissue all these problems were minimized.

With the silicone implants these side effects are diminished due to the fact that it is a solid, breast like substance. Most people have reported that it feels in every way just like a natural breast.

I can speak from my own experience. I had saline implants for 10 years and they never felt like my own. I was always aware the implants were there. As soon as I got silicone, this all has changed. They immediately felt like a part of me. I no longer felt like two water balloons logged into my chests. I was one of the unfortunate ones that started out with no breast tissue. The other amazing thing was the versatility in sizes and shapes. With my salines I had a very large gap and they stood out from my chest cavity. Since changing to silicone, I was able to go to a smaller size implant that was wider in dimension, so I have less projection and more cleavage. YEAH!

This becomes very important because women are shaped differently. A lot of women come into the office thinking that their height is the biggest factor into picking out their implants although this is very important, your chest cavity and your nipple placement play a major factor. For instance, if you have a wide chest cavity with wide nipple placement and your seeking cleavage you need to talk to your doctor about the dimensions you will need to achieve your goals. As an implant goes up in size it also goes up in dimension and projection. This can vary whether you are using low, medium and high profile.

Sometimes you will have to forgo one for the other. Example : If you happen to have a wide chest and you want small breasts you have to realize that you may not be able to get them close enough together to obtain cleavage (unless you are planning on moving your nipples as well). So talk to your doctor about alternatives when choosing the size and profile of your implants.

Michelle Heavens and Dr. Hochstein

Popular Trends

2007-11-02T17:29:00.000-05:00

I was recently watching the Today's Show where they were talking about the most popular cosmetic procedures in the Industry right now. To my surprise, Liposuction, followed by the Asian Eye Lid Surgery (Upper Blepharoplasty) ranked first.

The reasons Asian people have attributed to their deciding for the procedure, was not only their personal desire for a more Caucasian look, but they felt they their eye lids made them appear tired. What is wonderful about this procedure is that it can be achieved with the use of local anesthesia and takes about 20-30 minutes not to mention a quick recovery and a fairly instant result!

As for lipo, I can truly understand why it has gotten so popular. People continue to starve themselves with the latest diets only to find that there are stubborn areas that won't come off. Stubborn areas vary between men and women. For a man the stubborn areas are usually the stomach and hip area. For a woman, you will find the abdomen, hip area, inner and outer tights and occasionally knees!

Many factors come to play when a successful operation is to be achieved. It is important first to have a realistic goal of what liposuction can conquer for your body. It is not a good idea to consider liposuction a weight loss device, in fact, most people will not weight much less after lipo. but their shape, contour and outline will look drastically different. As for example if you have saddle bags, liposuction is the perfect solution for getting rid of them.

There are some limitations that cannot be overlooked. It is important to consider, skin tone and elasticity. These things can be affected either by age, or by drastic weight loss. Sometimes, by removing the fat, sogginess may occur. To determine if you are a good candidate for liposuction, a consultation with the plastic surgeon is a must!

Let's face it.... nobody loves a love handle!

Michelle Heavens

Wrinkles and Time !

2007-11-02T12:20:00.001-05:00

I am not sure if it is the wrinkles that bother me or if it is what they represent. I have noticed lately that when I look down at my hands or the corner of my eyes I have a feeling of anxiety, not for the wrinkles themselves but for what they represent to me. They remind me that life is short and precious. They remind me there is so much more to do and so little time to accomplish all my hope and dreams. I think that when we are young and our skin is perfect we feel immortality as if we are vampires, creatures of the night, able to live forever with perfect bodies and skin. Now when I see that my skin has started to fade I find myself in a hurry to do all the things I believed myself possible of doing. In this body that is ever changing I sometimes worry will there be enough time? I think that many women have the same worries, no matter what path you chose. I am not sure what the recipe is or even if there is one recipe, but I do know that I have spent a large part of my life worrying about the inevitable. We will grow old and we will wrinkle. As I go through my journey I become more comfortable with this process but I am so ever thankful that each year there are new techniques and solutions to slow down the inevitable. I guess I am happy to finally realize that time is precious even if I had to see it in my hands and the corner of my eyes, but I am also grateful that there is Botox and lasers that can buy me more time. Time is all we need when it comes to accomplishments. Michelle Heavens

What to do about the first signs of aging!!!!!

2007-11-02T12:11:00.000-05:00

I had my upper lids done (Blepherplasty) at age 37. This by far is now my most favorite cosmetic procedure! As we age our eyes start to change losing that amond shape that makes us look and feel young. The makeup starts to look bad and people start to ask you if you are tierd when you just had a good night's sleep. This procedure can take away years in just 30 to 45 minutes. Most of your friends and family will never know if you can stay away for a few short weeks. Then when you reemerge you will look so refreshed people will think you sold yourself to the devil! lol Best of all if you are afraid of general anesthesia, upper lids can be done under local. To round it all off I started using Botox around my eyes and forehead. And although I did not have deep set wrinkles I learned that wrinkles are a form of scars and if let go you will not be able to get rid of them. I also started using Radiesse around my Nasolabia folds. Radiesse is made from synthetic Hydroxyapatite, very much like the primary component in bones and teeth. The product last anywhere from a year to a year and a half. It is also a good filler for cheek enhancements and cost anywhere from $ 750 - $1500 depending on the doctor. For the tightening and resurfacing of my skin I opted for thermage and dermabrasion along with the use of Renova a few times a week. Renova is not an over the counter product so you will need to see your Dermatologist for a prescription but it is well worth it. Not only does it tighten the skin but it also reduces the fine lines and wrinkles. :) Recent research has also found that there is an increase in the ablilty for your skin to produce more collagen with regular use of Renova, which is the key to a young healthy face. = )

Healing is a Two Way Street!

2007-10-20T15:46:00.000-05:00

Often times patients do not fully realize that they are as much responsible for their healing as the doctor. The healing process has to be a partnership and this is where the patient comes in contributing to their own healing process proactively.

You have spent months if not years planning for this surgery. You have saved and put aside money, dreaming of the happy outcome. You have chosen the doctor of your life. You might have taken the first step by ordering your garments, buying your homeopathic remedies, but have you planned for a successful recovery?

Here in Dr. H's office, we take the extra step to educate our patients and provide them with resources to help them throughout their healing. The doctor goes over all the do's and don't's which are reinforced by the staff but still we find that people don't realize the magnitute of not complying with the post surgery instructions. This can be the most important part of your final result.

A doctor cannot be there for you every step of the way. Patients must take responsibilities for their aftercare.

If you just had a tummy tuck and you were explicitly told to walk bent down, there is a reason for that. And it is a big reason if you want to end up with a neat clean scar. Walking upright too soon might lead to an ugly scar or worst, the opening of the incision.

If you have just had breast augmentation and you are out having fun too soon, before your body had a chance to properly heal. You could run into complications that could end up costing you more time and money had you only stayed home and recovered.

You may be feeling a whole lot better than you had anticipated, which is wonderful but you need to remember this was major surgery and your body still needs a chance to properly heal. The decisions you make in the first couple of days may and will affect your final outcome. So it is important to follow instructions to the T and remember this is a short amount of time to give up compared to the benefits and years of enjoyment you will receive from the positive results.

So listen to your doctor. He knows what he is talking about it. He went through years of education and practice and this was the reason you chose him!

Michelle Heavens

The New Trend in Breast Augmentation!

2007-08-30T09:57:00.000-05:00

Last night I was up watching back to back episodes of Dr. 90210 (Dr. Rey) as I often do just to see what is going on in other plastic surgery offices. In those brief moments where he is not having personal interactions with his wife or someone is not being cut open, the show is actually very entertaining.

The one topic that interested me in this particular episode was the mention of women in L. A. over the past year opting for smaller breast implants. A lot of this has to do with trends and geographic locations. Let's face it, Pamella Anderson isn't getting any younger! LOL Who would ever think that breasts follow fashion trends. There used to be a time where chubby, flat chested, thin lipped women were considered hot! Thank God that is GONE, or I would be in trouble!

I happened to love large breasts, but it is important to consider shelf life and your lifestyle when choosing your implant sizes, specially now that silicone came to stay and the new technology is permitting them to last a lot longer.

There are many things to consider when making this decision, like your height, your weight, your chest cavity size and the capacity of your tissue stretch, meaning you may not be able to go from a A into a DDD your first time around. :)

I found that it is just as important to look at your own personal life. From talking to so many women on a daily basis, they have brought some questions to my desk. Things such as will they be able to wear couture clothing? Will they find appropriate business attire? If they are athletic, will they have problems working out? And the most famous question is " Will my boobs walk into the room before I do?" Now, for some women this is great and this is exactly what they are looking for and than others are just looking to get back to what they had before childbearing or would just like to have any breasts in general!

I, myself, felt like a boy before I had breast augmentation. I had them done when I was 22 years old with Saline implants and then again when I was 33 with Silicone by Dr. H (Dr. Hochstein) and I have always been amazed with the effect that it had on the way men interacted with me. Having had a great run, my priorities have shifted some and as I get a little older I have started to think about going a little smaller but I am not ready yet! Perhaps when I get my face lift in another 10 years, I will go down a few sizes just so the old men at the old folks' home don't have heart attacks!

Good luck with your decisions and happy planning!

Michelle Heavens

What's in a picture?

2007-08-29T10:53:00.000-05:00

People will say a picture is worth a thousand words and when it comes to Plastic Surgery this is definitely true!

Being in this business for fiver years I have had the chance to look at Doctors' works from all over the United States, and what struck me is that some of them will have no pictures, a few will have one or two pictures to illustrate a procedure and even fewer will have plenty.

Pictures should not be overlooked in the face of computer imaging, because they are a realist representation of the Doctor's capacity. It is one thing to have your own picture being manipulated in front of your eyes by a fancy digital imagery program, just like magic you look like a movie star! On the other hand, can it really be achieved? Recently I have come across an article posted on the Plastic and Reconstructive Journal, April 2007 issue, that brings this interesting discussion topic to attention and it says:

" ... 67% of those who use imaging software give printed copies of their images to their patients and all of them are annotated with a disclaimer - 'This is intended as a communication tool only' ..." Which basically means they cannot guarantee what they are proposing, but it looks good! From the pictures they posted not one of the patients turned out as good as the original computer generated image. So, I have concluded along with many others in our field that the only true way to know if a Doctor is up to par with your expectations is by their personal photos. Their realistic collections of before and after patient pictures!

Please do not get this wrong, I do not think that computer imaging is a bad , but is defiantly not enough. In this day and age when copy and paste is so easy and can do so much, it is even more important to have access to real photo albums filled with true pictures .

What prompted this article today was the shameful fact that we actually found pictures of Dr. H's (Dr. Hochstein) work posted on other plastic surgeon's website which led us to start water making our own pictures.

With that said, we really hope that your Plastic Surgeon turns out to be a really sweetie pie, but more important than that is that he is competent and able to fill your expectations. After all, this is all about you!

Michelle Heavens

How Dr. Hochstein became Dr. H to his patients!

2007-08-28T10:31:00.000-05:00

Over the last five years I have been working for Dr. Hochstein I have been hearing his name pronounced in every way imaginable! Even for myself it took at least a year until I was comfortable with pronouncing with confidence his last name! It was then that I started to realize our patients were also struggling with his last name! Then one day, the solution walked through the door on the beautiful face of a young patient who asked me whether it was okay for her to call him Dr. H! A few years later I had again, the same request. So here at the office we started telling the patients that if they felt more comfortable calling him Dr. H, he would not mind, in fact it draw them closer to him because it was more personal. I realized that being able to say your doctor's name with confidence was very important for our patients!

So if you are one of our patients who can't decide wether to call him Dr. Hock-Stine, or Hock Steen, just stop rehearsing and just call him Dr. H!

Michelle Heavens

DO NOT LET YOUR SURGEON PICK YOUR DESIRED SIZE.

2006-11-21T18:55:00.000-05:00

This has been interesting reading for me as I am a plastic surgeon who specializes in BA. I perform about 450 such procedures annually. Let me tell you what I have learned. The best way to choose your implant is to forget about cc's. Let the surgeon do that...it’s his job. What you should do is be able to communicate the look you are trying to achieve and often pictures of other people is a good place to start. There have been many times when a patient has told me they wanted to be a full c and then I see pictures depicting a d cup. It’s not exact but a good place to start. Take a look at the surgeon's before and after pictures to se if there are sizes which you find appealing. The measurements which we take are guidelines for some of the decisions which we make. They are not exact criteria for the size you should get and neither are the implant dimensions. There are certainly people who have chosen implants smaller than what their chest could accommodate and the corollary has occurred very often, as well. DO NOT LET YOUR SURGEON PICK YOUR DESIRED SIZE. We are not the ones living with it. Unless there is a definite anatomic restriction it may be the time to get another opinion.

Now a few words about implants. Saline are still the most common in the U.S. but are they the best choice? Not in my humble opinion. I believe them to have too much rippling upon palpation. The only positive aspect is that they require a much smaller incision for placement. As for silicone, I find them to feel the most natural. Silicone implants are much different than the ones which were taken off the market in the early 90's. The shells are much thicker and the silicone gel is much thicker (cohesive). Cohesive is a term for all silicone and is confusing because there are varying degrees of cohesiveness. The old implants were cohesive but in such a state that they would leak. The new implants (cohesive I) will not leak but if cut in half and squeezed it will not return to the original shape. Cohesive II (Mentor Lumera) are much thicker such that they have a jello appearance when cut and will return to their original form after being squeezed. These are available only in textured and tear drop shape. They offer a bit less rippling than the cohesive I but are also a bit firmer and I believe less of an option for purely cosmetic reasons. The last is cohesive III (gummie bear) which are the thickest. I have not had as much experience with these but am a little discouraged by the feel (too firm) and the incision required (long and inframmamary position). The cohesive II and III are much less pliable and require a larger incision as they are not pliable and have memory of form. My last point...there is never a reason to put an implant above the muscle (subglandular) position. It is a setup for problems. It appalls me that some surgeons still do it that way.

Welcome to our Blog!

2006-04-12T10:57:00.000-05:00

Hello! My name is Michelle Heavens and I work with Dr. Leonard M. Hochstein in Miami, Fl. Uncovering honest information about cosmetic or reconstructive surgery can be a challenge, so it is my pleasure to provide you with the details you can’t always find online or in books. Dr. Hochstein may contribute his thoughts as well. With 5 years of experience working in the plastic surgery field, I learned a lot and as the years go by I start to realize that plastic surgery is just an equalizer in a unfair world where woman are expected to look young and beautiful forever. Dr. Hochstein has been highlighted in the media through publications like The New York Times and The Miami Herald. Dr. Hochstein has also appeared on E! Entertainment Television’s “High Price of Fame: Under the Knife” in 2003, and was regularly featured on Bravo’s docudrama “Miami Slice” in 2004.
To stay current with what you need to know, continue to check out our blogs. We will keep you updated with fresh information!

- Michelle