Less-invasive alternative to tackle the Sagging neck

But it turns out that is not true. These days, less-invasive alternative to enhance the appearance of neck, provided that there is a full-scale Turkey wood. As a Romance, a neck go wrong in many ways. Weight gain or genetics may lead to a double chin. Loose skin can worsen underlying lax muscles. A neck-lift (on your own or with a face lift) remains the best basis for a striking, lasting correction.

But cautious liposuctioning superfluous fat can also help streamline full throat, especially those who have still relatively youthful elastic skin that can bounce back after the procedure. The trick is not to be suctioned to point see skeleton (it should look at the underlying Loose bands of muscle, which become more obvious after).

If the problem is these isolated bands, inject Botox in your neck muscle can make them less conspicuous in a patient with large colour, "said Dr. Rod j. Rohrich, Chairman of the Department of plastic surgery at the University of Texas Southwestern Medical Center in Dallas. But patch lasts only three to four months.

Promoted in the last year of "The Rachael Ray Show", Ulthera is a new lifting skin procedure using focused ultrasound to trigger collagen growth depth beneath the epidermis. A single treatment can improve the outlines of the under-chin laxity in patients about 40-55 years old who believe that they are not ready for surgery or placed, several doctors said, including Dr. Matthew White, facial plastic surgeon at NYU Langone Medical Center. Ulthera handpiece pressed to the skin can doctors to see underlying layers onto a screen (as with gynaecological ultrasound) before entering treatment, a first noninvasive Dermatological procedures. "We deposit energy into an exact depth below the surface of the skin without prejudice to the intermediate tissue," said Matthew Likens, CEO of Ulthera, Mesa, Ariz., the company behind it.

Patients may feel pain during treatment. Potential candidates should also be aware that peer-reviewed published studies have yet to quantify just how much sharpening can be expected in the neck and lower face. "It is true," confirmed Mr. Likens. (Research continues, "he says.)

Not to stop Dr. Mehmet Oz, a cardiologist, from proclaiming his television show last month that Ulthera was a "revolutionary nonsurgical facelift" and promises to get rid of a viewer sagging necks live scene. In the segment, said Dr. Haideh Hirmand, plastic surgeon in Manhattan, it was the first time she was "really excited" about a noninvasive technique for lifting of tissue. She stressed that Ulthera is no substitute for surgery, neck skin is too loose. (In a later interview she recommended a pain medication such as Percocet and antianxiety drugs Valium before treatment, which she said was worth for minimal cervical rotating.)

"The company will tell you to do this," said Dr. Tina Alster, a dermatologist in Washington, which has left a pain and an antianxiety medicines mandatory for her Ulthera patients. As I said, Dr. Alster, who will receive a scholarship for research from Ulthera to study its effect on off-face areas, is to see the results in the area of eyebrows, Cheeks and neck of middle-aged patients.

The segment "Dr. Oz" left the impression that the Ulthera device has been cleared by the Food and Drug Administration for the neck and lower face and eyebrow area.

Not so. "The company can only promote device for eyebrows-lift," Although treatment schedule includes the Cheeks and throat, too, Karen Riley, a spokeswoman for the Agency, wrote in an e-mail message. -But they can make any claims with respect to these areas and not promote their device for treating specific conditions in these areas. (As with other procedures, but the doctors can treat other body parts fit.)

Nina Fritz Meyerhof, carrying children on Earth, an organization for peace, was willing to chance it when she met Dr. White this month for Ulthera fixed up her throat and jawline. "I wanted everything to look fresh and tight," she said.

68 Is Ms. Fritz Meyerhof, of South Burlington, Vt., a decade or two older than Dr. White typical candidate, someone who is just starting to Notice during the chin skin laxity. But Dr. White, who has studied the focused ultrasound, knew his skin was still so elastic that it would tighten. (How fast the skin ages vary with factors such as sun exposure, genetics and smoking – which may be why your older pal neck skin is taut while your gave way at 47.)

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Plastic surgery among ethnic groups mirrors the beauty ideals

In Flushing, Queens, surgeons have their attention trained a few metres higher, fitted their nose as their Chinese patients want to turn down. Russian women in Bay Ridge, Brooklyn, with her breasts enlarged, while the Koreans in Chinatown have jaw lines trimmed.

As demand for surgical enhancement explodes worldwide, New York developed a variety of niche markets that allow the city's many immigrants to have tucks and tweaks that are carefully tailored their cultural preferences and ideals of beauty. Just as they can find Lebanese grape leaves or bowls of Vietnamese pho to taste home, finds immigrants surgeons be able to recover the fission of Thal?a, Mexican singer Lee Hyori, Korean or pop star bright eyes.

They can also find a growing number of physicians offering unsurpassed plans to help them afford surgery. If the price is still too high, are illegal surgery by unlicensed practitioners in many neighbourhoods.

Since these specialized clinicians transforming Asian eye brows and Latina silhouettes, they provide a filtered-level perspective on the ambitions and uncertainties for immigrants in 21st century New York — mosaic portraits buffed with Botox.

"When a patient comes in from a particular ethnic background, and of a certain age, we know what to look for," says Dr. Phillip Alizadeh, head of Long Iceland plastic surgical group, which has three clinics in the city. "We're kind of amateur sociologists.

Dr. Alizadeh, himself an immigrant from Iran, admits that the results may seem less like science than like gender stereotypes. Still, he and other doctors who are working on ethnic groups say they can scan their appointment books and detect unmistakable trends: many Egyptians may face lifts. Many Italians transform their knees. Dr. Alizadeh said his fellow Iranians favor nose jobs.

And there is no questioning the surge in demand in immigrant neighborhoods, where Mandarin and Arabic are spoken in the operating room and patients range in age from 18 to 80 ", as a doctor there.

Approximately 750,000 Asians in the United States underwent cosmetic procedures, from the surgery less invasive work as Botox injections, 2009 — approximately 5 percent of the Asian population and more than twice the number in 2000, according to estimates by the American Society of plastic surgeons. Among Latinos, the number of around 1.4 million, almost 3% of the population and a threefold increase from nine years earlier. 2009 Was about 4 percent of white cosmetic work.

In New York, new clinics have opened in immigrant enclaves and practice has expanded to keep pace with demand.

Extreme makeover is in many ways a tradition among the city's immigrants. A century ago, at the beginning of cosmetic surgery, European Jews underwent nose jobs and Irish immigrants had his ears pinned back in an attempt to see the "more" American, "said Victoria Pitts-Taylor, professor of sociology at Queens College who has written about popular attitudes to plastic surgery.

"Most of these transactions was targeted for assimilation issues," said Ms. Pitts-Taylor.

Today show feature as varied and complex procedures. Instead of trying to fit in their new country, transforming many immigrants to their home culture trends and tastes.

"My patients are proud of the rich Hispanic," says Dr. Jeffrey p. Yager, who speaks Spanish and the size of his Office has tripled since opening the 1997 in Washington Heights, a heavily Dominican neighborhood of Manhattan. "I do not have the patients to hide their ethnicity".

While clinics that advertise in the local Russian, Spanish, and Chinese media have much in common with each other and with those serving nonimmigrants – everyone wants to have a flat stomach and a smooth forehead – their core business is as diverse as the languages spoken by their patients.

Dr. Holly j. Berns, an anesthesiologist, feels as if she is a seesaw when she travels from Dr. Yager office to suburban train clinicians. On Long Iceland, she said, "they are doing everything they can get the fat out of their buttocks area." In Washington Heights, "it is the opposite – they just want the ends back enlarged and rounded."

Italia Vigniero, 27, Dominican patient of Dr. Yager 's, had breast implants in 2008 and is considering a buttocks lift to achieve, as she called it "silhouette of a woman."

"We Madrid define ourselves with our bodies," said she. "we have always curves."

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Dominique Browning's Argument for natural ageing

Now, before someone starts turning defensive, let me defensive. This is not an essay about why I categorically oppose cosmetic surgery. I as supportive as the next gal if some one feels so bad about her neck as she does not leave home, or if another is so heavy-lidded that he misses half image every time he blinks. Plastic surgeons have done wondrous things.

As regards dissemination of minor cosmetic procedures? Those that your dentist is offering to do while he is in the vicinity of the mouth? Injections of fillers to plump up lips, smooth wrinkles, pad out laughter lines? At this point, it is a wonder that salesclerk at Barneys does not offer to postpone your face while you are trying on hats.

I am again, not against it. Well, maybe Botox. I am calling for a RANT when my friends come to the brink of the matches to the PIN. I mean, who wants to inject a poison so deadly that it paralyzes nerves, sending small muscles to atrophy?

I'm not categorically opposed to a helping hand, so long as it has finesse. My current rule of thumb, when confronted with an improved face, is that if I am vaguely wondering whether there was work, change was well done. But these days, I wonder why – why did you?

We have gone too far. I am very, very afraid.

We have reached a stage where cosmetic surgery is so easily accessible to in some circles it is expected of men and women to make use of these age-deny. (You cannot call them youth-sticker when you are no longer young.) If you choose not to take advantage of the benefits of needle-knife, is deemed to be to make a statement. You take a stand against the current standards of beauty.

We have triggered a strange, collective, late onset of body dysmorphia. What is worse is that our fears on ageing have floated into our children's generation, so that the mantra about cosmetic procedures including among some 30-year-olds are "intervention early and often."

I began to worry about all this a year ago when I was on a book tour. I love reading aloud and watching people's faces as they listen. Within weeks, I was deeply in touch with my inner ham. Sometimes, I found myself Sila for a response. I would look at the audience, hear laughter and heckling, but sees only stern masks. Even afterwards, would these same faces says how much they had loved my presentation. It took a while to realise that people had trouble expressing emotions in its functions.

This is also when I started developing problem "who are you?".

Too many people have had procedures that have gone wrong. They look strange and tragic. Is it inevitable? You do one thing, the impact is beginning to fade, you make another, and so on. You get puffy. You get numb. Or you picture. And I wonder. Has no one said "stop"? Has no one, especially the chopped needle, carefully advised against further work? It used to be a rare sight site cosmetic surgery addict, but there has been surprisingly common.

We are now in position to watch politicians and newscasters talking about worrying questions — like, say, our education system, or environmental degradation – but they cannot muster signal of concern and less dismayed.

An evening catch in a segment on TV about nuclear disarmament. A celebrity spokesperson makes a case for fixing the amount of weapons, and part of my brain clicked gear: she is smart and passionate. But another part of me is distracted, because Visual does not match the message. Her forehead is not crimp with concern. her Cheeks is no crinkling with smiles, her eyes does not reduce the suspicion of trick questions. No matter what she says, actually her face frozen in place. It is grotesque fascinating — and that, before I know it, is the interview above. Medium lost message.

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Breast surgery requires reconstruction Talk, the law says

After her mastectomy in April Alantheia Pena cried for the loss of her breast. Her partner told her not to worry about flat spot on its chest, but she could tell it bothered him when he looked away as she took his shirt.

It was a friendly Secretary where she went to get his prosthesis, an artificial breasts fill her clothes, who noticed her cry and told her that she could have her breasts reconstructed with health insurance that covers costs. Ms. Pena said his cancer surgeon had told her.

A law on State was signed Sunday by Gov David a. Paterson; now require New York hospitals and doctors to discuss options for breast cancer reconstruction with their patients before you perform cancer surgery, providing them with information on insurance and to refer them to another hospital, if necessary, for reconstructive surgery.

The law came largely through the efforts of Dr. Evan Garfein, plastic surgeon at Montefiore Medical Center in the Bronx who gave Ms. Pena, who will turn 48 next week, a new breast, which made her so happy she wore a bikini last month for the first time in his life.

"It gave me back my life," said Ms. Pena, running H.I.V. Ministry of Friendship Baptist Church in Brooklyn and lives in the Bronx, on Wednesday. -It is like my breasts. It is beautiful. It is perfect. It is a perfect breasts. "

Dr. Garfein, who specializes in reconstructive surgery after breast cancer, head and neck cancer, said he had pushed for the law after a friend of his, Dr. Caprice Christian Greenberg, wrote a thesis demonstrating that poor, minority women were much less likely to get breast cancer reconstruction after cancer than better-off women.

Congress guaranteed universal coverage for breast cancer reconstruction after cancer surgery in 1998. But Dr. Garfein said that only 30-40% of women who have had mastectomies now breast cancer reconstruction.

Dr. Garfein said the number would be closer to 75% if more women were informed of their options. Ms. Pena, covered by Medicaid, had his surgery at North General Hospital in Harlem, which is disused, but she said his doctors had never discussed breast reconstruction with her.

One reason for the low proportion of reconstruction, Dr. Garfein said, be lack of plastic surgeons outside of large academic medical centres, and another can be financial. Medicaid pays about $ 11,000 to $ 15,000 to the hospital and $ 540 to the surgeon, according to Montefiore.

Repayment can vary from thousands to tens of thousands of dollars with private insurance, and some patients may have entire costs covered, while others may have to pay 30 percent, according to Dr. Scott Breidbart, Medical Director of Empire BlueCross BlueShield.

Ms. Pena is still recovering from cancer, but with her new breasts, she said, "at the end of it, you see some kind of rainbow".

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"Vampire Face Lifts": Selphyl injections of your blood platelets

In fact, it is not surgery, a procedure in the office which carries blood from the arm, then spun in a Centrifuge to separate out platelets. They are then injected in your face, hoping to stimulate new collagen production. Selphyl, which the system is called, arrived in the prosperous ansiktsbehandling-regeneration market in 2009 and is now used by about 300 doctors nationwide in the name of beauty, says Sanjay Batra, Managing Director of aesthetic factors which produce Selphyl system.

This year has "vampire facelift" been promoted on "The Rachael Ray Show" and "Doctor." It has also been broadcast in more than a dozen local news programs, some of which are presented unproved claim that results will last two years.

Dr. Drew Ordon, one of the hosts of "The doctor" and Ma plastic surgeon, gushed on air,-vampires have moved into plastic surgery, too, and I am one of them, Patient in his segment had recently also her own fat is injected into her face to the Oh, so it was not clear that platelets had anything to do with her fresher look. (Not to be stopped the audience's applause.)

Scary that process audio, some patients prefer the idea of using their own blood rather than a Neurotoxin or synthetic filler to rejuvenate their faces. "We all want to see better," said Joan Sarlo, 56, who underwent a Selphyl "vamp-lifting", performed by Dr. Lisa a. Zdinak, Manhattan-based doctor whose specialty is ophthalmic plastic surgery. But the "less unnatural better," Ms. Sarlo said. "What can be better than your own blood?"

Some doctors say that Fillers be taken from the body is less likely to cause irregularities and bumps on the agenda than synthetic and Sculptra aesthetic. But now, it is difficult to talk about "Platelet-Rich fibrin matrix" or P.R.F.M. (the medical term for the Golden-hued platelets Selphyl extract), is an effective supplementary means of hollowed-out cheeks and wrinkles.

Dr. Anthony p. Sclafani, Director of facial plastic surgery at New York eye and Ear Infirmary, said he has seen the revivifying the effects of P.R.F.M. on cosmetic patients last for more than a year – sometimes 18 to 24 months. (Dr. Sclafani is a paid consultant for aesthetic elements, and most of his research on the Selphyl financed by the company.)

But no national clinical trial has been done to prove such claims. "There is simply no objective data out there to justify the claim of two years," Dr. Jeffrey m. Kenkel, plastic surgeon masters degree and a spokesman for the physicians Coalition for injectable safety, wrote in an e-mail message.

Dr. Phil Haeck, Chairman of the American Society of plastic surgeons, plagued by a lack of research proving the effect of Selphyl, which costs $ 900 to $ 1,500 for a procedure which takes less than half an hour. "There are no scientific studies, the only personal certificates," he said, adding that he thinks "frightening" concept is so obsolete that bloodletting to cure the disease. "This is another gimmick that people use to make themselves stand on the Internet in a true everyone part of medicine".

In addition, doctors and consumers are not clear on which Selphyl is F.D.A. m.s. family medicine physician who works by refining MediSpa in Johnson City, Tenn., tells consumers that Selphyl is in a YouTube video with Dr. John Argerson, a "recently approved F.D.A. fillers" for the nose to lip creases. And in an article in the December 2009 in dermatology times, a trade publication, Dr. Ranella Hirsch, a master's degree dermatologist, said Selphyl is "a new F.D.A. approved dermal fillers." This week, Dr. Hirsch, who do not use Selphyl in their practice, said she could not explain why she misspoke, adding to an e-mail message to "the lack of clarity between F.D.A. approval versus F.D.A. Finish-to-market is a key issue."

Actually. F.D.A. has not been approved or cleared P.R.F.M. resulted in a Selphyl Centrifuge marketed for Facial rejuvenation. 2002 Cleared the Agency a blood-insamlingssystem called Fibrinet, whose Platelet-rich by-products orthopedic physician then be used to accelerate tissue repair. This same machine was born again as Selphyl 2009, and since then, the company promoted it as a way to "reverse the natural aging process." This week, said Shelly Burgess, a spokesman to F.D.A. Selphyls maker would have to file an amendment in order to obtain approval to market its system for the collection of blood in a new way, and any such amendment could be found in this letter.

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Chinese turn to plastic surgery in growing numbers

But her jaw line? Too square for her taste. As the 22-year-old television reporter recently traveled from a coastal province to a private hospital in downtown Beijing that reshaped – for about $ 6000. Her boyfriend, a 29-year-old businessman wearing designer glasses, picked up the Bill.

"I'm not nervous," said the Devil (English first name she chose for himself, and the only thing she would reveal) as she awaited surgery at Evercare Aikang hospital in downtown Beijing. "I look more sophisticated and delicious."

The breathtaking pace of transformation for upwardly mobile Chinese-from bicycles to cars, the village to the city, between the holidays to ski vacation — now extends to faces. In just a decade become cosmetic and plastic surgery is the fourth most popular way to spend discretionary income in China, according to Ma Xiaowei, China's vice health minister. Only houses, cars and travel rank higher, he said.

No official figures exist, but the international society of aesthetic plastic surgery 2009 estimated that China ranked third, behind the United States and Brazil, with more than two million transactions annually. And the number of operations is doubling each year, Mr. Ma said at a conference organised by the Health Ministry in November.

"We must admit that the plastic and cosmetic surgery has now become a joint service aimed at the masses," he said.

Face lifts and Wrinkle-removal treatments are in vogue, as in the West. But at Evercare, who operates a chain of cosmetic surgery hospital in China, two-fifths of the patients are in their 20s, said Li Bin, general manager and co-founder.

Nationally, most requested operations have nothing to do with age: The No. 1 measure aims to make the eyes appear larger by adding a crease in the eyelid, which constitute what is called a double eyelid, said Zhao Zhenmin, General Secretary of the Government-run Chinese Association of plastic and aesthetics.

The second most popular operation raises the bridge of the nose so that the more prominent – opposite of job characteristic nose in the West. The third is the transformation of the jaw so that the narrower and longer, "he said.

Youthful patients include job applicants hope to boost their prospects in the labour force, teenagers who have had cosmetic surgery as a high school graduation present and middle school students, most of which want an eye job, said surgeons.

China's regulatory system, through all the sources have not kept. At the Conference in Beijing in November, Mr. Ma, Deputy health minister, said the situation ", also called neglect."

11 Clinics and hospitals are offering cosmetic or plastic surgery that has been inspected late last year, said he met less than half the national standards. Staff lacked professional credentials, "said he; equipment and materials was subpar. Beauty parlors are obvious violations, illegal administer Botox injections and perform eyelid surgery.

Mr. Ma was similar to the industry at a medical "emergency zone" with frequent accidents. His point was underlined when a 24-year-old former contestants on Chinese reality show "Super Girl" died after his windpipe filled with blood during an operation to transform her jaw in Hubei Province.

Health officials demanded an investigation. But Mr. Zhao, who also serves as Deputy Head of Beijing's Government-run plastic and cosmetic surgery hospital, said that it was impossible to gather evidence because the body was cremated soon – a standard in China when the hospital privately settle claims unfair.

-Personally, I think it's quite disgusting, "he said. "We have to get to the bottom of such cases to protect people in the future."

Shortcomings in China's medical system is hardly limited to cosmetics and plastic surgery. But the industry now generates an estimated 2.3 billion dollars in revenues, and the Government has begun to note. Officials say the new regulations will probably be issued this year.

An implicit goal is to stop the flow of Chinese patients to better established hospitals in South Korea. Mr. Ma estimates that Chinese account for 30% of cosmetic surgery patients in Seoul.

Now many beauty salons, as well as a downtown Beijing Branch of a major chain, capitalize on the lack of supervision. One recent afternoon, said a 62-year-old woman in a white coat who described herself as a doctor she could call a doctor who can give the visitor the double eyelids in 20 minutes, about $ 180, a fraction of the fee as a standard hospital.

"Immediately you will look different," she said.

Shi Da, Li Bibo, Zhang Jing and Jonathan Kaiman contributed research.

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Tattoos and Permanent Makeup: Skin Deep

Even if the proceedings were "a little uncomfortable," said Ms. Reynoso, now 39, she was pleased with the results. "Everything for the beauty," said she. "It's amazing how you wake up looking quite amazing and get ready in five minutes. I apply only pink, Lipgloss, mascara and I am. "

Permanent makeup, or micropigmentation also known as cosmetic tattoo, go back to the 1980s, when it was developed to address alopecia, a condition that causes hair loss (including eyebrows). Then the field has been extended to Burn victims and cancer survivors, patients with arthritis and Parkinson's disease which is difficult to put on makeup and people like Ms. Reynoso, who would simply rather limit the amount of time spent in front of a mirror.

But while many are happy with their results, not light in the world of needles and ink. The word "permanent" is a misnomer because the color fades with time. Some patients develop granulomas, keloids, scarring and bladders and they report burning sensations when they undergo a M.R.I.

Although the inks used in permanent makeup and pigments of these inks are subject to inspection by the Food and Drug Administration, vary in addition regulations for practitioners (electrologists, cosmetologists, physicians, nurses and tattoo artists) by the State. "You can go on eBay and buy machinery and pigments and go into the garage and set up shop," said Dr. Charles Zwerling, an ophthalmologist in Goldsboro, N.C., and the author of the forthcoming book "Micropigmentation Millennium." He founded the American Academy of Micropigmentation, a non-profit professional organization that offers certification for practitioners, 1992.

"We see thousands of faces which is destroyed by people who may not be trained properly, and it is the biggest problem in permanent cosmetics," said John Hashey, owner of John Hashey advanced school of permanent cosmetics in Stockholm, Fla. Mr. Hashey said that 90 percent of its business activities, fixing mistakes. -Your average cosmetologist who cuts hair to make 1,200 to 1,500 hours just to do it, "he said. "How is it any more important than with a needle in someone's eye?"

The negative reactions to micropigmentation includes infections such as hepatitis, staph H.I.V., and strep has from dirty needles and allergic reactions to the permanent dyes, said Dr. Jessica j. Kranten, a dermatologist in Manhattan and a Clinical Assistant Professor of Dermatology at SUNY Downstate Medical Center in New York.

A report in this month's issue of clinical infectious diseases reported an outbreak of mycobacterium haemophilum, nontuberculous mycobacterium causing skin, joint, bone and pulmonary infections, permanent makeup was applied to the patients ' anletes. A study last september in contact dermatitis, a medical journal, examined the serious side effects such as swelling, burning, and the development of papules in four patients who had at least two permanent-makeup procedures on their lips. "In light of the reactions that are difficult and often therapy-resistant skin we recommend regulating and control of substances" are used in dyes, the authors wrote.

Nancy Erfan, a real estate agent in Monterey, California, had a bad experience. In November 2003, Ms. Erfan, now in his twenties had permanent color is applied on their lips and eyes. The technician told her she would be swollen for a few days, and gave her a cream to help. But swelling worsened, Ms. Erfan said, and soon she had "huge shock" around his eyes and lips.

"I could barely open my mouth to eat or speak," she said, she visited many dermatologists and plastic surgeons, but found no remedy. "They said I obviously having an allergic reaction, but they knew not what to do."

It turned out that the colors used in a colour that Premier pigments, a producer was tainted after F.D.A has received more than 150 complaints, said the company eventually across the Board.

Finally found Ms. Erfan Dr. Mitchel Goldman, a dermatologist in San Diego who specializes in the laser removal of tattoos. He made six treatments over a year, a total of about $ 10,000, which the insurance did not cover. Acupuncture and Chinese herbal medicine helped facial pain and swelling, she said. Dr. Goldman to larger F.D.A. supervision of permanent make-up. "I've had patients who have infections on their lips and eyebrows since those tattoo artists are not fully regulated," he said. "They use equipment that is not sterile. Many infections will also from tap water. The dipping their needles and transmit infections. Pigment goes to the lymph nodes. Who knows if 20 years down the line of patients will have Lymphoma or cancer due to these carcinogens in pigment tattoo? "

Mr. Hashey believes bodybuilding should be regulated nationally and is required to obtain 600 to 1,500 hours of training.

Elizabeth Finch-Howell, owner and founder of the Derma International, a permanent cosmetics manufacturers in Kempton, PA., believe at least 100 hours is enough. (She got a tattoo that matched her skin colour to cover up a port wine colored birth mark on half of her face, the adoption of the measure itself because "I do not trust anyone else," said she.)

Ms. Erfan, she is still ANGRY, years later. It took her more than a year and a half to recover, "she said, and she still has scars on his lips. She must wear make-up to cover the scars and white lines above its mouth, and face the pain persists. -Apply makeup is one thing, but injected into your body? I feel stupid, "said she;-but everything I read about permanent makeup was positive, how even Cleopatra tattoo his eye liner and lip liner. I thought it was safe. "

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Venezuela's newest enemy: Breast lifts

Blame for the boom in such operations here, Mr. Ch?vez said on State television over the weekend, rested with the doctors who "convinces some women that if they do not have large bosoms, they should feel bad." He said there was a "monstrous thing" that poor women seeking breast lifts when they had trouble making ends meet.

"What is this, friend?" Mr. Ch?vez declared its viewers.

Mr. Ch?vez's comments come at a time when Venezuela has emerged as one of the world's leading markets for breast augmentation. Between 30 000 and 40 000 women here to undergo the procedure each year according to the calculations of the Venezuelan society of plastic surgeons.

Signs in Caracas advertise bank loans to surgery. Gossip Blogs speculate about the improvements made to contestants in the Miss Venezuela ... Last year, tried a candidate to the national Assembly, Gustavo Rojas, to finance his campaign by raffling of breast cancer elevator (he lost anyway).

"I've never seen more silicone elsewhere," said Mireia Sallar?s, a filmmaker from Spain that focus on feminist issues and are working on a project about Venezuela, the newspaper Tal Cual.

Mr. Ch?vez regretted the amount of money spent on cosmetic breast surgery, there are also a darker side with procedures with reports of surgical mistakes resulting in death in some patients. A 20-year-old woman, Paola Rios, died in Caracas this month due to complications from breast augmentation surgery.

Mr. Ch?vez standing on a tripod in Venezuelan popular culture urges swift reactions from some quarters, particularly the medical profession. "I think not enough should be no kind of discrimination of these aesthetic procedures," said Dr. Ram?n Zapata Sirvent, leading plastic surgeon here.

In an acerbic leader on the subject on Monday compared the opposition newspaper El Nacional Mr. Ch?vez to Colonel Muammar el-Qaddafi, the Libyan leader, who regard Mr. Ch?vez as a friend. "Now, this obsolete militaristic, coarse, repressive stance on women's freedom to do what they want with their bodies," said El Nacional.

President, however, made it clear that breast augmentation did not square well with his revolutionary priorities. He said that among thousands of letters he receives from supporters, arrived asking for his help for a breast cancer Elevator, which would cost as much as $ 7,000. "Of course I had to reject it," he said.

State media in agreement with the President on the subject. The State newspaper the Correo del Orinoco claimed this month that plastic surgery "as common as dentist appointments, and it is not unusual for wealthy parents proudly buy his 15-year-old daughters breast implants for" come of age "birthday presents."

Maria Eugenia Diaz contributed reporting.

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The dispute over Cancer tied to implants

When talking to patients about a rare type of cancer linked to breast implants, should plastic surgeons call it "conditions" and avoid using the word cancer, tumor, disease or malignancy, Chairman of the American Society of plastic surgeons advised members in an online seminar on 3 feb.

Comments made by Dr. Phil Haeck, society President, published on Thursday by the public citizen Health Research Group, an advocacy group in Washington. The Group also wrote to the Food and Drug Administration, characterizing advice as part of a campaign of misinformation is scheduled to play down the risks of implants and urging health officials to put an end to it.

Dr. Haeck was traveling and unavailable for an interview, according to a spokesman for the plastic surgeons group, a statement in response to public citizen's claims.

Surgeons ' group said public citizen had taken Dr. Haeck remarks of context and misinterpreted them; he discussed a possible link between implants and anaplastic large cell lymphoma or ALCL, a cancer which means that the immune system.

The statement said, in part, "far from intending to trivialise or minimize this problem, Dr. Haeck tempore remarks were well understood by doctors present that type of ALCL observed in possible association with breast implants do not seem to have malignant course of classical ALCL is a systemic disease."

Events that grew out of a message on Jan. 26 by the Food and Drug Administration that breast implants can cause a small but significant increase of lymphoma, which is uncommon but treatable. It is not breast cancer. It is usually a systemic disease, but in those cases associated with the implants, grew Lymphoma in the chest, usually in the capsule of scar tissue around the implant.

Although some evidence suggests that Lymphoma associated with the implants may be less aggressive than the more common form of the disease, that evidence is not convincing, "said Dr. William Maisel, the first scientist and Deputy Director for Science at the Center for devices and radiological health to the Food and Drug Administration.

The disease is very rare. At the time of the announcement January said drug agency it knew only about 60 cases worldwide, a small number compared to 5 to 10 million women have implants. But even that small number appear to be an excess of cases compared to the regular presence in the breast of this type of lymphoma in women who do not have implants: 3 in 100 million.

In some cases, simply remove the implants and scarring appeared to eliminate disease, but other women received chemotherapy or radiation, or both.

Online Seminar, about an hour long, was available only to members of the American Society of plastic surgeons and the American Society for aesthetic plastic surgery. About 600 members logged in. Plastic surgeon who saw the session made a transcript of part of it and sent them to public citizen. New York Times showed the seminar and verified that Dr. Haeck enlighten the audience to call Lymphoma "conditions" when talking to patients ' rather than to disrupt them by saying that this is a cancer, it is a malignancy. "

The physician transcript said in an interview that he did so because he was disturbed by the advice to avoid calling for lymphoma, a type of cancer, and considered that the plastic surgeons society was misleading its members who in turn can mislead his patients. He asked that his name be withheld because he did not want to make enemies of their colleagues by contributing to the bad news about implants.

Food and Drug Administration issued a statement saying the review public citizens ' letters and added: "in F.D.A. has been very clear in our communications possible association between breast implants and the development of ALCL, which is a very rare type of cancer. It is important that health professionals and women who have breast implants, or considering breast implants are aware F.D.A. 's recommendations on this matter. "

The Agency has said that women with implants should pay attention to changes in their breasts and see a physician if swelling, lumps, pain, asymmetry or other symptoms develop. Lymphoma can occur years after implant surgery.

Dr. Felmont Eaves III, Chairman of the American Society for aesthetic plastic surgery, said: "when the numbers are so extremely rare that this danger is sometimes an overreaction. We want to ensure that women and surgeons put it in the right perspective. "

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A Boom in plastic surgery for them during the golden years

But one thing needed improvement, she decided: her figure. At his age, "she said," your breasts go in one direction and your brain goes into another. " So on July 22, Ms. Kolstad, a widow living in Orange County, California, underwent a three-hour breast lift with implants, which costs about 8 000 $.

"Physically, I am in good health, and just feel like, why not take advantage of it?" said Ms. Kolstad. "My mother lived for a long time and I will only take it for granted that it will happen to me. And I want my children to be proud of how I look. "

Ms. Kolstad is one of several septuagenarians and octogenarians, also cut the nonagenarians as golden years with the help of a plastic surgeon. Under were American society for aesthetic plastic surgery, 2010 84,685 surgery among patients age 65 and older. Those with 26,635 face-lifts, 24,783 cosmetic eyelid activities. 6,469 liposuctions, 5,874 breast reduction. 3,878 forehead lifts, 3,339 breast lifts and 2,414 breast industrial cooperation.

Except for a brief turndown during the recession, these figures had risen over the years, and experts say the trend looks likely to accelerate when the baby boomer generation starts to pass the age of 65. But growth has also raised concerns about safety and propriety reasons perform invasive elective surgery in elderly patients, who can in case of accidental physical and psychological consequences.

There are so many reasons to get plastic surgery that older patients, say experts. Some people are living longer and remaining healthier, and they want their physiques adjust after their psyches. Some are trimming for potential drivers ' mates and want their fans to see their freshest. Some are still working or seeking jobs and want to be seen as more youthful Challenger.

And some are simply sick slackened chaps, jiggly underarms and saggy eye brows. Gilbert Meyer, a retired film producer in Boynton Beach, Fla., which gave his age as only "over 75", saw Dr. Jacob Steiger, facial plastic surgeon in Boca Raton, Fla., for an eye and neck lift last year. He spent $ 8,000.

-I was looking at myself in the mirror and don't like what I see and did something about it, "said Mr. Meyer. "Why not look as good as you can when you can?"

Mary Graham, a 77-year-old restaurant owner in Thomasville, GA., was given a facelift and breast implants earlier this year. "The only time I go to the doctor for plastic surgery, she says.

Ms. Graham is planning to open another restaurant in Tallahassee, Fla., in the fall. "I work seven days a week," said she. "I wanted to look as young as me."

Her plastic surgeon, Dr. Daniel Man of Boca Raton, Fla., who said that he looks more and more patients over 70 years of age, said, "these people are healthy and want to be an active part in society."

Any measure involves risks, but surprisingly few studies have focused on elderly patients and cosmetic improvements. A report published in the journal of plastic and reconstructive surgery in June, found that the risk of persons over 65 years does not exceed the younger population.

Researchers from the Cleveland Clinic reviewed the medical records 216 facelift patients over the course of three years. The researchers found no significant differences in instances of minor or major complications between a group of patients whose average age was 70 and another group whose average age was 57.6.

"We say it is not the chronologic age which is so important, but it is certainly physiological," said Dr. James e. Zins, senior author study and Chair of the Department of plastic surgery at the Cleveland Clinic.

All patients in his study were screened for health problems such as lung cancer and heart disease, diabetes and high blood pressure, and the use of medication, anticoagulants, that could have complicated business. But not all elderly patients may be screened so thoroughly, so his result is not necessarily the risks are minimal in an older population.

"There is a theoretical age complications are more likely?" He mused. "It means that patients 70 and 75 years and older can safely undergo a facelift with complication is the same as young patients? We do not have enough numbers to answer that question. "

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Plastik kirurgs conversation draws a Mile-High crowd

I try usually arrive the night before when I have to lecture at meetings. It gives me a chance to unwind. Recently, I came to Las Vegas at 5 a.m. for a talk that started at 7. If I had done a procedure, it would be something that I could, or would have done so.

Most of my trips mean actually, medical meetings, lecturing and teaching. It is important to keep up with things and to train other doctors. So no I am opposed to take time away from practice.

I do also some pro bono travels to developing countries, mostly to correct photo malformations. That is incredibly rewarding. Sometimes, I'll also squeeze in a vacation, but now I am the proud father of 3-year-old twin daughters, so these vacations are few.

Last fall I flew to Milan to teach Rhinoplasty at an international course. There were more than 700 participants from almost 60 countries. This was a great event, and I spent the entire flight tweaking and retweaking my PowerPoint presentation, watch on for what seemed to be millions of times all the time I was on the plane.

I sat next to this attractive woman. I was close enough to tell that she had had excellent plastic surgery. She noticed what I did and we began to talk. Soon I was knee-deep in a discussion about plastic surgery and youthfulness in General. Flight attendants and surrounding passengers asked to see my pictures, which included some before and after shots and some surgery, which mesmerized many of the passengers, but many of them also grossed.

When flew home from a pro bono trip to Honduras, had I my surgical instruments such as scalpels or surgical scissors in my luggage. It is not like this stuff can go into a "carry-on.

Agent of customs in Miami, opened the set of instruments and questioned me as if I was some kind of serial killer. It was really bad and although I tried to explain why I travel with scalpel and other equipment, he was not listening. Before I knew it, I was surrounded by security and their main supervisor.

I turned on my laptop, which was already out, and showed them pictures of children I had operated on. All felt bad about giving me trouble, and I was actually an escort to my gate. I am sure that will never happen again.

I sometimes feel uncomfortable telling people I am "facial plastic surgeon" on a trip as this can make some people uncomfortable and others feel the need to break down the field.

I had one other passengers tell if they "believe" in plastic surgery. I really wasn't sure what meant, and I don't go into a speech about how surgery can improve lives and how many of us are doing humanitarian work to assist victims of domestic violence or those with birth defects.

But most people are really curious. And I have no problem not answering questions, especially if I can help educate people. I get always the question: what would you do for me? I am always honest.

There is always a responsibility to answer the call for integrated medical help. I would like to help and am updated on C.P.R. and advanced cardiac life support certification.

I did once a flight attendant whose blood sugar was low. But by sheer luck, primary care doctor or an emergency medicine physician has been among the passengers on other flights when crews were asked if there is a doctor on board.

It was great, because I really better equipped, so that in case someone needs an acute nose job at 35,000 feet.

By Steven Pearlman, who said that Joan Raymond. E-mail: joan.raymond@nytimes.com

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A Haitian family reunites in Miami, through Video

"I want to ask him something," said the boy's sister, Mary Rose, 28, in Port-au-Prince, pointing to Chad Henne, Miami Dolphins quarterback. She smiled coyly. Everyone expected her to ask for a date.

She asked, instead of a tent.

Mr. Her looked surprised. "We can try," he said.

Celebrities and refugees are oil and water of this tropical city, which rarely mix outside of valet parking. The Haiti earthquake on January 12, has however repeatedly upset the usual hierarchy. And so it was on Monday that in a part of Miami Vice President Joseph r. Biden Jr. met with Haitian-American leaders to discuss Haiti's redevelopment. In another separated a celebrated babies named Jane were reunited with their parents while Haiti here at Notre Dame D ' Ha?ti Catholic Church in Little Haiti, technology brought together dazzle, needs and a family.

In two rooms linked by broadband, false tragedy became. When Amelise Jean-Baptiste and her son Exais Peterson saw half a dozen relatives in Haiti on a larger TV, was their travails and triumphs all had. Peterson, who seized the boy, called limelight.

"Stand up, let me look at you," his sister said. He puffed out his chest and smiled. She asked him to turn his head. His left ear still missing its lower LOBE; part of his Kind looked so ragged that gravel. But his family in Port-au-Prince looked happy.

Peter's recovery was marvellous.

Much of his face had been virtually absent when his neighbors him out of the rubble of his home in Port-au-Prince, four days after the earthquake.

Dr. Chad Perlyn, plastic surgeon, recalled that the lift boy's bandages at the University of Miami field hospital in Haiti and discover hundreds of maggots. "He lost most of his stomach and scalp," said Dr. Perlyn. "His whole body was infected."

Peterson and his mother flew out on a military flight and ended up at Miami children's Hospital, where Dr. Perlyn methods. Eleven measures later Peterson is learn English and lives with his mother in a hotel with the families of 18 other children who fled after the earthquake.

He told his relatives at home that he was satisfied. His mother said the same thing, and it took a little time for the family to lose itself in catching up.

Half an hour in publicists reminded the translators that there were stars in the room. "Tell them who are here with you," says David Saltz, usually producing Super Bowl half time show. But nobody listened.

Eventually the family was in Mr. her and Pras Michel, a hip-hop artist, formerly of the Fugees. Family smiled kindly.

Mr. Her later said that he had been inspired by the family's strength and stamina to plan a trip to Haiti on Sunday to deliver a tent in person. But more than shelter, relatives in Port-au-Prince said they wanted an assurance that Peterson could stay in the United States permanently.

Conditions are so bad that "return to Haiti right now is certain death," says Mary Rose. Peterson must stay, she added, "even if it means we are dying so he can live."

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Breast surgery requires reconstruction Talk, the law says

After her mastectomy in April Alantheia Pena cried for the loss of her breast. Her partner told her not to worry about flat spot on its chest, but she could tell it bothered him when he looked away as she took off her shirt.

It was a friendly Secretary at the place where she went to get his prosthesis, an artificial breasts fill her clothes, who noticed her cry and told her that she could have her breasts reconstructed with health insurance that covers costs. Ms. Pena said his cancer surgeon had told her.

A law on State signed on Sunday by Gov David a. Paterson now require New York hospitals and doctors to discuss options for breast cancer reconstruction with their patients before you perform cancer surgery, to give them information about insurance coverage and to refer them to another hospital, if needed for reconstructive surgery.

The law came largely through the efforts of Dr. Evan Garfein, plastic surgeon at Montefiore Medical Center in the Bronx who gave Ms. Pena, who turns 48 next week, a new breast, which made her so happy she wore a bikini last month for the first time in his life.

"It gave me back my life," said Ms. Pena, running H.I.V. Ministry of Friendship Baptist Church in Brooklyn and lives in the Bronx, on Wednesday. "It's like my own breast. It is beautiful. It is perfect. It is a perfect breasts. "

Dr. Garfein, who specializes in reconstructive surgery after breast cancer, head and neck cancer, said he had pushed for the law after a friend of his, Dr. Caprice Christian Greenberg, wrote a document showing that the poor, minority women were much less likely to get breast cancer reconstruction after cancer than better-off women.

Congress guaranteed universal coverage for breast cancer reconstruction after cancer surgery in 1998. But Dr. Garfein says that only 30-40% of women who have had mastectomies now breast cancer reconstruction.

Dr. Garfein said the number would be closer to 75% if more women were informed of their options. Ms. Pena, covered by Medicaid, had his surgery at North General Hospital in Harlem, which is disused, but she said his doctors had never discussed breast reconstruction with her.

One of the reasons for the low proportion of reconstruction, Dr. Garfein said, perhaps the lack of plastic surgeons outside of large academic medical centres, and another can be financial. Medicaid pays about $ 11,000 to $ 15,000 to the hospital and $ 540 to the surgeon, according to Montefiore.

Compensation can range from thousands to tens of thousands of dollars with private insurance, and some patients may have entire costs covered, while others may have to pay 30 percent, according to Dr. Scott Breidbart, Medical Director of Empire BlueCross BlueShield.

Ms. Pena is still recovering from cancer, but with her new breasts, she said, "at the end of it, you see some kind of rainbow".

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Appreciate your value as you age

It would be easy to dismiss fear that such aesthetic concerns that weak. But two models-turned-psychotherapists argues in "Face It," their new guide for women, to struggle with changing appearance can not less terrifying than about a financial loss, a demotion at work or a divorce.

After decades of counseling patients, says Dr. Vivian Diller and Dr. Jill Muir-Sukenick to dread about growing older can spur an existential crisis of the kind. Such a fear is not about vanity per se, but has more to with a loss of opportunities and questioning his position in the world. It can lead to depression, alcohol abuse or disruption favourable sleep, they say.

Yet usually not therapy on the short list of solutions for those disturbed by an aesthetic "problems". A lunch laser treatment or a $ 180 face cream is.

Dr. Diller, 56, and Dr. Muir-Sukenick, 57, is here to tell the American women — no matter how stellar their achievements — that it is not superficial recognise the ageing is undeterred. They encourage their readers to figure out what drives them to daydreams about a subtle facelift instead of schedule one.

At a time when cosmetic surgery ever to be seen as a casual endeavor, and anti-aging injections as inevitable, "Face It" giving women the practical steps to analyze what they look at this beauty paradox. "Should women simply grow old naturally because their looks do not define them, or should they fight signs of aging, because beauty and youth is their currency and power?" asks writers in his book.

The answer is not easily, if they are 20 years worth of patient information that the book is based on is any indication. (The respondents also other women, 30-65, including models because they sometimes consult with a modelling agency.)

Mandate not to see your age has never been stronger. "We are talking about a generation of pioneers," said Dorree Lynn, a psychologist in Washington whose book about sex after 50 is expected to be released in April. "They don't need role models for the way older."

60 Is the new 40. "That is a pure lie," said Dr. Lynn. "What is true is 60 is the new 60. "

Although appearance matters can be painful for women who feel "somewhat insulted by the fact," said Dr. Diller. Was not feminism to do campaigns and ceiling-shattering the attention get, not a tense boiler?

The book's most exciting stories from patients who are surprised to find herself mourns its voltage peaks and veiny legs. Katherine, who did not use her real name in the book, is a 53-year-old science scholar and mother of three who saw himself in the camp "more important things to worry about." But when she nixed a beach getaway with her husband because she did not know any swimsuit, she was disturbed by how much she cared. She came late, admitting that her family may have taught her to care about appearance is superficial, but that she could be a woman of substance that have happened with a retinoid at night or visiting a spa sometimes.

This positive age of aesthetics is particularly stressful because the playing field is no longer equal. A baby boomer is pressed to choose between her forehead to be au naturel or smooth in his later years — a decision her mother did not face. Ann Kearney-Cooke, 54, an expert in body image in Cincinnati, said the message they heard their mother mothers look could was insulting: "you're not going to be pumping out babies anymore – you're not so much benefit to society." But at least, the sight of peers with the same number of wrinkles was a comfort. They might think we are "all in the same boat," said Dr. Kearney-Cooke, a psychologist.

The authors of "Face It" point out that today an odd moral creeps in our estimates of what we find acceptable. Ridicule too obvious cosmetic surgery is now a great American pastime. A post on Gawker asks why people still get plastic surgery recently received more than 400 comments, sent many via email from high soap boxes.

Much more fascinating is the 60-something celebrities masses anoint for having the courage to grow old "naturally" focus (gasp!), or at least does not utilize all available to them. Meryl Streep is one such actress. Helen Mirren is another. We like to imagine they are inoculated in any way against self doubt.

And so, in January, it was vaguely disturbing to hear that Ms. Mirren has a laissez-faire faire attitude to cosmetic surgery instead of the upright just-say-no thrust her fans had adopted. On a British morning show, "she said," you go, "I don't want to look at this face longer" and I understand it, absolutely. "

But why does that make her a sold-out, Dr. Diller asks. The authors said in an interview for this article, they were not against plastic surgery or less-invasive efforts to slow time's March. Choosing an intervention of fear or downstairs is what annoyed them. Sounding completely laissez-faire with myself, "said Dr. Muir-Sukenick she prefers women reflect first, before you act.

But just as both Dr. Diller and Dr. Muir-Sukenick invites women to enjoy their future, not their past, their modeling headshots keep stalking them as ghosts of Christmases past. They appeared on the screen during the authors ' 11 March appearance on "Today" show, and the two women brought them out after the interview for this article. So, why can't its 50-something faces lined with wrinkles – speak for themselves?

As Betty Friedan once said of a woman later years ' If you pretend it is youth, will miss it. "

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Cosmetic surgery Gets a little NIP and Tuck

Such procedures, including nose jobs, eyelid surgery, liposuction, tummy tucks and breast industrial cooperation, fell in line with almost 9% in 2009, the society reported Tuesday, 1,521,409 from 1,669,026 in 2008. Nose jobs, eyelid surgery fell 8 percent among the doctors who answered the survey, 715, while liposuction were down a whopping 19 percent. Tummy tucks and breast industrial cooperation decreased 5 and 6 per cent, respectively.

Wallet questions can be the story behind the numbers — an action that a tummy tuck costs on average $ 4,936 NET thousands of dollars in anaesthesia and operating room. But maybe the Americans also started to make the best of their glances, invest in closet improvement instead of, say, liposuction.

-Cosmetic surgery is an object of luxury, says Dr. Michael f. McGuire, President of the American Society of plastic surgeons, who practices in Los Angeles. "People think twice about money, even if they have it, I have noticed very wealthy patients, they postpone."

Dr. McGuire believes that these deferrers eventually will have the operation that they wish. "People shoot it, but if you have been unhappy about something, you get it fixed," he said.

Although the figures provided by the American Society of plastic surgeons offer a valuable snapshot, they are not definitive. The doctor replies to a survey cannot answer it next year. And the figures do not include doctors who perform cosmetic procedures and trained in, say, obstetrics-gynecology or general medicine.

The decline reported in the survey was repeated in another recent study by the American Society for aesthetic plastic surgery, which found an even steeper decline in cosmetic-surgery procedures performed last year to 18 percent.

Even some doctors expressed confidence that there is pent up demand. Dr. Robert Singer, a plastic surgeon in San Diego, said that people have tried to less-expensive alternative to the procedures they want.

For example, some patients have "chosen to be fillers or Botox because they felt – and it was marketed to them – it would be instead of a facelift," Dr. singer said. But "it does not provide the results they wanted."

Other patients "had a decent result" by injected with a mixture of Botox and fillers, said Dr. Singer, a former President of the American Society for aesthetic plastic surgery. But the result is temporary, and some of these patients now want a longer-lasting surgical improvement of their face, "he said.

Realself.com, a website where patients discuss cosmetic procedures, recently did a study with Harris Interactive to get a feel for how many consumers it is aesthetic dreams deferred. In an idealized world in which we all have enough money, they asked, how many of us would opt for cosmetic changes? Sextionio% of the nationwide sample of 2,148 adults were surveyed in March said they would choose to cosmetic work time, from 54 percent who said the same thing in November 2009.

Tom Seery, President and founder of Realself.com, said in an interview that the site's traffic grew and the visitors displayed "strength and interest around cosmetic surgery on invasive page."

For the first time reported the doctors investigated by American Society of plastic surgeons, surprisingly, that the number of wrinkle finish freezing botulinum toxin injections administered declined by 4 percent. Last year, approved by the Food and Drug Administration of Dysport for smoothing wrinkles between the eyebrows, clearing the way to give Botox a run for its market share. But it seems that the Dysport arrived just as the Americans do not decided to get as many botulinum toxin injections for aesthetic problems, perhaps a sign of a fatigue among people who received routine injections for maintenance.

"You've had it for years every couple of months, first of all, you've spent a lot of money," said Dr. McGuire, who shoot Botox and Dysport. "It will be added and it hurts every time you have." A staggeringly large number of doses of Botox or Dysport was still injected in 2009: 4,795,357, at $ 405 each on average. Such injections remain the topmost minimally invasive cosmetic procedure.

Some obscure cosmetic operations increased in 2009, despite their not inconsiderable cost. It was a small uptick in calf augmentation, which entails using a silicone implant to improve calves up to 259, from 247. Surgical pumping calves is not cheap — $ 3,649 on average – but apparently ballet dancers and Bodybuilders will find them worthwhile. "To be a success as a ballet dancer, is about as much your appearance as your ability to dance," Dr. McGuire said. "You may have good muscle, but it has no shape and appearance are considered optimal."

LIP industrial cooperation using a physical implants, which costs on average $ 1,736, is also increasing. More than 21,000 people had lips filled in this way as opposed to, say, at regular intervals with the lips are injected with a filler. Uptick is particularly remarkable given the no lasting lip implant has approved for the purpose of the Food and Drug Administration, which means that this use cannot be marketed by the company. Doctors may instead choose to use an implant approved for another part of the face.

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Plastic surgery group starts advice Web site

Conor Friedersdorf and Reihan Salam discuss the limits of presidential power. For some, the President's speech on Afghanistan troop withdrawal was repeated unfortunate moments in history.

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A little too ready for her close-up?

In small but significant number of beginning filmmakers and casting executives reconsider Hollywood's attitude to breast implants, Botox, collagen-injected lips and all kinds of plastic surgery.

TV executives at Fox Broadcasting, says for example, they have begun to recruit more natural looking players from Australia and the United Kingdom since more than well endowed positions, freakishly young professional crowd shows up for auditions in Los Angeles is suffering from too much sameness.

"I think all either looks like a drag queen or a stripper" said Marcia Shulman, who oversees casting of Fox network's scripted performances.

Independent casting directors as Mindy Marin, who worked with Jason Reitman film "Up in the Air", invites talent agents to prevent clients from having surgery, especially older celebrities as she argues, lose their jobs because their skin is too tense or swollen with. Said Ms. Marin: "what I want to see is real."

Even extras get once-over. Sande Alessi, who helped cast "Caribbean Pirates" movies, said she is offering to photograph actresses in their bathing suits, tell us if they can keep the photo for their audition books.

Professional courtesy? Not necessarily. Moviemakers prefer actresses with natural boobs for costume dramas and period films. So much so that when the Walt Disney Company announced recently for extras for the new "Pirates" movie, casting call indicated that only women with real boobs need apply. By taking a photograph, Ms. Alessi said, "we need not ask, we."

Step towards a ' less is more "is operated by a number of conflicting social and technological trends, said more than a dozen films and TV professionals.

Cosmetic improvements still popular, with 10 million surgical and nonsurgical procedures are performed in the United States in 2009, according to the American society for aesthetic plastic surgery. At the same time, the proliferation of HD television — as well as a curious generally trained eye – has made it easier to find a celebrity poorly sewn hairline or botched eyelid lift.

Men, is, of course, not immune to the lure of a youthful Surgeon a scalpel. But there are women, to no surprise that most closely, is to be examined.

Botox is the enemy in a post-"Avatar" 3D infatuated Hollywood, where the ability to crumple a mouth to a frown is as necessary as to remember their lines. More frightening is how young plastic surgery supporters become. In January was the actress Heidi Montag on the cover of people magazine, touting the 10 cosmetic procedures that she received one day. She is 23.

"Era" I see great since I did this to myself "has gone through," said Shawn Levy, Director and producer of "date Night" and "night at the Museum" movies. "It is seen as ridiculous. Ten years ago had actresses feeling that they had to get plastic surgery to get the part. Now, I think it works against them, go to a casting session hurts look fake even chances. "

Few in Hollywood are willing to admit that the Chin reduction or mini eyebrow lift. (Remember when Jennifer Grey M?deret nose job, a move that some say are damaging his career?) Celebrities are more open to discuss a previous drug problems or sex addiction, because there is less concern a confession which will damage their careers. But with so many types of cosmetic rejiggering is often painfully obvious results and difficult to fix.

Ms. Shulman, Fox met an agent recently to discuss hiring an actress who apparently had work. "What she did to his face?" Ms. Shulman said she asked the agent. "He said," nothing ". I lightly. I am thinking only not to argue. I said, ' she is not for me then. " ”

Head shots, is even more reliable. Ms. Marin said she sometimes checks AwfulPlasticSurgery.com, an advertising site that portrays the surgically enhanced confirm suspicions about who did what. When Ms. Alessi casting "The Curious Case of Benjamin Button" in 2007, she received hundreds of head shots. Some of the actresses who arrived for the audition, however, saw nothing out of their photographs.

"They would have these huge puffy lips and frozen units," said she. "you say to yourself," Oh, I can't use you. "I don't mind if they do a little bit of something, but it may not be obvious."

An actor can also lose a role of a Director, if the suspect surgery was performed or not. John Papsidera, a casting director for "Batman" films, "he said, a Director (he declined to say which one) recently discussed whether to hire an actress in his early 20s to play a teenager, falling in love. The actress was talented and naturally beautiful. But what is stopping the Director was his suspicions that such young, she already had breast implants.

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Awake for breast cancer implants? If you want to

How do I do? She was awake. Most women who get breast implants do so under general anesthesia. But Jane. Z. 's doctor was Dr. Robert l. True of Colleyville, Eg., one of more than 100 doctors across the country who are in favour of local anaesthesia and Sedation for aesthetic operations that breast cancer industrial cooperation.

"They're talking to me all the time," said Dr. True, a professor and gynecologist with training, the 75 patients whose breast he has expanded into their accredited facility. When the new implants is in, his patients is done at the operational, look in a mirror and have their say. "They want a little bit" independence, "he said.

Lots of plastic surgeons believe that it is possible to perform a breast augmentation without an anesthesiologist or nurse anesthetist ?, partly because of the risk to the patient if something goes wrong. These doctors say they are not their best work – dissecting a pocket for an implant and protecting it – without total control.

But recently, a set of doctors, most of which have not come through plastic surgery, has been touting the option awake as a blessing to the patient's choice and as a safer alternative than general anesthesia. Breast augmentation is often done in hospitals and accredited offices, but awake breast surgery is usually done at an Office which may not have been tested for safety by an accrediting organization.

-The problem is, doctors do major procedures on local with quote unquote Sedation to circumvent the need for accreditation, "says Dr. Lawrence s. Reed, Chairman of the American Association for accreditation of ambulatory surgery facilities.

For most of the surgery, Jane z., said 48, reviewing medical charts for a hospital, she felt "quite a lot of it." She added, "you are technically awake, but you will remember nothing." In a more coherent moments, she remembers is invited, before Dr. True sewn her up, if their new breast was sufficient. She asked to go a little higher and got his wish for a DD Cup.

"If you talk with 99% of women, they want contributions to what they will look like," said Dr. Jeffrey Caruth, a professor and gynecologist with training offering now awake cosmetic surgery in his Office in Plano, Tex. "people don't come to me because it is cheaper. They do not want to sleep. "

Doctors offer awake breast augmentation and awake Abdominoplasty (tummy tuck) advertise on YouTube.com and propagate local anesthesia and Sedation on their Web sites. In recent years, the market for awake breast augmentation ramped up. No organisation keeps track of how many doctors do the awake version of this surgery (or tummy tucks).

Dr. Anil k. Gandhi, which performs both awake procedures in their offices in Cerritos, California, said he had met "for more than 100 doctors" in two days $ 7,000 seminars for national society of cosmetic doctors. His students are doctors who usually made their group accommodation in ob/gyn or family medicine and takes a course on the weekend (or two) If you want to know how you make aesthetic operations with local anesthesia and Sedation.

This shortcut to practicing aesthetic surgery tends to be evangelists. After all, practicing plastic surgeons spend five to eight years after medical school learning operations and then have their surgical skills tested in exams.

-Two, it's just crazy, "says Dr. William p. Adams Jr., a plastic surgeon in Dallas who teaches residents at the University of Texas Southwestern Medical Center. "It took us six years to fully train plastic surgeons to breast augmentation." He said it was irresponsible to let fuzzy-headed patients choose their implants. "They don't let people drive after a six-pack of beer," said Dr. Adams, who is an investigator for the Mentor and Allergan, the makers of breast implants (and a consultant for Allergan). "How well will the people choose a size of implant after drugs?"

Dr. Adams and other plastic surgeons say that mid-surgery consultation can be harmful if the patient chooses implant too large for her breast. Overaugmentation can produce ugly then, "said Dr. Mark l. Jewell, a plastic surgeon who breast industrial cooperation with local anesthesia and intravenous Sedation in an accredited facility in Eugene, ore." decision should be made in advance, "said Dr. Jewell, an investigator for the Mentor and Allergan as a consultant for Allergan.

Several doctors said that promote local anesthesia and Sedation for aesthetic operations was just a gimmick that played down the risks. "The promotion of these operations that so easy to just local anaesthesia is required, has the intention to make someone believe" there is serious, ' "said Dr. Douglas r. Blake, an anesthesiologist in Providence, R.I., who specializes in office-based procedures."The promise to get by with only local anaesthesia might actually be shortchanging the patient. " Say a patient feels weak, or have a panic attack in mid-surgery, "who is it to devote itself to the patient?" asked he.

Practitioners of awake breast augmentation patients offer Sedation and then pump in a numbing fluid. This fluid — which has been used this year in a sort of liposuction is called "tumescent" — contains Lidocaine, an anesthetic and Epinephrine, that control the bleeding.

Cosmetic surgeons without group living in plastic surgery said that with local anaesthesia for breast augmentation will promote a quicker recovery, but plastic surgeons tend to question. "No surgeon performing awake augmentation has ever shown in an independent supervised study that their patients can be out to dinner that night and return to full normal activities within 24 hours," said Dr. John B Tebbetts, plastic surgeon in Dallas.

Jane z., who had her first breast augmentation with Dr. Tebbetts, said his recovery after 2004 effort and latest with Dr. True took about the same time. After general anesthesia, she said, she felt woozy but not nauseated.

Ambition — when the stomach contents back into the mouth and is breathing — is a rare complication to go. But under Sedation, Dr. Blake said, the protective reactions in the Airways can be reduced, making aspirations a possibility.

Dr. Keith j. Ruskin, an anesthesiology professor at Yale University School of Medicine, said doctors are using tumescent anesthesia must avoid an overdose, which can lead to seizures and abnormal heartbeats. Dr. Caruth gives his breast augmentation patients 5-10 mg Valium and Ativan (anti-anxiety drug) for the smallest Sedation. If a patient wants to moderate Sedation, she must pay $ 600 for an anesthesiologist. But not all doctors sedating patients for breast cancer industrial cooperation believes less is more. Dr. Caruth said, "I see these guys that say they" awake "and they slam heck these people with drugs."

Dr. Gandhi, who trained as a Surgeon General but not board certified, said his patients have minimal Sedation. He wants them alert. -It is more secure, "he said. "Patients can scream and you would know, I can't do that I cannot put my needle which, says Dr. Gandhi, whose offices are not accredited. Later, he made it clear via email: "breast augmentation technique that I have carried out and teach the tumescent anesthesia infusion results in excellent numbness, that patients do not feel a thing when I work."

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Opening argument

Conor Friedersdorf and Reihan Salam discuss the limits of presidential power. For some, the President's speech on Afghanistan troop withdrawal was repeated unfortunate moments in history.

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Cosmetic surgery Gets a little NIP and Tuck

Such procedures, including nose jobs, eyelid surgery, liposuction, tummy tucks and breast cancer industrial cooperation, reduced in number by nearly 9% in 2009, the society reported Tuesday, 1,521,409 from 1,669,026 2008. Nose jobs, eyelid surgery fell 8 percent among the doctors who answered the survey, 715, while liposuction were down a whopping 19 percent. Tummy tucks and breast cancer industrial cooperation decreased 5 and 6 per cent, respectively.

Wallet questions can be the story behind the numbers — an action that a tummy tuck costs on average $ 4,936, with the exception of thousands of dollars in anaesthesia and operating room. But maybe the Americans also started to make the best of their glances, invest in closet improvement instead of, say, liposuction.

-Cosmetic surgery is an object of luxury, says Dr. Michael f. McGuire, President of the American Society of plastic surgeons, who practices in Los Angeles. "People are thinking twice about money, even if they have it, I have noticed very wealthy patients, they postpone."

Dr. McGuire believes the deferrers eventually will have the operation as they wish. "People there, but if you have been unhappy about something, you will get it fixed," he said.

The numbers entered by the American Society of plastic surgeons offer a valuable snapshot, but they are not definitive. The doctor replies to a survey cannot answer it next year. And the numbers are not doctors who perform cosmetic procedures and trained in, say, obstetrics-gynaecology and general medicine.

Declines in this study also another recent survey by the American Society for aesthetic plastic surgery, which found an even steeper decline in cosmetic-surgery procedures performed last year to 18 percent.

Some doctors even expresses confidence that there is pent up demand. Dr. Robert Singer, a plastic surgeon in San Diego, said that people have tried less expensive alternative to the procedures they want.

For example, some patients have "chosen to be fillers or Botox because they felt – and it was marketed to them – is it instead of a facelift," Dr. Singer said. But "it does not provide the results they wanted."

Other patients "had a reasonable consequence" of which is injected with a combination of Botox and fillers, "says Dr. Singer, a former President of the American Society for aesthetic plastic surgery. But the result is temporary, and some of these patients now want a longer-lasting surgical improvement of their face, "he said.

Realself.com, a website where patients discuss cosmetic procedures, recently did a survey with Harris Interactive to get a feel for how many consumers it is aesthetic dreams deferred. In an idealized world in which we all have enough money, they asked, how many of us would opt for cosmetic changes? Sixty-nine percent of the nationwide sample of 2,148 adults were surveyed in March said they would choose to have cosmetic work, up from 54 percent who said the same thing in November 2009.

Tom Seery, President and founder of Realself.com, said in an interview that the site's traffic grew and that visitors viewed-strength and interest around cosmetic surgery on invasive page.

For the first time reported the physician were examined by the American Society of plastic surgeons, surprisingly, that the number of Wrinkle-botulinum toxin injections administered freezing decreased by 4%. Last year, approved by the Food and Drug Administration of Dysport for smoothing wrinkles between the eyebrows, deselect to give Botox a run for its market share. But it seems that came just as the Americans Dysport is not decided to get as many botulinum toxin injections for aesthetic problems, perhaps a sign of a fatigue among people who received routine injections for maintenance.

"You've had it for several years, every couple of months, first of all, you've spent a lot of money," said Dr. McGuire, renewing the Botox and Dysport. -Added, and it hurts every time you have. A staggeringly large number of doses of Botox or Dysport was still injected in 2009: 4,795,357, at $ 405 each on average. Such injections would remain the top minimally invasive cosmetic procedure.

Some obscure cosmetic operations increased in 2009, despite their not insignificant costs. It was a small uptick in calf support system, which involves using a silicone implant to improve calves up to 259, from 247. Surgical pumping calves is not cheap — $ amounted on average – but apparently ballerina and Bodybuilders will find them valuable. "To be a success as a ballerina, that's about as much your appearance and your ability to dance," Dr. McGuire said. "You may have good muscle, but it has no shape or appearance which is considered to be optimally."

LIP industrial cooperation by means of a physical implants, which costs on average $ 1,736, is also increasing. More than 21,000 people had lips filled in this way as opposed to, say, on a regular basis with the lips are injected with a. Uptick is especially remarkable considering that no lasting lip implant approved for that purpose by the Food and Drug Administration, which means that this use cannot be marketed by the company. Doctors may instead choose to use an implant approved for another part of the face.

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A little too ready for her close-up?

In small but significant number of beginning filmmakers and casting executives reconsider Hollywood's attitude to breast implants, Botox, collagen-injected lips and all forms of plastic surgery.

TV executives at Fox Broadcasting, says for example they have begun to recruit more natural looking players from Australia and the United Kingdom since more than well endowed, freakishly young looking crowd shows up for applicants in Los Angeles is suffering from too much sameness.

"I think everyone either looks like a drag queen or a stripper" said Marcia Shulman, who oversees casting for Fox scripted shows.

Independent casting directors as Mindy Marin, who worked with Jason Reitman film "Up in the Air", is a talent agent to counteract invites clients to have surgery, especially older celebrities as she argues, lose their jobs because their skin is too tense or swollen with. Said Ms. Marin: "what I want to see is real."

Also extra sheep once-over. Sande Alessi, who helped throw the films "Caribbean pirates", said she is offering to photograph actresses in their bathing suits, tell me if they can keep the photo for their audition books.

Professional courtesy? Not necessarily. Moviemakers prefer actresses with natural boobs for the costume dramas and period films. So much so that when the Walt Disney Company announced recently for extras for the new "Pirates" movie, casting call indicated that only women with real boobs need apply. By taking a photograph, Ms. Alessi said, "we need not ask, we."

Step towards a ' less is more "is operated by a series of conflicting social and technological developments, said more than a dozen film and television technicians.

Cosmetic improvements still popular, with 10 million surgical and nonsurgical procedures are performed in the United States during 2009, according to the American society for aesthetic plastic surgery. At the same time, the proliferation of HD television — as well as a curious generally trained eye – has made it easier to find a celebrity poorly sewn hairline or botched eyelid lift.

Men, is, of course, not immune to the lure of a youthful Surgeon a scalpel. But there are women, to no surprise, as the closest is to be examined.

Botox is the enemy in a post-"Avatar", 3-D infatuated Hollywood, where in possibility to crumple a mouth to a frown is as important as remembering his lines. More frightening is how young plastic surgery supporters become. In January was the actress Heidi Montag on the cover of people magazine, touting the 10 cosmetic procedures, she had a day. She is 23.

"Era" I see great since I did this to myself "has gone through," said Shawn Levy, Director and producer of "Date Night" and "night at the Museum" films. "It is seen as ridiculous. Ten years ago had actresses feeling that they had to have plastic surgery to get the part. Now, I think it works against them. Go to a casting session low. looks fake their chances "

Few in Hollywood is prepared to admit that the Chin reduction or mini eyebrow lift. (Remember when Jennifer Grey admitted to nose job, a move that some say are damaging his career?) Celebrities are more open to discuss a previous drug problems or sex addiction, because there is less concern about a confession which will damage their careers. But with so many types of cosmetic rejiggering is often painfully obvious and result difficult to fix.

Ms. Shulman, Fox met an agent recently to discuss hiring an actress who apparently had work. "What she did to his face?" Ms. Shulman said she asked the agent. "He said," nothing ". I lightly. I will just not to argue. I said, ' she is not for me then. " ”

Head shots, is no longer reliable. Ms. Marin said she sometimes checks AwfulPlasticSurgery.com, an advertising site that portrays the surgically enhanced, confirming suspicions of who edited what. When Ms. Alessi throwing "The Curious Case of Benjamin Button" in 2007, she received hundreds of head shots. Some of the actresses who arrived for the audition, however, saw nothing like their photographs.

"They would have these huge puffy lips and frozen units," said she. "you say to yourself," Oh, I can't use you. ", I received not if they do a little bit of something, but it may not be obvious."

An actor can also lose a role of a Director, if the suspect surgery was performed or not. John Papsidera, a casting director for "Batman" films, said he and a Director (he declined to say which one) recently discussed whether to hire an actor in his early 20s to play a teenager, falling in love. The actress was talented and naturally beautiful. But how did the Director was his suspicions that such young, she already had breast implants.

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A little too ready for her close-up?

In small but significant number of beginning filmmakers and casting executives reconsider Hollywood's attitude to breast implants, Botox, collagen-injected lips and all forms of plastic surgery.

TV executives at Fox Broadcasting, says for example they have begun to recruit more natural looking players from Australia and the United Kingdom since more than well endowed, freakishly young looking crowd shows up for applicants in Los Angeles is suffering from too much sameness.

"I think everyone either looks like a drag queen or a stripper" said Marcia Shulman, who oversees casting for Fox scripted shows.

Independent casting directors as Mindy Marin, who worked with Jason Reitman film "Up in the Air", is a talent agent to counteract invites clients to have surgery, especially older celebrities as she argues, lose their jobs because their skin is too tense or swollen with. Said Ms. Marin: "what I want to see is real."

Also extra sheep once-over. Sande Alessi, who helped throw the films "Caribbean pirates", said she is offering to photograph actresses in their bathing suits, tell me if they can keep the photo for their audition books.

Professional courtesy? Not necessarily. Moviemakers prefer actresses with natural boobs for the costume dramas and period films. So much so that when the Walt Disney Company announced recently for extras for the new "Pirates" movie, casting call indicated that only women with real boobs need apply. By taking a photograph, Ms. Alessi said, "we need not ask, we."

Step towards a ' less is more "is operated by a series of conflicting social and technological developments, said more than a dozen film and television technicians.

Cosmetic improvements still popular, with 10 million surgical and nonsurgical procedures are performed in the United States during 2009, according to the American society for aesthetic plastic surgery. At the same time, the proliferation of HD television — as well as a curious generally trained eye – has made it easier to find a celebrity poorly sewn hairline or botched eyelid lift.

Men, is, of course, not immune to the lure of a youthful Surgeon a scalpel. But there are women, to no surprise, as the closest is to be examined.

Botox is the enemy in a post-"Avatar", 3-D infatuated Hollywood, where in possibility to crumple a mouth to a frown is as important as remembering his lines. More frightening is how young plastic surgery supporters become. In January was the actress Heidi Montag on the cover of people magazine, touting the 10 cosmetic procedures, she had a day. She is 23.

"Era" I see great since I did this to myself "has gone through," said Shawn Levy, Director and producer of "Date Night" and "night at the Museum" films. "It is seen as ridiculous. Ten years ago had actresses feeling that they had to have plastic surgery to get the part. Now, I think it works against them. Go to a casting session low. looks fake their chances "

Few in Hollywood is prepared to admit that the Chin reduction or mini eyebrow lift. (Remember when Jennifer Grey admitted to nose job, a move that some say are damaging his career?) Celebrities are more open to discuss a previous drug problems or sex addiction, because there is less concern about a confession which will damage their careers. But with so many types of cosmetic rejiggering is often painfully obvious and result difficult to fix.

Ms. Shulman, Fox met an agent recently to discuss hiring an actress who apparently had work. "What she did to his face?" Ms. Shulman said she asked the agent. "He said," nothing ". I lightly. I will just not to argue. I said, ' she is not for me then. " ”

Head shots, is no longer reliable. Ms. Marin said she sometimes checks AwfulPlasticSurgery.com, an advertising site that portrays the surgically enhanced, confirming suspicions of who edited what. When Ms. Alessi throwing "The Curious Case of Benjamin Button" in 2007, she received hundreds of head shots. Some of the actresses who arrived for the audition, however, saw nothing like their photographs.

"They would have these huge puffy lips and frozen units," said she. "you say to yourself," Oh, I can't use you. ", I received not if they do a little bit of something, but it may not be obvious."

An actor can also lose a role of a Director, if the suspect surgery was performed or not. John Papsidera, a casting director for "Batman" films, said he and a Director (he declined to say which one) recently discussed whether to hire an actor in his early 20s to play a teenager, falling in love. The actress was talented and naturally beautiful. But how did the Director was his suspicions that such young, she already had breast implants.

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Plastic surgery Group launches advice Web site

When the governmental system of charges against the ex-prisoners with debt, loses all. A Vermonter writes to his wife about the first major battle of the war.

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A Haitian family reunites in Miami, by Video

-I want to ask him something, "said the boy's sister, Mary Rose, 28, in Port-au-Prince, pointing to Chad Henne, Miami Dolphins quarterback. She smiled coyly. Everyone expected her to ask for a date.

She asked, instead of a tent.

Mr. Her looked surprised. "We can try," he said.

Celebrities and refugees are oil and water in this tropical town, which rarely mix outside of valet parking. The Haiti earthquake on January 12, however, has repeatedly upset the usual hierarchy. And so it was on Monday that in a part of Miami Vice President Joseph r. Biden Jr. met with Haitian-American leaders to discuss Haiti's redevelopment. In another separated a celebrated babies named Jane were reunited with their parents while Haitian here at Notre Dame D ' Ha?ti Catholic Church in Little Haiti, technology brought together dazzle, need and a family.

In two rooms linked by broadband, false tragedy became. When Amelise Jean-Baptiste and her son Exais Peterson saw half a dozen relatives in Haiti on a larger TV, was their travails and triumphs all had. Peterson, seizures and the boy is called, in the limelight.

"Stand up, let me look at you," said his sister. He puffed out his chest and smiled. She asked him to turn his head. His left ear still missing its lower LOBE. part of his stomach looked so ragged that gravel. But his family in Port-au-Prince looked happy.

Peter Mandelson's recovery was marvellous.

Much of his face had been virtually disappeared when his neighbors him out of the rubble of his home in Port-au-Prince, four days after the earthquake.

Dr. Chad Perlyn, plastic surgeon, recalled that the lift boy's bandages at the University of Miami field hospital in Haiti, and discover hundreds of maggots. "He lost most of his cheek and scalp," said Dr. Perlyn. "His whole body was infected."

Peterson and his mother flew out on a military flight and landed at Miami children's Hospital, where Dr. Perlyn methods. Eleven measures later Peterson is learn English and lives with his mother in a hotel with the families of 18 other children who fled after the earthquake.

He told his relatives at home that he was satisfied. His mother said the same thing, and it took a little time for the family to lose out to catch up.

Half an hour in publicists reminded the translators that there were stars in the room. "Tell them who are here with you," says David Saltz, usually producing Super Bowl half time show. But nobody listens.

Eventually the family was in Mr. her and Pras Michel, a hip-hop artist from the Fugees. Family smiled kindly.

Mr. Her later said that he had been inspired by the family's strength and stamina to plan a trip to Haiti on Sunday to deliver a tent in person. But more than a roof over their heads, relatives in Port-au-Prince said they wanted an assurance that Peterson could stay in the United States permanently.

Conditions are so poor that "return to Haiti right now is certain death," says Mary Rose. Peterson has to stay, she added, "even if it means we are dying so he can live."

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Appreciate your value as you age

It would be easy to dismiss fear that such an aesthetic concern as weak. But two models-turned-psychotherapists argues in "Face It," their new guide for women, to contend with changing appearance can be less intimidating than having a financial loss, a demotion at work or a divorce.

After decades of counselling patients, says Dr. Vivian Diller and Dr. Jill Muir-Sukenick that fears about growing older can spur an existential crisis of sorts. Such a fear is not about vanity per se, but has more to with a loss of opportunities and questioning his place in the world. It can lead to depression, alcohol abuse or disruption favourable sleep, they say.

Yet are usually not in the list, brief therapy solutions for squabbling with an aesthetic "problem". A lunch laser treatment or a $ 180 face cream is.

Dr. Diller, 56, and Dr. Muir-Sukenick, 57, is here to talk about American women — no matter how stellar their achievements – it is not superficial recognise the ageing is undeterred. They encourage their readers to figure out what drives them to daydreams about a subtle facelift instead of schedule one.

At a time when cosmetic surgery ever to be seen as a casual endeavor, and anti-aging injections as inevitable, "Face It" giving women the practical steps to analyze what they look at this beauty paradox. "Should women simply grow old naturally because their looks do not define them, or should they fight signs of aging, because beauty and youth is their currency and power?" asks writers in his book.

The answer is not simple, in 20 years worth of patient information that the book is based on is any indication. (The respondents also other women, 30-65, including models because they sometimes consult with modelling agencies.)

Mandate not to see your age has never been stronger. "We are talking about a generation of pioneers," said Dorree Lynn, a psychologist in Washington whose book about sex after 50 is expected to be released in April. "They do not need to be role models for the way older."

60 Is the new 40. -Which is a pure lie, "said Dr. Lynn. "What is true is the 60 is the new 60."

Although appearance matters can be painful for women who feel "somewhat insulted by the fact," said Dr. Diller. Was not feminism to do campaigns and ceiling-shattering the attention get, not a tense boiler?

The book's most exciting stories from patients who are surprised to find herself mourns its voltage peaks and veiny legs. Katherine, who did not use their real names in the book, is a 53-year-old science scholar and mother of three who saw himself in the camp "more important things to worry about." But when she nixed a beach getaway with her husband because she did not know any swimsuit, she was disturbed by how much she cared. She came late, admitting that her family may have taught her to care about appearance is superficial, but that she could be a woman of substance that have happened with a retinoid at night or visiting a spa sometimes.

This positive aesthetic is particularly stressful because the playing field is no longer equal. A baby boomer is pressed to choose between her forehead to be au naturel or smooth in his later years — a decision that her mother did not face. Ann Kearney-Cooke, 54, an expert in body image in Cincinnati, said the message they heard their mother mothers look could was insulting: "you're not going to be pumping out babies anymore – you're not so much benefit to society." But at least, the sight of comrades with an equal number of wrinkles was a comfort. They might think we are "all in the same boat," said Dr. Kearney-Cooke, a psychologist.

The authors of "Face It" suggests that there is today an odd moral sneaks in our estimates of what we find acceptable. Ridicule too obvious cosmetic surgery is now a great American pastime. A post on Gawker asks why people still get plastic surgery recently received more than 400 comments, sent many emails from high soap boxes.

Much more fascinating is the 60-something celebrities masses Lubrication for having the courage to grow old "naturally" focus (gasp!), or at least not to use everything available to them. Meryl Streep is an actress. Helen Mirren is another. We like to imagine they are inoculated in any way against self doubt.

And so, in January, it was vaguely disturbing to hear that Ms. Mirren has a laissez-faire faire attitude to cosmetic surgery rather than the endurance of just-say-no thrust her fans had assumed. On a British morning show, "she said," you go, ' I do not want to look at that face longer "and I understand it, absolutely.

But why does that make her a sellout, Dr. Diller asks. In an interview for this article, the authors say they are not against plastic surgery or less-invasive efforts to slow the March of time. Choosing an intervention of fear or downstairs is what annoyed them. Sounding completely laissez-faire with myself, "said Dr. Muir-Sukenick she prefers women reflect first, before you act.

But just as both Dr. Diller and Dr. Muir-Sukenick invites women to enjoy their future, not their past, their modeling headshots keep stalking them as ghosts of Christmases past. They appeared on the screen for the authors, March 11, the appearance of the show "today", and the two women brought them out after the interview for this article. So, why can't their 50-something faces lined with wrinkles – speak for themselves?

Betty Friedan said of a woman later this year, "If you pretend to be young, you'll miss it."

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