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Published in U.S. 1 Newspaper on June 21, 2000. All rights reserved.

Looking Your Best, With Help from the Doctor

Options for improving your looks and self esteem

Include surgical, chemical, and laser treatments

E-mail:VivianFransen@princetoninfo.com

A day at the spa can make you feel glorious. But for

those who want a more long-lasting improvement in the way they look

and feel, a consultation with a plastic surgeon may be the next step.

"The satisfying results, the improvement in self-esteem, and the

good safety record of facial plastic surgery explain why it is so

very popular today," says Eugenie Brunner MD, a Princeton-based

specialist in facial plastic surgery and otolaryngology (the branch

of medicine focusing on the health and treatments for the ear, nose,

and throat).

In fact, a visit to her website (www.brunnermd.com) offers an eye-opening

introduction to the world of surgical and nonsurgical options that

are available through the expertise of today’s plastic surgeons. And

website visitors can expect to add a few more multi-syllable words

to their vocabulary, such as rhytidectomy (facelift), blepharoplasty

(eyelid surgery), rhinoplasty (nose surgery), mentoplasty (chin implants

and chin reduction), otoplasty (ear surgery), and malar augmentation

(enhanced cheekbones). Chemical peels, collagen treatments, botox

treatments, and laser resurfacing procedures are also defined.

"My job is to give information and to discuss what is best for

the individual so that he or she can make an informed decision,"

says Brunner in an interview at her office at the Woodlands Professional

Building at 256 Bunn Drive. Brunner is one of four plastic surgeons

to be featured on a panel, "Straight Talk About Plastic Surgery,"

at the U.S. 1 Health Fair on Tuesday, June 27, at 4:15 p.m., at the

Holiday Inn Princeton.

Brunner notes that the most frequently requested nonsurgical procedures

(which range in cost from $70 to $500) are light peels, collagen treatments,

and botox (or botulinum toxin type A) treatments. Also popular eyelid

lifts and various "rejuvenation surgery" combinations (including

face and neck lifts). Her initial consultation for $115 involves a

thorough facial analysis and a complete head and neck exam.

Brunner uses digital imaging to educate her patients to the before-and-after

treatment possibilities.

"The digital imaging is not a promise," says Brunner. "It’s

a worksheet to open up communication and help people express expectations."

She offers the following advice to individuals considering the services

of a plastic surgeon:

"First, have a heart-to-heart with yourself, defining what improvement

is your number-one interest. Then consult with one or two board-certified

plastic surgeons for their opinions. Ask each surgeon to explain both

surgical and nonsurgical options. Ask about risks, recovery time,

expectations, and pre-surgery and post-surgery photos of others they

have helped. Also ask your surgeon for the opportunity to talk to

other patients who have had the same procedure you are considering.

It’s so important to choose a surgeon you trust; communication style

and level of comfort are important qualities."

Eugenie Brunner was born and raised in Princeton, where

her father worked as a mathematician and her mother was a professional

ballet dancer with the New York City Ballet. She attended Rutgers

University and the UMDNJ-Robert Wood Johnson Medical School, received

her training in facial plastic surgery and otolaryngology at New York

University Medical Center, and completed a fellowship in facial plastic

and reconstructive surgery at the University of Toronto through the

American Academy of Facial Plastic and Reconstructive Surgery.

She describes her expertise as being "comprehensive surgical management

to improve, augment, and restore function and personal appearance

due to aging, birth defects, accidents, and diseases."

Thomas Leach MD and Jill Hazen DO of Princeton Center for Plastic

Surgery at 932 State Road also specialize in the latest advances in

cosmetic and reconstructive plastic surgery, as well as hand surgery

and microsurgery.

"We provide care to a huge mix of patients, ranging from children

bitten by dogs to women in need of breast reconstruction following

a mastectomy," says Leach, who serves as chief of plastic surgery

at the Medical Center at Princeton. "We also see many individuals

seeking what is called anti-aging treatments, such as face lifts,

liposuction, and changes due to sun damage. Privacy is a significant

issue for the patients we serve, and we are taking several measures

to increase each person’s comfort level." These include a recent

relocation to more private office quarters that include a full operating

room and a full-service spa.

"The most frequently requested treatments in cosmetic surgery

are what we call body contouring, which includes liposuction, tummy

tucks, breast augmentation or reduction, and facial rejuvenation,"

says Hazen. "We want people who are satisfied with the results.

That’s why we take the time to educate people and give thorough explanations

about what is available. Realistic expectations are key to patient

satisfaction, without glossing over the details." For example,

they tell patients receiving liposuction that although they will see

a 50 percent improvement following their surgery, it will take two

or three months to see the full results of their treatment.

Both Leach and Hazen spend at least an hour with a new patient during

the first office visit, which costs $100 and is later subtracted from

the charge for any surgery they do. "We don’t operate on anyone

without seeing them at least twice," they explain.

Born in Camden and raised in South Jersey where his mother was a nurse

and his father worked in the life insurance business, Thomas Leach

received his education at Rutgers University and the University of

Medicine and Dentistry of New Jersey. Fully trained and board-certified

in all areas of reconstructive surgery, he has been in practice in

the Princeton area for nine years.

Hazen was born in Tulsa, Oklahoma, where her father worked as an attorney

and her mother’s occupation was "raising seven children."

Before making the decision to become a surgeon, Jill Hazen was a

pianist, majoring in music at college. "I’ve always enjoyed working

with my hands," she says, explaining how well-suited she is for

the very meticulous and very delicate work of surgery. She attended

college and medical school at the Oklahoma State University College

of Osteopathic Medicine and Surgery, as well as serving a five-year

internship in general surgery at the University of Medicine and Dentistry

of New Jersey in Stratford, and advanced training in hand surgery

and microsurgery in Des Moines, Iowa, Phoenix, Arizona, and East Virginia.

After nine years of extensive training, she came to Princeton in 1994

with her husband (owner of the Metuchen Inn in Metuchen), and now

has three children.

In addition to choosing "someone who will spend time listening

and talking with you," Leach and Hazen offer the advice to individuals

who don’t have a clue where to begin in shopping for a plastic surgeon

who is right for them:

Women can ask their gynecologist, family doctor, or dermatologist

for referrals to plastic surgeons. Be sure your plastic surgeon is

board-certified. Ask about the hospital affiliations that each plastic

surgeon has. And shop around, meeting with three or four plastic surgeons

for initial consultations until you find the one you are most comfortable

with before making a final decision for surgery.

Kevin Nini MD FACS, another Princeton-based plastic

surgeon who offers a full range of surgical and nonsurgical treatments,

is also eager to discuss what’s new in his profession. His offices

of Plastic Surgery Arts are on 60 Mount Lucas Road and in New Brunswick.

"What makes us distinctive from others in the area is our highly

individualized care and commitment to new technologies, such as minimally

invasive endoscopic surgery," says Nini. "This technology

allows us to use small video cameras and smaller incisions. And we

also work with emerging holistic treatments, including vitamins, herbal

preparations, body wraps, and massage. We have discovered that these

advances can reduce the healing time, which means the recovery time

for eyelid procedures can be as short as a long weekend with no bruising

for our patients."

Born and raised in Princeton, where his father is a tradesman and

his mother serves as the dean of continuing education at Mercer Community

College, Kevin Nini began his medical education at UMDNJ-Robert Wood

Johnson Medical School. His advanced training included five years

at Pennsylvania Hospital, two years at the University of Florida,

and one year at the University of Miami. He started his practice in

the Princeton area in 1992.

"My profession is seasonal," explained Nini, who charges no

fee for an initial consultation. "In the spring, people request

facial surgery, liposuction, and breast reconstruction. During the

summer, we have a little of everything. And in the fall, the most

frequently requested procedures focus on facial cosmetic surgery.

We also can design a nonsurgical skin care treatment plan that helps

address aging of the skin, acne pock marks, or other conditions, based

on each person’s goals and time horizons."

The most satisfying aspect of his profession is the positive outcomes.

"I’m in a position to make people happy," says Nini, who along

with his partner Robert Olson MD FACS, volunteers overseas several

weeks each year to perform surgery for children with cleft palates

or burn victims in the Far East, Africa, and Central America. "Both

surgical and nonsurgical treatments can make a dramatic improvement

in the way people look and feel and function."

His advice in shopping for a plastic surgeon: Look for someone certified

by the American Board of Plastic Surgery. "There are many boards

with names that sound similar, but I recommend that people start with

a telephone call to this board," says Nini.

Certification requires five years of special training, passing a written

and oral exam on all plastic surgeries, from head to toe, and submitting

two years of work for review, says R. Barrett Noone MD, director of

the American Board of Plastic Surgeons, located on Market Street in

Philadelphia (215-587-9322). Noone went to the University of Scranton,

Class of 1961, and the University of Pennsylvania Medical School,

and he practices at Bryn Mawr Hospital. The most rewarding cosmetic

surgeries, he says, are breast reconstructions after mastectomies,

and he has done a thousand such procedures.

Noone also says to check with the state medical licensing board for

a valid and unrestricted license. The complication rate is difficult

to obtain, says Noone, but consumers could call the state medical

board to see if any complaints have been lodged. Ask how many times

the surgeon has done the operation you have chosen and whether he

or she has privileges to do that operation in any hospital.

Any operation causes scars and changes in sensation, warns Noone.

An article in U.S. News & World Report (www.usnews.com) reports that,

from eyelid lifts, scleral show can be a complication. A tummy tuck

can result in bowel paralysis. From vein removal or collagen injections,

there can be an allergic reaction to hardening solutions. Even from

pinning back a youngster’s protruding ears, an infection can develop.

Asked what surgery he would not recommend to his 19-year-old daughter,

Noone says it is easier to answer in the positive: someone that age

might benefit from rhinoplasty (commonly known as a nose job) or breast

reduction, to reduce discomfort in the back and shoulders. As a matter

of fact, except for cosmetic reconstruction after a mastectomy, breast

reduction is just about the only cosmetic operation that insurance

companies will cover. Even breast reduction might result in scars,

changes in sensation to the nipples or breast, and destruction of

the milk ducts, resulting in an ability of the woman to breast feed

later.

Liposuction is another suitable operation for the younger patient.

"It is not for fat people, but is best for the young person with

normal weight, localized areas of genetic fat disposition," says

Noone.

Not good candidates for any operation: patients who have high risk

medical problems such as uncontrolled diabetes, heart disease, or

significant anesthetic risks such as pulmonary disease.

Baby boomers are candidates for almost all operations, and they are

flocking to plastic surgeons in droves. "This is no epidemic of

aging actresses and jowly ladies-who-lunch," wrote U.S. News reporter

Doug Podolsky (October 14, 1996). "Even men, increasingly driven

to keep up appearances in a corporate world getting younger and leaner

by the quarter, are joining the beauty pageant in record numbers.

And the baby boomers, surely the most self-indulgent and youth-obsessed

generation, are turning 50. This is a crowd whose self-image does

not include a turkey neck. When reality hits, they’re there with their

credit cards and willing to dip into retirement savings to stop the

clock."

If baby boomers are good candidates for face lifts, younger people

are not. Noone turned down a request from a 40-year-old woman who

thought she was aging too quickly and wanted a face lift. "I did

not feel the benefit she would get would warrant the risks," says

Noone. "She looked too young for the operation."

By the way, is it time to change the terminology of

plastic surgery? The word "plastic" conjures up images of

Barbie dolls and Tupperware bowls and plastic slipcovers. Just how

much "plastic" is involved in the day-to-day world of plastic

surgeons these days?

"The word comes from the Greek root, to change," explains

Leach. "While we do work with such materials as facial implants

and silicone-based devices, there is not a whole lot of plastic in

my profession. But we’re all stuck with the term `plastic surgery’

for now."

And for those readers who need another good reason to quit smoking

cigarettes, feel free to bring up the topic of smoking with a plastic

surgeon. "Smokers are not good candidates for plastic surgery,"

says Brunner. "Smoking changes the blood supply to the skin, which

results in smokers not being good healers." Brunner tells her

patients who smoke to quit smoking — and that means being off

the nicotine patch as well — for at least two months. For some

patients, that accomplishment itself serves as the jumpstart to rejuvenate

their bodies with not only external enhancements but improvements

to their health in other ways.

Eugenie Brunner MD, 256 Bunn Drive, Suite 4. 609-921-9497;

fax, 609-921-7040. Home page: www.brunnermd.com.

Plastic Surgery Arts, 78 Easton Avenue, New Brunswick

08901. Robert M. Olson MD FACS and Kevin T. Nini MD FACS, 732-418-0709;

fax, 732-418-0747. Also at 60 Mount Lucas Road, 609-921-2922.

Princeton Center for Plastic Surgery, 932 State

Road. Thomas A. Leach MD and Jill Hazen DO, 609-921-7161; fax, 609-921-6263.

Home page: www.princetonplasticsurg.com (under construction).


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