For the millions of people who contemplate getting cosmetic surgery, it is perfectly normal to flip flop over whether to go for it or not. Whether it’s a bump in your nose from an old accident that never healed right, or a plump up to lips that you always thought were too small, it’s important to do your research. Dr. John Zannis a Board Certified Plastic Surgeon from New Bern, North Carolina, who blends his study of classical art and symmetry to his surgery practices, shares a quick list of 5 cosmetic procedures that can make you look worse if done wrong. 

1. Nose Job 

Most people don’t like the nose they were born with. They feel it’s either too wide, long, hooked or not in proportion to the rest of the face. According to Dr. Zannis one’s ethnicity, family resemblance and facial integrity is often found in the shape of the nose. “We have all seen plenty of celebrities who have dramatically changed their look with rhinoplasty. It’s a very intricate surgery that can lead to a significant change to one’s appearance if things like facial symmetry and bone structure aren’t factored in.” For those wanting a “perfect nose” Zannis offer this clarification. “There really is no such thing as a universally flattering nose. It truly depends the individual’s facial features. The best nose jobs are the ones where people can’t tell anything was done. It’s the same nose just smoothed out and reshaped without radically altering overall appearance.”

2. Dermal Fillers 

There seems to be an epidemic of very round puffy faces due to excessive use of fillers. Dermal fillers are used to smooth out facial lines and restore volume to aging faces for a more youthful look. There are several different kinds to choose from each offering a different benefit. For example the popular Juvederm, an FDA approved hyaluronic acid filler, boats fast results that last for up to a year. Fat transfers offer an even more long-lasting result. “Where people run into trouble is when they get that puffed up chipmunk look. “There is such a thing as too much filler,” cautions Dr. Zannis.  “The key is to go for a natural look that flatters cheekbones and jawline so you look like you’ve gotten a great facial or came back from a well needed vacation. You don’t want the facial shape itself to change.” 

3. Butt Augmentation 

A full rounded derriere is a very desired look these days. From Serena Williams on the tennis court to Jennifer Lopez, Beyoncé, and Scarlet Johansson on the red carpet, plus the countless fitness and swimwear models on Instagram, bodacious booty is everywhere. Ladies who try to amp up their rump with squats and lunges to no avail may start to consider augmenting their bottom. According to Dr. Zannis, height, weight, legs, and waist alignment all play a role when deciding if your body can achieve a certain look that appears natural. “Proportion is everything when it comes to breast and butt augmentation. People tend to think bigger is better and this is not always the case,” he says. 

4. Brow Lift

A brow lift gone wrong can lead to a permanently surprised look or brows that seem stuck or too tight, unable to relax. While a brow lift can instantly take 10 years off of someone’s face, especially when their aging eyes appear hooded and droopy; the procedure can also result in a scary expression where the eyes appear to be opened to wide. “The key to a brow lift is to look at photos of where the person’s eyebrows were 10-15 years before as a realistic guide. Then an assessment of the muscle and scalp area, which will anchor the lift, is also necessary to achieve a natural well-rested look that factors in the eye shape when several expressions are made,” explains Dr. Zannis. 

5. Lip Augmentation 

It seems like lip injections have gotten out of control. People look at pillow lipped celebrities such as Kylie Jenner, Angelina Jolie, Priyanka Chopra, Kerry Washington and Adriana Lima and want to plump their pouts more and more. “You want to maintain a good lip shape that looks youthful and not fake,” suggests Dr. Zannis. “Again, facial symmetry is key when augmenting lips. I look at the chin, the distance between the upper lip and nose and other facial features. You really need to seek out a doctor who appreciates a subtle, undetected look. It’s one of those procedures where one can get used to their new look and want to go bigger and bigger,” says Dr. Zannis. 

In the end Dr. Zannis reminds people to really do their research and understand what is involved and what can go wrong. He advises against discounted procedures and encouraged people to be absolutely certain the doctor is board certified. “This is your body and overall well-being. You want someone who truly knows what they are doing.” 

Dr. John Zannis is a New Bern, North Carolina board-certified plastic surgeon and best selling author. A graduate of Stanford University and The University of Cincinnati Medical College, he received his formal training in General Surgery and Plastic and Reconstructive Surgery at Wake Forest University in Winston-Salem, North Carolina under the guidance of world-renowned plastic surgeon Dr. Louis Argenta. During this time, he performed over 5,000 surgical procedures and covered all aspects of plastic surgery including cosmetic surgery of the face and body, complex reconstructive procedures of face and body, cleft lip and palate surgery, hand surgery, facial and jaw fracture repair, and reconstruction following massive weight loss. He blends his interests and studies of classical art and symmetry to his surgery practices. Connect with him via twitter @JohnZannisMD or his website www.zannisplasticsurgery.com  

Premenstrual syndrome (PMS) is such a regular occurrence for many women that they consider it a normal part of getting their period. The Mayo Clinic estimates about 75 percent of women get at least some form of PMS. Although the causes of PMS aren't well understood, “fluctuating levels of hormones and brain chemicals are thought to play a role. What a woman eats and drinks can also have an effect“ says  Dr. Christopher Calapai, D.O.  a Manhattan Osteopathic Physician board certified in family medicine, and anti-aging medicine. He shares with us 10 do’s and don’ts for getting through PMS as pain free as possible. 

1)Do get more calcium

Some studies have shown that calcium levels are lower in women with PMS, and that those with the highest intake of calcium reported the mildest PMS symptoms. Dr. Calapai suggests sourcing your calcium from foods such as low-fat milk and dairy, calcium-fortified breakfast cereals and orange juice, and leafy greens.

2) Don't consume excessive salt

Salt increases water retention, so if you suffer from premenstrual bloating, do limit the amount of sodium you consume in the run up to your period. Eliminate the salt shaker, and cut back on the canned foods, processed foods and condiments, all of which are overflowing with sodium.

3) Do drink more water

“Although this sounds counter-intuitive,” says Dr. Calapai,  “Water can actually alleviate PMS-related fluid retention. Drink plenty of H2O -- aim for 8 to 10 glasses a day; more when you exercise -- to flush toxins out of your system and reduce premenstrual bloating.”

4) Do Eat Dark Chocolate

Craving the sugary confections like chocolate and cupcakes is totally normal. Try and reach for dark chocolate when you need to satisfy your sweet tooth.  A bonus is, it will boost your mood.

5) Don’t Consume Coffee

While you may need that daily cup   (or two) to be functional, studies show that caffeine increases levels of anxiety. Dr. Calapai explains that, “Your blood vessels contract when caffeine is present in your body, which worsens menstrual cramps. Also, for those with loose stool while on their periods, adding caffeine to your diet will make it difficult for your body to retain water and worsen diarrhea.”

6) Do Eat Greens

Losing a lot of blood can cause iron deficiency, which can cause lightheadedness or nausea. To counteract this problem, Dr. Calapai recommends stocking up on darker greens, like spinach, kale and broccoli to get your iron levels back up, but avoid eating them raw. For spinach, sautée with minced garlic and olive oil for a warm, flavorful bundle of nutrients!

7) Don’t Drink Alcohol

It will only worsen feelings of depression and moodiness. One study published in the British Journal of Obstetrics and Gynecology also found that regular alcohol consumption increased length of and severity of cramps in women who experience cramps during PMS.

8) Do Eat Bananas

Sleep disturbances right before your period are the norm for many women. Plus, experts at John Hopkins University in Baltimore found that too little sleep made women more susceptible to pain (meaning those cramps will feel even worse). So make sure to get your z's by eating bananas, which contain melatonin—a sleep-aid hormone that's secreted at night and helps regulate our body's natural rhythms.

IS CREPEY SKIN CREEPING YOU OUT?

What is crepey skin? Is it wrinkles? Thinning skin? A combination?

Crepiness is a term used to describe the changes in skin noted with aging. Skin becomes thinner, more fragile, and wrinkles more easily. We can see this first occurring on the backs of hands, décolleté, and around the eyes. What causes crepey skin? Is it due to sun damage? Aging? 

Dr. Kally Papantoniou, a NYC board certified dermatologist explains that, “Crepey skin occurs with age and the process is accelerated by photo-aging (frequent sun exposure without protection) which leads to the break down of collagen and elastin fibers, causing skin to lose its elasticity and become thinner.” For those of us who already dabble in Botox, filler, and facials, what can be done about this additional “evil?”

Prevention for crepey skin.

Dr. Papantoniou says that, “The most important way to prevent creepiness is to protect skin from sun exposure, the UVA and UVB rays are the leading cause for crepey skin, thus daily photo-protection is key in preventing creepiness.”

Which over-the-counter products and solutions does Dr. Papantoniou  recommend to specifically treat crepey skin?

For face-  SkinCeuticals A.G.E. interrupter

For eyes- Revision makes a cream – DEJ repair, for the delicate area around the eyes to address crepiness.

For neck- Revision Nectifirm

For chest- SkinCeuticals Neck, Chest & Hand Repair

For arms- SkinCeuticals Body Tightening Concentrate

For legs- Excipial 10% lotion, or Amlactin

What is the ideal way to apply products?

For best results it is recommended that you make sure to cleanse the affected area prior to applying creams to treat skin. Applying the creams twice daily will provide the best results.

What can you expect from a crepey skin cream? Temporary or long-term?

Depending on the types of creams being used, in the short-term you can expect, reduction of the appearance of crepey skin. The long-term benefits from keeping skin hydrated and applying certain ingredients to heal and repair skin, may induce new growth.

What ingredients make these products work?

Dr. Papantoniou explains that, “Creams often will contain proteins called peptides such as Palmitoyl Tripeptide-5 which act on the cellular level to help prevent the degradation of collagen, and can help promote synthesis. Hyaluronic acid will help plump and hydrate skin, which improves the immediate appearance of crepey skin. The addition of antioxidants such as Vitamin C, E have the effect of reducing oxidative stress and damage to skin and can stimulate new collagen growth. Certain plant extracts can also be found as ingredients in tightening creams for their natural properties. Using a retinol containing product can also have great effect on rebuilding collagen and rejuvenating skin.”

Dr. Papantoniou warns to steer clear of creams that don't contain any active ingredients, and are essentially just moisturizers. These are just gimmicks and won’t help with crepey skin. 

Is there any evidence that higher-priced products are better?  

Dr. Papantoniou says that, “I would not base the effectiveness on the price tag of a product. Research instead what ingredients it contains and read reviews, this can help guide your selection.”

Are all over the counter products limited in what they can achieve?

Over the counter products can actually be very helpful in this instance, the only prescription medication that will perform better is retinoic acid, but retinol can still be very effective is used regularly.

What are Dr. Papantoniou’s in-office treatments for crepey skin? 

Her favorite treatments for crepey skin are the Thermismooth 250, which feels like a hot stone massage, it can be used under the eyes, neck area, and almost anywhere on the body. Thermismooth 250 works by stimulating skin to produce collagen and rejuvenate. It tightens and can even help the appearance of cellulite. The Ulthera is also a powerful energy based machine, using ultrasound energy to stimulate tightening and new collagen as well. “Ulthera is great for the face, neck and chest area especially. For even more of a lift there is the ThermiTight, which is a minimally invasive procedure in which radiofrequency energy is placed under the surface of the skin, and stimulates skin remodeling with results that are very impressive,” says Dr. Papantoniou.

About Dr. Kally Papantoniou

Dr. Kally Papantoniou is a Cosmetic Dermatologist, Board Certified by the American Board of Dermatology. She specializes in Injectables, Lasers, Body Contouring, Surgical and Medical Dermatology. Dr. Papantoniou is also a clinical professor at Mount Sinai Health Center in New York City. She applies expert techniques and the newest technologies to treat her patients. Dr. Papantoniou focuses on providing her patients with the highest level of care, with special interests in natural and healthy alternatives to treatments and disease prevention. Connect with Dr. Papantoniou via twitter @DrPapantoniou or her website www.DrPapantoniou.com