Beyond Beauty Blog: The Surgeon's Secrets

Ask the Doctor: Does “fat” cause snoring?

Only sort of! New research is coming out that links a fatty liver — a condition that frequently strikes those who are overweight or obese — with sleep apnea. Sleep apnea is characterized by interrupted breathing or snoring during the night, and the severity can range from only a nuisance to deadly.

Studies conducted over the past year have shown that those with fatty livers have a greater than 50% chance of also having sleep apnea. Additionally, the fattier the liver, the more severe the apnea. One theory doctors have is that the loss of oxygen from sleep apnea increases chronic inflammation, worsening the liver.

Although this doesn’t seem like good news, there is a silver lining: Helping one problem tends to help the other. Thus, if you have a fatty liver or sleep apnea, try getting tested — you may have new ways of combating either disease.

Additionally, your sleep apnea might not be related to your liver at all! If this is the case, Dr. Michelle Yagoda is an expert ENT doctor who has treated hundreds of cases of sleep apnea. From allergies to a deviated septum, she will help you fix your breathing problems!

The 36 Questions to Love!

Can love be accelerated?

Possibly! Arthur Aron, a famed psychologist, composed three sets of 12 questions designed to provoke intimate feelings between potential partners. The intent of the study is to create intimacy through mutual vulnerability: A key aspect of lasting relationships is reciprocity and being able to connect with each other on a deep level.

The sets of questions go deeper as you go through them, and the questions cover a wide range of topics. Want to give it a shot? We have the questions here:

Set I

1. Given the choice of anyone in the world, whom would you want as a dinner guest?

2. Would you like to be famous? In what way?

3. Before making a telephone call, do you ever rehearse what you are going to say? Why?

4. What would constitute a “perfect” day for you?

5. When did you last sing to yourself? To someone else?

6. If you were able to live to the age of 90 and retain either the mind or body of a 30-year-old for the last 60 years of your life, which would you want?

7. Do you have a secret hunch about how you will die?8. Name three things you and your partner appear to have in common.

9. For what in your life do you feel most grateful?

10. If you could change anything about the way you were raised, what would it be?

11. Take four minutes and tell your partner your life story in as much detail as possible.

12. If you could wake up tomorrow having gained any one quality or ability, what would it be?

Set II

13. If a crystal ball could tell you the truth about yourself, your life, the future or anything else, what would you want to know?

14. Is there something that you’ve dreamed of doing for a long time? Why haven’t you done it?

15. What is the greatest accomplishment of your life?

16. What do you value most in a friendship?

17. What is your most treasured memory?

18. What is your most terrible memory?

19. If you knew that in one year you would die suddenly, would you change anything about the way you are now living? Why?

20. What does friendship mean to you?

21. What roles do love and affection play in your life?

22. Alternate sharing something you consider a positive characteristic of your partner. Share a total of five items.

23. How close and warm is your family? Do you feel your childhood was happier than most other people’s?

24. How do you feel about your relationship with your mother?

Set III

25. Make three true “we” statements each. For instance, “We are both in this room feeling … “
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26. Complete this sentence: “I wish I had someone with whom I could share … “

27. If you were going to become a close friend with your partner, please share what would be important for him or her to know.

28. Tell your partner what you like about them; be very honest this time, saying things that you might not say to someone you’ve just met.

29. Share with your partner an embarrassing moment in your life.

30. When did you last cry in front of another person? By yourself?

31. Tell your partner something that you like about them already.

32. What, if anything, is too serious to be joked about?

33. If you were to die this evening with no opportunity to communicate with anyone, what would you most regret not having told someone? Why haven’t you told them yet?

34. Your house, containing everything you own, catches fire. After saving your loved ones and pets, you have time to safely make a final dash to save any one item. What would it be? Why?

35. Of all the people in your family, whose death would you find most disturbing? Why?

36. Share a personal problem and ask your partner’s advice on how he or she might handle it. Also, ask your partner to reflect back to you how you seem to be feeling about the problem you have chosen.

Get Warm to Block Colds!

Your mom’s advice was right: Put on a sweater. New research indicates that, yes, being warm helps protect against getting a cold. The body does not utilize its immune system as well at lower temperatures according to early studies. This research, being done at Yale on mice, indicates that low temperatures suppress cells’ ability to detect oncoming viruses as well as their ability to warn the immune system. This gives viruses more freedom to replicate — making you sicker!

For the mice kept at a normal, human-body temperature, they were able to fight off the virus easier than those in the cooler temps. Essentially turning the alarm signal of the body off, the virus grew until it became what we know as “the common cold.” Time to bundle up!

A Diet to Live Longer

A Diet to Live Longer?

Maybe! According to research being done at Harvard University, the “Mediterranean diet” has received even more accolades. Having already been linked to a decreased risk of chronic disease and cancer, this diet is now being associated with longer “telomeres,” – biomarkers of aging.

Telomere-shortening is linked to shorter lives. Shortening is accelerated by stress and inflammation, and the Mediterranean diet has been proven to reduce inflammation, thus possibly lengthening telomeres.

Although all healthy eating helped lengthen telomeres, the Mediterranean diet showed the best results. It is a simple diet based off of healthy oils, fish, and fresh fruits and vegetables. Considering it tastes good as well, why not give it a shot?

Gluten Sensitivity: Celiac or Fodmaps?

It is no secret that the gluten-free food industry has seen tremendous growth over the past year. Expected to reach $15 billion in sales by 2016, the gluten-free trend is not only found in supermarkets, but restaurant chefs are catering to those who are gluten-free or gluten-sensitive with special dishes as well.

People following the trend are torn: Is this just another health fad hitting its peak, or is it a real issue? Scientists now show that non-celiac gluten sensitivity – or NCGS – is in fact a problem in a growing amount of people. Those with NCGS experience bloating, gas, fatigue, and other IBS-like symptoms after consuming gluten. However, even after going gluten-free, some symptoms usually persist.

Researchers decided to test their findings by putting 37 patients on a diet low in certain carbohydrates. This diet, called Fodmaps, is an acronym for the various types of sugars that have been found to trigger abdominal symptoms in certain people. Including fructans (soluble fiber in bananas), lactose (dairy), fructose (found in many fruits, some vegetables, and products with high-fructose corn syrup), galactans (soybeans and soymilk), and polyols (artificial sweeteners), following the Fodmaps diet is not easy at first. However, using the process of elimination, it is possible to pinpoint exactly which groups (or foods) cause unwanted symptoms. Those that do not bother the individual are simply added back into their diet.

The Fodmaps diet is worth trying if you think you fall into the NCGS category. If you are definitely not celiac – determined using blood tests and biopsies – then an elimination diet will help determine if you are only gluten-intolerant, or if it is something more. Who knows, maybe gluten isn’t the worst abdominal pain “trigger” that it has been made out to be: Some participants of the Fodmaps plan safely added wheat back into their diets.

Top 8 Reasons to Get a Blepharoplasty

Blepharoplasty - eye lifts in New York CityEyes: They are the focal point (no pun intended) of your face. You can dress them up with makeup, but if you have serious cosmetic problems in your eye region, you probably look older than you should! Dr. Michelle Yagoda sees all different types of patients who would like to look younger and more refreshed, and, oftentimes, it is all in the eyes! Eyelifts provide permanent and natural solutions to various eye problems and concerns. Think about getting a blepharoplasty – or eye lift – if you…

  1. Want to get rid of bulging fat bags. Dr. Yagoda’s signature Tr-EYE-umph! non-surgical eye lift can temporarily remove fat bags that accumulate under the eyes, but only a surgical blepharoplasty will provide permanent results. Thickened skin and “bags” (pockets of fat) are some of the most common complaints for women in their 30s and 40s. With the tiniest of incisions, the bags will be gone!
  2. Want to tighten your lower lid area and correct tear flow. If you have tear trough depression and a hollow look under your eyes, consider fixing it with non-surgical blepharoplasty. Fillers can be used to eliminate the hollows under the eyes and plump up the tear troughs. Not only will you look refreshed, but volume will be restored in the space between the lower eyelid bags and the upper cheeks, providing symmetry.
  3. Improve your vision. Advancing years often bring reading glasses, uncomfortable dry eyes, and more serious concerns, such as an increased risk of glaucoma, cataracts, and age-related macular degeneration that can make even everyday tasks such as reading and driving next to impossible. Dr. Yagoda will help you decide if your vision can be improved through an eyelift procedure and, if so, what the best one is for you. Eyelifts not only address cosmetic concerns, but they can improve eye health, too.
  4. 4. Improve your overall appearance. It is a well-known fact that the eyes are the first thing most people notice about each other. If you are not happy with how your eyes, eyelids, or under eyes look, you might feel less confident in your daily life. Restore your confidence with a surgical or non-surgical blepharoplasty!
  5.  Want to have a double eyelid. After spending time at the prestigious Otsuka Academy in Tokyo, Japan to operate with the late, expert surgeon Dr. Hidetada Ishii, Dr. Yagoda has perfected the incisionless Asian double eyelid surgery. Hidden, permanent sutures are used to create the upper eyelid crease that many Asian patients desire, and the entire operation is done under local anesthesia in Dr. Yagoda’s office.
  6.  Want to repair skin cancer defects. If you had or have skin cancer around the eye area, any residual defects should be fixed by an expert plastic surgeon. Dr. Yagoda will help determine which surgery is right for you.
  7. Eliminate dark circles. Part of the difficulty in treating dark circles is figuring out their cause! It could be genetics, lifestyle, allergies, sinus problems, or just a good old lack of sleep. Dark circles make people look much more tired (and older) than they really are, and they are very hard to cover up. Both surgical and non-surgical blepharoplasties are options: In the former, surgical eyelid surgery will provide permanent, rejuvenating results, and, in the latter, Dr. Yagoda uses filler to plump up the circles without any downtime.
  8. Want to stay competitive in the workplace. Although this one could be used when talking about any cosmetic surgery, it is especially true for the eyes! Since your eyes are the most important features of your face – and they are what your coworkers and bosses see when they look at you – it is important to feel confident with your eyes and eyelids. If you don’t, that lack of confidence might transfer over to your day-to-day life!

Top Seven Reasons to Get a Face or Necklift

Man Checking His Throat
Having a neck or facelift done will entirely change the way you feel about yourself! If you are not happy with what you see in the mirror, consider visiting Dr. Michelle Yagoda to discuss your cosmetic concerns. Whether it is for the purpose of youthful rejuvenation or a long-awaited fulfillment of a profile change, neck and facelifts are life-changing surgeries (for the better, of course!).

  1. Correct drooping jowls: The skin that sits below the jaw will often sag and droop with age or excessive weight changes (which sometimes go hand in hand). As the skin ages, it loses collagen and elasticity, causing the droopy skin. Although fillers can sometimes be a temporary fix, only surgery will permanently fix jowls. Either facial liposuction (to remove the fat hanging below the jawline) or a facelift will remove the hanging and fat. You will immediately look younger!
  2. Soften nasolabial folds: Nasolabial folds are the wrinkles that run from the sides of your nose to the corners of your mouth. Deepening with age, there is no way to prevent them. Again, although fillers can lessen their appearance, facelifts can correct them permanently. Often cheaper than using fillers every year, you will love the subtle (but great!) results. Oh, and smiling does not cause them, so smile on!
  3. Restore cheek prominence: If you’ve dreamed of having high and sculpted cheekbones, dream no more! It is possible with surgery. Cheek implants can restore a more angular appearance to the face, but it is important to choose implants carefully. They must be in balance with the rest of you: Too thick implants can make the face appear heavy or overweight.
  4. Relieve effects of Bell’s Palsy: Affecting over 30,000 Americans, Bell’s Palsy is a facial disorder that affects facial nerves, causing a temporary or permanent loss of facial muscle movement (on one side). Symptoms include drooping mouth/eyelids, difficulty closing eye, difficulty eating/drinking, and a face that looks “pulled” to one side. Although sometimes symptoms dissipate over time, for many the effects are permanent. Once Dr. Yagoda deems you a good candidate for reparative facial surgery, she will be able to correct the effects of drooping/unevenness due to Bell’s Palsy.
  5. Provide an angular/sculpted neck profile: Surgical necklifts immediately rejuvenate your facial profile. Not only excellent at correcting hanging or excess skin, they can be used to remove fat around the neck as well. With only very small incisions (which are not visible to the average eye), your neck will become smooth, tight, and sculpted.
  6. Eliminate neck lines: Having horizontal or vertical neck lines is a common problem as the skin ages. You’d be surprised how many people complain of having a “crepey” neck! These fine lines and wrinkles are due to a loss of collagen in the skin, and their severity depends on each individual. Peels can be used in conjunction with necklifts to improve the skin’s texture, creating a smooth appearance.
  7. Eliminate double chins/turkey neck: This one is pretty self-explanatory! If you have excess fat around the chin area (or just do not have a prominent chin), then double chins or “turkey necks” are not uncommon. Fortunately, necklifts and neck liposuction offer solutions. Tiny incisions are made in the treatment area, and the extra fat is extracted by the surgeon. When combined with a facelift or surgical necklift, neck liposuction can do so much as create a chin where there wasn’t one!

10 Reasons to Have a Surgical Rhinoplasty

Considering a rhinoplasty? If you are, you probably have a good reason, whether it is cosmetic or functional. If you are still on the fence about it, read below for Dr. Michelle Yagoda’s expert comments on why her patients choose to have rhinoplasties. There are a lot of them: After twenty years of experience, this list isn’t even totally comprehensive!

  1. Fix a broken nose: After a nasal trauma occurs, the repercussions are not just cosmetic. Oftentimes, functional problems cause nasal airway obstruction and difficulty breathing. Although broken noses and fractures are common, they are not always easy to fix. Nasal bones need to be reset or repositioned, and the septum might need to be straightened. Additionally, the trauma from the broken nose needs to be corrected as well: Blood can become trapped in the soft tissues of the nose, compressing cartilages on the septum or the tip of the nose. Severe compression can cause the cartilage to lose its shape, strength, and even die off!
  2. Raise nose bridge: If you have a low nose bridge, you might just have to blame your genetics! Certain ethnicities and ethnic groups are more prone to low and flat noses, but, luckily, Dr. Yagoda is very proficient in addressing this cosmetic problem. When a patient wants to cosmetically address a low-bridged nose, Dr. Yagoda makes sure their “new nose” will be more balanced with their facial features. Sometimes this can be done with non-surgical rhinoplasty as well! Ever have the problem of your glasses constantly sliding off your face when you look down? This can be fixed!
  3. Lower nose bridge: On the opposite end of the spectrum, those with high-bridged noses want to make sure their nose isn’t the only facial feature they see! Again, due to certain heritages and/or genetics, noses with high bridges cause more than just cosmetic problems. Ever see two high-bridged nosed lovers try to share an intimate moment? It can get awkward!
  4. Narrow the nostrils: Although genetics and ethnicity can cause the nostrils to be wide and flat, nasal trauma can also cause them to flatten and widen. At first glance this may just seem like a cosmetic issue, but, in reality, the nostril size is very important for proper breathing. The triangle shape of the nostril contributes to the nose’s “nasal valve,” which is the “gatekeeper” of the nose. This important gatekeeper either lets enough air in, or, if the valve is compromised or collapsed, limits airflow.
  5. Change your profile: This is pretty self-explanatory! If you are not happy with how you look in the mirror, a rhinoplasty can help. Whether you’d like to change the nose you already have or correct an aging nose (perhaps it is drooping?) always ensure you and your surgeon are on the same page about what you’d like. There is nothing better than looking in the mirror and loving what you see!
  6. Make a nose smaller: Just because a nose is large does not mean it works well! Large noses and nostrils do not necessarily equal large valves, and bigger noses can have the same breathing problems as smaller noses. So, not only will you make your nose more in-line with your other facial features, you will probably breathe better!
  7. Make a nose larger: Those with short or small noses are the result of genetics or, sometimes, medical problems that are not often seen today in the United States. Because nose-lengthening cosmetic surgery entails augmenting tissue and not merely excising it, it’s one of the most challenging procedures in rhinoplasty. As you might imagine, it’s far easier for a facial plastic surgeon to remove an excess of cartilage and bone than it is to add to it. If you’re contemplating this cosmetic procedure, you’ll need the skills of a true rhinoplasty specialist such as Dr. Yagoda!
  8. Fix a breathing problem: Functional rhinoplasties can be done by themselves or in combination with a cosmetic procedure. Almost everyone knows that a deviated septum needs to be corrected, and abnormal turbinate repair is pretty common knowledge, too. However, not many know that the actual position of the nose bones can cause restricted breathing! To fix this, the surgeon needs to move the bones slightly out to allow adequate air passage.
  9. Fix a cleft nose: Cleft noses are genetic defects that occur in-utero. Treatment requires a team approach with multiple staged procedures and a skilled plastic surgeon to correct structural defects and asymmetrical features. Although the process is very long and involved, the positive results are always worth it.
  10. Fix a skin cancer: Skin cancers on the nose get tricky. They are much more complicated than other body cancers because they can be deceiving: What looks like a superficial skin cancer might actually be very deep! These deep skin cancers end up into the planes of fusion of two facial bones, i.e. the nose with cheek, nose with upper lip, or the nose with the eye. As a result, skin growths that appear to be small can cause significant destruction of the cartilage and mucus membrane below it. Although the removal of skin cancer is typically done during a MOHS surgery, oftentimes the repair requires a skilled rhinoplasty surgeon.

Ask the Doctor: Where should vocal cord surgery be done?

Swollen Glands and lymph nodes - vocal cord surgery in NYCAnswer: Vocal cord surgery should be done one place and one place only: in a hospital! There are a few reasons for this, and they are all very important.

When you undergo a procedure on your vocal cords at the hospital, you will be under general anesthesia. This is true for any vocal cord surgery/procedure, including biopsies, laser surgery and the removal of nodules and polyps. All of these conditions cause voice problems of varying degrees, and Dr Yagoda will let you know when surgery is necessary.

During general anesthesia for voice box surgery, a breathing tube will be inserted in your throat. This breathing tube is very, very important: Not only does it help you breathe, but it protects your airway!  Otherwise, when the vocal cords are “touched,” they will spontaneously close. This happens because the body assumes that if something touches the vocal cords, it is likely to be heading downward to your lungs.  Vocal cord closure is the body’s automatic mechanism to protect your lungs.  A breathing tube must be in place to keep the airway open so that oxygen can reach your heart and brain. 

In addition, vocal cord surgery should be done in the hospital for another reason.  Hospitals have the necessary equipment for vocal cord microsurgery.  This includes a surgical microscope that will magnify the vocal cords 400x.  In addition, lasers can assist the surgeon is performing precise and bloodless procedures.  

Now, true or false: Must vocal endoscopies be done in the hospital as well?

False! Vocal endoscopies can be done very safely and routinely in a voice specialist’s office. Endoscopies are simple procedures that do not require any manipulation or instrumentation of the vocal cords. In a matter of minutes — and while you are seated and awake — your vocal cords can be visualized. This allows the doctor to diagnose the vocal disorder.  But, remember, any procedure requiring a biopsy, laser or excision must be done in the operating room under general anesthesia.

The best hairstyle to look younger is…

…the ponytail! Associated with youth, ponytails are both easy to do and versatile. In fact, they are so versatile that a new face lift procedure is being named after them! The “Ponytail Face Lift” is a mini-face lift that is minimally invasive. It pulls back the face tissue and skin to tighten the area, and the key is to not have any visible tension. If done correctly, the results are great!