Saul R. Berger M.D. Inc.

Products And Services

• Plastic And Cosmetic Surgery

  Breast Treatments Breast Augmentation Breast Lift Breast Reduction Body Treatments Liposuction Body Lift Tummy Tuck Arm Lift / Brachioplasty Fat Grafting Facial Treatments Facelift/Neck lift Brow/Forehead Lift Eyelid Surgery Rhinoplasty Injectables Guide to Injectable Therapies for the Face Kybella A guide to Kybella Microneedling Kybella BOTOX Restylane JUVÉDERM Male Plastic Surgery For Men

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• Breast Augmentation

  Understanding Breast Augmentation The purpose of this section is to inform you about breast augmentation surgery, and also to highlight some of the details that are important to your results. As you are guided through the “experience” of breast augmentation, we hope you emerge with a better understanding of what is involved and how Dr. Berger and his team approach the procedure. The popularity of breast enhancement with implants remains high. In fact, according to 2010 data collected by the American Society for Aesthetic Plastic Surgery, breast augmentation was the #1 surgical procedure performed in the U.S., surpassing liposuction in the rankings. Interestingly, patients seek consultation for a variety of reasons and from all walks of life. Some of the reasons that women seek breast enhancement are: To provide increased size and better shape in a woman who, for personal reasons, feels her breast size is too small To recapture the size and shape that a woman may have lost after pregnancy, weight reduction or aging To help correct imbalances or shape problems that result from the way a woman’s breasts have developed To help correct imbalances or shape issues in women who have undergone treatment of a breast condition and need reconstruction In addition to those reasons, it is very common for women to consult with Dr. Berger to enhance or adjust their results after implants have been placed in previous years or have become old. As you can see from this list, it is important to assess each individual’s situation and be able to offer a “range” of treatments; we do not believe in a “cookie cutter” approach. Call 818.245.6101 today to schedule your breast augmentation consultation with Dr. Saul R. Berger! The History Of Breast Augmentations The history of breast augmentation is more complex than many people are aware. In fact, a variety of materials have been placed within the breast in an attempt to enhance size and shape, even as far back as the 19th century. While some of the materials would seem surprising by today’s standards (ex. paraffin wax injections), the current version of the silicone breast implant has developed a solid safety record. In fact, since the first silicone implants were placed in the early 1960s, the quality of the implants has steadily improved. Many women still recollect the period of the early 1990s when a “scare” about silicone safety was pervasive, and the FDA intervened in the handling of breast implant use. Now, two decades later, the fears of autoimmune illness have not borne out. And, with regard to an implant increasing the risk of developing breast cancer, no data has supported that fear.

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• Liposuction

  Liposuction is a procedure that can help sculpt the body by removing unwanted fat from specific areas, including the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck. During the past decade, liposuction, which is also known as “lipoplasty” or “suction lipectomy,” has benefited from several new refinements. Today, a number of new techniques, including ultrasound-assisted lipoplasty (UAL), the tumescent technique, and the super-wet technique, are helping many plastic surgeons to provide selected patients with more precise results and quicker recovery times. The Best Candidates For Liposculpture The best candidates for liposuction are normal-weight people with firm, elastic skin who have pockets of excess fat in certain areas. You should be physically healthy, psychologically stable and realistic in your expectations. Your age is not a major consideration; however, older patients may have diminished skin elasticity and may not achieve the same results as a younger patient with tighter skin. Liposuction carries greater risk for individuals with medical problems such as diabetes, significant heart or lung disease, poor blood circulation, or those who have recently had plastic surgery near the area to be contoured. All Surgery Carries Some Uncertainty And Risk Liposuction is normally safe, as long as patients are carefully selected, the operating facility is properly equipped and the physician is adequately trained. Your doctor must have advanced surgical skills to perform procedures that involve the removal of a large amount of fat (more than 5 liters or 5,000 ccs); ask your doctor about his or her other patients who have had similar procedures and what their results were. Also, more extensive liposuction procedures require attentive after-care. Though they are rare, complications can and do occur. Risks increase if a greater number of areas are treated at the same time, or if the operative sites are larger in size. Removal of a large amount of fat and fluid may require longer operating times than may be required for smaller operations. The scars from liposuction are small and strategically placed to be hidden from view. However, imperfections in the final appearance are not uncommon after lipoplasty. The skin surface may be irregular, asymmetric or even “baggy,” especially in the older patient. Numbness and pigmentation changes may occur. Planning Your Liposuction Surgery In your initial consultation, your surgeon will evaluate your health, determine where your fat deposits lie and assess the condition of your skin. Your surgeon will explain the body-contouring methods that may be most appropriate for you. Individuals considering liposuction often feel a bit overwhelmed by the number of options and techniques being promoted today. However, your plastic surgeon can help. In deciding which is the right treatment approach for you, your doctor will consider effectiveness, safety, cost and appropriateness for your needs. Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding vitamins, iron tablets and certain medications. If you develop a cold or an infection of any kind, especially a skin infection, your surgery may have to be postponed. The Liposuction Surgery The time required to perform liposuction may vary considerably, depending on the size of the area, the amount of fat being removed, the type of anesthesia and the technique used. Liposuction is a procedure in which localized deposits of fat are removed to recontour one or more areas of the body. Through a tiny incision, a narrow tube or cannula is inserted and used to vacuum the fat layer that lies deep beneath the skin. The cannula is pushed then pulled through the fat layer, breaking up the fat cells and suctioning them out. The suction action is provided by a vacuum pump or a large syringe, depending on the surgeon’s preference. Fluid is lost along with the fat, and it’s crucial that this fluid be replaced during the procedure to prevent shock. For this reason, patients need to be carefully monitored and receive intravenous fluids during and immediately after surgery. Liposuction Technique Variations The basic technique of liposuction, as described above, is used in all patients undergoing this procedure. However, as the procedure has been developed and refined, several variations have been introduced. Fluid Injection, a technique in which a medicated solution is injected into fatty areas before the fat is removed, is commonly used by plastic surgeons today. The fluid — a mixture of intravenous salt solution, lidocaine (a local anesthetic) and epinephrine (a drug that contracts blood vessels) — helps the fat be removed more easily, reduces blood loss and provides anesthesia during and after surgery. Fluid injection also helps to reduce the amount of bruising after surgery.

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• Facelift

  A facelift (technically known as rhytidectomy) can’t stop this aging process. What it can do is “set back the clock,” improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and redraping the skin of your face and neck. A facelift can be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery, or nose reshaping. Call 818.245.6101 today and consult with Dr. Saul R. Berger about your Facelift and Neck Lift surgery! The Best Candidates For A Face Lift The best candidate for a facelift is a man or woman whose face and neck have begun to sag, but whose skin still has some elasticity and whose bone structure is strong and well-defined. Most patients are in their forties to sixties, but facelifts can be done successfully on people in their seventies or eighties as well. A facelift can make you look younger and fresher, and it may enhance your self- confidence in the process. But it can’t give you a totally different look, nor can it restore the health and vitality of your youth. Patient Testimonial "I am writing to thank you for the fine job you did on my face. I feel you did a perfect job and I wish to thank you." - J.B. CLICK HERE TO READ MORE REVIEWS! All Surgery Carries Some Uncertainty And Risk When a facelift is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Still, individuals vary greatly in their anatomy, their physical reactions, and their healing abilities, and the outcome is never completely predictable. Complications that can occur include hematoma (a collection of blood under the skin that must be removed by the surgeon), injury to the nerves that control facial muscles (usually temporary), infection, and reactions to the anesthesia. Poor healing of the skin is most likely to affect smokers. You can reduce your risks by closely following your surgeon’s advice both before and after surgery. Planning Your Surgery Facelifts are very individualized procedures. In your initial consultation the surgeon will evaluate your face, including the skin and underlying bone, and discuss your goals for the surgery. Your surgeon should check for medical conditions that could cause problems during or after surgery, such as uncontrolled high blood pressure, blood clotting problems, or the tendency to form excessive scars. Be sure to tell your surgeon if you smoke or are taking any drugs or medications, especially aspirin or other drugs that affect clotting. Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly. If you smoke, it’s especially important to stop at least a week or two before and after surgery; smoking inhibits blood flow to the skin, and can interfere with the healing of your incision areas. The Surgery A facelift usually takes several hours-or somewhat longer if you’re having more than one procedure done. For extensive procedures, some surgeons may schedule two separate sessions. Incisions usually begin above the hairline at the temples, extend in a natural line in front of the ear (or just inside the cartilage at the front of the ear), and continue behind the earlobe to the lower scalp. In general, the surgeon separates the skin from the fat and muscle below. Fat may be trimmed or suctioned from around the neck and chin to improve the contour. The surgeon then tightens the underlying muscle and membrane, pulls the skin back, and removes the excess. Stitches secure the layers of tissue and close the incisions; metal clips may be used on the scalp. Following surgery, a small, thin tube may be temporarily placed under the skin behind your ear to drain any blood that might collect there. The surgeon may also wrap your head loosely in bandages to minimize bruising and swelling. After Your Surgery There isn’t usually significant discomfort after surgery; if there is, it can be lessened with the pain medication prescribed by your local surgeon. (Severe or persistent pain or a sudden swelling of your face should be reported to your surgeon immediately.) Some numbness of the skin is quite normal; it will disappear in a few weeks or months. Most of your stitches will be removed after about five days. Your scalp may take longer to heal, and the stitches or metal clips in your hairline could be left in a few days longer. You should be up and about in a day or two, but plan on taking it easy for the first week after surgery. Be especially gentle with your face and hair, since your skin will be both tender and numb, and may not respond normally at first.

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• Injectable Therapies

  What is Injection Therapy? Over the last 15 years, there has been tremendous growth in the area of injection therapies for rejuvenation and the consumer has a remarkable array of choices for looking their best. Naturally, with more options comes the “burden” of having to sort through what is available, and to determine what is best for each individual. Injectables This guide will provide you with a basic understanding of these treatments, and assist you in starting your journey toward the best results. What are the Different Types of Non-Surgical Facelift Injectables? Presently, there are three main classes of injectables, sometimes referred to as Non-Surgical Facelifts, that are FDA-approved in the U.S. and have a reputable track record of results: Neurotoxins, Fillers, and Fat Dissolvers. Each category is so distinctly different from the others that it is important to understand the role of each one and recognize that they are not interchangeable. What are Neurotoxins? Neurotoxins are agents that are injected in an area specifically to decrease muscle contraction that causes wrinkles or asymmetry. The muscle relaxation and smoothing effect will persist for up to four months. At the time of this writing, three such medications were approved for use in the U.S.: Botox, Dysport, and Xeomin. While these medications are slightly different on a molecular level, patients would find it difficult to distinguish them when receiving treatment or assessing their effectiveness. These neurotoxins act at the cellular level by reducing the ability of the target facial muscles to receive the signal to contract and wrinkle the skin. Once the effect wears off, muscle function will generally return to baseline. Neurotoxins can, thus, be thought of as muscle “relaxers” or wrinkle “smoothers” of the face or neck. What are Dermal Fillers? Fillers are agents that are used to add volume to areas of the face, whether on a “fine” level such as filling individual wrinkles or on a larger scale such as adding cheek volume. Fillers can be subdivided into categories based upon their chemical composition. They are primarily composed of molecules that are designed to be similar to molecules found in the human body so as to make them highly compatible. Injectables A very popular class of fillers are made of hyaluronic acid (“HA”), which is a widely found class of molecules in the human body. Examples of HAs include Restylane, Restylane Refyne, Restylane Defyne, Restylane Silk, Juvederm Ultra, Juvederm Ultra Plus, Voluma, Belotero, and Volbella. Another successful category of fillers is comprised of calcium hydroxyapatite (CaOH), a molecule like that found in human bone tissue. The popular filler composed of CaOH is called Radiesse. A unique filler that some categorize separately from the other fillers is Sculptra. This is an agent composed of poly-L-lactic acid (PLLA) which, when injected into an area, causes the body to produce its own collagen thereby adding volume. Based on its mechanism of action, many consider this Sculptr to be a collagen “stimulator” rather than a filler per se. In contrast to the classic fillers, Sculptra volume will increase over time, while other fillers will gradually decline over time. In general, how long a filler will last depends on a number of factors including the type of filler, where it is placed, and the individual. Fillers placed in areas of a greater movement, for example, tend to dissipate a bit faster because of movement in the area. Also, certain fillers that are prepared in a special way so as to create more chemical bonds between its molecules are also designed to slow the breakdown. What is Kybella? Currently, there is one injectable on the market that is used to dissolve fat: Kybella. This is a specific chemical that is devised to “melt” fat from the area of the neck and below the chin while avoiding an effect on the skin and other tissues in the area. Chemically, it is a component that is found in human bile, which aids in the digestion of fat in the intestine. How Long After a Kybella Treatment Do You See Results? The effect of Kybella is quite rapid and can be seen within four to six weeks. How Many Kybella Treatments Will I Need? It is common for several treatments to be needed for a full correction of neck fat. Are Injectables Safe? When the FDA approves an agent for use in the medical field, they do so with specific “indications,” or guidelines in which the agent “should” be used. These specific guidelines are called “on label” use. In the case of the injectables, they can be used effectively in other ways, termed “off-label,” provided it does not violate safety or ethical guidelines. This kind of flexibility works in the patient’s favor by offering more ways for these therapies to make people look their best, but demands that the physician be well-versed on the agent and its safe administration.

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• Microneedling

  Microneedling is an in-office medical treatment wherein a special device is used to create many tiny openings or “micro-channels” in the skin to stimulate collagen and the release of growth factors. The purpose is to improve skin quality, appearance, and texture, with an overall goal of looking younger and smoother. Scientific studies show that microneedling changes both the amount of new collagen produced and the pattern of it in the skin. Also, changes in the skin cell layers can result in much better skin appearance. What Is PRP? PRP is an abbreviation for “platelet-rich plasma.” It is a serum created from your own blood, which can be taken and processed easily while you are in the office having your microneedling treatment. Basically, a small blood sample is taken, certain cells are separated by rapidly spinning the blood in a centrifuge, and then the final serum is created with a few additional steps. The result is a remarkable serum that some refer to as “liquid gold;” and it contains high amounts of growth factors and stimulators. How Do Microneedling And PRP Work Together? Commonly, the PRP is used as a topical “booster” with the microneedling. As the treatment is carried out, the PRP is placed on the skin surface and the small microchannels allow the PRP to penetrate through the outer skin layer and absorb. This acts to stimulate a greater response from the treatment by infusing more growth factors and blood flow stimulators. PRP can also be injected directly under the skin for rejuvenation and other benefits. Does Microneedling Hurt? A full session of microneedling with PRP takes about an hour in office. A powerful numbing cream is used to ensure comfort during the process, and the PRP serum is created from your blood specimen while you wait. The microneedling process begins after numbing is completed, and it takes only about 20 minutes to complete. Most of our patients describe tingling and vibrations that feel more like “buzzing” than pain. Aftercare at home is very easy, and we have a few special products to optimize your experience. What Will I Look Like After The Procedure, And How Fast Will I Heal? How you look when you leave the office depends on the depth of the treatment. Even the deepest treatments, however, heal very quickly. You may have heard that some people look like a “vampire” when they finish this procedure. The amount of redness depends on how deep the micro-channels are, which is very controllable with the equipment. More shallow treatment means less redness, and looking normal in just a couple of days. Many patients undergo this treatment on a Friday, for example, and are back at work on Monday. Schedule Your Consultation Today! For more information on microneedling or to schedule your consultation today, give us a call at 818.245.6101 or click here to fill out an online contact form and we will reach out to you as soon as possible.

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• Plastic Surgery For Men

  The frequency with which men are seeking cosmetic surgery as well as nonsurgical procedures has continued to increase steadily in the U.S. My general impression has been that men have become much more comfortable consulting with a Plastic Surgeon nowadays, and many realize the value of looking and feeling their best. In 2015, the top five surgical procedures in men were (in order): (1) Liposuction; (2) Rhinoplasty/nose surgery; (3) Eyelid surgery; (4) Correction of gynecomastia (male breast reduction); and (5) Facelift. Each of these procedures offers its own unique benefits for those men seeking to improve their appearance and lifestyle. Liposuction For Men This procedure is ideally suited for the individual who wants to remove or reduce fat from specific areas of the body, but is unable to do so through exercise and/or weight loss. Despite a common misconception, people are unable to “spot” reduce fat from specific areas with weight loss or exercise. For example, performing all of the abdominal crunches possible will not reduce fat in the abdominal area specifically. male plastic surgery liposuction The changes in body fat and shape resulting from weight loss are more related to your metabolism and genetics than any specific exercise. Liposuction is able to achieve exactly what many men want – removal of unwanted fat deposits from specific areas of the body, and it uses a minimal-incision approach with barely any scarring. Common areas for men to request fat removal include the abdomen, flanks (“love handles”), neck, and chest/breast areas. The amount of fat removed in a single procedure can vary, and limits in larger cases may need to be imposed for safety reasons. The quality of the results with liposuction is highly dependent on the response of the skin and soft tissues overlying the area of fat removal. Many patients who seek information about liposuction are overwhelmed by the variety of “techniques” advertised, and many companies try to persuade people that their technology provides a better liposuction result. Do not be fooled by such marketing! In reality, whether the technique uses laser energy, ultrasonic energy, or any other energy source for that matter, the technique does not guarantee a better result. Results are actually related to your surgeon’s work and your body’s healing potential afterward. Recovery after liposuction involves a relatively short time of restricted activities, and normal activities can generally be resumed as discomfort resolves. A compression garment is often employed to facilitate healing. Rhinoplasty / Nose Surgery This procedure alters the external shape of the nose in order to improve its appearance. Some of the nasal features that are often changed include improving symmetry, correcting crookedness, removing a bump, changing the length or size, improving the tip, and much more. It is not unusual for breathing problems to be corrected at the same time by performing a “septoplasty.” As a matter of routine planning, all patients that I see in consultation for rhinoplasty have nose images taken, a detailed analysis performed, and a customized plan created so as to ensure that each patient is involved in the plan and his goals are addressed. Recovery after rhinoplasty can involve a relatively short time of restricted activities, and specific instructions are provided to guide you through the process. Patient Testimonial: You have made this experience for me very comforting and I would not hesitate to refer friends to a topnotch organization like Dr. Berger. – E.G. Read more patient testimonials here. Eyelid Surgery (“Blepharoplasty”) This procedure improves the upper and lower eyelids by adjusting the skin and the fat that contribute to an aging look. It is remarkable how dramatic an effect the eyelid correction can achieve, and it is one of the most popular procedures used to “turn back the clock” in men. Healing is generally excellent in this part of the body, and incisions are often barely visible or completely invisible. A detailed and careful consultation is recommended since planning eyelid surgery includes evaluating the adjacent facial areas such as forehead and cheeks. Recovery after eyelid surgery is generally fast, but does require a dedicated rest period especially during the first week. Discomfort is often described as mild, and many patients hardly require pain medication after surgery. Correction Of “Gynecomastia” (Male Breast Enlargement) Enlargement of the breast area in men is one of the most frustrating cosmetic issues men face. Regardless of its cause (and there are many for this condition), the effect can be dramatic and cause men to alter their social activities, wear layered shirts for concealment, avoid the beach or swimming entirely, or inhibit their intimacy.

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• Upneeq

  Do you have trouble seeing, particularly when reading? Do you feel like low-lying lids make you look older than you really are? Do you wish there was something you could do to improve your field of vision? If so, you may have ptosis and benefit from Upneeq at Dr. Berger’s Office in Glendale, CA. What Is Upneeq? Upneeq is an FDA-approved prescription eye drop designed to treat ptosis, a condition otherwise known as low-lying lids. This oxymetazoline hydrochloride ophthalmic solution can lift your eyelids quickly and improve your upper field of vision significantly. Specifically, it is known to lift low-lying lids in as little as two hours. Moreover, in some clinical trials, improvements were noticeable just 300 seconds after the application of the first dose. What Causes Low-Lying Lids? Sometimes, people are born with low-lying lids. In such cases, the low-lying lids are caused by genetics. However, if you do not suffer from congenital blepharoptosis, your low-lying lids are known as acquired low-lying lids. There are a number of reasons why acquired low-lying lids may occur. Among the most common causes of low-lying lids that develop later in life are: Fatigue Eye surgery Eye injury Years of wearing contacts Eyelid pressure due to edema Eyelid pressure due to sagging skin Eyelid pressure due to cysts Myasthenia gravis Autoimmune disorders How It Works This non-invasive vision-improving treatment works thanks to the oxymetazoline in the solution. Oxymetazoline is an alpha adrenergic agonist that encourages Muller’s muscle contractions. Put another way, it forces your eyelids to raise because the levator palpebrae muscles in your upper eyelids tighten and lift. When your upper eyelids lift themselves, you look younger. Additionally, your upper field of vision improves drastically. One of the best things about this treatment is that it is incredibly easy to use. Specifically, this medication can be applied in just two simple steps. The first step you need to take to apply this medication is opening the foil wrapper with a pair of scissors and pulling out the single-use vial. The second step you need to take to apply this medication is applying a single drop of medication into each affected eye. Is This Treatment Safe? Yes, this treatment is completely safe for adults with normal blood pressure and healthy heart function. However, you should be aware that the single-use vial is kept sterile. Allow nothing to touch the vial’s tip, including your eye, your desk, or your bathroom counter. You also should avoid touching the tip of the vial with your fingertip. Keep in mind that you should discard the vial after your drop or drops have been applied. Do not re-use the vial. How Effective Is This Treatment? This treatment is incredibly effective. In fact, 74% of people who used this drug for ptosis treatment reported that their upper eyelids were over 50% better. Also of note, 40.8% of people reported that their upper field of vision improved by over 50% two weeks after their first dose. How Long Do the Results of This Treatment Last? Generally, you can expect your treatment results to last for approximately six hours. However, it is important to note that individual results vary. It is also important to note that this is a once-daily treatment. Who Is This Right for? To determine whether this treatment is appropriate for you, it is imperative that you attend an initial evaluation. According to the FDA, it is safe and effective for most fairly healthy people who are concerned about upper eyelid sagging. However, we need to evaluate your concerns and discuss your health before we can make a final determination regarding your candidacy. For example, we need to know about any immune system disorders you may have that cause your eyes or mouth to become dry. We also need to confirm that you do not currently suffer from untreated narrow-angle glaucoma. As another example, we need to verify that you do not suffer from uncontrolled hypertension or hypotension, heart disease, or periods of feeling faint in the absence of physical activity. Can I Benefit From This Treatment if I Wear Contacts? Yes, you can benefit from this medication, even if you wear contacts every day. You just have to keep in mind that you must remove your contacts before you apply your medication. You should also keep in mind that you should wait at least 15 minutes after applying your medication before putting your contacts back in. Can I Benefit From This Treatment if I Use Other Topical Eye Medications? Yes, it is possible to qualify for this non-invasive eyelid lifting treatment if you use other topical eye medications. However, you should keep in mind that you must wait at least 15 minutes after applying your eyelid lifting medication to apply your other topical medications.

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