Episode 31 - Wendy Lewis: The Knife Coach

Transcript

Woman: This program is brought to you by PersonalLifeMedia.com.

[musical interlude]

Teri Struck: I'm Teri Struck, host of “Beauty Now.” Today, we're really lucky to have an author named Wendy Lewis, who wrote the book, “Plastics Makes Perfect: The Complete Cosmetics Beauty Guide.” So she's going to be able to share with us all sorts of information.

[musical interlude]

Wendy Lewis: And this goes on, and consumers are unaware. I find it absolutely shocking because no good can come from that. I mean, these are medical treatments and should be done by a medically trained individual. It doesn’t have to be a plastic surgeon doing Botox. Most plastic surgeons I know don’t have that much time in their calendar to do Botox. They may do it occasionally, but they’ll not going to be able to do it everyday because they maybe in the operating room. [xx] in California where operations take five or six hours each, and on the East Coast it’s actually much faster.

Now hopefully, you don’t have to use it too often, but it's good to know that it's out there just in case, particularly around the eyes. Nothing else around the eyes would be able to be broken down that quickly. So for example, fat transfer, which is often used around the eyes, if you end up having a lump, you're kind of stuck with it for a long time and that’s something patients are very concerned about.

Our technology developed in Italy that, basically, combines liposuction with a laser to shrink or tighten the skin. The reviews are very controversial and very mixed. A lot of doctors see it as a heavily marketed, touted device with mixed results; others see it as a huge moneymaker for their practices. But the results are somewhat underwhelming, I'm not convinced that the results couldn’t be achieved with other methods.

[musical interlude]

Teri Struck: Welcome, Wendy.

Wendy Lewis: Welcome. Thank you, I appreciate you having me on.

Teri Struck: We're really happy to talk to you because you know a lot about everything. So we'll try to touch base on a little bit of everything today.

Wendy Lewis: OK, terrific! It's a big subject, as you well know it.

Teri Struck: I do well know it, and I think what we should talk about is how do people find a consultant like you?

Wendy Lewis: You have to be a little bit careful about consultants because in my experience, a lot of them have their own kind of business model. It's not necessarily legitimate, so you do have to be pretty careful. Our business is very simple; we help the client, we don’t work for the doctor. So we see clients from all over the world, literally, and I see clients in London, New York, Palm Beach now, and Paris as well, a couple of times a year and also by phone.

People are truly interesting, Teri, because we see a lot of different types of people, men and women, and they have a lot of similar needs and very similar concerns no matter where they are. We have a lot more good doctors in the US, I'm happy to say, than we do have bad ones.

Teri Struck: That’s actually a really good point because in a lot of my shows, I always stress how you want to find somebody who’s Board certified in plastic surgery to do your surgery. But there's a lot of really great doctors as well as one that probably aren't certified or really, you know, the type of doctor that you want to choose to do your surgery.

Wendy Lewis: Yes. I mean, surgery is one thing. I think, with surgery, you and I probably share a lot of the same kind of concerns. With surgery, I think it should be a facial plastic surgeon or plastic surgeon exclusively when it comes to surgery. These are invasive surgeries and these are doctors who have extensive training and I've done several residencies in the area. But when it comes to Botox and Restylane, I think you have a lot more leeway.

Teri Struck: Definitely, I think that’s such as good point because there are so many great dermatologists out there.

Wendy Lewis: Oh, yes, and in Europe, we see a very, very different playing field. In Europe, plastic surgeons pretty much only do surgery.

Teri Struck: Right, and not to cater to everything.

Wendy Lewis: Right. But they will bring on, like for example, a busy plastic surgeon practitioner in Paris might bring on a cosmetic doctor to do injectibles and fillers.

Teri Struck: Right, and many people do that here. But the concern is who’s doing your injections? Is it a nurse or is it a doctor? Do you think that matters?

Wendy Lewis: I think it really matters depending on the individual person. I've seen great nurse injectors and I've seen bad ones, too. I think that it really has to do with that person and how involved the doctor or surgeon, who’s name is on the door, is in the practice? I think if you have just a nurse who does it once in a while and who does injectibles when the doctor is on site, then you can get into trouble.

Probably the worst culprits are the kind of med spa situations where there's kind of a doctor loosely affiliated, and it isn't really on site. Those are the areas where I would caution consumers to be much more careful.

Teri Struck: I just ran across that last week, that there is a facial salon that touts all these injections and all this kind of stuff and there's not even a doctor associated with it. But people that I know are going and they ask me and I'm like, “Well, have you checked out their doctors, the doctors [xx] there?”

Wendy Lewis: You see, that’s the problem with the industry at the moment because it's so well publicized. I don’t think people always realized the risks involved. It seems like, “Oh, you know, everybody does the same Botox. Everybody does the same Restylane.” But that’s not true at all. The treatment is completely different depending on the hands and you're in. Lasers are probably the worst area with its tremendous variability. Probably, the biggest problems we see aside from discoloration and scarring are someone who spends thousands of dollars and gets very little results because they’ve been so overly hyped and marketed. We have a lot of consumer dissatisfaction now out there, it's unfortunate to see.

Teri Struck: You know, I'm guilty of this myself and it's probably why I stress it is that I went to the old photofacial and a nurse did it and she burned my chest that I had scars for quite a while, a long time, actually. It finally went away, but it's so true that you really do need to do your research on all that, too.

Wendy Lewis: It's idiot proof, that’s part of the problem. We see this on television that looks like, “Oh, it's so simple. Anybody can do it.” But that’s not really true. I mean, Botox is a licensed drug, so clearly, it needs to be a healthcare professional. Do you know in Europe, we ran into this all the time and UK, beauty therapists, who in the US would be cosmetologists, can actually do inject it, and that’s frightening!

Teri Struck: In Europe, they can do injections? That is so serious.

Wendy Lewis: They actually do injections, and they claim it's because they're allowed to use instruments. This goes on and consumers are unaware. I find it absolutely shocking because no good can come from that. These are medical treatments and should be done by a medically trained individual. It doesn’t have to be a plastic surgeon doing Botox. Most plastic surgeons I know don’t have that much time in their calendar to do Botox. They may do it occasionally, but they're not going to be able to do it everyday because they may be in the operating room. [xx] in California where operations take five to six hours each and on the East Coast, it's actually much faster.

Teri Struck: That’s true, I heard that. [xx] faster.

Wendy Lewis: It's a real different. Don’t you find it?

Teri Struck: Definitely. I really agree with that. What's your favorite filler? I'm going to ask you, what's your favorite filler?

Wendy Lewis: Restylane is my favorite because it's been around the longest and it has such good track record, but there is a new one that’s getting very interesting. I'm looking forward to seeing get Evalence approval, which we're hoping for very soon they’ll be the new collagen. I like Juvederm very much, that has a lot of pick up.

Teri Struck: Now, let's talk about what the different applications for Juvederm versus Restylane.

Wendy Lewis: I don’t know that there's much difference. I think you can pretty much use Juvederm wherever you can use Restylane. It's a little bit like the Coke and Pepsi challenge, I think, with the analogy used in New York Times and I think that kind of sticks. Some doctors prefer Juvederm for one thing and Restylane for another, but most that I know are using a little bit of both. The difference to me is that Restylane has a little bit more swelling if you're prone to swelling.

It's hard to say, I think some people may find it last longer in them, but it's going to be fairly individual. They're very comparable treatments. The other HAs that are on the market, the hyaluronic acids don’t really measure up yet. Theirs are the kind of the two market leaders, at least, in my view and, definitely, so in Europe as well. The other products that are in the market in a big way are Radius, which many people really like.

Teri Struck: The Radius is more permanent. It lasts for about a year.

Wendy Lewis: Yes, [xx] little longer term, exactly. It's calcium hydroxyapatite. It gets injected in a slightly different way, it kind of looks like toothpaste. Whereas the hyaluronic acids are clear gels, Radius is a white pasty kind of substance and it's particularly good for the nasolabial folds, the nose to mouth folds, and also in the corners of the mouth. It's a niche product, it's not going to be used for lips, but it's also good for contours like cheeks; very, very much used in nose like little defects in the nose.

Teri Struck: It would pretty much like Restylane for lips. Right?

Wendy Lewis: Restylane is probably the leader for lips. Yes, at the moment.

Teri Struck: So Restylane for lips, Radius for around your nose, for our listeners. And then what do you like for around the eyes? That’s very difficult.

Wendy Lewis: Around the eyes, that’s a tough one. I mean, Restylane is probably used the most. Juvederm is used around the eyes as well. That is such a tricky area to inject but we're seeing amazing results. But for that, I am so careful as to who I send people to because you can have a lot of problems. And unless it's a doctor who's [xx]

Teri Struck: [xx] lumps around the eyes.

Wendy Lewis: What?

Teri Struck: Lumps around the eyes.

Wendy Lewis: Lumps around the eyes. The good news with hyaluronic acid is that if you have a lump and it can happen, if it's injected too superficially, or if you have really sensitive skin and some people do and you get that kind of bluing affect, at least, we know that there is an antidote for it. The doctor can use an injection of an enzyme that can break down the hyaluronic acid so at least you're not stuck with the lumps for long term.

Teri Struck: Tell us about that. I've not really heard about that one.

Wendy Lewis: It can happen. For any injection with hyaluronic acid, even if you have a lump in the lip or a little bit of a bluing in the nasolabial fold, which can happen when it's injected very superficially or with really translucent skin, there is an enzyme called hyaluronidase. This can be injected to break down the hyaluronic acid quickly. So you're not stuck with the lump until the filler breaks down, which could be six to nine months.

Now hopefully, you don’t have to use it too often but it's good to know that it's out there, just in case, particularly around the eyes. Nothing else around the eyes would be able to be broken down that quickly. So for example, fat transfer, which is often used around the eyes, if you end up having a lump, you're kind of stuck with it for a long time and that’s something patients are very concerned about.

Teri Struck: Fat doesn’t really last that long, does it?

Wendy Lewis: Fat?

Teri Struck: Right, fat.

Wendy Lewis: It depends on who does it and how it's done. There are some doctors who do it where it's permanent. I consider it a long-term volume filler. I don’t think it's great for the average person who just wants a line or a lip injected because it's very traumatic and it's a two-step procedure. You have to get the fat from somewhere and then inject it, and it's very variable. For someone who’s having liposuction who wants to have something on their face injected at the same time, since the fat has already been harvested, that’s actually a good use for it.

Teri Struck: That sounds really good to me. You go to sleep, have them take your fat out, and they’ll put it in your face.

Wendy Lewis: Yes. What woman doesn’t want that? [xx] one right now. Right now, we're seeing a real resurgence in fat injections into the breast.

Teri Struck: Let's talk about that.

Wendy Lewis: [xx] Yes. This is very controversial, but have you heard about it in California?

Teri Struck: I've heard about it, but I've heard it doesn’t really last. You don’t think that’s true?

Wendy Lewis: It depends, again. It's very technique-dependent. A lot of doctors are using it with reconstruction. I've heard really credible plastic surgeons speak about the long term effects and their feelings about that safety being quite excellent. So I think it's really something to watch.

Teri Struck: They [xx] your own fat, so that’s actually pretty safe.

Wendy Lewis: It's your own fat. I mean, think about the woman who's undergoing mastectomy or lumpectomy, and the idea of being able to have reconstruction using her own fat can be quite appealing.

Teri Struck: That sounds really appealing.

Wendy Lewis: [xx] more that fat is also very rich in stem cells, so there can be some quality given to the skin and some more radiance and richer blood supply. A lot of doctors are looking at this now very closely; I think, we're going to hear a lot more about it. Interesting stuff, that’s really the future. Autologous tissue is something that Science is working on and, I think, the public is very interested in.

Teri Struck: What's your favorite skin care product?

Wendy Lewis: That’s a tough question.

Teri Struck: I know.

Wendy Lewis: Yes, that’s a real tough one. It's hard to say, it's to answer. One, I use a retinoid everyday of my life, one form or another. Either it's Renova, Retin-A. I also love the ROC retinol products and I'm a big TNS fan, TNS Recovery complex.

Teri Struck: I love that.

Wendy Lewis: Do you know it? I love it, yes.

Teri Struck: I do, and I love Retin-A. I think Retin-A is a great product.

Wendy Lewis: Great product. You know, if your skin can tolerate it. Today, there's some form that every skin can tolerate. I like to see my clients on it, at least, a couple of times a week even for really sensitive skin. We've got the data, we know the science, we know that this is going to help your skin. Everything else, a lot of things are just a good moisturizer. There are some good products out there now.

Teri Struck: It's good to alternate, don’t you think?

Wendy Lewis: Definitely.

Teri Struck: I love [xx].

Wendy Lewis: I use much less of a retinoid in the summertime. Of course, where you are, it's beautiful and sunny everyday, but it isn't where I am in the West Coast. So I don’t use a lot of Retin-A in the summer but I'll use it in the wintertime and I'll a heavy moisturizer. You’ve got to switch off a little bit.

Teri Struck: Right. So what do you recommend for the summer?

Wendy Lewis: For the summer, I would use a much lighter version. I use an SPF 50. I use Anthelios because I don’t want to get any sun, I have very fair skin and the sun doesn’t like me anyway. I spend too much money having these [xx] spots lasered off to ruin it by going out in the sun. So I won't use a retinoid in the summertime at all.

Teri Struck: What's your favorite laser?

Wendy Lewis: Oh, that’s a good question. I don’t know that I have one. The last treatment I had was Laser Genesis by Cutera, which I thought was really effective for the diffuse redness and the little fine telengiectasy [sp] you get around the nose, and that was really good. I've had Fraxel in the past, which was not pleasant. It does hurt, but I have [xx].

Teri Struck: It does hurt.

Wendy Lewis: Have you had it?

Teri Struck: I recommend getting a friend to drive you, have a drink, and have some fun because I love Fraxel, it's for age-reversal sun damage.

Wendy Lewis: Yes, I feel [xx]. It hurts. Yes, I think, it's great for sun damage, I think it's really good for melasma or blotches or discoloration.

Teri Struck: It does, yes.

Wendy Lewis: But you know, I think, your doctor needs to tell you that, that it does hurt and there is some downtime. Now, I'm hearing amazing things about Fraxel Repair.

Teri Struck: The new Fraxel Repair is amazing. I have friends that have done it and they look amazing.

Wendy Lewis: But, it has downtime, isn't it?

Teri Struck: It's about 10 days downtime.

Wendy Lewis: Yes. I don’t think they will tell you that.

Teri Struck: No, I think they should tell you that. But you know, some people are different and that’s what I would say to our listeners is that, I think the fairer people do better left downtime, I don’t know. Like if you tend to do well with a lighter laser. But then, I have friends that have been out better on three days but I have friends that are down for 10 days, so you'll never know.

Wendy Lewis: Yes. I think that if you're going to schedule this, you should plan on somewhere in the 7-10 day range.

Teri Struck: Definitely.

Wendy Lewis: So at least, you can plan your life around it.

Teri Struck: Especially if you're working. We're going to need to take a quick break to thank our sponsors. We're talking with Wendy Lewis, our “Knife Coach.”

[podcast break]

Teri Struck: Hi! This is Teri Struck with “Beauty Now,” and we were just talking with Wendy Lewis, the “Knife Coach.” Welcome back, Wendy.

Wendy Lewis: Thank you, Teri.

Teri Struck: We're just talking about lasers, favorite lasers. I think lasers, actually, are such a God send for our skin, but we have to be very, very careful.

Wendy Lewis: Yes. Careful, and I think you have to choose wisely. Most of these devices work well, but not every device is right for every patient. So the two biggest decisions I find, first of all, is you’ve got to pick a doctor who's qualified to do this treatment and knows what he's doing. In most cased, it can be a plastic surgeon, it can be a dermatologist, it can be facial plastic surgeon, but it has to be someone who has more than one laser. Don’t you agree?

Teri Struck: I agree.

Wendy Lewis: But the kind of clinic you walk into and they’ve got one laser this week and another laser that week, that probably is because they rent them and they don’t really have vested interest in using these devices. You want someone who’s got a bunch of lasers. They don’t have to have 30 lasers, but they’ve got to have more than one because there's no one laser that’s right for every patient. That’s one way to weed out people [xx] investment.

Teri Struck: So we're going to talk about conditions, too, like melasma like you were just saying.

Wendy Lewis: Right, exactly. I try to break things down in very simple, lay terms - brown, red, and then there are acne scars and skin tightening and the other ones, but the basic ones are going to be brown and red. Some lasers work better for one or the other. I was saying I had a Laser Genesis by Cutera for red veins which was great. For the browns, I think Fraxel is definitely one of the best on the market.

But there are others, other than just Fraxel. There are many fractionated lasers out there on the market that work nicely for that area. If you want something deeper for skin tightening, the Fraxel Repair seems to offer some good skin tightening results, at least, that’s what I'm hearing from my doctor-friends that are using it. But that’s a big ticket treatment. I don’t know what it is in Newport Beach, but I'm sure it's a lot like New York.

Teri Struck: It is. You have to say that.

Wendy Lewis: But in New York, it's $5,000. Right?

Teri Struck: Right. I don’t think it's five, I think it's like three here.

Wendy Lewis: Oh, that’s better.

Teri Struck: Yes.

Wendy Lewis: I'm hearing it's five in New York, so that’s better [xx].

Teri Struck: But it's really new, so, people, wait until next year, the price will come down.

Wendy Lewis: Yes, that’s a good point, and not only that, we'll also work out all the kinks and we'll have more doctors who are familiar with the technology. But that’s a real downtown procedure, that’s a lot.

Teri Struck: That’s really important. Again, it's just to make sure, when you're getting laser to your face, you don’t want go with some doctor that’s not really experienced in laser.

Wendy Lewis: Also, someone who had experience with that laser. So as you said, it's a brand new laser, it's right out of the box. So there aren't that many doctors who are doing a lot of them yet. So you don’t want to be the first one on your block, you do want to wait a bit. The Fraxel is a good technology and it's been around for a while. So the company, definitely, has a vested interest in being in this area.

Teri Struck: That’s a really expensive machine, too, to buy. You know that [xx].

Wendy Lewis: It's [xx], isn't it? It's very expensive.

Teri Struck: Yes.

Wendy Lewis: Unfortunately, those costs get passed on to the consumer.

Teri Struck: Right, but I think that it's worth it, but I think also, the doctors that are buying it must have several lasers or be able to afford it, which is a good sign.

Wendy Lewis: Right. You know, if you’ve never done lasers before, you're certainly not going to start by doing a Fraxel Repair. If you're looking for a laser company, you want to go with the company that’s been around for a while, that has people on board, and management team that has experience in the laser world, that does their own R&D (research and development). Not just a distributor that’s selling a bunch of different lasers, but someone who actually has a vested interest in making these technologies the best they can be and has the support for the doctor. I think, the consumers are going to get better results from those companies and there are a lot of them out there now.

Teri Struck: What about VelaSmooth, the cellulite lasers?

Wendy Lewis: Yes, the cellulite lasers. Cellulite is not my favorite subject. I'm sure it's more of the factor in Newport Beach than it is where I am or at.

Teri Struck: Well, you're lucky.

Wendy Lewis: In New York City, most women buy--the course of a certain age kind of may come to terms with this cellulite. It's something most of us have; as you get older, it gets worse. I find that cellulite is much more a younger woman’s issue and, certainly, someone who has a beachy kind of lifestyle where you're living in a bathing suit. It's just such a tough nut to crack and these devices, I think, are very disappointing in the long term.

Probably, the biggest one now is VelaShape which is from Syneron. But you know, I hear very mixed reviews from doctors and patients, and it's a big commitment. It's a multiple treatment, it's not inexpensive, it doesn’t know if it gets the job done.

Teri Struck: I personally like it, but I have to say that, to our listeners, if you're not going to drink your water and walk or do any exercise, don’t bother. I find when I drink my water and I do my exercise, it really, really works. But if you don’t, then it's right back.

Wendy Lewis: That’s a [xx], and you’ve invested all these time and there's no residual effect. For me, it's good for someone who's going on a beach holiday. It's great for a bride, you know, going to on a honeymoon, who just wants to get her body in as good as shape as she can short term and will feel good putting on a bikini that’s fine. But long term, it's a lot to keep up with.

Teri Struck: Good advice.

Wendy Lewis: I mean, [xx] days.

Teri Struck: That’s really good advice because it is very tough.

Wendy Lewis: And it's expensive.

Teri Struck: It's something you have to keep up with.

Wendy Lewis: No, it's not like liposuction either. I think a lot of women mistakenly go in for liposuction and think that’s a cure for cellulite, and of course, it isn't. It's a cure for fat reduction, but it's not really a cure, but it's a treatment for fat reduction but not for cellulite. Dimples are going to be there, and with the aging process, as the dermis breaks down, you're unfortunately going to see more of them. With every baby and all the hormonal fluctuations and certainly with menopause, it's out there. I think you end up spinning your wheels at some point and spending an awful lot of money fighting cellulite that could be used in other ways especially in the current economy where you might want to see more visible results from things. It wouldn’t be my first choice of treatment to recommend for people.

Teri Struck: Let's talk about liposuction.

Wendy Lewis: Yes.

Teri Struck: I was going to ask about that.

Wendy Lewis: SmartLipo is huge in your area.

Teri Struck: You know, SmartLipo, actually, they're not really sure about it. A lot of those SmartLipo places are going under, so I want to know what do you know about SmartLipo?

Wendy Lewis: SmartLipo is a technology developed in Italy that, basically, combines liposuction with a laser to shrink or tighten the skin. The reviews are very controversial and very mixed. A lot of doctors see it as a very heavily marketed touted device with mixed results, others see it as a huge money maker for their practices. But the results are somewhat underwhelming, I'm not convinced that the results couldn’t be achieved with other methods.

Teri Struck: That’s what I want to tell our listeners about. I mean, that’s the thing. We're not here to make all the surgeons profit, we want to find out what works. Although I [xx]

Wendy Lewis: If I had a client today who wanted to have a liposuction, SmartLipo would not be my first choice unless there was someone who had very small fat deposits. The area that I personally think it works the best is where I've seen the best results is the chin area because the laser is doing something to tighten up the skin in that area. So I think that’s a particularly good use for it.

I'm not convinced that it has any tremendous benefits over the methods we already see out there like Vaser or just traditional liposuction with tumescent anesthetic for body areas. I don’t think it's that much better, if at all. But I can tell you that in New York, it is a huge thing and a lot of my doctors are doing it in a lot of patients, call me and ask about it and, “Where can I go to have this done?” Even if I go through the details of it and suggest another method, they’ve read about this and that’s what they want. [xx] at your own risk.

Teri Struck: That’s it, the warning is go at your own risk and then compare. Compare, compare, compare.

Wendy Lewis: Right. If you go to one doctor who’s only doing SmartLipo and isn't doing Vaser or any other liposuction technique, then of course, he's going to recommend SmartLipo to you. So it's better to go have a proper consultation with the plastic surgeon who is doing traditional liposuction and see if you can get a better results from that. At the end of the day, SmartLipo is not really a discounted procedure.

Teri Struck: No, it was very expensive.

Wendy Lewis: Right, it’s expensive. So you're spending the money already, and to not get a result--you know, in the UK, there are both [xx] that say that 20% of patients get no result at all, and I've never heard anything like that from liposuction. Have you, Teri?

Teri Struck: Well, I haven’t, but what I have seen is that if you get liposuction as a cure for weight loss and then you continue to eat your Cheetos and pizza and sit on your bed, then you're going to gain it back. That’s sad, because you spend a lot of money to get lipo and to look better, it does work but then, you’ve got to keep it up.

Teri Struck: No, you’ve got to do your part. Liposuction is not a panacea, but boy, if you see a woman who has saddlebags, the physical violent deformity, or really bulges on her outer thighs, that’s genetic. Her Mom has them and her grandmother has them and even if she's in great shape and she goes to the gym, she does her own thing, that’s a really tough area to get rid of and what a difference liposuction make.

Wendy Lewis: What a difference that is. I've seen so many patients with different [xx] great candidates

Wendy Lewis: Right. They can wear low cut jeans again. They fit into a pencil skirt. They look better and they're just so delighted with it. Liposuction is just one of those homerun procedures when it's done in the right hands. When it’s not done in the right hands, you end up with your face on the cover of US News and World Report for having had some horrible complications during surgery, God forbid, and, unfortunately, we do see this.

Teri Struck: And the complications are?

Wendy Lewis: Complications are, you know, fluid overload; in worst-case scenario, death. We've seen sepsis, which is a perforation, and that results in a--it could be a steph infection. I mean, these are serious complications if you go to someone who isn't qualified or gets overaggressive. A lot of the problems tend to be from large volume liposuction.

Teri Struck: Right, and then, you can see waves in the skin, which are very hard to crack.

Wendy Lewis: Oh, yes, ripples are a lot, ripples are big one. I think a lot of that has to do with bad patients selection. A patient who really isn't a candidate for liposuction who needs skin surgery, most of us would much prefer to have the quick fix. But if you're older or if you’ve had a lot of weight loss or multiple babies and you’ve got really loose skin, liposuction might not do you any good. In fact, it may make you look worse.

Teri Struck: So you’ve just brought up another really great point is that the loose skin for the tummy is not necessarily a liposuction fix. It's [xx] fix. Right?

Wendy Lewis: Liposuction is about fat removal; it's not about skin. The better results you get is going to be because you have better skin quality. So if you're starting out with poor skin tone to begin with, you might not be the best candidate for liposuction. The worst areas for this that we see where patients are really unhappy, I think, are inner thighs and upper arms. If that skin is flacid already, if it's hanging and it's not taut and it doesn’t have good skin tone or it's really sun damaged, you're probably not the best candidate for liposuction and it behooves the doctor to tell you that.

Teri Struck: But do you think that if we do pushups and weights and weight change and build muscles up, that we will get better results?

Wendy Lewis: Of course. But past a certain point, gravity is going to factor into this. Do you know many women, Madonna’s age who have arms like that? I don’t know any.

Teri Struck: I know one. I know one and her name is Jay Williams and she's [xx]. She's a trainer and she's amazing. She's almost 50 and she [xx].

Wendy Lewis: Exactly. She works at it. You don’t have arms like that by accident, that is absolutely a sign of hard work and perseverance.

Teri Struck: Right. So we just have to do a little work [xx].

Wendy Lewis: Yes, a lot of work. [xx] area.

Teri Struck: What else can women do for their arms?

Wendy Lewis: Not much weights. I think weight training, and I think, even aerobics won’t help that much. Even runners who have no body fat can still have some crinklies under the arm and they hate it.

Teri Struck: No. I've seen really thin women with big arms.

Wendy Lewis: [xx] and no fat. Right, really thin women with a little bit of craziness. You know, there was a time when they were trying to market thermage and some of the skin tightening devices for that. I, personally, have never seen fabulous results from that, but for those women, even a few millimeters of tightening may make a difference for them.

Teri Struck: No, they're not inexpensive treatments, too. I've heard [xx].

Wendy Lewis: Expensive and uncomfortable, yes.

Teri Struck: So we have to do our research. I can't believe we're running out of time already. We're going to have you back for part two.

Wendy Lewis: Anytime, Teri. It will be my pleasure.

Teri Struck: To all my listeners, we're going to have Wendy Lewis back for Part 2. You can go to PersonalLifeMedia.com and we're going to link Wendy Lewis’ book, “Plastic Makes Perfect: The Complete Cosmetic Beauty Guide.” She has so much information on this book, everything you ever wanted to know about plastic surgery and more. Thank you so much for talking with us today.

Wendy Lewis: Absolutely, Teri. [xx]. Bye bye.

Teri Struck: Thank you so much. If you, guys, want to contact me, please contact me at NowBeauty@aol with your ideas, questions, concerns, and we're going to link you up at PersonalLifeMedia.com with Wendy Lewis and her book. We're going to have her back. Thanks again.

Mark Winter singing “You Had A Little Work Done.” (http://www.mark-winter.com/) 

Woman: Find more great shows like this on PersonalLifeMedia.com.