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Posts Tagged ‘dermatologist santa monica’

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So the compliments keep coming…

Thursday, March 23rd, 2017

I keep getting told that “you look good ” “you changed your hair”. No, but thank you! My brows are lifted! I must’ve really needed that laser eye lift!

It was a pleasant surprise to get an update on my review paper of metastatic squamous cell carcinoma which was published 7 years ago. It has been cited by 135 other articles! Ask me how we can prevent this situation. It is not common but unfortunately, there are at least a few people with it every year. It’s very rare that women get them, but last year I did see the second woman of my career that had a SCC spread to her lymph nodes. The first patient I had met was mismanaged by a medical group in town and had her tumor treated numerous times without cure. She couldn’t talk or swallow by the time she met me. It was too late. The second lady had let the tumor grow too long and just had some bad luck.

Typically, the average SCC that spreads to the lymph nodes in my practice is an older white male who has had previous treatment of the lesion with radiation or liquid nitrogen. Size of the tumor, aggressive pathology, a delay of treatment and location on the upper half of the head or back of the hand are higher risk factors in my experience, and is backed up by research.

There are ways of avoiding this situation! Mainly, wear a hat and a zinc oxide-based sunblock such as Verdure. Get frequent exams and examine your own skin by looking and feeling. Talk to me about options for treating precancers that we can’t even see or may be too numerous to treat. And most of all, don’t delay seeking help.

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Back from Utah!

Wednesday, April 6th, 2016

Thank you for allowing me to take a week off! It was fun, though not very relaxing (taking care of 6.5 year old twins all by myself for 6 days-am I crazy?)

The weather was perfect. 40-50 degrees and it snowed every day. We secured a fabulous convenient condo two blocks to Deer Valley and I hope to stay there again-let me know if you want the referral. One of my daughters wanted to try snowboarding, so we went to Park City Resort-had not been in 21 years since I was an intern in Seattle when I took a trip by myself around April (and remember the slush). Taken over by Vail Resorts, the prices are steep and the service and facilities did not match up. It took an hour to get skis compared to no wait at DV, so definitely consider renting from one of the many shops on site in the mall or use one of the ski butler services. However, the ski conditions were great and the ski school for kids was also good.

However, nothing compares to Deer Valley when it came to service. I must say they have some of the KINDEST employees on the planet. Maybe it is their age/maturity, but these elderly sweethearts went the extra mile to carry all of our skis up to storage, to look for my kid’s gloves when she forgot them at school, and took the trouble to find us downstairs eating yogurt. They have a true love for the sport, the resort, and just want you to have a good time (and they take pity on moms who are by themselves schlepping all the equipment around!). The soup and salads are great at Empire Canyon Lodge as well. For the non-skiers, it’s just behind the Montage and can be reached by car.

I had an amusing time with all the powder this year. I’m a horrible powder skier and got a little too confident after making it down a run I had trouble with last year. For the record, double blue, such as Orion, at DV can mean super steep moguls. I could be wrong, but in Colorado those are always black. I know my limitations and took off my skis and had a peaceful, though exhausting walk through the trees back to Supreme-I had fantasies of some guy coming to my rescue and carrying my skis! (This actually happened once in a back bowl at Vail). I need to either take lessons or just keep being a groomer girl. You can weigh in next time you see me, but given what I do for a living, please talk me out of my inherent drive to go down difficult runs!

The trip was capped off by a new kiddie snowmobiling feature at Gorgoza Park, the best children’s book and clothing store I’ve ever been to (Children’s Hour in SLC-absolutely a must for moms and grandmas-unique stuff from Europe), and the fabulous young guy who works at Pei Wei at the airport who made my month by telling me “You’re very pretty!” when I was just meaning to order some beef with broccoli kiddie meals. OK, before you think he was trying to hit on me-he’s gay and that makes it all the more lovely. I would’ve liked to have stolen him for a personal assistant/yes man at that very moment had I had the option!

I have a new look-been rocking my glasses a lot lately, cut my hair and continue to maintain my skin with my own products. So exhausted lately, not wearing eye makeup, and somehow everyone says I look like a kid (?!). I take a lot of inspiration from some of my patients, who are 77-92 years young-these amazing women have wonderful energy, are funny and have great fashion sense. You know who you are-my heroes!

It’s been very busy in the office. Surprising since it’s April and if you look at the restaurants in LA lately, they are pretty darn empty. I’ll be taking about a week a month off every month until the end of the year (except maybe September), so please call and plan ahead so you won’t be disappointed.

Thanks also to the kind patients who have lifted me up into the Top 10 Santa Monica dermatologists on Yelp. I think Yelp is an awful concept for professional services, but I will take it!

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Posted in Juvederm, Mohs surgery, Restylane, Skin Cancer, laser | No Comments »

New Fillers

Saturday, November 7th, 2015

Restylane Silk is a new filler which we have been using lately which has given nice results!

Everyone is confused by the names. I will decide for you, unless you have a preferred wrinkle filler. Some fillers are better for gentle enhancement of cheekbones and chins and larger areas that need filling, while some are better for finer lines and thinner skin.

Everyone is afraid of looking overdone and overfilled. No one should notice your fillers. I don’t believe people should look like they have work done!

Another common question is how long do they last? The thicker the filler, the longer it lasts. Nonetheless, results vary. I’ve had patients who maintain results for years. Indeed, we keep finding more and more patients who have had surgery around their lips, where we find microscopic filler 4-5 years out! This study has been presented at a national dermatology meeting and is awaiting publication.

Filler such as Restylane, Juvederm and Belotero can always be reversed with an enzyme. Due to my artistic vision, skill and experience, I’m proud to say I’ve NEVER had to reverse filler I’ve done on my own patients. I have, however, reversed fillers done from other doctor’s offices or medispas. Sculptra, on the other hand, cannot be reversed. It does have the advantage of lasting longer, but also has risks of nodules.

It is best to plan on having fillers at least a couple weeks before any event. Occasionally a bruise can occur. It is best to avoid alcohol and over the counter pain medicines like Aleve and Motrin prior to your procedure. That being said, bruising is not as common as one would think, and the vast majority of patients experience no bruising at all. Also, results just get better and better as the weeks go by, so even plan several months ahead of an event if you’re that organized!

Also, rest in peace, Arnold Klein, MD. He was controversial, but we dermatologists do have to thank him for making fillers popular. We are lucky that now we have fillers much longer lasting than collagen and almost never cause allergic reactions.

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New laser for veins!

Saturday, October 17th, 2015

Thanks for your patience while waiting to replace my beloved vascular laser. I’m here in Chicago at the American Society for Dermatologic Surgery meeting doing my due diligence.

Happy to tell you it’s on it’s way! We have a list of people waiting-we expect it to arrive in November. If you’re not sure if you were put on the list, feel free to ask for my assistants to double check.

No downtime!

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Ahhh, summer!

Tuesday, June 24th, 2014

Please forgive my absence. It’s been a crazy month. I hope everyone is enjoying the spectacular June weather. Not much June gloom this year, but I’ll take temps in the mid-70’s forever!

We are transitioning many employees in the office this month, both medical and lab assistants. Many of our employees are moving on to graduate school, and we are welcoming many new faces. We are doing our best to train them properly. Thanks for your patience with this process. I must say, finding these gems in the mine has been quite a challenge this year. Never have we had so many flaky applicants. It really was disappointing. A lot of careless typos, regurgitated cover letters and poor etiquette from college graduates this year. I’ve never seen anything like it in the many years I’ve been doing this. I’m wondering if social media has just changed people’s behavior in the workplace. Nevertheless, I’m really proud of who we are sending off and who we are welcoming in, so I hope you enjoy getting to know my new assistants.

We’ve been spending a lot of time in our pool, and it reminds me to talk about sun protection in water. Water resistance in sunscreens is really important. I favor mineral based sunscreens (zinc/titanium) because they tend to last longer and usually do not sting the eyes. The term “water resistance” means that the sunscreen has been shown to last in 40 minutes of water. “Very water resistant” which is a term being phased out, means 80 minutes duration.

Our dog Gigi goes a little nuts when we are in the pool. She thinks we are all drowning. As a Belgian Malinois, it is her duty to protect us. This leads to incessant barking which echoes throughout Stone Canyon. The nice thing is that she is so worn out from “rescuing” us that it guarantees she is pooped for the rest of the day. She got 93 likes on Facebook from the Belgian Malinois enthusiasts. This may be almost as many Facebook friends as I have.

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Pasadena Top Doctors

Tuesday, June 10th, 2014

Thanks again to my peers and colleagues for naming me as a Pasadena Magazine Top Doctor in Dermatology!

On another note, many of you may not know that Ancestry.com offers a DNA analysis called Ancestry DNA. There are other companies which provide the same type of service. For another $5 Promethease.com will upload that data and give you a report on some risk factors (good, bad and the unknown) for multiple medical conditions. Although there is some controversy regarding how this data can be used against you and privacy issues, I find it fascinating. If anything, I think it’s helpful to know what diseases and conditions you might be at risk for and be aware of them.

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Restylane, Juvederm really do last

Wednesday, May 7th, 2014

How do I know? Our practice has the largest series to date of incidental hyaluronic acid filler found during Mohs surgery years after placement. This study was presented at the recent Annual Meeting of the American College of Mohs Surgery in Phoenix last weekend. One of my patients had filler put in her lips five years prior!

That being said, patients are often afraid of looking crazy after filler. After the Oscars, which I usually do not watch, I kept hearing about Kim Novak. OK, don’t know who she is, but I later caught a clip of her on TV. Oy! It reminded me of the movie Mask. I can assure you that I keep patients looking like themselves. The best cosmetic doctors have patients who do not look done. Unfortunately in LA there tends to be a strangely unnatural aesthetic which I don’t subscribe to. Most patients only need 1-4 syringes of filler, the younger you are, the less you need. I allow the patient to see themselves as we go along to make sure we are on the same page.

I get it though. Mid-life crises, anti-aging procedures and relationships were the dominant topic of conversation in Phoenix (I reassure you, I also did learn a lot about cutaneous oncology, but that might bore you). The best part of going to the meeting was the traditional slumber party with my 2 good friends. No Wedding Planner movie in the background-this time the Golf Channel. I diagnosed more orthopedic injuries from Cipro, saved my friend’s husband’s vision, played marriage counselor, and got helpful golf tips. I am putting Korean LPGA women to shame, I am just learning now, but at least I can make contact with the ball most of the time and drive it about 90 feet. Mini golf, anyone? I rock at that…

Saving people from blindness? This blog spans more than dermatology. If you know anyone with high myopia (translate into “blind as a bat”) they are at high risk for a spontaneous retinal detachment and should be examined annually by a general ophthalmologist or retinal specialist. Sudden floaters or flashing of lights are an eye emergency. Otherwise you face placing your head down in a special chair for 6 weeks, no plane rides, and possible permanent vision loss. Fortunately, I had mine caught early on a routine exam. My friend’s husband was trying to play his own doctor, and was given the advice to come back in 3 months. I prodded him to see a retina specialist. Luckily, I met him a long time ago and he is more apt to listen to me than his own wife (hence the counseling).

I watched more TV than I had in months. CNN is still talking about the downed plane, Fox News is still talking about Benghazi. I guess I’m not missing anything? Just kidding. Our news channels are embarrassing at times. I was just happy to get away from watching shows about aliens on H2. Sadly, there may be more substance there!

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Just say no to Cipro…if you can

Wednesday, April 9th, 2014

Ahhhh, Cipro. A convenient drug to take and prescribe. I’ve learned over the years that the pharmacologic side effect/complication of tendon rupture is a REAL problem. I’ve heard a lot of stories from patients and fellow doctors who have had personal problems with it.

In fact, I just had one of my favorite jetsetting patients come in with a leg brace on. She told me a vague story of thinking she bumped her leg on her luggage. I asked, “By any chance were you on Cipro before this happened?” The answer was yes. She thought something wasn’t right, and then worked out and boom…screwed up leg.

There are often alternatives to Cipro, or Levaquin another related drug. Please have your doctor consider other drugs first and feel free to educate them about this underreported and underrecognized problem!

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December has arrived!

Thursday, December 5th, 2013

Eh gads! Another year has sped by. I just saw a patient yesterday for laser hair removal. I could swear I saw her only a few months ago, but no, it was January!

Hope you all had a wonderful Thanksgiving week. My parents spent the week at our new house and my mom and I had fun finding out that the garbage disposers were not hooked up. Then, I tried to make that homemade green bean casserole with cream of mushroom soup/ fried onions on top dish. I followed a five star recipe, but cooking sour cream on the stove did not intuitively sound right. It curdled and it looked like someone vomited on the green beans. My yams were perfect though. I went all Paula Deen on them (i.e. “stick uh butta”). Thank you Bristol Farms for the best turkey ever. There was no way I was going to experiment on all my relatives this year with that one! It was cute to see my kids prepare the beans with my dad. I am in the reflection in the picture, kind of like Goya and Velazquez in those famous portraits. Next year, I am just going to use good old Campbell’s soup.

I hope you can all find the time to look out for those who might not have somewhere to spend the holidays. A lot of my elderly patients have no children or many of their friends and relatives have either died or moved away. It can be a really hard time for them.

I am looking forward to getting my face fraxelled again. It’s a good thing I don’t go out on New Year’s Eve anymore! A lot of you ask how I keep looking like I’m in my 20’s, well, say hello to Verdure glycolic acid products and the fractionated CO2 laser. I am approaching my 50’s (gasp!), in 6 years, so I need to do everything possible to keep my full Korean face from sagging!

The holiday schedule is quite full. I apologize for any delay in your care. If you feel something is urgent, or you just really want to come in this month, please notify my assistants and we will do our best to accommodate you.CLICK HERE TO SEE A WINTER WONDERLAND AT THE GROVE

Trying to beat the odds!

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Spot your own skin cancer

Thursday, October 31st, 2013

As I was reviewing my collection of research articles, I came across an abstract that was presented by some colleagues. They found that most skin cancers they operated on in their practice were discovered by the patient themselves! Get to know what your skin looks like so you can find the subtle changes. Besides the obvious, check your feet, your privates (epidemic of genital warts among my young patients), and go get your eyes and retinas examined by an ophthalmologist if you have had a lot of sun exposure or have a lot of moles. Let a friend or loved one check your back, or if you don’t have anyone, let me do it! It is always best for the dermatologist to do an annual total body skin exam if you have never been examined, or you have a personal or family history of skin cancer.

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