Actual patient of Dr. Devgan, before and 1 week after rhinoplasty.

A beautiful, subtle rhinoplasty changes the character of the nose by a few millimeters, but it can change the character of the face much more significantly.

When I am seeing a rhinoplasty patient in my practice, I take several steps to ensure beautiful results that are harmonious with the patient's overall face. This involves:

1. Detailed physical examination of the components of the external nose: the dorsum, the sidewalls, the tip, the soft triangles, and the nasal alae
2. Assessment of the physical characteristics of the nose: the skin type, sebaceous glands, the skin thickness, and the strength of the cartilages
3. Examination of the inside of the nose, including the septum, turbinates, internal and external nasal valves, and the mucosa
4. An overall facial analysis that takes into account other related facial features, such as the chin, eyes, cheekbones, and mouth
5. A detailed conversation with my patient about his or her goals and expectations for surgery

I take tremendous pride in my work and attention to detail, and these qualities are particularly important with rhinoplasty ("nose job") surgery. To see me as a patient in my New York City practice, please call 212-452-2400 or email office@LaraDevganMD.com.

Cheekbones are said to account for 70% of facial beauty-- they anchor the face, make the face look thinner and more sculpted, and set the stage for beautiful facial features.

One of my favorite techniques for improving facial balance and beauty is injectable filler to augment the cheekbones. Not only does it improve the sculptural quality of the cheekbones, but it also replaces the volume loss of the midface that starts to occur in our 30s.

This technique takes about 10 minutes, and results last 1-2 years. I typically use Voluma, an FDA-approved filler made by Allergan, to achieve soft, natural looking results, as shown above.

Some of the benefits of cheekbone augmentation include:

• better apparent bone structure of the face
• softening of the nasolabial folds
• improvement of facial volume and softness of the upper cheeks
• reduction of "midface descent" or malar bags/ festoons
• creation of a heart-shaped, youthful face, rather than a square-shaped, older face

For all of my cheekbone augmentation patients, I am precise and meticulous when it comes to their facial features. In my practice, I feel that it is mandatory to:

• carefully analyze facial balance and facial features
• measure anatomic landmarks
• mark with a white pencil the important anatomic areas for concern
• sterilize the skin
• use topical and vibrational pain control
• use microdroplet injection techniques for greater precision
• cleanse and massage the tissue after the procedure
• apply a topical steroid ointment to reduce inflammation

If you are interested in Voluma cheek filler (or cheekbone augmentation), please call 212-452-2400 or email office@LaraDevganMD.com.

Actual patient of Dr. Devgan, before and after Botox to forehead/ crows feet/ glabella/ DAOs, Juvederm to lips, Voluma to cheekbones.

Actual patient of Dr. Devgan, before and after Botox to forehead/ crows feet/ glabella/ DAOs, Juvederm to lips, Voluma to cheekbones.

Actual patient of Dr. Devgan, before and after Botox to forehead/ crows feet/ glabella/ DAOs, Juvederm to lips, Juvederm to nasolabial folds, Voluma to cheekbones.

The most definitive aesthetic results come from surgical interventions, particularly with facial aesthetics. The power of a modern facelift, necklift, blepharoplasty (eyelift), and fat grafting can truly refine the face in a manner that can last for decades.

However, for those who are not interested in pursuing surgery, options for minimally invasive, non-surgical interventions do exist. These options principally involve a combination of the following:

• Botox (or Dysport, Xeomin, or related neurotoxins) for softening of wrinkles and fine lines, including:
  • forehead
  • glabella
  • crow's feet
  • frowning angle of the mouth
  • "bunny lines" on the sides of the nose
  • platysmal bands in the neck
  • gummy smile
  • slimming the jaw/ masseter muscles
  • sweating (hyperhidrosis) of the palms and armpits
     
• Filler (such as Juvederm, Restylane, Voluma, Belotero, Radiesse, Sculptra, and others) for improving contour and volume of the:
  • temporal hollows
  • cheekbones
  • nasal irregularities ("liquid rhinoplasty")
  • nasolabial folds
  • marionette lines
  • lips

The term "liquid facelift" can refer to any combination of the above procedures, and others, depending on an individual's unique anatomic features and aesthetic concerns. In my practice, I perform a detailed facial analysis and in-person examination of each patient's face prior to offering any formal recommendations about which treatment approaches might be best for him her.

A liquid facelift can last months to years, and while it lacks the longevity of surgical procedures, it offers the benefits of short procedural time, no incisions, no anesthesia, and no downtime. It can be a good temporizing maneuver for those patients who are considering surgery at a future date, or for those who want to get a sense of the best case scenario without surgery.

If you are considering surgical or non-surgical improvements for your face or body and would like to discuss your concerns with me in person, please do not hesitate to reach out to my office. My patient coordinator, Erica, can assist you via phone at 212-452-2400 or email at office@LaraDevganMD.com.

Actual patient of Dr. Devgan, before and after under-the-chin liposuction

Actual patient of Dr. Devgan, before and after under-the-chin liposuction

Actual patient of Dr. Devgan, before and after under-the-chin liposuction

Actual patient of Dr. Devgan, before and after under-the-chin liposuction

Actual patient of Dr. Devgan, before and after under-the-chin liposuction

Many patients complain of focal fat deposition under the chin ("double-chin")-- not only is this area troublesome, but it can also make the face appear chubbier and the whole body appear heavier.

There are two major options for treatment of submental fullness, or under-the-chin fat. 

Submental liposuction

The first option, and what I consider to be the gold standard treatment, is submental liposuction. With this technique, I make a tiny 3 millimeter incision hidden underneath the chin crease and utilize narrow cannulae (sterile surgical instruments like straws) to physically suction out the fat.

The advantages of submental liposuction are that:

• fat removal is permanent
• I am able to focally and selectively reduce fat depositions wherever they are bothering you
• I can slim the entire jawline and angle of the mandible
• downtime is minimal
• the surgery can be done under local anesthesia only (wide awake)
• only one intervention is needed
• patient satisfaction is extremely high

There are essentially no disadvantages of submental liposuction, except for the fact that it does create a tiny scar underneath the chin. Overall, I find this to be the vastly superior approach for under-the-chin fat.

Kybella

A newer technique for getting rid of stubborn fat under the chin/ neck area is an injection called Kybella. This FDA-approved product is made by Allergan, the company that makes Botox and Juvederm. It contains deoxycholic acid, which is an enzyme that dissolves fat permanently. Kybella has gotten a lot of press lately because Khloe Kardashian and her sisters have credited it with helping them with sleeker, thinner necks and chins.

The advantages of Kybella include the fact that:

• it is an injection (and not a surgical procedure)
• there is no downtime
• the procedure is done while you are awake
• there are no scars created

The disadvantages of Kybella include that:

• patients can require 2 to 6 treatments spaced out over the course of year
• each treatment is associated with a moderate degree of swelling
• Kybella is best used right underneath the chin and cannot effectively target the angle of the mandible or further-back areas of the jawline
• it can be painful

For the most beautiful, robust results, I find that submental liposuction is the best approach for the vast majority of patients. However, I have had great success with Kybella as well. To figure out the best approach for your needs, lifestyle, anatomy, and goals for surgery, I would recommend coming into my New York City private practice for a consultation with me.

Recent review by an actual submental liposuction patient of Dr. Devgan

Actual patient of Dr. Devgan, before and after corrective lip augmentation of another doctor's work.

Actual patient of Dr. Devgan, before and after first time lip augmentation

Injectable lip fillers have become an extremely popular cosmetic treatment in my New York City private practice. Women and men of all descriptions, backgrounds, and ages are interested in lip augmentation to get a fuller contour of the visual focal point of the lips.

Reasons for seeking lip augmentation include:

• Getting dramatic, voluptuous lips like Kylie Jenner or Angelina Jolie
• Getting moderate, sensuous lips like Rachel McAdams or Selena Gomez
• Getting subtle, full lips like Taylor Swift or Gigi Hadid
• Smoothing smoker's lines (perioral rhytids) around the mouth
• Improving upper and lower lip volume loss (atrophy) that occurs over time
• Correcting aging-related changes of the lips, such as sagging and drooping
• Improving overall lip balance and shape
• Accentuating the Cupid's bow
• Correcting another doctor's previously performed fillers

I am passionate about the small details of facial aesthetics, and my goal for each patient is to offer a beautiful, custom-tailored result. If lip augmentation is something you are considering, I invite you to come visit my office for an in-person facial analysis, consultation, and treatment. Please call 212-452-2400 or email office@LaraDevganMD.com for more information.

Actual patient of Dr. Devgan, before and immediately after tear trough filler

Actual patient of Dr. Devgan, before and immediately after tear trough filler

Dark circles and aging under the eyes are among the most common concerns in my New York City private plastic surgery practice. Women and men of all ages report that these characteristics-- thin skin, wrinkling, puffiness, and darkness under the eyes-- make them look older and more tired than they actually are.

My approach to correcting the under-eye area is non-surgical in many patients. I use Botox to smooth out the crows feet and injectable hyaluronic filler to smooth out the tear troughs to achieve beautiful results in my patients. Botox lasts 3-4 months, while hyaluronic filler (Juvederm, Restylane, or Belotero) lasts 1-2 years in this area.

I caution patients to seek tear trough augmentation and correction only from highly experienced providers with extensive experience and proven results in this area. Not only is tear trough filler technically delicate and challenging, but poorly executed filler can cause tissue injury, asymmetry, lumpiness, skin necrosis, and permanent blindness. Please do your homework before seeking tear trough filler, and remember to find a board-certified plastic surgeon to take excellent, meticulous care of your face.

Actual patient of Dr. Devgan, before and after breast augmentation, with a rapid recovery technique and minimal downtime

Actual patient of Dr. Devgan, before and after breast augmentation, with a rapid recovery technique and minimal downtime

Actual patient of Dr. Devgan, before and after breast augmentation, with a rapid recovery technique and minimal downtime

Actual patient of Dr. Devgan, before and after breast augmentation, with a rapid recovery technique and minimal downtime

Actual patient of Dr. Devgan, before and after breast augmentation, with a rapid recovery technique and minimal downtime

Recently there has been a marketing blitz advertising "Flash Recovery" or "Rapid Recovery" breast augmentation. Interestingly, when I see these terms on other surgeons' websites, I often see "TM" or "R" symbols immediately following them, indicating that these excellent yet not uncommon surgical procedures are trademarked or registered.

What is Flash Recovery Breast Augmentation?

"Flash Recovery" and "Rapid Recovery" breast augmentation are two flashy terms that reference modern, gold-standard surgical practice in breast implant surgery. They refer to the technique of breast augmentation popularized by Dr. John Tebbets, a Texas-based plastic surgeon and pioneer in the field.

Dr. Tebbets' system has a number of components, including:

• precise analysis of an individual's measurements and tissue type
• careful handling of breast tissue while in the operating room
• bloodless technique
• minimal touching of the implants
• early motion of the arms and upper body
• minimal use of pain medication
• typically, placement of the breast implants under the muscle (in the "dual plane")

Most board-certified plastic surgeons trained in the modern era of plastic surgery will use a variation on the Tebbets technique for performing your surgery.

My unique modifications of the Tebbets technique include all of the above, plus:

• use of a long-acting intercostal nerve block that numbs pain for up to 3 days after surgery
• use of ice compresses after surgery to minimize swelling
• use of a triple antibiotic irrigation prior to placing a breast implant
• changing gloves and re-sterilizing the body prior to placing a breast implant
• covering the nipple areolar complexes when possible to reduce the risk of infection from these sites

What can you expect from your breast augmentation journey?

In my New York City private practice, there are a few things that you can expect:

• Your surgery will take under an hour, typically about 30-60 minutes
• You will feel comfortable after surgery because of your nerve block and gentle tissue handling. Many patients take a very small amount of pain medicine, and some take none. It is normal to feel muscle soreness.
• You will be able to raise your hands above your head after surgery
• All of your stitches will be fully dissolvable
• You will not have any drains
• You will be able to shower the day after surgery
• You will not have special restrictive corsets or bands

Now what?

If you are thinking about breast augmentation, it is more important to check the qualifications and attributes of your plastic surgeon than it is to be swayed by seductive marketing terms like "flash recovery" and breast augmentation. Seek a surgeon who is not afraid to be honest with you about standards of practice surgery practice, and who is dedicated to giving you the best experience possible.

Contact my office at office@LaraDevganMD.com or call 212-452-2500

Actual patient of Dr. Devgan, before and after breast cancer reconstruction.

Actual patient of Dr. Devgan, before and after breast cancer reconstruction.

 1 in 8 American women will get breast cancer, but not many of us truly appreciate what breast cancer means in the flesh. If you require a mastectomy (surgery to remove your breasts), you are not only left with a large soft tissue deficiency, but you are also left without an aspect of femaleness-- the breasts-- that can impact your perception of your own femininity.

I performed an implant-based breast reconstruction on both of these actual patients of mine under very different, but very challenging technical circumstances. Both women were extremely happy to feel whole again after having her body torn apart by cancer.

The vast majority of my practice deals with cosmetic surgery, but reconstructive surgery has a special place in my heart. These surgeries are gratifying, and this work is important. Moreover, doing these surgeries make me a better, more capable, more dexterous, more agile surgeon.

Performing a beautiful cosmetic breast augmentation (breast implant surgery) is second nature to me after spending so much time taking care of involved reconstruction cases like this one. 

Talk to your doctor about what type of breast cancer screening is right for you, and try to catch this disease in its early, treatable stages. For questions, please direct inquiries to my office at 212-452-2400 or office@LaraDevganMD.com.

Lara Devgan, MD, MPH, Board-Certified Plastic Surgeon & Diplomate of the American Board of Plastic Surgery

There are a number of "plastic surgeons," "cosmetic surgeons," "aesthetic specialists," and "cosmetic doctors" out there. The field can appear saturated at first glance, and it can be a real challenge to find the appropriate provider for your unique concerns.

There are a few absolute requirements, in my opinion, when choosing a plastic surgeon for an elective cosmetic enhancement:

1. Choose a board-certified plastic surgeon, certified by the American Board of Plastic Surgery. This is the most robust, strict, and highly regulated board that concerns cosmetic procedures, and surgeons with this designation are required to meet the highest academic, ethical, and technical standards.
   
   I am a board-certified Diplomate of the American Board of Plastic Surgery and have worked hard for many years to align my practice with the highest standards of best patient care.
    
2. Choose a plastic surgeon whose results (and before & after photos) you feel comfortable with. You may well end up looking like the patients you see.
   
   A small sample of my work is available for viewing under the "Before & After" tab of this website.
    
3. Choose a plastic surgeon who conducts his or her practice in a manner that you feel is appropriate and meets your needs. Most of us want a doctor who returns our calls, replies to our emails, sees us in a timely fashion, gives us his or her personal contact information, and employs a staff that is compassionate to our concerns.
   
   I am very committed to giving my patients' the best possible care, and I hope that you have an excellent experience with me and my office. You will have 24/7 access to me and my office via email, telephone, and cell phone, and your comfort and satisfaction are my priorities.
    
4. Choose a plastic surgeon who other patients rate highly. Beyond the bare minimum qualifications above, I find this one to be the most telling. The best predictor of future performance is past performance, and you are likely to have a similar experience to the person who was in your shoes last week or last month. Do your homework and read your doctor's reviews.
   
   My independently verified patient reviews are posted in the "Testimonials" tab of this website. A few of the reviews we received in the past few days are also posted below.

Facial cosmetic surgery is one of the most popular aspects of my New York City plastic surgery private practice. While these operations can be life-changing procedures with an extremely high degree of patient satisfaction, they are also a complex topic. This was an invited article for online physician magazine Healio.com about the ins and outs of contouring the face. The intended audience is medically oriented, so some portions of this article are more technical. -Dr. Devgan

A Three-Step Approach to Contouring the Face:

Buccal Fat Pad Excision, Cheekbone Augmentation, and Submental Liposuction

by Dr. Lara Devgan

The aesthetic ideal of a slim, sculpted face has gained wide acceptance over time. With the popularization of makeup contouring techniques, feature-amplifying filters on social media, and genetically blessed celebrities, many patients are focused on subtle ways to improve their facial contours.

My approach to contouring the face is a three-tiered one. Of course, aesthetic judgement must be used to custom tailor any procedures to determine what is right for a given patient. Generally speaking, my approach to sculpting and contouring a slimmer, more attractive face is as follows:

1. Buccal Fat Pad Excision

The buccal fat pads are the fat deposits of the cheeks. Originally intended to help nursing babies form an effective seal during breastfeeding, they persist in adults and can contribute to the appearance of chubby "chipmunk" cheeks. 

The buccal fat pads extend from the angle of the oral aperture to the temples. Selective reduction of a walnut-sized aliquot of fat from each cheek can slim the face and create a more sculpted, chiseled, attractive look.

Buccal fat pad incisions are hidden inside the mouth, and all stitches are fully dissolvable. The procedure takes about 30 minutes and can be easily done under local anesthesia in selected patients. Results are noticeable as swelling regresses, which can take weeks to months, depending on the patient's facial anatomy.

2. Cheekbone Augmentation

Cheekbones are thought to comprise 70% of facial beauty, and prominent cheekbones on both men and women can be strikingly attractive.

In order to augment diminutive cheekbones, I typically use either autologous fat grafting or injectable filler to create a beautiful, sculpted look of the upper face. Not only does this help resuspend sagging and depletion of the malar fat pads, but it also minimizes the appearance of the nasolabial folds.

Cheekbone augmentation with autologous fat grafting is permanent. It involves liposuction and centrifugation of abdominal fat, and reinjection of that fat over the zygomatic arches. Injectable filler, such as Juvederm, Voluma, Radiesse, and Sculptra, has no downtime and can last anywhere from 1-2 years.

Both submental liposuction and cheekbone filler can be performed under local anesthesia. Results are noticeable immediately, although full settling of swelling takes 2-3 weeks.

 3. Submental Liposuction

Submental liposuction is the gold-standard approach to sculpting and refining the area under the chin, where excess fat and fullness develop over time. 

Although Kybella, an injectable to dissolve stubborn double-chin fat, has gained popularity in recent months, submental liposuction remains the most durable and thorough way to sculpt the lower face and add definition to the jawline and angle of the mandible.

Submental liposuction can be performed under local anesthesia, with an extremely high level of patient satisfaction and results that are noticeable within weeks of surgery.

ombining Modalities

A tripartite approach to facial refinement and sculpting, involving buccal fat pad excision, cheekbone augmentation, and submental liposuction, is an excellent, thorough, and elegant way to subtly refine the features of the male and female face. All three of these procedures can be done under local anesthesia or sedation anesthesia, and all three work synergistically to create a beautiful end result.

For questions about this article, I can be reached via www.LaraDevganMD.com.

Click to read the full article on Healio.com.

Image credit Bill Watterson, Calvin & Hobbes

The summer sun is beating down in New York City in full force, and it's important to remember to wear sunscreen daily.

There is considerable debate about which sunscreens are best, but there are a few non-negotiable points, in my opinion:

• make sure your sunscreen is SPF 40 or higher
• make sure your sunscreen contains a physical block such as titanium or zinc, and not just chemical agents
• make sure your sunscreen is appealing enough in texture, feel, appearance, and experience that you will actually WANT to use it every single day

This last point is the least medically required but the most practically important. The best sunscreen is one that you will actually use everyday. 90% of our skin's aging changes are due to sun damage, so make a smart choice about a quality product that you will love. My favorite is the one I designed for my own line, Platinum SPF 45 Daily Tinted BB Cream. Learn more about it below.

1.75 oz. | 50 g

The one and only product you need to wear in the morning.

DETAILS

Platinum SPF 45 Daily Tinted BB Cream is the single product you need to wear in the morning. This multi-functional tinted moisturizer functions not only as a UVA and UVB protector, but also as a luxurious BB cream that will make your complexion glow.

Platinum SPF 45 Daily Tinted BB Cream contains the market’s most effective photostabilizer to significantly enhance broad spectrum sunscreen protection against UVA and UVB rays linked to sunburn and premature aging. It also contains titanium, which has been scientifically proven to be the most effective physical sunscreen block in existence. Formulated as an all-in-one sunscreen and foundation, this tinted protector moisturizes and provides sheer color coverage, minimizes the appearance of fine lines and wrinkles, and blends naturally to match every skin tone, leaving skin radiant with a natural, healthy glow.

BENEFITS

• Contains the market’s most effective photostabilizer to significantly enhance broad spectrum sunscreen protection against UVA and UVB rays linked to sunburn and premature aging.
• Moisturizes and provides sheer color coverage.
• Minimizes the appearance of fine lines and wrinkles

DIRECTIONS FOR USE

Apply to face and neck, avoiding eye area. Wait at least 30 minutes prior to sun exposure or as directed by physician. Reapply after prolonged physical activity, swimming or perspiring.

This product is safe for use during pregnancy and nursing.

INGREDIENT HIGHLIGHTS

Vitamin E, Ethylhexyl Methoxycrylene

ACTIVE INGREDIENTS

Octinoxate 7.5% Octocrylene 5.5% Oxybenzone 5 % Titanium Dioxide 3.5%

INACTIVE INGREDIENTS

Deionized Water, Glycerin, Mineral Oil, Caprylic/Capric Triglyceride, Cetyl Alcohol, C12-15 Alkyl Benzoate, Stearic Acid, Cyclopentasiloxane, Cyclohexasiloxane, Emulsifying Wax, Ethylhexyl Methoxycrylene, Sorbitan Stearate, Tocopheryl Acetate, Potassium Cetyl Phosphate, Phenoxyethanol, Ethylhexylglycerin, Cellulose Gum, Tetrasodium EDTA, Iron Oxides

DR. DEVGAN'S ADVICE

"If you care about your skin, you absolutely must wear something with an SPF of 45 that gives you protection against UVA and UVB radiation. Platinum SPF 45 Daily Tinted BB Cream gives you the sun protection you need, but also functions as a luxuriously moisturizing tinted BB (Beauty Balm) cream that will make your complexion glow," says Dr. Devgan. "This is truly all you need in the morning."

Return Policy: While we hope that you are 100% satisfied with our custom-formulated products, we regrettably cannot guarantee the satisfaction, appropriateness, or utility of each product for each person. Everyone's skin type, skin sensitivity, and health concerns are different, and we advise discussing your skin care choices with your medical doctor in advance of undertaking any new skin care routine. In the event that you need to return a product, we are pleased to accept returns for any unopened, unused products within 30 days of purchase. Return shipping cost is the paid by the customer. Please email info@LaraDevganMD.com with any concerns.

Increase the absorption of medically active skin care products & rejuvenate the texture and appearance of your skin.

DETAILS

This gold infused collagen treatment mask works to improve the quality of your skin in two ways. First, it contains a proprietary blend of collagen, hyaluronic acid, vitamin E, vitamin B3, natural mulberry extract, and essence of rosebud to soothe and relieve your skin. Second, its silicone bilayer improves the permeability of any medically active substances that are placed on your skin by increasing their absorption.

BENEFITS

• Proprietary blend of hyaluronic acid, Vitamin E, Vitamin B3, and amino acids improves the skin's moisture level and collagen production
• Increases skin permeability and improves the absorption of medically active skin care products that have been applied to the surface of cleansed skin. Use of the gold collagen sheet mask is recommended in conjuntion with Platinum Hyaluronic Serum and/ or Platinum Vitamin C+ Luminous Night Serum.
• Soothes and relieves the surface of the skin
• Decreases inflammation when cooled in a refrigerator prior to use

DIRECTIONS FOR USE

Apply 4 to 5 drops of Platinum Hyaluronic Serum, Platinum Vitamin C+ Luminous Night Serum, or both to the cleansed and dried surface of your face and neck, avoiding the eye area. Carefully remove your gold collagen sheet mask from its protective encasement with scissors and gentle handling. Apply the mask to your face, leaving the contoured cut-outs over your eyes, nose, and mouth. There is no sidedness to the mask, and either side can be used effectively. Leave the mask in place for a minimum of 30 minutes, and for a recommended 1-2 hours. For increased soothing and anti-inflammatory action, many clients enjoy refrigerating their mask prior to use. After use, carefully store in the original packaging if you would like to reuse the mask, up to 3-5 times, every 5-7 days. Note that effectiveness does decrease somewhat after the first use, as elution of vitamins, minerals, and amino acids is the greatest during the first use. In the unlikely event that you experience any discomfort or itching during the initial few minutes of mask application, you are advised to discontinue use.

INGREDIENT HIGHLIGHTS

Collagen, hyaluronic acid, vitamin E, vitamin B3, natural mulberry extract, essence of rosebud, amino acid moisturizer

INACTIVE INGREDIENTS

Distilled water, soy protein, glycerin, pearl powder

DR. DEVGAN'S ADVICE

"A gold collagen sheet mask is an amazing beauty innovation originally developed in Korea, and it is a great way to improve skin texture, moisture, and effectiveness of your skin care routine," says Dr. Devgan. 

35 year old woman, before and after treatment with Kybella. 6 total vials used (12 mLs). Image credit Allergan

I've had many inquiries about Kybella, the new FDA-approved injection that permanently dissolves double-chin fat. The active ingredient in Kybella is deoxycholic acid, an encyme that permanently dissolves stubborn pockets of fat under the chin, and also tightens and contours the overlying skin.

The above image is an example from Allergan about what Kybella can achieve. The patient is a 35 year old woman (142.5 lbs in the before pic and 145.5 lbs in the after pic) whose jawline and profile are significantly improved after treatment with Kybella.

Kybella takes about 10 minutes per session, and you may require anywhere between 1 and 6 sessions spaced out over the course of months, depending on your degree of submental fat. It does cause transient swelling, but there is no downtime in terms of missed time from work or school.

The main alternatives to Kybella are submental liposuction and necklift, both of which are excellent procedures and more definitive, in my opinion. However, not everyone wants surgery, and it is important for me to be able to offer everything on the aesthetic spectrum. I feel that this keeps my practice unbiased and ethical. I am equally comfortable performing surgery and doing injections, so my only incentive is doing what is best for you. 

To see me as a patient in my New York City private practice, please call 212-452-2400 or email office@LaraDevganMD.com. Due to high call volume, please leave a message if your call is not answered immediately.

Actual patient of Dr. Devgan, before and after lip augmentation with a dramatic "Kylie Jenner lips" style look.

Most of my patients desire natural looking lip augmentation, but a skilled plastic surgeon is able to deliver any type of result, from very subtle to very dramatic, as shown here.

The image above is an actual patient of mine. She is a high-profile public figure who desired a dramatic, voluptuous, "Kylie Jenner lips" type of look. This required multiple syringes of filler injected over the course of months, with attention toward correcting some of the baseline irregularities caused by another doctor.

I realize that an exaggerated lip look does not appeal to every patient, but it's my job as a plastic surgeon to listen to my patients' goals and do my best to help them achieve their desired looks.

To see me as a patient in my New York City private practice, please call 212-452-2400 or email office@LaraDevganMD.com. Due to high call volume, please leave a message if your call is not answered immediately.

The Ideal Implant: a novel new saline breast implant that feels more like silicone

Finally, beauty without compromise.

I'm pleased to announce the introduction of the Ideal Implant in my New York City private practice. As a female plastic surgeon who focuses on breast augmentation and breast implant surgery, I am thrilled to be able to offer this exciting new implant to my patients. As one of the first plastic surgery practices in New York City to offer the ideal implant, I am honored to participate in this innovative development.

The IDEAL IMPLANT® Structured Breast Implant gives you the natural feel you want, and with advantages over silicone gel implants. Although it is filled with only saline for your peace of mind, the implant has a natural feel because of its internal supporting structure that controls movement of the saline. 

If the IDEAL IMPLANT ruptures, the saline inside is harmlessly absorbed by the body. In addition, you have the confidence of knowing that your implants are intact just by looking in the mirror. In contrast, if a silicone gel implant ruptures, it is “silent” and cannot be detected by looking in the mirror. Current silicone gel implants have been shown to have a high rate of rupture based on MRI scans. 

Women have wanted a new type of breast implant – one that would combine the natural feel of a silicone gel implant with only saline inside for safety and peace of mind. After years of research, engineering, product development and a large US clinical trial, the IDEAL IMPLANT was approved by FDA and Health Canada, and is now available through a limited network of board certified or eligible plastic surgeons. 

The IDEAL IMPLANT has been in clinical use since February 2009, at the start of the clinical trial. By February 2010, 502 women received the IDEAL IMPLANT from 45 board certified plastic surgeon investigators nationwide. In clinical follow-up over five years, patient and surgeon satisfaction with the outcome has been high and the capsule contracture rate has been low.

The Hamptons Magazine Hot List, August 2016.

We are thrilled to announce that Dr. Devgan has been named to the Hamptons Magazine hot list, "The List." Featuring movers and shakers throughout the New York City, greater New York, the Hamptons, and surrounding areas, Dr. Devgan is honored to be listed with esteemed company, including:

Emily Ratajkowski, Brooke Shields, Mary-Kate Olsen, Oliver Sarkozy, Bebe Neuwirth, Alec Baldwin, Lauren Bush Lauren, Nacho Figueras, and more.

For more information on Dr. Lara Devgan, please contact office@LaraDevganMD.com or email 212-452-2400.

The Hamptons Magazine Hot List, August 2016.

Actual patient of Dr. Devgan, before and immediately after Microneedling treatment

Truly beautiful skin is soft, supple, and glowing. Yet with sun damage, acne, wrinkles, fine lines, freckles, and sun spots, a luminous complexion can be difficult to achieve. A large body of research supports the use of an exciting technique to aid in getting great skin: Collagen Induction Therapy.

Collagen Induction Therapy, also called Dermapen Microneedling, or Microneedling, is a minimally invasive technique that boosts your skin's production of collage and elastin, two of the most important substances in maintaining plump, youthful, glowing skin.

HOW DOES IT WORK?

Microneedling involves using a mechanized device called a dermapen to make thousands of miniscule needle punctures in the outermost layers of the skin. By precisely controlling the depth, spacing, frequency, and pattern of these needle pricks, the dermapen stimulates your body to make more collagen in the areas where it needs it the most. Microneedling has been scientifically demonstrated to show improvement in fine lines, freckles and sun spots, scars, burns, pitted and non-pitted acne scars, stretch marks, and large pores. 

CAN MICRONEEDLING BE COMBINED WITH OTHER TREATMENTS?

Microneedling can be combined with a liquid treatment on the skin surface-- such as growth factors, vitamin C, or platelet rich plasma (PRP)-- to further improve skin quality, evenness, and texture. This is highly effective because the skin absorbs more of these growth factors as a result of microneedling treatment. The so-called "vampire facelift" (shown on Bar Rafaeli and Kim Kardashian, above) is an example of this combination.

HOW IS THIS DIFFERENT FROM A MICRONEEDLING OR DERMAROLLER TREATMENT IN A SPA?

Spa & home needles are shorter and less effective.

In a spa or home-use setting, microneedling devices and dermal rollers have needles that are much shorter than the ones used by a plastic surgeon. A spa or home device will have short, fine needles that are 0.2 mm in depth and can be used two times a week or more. In contrast, medical microneedling performed by a qualified plastic surgeon uses long, fine needles with depths ranging from 2 to 7 mm, depending on your concern (in other words 10 to 35 times deeper than the spa model).

Spa & home needles can hurt your skin and cause scarring.

Microneedling must be done with a device that hits your skin surface at a 90 degree (perpendicular) angle, in order to minimize scraping, scratching, or other trauma that could cause scarring. Inexpensive spa devices often have poor quality needles that are slightly angled or bent and can thus hurt your skin. Similarly, circular devices like dermal rollers don't hit the skin at a straight 90 degree angle and can be injurious for this reason as well.

A licensed physician or medical professional is required to supervise any procedure that breaks your skin. A vigourous Dermapen Collagen Induction Therapy session should do this, and thus should be medially supervised.

WHY NOT JUST USE A LASER OR CHEMICAL PEEL?

Microneedling is preferable to laser and chemical peels in many patients because it is safe for use in all skin tones, all parts of the body (including stretch marks on the abdomen), and all times of life (including pregnancy and breastfeeding). In addition, the downtime with Microneedling is quite short, with transient redness usually lasting less than a day (as compared to one week or more with peels or laser).

Microneedling Collagen Induction Therapy is also a great technique for those who are concerned with their complexions but are relunctant to try Botox or fillers. Because it is mechanical and doesn't involve any chemicals or neurotoxins, the technique is reassuring to many.

DOES IT HURT?

Although Microneedling sounds scary (thousands of needles going into your face!), it is actually quite painless. Dr. Devgan uses lidocaine numbing cream on your face to keep you completely comfortable, and you are wide awake during the procedure. The experience feels similar to a deep facial with a bit of extra vibration. At the end of the procedure, your face will be slightly red and tingly, as the growth factors, vitamin C, or platelet rich plasma absorb into your skin. By the next day, you will be able to return to work and play, with minimal downtime.

Improved skin appearance begins to occur almost immediately and continues for 4 to 6 weeks. For best results, Microneedling can be repeated as frequently as every 6 weeks, or as infrequently as 2-3 times a year, depending on your concerns.

IS IT EFFECTIVE?

The before and after photos of Microneedling speak for themselves. Although individual results and situations vary, this technique has been demonstrated to be effective in facial wrinkles, acne scars, hyperpigmentation, burns, surgical scars, and stretch marks.

WHAT IS THE DATA?

The scientific literature supports the use of Collagen Induction Therapy using a Dermapen Microneedling device. More detailed data can be found here:

• Fernandes D. Minimally invasive percutaneous collagen induction. Oral Maxillofac Surg Clin North Am.2006;17:51–63. [PubMed]
• Aust MC, Fernandes D, Kolokythas P, Kaplan HM, Vogt PM. Percutaneous collagen induction therapy: An alternative treatment for scars, wrinkles and skin laxity. Plast Reconstr Surg. 2008;21:1421–9. [PubMed]
• Fernandes D, Signorini M. Combating photoaging with percutaneous collagen induction. Clin Dermatol.2008;26:192–9. [PubMed]
• Aust MC, Reimers K, Repenning C, Stahl F, Jahn S, Guggenheim M, et al. Percutaneous collagen induction: Minimally invasive skin rejuvenation without risk of hyperpigmentation-fact or fiction. Plast Reconstr Surg. 2008;122:1553–63. [PubMed]

HOW DO YOU SET UP YOUR NEW YORK CITY DERMAPEN MICRONEEDLING TREATMENT?

If you are interested in Collagen Induction Therapy (microneedling dermapen treatment), please call our Manhattan office at (212) 452-2400 to schedule a consultation and treatment with Dr. Devgan. If you have specific questions, you can also reach out to us at info@LaraDevganMD.com.

HOW DO YOU MAKE YOUR MICRONEEDLING RESULTS LAST?

Actual patient of Dr. Devgan, before and after labiaplasty

Actual patient of Dr. Devgan, before and after labiaplasty

Labiaplasty (or cosmetic rejuvenation of the female genitalia) is one of the most popular procedures in my New York City plastic surgery private practice. As a female plastic surgeon, many of my patients feel comfortable discussing their most intimate concerns with me. Equally important, I am committed to giving superb surgical results to each patient in my practice. Examples of results from my actual patients are displayed at the bottom of this page.

U.S. plastic surgeons have reported a 44% increase in labiaplasty procedures over the past several years, according to the American Society for Aesthetic Plastic Surgery. This makes labiaplasty the fastest growing plastic surgical procedure in America.

WHAT IS LABIAPLASTY?

Labiaplasty is an outpatient surgical procedure designed to make the female genital area more aesthetic and comfortable. Women seek labiaplasty because they are unhappy with the way their private parts look, or because they are uncomfortable with friction caused by exercising, sexual intercourse, or wearing fitted clothes. Labiaplasty can address the inner labia (labia minora), the outer labia (labia majora), the clitoral hood, or any combination of those areas. Atrophy or sagging of the labia majora can also be addressed with filler or fat grafting. 

WHAT IS THE ANATOMIC CONCERN?

The most frequent complaint related to labiaplasty is protruding or enlarged labia minora (inner labial lips). This is also the most common reason for women to seek labiaplasty in my practice. As women get older, some experience atrophy or sagging of the labia majora (external labial lips). Occasionally, women also complain of enlargement of the clitoral hood, looseness of the perineal tissues, sagging of the labial majora, or bulkiness of the mons pubis.

Labiaplasty is tailored to your individual anatomic considerations and concerns, as each woman is different. Labiaplasty does not affect sexual sensation, enjoyment, or ability to have an orgasm. The female erogenous zones, such as the clitoris and "g-spot" are not operated on and experience no changes during the operation.

WHAT IS THE SURGERY LIKE?

Labiaplasty is done under local anesthesia with or without light sedation ("twilight"), which is always supervised by my board-certified female anesthesiologist. About 70% of my patients elect to have the surgery done under local anesthesia alone. The surgery itself typically takes under 1 hour. When surgery is complete, you will have ointment and a maxi pad placed as a dressing. If you have had local anesthesia only, you will feel fine immediately after surgery. If you have had sedation, you will feel a bit tired and you will recover in one of our private recovery room suites, where you will be able to relax, sleep, watch TV, or read a magazine. Once you are feeling fully awake and alert, usually after about half an hour, you will be able to go home the same day. 

WHAT ARE THE SCARS LIKE?

Scars for labiaplasty are hidden in locations that are not visible under most circumstances. Even when scars are closely examined, as in during intimacy or mirror examination, the female genitalia generally heals extremely well. Any scars that are present will heal in a camouflaged manner, and care is taken to design your scar placement in a buried or hidden location.

EDGE OR WEDGE?

There are two well-described techniques for performing labiaplasty that addresses the labia minora: the external trimming technique (excising the "edge" of the protruding tissue-- the edge technique) and the v-shaped surgical excision (excising a "wedge" of the protruding tissue-- the wedge technique). I am well-versed and facile in both techniques and will tailor the procedure to your individual desires. Both procedures have their role in labiaplasty, however, generally speaking, I prefer the wedge technique in most women, as I consider it to provide a superior cosmetic result.

In general, the wedge technique is considered the gold standard of labiaplasty technique, and it has supplanted the edge technique in the hands of many modern and experienced surgeons. The wedge technique is more technically challenging from a surgical perspective, and for this reason, it is less common to find a plastic surgeon to perform this procedure. However, the wedge technique is considered a superior operation in most women for several reasons:

• The Edge technique creates a linear scar along the edge of the external genitalia, which can appear scallopped or irregular when the stitches heal. The Wedge technique has a buried scar that is less noticeable and leaves the external genitalia with a smooth contour.
• The Edge technique is associated with occasional complaints about dysparunia, or pain with sexual intercourse. These complaints are almost unheard of with the Wedge technique.
• The Edge technique is more traumatic to the tissues and has an increased amount of swelling, as well as an increased risk of wound breakdown. While swelling is also present with the Wedge technique, it resolves more quickly. Wound breakdown is not common with the Wedge technique.

WHAT IS THE RECOVERY LIKE?

After surgery, you will wear a maxi pad with a small amount of ointment on it, and use ice packs for comfort. All of your stitches will be dissolvable. You will use a "peri bottle" or water bottle to cleanse yourself after going to the bathroom. When you are resting at home, I advise pelvic elevation by keeping your pelvis propped up on 1-2 pillows to help the swelling come down.

Swelling after labiaplasty peaks in the first 2 weeks. During this time frame, swelling is gravity-dependent, so you will notice that spending more time doing pelvic elevation helps the swelling decrease. Even if you are up and about right after surgery, this will not effect your long term result, although it may take a bit longer for your swelling to go away. After the first 2 weeks, swelling continues to decrease on its own. You will have about 80% of the final surgical result at 1 month after surgery and 90% after 6 weeks, although it takes a full 6 months for all swelling to completely dissipate. 

WHEN CAN YOU RETURN TO WORK AND PLAY?

You will be able to do normal activities, such as walking around the block and running an errand, the day after surgery. Depending on the nature of your job, many women are able to return to work within 2-3 days. For more strenuous types of work, this may vary. Strenuous activity is not advised for the first four weeks after surgery, although pending Dr. Devgan's recommendations for your individual case, you may be able to resume some light exercises at 2-3 weeks. You will be able to return to sexual intercourse, strenuous exercise, swimming, and normal activities after approximately 6 weeks.

WHAT IS THE NEXT STEP?

Patient satsifaction with labiaplasty is extremely high. For questions about the procedure or to set up an in-person consultation, please call our office at (212) 452-2400 or email info@LaraDevganMD.com.

Actual patient of Dr. Devgan, before and after facelift (short-scar approach).

Actual patient of Dr. Devgan, before and after facelift and necklift (short-scar approach) with fat grafting.

Facelift and necklift are two of my favorite plastic surgery procedures. The face and neck are not only the seat of identity and beauty, but they contain some of the most complex anatomy and delicate tissues on the human body.

When I am addressing the concerns of a patient interested in rejuvenation of an aging face or neck, there are a few key questions that I ask myself to help me achieve natural, beautiful, and durable results:

1. What are the major issues that are concerning the patient? These could be fallen cheeks, jowls, deep wrinkles, neck bands, excess skin, or any combination of the above.
2. What are the patient's tissues like? This is an assessment of skin type, complexion, thickness, sebaceousness, tendency toward scarring, and ability to heal.
3. What are the unique anatomic characteristics that make this patient's face and neck different? Everyone has a set of qualities that give a sense of identity to their features. This could be deep set eyelids, prominent cheekbones, a beauty mark, or a baseline asymmetry-- really anything that makes you look like you.
4. In what way does the patient's overall medical status impact the proposed operation? Major medical problems, allergies, connective tissue issues, use of certain medications like steroids, and substance use all impact my operative decision making, before, during, and after surgery.

From a surgical standpoint, the major differentiating factor between a modern facelift or necklift and the old-fashioned, pulled, tight, shiny, windblown look of Park Avenue in the 1990s is a deliberate treatment of the skin and substructure of the face as two separate anatomic planes. The SMAS (muscular substructure layer of the face) and the skin (the overlying covering) must be addressed separately and systematically in order to achieve a beautiful results.

For questions about facelift and necklift, please contact my office at office@LaraDevganMD.com or 212-452-2400.

I was honored to be invited to discuss labiaplasty in The Guardian's new documentary series on the female body. Created by Emmy-winning producer Mae Ryan and brilliant data journalist Mona Chalabi, this project, entitled The Vagina Dispatches, is a long-overdue look at the things we don't know about the female body-- sponsored by one of the world's great news organizations, The Guardian. In this episode, I discuss labiaplasty, which is one of the fastest growing plastic surgery procedures in America and one of the most popular operations in my practice. 

Click to watch The Guardian's documentary, Vagina Dispatches, Episode 1. Dr. Devgan's interview begins at minute 6:18.