Anesthesia and plastic surgery: What you need to know

Anesthesia 101

For many people, the greatest concern when it comes to surgery is anesthesia. This is probably because one of our greatest fears is to have no control while our health and safety is in the hands of others. Our job as anesthesiologists is to help allay those fears by giving patients knowledge and guiding them through the surgical experience safely with minimal pain and discomfort. The following are some of the more common questions I have been asked by Dr. Fisher's patients along with some "need to know" information.

Anesthesia & plastic surgery: What you need to know

Who administers the anesthetic

First and foremost, you may have never asked yourself who will be putting you to sleep?

It’s important to know who your anesthesia provider is. Not all anesthesia providers are created equal! Ask your surgeon who he or she works with to administer your anesthetic.

Not all anesthesiologists are created equal

Not all plastic surgeons utilize board certified anesthesiologists. Some work with non-certified anesthesiologists or nurse anesthetists. There is a marked difference between the two. Anesthesiologists are fully licensed doctors who have chosen to specialize in the area of anesthesiology. They must first obtain a bachelor’s degree after four years of pre-medical studies then complete four years of medical school resulting in an M.D. or D.O. degree followed by a four-year anesthesiology residency program-for a total of twelve years. Board certification is obtained when an anesthesiologist meets the American Board of Anesthesiology requirements and passes both written and oral examinations. Board certification is not a guarantee but is an indicator of competency and depth of knowledge. Anesthesiologists are doctors first, and then become specialists in anesthesiology. By contrast, licensed nurse anesthetists obtain a bachelor’s degree in nursing and then complete a two to three year nurse-anesthesia training program. One-year experience as an acute care nurse is mandatory.

What types of anesthesia are there?

To simply things, there are basically 4 kinds of anesthesia that you may encounter.

1. Local Anesthesia

Local anesthesia is used to prevent pain in a smaller, specific area. Examples of this are when a doctor injects an area to numb it before stitching a wound or when a dentist numbs you for a filling. During a straight local anesthetic the patient is awake.

2. Intravenous Sedation

Intravenous sedation is when potent medications are given through an IV to help prevent pain and anxiety associated with medical and surgical procedures. Frequently, sedation is used in conjunction with a local anesthetic to provide the most comfort. With sedation, patients are usually very groggy and may briefly drift off to sleep. This is what people commonly call "twilight".

3. Regional Anesthesia

Regional anesthesia is when an anesthetic is injected around larger nerves to anesthetize/numb a larger area or region for surgery. A common example of this is when an anesthesiologist performs a spinal anesthetic or epidural for a C-section by injecting anesthesia near the spinal nerves which essentially anesthetizes the lower half of your body.

4. General Anesthesia

General anesthesia is when the patient goes completely to sleep for surgery. The patient is given medications, which cause loss of consciousness, and prevents pain. The medications are given intravenously or in combination with inhaled anesthesia gases. In plastic surgery this is the most common anesthetic you will likely encounter.

The type of anesthesia that you will need depends in large part on the kind of surgery you are having. With certain surgical procedures general anesthesia may be the only way for the patient to be completely pain free during the procedure.

Ask the right questions

It’s important to ask your anesthesiologist whether you are having general vs. sedation. I frequently get told distressing stories by patients who said they "woke up" in the middle of a procedure and were scared this would happen again. One explanation for this might be that the anesthesiologist did not communicated clearly to the patient that he never intended on putting them completely to sleep with a general anesthetic. His plan might have been sedation alone. In this case the patient coming in an out of consciousness could be expected. An example of where this might be the case is breast biopsies.

Alternative tips and tricks for products and tools

Leftovers do double-duty

Ever wondered what to do with those bottles of shampoo and conditioner you have lying around? Feel guilty about not using up the last remnants of the container before putting it in the recycle bin? Below, find out how to make those unwanted leftovers perform double-duty.

One thing is for sure, you will never look at your collection of hair care products and tools in the same way ever again!

Shampoo

Run out of shaving cream and no time to get to the store? Use a dollop of shampoo to soften the hairs and prepare your skin for a smooth, sweet-smelling shaving session.

Shampoo also makes a great shoe and purse cleaner. Dab a little on a soft cloth and apply to the leather, leaving for half an hour to soak in. Finally, buff to a shine. Your purchases will look as new and fresh as the day you bought them.

Don't want to spend copious amounts of cash on expensive makeup brush cleaners? Neither do we! Put your shampoo to good use and clean like the pros. Under a warm running tap, place a pea-sized amount of shampoo in the palm of your hand, then swirl your brushes. Remember to squeeze out the excess suds. You'll be amazed at the amount of grime and dirt flowing away!

You can also use shampoo as an inexpensive lingerie detergent. Hand-wash your delicates in a bowl of cool water with a little shampoo added. Make sure to rinse well. Leave your garments out to dry flat overnight.

Although shampoo is considered to be a 'gentle' product, it does contain de-greasing ingredients, making it suitable for use as a household cleaner.

Wash your floors with a mop soaked in shampoo suds. You can even wash your car with this solution. Need to clean the woodwork? Wipe away fingerprints, grime and grease with a soft cloth and a pea-sized amount of your old, unwanted shampoo. After a hard day of housework, run yourself a bath of -- you guessed it -- shampoo bubbles!

Conditioner

To solve your flyaway hair problem, simply smooth over the offending, misbehaving cuticles with a little conditioner!

Like shampoo, conditioner can also be used as an emergency shaving lotion.

Give dusty household plants a breather -- wipe their leaves with a soft, clean cloth dipped in conditioner.

Hairspray

Hairspray not only holds your hair in place but is also a great anti-static device. Spray on your hairbrush and smooth the frizz away!

Hairdryer

Use your hairdryer to blow hard-to-reach dust and dirt from your computer keyboard. You can also use it to dust fragile ornaments and works of art.

Rushing to clean up after your morning shower? Clean your steamed up bathroom mirror with a short blast of cool air from your hairdryer.

Hairdryers are also excellent tools for drying clothes and shoes on those occasions when you get caught in a downpour.

How to save on hair products

More bang for your buck

Times are tough, and a girl can't always spend the money she wants on beauty upkeep. No worries, though. We've got a few tips in mind that will help you save a bit of dough when it comes to hair products. No, we're not completely stingy -- we just believe in saving money where we can so we can spend it on other fun items like a girlfriend's getaway or a pair of must-have heels!

Buy in bulk

If you go through shampoo bottles like a thirsty dog goes through water, then consider buying in bulk. Shampoo and conditioner are two items that are cheaper when bought in larger sizes, and you’ll have more for longer. If you have more than one shower in your household, divvy up the big bottle into smaller ones instead of buying separate large bottles for each bathroom. Another tip: Add a bit of water to the bottle when you’re down to the last bit of shampoo. You’ll be surprised how much sticks to the side, and you’ll get at least another couple of washings from it.

Save on the cut

Hair grooming can get pretty expensive, especially if you’re on a four-week cycle. Instead of going in once a month, ask your stylist to give you a cut that grows out more evenly (chances are, she'll be glad to do this -- after all, she doesn’t want to lose your business). The money you save by spacing out visits even by a week or so will add up at the end of the year. Also consider visiting one of your neighborhood cosmetology schools. Students there are required to perform a certain amount of practice hours on real-life clients, and the service is offered at majorly reduced prices (often, completely free). Don’t worry: The students wouldn’t be allowed to cut hair if they weren’t qualified.

Discount brands

Beauty routines are give and take. You can definitely go bargain-bin on some things instead of always choosing the name brand. If you’ve got normal hair (that is, healthy and non-fried), try switching to a more affordable label instead of your designer-brand shampoo and conditioner -- not necessarily the $3 generic brand but a mid-range line that runs about $7 per bottle, which can be just as beneficial for your locks as the stuff that costs three times is just as impactful on your locks. Same goes for hair accessories like headbands and clips. There are plenty über chic (and über expensive) pieces on the market, but you can find just as many worthy accessories at your drugstore or discount department store. Invest in one or two high-end pieces and supplement your collection with a handful of cheaper options.

17 Dos and don'ts for daily hair care

Love your locks every day

To keep your hair looking its best every day, follow this simple guide. These dos and don'ts will keep your hair in tiptop shape and fashion-forward style.

Make an investment

1. Do invest in a good hair cut. Caring for your locks becomes so much easier when you are sporting a fabulous 'wash and wear' style.

2. Do wash your hair with the correct products. Dry hair requires a moisture-drenching shampoo, while oily hair benefits from frequent shampooing with a purifying, oil-regulating shampoo.

3. Do invest in a good quality clarifying shampoo. Although not designed for regular use, clarifying shampoos work to remove a build-up of product and chemicals. Experts recommend using this type of shampoo a few days before undertaking a color treatment.

Brushing basics

4. Do brush your hair each morning. This will help remove dust, dirt and loose scales. It also stimulates the blood supply and distributes sebum along the hair shaft.

5. Don't use a brush on wet hair. Use a wide-toothed comb instead. Start at the ends, gently working your way up towards the roots.

6. Do brush your hair at night before going to bed. If your hair is long, tilt your head forward and brush from the base of the head forward.

7. Do allow your hair to dry naturally as often as possible. Use a highly absorbent towel to mop up excess moisture then finger dry.

Protect your locks

8. Don't expose your hair to the sun during the hottest time of the day. Cover up and wear a hat instead.

9. Do wash hair after swimming in chlorinated water.

10. Don't forget to clean your brushes and combs. Let them soak in warm, soapy water once a week.

11. Do tone on a regular basis. Toning involves regular massage of the scalp. This stimulates the blood supply to the root of the hair follicle.

12. Do nourish your scalp with oil twice weekly. This will help to soften and strengthen graying hair. Choose from almond, coconut or extra-virgin olive oil. Soak a cotton ball in the oil and dab on to the scalp, leave for half an hour then wash with very warm water. Finish with a cold rinse to flatten the cuticle of the hair. The result? Softer, smoother, manageable hair.

13. Do wet your hair before stepping into the pool. When the hair shaft absorbs regular water, it helps negate the damaging effects of swimming in chlorinated water. Better still, wear a swimming cap!

Keep it healthy

14. Don't tie your hair back too tightly and never when it is wet. This stretches the hair shaft, causing it to break and split.

15. Do eat foods rich in skin and hair enhancing essential fatty acids. By taking care of your diet, the state of your inner health will reflect in the condition of your hair. Be kind to yourself.

16. Don't over-style. Experts recommend using a blow dryer only for special occasions. At the end of your styling session, switch to cold air. This closes the hair shaft, leaving the hair smooth, glossy and shiny.

17. Don't forget to keep regular scheduled appointments with your stylist. Making an appointment for a trim every 4 to 6 weeks will leave your hair in tiptop condition.

Secrets of a perfect salon blowout

Blowout 101

Want your hair to have va-va-volume with the kind of gentle, glossy curves that seem to happen only for celebrities? Try a blowout, a pricey salon luxury that you can do at home easily and affordably. A blowout simply means styling your hair with a round brush as you blow it dry -- no curling iron or flat iron needed.

Even better, a blowout is built to last. An at-home version will hold up for two to three days, depending on hair type. Sure, you put in some time on day one, but a quick touch-up is all you need the next couple of mornings.

"I tell my clients to sleep with a loose ponytail," says Stefanie Henriquez, a stylist at the Frédéric Fekkai salon at the Mark Hotel in Manhattan. "Throw your hair upside down and put it in a loose ponytail at the crown of your head."

We asked Henriquez to share more techniques, tips and favorite products that she uses on her clients.

How to get a long lasting, salon-style blowout at home

1. Shampoo and condition hair with volumizing products.

Apply conditioner to the ponytail portion of your hair only, not on roots. Rinse with cool water. "This seals the cuticle and holds in moisture," Henriquez says. "Rinse very, very well."

2. Wrap wet hair in a towel.

Wrap hair in towel or let it air-dry a bit to cut down on blow drying time later.

3. Prep with styling products.

You'll need two, Henriquez says: One for the ponytail portion of your hair, and another for the roots. For a splurge, Henriquez suggests using Fekkai's Ageless All-Day Hair Plump, $95, on the ponytail section. This leave-in treatment makes hair thick, healthy and smooth. (For a list of retail locations, visit fekkai.com/wheretobuy.) For an affordable option, try Umberto Thickening Spray, about $9 at Target.

To perk up roots, Henriquez recommends Fekkai's Coiff Bouffant Lifting & Texturizing Spray Gel, $23. (For retail locations, fekkai.com/wheretobuy.) For a steal, try John Frieda Luxurious Volume Lavish Lift Root Booster, about $6 at drugstores and mass retailers. Always use lightweight products on roots.

4. Turn head upside down and blow dry hair.

This gives roots even more lift. Don't use a brush just yet – comb through hair with your fingers. Begin drying at the roots and work toward the ends, getting hair about 75 percent dry.

5. Flip head upright and finish drying hair with a round brush.

A boar bristle brush is best, Henriquez says, because it has the right tension to make hair smooth and shiny. Work from the front of your head to the back, separating hair into small, defined sections. Dry each section by rolling it through the brush, root to tip. Lift the brush out and up to give roots a lift, and dry each section completely (damp hair means a frizzy finished style). Once each section is dry, give it a shot of cool air while it's wound on the brush. Then, wrap the section around a Velcro roller. This will set the style and add volume and bounce. Continue until all of your hair is in rollers.

6. Release hair from the Velcro rollers.

Shake out the curls with your head upside down. Flip hair upright and use your fingers to smooth the style into place.

7. Finish with a sheer-hold hairspray.

If necessary, apply a shine serum to the ends of hair.

Blowout do's and don'ts from Henriquez

• Do blow dry using a low speed and high heat. And, use a nozzle attachment, which funnels air in one direction. This results in smoother strands.
• Don't buy a giant hairbrush thinking it will add body to your tresses. In fact, the smaller the brush, the more volume it gives hair.
• Do invest in a professional-grade hair dryer that has at least 2600 watts of power. Henriquez says Twin Turbo dryers are used for perfect blowouts at the salon.
• Don't overdose on styling products. Each is important to the finished style, but be reasonable with the amounts. "The less product you use, the longer the blowout will last," Henriquez says.

DAY 2..... HAIR SHOW.... WHAT DO YOU THINK?

http://freddyo.com/2010/08/10/bronner-brother-hair-show-day-2/dsc_0303-15/

Update your look:Mom makeover: 6 Easy steps to a new look

Just because you’re a mom doesn’t mean glamour has to disappear. If you’re ready for a new look, here are six simple mom makeover tips to give you a fresh style and earn you the "hot mom" moniker.

New bra

“The first thing any woman should do as she begins a makeover is to get a bra fitting,” says fashion blogger Laura Coronado of Lollie Shopping. “I recommend going to a department store such as Nordstrom or Neiman Marcus, where the associates are trained to perform a proper bra fitting.” She continues, “Once a woman knows her correct bra size and carries her bust in the proper area of her body, she will discover a new, sexy figure she may not have been aware she had, including a smaller waistline than she originally thought.”

Find your personal accessory

Soul Stylist Dame Lori tells ladies to choose one signature style piece and run with it. “Every stylish person smartly chooses one item to indulge in. What is your favorite comfort and chic item? Wear it loud and proud. Make cool sneakers, scarves from around the world or cool earrings a daily, central part of your outfit and shopping focus. Even if the rest of your outfit is tossed on jeans and a T-shirt, you will always feel chic.”

Ditch the ponytail

If you love having your hair swept away from your face, substitute your everyday ponytail for an updated, fashionable look like an elegant chignon or the currently hot rope braid.

A touch of makeup

We know it’s easy to skip the makeup routine, but a little lip glass and mascara can really perk up your face. Terez Howard, mother and owner of The Write Bloggers says taking the time to apply a little makeup gives her a fresh, natural look while also boosting her confidence. Feel out of the loop in the makeup department? Stop by your local department store’s cosmetic counter for free makeup suggestions and tips. The cosmetic experts have a knack for helping women find the right shades and they can keep you up to date on the latest application trends.

Mani and pedi

You don’t have to go to a spa to enjoy some self pampering. Give yourself an at home manicure and pedicure. Use some white sugar and a few drops of lemon juice to exfoliate your hand, feet and smooth your cuticles. Rinse with a can of club soda and your hands and feet will feel renewed. Finish with a pretty new seasonal shade of nail polish.

Teeth whitening

The most important thing a mom can wear is her smile. Today, a trip to the dentist isn’t necessary to put a little sparkle in your pearly whites. The next time you’re at the local drugstore, pick up a home teeth whitening kit. This easy fix can be done while blow-drying your hair, folding the laundry or even as you lay in bed reading a book.