Dr. Goldberg on Rogers Health Matters

Hi, and welcome back to Health Matters. Today we're talking about how to get our ideal summer body. So, as we mentioned in the last segment, it's not just about diet and exercise. There's some changes that we can achieve through those methods. Joining us next is cosmetic surgeon Dr. Corey Goldberg. So welcome to the show, Dr. Goldberg.

Thank you very much. Nice to be here.

So much for coming on. I'm really interested to hear what you have to say, and I think what we'll start off with is what treatments do you typically see patients coming into the McLean Clinic for more often this time of year?

Well, I think spring and summer tends to be the time of year that people think most about their breasts and their body. It's bathing suit season and everybody wants to be tuned up so they can go out and show off.

That's right. So those are the most popular things. And who do you find is the typical patient as well at this time of year?

Well, it's an interesting thing. A lot of people have the idea that only the rich and famous come for plastic surgery and cosmetic surgery, but it's not the case. I would say the majority of my patients are ordinary people who have very simple concerns. Maybe concerned about a little extra fat on their tummy or the breasts have gone south since they've had kids and they're just looking to tune up one thing and get themselves ready to go out and wear their bathing suit around the pool.

That's right. And so you are serving the population of Mississauga, Brampton and Toronto. Right. So not celebrities, Everyday people.

No, everyday people. And that's by far the majority of patients who come in.

Well, and I love that you mentioned, too. You know, they probably want more confidence, so that's probably something that you're instilling in them with your services.

Well, you know, I'd like to think that most of the patients that come in have very realistic expectations. The plastic surgery junkies that come for multiple procedures, really not very common. Most people are just looking to fix one thing about themselves, and it really does make a big difference. It makes them a lot more confident and comfortable with who they are.

One thing I want to touch on is we had Miriam on just earlier. So with Botox and fillers available, like what she discussed, what role does surgery have in things like facial rejuvenation?

Well, Botox and filler are phenomenal tools. They really have a lot of versatility, and they can improve a lot of areas of concern. But it's important to remember that every tool has its Limitations. There are certain things that they can accomplish and certain things that are beyond them. And it's important to know when you're reaching the limits of a tool. So Botox and fillers, when you've gone past them and there are certain concerns that you can't address, then it's time to start thinking about surgical options. And those surgical options are exactly what you might think of facelift, brow lift surgery around the eyes for eyelid concerns. And people get to that point often a little bit later in life after they've gone through having some fillers and Botox to maintain themselves. And then when they're ready to take the next step, they go onto the surgical options.

And what kind of a downtime are people looking at with those types of options these days? Because I know that they've much improved over the past decade, I guess.

Well, it's a good point. And the surgery has improved a lot, but also the anesthetics have improved a lot. The types of medication that people get for the anesthesia, they wear off very quickly. Very low rates of nausea. So people really recover very quickly after these kinds of operations, which are generally fairly short. Almost all of them are day surgery. Patients go home right after the operation, and recovery times may be anywhere from three to seven days. And after that, most people are ready to get back to ordinary activities.

So that's a lot quicker than I think most people are aware of. I mean, they're in and out on the same day of the surgery almost all the time.

Yeah, absolutely. And it's only the rare patient for longer procedures or where there's more involved that they need to stay overnight. And we'll keep patients overnight when we need to. But the vast majority of the procedures we undertake are day procedures.

And now how would somebody go about selecting a procedure? Do they meet with you first or do they have a consultation? How would that work?

So usually we have patients come in and they meet both with my nurse and myself and go through their particular concerns. The first part of a consultation is really about eliciting and bringing out from the patient what they're concerned about. It's very important for me because I don't like to inflict on a patient what my concerns are or what I see. I want to know what their concerns are and bring that out. And then I try to see how we can address those things. So that's the main point in a consultation. And then we go into the details about the surgery and the recovery time and that kind of thing.

Excellent. And so you Alluded to at the beginning of the show. Fat loss, I guess, or fat removal and breast enhancement are popular in the summer. So let's talk a little bit about the breast enhancement. What I want to know first is what is the difference between a breast lift and a breast augmentation?

Sure. So the breast augmentation is meant to address volume concerns. So for patient is concerned that her breasts are not large enough or they want them to be enhanced in terms of size, a breast implant is the best option for that. A breast lift is a reshaping procedure. And usually that's something that's undertaken after someone has had children or perhaps if they're a bit later in life. And gravity has taken its toll on breasts. And when they're sagging and change in shape, a breast lift can lift things back up and bring things back where they belong. So both of them are very different, but they can also be done together. So some patients who have lost volume and their breasts are a bit smaller after having kids, for instance, they also need an implant to give themselves some volume and then the reshaping as well, on top of that.

So it sounds like quite a few options to address whatever the patient's goals are.

Exactly. And it's very. It's tailored to the patient, the type of procedure that they have. And if they have a breast implant put in, there are hundreds of different types and sizes of breast implants to choose the exact one for the patient.

And let's talk about that. We've got a couple of demos here. Can you tell us a bit about what we've got on the table here?

Sure, absolutely. So I brought in a selection of breast implants. These are all silicone gel implants.

Silicone gel.

Okay. So the two main options for implants are saline and silicone. I would say 95% of my patients, I use silicone implants. That's pretty much, at this point, the standard in North America.

What's the difference there?

Well, the difference is the content. So all implants have a shell. The outer shell is made of silicone, but the filling is the difference. So the filling here is silicone gel. In a saline implant, the shell would be almost identical to this, but what's inside is saline. And so there was a period of time that we consider that to be a safer alternative. And at this point, that's not really the case. We recognize that both are very safe alternatives. And in fact, in Europe, it was never even considered. Saline implants don't exist. In Europe, they never did. And the European Surgeons have never handled a saline breast implant before. They think we're weird, that we still use them sometimes. So the silicone in most patients, it's a better option. And the main reason is that saline implants have a lot of rippling. So implants tend to form some folds around the edges. Saline implants form a lot of them, and it's often visible through the skin, especially in thin patients or patients who don't have a lot of breast tissue. So for that reason, they're often not the best choice. For many patients, someone who's a bit bigger and a bit fuller, put a saline implant in and it's a perfect alternative. But for most patients, I usually steer them towards the silicone implants.

So it's more realistic look then we're talking.

Yeah, a more realistic look. Oftentimes if you look in those celebrity magazines, the thing that you can see immediately that shows whether someone's had a breast augment is the folds and the ripples that form the breasts. So have a look next time you'll look at color.

Keep that in mind. So the other topic too that we touched on was fat removal. Can you tell us a bit about the different options that patients have when they want to address unwanted body fat?

Sure. The two main options are surgical and non surgical. So the surgical side is what you might think of. It's liposuction is a common way of removing extra fat. And then there are other specific body contouring procedures. So for instance, to address the tummy area, tummy tuck is the most common thing that we do. Liposuction versus tummy tuck. A lot of people ask about that. And the main difference there is liposuction is a fat removal technique. If you think of any body part being like a beach ball, you can deflate that ball and make it smaller, but in the end the surface is still going to be excess and wrinkled. And that's often the case of people who come to me and ask for liposuction of the tummy. Really what they need is a tummy tuck, and that removes extra fat and extra skin and helps to slim and reshape. The other alternative for body contouring, that's the non surgical side. There are a few different machines available that can reduce fat without any surgery and with no incisions at all. And one of those options is something called liposonics.

I think we have a picture of that.

We do. So the liposonics unit is based on ultrasound energy. So ultrasound the same as we use to Image babies, heads and things like that. It's more intense and this degree of ultrasound energy gets transferred into the fat, heats it up and makes the fat cells pop. And then your body absorbs the fat and digests it and you lose fat. You can take off one inch with one hour treatment.

Wow. So I guess that's an option that people, if they're worried about this surgery, they can go with that option.

Exactly. A lot of people don't want to have the surgery. They're not interested in any downtime at all, and they don't like the risk that's associated with surgery. So they prefer a non surgical alternative. And we have a few good options for them.

Well, I love that. And I love that you addressed the liposuction too, because I was always concerned, what about the extra skin? So with the tummy tuck that would be addressed.

Exactly. And liposuction is still a great option. And that's one of the main reasons that we have to consult with patients and choose who's the best candidate for a particular procedure. For someone who doesn't have a lot of extra skin and they have just a bit of extra fat in an isolated area and they have good skin tone, their skin is nice and elastic, liposuction is a great option for them. But someone who has a lot of extra skin, whether it's on the tummy, the thighs, the arms, anywhere. Liposuction is not good for those kinds of people.

Right, which is why the consultation is key.

Exactly.

So tell us about the technology that you're using for patients to help visualize what their results will look like.

So the technology that I like to use is a system called the Vectra. And that's a phenomenal new technique that I have. The system is a very high resolution system that can capture a three dimensional image of a patient, face, breasts, body, and takes that image. And I can actually simulate certain operations for patients and show them what they could look like after surgery. One of the great things that it can do, for instance, is for breast augmentation. It can portray very accurately specific breast implants. So I can show a patient what one volume or one size of implant would look like compared to another in their body. And they get to see what it's going to look like. They get to try on an implant before they have any surgery at all.

That's great. That's something we definitely didn't have years ago.

Oh, yeah, years ago. What we used to do is we tell patients to go home and take Ziploc bags and fill it up with water or dry rice and stuff it in their bra, which usually ended up being just a messy thing to do and not very accurate. So this is a much better step forward.

Excellent. And one last thing I want to touch on before we head out. You are part of the opening of a brand new sanctuary international spa in Muskoka. So perhaps tell us a bit about that.

Sure. I'm very excited about that. We are going to be opening up a sanctuary day spa at the Windermere House Resort in Muskoka. So that's located on Lake Rosso. And we're partnering with Oliver and Bonaccini at the Windermere Resort. They're providing all the food services there. The spa is going to provide all the typical relaxation services that a resort spot would have. And in addition to that, we're going to be offering medical services, including injectables like Botox and fillers and the Liposonics. So we have a great offering up there and we're very excited about opening that up.

Great. And so perhaps in the last 30 seconds, any things that you recommend to patients at home that they can start doing to feel or look more healthy.

You know what? I think feeling and looking healthy starts internally. You have to look at your lifestyle, exercise and eating well, having a healthy diet. Those are the first things that anybody should do. And quitting smoking if they smoke.

Excellent. Well, thanks so much for coming on the show, Dr. Goldberg. If you have any questions, you can always refer to his website and his phone number. So today, that's the end of tonight's show. Basically, we took a look at how we can achieve our ideal summer body. So we spoke to your personal trainer, a yoga instructor, Dr. Goldberg, on plastic surgery options. And then, Miriam, that's it for tonight. We'll see you back next week. Facebook.