Follow your nose and you will follow
your beauty on this episode of Follow Your Beauty. Hi I’m Dr. Jon Mendelsohn
medical director of the Advanced Cosmetic Surgery Laser Center. And stay
tuned as we bring Josh back. Josh we’re gonna talk about your rhinoplasty
Today and we’re gonna walk through For anybody who hasn’t met Josh yet.
He’s been a longtime friend and patient of the practice and he
knows a lot about this topic. So let’s let’s go back a little bit
and I want to. I want to start by showing some photos that we found here and
this was I believe in 2008. I was just going to say that right.
OK hands right. So Josh when you when you look at the photos these are some
photos of Josh before his rhinoplasty. We were talking about it back then.
Tell me what you’re saying and tell me what you are hoping
to to achieve here. me what you are hoping
to to achieve here. Well this is probably not the best
way to describe it but I would say it My nose is like the shape of a beak
it almost you know or they call it like I guess the Roman shape. So I
didn’t like the curve in my nose I wanted a straight flat nose. I wanted that
little hump the hump that I would say most people don’t like. And looking
at me straight on in photographs. Growing up I looked great but whenever somebody
would snap a picture of me and they would get this side profile I
felt so ugly and like that’s not the way out I want to look. So when when did that first. When did
you first not like your nose I guess or want to change it I should say. Well I’ve always been in the beauty
industry so as soon as I started looking at other men’s perfect noses you know
Zac Efron knows all these celebrities knows this. And then I was I met you early on.
So I knew where to go. And so yeah that got me started wanting one. My fear is what kept me from doing.
And let’s talk about that. Well what were your fears. Yeah. Oh my God. Well you could just Google Nose jobs
and it’s very it’s a you know it looks like it’s going to hurt you only have
the hammer going in there and they’re slicing your nose open and go into
town and the chiseling and so that I was really really worried about and
also getting put to sleep. Oh that was a little worrisome too. Ok. So you worried about the safety
of going to sleep. You’re worried about the pain or just whatever you’ve thought
based on based on how rhinoplasty is performed. What about the outcome?
Because at the time you know I mean the Internet existed but well I guess
there’s only 10 years ago. But what what did you discover when you were
you know online about rhinoplasty. I You know after reading about it. It was I early on I was
worried because of all of the packing. They would call it. So I think it was
that having to go back to the doctor after you had the surgery to have the
packing removed all of the comments or that was so painful you know.
And so that was another reason why I did not do it because I was I
didn’t want to get packed you know online. They would people would
say there’s feet of packing. They just keep packing and packing in six feet
used to be six feet on each side. So twelve feet total that. So there
you go. You know a lot of packing. And so what Josh was referring to is his
back in the day we used to place six feet seventy two inches by half inch
gauze at the completion of the procedure packed in the nose and yes the nose
can handle that. Sure that’s not a problem when you’re asleep unaware. But a
couple of days later when the package comes out it’s gross, it’s filled
with mucus, it smells, it bleeds people pass out. So you know when we
do talks or seminars you know and I say ok who here wants admit they’ve
had a rhinoplasty a few hands go up and I’ll
say what can tell me about it. Oh that’s all they talk about.
They don’t they really don’t recall anything else except for that packing and
so just so you know and I know you know this but I haven’t put packing
in a know since about nineteen ninety seven. So I think you were pretty three years
old or something so. But so we don’t use packing anymore and that and that
is a big deal. I just want to say with this episode this is going to
run a little bit longer. We’ve got a lot to get through.
My goal is for anybody who is thinking about this who anybody has questions
about it. Hopefully by the end of this episode you’re going to know what
you need to know you’ll be able to analyze your own nose you’ll understand
even some things that need to be done for your nose and it’ll
it’ll get you started in the right area. I was gonna break this up but so. So anyway I appreciate
you listening or watching this and we’re gonna go through the surgery as well
in a few minutes. But what I want to do first is I and I
think that this is probably the best way to do this and Josh you may remember some
of this but I do want to say that there’s a big difference today how
we conduct the the whole process. OK. Now there were a few things A we’ve
changed things over time how we do it and B we already had a relationship
established so there was some trust there and we would talk a little bit
you know maybe not each time but over the years about goals and so you had
time to just digest things a little bit. So the Internet is a great resource.
I think it’s great. Our rhinoplasty patients are probably with some of
the best educated patients anywhere because they have a lot of resources
and it’s not just because you’re looking at botched rhinoplasty it’s because there’s a
lot of good stuff out there too so patients come in they understand
a lot of this terminology and sometimes they don’t. But it’s our job when we
see patients to make sure that we’re communicating effectively this is true
for everything. But it’s particularly in or especially true for in rhinoplasty.
It’s the difference between a good outcome and a great outcome. And it used to be and
you probably did this honestly just remove the bump whatever. Yeah I trust you.
Go ahead. OK. And that’s fine. And things worked out and generally they do but
sometimes it’s the nuances or the assumptions that patients make
that make a difference in terms of not being happy with things. Also because
of the high level of fear with these things because you see so many
botched rhinoplasty’s is we have difficulty sometimes getting patients
to communicate with us what their REAL need is. I know this isn’t your example but
I’m going to use you as an example. Let’s just say let’s say you were female
and you had this bump on your nose. One of our big questions is OK
I understand you don’t like the bump. We can remove the bump but do
you want that Dorsum to be slightly concave? Oh right away. People you know they
they worry they freak out because you know that they think about this and
the old rhinoplasty so it takes it takes a little bit of trust and communication
to get through. So what I want to start with is
just naming some of the anatomy. And the reason for this is important
is because that way we’re all speaking the same language when we talk about
rhinoplasty and there’s no confusion when you say you want. You want to
slope a certain way. Well what does that mean. So I’m going to go through
this it’s really pretty some basic stuff here. So I’m going to try to use my
nose here. So this is the dorsum. OK that’s This is called the columella. OK.
This is called the philthrum and I’ll go through that. And this is called
the alar rim. But those aren’t terribly important for for what we’re
talking about. So I did this ahead of time and I want to walk through this.
It’s not a great drawing but it’s me just sketching on the I pad what
these some of these structures look like. With regards to to the anatomy rather than you talking
there I’m going to show you here so it’s a great drawing. These are
called Lower lateral cartilage’ And those are where your nostrils are and
you can see where your skin would be so if you put your finger on the
tip of your nose or that dot is you’re going to feel the right and the left
lower lateral cartilage. OK. So that’s. Yeah. Right. So that’s an important step.
Here’s my feel a little more stiff. We’ll talk about that in a minute
but we’ve got to right the left side. These little maneuvers that you see here
commonly these are common maneuvers they aren’t always used
but they commonly are. This is called cephalic trim cephalic
it just means towards the head trim means we’re removing it they’re just removing
a little bit of that. These are some things where we can refine the tip.
Ok. We can we can help set the projection and rotation of the tip.
We do that commonly by borrowing a piece of the nasal septum if you put
your finger inside your nose and you feel that rubbery thing. That’s our
nasal septum. And people have a deviated septum. A lot of times we’ll fix the functional
part of that but we’ll borrow that and we’ll recycle that part by placing
it between the right and the left lower that cartilage there. And now this becomes a strut it becomes
what we call a columella strut. I told you before that’s the location
of it and we’ll take a little suture and we’ll sort of zip up we’ll stabilize
that and that columnella strut Acts to support the nose. It acts to
help again deliver some of the appropriate projection or deep projection and rotation. OK.
So these are very common maneuvers both of which we performed
when we did your rhinoplasty. So you can see here where we can
draw the tip together sometimes patients have a bulbous tip or a wide tip Josh. That wasn’t a complaint of yours at
all but one of the important things about this is I’ve got longer hair than you do. But let’s
say a woman or me wearing a ponytail. If we pull our hair back OK something
looks different about our face even though we haven’t changed our face. OK.
And most women and men who have long hair might know that if they wear
their hair back the same thing here. If we’re reducing a bump on the nose.
Now all the sudden something might look different. Ok. Did we even though
we really haven’t changed it. So our job is to make sure not
that we’re trying to do more we don’t want to do more. We just want to fix things appropriately
one time. And have you live happily ever after. OK. So make sense. Yes.
So a few few basic things you’re about rhinoplasty as you would call
we perform this under I.V. sedation. That means you come in we start
an I.V. you’re breathing on your own you’re not intubated. There’s there’s an oral
airway I’ll explain that in a minute. But you’re not intubated. There’s no
there’s not a machine breathing for you. You’re not paralyzed. Sometimes you get a
little bit light during the anesthesia. I just give them more. But it’s a nice
safe way to do it where we don’t have post-operatively a lot of nausea
vomiting those things can lead to bleeding and other problems of course. And so we find that a very safe way
to do it for anybody who’s had a colonoscopy A colonoscopy Ii’s the same type
of medication that we use for that. Additionally we’ll localize the area will numb it
up you won’t feel that. And from prior episodes you might recall that the
Lidocaine numbs it but there’s also epinephrine in the solution and that
reduces the blood flowing to the area. So we have virtually no blood loss
during this procedure and that’s what we want. Ok. So that’s the setup for
what for what we’re doing here. So Josh I know you’ve never seen these
photos because I just uncovered them. We haven’t used them anywhere. I don’t
know how you are. But I’m going to show you some of the surgical procedure
with photos if you don’t want to look don’t look. But for those viewers
who are out there who do want to look we’re going to walk through this.
OK so this is pretty straightforward. Here you can see this little purple
marking this is where we make what’s called the transcollumnellar incision
a little marking here anytime you see this or and this is a common way
to approach it it’s called an open approach rhinoplasty. And the majority
of rhinoplasty is performed these days are probably open approach. We can talk about the differences between
open and closed but this is commonly what we do. And so here I am marking
Josh’s nose you can see that yellow thing in your mouth there Josh.
That’s the oral airway. We do that because just like when you sleep your tongue
may fall backward. And we want to make sure that you’re breathing that
your tongue is not obstructing your airway. It’s a good thing. We’ve got that little
oxygen cannula in there and you can see we’re marking your main area
of concern which is that nasal dorsal area as we move into the inside of
the nose here. There’s a marking we don’t always mark it. I’m doing this just
for for these purposes. Is this is called a marginal incision and it’s placed
right along the lowest part of that cartilage that lower lateral cartilage. And we’ll
plan to make an incision there. So here we are making the incision
and you can see we’re going to come right along. It’s basically where the
hair inside the nose stops it’s right along that edge and that’s
where we make our incision then we’ll dissect we’re just going
to elevate over this area, and voila you’ve probably never seen that
before. That’s what those lower lateral cartilage is look like.
Okay so we’re retracting that skin and we’re looking in what we call
an anatomic position. What that means is this is the way your nose is we’re
not pulling it or bending it we’re just looking at what’s going on. Some of
the things that you alluded to earlier this is a little nasal rasp so it’s
just like a little nail file that may take down the top portion of
the bump the top portion is bone. The lower portion is actually sculpted
It’s cartilage. So the rasp won’t work. So we actually sort of sculpt that ear.
So the top part we’re using the rasp on and then I’m just showing here that
these lower lateral cartilage is generally we want to make sure that we leave
7 millimeters behind. That’s what people talk about and that’s the general we
want to leave enough structure behind. However that’s cephallic trim though
will be made that skin care isn’t meant to be a pointer. But that’s right
at the area for the tissue that we would actually be removing we can
perform removing some of that so that we can reduce that. This is a small
piece of cartilage we took from your nasal septum that we fashioned and
then we’re going to dissect and place between the right and the left lower
lateral cartilage this graft it’s called the columella strut, remember
that and then we’re going to suture it into place we’re going to kind
of check things out. really differs a lot. I want just one to go back
to something in the overall process. So you meet with me. Well here let me let
me go through the whole process. You come in for a consultation you don’t
know me. We talk about it you’re all excited you want to sign up.
Guess what. We don’t usually allow you to sign up right then. What we do
is there’s a little bit of homework and there’s a little bit more communication.
You just showed me some things before we got started here with Snapchat
or face or whatever facetune or whatever you were showing me I don’t
I don’t know but there were filters. And so a lot of patients will come
in with their filters and they’ll play with their nose and that’s a good tool.
It’s a great tool to say this is kind of what I was interested in. OK.
There’s an app called Face tune. Not that we promote FaceTune
but rhinoplasty patients brought it to me. It’s a wonderful way to manipulate
your own profile to move things around it really makes you think you’ve got
to be very thoughtful about what you’re doing. What do I really want that is that
too much and then so in our second meeting we’ll also do some computer imaging
so we’ll go through that. And it’s a tool to communicate. It’s not. Here’s your result. Right. OK.
It’s a direction that we’re headed and that’s very important. But as we
do this in another episode we had a guest who was worried about
her friend having eyelid surgery. And what we talked about was encouraging those
significant others to come in for the consultation or at any point so
that they’re part of it. So they’re involved OK so that they understand
what to expect. All right. So that’s important to kind of set
things up set the right expectations. The next thing is let’s say somebody
you decide to schedule will schedule a preoperative consultation and with
one of our nurses and we’ll further review medical history that sort
of thing. But more importantly you’ll also review the same sorts of things
with her. And the significance is at this point in the operation once
we’ve gone through the first hour and a half usually it takes between an hour
and a half in two and a half hours. But once we’ve done 90% of the
work we’ll go back. I hand everybody a Qtip. And they’ll start pointing
out the flaws or where we need to do more. And that’s the anesthetist
gets involved now or scrub tech our nurse. So we’re really trying to bring
everybody together. And it’s not about their views about how your nose should look.
It’s about how your nose how you desire your nose to look. So collectively
we do a better job of not leaving the operating room until we’re
all satisfied. Ok. That’s a big big difference in terms of how we used
to do things. If you look at your next photo here which we took at some
point you can still see on your Dorsum a little bit of a bump there.
So we’re just kind of stabilizing you know the nose and we’re you know we’re
just kind of taking photos so we’ll go back and we’ll then trim
some additional cartilage that a white vertical cartilage there in the middle that
you see is your nasal septum. OK this is another part that this is
part of the most common question. Doc, do you need to break my nose? Well I phrase it differently. I say
we’re making a cut in the bone but yes this instrument that I have in
my hand here is called an osteotome And what we’re doing again if we take
the bridge of your nose down I’m going to try to do this is maybe I’ll
try to do the best I can. Our nose is roughly triangular in shape. If you take the bump down we flatten
the top. Now it’s more of a trapezoid. OK. If we left you like that then that’s
what we call an open roof deformity. Ok. So we make the little cuts in the bone
so that we can bring the nasal bones back down to reconstitute a nice
triangular shape. Does that make sense? So that’s that’s why we are making
a cut in the bone and asked the Osteotomy breaking the nose. OK. It doesn’t add
any more time in terms of recovery. We don’t use any packing. It’s not always done. But I would say
probably 75% of the time it is OK. OK
and then oh, And there’s. That’s what you were talking
about right there. So that’s called a mallet and somebody. Yes. I see
that. Cindy was our nurse at the time she’s helping us out here and
then and then we’ll meticulously go ahead and close close the incisions
on the table. This is kind of what we’re seeing there’s already
some swelling there. Do Do you like it a salve on my eyes. Yes we do. Good point.
You’ll see in the next photo here. Yes we do we do that to protect
your eyes during the procedure so they don’t dry out because you may
not be blinking as much. Got it. And we don’t want to
cause problems. Yeah. So that’s what you’re saying. This is what we call Aquaplast.
It’s a little tiny piece of plastic that when we put in hot water it’s
very malleable. And then we go ahead and we’ll tape your nose and we’ll
put the Aquaplast over it. This little piece here to stabilize
from the Osteotomy that we just performed and we’ll put some tape over
that and we’ll put little tiny pieces. It’s It’s called surgicel. We just
took a put a little bit something right under your nose there just in
case there’s any bleeding overnight. We don’t want it to crust at all.
So we put some ointment it’s really just to hold ointment in
that area. But that’s not packing it’s a little tiny piece of gauze OK. So I
don’t know if you’ve approached your prior rhinoplasty like that before. I have this is my first. OK.
So you seem to do pretty pretty fascinating. It’s good stuff. And yes
I need some of these pictures. We we have I think we have
like two hundred and thirteen photos or something that was taken at the time I
don’t know. I remember Whitney. She’s the one who took the photos and I I
uncovered them. Ok. So let’s take a look at this. This is how well actually
before we go there. Tell me how it was if you can recall that night
and throughout the week in terms of the recovery. I remember it. I remember every
part of my surgery that with the exception of me being put out. It was
I just followed directions. So I remember you have to sleep elevated. That’s important.
So you need the blood to flow correctly that minimizes your swelling. And
do not get your face wet. You can’t get the splint wet. Right. And let me share with you why. What we don’t want is we don’t want
the water or any moisture sitting underneath that splint your skin may break down
and we could end up with some problems. So we do like to keep that dry. If it
does get wet let me just say we advise patients take a hairdryer on cool and
just to cool it off but that is important. So thank you for sharing that. Yeah yeah.
So I just followed you know I was extremely careful with not getting
my face wet and sleeping correctly and I had it was insane. I had like
no undereye bruising I had just minimal kind of like the onset of a bruise
it was more yellow but nothing like I seen most pictures people went through.
So I don’t know if I was just you know. It’s pretty typical. I mean
we try not to bruise. And the other thing is the packing that we talked
about that used to be in your nose there’s still blood that’s that’s in
your nose and still mucous that’s produced. So it forces that into the tissues
as well. So we rarely see much bruising. It’s surgery so I have to be careful.
But but it is pretty typical not to see a big degree
of bruising with this. Yes yeah. So I and I went to
the hair salon because the first thing you know I’d like to take two showers a
day and I like to wash my hair twice a day or if I don’t do that I don’t
feel clean. So I was freaked out like What I can’t get my head wet? But I
did go to a hair salon and they washed my hair carefully for me. So.
You know every day pretty much. Yes. Well that’s good. Well that’s good advice.
I was a regular at the time. So they didn’t even charge me
to wash my hair. That’s nice. Yeah. So I think that I didn’t
feel any of it. So that was amazing. It looks scary but I honestly did not
feel any of that. None of it. Did you take any pain medication afterward?
Oh yeah. Oh yeah. That’s the best. OK. Yes. You’re still taking it aren’t you.
I still am… I think that what you need to
do is make sure you when you leave here you know you’re still out of it.
Your driver you don’t know what’s really going on. And so your pain medication
is still there but it will start to linger and go away. So you need
to make sure that you have somebody with you that can remind you here take
your Percocet or whatever to help. And I had that. So I really did not
have any pain just a little discomfort you know more of that annoyance having
this thing on your face or for a few days. Were you able to. Did you get out at
all did you. Besides the salon. Oh yeah yeah. I didn’t have any swelling or bruising so I went and bought new sunglasses
because you shared with me in the not too heavy. So at the beginning so I
was able to go buy some nice new shades. That was my excuse. I got real expensive
ones because they were you know lighter weight why not lighter weight.
I don’t want the pressure on my nose. Alright. So you did
pretty well that week. Alright let’s let’s do this. I want to show you a
little clip from when we took that splint off. So this is usually about
five to seven days afterward. I want to make a few quick comments
from Josh in terms of pain medication. We do give you the Vicodin or Percocet
if you need it. Honestly most patients either take a half or Tylenol.
It’s surgery. I don’t want to. So we’re not trying to create any pain. It does
you know that when the local wears off there’s some discomfort but that’s
probably how I would describe it. That’s how Josh just described it.
It’s not terribly painful. So if you if you did view these videos or if
you’re still thinking Oh my God I could never do that it’s very painful.
It’s amazing that it really isn’t. And I think most rhinoplasty patients are
pleasantly surprised that that their experience is better than they anticipated. I would do it again. I mean even though
it does not hurt. I would say out of all the surgeries that’s probably
even in the least. Right. Well you know about for for you and
for most but but it’s it’s a lot of anxiety so let’s look at this.
This is you getting your splint off and I’m on just let
when actually I think that You can see it And I guess I’ll just stop. Maybe I’ll
just narrate over it here instead is I just wanna go through the important
things that that you would be seeing here. So we take the tape off it takes about
10 or 15 minutes. It’s affixed with Mastisol to the sticky stuff that the tape is
on with. We’ll take it off. So what you’re seeing Josh with your nose.
I don’t know if you remember this but what I’m showing you is where the splint
was so you can see a little depressed area. And we always point this out because
you can see where the swelling is in the tip. Obviously you just had
surgery right. This is six days later we’re taking the tape off. But within
a few hours the swelling that line goes away. And so for individuals
who are at one of their primary reasons is to address the tip of the
nose we want to point out that they have swelling OK because a few if you
were concerned about your tip now you might feel that your
tip is actually larger It’s wider. Oh my gosh, what’s going on?
So of course we go over all these things beforehand. You’re OK at this
stage when you’re not ok sometimes as a couple of months down the road
or you’ll come back to be real nice you’ll say I know there’s still swelling but is
there really still swelling? Ok so. So it’s really important to understand
what you’re going through and what you could see it very well and you
know in your photo there. So here’s here’s it while your eyes
are closed but you’re admiring yourself. And we’re in the same ring too. We’ve got some consistency going on
with the same jewelry you like it. Is it the same shirt? anyway. So what. So I appreciate you being patient with us.
I know it’s I know this is a little bit a little bit longer here.
But do you have any advice for patients that might be seeking
some changes in their nose. Definitely check, you know, your plastic
surgeon out make sure that they’re Board
Certified like you’re a board certified like one hundred and fifty times I believe?
So you know and you’ve written books and so you when it goes
to someone who has an amazing reputation and then I recommend getting you know
speaking to people that have gone to that surgeon. So getting direct
feedback from possibly if you can their patients. Have you spoken to people who are interested
in their nose in it but who didn’t decide to do anything? And if
so what were the reasons that they that they give you. I would say 100 percent of the time
it’s the the pain they’re afraid they’re just afraid and they think that I’m
crazy that I think it doesn’t hurt because they see these pictures and
they see what it looks like and how can that not hurt. But you know I just
say you take a gamble take a chance. It’s worth it. Yeah. Well I’ve known you for a long time.
I’ve never known you not to have self-confidence but I. But I’m. But I’m curious.
Looking back I don’t think I’ve ever asked you this. What is the rhinoplasty if
anything done for you in terms of in terms of looking in
the mirror and doing your thing. Well I would say rhinoplasty. You can’t
look at me before and after and say I don’t look any different. I mean
definitely my side profile. I think I look more handsome I look more I
just look better. I mean look at that. What that I mean come
on that’s insane. That is insane. So I mean I look like
two different people. So you’re right rhinoplasty it can change where you look. But I
would say it changes you for the better if you go to someone who knows what
they’re doing. It can. It makes you look better. Well Well good. Well I’m glad. Yeah know
you’ve done very well. I mean and you and you look great and you didn’t
have any problems. I think I think for rhinoplasty there’s such
a psychology and you mentioned you know when you were younger you looked in
the mirror we see a lot of people who start and you know at a
younger age and it’s difficult sometimes growing up especially these days especially if somebody
is teased about about something. Right. So it does have a very
profound impact. And so it’s really important that things are communicated. Ok forget
all the technical stuff about rhinoplasty. But it’s really important that that
you as a patient understand what you desire and that you and
that you communicate that very effectively. There are unfortunately patients who you
know we do a lot of revision rhinoplasty as well. And I would say of all areas of the face
this is the most complex one to to do well not every rhinoplasty turns
out perfect in fact I’m going to say that another way no rhinoplasty is
are ever perfect. There’s there’s always something. So we strive for perfection but we
never achieve it. We let patients know that immediately everybody nods their
head that’s fine. It’s just the reality of it. And it’s a tricky operation.
So this is an area where there are some great rhinoplasty surgeons out
there who are not facial plastic surgeons but I’m gonna give a little call to
to our community of facial plastic surgeons. One of the things that differentiates
many rhinoplasty surgeons that are facial plastics is during their training
during our training there are days that we may have performed multiple
rhinoplasty is in a single day. OK. As primary surgeon some other types
of general plastic surgeons may not have performed four or five rhinoplasty
as general surgeon during their entire training. OK. So it’s kind of
like going to a hand specialist. So this is and I’m not advocating
for me. I’m letting patients know that it’s really important to make sure that
you understand what that surgeon’s abilities are. OK. So anyway with that being said
we’re going to turn it over to Julie for what’s in and what’s out what’s
hot and what’s not in plastic surgery. Julie. Thank you Julie.
Welcome back. Before Before we go I’d like to send it over
to Karen Whitney to say a few things about Studio A and what’s happening
with some of the studio a rewards savings that’s it for today. Thanks for tuning
in for this and other podcast episodes. Please go to 3 5 1 face dot
com forward slash follow your beauty. You can sign up and log in.
Schedule your complimentary consultation we’re happy to see you for
rhinoplasty or anything else. Josh thank you again. Thank you for
sharing your rhinoplasty with everybody now. Everybody knows what the inside your
nose looks like. Thank you so much. So we hope to have you back again.
We hope you tune in again for another episode of follow your
beauty Live from Studio A. The advanced cosmetic
surgery and Laser Center