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*Since 1985, October has served as Breast Cancer Awareness (BCA) Month — a period devoted to educating the public on the disease that, [according to the Centers for Disease Control and Prevention (CDC)](https://www.cdc.gov/cancer/breast/statistics/index.htm), is the second most common form of cancer in women, regardless of race or ethnicity. Men can also be diagnosed with breast cancer (albeit at a much lower rate), and The AEDITION is devoting much of its coverage this month to BCA, from expert guides to mastectomies and reconstructive breast surgery to powerful patient perspectives and roundups of products that give back.* 

Because breast cancer awareness has become so mainstream in recent years with everyone from celebrities to the NFL dedicating time and resources to supporting the cause, men and women alike are increasingly aware of the warning signs. Women especially are encouraged to regularly conduct their own self breast exams and may even ask their partners to let them know if they notice any changes, too. 

But happens if/when you find a lump? Because breast cancer has such a high profile and statistics like *one in eight women will be diagnosed in their lifetime* are well known, people are often fearful to seek medical advice after noticing a change in their breast tissue because they assume the worst. 

While it is absolutely essential to get any changes checked out by a medical professional, it is also important to remember that 80 to 85 percent of lumps found in women under the age 40 are benign and caused by fibrocystic changes, cysts, fibroadenomas, or fat necrosis to name a few.

With this in mind, it is important to understand the function and importance of breast exams. We’ve already shared the resilient stories of mastectomy patients ([HERE](https://aedit.com/aedition/mastectomy-breast-cancer-experience-from-patient-perspective)) and those who have undergone breast reconstruction procedures ([HERE](https://aedit.com/aedition/post-mastectomy-breast-reconstruction-process-breast-cancer)), and in this article The AEDITION speaks to women who found a lump and decided to do something about it.

## __Breast Check Basics__

For women with no family history of breast cancer, [the American College of Obstetricians and Gynecologists advises](https://www.acog.org/Clinical-Guidance-and-Publications/Practice-Bulletins/Committee-on-Practice-Bulletins-Gynecology/Breast-Cancer-Risk-Assessment-and-Screening-in-Average-Risk-Women?IsMobileSet=false) people in their twenties and thirties have a breast examination carried out by a healthcare provider every one or three years. The American Cancer Society, meanwhile, [recommends annual mammograms](https://www.cancer.org/healthy/find-cancer-early/cancer-screening-guidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html) for women between the ages of 40 and 55. Women over 55 can switch to mammograms every two years or continue with yearly screenings. But that doesn’t mean you should just sit around for your next trip to the gynecologist. 

Women are encouraged to conduct a self examination about once a month. Because benign lumps are known to appear over the course of a woman’s menstrual cycle, it is best to perform the exam at the same time every month — ideally a few days after your period ends.

During the exam, it is important to be on the lookout for any changes in the appearance of both the exterior breast (skin, areola, and nipple) *and* the interior tissue. Things to feel and look for include:

- A visible change in the shape or size of the breast or nipple
- A change in how the breast skin looks or feels (think: dimpling or puckering) 
- Soreness, redness, or rashes on the breast or underarm area
- Any areas that are visibly different compared to the rest of your breast tissue
- A lump (can be a small as the size of a pea) that persists in the breast or underarm area

If you notice any of these symptoms or something just doesn’t feel like your version of ‘normal,’ it is time to consult a medical professional for a more thorough check. Chances are, it is simple to treat. But if it is breast cancer, early detection is key.

## __Patient Perspective__ 

There are no two ways about it: finding a lump in your breast or noticing some other change to the chest can be alarming. But that is not an excuse for inaction. Here, The AEDITION speaks to three women who lived through a breast cancer scare about their experiences and why they encourage everyone to consult a doctor as soon as they notice something isn’t quite right.

__Anna, 29, Los Angeles__ 

__The AEDITION__: *What caused you to become concerned about your breasts?* 

__Anna__: I was at college and aware that I needed to check myself every so often. I didn’t check as often as I now know I should, but one day I was in the bathroom and found a lump. It was probably around the size of an olive. I panicked and decided I wouldn’t tell anyone. My theory was that if I ignored it, it would go away. I would prove to myself that it wasn’t anything serious. But after a while, it was still there. A family friend had been diagnosed with cancer recently, so I guess it was on my mind. I made an appointment to see my doctor. At that point, I was convinced the only thing it could be was cancer.

__The AEDITION__: *What happened during your doctor’s appointment?*

__Anna__: I explained to the physician that I found this lump and that I thought I might have breast cancer. I was so anxious, but the doctor took the time to listen to me while I gave my garbled version of events. She then checked the lump herself, which was uncomfortable, but it didn’t take too long. She then asked me whether I had any pain, whether it changed during my cycle, and whether or not I’d noticed any other symptoms. I was referred for an ultrasound — my doctor explained it would give her a clearer idea of what was going on — but she also took some time to reassure me that it could very easily be something simple to treat and not cancer at all. 

__The AEDITION__: *What did the next steps look like for you?*

__Anna__: First of all, I told a friend, which was probably the best thing I did throughout the process. She was able to reassure me and she also came with me to my other appointments. I had the ultrasound quite soon after the first appointment. Again, it was uncomfortable in that I’m not keen on being naked in front of random people, but, other than that, it wasn’t painful or anything. About a week after that I went back to the primary care doctor, who explained to me that it was a cyst. Because it was filled with liquid and not solid, I didn’t even need to have a biopsy. She told me to keep an eye on it, and if it became painful, they could offer me some other treatment options. That was about four years ago now, and I haven’t had any problems since. I do check my breasts regularly though, and I’m such an advocate for people getting any concerns checked out quickly.

__The AEDITION__: *What advice do you have for someone who finds themselves in a similar situation?*

__Anna__: I would say do the brave, grown-up thing and get it checked. Don’t bury your head in the sand because, if it is cancer, that’s literally the worst thing you could do. I think the awareness we have of breast cancer is amazing now, but it can make finding an issue so scary because the first thing that comes to mind is cancer. I also think people should share their concerns. Chances are a friend has been through a very similar thing — especially by the time you reach your late twenties. I know so many people who have been through the same panic. It’s best to share with both friends and doctors.

__Stephanie, 58, Texas__

__The AEDITION__: *Would led you to believe you might have breast cancer?*

__Stephanie__: I was checking my breast, which I do regularly now that I’m older. I felt something a bit different on my right side — almost in my underarm area. I had a sinking feeling when I first felt it and managed to calm myself down enough to have a Google, which, in hindsight, was not my best idea. I was pretty sure what I found could be a sign of breast cancer, and, honestly, I was scared. It took me a few days to gather together the courage to get a consult, but I didn’t want to leave it because I know how important it can be to get a diagnosis as soon as possible.

__The AEDITION__: *What pushed you to visit a doctor?*

__Stephanie__: I think breast cancer awareness has reached this amazing level where most of us know to check ourselves and not to mess around with it if we do find something a bit suspicious. I gave myself a couple of days to accept the potential reality of the situation and went to see my doctor. I explained the situation, and he took a look. Fortunately, the office also has an ultrasound room and I was able to sit and wait for it to come available there and then. I was told I had a liquid-filled cyst, and I was booked in for a biopsy. A couple of days after the biopsy, I received a call from my doctor, who explained what it was. He told me that I had an oil cyst, which can happen when fat is damaged. It wasn’t cancer at all. He praised me for being so reactive when I found it and told me to go and get on with my life — but to keep on checking in the future.

__The AEDITION__: *Did you know about fat necrosis when you initially felt the scar tissue in your breast?*

__Stephanie__: I honestly thought I was well informed about all things breasts, but apparently I was not. I hadn’t ever heard of it. I think it’s really important that, as much as we now all learn about checking for cancer, we also get told about other, far less life-altering issues we could develop in that area. I think it can be reassuring — especially for younger people — to know there are other conditions out there. Finding out quickly can save a lot of stress, but it is also important if it is cancer.

__Jennifer, 34, Miami __

__The AEDITION__: *Could you give us an idea of the symptoms that led to your concern?*

__Jennifer__: It happened not long before I stopped breastfeeding my daughter, so I was kind of acutely aware of what was going on with my breasts. One of them started to get a little painful and, over time, got somewhat swollen and warm. My main concern was getting it seen quickly. Not only was I in pain, but I was scared that if I left it, I could jeopardize my future with my daughter.

__The AEDITION__: *What was your experience like with your doctor? *

__Jennifer__: I went to see my daughter’s pediatrician for an appointment that had been booked for weeks. While I was there, I broke down in tears and explained what was going on. The doctor was so lovely. She told me it sounded like an infection called mastitis, which is super common for new moms. She explained to me that I just needed some antibiotics and to keep an eye on how it progressed. She was so sweet and completely understood why I was so worried about the situation. Since then, I’ve done a fair bit of research just out of curiosity, and it turns out there are so many breast conditions I had no idea even existed. I think it’s so amazing that cancer awareness pushes people to check themselves and to consult quickly. I’m certain it’s helping to save hundreds of lives every year.

__The AEDITION__: *What advice would you give to someone who is feeling worried about consulting a doctor about a concern they have with their breasts?*

__Jennifer__: I think the concern stems more from the fear of it possibly being something ‘big’ as opposed to the fear of consulting in itself. And I do think that people knowing there are other things the symptoms could point to — aside from cancer — is reassuring on that front. That being said, I think the urgency that has been created from awareness is crucial when it actually is cancer. I think, if you’re concerned, ask for help as soon as possible, but hold on to the fact that 85 percent of lumps and bumps that people consult about are not cancer at all.

AEDITION expert perspective-min

Patient Perspective Collection | The AEDITION

Patient Perspective

There are no two ways about it: noticing a change to your breast can be scary. But that is not an excuse for inaction. Here, The AEDITION speaks to three women who experienced a breast cancer scare and did something about it. 

What To Do If You Find A Lump In Your Breast

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*Since 1985, October has served as Breast Cancer Awareness (BCA) Month — a period devoted to educating the public on the disease that, [according to the Centers for Disease Control and Prevention (CDC)](https://www.cdc.gov/cancer/breast/statistics/index.htm), is the second most common form of cancer in women, regardless of race or ethnicity. Men can also be diagnosed with breast cancer (albeit at a much lower rate), and The AEDITION is devoting much of its coverage this month to BCA, from expert guides to mastectomies and reconstructive breast surgery to powerful patient perspectives and roundups of products that give back.*

[According to the World Cancer Research Fund](https://www.wcrf.org/dietandcancer/cancer-trends/breast-cancer-statistics), breast cancer is the most commonly occurring cancer in women worldwide and the second most common cancer overall globally, with two million new cases in 2018. In the United States, [it is estimated](https://www.breastcancer.org/symptoms/understand_bc/statistics) that one in eight women (or approximately 12 percent of the female population) will be diagnosed with breast cancer in her lifetime. 

The mastectomy plays a large role in the prevention and treatment of breast cancer, and, while The AEDITION has covered what to expect before, during, and after the surgery from a medical perspective (more on that [HERE](https://aedit.com/aedition/what-to-expect-before-during-after-mastectomy-breast-cancer)), calling attention to the emotional toll of choosing to remove one or both breasts is just as important.

Here, two women share their deeply personal and resilient experiences with breast cancer, mastectomies, and breast reconstruction. 

## Rena, 53

In a six-month period, Rena’s relationship with her body and her breasts completely changed. Her breast cancer diagnosis and subsequent unilateral mastectomy happened very quickly, and she was forced to face her new reality much sooner than expected. Rena made the decision not to undergo breast reconstruction and quickly learned that the subsequent transformation was more emotional than physical. 

“The emotional scars take much longer to heal than the physical scars do,” she shares. “The breasts are symbolic of so much. They’re symbolic of feminine beauty and motherhood. Breasts come with a lot of baggage.” 

Following her mastectomy, Rena felt deep waves of emotion that resembled grief, pain, and sadness. “There was a point after the mastectomy where I genuinely thought I was losing my mind because I was so sad. I felt so unwell. I was in a lot of pain. I didn’t really want to leave the house,” she recalls. “And now I look back at that and go, ‘Of course.’ Grief is going to come your way, and you can name it. Now if I feel sad, I go, ‘Oh yes, grief. I know what that is. It’ll be gone tomorrow. Just having a sad day.’ I don’t have that, ‘Oh my god, I haven’t just lost my breast, I’ve lost my mind’ feeling.”

Rena says the emotional labor was hard, but learning to sit with it and honor how she was feeling was key. She allowed herself to feel her emotions and didn’t pressure herself to feel strong all the time. The driving force of Rena’s recovery came when she stopped letting the situation control her and instead could respond to what was happening around her.

“Take control of what you can,” she explains. “Take an empowered approach and come from a place of strength. You get to decide when you want to take the next steps and how your mastectomy process goes.”

In the moments before her surgery, for example, Rena insisted on walking into the operating room instead of being wheeled in by the nurses. When she got home, she turned all the full-length mirrors in her house around until she decided she was ready to look at her body again. 

Her advice to those on a similar journey: “As soon as you get that news, the time is now to start saying goodbye to your breasts and thanking them for everything they’ve meant to you and done for you,” she says. “Quickly get it into your head that it’s your choice to do away with your breasts in exchange for your life. I chose to sacrifice my breast in order to live. I know that’s sad, but you can say, ‘I will be sad to lose my breasts, but I want to live.’”

## __Tracey, 45__

Like Rena, Tracey has been on her own unique journey. Her diagnosis was a long time coming because she knew she was at risk of developing breast cancer and was able to anticipate at least part treatment and recovery. Due to her family history of breast cancer, she was screened regularly for the disease and discovered she carried the BRCA1 gene mutation in late 2010. She decided she would preventatively have her ovaries removed and undergo prophylactic (a.k.a. preventative) mastectomy and breast reconstruction procedures at the same time.

“If I just had a mastectomy, I know I personally would not have felt feminine,” she shares. “Because I was doing elective surgery, I was lucky enough to be able to consider this option and have the two procedures done together.”

Opting for an immediate reconstructive surgery gave Tracey the opportunity to feel like she was reclaiming power over her experience, but, post-mastectomy and breast reconstruction, she experienced a series of complications and side effects that prolonged her recovery time.

“A few days after the procedure, my cosmetic surgeon noticed that my right nipple wasn’t going to survive, so I had to be taken back in for surgery to remove it. After about a month at home, I got really sick due to an infection in the right breast, and I had to be rushed to hospital to get the expander out,” she explains. “All up, I think I’ve had about six or seven surgeries now — this includes having the implants put in and a nipple reconstruction on my right breast, which looks great. My left breast is perfect and I’m happy with it. The right one, not so much. But who is ever happy with the way their breasts look? Even naturally, they’re different. I continue to see my plastic surgeon once a year for a follow up.”

While her road to recovery was a winding one, she remains upbeat about the results. “I’m not affected by it from day to day. Yes, my breasts are hard, one is quite scarred, and one nipple is bigger than the other, but did I make the right decision? Absolutely, 100 percent,” she says. “To look at me, you would never know that I’ve had a mastectomy and reconstruction and that I’m going through menopause. I still feel like me.”

Tracey’s advice to anyone who is considering a preventative procedure or currently undergoing treatment: “I think it’s a personal journey. Everyone is different and has different feelings and expectations,” she says. “My only advice would be to ensure that you do go through all the options of the procedure, have a great surgeon, and surround yourself with a good support group and care team. Try to be positive as much as you can and reassure yourself with the reason why you’re going ahead with these procedures.”

## __The Takeaway __

Rena and Tracey’s experiences prove that there is nothing linear about breast cancer diagnoses and treatment, but hearing from survivors and those who have elected for preventive mastectomies helps to shine a light on the fact that — regardless of your circumstances — the experience is as emotional as it is physical. While finding board certified surgeons who you trust and feel comfortable with is paramount to your medical care, reading about other people’s journeys and creating a strong support system before, during, and after surgery can help to alleviate some of the emotional burden. 

While it is important to know what to medically expect from a mastectomy, understanding the emotional toll of choosing to remove one or both breasts is equally vital. Here, two women share their deeply personal and resilient experiences.

How To Take Control Of Your Mastectomy Journey From Patients' Perspective

How To Take Control Of Your Mastectomy Journey

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If circumstances have you rethinking your ink, here’s what you need to know about the tattoo removal process from both an expert and patient perspective.


People get tattoos for any number of reasons — be it sentimentality, a special occasion, or just because — and, likewise, people choose to have their tattoos removed for a variety of reasons. Arriving at that decision, however, can be difficult, especially if you don’t understand what the process entails. 

The most common way to remove permanent tattoos is with laser treatments. While there are several types of lasers that can be used to remove tattoos, they all rely on the same principle. Lasers employ different wavelengths of light (each with the ability to treat specific pigment colors) that are absorbed by the ink particles in the dermis layer of the skin. The energy causes the pigment to shatter into fragments that can then be digested and excreted via the body’s immune system. Over time, this process lightens the appearance of the tattoo.  

With the basics in mind, The AEDITION got the scoop on what to expect from [laser tattoo removal](https://aedit.com/procedure/laser-tattoo-removal-procedure) from West Hollywood dermatologist [Jason Emer, MD](https://aedit.com/provider/jason-emer-md-722), and spoke to three patients about their personal experiences with the treatment.

## __The Laser Tattoo Removal Process__
Let’s get this out of the way: tattoo removal requires patience — and, sometimes, lots of it.  

For starters, Dr. Emer warns that “even the smallest black ink tattoos” can take “six to 10 sessions” to remove (though newer technologies, like the PicoLaser, may require fewer). While no two patients are the same, the time it takes for the fractionalized pigment to be excreted after a procedure can last several weeks, which is why patients are encouraged to space laser treatments anywhere from three to 12 weeks apart. 

To maximize each session, Dr. Emer suggests patients request a perfluorodecalin (PFD) patch be used. The patch absorbs some of the energy produced by the laser, which, in turn, allows practitioners to pass over the affected area up to four times more than they would be able to without the patch in place. The result: fewer treatments and faster results.

And, while the process of removing an unwanted tattoo can be long and costly (the [American Society for Aesthetic Plastic Surgery estimates](https://www.surgery.org/node/1056530)  one laser tattoo removal session costs, on average, $463), it doesn’t have to be painful. Dr. Emer says patients can ask for topical numbing creams, nerve blocks, or even sedation to ease any laser-related discomfort. 

## __Laser Tattoo Removal Recovery and Results__
As with any laser treatment, the downtime after each session is relatively minimal. Patients are asked to protect the affected area from sun exposure and to avoid submerging it in water for up to two weeks. They are also encouraged not to sweat or rub the site for 72 hours. Additionally, patients may notice scabbing, discoloration, swelling, and/or peeling as the area heals. 

The number of sessions it will take to remove a tattoo depends on a variety of factors. The age of the ink and its location on the body, for instance, are key indicators. “The further away from the heart the tattoo is, the longer it will take to remove,” Dr. Emer explains. Whether or not it was done by a professional tattoo artist (amateur tats are typically easier to treat due to their superficial nature) and the colors that were used (green and light blue ink are the hardest to erase) also matters.

Another factor? Skin tone. 

“The darker the skin tone, the harder it is to remove a tattoo,” he says. “The laser energy attracts the darker skin as opposed to the tattoo, so those with light skin and dark ink are likely to achieve the most effective results.” 

Generally speaking, the tattoo should fade with time (and as additional treatments are performed), but the reality is that some tattoos will never be 100 percent erased. And while technological advances have significantly improved laser results, the potential for “ghosting” (no, not the dating kind) or lightening of the skin where the laser was applied is possible.

## __Patient Perspective__ 
So, what’s it like to go through the tattoo removal process? A few patients get candid about their experiences. 

### __Sadie, Los Angeles__
*Sadie is in the process of removing two tattoos — a small green, white, and yellow daisy on her lower back and a medium-sized butterfly on her hip bone. She commissioned the latter (a pink, yellow, and green design) to cover up an older tattoo but has since decided she wants to remove them all.*

__The AEDITION:__ *Why did you decide to have your tattoos removed?*

__Sadie:__ I got the daisy when I was 18 simply because I thought tattoos were cool. I got the second one a year later and the cover up a couple of years after that. I didn't put much thought into it at the time, and they have no meaning to me. I don't like the way they look, and I also don't like colored tattoos.

__The AEDITION:__ *How did you go about finding a doctor for your tattoo removal? *

__Sadie:__ I did a lot of research about the laser machine itself and some on doctors. My best friend's husband, who is a dermatologist but doesn't do tattoo removals, recommended a dermatologist to me who he said is great at tattoo removal and uses PicoSure. 

__The AEDITION:__ *What has the removal process been like for you?*

__Sadie:__ I just did my fifth session last week. It's a very long and slow process overall. I wait six weeks in between each session and do both tattoos at the same appointment. I’ve always heard horror stories about the pain of laser tattoo removal — and that it was much worse than laser hair removal, which I have also done — but I have zero pain when the doctor is using the laser on me. If I didn't hear the sound of the machine, I would almost think nothing is being done. 

Before the laser itself, a nurse numbs both areas with injections. It's a bunch of tiny needle injections, which can be a little painful, and I do bleed a little. The nurse pokes the area to make sure I don't feel anything before the doctor comes in to start the laser. After a session is done, they bandage the area up and I don't work out for 48 hours. I can shower after 24 hours. I wash the area with unscented antibacterial soap, and, for the first five to seven days, I cover it with a large bandaid. I have been told to use Aquaphor on it and was also given a cortisone cream for the itch, but I rarely use them. 

I have only had one large blister after my third session, which went away quickly, and then I have had some tiny ones, which, again, went away fast. I also don't go in the pool for a couple of weeks since it's technically an open wound. Anytime I am in the sun, I use sunscreen on the tattoos being removed. 

__The AEDITION:__ *Are you pleased with the results so far?*

__Sadie:__ I am very content with the results so far, but I wish there was a way to do the sessions more often. I am very excited to see the final results.

__The AEDITION:__ *Do you have any advice for people considering having a tattoo removed?*

__Sadie:__ You need to be patient! It's a long process and doesn't look so great to have a faded tattoo on your body, which, after a few sessions, doesn't even look like anything but some light ink. It's not pretty, and you can't speed up the sessions or see drastic results fast. But if you're patient, you will reach your desired results. It's also an expensive process, so make sure you're ready for that. You don't want a lack of patience or not being able to pay for it to be the reason you are left with a faded tattoo that no longer looks like anything. It's a commitment for sure.

### __Lauren*, Long Beach, CA__
*Lauren got a tattoo on her wrist when she was in her early twenties. She has since become a business owner and regularly presents her products to large groups of people. She found that having visible tattoos affected her confidence, which led her to begin the removal process.*

__The AEDITION:__ *Why did you decide to have your tattoos removed?*

__Lauren:__ I got my tattoos impulsively when I was relatively young. They didn’t particularly have any meaning to me, so I think that made the decision easier. I found that, in the industry I work in, having visible tattoos led to a fair bit of silent judgment. As a business owner, I couldn’t afford to be judged on something that I could have fixed relatively easily.

__The AEDITION:__ *What has the removal process been like for you?*

__Lauren:__ So far, I have had four sessions, which my practitioner estimates leaves me around halfway towards the final result. The sessions themselves are quick, but I do find them quite uncomfortable. It is a little annoying to have to remember to keep the area away from sunlight as much as possible, but, on the whole, the process feels more like a bit of an inconvenience rather than anything dramatic or painful.

__The AEDITION:__ *Do you have any advice for people considering having a tattoo removed?*

__Lauren:__ I actually consulted a couple of practitioners before settling on the one I am going to now. I wanted to find someone who had a decent amount of experience dealing with tattoos similar to mine, which were quite colorful. I also made sure we were clear on how much pain I should expect and asked them to explain how they would minimize that. If you’re nervous about the pain, definitely have a discussion with your practitioner about what they can offer to help. And, finally, don’t expect miracles. I’m told mine have a good chance of being more or less completely removed, but it’s definitely not a quick fix.

### __Josh*, Newark, NJ__
*Josh had a tattoo removed from his upper arm because it was a reminder of a past relationship. His removal process was completed a few months ago, and he is generally pleased with the results.*

__The AEDITION:__ *What was the removal process like for you?* 

__Josh:__ I consulted with a dermatologist who practices in the same office that I go to for [Botox®](https://aedit.com/procedure/botox), so I was already confident in the level of care I would receive. I had done some research ahead of my consultation and asked them about the PFD patch that can be used to reduce the number of visits you need. They offered that, so I was happy to go ahead. The tattoo was relatively small —  a couple of inches by about half an inch — so the sessions didn’t take long. There was a bit of discomfort the day after, but, other than that, it was straight forward.

__The AEDITION:__ *Are you pleased with the result?*

__Josh:__ I’m pleased with what my dermatologist was able to achieve, but I did have to lower my expectations to an extent. In my mind, they were going to be able to completely erase any trace of the tattoo. In reality, the skin still looks different in the area. I am hoping with time the area will continue to heal and look more normal, but it’s still better than the situation I had before.

__The AEDITION:__ *Do you have any advice for people considering having a tattoo removed?*

__Josh:__ Honestly, I think if you’re just getting rid of it because you don’t like how it looks anymore, I would consider looking more into either cosmetics to cover it or getting a cover with something else. In my experience, the area won’t go back to being 'normal skin.' If there are more profound reasons, then I would say it’s worthwhile. My advice would be to find a doctor you feel you can trust, talk through any concerns you have, and take the process at your speed. It’s not the most comfortable, so remember there’s no real rush and it will look better with time.

*Patient names have been changed

If circumstances have you rethinking your ink, here’s what you need to know about the tattoo removal process from both an expert and patient perspective. 

Everything You Need To Know About Laser Tattoo Removal

The Truth About Laser Tattoo Removal

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As long as she could remember, Linda had beautiful skin (you know, the glowy and youthful kind you receive compliments on). But everything changed during a particularly stressful time in her life two years ago. At age 57, small blood vessels began reddening her cheeks and nose, and her facial skin grew so sensitive and painful that she dreaded even washing it. “It was really hard to look at myself in the mirror and accept that I was having this extreme redness,” she shares.

Linda sought out doctor after doctor — some of whom even tried to prescribe antidepressants to treat her skin condition — until, after seven agonizing months, a dermatologist finally diagnosed her with rosacea. The skin disorder, which impacts an estimated 16 million Americans, has symptoms ranging from facial redness and extreme sensitivity to pimply bumps (a.k.a. papulopustular rosacea) and irritated eyes (i.e. ocular rosacea).

The exact cause of rosacea is unknown, and flare-ups can be triggered by exposure to stress, heat, hormones, spicy foods, alcohol, and even caffeine. In Linda’s case, her constant worrying about her complexion definitely wasn't helping matters. “Because I was so stressed out about it,” she says, “I’m sure I was making it worse.”

Dermatologists usually treat rosacea symptoms with a combination of lifestyle modifications, light and [laser therapies](https://aedit.com/procedure/ablative-fractional-lasers), specialized skincare routines, and antibiotics, but many patients find it difficult to obtain coverage for these treatment options because insurance companies categorize the skin condition as “cosmetic.”

Frustrated by the lack of results from doctor-prescribed meds, Linda sought out a naturopath, who helped balance her hormone levels with supplements and an anti-inflammatory diet. But she still wanted more. Extensive research led Linda — a Minnesota resident — to West Hollywood’s [Jason Emer, MD](https://aedit.com/provider/jason-emer-md-722), a cosmetic dermatologist who specializes in laser technologies.

Since there is no cure for rosacea, Dr. Emer opts for a multi-modality approach to manage it. He likens its chronic nature to having diabetes or high blood pressure. "You’re always going to have it, so you have to maintain treatment for it,” he says. He employs a regimen of in-office lasers, facial treatments, and light therapy, as well as various at-home therapies, to help patients keep their condition under control.

The treatment program is intensive at first. Linda, for instance, made monthly trips to Southern California for the first six months before switching to quarterly visits. Now two years into her journey, Linda invited The AEDITION to experience firsthand what it’s like to undergo one of her laser treatments.

When I met Linda in the reception area of Dr. Emer’s new Sunset Boulevard facility, the first thing I notice is her skin: It looks healthy and porcelain-hued, with no sign of the redness or inflammation I’d expected to see. Dr. Emer’s staff leads us into a treatment room, where a nurse applies a topical numbing cream to Linda’s face, before leaving the two of us to chat for about 40 minutes as the lotion takes effect.

Over the steady buzz of the laser machine warming up, Linda tells me that one of the hardest parts about having rosacea is the impact avoiding her triggers has had on her previously active lifestyle. “I like to ride my bike, kayak, walk,” she says. “But now I can’t just go out without thinking about it — I have to be careful.” Going out to eat can also be a challenge due to her dietary restrictions. “I can’t just have a glass of red wine with friends,” she shares, “because it’s not worth having to deal with the consequences.”

The nurse returns to remove Linda’s numbing cream in preparation for her treatment, and Dr. Emer arrives to calibrate the laser before getting started. In the past, he explains, the standard rosacea treatment was light therapy in the form of [intense pulsed light (IPL)](https://aedit.com/procedure/ipl), which just wasn’t that effective. Dermatologists were reluctant to combine technologies for fear that using lasers, light, and peels would overly irritate sensitive skin. “As it turns out,” he says, “[non-ablative lasers](https://aedit.com/procedure/nonablative-laser-skin-resurfacing) — ones that don’t burn the skin but just heat the underlying surface — actually help.”

Depending on the patient’s skin tone, Dr. Emer uses different lasers with an array of wavelengths. In Linda’s case, he combines the Vbeam® vascular laser (which exclusively targets the skin’s blood vessels) with the [Clear + Brilliant®](https://aedit.com/procedure/clear-brilliant) laser (which works on the skin’s surface to help decrease inflammation). According to Dr. Emer, just two or three sessions with these tools (coupled with a program of facials, skincare, and at-home light therapy) can help many patients achieve up to a year of remission. 

But is there any risk to doing all of this at once? Dr. Emer says that, when used incorrectly, the heat from the vascular lasers can damage the skin and advises patients seek treatment with a board certified dermatologist for mild cases of rosacea and a cosmetic dermatologist (i.e. someone with extensive training in these advanced therapies) for more severe cases.

And what about the cost? On average, one session with a vascular laser ranges from $250 for a spot treatment to between $500 and $750 for larger areas like the face. [Clear + Brilliant®](https://aedit.com/procedure/clear-brilliant) runs about $500 per session, depending on the doctor and location.

As Dr. Emer prepares to apply the laser beam to Linda’s face, he places metal shields over her eyes and requires everyone else in the room to slip on purple-hued glasses to protect the blood vessels in our eyes (this laser can cause blindness). As the procedure begins, the handheld device imparts a dime-sized green light that glows on the skin in the moments before each high-pitched laser pulse. It sounds painful, but Linda seems unfazed. “They always say it feels like a rubber band snap,” she explains, “but I’ve never been super uncomfortable, no matter what he’s done.”

Partway through Linda’s treatment, Dr. Emer re-calibrates the Vbeam®, honing the focus to target her visibly dilated blood vessels. “This laser attracts the blood in the blood vessels. So, it heats it up and the vessel starts to spasm, which causes inflammation,” he says of the eight-minute procedure. “Then the body comes in and eats up the blood vessels.”

Next up: the Clear + Brilliant® treatment. The machine is considerably smaller than the Vbeam® — and much quieter, too. The nurse gives Linda a small, handheld fan to cool her face, as Dr. Emer carefully glides the device back and forth along every section of her skin. “By combining the deeper, vascular laser with the lighter, superficial laser, you actually get more improvement,” Dr. Emer says.

Minutes later, Linda's face is flushed but otherwise smooth and plump looking. She says her skin feels hot from the laser, and the nurse applies a crystal-fiber cooling mask to soothe it. After letting it sit for five minutes, the nurse follows it up with a 10-minute red LED light treatment to further soothe the inflammation. Post-treatment, things get worse before they get better — Linda says the redness usually persists for a few days and calms down over time.

Finished with her light therapy, Linda bids me farewell, still peppy and positive in spite of the afternoon’s scrutiny. She realizes how fortunate she is to have the means to make traveling for treatment a possibility. “For me, coming to Dr. Emer is more than worth it,” she says of her regular trips. “I have to take time off work to fly out here, but I see the results. I know I’m going to have rosacea for the rest of my life, but there is hope.”

She says her journey with rosacea has made her passionate about being her own health advocate. “Don’t take ‘no’ for an answer,” she shares. “There are things that can be done — you just have to find the right person to help you.”

An estimated 16 million Americans have rosacea. Here, one patient chronicles her experience with the skin condition and invites The AEDITION to join her for a laser treatment with her cosmetic dermatologist. 

What It's Really Like To Live With And Treat Rosacea 

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*Finding the right plastic surgeon is a lot like dating. You’ll likely have to consult with a few doctors —and maybe meet a frog or two along the way — before you find the best one for your cosmetic surgery.*

*So, how do you know when you've found the one? There are a few important factors. For starters, he or she must be board-certified by the [American Board of Plastic Surgery](https://www.abplasticsurgery.org/), must have attended an accredited medical school, and must perform all procedures in an accredited or state-licensed surgical facility and operating room. What makes them the right doctor for you beyond professional accreditation is a bit more subjective. In this series, we ask real patients to share their surgeon-selection stories to help guide — and safeguard — your own cosmetic surgeon search.*

*The below interview has been edited for length and clarity.*

__Susan, 53, spent years getting to know her doctor via non-invasive procedures until she was finally ready to go under the knife.__

My plastic surgeon and I had a slow courtship. About 10 years ago, I started to feel like my eyelids were sagging. And, while I knew surgery may be the answer down the road, I was determined to try the non-invasive route first to see if that would garner good-enough results. Thus, when I initially met my doctor, I asked her to give me [BOTOX®](https://aedit.com/procedure/botox) to lift my brows — instead of going straight for a [blepharoplasty](https://aedit.com/procedure/blepharoplasty-eyelid-surgery) (a.k.a. eyelid surgery).

I continued the non-invasive cosmetic procedure route for years and, over that time, really got to know my doctor. She, like me, was a busy, working mom with young kids, and she had a practical approach. She understood that I wasn’t trying to look younger or “good for my husband,” as one (male) doctor suggested to me when I visited him for a consult (next!).

About four years ago, I told her I thought we’d exhausted the non-invasive strategies and it was time to talk about surgical procedures. She agreed and began outlining what that would entail. She told me that we would only operate on my upper eyelids and that it would be a mistake to do the lower ones, too, because the shape of my eye would start to change.

I pushed back, but she held fast, and I now realize she was right. She told me she’d rather err on the side of doing less because we could always do another type of procedure later. But, if we did too much, too soon, there was no going back. I appreciated that sensibility. She also shared insight into how I could handle talking about the surgery with my children and how recovery would impact my ability to get back to work. She really got it.

I did talk to other doctors — including the one who said “your husband will be so happy with the way you look” (ugh) — but no one compared to her practical approach. And, having known her for years, I really did trust her with my face. So, she performed my eyelid lift, and it went very well.

I think my success story lies in the fact that I spent years getting to know my doctor and her staff. I trusted them before plastic surgery procedures were even a consideration for me. While not everyone may have the luxury of waiting that long, starting smaller (with a [peel](https://aedit.com/procedure/chemical-peels) or [facial](https://aedit.com/procedure/hydrafacial) or BOTOX®) can certainly help you get a better sense of a surgeon's office, aesthetic, and his or her team's professionalism before signing up for a specific procedure.

I also think it’s important that your personal sensibility syncs up with that of the doctor. In my case, we were both working women who strived to look refreshed and healthy — but not necessarily younger or "sexier" (yes, one board certified plastic surgeon really did use that adjective in my consult). Ultimately, I felt like my doctor approached my eye procedure the way she’d want to handle her own, and that was very reassuring.

Finding the right plastic surgeon is a lot like dating. You’ll likely have to consult with a few doctors — and maybe meet a frog or two along the way — before you find the best one for your cosmetic surgery.

How I Found My Plastic Surgeon: Don't Rush It 

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Before I reached a certain age (let’s just say, it rhymes with “sporty”), I’d only ever cared about what I considered to be an excess of body fat. I had, admittedly, never given much thought to the fat in my face — until it started to disappear. It hardly seemed fair: Did I really have to choose between a slim physique and a smooth face?

To see if I could bring back a bit of my baby face, I met with board certified UCLA plastic surgeon [Jason Roostaeian, MD](https://aedit.com/provider/jason-roostaeian-md-449). He explained to me that facial aging isn’t just caused by gravity, but also by the redistribution and loss of fat throughout the face. The result: wrinkling and irregularities. 

[Fillers](https://aedit.com/procedure/temporary-lip-fillers), he explained, can restore some of that lost facial volume and refresh the youthful contour temporarily. After discussing all of the risks, I decided to give it a try — peppering Dr. Jason with questions as he thoughtfully examined my face, injecting hyaluronic acid filler into my tear troughs and cheeks.

I tried not to wince as I wondered aloud: How often am I going to have to do this? “It varies from patient to patient,” Dr. Jason told me. “But plan on dermal fillers lasting about six months to a year.” 

While I’d never been stellar at mental math, it seemed obvious that, as a sporty-something-year-old, this was going to get pretty pricey by my golden years. “Once you get older, you’re better off getting a facelift with fat grafting,” explained Dr. Jason, “which will take care of the skin laxity and the volume loss at the same time.”

He had me at “[fat grafting](https://aedit.com/aedition/why-everyone-is-talking-about-fat-grafting).”

## __The Technique Used In Facial Fat Grafting__  

Sure, I’d heard about the [Brazillian Butt Lift](https://aedit.com/procedure/brazilian-butt-lift-fat-grafting) (during which plastic surgeons transfer [liposuctioned](https://aedit.com/procedure/power-assisted-liposuction) fat from the belly and flanks to bulk up the booty), but I had no idea that similar fat injection techniques were being used to permanently plump up cheeks, lips, under eyes — basically, anywhere facial fillers were gaining fame. 

I needed to know: Why isn’t everyone doing this? “First off, it’s a surgical procedure that includes all of the associated risks and recovery time,” Dr. Jason explained. “Secondly, because fat is a living tissue, it’s less predictable — though, at the end of the day, using your body’s own fat as filler is always going to be the gold standard.”

When pressed for more details, Dr. Jason told me that although some doctors perform facial fat transfer procedures under local anesthesia, he prefers to use general to ensure patient safety and comfort. “We have to be very careful with our technique,” Dr. Jason told me. “Imagine we’re taking tiny seeds of purified fat and dispersing them throughout the area to give them the best chance to grow and survive, while providing a smooth, even result over time.” He said that plastic surgeons generally overfill areas of the face during a fat grafting procedure because it is not unusual to lose about 30 (or even as much as 50) percent of the transferred fat cells over time.

When I asked about possible complications associated with facial fat grafting, Dr. Jason pointed out that because a patient’s fat is their own tissue (known as “autologous fat”), there’s no risk of adverse reaction — though swelling and bruising are typical and may be quite pronounced. “Because we’re distributing the fat throughout a given area through a very small incision, we end up affecting a lot of tiny blood vessels, which is bound to cause bruising,” he shared.

## __The Facial Fat Grafting Procedure__   

Full disclosure: I don’t think I was totally listening at this point. Instead, I was already fantasizing about the fate of my face and whether it was possible to tack on this fat transfer treatment to an unrelated procedure I had coming up. Since I was going under anesthesia anyway, why not wake up looking younger? Dr. Jason told me that the facial fat grafting would add about 45 minutes to my existing surgery and that the recovery typically takes about two weeks. I decided to give it a go.

Right before my fat grafting surgery, I came face to face with Dr. Jason and his purple surgical marker. He sat in front of me, considering the peaks and valleys of my face before tracing a pattern along my contours. We then discussed possible donor sites during an informal body fat analysis (which I can only liken to swimsuit shopping with a stranger) to determine exactly where Dr. Jason would be harvesting the filler for my face. 

He planned to make a total of four small incisions: one in each thigh to collect the fat and then one in each cheek about halfway between my mouth and nose. It’s through the latter that he’d inject the fat after purifying it in the operating room.

## __Recovery After Facial Fat Grafting__

The next thing I knew I was lying in recovery with a surgical glove filled with ice water splayed across my face. I was too groggy to even wonder about my results. After about an hour, the nurse cleared me to leave, sending me and my husband home with instructions to apply cold packs consisting of gauze soaked in ice water for the first 48 hours and to sleep as upright as possible to prevent swelling.

Standing before my bathroom mirror, I looked like I’d passed out after a fraternity hazing: bloated, a little bruised, and covered in Sharpie babble. But my skin was so smooth, plump, wrinkle-free, and refreshed. Though Dr. Jason had told me that the initial swelling from the procedure would obscure the final result, I was already pleased.

For the first 48 hours, I was totally unproductive. The cold packs made reading or even watching TV too challenging, but, after a couple of days, I was able to be up and about around the house — albeit with soreness in my cheeks and at the donor site. I’d also developed moon-shaped magenta bruises across each tear trough that seemed to be growing larger and darker daily. 

I realized that not being equipped with the proper concealer was going to be problematic. I threw on a baseball cap, pulled the brim down extra low, and ran to CVS to grab a tube of color corrector. I dabbed the makeup over the bruises, took a step back, and saw a woman with purplish-green shiners staring back at me. But, man, she looked so young.

## __The Results After Facial Fat Grafting__

Over the subsequent weeks, I became pretty adept at camouflaging my ever-changing bruises as they morphed and shrank unevenly from red to purple to blue, green, and yellow before finally fading away. If anyone noticed my technicolor transformations, they didn’t let on (with the exception of my mother-in-law, who deadpanned, “You look like you’ve got two black eyes.”). 

When I asked Dr. Jason whether or not it was typical for patients to have lingering bruising, he said it generally “clears up completely within 10 days or so. But every patient is different.” For me, caking on the concealer for a few weeks seemed a small price to pay in exchange for a positive, permanent result.

Dr. Jason also told me that it would take about three months for the swelling to subside completely and the surviving fat to become established. With the passing weeks, every sign that appeared from my “old” face made me wonder: Would I end up looking happily refreshed or disappointingly unchanged? 

I felt strangely conflicted. On one hand, I was incredibly satisfied with my initial appearance, but I was equally reluctant to invest too much in the outcome. Notes from my journal about one month post-op capture the conundrum: “Woke up this a.m. and the left smile wrinkle was back. Ugh. Yesterday went shopping without concealer — felt amazing.”

By the time I saw Dr. Jason for my three month follow up, the soreness in my cheeks and thighs (initially akin to a pulled muscle) and small red scars from the incision sites had completely resolved. Much of the fullness in my cheeks and the evenness under my eyes remained. As Dr. Jason evaluated the outcome, I held the hand mirror and saw no apparent signs of plastic surgery other than a slightly younger self was staring back at me, smiling.

After growing weary of the price and upkeep associated with dermal fillers, one writer decided it was time to try something a bit more permanent.

What It's Really Like To Get Facial Fat Grafting 

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_Finding the right plastic surgeon is a lot like dating. You’ll likely have to consult with a few doctors — and maybe meet a frog or two along the way — before you find the best one for your cosmetic surgery._

_So, how do you know when you've found the one? There are a few important factors. For starters, he or she must be board-certified by the American Board of Plastic Surgery, must have attended an accredited medical school, and must perform all procedures in an accredited or state-licensed surgical facility and operating room. What makes them the right doctor for you beyond professional accreditation is a bit more subjective. In this series, we ask real patients to share their surgeon-selection stories to help guide — and safeguard — your own cosmetic surgeon search._

_The below interview has been edited for length and clarity._


**Elizabeth, 52, might have avoided reconstructive surgery if she had read more online reviews and trusted her gut.**


My two aesthetic plastic surgery experiences were at two extremes: the worst and the best.

The first time I had surgery was more than twelve years ago. I wanted my [nose reshaped](https://aedit.com/procedure/rhinoplasty-nose-job) and, during the consultation, was convinced by the doctor that I should also have a [chin implant](https://aedit.com/procedure/alloplastic-chin-implant) and some [liposuction](https://aedit.com/procedure/liposuction). The surgeon I chose was older — probably in his sixties at the time — and I figured he’d had lots of experience. He’d also appeared on _Oprah!_, which, in 2005, was a big deal. The first time I went to the surgeon's office, I took a friend from the beauty industry with me, and we were both impressed. Maybe less by him and more by his art-filled Upper East Side office and name-dropping, but I felt that if he’d had a successful practice for years, I’d be safe in his hands. Now, more than a decade later, I can see the red flags I missed.

For starters, he smoked a cigar throughout our consultation. Seriously. He also talked at me the entire visit, bragging about his accomplishments and not really taking any time to get to know me or understand my concerns. He (successfully) upsold me on more surgery procedures — that chin implant and lipo — when I’d only come in about my nose. He never showed me his operating room, which was in the same building as his office. I also dismissed negative reviews I’d read online. At the time, chat rooms and community boards were relatively new and, while I did look at them, I didn't take them seriously. They were littered with negative comments about him, mostly referring to the fact that he had terrible bedside manner. I should have paid closer attention. 

I could write a book about my negative plastic surgery story, but one detail sums up the experience: I woke up in the middle of my surgery to the doctor banging on my nose. That was emblematic of everything that followed. He botched my nose job, taking too much off the end and making my nostrils look over-exposed. He also left stitches inside my nose that caused an infection. He put in a chin implant that was too large and he overdid the liposuction, causing the skin in my stomach to permanently tighten and twist. In the end, he accepted no responsibility for anything and, while I did try to pursue legal action, my lawyer told me to save my money and put it toward reconstructive surgery. 

It was during the pursuit of corrective surgery for my nose that I found the best surgeon. I first met him when I developed the infection in my nose. I’d been treated so poorly by the first doctor that, when the pain started, I didn’t trust him to take care of it. So, I searched online for they type of procedure I wanted and board-certified plastic surgeons who had rave reviews when it came to nose jobs. I called the one whose name came up most often. I was desperate and scared. I explained my story to the nurse on the phone, which she communicated it to him, and told me that even though he was done seeing patients for the day, he would wait at the office for me until I could get there. I was so thankful. He immediately put me on antibiotics and followed up with me until the infection was gone. 

He also helped outline the surgical procedures he thought would help me and explained that I would have to allow my nose to fully heal and wait a year before I could go under the knife again. In our follow-up meetings, he took the time to understand what I wanted and even asked me to draw a picture of what I wanted my nose to look like. He was an excellent communicator and explained clearly explained the kind of result I could realistically expect from these new plastic surgery procedures. He seemed to both understand what I wanted and be capable of creating it for me. I trusted his artistic skill as much as his medical acumen. I did wait a year until the second surgeon could do my corrective surgery. He restored my nose and removed the oversized chin implant. 

I learned a lot during those two years of surgery and recovery. First, don’t dismiss what you read online. The negative reviews are good cautionary tales, but the positive ones are also important. People are more apt to pound out angry comments, but when someone takes the time to write about exemplary work, that’s just as telling. I also believe you should trust your gut. There were warning signs with the first doctor — the smoking, the over-talking, the disinterest in me — that made me wary, but I repressed that anxiety because of this doctor’s fancy office and television appearance. Always listen to your inner voice. Beware of any doctor who goes overboard telling you everything they think is "wrong" about you and all the additional cosmetic procedures they think you "need." If you go in for a nose job, that’s what you should be discussing. Finally, consider a surgeon with a specialty in the specific procedure you want. The second surgeon I chose is known for nose jobs—it’s what he does the most often. That turned out to be one of the most important things for me.

How I Found My Plastic Surgeon: Trust Your Gut

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With nearly 8 million subscribers and 3.5 million [Instagram](https://www.instagram.com/gabi/?hl=en) followers, YouTube personality Gabi DeMartino is no stranger to scrutiny. What’s surprising, however, is that for years, the criticism came not from her fans, but from herself. We spoke to the social media sensation about the influence of family, friends and Internet fame on her quest to finally become comfortable in her own skin.
 
“I wasn’t happy with my face forever,” says Gabi, 24, and host of YouTube's wildly popular [Fancy Vlogs by Gab](https://www.youtube.com/channel/UCLGe0PxyRFWmXVGJKq_gGvw) and [Niki and Gabi](https://www.youtube.com/channel/UCuVHOs0H5hvAHGr8O4yIBNQ). She spent much of her early teens fantasizing about fixing the features she found so unpleasant. “I didn’t even know what surgery was, and I was in 7th grade saying, mom and dad, let me change my nose, and they were like, WHAT?”

Despite her insecurities, Gabi started making makeup tutorials for YouTube alongside her identical twin sister Niki when the two were just 17. She was enamored by the transformative power of makeup, yet frustrated with herself as a model. “I didn’t have that makeup face,” Gabi explains. “I didn’t have lips to put lipstick on. I didn’t have a tiny, cute little fairy nose that makes everything look proportionate when you do makeup. I had a bulbous nose, thin lips, tiny teeth. The only feature I was actually not ashamed of was my eyes, so if you look at my older makeup videos, everything is about the eyes.”

Becoming a successful beauty blogger may have magnified Gabi’s dissatisfaction with her face, but it also inspired her to do something about it. “People might think it would make me feel more insecure, but it actually made me feel empowered to follow what I want to do with my life.” It also afforded Gabi the money she needed to make those cosmetic changes she’d been longing for all through high school.

As soon as she turned 18, Gabi used the money she’d saved to get [lip filler](https://aedit.com/procedure/temporary-lip-fillers) (without realizing it required periodic upkeep) and [dental veneers](https://aedit.com/procedure/veneers), but The YouTube star was afraid to go under the knife because of the risks and the stigma associated with plastic surgery. Her parents, both well-known dentists in their small Pennsylvania town, were adamantly against it. “I think they were insecure about looking like bad parents," she says, "and I feel like my mom has wanted to change her nose for her entire life, but felt she couldn’t.”

Gabi also experienced blowback from some of her friends, even the ones who’d expressed interest in having their own cosmetic procedures. “There were friends I knew wanted to get their lips done, but told me I'd changed and I was full of myself," she says. "I told them I just modified something that I never liked and that doesn’t change me. I did lose some friendships over it.”

And in a candid episode of Niki & Gabi last year called [The Truth about Gabi's Face Transformation](https://www.youtube.com/watch?v=vu9TNw8i25A), the twins talk openly about the profound effect Gabi's non-surgical cosmetic procedures have had on their relationship as identical twins. Niki "has the same insecurities as me," Gabi says, but she's become more accepting now that she's started to get cosmetic procedures too.

The more Gabi's look changed, the more some began to accuse the YouTube star of trying to look like Ariana Grande, her pop idol. Online, she was labeled Ariana's doppleganger by some and her stalker by others. When Gabi made a parody video entitled [I Lived Like Ariana Granda for a Day](https://www.youtube.com/watch?v=BX41qvpKbBs), it inadvertently set off a Twitter feud between [@gabcake](https://twitter.com/gabcake?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor) and [@ArianaGrande](https://twitter.com/ArianaGrande?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor) that was ultimately cleared up amicably. Grande apparently held no grudge, inviting Gabi to be in her Thank U, Next music video. Gabi later gushed on YouTube, "She looks like a Snapchat filter, I look like when you take the Snapchat filter off." 

It was a very public reference to Gabi's continuing insecurity about the one thing she hadn’t crossed off her cosmetic wish list: her nose.  “I was getting [non-surgical nose jobs](https://aedit.com/procedure/liquid-rhinoplasty) for the last two years, but no matter what we did with it, I was still completely miserable with the nose I had.”

<a href="https://www.instagram.com/p/Bs6zmsgFs9G/" class="embedly-card" data-card-width="80%" data-card-controls="1">Embedded content: https://www.instagram.com/p/Bs6zmsgFs9G/</a>

Last fall, Gabi had an epiphany. “I remember thinking, do I want to go through another Christmas with this nose? Do I want to go through more birthday pictures with this nose? Do I want to go through more screen shots from fans with this nose?’” She finally realized that although approval from her friends and family was important, it was also holding her back. “My parents aren’t the ones putting themselves out there for 8 million followers to see. They’re not the ones doing what I’m doing. It’s so easy for them to say it’s not a big deal, get over it, don’t be vain. But they’re not the ones trying to deal with something that makes them very upset.” 

Gabi confided in her injector, who recommended she make an appointment with plastic surgeon [Jason Bloom, M.D.](https://aedit.com/provider/jason-bloom-md-2248) She’d already been to six consultations with surgeons in New York, Los Angeles, Miami, and beyond, but none of them felt right. That changed, however, once she met Dr. Bloom. “First, I made sure that I found a doctor that I felt comfortable with to put me under anesthesia and cut open my face," she says. "Second, I found someone who could make my nose look like me, like I was born with it.” 

During the consultation, Gabi looked through before and after photos of patients who had a similar anatomy and aesthetic goal to hers. “What I try to do in consultation is show patients particular pictures which are going to match what their needs are," says Dr. Bloom. "Once they see that I can do something that they’re interested in, then it’s a match.” He also provided Gabi with 3D imaging of her nose, which allowed her to see just how she’d look post-surgery. “3D imaging really lets the patient see what their nose is going to look like in all dimensions,” he says. “The main reason I do it is so that my patient and I are both headed towards the same goal."

For Gabi, seeing how Dr. Bloom's 3D images matched with the post-surgical results is what sold her. “That gave me so much confidence," she says. "If he’s able to do this 3D imaging at a consultation and then actually make your nose look like what he showed you at your consultation, then this is the guy.’”

Gabi scheduled her surgery immediately, but was sidelined for four months with pneumonia. It was worth the wait. “It was the most painless, comfortable, easy thing I’ve ever done,” she gushes. "Lip injections hurt more than a [nose job](https://aedit.com/procedure/open-rhinoplasty) did. I had absolutely no pain, barely any bruising and no swelling.” 

Dr. Bloom attributes Gabi’s smooth recovery to his endonasal surgical approach, which causes less nasal trauma, and therefore less swelling, than an open rhinoplasty. The day before the surgery, Dr. Bloom dissolved the filler in Gabi’s nose so that he could accurately gauge her anatomy. He determined Gabi's nose "was overall wide, flat, lacked a little bit of definition, and her bridge was a little bit higher than she wanted it. So I brought the bridge down, both the bone and a little bit of the cartilage,” he recounts. “I shaped the tip cartilages to make it a bit more defined, and I did some tip suturing to give some projection and support to the tip. I narrowed the nasal bones and lastly, I did internal nostril base reductions to bring the nostrils more toward the midline.”

Gabi credits her post-procedure comfort level, both physical and emotional, to her years of experience in the public eye (“I was used to being stared at,” she says) and to Dr. Bloom’s expertise. “I didn’t take any painkillers, because I felt no pain at all,” she says. Dr. Bloom also sent Gabi home with Ocumend arnica pads to help with healing. “Those patches saved my life,” she exclaims. "I’d seen those videos of people with big eggplant-colored bruises around their eyes. I was so fortunate to have those patches because the only bruising I had was for the first two days and it was very minor.”

<a href="https://www.instagram.com/p/BsykOxjlFUp/" class="embedly-card" data-card-width="80%" data-card-controls="0">Embedded content: https://www.instagram.com/p/BsykOxjlFUp/</a>

Throughout her entire rhinoplasty process, Gabi was completely forthcoming, walking fans through her surgery plans in a YouTube video called [I Lied to You All of 2018 NOT Clickbait](https://www.youtube.com/watch?v=uEkWBh71sDU) and chronicling the procedure in another called [I Just Got a Nose Job. My Entire Nose Job Experience (So Fun)](https://www.youtube.com/watch?v=xwTY2YnwaGk). Gabi also posted pics, cast and all, to Instagram, including a video of herself at a store listening to an Ariana Grande song, which the superstar reposted to her own account. “She thought it was really funny,” explains Gabi. “Ariana even asked me about my nose job process and how I was doing. She was really sweet about it.”

The public response to Gabi’s nose job has been overwhelmingly positive. “I really haven’t gotten any bad comments,” she reveals. “The only negative comments I got in the past were before I owned up to my lip injections.” The lesson wasn’t lost on Gabi. She feels a moral obligation to be honest about everything she’s changed. “I think people are cowards when they try to hide it,” she says, “especially when they’re public figures. They could really be helping people by sharing their experience.”

Now that Gabi’s family and friends have seen how happy she is after her rhinoplasty procedure, they’re more accepting. She hopes to dispel the belief that cosmetic surgery is all about vanity. “A lot of people look at the vanity and not the internal happiness aspect of it,” she muses. “I finally found peace within myself the moment I changed my nose. Yes, it's a lot of money, but at the same time, it’s on your face - something you wear everywhere, every day, and it’s something that will make you feel so good about yourself if that’s what you truly want.”


We spoke to the social media sensation about the influence of family, friends and Internet fame on her quest to finally become comfortable in her own skin.

Why YouTube Star Gabi DeMartino Got A Nose Job

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_Finding the right plastic surgeon is a lot like dating. You’ll likely have to consult with a few doctors — and maybe meet a frog or two along the way — before you find the best one for your cosmetic surgery._

_So, how do you know when you've found the one? There are a few important factors. For starters, he or she must be board-certified by the American Board of Plastic Surgery, must have attended an accredited medical school, and must perform all procedures in an accredited or state-licensed surgical facility and operating room. What makes them the right doctor for you beyond professional accreditation is a bit more subjective. In this series, we ask real patients to share their surgeon-selection stories to help guide — and safeguard — your own cosmetic surgeon search._

_The below interview has been edited for length and clarity._

**Jon, 46,  discovered that finding a board certified doctor who’d done thousands of eyelid lifts was a smart strategy when planning his own cosmetic procedure.**

I decided about five years ago to do something about my heavy eyelids. My whole family has these hooded upper eyelids that seem to get heavier and heavier with age until they are literally hanging over our eyes and hampering our ability to see. My mom was the first to get a surgical procedure, followed by my older sister. I wanted to do it too, but I worried because, with men, facial plastic surgery can get really weird-looking. I feared that it would end up going too far. I didn't want my doctor to remove too much skin and leave me looking like a different person.

But my sister had her eyelid procedure done a couple of years prior and she looked great. Her eyes were still her eyes, but she looked restored. So, I decided I’d start my search by talking to her board-certified plastic surgeon, who’d largely built his career on plastic surgery procedures for what he called “ethnic eyes” like mine.

Within ten minutes of meeting this doctor I knew I was going to look no further. His demeanor made me instantly comfortable — and I am someone who gets very anxious in a medical setting, so that is saying a lot. He had an easy sense of humor and he completely understood and validated my concerns, both about being a man getting aesthetic plastic surgery and my worry regarding altering the shape of my eyes. I felt like he’d worked on my type of eyes a thousand times, which was very comforting. I also mentioned to him that I was considering doing my nose at some point too, and he said "absolutely not.” He told me he would not recommend touching my nose because it gave my face character. I now realize that he was right and, at the time, I appreciated his candor and the fact that he didn’t jump at the opportunity to make more money with more surgical procedures.

I found his staff helpful, comforting, and very professional. I don’t think one can overstate how important it is to check out both the doctor and the other people in the surgeon's office because they will also be an integral part of your care. 

My initial impression was accurate, and the surgery itself was a breeze. Five years later, I am still thrilled with the results. That said, if I ever wanted more surgery, I’m not sure I would necessarily go back to him. As great an experience as it was, I do think there is something to be said for choosing a doctor who specializes in the specific surgery you want. I think one reason my surgery was such a success is that eyelid surgery was this doctor’s primary area of expertise. So, if I wanted a face lift or tummy tuck down the road, I might go with someone who specializes primarily in that specific procedure.





How I Found My Plastic Surgeon: Look for Specialization

How I Found My Plastic Surgeon: Look For Specialization

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_Finding the right plastic surgeon is a lot like dating. You’ll likely have to consult with a few doctors — and maybe meet a frog or two along the way — before you find the best one for your cosmetic surgery._

_So, how do you know when you've found the one? There are a few important factors. For starters, he or she must be board-certified by the American Board of Plastic Surgery, must have attended an accredited medical school, and must perform all procedures in an accredited or state-licensed surgical facility. What makes them the right doctor for you beyond professional accreditation is a bit more subjective. In this series, we ask real patients to share their surgeon-selection stories to help guide — and safeguard — your own cosmetic surgeon search._

_The below interview has been edited for length and clarity._

**Sara, 36, learned the hard way that a surgeon's office is not a reliable indicator of their expertise.**

My first experience with a plastic surgeon was horrific, and I don’t use that word lightly. I was 25 and living in New York City when I decided to have plastic surgery on some tubular birth defects in my breasts and stomach. The surgeon I chose was based on a friend’s recommendation; that friend had been researching breast augmentation for herself and said this doctor was supposed to be the best. I wasn’t interested in breast augmentation, but figured the surgeon would be working on my chest so "breasts" was a good expertise to have. 

At my first appointment, I was impressed by the surgeon's office. It was on Park Avenue in a beautifully-appointed carriage house. I figured the doctor couldn’t be bad if she could afford to pay that kind of rent for her office. It was also nicely decorated and felt comfortable, not at all clinical or like I was in a hospital. Now, I look back and I think that was a bad thing—I was never even shown the operating room. But at the time, the environment was a positive. 

My experience during the meeting with the doctor, however, was less comforting. She herself had obvious breast implants, and they were large, hard, and very high with protruding nipples. They were distracting. She told me within minutes of meeting that I’d look "much prettier" with bigger breasts, which was a pretty lousy thing to say since I was not in her office for breast augmentation and I’d told her from the beginning that I had no interest in getting them. Despite these warning signs, I decided to let her operate. I was young and my birth defects were something I was loathe to have to talk about again with another doctor. Plus, the idea of navigating a big New York hospital felt scarier than the carriage house. Big mistake.

The first thing I remember after my surgery is waking up sobbing over a toilet with a nurse yelling at me. The whole post-surgery experience was terrible, and now I know they were shockingly negligent in their care. They basically pushed me out of the office when my friend arrived to pick me up and, on the way to my apartment, we had to pull over so I could throw up. My friend looked terrified. No one had prepped me on the seriousness of my surgery or what my aftercare would be. My friend helped as much as he could but he was also young, had to go to work, and couldn’t stay with me around the clock. Once, when he wasn’t there, I passed out and woke up on the floor by myself. I obviously survived and am here ten years later to talk about it, but I have scars (literally and figuratively) to show for it.

Thankfully, that’s not where the story ends. About ten years later, after I’d moved back to the Midwest, I decided to see if anything could be done about the scarring and lumps I’d developed in the wake of that initial surgery. This time, I went to a doctor at the recommendation of my mother, who’d had a few nonsurgical cosmetic procedures at this doctor’s office connected to a hospital. It was during that initial meeting that I realized what I should have expected from a board-certified plastic surgeon all along. 
This doctor was kind and empathetic. He asked me lots of questions, and I felt like he was trying to get to know me as a person to better understand what I did and didn’t like about my body. He was horrified at what the previous doctor had done and assured me he could help.  

My surgery experience with him was the complete opposite of the one I’d had before. I woke up in bed in an actual hospital with an anesthesiologist sitting beside me. The doctor and his team kept me in the recovery room until they felt confident I could safely be released. I was wheeled out of the hospital in a wheelchair and given strict instructions on aftercare and my follow-up appointments. I had to go see my doctor the next day and again the next week. They even set me up with a massage therapist to help break up scar tissue. I felt like they treated me with respect and exceptional care.

What I learned from these two experiences is to find a doctor who sees you as a human being. You want someone who takes the time to get to know you and understand what matters to you about your body. I also found that studying the doctor’s staff can tell you something about the cosmetic surgeon's approach and aesthetic sense. At the New York office, that surgeon’s team all had a more plastic, big-chested appearance. At my second doctor, the staff was very natural-looking, and that was what I wanted.

I’d also say to make sure your doctor is affiliated with a good hospital and ask to see where the surgery will happen in advance. If I’d seen the operating room in that carriage house ahead of time, I might have saved myself a lot of trouble. Finally, always make sure you feel in control and are not being told what to do or what surgical procedures you need to "look prettier." You are the patient asking for help and the doctor should be offering solutions to your requests, not trying to upsell you.






How I Found My Plastic Surgeon: It's Surgery, Not A Spa Appointment

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In the year leading up to my wedding, my skin prep was so militant, I left no pore unpurged and no wrinkle unfilled. Friends said I had the glow of a woman in love. At a business meeting, I was told I looked “dewy.” Not to take anything away from my husband, but my newfound luminosity had less to do with the chemical cascade released by our looming nuptials and more with the chemical blend in the [peels](https://aedit.com/procedure/superficial-chemical-peels) I had added to my anti-aging arsenal. When I look through my wedding album, I may just be the most “well-rested” person I’ve ever seen. Little do people know what was involved.  

As it turns out, I’m not the only one obsessed with tweakments. Take one look at social media and you'll realize it's one of the dominant trends in skin aesthetics and plastic surgery. Best described as non-surgical or minimally invasive cosmetic procedures, the goal is less-noticeable, subtle improvements that make it hard to figure out if someone is just taking better care of themselves, or making regular dates with their dermatologist.  “My goal is to never have anyone know a patient has had a treatment," says New York dermatologist [Cheryl Karcher, MD](https://aedit.com/provider/cheryl-karcher-md-4323). "They should simply look rested, refreshed and confident. We want people to guess if they maybe got a haircut or lost 5 pounds, but never be able to pinpoint a cosmetic treatment from me."

So, what exactly are the most in-demand tweakments? Some of them are no-brainers, others may surprise you, and all of them can be done on your lunch break.

## Sculptra® Facial Rejuvenation

“I tell my patients to think of Sculptra® as their facial rejuvenation 401k,” says Philadelphia-based plastic surgeon [Jason Bloom, MD](https://aedit.com/provider/jason-bloom-md-2248).  “The results aren’t immediate, but gradually improve over months and last for over two years.” Yes, that means you can expect Sculptra to help grow collagen for about 24 months. 

Sculptra® Aesthetic is an FDA-approved injectable that helps gradually replace lost collagen — an underlying cause of facial aging. Unlike a [hyaluronic acid dermal filler](https://aedit.com/procedure/cheek-augmentation-with-fillers), you probably won't see volume after the injection. Instead this non-invasive procedure helps the body grow its own collagen to correct shallow to deep facial wrinkles and folds.

“It’s perfect for on-air personalities and models who don’t want to look overfilled," says Dr. Bloom. "This is less like facial fillers and more like a collagen fertilizer—perfect for someone who wants that youthful plumpness in their face but doesn’t want to look different from one day to the next." It’s best used to add volume to areas like the cheeks and hollows of the face, but not around the eyes or mouth. 

## Botox®

This one’s a no-brainer, but the big difference with this cosmetic tweakment is that patients aren’t asking for motionless, expressionless faces anymore. “No one, not even an 18 year old, has a frozen forehead. We want to soften the lines using [Botox®](https://aedit.com/procedure/botox-facial), but not totally erase them; it almost always warrants the best overall look for them,” explains Dr. Karcher. 

## Tear Trough Augmention 

There’s one aging dilemma that’s just as frustrating in our twenties as it is in our seventies—the depletion of our undereye fat pads. “It’s the first place to go in terms of fat loss, regardless of who you are,” says Dr. Bloom. As the fat pads in the lower eye dwindle in volume, the result is a sunken, perpetually exhausted look and dark circles. Once upon a time, the only solution was through cosmetic surgery. But in the land of tweakments, the go-to choice is now [injectable dermal filler](https://aedit.com/procedure/under-eye-filler) – usually hyaluronic acid. 

“One syringe can be all it takes to erase years from your undereyes," says Dr. Karcher. "It's a subtle, nearly undetectable treatment that really helps rid you of that ‘always tired’ face." Results typically last around 6 months.

## Complexion-Perfecting Lasers

Gone are the days when you need to spend a week hiding out at home in the name of dramatic skin rejuvenation. “Now you don’t need a big [Fraxel® laser](https://aedit.com/procedure/fraxel-repair) with downtime to see a reduction in fine lines, wrinkles, discoloration and large pores,” says Dr. Bloom. “The [Clear + Brilliant®](https://aedit.com/procedure/clear-brilliant) laser is a low-level Fraxel® — it’s like aerating the skin. If you make fine tiny holes, not only are you treating the same problems without the downtime, but you’re allowing the products you apply to penetrate deeper and make a bigger difference in how they affect your skin and the results you’ll see.” Treatments are recommended every 2 weeks for a series of four.

Dr. Karcher’s favorite is the Laser Genesis®, because there’s no downtime and “it helps shrink pores and promotes glowy skin. Our models and influencers love that one for red carpet events.” The non-invasive laser treatment is designed to target fine lines, acne scars, large pores, and uneven skin tone by heating the upper dermis, which accelerates collagen regrowth. The non-ablative Nd:YAG laser uses heat to penetrate deep enough into the skin to stimulate the natural production of collagen, which shrinks pores, evens skin tones, and increases the speed of cell turn over. It also kills bacteria on and under the skin, preventing future acne outbreaks. Bonus: The entire treatment takes just 30 minutes, but you’ll need at least three treatments, spaced four weeks apart.


These beauty treatments make little tweaks that reap big results. Here's how to look fabulous without looking like you had major work done.

Why I'm All About Tweakments

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*When should I start getting Botox? Is it time to incorporate retinol into my skincare routine? What is a “[mommy makeover](https://aedit.com/procedure/tummy-tuck-abdominoplasty)”? How about a “daddy do over”? Do I really need to, as the saying goes, sacrifice my ass for my face? Should I swap my hyaluronic acid fillers for something a bit more permanent?* 

*When it comes to beauty and aesthetics, there is no such thing as one size fits all. But there are some tried and true principles that will keep you looking and feeling your best. In this series, [Coming of Age](https://aedit.com/aedition/category/coming-of-age), The AEDITION answers your most pressing questions about the best treatments, procedures, and practices — from surgery and skincare to health and wellness and everything in between — to consider at any age.*

I’ve worked in the beauty industry for most of my adult life, so when it comes to skin care and cosmetic procedures, if you’ve dreamt it, feared it, or loathed it, I’ve probably tried it. At the ripe old age of 24, I giddily succumbed to a big-name dermatologist as he injected [Botox®](https://aedit.com/procedure/botox-facial) into my forehead to erase furrows that didn’t exist. Mind you, this was shortly before we even rang in the 21st century — and well before the advent of Instagram, selfies and Facetime. At the time, many of my friends gasped in horror that I would allow for such a thing to be done to my face. I didn’t need any “work,” they told me. But fast forward 20 years, and it looks like I was an early adopter of one of the biggest current trends in beauty — prejuvenation.

The essence of this movement? Young patients using these treatments as a preventative measure. The goal is anti-aging: to stop that forehead wrinkle before it becomes a wrinkle or to avoid ever having crow’s feet at all (while smiling all you want).  And the only way to do that is to start non-surgical cosmetic treatments before time begins to take its toll on your skin. The recent American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) annual member survey showed a 24% increase in cosmetic surgery or injectables in patients under age 30 since 2013 which they say points to a larger trend. 

“Selfies and social media put us all under the microscope.  We look at ourselves on posted images much more frequently, closely, and critically than any generation before us,” explains facial plastic surgeon [Oren Friedman, MD](https://aedit.com/provider/oren-friedman-md-1609). “We become self conscious of our appearance because we see ourselves in close-up, and sometimes distorted, pictures so often.” At the same time, he says the same social media spreads the word about minimally invasive injectable procedures very rapidly, drawing people’s attention to these no-downtime, relatively painless interventions that can be transformative over the course of a 10-or 20-minute office visit.

Dr. Friedman explains that neuromodulators and botulinum toxin such as Botox®, Xeomin®, and Dysport® are the most common non-surgical procedures for younger women, since the injection of these products helps remove fine lines and wrinkles from the face that are associated with muscle activity, especially around the eyes and forehead.  

His experience is echoed by another facial plastic surgeon, [Jason Bloom, MD](https://aedit.com/provider/jason-bloom-md-2248). “Neuromodulators actually weaken the muscles that create wrinkles, like the 11's between the brows and crow’s feet,” he says. “If you wait until these lines are etched into the skin to start using Botox®, you’ll still have the line even if you don’t have the movement. At that stage, you’ll need to [inject it with filler](https://aedit.com/aedition/everything-you-need-to-know-about-dermal-fillers) to fully erase it. But injecting small amounts in your twenties or thirties actually stops the movement so the line never gets etched in.” Stopping the movement doesn’t necessarily mean you’ll end up with “frozen face” — that state when your face remains the same regardless of what emotion you’re feeling. The goal is to retain just enough movement to look natural.

Once you’ve stopped the progression of creases, the next area to target is restoring the fat that makes our faces look youthful. “The loss of fat in the face proceeds in a standard way for all of us,” explains Dr. Bloom. “The first fat pads we lose, beginning in the early to mid 20s, are the ones around and under our eyes. That’s what’s happening when young women say they want to look less tired, without the [dark circles](https://aedit.com/procedure/under-eye-filler).”  This common request is addressed by injecting a hyaluronic acid filler into the [tear troughs](https://aedit.com/aedition/how-i-quit-crying-about-my-tear-troughs) or under the eyes. 

Another way to think of prejuvenation? That millennial super-buzzword: self-care. While we’re taking care of ourselves by taking an extra workout class, sipping on collagen smoothies, and practicing meditation, what we are essentially doing is trying to keep the aging process at bay (or, at least, stalling it). These quick treatments are an extension of staying in a youthful state. The extra bonus: You don’t need a filter to take your best selfie.

What if you could stop fine lines and wrinkles before they even show? That’s exactly why many twenty-somethings are turning to cosmetic procedures today, but beauty insiders were doing it decades ago. Here’s how the prejuvenation trend hit it big.

I Was Practicing Prejuvenation Before It Was A Trend

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When I started noticing some early signs of aging around my eyes, I didn’t dash to the doctor right away. I was a little apprehensive about cosmetic treatments, even non-surgical options. I had mixed feelings about modifying myself in the name of beauty. I wanted to still look like myself and not like I'd had "work done." I wondered if I was being vain or succumbing to some perceived pressure from society's standards. After a bit of soul searching, I realized that I’d been letting fear of possible judgment interfere with my own desires. As long as a treatment is safe, both physically and psychologically, I believe people are entitled to self-improvement in all forms, cosmetic procedures included.

Armed with self-confidence, I took the plunge. I did extensive research and met with a board-certified plastic surgeon who treated my wrinkles with [BOTOX®️](https://aedit.com/procedure/botox-facial) and my volume loss with a hyaluronic acid-based filler. I was pleased with the results, but not with the idea of periodic upkeep. I eventually opted to undergo surgical fat grafting, a procedure designed to provide more permanent facial volume. I was excited to talk about the surgical procedure with my family and friends. After all, my trusted inner circle would be accepting of anything that made me happy, right?

Not so much. While a few of my friends were genuinely interested and supportive, some others, particularly people related to me, were not as enthusiastic. Most of them didn't say it outright, but their body language, skeptical tone, and relative silence said it all. They didn’t really approve, but they didn’t want to hurt my feelings by admitting it. 

While their judgment didn’t lead me to regret my choice, it did make me question being so vocal about it. Should I have kept my cosmetic procedures a secret? I’d made subtle changes, so presumably keeping it under wraps would have been a possibility, but it didn’t feel right to me. I wanted to share my experience, rather than keep it from my loved ones for fear of a negative reaction. Was there a way to educate people about my cosmetic surgery in a way that wouldn’t prompt pessimism? Where was that unfavorable reaction coming from? In search of answers, I sought out plastic surgery professionals and other patients to learn more. 

“Good plastic surgery is invisible,” says [Jason Roostaeian, M.D.](https://aedit.com/provider/jason-roostaeian-md-449), Associate Professor of Plastic Surgery at UCLA. “My goal is always to produce a result that looks as though my patient might've been born with it. Of course, depending upon the area and the extent of what we change, patients may or may not be able to keep their surgery to themselves.” 

As plastic surgery procedures become less detectable, it surely impacts is that having on people’s decisions to disclose them. “As technical advances allow for increasingly natural looking results, patients are actually having to face that dilemma more and more frequently," says Dr. Roostaeian. "Fortunately, the popularity of plastic surgery procedures, combined with increased exposure via social media, continues to significantly reduce the stigma associated with aesthetic surgery.”

Understanding that our society is becoming more accepting of plastic surgery made me feel less self-conscious, but I was curious how other patients had navigated talking to family and friends about their cosmetic surgery.

Dr. Sean Saadat is a plastic surgery resident at UCLA who has had two [rhinoplasties](https://aedit.com/procedure/closed-rhinoplasty). The first was at age 19, followed by a revision which he chronicled on social media. Dr. Saadat told me that he didn’t initially disclose his desire to change his nose because he felt admitting his insecurities about his appearance would make his parents nervous. He also worried that he’d be judged as a male seeking plastic surgery, which is stereotypically for females. “When I did bring it up, I said I was having trouble breathing,(and that) when the surgeon suggested fixing the prominent hump on my nose at the same time, I just kinda went along with it," he says.

Dr. Saadat's family turned out to be supportive. “Once I’d made the decision, my family stood behind me," he says. "Having your nose done is quite common in Iranian culture. Many women in my family had undergone rhinoplasties, so I felt like I was surrounded by a rhinoplasty support group.” He wasn’t so confident about his friends, however, so he lied and said he was having his wisdom teeth removed. “In my first couple of days post-operation, with my splint intact and eyes still bruised, I invited them over one by one for a big 'ta-da' moment," he says. "Surprising my friends felt satisfying and prevented them from saying anything negative beforehand. Ultimately, they were happy for me because they knew how insecure I’d been about my nose.”

Aubrey Nolan, co-founder of CrushFit, also felt apprehensive about revealing her cosmetic treatments. “I feel like there’s a huge stigma against getting any kind of work done, especially on your face," she says. "I got my [lips](https://aedit.com/procedure/permanent-lip-fillers) done and I was scared to even talk about it on social media. I feared what people would think of me and I considered not telling anyone.” But after giving it some thought, Nolan reconsidered. “I’ve been as transparent as possible with everything that I do.  I guess I just don’t see what the big deal is.” When a few followers responded negatively to her choices, she initially felt defensive, but now realizes that “getting work done doesn’t change the heart I have and I no longer feel the need to defend my actions.”

YouTube beauty blogger Elwa Saleh had a different concern surrounding her decision to have plastic surgery to correct her partial nasal collapse. Her family and friends were very supportive from the beginning, so Saleh says she “was not concerned about any judgment or scrutiny. But I was worried about the swelling lasting a long time (since I make my living blogging) about beauty and fashion. Most of my work is on camera and my face is a big part of my job.” After the procedure, “I did get a lot of questions about why I did it from my social media community," she says. "Some jumped to conclusions and thought I had major cosmetic surgery but once I spoke up about what I had done, the judgments dissipated.” 

One thing is clear: everyone has an opinion about plastic surgery and the more obvious the change, the stronger people tend to feel. But the degree to which people notice a person’s plastic surgery depends on more than just the procedure and the surgeon’s skill. It’s directly linked to the level of familiarity involved. The better we know someone, the more likely they are to notice a change. 
This connection was the key to understanding my family’s lackluster response to my own cosmetic surgery. They felt comfortable enough with me to express their uncensored emotions. Strangers risk this behavior, but social media has reframed what we consider familiar. All people are prone to pass judgment. “When you decide to go under the knife, that decision should be made with the understanding that people will judge because of their own insecurities and they may try to hurt your feelings," says Dr. Saadat. "If you do your homework and find a surgeon who will do a very good job, people will be pleasantly surprised to realize that you actually look like an improved version of yourself, and they’ll come to terms with it.”

Here are some tips for talking to your family and friends about cosmetic surgery 

**Choose Wisely**

“You need to be careful about who you tell beforehand," says Dr. Saadat. "They need to be open-minded people who aren’t going to be thinking about their own insecurities.” Although it’s impossible to really predict how a person will react to your decision to seek cosmetic surgery, confide only in those friends or family members who have your best interest, and self esteem, at heart. 

**Keep Calm and Confident**

If you’ve thoroughly considered every aspect of choosing cosmetic surgery, from examining your own psychological motivation to researching your procedure and plastic surgeon, someone else's snarky comments become insignificant. Relay your reasoning without defensiveness or excessive emotion. If you communicate your seriousness about improving your quality of life, your friends and family may be less likely to find fault in your choice.

**Look Deeper**

Fear or insecurity could be behind someone's negative reaction. The topic of cosmetic surgery is so charged because it can tap into our deep insecurities and can sometimes bring up feelings of inadequacy in someone. Keep in mind, your loved one’s negative response may have very little to do with you.

**Don’t Try To Win**

Stay focused on your purpose. You're having this conversation to inform your loved one about a decision that you’ve made for yourself, not to try to change their mind about plastic surgery. If things start getting heated, agree to disagree before feelings get hurt. 

**Be Patient**

Sometimes time is all it takes for people to accept their loved one’s decision to undergo a cosmetic procedure. “At the end of the day, it’s the patient who truly has to live with their transformation," says Dr. Roostaeian. "If an aesthetic surgeon does their job well, the results will blend so seamlessly with their existing features that eventually, even their closest friends and family may forget there was ever a change.” 

**Be Yourself**

While there’s no magic formula for talking to your friends and family about plastic surgery, keep these pointers in mind and be prepared for the onslaught of opinions. People who truly care about you will appreciate your honesty, so be as forthcoming as you feel comfortable being. Remember, how we present ourselves is up to us, but how we are perceived by others is beyond our control. Staying true to yourself will keep you feeling beautiful, inside and out.


Talking about your cosmetic procedures with people close to you can be tricky. You never quite know how they'll react. We spoke to plastic surgeon Dr. Jason Roostaeian, as well as actual patients, for tips on how to make the conversation work for you.  

How To Talk To Your Friends and Family About Cosmetic Surgery

How To Talk To Your Friends And Family About Cosmetic Surgery

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Sitting in front of her closest family and friends, Melissa* made a wish and blew out the 26 candles on her birthday cake. All around the table, her friends snapped away to document the special occasion. The next day, when Melissa looked at the photos of her blowing out the candles, she did not see herself.

“I saw a photo of my profile and I was shocked! I did not think the photo looked like me, yet it was,” Melissa said. “I realized I did not look the way I thought I looked which was a strange feeling.” 

While a cosmetic procedure certainly can enhance someone’s appearance, it can do so much more than just that. Reconstructing a feature or [enhancing body shape](https://aedit.com/procedure/velashape) can not only make someone look better but also it can boost their confidence and make them feel more like themselves. 

Choosing to undergo a cosmetic procedure is not an overnight decision for most. While some procedures are reversible (e.g. [dermal filler](https://aedit.com/procedure/under-eye-filler)), others are permanent (e.g. [facelift](https://aedit.com/procedure/minifacelift) or nose job). Because of that, the research process can be quite lengthy as patients look to gain a holistic understanding of the different options and what each procedure entails. 

Like Melissa, many patients undergo a considerable process of pre-contemplation, consideration, and research before following through. All of Melissa’s life she had joked about pursuing a nose job ([rhinoplasty](https://aedit.com/procedure/open-rhinoplasty)) before giving plastic surgery serious thought. For as long as she could remember, she never liked her nose and felt “it better suited a man and was not feminine.” It was not until she moved to Manhattan that she realized, it was now or never. She was surrounded by some of the best plastic surgeons. In Melissa’s mind, there was no excuse not to.

As a first step, Melissa, like most prospective cosmetic procedure patients, turned to the internet to research options. She focused on people who were happy with results but also sought out less successful stories to better understand potential risk. Similarly, Anne*, an [tummy tuck](https://aedit.com/procedure/abdominoplasty) (also known as abdominoplasty) patient, shared how she watched a video of an actual abdominoplasty procedure on YouTube when contemplating surgery. From that, she learned that an abdominoplasty is not a light decision, but a “major procedure.” Regardless, to Anne, it was worth it to rebuild her confidence by removing the extra skin she had from weight loss and tightening the loosened stomach muscles that were stretched out from pregnancy. 

After identifying which procedure and type of doctor, the natural next step is to schedule office visits for consultations. Anne had a friend who had a tummy tuck and was happy with the results, so Anne knew that if she were to follow through with a tummy tuck, she would see her friend’s board certified plastic surgeon. On the other hand, Melissa did not know anyone who had had a rhinoplasty before so she consulted with two rhinoplasty specialists and one general plastic surgeon. In addition to reviewing potential cosmetic surgeons’ credentials, like medical school, residency program, and plastic surgery training, Melissa made sure to discuss surgical techniques as well as request examples of each plastic surgeon’s past rhinoplasty work. Using a platform like AEDIT is also a great way to find a top rated doctor. With a curation of only board certified doctors, users can easily find and be confident in their selection. 

While Melissa and Anne knew exactly which procedures they wanted to pursue, sometimes it can be less clear for others. For instance, when targeting unwanted fat, there can be several methods available, like [CoolSculpting](https://aedit.com/procedure/cool-sculpting), [liposuction](https://aedit.com/procedure/laser-assisted-liposuction), or [KYBELLA®](https://aedit.com/procedure/kybella), just to name a few. As Matt, a KYBELLA® patient, shared “after doing the research it still was hard for me to find a procedure that was right for me and I kinda gambled.” Before learning about AEDIT which is a one stop shop for information about cosmetic procedures, Matt found the research process time consuming and difficult. He explained that “the information is sprawled all over the internet, and I had to cobble it together from different sources.” Like Melissa, Matt did not like the way he looked in pictures and never felt comfortable taking photos with family or friends. In his case, he knew that weight loss alone was not going to solve his issue. Even at his skinniest, he still was unsatisfied and uncomfortable with his appearance in photos. KYBELLA® was a non-invasive way to treat the excess fat under the chin (also known as submental fullness) with injections administered by a KYBELLA® trained specialist..

Recovery is just as important as the surgery so patients must also plan for recuperation as well. Depending on the procedure type, patients can be out of commission for days or even weeks. With Anne’s general surgery, she had to stay in bed and lay flat on her back for a week. Prior to her surgery, Anne had arranged for her daughter to care for her. With less invasive treatments like KYBELLA®, recovery time is much shorter when compared to a procedure like a tummy tuck or facelift. However, with less invasive treatments like KYBELLA® or [dermal filler](https://aedit.com/procedure/temporary-lip-fillers), patients may have to have several treatments before seeing its effects and a noticeable difference. 

Possibly even more difficult than the physical stress of procedures is the trust patients must have in their doctors. Patients must trust that their plastic surgeons or certified injectors understand their vision of what they would like to look like coming out of the procedure. They also must find the right balance of change so they still look like themselves but are not a completely different looking person. Fortunately, there are simulators, like the AEDITOR app, which is a precise facial morphing tool where people can adjust their nose, brows, and lips in order to ensure they are comfortable with the changes before following through with surgery.

“Looking back, I was nervous and told the doctor I wanted a nose job but I still wanted to look like ME,” Melissa said. “And thinking back now, that was the wrong thing to say because the fact was- I was seeking plastic surgery because I did not want to look like me.”

Feature focused plastic surgeries, like Melissa’s rhinoplasty, can feel risky for the person undergoing the surgery because they are reconstructing a feature in an entirely new way. The outcome is not as easy to visualize compared to procedures, such as facelifts or tummy tucks, which have clear objectives to leave the patient looking naturally younger or thinner. When possible, it is important to use a facial simulator, like the AEDITOR app, especially when trying to communicate objectively with the doctor. When pursuing weight loss or rejuvenation procedures, most patients have already seen themselves in that younger or thinner state and know exactly what to expect. On the other hand, when changing specific features, such as the nose, cheeks, or lips, or undergoing reconstructive surgery, like fixing a cleft lip, patients are hoping to uncover a new external identity. The goal is for them to look in the mirror and see their true selves for the first time. 

With major advances in aesthetic surgery over the years, people can be the best physical versions of themselves through the endless options of cosmetic procedures. Dreams of having the perfect curves, toned abs, or plump lips are made a reality through surgery and/or injections. Even more impactful, are the advances that benefit those seeking reconstructive or preventative surgery. Breast Cancer survivors can mask their wounds through breast reconstruction surgeries and citizens of third world countries can regain confidence through plastic and reconstructive surgeries offered by mission trips. 

For larger surgeries, such as a tummy tuck or breast surgery (e.g. [breast augmentation](https://aedit.com/procedure/breast-augmentation-with-fat-transfer) or [breast reduction](https://aedit.com/procedure/breast-reduction)), changes can be immediately noticeable. Even so, patients can still keep their procedures private if they wish to. “I didn’t tell many people about the surgery and just told them I had lost weight, which was pretty obvious,” Anne explained. To this day, only Anne’s closest family and friends know about her recent surgery.

So, can cosmetic procedure patients find the inner confidence they were hoping for? The short answer: absolutely.

With treatments like Xeomin®, KYBELLA®, or CoolSculpting, improvements can be delayed because of the multiple sessions needed, but can still be highly transformative. Matt shared that he required three sessions of KYBELLA® but “once there was a noticeable difference it made me much more confident on a daily basis.”

Melissa felt her confidence boosted immediately after healing from her rhinoplasty. Prior to surgery, she was self-conscious that the first thing people noticed about her was her nose. After surgery, Melissa was relieved that her nose would no longer be the focal point of her face. Even though Melissa is so happy she took action and control of this pain point of hers, she admits she would have approached the surgery differently by working with a rhinoplasty specialist rather than a board certified plastic surgeon. “I still do not love the way it looks which is a little disappointing, but it is better than it was, and I have accepted that as being better than nothing,” Melissa said.

It can be hard to achieve perfect results and complete satisfaction, but it is not impossible! Anne shared how happy she is with her tummy tuck, even several years later. Anne opted for a tummy tuck to regain her confidence for her daughter’s wedding. “When I went to try on the dress for my daughter's wedding and looked in the mirror, I was incredibly overwhelmed,” Anne shared. “Besides having lost weight, the surgery made my torso look incredible. I never thought I could look that good!”

With open expectations and willingness to change, aesthetic procedures have the potential to not only enhance appearance but also transform someone’s confidence! 

*The patient’s name has been changed.*


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