Author Archives: Greer

About Greer

Dr. Greer is a native of the midwest. After earning a Bachelor's at the University of Chicago, she received her medical degree at Case Western Reserve University School of Medicine. While at Case, she also earned a Master's degree in Biomedical Ethics. She did her Plastic Surgery training at Saint Louis University Hospital, in St. Louis, MO, and returned to the greater Cleveland area to set up practice in general Plastic and Reconstructive Surgery.

What is a weight loss plateau?

If you’ve spent any time at all trying to lose weight, you’ll probably look at “plateau” as a dreaded word. Plateaus represent an obstacle in the battle to lose weight. But what is a weight loss plateau?

photo of scale with measuring tapeInformation is scarce.

I realized I’ve never actually asked, “what is a weight loss plateau”, so I googled “definition weight loss plateau” and found… nothing. Okay, so obviously google returned hundreds of search results. But they were all focused on breaking through a plateau and resuming weight loss. Call me crazy, but I think looking for a solution to a problem before actually defining the problem is putting the cart before the horse.

Definition of a plateau.

If you’ve been reading my blog, you’ll know that I’ve lost 50 pounds over the past year and a half. I’ve spent the past six months working with an amazing weight coach, Dr. Katrina Ubell, and she offered the first actual definition of a plateau I’ve ever heard. As Katrina defines it, a plateau is:

  1. No weight loss for 2-3 weeks,
  2. while following your plan 100% of the time.

Plateaus are long!Woman yelling at scale

I think so many of us fail to lose weight for a week, or even a few days, and huff in frustration, “Stupid plateau.” But when we ask, what is a weight loss plateau, it’s pretty evident that plateaus are longer than the normal variation in weight loss. It’s super common for weight loss to go in fits and spurts. If you don’t believe me, look at the graph of my weight over a seven month period. Even when I’m losing weight steadily, I’ll stay at the same weight for many days. This is a normal part of the process!

If you aren’t following your plan, you’re not in a plateau.

If you think about it, a plateau is something external. It’s your body no longer losing weight, despite changes in your eating habits. Really it’s your body adjusting to a new weight set-point. So if you’re sneaking bites of dessert, or eating more than your plan allows, a plateau is not the reason you aren’t losing weight. You aren’t losing weight, my friend, because you aren’t following your plan.

I love this definition because it negates the vast majority of the time we think we’re in a plateau.  Often we’re not giving our bodies enough time to adjust, or we’re not really following our plan.

So what do you do if you truly are in a plateau? I’ll touch on that in a future post, but for now I’m going to direct you to Katrina’s fabulous podcast on the topic of plateaus. Thank you for joining me today! If you like what you’ve read, enter your email on the right side of the homepage to subscribe to future blog posts!

Dr. Greer is a Plastic Surgeon in Cleveland, OH. Her passion is helping moms regain their self-confidence by getting rid of sogginess, wrinkles, and stubborn fat. You can read more about her at www.greerplastics.com.

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

Oven Roasted Chicken – Plastic Surgery Style

a roasted chicken that has been trussed without twine

Let me tell you about my recipe for oven roasted chicken. The week before last I went grocery shopping (all by myself- does that count as time to decompress?). And I must confess: I actually bought a whole chicken. They were on sale, and cheaper than rotisserie for a change. Does anyone else wonder why a whole, cooked chicken costs less than an uncooked one? That’s always bothered me somehow. Regardless, the whole roasting chickens were on sale, so I bought one.

I was working at home for the day, which meant I had a little extra time to cook dinner. And I thought the sight of an oven roasted chicken and vegetables might impress my husband a little bit. Should be fine, right?

I’m not a stranger to roasting meat. I’ve done a couple turkeys on Thanksgiving. I can roast a juicy pork loin. My number one tip? The meat thermometer is key. If you cook to 5 degrees under temp, and let it rest for 10 minutes, whatever you’re cooking will hit the right temperature without drying out.

What’s this about trussing?!

So, back to the oven roasted chicken. I looked up roasting instructions to make sure I cooked it to the right temp. And then I saw in the instructions… trussing the bird. Tying the legs together to keep them moist is apparently an integral part of making oven-roasted chicken.

 

 

 

 

 

So… we don’t have kitchen twine at my house (does anyone, really?). And this did not seem like the time to substitute duct tape or yarn (my usual go-tos). Paper clips maybe?

But wait… I look at the chicken again, and there’s extra skin around the butt. Two quick slashes with my paring knife, and voila! The chicken is trussed with it’s own skin.

The chicken was moist and delicious. And the legs? Not dried out a bit!. That, my friends, is how you make oven roasted chicken Plastic Surgery style!

 

Dr. Greer practices in Cleveland, where she helps moms regain  confidence  by getting rid of wrinkles, sagginess, and stubborn fat using surgery, laser, Botox and fillers. Learn more about her at her practice website.

 

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

Permanent Hair Removal – Your Guide to Laser Hair Removal and Electrolysis

woman getting laser hair removal over the underarm, over a photo of a woman's legs

Is permanent hair removal really possible?

Emphatically yes! There are two types of permanent hair removal we do at my practice: laser hair removal, and electrolysis. I will discuss them both today, including how they work, what areas can be treated, what the treatment feels like, and the cost.

Laser hair removalWoman having underarm treated with laser hair removal

Laser hair removal (LHR) is the most popular type of permanent hair removal. It can be done on most areas of the body, including the legs, arms, underarm, back, upper lip, and cheeks.

  • LHR works by damaging the hair follicle. So the hair isn’t actually gone, but it’s so fine and thin you can’t really see it, like the hairs on your cheek.
  • Hair growth can change with hormones, so you may see increased hair growth with puberty, pregnancy, or menopause. If that occurs, additional treatments may be needed

myths of laser hair removal

What does laser hair removal cost?

Laser hair removal is usually sold in a package of treatments. Hair rotates through a growth cycle, and only the actively growing hairs are affected by the laser. Depending on the body area, 6-12 treatments are needed to get a good result. Expect to pay $1500-2000 for a complete treatment package on the legs, or $750-1000 to treat the underarms.

Does laser hair removal hurt?

Yes, LHR is a little uncomfortable. It feels like a flash of heat or maybe a sting. But we apply numbing cream to sensitive areas, such as the upper lip, to help with discomfort. We also have a fan that blows super-cooled air during the treatment; this helps quite a bit as well.

Does laser hair removal work on any hair type?

  • The laser targets the pigment in the hair follicle, so LHR works best on darker hair. It can be effective on lighter hair, but more treatments may be needed.
  • LHR can be safely done on all skin types as well.

Electrolysis

There are two instances when laser hair removal is not a good option:

  1. Gray hair. Gray hair has no pigment, so there isn’t anything for the laser to target.
  2. Eyebrows. Eyebrows take so many laser treatments, and the area is so small, that electrolysis is a more effective option.

What is electrolysis?

Electrolysis uses an electrical current to destroy the hair follicle. A very tiny needle is inserted into the base of the hair follicle to apply the current, then the hair is removed with tweezers.  Electrolysis only removes one hair at a time, so it’s usually scheduled for specific length of time, such as a 30 minute visit. Treatments are repeated until the entire area has been treated.

 

Would you like to find out more about permanent hair removal? Download my freebie below!

myths of laser hair removal

 

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

Will liposuction give me a flat stomach?

will liposuction give me a flat stomach - diagram of abdominal muscles and woman's stomach showing rectus diastasis

When diet and exercise don’t work, surgery may be an option to obtain a flat stomach. In previous posts I’ve talked about abdominoplasty and combining abdominoplasty with liposuction. But how do you know which is right for you? It depends on what is causing the problem. And there are several possible culprits:

Stretched abdominal muscles.

The rectus abdominus muscles are your six pack muscles which extend down the front of the stomach, as you can see in the diagram below (left). The two strips of muscle spread apart during pregnancy or with significant weight gain, and they don’t always rebound back into place when the pregnancy ends or the weight is lost. This widening is called a rectus diastasis (diastasis means separation). If you look at the photo below (right) you can see the space between the muscles. Surgery is the only way to fix a rectus diastasis; the separated muscles are brought back together in the midline using suture, recreating a flat stomach. This is one of the main components of an abdominoplasty surgery.flat stomach - diagram of abdominal muscles in a womanflat stomach - photo of woman's abdomen showing diastasis between her abdominal muscles.

 

 

 

 

 

 

Excess skin

Extra skin can also prevent you from having a flat stomach. Excess skin is another common side effect of weight loss or pregnancy. And like a rectus diastasis, the only way to remove excess skin is surgery. Skin removal is the other main component of an abdominoplasty.

Excess fat

This is where liposuction comes in. Liposuction removes fat over a focused area, which can be perfect if you want a flat stomach. But most people don’t realize that there are two types of abdominal fat. Subcutaneous fat is the fat right under the skin, and this fat can be removed using liposuction. While you’re reading this, go ahead and pinch the skin of your stomach between your finger and thumb. The thickness of this pinched skin is determined by how much subcutanous fat you have. If it’s a big, wide fold of skin, then there is lots of fat under the skin, so liposuction will go a long way toward giving you a flat stomach. Compare a pinch of skin over your abdomen or hips with a pinch of skin over your forearms or neck and you’ll see what I mean.

The second type of fat is called visceral fat. This is the fat which surrounds your internal organs. It is inside the abdominal cavity, below your abdominal muscles, and liposuction cannot remove this fat. If you have a lot of visceral fat, the only way to get a flat stomach is to lose weight. Read more on weight loss in other blog posts.

Surgery can in many cases give you a flatter stomach. But what type of surgery you need depends on what is causing the problem. Seeing a plastic surgeon for an consultation is the best way to find out. You can find a board-certified plastic surgeon in your area by checking the American Society of Plastic Surgery website.

Want to learn more about liposuction? Check out my website to learn about how liposuction is done, what areas of the body can be treated, and what the recovery is like.

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

Botox Gone Wrong – Why Does Bad Botox Happen?

botox gone wrong

When I see new patients who want Botox for the first time, they often bring up examples of Botox gone wrong. So what exactly is Botox gone wrong? And why does bad Botox happen? FYI, I use two types of neurotoxin in my practice – Botox and Xeomin. But for the sake of simplicity I will refer to all neurotoxins as Botox.

botox gone wrongHow does Botox work?

Botox is a neurotoxin produced by the Clostridium botulinum bacteria. The toxin acts at the junction between nerves and muscles, and blocks the nerve from transmitting signals to the muscle.  So injecting small amounts directly into a muscle results in paralysis of that muscle.

Botox only works on dynamic rhytids, meaning those that appear with facial expression. If you have visible wrinkles when you aren’t frowning or raising your eyebrows, you may need fillers or laser resurfacing to get an optimal result.

botox or fillers

Botox is most useful on the upper third of the face. I use it over the forehead, on the frown lines between the eyebrows (affectionately called the “elevens” by Allergen, the company that manufactures Botox), and on the crow’s feet around the eyes.

I will occasionally, and cautiously, inject Botox around the mouth. But because it paralyzes muscles, using too much Botox or putting it in the wrong place can cause difficulty speaking and eating. If you’ve ever seen Christmas with the Kranks, the scene where Tim Allen is drooling after getting botox is a great, although exaggerated, example of what could happen if you were to get Botox injected around the mouth. Granted, it would actually take 5-7 days for the Botox to kick in, but then the movie wouldn’t be as funny.

So why does Botox make people look fake?

There are three common examples I see of Botox gone wrong:

  • If your face is totally frozen. I think we’ve all seen that expressionless person who wouldn’t blink an eye if she had a gun pointed at her face. You know. Because she can’t. I’m a big proponent of a natural result, and I think your face should move at least a little bit after Botox injections. Granted, I have patients who like a more dramatic result. And I’m happy to tailor my treatment to their preferences. But my go-to treatment result is very natural.
  • The Spock eyebrow. When botox is injected only over the central forehead, the lateral brow can arch too much and make you bear an unfortunately resemblance to everyone’s favorite Vulcan. Fortunately this is totally correctable; injecting a little Botox over the lateral forehead will take care of the problem.
  • The eyelid droop. Drooping of the upper eyelid can happen when Botox diffuses into the muscles that raise the upper eyelid. This is thankfully very rare; I’ve actually never seen it happen.  The eyelid droop does go away in a couple of months when the Botox wears off, and eyedrops can improve it in the meantime.

Now that you know what causes Botox gone wrong, how do you avoid it? If you want a good result, go to a good doctor. Plastic Surgeons and Dermatologists have special training in cosmetics and facial anatomy that make them the experts at injecting Botox and facial fillers.

Would you like to learn the differences between Botox and fillers? Click on the link to download my freebie!

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

4 Reasons Diets Don’t Work

diets don't work

**Let’s be honest with ourselves: diets don’t work. Traditional diets state if you take in fewer calories than your body burns, you’ll lose weight:

Calories In – Calories Out = Body Fat

diets don't workSo if you take in more calories than you burn, the rest is stored as body fat. Seems simple,
right? But if it is that simple, why is it so freaking hard to lose weight? Here is why: because this is WRONG. And today I’m going to explain four reasons the calorie-based method of weight loss does not work.

Reason 1 that diets don’t work: Calories in and calories out are NOT independent of one another.

The traditional teaching (aka “move more, eat less”) is pretty simple: if your body needs 2000 calories a day to live, then cutting your calorie intake to 1500 calories per day creates a 500 calorie deficit. There are 3500 calories in a pound of fat, so a 500 calorie/day deficit means you should lose a pound in a week, right?

Nope. Not even close. When you cut calories, your body actually burns fewer calories to conserve energy. In evolutionary terms this makes sense: if our bodies kept burning calories at the same pace during a food shortage, we would have died off pretty quickly as a species.  Think of it another way: if you suddenly get a pay cut at work, you aren’t going to keep spending money at the same rate. You’ll cut your monthly budget down before dipping into your savings. In the same way, your body will burn fewer calories when access to food is low, rather than burning through fat stores.Download my freebie

Reason 2 that diets don’t work: All calories are not equal.

I think intuitively we know that our body does not treat 200 calories worth of broccoli and 200 calories worth of ice cream the same way. Nobody ever got fat eating a ton of broccoli, right? Yet the concept that we must cut calories to lose weight treats all calories equally. This is another reason diets don’t work; they focus on the quantity (i.e. calorie count) of food rather than the quality of food. Over the past two decades we’ve seen obesity rates surge despite increasing availability of low-calorie foods.

Reason 3 that diets don’t work: You have less control over “calories out” than you think.

Traditional diets focus on exercise as a way to burn calories and increase the calorie deficit, in an attempt to nudge our bodies toward accessing stored fat. On The Biggest Loser contestants spend hours a day exercising in an attempt to burn calories and lose weight. But guess what? It doesn’t work.

First, you just cannot burn that many calories with exercise. Run a marathon and your body burns a whopping 2600 calories. But you can consume 1300 calories eating your average dinner at Olive Garden. And I’m guessing most of us eat dinner at Olive Garden far more often than we run a marathon.

Second, your body responds to exercise in a way that actually prevents weight loss. Exercise triggers increased hunger, which most of us have probably noticed at some point. (full disclosure: I thought the increased hunger after a run meant my body needed that deep-fried French toast!) But what you may not have noticed is that your body also compensates for exercise by being less active throughout the day. So the average number of calories burned stays the same. This has been shown in studies that followed kids with increased gym class time; the kids were more sedentary the rest of the day, so their average activity remained the same. That old adage to eat less, move more? It just doesn’t work.diets don't work

Reason 4 that diets don’t work: We have less control over hunger than we think.

Hunger is hormonally regulated. Our bodies send signals to tell us when we’re hungry, and to tell us when we are full. Over thousands of years the human body has evolved mechanisms for homeostasis, i.e. maintaining a stable equilibrium. This includes body weight. And our bodies are very, very good at this. Which means part of the reason diets don’t work, is that you’re literally fighting your body when you cut calories. You may have noticed that trying to cut calories results in ravenous hunger. Your body is telling you it needs more food. And as I’m sure you’ve noticed, extreme hunger is pretty hard to ignore.

After reading this post, you’re probably thinking two things:

  1. No kidding I’ve never been able to lose weight! Cutting calories and exercising has doomed me to fail! (i.e. diets don’t work).
  2. Wait- does that mean losing weight is impossible?

I assure you, losing weight is possible. I have lost over 45lbs in the past year and a half, diets don't workso I know it can be done. Want to learn a little more?

diets don't work

 

 

 

You can also read more diet myths on a previous post.

** This information is for general knowledge only, and is not intended as medical advice.

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

Be More Productive in 3 Easy Steps!

be more productive be more productive be more productive

We all want to be more productive, right? But I often feel like there just aren’t enough hours in tips to be more productivethe day to get everything done. And if you have kids, you know what I mean! I recently listened to a fabulous podcast of an interview with Michael Hyatt, a guru in leadership and getting things done. Amy Porterfield did the interview as part of her regular business podcast. If you’re not familiar with her, she is a fabulous source of expertise in running an online business. Today I want to share some of the great tips they offered to my readers today so we can all be more productive.

Tips to be more productive:

List all your tasks

This means every last thing you have on your plate, from folding laundry to creating a presentation for work. Now you’re going to divide this list into two categories: things that have to be done, and things that don’t. Be ruthless in deciding what doesn’t actually need to be done. For example, about two years ago I stopped sending Christmas cards. (Full disclosure: I actually stopped sending them about five years ago, but two years ago I decided to stop feeling guilty about it!) I just don’t see them as a necessary part of my life, and my friends and family all still speak to me.

Decide what must be done by you, and what you can delegate.

You can delegate way more than you think! There are so many things we continue to do because teaching someone else how to do it seems harder. But in the interview Michael Hyatt talks about hiring a virtual assistant to outsource. He initially started at five hours a week. Within a month he was up to 20 hours a week, because he’d found so many things he could take off his plate and delegate.

Decide what is most important, and schedule time for this in your calendar.

Notice I didn’t say what’s most urgent, but what’s most important. Work will expand to fill the gap. So it’s important we set aside time for the things that mean the most to us. This might be hanging out with our kids, taking the dog for a walk, or going to a yoga class. Taking breaks like this allows you to recharge, and actually helps you be more productive in the end.

If you’d like to listen to the full interview (which I would highly recommend!) you can catch it on the Amy Porterfield website. But even making these three small changes can help you be more productive!

Want to learn more about my crazy life as a mom, wife, and Plastic Surgeon? Check out my home page!

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.