A Look at Kybella

If you are like most Scottsdale residents, you are constantly looking for the newest and most effective ways to improve your health and cosmetic appearance. If you have struggled with a “double chin”—or what plastic surgeons call submental fullness—you may be a good candidate for a new, non-invasive treatment called Kybella.

Kybella is the first and only FDA- treatment for submental fullness. Kybella works to contour a patient’s chin through almost painless injections. Each patient is different, but most men and women see noticeable improvements within two to four treatment sessions spaced at about 2 months apart. In fact, 79% of approved nonsurgical patients report being satisfied with their face and chin appearance after Kybella. If you are concerned about extra fat underneath your chin, ask Dr. Bash if Kybella is right for you.

Do you want to learn more about your options for cosmetic surgery in Scottsdale? Find out more about Kybella and other procedures by calling Dr. Bash at for Plastic Surgery at (602)-792-5789 today.

Choosing a female plastic surgeon or a male plastic surgeon

I have always found it interesting why some women prefer a female plastic surgeon over a male plastic surgeon (or visa versa), and the reasons why.  When it comes to the gynecologist, I get it—there are just some things a woman may not feel comfortable sharing with a male doctor.  But what about a plastic surgeon?  Does it make a difference if it is a tummy tuck, breast augmentation or a facelift?

Let’s start with breasts. 

Do women have a preference?  I can honestly say in my experience that some of the women who come to me say they afraid that they will be too large and look “too fake” if they go to a male plastic surgeon. They tell me that they think a woman understand their desires better.  Of course, that isn’t necessarily the case. There are many male plastic surgeons who won’t make excessively large breasts and are good listeners.  There isn’t any published data from the manufacturers about the average size breast implants ordered from male plastic surgeons compared to a female plastic surgeon, but it might be a fascinating statistic.   I had a patient in my office a few weeks ago for a consult who told me that her friend tried to convince her to go to one of my male colleagues “because he makes really big boobs”.  As a trained plastic surgeon, I am here to listen to my patients and their desires, hopefully meet their expectations, advise them about what implants will fit their body, and what the long term effects will be with a particular size.  It shouldn’t matter if the surgeon is a male or female.

What about tummy tucks or facelifts?

I haven’t heard anything different from any of my patients about a preference when it comes to these procedures. Some patients might think a woman surgeon will understand better, but again, as a physician, we are all trained to listen and use our training to give the best advice to our patients and make a surgical plan.  With that being said, there is excellent published data to show that female doctors spend significantly more time with their patients, and perhaps that makes a difference.  Everyone has a personal bias about what constitutes “beauty”, and it would be naïve to say that biases don’t influence our surgical plan. 

So does it make a difference seeing a female plastic surgeon?

The answer is “that depends”.  Yes, I have my personal biases, and I tell my patients what my biases are so that they can make an informed decision.  Some of my perceptions of what makes a person beautiful are just simply my own preferences, and some of my preferences may be because I am a woman.  

Why Butt Augmentations (Brazilian Butt lifts) may not be the best way to go..

I came across an article the other day about the popularity of butt lifts.  Is this just a fad?  When will the fad go away (if ever)?  As a woman in her 50’s, I know that most women my age have always been concerned about having a butt that is too big. Why the “big butt” trends now?

A few months ago I asked my nieces about the “J. Lo butt”—they quickly corrected me and said “that is old school”.  I guess it is the Kim-K butt now.  Super-sized!

Remember your mother saying “if all of your friends jump off a bridge, would you too?” It’s idiotic. Unless you are bungee jumping, it probably isn’t a good idea. The concept of doing something everyone else is doing is actually unappealing and disingenuous to me.

Fat transfer to the buttocks actually works very well and can product great results. Statistics show that there has been a huge leap in the number buttocks augmentation (aka Brazilian butt lifts) in the past several years. What many call the Kim K-effect has women seeking a thicker, perkier butt. But with every trend comes danger– this is the jumping off a bridge part.


I think it is important to perform fat injections to the buttocks with a conservative eye and an awareness that what looks good now many not look good five or ten years from now--when the trend for fuller buttocks might not be "in"

So there you have it. The key to doing something everyone else is doing, is doing it in careful moderation. As I read in the article “That way, when you jump off that theoretical bridge, you land on a cushy tush.”

What is a Breast Capsular Contracture?

After breast augmentation surgery, the body forms a protective scar lining around the  breast implants called a “capsule.” The body makes the same scar tissue capsule around any foreign object placed in the body-- a heart pacemaker, an artificial hip joint, or a breast implant. Contracture occurs when the scar tissue capsule shrinks and starts squeezing the implant. Since the implant is soft, any pressure will make it feel more firm.

The typical symptoms of capsular contracture are firmness and sometimes discomfort of the breasts. The capsule may involve one or both breasts. Sometimes one breast will look higher than the other side.

If you are experiencing these symptoms, consult with Dr. Bash to evaluate to determine the best course of treatment. Depending on the severity, Dr. Bash may recommend massage of the breast. However, if the breast has been firm for many months, most likely the only remedy is surgical intervention.


For more information on breast augmentation go to the procedure page.

Learn more about Dr. Bash at www.BashMD.com

Breaking Down Your Fears and Myths of General Anesthesia

All too often I hear my patients say “but I’m afraid of general anesthesia”

“But why?” I ask.

“I’m afraid that I won’t wake up”.

If a person believes everything they see on TV shows and moves, I suppose this fear would be justified. But the reality is that general anesthesia is very safe, and even safer than sedation alone.  When a patient has general anesthesia, they are completely asleep and do not feel any pain. The anesthesiologist is right there, breathing for them, giving them oxygen, watching their heart and making sure they are very, very comfortable.  That way, I can do my job by focusing on just the surgery!

When you have “twilight anesthesia” (which can mean many things), the anesthesiologist is not there. The surgeon asks the nurse in the room to give some medication through the IV to the patient to keep them relaxed but hopefully awake enough to breathe on their own. The surgeon has to monitor the patient and give orders to the nurse while performing the surgery. The patient is not completely asleep and should be able to talk to stimulation. Depending on the procedure that is being done, it may take a significant amount of IV pain medication and sedatives to keep the patient calm and comfortable—in most cases, MORE than what would be needed if the patient were completely asleep.

When surgery is performed with a patient under general anesthesia, there are 2 doctors in the room—the surgeon and the anesthesiologist.  Yes, it may cost a little more, but isn’t that worth it?

All of the surgery I (Dr. Bash) do is with a board certified anesthesiologist. When you are asleep, I am your voice. I don’t want anything bad to happen to you. I am right there beside you from the time you go to sleep until you wake up and we go to the recovery room together.

Reality—the risk of not waking up from anesthesia is very, very, very, very small during cosmetic surgery. Be safe.  Request a board certified anesthesiologist.

If you have any other questions or concerns about general anesthesia call Dr. Bash at 602-792-5789.

New FDA Warning for Facial Fillers

This weekend the FDA posted a new warning for both the manufactures of facial fillers, and for practitioners who inject the products. New labeling will include the following notice:

Warning: One of the risks with using this product is unintentional injection into a blood vessel. The chances of this happening are very small, but if it does happen, the complication scan be serious, and may be permanent. These complications, which have been reported for facial injections, can include vision abnormalities, blinds, stroke, temporary scabs, or permanent scarring of the skin. If you have changes in your vision, signs of a stroke, (including sudden difficulty speaking, numbness or weakness in your face, arms, or legs, difficulty walking, face drooping, severe headaches, dizziness or confusion) white appearance of the skin, or unusual pain during or shortly after treatment, you should notify your health care practitioner immediately."

Dr. Bash does all of her own injections--she does not have her staff injecting, specifically for this reason. Yes, it may cost a little more that at a medispa (and many nurses who do the injections do a wonderful job). BUT--can they recognize and TREAT a complication??

Make sure you know who is doing your injections and what their qualifications are. Who is the medical director? Where are they? What is the medical director's specialty? Can the medical director treat a complication? Be a smart consumer!!

Who is really qualified to inject Botox® and fillers?

Have you ever wondered why prices vary so much on Botox®? Have you ever wondered why your less expensive Botox® didn’t last very long? Neurotoxins such at Botox can only be purchased from the manufacturer or a licensed distributer.  Very inexpensive product can be purchased over the internet from foreign countries (which is illegal) and may be counterfeit.

Prices are usually higher if the plastic surgeon is doing the injections. The board certified plastic surgeon has the most training and expertise to handle any problems that could occur.

In the state of Arizona, the following licensed professionals may inject Botox® or dermal fillers:

• MD
• DO
• Naturopathic physician (NMD)
• Nurse Practitioner (NP)—does not require supervision by a doctor

Per the Arizona Board of Nursing, a licensed RN in Arizona may inject if:

• The can show they have taken a course on injection and have adequate training
• They have immediate access by phone with the supervising MD or DO 
• AND that supervising physician is available in person within 4 hours when requested by the nurse or the patient. 

If you are having injections done in a med spa by someone who is not a physician, always ask who is doing the injections (RN, NP, etc.) and ask about their qualifications. Who is the medical director? What is the medical director’s specialty, and what is their board certification? Does the doctor also do the injections? Can the medical director handle any complications?

Be safe.  Be smart. Ask.