5 Things to Consider Before Having Cosmetic Surgery

cosmetic procedure risks are reduced by doctor's knowledge
Can your cosmetic concern be addressed by a lifestyle change?

During consultation, I often begin by asking about lifestyle with a focus on healthy habits. Some people find themselves focusing on aspects of their appearance without factoring in lifestyle related actions which can also help them look better. There are often certain cosmetic issues which can be improved with diet, weight management, exercise and skin care.

ideal body weight for cosmetic procedures
Cosmetic medical procedures are best done when within 10 pounds of ideal body weight.

For example, someone who complains of excess fat under the chin or love handles may see a significant difference after a change of diet which results in weight loss. This is particularly relevant for people who are more than 10 pounds over their optimal body weight. In terms of procedures such as liposuction, ideal candidates are those who are within 10 pounds of their ideal weight.

What do you really want?
 have clear and focused aesthetic goals
Have clear and focused aesthetic goals before consulting a cosmetic surgeon.

Make sure that your goals for cosmetic surgery are clear and realistic. In my opinion, the purpose of cosmetic surgery is not to change your looks, but to enhance your appearance in a natural way. If you’re concerned about the appearance of your face and looking in detail on a particular area of concern will more likely result in being able to express specifically what you’d like to address. This is more helpful to the doctor something like “I don’t like my nose.” Of course, I am asked daily by patients “Doctor, look at my face and tell me what you think I need.” I’m always ready to offer my perception as an to what features are more significant in terms of the overall facial appearance.

Be clear and detailed with your doctor
Be clear and detailed with your doctor about you want to improve. If your doctor suggests something, make sure you understand it clearly before deciding on it.

Nonetheless, being able to articulate as clearly as you can what bothers you helps the surgeon gain a better sense of what you want to achieve and what issues are most important to you.

Are you ready to make lifestyle changes?

After cosmetic surgery, a healthy lifestyle will continue to support and maintain the benefits of your surgery. This can include adopting a good skin care routine, protecting your skin against the sun, watching what you eat, and eliminating unhealthy habits such as smoking and excessive alcohol use. Cosmetic surgery is an enhancement of the external appearance which can be optimally sustained by taking care of your health.

lifestyle changes after cosmetic procedures
Lifestyle changes such as reduced to minimal sun exposure are needed right after certain procedures, and to maintain results of most procedures
What are the risks?

Like any surgery, cosmetic surgery comes with some risks. It is important that you sit down with your surgeon and discuss all the possible outcomes of your procedure so you can fully understand the risks and benefits of your planned procedure. An experienced and safety focused surgeon can minimize risk. Each surgeon is an individual with experience in specific procedures based on training and practice.

cosmetic procedure risks are reduced by doctor's knowledge
There are risks to any cosmetic procedure, but they are reduced by the experience, expertise, specialization of the doctor

For example, as an oculoplastic Surgeon, my training was focused intensively on cosmetic eyelid surgery which is in contrast to a general plastic surgeon whose residency is typically hospital based reconstructive surgery. Understanding what specific areas your prospective surgeon is most proficient in is in my opinion a good way to lower the risks of the surgery you’re going to have. There is (in my experience) no surgeon who is great at “everything” .

Are you doing it for yourself or for someone else?
happy after cosmetic procedures
When choosing to do a cosmetic procedure, it’s important that the person you want to please most is yourself

Cosmetic surgery is a very personal decision, and while there is no harm in asking for the opinions of close friends or family members, the final decision is ultimately only yours to make. Some people will undergo surgery because they feel pressured by certain people in their lives to look a certain way, or they’re trying to make someone else happy by changing an aspect of their appearance. As long as you’re excited about improving your appearance for yourself, your happiness is the only thing that matters.

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    Causes of Dark Under Eye Circles And How to Treat Them

    dark circles under eyes causes

    [su_youtube url=”https://www.youtube.com/watch?v=QBvjjvxPt2g” width=”800″]

    Under dark circles are a fairly common problem that can affect people of all ages. There are several causes of under eye dark circles which makes it important to have the right strategy for your situation.

    Dark circles around the eyes can make people look tired and weary, even if they actually feel great, and have a lot of energy. Having dark circles can give the wrong impression about you and how you feel. In a world where first and lasting impressions are so important, it’s understandable why people are seeking all kinds of solutions for this common issue.
    man with dark circles under eyes

    Under eye dark circles can be caused by several issues:

    • Thin eyelid skin revealing the anatomy underneath the eyes such as the orbicularis muscle and blood vessels
    • Lack of fat and bone structure under the eyes resulting in a hollow look,
    • Ethnic pigmentation
    • Hyperpigmentation from previous procedures, such as laser treatment
    • Iron deposits from the blood circulation such as allergic shiners

    dark circles under eyes causes

    Popular strategies used by many people is the application of over-the-counter creams which make claims which they never live up to. While creams can moisturize the skin, they are limited in addressing any other anatomic issues which if addressed can result in more significant benefit. Upper and lower eyelid skin is the thinnest in the body at 0.5mm thickness when healthy. When eyelid skin becomes thinner from aging, sun exposure or smoking, the challenge is to improve the quality of the skin without compromising the thickness.

    man with obvious dark circles under eyes

    With this principle in mind, I have focused more than 10 years on the application of regenerative medicine technology, specifically platelet rich plasma or PRP. I use platelet-rich plasma, or PRP, routinely to treat several causes of under eye dark circles. Platelet-rich plasma is the concentration of wound healing and growth factors naturally present in your blood for when you have a cut.

    When concentrated, it can be used as an serum to improve skin quality, thickness, and overall skin health, while improving the blood circulation and blood supply in the area of treatment.

    dark circles under eyes treatment with PRP

    PRP is prepared from your blood, which is drawn in our office like you would have during a routine blood test. The blood is spun in a centrifuge to concentrate the platelets into a clear, yellow plasma, which can then be drawn into a syringe. The PRP is carefully placed under the eyelid skin. The regenerative process of this treatment is continuous, as increased blood supply and healing factors work after the injection to improve skin quality and thickness, stimulate collagen, and increased circulation.

    dark under eyes circles treatment with PRP and Filler

    In cases where the under eye area has concurrent hollowing, I can combine the placement of PRP with the deeper placement of a hyaluronic acid filler like Restylane to add volume. This combination treatment has a synergistic effect as both hollowing and skin quality are treated. For optimal, results, PRP is performed with regularly scheduled sessions. The frequency of these sessions depends on the conditions being addressed such as sun damage, wrinkles, and discolorations. PRP application helps change.

    dark circles undereyes treatment with CO2 Laser

    Lasers can also help with improving skin quality under the eyes, through resurfacing of the epidermis and collagen stimulation in the dermis. Lasers must be used carefully to avoid potential over treatment which can result in thinning of the under eye skin further, and possibly causing problems with pigmentation. When lasers used appropriately, they can be quite effective.

    I routinely combine PRP with laser treatments to reduce to create maximal synergy to achieve best results.
    PRP and Laser combined to treat dark under eye circlesDepending on the techniques employed, there is generally very little healing time with PRP treatment. Laser treatment for eyelid skin such as smooth eye long pulse erbium laser can be performed with no downtime. Fractional lasers such as fractional erbium or fractional CO2 laser may require a few days before the skin heals over.

    This means that most patients can go back to work right after PRP treatment and some laser treatments with basic precautions related to sun exposure and skin protection.
    A common question which comes up about every skin treatment is “how long will it last”. The answer is, it depends.
    Laser and PRP combined for optimal resultsThe collagen response of your skin is affected by age, extent of sun damage, wrinkling and pigmentation as well as your lifestyle such as smoking and amount of time spent in the sun. I evaluate every patient and develop a customized treatment plan for them based on these and other important variables.

    Dark circles can be treated without surgery, and results can really last. It’s important to note that ethnic pigmentation cannot be taken away, but you can improve skin quality so your eyes look more vibrant. As is important for any aesthetic procedure, knowledge and experience is important. In my experience, combining regenerative medicine technology such as PRP with advanced laser and radiofrequency technology has been successful for my patients.

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      Deciding Factors For Choosing Your Cosmetic Surgeon


      Amiya Prasad, MD, chief Oculofacial Plastic and Reconstructive Surgeon of New York’s Prasad Cosmetic Surgery & Medi-Spa addresses the criteria for prospective patients choosing a cosmetic surgeon. For those opting for cosmetic surgery of the face, eyes, or body, Dr. Prasad stresses the importance of doing research before choosing a doctor for surgical procedures is necessary to achieve optimal results.  An innovator and author, Dr. Prasad shares his twenty years of knowledge in the field of plastic and reconstructive surgery and lends this to determining the factors for choosing a specialized cosmetic surgeon.

      Expertise in Plastic Surgery is a controversial issue.  Many surgeons simply claim to be the “best” or advise that if you “Ask for a board certified surgeon” you have completed your research. However, if you want to determine a physician’s level of expertise, follow this straightforward assessment. The first level of expertise is based on the formal training pursued by a surgeon. For example, a neurosurgeon has expertise in brain surgery based on formal training. A neurosurgeon can be easily regarded as having a higher level of expertise in brain surgery when compared to a General Surgeon who had less exposure to neurosurgery during training and did not pursue this type of surgery after he or she finished training.

      Eye plastic surgery training is specialized compared to general plastic surgery. This extra focused training as a specialist has served as the foundation for my expertise in Cosmetic Eyelid Surgery. As an Eye Plastic Surgeon, I have spent much more time than a general plastic surgeon on advanced eye plastic surgery and have spent many years instructing other eye surgeons on the topic.  A second level of expertise is based upon types of experience. This can be quantified by the type of training pursued after residency, the number of years spent during and after formal training on specific types of procedures and whether or not the person has engaged in teaching others his craft.

      In addition, an experienced cosmetic surgeon has numerous before and after photos and can produce a list of patients who have undergone the same procedure you are inquiring about  who would be happy to speak to you about their procedure.

      Finally, the last level of expertise to inquire about is the professional development that the surgeon has pursued in his career. Has he written books on his topic? Does he attend professional meetings and make presentations there? The field of cosmetic surgery, as in all disciplines, requires the pursuit of continued professional education, constant refining of our skills and knowledge and an unlimited curiosity to learn about the newest and most modern technologies available.


      Formal training is an excellent foundation for expertise. Experience, however, can bring expertise to a higher level. For example, a highly experienced pilot landed an airplane in an emergency situation onto the Hudson River. Would a recently trained pilot have been able to do the same?

      Experience as a Cosmetic Eyelid Surgery specialist helps the clients who are considering eyelid surgery feel more secure about having a surgeon who has the “miles” to be more than familiar with their procedure. Author Malcolm Gladwell who wrote “The Tipping Point” and “Outliers” states that to master any skill requires “10,000 hours” of practice in order to be successful.  The same rule applies whether it is becoming a virtuoso performer, an Iron Chef, a master sculptor or a skilled surgeon.  Performing eyelid surgery daily for 17 years has enabled me to reach and surpass the “10,000 hour rule”.  Another mark of expertise is how well esteemed an artist is among his peers. It is important to ask whether a surgeon is called upon by others in his field to perform “revision surgery” or to fix undesired results. A surgeon who has been practicing for many years and is well respected by his peers will be able to describe to a patient the types of revision surgery he has performed over his career.


      Any true artist will say that artistry is intrinsic, not learned.  The medical field uses a training structure which tends to attract more “square” personalities, that is people who are intelligent, detail-oriented and organized, but not typically creative and artistic. This essentially means that many plastic surgeons are not artists but rather surgeons who follow a visual formula for each problem. In some ways this explains the often seen “plastic” appearance found in many people who have undergone cosmetic surgery. As an artist, I recognized during my training that there was a certain disconnect between patients’ desires to look fresh and youthful and the results of the plastic surgeons’ procedures. I have learned to appreciate the “true character” of a person’s face and understand the balance of features so that I can create a more natural appearance instead of a “manufactured face”. I have found that the judgment of beauty and balance is intrinsic and an awareness  of the planes of the face and the dimensions of balance is difficult to communicate but easy to perceive.


      Commitment in plastic surgery means that you will do your utmost to ensure that your patient achieves desired results. In order to accomplish that, you have to practice your craft ethically.  By that I mean that you have to listen to your patients and understand their aesthetic goals and their deep seated fears. You have to discuss honestly and openly how you will address all related issues. If a patient has unrealistic expectations, you need to tell them. If they are asking for a procedure that is outside of your expertise, you need to refer them to the right specialist. You should always encourage a second opinion.  And most importantly, never push a patient into a procedure if they don’t want it or don’t need it. It is imperative to be available for questions or concerns before and after surgery. The best cosmetic surgery practice provides all levels of care to its patients to make sure that they always look their best. We have an on-site spa which provides non-invasive skin care and we have our own line of skin care products to protect your skin and keep it healthy.

      It’s hard to teach ethics to someone. Ethics is just something you have. Unfortunately, there is no measure for ethics when you screen physicians. Medical training for ethics is quite variable and ultimately depends on the trainee and his own experience.  As surgeons, we all have to determine which ideals will serve our mission. Caring for my patients the way I would care for my own family has been the core value which guides how I practice. It’s based on this core value that I developed techniques which make my patients comfortable, look natural and recover quickly. When choosing a surgeon, you should get a “caring, compassionate, and professional” feeling from the surgeon as well as the staff and the office environment. In order to achieve this goal, I work with the most qualified and attentive staff and I have invested in my state-of- the-art facilities to provide a cutting edge care in a comfortable environment.

      I am committed to providing my patients with the best care possible.

      Vampire Facelift (TM)

      Vampire Facelift (TM) doctors
      Drs. Charles Runels and Amiya Prasad

      I had the unique opportunity this past weekend to visit Dr. Charles Runels in beautiful Fairhope, Alabama. Dr. Runels is the creator of the famous “Vampire Facelift (TM)”. The day with Dr. Runels and his assistant Laura left me with a great impression. Many of my colleagues perceive Dr. Runels from his videos and website as being a “fringe” physician. Nothing could be further from the truth. Although his personal style (which is seen on his YouTube videos) and passionate desire to protect the quality of his creation “The Vampire Facelift (TM) can be interpreted as “strange”, my feeling is that he is an exceptionally creative and caring physician whose mission is help people live life to their fullest potential.

      He was very gracious and specific in instructing me on how to perform the Vampire Facelift (TM) which is a method to enhance areas of the face which are sunken using hyaluronic acid (such as Juvederm and Restylane) and your own blood’s growth factors (drawn like you would for a routine blood test) which are processed into something called “PRP or Platelet Rich Plasma”. This combination as designed by Dr. Runels is very safe and creates instant results with typically no downtime. The clients of Dr. Runels I met at his office were huge fans of the procedure and could not say enough about how happy they were. In unapologetic Southern style, one client said “I’d follow Dr. Runels anywhere for my Vampire Facelift!” (the accent and voice made the phrase unforgettable). The idea of using your own blood to create a youthful appearance is a concept which has great appeal to many of our clients who have heard about the “Vampire Facelift (TM) on the TV show “The Doctors”.

      My wife and I enjoyed a very educational day with Dr. Runels and Laura with only a little time to enjoy the beauty of Fairhope. We did have a wonderful dinner at Camellia Cafe with them and I have to say the service and food was on par with top Manhattan restaurants we’ve been to.

      Just in time for Halloween, the “Vampire Facelift (TM)” is now a procedure we are offering at our offices in Manhattan and Garden City, Long Island.

      Once again, I want to acknowledge Dr. Runels for his creativity and passion and thank him for his instruction and hospitality.

      Look Beautiful Without Makeup!

      Looking beautiful without makeup?  What a concept!  Beauty has evolved, and looking natural and beautiful is not just a celebrity trend… it’s an ideal! Going bare-faced might make you a little uneasy, especially if applying makeup is much a part of your daily routine as, let’s say, brushing your teeth. Covering up those problem areas, such as dark circles, wrinkles, hollowing, scars and discolorations can be a thing of the past. And, let’s face it: makeup cannot camouflage everything!

      If you have specific conditions that affect your appearance, there are appropriate treatments that can correct and restore your natural beauty. In my practice, our goal is to reduce the dependency on makeup by addressing the most common reasons women apply makeup:

      1) Improve Skin Tone – Sun damage, brown spots and “broken blood vessels” are treated with IPL (Intense Pulsed Light) which is a no downtime 15 min- 30 min painless procedure.

      2) Diminish Fine Wrinkles – Non invasive skin tightening with Pelleve, a painless 45 minute in office procedure.

      3) Soften Deep Lines – Fillers such as Restylane, Radiesse and Dysport can take as little as 15 minutes and last up to 1 year

      4) Prevent Aging Effects – Healthy diet, exercise and protecting your skin from environmental toxins such as excess sun and smoking

      In my upcoming book, The Fine Art of Looking Younger (due May 2010), you will find plenty more information on advanced medical techniques and technology with a holistic approach to reaching your aesthetic goals.

      It’s time to put the makeup down, and start looking your best!


      To set up your consultation with Dr. Prasad, please call (212) 265-8877. Dr. Prasad is located in Upper East Side Manhattan, New York City, NY.

      Welcome to Dr. Amiya Prasad’s Blog!

      Welcome to the blog of Dr. Amiya Prasad, New York City cosmetic surgeon. Dr. Prasad likes to keep his patients informed and educated about cosmetic surgery and rejuvenation procedures. Subscribing to his blog is a great way to stay in the loop and to get the latest news on Amiya Prasad, M.D.

      Our office is a boutique practice especially designed for the discerning client who desires rejuvenation treatment with a natural appearance. We hope that this website will answer some questions for you about Dr Prasad’s practice. Please inquire with our patient coordinator in case you have more specific questions.