Our statement on the Black Lives Matter

To our valued Patients,

My name is Vanessa Bogaert, and I am the co-owner of Gorin Plastic Surgery & Medspa. The tragic murder of George Floyd has prompted conversations with my husband, Dr. Aaron Gorin (Medical Director) and members of our team, about how our company should respond.

We do not want to simply make statements to check the box and consider our work done.  The issue of racism and its pervasive presence in our society has always affected me deeply as it has been a personal experience of mine. Growing up one of the few Latina children in my school, I received countless slurs and attacks from racist classmates and even sometimes their parents. My parents often had to fight to make sure my siblings and I received the same educational resources as white students did.  I grew up very aware that being different came with the struggle for acceptance and fair treatment. As I began attending bigger, more diverse schools, I made many friends from a myriad of different backgrounds, and began to see as the world became larger, in some ways it became safer and more accepting. But I also understood that the struggle for equity in our system would take ongoing work. In my personal life, I have committed to fighting systemic racism by donating regularly to the ACLU and the SPLC. I have used my personal social media accounts to speak out about injustices, and yes, have even lost patients and friends who do not agree with my positions. But as I witnessed the violent death of not only George Floyd, but  Ahmaud Arbery and Breonna Taylor, it has become apparent to me that I must utilize our company to push this work further along to our collective goal of a more just and equal society.

The last few days we have seen great tragedy, sorrow and anger. We have had friends of ours have their businesses attacked in the looting incidents that have hit the city. We have seen our friends and family members in the police force express frustration of their profession yet again being undermined by corrupt agencies and bad actors that act with impunity. But most importantly we have seen the anguish of black mothers, daughters, fathers and sons who have lost their loved ones to violence, and that effect on the broader black community. While the structures of our community can be rebuilt, the lives of these loved ones lost can never be replaced.

So knowing this, where do we go as a member of our community?  It is not enough to make simple statements expressing our recommitment to conducting our business without preference or discrimination to any race, gender, sexual orientation, or religion. We must do what we can to push the conversation forward on challenging systemic racism and prejudices in our community. With that in mind, I wish to express our first thoughts on the actions we as a company can take to help our community move closer to the above goals. This is by no means a definitive list, and as we learn and grow more, we hope to expand our goals and targets:

1. We will work towards further diversifying our marketing campaigns and expanding our reach to communities of color.

2. For new hire positions, we will work to ensure we actively recruit with diversity as a goal.

3. We are making an initial donation of $5000 to the Urban League of Portland which has worked since 1945 to safeguard the civil rights and empower the black community to achieve equality in education, employment, health and economic security.

4. Require and provide our staff with continuing education opportunities on how to best serve our patients of color, especially in regard to medical treatments and services.

5. Empower our staff to speak out if they witness racial mistreatment of any kind in our office, either from staff or patients.

We encourage you, our valued patients, to reach out with any questions, concerns, or suggestions on how we can do better to reach our commitment to fighting racism. We are not by any means experts in this fight, and we will continue to learn, listen and follow those who have studied and researched solutions to the issue of racism. Lastly, if you feel moved to act, to speak out, to donate, we hope that you take those first steps towards getting involved. We are including at the bottom of our statement some resources you may find helpful.  I truly believe as Dr. Martin Luther King said “that the arc of the moral universe is long, but it bends towards justice.” but it cannot move that way without our collective efforts.

With great sadness, hope and love,

~ Vanessa Bogaert, Dr. Aaron Gorin and the team at Gorin Plastic Surgery & MedSpa

 

1. Donate to one or more of these:

ALCU: https://action.aclu.org/give/now

NAACP: https://secure.actblue.com/donate/naacp-1

Black Lives Matter: https://secure.actblue.com/donate/ms_blm_homepage_2019

Urban League of Portland: https://ulpdx.org/

 

2.  Read these:

The Case for Reparations by Ta-Nehisi Coates: https://www.theatlantic.com/magazine/archive/2014/06/the-case-for-reparations/361631/

The 1619 project (also an amazing podcast series): https://www.nytimes..com/interactive/2019/08/14/magazine/1619-america-slavery.html

the New Jim Crow (Book) by Michelle Alexander: https://www.amazon.com/New-Jim-Crow-Incarceration-Colorblindness/dp/1595586431

 

3. Pick a few of these to commit to doing together or alone, acting locally is a really good way to approach massive problems:

75 Things White People Can Do for Racial Justice: https://medium.com/equality-includes-you/what-white-people-can-do-for-racial-justice-f2d18b0e0234

 

4. If you use Instagram, follow some accounts that provide really good content about how to be more aware and take action on these issues. Just a few of my favorites are:

5. If you use twitter, here are some other accounts you can check out:

Our response to COVID-19 – Medspa closure


To our valued patients,

 

The last several days have presented all of us with unique challenges on how to plan our days. As always, the safety of our patients and employees is our number one priority. With that in mind and out of an abundance of caution, we have made the difficult decision to close the Medi-Spa side of our clinic until 4/6. We will have staff answering phones and checking messages if you have any questions or concerns, and we will be rebooking currently scheduled appointments, as well as continuing to book future appointments starting 4/7. Our surgical side will remain open, and we are continuing to see new surgical consults and are still booking surgery. However, available appointments times have been reduced in order to comply with the CDC directive of less than 10 people together at a time. Our surgical suite is Quad A certified and we adhere to the strictest policies and procedures related to infection control. This includes continuing education of staff on the most current procedures for hand-washing and sterile processing of all instrumentation, a strict no-work rule for any employees who are ill with any symptom, requiring staff to wear gloves and masks when interacting with patients, and having patients wait in their car to facilitate social distancing guidelines. We have also instituted additional disinfectant rules for our office, which include regular and frequent wiping down of surfaces.

We will continue to monitor the health of all our staff, and should any of us come into contact with another person suspected or confirmed to have contracted Covid-19 OR have any symptoms of fever, cough, shortness of breath, malaise, etc… they will be asked to remain home and to contact their health care professional for guidance. They will not be allowed to return to work until they have a passed a two week period AND are symptom free. We ask all patients to do the same and notify us if you need to reschedule your appointment. During this period, we are suspending any late cancellation or no-show fees, though we ask that you give us the courtesy of notifying us as soon as you determine you cannot make your appointment. It is important to note that the vast majority of patients infected with this virus have very mild symptoms or a mild flu leading to complete recovery. We are also constantly monitoring the news as well as following the Oregon Medical Board news board, other hospital notifications and the CDC to make sure we have the most current information in order to better serve you.

As always, we are incredibly grateful for all our wonderful patients and the support you have shown us. We encourage you to follow the CDC guidelines of frequent hand-washing, social distancing, and disinfecting your work and living spaces on a regular basis. But most importantly, we encourage you to use this time to practice self-care activities. Reading, spending time in nature, music and other such activities will help to ease the mental stress and burdens we are all feeling at this time. We are working behind the scenes with other businesses to see how we can best support our community through all this as well.

Stay positive and stay healthy!

 

-The Gorin Plastic Surgery & MedSpa Team

Is a Revision of Silicone Breast Implant Surgery Advisable?

Question: Is a revision of silicone breast implant surgery advisable?

In 2006 I got silicone breast implants and a breast lift. In 2009 I had a mammogram and was told the implants were not positioned correctly. They are not in a “pocket”, instead, they are positioned sideways of the breast not in the front. I want to have a tummy tuck in the near future and wonder if it would be advisable to have a revision of the implants at the same time. Will the original implants be reused or should I get new ones?

Answer: Combining the procedures is do-able

Assuming there is no health issue that would preclude you from having a surgery that would last 4-5 hours, it would be a good time to perform the breast revision at the same time as the tummy tuck.

However, the first thing to do is get examined by a plastic surgeon board certified by the American Board of Plastic Surgery to figure out what type of revision is necessary. It is difficult to figure that out based on a mammogram.

Can Under the Muscle Implants Be Moved to Over?

Question: Can Under the Muscle Implants Be Moved to Over?

I am 5’8″ in height and weighing 138 lbs. I’m in good shape–I jog, do push ups, and light weights. I’ve nursed 3 children for the last 5 years. I have 425 cc implants placed partially submuscular a year ago. The slightest flex of chest muscle makes my breasts appear unnatural. It makes the implants move upward while the bottom part ripples out. It’s becoming more obvious over time. Overall, my breasts look natural and pleasant when the muscle is relaxed. But to keep this from worsening, can one go from under the muscle implants to over?

Answer: Definitely possible, but, is it the best idea?

A ‘plane switch’ from behind to in front of muscle is do-able. However, the long term result could be compromised with excessive stretching, etc. There is a technique called ‘subfascial placement’ which is ‘sort of’ above muscle, but, might help prevent the above muscle downsides. The place I would suggest looking into would be Dr. Richard Baxter in Seattle. Whenever I come across a consult that I feel could be better served by one of my colleagues I am happy refer there.

Uneven Nipples After Breast Augmentation and Lift

Question: Uneven Nipples After Breast Augmentation and Lift

Uneven-nip

I had breast lift and implants (200 cc, 1 cup size bigger, age 26, no kids) 2 weeks ago, and my nipples look like something out of a child’s coloring book. They’re completely uneven, choppy, and not at all near perfectly circular. Will these eventually fix themselves? I also thought the breasts would be higher. Does this look like a well executed lift?

A: Too early to tell

This is actually a very good result. You will be amazed at how much things soften and smooth out/even out over the first 3-6 months. Things can be quite easily revised later on if necessary, but, based on the photos, you are right on track :)

How Much Does Breast Implant Revision Cost?

Question: I had Breast implants done 1 year ago and I think one has bottomed out. What’s an average price? I had 430cc’s under the muscle.

revision-blog

Answer: revisions are unfortunate, but, are a part of all of our practices

This is definitely something that I see and tell all of my pre-op patients that this is one of the risks of this surgery. I actually do not charge anything in the first year post-op for any revision. However, this is a bit unusual. Most docs here will waive the surgeon’s fee and still charge for the facility fee, anesthesia, etc. Your best bet is to return to the original surgeon to discuss the options.

Areolar Incision After Breast Lift

Question: There’s a “hole” around my areolar incision after Breast Lift, Is this normal? (photo)

aereola

Keep in mind that I am quite pale and even the smallest scrapes look red and terrible when I get hurt! That being said, I had a breast lift done exactly 3 weeks ago and now notice this spot around my areolar incision. I had something similar underneath my breast last week which has since cleared up. Does this look alarming or should it heal on its own as the other “hole” did?

Answer: Not uncommon

I generally tell all patients to expect some minor wound healing issues at the top and bottom of the vertical incision after a breast with with implants. They generally are extremely small in nature but sometimes can get quite large especially in smokers At this point, I assume your plastic surgeon is actively involved. However, this is likely a situation that would only require a topical antibiotic cream and extra healing time. In the end, it should look very good.

Silicone Implants with Lift, Too Big?

Question: 425 cc High profile silicone implants with lift, too big? Measurements and pics attached.

blog-question

I was very persistent on getting the mod plus 371 but my surgeon said that I would benefit from the 425 Hp due to my loss of volume. (With circumareolar lift) 36 years old, 5’8″ tall, 125lbs. Breast fed for over a year. Currently deflated A-B cup. I am active, gym, weights, yoga, surfing. Measurements/ pics attached. Every body is different, we have different starting points, my starting point is with very deflated breasts. He said that the 425 hp won’t look too big because of my volume loss.

Answer: Needs more than a Benelli

I personally feel that, in order to get the best result, you would need more than just the circumareolar lift.

In my opinion, you need at least the lollipop scars if not more. I would highly recommend asking your surgeon to review with you photos of women with similar anatomy. This is very much surgeon dependent. In my experience, the circumareolar lift does very little actual ‘lifting’.

How Can My Asymmetry Be Fixed And Do I Need A Lift?

Question: Follow up to my previous question: How can my asymmetry be fixed and do I need a lift?

asymmetry

I asked if I need a lift previously and posted a side view to hide my tattoos. Most Doc comments requested front view. Sorry for the scarf! Might as well ask how to address my asymmetry as well. What procedures do you recommend? I will be scheduling my breast aug for next summer when I find the right doctor.

A: Breast Asymmetry

Thanks for the question. A few things to consider. Based on the photo, it does not look like the left side needs a lift. The right side very well may need it. I always tell my patients, with pre-op asymmetry, to really expect asymmetry post-op despite all of our efforts. However, you still should like the final results.

Another thing to consider is checking out an office that uses the 3D imaging (like ‘Vetra’) which can give you an idea of what to expect with just implants. Best thing to do is ask the surgeon to show specific examples of before and afters of patients with similar asymmetries.

Should I get a Benelli Lift?

Question: I scheduled for a Benelli Lift and 600cc Implants…..good idea?

breast-blog

I’ve always had some droop to my breasts….now after 3 kids I want to have a pair to be proud of! One dr said a vertical scar lift with 500cc gummy bear implants and the other 2 I went said a benelli lift with 600cc implants…I wear a D cup bra already…

Answer: Benelli?

The Benelli lift is a procedure that is loved by some surgeons, disliked by most (in my area, at least). The problem is that the (IMO) the benelli doesn’t really ‘lift’ anything. I feel it’s best for circumferential skin removal without really moving the nipple that much.

In your case, my guess is that you want the breasts as high and full as possible. In my hands, this would definitely require a vertical scar. Additionally, whenever I contemplate a breast lift with implants that big I always have the discussion with the patient as to the increased risk of complications. Many surgeons would suggest doing the lift or implant first f/b a 2nd stage.

One thing to consider is to ask for specific before and afters with each of those surgeons on cases with a similar anatomy.