2019 Let This New Year Inspire You to Take Better Care of Your Health

Start With Your Skin — First Impressions are Everything

New Year’s resolutions can be sustained as long as you make resolutions simple, thematic and turn them into a habit. Do not think of your resolution as a single task to prevent your brain from shutting off the good habit once it has been performed once or twice. Sustain them even if you miss one week…do not let one week become 3 months.

Let 2019 be the year of better health. That can mean better food choices, smaller portions, fewer starches/carbs, scheduling a 20 minute walk per week, one work out class per week…simple healthy choices that you can make a HABIT.

Consistent daily skincare is essential for your health. This habit translates to beautiful skin if you use the correct medical products for YOUR skin needs and skin type.

What are the correct products for YOUR skin?

1. An anti-oxidant serum, such as Dr. Koo’s GLOSS Vitamin Serum, that protects against the formation and the penetration of super-oxide free radicals that damage skin (wrinkles and uneven pigmentation) and go on to cause skin cancers. Pollution and UV rays are the greatest producers of free radicals in our skin. Layer the anti-oxidant serum under daily sunscreen, makeup, and all other products EVERY DAY, TWICE A DAY.

2. Use the appropriate skin cleanser to remove dead skin cells. This does not mean using harsh cleansers or brushes which will irritate and redden the skin. Harsh detergent cleansers or too frequent washing will strip your own skin’s natural oils thereby stimulating your oil glands to overproduce oil. This will lead to the opposite of what you want; it will create breakouts, clogged pores, and even more oily, rough, and irritated skin.

  • Use gentle GOOD quality cleansers for your skin needs.
  • Dry/Very Dry Skin: use a creamy cleanser
  • Oily/Acne Prone Skin: use either a clarifying or exfoliating cleanser
  • Congested Pores/Rough Skin: use a gentle cleanser with TINY ORGANIC  crystals (Dr Koo POLISHING CLEANSER) to cleanse the pores without aggravating them with harsh scrubs
  • The appropriate cleanser will allow the actives you use to penetrate and fulfill their purpose.

3. Use the correct level of moisturizer your skin craves. If you have dry to very dry skin, you will need a cream AND perhaps a more rich dense serum. Your own skin’s level of moisture will determine the level of moisture product (Dr Koo BOOST) required. Moisturizers should be applied twice daily, under makeup and with the GLOSS Vitamin Serum.

The weather and temperature will determine the frequency of use. If you are in a high altitude in a dry climate, you may need to moisturize even more than twice a day. If you are in a temperate, humid climate such as Florida, you may only need to moisturize at night.

The season and how your skin responds to the products will guide you to the frequency of use.

The above 3 products are the most basic and most important products you must use. If you are in your 20’s or 30’s, those are the ONLY products you need (anti-oxidant sunscreen of course also)!

If you have pigment, wrinkles, and thin skin concerns, you will also need an anti-pigment and retinol product such as Dr. Koo’s REJUVENATE & GLOW products.

The correct level of Retinol/REJUVENATE product is used at night only and will increase the thickness (plumpness) of your skin. REJUVENATE will lessen the appearance of the fine and deep wrinkles. In combination with the correct PIGMENT product (Dr Koo’s GLOW), your blotchiness/pigmentation will lessen and the skin tone will appear milkier, smoother, and more even.

5 products plus a sunscreen is the maximum amount of products you honestly need. Additional products are only if you have particular concerns of redness/ruddiness, thin crepe-like eyelid skin, significant acne, or very sun damaged skin.

Your skin is a dynamic changing organ. In fact, your skin is the largest organ of your body and deserves continued care due to its constant exposure. You will help your own systemic health AND the health of your children if you take care of yours and their skin CONSISTENTLY and early-on!

The beauty will follow the functional care of your face.

I haven’t even started on the protection of your neck, chest and knees!!! Stay tuned for the next BLOG!

xo Happy New Year, let the intrinsic reward of healthier and therefore more fresh looking skin and health motivate you to continue the routine!!!

Dr Koo Skincare for Health

How Do I Choose the Perfect Breast Implant for Me?

My patients ask me this question during every consultation.

My reply is: it has taken me 25 years of experience to really understand, to truly “see” how an implant will fit a patient’s breast, chest wall, rib cage, lifestyle, clothing choices, comfort level…let me be your expert and I will pick the perfect implant with you depending on what you want, your body, and your lifestyle.

I say don’t worry about the size or shape of the implant, simply look at pictures of your perfect world breasts, and “shop the look.” Bring me the pictures of the size, and “look” of the breasts you love, and I will match that  “look” for your body size, breast shape and desires!

The most important point for you is, what look are you going for? What is your comfort level with the amount of attention your breasts will receive? What type of neckline do you like to wear? Do you simply want to have some fullness and firmness in a swimsuit? Do you not want anyone to notice? Do you want a little or a lot of curves?

Everyone is different. Every breast and rib cage is different even from one side to the other. These tiny nuances and details are what I pay particular attention to in order to achieve YOUR perfect breasts.

YOU only have to “shop the look” and ask yourself what you want!







  • Hyaluronic Acid microsomes diminish eyelid wrinkles, puffiness, and dark circles. Rejuvenates and restores the delicate upper and lower eyelid skin. Squalene, Arginine, & Proline enrich and penetrate the skin cells to smooth the eyelid skin. Prevention and maintenance are your best anti-aging solutions!


  • Intensely concentrated Tocopherol, Jojoba Esters, & intense anti-oxidants diffuse and lighten photodamaged pigmented skin spots. Excellent for the very stubborn pigment age spots. Precise application tip targets pigment spots.


  • Prevents and calms hormonal acne breakouts. Alpha Lipoic Acid & Buffered Salicylic Acid extract toxins, blackheads and oils to shorten acne breakout without overly drying or irritating blemish prone skin. Quiets the angry red stage to help prevent long-term scarring.

To view and learn about all of Dr. Koo’s Skin care products visit Dr. Koo Premier Skincare site

Too Much Sun When You Were Young…Do You Look Older than Your Chronological Age?

Many of my patients tell me they look so much older than their actual age. What is the reason for this? Let’s start with the basics:

  1. Too much sun exposure during the teen and young adult years and continued lack of sun protection.
  2. Years of smoking.
  3. Early loss of one’s own hormones (early menopause).
  4. Poor skin regimen with ineffective skin products.
  5. Poor nutritional choices.

The number one offender is too much sun exposure. The sun damages the skin cells (keratinocytes) and the arrangement of the collagen and shape of the cells. All of this damage leads to rough, unevenly pigmented skin that is leathery and crepey appearing.  Inhaling nicotine and various toxins associated with smoking also causes direct damage to the cells and the blood vessels that supply the entire body as well as the skin. The loss of hormones can also profoundly affect the quality of skin also. Your choice of foods can also be a factor if you already have trouble prone skin i.e., acne oily prone skin. Drinking more water, and cutting out sugary carbonated sodas can lessen this last offense. The more green the choice of your vegetable the healthier it will be for your skin.

The best advice for your food choices: try to avoid any food that you have to open a can or unwrap a wrapper to consume. The fresher the food, the more natural the state of the food, meaning having to cook it yourself, the better nutritional value it will have and the healthier it will be for you.

Your best weapon to undo the previous wrongs committed against your skin is to start using sun protection EVERY day and cut down (or quit) smoking. I am not a fan of taking exogenous (supplemental) hormones after menopause, but I am a strong proponent of taking vitamin supplements to make our cells more efficient and be able to perform as previously (produce more normal collagen, more tiny capillaries, normal pigment).

I also believe that medical quality skin products can make a significant difference in the skin quality, color, and texture. These products need to contain true tested pharmaceutical active components NOT simply COSMETIC ingredients you can purchase at the drugstore or mall.

I have technologically engineered skin products formulated specifically by my formulating pharmacist and myself! The natural products and their derivatives are blended in a proprietary technique to drive the actives much more effectively into the actual skin cells to stimulate the cells to return to normal function. This translates to healthier, more brilliant appearing skin erasing much of the damage.

The catch: you have to use it on a regular basis! That part isn’t rocket science. This is truly the best value for your money spent. You spend more money at Walgreen’s, CVS, and Target on products that fill your bathroom cabinets that do nothing for your skin. The products have little penetration and the ingredients that do penetrate do nothing to actually change your skin quality.

If you start on the products and don’t see any change after CONSISTENTLY using them following my instructions in 8 weeks, I will refund your money. You may need to add or change one of the products but my office and I will get the correct combination of products for your skin type! We also will continue to progress your skin to more concentrated and intense components as your skin improves to make sure you are achieving the most you can from your medical skin care.

Do Breast Augmentations have to look big and… fake?

The answer is no! A breast augmentation with breast implants can simply fill in your skin envelope and take up the slack in your breast skin.

If you see yourself as an athletic person, and you’ve always had smaller breasts but now after children, you don’t have any roundness or shape to your breasts, you can have a breast augmentation and still have small but now rounded, more firm and more pleasing breasts.

The key to remember is that breast augmentations are not always about size! It is about the look!! Some of my patients do want very large “fake” breasts and they are very comfortable with that look and I make sure I achieve their perfect world desires.

For those who want a change in shape but not much of an increase in size I feel it is important to address the following issues with your plastic surgeon:

  • How much roundness you want
  • How high on your chest wall you want your breasts to start, how full on top
  • How much “side boob” curvature you want
  • How much cleavage you want
  • And especially important is how noticeable you want your breasts to be on your body

A small volume breast implant with the appropriate projection and fill ratio (firmness) can create soft, natural, well proportioned breasts that are well balanced and elegant for your body size and compatible with your lifestyle.

I try to discuss all of these points with my patients and try to understand your lifestyle to help direct your ultimate decision for the size, shape and LOOK you want. I find it much more important to discuss the look rather than the size. There is too much variability in bra cup sizes to finalize a breast augmentation based solely on cup size. In my communication with my patients, it is imperative I understand the LOOK of your breasts you want to achieve.

Furthermore, if you haven’t finalized the shape and look that you want, it would be impossible for your plastic surgeon to pinpoint it for you at the time of surgery. This must be discussed and agreed upon prior to your surgery.

Take home point: breast augmentations are very safe and you should be able to achieve whatever size and look you desire, but you must have that LOOK well defined in your mind and show your plastic surgeon that LOOK before the surgery!

How Do you Find the Right Breast Implant for Your Breast Augmentation??

You’ve wanted a breast augmentation for such a long time and now you’re at least ready to start the interviewing process for the right plastic surgeon. Now the real question is how do you know what the right breast implant is?

I feel it is extremely important that you tell your plastic surgeon about your lifestyle, profession and activity level. If you are a teacher and really don’t want your friends and pupils to notice your new breasts or make ANY comment at all, you may want a lower profile softer sitting implants that allow some fall and roundness.

If you are a Mom of young children and teenagers, you may especially be self conscience of being noticed. You want some sexiness and fullness but above all you want your breasts to look natural and in proportion to your body. In this case you will want a full implant but one that is perhaps smaller in width and a little more firm to give your breasts a slight lift in addition to the volume.

If you are in your 20’s and you’re looking for a breast augmentation, the sky is the limit. The choices will truly be only limited by the anatomy of your breasts and your desires. If you want to rock full, sexy, up in your face breasts, you should have them with a full profile, firm, wide breast implant.  You can also choose to have a slightly softer fill implant if you want to only have them in your face when YOU want to show them off with a push up bra or in a swim suit. The exact type and size of breast implant will be determined by your plastic surgeon. Don’t make the mistake of dictating the actual cc size of the breast implant. Your plastic surgeon will place sizers in to determine the perfect fit.

The take home message is have many conversations with your plastic surgeon and ask many questions. Tell her/him about your concerns, if you are planning to have children, breast cancer history, the type of skin you have, the amount of time you spend in the sun, your profession, exercise routine, etc etc etc, in essence everything about your life you think is important actually.

If your plastic surgeon doesn’t want to hear all of your concerns or someone other than your surgeon is talking to you, run for the door. Take the time and make the effort to know the quality of the person your plastic surgeon is!

Breast augmentations are extremely safe and you should have a wonderful experience obtaining the perfect breast enhancement for YOU!!

Enjoy the process—

CELLULITE….What the …. is it? How Do I Get Rid of it?

If you have cellulite you are certainly NOT alone. Most women and many men have the same problem. Some have a very mild case of it so it is not very noticeable and some have severe cases of it that they do not feel they can wear shorts or even tighter clothing for fear that the cellulite will show through the clothes.

Some researchers and physicians believe cellulite is a normal fat distribution that occurs more in women than men and can be linked (not necessarily caused by) to hormones, genetics, diet, and lifestyle choices (such as smoking, obesity, dehydration and lack of exercise).

Cellulite is an enlargement of normal adipose cells in the superficial layer of our skin. Everyone has these fat cells but when they enlarge and stretch the skin and tether the normal intermittent fibrous bands in our skin, the end result is a dimpling appearance in our skin.

Cellulite typically becomes noticeable during adolescence during weight gain and increase in circulating hormones. This does not occur in everyone and even occurs in people who are thin.

Unfortunately, there is nothing you can do to prevent cellulite specifically if you are predisposed to it with the genetics of your body type and fat cell type. However,….sensible lifestyle choices of regular exercise, not smoking tobacco, adequate hydration, and healthier food choices of dark green vegetables and fewer carbohydrates will all help to deter and minimize the sometimes inevitable development of cellulite. Maintaining a healthy (not thin but healthy for your genetics) weight is key.

The treatment options are varied and many, and again unfortunately not very effective. There is currently an FDA approved laser for the treatment of cellulite but the results are minimal and subjective in my opinion. Liposuction while it improves the contour and shape to perhaps make cellulite appear less noticeable, it can actually also worsen the appearance of cellulite! Mesotherapy, injection of various medications and vitamins have not been proven to reduce cellulite and fat and can cause more irregularities, swelling, skin changes, and infection.

Spa treatments and external massage and wraps are temporary. The results are most likely due to temporary removal of the water content of the superficial and deep skin and fat layers.

Creams and lotions are extremely tempting but costly and a waste of your money!

What lies ahead for cellulite treatment? I know I sound like a skeptic and a naysayer, but the truth is there is ongoing research for certain wavelengths of light (lasers) that may disrupt fat cells and cause them to shrink but these are only at the research stages.

DR KOO’S ADVICE: Try to prevent cellulite from worsening by staying within your ideal weight zone to begin with; make healthy food choices and engage in regular aerobic exercise with weight training incorporated. This doesn’t mean you can’t occasionally eat or drink what you like, but key concepts are limits, portions, and continue to make the right choice EVERYDAY NOT JUST WHEN YOU FEEL LIKE DIETING.

Been Considering Breast Enlargement Since You Were A Teenager?

Now how do you go about accomplishing this? How do you get the perfect size breasts for your body? How do you find the right plastic surgeon that will understand what it is you want?

More importantly, how do you get your St. Louis plastic surgeon to understand it is not only about the size of the breasts but the shape of the breasts? Do you also need a breast lift along with a breast implant?

How do you convey the desire for a rounded, shapely breast that still has a natural fall, some “side boob” but not armpit breasts? Breasts that aren’t too obvious and still professional but are still big enough to be sexy when you want to be?

The answers to all these questions should come from your plastic surgeon before you even ask them.

The truth is there are so many sizes that would be perfectly compatible with your body — the deciding factor is your personal comfort level with how full the breasts become.

By that I mean, how noticeable do you want your breasts to be? How much do you run and what types of exercise do you enjoy? How do you envision yourself — athletic and slim or full bodied and curvy? How tall are you? How much do you weigh? Have you had children? Do you plan to have more children?

Those answers will determine what type and size breast implant I recommend for my patients. I always discuss size and shape while looking at actual photographs with my patients. This will give a visual reference point that is so much more accurate and meaningful than discussing the bra cup size or implant size.

These are excellent starting point questions you should always discuss with your plastic surgeon prior to a breast enlargement. Talk to other patients and consult with your plastic surgeon as many times as you want until you are completely sure and comfortable with the surgical plan.

Remember, ultimately the choice is yours and it is up to the plastic surgeon then to guide you, inform you, and understand what it is YOU want!

Does Plastic Surgery of the Face Always Look Peculiar and “Done”?

When I am performing facial aesthetic surgery, I respect the natural architecture of the entire face. I respect the natural lines that are the patient’s unique look. I replace the skin and tissues to where they were previously; I don’t change the inherent structure.

Mickey Rourke or Renee Zellweger illustrate exactly my point. Their unique facial structures have been obliterated by their plastic surgery. Whether they’ve been overfilled or over pulled, it’s not a good look.

I recreate the natural and individual beauty of my patients’ former youth by replenishing and repositioning. This is the key to looking rested and not “done”. I completely understand and respect the soft tissue AND skeletal anatomy.

Meticulous attention to the positioning of the eyes, nose, and mouth within the face is imperative. I balance the face in its entirety therefore my patients never look odd or incongruous. For instance, addressing the neck without attention to its relation to the rest of the face creates a mismatch and a “done” pulled look.

A layered comprehensive approach with filler, BOTOX, skin care, and mini office eye and face-lifts can continue to keep the aging process in check. You can continue to look better and better without creating a significant one-time change. Again the key is regular maintenance. The subtle layered approach is especially important for MEN. As men age, their eyes narrow and brow drops and that becomes a sexy distinguished look that can be enhanced and tweaked but not entirely changed. Men especially do not look appealing with the “wide eyed surprised doe in headlights” look.

The maintenance should start as early as the teen years with acne prevention and sun protection. This will prevent long term scarring and the irreparable deep creases from sun damage. The pigment changes of aging skin can also be prevented and reversed with early intervention and regular maintenance. Medical strength products will achieve far more than any over the counter “feel and smell good” lotions. This is the only way to truly prevent skin damage and restore the luster and sheen of youthful skin.

Bottom line: See your Board Certified Plastic Surgeon early and often. It is better to do a little at a time than too much at once.

If I Have Plastic Surgery On My Face Will I Still Look Like Me?

facephotoThis is a question I often hear during my office consultations for facial rejuvenation. My philosophy is that well-done plastic surgery makes you look rested, with softer smoother features not create a face and eyes that look pulled and “done.”

This is especially true for male plastic surgery. If you’ve seen pictures of Kenny Rogers or Mickey Rourke, you’ll know exactly what I’m talking about. They’ve lost the natural architecture of their faces and are not recognizable. You can see that result also if you Google Uma Thurman and Renee Zellweger.

So what happened to them? Did they not know where to go to get the best possible results? I don’t know what these celebrities requested during their consultation with their plastic surgeons but I feel it is my job to guide you as to what the best approach is to achieve an extremely natural improved look that allows you to completely keep your own features. I replace the tissues to their previous positions to achieve the very natural rested look.

‘LESS IS MORE’ is my approach when addressing the face, especially for men!

My job is to advise you what can and cannot be achieved and the best way to do it. I respect the natural contours of the face and eyes. Sometimes it is better to do a little at a time during the rejuvenation process. I term this the layering effect. This technique allows you to continue to improve slowly to achieve an unaffected look.

The answer to the question is, of course, yes you can look unaffected if you take the layered approach to rejuvenation. You can always do more but it is really difficult to correct what is overdone!! You don’t need to do it ALL at one time and the mission is NOT to make it as TIGHT as possible.