Before you call and book an appointment for cosmetic surgery, sit down and think about why you want it. Is it something that's bothered you since childhood? Or are you doing it to simply boost your self-esteem? Explore your thought process and ensure you're doing this because you want to, not because a loved one is pressuring you, or you're feeling like you have to keep up with your friends or colleagues. Here are a few things you should consider before making a life-changing physical alteration.
1. Do your research "A great place to start is the Internet, says Dr. Stephen Mulholland, cosmetic surgeon and owner and director of SpaMedica in Toronto. When looking into a particular surgeon, cosmetic dermatologist or clinic, visit the following sites to verify that the doctor and/or clinic you are considering is accredited:
Canadian Society of Aesthetics Plastic Surgeons (csaps.ca); and
Canadian Association for Accreditation of Ambulatory Surgery Facilities (caaasf.org)
All surgeries performed in a clinic must be accredited and approved by the CAASF, and all physicians that maintain their fellowships in good standing are listed (along with their specialty and certification date) on the Royal College's of Physician and Surgeon's Maintenance of Certification section. Be thorough – you're interviewing the people who will change the way you look, so take the extra time to investigate.
2. Don't be shy Just like a fresh set of highlights, if you like the way the furrow in your friend's brow has suddenly vanished, ask her who did her work. To counter, if you didn't love her work, make sure you get that surgeons name too, says Mulholland. Ask your surgeon to show you before and after photographs of patients who've had the procedure(s) you're considering. For further reassurance, ask to speak with a patient who visited the doctor you're considering.
3. Get the right Doc for the job If you're after a nose job or an eyebrow lift, a physician who specializes in body contouring and breast augmentation might not be the best fit for you. Surgeons tend to develop reputations for what they're best at. Look for someone with a specialty in your category of concern so they can best assist you in getting a great result.
4. Meet and greet "At the end of the day, you need to meet the physician, interview them and see if there's a sense of trust," says Mulholland. "If your friend had a good outcome, you probably will too."
5. Remain focused If a surgeon or cosmetic dermatologist is pushing you into additional surgeries that seem unrelated to your area of concern or procedures that make you weary, go home and think about it before agreeing to anything. Remember, you're undergoing a change, regardless of how big – feeling comfortable is incredibly important.
6. Anticipate the unexpected Sure, maybe your best friend healed completely over a weekend after a laser treatment or your sister can do her Botox over lunch. That doesn't mean you're in the clear. "Different types of skin can react very differently," says Dr. Mulholland, who says lifestyle and genetics can influence how a person responds to certain treatments.
Page 1 of 2 – Thinking about plastic surgery? Discover four more must-dos before going under the knife on page 2. 7. Pain free? Think again While many new procedures, such as dermal fillers, Botox and skin tightening, are less invasive than their predecessors, this doesn't negate their pain potential. "It's not that there's no pain, it's just that there's less pain," says Mulholland. "It's not that there's no healing time, it's just that there's less downtime."
8. Anticipate additional time with your doctor To achieve the results you desire, tweaking the original procedure (for example, with Botox and fillers) may be required, which doesn't necessarily mean it was done incorrectly, says Mulholland. "We often can't predict how different people will react," he says. Patients who try filler may require a little more or a little less upon follow up. Removal is simple: an enzyme is injected to dissolve the filler in the same way it was initially delivered. 9. It's a risk Consider the potential risks and side effects that come with the procedure you're interested in. Make sure you ask as many questions as possible in your initial consultation, and come to terms with the potential complications before you decide to proceed. Determine who will cover the costs if something unexpected occurs.
10. The cost Surgery can be expensive, especially if you require anesthetic. But don't be seduced by street signs or in-office promotions promoting special deals or deep discounts; this is your body, after all!
Which cosmetic procedure is best for you? Here are a few need-to-know facts about some of the most popular cosmetic procedures. Botox This injectible drug relaxes a small area of muscle, softening expression lines such as frowns, lip lines, crow's feet and forehead creases. The procedure takes 15 minutes to perform, and results last three to four months. Most patients can return to normal work immediately.
VolumaLift Injected with a needle, this hyaluronic acid base (a filler) holds water, making it swell under skin. This restores volume to areas such as sunken cheeks, marionette lines, hallowed eyes and lips. Results last up to 24 months from a procedure that takes under one hour to perform with combined topical and local anesthesia. Some patients may experience a reaction, and bruising can take up to three days to vanish.
Fractional Laser (often called "Fraxel") For those looking to banish scars, fine wrinkles and pigment irregularities, a focused-energy laser sends creates microscopic tears to the dermis level, creating the production of new collagen and elastin. The procedure takes approximately 30 minutes and is combined with a topical anesthetic cream. While some patients are fine two hours afterwards, the redness and warm feeling can last up to 48 hours.
Fotofacials (or IPL laser) For people seeking to repair aging, sun-damaged or enlarged pores, a tool is guided over the skin (with flashing light) and painless radio frequency signals to target the deeper layer of epidermis. Most people leave the treatment with a flushed face, and it takes at least five sessions to see optimum results.
Neck Liposuction (or "NeckTyte") If you're looking to vanquish excess fat that hangs around despite diet and exercise, liposuction can be effective, but isn't free from drawbacks. Patients require local anesthesia as force is required to extract fat from the area via a small hollow tube and suction, which is inserted after an incision is made in the neck. A radiofrequency pulse follows, tightening skin and minimizing bruising. A neck and compression guard is required for 5-7 days, and bruising and swelling can last anywhere from 2-7 weeks.
Heart disease and stroke are one of the leading causes of death for Canadian women—and risk factors, symptoms and even treatment might vary by age. Here's what you need to know.
It was Dec. 13, 2014. I was getting ready to go out for dinner when suddenly everything went wrong. I lost coordination, almost like I was drunk. I went numb, as if the local anesthetic that dentists use had been applied to half of my body. My arm went limp, I could barely walk and, out of the blue, I got a raging migraine. At 31 years old, I was in the midst of a transient ischemic attack, often called a ministroke, but I had no idea.
It wasn't until the next day, when I was feeling only slightly better, that I realized something was really wrong. I didn't want to wait for an appointment with my family doctor, so I called Telehealth Ontario, the provincial service that connects callers to a registered nurse via telephone. In the very back of my mind, I wondered if I'd had a stroke—but I was too young, or so I thought. But when I described my symptoms, it became clear that I wasn't too young. In fact, the nurse who took my call was worried enough to send paramedics to my house. Soon, I was in the back of an ambulance, rushing through Toronto's busy streets on the way to the hospital.
The statistics Luckily, my stroke was mild, and, in July 2015, I underwent surgery to have a patent foramen ovale closure device inserted to close the hole in my heart. But, to this day, I'm still shocked at how little I knew about the risks associated with stroke and heart disease, or just how common they are. As I soon learned, about 1.6 million Canadians—557,000 of them women over the age of 24—report having cardiovascular disease. And, according to a study looking at factors and behaviours affecting cardiovascular health published in 2013 in the Canadian Medical Association Journal, fewer than one in 10 adult Canadians were in ideal cardiovascular health from 2003 to 2011, which means 90 percent of us are making choices that are increasing our risk for a cardiovascular event. In fact, heart disease and stroke is one of the leading causes of death for Canadian women, and most of us have at least one risk factor.
It's a club that I didn't particularly want to be a part of, but having joined, I began wondering what other women's experiences had been like.
Unlike me, when Victoria resident Carolyn Thomas started having a range of symptoms— crushing chest pain, nausea, weakness, sweating and a persistent ache down her left arm—on her 58th birthday, she immediately thought it could be a heart attack and went straight to the ER. But when she got there and told the doctor on duty about her symptoms, he said it was just acid reflux. "I remember exactly what he said," she recalls. " 'You're in the right demographic for acid reflux. Go home and call your family doctor for a prescription for antacids.' " Embarrassed and apologetic, she did just that. But her symptoms persisted for two more weeks. She eventually went back to the hospital, and this time, she was told she was suffering from what was actually one of the most serious types of heart attacks—a complete blockage of her left anterior descending artery, which is often referred to as the widow-maker.
Since then, she has recovered, but it's far from full—she had to retire early and continues to see a specialist at her regional pain clinic.
Irmine MacKenzie also went to the hospital immediately. It's been 35 years since the New Waterford, N.S., resident lost the use of her left arm and leg after suffering a stroke caused by carotid artery stenosis, narrowing of the arteries that carry blood from the heart to the brain. She was 61 years old and, having just finished eating breakfast with her husband, John, she headed to the kitchen to tackle the dishes. Suddenly, plates started dropping from her hands, shattering as they hit the floor.
After a six-week hospital stay and a three-month stint in a rehabilitation program in Halifax, she eventually learned to walk again. Her ability to manage quite well over the past three decades is clearly a testament to her grit— and maybe some kind words from a stranger. "I won't ever forget the ambulance driver who took me to the rehabilitation centre," she says. "He told me, 'We're taking you by stretcher now, but you'll be walking out of there with a cane.' " Sure enough, that's exactly what she did.
A better understanding It has now been two years since I suffered my transient ischemic attack, and I feel like I'm still learning about heart health. I now understand the importance of cardiac rehabilitation, for one thing. When I had my stroke, I didn't know this kind of program existed—my cardiologist didn't refer me to one, but having access to dedicated professionals in a safe, encouraging environment could have helped me navigate the health-care system and guided me toward healthier choices.
One thing I found myself, Carolyn and Irmine echoing is how, as women, we must advocate for ourselves in the health-care system, ensuring that our voices are heard and our health is looked after. We need to put ourselves first, without shame or guilt. As Dr. Paula Harvey, director of the cardiovascular research program at Women's College Hospital in Toronto, says, "It comes back to education and partnership with your health provider. Don't be afraid to ask questions and be informed."
Heart health by the decade Nearly two-thirds of all heart attacks and strokes occur in Canadians 65 or older, but younger Canadians are increasingly at risk. Here's what you need to know at every age.
In your 20s and 30s: Young people with heart-health issues are part of a growing minority. A study published in 2012 out of the University of Cincinnati College of Medicine found that, over a period of 12 years, strokes among people aged 20 to 54 made up an increasingly greater proportion of strokes across all age groups, growing from about 13 percent in 1993–94 to 19 percent in 2005.
Closer to home, the Heart and Stroke Foundation says several studies predict that the rate of strokes among younger adults will double in the next 15 years. The main reason? According to Dr. Tara Sedlak, a cardiologist at Vancouver General Hospital and clinical assistant professor at The University of British Columbia, it comes down to lifestyle—high stress levels, poor eating habits, lack of exercise and smoking. Research bears this out: The University of Cincinnati study suggested that a rise in lifestyle-related risk factors (such as diabetes, obesity and high cholesterol) may contribute to a higher incidence of stroke.
But there is a way to turn the tide: As with other age groups, simple changes such as exercising regularly, quitting smoking and eating healthily could see the rates of cardiovascular disease—and, more specifically, stroke—decrease, says Dr. Paula Harvey, director of the cardiovascular research program at Women's College Hospital in Toronto.
In your 40s and 50s: Cardiovascular disease is less common among younger women, in part because of their higher estrogen levels; the hormone offers some protection to the arteries. But as women approach menopause and their estrogen levels drop, the incidence of stroke and heart attack increases.
Unfortunately, broad knowledge of their increased risk may not protect perimenopausal women from misdiagnosis. According to research by the Canadian Medical Protective Association, which provides advice, legal assistance and risk-management education to 95,000 Canadian physicians, doctors are missing the signs of stroke in patients nearly 10 percent of the time, largely because symptoms are often nonspecific—patients often complained of headache, dizziness, nausea and vomiting.
And women, who have historically been less inclined to advocate for themselves, are particularly at risk. Research out of the University of Leeds in England showed that, between April 2004 and March 2013, 198,534 heart attack patients at National Health Service hospitals in England and Wales were initially misdiagnosed—and most of them were women. During that time, women suffering a heart attack were 50 percent more likely to be misdiagnosed compared to men.
It might be difficult to challenge doctors who tell you nothing's wrong, but Dr. Sedlak encourages women to listen to their bodies and to be firm with health-care providers about what they're experiencing. "If you feel there is a real problem, be persistent," she says.
In your 60s and beyond: Women over 65 have the most strokes of all age groups, but they still have fewer strokes than men the same age. However, a Danish study published in the Journal of the American Heart Association in 2015 found that, after 60, women tend to have more serious strokes than men—and they're more likely to survive, which can have serious repercussions on quality of life.
John Sawdon, the public education and special projects director of the Cardiac Health Foundation of Canada, explains that cardiac rehabilitation programs, which are free with a referral from your doctor, are the perfect next step for recovering cardiac patients of all ages, but they're particularly important for older Canadians, who tend to live more sedentary lives. These programs are supervised by a cardiologist and, after an assessment, are tailored by your cardiac rehab team, which usually includes nurses, physical therapists, kinesiologists and social workers. They can provide exercise training, education on heart-healthy living and stress counselling—all of which can contribute to the health and well-being of people who have heart problems. And they're effective, too: "Research has shown that those completing cardiac rehab live seven years longer than control groups," says Sawdon. It also "reduces incidence of another heart attack by 50 percent."
What's your risk? Ninety percent of adult Canadians have at least one risk factor for cardiovascular disease. But while factors such as obesity, hypertension, alcohol abuse, family history and ethnicity increase everyone's risk, regardless of gender, the following three are particularly relevant to women.
Smoking: While we all know that smoking is seriously unhealthy, it can be especially damaging to women's cardiovascular health. Smoking when taking the oral contraceptive pill can drastically increase the risk of heart attack and stroke. But quitting can cut your risk within a year.
Diabetes: According to the Canadian Diabetes Association, people with diabetes are at a very high risk of developing cardiovascular disease. In fact, "they may develop heart disease 10 to 15 years earlier than individuals without diabetes."
Mental illness and stress: "Women have a higher frequency of stress-induced heart disease, and women's hearts are affected by stress and depression more than men's," says Dr. David Fitchett, a cardiologist at St. Michael's Hospital in Toronto and associate professor of medicine at the University of Toronto.
Heart health dictionary
Atherosclerosis: When arteries narrow and harden due to plaque buildup.
Cardiomyopathhy: Diseases of the heart muscle, which cause it to become enlarged, thick or rigid.
Cardiovascular disease: A broad term for problems with the heart and blood vessels, often due to atherosclerosis. These conditions can lead to heart attack, angina or stroke.
Heart attack: Also known as a myocardial infarction, these attacks happen when the flow of blood to a section of the heart is blocked, preventing the muscle from getting oxygen.
High blood pressure: Also called hypertension, this is when the long-term force of blood against artery walls is elevated, requiring the heart to work harder, which may eventually lead to heart disease.
Microvascular angina: A disease of the small coronary artery blood vessels. Many angiograms do not view the small blood vessels, so this can be difficult to diagnose.
Spontaneous coronary artery dissection: A tear in the coronary artery wall. Physical or emotional stress appears to play a role. Most cases (around 70 percent) occur in women under 50—and a third of those are pregnant or postpartum women.
Stroke: When the blood supply to a portion of the brain is interrupted. This can happen when a blood vessel carrying oxygen and nutrients to the brain either bursts or is blocked.
Wayfair, the largest U.S. online retailer of furniture and home decor, launched their
Canadian website this week, not only making shopping easier and less expensive, but offering free shipping on all orders over $75. With a selection of over 7 million items at a variety of price points, there is literally something for everyone. Here's the 6 items we are most excited about.
Colin D. Ford, Artistic and educational director for Kérastase Paris
"The biggest mistake women make is using the incorrect hair-care products for their hair style, which can leave mid-lengths and ends looking dry. A professional consultation will [determine] what hair-care regimen is best."
Hair advice that professionals swear by
Stacey Staley, Founder and creative director of Blonde in Toronto
"Make sure you're rinsing your hair correctly. That means spending between two and three minutes in the shower rinsing both your shampoo and your conditioner. Contrary to popular belief, warm water isbetter for rinsing products. Then, finish with a 60-second cool rinse to add shine."
Hair advice that professionals swear by
Danilo, Global ambassador for Pantene and celebrity stylist
"Hair needs all the help it can get. It needs added moisture, emollients, supportive structures. Treat your hair like you do your skin."
"The tendency to want what we cannot have is universal, but a cut will sit better, last longer and be so much easier to maintain if you work with your hair type instead of fighting against it. With a cut that's customized, getting ready is so much simpler—and prettier."
Hair advice that professionals swear by
Kevin Mancuso, Global creative director for Nexxus
"People with really fine hair and lack of density should consider colouring their hair because they're going to benefit by swelling the hair fibre. If your hair is not damaged, you should consider double process, or single process with your own colour. When you damage the cuticle, you're going to lose some lipids, and that may be good for someone with fine hair looking for volume. Once the hair cuticle is lifted, the hair fibre can look nearly double in size."
We needed help demystifying the seemingly endless list of milk alternatives, so we went to the experts for real talk on dairy-free drinks.
Whether you're lactose intolerant, vegan, or just like the taste, there are plenty of reasons to experiment with adding milk alternatives to your diet. But with more varieties than ever before, how do you know which option is best for you? We asked two registered dietitians, Carol Harrison and Crystal MacGregor, for the skinny on dairy-free drinks.
Why does cow's milk get a bad rap?
Carol Harrison: Some people are worried about hormones or antibiotics in milk. But the truth is, growth hormones are not approved for use in dairy cattle in Canada. As well, The Canadian Food Inspection Agency reports compliance for veterinary product residues in milk is greater than 99 per cent.
Crystal MacGregor: Cow’s milk is a nutritious and safe choice. Non-dairy beverages are actually not suitable for children under the age of two because they do not contain enough calories, protein and fat to support children’s needs.
Which beverage is closest to cow’s milk in terms of nutritional profile?
CM: Soy is the closest to dairy in protein per serving at 7 grams of protein per cup. When possible, choose organic versions, as many conventional soy milks can come from genetically modified soybeans, which may contain higher levels of pesticides and fertilizers.
CH: The only beverages I consider nutritional substitutes for cow's milk are goat’s milk fortified with vitamin D and soy beverages fortified with calcium and vitamin D.
What are some things a person should consider when choosing a dairy-free beverage?
CM: If choosing a non-dairy alternative for a source of protein it is important to note that not all are created equal—most nut milks such as almond, coconut and cashew milk contain less than 1 g of protein per cup.
CH: Aim for 30 per cent daily value calcium and 45 per cent daily value vitamin D. Also choose unsweetened options to curb unwanted added sugars.
Check out our slideshow of popular dairy-free drinks, with pros and cons from our experts.