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A Local Doctor Makes A Difference Pearl Plastic Surgery
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A Local Doctor Makes A Difference
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- Heart Conditions, Symptoms & Treatment - Signs of Cardiac Arrest - What You Should Know About Smoking - Healthy Diet Article Interview
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Located parallel to I-5 on the west side between 38th Street and 48th Street in Tacoma. Shopping Line® 253.475.4565. Located parallel to I-5andonconditions the west side between 38th Streetfeeand Handling fee applies. Terms apply (including an administrative ® of $2.95 per month beginning Shopping in the thirteenth after the month of card 253.475.4565. 48th Street in Tacoma. Linemonth
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BH B u siness h ig h l ig h t Pearl Plastic Surgery
By Michele McGehee
W
A Local Doctor Makes A Difference
hen you think of plastic surgery, most people think of enhancing your body or correcting something you do not like. But there is much more than meets the eye. Dr. Chris Nichols of Pearl Plastic Surgery is dedicated to improving the lives of his patients, while providing the ultimate customer experience, products and services in Tacoma. Dr. Nichols began his studies in biology, which ultimately led him to medical school. During his training, he went through different specialties and decided to pursue a residency in plastic surgery. “I really liked the diversity of the patients and the cases,” explains Dr. Nichols. He grew up in Florida, but he has slowly worked his way to the West Coast. “I have always loved the Pacific Northwest. I had visited as a kid because I have family nearby and I love the topography, the water and mountains. Socially, it is laid back and people are warm and relaxed. My wife and I enjoy the community and the relationships we have built.” He and his wife, Susan, opened the practice a year ago and they have built a wonderful and caring staff. Though Dr. Nichols does practice general plastic surgery, his main 4
passion is breast cancer reconstruction. He works with great surgeons in town who do the oncological procedures and he does the rebuilding portion of the procedure. This is relatively a long process and sometimes takes up to a year for the reconstruction portion of the treatment to be completed. “I have the opportunity to spend time with my patients and really get to know them and watch them heal both physically and emotionally. It is a privilege to be with them and help them heal through this difficult time.” In addition to breast reconstruction, Dr. Nichols does wound and burn care, craniofacial and cosmetic surgeries. Cosmetic surgeries include facial enhancements, breast augmentation, tummy tucks and body contouring in weight loss patients. “When patients loose a large amount of weight through gastric bypass surgery or on their own with diet and exercise, they usually have a lot of excess skin left behind. That skin is not only cosmetically a problem, it can also cause medical issues as well.” There are many different types of procedures and equipment to help make the process of plastic surgery easier. For example, Dr. Nichols uses a process called Smart Lipo.
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February 2010
SmartLipo™ LaserBodySculptingSM produces similar results procedure pain and need for narcotics. These are a great tool to traditional liposuction. SmartLipo™ is a minimally invasive for surgeons in post operative pain control. It is similar to the procedure that permanently destroys fat cells, improving Novocain shot that you get at the dentist. There is a reservoir overall body shape by permanently removing unwanted fat and of pain medicine that has a small catheter that is inserted tightening skin. Laser technology liquefies the fat cells while through the skin at the time of surgery. The pump has a set often smoothing and tightening the skin that often remains a bit rate which numbs the wound continuously. This device can loose after traditional help reduce the need for narcotics that can have undesirable liposuction. This side-effects and slow your recovery. Having a pain pump for procedure cuts down on blood loss, requires smaller incisions and He was also can be done right in the st friend to cancer. be y m t los I , 06 20 , I was still so In August of office. The risk and years. By Christmas and husband of 20 er lov use and y ho m y want to leave m recovery of anesthesia d that I didn’t even sse re ally crying) su ep (u d ht ht after nig nig e ak time is reduced aw lie uld wo in found that I ng instead of lying significantly. to the fact that walki on rted ed bl sta I m s, stu I wa , it en as r. Yes, as crazy tte unable to sleep. Th be l fee e m Pearl Plastic Surgery also has a e ak seemed to m the night. bed trying to sleep ad in the middle of ro Medical Spa. “Rebecca is a licensed try un co st, could y m wn erweight and, at fir walking up and do I was extremely ov as t esthetician and does a wonderful fea ir of tennis sy pa ea od no s go Now, this wa two things: a elf ys m ht ug bo I step each job with her patients. She brings t distances. So lk at least one more wa only walk very shor uld wo I at th elf ow eter. I told mys a wealth of knowledge regarding day...rain, sleet, or sn shoes and a pedom re. I never missed a fo be y ing da go e m th d fro ha e I facials, makeup consultation and ing m day (night) than s the walking keep stman). Not only wa po a u a natural high... e yo massage,” Dr. Nichols explains. lik , e ow giv kn at u th (yo ll those things ca ey th d from a size do t ha (w Rebecca also helps with the Fraxel™ disappear. I droppe to d off the deep end rte sta ds un po ory”... “Who is ds and more Laser. With Fraxel treatment, you aria in “West Side St M endorphins?), poun e lik t fel I e! bl va of 6. Unbelie 26-28 to a pant size get dramatic results without y convinced mirror there?” e th r over a year, I finall fo f that pretty girl in of t going under the knife. los d ha I at 0 lbs. th had saggy, After keeping the 13 ecause, of course, I (b n eo rg su Instead, it uses points of light tic as pl owed me refer me to a y came, the nurse sh da my HMO doctor to g bi e th , ell W to precisely treat thousands .) everywhere u shortly.” baggy, hanging skin ctor will be with yo do of microscopic areas of he “T e m ogie Houser! I ld to d and there stood Do into the room an ed en op or do e th your skin. The treatment e when ger than my Imagine my surpris e he was way youn lik d ke loo y gu is saying goes, penetrates deep into the ended)! Th dson. Well, as the old kid you not (pun int an gr y m be to gh kiest days of ung enou skin to remove old, t to be one of the luc son...maybe even yo ou ed rn tu at Th . r” by its cove damaged skin cells, “Don’t judge a book tic surgeons stimulates your body’s t, most talented, plas my life. es fin e th of e on rate Nichols own natural healing t caring and conside Not only is Dr. Chris also, one of the mos t bu t; n after ee tio m es to qu pe ed me, answer process, and replaces the to you will ever ho d ne te lis He d. re er encounte office) were never physicians I have ev other ladies in the e cells with fresh, glowing, th of all d (an is ke outstanding d Nurse Kr ns, and just plain ta question, and he an er nc co healthy skin. Because the y m ay all , y phone calls too busy to take m technology is so precise, my, breasts, from my arms, tum in care of me. sk ss ce ex ing this treatment works not ng oved ha for over 40 Dr. Nichols has rem this flat and smooth d ke loo ’t sn ha h ac only on the face, but also on u over and s. My stom sure isn’t! Thank yo buttocks, and thigh dy bo y m t bu ar ye delicate skin areas like the ing 65 this years! Yes, I am turn ne for me. neck, chest and hands. all that you have do r fo over Dr. Nichols Dr. Nichols believes in making the healing process as pain free as possible. He uses implantable OnQ Pain To learn more about Marty’s story Pumps™ to minimize postvisit www.pearlplasticsurgery.com
BEFORE
- M a rty
AFTER
February 2010
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surgery can help you move about quicker, breathe more deeply and return to normal daily life quicker. Pearl Plastic Surgery is a state-of-the art facility. “When we started the practice, we wanted to have the best resources for our patients, so we made the decision to implement electronic medical record (EMR) software that streamlines the process for our patients and keeps our office paperless.” The EMR allows patients to fill out the necessary paperwork in the privacy of their home on a secure internet link so the time spent at the office is not wasted by unnecessary paperwork. “Our philosophy at the office is to personalize the experience for each patient. We spend a lot of time with each patient rather than seeing as many patients as possible, which seems to be the norm in healthcare today. My staff and I support my patients not only from a medical perspective, but an emotional one as well, especially my cancer patients.” Dr. Nichols does have a passion for what he does and it shows. He is making a difference in people’s lives on a daily basis and continues to provide quality service to the local community. TCG
If you are interested in learning more about Pearl Plastic Surgery, visit their website at www.pearlplasticsurgery.com or call them at 253-759-4522.
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Crossword Puzzle
ACROSS 1 Captured soldier 4 Nearly horizontal entrance 8 Cliff 12 Tree 13 Triad 14 Canons 16 Mountain ___ 18 Clerks 20 Asian nation 21 Chops 23 Bone 24 Amateur 25 Baby eating apparel 26 Shriveled 27 Shinny 29 7th day 32 Price sticker 33 Baby’s “ball” 34 Fingers 38 Divorce term 40 Synod 41 Fruit avored dairy product 42 Torso extensions 43 Genetic code 44 Crying smoke (2 wds) 46 Person 47 Make a present of 50 Build up 51 Vase 52 Kimono sash 53 __ matter 55 Jeweled headdress 58 Hindu god 60 In plasma 63 Special menus 64 Compel to go 65 Digital audio tape 66 Rally
67 Abbreviate (abbr.) 68 Artful DOWN 1 Mob 2 Capital of Norway 3 Carousel 4 Treed (2 wds.) 5 Wrath 6 Director (abbr.) 7 Electronics brand 8 Animal stomach 9 Floor covers 10 Lager 11 Literary composition 15 Uproar 17 Catty 19 South by east 22 Move away 25 Babe 26 Eschew 27 Bide 28 Aura
29 30 31 33 35 36 37 39 40 42 45 46 47 48 49 51 53 54 56 57 59 61 62
Christmas man Tiny particles Because of this Dullard Golden Arches home Hogtie Kill Remote control button Ram Sayings by Christ not found in the Gospels Male sheep Soft cheese Governor (abbr.) As previously cited See Speak Opposed Crave Not fake Lawyer (abbr.) Cut Workplace Loose gown worn at mass
4755 South 48th Street, Tacoma, WA 98409 253-475-4611 www.cplorchardpark.com February 2010
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LS Lifest y l es
A Guide to
Heart Disease “H
eart disease” is a broad term used to describe a number of ailments affecting the heart. When most people think of heart disease, they typically call to mind heart attacks. However, there are a number of conditions that can affect the heart. “Heart disease remains the number one killer of adults in the United States. The incidences of heart disease are on the decrease to some degree and the prognosis has improved,” explains Dr. Philip William Berger, DO, FACC at Olympia Multi-specialty Clinic in Olympia, WA.
Following is a listing of common heart conditions, symptoms and treatment ANGINA: Chest pain or discomfort that occurs in and around the heart when the muscle does not get enough oxygen-rich blood. It can be brought on by stress, exertion, emotion, extreme cold, or may be a symptom of a more significant problem such as clogged arteries. There are three types of angina: stable, unstable, and variant. Stable angina follows a pattern and is generally the most common. Unstable angina does not follow a pattern.
Variant angina occurs while you’re at rest and is rare. Angina may be treated with rest and medicine. All heart pain should be checked by a doctor to see if it’s a sign of something deeper. ANEURYSM: An aneurysm is an abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel. Depending on where the aneurysm occurs (brain, aorta or abdomen, for example) there
may be no pain or bulging. Aneurysms are serious, and if not caught early and treated, can lead to death. ARTERIOSCLEROSIS: This is any hardening or loss of elasticity of medium and large arteries, generally as a result of hypertension. The most common sites for arteriosclerosis are arteries in the brain, kidneys, heart, abdominal aorta, or legs. Symptoms of arteriosclerosis vary according to which
According to the American Heart Association, signs of cardiac arrest can include: ■ Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness, or pain. ■ Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach. ■ Shortness of breath with or without chest discomfort. 8
■ Other signs include breaking out in a cold sweat, nausea or lightheadedness. Women tend to have additional symptoms: ■ Unusual fatigue ■ Sleep disturbances ■ Shortness of breath ■ Indigestion ■ Anxiety
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February 2010
arteries are affected. Risk factors for arteriosclerosis include smoking, obesity, high blood pressure and/or cholesterol, stress and diabetes.
the limbs. Pain or immobility may occur due to lack of blood to meet demand. Generally PAD is a sign that atherosclerosis is taking place and medical intervention should be taken.
ATHEROSCLEROSIS: This is a condition when fatty material collects in the arterial walls. It can harden over time, causing calcium deposits, resulting in the restriction of blood flow. Avoiding fatty, high cholesterol foods, exercising regularly and routine checkups at your doctor are all ways to head off atherosclerosis at the pass.
STROKE: This is an interruption of blood supply to any part of the brain. It can come on suddenly or display symptoms over time. Changes in alertness, sleepiness, speech, loss of coordination, trouble moving limbs, and many other symptoms can be indicative of stroke. A stroke may
HEART ATTACK: Also known as cardiac arrest, this is the culmination of many heart conditions, such as angina, arteriosclerosis, and atherosclerosis. It occurs when blood and oxygen are not able to reach the heart. Symptoms of a heart attack are different for men and women. “Heart attacks are often more subtle and less apparent in women. It often goes unrecognized for longer periods of time and when found, it is often more serious,” explains Dr. Berger. “Don’t wait for chest pain. It can be a pressure or tightness or an even more subtle difference. Often associated symptoms may be more apparent than the discomfort. These may include breaking out in a sweat, suddenly feeling short of breath and that can be more prevalent than the pain that we associate with a heart attack.”
GoRedForWomen.org is an online resource that can help you identify and manage heart health and provide valuable information, resources and support to help you have a healthy heart.
HIGH CHOLESTEROL: High cholesterol can be a factor in a number of heart conditions. Therefore, it is desirable to maintain low cholesterol levels. Cholesterol is measured as total cholesterol, HDL (the good cholesterol) and LDL (the bad cholesterol). Total cholesterol under 200 mg/DL is optimal. Less than 100 mg/DL of LDL and HDL levels of 60 mg/DL is even more desirable. HYPERTENSION: This term is used to describe high blood pressure. Blood pressure is measured in two readings, the systolic pressure, or the pressure created when the heart beats, and the diastolic pressure, or the pressure in the heart when it is at rest. Blood pressure higher than 120 over 80 is considered high and should be monitored. How much water and salt you have in your body; the condition of your kidneys, nervous system, or blood vessels; and the levels of different body hormones can all cause hypertension. A change in diet or medication may be needed to control blood pressure. PERIPHERAL ARTERIAL DISEASE (PAD): PAD is when insufficient blood flow reaches the arteries that supply
February 2010
The Community Guide
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be mild and cause temporary conditions. A massive stroke may lead to paralysis, brain damage or even coma. A stroke is a medical emergency. It is important to get the person to the emergency room immediately to determine if the stroke is due to bleeding or a blood clot so appropriate treatment can be started within 3 hours of when the stroke began. Clot busters may be given if it is a clotting condition. “The heart attack survival rate is much higher now than it was in the past. This is due not only to the public’s increased knowledge of symptoms, but also to our improved healthcare delivery. There are many proven interventions that make a big difference,” says Dr. Berger. What is his advice for staying heart healthy? Do not smoke! Live life in moderation and stay active. TCG
{
Each year heart disease kills more women than men. 38% of women die within one year of suffering a heart attack (compared to 25% of men).
{
What You Should Know About Smoking THE BAD ■ More than half of heart attacks among middle aged women are attributable to tobacco. ■ Smoking lowers the age of first heart attack. Woman smoker get a heart attack 19 years earlier than nonsmoker woman. In comparison, men 7 years earlier. ■ Risk of coronary events starts to decline within 3 to 5 years of stopping smoking and reaches levels for people who had never smoked. THE GOOD ■ The risk of heart attack starts decreasing within 24 hours of quitting smoking. Within 1 year of quitting, the risk decreases significantly and within 2 years it reaches the level of a nonsmoker! ■ Smell and taste improve within days! ■ Within three months of quitting, the smokers’ cough disappears in most people!
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The Community Guide
Steps to reduce
your risk of
Heart Disease
Simple changes such as watching what you eat and exercising are two powerful steps in helping to reduce your risk of heart disease. Here are some simple tips to help reduce your risk of developing heart disease. ■ Add heart-smart foods. Living a hearthealthy lifestyle does not mean giving up delicious foods. Fruits, vegetables and whole grains are heart-healthy winners. Talk to a dietician or your doctor to find the right food for your family and health goals. ■ Get a move on. Physical activity is essential for a healthy heart. Start small. Take the stairs instead of the elevator, squeeze in a 30-minute walk during your day or park your car in the farthest parking spot at the grocery store. Swimming, running, social dancing or skiing can also do the trick! ■ Weigh your options. Being overweight puts your heart at risk. If you are overweight, losing as little as 5 percent to 10 percent of your current weight can help reduce your risk for heart disease. Healthy eating and physical activity can help you reach your healthy weight goals. ■ Know your numbers. Learn about your own risks for heart disease. Keep tabs on your health and pay attention to any abnormal signs and symptoms. Visit your health care professional and have your cholesterol checked regularly. February 2010
These Foods Can Help Lower Cholesterol Diet and heredity play key roles in cholesterol levels. While it’s relatively impossible to change what you’ve inherited from a long line of relatives before you, you do have control over what foods you eat -- especially those that can help lower cholesterol in a natural, drug-free way. • Enjoy oatmeal and other fiber-rich foods. Oat bran and rice bran have been shown to moderately reduce cholesterol levels. • Consume five servings of fruits and vegetables daily. Fruits and vegetables are high in antioxidants, which in general are good for fending off diseases in the body. • Choose legumes several times a week. Replace the animal protein in your diet (meat and poultry) with plant protein. Beans are a good source of protein and fiber and can make for filling meals. Soy products are also effective for keeping cholesterol in check. • Go for garlic. Research indicates that compounds in garlic help to staunch production of cholesterol in the liver. It works in much the same way as some of the prescription cholesterol-lowering drugs. • Get the benefits of blueberries. Studies show that a compound in blueberries (pterostilbene) may help lower cholesterol as effectively as commercial drugs, with fewer side effects. • Factor in good fats. Not all fats out there are bad. Omega-3 essential fatty acids can help raise levels of “good” cholesterol, or HDL. Good fat foods include olive oil, avocados, olives, and some nuts. • Pour a glass of pomegranate juice. This tart treat is full of antioxidants and has been touted for years as a sound choice for improving health. • Grab some yogurt with live active cultures. There is research that indicates that yogurt with active cultures (probiotics) can do more than just settle your stomach ailments. Yogurt may help to prevent reabsorption of cholesterol back into the blood stream. • Look for supplemented foods. Stanol esters and plant sterols are plant-produced compounds that block the absorption of cholesterol in the intestines. Some foods and margarines are adding plant sterols to help fight high cholesterol. TCG February 2010
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‘10
F ebr u ar y e v ents
February 2010 February 13, 2010 Big Cats, Big Party: This Valentine’s weekend, fall in love with tigers all over again at the Big Cats, Big Party celebration. All three of the zoo’s tigers, Bali, Java and Jaya, will be on exhibit Saturday and Sunday, and their home in the Asian Forest Sanctuary will be bubbling with fun and activities all weekend long. 10 a.m. to 3 p.m.; Point Defiance Zoo & Aquarium; $7.50 - $13.50. www.pdza.org/calendar.php?eid=134 Februay 14, 2010 The Philadelphia Story: Only days before Philadelphia heiress Tracy Lord (Katharine Hepburn) marries a respectable society man, her playboy ex-husband (Cary Grant) and a tabloid reporter (James Stewart) show up determined to disrupt the nuptials. Tracy soon finds herself the center of a tangled love triangle with hilarious consequences. Nominated for six Academy Awards! 3:00pm; Theatre on the Square, Tacoma, WA; Tickets are $9; 253-591-5894; www.broadwaycenter.org/season/showDetails.asp?key=15. Feburary 12 – 15, 2010 Great Back Yard Birdcount: Tahoma Audubon Society is excited to announce the 2010 Great Backyard Birdcount! This is Citizen Science at its best! Count for fun, Count for the Future. http://www.tahomaaudubon.org, 253-565-9129, Free. February 18, 2010 Educator Evening: Tacoma Art Museum. Enjoy snacks, relax and mingle, and meet some animals in the galleries and in real life. Free for educators. RSVP to Education@TacomaArtMuseum.org. Members, FREE Adults, $9 Students, Military, Seniors (65+), $8 Family, $25. www.tacomaartmuseum.org. 253.272.4258; 4:30pm.
MARCH 2010 March 6, 2010 Ghosts of the Great Hall; Unsolved Mysteries: Uncover some of Washington’s unsolved mysteries with characters from the past. Washington State History Museum, Downtown Tacoma; Free. 1 p.m. to 3 p.m. www.wshs.org/wshm/event-programs.aspx.
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March 13, 2010 Molly Wizenberg: A Homemade Life: For more than four years, Molly Wizenberg has explored the relationship between food and memory on her hugely popular and award-winning blog “Orangette”. She recently opened a new restaurant, “Delancey”, in Seattle and released “A Homemade Life: Stories and Recipes from My Kitchen Table”, both of which allow Wizenberg to share the flavors that have helped shape her life. Wizenberg will discuss her journey through “a life with the kitchen at its center” at Tacoma Art Museum. This program is free and will be followed by a book signing. Email Education@TacomaArtMuseum.org or call 253.722.2455 for more information. Tacoma Art Museum, 1701 Pacific Avenue Tacoma; 1pm; www.tacomaartmuseum.org; 253.272.4258. Free. March 12, 2010 RAGS Wearable Art Sale: Love beautiful handmade jewelry, clothing, etc? Support YWCA Pierce County’s Domestic Violence Prevention and Intervention Programs: RAGS Wearable Art Show and Gallery: March 12-14, 2010 at Larson’s Mercedes Benz of Tacoma in Fife. Fri, Sat: 10-6; Sun, 10-4; Free; Larson’s Mercedes Benz of Tacoma in Fife; 206.375.7503; www.ywca.org. March 10, 2010 Foothills Dash: This fun run/walk take place on The Foothills Trail and is open to people of all ages and ability levels. The course starts and finishes at Ptarmigan Ridge Elementary School. Foothills Trail, Orting; 8:00 a.m. $15.00 (Pre-register by March 8); www.co.pierce.wa.us/pc/abtus/ourorg/parks/footdash.htm. March 20, 2010 Most Magnificent Mutt Show: There are no fees to enter your pet, however registration is limited to girls and boys up to the age of fourteen. The winning contestant will be a V.I.M. - “Very Important Mutt” - in the Junior Daffodil Parade. This is a fun event for kids and the young at heart. So come on out and enjoy the fun. The Daffodil Festival Royal Court will conduct the Judging and will be on hand for picture taking and autographs. 10 a.m. to 12:30 p.m; Frontier Park, 21802 Meridian Ave E., Graham, WA; Registration at the door. www.daffodilfestival.net/Mutt_Show/Muttshow.htm
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February 2010
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www.Olympusspa.com
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P.O. Box 11871 l Olympia, WA 98508 Office 360.350.1237 l Fax 253.292.3667 www.catalystmediagroupinc.com
www.pearlplasticsurgery.com
PE A RL P L A S T I C S U R G E RY D R. C H R I S N I C H O L S PLASTIC & R E C O N S T R U C T I V E S U R G E O N
6002 North Westgate Blvd. Suite 160
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Tacoma, WA 98406
253.759.4522 Our services include U
Botox
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Juvederm
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Restylane
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SmartLipo
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Breast/Body/Facial
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Cosmetic Procedures
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Mommy Makeovers
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Body Contouring
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Microdermabrasion
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Latisse Eyelash Enhancer
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Fraxel Laser Skin Rejuvenation
See our website for details on these and other services we offer.
Refresh your look for the holidays!
$500 OFF
any SmartLipo procedure Offer cannot be combined with other discount. Must present coupon to receive discount. Expires 03.31.2010
Save 15% on
Botox, Juvederm, Restylane & Sculptra Offer cannot be combined with other discount. Must present coupon to receive discount. Expires 03.31.2010
Dr. Nichols wants you to have a faster, more comfortable
ON-Q PainBuster
recovery with ON-Q® PainBuster®. Used following surgery,
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Starts working right after surgery
ON-Q PainBuster automatically and continuously delivers
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Provides significantly better pain relief than narcotics alone
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Significantly reduces your need for narcotics
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Can help you get back to normal quicker
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Helps reduce or prevent narcotic side effects like nausea and grogginess
non-narcotic pain relief right to the surgical site for up to five days—so you can feel better faster.
www.iflo.com Rx only. I-Flow, ON-Q and Painbuster are registered trademarks and Redefining Recovery is a trademark of I-Flow Corporation. M1306448 01/2010
There are inherent risks in all medical devices. Please refer to the product labeling for Indications, Cautions, Warnings and Contraindications. Failure to follow the product labeling could directly impact patient safety. Physician is responsible for prescribing and administering medications per instructions provided by the drug manufacturer. Refer to www.iflo.com for product safety Technical Bulletins.