R. Laurence Berkowitz, MD

I can't say enough about the entire team at Aesthetx. I noticed that my face was getting more and more sallow as I aged, and I looked tired. After meeting with several plastic surgeons, I decided to go with Dr. Berkowitz at Aesthetx. Here's what set him apart:

• Another plastic surgeon wanted to give me a lower bleph for my lower lids, but Dr. B told me not to touch the lower lids - it could pull my eyes down (separately, I had to see an ocular surgeon for a medical issue who is actually a plastic surgeon and she told me the same thing, so it was good to get that confirmation).

• He told me that a mini facelift with fat grafting would give me the results I wanted - natural and refreshed. We also did my hands since I would be out and he was harvesting fat for my face anyway.

• The before and after care really sold me. First, they had me on a nutritional supplement program and skin care regime to speed healing. I also received laser treatments after to reduce bruising and scarring - all part of the cost, and it helped tremendously. (Note that I got another laser treatment for the scarring at my 6 month appointment, but unfortunately, I had to pay for that - and it's not cheap - $450).

• The team is super professional and friendly - I really enjoyed working with all of them.

• I’ve been working with Dr. Hausauer separately (she’s a dermatologist) because I developed an unrelated case of melasma and rosacea. The melasma was actually brought on by another plastic surgeon who used a laser on my face on a setting that was too high, and Dr. H. is helping me correct this. I am certain no mistakes like the last plastic surgeon will happen in this office. They’re actually competent.

But I digress. Back to the procedure and subsequent healing. The procedure was almost 6 hours long, and relatively painless. I only needed pain meds for the first few days. My swelling was worse weeks 3-4 and I looked a little weird until about 6-7 weeks, but then things just got better and better. No one would ever guess I had surgery and I'm really happy with the results. In fact, I'm thinking of getting a little more fat grafted, but Dr. B. told me to wait a full year and then we can decide.

Note that they are NOT cheap! They weren't the most expensive by a longshot (that honor went to Dr. Hessler in Palo Alto who quoted me $60K (which included my eyes))! What really jacks up the price is not the actual surgery but the cost to rent the medical center & staff, which is almost as much as the surgery itself, unfortunately.

Anyway, results below!



Updated on 30 Aug 2023:
Quick update one year later. I’m so, so, so happy with my results. However, when I went in for my one-year follow-up, I mentioned that I was a little sad my tear troughs and temples weren’t quite as full when I first had it done (because I was so swollen!) and Dr. B said, “Oh, let’s do a little more! On me - all part of your original surgical costs.” How fabulous! So for no fee from Aesthetx (I did have to pay the surgical center costs, of course), I just did some additional fat grafting under my eyes, temples and lips. If I remember, I’ll post pics after the swelling goes down. But again, just can’t say enough about this team!

My experience with Dr. Berkowitz has been exceptional. He and his office staff are knowledgeable, kind and efficient. I am 6 weeks post op from a breast reduction with lipo procedure, and am thrilled with my decision to choose Dr. Berkowitz. At 64, I had been suffering from back, shoulder and neck pain for decades; since the surgery the back pain gets better by the day, and the neck and shoulder pain are almost completely out the door! I wish I could have done this years ago!

My breasts look great! My breasts are symmetrical and the nipples did not lose their sensitivity. Scarring around the nipple is minimal and disappearing daily. Dr. Berkowitz uses internal stitches and no drains. I have been recovering very well from the beginning; took only tylenol after the first three days and didn't need to take even that after a very short time.

Dr. Berkowitz's knowledge, experience, skill and integrity enables him to provide a perfect experience. Choosing him to do the surgery is one of the best decisions I have ever made!

After my 3rd baby 2.5 years ago, my breasts were horribly saggy with no fullness. Hydrasolve used in fat removal of inner and outer thigh, 300 CCs of fat transferred to each breast. Strattice used in lift. Two weeks later, I am feeling much better. Lipo is very painful, more than expected. Lift pain manageable.

Dr. Berkowitz is, quite simply, the best. It is beyond clear that he cares deeply about all of his patients. I had rhinoplasty with him and am receiving a revision soon to make some minor touch ups. His warranty to waive the surgeon's fee for revision is proof that he truly cares about the patient's happiness and isn't just after your money. He has the best bedside manner of any doctor I've ever met in my life, he is kind, caring, and gentle. If you are looking for a doctor who will help guide you to achieve the look you want and take care of your physical and mental health in the process, you are looking for Dr. Berkowitz. He's an angel, and his work is masterful and architecturally sound. Truly an artist and the best in the business.

I decided on breast augmentation because I have always been insecure about my breast. I am 5'1" and 115lbs, currently wear a 32-34 A cup. I went to many plastic surgeons for consultation and even made an appointment for surgery with one doctor but cancel the day before surgery because I didn't feel comfortable in the end with him. I found Dr. Berkowitz through a coworker/friend of mine. Dr. Berkowitz is confident and has been doing cosmetic surgery for more than 30 years so I felt very confident in his work. We went over several different CC sizes and we eventually came to the decision of 370cc Sientra Classic Shaped Textured implants. I did not want to look unnatural so the shape implants offer more of a natural look I was looking for. However,I went back and forth with the 370-400cc size but Dr.B believed it would be to large for my size.

Updated on 25 Jun 2016:
The first night of surgery was a blur. The percocet that Dr. Berkowitz order for me kept my pain level low but on a pain scale 0-10, I think I was constantly at 5 to 6 when awake. I did not want to overdo it with the pain medicine for fear of constipation.
By the first day postop I was walking around (from bed to couch) but was very sore.
I highly recommend investing in a recline pillow because you will not be able to lay flat for at least 1 wk (well at least for me).
Second day postop, I was allowed to shower which was great. During that time I examined my breast and they felt so tight and firm. They did not really feel like they was part of my body when I touched them. Because of that I really did not like to touch them during the initial recovery phase.

Updated on 25 Jun 2016:
New boobs????

Updated on 28 Jun 2016:
Postop day 6, my boobs are still swollen and the left breast hasn't drop yet but it still early. I am getting nipple sensation back into my left breast as oppose to the right one. Dr. Berkowitz told me to massage the nipples. Because I have texture implants I don't have to massage the entire breast.

Updated on 28 Jun 2016:
Postop day 6 my breast was still swollen and the left breast was higher than the right one. My nipple sensation seems to be returning quicker in the left breast, which is weird because the left breast seems to be more swollen.

Updated on 28 Jun 2016:
3 months postop. The nipple sensation has not full return but I will keep stimulating them.

Updated on 2 Jul 2016:
Went to Victoria Secret( 2 mo postop) and got measure, surprisingly I am 32 DDD. I think I was still a little swollen when I've got measured. But I normally don't wear bras anymore, I wear silicone nipple covers.

Updated on 4 Jul 2016:


Updated on 23 Oct 2016:
The left breast is still higher in my opinion. I guess it my normal anatomy. Boobs are very soft and squish. I sleep on my stomach, I have been for several months now. One thing I'm noticing a lot more is like electrical shocks in my right breast. I think I read somewhere it the nerve ending reconnecting. Oh yeah still no nipple sensation just nipple soreness in both breast.

Updated on 30 Mar 2017:
So it's been a year since my breast augmentation surgery. I have to say I am please with the results for the most part. I do however wish I had went up to the 400cc size but I still love my results. They are soft and squishy. I still do not have much nipple sensation but I can fell every where else around the breast. I still hoping it will return completely.

Updated on 9 Apr 2017:
My scar

Now that my kids are in college, Im ready to get back to me and what makes me feel good. Love my kids but having them left my belly buldgy with a lot of stretch marks. Dr Berkowitz told me that CoolSculpting probably woudn't tighten my skin but I will say that not only is the fat going away but the skin is tighter too!

I just went for my second round of treatment because I wanted to see more results. The first session was great, but it only scratched the surface of what I really wanted. After talking to my doctor, I went back to work on my love handles. I'm looking forward to seeing the full result from my treatments.

I wished to get a tummy tuck or breast augmentation so long already. My oldest is 13 my youngest is 7. I didn't think I could take much time off work to do the tummy tuck because I'm very active at my job, so I chose BA first. Yesterday morning was my operation, and I have been in a lot of pain.
It feels as if the center of my chest sternum area is being pulled in opposite directions. I was a 32 C and received 325cc silicone gel. I'm not sure what the results will be. So far I have numbness on the nipples and under the breasts. I'm only 5'1 and 98 lbs so I couldn't go much bigger than this, especially because I wanted something natural looking. It looks great for now, but still way too early to tell.

Updated on 20 Dec 2015:
I'm in this phase where I don't see anything special, and the pain is hardly tolerable. I did not take pain meds the second day, because I mostly just slept. The 3rd day, I needed them badly. The percicet pills don't seem to alleviate the pain, but they do put me to sleep. Sleeping is awful, I can't get comfy. I'm up in a sitting position still. I cannot stand to wear the sports bra either. I was able to get up and go out to the mall with my family, but every bump on the drive was very painful. I also have a lot of numbness in both breasts. I hope everything resolves ok, and soon. I have my first follow up on Monday, 2 more days.

Updated on 20 Dec 2015:
So I've been having 2 things bother me that I'm bringing up at my post op. The first thing is a muscle spasm. It is a strong jolting that is more annoying than painful in my mid back. I've iced it and that seems to help. The second thing is my stomach feels very sore and bloated. I don't know if it's because of the pain pills, percocet, or if it's because I had to get off my birth control pills to get this done and I'm going to have a period. I just know that my stomach looks and feels bloated, and feels like I've done crunches. The soreness in my breasts has went down more, and I can change my own shirt slowly now. They still feel pretty solid, and numbness is still present. I haven't taken percocet in 14 hours and I'm ok. I was able to take a walk around the neighborhood today no problem. I go back to work in 3 days and I think I'll be ok then.

Updated on 21 Dec 2015:
So it has been a full 4 days, and my post op was today. My surgery was Thursday morning at 8 am and today is Monday. I'm feeling much better, with less pain. It's only sore when I've been laying down too long and need to get up.
My Dr. Told me everything looks good, but he is concerned about the numbness. He did recommend the 290cc for me, but said the highest I can go was 325cc. So being excited and not wanting to wish I went bigger, I chose the 325cc. Now my nerves are stretched and I lost feeling and I'm not sure when it will come back. :-(
Of I pinch hard enough, I can feel the nipple area, but anything else is very numb and tingly except the top part of my breasts. These implants don't require massages so I'm happy about that, and I was told to continue to wear the sports bra and underwire is ok. No more pain meds, and sleep is still uncomfortable.

Updated on 25 Dec 2015:
I didn't want to go back so soon, but financially I had to. I am a bartender and lift bottles, other items under 10 lbs. I do this all day. I tried to take it very slow and asked for help a lot. I made it through, but I did get sore after. I'm not anxious about this. I did this for me, not for show and tell. I can wait for them to settle I just had to work. I'm taking it easy and hoping I'm not over doing it. There is no more pain, but they're very hard and high. Just like the previous pic. I'll update when I can show y'all a change :-)

Updated on 30 Dec 2015:
Doc says everything looks good. Feeling is coming back gradually on my right side, a little slower on the left. The left breast had a fold height change as well, and was slightly larger. It's still numb around the bottom and sides. It's been 12 days, and I am happy with them this far. I know I have a while to go before I see full results, but I see the shape they are taking and I like it. They are the perfect size for me. I've worked a few shifts at work and I'm ok. I do feel the implants being pushed by my muscle when I lift something or push something, so I take it easy as much as I can.
I know I really wanted a full tummy tuck to get the stretch marks off and wear a bikini next summer, but this I feel was a way better choice. The downtime was not as bad, and I just love them.

Updated on 31 Dec 2015:
Tenderness for sure, but nothing too bad. I just wanted to share the healing progress. I don't feel they've dropped yet, or maybe only slightly, but I love them. I have not dressed them up yet or anything because I was told to wear the sports bra a little longer due to the left scar placement. They are still very stiff, and haven't softened, but like I said it's only been 2 weeks.

Updated on 4 Jan 2016:
Well I'm 3 weeks in now, and nothing else has changed. I still have numbness on the outer part of the breasts and the nipples are very tender and sore.
They still appear high, and I can feel them moving around when I do certain things or lay a certain way.
The scars look the same, and I have alternated between a sports bra and regular bra. I have not been properly sized yet. I wore am 34 D and it seems ok with the band not being as snug as a 32.
I was a 32 b/c before.
I hope the tenderness goes away soon, and that they soften up more. They definitely don't feel like my own yet.

Updated on 11 Jan 2016:
So I went to my 3 weeks appointment today, when I am actually a little over, and things went well. I was given the clear tape to minimize scarring, and told that maderma is not very efficient at reducing scars. I was concerned that the shape of my left breast is different from the right, but it's still very early and the final results aren't there yet. I don't feel the need to raise that concern yet. They look normal in a bra. I am also able to wear a regular bra now. The tenderness is pretty much gone except on the nipple area where it's a little sore still, and the numbness is gradually subsiding. I can feel more of the breast now. The scars seem to be fading fast, and I don't think they'll be visible at all in another 2-3 weeks and I'm a slow healer. Like I said, I don't like the shape of my left side, but I think that I'm the only one noticing it. I don't see it in pictures, only when I look in the mirror.
I went to victorias secret today to get a new bra, but their sizing is s little bigger than other stores. They put me in a 32DD but I'm guessing I'm a full D anywhere else.
My original size was 32 C and like I mentioned before I am petite, 5'1 around 100lbs.

Updated on 19 Jan 2016:
There is still numbness in my breasts but not in the nipple area, mostly under and on sides. But sure on bra size still, this in the pic is a 32 dd from VS. I'm still using scar tape. No issues or pain, but I feel weird how they look without a bra :-/ still settling in though

Updated on 21 Jan 2016:
Just for comparison I've added my before pics. I was a 32 b/c. My smaller frame is probably why my chest hurt so bad after. The stretching on the sternum was so painful.

Updated on 3 Feb 2016:
I went to my follow up yesterday and we took pictures. I feel like even though the Dr did some adjustments to my left fold that they are still uneven. He said that it would have been much more higher if he'd left it alone but it was impossible to tell just how much the implant would change the breasts. Maybe only my eyes see it more because it's my body. Either way I'm happy because they look much more natural and are softening well. I'm so glad I don't have an artificial look which was my biggest concern. I wanted these to droop with my natural shape. He says that in another month they should be close to final results and won't change much unless I gain or lose weight.
In the pic I am squeezing them a little to show just how soft and squishy they've gotten compared to the solid way they looked and felt in the beginning. I do have the gel natrelle 410 style in 325 cc and as I've mentioned before I'm have a small frame and was previously a 32 C or D in some bras. At Victoria Secret I'm a 32 dd which is annoying because they don't have many items in that size and the 34 d is a little loose.

Updated on 3 Feb 2016:


Updated on 16 Feb 2016:
I do like them a lot, but lately I've been annoyed with it. I feel like they haven't dropped much since the first month wrapped up. To me they seem really high. Nonetheless I do enjoy them. I have nearly full feeling back, and the scars are practically gone.

Updated on 17 Feb 2016:
So the scars are light, but the darker one is from a fold correction on the left side. I'm using silicone tape and vitamin e oil.

Updated on 29 Mar 2016:
It's been 3.5 months now and I just don't like how they feel or look. My dr had to readjust the fold on one side during the surgery, and I feel like he should have left it alone. That one side he claimed was too big, is now a huge bulge. My left breast looks very large to me. I don't like the shape either. I think I should have went smaller. I have 325cc and I think 290cc would have been okay. I also have very little feeling in my nipples and under the breast area. I put an ice cube around them to see where the feeling cuts off, and it's right underneath my nipples and on them, although they do feel tender and sore. There's just no sensitivity right now. I'm stuck with them I guess.

Updated on 11 Apr 2016:
Well I'm not very happy how they look without a bra. They're uneven and I don't like it at all. The bra in the pic is a 32 D by Victoria Secret, slightly padded. Obviously it's still too small. I was measured as a 32d at a different store and a 32 dd at V S. The scars are being treated with vitamin e and maderma. I'm just approaching 4 months post op. I love how they look in a bra, and in shirts, but not nude. The scars are hidden now, but healing slow.

Updated on 11 Apr 2016:


Updated on 9 Jan 2017:
Do it has been 2 years now since the initial surgery and I would just like to tell everyone that I'm happy with it. Some of the ideas I've had in this time were that I became single recently, and men I have gone out with made comments that seemed to be negative towards women with implants. My answer is always the same, I did not do this for any attention from the opposite sex. This was entirely for me myself and I. Just add I'm not judging men on their sizes, I don't expect that in return. I know if I'm wearing certain clothing that my breasts will be more noticeable, and I'm not very showy about it. But when someone asks I simply tell them yes, I had a little help. And I no longer feel self conscious about them asking. My girlfriends are all supportive as well and I'm dating a great guy now who had never asked about them and adores my body ????
With that said, there are no more changes that I can see. There is still numbness more do in my left breast, and the nipple area has not gone back to its original sensitivity sadly. I can feel them when touched firmly, but the bottom half of my breasts still have blank feeling areas. I'm not sure if this is permanent. I hate this part, but oh well. I do get cramp pain every now and then in my left breast but I think it's because of side sleeping and sometimes tummy sleeping. Well ill leave y'all with 1 more pic and I hope everyone is happy with their decisions and love your body!

I have 4 kids ages 4-14. I am fairly thin about 125 pounds and have tried everything to strengthen my tummy muscles. But... they have split. I also have bad scarring from the stretching that others moms my age don't have. I also had an umbilical hernia he repaired that was small. While I was under, I had him revise a mole scar on my thigh and it looks so much better. I also did fat grafting from my stomach to my breasts (previously had implants 3 years ago). I am 3 weeks out and it's been a long recovery. Hoping it will be worth it for the rest of my life:-)!!!!

I am a very active 57 year old, play competitive tennis and surf. Living near the beach all my life, my face has been exposed to a lot of sun damage. I had deep marionette lines and jowls in my lower jaw area. My lips were very thin and more than one person even commented on that fact! It was embarrassing. I had no eyelid and my makeup was always smeared under one eye that drooped more than the other.
I asked Dr. Berkowtiz what he would recommend if it was up to him and I followed all of his advise. At first I was skeptical about facial fat grafting, it causes more swelling and takes longer to heal. He said he could do a better job if he did that as part of my procedure. I trusted him because I had previous experience with him. He fixed a tummy tuck that I was not happy with that another surgeon had performed. I also knew a woman in her 70's who had a facelift that Dr. Berkowitz performed when she was in her late 50's, and she still looks great! After only 10 days post surgery I was ecstatic.
The team in his office is very warm and professional. Dr. Berkowtiz really took his time in my initial consultation and each visit that followed. He really listened to my concerns and I never felt "brushed off or silly" for raising my concerns, which were many!
Dr. Berkowtiz takes his time, has a gentle manner, soft touch and is an expert in his field. He understood that I didn't want anyone to look at me and notice that I had "work done". I am the natural type and wanted to keep it that way.
After 2 weeks I began seeing friends and today at 3 weeks am back to all my regular activities. I have only told a few very close friends and family. People I see have said this.. "wow, you look great, did you get a new hairstyle, you look like a teenager"... another person said "you look really good, very rested".
At 3 weeks I am very, very happy and feel it was worth the time, effort in recovery and money spent!