Dr. Jeffrey Klugman hails from Philly.  Our mild winters coupled with Atlanta’s friendly people caught his attention and The Hand and Upper Extremity Center, where his medical practice is based, sealed the deal. Although he has yet to switch his love for the Philadelphia Eagles to the Atlanta Falcons, we are honored and thankful that Dr. Klugman calls Atlanta home. Always up for a challenge — when he’s not teeing up on the golf course or building LEGOS with his beloved son Harris or his enjoying a tea party with his cherished daughter Samantha — he’s conferring with his patients and executing incredibly skillful procedures for both children and adults in the operating room. 

     A surgeon’s life is intense and when it’s time to relax, he loves to travel and high on his list of favorites are African safaris, journeys to Israel and beach getaways, all together with his incredible wife Robyn. His family’s favorite destination is Margate City on the Jersey shore; he’s been vacationing there since he was a child. One of Atlanta’s and the Southeast’s foremost experts in hand surgery, known for his acumen with both children and adults, his services are in very high demand. He’s the crème de la crème, one of the most sought after and specialized hand surgeons in the South; we are lucky he made Atlanta his home.

     Dr. Klugman’s prestigious resume includes graduating from Tufts University School of Medicine in Boston where he  was selected for the Alpha Omega Alpha Medical Honor Society; a residency in orthopedic surgery at the world-renowned NYU/Hospital for Joint Diseases Orthopedic Institute and a distinguished Harvard University Hand Fellowship at Brigham and Women’s Hospital, Boston Children’s Hospital and Massachusetts General Hospital.

    Dr. Klugman has authored multiple publications and is active in training residents and fellows. He holds a Certificate of Added Qualification in Hand Surgery and is a member of the American Society for Surgery of the Hand and the American Academy of Orthopedic Surgeons. 

TG: Dr. Klugman, you treat both adults and children. How can you help newborn infants with congenital deformities? 

JK: My partners and I have a special interest in pediatric hand surgery and we are often asked to see children with congenital differences. These patients require specialized care and attention as these often are unique problems. Time must be spent in discussion with the family so they can understand the medical issues, treatment options to improve function and cosmesis (preservation of bodily beauty), timing of treatments, and long-term prognosis.

    Congenital issues affect the child but also have an impact on families. Treatments can include therapy, splints, comprehensive medical work-ups, and surgical intervention. Our practice supports a Pediatric Hand Fellowship through the Children’s Healthcare of Atlanta System to hopefully educate future clinicians in how to manage these difficult problems. 

TG: What other pediatric hand problems do you commonly treat?

JK: There are a wide variety of pediatric hand issues. Trauma, such as fractures of the wrist, hand, and fingers, are the most common. I see a large volume of wounds and lacerations often involving tendon and nerve injuries. Masses and cysts are also frequent problems. We care for recreational to high-performance athletes with traumatic injuries, sprains and overuse problems. Crush injuries, finger tip injuries, congenital trigger thumbs/fingers and inflammatory problems, are also quite common.

TG: Let’s talk about your life-changing work with adults. How soon do you like to see a patient after their initial injury?

JK: Often after an acute injury people are seen at an ER or an urgent care. Other times, injuries may be less severe. I believe with injuries of the hand/wrist/forearm it is best to be seen early. Problems are easier to treat when they are more acute. Fractures may heal with malalignment or displacement if not treated properly, and tendon injuries often have a strict time line associated with repairs that dramatically affects outcomes.

    In addition, ER and urgent care MDs are not specialists so it is not uncommon for them to not fully appreciate the severity of an injury or miss subtle issues. Coming for an evaluation early allows for a more accurate and effective treatment with improved outcomes. If the injury is not severe, then patients can be reassured and encouraged to progress with motion and functional activities to prevent stiffness and other complications.  

TG: Arthritis is a common problem. I can remember my mother suffering with arthritis both via pain and the shape of her fingers. Are there any new solutions? 

JK: There are multiple types of arthritis such as osteo, rheumatoid, post traumatic, septic, etc. It sounds like your mother had osteoarthritis. This is a very common problem affecting the hands more so in women than men. It is typically a genetically pre-programed process, meaning it affected your grandmother, mother and will likely affect you. Arthritis of the hand can result in deformity, stiffness and pain.

    Unfortunately, there is no way to prevent this process from occurring or progressing in patients with a pre-disposition. There are options to help with function and cosmesis. Arthritis of the thumb base is a particularly common problem we see that can be painful and functionally limiting.  Fortunately, there are good options available to treat this issue and dramatically improve both pain and function. Non-surgical treatments can include steroid injections, a variety of splits, and nonsteroidal anti-inflammatory medications.  Outpatient surgical treatments can often provide a more permanent solution.  

TG: Is there a treatment for carpel tunnel syndrome? Many people, especially in our computer age, suffer from this malady. Please also tell us about Trigger Finger — what is it and can it be treated?

JK: Carpal Tunnel Syndrome is among the most common problems I see. Carpal Tunnel is compression of the median nerve as it traverses from the forearm into the hand. The carpal tunnel is a defined space with three side bones and a dense ligament forming the roof of the tunnel. When pressure increases in the space it causes the nerve to become compromised and this results in numbness to the thumb, index, middle and part of the ring finger. It can also cause weakness to the muscles at the base of the thumb, which significantly affects fine motor function.

    Patients with Carpal Tunnel Syndrome often require an EMG/Nerve conduction study to objectively evaluate their complaints. Treatment can include a variety of non-operative measures as well as carpal tunnel release surgery, which has a very high success rate in improving symptoms and preventing them from worsening or recurring over time.     

Trigger finger is another common problem I often treat in my office. Trigger finger results from inflammation and catching as the flexor tendon glides through the sheath and first pulley that keeps the tendons adjacent to the bone. In a trigger finger, the tendon becomes inflamed and catches at the first pulley creating a mechanical block, like a truck that’s too big to fit through a tunnel. The solution is to make the truck smaller with a steroid injection or, if that does not solve the problem, I can permanently make the tunnel bigger with a small outpatient procedure to release just the first pulley. Trigger finger release surgery is very effective with high patient satisfaction and minimal down time.  

TG: What separates a hand surgeon from an orthopedic surgeon or plastic surgeon? 

JK: Hand surgeons are typically orthopedic or plastic surgeons who do additional fellowship training specifically in hand surgery. The hand is an extremely complex area anatomically. I tell patients the hand is like Manhattan, lots of expensive real estate in a small area. I believe subspecialization allows for more accurate diagnosis, improved treatment options, more effective therapy and overall improved outcomes.

Renowned in his field, the extraordinarily gifted Dr. David Brothers has one of the premier plastic surgery practices in the country.  He was born in New York City but came to Atlanta and completed his undergraduate degree from Emory University where he graduated Phi Beta Kappa. He received his medical degree from the University of Miami School of Medicine where he was elected to the Alpha Omega Alpha national medical honor society.

    Dr. Brothers is certified by the American Board of Plastic Surgery, a member of the American Society of Plastic Surgeons and is a Fellow of the American College of Surgeons. He is the founder of the Plastic Surgery Centre of Atlanta, P.C. and has served as the chief of plastic surgery at Saint Joseph’s Hospital of Atlanta, Northside Hospital and Perimeter Surgery Center of Atlanta. The former secretary of the Georgia Society of Plastic Surgeons, Dr. Brothers has been published in the field of reconstructive and cosmetic surgery and is a frequent guest lecturer. 

    He’s an avid traveler and a family man; his three beloved children, Danielle, Amanda and Samantha, accompany him almost everywhere he goes.  Whether he’s relaxing in a villa in the Caribbean or trekking through Europe, his focus is always his family and his patients.  Blessed with hands of gold, this premier plastic surgeon has changed the faces and lives of both men and women throughout the U.S. and Canada.  People come from far and wide to seek his skill and advice.  Dr. Brothers says he enjoys growing older with his patients, but “unfortunately, they are looking younger while I am looking older.”

TG: Twenty years ago, a face lift seemed the best answer to look younger. Today, are there alternatives to a full facelift?

DB: Yes, people can turn back the clock and rejuvenate their faces with non-surgical techniques. We offer many. A good solution for some patients who want to soften fine lines and wrinkles can be to start with injectables such as Botox, which paralyzes the muscles that create wrinkles and lines between the eyebrows and in the forehead. There are also volumizing fillers that allow for a fuller more youthful appearance through the mid-face area. We also offer stimulators like Sculptra, that help replace lost collagen. In combination these fillers and injectables, sometimes known as a “Liquid Lift,” can be a great start into the cosmetic world of rewinding time without having surgery.

    We have laser treatments, such as Fractional C02 laser treatments that help rejuvenate the skin and give it a revitalized appearance. We also offer Venus Viva and Legacy treatments, which are radio frequency treatments that can help with acne scars, rosacea, stretch marks, fine lines, wrinkles and cellulite. All these treatments can be done in the office with little or no downtime in some cases.

TG: You mean someone can visit your office and leave looking younger?

DB: Absolutely. When I came out of my residency none of these products were available. We were trained as surgeons and therefore we were trained to focus on areas that we could only improve surgically. Now, when I examine people, I not only look at things that I can correct surgically, but I also observe  the person’s pattern of aging, where they are losing fat and how it is being redistributed throughout the face.

    The trend in plastic surgery today is no longer to just do a facelift and pull people as tight as you can but rather to turn back the clock and restore the lost volume of youth. A lot of aging is simply lost volume. Our job is no longer simply a matter of examining someone’s face and deciding what surgery you can do for them. Instead, it is evaluating a patient’s face in three dimensions, noting their pattern of aging and why they are aging. Today we have so many more tools to non-surgically rejuvenate the aging face.

TG:  There is a myriad of topical products available, some expensive, that promise a youthful appearance. Are they worth the cost?

DB: Unfortunately, I don’t believe that anything sold over-the-counter will really have any positive effect on your skin. The FDA is a strict regulating organization and anything that has a tremendous impact on the skin or potentially changes the skin significantly would need FDA approval. When people purchase these over-the-counter products very often they are paying for name, packaging and nice smells.  Unfortunately, most of these products are not going to do very much.

     In my office we offer Alchemy SkinCare, a private label made exclusively for us. We also offer Revision Skincare and Venus Skin products. It is best to make an appointment with one of our expert medical aestheticians with Alchemy Aesthetics who will carefully evaluate your skin, customize your regimen and teach you how to use the products.

TG: Let’s talk about Botox. Is it safe?

DB: Botox is very safe. The only complications I have ever had from Botox would be a little bruising; rarely it can drift and just touch a small muscle in the upper eyelid, causing it to droop slightly. If this happens, and again it is quite rare, it usually goes away within a week or two. Ideally, you would repeat Botox three to four times a year. It beautifully and naturally relaxes someone’s facial expressions, and done correctly, it does not give a surprised or frozen look. Botox relaxes the area between the eyebrows where people tend to look very severe. I can inject Botox to relax transverse lines in the forehead. We can also place it under the eyebrow to give a very natural lift to the lateral or outer eyebrow.

TG: What about Sculptra?

DB: Sculptra is a fascinating product and the only product in its class. I am a master trainer for Sanofi-Aventis-Dermik, the pharmaceutical company that manufactures Sculptra. It is a collagen stimulator, a naturally derived product that we inject over a few months that causes a gradual correction of lost volume. And, as the body degrades or breaks it down, eventually into carbon dioxide and water, Sculptra stimulates new collagen production. The actual correction that you get is from your body’s production of natural type 1 collagen. Once corrected, the results last no less than 25 months. I have patients whom we brought to full correction years ago and I have not yet had to re-treat. The product is amazing!

    There is no product out there that can do what Sculptra can do. Sculptra can replace lost volume in the temporal regions, the cheeks and close to the jowls. Even if you tighten the skin surgically you are still not restoring the lost volume. Sculptra, whether it is done without or after a facelift, will restore a youthful fullness to someone’s face.

TG: Can you talk about Restylane and collagen, which are also fillers. Is one product better than the other?

DB: There are many intradermal fillers on the market. I have narrowed the list down to the Juvederm and Restylane family of products. I use the products for the nasolabial folds (the lines from the nose to the mouth), for deep lines around the eyes and for cheek augmentation. These products give the best and longest lasting correction for the volume injected. Juvederm and Juvederm Ultra Plus are mostly used in the lips and some facial lines. Juvederm Ultra Plus is a very good product for natural lip augmentation that is soft and long lasting.

Dr. Stephen A. Rosenberg is one of Atlanta’s preeminent OB/GYN physicians. He’s the go to expert for women: guiding them with skilled care and concern through pregnancy and giving  birth, to helping women navigate the life-changing issues of menopause. Dr. Rosenberg says it is a privilege to be a help to so many wonderful people. He’s the consummate professional, an avid traveler and a loving husband to his wife Eliane and dad to his two beloved children. His daughter Talia and son Lucas are his pride and joy and no vacation is complete unless he has them aboard. He is the gold standard in women’s healthcare, providing his patients with expertise coupled with kindness and concern.

    Dr. Rosenberg received his undergraduate and medical degrees from Emory University.  Already a fan of Atlanta, he then completed his residency at the Emory University School of Medicine. Dr. Rosenberg is certified by the American Board of Obstetrics and Gynecology and he is a Fellow in the American College of Obstetrics and Gynecology.

TG: Dr. Rosenberg, please tell us a little about yourself, your education, and how you ended up in Atlanta involved in women’s healthcare.

SR: I grew up in Virginia and came to Atlanta to attend Emory University School of Medicine.  I did my residency at Grady Memorial Hospital, which is a large inner city hospital in Atlanta. Once I completed my four years of residency in obstetrics and gynecology, I joined North Atlanta OB/GYN some 30 years ago, and I am still delivering babies at Northside Hospital. 

TG: Did you know at an early age that you wanted to go into women’s healthcare?

SR: I think I knew in my early teens that I wanted to be a doctor, but I was uncertain what field of medicine I would go into. At one point I wanted to be a heart surgeon and then a psychiatrist. However, in my third year of medical school, I had the opportunity and responsibility to deliver five to 10 babies during my OB rotation.

   For some doctors in training, delivering a baby can be a life-altering experience, and it was for me! I knew this was what I wanted to do with my professional life. Caring for a woman throughout her pregnancy and then delivering her baby is an awesome responsibility and privilege. There is an intimacy that is unique to this process that is different from any other found in medicine. Women who have a positive obstetric experience often remember their doctor for the rest of their life. 

   Now that I have been in practice for more than 30 years, I have had two very special experiences recently. First, I have now taken care of and delivered a baby for a patient whom I actually delivered myself, during the first year I was in practice, 30 years ago. The second experience involved being invited to the wedding of a gentleman whom I delivered early in my career. How many people can go up to the bride at her wedding and say that they knew the groom before he was born and then delivered him? Needless to say, she, the bride, was at first confused and then shocked. These are the things that make what I do so interesting and exciting.

TG: How has your practice evolved as you have moved through your career?

SR: One of the most wonderful things about being an OB/GYN is that you age with your patients. I see patients when they are having their families, and then every year they come in for their annual exam and I get to keep up with the babies I delivered as they grow up and go off to college. The patients whom I delivered years ago are now approaching the perimenopausal and menopausal phases of their lives, which is typically the mid-40s and on. Of course, this brings on different challenges for women as their hormonal milieu evolves. The good news is that there are new treatment modalities to help women with problems specific to this transitional life phase.

TG:  Can you share with us some of these new treatment options?

SR: Of course. The first thing I would like to discuss is hormone replacement therapy. As you know, much has been written over the years about giving women estrogen and progesterone to help with menopausal symptoms. Suffice it to say that the earlier studies conducted to look at the safety of this therapy were done at a time when women were being given synthetic hormones. The estrogen came from the urine of pregnant horses and was therefore equine estrogens. The progesterone was completely synthetic.

   I have long been a believer in hormone replacement therapy using bio-identical plant-derived hormones, which are identical to the molecules the body naturally makes. I have recently started offering a new hormone regimen called BioTE hormonal pellet therapy.

   I am very excited about this therapy choice because it focuses on not only estrogen but also testosterone. Before menopause, the ovary makes testosterone which is, in part, responsible for libido. I cannot tell you how many menopausal women I see who are very frustrated with their loss of sex drive. Studies have shown that some menopausal symptoms including night sweats, loss of libido, and a general lack of energy may be related more to low testosterone than estrogen. Many women on hormone replacement are not having their testosterone replaced and therefore find the treatment less than satisfactory.

   I am not going to suggest that replacing testosterone is a panacea, curing every menopausal symptom, but a large percentage of my patients receiving this therapy are definitely noticing a marked improvement in how they feel. The other advantage of this therapy model is that the estrogen and testosterone are administered as pellets under the skin in the buttock region. This allows for an even distribution of hormones over a four to six month time frame. It is interesting that when I started my career a few older physicians were doing pellet therapy and then it went away. I guess everything that’s old…

TG: Are there any other treatment options you are using specifically for menopausal women?

SR: Yes. Actually, the other therapy I am now offering in the office addresses a real problem I hear very often, which is pain with intimacy. We all know that 60 is the new 40 but sometimes the body doesn’t quite go along. As women enter menopause and the estrogen levels wane, the vaginal lining can become thinner and less resilient. This can lead to significant pain with intercourse. Who wants to do something when they know it is going to hurt? This can have a very significant impact on a marriage or relationship. I am now offering the Mona Lisa Touch laser therapy in the office. It involves three treatments performed six weeks apart. Although the thought of this treatment might be a little frightening, the treatments are virtually painless.

   The science behind the therapy is that using laser energy on these tissues stimulates more blood flow to the tissues and more glycogen formation, which makes the tissues healthier.  Before I committed to this therapy, I performed a study with several test patients and 98 percent had a very favorable response. Those that did not, needed one extra treatment. I have been told by more than one patient that bringing intimacy back into a relationship is life altering.

Atlanta is the shopping center of the Southeast and whether it’s in prestigious malls such as Lenox Square or Phipps Plaza, or boutiques that line Buckhead, Midtown and other neighborhood shopping zones, if you can’t find it here, you won’t find it anywhere. Atlanta offers the best in international brands as well as local or regional designers.

TG took to the streets to find the best in shopping in Atlanta.

Killer Heels

Who doesn’t love shoes, especially killer heels. In Atlanta, the first place to go for shoes is to Phipps Plaza and Jeffrey New York. Not only does this Atlanta icon have a variety of fabulous shoes that Carrie Bradshaw would love, but the entire boutique is full of men’s and women’s designers, such as Dries Van Noten, Marques Almeida, Simone Rocxha and J.W. Anderson, that meld high fashion with subcultures. Of course, you can’t ever go wrong with Christian Louboutin or Jimmy Choo, both at The Shops Buckhead.

Other fabulous shoes can be found in such as such as Saks Fifth Avenue, Bloomingdale’s, Neiman-Marcus, as well as specialty stores such as Gucci,  Tod’s and Bottega Veneta.

Kane is another local favorite where classic and edgy are in harmony. Located in Midtown, this shop features labels that are well known as well as those that will be well known soon. www.kaneboutique.com.

Bill Hallman has been an Atlanta fashion institution in the area for the past 20 years and offers the best in modern designer fashions as well as customized services for women and men. www.billhallman.com.

Bridal Gowns

You’ve seen Lori and Monty on “Say Yes to the Dress: Atlanta,” and in addition to bridal and  bridesmaids gown, this Sandy Springs institution has a wide variety of formal and semi-formal dresses. www.bridalsbylori.com.

Located in Buckhead, Winnie Couture is a high-end bridal and evening wear attire brand with a modern mix of classic elegant and sophisticated couture. 
www.winniecouture.com.

Southern Style

Southern women love bright colors, natural fabrics and feminine clothes with a touch of preppy. There are several shops where the clothes will go perfectly with sweet tea and red velvet cake.

Mint Julep, located in the Peachtree Batlle Shopping Center, offers the Lily Pultizer line as well as resort and casual lines such as Sail to Sable, Persifor, Southern Tide, Suncoo, Majestic Tees, HIHO, and Eberjey sleepwear.
www.mintjulepga.com

Pure Couture

When it comes to the best from Paris, London, New York and Rome, you’ll find it in Atlanta. Here are some of the best boutiques in the world. Enjoy the best of the best at: Valentino,  Hermés, Celine,  Christian Dior, Fendi, Giorgio Armani, Gucci, Herve Leger, Johnny Was, Tom Ford, Louis Vuitton, Prada, Versace, Brahmin, Burburry, CH Carolina Herrera, Akris, Diane Von Furstenberg, Escada, Halston Heritage, Henri Bendel, Michael Kors, Salvatore Ferragamo, and St. John.