Frequently Asked Questions
What is Plastic Surgery?
Plastic surgery is a surgical sub-specialty that deals with the healing and restoration of patients with injury, disfigurement or scarring resulting from trauma, disease or congenital defects. It includes aesthetic, or cosmetic surgery to correct or rejuvenate facial and bodily features not pleasing to the patient. Derived from Greek, the word plastic means molding or giving form and does not refer to the use of plastic materials.
How does a physician become a plastic surgeon?
Training to become a plastic surgeon is a difficult task. To become board certified by the American Board of Plastic Surgery a physician must complete a specialized post-graduate training course of five to seven years. Background training usually includes a thorough grounding in general surgery however, a background in ENT or orthopedics may be acceptable. The final two to three years of training must be in an approved plastic surgery training center. Prior to official certification by the American Board of Plastic Surgery the physician must pass a rigorous set of both written and oral examinations. While numerous physicians use the term “plastic” surgeons only those certified by the American Board of Plastic Surgery are true plastic surgeons.
Does certification by the American Board of Plastic Surgery ensure that a patient will get a perfect result from an operation?
No. Healing of operated tissue is affected by several factors, and some of these are beyond the control of the surgeon. As in any other type of medicine, no guarantee of perfection or even a good result can be given. By making sure to do your homework before choosing a plastic surgeon, you can check out a surgeon’s training, skill, and experience to better ensure your safety and desired results. Board certification by the American Board of Plastic Surgery means that the surgeon has completed the rigorous requirements for full time practice as a specialist in plastic surgery.
What questions should I ask before choosing a plastic surgeon to make sure he/she is qualified to operate on me?
Bringing a checklist of questions can help ensure the safety and quality of your procedure. Questions to ask are:
- Are you certified by the American Board of Plastic Surgery?
- When the doctor claims to be board-certified, ask by which board. Only the ABPS is recognized by the American Board of Medical Specialties to certify doctors in the area of plastic surgery.
- Do you have hospital privileges to perform this surgery?
- Some surgical procedures can be performed in the doctor’s office or other outpatient facility but it is important to find out if the doctor has operating privileges in an accredited hospital for the same procedure you are having. Before granting operating privileges, hospital review committees evaluate a surgeons training and competency for specific procedures.
- Where will you perform my surgery?
- If it’s in an office-based facility, ask if it’s accredited. Most states don’t require ambulatory or office-based facilities to be accredited, but voluntary application can be made to an accrediting body such as the American Association for Accreditation of Ambulatory Surgery Facilities. Such accreditation means the facility has met strict requirements and denotes a high standard of care.
- How many procedures of this type have you performed?
- Also ask what training has been completed, especially in new techniques. Ask to see certificates of training.
- What are the risks involved with the procedure?
- There are risks with any surgical procedure. Find out what they are, how often they occur, and how they will be handled if they do occur.
- What is the expected recovery time?
- Be sure to discuss postoperative restrictions on activity and typical time periods for resuming work.
- What is your policy on surgical revisions?
- Some cases may require revisions to achieve the desired results. Find out about any costs for which you may be responsible.
- How much will the surgery cost?
- Cosmetic surgery is not covered by insurance, and payment usually is required in advance. Costs include the surgeon’s fee and fees for the surgical facility and anesthesia. Other possible costs are the preoperative physical and blood work, medications, surgical garments and private-duty nursing.
What procedures do plastic surgeons perform?
Aesthetic (also called cosmetic) problems with the face, neck and trunk, including forehead, eyes, nose, ears, lips, chin, neck, breasts, abdomen, hips, buttocks, thighs, calves, arms, and skin.
Congenital deformities of the hands and face, including clefts of the lip and palate.
Benign (non-cancer) and malignant (cancerous) tumors of the head and neck, skin and soft tissues.
Traumatic injuries of the bony facial skeleton and hand as well as soft tissue injuries of any part of the body.
Surgery of the hand.
Surgery of the jaw and facial skeleton.
Any type of skin cover and replacement problems.
All types of reconstruction following removal of cancer resulting in disfigurement of any part of the body including the face, breasts, trunk.
What is aesthetic (cosmetic) surgery?
Aesthetic surgery, also known as cosmetic surgery, seeks to improve an individuals appearance. These type of operations most often involve the nose, ears, face, forehead, eyelids, breasts, abdomen, hips and thighs.
Is a plastic surgeon a skin specialist?
Dermatologists specialize in skin, but the plastic surgeon has an equally important role of the treatment of benign and malignant tumors of the skin. The skills of a plastic surgeon are especially needed when large areas of the skin must be removed and replaced especially where disfigurement may result or when these areas are in conspicuous areas such as the face. Plastic surgeons also perform skin resurfacing techniques, for cosmetic purposes, in order to achieve healthier looking skin by reducing facial wrinkling and pigmentary changes of the skin.
Will I have a scar after plastic surgery?
Scarring is inevitable of healing, however a very fine lined scar placed in the correct orientation may be virtually invisible. A plastic surgeon spends years trying to master techniques to place scars in the most desirable location. Plastic surgeons will try to make incisions in areas that will not show, like under undergarments or along natural creases. Scars will normally fade over time, but certain areas of the body such as the back and chest, produce more severe scarring regardless of the technique used for reconstruction and closure. The severity of the scarring varies from person to person.
Does plastic surgery always involve skin grafting?
Skin grafting is only used when it is the best way of closing a wound or defect. A qualified plastic surgeon uses judgment to decide the best way of reconstructing a defect. A skin graft may appear to have poor color match and texture compared to the native skin, but with careful selection of a skin graft donor site these problems may be minimized.
What is a pedicle graft or flap?
A pedicle graft also called a flap, consists of a segment of skin, underlying subcutaneous tissue and/or muscle which is shifted from one area to an open wound or defect for coverage of that wound. The word pedicle means that the blood supply to the flap is never divided. When the blood supply is completely divided and reattached this is called a free flap, and requires specialized skill in microvascular surgery.
What is rhinoplasty and nasal reconstruction?
Rhinoplasty, or nose reshaping, reshapes the nose to improve appearance, and it may also be used to alleviate breathing problems.
Pain from nose reshaping procedures are surprisingly mild. A splint is usually worn over the nose and sometimes inside the nose for five to seven days. There may be some bruising around the eyes, but this usually clears up in one to two weeks.
Can I receive a second nose reshaping if the first surgery does not produce the desired result?
Sometimes a touch-up is necessary after a nose reshaping, but it is generally better to wait a year before any additional surgery is performed. This also allows the maximum time to see the final results of the surgery.
What aesthetic surgical procedures are performed to improve the aging face?
There are various degrees and stages of facial aging that can be caused by the natural aging process, heredity, and lifestyle choices. Plastic surgeons have undergone training to address all areas of facial rejuvenation. A face lift tightens and lifts the redundant skin in the face and neck. Additional procedures are available to improve the aesthetics of the forehead, eyes, mouth, chin and neck. Minimally invasive endoscopic techniques are also available. Fine wrinkles of the face may be best treated by skin resurfacing techniques, like laser resurfacing, chemical peels or other skin care treatments.
How is a face lift done?
During a face lift incisions are made in the hair line, temple region extending down in front of the ear and then around the back of the ear into the hairline. These incisions vary depending on the technique used by your plastic surgeon. Many plastic surgeons are well trained in more than one face lift technique. The skin of the face and neck is dissected into the cheeks and neck allowing it to be mobilized upward producing a tightening and smoothing result. Many plastic surgeons can now also tighten the muscular layers underneath the skin as well during a face lift procedure. Years of specialized training are necessary to safely perform this procedure. The results can be subtle or drastic depending on the condition of the facial area prior to the surgery and the desired results.
Does a face lift leave scars?
Yes, but as with other scars plastic surgeons have been trained to place them in areas that are very inconspicuous. Your plastic surgeon will be able to show you exactly where your scars will be following your surgery. Normally your hair will cover up most of the scars and makeup can touch up any leftover marks.
How is excessive wrinkling and bagginess of the eyelids corrected?
Eyelid surgery can correct this condition. Excessive skin and fat may be removed from both upper and lower eyelid. Tightening of the lower lid may also be done in concurrence with this procedure. One to two weeks of bruising and swelling is expected from this procedure. Eyelid surgery may be done in combination with or separate from face lifts or other types of aesthetic surgeries of the face such as brow lifts to better proportion your facial features.
What surgery can improve the appearance of breasts?
Three common procedures are performed: breast augmentation, breast lift, breast reduction.
Augmentation mammaplasty is a procedure that can safely enlarge a small breast or increase an undesired size. Different techniques are used, but in general this is performed using a saline breast implant, after the FDA ruled silicone unsafe in 1992. Implants may be placed in different positions depending on the physical make-up of the patient and her breasts. The implant may be introduced through three different incisions: below the breast, around the nipple areolar complex, or in axilla (arm pit).
A breast lift is used when the patient is happy with the size of her breasts however due to aging and pregnancy the breast gland has begun to droop. Various techniques are employed to accomplish a breast lift and results are generally excellent.
Breast reduction is designed to make overly large breasts smaller. Patients seeking this type of surgery often have multiple severe physical symptoms secondary to their large breasts including neck, shoulder, back pain, paresthesia of the arms and bra strap grooving of the shoulders. The technique of breast reduction requires lengthy incisions; however, they may be placed in inconspicuous locations such as the fold underneath the breast. Typical symptoms of back pain, neck pain etc. are almost always improved after a breast reduction if not completely eliminated. This procedure is often covered by insurance.
Am I a good candidate for liposuction?
Liposuction is not used for weight loss, rather to correct problem areas or fat bulges. A candidate will be close to their ideal weight because a liposuction is typically performed in patients that have an area of fat they find hard to lose. The fat removed does not weight a lot, so patients should expect a shape change, not a weight change.
Do the results of liposuction last?
As long as the patient maintains a healthy life-style, including exercise and a sensible diet, liposuction results are long lasting. Once the fat cells have been removed from an area there is no longer a preferential fat storage area and any fat gain will be distributed more evenly over the rest of the body.
What areas of the body can be treated with liposuction?
Most body areas can be treated with liposuction, though the most common areas in females are the abdomen, hips, and thighs. Men are often treated for liposuction in the breasts, hips, and abdomen. Liposuction is not limited to these areas, though other places may include the upper arms, under the chin and the buttocks.
Does liposuction leave scars?
Incisions made during liposuction are generally very small and put in areas that are more inconspicuous. Most cases of liposuction will heal well and it will be difficult to see where they were originally made.