[toggle title=’What is Plastic and Cosmetic Surgery’ group=’1′]
Plastic surgery or cosmetic surgery is a surgical specialty dedicated to reconstruction of facial and body defects due to birth disorders, trauma, burns, aging process and disease.   The art and science of plastic/cosmetic surgery is also involved with the enhancement of the appearance of a person through such operations as face-lift, rhinoplasty, breast augmentation, liposuction and more.[/toggle]

[toggle title=’What is the difference between cosmetic and reconstructive surgery?’ group=’1′ closed=’1′]
Cosmetic surgery is performed to reshape normal structures of the body in order to improve the patient’s appearance and self-esteem.   Cosmetic surgery is usually not covered by health insurance because it is elective.

Reconstructive surgery is performed on abnormal structures of the body, caused by congenital defects, developmental abnormalities, trauma, infection, tumors or disease.   It is generally performed to improve function, but may also be done to approximate a normal appearance.   Reconstructive surgery is generally covered by most health insurance policies although coverage for specific procedures and levels of coverage may vary greatly.

There are a number of “gray areas” in coverage for plastic surgery that sometimes require special consideration by an insurance carrier. These areas usually involved surgical operations which may be reconstructive or cosmetic, depending on each patient’s situation. For example, eyelid surgery (blepharoplasty) – a procedure normally performed to achieve cosmetic improvement may be covered if the eyelids are drooping severely and obscuring a patient’s vision.[/toggle]

[toggle title=’What is recovery from plastic surgery like?’ group=’1′ closed=’1′]

Each patient will tolerate pain post-operatively in a different way, and we consider this.   While some patients may describe the pain as an ache, others experience greater discomfort.    Appropriate pain medications are prescribed for the post-operative patients, and these help minimize discomfort.   Most facial cosmetic operations have minimal discomfort post-operatively. Liposuction has minimal discomfort, however operations that require elevation or tightening of the muscles-such as an abdominoplasty or breast augmentation have slightly more discomfort.

How long is the recuperative period and when can I return to work?

The length of time it takes to recuperate after plastic/cosmetic surgery varies depending on the procedure performed and the person operated on.   Most patients will require assistance for the first two days.   Then most patients are able to care for themselves, but may still need assistance if they have small children to care for.   The specific lengths of disability are outlined below each procedure.   These are approximations, and do not include return to exercise.

Eyelid Surgery – Usually can get around independently by the second day.   With the use of sunglasses, may feel comfortable going to the store by day 3-4, and with makeup could return to work by 5-7 days.

Facelift Surgery – Usually can get around independently by the second day.   Usually do not feel comfortable going out in public for 5-7 days.   Requires 10-14 days before returning to work if in the public eye.

Breast Surgery – Usually can get around independently by the second day.   May return to work at 5-7 days if not required to lift more than 15 pounds.

Liposuction – Usually can get around independently by the second day, earlier if smaller number of areas treated.   One can return to work and normal activities in 5-7 days.

Abdominoplasty – Patients may take between 2-4 days before getting around independently.   The recovery is almost identical to C-section.   One can return to a desk job at 5-7 days, other jobs 10-14 days.[/toggle]

[toggle title=’When can I resume regular exercise after plastic surgery?’ group=’1′ closed=’1′]The time a patient resumes regular exercises varies based on the operation performed.   All patients are encouraged to start a slow walking routine on the second postoperative day if not the same day.   Weight lifting and contact sports are allowed at 1 month in most cases.[/toggle]

[toggle title=’What should you know about the safety of outpatient  plastic surgery/cosmetic surgery?’ group=’1′ closed=’1′]

When considering plastic/cosmetic surgery, it’s natural to focus more on the expected result than on the surgical process. However, to be fully informed, it’s important to learn about the safety of the procedure as well as the expected outcome.   Although thousands of people have plastic surgery every year without complications, no surgical procedure is risk-free.   To maximize safety, ensure that:

  • Your surgeon is adequately trained and is board certified in his field of specialty;
  • The facility where your surgery will be performed conforms to strict safety standards;
  • Your surgeon is informed of any drugs you are taking and your full medical history, especially if you have had any circulation disorders, heart or lung ailments or problems with blood clots;
  • The surgical facility will use skilled, licensed personnel to administer and monitor your anesthesia and your recovery immediately following the procedure
  • Extra safety measures are taken if you are having a more extensive liposuction procedure.

[toggle title=’How can I be sure that my surgeon has adequate training?’ group=’1′ closed=’1′]

Good credentials can’t guarantee a successful outcome; however, they can significantly increase the likelihood of it.   Patients are advised to find a doctor who is properly trained surgeon as well as cosmetic surgery.

  • Has completed at least five years of surgical residency training after medical school, as well as training in cosmetic surgery.
  • Is qualified to perform cosmetic and reconstructive procedures – everything from liposuction and facelifts to intricate wound repair.[/toggle]

[toggle title=’How can I determine if my surgeon’s surgical facility meets acceptable safety standards?’ group=’1′ closed=’1′]

Almost all plastic surgeries are performed under anesthesia, other than minor local anesthesia and/or minimal oral tranquilization, must be performed in a surgical facility that meets at least one of the following criteria:

  • Accredited by a national or state recognized accrediting agency/organization such as the, Accreditation Association for Ambulatory Health Care (AAAHC), or Joint Commission on Accreditation of Healthcare Organizations (JCAHO), American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) or
  • Certified to participate in the Medicare program under Title XVIII or
  • Licensed by the state in which the facility is located

Patients should ensure that the facility is accredited or is in the process of being accredited.   To find out about a facility’s accreditation status, contact  the AAAHC at 847-853-6060 or www.aaahc.org the JCAHO at 630-792-5005 or www.jcaho.org or the AAAASF at 1-888-545-5222 www.aaaasf.org.

Plastic / cosmetic surgery procedures performed in accredited surgical facilities by board-certified cosmetic surgeons have an excellent safety record.   A 1997 survey 1 based on more than 400,000 operations performed in accredited facilities found that:

  • The rate of serious complications was less than half of 1 percent.
  • The mortality rate was extremely low – only one in 57,000 cases.
  • The overall risk of serious complications in an accredited office surgical facility is comparable with the risk in a freestanding surgical center or hospital ambulatory surgical facility.[/toggle]

[toggle title=’Why is it so important for my plastic / cosmetic surgeon to know detailed information about my personal and family health history, even if I am only having a simple cosmetic procedure?’ group=’1′ closed=’1′]

There is always risk with any surgical procedure. However, as a patient, you can play an important role in reducing your risk by providing a full and complete health history to your surgeon.

Although rare, one of the most serious complications associated with surgery is the development of blood clots in the large veins of the abdomen and legs.   This complication can lead to a potentially fatal pulmonary embolism (blocked lung artery).   Therefore, it is extremely important to tell your plastic / cosmetic surgeon if you or any of your family members have a history of blood clots or if you have had a family member who died suddenly, shortly after surgery or childbirth.

You will also be evaluated for other factors that may increase the risk of blood clots. These include:

  • Being extremely overweight
  • Having recent traumatic injury
  • Any disorder of the heart, lungs or central nervous system
  • A history of cancer, recurrent severe infection or genetic problems that affect blood clotting

For women, additional risk factors include:

  • Taking oral contraceptives or having recently ceased taking them
  • Undergoing hormone-replacement therapy

Safety measures to prevent blood clots will be determined by your individual degree of risk.   If you are considered low risk, your doctor may simply ensure that you are positioned on the operating table in a way that allows for adequate blood circulation to the legs.   If you are of moderate or high risk for developing blood clots, you may also be advised to wear elastic stockings before, during and after your procedure, or to take special anti-clotting medications.   Compression devices on the legs may be used during surgery to support your normal circulation.[/toggle]

[toggle title=’How can I be sure that the anesthesia care I receive in my plastic / cosmetic surgeon’s surgical facility is adequate?’ group=’1′ closed=’1′]

Anesthesia care in an accredited or licensed facility has reached a level of sophistication that is absolutely comparable to the care received in the hospital. For maximum safety:

  • Any planned anesthesia should be administered by skilled, licensed personnel acting under the direction of an anesthesiologist or the operating surgeon.
  • Before any type of anesthesia is used, the surgeon or anesthetist must take a full medical history.  A physical examination and appropriate lab tests may also be performed.   Your surgeon needs to know if you have any serious medical problems or have had previous adverse reaction to any other type of anesthesia.   Also, you must let the anesthetist know about any medications you are taking (including herbal supplements), any known drug allergies, when you last ate and whether you smoke cigarettes or use alcohol or illegal drugs.
  • You should be assured that you will receive individual monitoring by skilled, licensed personnel before, during and after the procedure.   Staff who are familiar with the warning signs of cardiac or respiratory distress and are trained in advanced cardiac life support (ACLS), should be on hand to monitor your procedure and recovery following your surgery.
  • If you are told that you will be kept overnight at the surgical facility while you recuperate, make sure that the facility is accredited by a recognized agency.   In an accredited facility you will receive around-the-clock care and monitoring by two or more skilled and licensed staff members with at least one trained in ACLS.   You will also be assured that the facility has the necessary equipment and medications to handle complications that may arise and an emergency plan in case you need to be transferred to the hospital.[/toggle]

[toggle title=’To achieve the cosmetic results I want, my plastic / cosmetic surgeon has recommended “large-volume” liposuction. What types of safety measures should I expect my surgeon to take?’ group=’1′ closed=’1′]

Due to recent advances in technique and technology, serious medical complications in liposuction are quite rare.   However, the risk of complications increases with the number of areas treated and the amount of fat removed.   A liposuction procedure is classified as “large volume” when 11 pounds (5,000 cc) or more of fat and fluid are removed.

Factors that may increase the risk of complication are:

  • Excessive amounts of local anesthesia or excessive amounts of fluid administered intravenously or within the tissues at the surgical site
  • Multiple, unrelated procedures performed during the same surgery
  • Being in poor health prior to surgery
  • Having a personal or family history of blood clots of the legs or a blocked lung artery
  • Having a personal or family history of breathing or bronchial disorders or other lung problems
  • For women: Current use of oral contraceptives

For maximum safety, a patient planning to have either large-volume liposuction or ultrasound-assisted liposuction (known as UAL) should be aware of the following:

  • Large-volume liposuction requires specialized knowledge.   Therefore, it’s important for your surgeon to have additional training specifically in UAL or large-volume liposuction.
  • Your surgeon should keep track of the amount of fluid that is infused into your body and the amount that is withdrawn from your body.   The surgeon should also have systems to record intravenous fluid, the amount of fat removed and urinary output.
  • Extended post-operative monitoring of vital signs and urinary output is critical following large-volume liposuction. An overnight stay in a hospital or other overnight-stay-accredited facility may be required.

In the hands of an appropriately trained specialist, liposuction is a generally safe procedure.