Cosmetic Surgery Frequently
Asked Questions
Even if you are in perfect
physical condition, this does not always mean you are a candidate
for cosmetic surgery.
Of course, physical condition is important, and for any major procedures,
your plastic surgeon will want to communicate with your primary
care physician. Your primary care physician may want to examine
you to make sure you’re in the best possible physical condition
for the surgery.
It is very important that you and your surgeon discuss your expectations
in detail before you proceed with surgery.
At the first office visit, you will be expected to answer questions
about your medical and surgical history, any medications you are
taking, and your family medical history. All of these questions
help the physician understand your physical ability to undergo surgery.
In addition, the surgeon will ask questions about the feature you
want to change and why, as well as your expectations after the surgery
is completed.
Now is the time to ask questions you may have. It’s a good
idea to write them down before you come, so that when you are with
the surgeon you can remember all of them.
Once the surgery has been agreed upon, the surgeon and his staff
will talk to you about risks and benefits of the surgery, recovery
time, expectations, home care and other issues. The staff also will
talk to you about costs and payments.
There are several boards that certify plastic or cosmetic surgeons.
Cosmetic surgeons at Washington University are certified by the
American Board of Plastic Surgery (ASPS). The ASPS encourages patients
to choose plastic surgeons who are certified or board eligible by
the American Board of Plastic Surgery.
Board certification is important, along with the comfort level,
or “fit,” you have with the surgeon you choose.
Insurance companies differ. There are some procedures that insurance
will cover if a physician attests to the fact the patient’s
life is affected by the condition. For example, some patients have
eyelids that droop over their eyes and make seeing difficult. In
this case, insurance will typically pay for the procedure. Some
insurance companies also pay for breast reduction if the patient
has a medical history that qualifies – such as back pain,
shoulder pain or other conditions.
Exercise can tighten the muscles and reduce the fat on your stomach,
but it can’t repair muscles that have been widely separated
or stretched apart because of pregnancy. Exercise can’t tighten
skin or take care of stretch marks. However, if you’re in
the middle of a successful weight loss program, we suggest you get
to the weight you want to maintain before the surgery. A tummy tuck
takes care of loose, stretched-out skin and can tighten the underlying
muscles so that the whole abdomen is taut.
Yes. Depending on the magnitude of the surgery, you may have a scar
that goes from hip to hip. Sometimes the scar can be smaller and/or
hidden so that you can’t see it with a low, French-cut swimming
suit. Some patients bring the type of underwear or swimming suits
they like to wear so the surgeon can plan where to make the incision.
It is important to recognize first that liposuction is NOT a weight
loss tool. Liposuction reshapes bulges and smoothes out the contour
of the skin. So the fit of your clothes always changes after a liposuction,
but the size may or may not. Sometimes your weight on the scale
doesn’t change after liposuction, but you appear thinner because
of the contouring. Your size may continue to change for up to six
months as swelling goes down.
Fat cells don’t multiply so they won’t come back where
they’ve been sucked out. However, if you take in more calories
than you burn, you will gain weight. The difference is that your
weight gain will be more even because those bulges of fat cells
have been removed.
Initially, you will have pink scars for about three months. These
will eventually fade and blend in with the skin. Various surgeons
have individual preferences for incision sites. One is in the armpit,
another is on the lower edge of the nipple, and a third is in the
breast fold. Most surgeons prefer the breast fold approach because
it allows manipulation of the implant. Ultimately, you will have
scars with any approach, but they should fade over time.
Saline implants are filled with salt water, and if the implant ruptures
or leaks, your body absorbs the salt water naturally. Silicone implants
are filled with silicone gel and are used only with study patients
involved in breast reconstruction.
Both silicone and saline implants are man-made products. They won’t
last a patient’s lifetime. When you discuss breast augmentation
with your surgeon, he or she will provide you with information required
by the Food and Drug Administration entitled “Breast Implants
– An Informational Update.” There also is a website
sponsored by the FDA that will answer many questions. The URL is
www.fda.gov/cdrh/breastimplants/.
There is no evidence supporting the idea that women who have breast
implants have a higher incidence of breast cancer. But women with
breast implants should continue to do monthly breast exams and to
have regular mammograms as ordered by their primary care physician.
It’s important when the patient does have a mammogram that
the mammographer is told about the implants so that additional views
can be taken.
It’s not unusual to have a change in sensation after breast
augmentation. This is related to the swelling right after surgery.
After several months, most patients return to having normal sensation
in their nipples, but temporary or even permanent loss of sensation
can occur.
Any surgery produces scars; however, after several months, blepharoplasty
scars become less and less noticeable because they are placed in
the normal creases of the eyelids.
As the skin tightens, some – but not all – may go away.
There are some skin treatments that, when combined with blepharoplasty,
can help minimize fine lines.
Dark circles under the eyes can sometimes be minimized with modifications
to the standard surgery used for drooping eyelids. You should talk to your
surgeon about this.
Disclaimer:
The photos on this website are of models, not actual patients.
Washington University physicians are the medical staff of
Barnes-Jewish Hospital and St. Louis Children's Hospital
Please direct any questions concerning this site to the Site Administrator.
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