Answers from the Doctors Facial Plastic Surgery Non-Surgical Cosmetic Procedures Dermatology Issues

Facial Plastic Surgery ...

1 What is a facial plastic surgeon?

Facial plastic surgeons are board-certified otolaryngologists or plastic surgeons who have received extra training in plastic surgery of the face, head and neck and are board-certified by the American Board of Facial Plastic and Reconstructive Surgery.

2 Is board certification important in choosing a surgeon?

Yes, it is the basic step in documentation of a physician's training and knowledge in a specific area, but it alone is not sufficient. You generally should investigate the physician’s credentials further: hospital privileges for the procedures they perform, recommendations from patients who have used them, certification of the surgery centers they use, but finally it will come down to how you feel about your interactions with the surgeon on a one-to-one basis.  You should feel comfortable with the professionals you choose to provide your care.

3 What is the most common facial plastic surgery procedure today?

Currently, BOTOX® Cosmetic injections are the most popular non-invasive procedure, with more than 3 million injections performed in 2004, followed by chemical peels with over 1 million performed in the same time period. The most common cosmetic surgical procedure on the face was rhinoplasty, followed closely by surgery of the eyelids.

4 What is the best age to have a facelift?

While this varies from person to person, for most, from about 40-55 is a good time to consider facial rejuvenation. Most people have begun to show signs of aging at that point, and the skin still retains enough elasticity that the result is usually better and longer lasting than if one waits to a later age. If the skin has lost a lot of elasticity, it will stretch out faster and will require revision sooner.

5 My upper eyelids are sagging.  Is this something that insurance will pay to have corrected? This is a very common problem and one that can usually be readily corrected. It is true that some insurance will cover the cost of upper eyelid surgery under some circumstances, but this is becoming more uncommon. In order for this to happen, a problem with the vision must be documented by a test called visual field testing.  In other words, if the skin is so excessive that it falls over the eye and blocks vision, it may be covered by an insurance company. Most patients I see do not have that degree of excess skin. It is important to recognize the role that brow position plays in upper eyelid problems. This can be easily demonstrated by looking in the mirror and lifting your eyebrow with a finger while observing the effect it has on the upper eyelid skin. Many patients that I see are not aware of this, and often a brow-lift is recommended along with an eyelid lift.

6 I don’t like the shape of my lips- is there anything that can be done for this?

Lips can be seen as too big or too small and both can be improved. Lips that are too big can be permanently reduced with surgery - actual tissue is removed. Small or flat lips can be plumped up with a variety of injectable materials.  Restylane™ is the most popular one currently used, but collagen, fat, and several other materials are also used. Most of these are temporary, with Restylane™ usually lasting around 4-6 months.

7 I don’t like my nose.  Can you make it look like Michelle Pfeiffer’s (or someone else’s)? While reshaping the nose is a very common plastic surgery procedure, trying to make you look like someone else is seldom realistic or a good idea. Each of us has our own unique characteristics and the goal of cosmetic procedures is to enhance what you have been given naturally, not change you into someone new. Most patients with realistic expectations are very happy with the result of their surgery, but realistic expectations are the key phrase here, and trying to look like someone else is not realistic.

8 I broke my nose some time ago and now I want to get it fixed. Will insurance pay for this?

If the injury is well-documented in the medical record and the problem is functional, i.e. nasal obstruction or deformity, then the answer is often yes; but if it is just for cosmetic purposes, then no.

9 My neck is fat right under my chin. Is there any easy way to help this?

Yes. In this situation, it may be possible to perform liposuction alone to remove the fatty deposits. This can often be done through several small incisions under the chin and behind the earlobes. If the skin is too loose, however, it may require a neck lift as well.

10 I’ve heard about a new facelift technique that uses smaller incisions.  Can you tell me about this?

Yes, there are many variations on this and depending on your facial anatomy, one or another technique may be best for you. The short-scar lift and S-lift are similar in that the incision is not carried very far behind the ear as in a regular facelift. The endoscopic lift uses small incisions in the temporal hair to access the midface for suspension of this area. You will need to consult your physician about which is most appropriate for your particular condition.

 

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