General Plastic Surgery Questions

Can you have more than one surgery at a time?


Yes, you can have more than one surgery done at a time. Ideally they should total less than 5 hours of surgical time.


Am I awake when I go into the OR?


Yes, the surgeon see you in the holding area or pre-operative area. You will be marked for surgery, operative plan reviewed and final questions will be answered. You will be given a little bit of medications to make you just a bit drowsy and to relax you, but you will be awake. You will actually help us position you in the operating room. You will be attached to several monitors to follow you while you drift off to sleep. You will then be given some more medication in your IV and will fall asleep.


When can ointments, oils, vitamins, herbs, etc. be put on the incisions after surgery to help the scars?


These types of products may be started usually about 4-5 days after the sutures have been removed. During the initial few days it is best to allow the wounds edges to heal completely prior to starting to apply scar improving treatments. A more detailed answer regarding scar management is listed in the FAQ page about scar management.


Stop smoking before plastic surgery?


It is better to stop smoking before any surgery, but it is not required for most surgeries. It is the best thing to do though. If you are going to stop, it is best to stop at least 3 weeks before the surgery. If you stop or cut back there will be less coughing and experience less discomfort. Wound healing has also been shown to be compromised in people who are actively smoking during the healing process. Smoking causes blood vessel constriction and this leads to less blood flow, delayed wound healing, and increase chances of an infection.


Sex after plastic surgery?


Non exertional sex without elevations in blood pressure may be entertained when a person decides that they are interested. As with other forms of exercise and elevations in blood pressure, it is best to not experience elevated blood pressure for 10-14 days. As an important side note, antibiotics taken after the surgery may make birth control pills ineffective. So it is best to use other sources of birth control during the first month after antibiotics


Is there anything that can improve the quality of the scar from plastic surgery?


A healing wound heals best when it does not move. Movement causes pulling or tension across the wound. Tension is perhaps the worst thing for a healing wound. Keeping tape or a steri-strip or silicone sheeting will help the best during the initial healing phase.

After the initial phase, some will use an ointment, vitamin E, etc to improve the scar. If the ointment or cream can penetrate the skin, then it may be of some limited benefit. Keeping tape over the incision for a month really works the best. Unfortunately, most women prefer to remove the tape for comfort. Then apply the ointments, etc. If the scar starts to thicken or change color, please contact the office. In these rare events, medicated tapes and/or injections into the scar may improve the final outcome.


Can people with latex allergy have plastic surgery?


Yes. The operating room equipment and surgical gloves must be latex free and this can be done. The hospital or surgery center will prepare all of the surgical supplies using non-latex materials. The surgeon and surgery personnel all wear non-latex gloves. This is not a problem at all.


What kind of anesthesia is used for plastic surgery?


Anesthesia medications are placed in the tissue and throughout the body using different medications. When the meds are administered through the the vein (intravenous or IV), it is believed that this is IV sedation and not a general anesthesia. IV only refers to the route of delivery of a medication. It has nothing to do with the level of anesthesia. Breathing gases is another route to administer medication and achieve sedation. Inhalational delivery of medications are delivered into the body using specialized airway or breathing tube.

A level of sedation is classified by how the body responds/or fails to respond to a stimuli. There is light sedation and deep sedation, the later category is referred to as general anesthesia. It does not imply a breathing tube but rather a level of unconsciousness. General anesthesia can be achieved using IV or inhalation access. It is a misconception that IV anesthesia is less anesthesia than inhalation anesthesia.

Another misconception is that if you have general anesthesia and you will be paralyzed. Being paralyzed has nothing to do with levels of anesthesia. Again, you do not need to be paralyzed to have general anesthesia. The important thing is that you will be asleep and will not feel anything. If you were to lighten and start to wake during the surgery, you would be able to move and this would signal to the anesthesiologist that you require more medicine. This is extremely rare, and you would not remember it even if it was to occur. Technically speaking, plastic surgery is performed under general anesthesia without a breathing tube and without being paralyzed. The anesthesia is administered both using IV and inhalational medications.


What happens during the consultation?


You will be asked to provide your medical history. We will discuss your concerns, your reasons for the cosmetic plastic procedure(s) and your expectations. After an examination, the discussion will center on the success of accomplishing what you desire and the details involved. After our discussion, you will probably require time to decide whether or not you would like the cosmetic surgery.

If you would like to think about our discussion or discuss it with your family before making a final decision, it is encouraged for you to do so. However, it is important that you are the one who makes the final decision, not anyone else. A second office visit may be scheduled if necessary. Preoperative photographs will be made so that your problem can be studied more thoroughly and will be taken and used for reference during the cosmetic surgery, if you decide to proceed. You should wear clothing to the consultation that is easily removed to expose the area to be examined. Also, please keep makeup to a minimum if your plastic surgery consult concerns your face.


Will insurance pay for any part of cosmetic surgery?


As a general rule, insurance will not pay for operations that are cosmetic. Occasionally, insurance will pay for part of a cosmetic surgery if it improves function by relieving symptoms such as restricted vision, impaired breathing, back and shoulder ache due to heavy breasts, separation of the abdominal muscles resulting from multiple pregnancies, etc. If it does pay for part of the procedure, insurance usually will pay the related hospital and anesthesia costs. The center will be glad to assist you filing any insurance claims for you, however, we cannot fill out claims stating the surgery was performed to improve function if it was not. Since our office does not work directly with insurance, we are not able to file claims on behalf of our patients. We recommend that any patients wishing to file through insurance reach out to their provider as early in the process as possible and obtain a list of any documentation or other information they will need. We will send all supporting information possible, but we are not responsible for the final decision of your insurance company. It is best to have an answer from them before you elect to have cosmetic surgery.


What are the costs of cosmetic surgery?


The fees for the different cosmetic plastic surgeries vary with each operation and the complexity of the problem. There is typically a fee to use the surgery center, anesthesia fee, plastic surgeon fee and perhaps implants or garments. Since cosmetic surgery is strictly elective, the fees are payable in advance. There are prescriptions for antibiotics and pain control. These are typically covered by insurance.


Are there any risks involved in cosmetic surgery?


Every cosmetic surgery or procedure, no matter how simple, entails some degree of risk and the possibility of complications. These risks should not be taken lightly. Fortunately complications seldom occur and are usually amenable to treatment. You will be provided with an informed consent for the specific procedure(s) you will having. This document should be read and fully understood before signing. You should be aware of the risks and make an educated decision for any cosmetic surgery.


Will there be scars after cosmetic surgery?


All surgical incisions and wounds of human tissue heal by forming a scar that is permanent and cannot be erased. However, care is taken to try to make the scars as thin-lined and inconspicuous as possible. To accomplish this, they are placed in areas where they can be more easily camouflaged. While such scars are permanent, these are rarely noticeable or cause trouble. The experience of the cosmetic plastic surgeon is a valuable tool that aides in improving the outcome and result.


Is cosmetic surgery painful?


Regardless of the type of anesthesia used during the cosmetic surgery, there is no significant discomfort. Will there be pain? Yes, because the initial IV may hurt or the injections to numb an area. After the numbing or anesthesia has taken effect, there should be no pain. If there is, it is easily remedied with additional medication. After the surgery in the initial period the involved areas may be numb for nearly 12 hours. Then the area will become sore or be painful which can be remedied using oral pain medications. While discomfort and limitations of activity after plastic surgery are minimal, they do exist. Please remember that the healing process is temporary and the benefits typically long lasting.


Who is a good candidate for cosmetic surgery?


People who are seeking an improvement in their appearance is only part of the answer. People with realistic in their expectations as to what cosmetic plastic surgery can accomplish are the best candidates. At certain ages and health conditions, medical clearance may be required. A person who is seeking absolute perfection or expects a transforming miracle from cosmetic plastic surgery is not a good candidate. While cosmetic surgery is often psychologically beneficial in increasing one’s self-confidence and esteem, it is not the solution for all of one’s problems. If a person is expecting more from cosmetic surgery than can be accomplished physically, psychologically or socially, I will recommend they not have cosmetic plastic surgery until they have worked out their other concerns.


How successful can cosmetic surgery be?


The degree of success of an operation depends on the skill of the cosmetic plastic surgeon and the cooperation of the patient, but also on a variety of factors. Such as the characteristics of the specific problem, the person’s general health, age, skin, texture, bone structure and genetics. The healing process is influenced by these factors and is not entirely under the control of the patient or the plastic surgeon. While good results should be anticipated in properly selected cases, it would be unethical for the plastic surgeon to imply any type of warranty or guarantee. It is best to not think about perfection or guarantees, but rather good outcomes.