Cosmetic Surgery: December 2007

Monday, December 31, 2007

5 Questions to Ask Before Getting an Eye Lift

With newer techniques, better technology and an enhanced understanding of what "looks good" and what doesn't (see some celebs who don't look good, e.g. Kenny Rogers), prospective patients need to do more homework than ever. Here are some questions that you need to ask in order to be fully informed before signing up for eyelid surgery.

Will the eyebrows also be lifted with the upper eyelids?

Eyebrow elevation is not automatically done. However, evaluation of the brow position and its influence on upper eyelid excess is essential. For females, the ideal brow position is at the bone level or slightly above. The brow should be arc-shaped. For men, the brow should sit at bone level or slightly below. The ideal time to deal with droopy brows is when the upper lids are being lifted. The doctor needs to check this out thoroughly at consultation.

My upper lids feel very heavy and it seems my vision may be affected. Will insurance help pay?
In the extreme, heavy upper lids can obscure vision. This needs to be confirmed by an eye specialist. When confirmed on testing, it is considered a medical condition and usually insurance benefits apply.

I wear contact lenses. How soon can I resume wearing them after surgery?

Contact lenses can be worn as soon as upper lid swelling has receded such that the lash-line sits at the normal position just above the iris colored portion of the eye); usually 5-7 days. Then, the contacts will not be pushed down by the heavy lids. After only lower lid surgery, the contacts can be inserted in one or two days.

Besides heavy upper lids, I have baggy lower lids. What is done for those?

Bagginess of the lower lids is usually caused by fat pads pushing forward. Correction via hidden incisions, behind the lid; the excess fat is removed or repositioned or both. If there is excess wrinkled skin, additional measures may be required.

I'm afraid of that surprised, startled look, the tell-tale sign of poor eyelid cosmetic surgery. Is that automatic? And, if not, what is done to avoid that unsatisfactory look?

No one likes to look like "a deer in the headlights". That startled look is the consequence of amateurish, overzealous surgery. Too much was done. Either the brows were lifted too high or too much overhanging eyelid skin and fat removed. Not easily corrected. Your best protection: Be sure to see lots of the doctor's before-and-after photos. Ask to see some former patients. Those surgeons who specialize in eyelid surgery, such as ophthalmic plastic surgeons and cosmetic surgeons who do more facial than body work are less likely to error. Always select the most specialized doctor who works from a short menu. Think superspecialist.

Doctors' Board Certification

What is it? What is the Importance?

The terms "board certification" or "board certified" have been much bandied about recently. The death of Kanye West's 58-year-old mother has naturally focused on the qualifications of her surgeon. As the media dissected the doctor's resume, it was reported that although he practiced the specialty of plastic surgery, he was "not board-certified by the American Board of Plastic Surgery".

Not all lay people understand "board certification". Does a doctor being "board certified" – or not - impact on their medical care? How important is it?

Succinctly, a doctor who is "board certified", whether he be a plastic surgeon, pediatrician, internist or radiologist, has met the standard of the medical profession to be able to hold himself to the profession and the public as a specialist. The credential is awarded after successfully completing an approved residency of anywhere from two to six years, and subsequently passing a series of oral and written exams. Some specialties, including plastic surgery, require specific practice experience before one can take the exams. Think of this as the medical educational system's version of the Good Housekeeping Seal of Approval, awarded by fellow specialists.

The concept of long, supervised training, demonstrated actual in-practice experience and passing tests is laudable. No other occupation or profession demands such an exhaustive and rigid requirement for formal recognition. This is the medical profession's and specialties' way of saying: "Our student, the product of our highly-structured educational (book learning) and training (hands-on, practical) program is deemed fit to practice this specialty. He has met our standards which have been designed to protect the patient."

Some doctors may choose to not take the exam; some flunk it. They still have a license to practice and obviously their knowledge, skill and talents are there to be employed. However, many hospitals will not grant staff privileges to those not certified and one has little chance of being accepted as a teacher by any of the medical schools without such a diploma.

Should all this matter to you, the patient? Frankly, it should. Because when one voluntarily expends time and energy to pass the exam and then can proudly say to you, his patient, that he has met the standards of his profession and his specialty, doesn't that does say something about his desire for excellence and dedication? That, of his own volition, he studied hard and did "pass" every test presented along that interminable, laborious route of medical education and training.

Voluntarily taking the ultimate, final test for certification as a bonafide specialist does say a lot about a person and his character. About individual tenacity, diligence and focus; about going the extra mile. All to benefit the patient.

That is why I appreciate and respect the concept of board certification. Hence I prefer to have board certified doctors as consultants for my patients, my family and myself.

Robert Kotler, MD, FACS

Related Topics:

Technorati Tags: cosmetic surgery, board certification, medicine, wellness

Posted by: Robert Kotler, MD, FACS at 12/26/2007 04:50:00 AM

Comments (2)

EMail This

Discuss with others Link

Link to this post

Wednesday, December 5, 2007

5 Most Common Questions Asked of Cosmetic Surgeons

We find that some of the same questions repeatedly come up when prospective patients are consulting with me. We have listed the most popular ones. I don't want to sound like a broken record, but it's extremely important to be informed and feel that all your questions are answered when deciding to have cosmetic surgery. If you are left with unanswered questions, you should be concerned.

Q: If I see a picture in a magazine of a particular feature that I like, should I bring the photo to the consultation?
A: Yes, this can help the doctor understand your desires. It is also helpful when the doctor offers computer imaging so you can see the predicted result of your procedure. Imaging is the best way to determine what you like and what will look the most natural.

Q: Will I meet the doctor during the consultation?
A: The answer better be "yes". It is imperative to meet with the doctor who will be performing your procedure.

Q: In addition to reviewing the hundreds of before/after photos on the website and in the photo albums in the office, would it be O.K. to speak with a patient who already had the procedure?
A: This is a great way to get first hand knowledge of someone's experience the doctor and the office. You will also learn about recovery from a patient's viewpoint. An even better opportunity would be to meet the patient.

Q: I did not realize I needed several different procedures to accomplish what I hoped for. I may be exceeding my budget. Are there ways for me to reduce cost, but without compromising the result?
A: Yes there are. In Chapter 11 of my book, Secrets of a Beverly Hills Cosmetic Surgeon, I share some very practical strategies. For example, if you have flexibility in your schedule and can fill a surgery center opening when one arises, you can save a healthy percentage of the surgeon's fee. There are other ways too. No shame in asking.

Q: I am concerned about pain.
A: Today, there is no reason for any patient to suffer pain. We have a big assortment of pain medications and tranquilizers to keep you comfortable and relaxed. If you have had experience - good or bad - with certain medications, we need to know and we can alter our prescription plans accordingly.