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July 25, 2008
Welcome to Cosmetic Surgeon
USA
Cosmetic Surgeon USA is an online directory of board-certified
plastic surgeons that specialize in procedures such
as tummy tucks (abdominoplasty), liposuction
(lipoplasty), face lifts, nose surgery (rhinoplasty),
ear pinning (otoplasty), eyelid surgery (blepharoplasty),
breast augmentation, breast lifts, breast reductions
and breast reconstruction. We encourage you
to contact our sponsoring doctors for specific questions
or to set up a consultation to find out if a specific surgery
is right for you. To begin your search please select
a state from the menu on the right.
Picture Perfect
Looking for the fountain of youth is a national pastime.
Some of us look to nutrition, others work out to stay
young while still others look for magic in jars. But
when those vitamins, face creams and crunches just aren't
doing the trick , many of us turn to plastic surgery.
Here's what you need to know before deciding if plastic
surgery is right for you.
Being an Informed Consumer
For anyone considering plastic surgery, it is crucial
to become an informed consumer. This is not a new car
you are thinking about; this is your body.
The first question to ask yourself is how much does
the status quo bother you. A doctor cannot tell you
how much distress a sagging neck or droopy eyelids or
prominent ears cause you. Plastic surgeons can operate
on ears; they cannot operate on what is between the
ears.
My basic philosophy is that if there is something that
concerns you for more than a certain number of hours
of most days, you should do something about it. Similarly,
if something interferes with your activities of daily
living (for example, not wearing low neck clothing because
you hate the way your neck looks), you should do something
about it. Doing something about it may range from buying
more turtlenecks to having a facelift.
Learning All Your Options
The next step is to find out as much as you can about your
options. The idea of having surgery you don't absolutely need
can be the source of much anxiety. Don't let fear of the unknown
overwhelm you. You need to familiarize yourself with the possibilities.
Input from friends who have had cosmetic procedures can be
invaluable.
In the Bay Area, it is sometimes hard to gather information
discreetly. Unlike in Southern California, where patients
walk around the grocery store with their facelift bandages
on, many people around here don't want to publicize the fact
that they are thinking about doing something, let alone tell
someone they did it.
There are those who have had surgery and want to recommend
a plastic surgeon to a friend without telling the friend that
they themselves had a procedure. It's like recommending a
restaurant to a friend where you claim never to have eaten.
It is generally agreed by most plastic surgeons that the mark
of excellent aesthetic surgery is when people don't immediately
notice that surgery has been done, but make comments such
as, "Oh, did you go on vacation? You look like you lost weight,"
or "Did you cut your hair?" This is in contrast to second
rate surgery that elicits behind the back barbs such as, "Oh,
I love that new ski jump nose," or "How was that trip through
the wind tunnel?"
Sorting Through the Information
As a result, many people turn to published material to learn
about different doctors and procedures. Some of these books
like Helen Brandford's "Welcome to Your Facelift" and Dr.
Richard Jobe's "The Sophisticated Shoppers Guide to Plastic
Surgery," are helpful reading to people beginning the search.
Other publications, such as the Yellow Pages, are often marketing
battles between plastic surgeons that benefit Pacific Bell
more than the doctor or the patient. Other forms of advertisement
also disguise themselves as the "real information," such as
advertorials in newspapers and magazines. Magazine and television
features other tantalizing bites of information that are often
incomplete assessments of the pros and cons of cosmetic surgery
procedures. As always, be sure to read between the lines and
watch with a cynical eye. There are 800 numbers to call that
guarantee you "an excellent plastic surgeon in the area,"
Be aware that these services make their money from the doctor.
The doctor pays the service to be on the "A" list, and while
some of these services screen the physicians they promote,
others do not.
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The Internet can be a useful source of good facts without
broadcasting to the world that you are thinking about having
plastic surgery. However, there are no editors on the Internet
doing fact checking, as there are in the print and broadcast
media. As a result, there is as much misinformation as there
is good advice.
The American Society of Plastic Surgeons (ASPS) maintains
a web site with a referral service to board certified plastic
surgeons in your area. There are also many web sites for individual
physicians, cosmetic surgery, marketing companies and plastic
surgery chat rooms.
The most useful thing to be gleaned from the net is learning
about the credentials of various plastic surgeons and what
questions to ask them. Most plastic surgeons have e-mail addresses.
You can find these ON the Internet or you can call their offices
to get their e-mail addresses. You can then ask them specific
questions through e-mail, which may help you to learn more
about procedures and their special areas of interest before
you ever go in for a consultation.
Finding a Surgeon
After you have learned as much as you can without seeing a
physician (and you're still interested in going the next step),
it is time to find a plastic surgeon. The San Francisco Bay
Area has the highest number of plastic surgeons per capita
in the world. As a result, there are a great many to choose
from. But they vary widely in credentials, specialties, costs,
experience and personalities. You may consult a plastic surgeon
who has already operated on your friends, or maybe you are
seeing someone you found on the web or in the yellow pages.
Either way, your objective should be the same. You should
find someone with first-rate credentials who performs the
procedure you're interested in often. Ideally, you should
see his or her work in photos and/or talk with previous patients
who have already had the same procedure.
The doctor should certainly be someone who you feel listens
to you and understands your concerns. It may take a few consultations
to find the right physician for you.
In all the "how to find a plastic surgeon" guides and suggestions,
the first edict is to make sure your doctor is board certified.
But that is really not the most important question. It is
more important to ask the next question: what is the name
of the board that has certified the physician?
You should look for certification by the American Board of
Medical Specialties, which is the governing board in the United
States. The only member plastic surgery board is the American
Board of Plastic Surgery. Because managed care has wrought
havoc with reimbursement in medicine, many physicians without
proper surgical training practice "cosmetic surgery" because
that is one of the few areas in medicine which is still fee
for service and free from managed care.
Finally, if you decide to shop by phone for prices, make sure
you are quoted global fees. This fee should include the surgical
fee, the operating room cost, the anesthesiologist and any
special charges such as laser fees.
Consulting with Your Doctor
Once you have selected a plastic surgeon, you need to be proactive
in predetermining what it is you are trying to accomplish.
It is important for the plastic surgeon to help you with what
bothers you when you look in a mirror rather than what bothers
him or her.
You will need the plastic surgeon's help to determine if liposuction
of the abdomen will accomplish what you want or whether an
abdominoplasty (tummy tuck) is more appropriate. Similarly,
you probably will not be able to decide by yourself whether
your droopy eyelid condition is caused from your eyelids or
mainly from your brows.
These are questions to be answered in the consultation. Risks
and possible complications should be carefully explained.
Make sure you get all your questions answered.
One of the newer areas in cosmetics consultations is computer
imaging. Although this technology is sometimes most useful
as a physician's marketing tool, it can be helpful for patients
to see what they might look like after surgery and helpful
to the doctor to get an idea of what the patient expects.
Current state-of-the-art software is excellent for noses and
chins. It is also good for facelifts and liposuction, but
not ideal for eyelids and breasts.
Although the chance to see what you might look like is very
appealing, remember, it is only a computer simulation. Realistic
expectations are vital to surgical success.
Confronting Your Concerns
The common worries prospective patients have concern safety,
recovery time and looking bizarre. National tabloids love
to highlight plastic surgical complications. In skilled hands
and in an accredited surgical facility, cosmetic procedures
are extremely safe.
Many patients like to have multiple procedures done at the
same time. However, combining too many together can be dangerous.
Recovery time depends on the procedure and what is meant by
recovery. Pain, bruising, and swelling subside at different
rate depending on the body and extensiveness of the procedure.
Make sure you tell your doctor what medicines, vitamins and
herbs you take. Vitamin E, aspirin, and Advil type medications
need to be stopped several weeks before surgery because they
thin your blood and can cause excessive bleeding.
Looking "pulled" or "surprised" is a concern of many prospective
aesthetic surgery patients. It is important to have realistic
expectations and to convey these to the physician. You need
to have complete trust in your doctor as you go into the operating
room. Anything less is unsatisfactory.
Considering Some New Procedures
As always, there are some new procedures in the cosmetic arena
now. Botox (short for bonilinum toxin) was used originally
for twitching eye muscles but has become effective in treating
frown lines and crow's feet. It works by deactivating the
muscles that cause these unwanted aspects of aging. It is
quite safe, but it only lasts a few months and it can also
cause temporary eye droopiness.
The Erbium laser for facial wrinkles tends to cause less redness
than the carbon dioxide laser, but does not penetrate as deeply
into the skin.
Lasers for removing hair have recently gained popularity as
well. These work by going after the melanin in your skin and,
at the same time, destroying the hair follicle adjacent to
the melanin. However, it is not permanent and requires multiple
treatments. Also, it can cause lightening of the skin, usually
in darker-skinned people.
In the liposuction field, there are a few different machines
for ultrasonic liposuction. These work by emulsifying and
suctioning only the fat, thereby leaving many of the other
fibers attached to the skin. It is especially useful in thick-skinned
areas such as the back. Recovery time is probably equivalent
to traditional liposuction. Advantages are possibly more skin
contraction and contour results. Disadvantage are risks of
skin burning (should not happen in experienced hands) and
fluid collections.
Another very helpful technique in liposuction is the use of
post-operative massage. This can markedly improve the contour
results.
As with any procedure, especially the newer ones, it is important
to get as much information as possible before proceeding.
This Is Happiness Surgery
Finally, remember that this is happiness surgery. You should
be happy with the doctor, the procedure, the timing, the anticipated
recovery time, the cost and the result. Try to have realistic
expectations. Taking the time to be an informed consumer is
an important first step.
Article taken from Breast Implants USA, the leading source
for Breast Implants
and Breast Augmentation information, courtesy of Josh
Korman, M.D., F.A.C.S.
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