Sunday, October 24, 2010

Tips And Traps Of Plastic Surgery

Plastic Surgery Tips and Traps To Avoid

Traps abound in the realm of cosmetic surgery. One way to avoid potential pitfalls is to be aware of them. Print this page and keep it handy. Some of these items might help protect you from an adverse outcome. In addition to the general tips and traps listed here, you will find specific ones along with each procedure on this site.

Questions to Ask when Scheduling an Appointment

When calling to schedule your appointment, ask questions freely. Expect the staff to be courteous, informative, and accommodating. If they are not pleasant before surgery, they certainly will not be afterwards.
  • Is the doctor certified by the American Board of Plastic Surgery? Beware of other board certification even if it sounds similar or better.
  • What is the surgery fee? Does the cost include the anesthesiologist, the facility, and the implant?
  • What is the consultation fee? Is it deducted from the cost of surgery?
  • Is the doctor punctual? If so, then expect to be seen promptly.

Checklist for Your Plastic Surgeon:

  • Is she certified by the American Board of Plastic Surgery?
  • Did he explain procedures, risks, and alternatives in detail and with clarity?
  • Did she describe recovery time and postoperative care?
  • Did she convey realistic expectations?
  • Did he answer questions thoroughly?
  • Did he listen to your concerns?
  • Did she make you feel comfortable?
Unless the answer to each of these questions is a resounding “yes,” then you should consider seeing another plastic surgeon.

Questions to Ask Your Plastic Surgeon During the Consultation

  • Will I be awake or asleep for surgery? Consider general, sedation, and local anesthesia. Note that you may sleep during either general or sedation anesthesia, although the depth of sleep varies.
  • How do you avoid the telltale signs of surgery? Bring a list of telltale signs to the doctor’s office (you will
    find them on this site on the page which describes the procedure you seek).
  • May I see pictures of others who have had the same procedure? Know that most will show you their best pictures, so this exercise may be of limited help. This is actually most useful if you dislike the results you see, because it tells you that your surgeon’s best results are below your expectations and it is time to see someone else.
  • May I speak with others who have had the same procedure? Know that most doctors will refer you only to their satisfied patients. This is not generally a useful activity.
  • Do you have privileges to perform this procedure in a hospital? Even if performed in the office, your surgeon should have hospital privileges to perform the procedure as evidence of his or her qualifications.
  • Will surgery be performed in the office or hospital? If your surgeon suggests the office, be certain that the office is accredited for your procedure and that the surgeon has hospital privileges to perform the procedure you seek.
  • If surgery takes longer than expected, who will pay the extra cost? This is an important question
    when surgery is performed in the hospital because the operating room and anesthesia fees may accrue hourly.
  • Do you charge for revision surgery? Know that some procedures have as high as 15-20% revision rate.
    Unless you want to get stuck with another big bill, it is best to establish this ahead of time. You cannot simply assume that you will not need revision surgery.
  • Will I be charged for follow-up appointments? Expect at least one year of follow-up appointments at no charge.


Jean Loftus MD

Plastic Surgery Cincinnati from The Loftus Plastic Surgery Center

Wednesday, October 20, 2010

Size Matters | Breast Augmentation Cincinnati Ohio


Size Issues

Whoever said size isn’t important has never dealt with breast implants. One thing I know for sure, after 15 years and thousands of breast implants, is that size does matter. It matters a lot. If you don’t get the size right, you probably won’t be too happy with the outcome of the procedure. In fact, I advocate that women who choose to have breast augmentation choose the best size implant and then work every other decision around that decision.

This is not to say that bigger is better. In fact it is not. The important thing about breast implant size is to select the best size for each woman. This is where things can get a little tricky, because women are all so different in where they start and where they want to go with breast size. For example, I could have 10 women walk into my office who have identical bodies, and each could choose a different size breast implant, and each could be happy with her selection. This is because a single size is not necessarily appropriate for a given body or breast size. Each plan must be individualized to that woman’s personal goals of how big she chooses to be, taking into account where she begins.

In order to find the size that is best for any given woman, I recommend the following steps:

1. Use silicone sizers. Even if you want saline implants, silicone sizers are the best. I used to recommend rice in baggies, but it just does not conform to the breast the same way. When using sizers, wear a tight-fitting sports bra (preferably 2 tight sports bras). The reason for the tight sports bras is because anything else will allow the sizers to appear larger than they actually are. Hence, a woman wearing looser bras or a cupped bra is very likely to select a size that is smaller than the size she truly desires.

2. Wear several different tops with your breast implant sizers in place to see how you look. Keep in mind that tighter clothes will always make you appear larger, and loose clothes will always make you appear smaller – no matter what size you select.

3. You may end up liking several different sizes. This is common. I recommend that you select the largest of all implant sizes that you like, stopping just short of the first one that is too big. This is soooo important. Here’s why: most of my patients are sitting on a fence with implant size. They want to go large enough so as to make the operation worthwhile, but they do not want to go so large that others notice or that they feel uncomfortable or that they are disproportionate. My strongest recommendation for women who wish to strike this balance is for them to select that very largest size that they like – but not one that is too big. Ever since I began advocating this approach, my rate of revision for change in size has dropped well below 1%, whereas the national average for revisions for change in size is between 10-20%. Of the few patients of mine who have chosen to undergo breast implant revision for change in size, half have chosen a larger size, and half have chosen a smaller size.

4. When you are viewing yourself in the mirror with sizers in place, be aware of the constraints of an established self-image which you might need to overcome. This is especially true for women in their 40s, 50s, and 60s who have become accustomed to looking at their modest sized breasts for decades, but it can also be true for younger women. I recommend that when you view yourself with sizers, you try to imagine that you are looking at the body of another woman rather than yourself. This helps make the decision-making process slightly more objective.

5. Bring your husband, boyfriend, sister, neighbor, cat, etc to help and offer their opinions and support, but be careful to avoid putting the size decision on them. This is especially true of boyfriends and husbands who may feel that if they help you decide, they will be to blame if you do not like the final size. So, my advice is that you should bring them along, but do not press them to give you input if they are hesitant to do so.

6. Ask your plastic surgeon to help you correlate breast diameter with implant size if you wish to be proportionate…but be careful with this, as there are many pitfalls with this approach. This may be the topic for an entire blog of its own.

7. Try to avoid using your desired cup size as a way to select implant size, as cup size is not standardized. The main place that cup size is relevant is with regard to selection of implant profile, but again, that is based on other factors as well…perhaps the topic for yet another blog.

8. If your plastic surgeon does not use sizers or if your plastic surgeon tells you that he or she will select your size, be wary. Most plastic surgeons will choose sizes that most women would be pleased with, but this does not help women who fall outside of the bell curve in their desires to be either larger or smaller than “most” women. Also, some plastic surgeons impose on other women their own perceptions of ideal breast size, which can sometimes be alarmingly large or disappointingly small.

Now, having asserted that size is the most important decision in breast augmentation surgery with regard to satisfaction, here are a few caveats:

* Please do not torture yourself over 30cc. For example, if you like the 360cc implant, you will like the 330cc implant as well as the 390cc implant. If you end up deciding that the 360cc implant was too small, then the 390cc implant would have been too small also. If you end up deciding that the 360cc implant was too big, then the 330cc implant would have been too big, also. Thirty cc is a relatively negligible amount, equivalent to 2 tablespoons. So, once you have decided on your implant size (or range), know that in order to change size in any visible way, you should change by at least 100 cc to be able to see the difference. (By the way, cc=cubic centimeter and ml=milliliter. One cc is the exact same as one ml).

* I view each woman as having a range of sizes that will all work well for her and will give equally satisfying results. So when I say that we need to get the size right, I am talking about a range rather than a specific size. That range may be 50-100 cc in either direction of the size selected – even taking into account that the woman selected the largest size that she liked among all sizers.

* Just getting the size right does not guarantee satisfaction, as other issues exist as well. See the rest of this site for details of all of the other factors that play a role in breast augmentation results.

Breast Wishes!
Jean M. Loftus, MD
PS: sorry for the corny sign-off, but I just couldn’t help myself!

Plastic Surgery Cincinnati from The Loftus Plastic Surgery Center