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FAQs

Q) Three years ago I got a doctor recommendation to get a breast reduction. I lived in South Carolina, was on Medicaid, and I was told to lose weight in order to receive approval for the breast reduction. I now live in Georgia where I am experiencing the same back problems and dealing with extra breast tissue under my right arm. I’d like to know if my insurance would approve my reduction now that I’ve been at my job for over a year. I am on Aetna PPO insurance and my breast size is 42 DD.

A) Whether or not your insurance covers your breast reduction will depend on certain factors. First, is your physician in network or out of network? Not all physicians participate in insurance plans, especially plastic surgeons. If you’d like to stay in network, meaning that you will have no payments or a limited number of payments, you should find which plastic surgeons participate in your plan. Second, does you health insurance plan cover breast reduction surgery? Not all plans cover all surgeries. It is up to your employer providing you with your health plan to decide if the plan covers all procedures. Unfortunately, you may not be able to find out unless a code is created after being examined by a physician. The insurance company uses this code to decide whether or not the procedure is covered. If you go to a network provider then you just need to bring your insurance information with you to the examination. All of my patients who have undergone a breast reduction tell me it has improved their lives drastically. Good luck!

Q) I’m looking into getting a rhinoplasty here in Brooklyn, where I live, or in California. I’d like a surgeon who is also a great listener and who understands that I want a unique nose. What doctors would you recommend?

A) I recommend that you find a board certified plastic surgeon in New York because you live there. After a rhinoplasty surgery you will have frequent follow-up visits for at least a year. It is easier to follow up where you live than having to travel to a faraway surgeon. Also, I always encourage that my patients come and see me post-op when they have any questions.

I also recommend that you go to a surgeon who is a member of the ASPS (American Society of Plastic Surgery). A physician needs at least six years of surgery experience and training, with three of those years specific to plastic surgery, in order to be an active ASPS member. They follow a strict code of ethics and are required to take continuing education courses that include techniques on patient safety. Your surgeon should be able to work with you, as your partner, to achieve your desired goals.

Q) I have lost a lot of weight in the past year but I still have a belly and love handles. I’d really like to get liposuction and tummy tuck surgery. Is it possible to get both surgeries done right after the other?

A) There are a few factors that depend on the answer. Liposuction works well on love handles and I prefer VASER liposuction because of the quick recovery time. However, because belly fat is not always superficial, liposuction is not always a good option.

During a tummy tuck, liposuction is used to remove fat along with the surgical removal of extra skin from the lower abdomen and the relocation of the belly button. Because they are often done together, you would not need to have them done separately.

I suggest you schedule a consultation with a local board certified plastic surgeon to be examined; you can find one through the ASPS (American Society of Plastic Surgeons) website. During the consultation, you can get advice on how to achieve the results you are looking for.

Q) Do saline implants look good when they are placed over the muscle?

A) The way saline implants look when they are placed over the muscle depends on how much breast tissue and body fat you have. Saline implants have a tendency to wrinkle or ripple so if you do not have enough breast tissue or body fat to cover the implants and hide them, these ripples could be highly visible. In fact, when touched, the wrinkles or ripples might still be felt whether they are placed over or under the muscle. With time, the muscle stretches and the wrinkles or ripples show through or are felt if there is not enough breast tissue or body fat.

This tendency for wrinkles or ripples to occur is one drawback of saline implants—they aren’t as common with silicone gel implants. Nevertheless, I have many patients who love their saline implants and would never change them. Your surgeon should be able to review the pros and cons of both saline and silicone gel implants with you in relation to your unique body structure and personal preferences.

Q) I weigh 160 pounds, I am five feet seven inches tall with a 25-inch chest, and I am getting breast implants in December. I’d like to add volume and also keep a natural look. I am having trouble deciding between going high profile or moderate plus because a lot of photos show implants in a much higher position, which looks fake. Can breast implants be positioned to look more natural?

A) Different positions, sizes, and dimensions of implants all create different looks. I have many patients who have the same concerns. It is also very common for patients to request naturally positioned implants. I spend time with my patients to find the precise look they desire because there are so many implant varieties that come in many shapes and sizes. I also measure as many times as necessary to give my patients every option. This is an important decision so I suggest you discuss your concerns with your surgeon. It is also important to get an idea of how you will look with the size implant you choose because you will be living with the results for the next ten, 15, or 20 years.

Q) I have seen three ASPS-certified surgeons for Liposuction consultations. The surgeon’s fee ranged from $3,500 to $6,200, they all had the same anesthesia fee, and the facilities fee varied depending on the hospital used, from $1,500 to $2,470. Price is not an issue; I am merely looking for the best surgeon. However, I would like to discuss the role of price because I preferred the physician with the highest fee. What is your advice on how to approach this discussion?

A) I congratulate you for choosing only ASPS (American Society of Plastic Surgeons) certified plastic surgeons for your liposuction evaluations. I agree that price should not be the only factor in this decision. When comparing price, remember that a plastic surgery procedure isn’t a commodity that’s identical from one provider to the next. The results of liposuction, like those of any procedure, depend on your surgeon’s aesthetic judgment and surgical skill. These obviously differ widely. I always tell my patients that it is not necessarily how much fat I remove that is important, it is how much fat I leave.

Additionally, you’ll want to choose the plastic surgeon and staff with whom you feel the most comfortable. There’s value in knowing that you will be cared for by people who understand your goals, answer your questions, and respond to your concerns.

Always check before and after photos to gain a sense of their work. Some of my patients who are considering a procedure ask to speak with some of my other patients who have already gone through the procedure so they can ask specific questions about the experience. You may want to do the same, as it can help with your decision

Q) In your opinion, who is the best plastic surgeon in NYC for natural-looking Breast Augmentation surgery?

A) There are many highly regarded plastic surgeons in New York City. To assure that your plastic surgeon has gone through appropriate training, it is important to find a surgeon certified by the American Board of Plastic Surgery. Whenever you are considering a new plastic surgeon, always ask to see their pre and post-op photos and make sure they provide clear, full answers to all your questions. You should never have the feeling that you are being “sold” on a procedure. In my opinion, the best surgeons are often the ones who tell you what they can’t do for you as well as what they can.

Q) I have been told that it is dangerous to have surgery in Mexico because they have no ICU, but I’ve been considering getting breast implants at a clinic there. Do all US plastic surgery offices have an ICU or are they only found in hospitals?

A) Generally, it is not the best choice to get plastic surgery outside of the US. It’s not a question of whether or not there’s an intensive care unit (ICU) at the clinic. (Incidentally, in the US, “quad A” certification is the gold standard of patient safety for office-based surgical suites.) There are certain standards of care here in the US that you will not find elsewhere. I’m not sure what they are in a clinic in Mexico.
Studies have shown that complication rates are high among patients who have undergone breast implant surgeries in other countries. Part of the problem is that you won’t be followed by the surgeon who performed your procedure. In the event of complications, the same studies indicate that you’ll have a hard time finding a local plastic surgeon willing to correct them.

To assure that your plastic surgeon has gone through appropriate plastic surgery training, go to an American Society of Plastic Surgeons (ASPS) member. A physician needs at least six years of surgery experience and training, with three of those years specific to plastic surgery, in order to be an active ASPS member. They follow a strict code of ethics and are required to take continuing education courses that include techniques on patient safety. If money is an issue, you may want to consider finding a resident’s clinic at a medical school. The prices there are generally considerably lower.

Q) Three years ago I got a doctor recommendation to get a breast reduction. I lived in South Carolina, was on Medicaid, and I was told to lose weight in order to receive approval for the breast reduction. I now live in Georgia where I am experiencing the same back problems and dealing with extra breast tissue under my right arm. I’d like to know if my insurance would approve my reduction now that I’ve been at my job for over a year. I am on Aetna PPO insurance and my breast size is 42 DD.

A) Whether or not your insurance covers your breast reduction will depend on certain factors. First, is your physician in network or out of network? Not all physicians participate in insurance plans, especially plastic surgeons. If you’d like to stay in network, meaning that you will have no payments or a limited number of payments, you should find which plastic surgeons participate in your plan. Second, does you health insurance plan cover breast reduction surgery? Not all plans cover all surgeries. It is up to your employer providing you with your health plan to decide if the plan covers all procedures. Unfortunately, you may not be able to find out unless a code is created after being examined by a physician. The insurance company uses this code to decide whether or not the procedure is covered. If you go to a network provider then you just need to bring your insurance information with you to the examination. All of my patients who have undergone a breast reduction tell me it has improved their lives drastically. Good luck!

Q) I’m 55 years old and I’m having a tummy tuck with some liposuction done next month. I was told that I should move around after surgery as soon as I can get out of bed and that moving around encourages healing and assists in a shorter recovery time. I would think rest after surgery would be more beneficial. Why does moving around help?

A) There are a few reasons why I also encourage my patients to move around and walk after surgery. During surgery, massage boots are used to help blood circulate from the legs. The best way to help blood circulate after surgery is by simply walking because the muscles in your legs contract, sending blood back to your heart. This decreases the chance of blood clots that can break off and go to the lungs. We often encourage our patients to drink clear liquids the night after surgery to get them up and walking to and from the bathroom. The sooner you get back to performing your normal activities, the less sick you will feel.

I encourage my patients to walk for about five minutes, or for as long as they can, every two to three hours the night after surgery. Then the next day, I encourage my patients to get dressed in comfortable clothes and to walk around the house and even outside. It decreases the chance of pneumonia, blood clots, and other symptoms when patients are as active after a tummy tuck as they were before. Most of my patients also do not simply have the time to lie around; they have responsibilities or work that requires their attention. I also recommend that you use as little pain medication as possible due to the associated side effects.

Q) I’m 31 years old with three kids and I live in the Virginia Beach area. I’m interested in getting a tummy tuck because I have bad stretch marks and loose belly skin. I’m worried about finding a great doctor and the cost. Do you recommend any great doctors in my area who offer the tummy tuck procedure?

A) I recommend that you find a qualified board certified plastic surgeon on the ASPS website (American Board of Plastic Surgeons) or on the ASAPS Web site (American Society for Aesthetic Plastic Surgery). Each physician needs to have at least six years of experience and training, with three of those years specific to plastic surgery, to be an ASPS member. They also have to be certified by The American Board of Plastic Surgery and follow a strict code of ethics. They are required to take continuing education courses that include techniques on patient safety and they work with you, as your partner, to achieve your desired goals.

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