Category: Other Surgical Procedures

Do you ever reject a patient for plastic surgery?

I have seen a small number of patients who seemed dissatisfied with so many of their features (inappropriately), that I’ve recommended self-evaluation and/or psychotherapy instead of cosmetic surgery. Some of these patient admit to being harshly criticized by a parent during childhood, and may have severe self-esteem issues that will not be addressed by the cosmetic surgery process. It is important for patients to be mentally sound, able to understand what cosmetic surgery will and will not do for you. I try to probe the person behind the request to understand if what I can do will truly meet the objectives of the patient. This is a difficult process for the plastic surgeon because each patient does not undergo an extensive psychological analysis, so I have to trust the instincts I have developed over the years. I do reject patients who do not have realistic expectations or those who are psychologically imbalanced.

This question was answered in conjunction with Jon Perlman, M.D.

I saw you on Extreme Makeover last year. I was wondering if many patients become addicted to plastic surgery once they start doing it?

I find plastic surgical addiction to be extremely rare in my practice. Most patients are genuinely made to feel better and become happier when “flaws” are improved or fixed.
My Extreme Makeover (ABC Network) experience has shown me how for some, a “makeover” can be more effective in improving self-esteem (and be longer-lasting) than psychotherapy.

This question was answered by Jon Perlman, M.D. Dr. Perlman appeared on Extreme Makeover many, many times.

I am a 55 and my wife is 45. She wants to do a face lift and is pushing me to look into it as well. I feel that I am too young to get a face lift and that it is a better surgery for a woman than a man. Are we too young for a face lift? Is it better to undergo a surgical procedure (i.e., facelift) at a younger age when the skin elasticity is better or at an older age when everything hangs down lower?

My feeling is that one should only undergo surgery when one is excited by the prospect of change and feels that he or she will benefit maximally from the procedure (physically and emotionally). Feeling compelled to have a facelift at an earlier age is ill-advised. The key is to get a good doctor and bond with him/her to help you decide if this is the right decision for you at this time. More and more men are getting facelifts today and the results can be as dramatic as the results we get on women.

This question was answered by Jon Perlman, M.D.

Some people tell me that liposuction could leave them with an imbalanced look. Might fat “go elsewhere” if I undergo liposuction?

If you regain weight after liposuction through an imbalance between diet and exercise, the body will find remaining areas of fat cells (that were not removed with the liposuction) to enlarge to take on additional fat. This may be unnoticed if it spreads through several regions, but it could be localized, creating a new bulge or area of thickening in an undesirable area. If there are not enough fat cells in the ‘love handle area’ that was removed in a previous liposuction, for example, fat may accumulate in the under-hanging arms. Liposuction is often performed by region and with some regions untouched, it could pick up the excess fat you eat and store if your gut liposuction was successful.

I feel that if I tackle what bothers me about my looks I would be shallow and superficial. I don’t like the absence of a hairline, the skin that hangs from my chin, or the rolls of fat (love handles is a poor name for it). IS there something wrong with me for wanting to look younger? What drives people to get cosmetic surgery?

Aging is not easy and not a graceful process as we might think it is. Often, some precipitating factor motivates a person to seek a return of his/her youthful look. With the many wonderful techniques that are employed for cosmetic surgery, change is easier than most people realize. It is not unusual for men and women to seek cosmetic surgery consultations as they approach a decade birthday, when they anticipate divorce or after discovering that they are being divorced, when they look in the mirror and see their body fat distribution has changed with or without weight gain, or even for women following menopause complaining that their face and neck skin has dropped. In effect, the person in the mirror is not who they think it is and they may not like what they see. You are not a freak and provided that you are not afraid of change, you can empower yourself to look further into how to get that younger look.

This piece was answered in part by Jon Perlman, M.D.

Here’s a plastic surgery question I received this week. I’ve opened the blog to questions regarding cosmetic surgery, rather than limit it to strictly hair loss questions (at least on a trial basis). If you have plastic surgery questions, please write…

I have a question in regards to rhinoplasty. I feel that my nose is relatively large and has a bump on the bridge, and I am looking for a completely new nose. I have a consultation scheduled in june with a surgeon and I wanted to know would this bring the cost higher, and is this possible?

Nose jobs (rhinoplasty) are one of the more difficult and artistic plastic surgical procedures. Some plastic surgeons do not take them on, while others feel that they have the artistic skills to create the nose that the patient wants. Costs vary significantly between surgeons and locations; the well known 5th Avenue (New York docs) and the Beverly Hills plastic surgeons are probably more expensive. You have to check out your doctor by finding out his/her experience with nose jobs, see many pictures of their work, speak to a few patients if that is possible, get to see that the number of patients he/she has done, etc.. Make sure you understand the risks from his/her perspective. Fixing the bump on the bridge of your nose is more common than other types of nose jobs where missing ‘bony’ infrastructure needs to be brought in. Do you bond with your doctor? Do you like the doctor as a person? Does he/she spend enough time to answer your questions and address your concerns, dealing with your worries with compasion? I use these rules for selecting any and all doctors.

Good luck.