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Below are some of the most frequently asked questions patients have about plastic surgery procedures.  This includes a facelift, tummy tuck, liposuction, rhinoplasty, ear surgery, eyelid surgery, breast lift, breast augmentation, or a breast reduction.  If you have any other questions, or would like to schedule an appointment, we would love to hear from you.  Baltimore plastic surgeon, Dr. Jeffrey Schreiber, enjoys answering all of your plastic surgery needs.  In fact, he answers many cosmetic surgery questions on Realself.com, Baltimore Examiner website, Facebook, and Twitter.  Thank you for browsing our FAQ page, and please don't hesitate to ask Dr. Schreiber anything about cosmetic and plastic surgery!

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A:

All surgical procedures are accompanied by a certain degree of risk, whether the procedures are for medical or cosmetic reasons.  Our expert team is dedicated to making your operation go smoothly.  We careful review your medical history and current health condition before deciding if it is safe for you to proceed with surgery.  It is important that you fully disclose all pertinent information so that we are able to make an accurate assessment of the risks involved.  We will take every precaution necessary to reduce the possibility of any complications.
A:

There several important factors that come into play when deciding whether plastic surgery is the right option for you.  One of the most important factors is your health.  Being in good health greatly reduces the risk of complications occurring during surgery and leads to a speedy recovery.  Next, you need to ask yourself what your motivations are.  People who have plastic surgery generally find that the surgery enhances their overall appearance and self-esteem.  Thirdly, you should have realistic expectations.  Plastic surgery is both a science and an art, neither of which are perfect.  Set reasonable goals as to the result you wish to achieve and be prepared to thoroughly discuss these goals during your initial consultation.
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It is a relatively common practice for a plastic surgeon to perform multiple procedures during one operation.  This allows the surgeon to better “sculpt” your final appearance.  In addition, having several procedures done simultaneously saves you the expense of paying the operating room and anesthesia costs more than once.  However, having too much done at one time can lead to complications.  The decision to have multiple procedures done depends on which procedures are being done, the extent of surgery, the operating time, and your age/health.  Ultimately, the surgeon decides whether or not it is appropriate to include more than one procedure in your operation.
A:

Due to the variety of procedures available in plastic surgery, there can be no blanket rule on age although age will be taken into consideration when planning your operation.  People of all ages have taken advantage of the image-enhancement offered by plastic surgery.  There are even procedures appropriate for young children!  It is important to realize the limitations of plastic surgery.  Plastic surgery cannot “fix” every situation or reverse the aging process.  What is a good procedure for one person may not be an appropriate procedure for another.  We are committed to making your plastic surgery experience a successful one.
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During your consultation we will discuss your desired changes and expectations, review your medical history and current health, and make an assessment on whether the procedure(s) in question are right for you.  This is a good time to ask specific questions about the procedure so that you are fully prepared, mentally and emotionally, for surgery.  We will discuss the results that can be achieved, with the aid of photos and/or computer imaging.  When a final decision is made, you will need to sign an informed consent stating that you are fully aware and understand what is entailed by your pending operation, including the potential complications and secondary effects.
A:

Generally, post-operative instructions call for rest and limited movement in order to speed up the healing process and recovery time.  The length of recovery varies with each procedure and is different for each individual.  Bruises usually disappear within a few days, and most swelling is gone in a matter of weeks.  If you follow our post-operative instructions carefully, you will be able to enjoy your normal activities within no time.  Your scars will fade over time but are permanent.  We take care to conceal any scars so that they are barely visible, if at all.  The image-enhancing effects of plastic surgery become more evident over time with certain procedures taking up to a year for your body to fully adjust and settle into its new look.  When you come in for your consultation we can discuss your expected recovery period and any post-operative instructions in detail.
A:

Insurance providers generally cover costs for reconstructive surgery but not for cosmetic surgery.  For example, insurance providers will often pay for breast augmentation to reconstruct a breast following a mastectomy; breast reduction to remedy back pain caused by heavy breasts; eyelid surgery to remove sagging skin that blocks vision; nose surgery to allow for a patient to breathe better; or tummy tucks to remedy the vertical separation of abdomen muscles known as diastasis.  Insurance providers are required by law to cover breast reconstruction surgery and any cosmetic operations necessary to create symmetry in either breast. If your surgery is covered by insurance, pre-certification is required.  We will be happy to assist you with the process.
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The issue of breast implant safety has been a hot topic throughout the last few decades.  As a result, more stringent standards have emerged in order to protect patients.  Current breast implant procedures primarily use silicone shell implants filled with a saline solution.  Occasionally, silicone-gel filler is used; but this is highly regulated by the FDA, and generally only acceptable in reconstructive surgery procedures.  Rarely, an implant will rupture or leak.  With saline implants, the saline is safely absorbed into the body.  The effect of silicone-gel leaking into the body is still being researched.  If rupture or leaking is detected early, the implant can be easily replaced.  Other possible complications from breast implant surgery may include blood clotting or pooling, overly sensitive breasts or loss of sensation in the breasts, and capsular contracture (a hardening of the tissues surrounding the implant).  Our expert team is dedicated to making your operation a smooth one.  We take every precaution necessary to reduce the possibility of any complications.
A: A full tummy tuck can remove most, if not all, of the stretch marks below your belly button.  However, for you it's difficult to determine the extent of skin removal possible without actually examining you.  The stretch marks above the belly button are harder to remove, and may require a reverse tummy tuck where the skin is pulled up and removed.  Check with a local plastic surgeon to see which procedure is best for you.
A: Brachioplasty is a great procedure to remove the excess skin and fat from the arms as well as make them look more trim and thinner.  The procedure can be done alone as an outpatient or combined with other procedures as a brief overnight stay in the hospital.  The scar is the only downside as it extends from the elbow to the armpit, but with good scar therapy you can minimize the scarring.  For recovery, I would recommend a week for work and exercise.  Then, return gradually and the pain is also well controlled with oral pain medication. 
A: This tissue can be removed by under either local or general anesthesia.  Another option would be sedation anesthesia where you would get a little "twilight" anesthesia without the breathing tube and then your surgeon could inject the local anesthesia.  This way, you wouldn't be aware of the injections, and when you wake up a little you're axillae will be numb.
A: Surgery for underarm skin, or brachioplasty, can leave you with scars from your elbow to your armpit.  However, there really is no other good way to remove this skin.  If it's only fat that's a problem, liposuction may do the trick.  A tuck only under the armpit may not fully adress all of the exces skin that you're concerned with.  Talk with other patients and look at their scars to see how the scars can turn out.
A: In order to soften the appearance of the scars, I would recommend filling in the scars with Restylane along with resurfacing with a CO2 laser.  Before paying for anything, know that it is very difficult to completely eliminate the scars and that most treatments will only soften them and make them less noticeable.
A: Tubular breasts can be corrected with implants over the muscle.  However, if extensive work will be done around the areola you may want to get the implants under the muscle to prevent any blood flow problems to the nipple-areola area. 
A: Uneven breasts don't necessarily need implants to make them more symmetric.  You can get breast lifts to help increase the symmetry, and this can be done with incisions around the areolae, vertically from the areolae, and vertically and horizontally from the areolae.  In order to determine the best options for you I would need to see you in person or at least a photo.  However, in order to correct any severe volume discrepencies, you may need a small implant.  If you got pregnant in the future, your scars may stretch as well as the skin and the procedure may have to be repeated or at least redone minimally. 
A: If you have your goal weight of 120, I would recommend getting as close to it as possible before surgery.  This way, all of the excess skin will be removed and if you continue to lose weight you may have more hanging skin.  If you can't get to 120, I would recommend waiting until your weight is stable for 3 months.  Liposuction will work at most weights, but try not to use it as a weight loss treatment.  Instead, follow a good diet and exercise as this will also help you maintain your great results from your mommy makeover. 
A: A circumvertical breast lift is great for moderate droopiness, or ptosis.  This type places the incisions around the areola with a small incision below it.  It provides a lift to the nipple/areola as well as improving the shape of the breast.  Potential problems scarring, altered nipple sensation, and recurrence of the sagginess.  A breast lift can be done entirely as an outpatient with minimal pain and downtime.
A: I would recommend obtaining your chart from the plastic surgeon who placed your breast implants.  This record will have what kind of implants you have and what size.  It will also have the operative notes which are very helpful for the surgeon doing your revision.  If you can't get your chart, contact the hospital where your breast augmentation surgery was performed for your records.  Finally, if you have the plastic identification card that came with your implants this will also have some helpful information.
A: Many patients have several medical problems who undergo plastic surgery.  As long as you're cleared by your internist/cardiologist, you should be okay for your tummy tuck.  The procedure may need to be delayed until your pressure is well controlled, but it is worth the wait.  Proceeding with a tummy tuck with uncontrolled high blood pressure may lead to excessive bleeding and/or hematomas.
A:
A SMAS facelift addresses the underlying structures of the skin, such as the muscles and the tissues that cover them.  This type of facelift involves lifting these structures to restore volume to your cheeks as well as to lift the skin of your face.  A lower face lift may only address the skin of the neck or cheek, but not really the underlying structures.  It is this confusion that should guide you to really understand what your plastic surgeon is offering you in terms of surgery and the results that you are looking for.
A: As my former chairman used to say, "There's no scar like no scar."  With that being said, I wish surgery could be done without scars, but it just isn't so.  Breast lifts included, they are great to restore volume to the upper parts of the breast as well as lifting the nipple-areola, but scars are necessary.  Good scar therapy after the procedure can assist in making fine line scars, and most breast lift scars do heal really well.
A: With a hernia present and the desire for a tummy tuck to repair the diastasis recti, you will most likely need two surgeons.  This is really a safety issue for you as the hernia may involve your intestines requiring the skills of a general surgeon.  Then, your plastic surgeon can help with the tummy tuck.  It may take some extra prep time for you, but it is well worth the effort to have two surgeons in your operation.
A:
Whether it's for a rhinoplasty or any other cosmetic procedure, there are certain questions you should ask.  Please see the following list:

1.  What would you do meet my aesthetic goals?

2.  Can I speak to other patients who have had this procedure?

3.  What happens if I have a complication?

4.  Can I see some of your before and after pictures?

5.  Are you board eligible or board certified?

6.  How do I get in touch with you if I have any questions?

7.  What is my recovery like?

8.  How long do I need off of work?

9.  When can I exercise again?

10.Where will my surgery take place?
A: To help with a smooth course after your surgery, it's important to follow your surgeons instructions.  This may include no exercise for 1-2 weeks, limited bathing, and taking care of your drains.  For creams, I recommend Mederma for scars after surgery.  Also, make sure you don't smoke for at least 2 weeks before and after your surgery and this includes second-hand smoke.
A: In order to address your aesthetic goals, I would recommend a mini-tummy tuck as the first operation to remove the pouch of skin and to re-shape your belly button.  At the second stage, I would recommend liposuction for the upper part of your abdomen and hips.  It's great that you're doing so well after your gallbladder removal, but it might takes several steps to reshape your abdomen to your liking.
A: Yes, liposuction would most likely be great to address the areas that you're concerned about and to improve your overall aesthetic appearance.  However, it's difficult to give you an exact answer without pictures.  The recovery after liposuction may not be as involved as your tummy tuck, and the results can be terrific.  
A: A tummy tuck can tighten loose muscles, but if you don't have any looseness you can skip this part.  A side view of your abdomen helps to determine this as well as a physical examination while you're lying on an examining table.  Skin below the belly button is removed with a modified tummy tuck and the scar is a lot smaller than a standard tummy tuck.
A: Recovery from these procedures takes about 2 weeks from work and 6 weeks from working out.  I typically remove the dressings at 1 week, and you may have drains that will be in for about 1-2 weeks.  Driving can usually be resumed at 1-2 weeks depending on how you do.  Also, pain is well controlled with oral pain medicine.
A: A tummy tuck can tighten loose muscles, but if you don't have any looseness you can skip this part.  A side view of your abdomen helps to determine this as well as a physical examination while you're lying on an examining table.  Skin below the belly button is removed with a modified tummy tuck and the scar is a lot smaller than a standard tummy tuck.
A:

There really is no limit as to the number of facelifts that you can have. As long as you need one, you should be fine and get a good result.  Your Baltimore facelift specialist, Dr. Jeffrey E. Schreiber,  should tell you when a facelift is not really needed and that when a facelift is performed anyway is when people get a look that appears "fake." Signs that a facelift is necessary include prominent nasolabial folds, significant jowling, and excess hanging skin of the neck.  Make sure you tell your Baltimore plastic surgeon, Dr. Jeffrey Schreiber, your entire past surgical history, including any previous plastic surgery, in order to avoid any unnecessary procedures and risks.  When done correctly and for the right patient, a facelift can be a very "uplifting" experience!
A: A facelift will allow access to the skin and muscles at the jowl areas and allow a good "pull" to make your jowls less noticeable.  The procedure can also correct any hanging skin of the neck as well as lifting the cheeks.  The incisions are kept right in front and behind the ear, so they are not very noticeable.  Also, the recovery takes about 1-2 weeks with pain being well controlled with oral pain medications.
A: Sometimes, it is very difficult for patients to know whether they need a breast lift or a breast reduction.  Basically, a breast lift raises the nipple/areola and can restore volume to the upper portions of the breast.  Sometimes, a breast implant (silicone or saline) can be used with a lift to help when a lot more volume is desired.  A breast reduction not only lifts the nipple/areola, it also makes the breast smaller.  The incisions for a breast lift and a breast reduction can be as small as only around the areola or as large as the "anchor" type incision.  Check with your Baltimore plastic surgery specialist to determine what approach is best for you to achieve your aesthetic goals.  In both the breast lift and reduction, the areolae are made smaller if they are extremely large.  This can happen especially after breastfeeding.  The recovery is generally easier for a breast lift which takes about 5-7 days.  A breast reduction may take longer (10-14 days) depending on how much breast tissue is removed.
A:

A full rhinoplasty includes all aspects of shaping and contouring the nose to achieve your aesthetic goals. This can include the following things:

1. Rasping of the dorsal hump (bridge) of the nose to make it curved.
2. Infracturing or breaking the bones beside the nose to make the width of the nose more narrow.
3. Placing cartilage grafts on the dorsum of the nose to improve the shape.
4. Reshaping the tip of the nose with cartilage grafts or stitches.
5. Contouring the base of the nose by removing skin from around the nostrils.
 

A tip rhinoplasty only includes work done on the tip of the nose (nostrils) and not the dorsum.  If you desire a more curved appearance to the dorsum of you nose you'll need a full rhinoplasty.

The access to the nose can be done either "closed" or "open" depending on the experience of your Baltimore plastic surgery specialist and depending on what you want accomplished.  Each Baltimore rhinoplasty specialist has his/her own specific post-operative instructions, but the recovery usually takes about one week with nasal splints usually placed when cartilage is removed from the middle (septum) of the nose. Exercise can usually be resumed 1-2 weeks after rhinoplasty surgery, but contact sports should be avoided for 6 months afterward to allow adequate healing. Also, swelling of the nose can take up to one year to fully resolve.  All in all, your rhinoplasty surgery should be a pleasant experience.
 
A: If you're considering a breast augmentation, achieving a natural look is very important to many women.  Smooth, round, silicone breast implants give a very natural look and they feel very natural as well. This is especially true for women with very little breast tissue to begin with ('A' cup.)  To get a better idea of the size you may like, place samples of breast implants in your bra.  These can be found in the office of your Baltimore plastic surgeon and is typically done during your consultation.  Bringing in photos of breasts that you like is also a good way to let your Baltimore breast augmentation specialist know what size implants you want.
A:

Insurance companies are all different in how they determine coverage of a breast reduction. For example, many Blue Cross plans require a certain amount of tissue to be removed based upon your weight. For some Aetna plans, photos are required along with supporting documentation from several physicians claiming that the large breast size is a cause of neck and back pain. So, the best way to determine whether or not you insurance plant will cover your breast reduction is to look at the exact requirements in your plan. Then, go to your Baltimore plastic surgery specialist and review this with him/her to talk about how small you want to be.  Baltimore breast reduction plastic surgeons know that you desire smaller breasts, but if you go too small you may end up needing implants.  It's important to be realistic about your aesthetic goals.  Typically, only extremely large, pendulous breasts get covered for a breast reduction. However, it never hurts to ask!
A:

The most frequently performed methods of liposuction are standard liposuction and ultrasonic liposuction. Power-assisted liposuction is the same as standard liposuction, except that the tip of the instrument used to remove the fat is actually motorized to aid in removing the fat. Many other "forms" of liposuction can be found on the internet, but make sure you do your research into what is really happening if you decide to go with a form of liposuction that isn't standard or ultrasonic liposuction. Standard Baltimore liposuctioninvolves the instillation of a numbing fluid underneath the skin into the area of fat to be removed. This can be done under general, sedation, or even local anesthesia (for smaller areas.) Then, the standard liposuction cannulas (instruments) are used to remove the fat. Ultrasonic liposuction is basically done the same why, except the tip of the liposuction cannula emits ultrasonic waves. This emulsifies the fat and allows easier removal of the fat. Check with your Baltimore plastic surgeon as recovery varies depending upon how much fat is removed, but is generally around 1 week. Compression garments are used to mold the treated areas and to prevent any seromas (fluid collections) from forming. Most Baltimore liposuctionexperts state that exercise can usually be resumed in a week as well. Results can be seen in about 3-4 weeks after the swelling resolves. Tightening of the areas treated is actually performed, but a "tighter" look may appear after the fat is removed and the swelling is gone.
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Choosing whether or not to lose weight before a tummy tuck all depends on how you look now and the appearance you want to acheive.  Baltimore liposuction expert, Dr. Jeffrey Schreiber, commonly performs liposuction of the hips with a tummy tuck.  However, if extensive liposuction is required for the upper part of the abdomen or hips and thighs it may be better to wait about 3 months between the tummy tuck and liposuction.  Losing weight before a tummy tuck can only benefit you.  Your Baltimore tummy tuck expert will be able to remove more skin after weight loss giving you an overall better result.  Also, losing weight with diet and exercise will contribute to a healthier lifestyle and help you maintain your tummy tuck results longer.

NEW!  Click here to view a tummy tuck procedure 3-D animation.