Plastic Surgeon is one who specializes in reducing scarring or disfigurement that may occur as a result of
accidents, birth defects, or treatment for diseases, such as melanoma. Many plastic surgeons
also perform cosmetic surgery that is unrelated to medical conditions, with the goal to
aesthetically enhance various parts of the body and face.
The techniques employed in aesthetic surgery are derived from those used in reconstructive
surgery. In fact, aesthetic surgery is an extension of reconstructive surgery. It requires competent
surgical skill, a sense of harmony of the body parts and good aesthetic judgment on the part of
It is common for many plastic surgeons to devote their time to
cosmetic surgery procedures. Typical cosmetic surgery procedures include
Rhinoplasty (cosmetic surgery on the nose), Blepharoplasty (cosmetic
surgery on the eyelids), Face Lift (cosmetic surgery to tighten facial
tissue) and other cosmetic procedures that reducing and enlarging the
Plastic Surgeons Were Selected
Consumers' Research Council of
America has compiled a list of Top Plastic Surgeons throughout the United
States by utilizing a point value system. This method uses a point value for
criteria that we deemed valuable in determining Top Plastic Surgeons.
The criteria that was used and
assessed a point value is as follows:
Each year the Plastic Surgeon has been in practice
Education and Continuing Education
Member of Professional Medical Associations
Completing an approved residency program and passing a
rigid examination on that
Simply put, Plastic Surgeons that have
accumulated a certain amount of points qualified for the list. This does not
mean that Surgeons that did not accumulate enough points are not good health
care professionals; they merely did not qualify for this list because of the points needed for
Similar studies have been done with
other professions using a survey system. This type of study would ask fellow
professionals on who they would recommend. We found this method to be more of a
popularity contest, for instance; professionals who work in a large office have
much more of a chance of being mentioned as opposed to a professional who has a
small private practice. In addition many professionals have a financial
arrangement for back-and-forth referrals. For these reasons, we developed the
point value system.
Since this is a subjective call,
there is no study that is 100% accurate. As with any profession, there will be
some degree of variance in opinion. If you survey 100 patients from a particular
physician on their satisfaction, you will undoubtedly hear that some are very
satisfied, some moderately satisfied and some dissatisfied. This is really quite
We feel that a point value system
takes out the personal and emotional factor and deals with factual criteria. We
have made certain assumptions. For example, we feel that the more years in
practice is better than less years in practice; more education is better than
less education, etc.
The Top Plastic Surgeon list that we
have compiled is current as of a certain date and other Surgeons may have
qualified since that date. Nonetheless, we feel that the list of Top Plastic Surgeons is
a good starting point for you to find a qualified specialist.
No fees, donations, sponsorships or advertising are accepted from any
individuals, professionals, corporations or associations. This policy is
strictly adhered to insure an unbiased selection.
Choosing a Plastic Surgeon is an important
decision. The Surgeon you are looking for should be qualified at performing the
procedure you need as well as understanding the particular circumstances of your
case. The Plastic Surgeon should provide you with realistic information about the
procedure and the outcome of your results. We strongly recommend finding a
Surgeon that is board certified and whom has received surgical instruction,
training and experience in the procedure you need. Thus, our goal is to assist
you in making that decision.
First of all, when selecting a
Surgeon, you may want to begin your search several different ways:
a family physician. He or she is in constant contact with all kinds of
healthcare professionals and will be able to point you in the right
family, friends, neighbors and/or co-workers.
your local hospital and speak to surgical nurses that do a lot of
the procedures you are having done. These nurses take care of the end
results of all Plastic Surgeons.
your city, county or state medical agencies for names of qualified
Surgeons. Contact and ask for referrals from medical associations. Many
are listed in this book.
A plastic surgeon is able to form a breast mound by using an implant or by using tissues from
another part of your body. Breast implants are silicone sacs filled with saline (salt water) or
silicone gel. The sacs are placed under your skin behind your chest muscle. Your body type, age,
and cancer treatment will determine which type of reconstruction will give you the best result.
Saline and Silicone Implants
Saline-filled breast implants are available for anyone who wants them.
Some scientists are concerned about possible short-term and long-term health problems
associated with silicone gel-filled breast implants. The Food and Drug Administration (FDA) has
decided that breast implants filled with silicone gel may be used only in an FDA-approved
clinical trial. Your surgeon can determine if you are eligible and can make arrangements for you
to join the study.
As with any surgery, you may have some pain, swelling, bruising, and
tenderness. These problems should disappear as you recover. Scars will fade over time. You
should let your doctor know immediately about any fever, infection, or bleeding.
Side effects that could appear later include rupture, leakage, deflation or shifting of the implant,
or interference with mammography readings. Breast implants age over time and may need to be
For more information about Breast Implants:
* Contact plastic surgeons and other medical experts.
* Call NCI's Cancer Information Service (CIS), 1-800-4-CANCER.
* Call the Food and Drug Administration (FDA), 1-800-532-4440.
* Call the American Cancer Society (ACS), 1-800-ACS-2345.
* Talk to breast cancer survivors who have had reconstruction.
* Contact your health insurance company.
Reconstructive surgery is a type of plastic surgery. This type of surgery is performed to reshape
abnormal structures of the body to improve function and appearance. Reconstructive surgery is
different than cosmetic surgery, which is performed to reform or reshape normal structures of the
body to improve a patient's appearance and self-esteem.
It is to also allow a person to have a more normal appearance. Abnormal
structures of the body that are corrected during reconstructive surgery may be the result of birth
defects, developmental abnormalities, trauma or injury, infection, tumors, or disease. The three
most commonly performed reconstructive surgeries in the United States are tumor ablation
(removal) and reconstruction, hand surgery, and breast reconstruction.
Reconstruction with Tissue Flaps
A flap (section) of skin,
muscle, and fat can be
moved from another part
of the body to the chest
area where it is formed to
create a breast shape. This
tissue can be taken from
the lower abdomen, back,
of skin, muscle, and fat is
moved while still
connected to its blood
supply. It is then shaped to form a new breast mound.
Choose a plastic surgeon who has been trained in this procedure and has performed it
successfully on many women. Of course, you will need to have regularly scheduled
follow-up care and mammograms.
Tissue flap reconstruction is a major operation, resulting in large
surgical wounds. If there is a poor blood supply to the flap tissue, part or all of the tissue in the
breast area may not survive the transplant. Infection and poor wound healing are possible
What You Should Know
Most women who have breast reconstruction are happy with their decisions. A woman starting
this process, however, should know that breast reconstruction requires more than one surgery.
Extra steps may include:
* Adding a nipple.
* Changing the shape or size of the reconstructed breast.
* Surgery on the opposite breast to create a good match.
With most of these extra surgeries, you can go home the same day as the operation.
Questions to ask your Plastic Surgeon about Breast Reconstruction
What is the latest information about the safety of breast implants?
How many breast reconstructions have you done?
Which type of surgery would give me the best results?
How long will the surgery take? What kind of anesthesia?
When do you recommend I begin breast reconstruction?
How many surgeries will I need?
What are the risks at the time of surgery? Later?
Will there be scars? Where? How large?
Will flap surgery cause any permanent changes where tissue was removed?
What complications should I report to you?
How long will my recovery take? When can I return to my normal activities?
should I avoid?
Will I need follow-up care?
How much will it cost?
Will my health insurance pay for breast reconstruction?
Rhinoplasty is plastic surgery of the
nose. This procedure is very common and you are a good candidate for
this procedure if:
Your nose is
crooked or off center
excessively wide or flared
A bump or high
point on your nasal bridge
Your nose is too
large for your face
The nasal tip is
sagging or thickened / enlarged
Many Plastic Surgeons prefer not to operate on
teenagers until they have completely stopped growing. Each case is individual and
needs to be discussed in detail with your Plastic Surgeon.
The actual procedure usually takes
between one and two hours. Rhinoplasty can be performed under local or
general anesthesia depending on what procedure you and your Surgeon have
decided upon. The skin of the nose is separated from the bone and
cartilage and then is sculpted to the desire shape. Many times the
incisions are made on the inside of the nose and it depends on each
particular Surgeon and what needs to be exactly done.
Your face will experience
discomfort for the first
twenty-four to forty-eight hours. It
is common for your face to feel swollen and to have a headache. It is
usually recommended to stay off of your feet for the first 24 hours and
get proper rest. By applying cold compresses, swelling and aching will
be reduced to a minimum. Slight bleeding will occur and blowing your
nose is a no- no for the first week.
What is Liposuction?
Liposuction is a surgical procedure intended to remove fat deposits and shape the body. Fat is
removed from under the skin with the use of a vacuum-suction canula (a hollow pen-like
instrument) or using an ultrasonic probe that emulfsies (breaks up into small pieces) the fat and
then removes it with suction.
Persons with localized fat may decide to have liposuction to remove fat from that area.
Liposuction is a procedure for shaping the body and is not recommended for weight loss.
Liposuction may be performed on the abdomen, hips, thighs, calves, arms, buttocks, back, neck,
or face. A liposuction procedure may include more than one site, for instance, the abdomen,
back, and thighs all on the same day.
Liposuction is also used to reduce breast size in men with large breasts
(gynecomastia) or to
remove fat tumors (lipomas) but it is most commonly used for cosmetic body shaping.
Who Performs Liposuction & Where is Liposuction Performed?
Many liposuction surgeries are performed by plastic surgeons or by dermatologists. Any licensed
physician may perform liposuction. While some physicians' professional societies may
recommend training before performing liposuction surgery, no standardized training is required.
As a result, there will be differences in experience and training in physicians performing
liposuction. You can ask your physician to tell you whether he or she has had specialized training
to do liposuction and whether they have successfully done liposuction before. But remember,
even the best screened patients under the care of the best trained and experienced physicians may
experience complications as a result of liposuction.
Liposuction may be performed in a
* doctor's office.
|| * surgical center.
|| * hospital.
Because liposuction is a surgical procedure, it is important that it be performed in a clean
environment. Emergencies may arise during any surgery and access to emergency medical
equipment and/or a nearby hospital emergency room is important. These are things that you
should ask your physician before the liposuction.
How can I find the right doctor for me?
The FDA cannot recommend physicians to you. However, there are some things that you may
Ask questions. If you decide to take the step to talk to a doctor about liposuction, be sure that
you ask questions and understand what happens during the liposuction procedure and what you
can expect. Your physician should also answer any and all questions you have about potential
problems with the procedure. Remember that you are purchasing a service when you pay a
physician to do a liposuction procedure and you shouldn't feel embarrassed to ask hard questions
about the procedure or about the physician's experience in performing liposuction.
|| Advertising. Be wary of advertisements that say or imply that you will have a perfect
appearance after liposuction. Remember that advertisements are meant to sell you a product or
service, not to inform you of all the potential problems with that service.
|| Don't base your decision simply on cost and remember that you don't have to settle for the
first doctor or procedure you investigate. The decision you make about liposuction surgery is an
important one but not one that you must make right away.
|| Read. You should learn as much as you can about liposuction. It is important for you to read
the patient information that your doctor provides.
|| Don't be pressured. Do not feel that because you speak to a physician about this procedure
that you must go through with it. Take your time to decide whether liposuction is right for you
and whether you are willing to take the risks of undergoing liposuction for its benefits.
Tummy Tuck (Abdominoplasty)
Abdominoplasty is a cosmetic surgical procedure designed to remove excess skin and fat from
the lower abdomen and to tighten the abdominal muscles. You may be a prime candidate if your
abdomen is affected by obesity, skin laxity following pregnancy or weight loss, or scars from
previous surgery. The overall body appearance is improved by reducing and recontouring
abdominal skin and fat. It is not a substitute for weight reduction nor a cure for obesity.
We suggest you set up a consultation with your plastic surgeon and discuss abdominoplasty.
You should tell the physician your goals and expectations. You should always keep in mind that
the desired result is improvement, not perfection. Abdominoplasty can improve your appearance
and renew your self-confidence; the rest is entirely up to you.
The procedure is usually performed under general anesthetic. Excess skin and fat is removed
from the lower abdomen and the abdominal muscles tightened. In some cases the navel is
repositioned. Scars are common in this type of procedure but your surgeon will make every
effort to make the scars as inconspicuous as possible. In some circumstances the scars can be
hidden inside the bikini line where they may be easy to conceal. Scarring is an individual
characteristic and can vary from patient to patient.
The best results are obtained in patients of near normal weight with some laxity of the abdominal
skin or a slight excess of fat or bulging of the abdominal muscles. The result is usually
permanent although of course excessive weight changes or future pregnancies may undo some of
the benefits of the surgery. Your surgeon can discuss with you your expectations and let you
know if they are surgically possible.
A facelift is a cosmetic surgical procedure to improve and sometimes eliminate evidence of aging
on the face and neck. A consultation with your plastic surgeon is advised when you are
considering a facelift. You should discuss your goals and expectations about looking and feeling
better after surgery.
You may wish to have a facelift to correct signs of aging such as facial lines and wrinkles,
sagging facial skin or a sagging neck. Only you can decide the best time for a facelift, as it is a
personal decision and your options will become apparent at the time of your consultation.
The aim of facelift surgery is to leave scars that are as inconspicuous as possible. Most scars fade
considerably with time although there is an individual variation in healing time and scar
formation. Occasionally thickened scars may develop which require specific treatment by your
In most cases, an incision is made commencing in the hairline at the temple, extending in a skin
crease down in front of the ear, around the ear lobe and then behind the ear finishing in the
hairline of the scalp. This provides enough access for your surgeon to separate skin from the
underlying fat and muscle. The skin is then stretched upwards and backwards, and the excess
skin removed. In certain cases additional procedures such as removal of the fat under the chin
and tightening of the underlying muscles is performed. A facelift may be performed under local
anesthetic or general anesthetic. Depending on the extent of the procedure, facelift surgery may
last from 2 to 4 hours.
A successful facelift operation will make you look refreshed and more youthful. A facelift
performed to correct sagging skin before lines and wrinkles have developed will often prevent
the formation of these lines and wrinkles for many years and thus preserve a more youthful
What does the FDA Regulate?
In the United States, the Food and Drug Administration (FDA) regulates the sale of medical
devices, such as the equipment (canulas, pumps, collecting containers, ultrasound probes, etc)
and drugs (anesthesia) used for liposuction.
Before a medical device can be legally sold in the U.S., the person or company that wants to sell
the device must seek approval from the FDA. To gain approval, they must present evidence that
the device is reasonably safe and effective for a particular use, the "indication." Once a device is
approved, other similar devices may be cleared by the FDA for use. This requires less
information since an equivalent device has already been shown to be safe and effective. In some
cases, devices that were on the market before FDA started regulating medical devices may be
cleared. Once the FDA has approved or cleared a medical device, a doctor may decide to use that
device for other indications if the doctor feels it is in the best interest of a patient. The use of an
approved or cleared device for other than its FDA-approved indication is called "off-label use."
The FDA does not have the authority to:
|| Regulate a doctor's practice. In other words, FDA does not tell doctors what to do when
running their business or what they can or cannot tell their patients.
|| Set the amount a doctor can charge for liposuction surgery.
|| "Insist" that patient information be provided to the potential patient.
|| Make recommendations for individual doctors, clinics, or liposuction centers. FDA does not
maintain nor have access to lists of doctors performing liposuction.
|| Recommend a physician to you.
|| Conduct or provide a rating system on medical devices it regulates.
Newest Surgical Procedures
Robotic surgery is a new and
very promising type of surgery. These mechanical marvels lend a helping
hand to Surgeons performing delicate and intricate surgeries. Robotic
Surgeons require a human Surgeon to operate them and input instructions
via voice activation and various computer interfaces.
Robotic technology is being
introduced in the medical field because they allow for unprecedented
control and accuracy performing surgical procedures. Robotics decrease
the fatigue that many Surgeons experience during long and tedious
operations. When Surgeons get tired it is common for them to experience
hand tremors, twitching and shaking. Robotics eliminate this by the
mechanical arm keeping steady.
The Food and Drug
Administration approved the first robotic system that is allowed to be
used in American operating rooms. It is presumed that robotic technology
could be used in over three million surgical procedures per year. As
this technology advances we believe that this will be a common
instrument in operating rooms throughout the country.
Lasers were developed in the
mid 1960's for industrial applications. These lasers emitted a
continuous beam of light and were non specific in their effects on
tissue. For the first twenty years the use of lasers in the medical
fields were limited, to say the least. In the early 1980's, lasers were
developed that emitted pulses of light. This development made the use of
lasers in medical applications popular due to the precise and effective
results of this new technology.
Today, many surgical
procedures are performed by lasers. Lasers are used to cut, coagulate,
vaporize and remove tissue. Lasers are used are for open and laproscopic procedures, as well as breast surgery, gallbladder removal,
hernia repair, bowel resection, hemorrhoidectomy, solid organ surgery
and pilonidal cyst.
Dermatologists use lasers for
many medical applications. These applications include:
|Benign Skin Growths
Ophthalmologists use lasers
frequently. The excimer laser is used to reshape the cornea and help the
eye focus properly. Laser vision correction is used to correct
nearsightedness, farsightedness and even astigmatism. Retina specialists
are using lasers to help treat Macular Degeneration. Glaucoma and other
diseases that cause pressure on the eye is now treated with lasers
Urologists are utilizing
lasers in the treatment of diseases that affect the urinary and genital
systems. Common diseases that are treated are urinary tract disorders,
urinary stones, urothelial tumors, obstructions, tumors and warts.
Podiatrists use lasers to treat fungal nails; ingrown nails; deformed
nails; Plantar warts; skin fissures; certain types of cysts, and many
With the continuing
advancements of laser technology and the advantages minimal invasive
surgery we expect see many new advances in this field.
Patients' Bill of Rights
You have the right to receive accurate and
easily understood information about your health plan, health
care professionals, and health care facilities. If you speak
another language, have a physical or mental disability, or just
donít understand something, assistance will be provided so you
can make informed health care decisions.
II. Choice of Providers
You have the
right to a choice of health care providers that is sufficient to
provide you with access to appropriate high-quality health care.
III. Access to Emergency
If you have
sever pain, an injury, or sudden illness that convinces you that
your health is in serious jeopardy, you have the right to
receive screening and stabilization emergency services whenever
and wherever needed, without prior authorization or financial
IV. Participation in
You have the
right to know all your treatment options and to participate in
decisions about your care. Parents, guardians, family members,
or other individuals that you designate can represent you if you
cannot make your own decisions.
V. Respect and
You have a right
to considerate, respectful and nondiscriminatory care from your
doctors, health plan representatives, and other health care
VI. Confidentiality of
You have the
right to talk in confidence with health care providers and to
have your health care information protected. You also have the
right to review and copy your own medical record and request
that your physician amend your record if it is not accurate,
relevant, or complete.
VII. Complaints and
You have the
right to a fair, fast, and objective review of any compliant you
have against your health plan, doctors, hospitals or other
health care personnel. This includes complaints about waiting
times, operating hours, the conduct of health care personnel,
and the adequacy of health care facilities.
As a Medicare beneficiary, you have
certain guaranteed rights. These rights protect you when you get health care;
they assure you access to needed health care services; and they protect you
against unethical practices. You have these Medicare rights whether you are in
the Original Medicare Plan or another Medicare health plan.
Your Rights Include:
| The right to protection from discrimination in
marketing and enrollment practices.
The right to information about what is covered and how much
you have to pay.
The right to
information about all treatment options available
The right to
appeal decisions to deny or limit payment for medical care.
The right to know how your Medicare health plan pays its
The right to
choose a womenís health specialist.
The right, if you
have a complex or serious medical condition, to
treatment plan that includes direct access to a specialist.
The right to receive emergency care.
If you believe
that any of your rights have been violated, please call the State Health
Insurance Assistance Program in your State.
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