Specialty Area: Plastic Surgery

Description of Specialty: Plastic surgeons provide a range of clinical services including cosmetic surgery, hand surgery, certain forms of cancer surgery, as well as a broad range of reconstructive procedures, performed after injury or to correct birth defects.

1. Diagnosis: Macromastia (large breasts) Surgery: Reduction Mammoplasty

Questions that should be asked:

  1. What size will I be postoperatively?
  2. Will I need a preoperative mammogram?
  3. Will my insurance cover the procedure?
  4. Recovery time?
  5. What symptoms will likely improve after surgery?
  6. What are the risks of surgery?
  7. Where will my scars be placed and will there be scarring?

2. Diagnosis: Breast Ptosis (sagging breasts) Surgery: Mastopexy

Questions that should be asked:

  1. Will implants be utilized?
  2. Placement above or under the muscle?
  3. What size will I be postoperatively?
  4. Will there be scarring?
  5. Cost?
  6. Recovery time?
  7. What are the risks of surgery?
  8. Will the condition recur?

3. Diagnosis: Micromastia (small breasts) Surgery: Augmentation Mammoplasty

Questions that should be asked:

  1. What type of implants will be utilized?
  2. Will the implants be placed under or above the muscle?
  3. Should I get a preoperative mammogram?
  4. Where will the incisions be made?
  5. What are the risks of the breasts becoming hard after surgery?
  6. Cost?
  7. Recovery time?
  8. How often do the implants need to be replaced?
  9. What are the other risks of surgery?
  10. Can the implants interfere with the detection of cancer?

4. Diagnosis: Breast Cancer Surgery: Breast Reconstruction

Questions that should be asked:

  1. How long after chemotherapy/radiation can I have surgery?
  2. How many surgeries will be required to complete the reconstruction?
  3. Should I donate blood before surgery?
  4. Will "balancing" surgery be necessary on the other side?
  5. Can this surgery interfere with detection of recurrent cancer?
  6. What are the risks of surgery?
  7. Can the breasts be reconstructed using my own issue without an implant?
  8. Do I have a choice of the type of implant that can be utilized?
  9. Recovery time?

5. Diagnosis: Facial aging Surgery: Facelift

Questions that should be asked:

  1. Can I expect dramatic or conservative results and how long will results last?
  2. Should I get a preoperative physical?
  3. Are there areas the surgery will not affect?
  4. Cost? Recovery time?
  5. What are the risks of surgery?
  6. Can this be combined with other facial procedures?

6. Diagnosis: Droopy eyelids Surgery: Blepharoplasty

Questions that should be asked:

  1. Will I need a tear production test preoperatively to check for dry eyes?
  2. Can the incision be made "inside" the lower eyelid?
  3. When can I wear contacts again?
  4. Will I need brow surgery at a later time?
  5. Cost? Recovery time?
  6. What are the risks of surgery?
  7. Can this be combined with other facial procedures?

7. Diagnosis: Droopy brow Surgery: Forehead Lift/Brow Lift

Questions that should be asked:

  1. Will an endoscopic approach be used?
  2. Will the surgery have any effect on my upper lids, or will I need further surgery?
  3. Cost? Recovery time?
  4. What are the risks of surgery?
  5. Will there be scarring?
  6. Will there be numbness?
  7. Will there be hair loss?

8. Diagnosis: Deviated septum with/without external nasal deformity Surgery: Nasoseptal Reconstruction/Rhinoplasty

Questions that should be asked:

  1. Can I expect conservative or dramatic results?
  2. Will cartilage grafts be utilized?
  3. If I have a septal deviation, will my insurance cover a portion of the surgery?
  4. Will the surgery have an affect on breathing problems/seasonal allergies?
  5. Will I have packing/splinting postoperatively?
  6. Recovery time?
  7. What are the risks of surgery?

9. Diagnosis: Facial Aging/Scarring Surgery: Laser Resurfacing

Questions that should be asked:

  1. How much improvement can I expect from the surgery?
  2. What are the risks of sun exposure postoperatively?
  3. Which laser is appropriate for me?
  4. What are the benefits of using Retin-A and Hydroquinone preoperatively and postoperatively?
  5. Is it advisable to take medicine preoperatively to avoid infections?
  6. Cost?
  7. Recovery time?
  8. What are the risks of surgery?
  9. What could I expect if you only lasered a portion of my face, i.e., around my eyes?
  10. Is there a risk if I have a history of facial herpes?
  11. Will there be scarring?

10. Diagnosis: Lipodystrophy (excess fat deposits) Surgery: Liposuction

Questions that should be asked:

  1. Am I a good candidate for the procedure?
  2. Is there a risk of skin looseness postoperatively?
  3. Do you perform tumescent Liposuction?
  4. Cost?
  5. Recovery time?
  6. Will you use the "ultrasonic technique"?
  7. What are the risks of surgery?

11. Diagnosis: Diastasis recti and/or abdominal panniculus (loose abdominal tissue) Surgery: Abdominoplasty

Questions that should be asked:

  1. Should I be at my ideal weight before contemplating surgery?
  2. Would liposuction of my abdomen be an alternative?
  3. Where would the incisions be placed?
  4. Do I have a separation of my abdominal muscle?
  5. Cost?
  6. Recovery time?
  7. What are the risks of surgery?

12. Diagnosis: Basal cell skin cancer Surgery: Excision of Basal Cell Carcinoma

Questions that should be asked:

  1. Do I have other options, such as radiation therapy or a Mohs' technique?
  2. If surgery is indicated, what form of reconstruction will you use?
  3. What will be the final cosmetic result?
  4. What are the risks of recurrence?
  5. What are the risks of surgery?

13. Diagnosis: Malignant Melanoma Surgery: Wide Excision Malignant Melanoma

Questions that should be asked:

  1. Should I have my biopsy slides sent for a second opinion?
  2. Is it advisable to see an oncologist for an evaluation?
  3. How often should I have other lesions checked?
  4. Recovery time?
  5. What are the risks of surgery?

14. Diagnosis: Scar Surgery: Scar Revision

Questions that should be asked:

  1. Is it advisable to wait a certain period of time after injury before contemplating surgery?
  2. What conservative treatment can be tried if the scar needs time to mature?
  3. What are the risks of sun exposure?
  4. If I am a candidate for surgery, would you perform dermabrasion, laser surgery or perform a direct excision of the scar?
  5. Cost? Recovery time? What are the risks of surgery?

15. Diagnosis: Carpal Tunnel Syndrome Surgery: Carpal Tunnel Release

Questions that should be asked:

  1. Do you perform an open or endoscopic technique?
  2. Can I try a course of conservative treatment, such as splinting, anti-inflammatories and Vitamin B6?
  3. If I have classic symptoms, is it necessary to have a nerve conduction study?
  4. Is postoperative therapy necessary to maximize the rate and extent of my functional return?
  5. If I return to repetitive work, what are my chances of developing carpal tunnel syndrome again?
  6. Recovery time?
  7. What are the risks of surgery?

David Caplin, M.D. Clinical Instructor, Department of Surgery Washington University School of Medicine St. Louis, MO

                                                                                           

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