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:
- What size will I be postoperatively?
- Will I need a preoperative mammogram?
- Will my insurance cover the procedure?
- Recovery time?
- What symptoms will likely improve after surgery?
- What are the risks of surgery?
- Where will my scars be placed and will there be scarring?
2. Diagnosis: Breast Ptosis (sagging breasts) Surgery: Mastopexy
Questions that should be asked:
- Will implants be utilized?
- Placement above or under the muscle?
- What size will I be postoperatively?
- Will there be scarring?
- Cost?
- Recovery time?
- What are the risks of surgery?
- Will the condition recur?
3. Diagnosis: Micromastia (small breasts) Surgery: Augmentation
Mammoplasty
Questions that should be asked:
- What type of implants will be utilized?
- Will the implants be placed under or above the muscle?
- Should I get a preoperative mammogram?
- Where will the incisions be made?
- What are the risks of the breasts becoming hard after surgery?
- Cost?
- Recovery time?
- How often do the implants need to be replaced?
- What are the other risks of surgery?
- Can the implants interfere with the detection of cancer?
4. Diagnosis: Breast Cancer Surgery: Breast Reconstruction
Questions that should be asked:
- How long after chemotherapy/radiation can I have surgery?
- How many surgeries will be required to complete the reconstruction?
- Should I donate blood before surgery?
- Will "balancing" surgery be necessary on the other side?
- Can this surgery interfere with detection of recurrent cancer?
- What are the risks of surgery?
- Can the breasts be reconstructed using my own issue without an implant?
- Do I have a choice of the type of implant that can be utilized?
- Recovery time?
5. Diagnosis: Facial aging Surgery: Facelift
Questions that should be asked:
- Can I expect dramatic or conservative results and how long will results last?
- Should I get a preoperative physical?
- Are there areas the surgery will not affect?
- Cost? Recovery time?
- What are the risks of surgery?
- Can this be combined with other facial procedures?
6. Diagnosis: Droopy eyelids Surgery: Blepharoplasty
Questions that should be asked:
- Will I need a tear production test preoperatively to check for dry eyes?
- Can the incision be made "inside" the lower eyelid?
- When can I wear contacts again?
- Will I need brow surgery at a later time?
- Cost? Recovery time?
- What are the risks of surgery?
- Can this be combined with other facial procedures?
7. Diagnosis: Droopy brow Surgery: Forehead Lift/Brow Lift
Questions that should be asked:
- Will an endoscopic approach be used?
- Will the surgery have any effect on my upper lids, or will I need further surgery?
- Cost? Recovery time?
- What are the risks of surgery?
- Will there be scarring?
- Will there be numbness?
- Will there be hair loss?
8. Diagnosis: Deviated septum with/without external nasal deformity
Surgery: Nasoseptal Reconstruction/Rhinoplasty
Questions that should be asked:
- Can I expect conservative or dramatic results?
- Will cartilage grafts be utilized?
- If I have a septal deviation, will my insurance cover a portion of the surgery?
- Will the surgery have an affect on breathing problems/seasonal allergies?
- Will I have packing/splinting postoperatively?
- Recovery time?
- What are the risks of surgery?
9. Diagnosis: Facial Aging/Scarring Surgery: Laser Resurfacing
Questions that should be asked:
- How much improvement can I expect from the surgery?
- What are the risks of sun exposure postoperatively?
- Which laser is appropriate for me?
- What are the benefits of using Retin-A and Hydroquinone preoperatively and
postoperatively?
- Is it advisable to take medicine preoperatively to avoid infections?
- Cost?
- Recovery time?
- What are the risks of surgery?
- What could I expect if you only lasered a portion of my face, i.e., around my eyes?
- Is there a risk if I have a history of facial herpes?
- Will there be scarring?
10. Diagnosis: Lipodystrophy (excess fat deposits) Surgery:
Liposuction
Questions that should be asked:
- Am I a good candidate for the procedure?
- Is there a risk of skin looseness postoperatively?
- Do you perform tumescent Liposuction?
- Cost?
- Recovery time?
- Will you use the "ultrasonic technique"?
- What are the risks of surgery?
11. Diagnosis: Diastasis recti and/or abdominal panniculus (loose abdominal
tissue) Surgery: Abdominoplasty
Questions that should be asked:
- Should I be at my ideal weight before contemplating surgery?
- Would liposuction of my abdomen be an alternative?
- Where would the incisions be placed?
- Do I have a separation of my abdominal muscle?
- Cost?
- Recovery time?
- What are the risks of surgery?
12. Diagnosis: Basal cell skin cancer Surgery: Excision of Basal Cell
Carcinoma
Questions that should be asked:
- Do I have other options, such as radiation therapy or a Mohs' technique?
- If surgery is indicated, what form of reconstruction will you use?
- What will be the final cosmetic result?
- What are the risks of recurrence?
- What are the risks of surgery?
13. Diagnosis: Malignant Melanoma Surgery: Wide Excision Malignant
Melanoma
Questions that should be asked:
- Should I have my biopsy slides sent for a second opinion?
- Is it advisable to see an oncologist for an evaluation?
- How often should I have other lesions checked?
- Recovery time?
- What are the risks of surgery?
14. Diagnosis: Scar Surgery: Scar Revision
Questions that should be asked:
- Is it advisable to wait a certain period of time after injury before contemplating
surgery?
- What conservative treatment can be tried if the scar needs time to mature?
- What are the risks of sun exposure?
- If I am a candidate for surgery, would you perform dermabrasion, laser surgery or
perform a direct excision of the scar?
- Cost? Recovery time? What are the risks of surgery?
15. Diagnosis: Carpal Tunnel Syndrome Surgery: Carpal Tunnel Release
Questions that should be asked:
- Do you perform an open or endoscopic technique?
- Can I try a course of conservative treatment, such as splinting, anti-inflammatories and
Vitamin B6?
- If I have classic symptoms, is it necessary to have a nerve conduction study?
- Is postoperative therapy necessary to maximize the rate and extent of my functional
return?
- If I return to repetitive work, what are my chances of developing carpal tunnel syndrome
again?
- Recovery time?
- What are the risks of surgery?
David Caplin, M.D. Clinical Instructor, Department of Surgery Washington University
School of Medicine St. Louis, MO