Tru You

Can Plastic Surgery have a bad result?

erez — Sun, 19 Feb 2012 15:41:17 +0000

It is always a touchy subject to discuss bad surgical outcomes. Surgery can have a bad outcome for many reasons:

1.Adverse effects can happen to anyone, regardless of the surgery or doctor. Things like infections, drug reactions, implant rejections or skin necrosis (wound healing problems) can happen to anyone. I always say that if you do not want any risk of complications then don’t have surgery.
2.Adverse effects can happen because of poor patient selection. Many patients actually do not help themselves toward a positive outcome. These type of patients include smokers, drug abusers and patients who are morbidly obese.
3.The main reason patients love to complain (and lawyers love to sue) is poor outcomes as a result of a physician’s treatment.

Now, most doctors are brilliant hard-working caring surgeons who try their best. In most circumstances everything turns out great, but sometimes treatment plans are sound but judgement in the amount of skin excised or the angle of pull is off. These are things that can easily be corrected by the attending physician.

Often, patients expect perfection immediately after surgery and then transfer their disappointment into anger towards their doctor. In that case, they will often see another surgeon to perform the minor corrections even though their first doctor is capable of the correction.

Other outcomes may, in a small group, be the result of of the doctor not demonstrating a caring attitude toward the patient. As a result, treatment plans may not reflect that which is most beneficial for the patient. These are the cases that give doctors the worst problems as a group. It is sort of like letting a bad apple spoil the entire bushel.

In our practice, we see patients that fit into all of these groups. We look at the treatment with understanding and compassion. For those that we know we can help (those that have reasonable expectations and are willing to help themselves), we finish with a well-tailored plan for a successful outcome.

“Can I have Plastic Surgery if I have diabetes or high blood pressure?”

erez — Sun, 19 Feb 2012 15:34:13 +0000

The medical conditions you describe place you at some increased risk but do not necessarily mean that you can’t have a tummy tuck. It is important to discuss all of your medical conditions with both your plastic surgeon and your medical doctor.

It will be important to have your diabetes, blood pressure, and cholesteral under control and monitored prior to any surgical procedure. Only proceed with elective surgery when you have medical clearance from your health care providers and follow their instructions to help ensure the best possible outcome.

Medical conditions do pose risks for surgical procedures. It all depends on how you manage those risks and if the benefits justify the risks.

Should I get a “mini” or a full “tummy tuck?”

erez — Sun, 19 Feb 2012 14:41:17 +0000

This is a very commonly asked question, “which would be best for me?”

Well, the answer is complicated. Mini-tucks are appropriate procedures for patients with only a small amont of fat or excess skin below the belly button that hangs over their pant line or bikini bottom when they lean forward. This procedure is limited in the amount of stretch marks that can be remove and the amount of tightening that can be achieved. Often, liposuction can be added to this procedure to improve the results on the appropriate patient.

A full tummy-tuck, is a much more extensive procedure that aims to tighten and improve tone along the entire abdomen. This is achieved by elevating the skin up to the rib margin and then tightening the muscles along the middle all the way down to the pubis. The excess skin and fat are then trimmed off and the belly button repositioned to look natural. Depending on the patient and the amount of excess skin, we are often able to remove stretch marks all the way up to the belly button. This procedure has more down-time, and requires the use of internally placed drainage tubes to help with fluid build up. The results are generally superior to the mini-tuck in most patients.

Finally, I will also add, that not everyone is a candidate for these abdominal procedures. Some patients would not have a good result with either one depending on their body habitus and pre surgical weight or health. The only way to know for sure is to seek the professional opinion of a board certified plastic surgeon. Hope this helps.- Erez Sternberg, MD

Exciting News: “Dr. Hollie Hickman named Medical Director for Ideal Image Jacksonville!”

erez — Sun, 05 Feb 2012 15:33:12 +0000

We are excited to announce that TruYou’s, Dr. Hollie Hickman, has now teamed up with Ideal Image Jacksonville as their new medical director. This step will ensure that Ideal Image patients always have an experienced plastic surgeon available to answer questions. Ideal Image is Jacksonville’s expert location for hair removal. With the latest in laser technology available, they can treat patients of all skin types, ethnicities, and thickness of hair. All the staff at Ideal Image are advanced trained physician assistants experienced with patient care and customer service.

Question: “When am I too old for a facelift?”

erez — Sun, 05 Feb 2012 15:03:15 +0000

The question is not whether you are too old, but instead, how healthy are you? Chronological age can me much different than a patient’s physical and mental age. I have had 60 year old patients that look and feel 80 years old and visa versa. The important issue is how good your health is and how your recovery will be? This is usually best answered by a good physical exam by your surgeon and a medical clearance exam from your primary care physician. There are always risks and dangers with surgery, but age doesn’t necessarily have to be one of them. In general, facelifts are best performed on 50-60 year olds, and the results usually last 7-10 years. Expect a facelift to cost between $8000-13000 depending on additional procedures (such as eyelid lifts, brow lifts, fat grafting, etc.) and extent of surgery.Good luck with your decision. We would be happy to see you for a free consultation at TruYou Plastic surgery.

Dr. Hickman, what are some of the most rewarding procedures that you perform which are not cosmetic?

erez — Sun, 18 Dec 2011 02:46:37 +0000

About half of the surgeries we perform at TruYou Plastic Surgery are reconstructive in nature, and a large part of that is breast reconstruction. As you can imagine, this is a very rewarding aspect of our practice. For a women and her family, the emotional roller coaster following the diagnosis of breast cancer is an extremely difficult event to go through. We are involved from the beginning, getting to really know and gain the trust of the patient even before surgery; and then forming a strong ongoing bond during the course of reconstruction which can often take as long as 6-9 months to complete. In addition, we stay connected with the patient for life performing yearly exams and following the aesthetic and functional outcomes of our reconstruction. We feel truly honored to have this opportunity and be able to take part in such a remarkable journey.
In addition to breast reconstruction, we also repair wounds of the extremities, treat burn contractures, heal chronic wounds, perform breast reductions, scalp repair, and many biopsies and reconstructions after the removal of skin cancers. There are many other procedures, not named above, that we perform and which really define the technical range and versatility of our specialty.

Dr. Sternberg, What made you choose to go into the field of Plastic Surgery?

erez — Sun, 18 Dec 2011 02:43:18 +0000

When I was growing up, we had close family friends who’s child was born with some severe facial deformities. Over the years, she underwent many plastic surgery procedures to reshape her face. I witnessed this introverted child blossom into an amazing outgoing woman. This transformation solidified my love for plastic surgery and what I would one day be able to offer my patients. I began a course set for surgery and never looked back.
Even today, when people say that “so much of what you do is for vanity,” I have to whole heartedly disagree. Instead, I believe that what some may think is insignificant, superficial, or vain may make all the difference for someone who is holding back their true potential by worrying over a bodily flaw or hoping that someone can make them feel whole again by restoring the figure that cancer or disease has taken away.

What do you tell patients who ask if Plastic Surgery is Safe?

erez — Sun, 18 Dec 2011 02:41:44 +0000

Any surgical procedure carries certain risks and plastic surgery is no different. That is why I tell my patients to know what you are going in for, don’t be afraid to ask your surgeon tough questions, and really investigate what you are paying for. For example, at our surgery center, we take every precaution to ensure patient safety. We are certified and held to the highest standards of outpatient surgery by the AAAHC (the board that credentials surgery centers). We work only with board certified anesthesiologists who monitor every parameter of the patient while they are sleeping, to ensure the patient is completely comfortable and safe. We take steps to minimize any unnecessary risk by padding the patient, keeping them warm during surgery, placing compression devices on their legs in order to prevent blood clots, and perform meticulous surgical procedures with minimal blood loss. All of these things are so important, and are not universally performed at all office based surgery centers. The ASPS (national plastic surgery society) recently underwent a large campaign to help inform and educate patients about safety in the operating room after so many recent stories of patients falling victim to illegal or non-certified physicians performing surgery without a license or in unsafe environments.
So that is my message to patients. Ask where surgery is performed, what safety measures are in place, and who puts you to sleep? Elective surgery can and will go very smoothly when precautions are put in place and your surgeon practices safe and ethical surgical procedures.

How Long Do You Need to Wear the Binder after Tummy Tuck Surgery?

erez — Mon, 31 Oct 2011 20:36:59 +0000

Patients always ask: “how long do I need to keep my compression garments on after a Tummy Tuck surgery?”

Well, you will never find an exact answer or consensus amoung plastic surgeons to that question. That is because there is no exact science or research on this question. In general, the longer you are able to keep it on, the faster the post surgical swelling will go away. Will wearing a binder prevent you from popping stitches, over doing it, or hurting yourself… the answer to that is no. So be careful not to work out or lift heavy objects until your surgeon says you can.

This is the advice I give my patients: I recommend using a compression garment for 6 weeks after a tummy tuck. Many of my patients find them comfortable and want to wear them even longer for that extra “support”. I have a few patients who can’t stand wearing them so we monitor the swelling closely and will get them out of the garment and into something lighter such as spanx as soon as possible. The garment is meant to help reduce swelling and prevent fluid collections from accumulating.

Breast Reduction Surgery

erez — Thu, 27 Oct 2011 18:11:33 +0000

Did you know that most insurance companies still cover breast reductions?

A breast reduction is considered medically necessary if certain criteria are met: symptoms such as neck, back, and shoulder pain must be documented by your physician, and generally the breasts need to be a DD cup or larger. The surgery is performed as an outpatient procedure and recovery takes about 2 weeks or less. Women who have had this procedure are so happy with the results of lighter, lifted, sexier breasts.