American Medical Association Family Medical Guide - American Medical Association [771]
Plastic surgery includes both cosmetic surgery and reconstructive surgery. Doctors perform reconstructive surgery to correct abnormalities caused by birth defects, injury, or infection, or deformities from diseases such as cancer. For example, many women who have had a cancerous breast removed undergo reconstructive breast surgery (see page 860). Reconstructive surgery usually is covered by health insurance, although the extent of the coverage varies by policy.
This chapter focuses on cosmetic surgery—surgical procedures performed to enhance a person’s physical appearance. Cosmetic surgery originally developed from reconstructive surgery and uses many of the same techniques. Health insurance usually does not cover the cost of cosmetic surgery because it is considered elective surgery. Read your health insurance policy carefully to find out what is and is not covered.
Set realistic goals when you are contemplating cosmetic surgery. Changing the way you look can enhance your appearance and might increase your self-esteem, but the final result may not completely match your preconceived image. The first time you meet with your surgeon, he or she will evaluate your general health and carefully examine the part of your body you want to change. Be honest when talking about what you expect from your surgery. Your surgeon will explain your options and the risks and benefits of each. He or she will recommend the alternative that will most closely produce the results you are looking for.
How to Choose a Plastic Surgeon
All surgery involves risk. The most important step you can take to ensure a good result is to choose a skilled and experienced plastic surgeon. Make a list of potential surgeons recommended by your family doctor and friends and relatives who have had cosmetic surgery. Check to make sure that the surgeons have been adequately trained and are certified by the American Board of Plastic Surgery, which sets high standards of training and care in the specialty of plastic surgery. To be certified by the board, a surgeon must have completed at least 5 years of residency training after medical school (including 2 years in plastic surgery), passed comprehensive examinations, and been qualified to perform both cosmetic and reconstructive procedures.
Experience is another key qualification to look for in a plastic surgeon. Select a doctor who has performed the procedure you are interested in many times. Ask the surgeon how many times he or she has performed the procedure, and ask to see before-and-after photographs of previous patients.
Make sure that the facility where your surgery will be done meets strict safety standards. It should be certified by a national or state accrediting agency. All members of the American Society of Plastic Surgeons agree to operate only in certified facilities. Procedures performed in a licensed or accredited facility by a board-certified surgeon have the highest safety record.
Facial Surgery
Plastic surgeons perform plastic surgery on various areas of the face to give a more aesthetically pleasing appearance or to reverse signs of aging such as wrinkles or sagging skin. Cosme- tic facial surgery encompasses a wide variety of procedures, including upper and lower eyelid surgery, forehead lifts, nose surgery, facelifts, facial implants, and collagen injections. Injections of botulinum toxin or collagen can improve the appearance of frown lines.
Nose Reshaping
Plastic surgeons perform surgery on the nose (known medically as rhinoplasty) to reshape the nose and correct breathing problems. Nose reshaping is the most commonly performed type of cosmetic surgery in the United States—more than 500,000 people have the procedure each year. Doctors recommend waiting to do nose-reshaping surgery until the nose has reached its full size, usually around age 14, unless a child’s breathing is severely impeded. There is no upper age limit for nose reshaping. Many people request surgery on the nose at the same time as a facelift or other cosmetic surgery to correct age-related