TOPIC: HOW TO CHOOSE A COMPETENT FACIAL PLASTIC SURGEON
Facial plastic surgery and general plastic surgery are two similar surgical specialties. Both types of surgeons complete the same undergraduate and medical school degrees, followed by surgical residencies.
For cosmetic procedures involving the nose, eyes, face and neck, choosing a facial specialist over a general plastic surgeon offers the advantage of a surgeon who solely focuses in these areas and performs these highly intricate procedures regularly.
The consumer should refer to The American Board of Facial Plastic Surgery, (ABFPRS) www.abfprs.org. The ABFPRS has established the most rigorous standards which a surgeon must meet in order to hold the title of a “Board Certified Facial Plastic Surgeon”.
- The American Board of Facial Plastic Surgery (ABFPRS) credential certifies that your surgeon:
- Has completed an approved residency after medical school in one of two surgical specialties focusing on facial plastic surgery (Otolarynology-head and neck surgery or general plastic surgery).
- Is double-boarded, having earned prior certification in one of these specialties through the American Board of Medical Specialties;
- Has successfully completed a two-day examination;
- Has submitted for peer-review an acceptable record of at least two years clinical experience, including operative reports for a minimum of 100 facial plastic surgeries; and holds proper licensure and subscribes to the ABFPRS code of ethics.
- However, board certification is just the beginning. A patient choosing a surgeon for plastic surgery must ASK IMPORTANT QUESTONS IN ORDER TO CHOOSE THE RIGHT SURGEON! It is important to understand that not every surgeon performs every plastic surgery procedure. Some focus on specific procedures. Make sure your surgeon is experienced in the procedure you want and regularly performs that procedure with consistent, positive results.
- PRIVILEGES: Your surgeon should have operating privileges at an accredited, local hospital for the procedure you plan to have performed even if that surgeon suggests your procedure be performed in an accredited office-based surgical facility or at an ambulatory surgery center.
- To verify certification one may contact the ABFPRS at www.abfprs.org
or call (703) 549-3223; One Prince St, S. 310, Alexandria, VA 22314.
ARE THERE SPECIAL ARRANGEMENTS MADE FOR OUT OF TOWN PATIENTS? HOW LONG DO I HAVE TO STAY LOCALLY BEFORE I CAN GO HOME?
Absolutely! Please see our section for “Out of Town Patients” in the PATIENT INFORMATION tab to learn more about the length of stay and hotels in the area. Normally, for most procedures, the length of stay will vary from 3 to 10 days.
Recovery time varies for each procedure. See our Procedures section to learn more about recovery times for specific procedures, or call us to schedule a consultation. With some surgeries you can be back at work after several days. More complicated operations may require additional time away from work.
Procedures that focus on rejuvenation, such as facelift, forehead lift, eyelid surgery, and laser skin resurfacing can last from 5 to 15 years, depending on the type of operation performed.
Procedures that reshape or correct an imbalance such as surgery of the nose or chin can offer results that last a lifetime.
See the outstanding post-operative results for yourself! See our photo gallery and browse through many before and after photos of satisfied patients.
Patient privacy is very important in the field of plastic surgery. Our facilities include a separate private waiting room for discreet access to and from the office for patients who require extra privacy.
Most of the time insurance does not cover elective cosmetic surgery. However some functional surgical procedures such as intranasal procedures, removal of skin cancers, scar revision and others may be covered by health insurance in part or in full. This is also dependent on your health insurance policy. Our staff will assist you with forms, verification, and submission of claims.
During your consultation, Dr. Binder will assess all aesthetic aspects related to potential changes in the shape to your nose. In addition your nose will be examined intranasally to address possible problems with breathing. No aspect of your nose will be overlooked during your consultation.
I AM INTERESTED IN HAVING CHEEK IMPLANTS. ARE THERE DIFFERENT SHAPES AND SIZES OF IMPLANTS THAT CAN GIVE ME THE DESIRED LOOK I WANT?
One of the things implants offer versus fillers is that implants have the ability to provide specific structure and dimension to the face. Implants are always customized to suit the needs of each individual patient. (Click here to see the FAQ’s re: Fillers and Implants)
WHAT ARE THE IMPLANTS MADE OF? CAN THEY RUPTURE? COULD I END UP WITH THE SAME PROBLEMS ASSOCIATED WITH SILICONE BREAST IMPLANTS?
Facial implants are made of a solid silicone elastomer and not a gel-filled bag (as found in breast implants) They cannot rupture and are easily removed or replaced.
The infection rate is extremely low, less than 1%. In most cases, the patient may be treated with antibiotics without having to remove the implant. If the implant is required to be removed, it can easily be replaced in a short period of time.
The nice thing about implants is that they are easily removed and replaced if desired. Only in extremely rare cases are the implants permanently removed.
I HAVE SEEN PEOPLE AFTER SURGERY WITH A PERMANENT "SURPRISED" LOOK…WHY DOES THIS HAPPEN? HOW CAN I BE SURE THIS WON’T HAPPEN TO ME?
The surprised look does not come from eyelid surgery. This look comes from an overly-corrected brow lift.
Avoiding the “hollow” look is a matter of not removing an excess amount of fat from the area. In some cases Dr. Binder will do fat-repositioning to prevent the “hollow” look.
I HAVE HEARD THAT RECOVERY IS LONG FOR A FACE LIFT PROCEDURE, AND THAT I MAY MISS WORK FOR 2-3 WEEKS. IS THIS TRUE?
Allowing yourself about 7-10 days should be ample time for the swelling to subside.
I DON’T WANT TO HAVE THE "WIND TUNNEL" PULLED LOOK THAT IS ASSOCIATED WITH SOME FACE LIFT RESULTS. CAN THIS BE ADDRESSED AND PREVENTED BEFORE SURGERY?
Yes, it can be completely avoided. Using the newer modern surgical techniques performed in face lift surgery will specifically address this problem. Please see section on “Vertical Facelift”.
Any procedure that takes more than 4 hours in the operating room requires you to be supervised by a registered nurse at a facility. A private duty nurse can also be arranged to stay with you in your hotel room.
FAQ’S ABOUT FILLERS AND IMPLANTS
A WORD ABOUT FILLERS AND THEIR USE IN THE FACIAL REJUVENATION PROCESS:
Yes, fillers do have a defined role in facial rejuvenation. However, there should be an emphasis placed on the “multi-modality” approach to facial rejuvenation. Depending on the circumstance, peels, the use of lasers, fillers or surgery should be considered to determine the most appropriate and cost effective procedure(s), for each individual patient.
- I have been involved in using fillers since the original filler, Zyderm®, was approved by the FDA in the early 1980’s. Since then, I have used most of the fillers including Cosmoderm®, Dermaologen®, Zyplast®, Fascion®, Isolagen®, Fascia®, Fat®, Dermal fat grafts, Cymetra®, Alloderm®, ePTFE, Restylane®, Juvederm®, Perlene®, Sculptra® and Radiesse®.
- I prefer using the hyaluronic acids (i.e. Restylane® or Juvederm®) and the collagen fillers which, I personally believe have a more physiological and biocompatible basis for injecting into soft tissue.
Fillers are extremely useful in treating fine lines and wrinkles, facial folds, redundant folds that are within the skin and subcutaneous levels. However, they cannot and should not be substituted for other modalities that are more appropriate and better suited to treat different aspects of the aging process. Trying to apply or use too much filler to accomplish what they are not designed to do can create problems.
- For example, there are different groups of physicians filling many different roles in the field of facial aging. Some are board certified Facial Plastic and General Plastic Surgeons, some are Dermatologists, and some are “Cosmetic” surgeons trying to obtain similar goals. Not all groups offer all procedures. Fillers should not be substituted for other modalities or surgical procedures, merely because the “physician or nurse injector” cannot perform other surgical or laser procedures that may be more appropriate.
The answer can be summed up in one word – “PERMANENT!”. There have been recent articles in the lay press quoting certain groups of doctors indicating that implant procedures have been replaced by fillers. Nothing could be further from the truth. In fact, implant procedures over a 12 – 18 month period of time are less expensive than continued use of large amounts of fillers. In most cases, the operative process and postoperative recovery time for implants is actually less than for fat injection. Fillers or fat will provide volume temporarily and amorphously. Implants, when used appropriately, will not only provide volume, but also provide DIMENSION, PERMANENCE, STRUCTURE and most importantly, will provideSUPPORT for the soft tissue. (See example No. 1)