A broken nose? Not so!
The well known Beverly Hills board-certified plastic surgeon Stuart Linder, M.D – who blogs as “Dr. Body”– tells about the most common myths that patients ask about. Also commenting is the equally well known Robert Kotler, M.D., a top Beverly Hills board-certified cosmetic plastic surgeon (and a former Dr. 90210 star) who blogs as Dr. Face; he also tells about the myths and beliefs he hears.
Dr. Face is a member of the American Academy of Facial Plastic Surgery and Reconstructive Surgery. Dr. Body holds a membership in the American Society of Plastic and Reconstructive Surgeons, among many other medical organizations.
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Dr. Face (Dr. Kotler): I don’t know about you but I’ve found a few myths about facial plastic surgery circulating out there. We hear them at the first patient consultation.
Dr. Body (Dr. Linder): Such as?
Dr. Face: Take rhinoplasty, for instance. The myth seems to be that the nose will be “broken.” Some prospective patients seem to envision the process of correcting any malpositioned nasal bones as crude and barbaric. In reality, the nasal bones are sometimes re-aligned and must first be parted but it’s not as though you take a sledge hammer to the nose. Actually, that realignment is a carefully and delicately controlled repositioning of the nasal bones. In addition, the patient is asleep and we use drugs to control pain and bleeding, if any.
Dr. Body: The most common question like that I get in body surgery is from breast augmentation patients who want to know if it’s really true that breast implants must be replaced every ten years.
Dr. Face: How do you explain it?
Dr. Body: I tell the patient that that any one breast enhancement procedure will probably result in another such operation sometime during the life of the patient. But it’s nothing predictable like when the oil in a car must be changed. And, yes, implants do fail due to wear and tear but I have no way of knowing when that might happen. It might be in 20 months or 20 years. I’ve seen both extremes.
Dr. Face: After I explain the broken nose myth, I listen carefully to make sure that nose surgery patients understand they will look quite decent by ten days after the operation and very good indeed by two weeks. Some have the misconception they will appear battered and bruised for months, post-op. Nasal surgery super-specialists typically deliver results that look very good only seven days after the procedure.
Dr. Body: I must tell breast enlargement patients one thing they hate to hear.
Dr. Face: The cost of plastic surgery?
Dr. Body: No, that they can’t take a shower for 14 days after getting breast implants. But there is a method to my seeming madness. Water washing into a fresh wound can cause a staph infection which means the entire procedure has to be redone. But patients who take no showers for two weeks after the procedure have an infection rate of 1/10th of one percent. The usual, common, accepted benchmark is an infection rate of about one percent of patients.
Dr. Face: Even though nose surgery patients look good after one to two weeks, I have to remind them the nose will be fragile for at least six weeks.
Dr. Body: I almost always put breast implants under the chest muscle so I receive a lot of questions about why that is necessary. (Read more about breast implants placed under the muscle.) Many want to know when they can again exercise and the answer to that is a minimum of three weeks. For tummy tuck patients, it’s more like six to eight weeks.
Dr. Face: Many patients quiz me about training. They often ask about the difference between a general plastic surgeon and facial plastic surgeon.
Dr. Body: What do you say?
Dr. Face: Easy. While a general plastic surgeon performs cosmetic procedures all over the body, the facial plastic surgeon limits his work to the face and neck. Training for that is two years of post-M.D. training in general surgery followed by at least another four years specializing in head and neck surgery and facial plastic surgery. Surgeons who want to be eligible for certification by the American Board of Plastic Surgery must complete a minimum of three years of general surgery and three years of plastic surgery throughout the body. Fellowships, the finishing school of both specialties, can add another one or two years of training.
Dr. Body: Next time, let’s talk about how the media influences the practice of plastic surgery. I know I’ve got some thoughts on it and I’ll bet you do, too.
Dr. Face: In spades, doctor! In spades!
