After Cosmetic Surgery: A 2nd Opinion

Stuart Linder, M.D. (“Dr. Body”) and Robert Kotler, M.D. (“Dr. Face”) tell what to do if you have unsatisfactory cosmetic surgery anywhere in the world.

The key to getting the look you want? Cosmetic plastic surgeons have a saying, “A happy patient brings at least three more eager patients; but an unhappy patient turns away 10 others who would have knocked on your office door.”

Thus, most plastic surgeons are willing to go the extra mile to make sure you join their lists of happy patients.

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Dr. Face (Dr. Kotler): People find bad plastic surgery fascinating. More pictures of celebrities with less-than-perfect or awful results are shown than the millions of people who come away with an improved facial or body procedure and a renewed sense of self-confidence.

Dr. Body (Dr. Linder): But if you think you have an undesirable result from cosmetic surgery, the last thing you want to do is get hot under the collar, flame the plastic surgeon or his staff with contentious email or make angry phone calls.

Dr. Face:  Sure, because you, the consumer, have an edge with your rejuvenation surgeon, just make an appointment, go in and talk with him or her. Any surgeon wants all this patients to look good because future patients will be looking at your before and after plastic surgery pictures to judge the surgeon’s skills.

Dr. Body: First thing to ask is: does your complaint has anything to do with the normal healing process.

Dr. Face: Correct, given that some healing process can take a full year to settle in. But you should already know that before undergoing the procedure. If you are using a board-certified cosmetic plastic surgeon, he or she has probably explained the after surgery process toward getting the look you want. Many plastic surgeons will urge you to have pre-surgery consultations with two, three or even four surgeons so you have a complete picture of what can be done and how you can expect to look. If you haven’t had surgery yet, ask during the initial consultation what happens if you’re not happy with the results and who – the surgeon or the patient – covers additional touch up or redo costs.

Dr. Body: If you do need some touch-up work or a small nip or tuck, your surgeon may offer to do a correction at no charge. You can at least ask and give the doctor a chance at converting you into a happy patient.

Dr. Face: In many cases, a touch up can be done in the doctor’s office. If you have to undergo surgery again, it may involve another fee for the surgery center and an anesthesiologist. According to the Healthy Woman Blog, about 15 percent of cosmetic surgeries require some touch up work or a minor do-over.

Dr. Body: Try looking at your before surgery pictures and compare those with the way you look now. People become accustomed quickly to seeing their own faces in mirrors and often forget how they looked before surgery.

Dr. Face: If you and the surgeon can’t make any progress, try getting another opinion from a board-certified surgeon who does the same type of surgery. After making sure the second surgeon is neutral, show him or her your before and after plastic surgery pictures while the second doctor takes a look at your surgical treatment area. It just could be that, for instance, an upper eyelid reduction case could not trim the eyelids any more than what has already been done. The major risk to upper blepharoplasty is that too much of the eyelids are taken away and the patient is left unable to close the eyes.

Dr. Body: Or, perhaps a nose can’t be made any smaller without affecting the patient’s healthy breathing.

Dr. Face: And, remember, be sure to get copies of your pre-op photos plus the operating doctor or doctors’ medical records including operative reports. The more the consulting specialist knows about what did or did not happen, during and after surgery, the more valuable the consultation.

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Doctors Face and Body are both specialists in a field of surgery known as revision surgery. A revision is done to correct surgical imperfections performed by another surgeon somewhere else.

View some of Dr. Body’s breast revision before and after pictures.

Here are some of Dr. Face’s before and after pictures of nose job revisions

Stuart Linder, M.D. (who blogs as “Dr. Body”) and Robert Kotler, M.D. (“Dr. Face”) are two board-certified Beverly Hills cosmetic plastic surgeons who recently became inventors too.

Plastic surgeons work with the same tools on the same sections of the human anatomy, day in, day out, year after year.

Is it any wonder those surgeons often tinker and design better mousetraps and ways to do things?

Doctors Face and Body came into the ranks of inventors by coming up with some new garments and devices to make plastic surgery more comfortable on patients.

Doctors Face and Body jointly belong to the following medical organizations:

• American Medical Association
• American Board of Plastic Surgery
• The American Academy of Facial Plastic Surgery and Reconstructive Surgery

Look at some of Dr. Body’s breast revision before and after pictures.

Here are some before and after pictures of nose job revisions performed by Dr. Face.

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Dr. Face (Dr. Kotler): Congratulations, doctor. I see the Linder bra is now on the market and available for consumers. Just how did you come up with the idea?

Dr. Body (Dr. Linder): After placing somewhere around 10,000 breast implants over the last 13 years and closely listening to those same patients, I saw a need for a new bra, especially one for women who had just undergone breast surgery.

Dr. Face: What makes the Linder Bra different from others?

Dr. Body: Most bras are only concerned with aesthetics, and not comfort. The Linder bra has adjustable panels under the arms and can allow for another two inches around the chest. Plus, it slims down back, or bra, fat that women just hate. It also creates cleavage by naturally lifting the breasts.

Dr. Face: It sounds like it could also serve as a sports bra.

Dr. Body: Correct! All women are different and each actually needs a custom fit – which this bra can be, it is so changeable. The Linder Bra even breathes well and prevents sweat buildup. It’s also convenient—a front panel has a zipper that makes it easy to slip on and off.  (Read more about the breast surgeon’s bra.)

Dr. Face: We’ve also done a little tinkering.

Dr. Body: For facial surgery?

Dr. Face: Yes, for nose surgery to be exact. Nose surgery to improve appearance, help breathing and relieve sinus problems is not particularly painful after surgery.  However, one item that has not won any patients awards is a technique known as nasal packing. The surgeon packs the entire interior of the nose with a variety of cotton-like or gauze material for up to five days after surgery. That also means no breathing through the nose. Results? Dry mouth and even some anxiety and claustrophobia. One patient said it was like drowning for five days; another side it was like having a clothes pin on the nose for days. The packing is medically wise but patient unpopular.

Dr. Body: Sure, it keeps the tissues in place and perhaps deliver a little medication.

Dr. Face:  Correct. But one recent patient left our office during a pre-surgery consultation after he found out the procedure – which he really needed for normal breathing – required nasal packing.

Dr. Body: He was having none of it?

Dr. Face: None! And after that, I got to thinking. There must be a way to do both – pack the nose and also allow for packing.

Dr. Body: So what did you come up with?

Dr. Face: It’s so simple; I’m surprised I didn’t think of it years ago. It’s the same principle as artists use when they make a life mask. They put some hollow tubes in the subject’s nose to allow for breathing before covering the face with plaster.

Dr. Body: Oh, I get it. You lay the tubes down and then insert the packing around the tubes.

Dr. Face: Correct, again! (Read more about the rhinoplasty tubes.)

Dr. Body: Know of any other plastic surgeon inventors?

Dr. Face: Yes, one that comes to mind is plastic surgeon Elliot Jacobs, M.D., one of our Park Avenue colleagues. He invented some very effective liposuction tools for gynecomastia surgery. Gynecomastia is when men have actual, dense breast tissue that usually cannot be liposuctioned. Most of the time, an incision is made to remove the breast tissue.

Dr. Body: How does the tool work?

Dr. Face: It’s a liposuction tool with a sharpen tip. The surgeon pushes the tool through the dense, fibrous breast tissue and then on the backstroke, a sharp aperture shaves off some of the tissue and sucks into the liposuction system. Going back and forth through the breast tissue many times, speeds up the task. The tool actually works like a Danish cheese slicer. (Read more about the liposuction tool.)

Perhaps you have seen Dr. Kotler on T.V.’s Dr. 90210 or Dr. Linder on The BBC (British Broadcasting Corporation) programs about American plastic surgery.

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Dr. Face (Dr. Kotler): I’ve noticed that some of my face lift and rhinoplasty patients, when returning for their after surgery check-up, mention how cold it was in the operating room.

Dr. Body (Dr. Linder): That’s understandable but there are some things that patients can do.

Dr. Face:  I think I know where you’re going but what do you have in mind exactly?

Dr. Body: Speaking up! If a patient is in any way uncomfortable, he or she should let somebody know. There are some very good medical reasons for a patient not to be chilly but we also want your surgery to be as pleasant as possible. We have blankets available.

Dr. Face: Of course. Remember that all our procedures are done under anesthesia so the patient will be made warm by the sheets and coverings placed over him or her. So recollections of  “the cold operating room” is only for the five short minutes before going to sleep. In the 1960s’, before air conditioning came into wide use in hospitals, the room could become stifling. As you observe, the huge lights produce heat and the surgeon is also encased in his surgical gowns.

Dr. Body: True enough, doctor. I personally like it cool in the operating room because bacteria grow like crazy in heat. Coolness tends to stifle any stray bacteria that have floated into the room.

Dr. Face:  A very warm room can also make the surgeon groggy or work without efficiency. Back in the pre-A.C. days, surgeons have been known to drip sweat onto patients!

Dr. Body: Today, our high-tech monitors measure the patients’ temperatures, blood pressure, carbon dioxide and oxygen saturation. So patients’ body temperature can be kept at the proper level.

Dr. Face: When needed, even in the pre-op and post-op areas, we can always rig up a special warmer, known as a Bair Blanket. It’s like a very light weight sleeping bag that blows warm air down its length and over the slumbering patient. Patients love it more than electric blankets.

Dr. Body: If anesthesia did not paralyze the muscles, we could watch for goose flesh!

Dr. Face:  If you tend to be “cold blooded”, ask your surgeon if it’s possible in his operating room to warm the fluids before they are transfused into you. We have little ovens to warm the intravenous fluids. Sorry, the one thing we can’t offer is a hot cup of coffee.

Dr. Body:  What did we ever do without microwave ovens?

Dr. Face: Large toaster-type warmers. Now, We use them now to warm ordinary blankets.

Dr. Body: Another place that some patient body heat is lost is in body surgery. If incisions are long, as in a tummy tuck or body shaping, some heat escapes through the incisions.

Dr. Face: There are even smaller Bair devices that warm smaller areas like only the legs or only the chest.

Dr. Body: Now, if somebody would just come up with a way for stethoscopes and other instruments to be instantly warm before touching anybody’s bare flesh!

Dr. Face: Actually, I’ve seen instrument warmers for the office; certainly gynecologists use them. Another way to warm a stethoscope is the old-fashioned way: the doctor, hands washed, presses the stethoscope against the palm of his hand. That’s the ultimate low-tech warmer.

NEXT: Both Dr. Face and Dr. Body are book authors. Dr. Face’s most recent book, “Secrets of a Beverly Hills Cosmetic Surgery” about cosmetic plastic surgery can be seen online. You can also find Dr. Body’s book—The “Beverly Hills Shape” is about  plastic surgery of the body and is at online bookstores.

In our next post, we’ll tell how those books came to be and why they are valuable if you are coming to Beverly Hills for rejuvenation surgery.