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Plastic Surgery Information. FAQ













What is plastic surgery?
The word plastic is derived from the Greek word “plastikos” which means “to mold”. This molding or repositioning of tissue is the essence of plastic surgical technique, and involves both aesthetic and reconstructive surgery.

Aesthetic (cosmetic) surgery is designed to enhance one’s appearance, and often to minimize the effects of aging. Reconstructive surgery, on the other hand, is surgery designed to restore form or function. This type of surgery is used to repair physical deformities due to injury, disease, birth defects, or previous surgery.

A variety of techniques are available to remove or reposition tissue, including surgical incision and excision, laser surgery, chemosurgery, dermabrasion, and electrosurgery. Aesthetic and reconstructive surgeries are often performed simultaneously. For example, while opening an obstructed nasal airway (functional) one may choose to simultaneously alter the external contour of the nose (cosmetic).

What is a facial plastic surgeon?
(Facial Plastic Surgeons vs General Plastic Surgeons)

All practicing physicians have the same basic training: a four year undergraduate degree (BS or BA), four years of medical school (MD), and at least one year of residency (sometimes called internship). Then it changes. In the following years either a medical or surgical path is taken. Thus, dermatologists are not considered surgeons since their medical residency does not include surgical training in invasive procedures.
     Two closely aligned surgical specialties are facial plastic surgery and general plastic surgery. Both types of surgeons complete the same undergraduate and medical school degrees, followed by a general surgery internship. General surgery involves the most common of surgical procedures: hernia repairs, appendectomies, gallbladder removals, etc. The internship serves to acquaint the young physician with the basics of surgical technique, but neither the facial plastic nor general plastic surgeon will continue perform those surgeries once in practice.
     The focus of the two surgical residencies are different:
Facial Plastic Surgeon
1-2 years of general surgery (internship)
4 additional years of specialty training in head and neck surgery and facial plastic surgery
Plastic Surgeon
3-5 years general surgery (internship/residency)
2 years of plastic surgery
   For instance, Dr. Simoni's final four years of training focused exclusively on the anatomy, physiology, and pathology of the face, head, and neck structures. This in-depth concentration provides the facial plastic surgeon with a strong background in the exact area you want to have your surgery. And, in fact, these surgeons perform the majority of elective facial plastic surgery procedures in the United States.
    By way of contrast, a plastic surgeon completes three to five years of general surgery before pursuing only two years of specialty training. The two year plastic surgery residency covers a wide range of diverse areas all over the body. The lion's share of cosmetic body liposuction, breast augmentation or reduction, and tummy tucks (abdominoplasties) are performed by this kind of surgeon.

Is plastic surgery for you?
Our appearance affects the way we feel about ourselves. We all want to look our best, but occasionally, some of us would like to change a facial feature that we feel is not ideal. Perhaps it is a nose that is too big, ears that protrude, or a chin that is too small. It may be drooping eyelids, a sagging neck, or wrinkled skin that makes us look older than we feel. Additionally, unsightly scars or irregular skin from acne may undermine one’s self-confidence.

Facial plastic surgery has become increasingly popular throughout the world. In the United States alone more than four million people per year undergo facial plastic surgery to improve their appearance and quality of life through an enhanced self image; greater than 25% of these are men. Modern surgical techniques have made facial plastic surgery safe, effective and affordable. Therefore, it has been sought by a growing number of people, not just the rich and famous.

Before you make a decision regarding facial plastic surgery, you will want to learn as much as possible about the procedures that interest you. You will also need to explore your own attitudes and expectations about facial plastic surgery. Finally, you should understand the costs and risks involved.

As you read the following information, please write down any questions you may have about the surgical procedures that you are contemplating. These questions can then be addressed at the time of your consultation. We believe that an informed, prepared patient has the best possible surgical experience.


Your consultation
Your consultation is a special time designed to allow you the opportunity to discuss the improvements you are considering, and to decide which surgical procedures are best for you. The expected improvements of each procedure will be discussed, along with the limitations, risks and alternatives. This consultation time also allows you to address any concerns or questions you may have regarding your proposed surgery. At your consultation, an advanced 3d virtual imaging system is often used to illustrate what results you may realistically expect.

Also during the visit, Dr. Simoni will take photographs to accurately record your facial features. These photographs become part of your permanent, confidential medical record and help with planning of your surgery. They also provide a mechanism for comparison after surgery.

Plastic Surgery Goals
A prerequisite for undergoing any type of successful facial plastic surgery is to ensure that you have realistic goals and expectations. Facial features may be refined but not totally changed. The goal of this type of surgery is to enhance appearance, improve facial harmony, or restore function. Surgery can improve your appearance or correct a physical dysfunction, but it will not solve personal problems or give you an entirely new face. Anyone searching for a miraculous transformation into an absolutely perfect or totally different person has expectations that exceed the reach of facial plastic surgery.

Plastic Surgery limitations
The level of improvement one should expect depends not only on the skill of the surgeon, but on the patient’s age, health, nutritional status, skin texture, bone structure and specific needs. In other words, the surgeon is limited by the materials with which he has to work, and it may or may not be possible to create exactly what you desire. Though guarantees in medicine are not realistic or ethical, one thing that can be guaranteed is that every effort will be made to achieve your desired result.

Plastic Surgery risks
Every surgical procedure, even a simple tooth extraction, involves some degree of risk. Risk can be defined not only in terms of possible surgical complications but also by disappointment if the surgical result does not match one’s expectations.

The risk of disappointment due to unrealistic expectations is one that can be best avoided through communication during the preoperative consultation(s). Computer imaging is an excellent communication tool and is often performed during your consultation.

The physical risks associated with facial plastic surgery are usually minimal. There are four basic risks which include bleeding, infection, reactions to anesthesia and scarring. Intra-operative bleeding is minimized by meticulous surgical technique and is usually expressed postoperatively as a bruise, which will fade. Infection may be minimized by the use of antibiotics and careful postoperative wound care.  Additionally, all incisions result in a scar. It is the body’s way of binding a wound together. Scarring is minimized by meticulous surgical technique and the placement of incisions in inconspicuous areas. Although rare, other risks may include poor healing, adverse reactions to medications or injury to nerves and muscles, among others.

Almost every action in life is associated with some degree of risk. The relatively low risks associated with facial plastic surgery, weighed against a high degree of patient satisfaction are among the reasons why this type of surgery is so popular today.

Anesthesia in Plastic Surgery
General anesthesia and twilight anesthesia is available to all our patients.  In the interest of safety, comfort and ease of recovery, our anesthesia  is performed by certified anesthesiologists.
Most surgical procedures performed at our office setting do not require general anesthesia.  Click here for more detail information regarding  anesthsia in plastic surgery.

Financial Information
Plastic Surgery Fees

Surgical fees vary depending upon the extent of surgery required and will be discussed during the financial consultation portion of your visit. When surgery is scheduled, it is our policy that all cosmetic surgery fees are to be paid in full prior to the surgery. This is customary and appropriate for elective cosmetic surgery. The surgeon is then assured the patient is not undertaking elective surgery they cannot afford, and that the patient is sincere about proceeding with this treatment.

The surgical fee does not include other operative costs such as preoperative laboratory studies and medications used for postoperative care. These expenses will be discussed with you at your consultation.  In some instances, your insurance may cover these expenses.

Any tissue removed at the time of surgery such as moles, cysts, etc. must be sent to the pathologist for evaluation. There is a separate fee for this study which is billed from the pathology lab directly to the patient. Most often, your insurance may cover these expenses.

INSURANCE and Plastic Surgery
The expenses connected with cosmetic surgery will not be covered by medical insurance. However, if the surgery performed improves function such as difficulty breathing through your nose, your insurance policy may cover a portion of the surgical expenses.

Before your operation, our staff can assist you in applying for reimbursement of surgical expenses. We will provide you with the appropriate forms and reports of the operation for you to submit to your insurance company. However, our office cannot ethically fill out forms in such a way as to make cosmetic surgery appear to have been performed for functional reasons. You must remember that health insurance policies are contracts between the insurance company and the insured. You, the patient, not the insurance company, are ultimately responsible for the charges incurred.

Scheduling your cosmetic Surgery
When you decide to proceed with surgery, a pre-surgical appointment will be scheduled. At this appointment, our staff will discuss the planned surgery in further detail, and provide written preoperative and postoperative instructions and prescriptions.

We feel it is essential for each patient to have a controlled, safe environment the evening after surgery.

In most cases, certain preliminary laboratory tests are required such as blood counts, urinalysis or electrocardiograms (EKGs). Additionally, consultations with other medical specialists (such as your primary care physician) may be necessary prior to your surgery.
Post Operative
There is generally little discomfort after facial plastic surgery, but one must be prepared to accept what little there is during this temporary period. Pain medication will be prescribed for the postoperative period, but may not be needed.

Following surgery, patients must also be willing to accept the temporary swelling and any bruising which occurs. Although this may be unsightly, it is not painful and is a minor inconvenience compared to the physical and psychological benefits which eventually result.

You should expect to feel tired and perhaps a bit weak for a few days following surgery. If you have had outpatient surgery and are allowed to go straight home, you will need to have someone drive you to and from the office and be available to help care for you overnight.

Normal Activities
Depending on the type of surgery, most people can resume normal activities after one to two weeks. We encourage light activity, such as walking, within a few days after surgery, but will advise you regarding strenuous exercise.

In general, a gradual progression from walking to stretching and light repetitive exercises will help you prepare for resuming your normal exercise schedule. You should wait approximately two weeks before resuming aerobics, tennis, weight-lifting, swimming or other heavy exercise. Contact sports should be avoided for at least six to eight weeks. Common sense will also help determine exactly what type of exercise to do and how much.

It is important to avoid sun exposure of the surgical sites for approximately six months, particularly skin resurfacing. A high-grade sun-block (SPF 30 or higher) and a hat should be used when going outside. Avoid excessive exposure to heat, cold and wind, as these can also damage delicate new skin.

The new You
The decision to have facial plastic surgery is an exciting one. It is your decision whether or not to share this experience with your friends and family. If you wish to keep your surgery private, you may decided to change your hairstyle to better flatter the “new you.” Similarly, you may choose to change your hair color or switch from glasses to contact lenses. Friends will often associate your new look with one of these changes.

Depending upon the surgical procedure that you have had, there may be some post-surgical swelling, discoloration and numbness, most of which should subside within two to three weeks. However, during this recovery period, you may feel self-conscious about going out in public or being seen by friends and family.

Temporary use of corrective cosmetics can help camouflage discoloration, and give you a significant psychological boost. Many people find they will need less make-up after the recovery period. Learning how to apply corrective cosmetics with the help of a trained aesthetician can help you face the world confidently.