What is the difference between a plastic surgeon and a ‘cosmetic surgeon’?
People often confuse Dr. Simon, a plastic surgeon, with those who call themselves “cosmetic surgeons.” The difference is important. A cosmetic surgeon may not be a surgeon at all. Credentials can be earned with as little as a month’s apprenticeship by almost any doctor with very limited surgical training – or none at all. A plastic surgeon went through medical school, was accepted into a competitive residency surgery training program and a nationally accredited institution, and was specifically trained in plastic and reconstructive surgery. For his part, Dr. Simon received his medical degree from the University of Miami Miller School of Medicine, performed five years of general surgery residency, followed by two years of specialty training in plastic surgery. He is double board certified in general surgery and plastic surgery.
How do I select the right plastic surgeon?
Selecting the “right” plastic surgeon often comes down to a mix of objective and subjective measures. For example, the most educated and experienced surgeon will have a medical degree from a respected, accredited university; and board certification in plastic surgery. He also will have earned the praise of peers and patients like, who respect his approach and results. As for subjective measures, when you meet with the physician, does he talk to – not at – you? Does he thoroughly address your specific questions, without brushing off any worries or concerns you may have? Does he physically examine you – whether your breasts, buttocks, abdomen, arms, thighs or face – so he can discuss your case from a deeper, more insightful perspective? Selecting the “right” surgeon often comes down to a gut feel. If you feel comfortable with him or her, you may have the right choice looking back at you.
Why is ‘Board Certified’ important?
Board Certification is bestowed by the American Board of Plastic Surgeons. “Board certified” connotes a deeper, most dedicated level of training. This physician has gone through an accredited residency program, completed the training, and sat for written and oral examinations, presenting his or her cases to a national board of plastic surgeons. Once completed and maintained with 50 hours of Continuing Medical Education credits each year, the plastic surgeon becomes and remains a member of a very elite organization from which any patient search for a plastic surgeon should look. Maintaining membership also requires 50 hours of continuing medical education annually, presentation every three years of relevant surgical case work and a written examination every 10 years.
What is American Society of Plastic Surgeons?
The American Society of Plastic Surgeons (ASPS) only accepts plastic surgeons trained in an accredited training program. Plastic surgeons must be board certified by the American Board of Plastic Surgeons to become members. They then pass through a rigorous screening process and must display their competence and expertise to become a member. Plastic surgeon members also adhere to a strict code of ethics outlined by the ASPS.
How can I if the doctor is actually qualified to perform the surgical procedure I am interested in?
In addition to the and searching the site of the American Society of Plastic Surgeons (or ASPS), inquire with your area’s leading hospitals. Top-tier plastic surgeons will have Medical Staff Privileges at one or more reputable and accredited local hospitals. Privileges mean the doctor has met the hospital’s demanding criteria for professionalism and patient care. Dr. Simon has privileges at Baptist Hospital and South Miami Hospital, and several ambulatory surgery centers, including South Miami Medical Arts Surgery Center and Bayside Ambulatory Center.
What is Dr. Simon’s education and training background?
Dr. Simon graduated phi beta kappa with honors from the University of Florida, as a pre-med student earning his Bachelors of Science in Psychology. He attended the University of Miami Miller School of Medicine, graduating with honors in the top 10% of his class. He then performed five years of general surgical training, followed by two years of plastic surgery training, both at the University of Miami / Jackson Memorial Hospital. He is Double Board Certified by both the American Board of Plastic Surgery and the American Board of Surgery, and is a Fellow of the American College of Surgeons.
How do I know if I’m a candidate for plastic surgery?
Depending on individual circumstances, most people are candidates for plastic surgery. If you have a concern for something aesthetic on your face, body or skin, the best way to find out if you are a candidate is to schedule a consultation with a plastic surgeon to determine whether you a candidate. Not everyone who walks in is a candidate for the specific procedure in which they are interested.
How safe is plastic surgery?
Plastic surgery can be extremely safe – when the right procedure is done on the right patient candidate by a qualified surgeon in the appropriate facility.
Where will my surgery be performed? What is the difference between surgery in the office versus the hospital?
At this Miami plastic surgery practice, almost all procedures are performed in a certified and accredited ambulatory / outpatient surgery center. The reasons for this decision are numerous, and begin with safety and cost. Ambulatory / outpatient surgery centers often are more hygienic and sterile than traditional hospitals, where infection rates are much higher. The hand-picked team of anesthesiologists, nurses and technicians that work with Dr. Simon has been together for many years (in hospitals, surgeons may not get to pick their team and often are reliant upon whatever shift is working that day). Ambulatory / outpatient facilities often are more convenient and operate at a lower cost than most hospitals, which have much higher overhead and costs – costs that often are covered by patients.
What financing options do I have to pay for plastic surgery? Will insurance cover the cost?
Most plastic surgery procedures are considered “aesthetic” or “cosmetic,” and therefore are not generally covered by insurance. In those situations where plastic surgery is called for as part of a greater medical situation, whether to remedy appearance following an injury or following gastric bypass and massive weight loss, some insurance providers may cover procedures. This Miami plastic surgery practice works with patient financing providers, like CareCredit.
Can multiple procedures be combined and performed safely in one operation?
Yes. This is frequently done for the appropriate candidate seeking the right procedures – at the hands of a surgeon capable of accomplishing the operation in a reasonable amount of time without significantly increasing the risk. Dr. Simon evaluates each patient individually to determine whether they may be a candidate for combined procedures.
I’m a mother – or may have kids in the future – should I have surgery?
Every potential candidate for plastic surgery has her own reason or timetable. Whether you’ve had children, plan to have children, or aren’t quite sure whether kids are in your future, you may be a candidate for a breast augmentation, tummy tuck, liposuction or almost any plastic surgery procedure. Some procedures are better left for after the patient believes she’s done bearing children. For example, child birth after a tummy tuck could result in the need for revisional surgery. Still, the decision often is unique to the individual patient based on her plans or desires, physique and the advice of her plastic surgeon.
What can I expect for the recovery process and time?
Recovery time is procedure specific. Expected recovery times can range from returning to work immediately for injectables, to taking two to three weeks to recover from a large procedure, like an extensive tummy tuck or massive fat loss skin removal. This all is discussed during initial and pre-operative consultations and visits.
I’ve seen celebrities whose body features I’d like for myself. Is that an option?
Achieving the best plastic surgery results starts with setting realistic expectations. Patients will come to this Miami plastic surgery office with photos of celebrities whose features they like – whether those are the breast, buttocks or some other aesthetic. While that’s not a bad idea and can help give the doctor a visual image of what the patient seeks, few doctors will promise or even try to make you “look” like another person. Instead, doctor and patient together will discuss the desired look – and establish a window into your real expectations. This will help align expectations with what is realistically – and surgically – possible.
Does someone have to stay with me after the surgery?
Patients having general anesthesia need someone to drive them to and from surgery and to stay with them the first night after surgery (this is not required for local anesthetic). Depending on the extent of the procedure, patients might need assistance from friends and family for first few days.
How soon will life return to normal after surgery?
This varies – from days to weeks – depending on the patient. Patients can drive, for example, immediately after an injectable procedure, in a few days after breast augmentation, two weeks after more extensive tummy tuck and even longer following a massive weight loss procedure. Depending on the procedure and rate of recovery, patients often can shower two days after surgery and swim within a few weeks. Sunbathing is to be avoided for at least two months; those who will be exposed to sunlight are advised to limit exposure to the surgical area and wear sunscreen and protective clothing. While many patients fly to Miami for plastic surgery procedures, travel should be limited in the days or weeks following surgery – again, depending on the procedure and individual recovery.
What medications or habits do I need to stop before surgery?
Ten days before surgery, patients must stop taking aspirin, aspirin-related pain medications or any medications that can increase bleeding, as well as green tea and other dietary supplements not recommended by your plastic surgeon. Three to four weeks before surgery, patients are to stop smoking cigarettes. Tobacco can have a harmful effect on wound healing. Nicotine causes vaso-constriction, therefore reducing the body’s ability to deliver oxygenated blood to surgical areas. This can diminish the body’s ability to heal and possible increase the chance of infection. In some cases, patients never begin smoking again.
Will I have stitches or drains?
For the majority of procedures, Dr. Simon in his Miami plastic surgery practice uses sub-dermal, absorbable stitches. These are more comfortable and dissolve over time so they won’t need to be removed. They also yield a better healing, less visible scar. Dr. Simon uses drains for tummy tucks and occasionally other body contouring procedures, such as arm lifts (brachioplasty) or thigh lifts. The drainage tube usually is left in place for approximately one week, then is removed in the office.
Will I loose sensation after surgery?
This is a common question for patients having cosmetic or plastic surgery. Any surgical site – even where liposuction is performed – may result in loss of sensation. With a breast augmentation, for example, some 10% of patients experience a change in sensation in the nipple area regardless of the incision site. Some 20% of patients who have a breast lift or breast reduction could experience an altered level of sensation.
Do breast implants need to be changed every 10 years?
No. This is a common question propagated by an old mentality first stirred up by a 1970s article. Before saline implants, silicone gel implants didn’t last as long as they do today. So after 10 years, the implants had a high chance of rupture. That’s no longer the case. The chance of a silicone gel implant rupturing over 10 years is less than 1%. I recommend regular self-examinations. Feel for any change in size or placement. If the area feels different or uncomfortable, schedule a visit with your doctor. Otherwise, there’s no reason to change a silicone gel implant after an arbitrary amount of time.
Are silicone gel breast implants safe?
Yes. Patients assume they’re relatively new. But silicone breast implants have been in use since the 1960s. In fact, they were the original breast implants – long before saline breast implants arrived in the 1990s. A news story incorrectly made a link between silicone breast implants and connective tissue diseases, lupus and autoimmune disease. The products were removed from the market for two months. Then from 1992 to 2005, thousands of women with silicone gel breast implants went through an extensive study. Over the course of study, no correlation was found between the implants and health issues. In 2006, the U.S. Food and Drug Administration closed the book on this issue. So silicone gel breast implants are safe. In fact, they’re as safe as saline – and have lower overall complication rates than saline. Additional information about the safety of silicone breast implants can be obtained through the breast implant companies’ websites (Mentor [ www.LoveYourLook.com] and Allergan [ www.Natrelle.com]
What is the difference between silicone gel and saline breast implants?
Both use implant shells made of silicone. The difference is in the contents. The saline used to fill the breast implants is a sterile saltwater solution. Saline implants come from the manufacturer empty with a one-way valve allowing the implant to be filled at time of surgery. Therefore, the surgeon determines the final fill volume during surgery. Silicone gel breast implants are sealed at the manufacturer, coming in a variety of sizes and profiles. For these reasons, a silicone gel breast implant requires a slightly larger incision for insertion. Also, the plastic surgeon might use a “sizer” or temporary implant filled with saline to approximate the resulting breast size once the silicone gel implant is inserted. Patients like silicone gel breast implants because their shape, appearance, consistency and feel are more natural and similar to natural breast tissue than those of saline breast implants. Patients can see and feel the edge of a saline implant, especially in thin patients. As always, discuss the pros and cons of any implant option with your plastic surgeon.
What are the different options and pros and cons for breast implant position?
Breast implant placement often boils down to two locations: above or below the pectoralis major muscle. In my Miami plastic surgery practice, the majority of breast implants – whether silicone gel or saline – are placed beneath or under the muscle. This provides a more stable position for the implant. With more skin, natural breast and muscle tissue above the implant, the implant is better hidden and pushes natural tissue to the forefront. Sub-muscular placement also reduces the chances of the patient developing capsular contracture (see below). In a few cases, especially with surgeons in Latin America, implants will be placed on top of the muscle. This can be switched in a secondary surgery, as must U.S. surgeons – and patients – agree that sub-muscular is better. There are circumstances where an implant placement above the pectoralis muscle is better, and this is also determined and discussed at the time of consultation.
What is capsular contracture with a breast implant?
A capsular contracture occurs when the scar tissue capsule around the implant shrinks and tightens, causing a deformation of the implant and discomfort (regardless of whether it’s a silicone gel or saline breast implant). Every breast implant has a thin layer of soft layer of scar tissue around it called a capsule. It only becomes noticeable or problematic if it shrinks or tightens around the implant. Capsular contracture is an inherent risk of getting breast implants. In about 5% of cases, the capsule shrinks, tightens up and causes a deformity. This could require corrective surgery. Sub-muscular implantation has helped reduce the rate of capsular contracture. The capsule naturally forms about six to eight weeks after surgery; if a problem were to occur, most patients see it within the first year, though it can occur years later. Corrective surgery becomes more difficult as the plastic surgeon must remove scar tissue; the breast implant might also need to be changed. The goal is the prevent the capsular contracture from occurring in the first place. Dr. Simon will irrigate the site during surgery with three different antibiotics and use the Keller Funnel to help reduce chance of infection or foreign body being introduced during insertion of a silicone gel breast implant.
Are massages required after breast augmentation?
Possibly, depending on the patient. In the post-operative visit about a week after surgery, Dr. Simon will examine the patient and may instruct specific patients to start breast massages. Some don’t require massages, and there’s no scientific, proven benefit for random prophylactic breast massage. Yet, for certain patients who may get a benefit, massages may loosen tight muscles or improve asymmetry where one breast is higher than the other.
What cup size are the implants?
This varies and is determined by patient’s desire and physique. But implant volume is not measured in cup size, and different implants can deliver a different cup size. Sizers are used for the consultation to demonstrate and simulate how certain sized implants will look after implantation.
When can I wear an underwire bra?
For the first six weeks after breast augmentation with silicone gel or saline breast implantation, patients must wear a special surgical bra or a sports bra. From six to 12 weeks, they can wear a bra without wire. After three months, patients can wear any bra.
Is it safe to breastfeed with implants in place?
Yes. It is safe to breastfeed with silicone gel or saline breast implants. The real question should be, can breast augmentation affect one’s ability to breastfeed? In most cases, the answer is no. But the real answer exists in the statistics. Some 75% of all women who have never had breast surgery can successfully breastfeed, meaning 25% of all women who never have had breast implants will experience some difficulty. For those who may seek to breastfeed in the future, this Miami plastic surgery practice recommends the implant go inframammary, or where the breast and chest meet. This may decrease the likelihood of breastfeeding issues, by avoiding the need to cut through any breast tissue while creating the sub-muscular space for the implant. Moreover, a simple breast augmentation won’t change these numbers. But a breast reduction or lift tends to reduce the number of women who can successfully breast feed to around 50%. Regardless of whether the implants are silicone gel or saline, the numbers are the same.
What is the difference between having laser hair removal in a medical spa versus a doctor's office?
We’ve all seen the advertisements for laser hair removal at a spa or laser treatment center. What the ads don’t tell you is the qualifications and experience of the technician. This is an important distinction. In our Miami plastic surgery practice, patients expect and receive a heightened level of care and expertise. In most spas, treatments are given by an “electrologist.” In our practice, a registered nurse board certified in aesthetic laser treatments and injectables administers laser treatments under the consultation of board certified plastic surgeon Dr. Sean Simon. The quality of the machinery also is critical. In our office, we use the most advanced laser system in the world to achieve the best, most long-lasting results with minimal complications and down time. We also provide training to other nurses, physicians and practitioners on our Palomar Icon aesthetic laser system. This market-leading machine is the next generation of platform technology, offering the industry’s only FDA-cleared melanin reader, fast treatments with excellent outcomes and user experience.
What is a photo facial?
The “photo facial” is a procedure ideal for patients with sun spots, age spots or hyperpigmentation related to sun over-exposure anywhere on the body. A laser or Intense Pulsed Light Device (technically not a laser) is focused on pigmentation in the affected areas, including the hands, arms, chest and face. It’s more effective than a chemical peel, which targets nothing specifically.
What is a fractional laser treatment?
Fractional laser resurfacing, also called non-ablative laser resurfacing, is a procedure that improves tone, texture and general appearance of the skin by smoothing out the appearance of the skin. Unlike ablative resurfacing that uses carbon dioxide to burn off outer layers of the skin, fractional laser resurfacing causes no burning or patient recovery or downtime. Ablative resurfacing also can lead to hyper or hypo pigmentation, depending on the particular patient’s recovery. With fractional laser resurfacing, the laser light passes through the outer surface directly to the deeper layers to help stimulate collagen growth. This can help smooth out the skin of patients that have wrinkles, enlarged pores, uneven texture and/or acne scars. The procedure usually is done over several sessions, and because the process does no damage to the outer layers, patients have very little to no downtime.
What happens if I have another child after a tummy tuck?
It’s unpredictable how much your body will change with pregnancy after having had a tummy tuck. It certainly will undergo the natural changes of pregnancy. Some women who have had tummy tucks and later have full-term pregnancies see their bodies return to their pre-pregnancy state. Others, though, must redo the entire abdominoplasty or tummy tuck. Don’t be worried, though: After having a tummy tuck, your body can go through a full-term pregnancy without causing any permanent harm to you or the baby. Of course, the ideal time to have an abdominoplasty is after a woman has decided to have no more children.
Do you work with post-gastric bypass patients?
Yes. Dr. Simon has years of experience working with patients who have lost significant weight through diet and exercise or through surgical means. These patients typically are “massive weight loss” patients who have lost 100 pounds or more. Together, we explore issues of skin laxity around the trunk, torso and arms. A “body lift” can include a tummy tuck for the front, side and extension to the back to address buttock and thigh laxity (droopiness). This procedure is also called a circumferential body lift or a “belt lipectomy.” Weight loss patients also frequently have excess skin of the arms, therefore requiring an arm lift (also known as brachioplasty). These patients also typically could benefit from a breast lift, with or without implants.
If I have an umbilical hernia, can this be repaired at the same time as a tummy tuck?
Yes. In our Miami plastic surgery practice, we frequently will repair an umbilical hernia at the same time as performing a tummy tuck or abdominoplasty. As a board certified general surgeon and board certified plastic surgeon, Dr. Simon has experience in repairing all types of hernias. An umbilical hernia is fairly common after child birth. Given the inherent weakness of the abdominal wall, the connection between the intra-abdominal space and the subcutaneous space can create a hole will never go away on its own. If large enough, a section of the bowel could get stuck and require surgery. The signs of an umbilical hernia include the appearance of the belly button changing from an “innie” to an “outie”; occasional tenderness or discomfort, especially if the patient digitally manipulates the area; and pressure or discomfort when coughing, sneezing or laughing. Because Dr. Simon performs a comprehensive physical examination on each patient, he frequently diagnoses umbilical hernias that may have been previously unknown.
What is the difference between a Tummy Tuck and a Mini Tummy Tuck? And how do I know which one I am a candidate for?
In this Miami plastic surgery practice, a tummy tuck and mini tummy tuck are differentiated by the amount of skin removed or the areas addressed. Each patient’s case is unique and addressed according to her or his individual circumstances. A full tummy tuck or abdominoplasty generally addresses extreme laxity of the abdominal skin and muscles after pregnancy or significant weight loss. A rectus diastasis is often present after childbirth (a separation of the abdominal muscles in the midline causing a bulging of the abdomen). The procedure often involves removing skin and fat from pubic area to the belly button and tightening the abdominal wall and oblique muscles, referred to as an internal corset. The procedure can be combined with liposuction of the abdomen, waist and back. A mini tummy tuck involves a smaller incision and removal of some skin and fat. The incision and resulting scar can be the size of that from a traditional tummy tuck, or smaller, and the procedure may or may not include muscle tightening. The way Dr. Simon performs tummy tucks, the main scar is kept low with little to no visible scarring around the belly button. Ideal candidates for a mini tummy tuck procedure are those who don’t have as much loose abdominal skin and/or may have a higher natural belly button position. With the scar low on the abdomen, a bikini bottom often can cover it up.
Is liposuction a substitute for weight loss?
No. Liposuction is not a procedure designed for weight-loss. It is for body contouring and improved curves. For that reason, diet and exercise remain the most important remedies for weight loss. In fact, the best candidates for liposuction are those who already are in reasonably good physical shape and health. Patients who are obese are usually not a good candidate for liposuction. Liposuction is best for those areas of the body where accumulated, isolated fat deposits won’t respond well to diet or exercise. These can vary by patient, but generally include the waist or “love handles,” thighs, abdomen, back and arms.
Is there a limit to how much fat can be removed in one operation?
Yes. This can vary by each patient’s physical characteristics and general level of health and fitness, and whether liposuction is being combined with other surgeries. But generally, liposuction and several other procedures can be combined into the same operation. If one liposuction session is insufficient to address all the problem areas, follow-up sessions might be required.
What is fat grafting?
Sometimes referred to as fat transfer, this is when a patient’s natural fat is removed or harvested via liposuction from one area of the body and reinjected into the body for a more aesthetically pleasing appearance. Most commonly, fat is harvested from the abdomen, waist, back or thighs. Before reinsertion, the physician’s team will separate healthy fat and the stem cells to be reinjected into the desired area. Fat grafting can be used for the buttocks (often called a “Brazilian butt lift”), breast, face or hands. When used in lieu of a breast implant, the plastic surgeon can provide more moderate volume than when using implants. Fat also can add to the face or hands volume that has been lost to age. This can provide a younger appearance.
How much of the fat that is grafted to the buttocks with a Brazilian butt lift survives?
This answer depends on the technique – how the fat is harvested, prepared and reinserted. All come into play regarding the survival rate of transferred fat. Also, how compliant the patient is with post-operative instructions – for example, not sitting on the buttocks for several weeks to prevent damage to grafted fat or wearing the compression garment as instructed – will help determine a positive outcome. Though some patients enjoy 100% retention, generally 75-80% of transferred fat will remain permanent. The remainder is resorbed by the body.
Is it true that after liposuction, fat can return in the same area?
Yes. When a plastic surgeon performs liposuction, not all fat cells from any particular area are removed. A thin layer is left to maintain a smooth appearance. When you gain weight, fat cells swell with lipid. Fat distribution is different by patient, but it’s unlikely a patient will have an abnormal accumulation in a particular area after liposuction, however with weight gain the distribution of fat may be different than before liposuction.
What is Laser Liposuction? What are the benefits?
Laser liposuction – also known by the brand names of SlimLipo and SmartLipo – is a procedure that uses laser light to break down fatty areas and suction to remove the treated fat from the body. The laser light directly targets and is absorbed by the fibrous tissue and fat. The heat destroys the fat cells, breaks up the fatty tissue and “melts” it away. Using power-assisted liposuction, the resulting tissue is removed from the body, leaving a thinner, smoother contour. Laser liposuction is ideal for patients who don’t have perfect skin tone or reduced elasticity as a result of age, childbirth or weight loss. The laser energy of the Slim Lipo platform, the surgical laser Dr. Simon uses, is also utilized to stimulate skin tightening and to treat cellulite.
Are massages required after liposuction?
At this Miami plastic surgery office, we recommend massages after liposuction. When performed by a trained masseuse, massages can be beneficial in helping reduce swelling faster, address areas of irregularity or scar tissue, and possibly improve smooth appearance of the skin. Patients could benefit from three to 12 sessions, based on extent of procedure, how they’re responding to the procedure, and the results of the massage sessions themselves. Massages usually are started within a few days of the surgery.
What is the best treatment for my facial wrinkles?
Often, the best treatment for facial wrinkles is fractional resurfacing [link to that answer in FAQ]. Other options include injectables, like muscle relaxants (including Dysport or Botox). These relax facial muscles and prevent muscles from squeezing skin together, creating wrinkles. Injectable fillers can add volume and smooth out wrinkles. At our practice, we also recommend heightened attention to skin care. We recommend and carry a line of products called SkinMedica and SkinCeuticals. As adjuncts to injectable and lasers, these products help maintain and improve the long-term appearance of skin. Use of skin care products and foods, especially those with antioxidants, can help reverse sun-damaged skin DNA. These also can be found in fish oils and Omega 3 fatty acids.
How long does Botox or Dysport last? What about Restylane or other fillers?
Botox or Dysport often last from four to six months. Restylane and other fillers may last from nine to 12 months. Conditions may vary by patient.
What foods can I eat to improve the appearance of skin?
As with much of our life and health, simple healthy choices are best for keeping our skin healthy and vibrant. These can include broccoli and carrots, as well as those foods with essential fatty acids, like flax seed, walnuts, salmon and canola oil. Low-fat dairy products can be skin-healthy, as they contain vitamin A, which is critical for skin cell health. Berries – whether blackberries, blueberries, strawberries or even plums – have high antioxidant levels and are ideal for healthy skin. Skin health also includes avoiding excessive sun exposure by wearing good sunscreen, a hat or long sleeves while outside for long periods.
Can I exercise after Botox or facial fillers?
Yes. Even the day you have the treatments done, you are free to go about your normal daily routine afterward. It’s advisable to wear additional sun protection – like a hat – or avoid excessive exposure. With Botox or Dysport, it’s recommended that the patient not massage the area for a few days, and specific instructions are given to each patient at the time of the procedure.
Does Dr. Simon do silicone injections?
No. In South Florida, we’ve read horror stories about “silicone injection parties” where participants (let’s not call them “patients”) have had unknown substances injected into their buttocks in pursuit of a different appearance. Despite the many names, this substance typically is industrial-grade silicone. Dr. Simon will not inject silicone directly into a patient. Silicone has not been approved by the U.S. Food and Drug Administration for such use, and the practice is not accepted as a standard of care by The American Society of Plastic Surgeons, the American Board of Plastic Surgeons, the American Medical Association or any accrediting board. However, Dr. Simon frequently sees patients with silicone injection related problems and complications and will offer recommendations as to treatment choices.
Is anesthesia safe? And what is the difference between twilight or sedation anesthesia and general anesthesia?
To answer the first question, Yes. Anesthesia is safe. While complications may arise, at our Miami plastic surgery practice, our team includes experienced anesthetists with whom we’ve worked for years – and trust to handle all our cases. Questions about anesthesia often arise from patients, especially those who never have had surgery or general anesthesia. What is “twilight”? What is general anesthesia? Why can’t I have my tummy tuck or breast augmentation done under local anesthetic? Twilight sedation is administered by pills or intravenous injection. We perform procedures under this form of anesthesia or sedation, when indicated and desired. Many of the procedures we do in our Miami plastic surgery office are significant operations, and almost all of those are done under general anesthesia. General anesthesia is the safest option for the procedures we do. With general anesthesia, the patient may be breathing on their own – albeit with a tube in place to ensure the airway remains open. We’re monitoring breathing and all vital signs in a very controlled situation. This type of anesthesia allows Dr. Simon to perform surgery in a safe, controlled manner while minimizing the chance of complications.
What options does the practice offer for reducing post-operative pain?
The first and most important way to reduce post-operative pain is to select the right surgeon. The surgeon must be skilled, experienced and employ careful surgical techniques that can make a significant difference in minimizing tissue damage and swelling. When asking your friends for referrals, make sure to inquire about post-operative swelling, discomfort or pain. Different dietary supplements and medicinal products can help, too. A few days prior to surgery, taking the nutritional supplement Arnica, extracted from a flower, can reduce swelling and bruising. For patients having a tummy tuck or liposuction, use of a surgical foam between the skin and surgical garments also can help reduce swelling and discomfort. Dr. Simon typically places this at the time of the surgery or at the first post-operative visit. While local anesthetics are effective at the time of a medical procedure and immediately afterward, use of Exparel can help longer term. This single-dose, time-released analgesic is injected during the procedure and helps manage post-operative pain in the 72 hours following a procedure. Use of Exparel also can reduce a patient’s need for oral pain medications during those first few days after surgery. In clinical trials, patients noted a 30% reduction in pain, and a 45% decrease in the need for oral pain medications. Some plastic surgeons also use a pump and catheter to dispense pain medications into the surgical site in the days after an operation. Once the medication is done, the pump and catheter are removed.