Cosmetic Surgery FAQ

The Center for Cosmetic Surgery

Questions About Cosmetic Surgery

Is it possible to replace implants under the muscle?

It is possible to remove your saline implants that are on top of your muscle and replace them with silicone implants under the muscle. The combination of material (silicone) and placement (under the muscle) will give a much more natural result; most patients do not have any rippling in this situation.

I have been doing a lot of research and your website offers the best and the most before & after photos than any other practice. I was wondering if I would still be eligible due to having Hashimoto’s Thyroiditis since 1997.

You are not disqualified from being a candidate for breast augmentation surgery due to your condition. As long as your thyroid levels are normal, you are not at greater risk for complications from the surgery.

I have breast implants and one of my breasts has started to get firm. If I have a capsular contracture, can this be fixed and if so, is this urgent?

Capsular contracture does not cause any harm to you or your breast implants. It can cause discomfort and sometimes pain and will not resolve without surgery. Your breast will continue to get firm and eventually hard. The only solution is to remove the scarred capsule, most often using the same implants. This is a relativly easy surgery and short recovery with the end result being a soft breast.

Can I have my hernia repaired at the same time as an abdominoplasty?

It is not uncommon to see different types of hernias when performing an abdominoplasty. Both our physicians, Dr. Andrew Wolfe and Dr. Steven Vath will often repair hernias in conjunction with a tummy tuck/abdominoplasty. In our experience though, the tummy tuck portion of the procedure is not covered by insurance. The hernia repair portion can be billed to insurance, but you would have to use your out of network benifits which is not always cost effective. Most of out patients have found that paying their insurance deductible along with the cost of a tummy tuck is actually more expensive than simply paying out of pocket as a cosmetic patient.

Would I be able to have a tummy tuck done the same day as a breast lift?

Many people have tummy tucks and breast procedures at the same time, this is commonly referred to as the “mommy make-over”. Take a look at our before and after pictures and you’ll see that many patients have chosen to undergo these two procedures in one surgical setting. This means only one recovery and less overall cost to you.

Do your surgeons do labial reductions.

Labial reduction has become a popular procedure and can be done in our office surgical suite or in combination with another procedure at our outpatient surgical facility. Both Dr’s Wolfe and Vath perform labial reductions.

I am a 23 year old mother of two and I have stretch marks all over my stomach and upper thighs, can this surgery remove my stretch marks?

In order to remove stretch marks, they must be excised or “cut out”. This is achieved with a tummy tuck, which will give you a flat tummy and remove all of the stretch marks from below your belly button to above your pubic area.

Hi, I am interested in eyelid surgery and am impressed with your before and after photos. I would like to know if you have performed this procedure on any African American women?

Certainly, Drs. Wolfe and Vath have performed eyelid surgery (blepharoplasty) on African American patients.

Does Dr. Vath or Dr. Wolfe perform the medial thigh lift?

Yes, our physicians do perform that procedure.

Hello, I am considering a chin implant. I was wondering if I could get a cleft chin in addition to the chin implant?

Our Doctors do not perform surgery to make a cleft chin. We do, however, perform chin augmentation.

Where do you hide the scar on the eyelid? How long are your consultation appointments?

You can plan to spend approximately 1 hour at the Center for Cosmetic Surgery for a complimentary consultation appointment with Dr. Wolfe or Dr. Vath on blepharoplasty. When you come in for a consultation, the doctor will first meet with you and go over the procedure in detail. You will then have a physical exam to address your individual needs. Afterwards, you will meet with our patient counselor to discuss pricing, financing options, and tentative surgery dates. The incision for upper blepharoplasty will be right along the crease line.

Hello, I have excess stretchmarks on my upper & mid arms as well as excess skin. I was wondering if i can get the excess skin pulled taught to reduce the appearance of the stretchmarks?

Surgery will only reduce the appearance of stretch marks if the area of skin affected by them is removed. Brachioplasty can reduce the laxity on your upper arms, but may or may not reduce the appearance of stretch marks.

Where do you do your breast reductions?

We do these surgeries at Denver West Surgery Center. They are a Health One outpatient surgery center and are accredited by JACHO.This ensures the highest degree of safety and the lowest infection rates.

If your breast implants need to be replaced do you need to pay for the breast augmentation all over again?

The cost of replacing breast implants greatly depends on the reason and when the initial surgery was done. Your implants may be under warranty by the implant company if there is a rupture and this may possibly include some financial assistance. The surgical requirements are usually much less than the original surgery, therefore decreasing the cost and the post operative pain involved with the initial breast augmentation surgery.

I have an ear lobe tear on my right earlobe from a piercing. I want the hole stitched and re-pierced in 6 months to 1 year. Is this possible?

Both our surgeons perform earlobe repairs for various reasons. After an earlobe is repaired we recommend you wait just 6 weeks before re-piercing.

How long do I have to wait after giving birth to have breast augmentation and a tummy tuck?

It is best to wait 6 months after giving birth to have breast and tummy surgery. If you are breast feeding you should wait until 3 months after you are finished nursing.

I have had a c- cection.. is there anyway to remove the scar?

When there is extra skin on your tummy after pregnancy, an abdominoplasty is generally the best means of managing it. The procedure tightens the abdominal muscles and removes excess fat and skin leaving you with a flat abdomen. The c-section scar is removed during the procedure. Often, women choose to have liposuction of nearby areas such as the flanks (love handles), hips, back, or thighs at the same time to improve their overall look.

Hello! I’ve been interested in getting a tummy tuck for awhile now, but have a tattoo above my belly button. Would this interfere with the surgery?

Having a tattoo in that area would not interfere with your surgery, but it may move or change your tattoo. An abdominoplasty is a surgery where the fat and skin from your belly button down to your pubis is removed. The muscles are tightened from under your breasts down to the pubic bone. The skin is then pulled down and closed resulting in a scar from hip to hip, but low enough to hide under a two-piece bathing suit. The length of the scar varies a bit depending upon the degree of skin redundancy. But as you can see from the photos of our surgeon’s work, this surgery is a wonderful trade off for a flat tummy!

Do you have a permanent cellulite removal treatment?

Contrary to popular belief, “cellulite” is not a type of fat. The dimpling you are referring to is caused by laxity in your connective tissues that hold the body and skin together. Rarely, liposuction can help flatten the area, but, more likely, a tightening procedure is necessary.

Can i smoke after getting a breast lift?

Smoking adversely affects wound healing. The small vessels that supply blood to the tissues shrink up and prevent the necessary nutrients for healing to get to the wound. The incidence of having a wound complication such as an open wound or skin death is much higher in smokers. Furthermore, the rate of wound infection is also significantly increased in smokers for the same reason of limited blood flow. Because of this, a patient must stop smoking for a minimum of 4 weeks prior to and 4 weeks following surgery to decrease the risk of these complications.

Can I have a tummy tuck and a thigh lift at the same time?

It may be possible to have a tummy tuck and thigh lift at the same time. Many of our patients choose to combine procedures.

Do you have to take off all make-up and lotions before surgery?

We will advise you not wear any make-up, jewelry and lotions for most procedures. Some facial lotion and lip balm may be used if a facial surgery is not involved.

I have thin lips. Will a mini face lift accentuate the thin lips and give it a pulled appearance?

The mini-face lift will not affect the appearance of your lips. The goal of a mini-facelift is to lessen the wrinkles on your face, decrease jowls, elevate the cheeks, and tighten the neck. You will not have a pulled appearance. A facelift should not pull on the corners of the mouth or the lips and therefore, has no affect on the mouth or lips whatsoever. We can use Surgisil lip implants to plump thinning lips if the patient desires.

I am interested in full face laser resurfacing. Can you laser the neck as well? Thank you!

The neck is an area that cannot be lasered. However, our office also has a skin care center “Rejuvenate” and different peels and medical grade skin care products are effective in improving the skin on the neck. That would include Blue Peels, MicroPeels, Microdermabrasion and IPL.

When would be the right time for my first consultation if I am currently pregnant?

Thank you for contacting the Center for Cosmetic Surgery and your interest in a Tummy Tuck and Breast Augmentation. We would recommend seeing you about three months after the birth of your baby. You will want to be finished nursing and your breasts have finished changing before having surgery. This may be anywhere from 1 to 6 months after nursing.

Will you be offering laser assisted liposuction?

Thanks for your inquiry about liposuction. Please understand, there is no such thing as laser assisted liposuction. The “Vaser” is the name of a liposuction machine that uses ultrasound, not laser, to “melt” the fat. The company conveniently chose the word “Vaser” because it sounds like laser and therefore gives the impression that laser is being used- a concept that sounds special to the prospective patient. But we assure you, there is no laser assisted liposuction. There is no study to prove that one type of liposuction machine is superior to another. Your results will depend completely upon the skill and experience of the surgeon, not the tool in his or her hand. We prefer power-assisted liposuction which is a machine that shakes the liposuction tip allowing the fat to be more easily and efficiently removed without heating or melting it. Take a look at our before and after pictures and compare them to others to help decide for yourself.

Would getting a new tattoo or piercing interfere with an upcoming surgery?

Getting a tattoo or piercing should not interfere with an upcoming surgery, but it does depend on what type of surgery you are having.

Do you perform liposuction on men?

We certainly perform liposuction on men. The most common areas are the abdomen, flanks (love handles), and chest. Our doctors use power-assisted liposuction (PAL) which is particularly helpful in men due to their dense, fibrous fat.

What is the difference between UAL (ultrasound assisted liposuction) and PAL (power assisted liposuction)?

Ultrasound assisted and power assisted liposuction are two methods of removing fat using different machinery. Neither is definitively proven to offer better results. Just as the type of pen does not determine the quality of the author’s novel, the type of liposuction machine does not determine the quality of the liposuction result, but rather the surgeon. UAL is associated with a higher seroma (fluid collection under the skin) rate. Additionally, UAL heats up to thermally disrupt the fats cells at the risk of causing skin injury. Power assisted liposuction is the preferred method at the Center for Cosmetic Surgery. The cannula mechanically shakes and gently removes the fat in a smooth fashion without the risks of UAL. PAL removes the fat more quickly saving surgical time and cost to the patient.

Is the minifacelift the same as a lifestyle lift, with 4 incisions and minimal downtime? Also, which of the injectables (ex. Juvederm) last the longest-I am interested in vertical lines around mouth-mainly upper lip area?

The mini-facelift is a shorter scar version of a traditional facelift and requires less invasiveness and achieves wonderful results. The mini-facelift will reliably and safely elevate the cheeks, tighten the jawline and neck, and reduce facial wrinkling in a long-lasting fashion. Down-time is minimized. The “lifestyle lift” is not an accepted terminology within the world of plastic surgery. There is no published paper on the “lifestyle lift” nor is it an entity in any legitimate plastic surgery text book. The “lifestyle lift” is a term created for marketing. We therefore can not elaborate upon the details of this procedure and there is no discussion as to the technical aspects of the operation on the “lifestyle lift” website. As far as injectables for lip lines, juvederm does last longer than restalyne and may be the ideal option for you. We have a skin care center called rejuvenate with nurses specially trained in performing these injections and they would be happy to meet with yo to discuss your concerns.

What is the youngest age that I could have either a tummy tuck or liposuction?

An adult (>18 years old) can be a candidate for either a tummy tuck or liposuction, given that she understands the risks, complications, and goals of the procedures. Tummy tucks are generally reserved for women who are finished having children or have had massive weight loss. Liposuction is used to reduce fatty bulges in the context of good skin tone. Liposuction is not a weight loss operation and you want to have exhausted all weight reduction and toning efforts prior to considering liposuction.

I have lost a significant amount of weight but still have some to go and I can see that there is extra skin. I am interested in having the body lift surgery and breast reduction next summer after I finish graduate school. I wanted to know if I need to ma

Thanks for your inquiry and congratulations on all of your weight loss. It is ideal that you have reached a stable weight for at least 6 months prior to undergoing a body lift and breast reduction. Good luck with your goals and we welcome you to a free consultation to discuss your surgical options with either Dr. Vath or Dr. Wolfe at your convenience.

Do breast implants ever need to be replaced?

After having implants placed, there is no maintenance or preventative care to speak of. In other words, unless you have a problem, there is no need to routinely replace the implants at a particular age. With that in mind, many women will eventually need their implants replaced due to breakage of the shell. With saline implants, you’ll know right away because your body absorbs the saline and you “deflate” quickly on that side. With silicone implants, when the shell breaks, the gel remains in the breast capsule that your body creates around the implant and you may not know that the shell is broken. The capsule may harden over time creating the need to remove it and replace with a new implant. Keep in mind that breakage of an implant, saline or silicone, is not dangerous and it is very simple and relatively pain-free to replace.

Can I get a breast augmentation and tummy tuck at the same time? If so, what is the recovery time?

You can absolutely have a tummy tuck and breast augmentation at the same time. This is commonly referred to as the “mommy makeover” and is a combination procedure we do often. Most people are out and about by 7-10 days and are able to return to work by 10-14 days. You can resume low impact exercise at 3 weeks and are restriction free at 6 weeks.

How long is the recovery from a tummy tuck? I am a runner, how long would I have to take off from running?

A tummy tuck requires a one to two week recovery before getting back to non-exertional activities in a comfortable way. Recovery time varies a great deal between individuals. For higher impact activities such as running, you will need to take 5-6 weeks off. It may be difficult to stay away from running for that long, but most women feel it was worth it. No amount of exercise can tighten up your tummy like a tummy tuck.

Can I still have breast implants being on methadone for pain?

The surgeons would need more information regarding your overall health in order to determine if elective surgery is a safe option for you. You should check with your primary care physician and pain specialist as well. Being on methadone is not an absolute contraindication for surgery. You may just have a more difficult time with pain control after the procedure. Our patients on Methadone have done quite well.

How extensive is the scarring from a breast lift? Do implants fix the problem of pendulous breasts?

The goal of breast lift or mastopexy surgery is to minimize scarring as much as possible while creating the best shape achievable. If your nipple is below the fold of your breast, you would need a mastopexy. Implants alone would not give you the desired result. The necessary scarring differs depending upon the degree of sagging. Usually, a short or “lollipop” scar around the areola and down to the breast fold is employed to get the best breast shape. As you can see from our photos, the trade off is a positive one.

Are there shapes of implants other than the round ‘fakey’ looking ones?

There are round and anatomic (tear drop shaped) implants. The round implants come in various profiles, meaning the amount of projection for a given width varies. The anatomic implants do not provide a better, less fake appearing breast. Occasionally, the anatomic implants can rotate creating an abnormal and unattractive breast shape. Round implants will assume a natural, “tear drop” shape when placed correctly and the proper profile of implant is used. During the consultation, Dr. Vath and Dr. Wolfe take measurements to accurately determine the appropriate size and profile of implant to create the most natural breasts.

Is it possible to have breast implants and never need to change them?

It is possible, but deflation happens approximately 1% per implant per year, so it is not uncommon that women need an implant replaced at some point in their lives. Most women who have implants end up having further surgery down the road, either to replace the implants or lift the breasts. Becoming fully informed about the risks and complications of breast surgery is essential prior to undergoing any procedure.

Is there a limit to how big I can be after breast augmentation?

There are limits, but these vary depending upon each patient’s anatomy and aesthetic goals. Larger implants may not fit beneath tight skin and may create a less natural looking breast. Additionally, the risks and complications associated with breast augmentation slightly increase as the implant size increases. As long as the patient is well informed and understands the goals, there is a large degree of flexibility in the size of implants that can be used. Size is largely dependent upon the patient’s desire.

What are the pros and cons of having implants after a breast lift?

A breast lift or mastopexy will lift the breast and nipple restoring a youthful, perky breast shape. Once healed after a mastopexy, it is unlikely that any further surgery will be necessary. Women after a breast lift generally feel that their breasts are smaller even though no breast tissue has been removed. Only skin is removed during a lift; however, because the breasts no longer “hang,” they look and feel smaller to the patient. Because many women desire increased size or fullness after sagging, they opt for an implant with the mastopexy. Implants, although medically safe, carry many risks, including deflation, that may necessitate further surgery. The decision is ultimately the patient’s, as long as she is well informed of the risks, complications, and goals associated with the different options.

I delivered twins eight years ago by c-section and have that overlap of skin that looks so ugly. What can I do?

When there is extra skin on your tummy after pregnancy, an abdominoplasty is generally the best means of managing it. The procedure tightens the abdominal muscles and removes excess fat and skin leaving you with a flat abdomen. The c-section scar is removed during the procedure. Often, women choose to have liposuction of nearby areas such as the flanks (love handles), hips, back, or thighs at the same time to improve their overall look.

I want to have a tummy tuck during a c-section. Can it be done?

You should be healed from your c-section before an abdominoplasty is performed. Once you have lost your weight gain from pregnancy and you have stabilized, the maximum amount of tightening can be achieved to optimize your results. Although it would make sense to have it all done at once, the studies show that the complications from surgery increase when combining these two procedures.

Do you use implants in a breast reduction to firm up the breasts?

A breast reduction entails the removal of breast tissue and skin to reduce the breast volume and lift the breast to create a better overall shape and size. The breast will be “firmed up” by compacting the tissue into a smaller area by tightening the skin. Implants are used to enlarge breasts and would not be appropriate for placement during a breast reduction.

What scarring is created from a mastopexy?

The goal of a mastopexy is to create the best breast contour possible with the shortest scar. A mastopexy can be performed with a circumareolar scar, “lollipop” scar, or the “anchor” scar depending upon the degree of skin excess and breast sagging. During the first year, the scars will fade to a flesh toned color and are generally considered a very good trade off for perky breasts.

What is the recovery like after a labial reduction?

Labial reduction surgery reduces the excess labial skin that can not only create hygiene problems for many women, but serves as a source of embarrassment for them. The recovery varies form person to person but generally requires pain pills and relaxation for a few days followed by a gradual resumption of normal activities.

What can I do about my lower eyelid bags and dark circles?

A transconjunctival blephoraplasty, or reducing the fat pad from the lower lid can decrease the lower eyelid “bags”. The dark circles are usually less noticible when the contour of the lower lid is flatter. This surgery is done in our surgical suite under local aneshesia with sedation.

Is liposuction a viable option for people in their mid-20’s?

Yes, liposuction can be performed on any adult as long as he or she is a good candidate for the procedure. This means that there are unwanted fatty bulges out of proportion with the rest of the body and the skin elasticity is good. Liposuction is not a weight loss operation and should not be used in this capacity.

Do you perform the LeJour or “lollipop” breast reduction/lift? Should I wait until I am done having children to get a reduction/lift?

Yes, we perform the LeJour, short-scar, or “lollipop” breast lift and reduction. This is an excellent method in many women to achieve the best breast shape with the shortest scar. Usually, it is appropriate to wait until you’re done having children before undergoing this procedure so that you don’t stretch out the skin again possibly necessitating another surgery.

How long is the scar from an abdominoplasty? Will my stretch marks be removed?

An abdominoplasty is a surgery where the fat and skin from your belly button down to your pubis is removed. Any stretch marks in this region will be removed. The muscles are tightened from under your breasts down to the pubic bone. The skin is then pulled down and closed resulting in a scar from hip to hip, but low enough to hide under a two-piece bathing suit. The length of the scar varies a bit depending upon the degree of skin redundancy. But as you can see from the photos of our surgeon’s work, this surgery is a wonderful trade off for a flat tummy!

How do I eliminate saggy areas at the corner of the mouth to jawline and under the chin? Do tissue glues help?

The lines from the corner of the mouth (marionette lines), saggy jowls, jawline, and neck skin are all best managed by a facelift or mini-facelift. This has stood the test of time and is undeniable and reliable. The actual tightening of the underlying facial layers beneath the skin to lift the face and then the removal of excess, lax skin will decrease unwanted lines and sagginess in the face. Fibrin sealant and plasma products have been employed in order to decrease the risk of bleeding beneath the skin and have not been accepted as the standard of care for minimizing this risk. The use of these products to assist with the aesthetic goals of a facelift (tightening skin laxity and ridding of unwanted lines) is unsubstantiated and experimental at best. I would recommend that you stick to tried and true techniques that we know work well.

Do you perform liposuction on “buffalo” humps?

Yes, the buffalo hump or fat pad that can develop on the lower back of the neck can be liposuctioned. Power-assisted liposuction works especially well in this area.

Can a breast lift be performed without implants?

A breast lift or mastopexy can be performed with or without implants. When a mastopexy is performed, skin is removed in order to tighten the breast tissue into a lifted, perkier breast. An implant can be used at the same time to increase breast size, but this is certainly optional.

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