What You Should Know Before Deciding to Have Surgery

Fees and insurance. Fees for aesthetic plastic surgery traditionally are paid prior to surgery. Costs vary widely and depend on the complexity of the operation, where the surgery takes place and which anesthetic is administered.

As a rule, aesthetic plastic surgery is considered "elective surgery" and is not covered by most insurance plans. Sometimes, however, there is a fine line between whether the surgery's prime objective is to improve appearance or to improve function. For example, protruding or large ears may be considered a birth defect and ear surgery deemed necessary to correct it. Similar judgments may be made regarding eye surgery if drooping lids impair vision, or breast reduction if the weight of the breasts causes pain or interferes with normal activity. If this is the case, contact your insurance company before surgery to determine how it views your particular surgery.

Surgical facilities and anesthesia. Surgery can be performed in a number of locations, depending on the procedure and what your plastic surgeon regards as appropriate. Generally, aesthetic plastic surgery takes place in a hospital or an ambulatory care setting, such as an outpatient center or your surgeon's office-based surgical facility.

In many cases, a local anesthetic will be administered to numb the area to be treated, along with a sedative to relax you. For some aesthetic surgical procedures, however, you will be given general anesthesia so that you sleep through the entire operation. Postoperative discomfort is normally controlled with medication.

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Risks and complications. Although some of the procedures described in this booklet appear to be relatively simple operations, it is essential for you to understand that aesthetic plastic surgery, like all surgery, has attendant risks.

Plastic surgeons perform thousands of successful aesthetic procedures each week, but as with any type of surgery, a patient can have an adverse reaction to the anesthetic or be affected by postoperative complications such as blood clots, infection or poor healing. These problems can occur even when the surgeon has performed the operation with the utmost skill. Since smoking may interfere with proper healing and aspirin may increase the risk of excessive bleeding, you may be advised to avoid them before and after surgery. Occasionally, surgical revisions may be desirable to achieve optimal results.

It is important to remember that aesthetic plastic surgery molds and reshapes living tissue, and the results are not absolutely predictable. No surgeon can offer risk-free surgery or guarantee a perfect result.

Recovering from your surgery. Your plastic surgeon will inform you of any restrictions to your normal activities following surgery. In general, you should avoid strenuous exercise and other activities that raise your blood pressure, including bending, for several days to weeks (depending on what type of surgery was performed). It takes time as well for the visible signs of healing to subside. Do not expect to see the final results of your surgery right away. Plan your social activities to allow sufficient time for recovery.

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Other considerations. The results achieved in some aesthetic surgical procedures, such as surgery of the nose, ears and chin, are permanent. In others, particularly those that diminish the effects of aging, results may be long-lasting but are not permanent. Plastic surgery may be able to turn back the clock but will not stop it from running.