Brought To You By: YOUR COMPLETE GUIDE TO EVALUATING COSMETIC SURGERY June 2017
Table of Contents 2 Introduction 3 Are You A Good Candidate? 4-6 Common Concerns 7-9 10 Questions to Ask Yourself and Your Doctor 10 Avoid These Mistakes 11 Select the Right Doctor 12-14 Emotional Considerations 15 Pre-Op Information 16 Post-Op Care 17 Patient Satisfaction 18-19 Notes 20 Resources 21 Conclusion 22 About the Author 23-24
3 The decision to have a plastic surgery procedure involves multiple considerations safety, health, finances, your goals, the doctor s skills and your trust in them and so much more. The Best Decisions Are Informed Decisions: For those that have considered the relevant facts and have taken the time to research the procedure, benefits and doctor; find their decision to proceed with the procedure to be one of the best choices they ve ever made. The benefits to cosmetic surgery are numerous. Consultations Are Key to the Process: The best surgeons work with patients that know what they want and are comfortable with their decision. However before patients reach their decision, you want a doctor that offers a consultation to get your questions answered and determine if you are truly a good candidate for the procedure. The Purpose of This Guide: This is designed to walk you through the considerations and offer helpful tips and insights to make an informed decision. Your Journey: This Guide is the first step on your journey. Make notes and questions as you go bring this in if you choose to have a consultation and explore your options. Preparing for Your Consultation: Discover what to ask your doctor, if you are a candidate for procedures. Read about patient s satisfaction after a procedure and much more.
Who is A Good Candidate? 4 Mommy Makeover Breast Augmentation You are a good candidate if you want to achieve a significant improvement in figure, shape and form after multiple children and breast-feeding. In general, patients want to have a return to ideal proportions and shape of breast, waist and hip ratios, with tightening of abdominal tissue. The scars that result from both breast augmentation and breast implant surgery and various forms of tummy tuck surgery can generally be well hidden and can be faded with modern laser scar treatment techniques. Contraindications would be those individuals who may be pregnant at the time of the procedure, have unrealistic expectations, are medically unwell, or have inflammatory, infectious lesions or skin cancers in the areas of treatment. It is OK to have the procedure and get pregnant again afterwards, however it is advisable for maximum benefit to wait until child bearing years are behind you. If you are realistic and have given careful consideration to the advantages of having breast implants to create more volume, projection, perkiness, proportion and figure enhancements, then you are a good candidate. Good candidates have often tried diet and exercise to achieve ideal figure, shape and form and generally use breast augmentation surgery to increase the projection and volume of the breast to better match their shoulders, hip and waist ratios. Contraindications to breast augment surgery may include unrealistic expectations, medical diseases that prevent general anesthesia and various severe and advanced forms of multiple sclerosis and ALS, scleroderma, rheumatoid arthritis or other immune diseases. Fat Grafting If you want modest enhancement and volume of deflated areas of face or upper/lower poles of the breast or areas of the buttock, then you are a great candidate for this procedure. Other fat grafting areas include post-liposuction indentations and defects, as well as some deep cellulite pits. Good candidates for fat grafting realize there are sometimes other augmentation procedures that could be performed, such as breast implant surgery or buttock implant surgery or facial implants, but would prefer to have a more natural, autogenous augmentation performed with their own fat material by taking it from where they don t want the fat and transplanting it to where they need it. Contraindications for fat grafting include any patient or individual who is unrealistic, who may be pregnant at the time of the procedure or any patient with inflammatory, infectious or cancerous lesions to the area to be harvested or grafted.
Who is A Good Candidate? 5 Liposuction Tummy Tuck Rhytidectomy (Face/Neck Lift) You are a good candidate if you have unwanted deposits of fat that detract from your ideal shape and contour and have tried your best at diet and exercise to modify your shape and figure. Good candidates are medically healthy patients without uncontrolled illnesses such as diabetes, heart disease or hypertension. Contraindications to liposuction include anyone who is unrealistic about the shape and figure they can achieve, are medically unwell, excessively overweight, or have excessively loose and damaged skin. If you are an otherwise healthy patient with an excess of fat and skin in the lower abdomen this procedure would be effective for you. The facelift will be successful for you if the skin and soft tissues on your face and neck sag with deep wrinkles, jowls, and a double chin. You are not a good candidate if your skin is not elastic and flexible or if you are significantly overweight. Aging continues and will alter your skin and appearance over time. Hair Transplantation Lip Augmentation If you have a good supply of donor hair which will cover your current and future needs, you would do well with a hair transplant. The key to determining good candidates for hair transplantation surgery is estimating what the patient's hair loss pattern will be. Transplanted hair won t fall out, however your native born hair will continue its loss. Typically it is best to wait to have a hair transplant until at least the age of 25. If you are young and want bigger lips or if you are older and your lips have thinned, the outcome of this procedure will be to your satisfaction. You are not a good candidate if you have recently taken the acne drug Accutane or if you have: herpes, diabetes, an autoimmune disease like lupus or rheumatoid arthritis, serious allergic reactions of any type.
Who is A Good Candidate? 6 Rhinoplasty (Nose Job) Blepharoplasty (Eyelid surgery) Forehead/Brow Lift Cheek Implants Chin Implant If you have a large or crooked nose that is droopy or has a bump you would be a good candidate for Rhinoplasty. You are not a good candidate if you have thick skin, are a child (not fully physically developed). If you have droopy eyelids, bags, or puffiness around your eyes, Blepharoplasty is the right procedure for you. You are not a good candidate if you have dark circles, fine lines, or crow's feet. Note that dark circles as a result of bags under the eye will improve with this procedure. Do you have heavy eyebrows, deep forehead wrinkles or frown lines? That would make you a good candidate. You are not a good candidate if you are balding or scar easily. If you have flat cheek bones or early sagging of the cheeks, you are an ideal candidate for implants. You are not a good candidate if you have excess sagging of the skin, which is better treated with a facelift. You are a good candidate if you have a weak chin or if your chin is not balanced with your nose. You are not a good candidate if you have an abnormal dental bite that requires jaw realignment.
Common Concerns 7 Plastic surgery is more popular (and affordable) than ever before, however there are still a number of concerns that cause people to pause and ultimately not proceed with their cosmetic surgery. Between tabloid magazines, uninformed Bloggers and reality TV, there is plenty of information floating around much of it is inaccurate. It is perfectly normal to have some concerns before a surgical procedure; it is also possible to have a safe and wonderful experience with the exact outcome you were looking for. Choose your surgeon carefully and take the time to plan your surgery, it s the best way to minimize any risks and concerns. Cosmetic Surgery is growing in popularity. Increased accessibility due to improved technology making it safer and more affordable. The table to the right shows the number of procedures performed in the U.S. in 2015 Surgical Procedures # Performed in 2015 Breast Augmentation 309,985 Liposuction 240,565 Eyelid Surgery 141,505 Abdominoplasty 137,605 Breast Lift 106,535 List your thoughts and questions for your meeting with a surgeon Source: https://www.isaps.org/media/default/global-statistics/2016%20isaps%20results.pdf
Common Concerns 8 List your thoughts and questions for your meeting with a surgeon Concern #1: Will there be complications during and after the procedure? Every surgical procedure comes with an element of risk and it s important that you discuss the risks with the doctor. It s also true that experienced doctors know how to drastically minimize the risk and produce the outcomes you are looking for. You can help mitigate risk by ensuring you are in the best possible health before your surgery. Some conditions, such as diabetes and high blood pressure, can increase your risk for bleeding, so it is important you disclose your medical history to your surgeon and ensure you have any health issues well controlled.
Common Concerns 9 Concern #2: Can I afford cosmetic surgery? One of the most stressful concerns is the financial one. If you have the cash flow to cover the surgery in full upfront, that s great. If you don t, there are other options and they don t have to involve taking on a lot of high interest debt. Explore special medical financing programs, which offer either no interest payment plans or low interest plans. SpaMedica shares information on financing available: https://www.spamedica.com/patient-financing-toronto/ Concern #3: How much time will I have to take off? Is recovery difficult? The recovery time varies based on the procedure performed and your general health and ability to heal. Typically patients need 1-2 weeks off work for larger procedures and 3 days for smaller ones. A consultation with a surgeon prior to making a decision can help you better grasp the specifics as related to you. The doctor will provide detailed instructions for you, making the recovery process easier. Some patients choose to reveal their new look after fully healed and others are quicker to share their look, maybe while still healing. As long as you follow the doctor s guidelines, it s really a personal choice.
10 Top 10 Questions to Ask Yourself and Doctor: To ensure you fully understand all options, risks and details, it is important that you ask certain questions of your doctor. Here are some prompts to help you, along with space for you to insert your own questions and comments that you want to share with the doctor. Am I healthy enough to undergo this procedure? Do I understand the procedure and recover time? What am I hoping to gain? Is my goal attainable? What results are realistic? Are there alternatives? Will there be scarring? Are results immediate? What medications will I need to take before/after procedure? What type of anesthesia will be used (eg. Local or General?) How often has the doctor performed the procedure?
How to Avoid Making a Mistake 11 The only mistake you can truly make is not doing your research and getting your questions answered. A few things to remember: Take your time and get the info you need to feel comfortable. Doctor rating sites get a lot of attention and exposure but they should be taken with a grain of salt. Every doctor is going to get an occasional bad rating. Check out SpaMedia and Dr. Mulholland on RealSelf: https://www.realself.com/find/canada/ontario/toronto/plastic-surgeon/r-stephen-mulholland Visit the doctor s website to see before and after pictures. Find a doctor s accolades and achievements, and learn about their education. We often hear that children are a distraction at a consultation and it s easier to focus without them there. Something to consider! Many practices see 20% of patients come in for the repair of other surgeons mistakes. Your cosmetic surgeon may have to do touch ups from time to time, so give them two chances. If they are talking about a third procedure, get another opinion. If that outside opinion is the same, go back to your original surgeon The most important thing that you have to remember is that you have to take responsibility for yourself. Take in all the information for yourself and process it and trust your intuition.
How to Select the Right Doctor 12 REFERRALS: Start by going to your family doctor for a referral. You can also ask your friends who they have used for surgical or non-surgical cosmetic procedures. If you can t get a referral, turn to the internet to research doctors. FINANCIAL: Remember, plastic and cosmetic surgery is elective and you should start by understanding the finances and determine if there is anything that is covered. Ensure that you understand all costs involved for example the surgeon's fee, operating room, anesthesia, and any other charges. EXPERIENCE: An experienced doctor will have an impressive surgical portfolio but will also be sought after to share his insights and opinions, so you will find interviews and videos and conference presentations. Dr. Mulholland for example, has performed numerous procedures and held workshops all over North America. He is highly regarded by his peers. Look for a surgeon that is respected and an expert in their fields. Some plastic surgeons specialize in a highly specific field such as Rhinoplasty or Breast Augmentation. Look for one that comes with years of experience and a portfolio to see which procedures are they well-versed in.
How to Select the Right Doctor 13 CREDIBILITY: Please remember that plastic cosmetic surgery is competitive and it s easy for anyone to make claims they are the best. Look for the information to substantiate that claim. For example, Dr. Mulholland not only founded SpaMedica and has 20 years of proven results and satisfied patients, he has trained over 5000 doctors and he travels the world to speak. He s regularly featured on TV and radio in Toronto and has repeat patients. Dr. Mulholland has creative a clinic that puts safety first, delivers results and has the most talented staff on his team. TRAINING: Ask your plastic surgeon how he trained in the procedure you are considering and how long he/she has been performing the procedure and how many procedures have they performed. You are looking for someone with a strong education that has honed and sharpened their skills through vast experience. Be totally candid about your medical history, your expectations and any concerns you have. If you find you are holding back information, that is a concern and very unsafe. Your doctor needs full disclosure. RESULTS: Ask to see before and after photos, or check the website for some photos. Look at the outcomes and get a feel for the doctor s work. Do they match your expected outcome? Look for consistency in the work on different patients and try looking at people with similar features as yourself it is easier to picture the outcome.
How to Select the Right Doctor 14 COMFORT: Do you feel comfortable being totally candid with your doctor? If you find you are holding back information, not only is that a health risk but it could be indicative of a communication problem with your surgeon. Make sure you select a surgeon you can be fully open with. You need to feel comfortable and like you are being heard. RESOURCES: Ask what materials they have for you so you can understand prep and aftercare. Vectra 3D imaging is a fantastic tool that allows you to see what you will look like, in 3D. Ask your doctor if this tool is available.
Emotional Considerations 15 Emotions will play a role in your decision making process. You will have to deal with nerves which are usually best calmed by getting the facts and using knowledge to calm concerns. It is important to know your personality type for example, if you are a perfectionist it will be very important to let the doctor know and discuss how you will handle any problems or concerns and also discuss your expectations you do not want to set yourself up for disappointment. The doctor will tell you if they can accomplish what you want. If they can t, you need to decide if you can accept an alternative outcome. While the decision should be based on sound information, you also need to factor in your emotions and consider if there are any emotional issues that need to be addressed.
Pre-Surgery Prep 16 To ensure you have the smoothest possible procedure, there are some pre-surgery guidelines for you. Talk to your doctor about the specifics and always follow the instructions provided by the doctor performing your surgery. Here are some common guidelines give by doctors. Quit smoking before the procedure Eat a healthy diet and exercise regularly to keep your body strong prior to surgery Get a checkup to ensure your body is healthy enough for surgery Eliminate caffeine and alcohol prior to the procedure Organize your home life prior to surgery to make it easier for your care givers and yourself during your recovery period
After Care 17 Your doctor will provide you with all of the specific and relevant instructions for your after care. To give you an idea of the process, here are some very common guidelines. Get help - Most doctors want patients to have assistance at home for 24-72 hours after a surgical procedure. Follow Instructions The doctor will provide you with complete post-op information and instructions. Follow these directions closely. Instructions may include pain medication, the use of ice to control swelling and restrictions on physical activity. The doctor will also offer advice on keeping the surgical area clean and promoting healing of the incision. Stock up on supplies and full prescriptions prior to surgery Be Realistic - When you undergo plastic surgery of any kind, you are likely to look and feel worse before you look and feel better. Swelling and bruising is not uncommon. If possible, take a few weeks off work to allow your body time to fully recover. Check incision sites regularly, and call the doctor if you notice signs of infection or other symptoms that might indicate the area of the surgery is not healing properly. Once you return to normal activity, you will find yourself outdoors again. Be careful to protect your skin from the elements. Especially sun. Protect your skin from the damaging UV ray. Use a sunscreen that contains a minimum SPF of 15 and wear a hat whenever possible. Remember, sun exposure can make scars more visible and hinder the healing process. Rehydrate your body often. Surgery can reduce fluids in your body. Drinking water frequently will help replenish these lost body fluids. If you have had surgery to the head or neck, such as a brow lift or neck lift, it is important to keep the area elevated for several days following your surgery to reduce swelling and discomfort. Avoid aspirin or anti-inflammatory medications. These might interfere with medications prescribed by your doctor. Be sure to discuss with your doctor about any over-the-counter and prescription medicines you should avoid during recovery.
18 Satisfaction of Cosmetic Surgery Patients Confidence and Control Plastic surgery has become more accessible and more affordable. The advances in technology have improved results significantly. The technology now allows for less invasive procedures and shorter recovery times. Those that have made the decision to have plastic surgery have educated themselves in advance while discussing their expected results, find plastic surgery a very positive experience. The most common feedback we hear after a cosmetic procedure is that the patient feels a renewed sense of confidence and control. Increased Satisfaction We ve seen the impact spill over into other areas of their lives. When someone feels good about themselves and how they look, they are likely to be more willing to put themselves out there and try new things. They tend to be more in control and have greater satisfaction. It is healthy and rewarding to be proactive and ensure you are satisfied with your appearance.
Satisfaction of Cosmetic Surgery Patients 19 A study by the American Psychological Association showed patients felt better about themselves following plastic surgery. These patients reported a boost in self-image and overall well-being. The same study reported negative responses from those who had high expectations that were not fulfilled by the cosmetic procedure. Patients who were not satisfied with the results of the surgery often followed up with additional work. This is another reason to ensure you find the surgeon. Prof. Dr. Jürgen Margraf, Alexander von Humboldt Professor for Clinical Psychology and Psychotherapy at the RUB, recently studied the psychological impact plastic surgery had on 550 patients. They found that patients that underwent plastic surgery had greater self-esteem, more enjoyment and increased satisfaction with life.
Use this page to jot down notes about your expectations. Consider what you want the outcome to look like, what you are hoping/expecting to pay and what your expectations are for recovery, maintenance and the future. Bring this to discuss with the doctor on your consultation. Share any images that are similar to the look you want to achieve. 20
Resources and Information You Need 21 https://www.spamedica.com https://www.facebook.com/pages/spamedica-canada/195389573827663 https://plus.google.com/+spamedicaplasticsurgerycentreandmedspatoronto https://twitter.com/spamedicacanada https://www.instagram.com/spamedica_toronto/ https://www.pinterest.com/spamedicato/ https://www.youtube.com/user/spamedicacanada https://www.spamedica.com/blog/ https://www.spamedica.com/about/dr-mulholland-media/ https://www.realself.com/find/canada/ontario/toronto/plastic-surgeon/r-stephen-mulholland
22 Conclusion With the improvement of technology, men and women are more willing to have procedures done today than ever before. Cosmetic surgery has become affordable and doctors are now more specialized. You are empowered to make the decision that is best for you. Armed with the knowledge of this guide, a logical next step is a consultation to determine the specifics of your procedure. Call Us Today Surgical: 877-695-2835 Non-Surgical: 877-712-8367
About the Author 23 Dr. Mulholland is one of Canada s leading cosmetic plastic surgeons and an internationally-recognized specialist in cosmetic plastic surgery of the face and body. For 20 years, Dr. Mulholland has continued to have one of the most successful and recognized aesthetic plastic surgery practices in Canada. He is known for his surgical skill, excellent outcomes, aesthetic artistry and innovative cosmetic surgery procedures for the face and body. Dr. Mulholland is a board-certified plastic surgeon and a Fellow of the Royal College of Physicians and Surgeons of Canada. Dr. Mulholland is one of the few plastic surgeons in North America and the only Toronto Plastic Surgeon that has dual-certified specialty training in advanced Otolaryngology, Ear Nose Throat Surgery Head and Neck Cancer, as well as being board certified in plastic surgery, facial plastic Surgery, micro-vascular surgery, auto-tissue transplantation and adult craniofacial Trauma. SpaMedica is the brainchild of Dr. Mulholland and is celebrating 20 years of helping patients reach their aesthetic goals. Dr. M shares his live surgical techniques and results with the interested viewers of CityLine, Breakfast Television, ET Canada, ETalk, Global, City, CBC and CTV news.
If you have any questions regarding cosmetic surgery options, don t hesitate to call us at our SpaMedica Toronto office at 877-695-2835 Visit us online at: https://www.spamedica.com/book-an-appointment/ 24 If you feel empowered and are ready for the new you with greater satisfaction and confidence, we will help you get there. Be the You That You Want to Be Call Us Today Surgical: 877-695-2835 Non-Surgical: 877-712-8367