Breast Reduction Surgery: Is it Cosmetic Surgery, Reconstructive Surgery, or Doesn’t It Matter?

January 3rd, 2018 by doctor

Breast Reduction Surgery: Is it Reconstructive Surgery, Cosmetic Surgery or Doesn’t It Matter? Will my health insurance cover the surgery?

I recently saw a female college student, as a new patient consultation concerning “Breast Reduction Surgery”. This procedure also known as “Reduction Mammaplasty” is indicated for the treatment of symptomatic macromastia (large breasts). The commonly reported symptoms related to macromastia are that of: neck, shoulder and back pain secondary to the weight of the large breasts upon the musculoskeletal system. Other secondary symptoms include: breast pain and dermatitis or rashes beneath the breasts.
This above patient was referred by her gynecologist and arrived with a “prescription” recommending a consultation with a “plastic surgeon”. The patient believed, as many do, that since she was referred by her physician, that the surgery would be covered by her health insurance plan. She was requesting that the surgery be scheduled in four weeks, during her “winter recess” from college.
After completing a patient history and regional breast examination, my staff proceeded to explain to her the procedure necessary to try and obtain insurance authorization for her requested and indicated surgery. She had no other medical treatment or consultations concerning her macromastia. No history of being referred for physical therapy, chiropractic treatment, orthopedic consultation, or dermatology exam. The patients understanding of the “health insurance system” was that, if her referring physician recommended her for treatment, it must be a medically indicated and covered procedure.
Reconstructive Surgery vs. Cosmetic Surgery: It is universally believed by patients, that if a surgery is classified or considered “reconstructive”, it is medically indicated and an insurance covered procedure. This usually means to patients, that all fees related to that procedure will be paid by their health insurance. And if a procedure is considered “cosmetic”, it is not a medically indicated and covered procedure. It is my opinion that for years, breast reduction surgery has been thought of as a “Hybrid”. It is considered “reconstructive” in attempts to obtain insurance coverage for the surgery. It is considered “cosmetic” in that patients expect meticulous aesthetic expertise in the surgery and the post-surgical results. In our practice, it has recently become extremely difficult to obtain insurance coverage for breast reduction surgery. Insurance companies frequently require 2-3 documented reports from other referred specialists. Also the insurance companies commonly requests 6-12 months of documentation and treatment by either a: physical therapist, chiropractor, dermatologist or orthopedist.
Do Your Homework: The intent of this blog is simple and I hope that everyone who reads it understands one point. If you feel that you are a candidate for breast reduction surgery, and requesting coverage under your health insurance, it is important that you contact your health insurance carrier, and have them forward to you in writing, what their criteria are for coverage. Every insurance company has difference, independent criteria and indications, and one should not confuse the fact that “my friend” got it covered by her insurance, and she had “smaller breasts” than me. On the average, it takes between 3-6 months of preparation, seeking secondary consultations with other healthcare providers and possible therapy (physical therapy or chiropractics). Notify your primary care physician as soon as possible concerning any symptoms which may be related to your macromastia. It is never too early to start the process, and remember that what the insurance company’s criteria are this year might not be the same next year. Please contact our office concerning any questions you might have that relate to breast reduction surgery and coverage through your health insurance.

Facial Cosmetic Chin Surgery and Chin Augmentation

January 2nd, 2018 by doctor

“Doctor, I have no chin.” I can’t tell you how many times I hear that from a patient. It is a regular concern of many of my cosmetic facial surgery patients. In a majority of these cases, the patients report that they had prior orthodontics at one time in their life. And, in most of these cases, the patients usually states that they had a deep overbite.

Cosmetic chin surgery (genioplasty) can be performed on patients who have: a recessed or small chin, a large or protruding chin, or an asymmetric or crooked chin. During the consultation, the surgeon will examine not only the patient’s profile, which is usually the most concerning to the patient, they will examine the patient’s “dental bite” or occlusion. I will be reviewing “small or recessed” chin in this blog, and other chin deformities in future posts.

Pre-operative evaluation
The surgeon may recommend that the patient have a special radiograph to evaluate the boney architecture of the jaws, and its relationship to the skull bones (cephalogram). In a majority of the cases, the patient’s lower jaw is anatomically positioned further back than normal, in comparison to the upper jaw.

Treatment options
Alloplastic genioplasty
If the patient is only cosmetically concerned about their small chin, and not the position of their teeth or jaws, then there are two common options for this patient. The patient can have the placement of a chin implant. The implant is fabricated from a form of synthetic material. The implants come in many sizes and shapes. The surgeon will perform measurements of the patient’s facial aesthetics to determine what size implant will give the patient the cosmetic profile desired. The implants are surgically placed through an incision either through the mouth or under the chin. The surgery is commonly performed as an outpatient procedure with the assistance of local anesthesia and/or intravenous sedation.

Horizontal Sliding Genioplasty
This is another form of surgical procedure, in which the “boney” chin is surgically cut with a precision saw from inside the mouth. This boney chin segment is horizontally “slid” forward, giving the patient an enhanced chin profile. The boney segment is then secured and fixated in this new position, with a combination of specific plates and screws. In this procedure in comparison to the above, the patient’s own bone is used to perform the augmentation vs. a synthetic implant. However, the extent of the surgery and post-operative course is greater.

Additional cosmetic facial surgery
I commonly recommend and perform a genioplasty (chin implant) on patients in combination with a facelift or neck lift. Chin implants are also commonly recommended in cases of rhinoplasty when the patient presents with a recessed chin. This presentation actually makes the nose appear larger and out of proportion to the rest of the face.

Post-operative course
The patient may be placed into a compression dressing on the chin for 3-5 days after surgery. There will be moderate swelling and bruising of the chin and neck region for 7-10 days after the surgery. In the case of the sliding genioplasty, there is a chance of numbness to the lip, usually temporary, after the surgery. This is due to the extent of the swelling, and stretching of the soft tissues forward. In both types of genioplasty, the final cosmetic results are not apparent for approximately 2-3 months after the surgery, to allow for all of the swelling and bruising to resolve.

Do Your Homework

Information for our Patients on BIA and ALCL

March 27th, 2017 by doctor

Information on BIA-ALCL

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a very rare and treatable type of lymphoma that can develop around breast implants. According to the most recent data available, the risk of association between breast implants and ALCL is extremely low. A March 2015 study published in the journal Plastic and Reconstructive Surgery identified 173 individual patients presenting, via a world literature review, with BIA-ALCL since the initial case report in 1997.

Most of the patients who have developed BIA-ALCL receive an excellent prognosis following surgical removal of the breast implants and the surrounding scar tissue capsule. Continued follow-up after any breast implant surgery is suggested and important for patient health, but patients who notice pain, lumps, swelling, fluid collections or unexpected changes in breast shape, including asymmetry, should contact their plastic surgeon. In most cases, women observed changes in the look or feel of the area surrounding the implant after their initial surgical sites were fully healed.

Patients undergoing plastic surgery procedures, aesthetic or reconstructive, should be thoroughly informed of the potential risks and possible complications known to be associated with the procedure, and any device used in that procedure. In the very rare cases where a diagnosis of BIA-ALCL is made, surgical treatment is essential for the management of the disease.
ASPS/ASAPS joint advisory: FDA updates website on BIA-ALCL

The American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS) would like to make members aware of a recent safety communication update to the Food and Drug Administration (FDA) website regarding breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).

The March 21 website update acknowledges that while it remains difficult to determine the exact number of BIA-ALCL cases, there have now been 359 medical device reports (MDR) reported to the FDA Manufacturer and User Facility Device Experience (MAUDE) database as of Feb. 1, 2017. Of these MDRs, the FDA reports that 232 included information on the breast implant device, with 203 identified as textured, 28 smooth and one identified as “another surface.” The update also confirms that both silicone gel and saline implants have been reported in cases of BIA-ALCL.

It’s important to note that the MAUDE database may contain limited and potentially inaccurate adverse event reports, and does not represent the true number of U.S. cases, as some entries are duplicates and not all cases are confirmed as ALCL. To date, there has been no confirmed smooth surface-only case of BIA-ALCL reported. As of March 21, 2017, 126 unique confirmed U.S. cases of BIA-ALCL have been reported to the Patient Registry and Outcomes for Breast Implants and Anaplastic Large Cell Lymphoma Etiology and Epidemiology (PROFILE) database, a joint collaboration between ASPS, PSF, and the FDA.

The FDA’s website update confirms previous ASPS/ASAPS communications, noting that BIA-ALCL remains a rare condition that occurs most frequently in patients who have breast implants with textured surfaces. The report also reiterates that patients should discuss with their health-care provider the benefits and risks of textured-surface versus smooth-surface implants. The FDA highlights the World Health Organization recognition of BIA-ALCL, and standardized diagnosis and treatment guidelines established by the National Comprehensive Cancer Network (NCCN).

The FDA recommends that all cases of BIA-ALCL be reported to the FDA and to the PROFILE registry.

For more information on BIA-ALCL, visit plasticsurgery.org/alcl or the FDA website.

ASPS and ASAPS are committed to patient safety, advancing quality of care, and practicing medicine based upon the best available scientific evidence. We will continue to monitor and review all new information as it becomes available to keep the plastic surgery community informed.

Male Cosmetic Surgery- Body Contouring

March 27th, 2017 by doctor

Men and Plastic Surgery
Male-Specific Considerations

Information for men contemplating plastic surgery for cosmetic reasons.
Find a Plastic Surgeon
Patient Safety
Liposuction and body contouring

The ideal male body shape is considered to be trim and athletic-looking, with broad shoulders and chest, a flat abdomen, and a narrow hip-thigh area. However, as men age, areas of fat tend to accumulate around the abdomen, the flanks (“love handles”), the breast area (a condition called gynecomastia), and along the chin and neck. Men sometimes seek liposuction to remove these fatty areas that are resistant to diet and exercise.

In many cases, liposuction alone can effectively correct these problem areas. Men retain their skin elasticity longer than women do, and the areas of fat beneath the skin tend to be firmer and more vascular than those in women. Because of these and other factors, liposuction in men is usually very effective.

Men who have some loose, hanging skin, as well as areas of excess fat, may opt for a traditional excision procedure (surgical skin removal) in addition to liposuction. An excision may also be performed on gynecomastia patients whose breast enlargement results in excess skin.

Abdomen reduction: A full abdominoplasty (or “tummy tuck”) may be chosen by men who have hanging abdominal skin (usually the result of massive weight loss), loose abdominal muscles, and/or neglected hernias. It is a major surgical procedure that removes excess fat, tightens the muscles of the abdominal wall, and trims the waistline. Men who have a full abdominoplasty are often surprised at the long recovery period. Some patients aren’t able to return to work up to 4 weeks after surgery.

Men with good skin elasticity who have only a moderate amount of excess abdominal fat may benefit from liposuction alone. Muscle-enhancing surgery: In recent years, plastic surgeons have developed ways of improving muscle contour with cosmetic implants and “sculpting” techniques.

2016 Plastic Surgery Statistics

March 2nd, 2017 by doctor

New Statistics Reflect the Changing Face of Plastic Surgery
American Society of Plastic Surgeons Releases Report Showing Shift in Procedures

ARLINGTON HEIGHTS, IL – New data released by the American Society of Plastic Surgeons (ASPS) show continued growth in cosmetic procedures over the last year, and a shift in the types of procedures patients have chosen since the start of the new millennium. According to the annual plastic surgery procedural statistics, there were 15.9 million surgical and minimally-invasive cosmetic procedures performed in the United States in 2015, a 2 percent increase over 2014.

Since 2000, overall procedures have risen 115 percent, but the types of procedures patients are choosing are changing.

“While more traditional facial procedures and breast augmentations are still among the most popular, we’re seeing much more diversity in the areas of the body patients are choosing to address,” said ASPS President David H. Song, MD, MBA, FACS. “Patients have more options than ever, and working closely with their surgeon, they’re able to focus on specific target areas of the body to achieve the look they desire.”
Lifts Lead the List

It used to be that the term plastic surgery was nearly synonymous with facelifts, and while they remain a popular option among patients, other types of lifts are surging.

Since 2000, ASPS statistics show considerable growth in:

Breast lifts, up 89 percent (99,614 in 2015, up from 52,836 in 2000)
Buttock lifts, up 252 percent (4,767 in 2015, up from 1,356 in 2000)
Lower body lifts, up 3,973 percent (8,431 in 2015, up from 207 in 2000)
Upper arm lifts, up 4,959 percent (17,099 in 2015, up from 338 in 2000)

Top 5 Cosmetic Surgical and Minimally-Invasive Procedures

While procedures like upper arm lifts and lower body lifts have shown substantial growth, for the first time since at least 2000, facelifts slipped out of the top 5 most-performed procedures last year, giving way to tummy tucks.

Of the 1.7 million cosmetic surgical procedures performed in 2015, the top 5 were:

Breast augmentation (279,143 procedures, down 2 percent from 2014, up 31 percent from 2000)
Liposuction (222,051 procedures, up 5% from 2014 but down 37 percent from 2000)
Nose reshaping (217,979 procedures, unchanged from 2014, down 44 percent since 2000)
Eyelid surgery (203,934 procedures, down 1 percent from 2014, down 38 percent since 2000)
Tummy tuck (127,967 procedures, up 9 percent from 2014 and 104 percent since 2000)

Among the 14.2 million cosmetic minimally-invasive procedures performed in 2015, the top 5 were:

Botulinum Toxin Type A (6.7 million procedures, up 1 percent from 2014 and 759 percent since 2000)
Soft Tissue Fillers (2.4 million procedures, up 6 percent from 2014 and 274 percent since 2000)
Chemical Peel (1.3 million procedures, up 5 percent from 2014 and 14 percent since 2000)
Laser hair removal (1.1 million procedures, unchanged from 2014, but up 52 percent since 2000)
Microdermabrasion (800,340 procedures, down 9 percent from 2014 and 8 percent since 2000)

“The number of available providers, lower costs and the less-invasive nature of these procedures obviously appeal to a much broader range of patients,” said Dr. Song. “However, we urge anyone who is considering a minimally-invasive procedure to consult with a board-certified, ASPS-member surgeon.”

Many of these minimally-invasive procedures are performed by a variety of providers, and not all of them have the expertise or rigorous training of ASPS-member surgeons. “It may not be surgery, but there is still a lot at stake,” said Dr. Song. “Before you undergo any procedure, do your homework and make sure you’re putting yourself in the hands of only the most most qualified and highly-trained expert available.”
Bottoms Up!

New ASPS stats showed that 2015 was another year of the rear, as procedures focusing on the derriere dominated surgical growth. Buttock implants were the fastest growing type of cosmetic surgery in 2015, and, overall, there was a buttock procedure every 30 minutes of every day, on average.

Here are the top procedures related to the bottom in 2015:

Buttock augmentation with fat grafting (14,705 procedures, up 28 percent from 2014 to 2015)
Buttock lift (4,767 procedures up 36 percent from 2014 to 2015)
Buttock implants (2,540 procedures up 36 percent from 2014 to 2015)

For the First Time, Men Account for More than 40 Percent of Aesthetic Breast Reduction Surgeries

There were 68,106 aesthetic breast reduction surgeries in the United States in 2015, and for the first time men accounted for more than 40 percent of those procedures.

A total of 27,456 breast reduction surgeries (Gynecomastia) were performed on men, representing a 5 percent increase over the previous year and a 35 percent growth since 2000.

“As plastic surgery is becoming more common and accepted in men, we’re seeing more of them undergo procedures to tighten and tone problem areas, like the breasts,” said Dr.Song. “This procedure is often done in younger men who face genetic challenges with the size and shape of their breasts, and when appropriate, surgery can make a big difference in their lives.”
More Breast Cancer Patients Aware of Reconstruction Options

In 2012, ASPS launched a national Breast Reconstruction Awareness Campaign to educate, engage and empower women to make informed decisions about their healthcare following breast cancer diagnosis and mastectomy. We’re happy to report that in 2015, the number of reconstruction procedures increased another 4 percent to more than 106,300, and since 2000, the numbers are up a remarkable 35 percent.

“That’s encouraging, and we hope to continue to get the word out to all women who are facing breast cancer, so they will be well aware of all their reconstructive options from the outset of diagnosis,” said Dr. Song.

Breast reconstruction may be performed using several plastic surgery techniques, depending on which is most clinically appropriate for the patient, and is important to restore the breast to near normal shape, appearance and size following a lumpectomy or mastectomy.
About the ASPS Annual Procedural Statistics

ASPS members may report procedural information through the first online national database for plastic surgery procedures, Tracking Operations and Outcome for Plastic Surgeons (TOPS). This data, combined with an annual survey sent to American Board of Medical Specialties’ certified physicians most likely to perform these procedures, results in the most comprehensive census on plastic surgery.

2015 Plastic Surgery Statistics- Show Increase in Plastic Surgery Procedures

March 7th, 2016 by doctor

American Society of Plastic Surgeons Releases Report Showing Shift in Procedures

ARLINGTON HEIGHTS, IL – New data released by the American Society of Plastic Surgeons (ASPS) show continued growth in cosmetic procedures over the last year, and a shift in the types of procedures patients have chosen since the start of the new millennium. According to the annual plastic surgery procedural statistics, there were 15.9 million surgical and minimally-invasive cosmetic procedures performed in the United States in 2015, a 2 percent increase over 2014.

Since 2000, overall procedures have risen 115 percent, but the types of procedures patients are choosing are changing.

“While more traditional facial procedures and breast augmentations are still among the most popular, we’re seeing much more diversity in the areas of the body patients are choosing to address, “Patients have more options than ever, and working closely with their surgeon, they’re able to focus on specific target areas of the body to achieve the look they desire.”

Lifts Lead the List

It used to be that the term plastic surgery was nearly synonymous with facelifts, and while they remain a popular option among patients, other types of lifts are surging.

Since 2000, ASPS statistics show considerable growth in:

Breast lifts, up 89 percent (99,614 in 2015, up from 52,836 in 2000)
Buttock lifts, up 252 percent (4,767 in 2015, up from 1,356 in 2000)
Lower body lifts, up 3,973 percent (8,431 in 2015, up from 207 in 2000)
Upper arm lifts, up 4,959 percent (17,099 in 2015, up from 338 in 2000)

Top 5 Cosmetic Surgical and Minimally-Invasive Procedures

While procedures like upper arm lifts and lower body lifts have shown substantial growth, for the first time since at least 2000, facelifts slipped out of the top 5 most-performed procedures last year, giving way to tummy tucks.

Of the 1.7 million cosmetic surgical procedures performed in 2015, the top 5 were:

Breast augmentation (279,143 procedures, down 2 percent from 2014, up 31 percent from 2000)
Liposuction (222,051 procedures, up 5% from 2014 but down 37 percent from 2000)
Nose reshaping (217,979 procedures, unchanged from 2014, down 44 percent since 2000)
Eyelid surgery (203,934 procedures, down 1 percent from 2014, down 38 percent since 2000)
Tummy tuck (127,967 procedures, up 9 percent from 2014 and 104 percent since 2000)

Among the 14.2 million cosmetic minimally-invasive procedures performed in 2015, the top 5 were:

Botulinum Toxin Type A (6.7 million procedures, up 1 percent from 2014 and 759 percent since 2000)
Soft Tissue Fillers (2.4 million procedures, up 6 percent from 2014 and 274 percent since 2000)
Chemical Peel (1.3 million procedures, up 5 percent from 2014 and 14 percent since 2000)
Laser hair removal (1.1 million procedures, unchanged from 2014, but up 52 percent since 2000)
Microdermabrasion (800,340 procedures, down 9 percent from 2014 and 8 percent since 2000)

“The number of available providers, lower costs and the less-invasive nature of these procedures obviously appeal to a much broader range of patients,. “However, we urge anyone who is considering a minimally-invasive procedure to consult with a board-certified, ASPS-member surgeon.”

Many of these minimally-invasive procedures are performed by a variety of providers, and not all of them have the expertise or rigorous training of ASPS-member surgeons. “It may not be surgery, but there is still a lot at stake,” said Dr. Song. “Before you undergo any procedure, do your homework and make sure you’re putting yourself in the hands of only the most most qualified and highly-trained expert available.”

Bottoms Up!

New ASPS stats showed that 2015 was another year of the rear, as procedures focusing on the derriere dominated surgical growth. Buttock implants were the fastest growing type of cosmetic surgery in 2015, and, overall, there was a buttock procedure every 30 minutes of every day, on average.

Here are the top procedures related to the bottom in 2015:

Buttock augmentation with fat grafting (14,705 procedures, up 28 percent from 2014 to 2015)
Buttock lift (4,767 procedures up 36 percent from 2014 to 2015)
Buttock implants (2,540 procedures up 36 percent from 2014 to 2015)

For the First Time, Men Account for More than 40 Percent of Breast Reduction Surgeries

There were 68,106 breast reduction surgeries in the United States in 2015, and for the first time men accounted for more than 40 percent of those procedures.

A total of 27,456 breast reduction surgeries (Gynecomastia) were performed on men, representing a 5 percent increase over the previous year and a 35 percent growth since 2000.

“As plastic surgery is becoming more common and accepted in men, we’re seeing more of them undergo procedures to tighten and tone problem areas, like the breasts,” said Dr.Song. “This procedure is often done in younger men who face genetic challenges with the size and shape of their breasts, and when appropriate, surgery can make a big difference in their lives.”

More Breast Cancer Patients Aware of Reconstruction Options

In 2012, ASPS launched a national Breast Reconstruction Awareness Campaign to educate, engage and empower women to make informed decisions about their healthcare following breast cancer diagnosis and mastectomy. We’re happy to report that in 2015, the number of reconstruction procedures increased another 4 percent to more than 106,300, and since 2000, the numbers are up a remarkable 35 percent.

Breast reconstruction may be performed using several plastic surgery techniques, depending on which is most clinically appropriate for the patient, and is important to restore the breast to near normal shape, appearance and size following a lumpectomy or mastectomy.

About the ASPS Annual Procedural Statistics

ASPS members may report procedural information through the first online national database for plastic surgery procedures, Tracking Operations and Outcome for Plastic Surgeons (TOPS). This data, combined with an annual survey sent to American Board of Medical Specialties’ certified physicians most likely to perform these procedures, results in the most comprehensive census on plastic surgery.

The Mommy Makeover

September 30th, 2015 by editor

The concept of the total body makeover has become popular over the last several years with the onset of many reality shows.  The basic premise is that a patient can have multiple cosmetic surgical procedures performed at the same time all while undergoing one recovery period.  The issues which are not popularized or reviewed on television are the greater chances of post-operative complications and that recovery is not always as easy as shown.

For instance with the development of bariatric and massive weight loss surgery, patients may require multiple surgical procedures after their weight loss in order to re-contour both their upper and lower body regions.  These patients often require surgery of the abdomen, breasts, thighs, arms, and face.  It would be nice to think that one could have surgery on all of these body regions in one operative setting.  However, these surgeries can take up to eight hours to perform which is not always in patient’s best interest.  The surgeon needs to take into account any medical conditions the patient may have, along with a history of smoking or oral contraceptive use.

So how many surgical procedures can be performed safely at the same time?  It depends on many factors.  Dr. Chidyllo divides up the body regions and asks the patient what bothers them the most.  If it is the abdomen and lower body, he will recommend an extended abdominoplasty (full tummy-tuck) along with liposuction of the back and flanks.  This can be combined with liposuction of the extremities and buttock recontouring or augmentation if required.

If the concern is the upper body, Dr. Chidyllo recommends that breast surgery (reduction, lift or augmentation) be combined with arm skin reduction (brachioplasty) along with an anterior abdominoplasty (tummy-tuck) and possible liposuction of the anterior abdomen and pubic lift if required.

Facial surgery is usually performed by itself with Dr. Chidyllo’s patients.  A face and neck lift along with a forehead lift and upper and lower eyelid surgery can be combined safely with most patients.

So what does all this cost?  Some surgeons will give a significant reduction if all the procedures are performed together.  Our office usually offers a staged financial agreement; the first procedure at the normal rate and each additional procedure at a reduced rate.  In this way the patient can have a reduction in the price of any future surgeries.

Some questions to ask your plastic surgeon before you proceed with multiple cosmetic surgeries:

  • Is my surgeon certified by the American Board of Plastic Surgery?
  • Is my surgeon a member of the American Society of  Plastic Surgeons?
  • Am I medically appropriate for such surgery?
  • Have I been educated about the process and length of recovery?
  • What type of facility will the surgery be performed in?
  • During surgery, am I monitored by a board certified anesthesiologist?
  • What are the costs incurred?

Due to advances in anesthetic techniques, multiple cosmetic surgical procedures can be performed safely.  Once these questions are answered appropriately and other factors are taken into consideration, then surgery can go forward.  All of the surgeries we schedule at Central Jersey Plastic Surgery are performed at one of the regional medical centers such as Jersey Shore University Medical Center, Riverview Medical Center or Southern Ocean Medical Center.  Dr. Chidyllo also performs surgery at NJ State Licensed and certified surgical facilities such as the Shrewsbury Surgery Center.  All of our patients are administered anesthesia under the direction of a board certified anesthesiologist.

Why Do Good People…Make Bad Choices?

June 2nd, 2015 by doctor

Why Do Smart People Make Poor Decisions?

PART I

People often ask me, “Doctor, how can I make better decisions and choices in life”?

I feel like my life is in a descending spiral which I cannot stop”.  Often one thinks that because they seem to be highly educated, with lots of degrees or diplomas on the wall, or financially stable with lots of material wealth, that is synonymous with “good decision” making skills.   One often thinks that decisions in life go hand and hand with the above. People who are close to me hear me regularly repeat my mantra of life, “got to have a plan”.  Not just one plan, but plan A, plan B, and plan C.  Plan A, is always the plan that will give you the results which you think you really want and desire. Plan B, is a good and sometimes more realistic plan, that takes a different route or results than Plan A does.  Plan C is “Damage Control and Survival Mode”, to prevent you from going backwards or  losing ground. Plan C is there until you can reassess your choices and develop a revised Plan A or B.

Insanity: “repeating the same thing over and over, but expecting a different result”.

As a good friend told me you never learn anything by listening to yourself.  ”Give every man thy ear but few thy voice ” (Polinous, Hamlet, Act 1, Scene 3)  Also, I was told that if “Plan A doesn’t work, you NEVER repeat plan A” ( unless of course the situations change, or you revise Plan A, and then it is really Plan B). If nothing else, these are the two most important parts of this Blog: listen to everyone and everything and stop repeating the same wrong ways. You can stop reading or continue if you want more.

PART II

So why do good smart people make bad choices and decisions? This may not be the same for everyone and we need to take several factors out of the equation from the start, such as substance abuse and mental illness. In my opinion, it is due to a combination of several and often complex factors. My thoughts are that some of these factors include: 1-Family values and experiences.  Such factors include events during your childhood and life, religious and moral beliefs, and family and parental structure and happiness. 2- Money- Many people will base their decision making on a financial goal, thinking that the correct choice is the one that will make them financially secure, even though they may be poorer emotionally (Scrooge phenomenon).  3-Ego-  I feel that this can be the most powerful and or dangerous force. The fact that you always know what is right and that everyone else is wrong.

So let us now step back and look over our decisions and decision making process in life. Were any of your bad decisions made based on one of the factors outlined above? I’m not saying that this is good or bad.  What I’m implying is that, maybe one consistently  makes the same bad or incorrect life choices because of one of the above influencing forces. When we make a good or correct decision, we often forget about it and move on never giving it a second thought. When we make a bad or poor choice in life, it often haunts us forever, influencing future of additional incorrect choices. So let’s look at this more closely. But not at the bad, rather at the good choices in life. LG (life is good)

Think about a good decision you made in life: school, education, profession, marriage, children, etc. I am not implying that all of these were good choices in your case, rather try to find one that stands out. Now look and search for the people, place, situation or things that assisted you and made that choice correct in your life. Hopefully, you have found at least one. You need to go back to that place in your mind. You need to find that situation that allowed you to make that correct, good and emotionally rewarding decision. Now base future decisions in a similar fashion. Go back to people you trust to help you. We all need help! (no man is an island).  You have to break the chain of bad choices and events by going back to a good place in your life and mind and ask yourself, who helped me get here, what were the situations surrounding my success and how can I change things NOW in my life to make similar good choices. You already have everything you need to move ahead listed above in Part I and Part II. If you want more, read on:

PART III

Let’s move to the opposite side.  Let’s look at our bad decisions and life choices, and why we repeat then. We all make bad decisions. Its part of the learning process of life, right? But why do we repeat them?  Did you have a plan A and B?  Or did your ego say, I know it’s going to work, I know I’m right, everybody and everything is wrong.  So, why do we continue to make bad choices? You should know by now!  It is not simple but a combination of all of the above factors, and more!

First: You didn’t have a well thought out Plan A, you let your emotions or one of the above factors influence you, incorrectly!  Ego, Money, etc

Second: Did you have a Plan B to revert to. And sometimes you need to cut your losses and move fast like in the stock market. When a stock drops 10%, dump it, move on, you can always buy it back. In life, plan B should be set as a “default”. It should automatically kick in. Yes, you can cry, kick yourself, or whatever you want, but let Plan B takes it course. And never repeat Plan A.

Third: And this is bad when you keep on repeating Plan A.  It is because there is a feeling of comfort in Failure!  What is he saying?  I want to fail; it is comfortable for me to fail?  This makes no sense, unfortunately it makes a lot of “bad sense”. If you know that Plan A is the wrong decision and you are going to fail, and you do, then you have been successful in your endeavor! Cause you planned and completed your own failure! You may not agree with this theory, however, if you do, one of the only ways to get off of this carousel is to step off while it is moving! Fall flat on your face! And pick yourself up! And thank God you are still alive to move on.

PART IV

Come on let’s end this already! You are telling me nothing! OK, here goes, bad decisions are contagious. But so are good choices. So you need to break the streak before you break your neck. Why does research state that you should never go food shopping on an empty stomach because you are hypoglycemic and hungry.  You therefore buy more, and the incorrect food products (make bad choices). The hormonal response of hunger affects your decision making! That’s It!  Why didn’t you just say that 1218 words ago! Because you wouldn’t understand the meaning of “HUNGER” as it relates to daily decisions and choices in life. We are all hungry for: Love, Friendship, Security, Good Health, Well Being and the Meaning and Purpose of life.  We hunger for the hope that we are here to make a difference, small or larger! Yes and that is it, simply stated, so don’t go shopping hungry, and don’t make decisions in life hungry.  Fill your life with the people and things that matter, and you will never be hungry. If you are not hungry, your decision process will be clear, focused and direct. “I am the bread of life, those that believe in me will never be hungry” (John 6:35).

April 2nd, 2015 by doctor

The American Society for Aesthetic Plastic Surgery Reports Americans Spent More Than 12 Billion in 2014; Procedures for Men Up 43% Over Five Year Period

NEW YORK, NY (March 11, 2015) – The American Society for Aesthetic Plastic Surgery (ASAPS) released its complete 18th annual multi-specialty statistical data today showing an aesthetic plastic surgery spend consistent with the figures for 2013, with Americans spending more than 12 billion dollars on surgical and nonsurgical procedures for the second year in a row. With more than 10 million cosmetic procedures performed in 2014, those that showed the largest growth in volume on a year-over-year basis included buttock augmentation (up 86%), labiaplasty (up 49%), and nonsurgical fat reduction (up 42%). Additionally, more men are turning to aesthetic cosmetic procedures, with dramatic increases seen in both surgical and nonsurgical options over the past 5 years and a 43% increase overall.

The top five surgical procedures for both men and women combined in 2014 were:

Liposuction (342,494 procedures)
Breast Augmentation (286,694 procedures)
Eyelid Surgery (165,714 procedures)
Tummy Tuck (164,021 procedures)
Nose Surgery (145,909 procedures)

The top five nonsurgical procedures for both men and women combined in 2014 were:

• Botulinum Toxin (3,588,218 procedures)
Hyaluronic Acid (1,696,621 procedures)
• Hair Removal (828,480 procedures)
Chemical Peel (484,053 procedures)
Microdermabrasion (417,034 procedures)

Some of the more popular procedures, including a few in the top five lists above, did see decreases in 2014 including breast augmentation (down 8.5%), ear surgery (down 12.3%), injectables, (down 6.5%) and Photorejuvenation, (down 18.9%). “Despite the decreases in specific procedural areas however, one thing is abundantly clear: The number of men flocking to plastic surgeons for both surgical and nonsurgical procedures continues to increase dramatically and are up 43% this year alone,” states Michael Edwards, MD, President of the American Society for Aesthetic Plastic Surgery.

Over the past 5 years, (since 2010), there have been significant increases in the following procedures for men:

Surgical:
Blepharoplasty (up 34%)
Male Breast Reduction (up 33%)
Facelift (up 44%)

Nonsurgical:
Botulinum Toxin (up 84%)
Hyaluronic Acid (up 94%)
Nonsurgical skin tightening (up 37%)
Intense Pulsed Light (up 44%)

Motivation, Execution and Support-”The Team Approach”

March 25th, 2015 by copywriter

Plastic surgery is not all “Nip and Tuck”; Cosmetic surgery is not a quick fix.  In order to have lasting cosmetic enhancement, one needs a combination of both external as well as internal (mental) support.  The theme of this blog is to focus on an area which is rarely discussed, “internal (emotional) support and enhancement”.

If you have been reading and following our prior month’s posts, you will recognize that we believe in a “wholelistic” approach to cosmetic surgery, external beauty and enhancement.  Cosmetic surgery cannot make a person happy who is not satisfied with themselves in life.

Motivation: One needs to be motivated or have the desire for change whether it is a small improvement concerning facial wrinkles or a larger cosmetic surgical procedure.  One must have a reason in order to move forward and seek a consultation, review your choices and make an educated decision.

Execution: My staff and I will prepare you for your procedure, the best we can. Cosmetic surgery is not a day at the “spa”.  You are not getting a haircut or a facial.  There are many issues which will be discussed with you, such as: anesthesia, scars, infection, bleeding, as well as the need for revisions if necessary. With all surgical procedures, whether cosmetic or reconstructive, one needs to recognize the possibility that the results are not exactly what you expected, and further procedures may be recommended or required.  Preparation of a patient for surgery is just as important as the procedure itself.

Support: There are few other cosmetic medical practices in which you will receive the level of support before, during, and after your procedure.  First: During your consultation you will be examined, and your past medical history reviewed extensively.  We will review any and all issues as they relate to your requested cosmetic concerns. Second: Prior to your surgery you will receive copies of all of your signed consents.  We encourage you to re-read them and contact our office immediately with any new questions or concerns. You will receive written Pre and Post operative instructions concerning what to expect, along with how to contact our office if an emergency situation should arise. Third: You will receive constant telephone support and follow up, either personally by Dr. Chidyllo or his staff during the post-operative period.  We will “hold your hand”, either literally if needed or figuratively, to help you recover from you surgery or procedure.  There is no other office that will provide the needed personal contact and support that is provided by our office and staff.

Selecting a cosmetic medical practice is not as simple as doing a “Google search”. Search for a “team approach” that will answer all of your questions at the time of your initial telephone conversation. Search for a “team approach” that gives you the necessary time required, at the time of your consultation.  Search for a “team approach” that will care for you before, during and after your surgery or cosmetic procedure. That “Team Approach” is provided by Dr. Stephen A. Chidyllo and his staff at Central Jersey Plastic Surgery.