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Jeffrey M. Kenkel, M.D., FACS
- UT Southwestern Med. Center
1801 Inwood Road
Dallas, TX 75390-9132 - Tel: Click for phone number
- Fax: 214-645-3105
- Send E-mail
- www.drkenkel.com
Answered Questions
Q:
Is it OK to have twilight anesthesia instead of general anesthesia for a facelift and eyelid surgery?
Will twilight anesthesia be OK for a 4+ hour facelift, along with upper and lower eyelid surgery?
A:
Janet, thank you for your excellent question. The type of anesthesia performed is usually determined by both your plastic surgeon and the anesthesiologist they work with. In many cases, the procedure you described could be done under twilight. In our institution our anesthesiologist prefers general anesthesia for most of what we do. The most important thing is that you are cared for by an ABMS board certified plastic surgeon and anesthesiologist in an accredited facility.
Q:
How much facial and body surgery can be done at one time in a healthy 53 year old woman?
I want to have a facelift, upper and lower eyelid surgery, nose reshaping and a browlift. I also want a breast lift with implants, a tummy tuck and liposuction of the waist, buttocks and upper thighs. How much of this surgery can be done at one time? I am a 53 year old female in good physical condition. I am a non smoker with no health problems except chronic back, neck and shoulder pain which is controlled with pain medication.
A:
MC, this is a great question. While you raise many concerns that can be addressed with plastic surgery, the most important question you raise is about patient safety. So how do we determine what is a safe number of procedures to combine in one operation? The short answer is it varies completely on the patient and the types of procedures done. Obviously the stress that a facelift puts on the body is totally different than that of a tummy tuck. We also try to limit how much time you are under anesthesia in one sitting. In my hands, your requests would require a minimum of 2 but likely 3 procedures. It would be very important for you to discuss this with your board certified plastic surgeon, ASAPS member. Every patient is different, so a procedure(s) that is tailored to your needs would be determined. Thanks so much for raising important safety issues.
Q:
My mother wants me to have a breast reduction in my larger breast but I want a breast augmentation of both breasts.
I am 16 years old. I have one breast that is larger than the other. My mother said that she would get me a breast reduction of the bigger breast. I want a breast augmentation of both breasts because of sagging when I get older. What is your opinion?
A:
Everyone has asymmetries especially of the breasts. Our goal is to make your breasts more symmetric and proportionate to your body frame. We can accomplish this with a number of different techniques including reduction, lifts, and augmentation. A proper analysis by a board certified plastic surgeon and ASAPS member will help you and your mother make the right decision for you.
Q:
Is there a way to add extra skin to the waist area after having two tummy tucks?
I have had two tummy tucks after losing a lot of weight some years ago. My first one was in October, 2005 and the second was in November, 2007. Even though two surgeons have told me otherwise, I'm afraid the second procedure was a mistake. I barely have enough skin to pull my jeans up on, among other things. I've been told that a skin graft can be done, but I want some other opinions on the subject.
A:
A skin graft on your abdomen won't look very good and isn't a very stable skin coverage. There are other ways to grow more skin such as tissue expansion among other things. I would recommend you see a board certified plastic surgeon who specializes in abdominoplasty for another perspective.
Q:
Can silicone injected into the hips and buttocks be removed?
My wife has hard lumps on her hips and buttock area from silicone injections she received over seven years ago. Can this silicone be removed by a surgeon now?
A:
Silicone injections anywhere can be problematic to deal with. They often form hard and sometimes tender nodules. Currently, the only way to remove them is to surgically excise the area. In your wife's case, this may be an extensive area and leave her with a deformity. The deformity may be able to be corrected by taking fat from one area of her body and transferring it to this specific site. Usually this would require several procedures to correct.