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Michael A. Bogdan, M.D., FACS
- Suite 170
410 N. Carroll Avenue
Southlake, TX 76092 - Tel: Click for phone number
- Fax: 817-442-1247
- Send E-mail
- www.drmichaelbogdan.com
Answered Questions
Q:
Is it safe to have a full tummy tuck and breast augmentation at the same time?
Is it safe to have a full tummy tuck and breast augmentation at the same time?
A:
As long as you are healthy and have a BMI in the normal range, yes, a breast augmentation and abdominoplasty can be performed safely. Depending on your size, the procedure will take 3 to 4 hours of surgical time, and can be performed on an outpatient basis. If you are planning an abdominoplasty, you can consider having simultaneous breast surgery (augmentation, lift, reduction), so long as your surgeon can perform the procedure in a reasonable amount of time. (Personally, I limit my cases to less than 6 hours as I feel this is a safe time-length for elective procedures.) Generally, the tummy tuck component has more discomfort, so patients don't notice additional discomfort by adding on breast surgery.
Q:
Is fixing a deviated septum more complicated after a primary rhinoplasty?
Is it more difficult to correct a deviated septum after one has already had a rhinoplasty for aesthetic purposes to correct a nasal bump?
A:
If you had a closed rhinoplasty with dorsal hump reduction and possibly infractures, it is really no more difficult to perform a delayed septoplasty than if you never had any previous surgery. (Although I'm surprised your surgeon didn't address this issue at the time of the rhinoplasty.) If you had an open approach with a columellar strut, the septoplasty is just slightly more difficult to perform due to some existing scaring. On the other hand, if you had previously had an aggressive septoplasty and later want to perform a reduction rhinoplasty, this scenario might be significantly complicated and could require utilization of a remote cartilage donor site.
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:
Anesthetic “depth” is on a spectrum, and practitioners will mean different things while using the same terms. In general, twilight anesthesia means that the patient is just on the verge of being asleep and can still respond and protect their own airway - they are just at the precipice of slipping into general anesthesia. Once you enter the realm of general anesthesia, the patient cannot protect their own airway, so some type of breathing tube is used to keep it open (such as a Laryngeal Mask Airway or an Endotrachial Tube). General anesthesia is quite safe, as your airway is fully protected. Twilight is a bit of a balancing act, but can be done quite well by vigilant anesthesiologists. My concern with twilight anesthesia is that it does not necessarily require an MD anesthesiologist to be present - it could be managed by the operating surgeon and monitored by an RN. Some surgeons will go this route as a cost savings measure (MDs are more expensive than RNs), but I do not think this is a good place to cut corners. If your surgeon uses an anesthesiologist and they prefer twilight, then it should be fine. I would not recommend twilight if it is going to be managed by the operating surgeon. (Think about it - are you better at concentrating on one task, or trying to do two things at the same time?)
Q:
Computer Imaging
Is it bad if a surgeon doesn't have computer imaging to preview your nose before surgery?
A:
I think that computer imaging is extremely useful in discussing potential goals during rhinoplasty consultation. When imaging is used, both the surgeon and the patient can feel more comfortable that there is no misunderstanding regarding the cosmetic goals of the procedure. (A picture is worth 1,000 words.) If I display a morphed image that I think is both possible and what the patient desires, and then the patient absolutely hates the image, we both really have to reconsider moving forward! If they love the picture, I’m happy to be their surgeon.
Best regards,
Q:
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Will I have to stop BTX (Botox) injections before getting a facelift and getting my eyelids done? If yes, how long before? I get BTX above my nose and at the corners of both eyes and lips.
A:
Botox relaxes facial musculature and helps reduces "expendable" facial wrinkles. If you are having surgery that directly affects the muscle groups, then you should wait for the Botox to wear off before the procedure. A brow lift operation addresses forehead wrinkles, glabellar lines, and eyebrow position. As BTX injections in the forehead, glabella, and crow's feet affect all of these regions, I'd advise you to let the Botox wear off before you have your assessment, photos, and surgery if you are undergoing a brow lift. Although there are obicularis weakening procedures (that help with the crow's feet) which can be performed as part of a facelift, these are not common, and it should be OK to undergo a facelift and blepharoplasty while BTX is still active. Since all patients are different and there are many intricacies of these procedures, it is best to discuss these specific issues with the surgeon performing your surgery to decide what is most appropriate in your individual circumstance.