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Todd B. Koch, M.D., FACS
- 6315 Sheridan Drive
Williamsville, NY 14221 - Tel: Click for phone number
- Fax: 716-631-1222
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- www.toddbkochmd.com
Answered Questions
Q:
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Is it always necessary to remove fat and or reposition fat deposits and tighten muscle and tissue when doing a blepharoplasty to the upper eye lid. If eye surgery would be to correct vision problems and health insurance would cover skin removal only, but not the other stuff, will the results be less than satisfactory? Would the eyelids look funny?
A:
If a person is diagnosed with visual field obstructon secondary to excess upper eyelid skin, then the surgery may be covered by your insurance. Generally, the results of visual field studies and photos are submitted with a letter to the insurance company for approval of the surgery. When I perform the Upper Blepharoplasty to correct visual field obstruction, I am also trying to achieve the best cosmetic results. I do whatever is necessary whether or not it is covered by the insurance.
Q:
What can I do to help my floating up sub-muscular implants go down one week post surgery?
I am one week post-surgery and my sub-muscular implants are floating up very high on my chest. I'm wearing a band, but it doesn't seem to help. I'm in extreme pain, so pushing them down is difficult and they just work their way back up. Will they go down eventually? Is there anything I can do to help them go down? I teach fitness classes and have strong chest muscles. Should this have been a detriment to my getting implants?
A:
It is very common for breast implants to appear high after submuscular augmentation. Since you are only one week post surgery I would give things more time to settle down. Wearing a band is very helpful. I think the best approach is to relax and calm down. When your surgeon allows you to return to exercising this will also help things to settle. I would discuss your concerns with your surgeon and follow his/her advice.
Q:
Can rhinoplasty reshape a very large nose?
I have quite a large nose. It is straight but long and large in general. I am looking to get a nose job and was wondering how much my nose could be reshaped to make it smaller. I like the shape but want to have it scaled down quite a bit. Please advise.
A:
I recommend you consult with a Rhinoplasty surgeon who offers computer imaging. This offers you the best opportunity to view what your new nose, without actually having surgery, would look like. It will give you a very good idea if you would be pleased with the results.
Q:
Can breast augmentation be performed on fibrous tissue?
I have been told that my breasts are over 92% fibrosis tissue. This causes me pain and discomfort almost all the time. I am wondering if there is an option of removing it and then undergoing a breast augmentation procedure.
A:
You have a condition called Mastalgia. If your symptoms are severe enough and have failed medical treatment, you may be a candidate for subcutaneous mastectomy. Frequently this procedure is covered by health insurance. Reconstruction can be performed at the same time by placing a breast implant under the muscle. This may not be covered by your health insurance. You need a consultation with a Board Certified Plastic Surgeon to help you work out the details of this procedure.
Q:
When having a capsulectomy and replacing implants, how much breast tissue is lost?
If you have silicone implants and are having a capsulectomy, also replacing the implants with new ones, how much if any breast tissue is taken out and how long does this surgery take? Would a mammogram tell if breast tissue has to be removed with the capsulectomy? I am already small breasted and have heard that sometimes breast tissue is removed during the procedure. Will a mammogram tell how much tissue would need to be removed? How much time will I be in the operating room for the surgery?
A:
The goal when performing a complete capsulectomy is to remove as little breast tissue as possible and all of the scar tissue capsule. However there is a small amount of breast tissue that is adherent to the capsule that is removed inadvertently. This amount is no where near a cup size, probably around 10-20 grams maximally. A mammogram will not help in determining how much breast tissue will need to be removed. Generally a total capsulectomy with removal of breast implants and then replacement with new implants takes around 2 - 2 1/2 hours. Your plastic surgeon will review all this information when you have your consultation.