Plastic surgery on the very young.

There is no more controversial topic in plastic surgery than plastic surgery on the younger patient.  As a board certified plastic surgeon I feel that younger patients should need us the least. We are not a substitute for a healthy lifestyle, diet and exercise.  There are however certain instances where I find that surgery at a younger age is justified and even beneficial. Here are some examples:

Male breast reduction:

This procedure is indicated in enlarged male breasts or gynecomastia. In certain young men, often for no discernible medical reason, the male breast tissue is enlarged. This can happen even without weight gain. Long lasting gynecomastia leads to stretching of the breast skin over time. When the skin is loose it is often necessary to excise it, leading to more visible scarring.  Early treatment is therefore preferable and can often be done with minimal incisions and visibility.

Rhinoplasty

The majority of nasal growth ends with puberty, so rhinoplasty at this time makes medical sense for an appropriate candidate. The driving force here, though, is social. For many of my patients, the end of puberty, the end of high school and the break before college all coincide.  It is a time when many patients have the support from their families, time off to recover and the opportunity to subtly transition to a new environment.

Otoplasty

Otoplasty is the setting back of protruding ears.  For the child with prominent ears, otoplasty at a young age can save a lot of peer teasing and unnecessary ridicule. Ear cartilage is softer in the younger patient as well, which often leads to a more stable result.

Surgery after massive weight loss

The message is getting out and people are listening. Each year I see more and more people, particularly young people who, through shear perseverance, diet and exercise have lost a large amount of weight. One remnant from massive weight loss is an excessive amount of loose skin that won’t recoil without the help of plastic surgery.  While most of my tummy tuck patients are post partum mothers, it is the most common surgery in the massive weight loss patient at any age.

Breast augmentation for Amastia

Amastia means no breast tissue. Each year I see a number of very young women, often with their mothers, exploring breast augmentation for the sole purpose of feeling “normal.” These are healthy young women who don’t have small breasts; rather, they have almost no breast tissue at all.  These younger patients return to school and life in general with a sense of feeling whole or balanced.

If you are a young person or parent reading this, please know that I will never push you or your child into surgery.  The greatest joy in my practice is educating patients and families about the surgeries they are contemplating.  If these are thing you have been thinking about it would be my pleasure to educate you as well.

Pricing plastic surgery

In a single day of patient consultations I often have two patients asking about the same surgery.  One will tell me my prices are too high, the other will ask me why my prices are low.  It’s a paradox that as a physician they just don’t teach you about in medical school. I know medicine. I don’t know marketing, which I hope you will think is an asset.

Priced too high will put surgery out of reach for people with achievable goals. In this world of plastic surgery pricing I strive to be the one in the middle and provide good value.

Over a decade ago I started publishing the prices of my most common surgeries.  It’s the age of the internet (as you know if you’re reading this) and people want to know what to expect. Most of my colleagues hated it; now most of them do it. The world has changed.

Price notwithstanding I want to be the physician who gives the best consultation even if you don’t have surgery. I want my patients to feel they have learned all the ins and outs of what they are embarking upon so that they can make the most educated decision possible.  Even if you don’t like what you hear in my consultation because it is not what you were hoping for I want you to leave feeling that you got candid and sincere advice and that what I’m saying makes sense.

As a final word of heartfelt parting advice… don’t choose your doctor based on price. A few dollars plus or minus will never make up for lack of information or unrealistic expectations. Beyond any dollars it is important that you like and respect your doctor and feel comfortable in their care. I have never charged for cosmetic surgery consultations. I hope the information speaks for itself.  You can’t put a price on that.

I answer a lot of questions in my surgical consultations and even pose some for my patients to consider. One of the questions I get asked periodically is “would you let your wife do this?”

Now of course as an adult, she makes her own decisions. I guess the question really is… would I support her choices?
Each day as I sit across the desk from my patients, I often imagine I am talking to my wife. My wife, my family and friends are the benchmark by which I treat my patients. If a surgery or procedure is something I would not feel comfortable with for my wife, then it is not something I would recommend to my patients.

My consults and interactions with my patients are an attempt to focus on their goals and make sure that they are realistic and can be accomplished as safely as possible. The greatest joy in my practice is helping others achieve their goals when possible and in some cases preventing them from taking a path that is unrealistic or unsafe.
Yes, if my wife wanted cosmetic surgery, if I felt it was safe and realistic and could accomplish her goals, I would support it. So what has she had done…? I value my marriage too much to kiss and tell.