Cosmetic Surgery - Get the Facts from Doctors Park & Rebowe
Drs. Christopher Park and Ryan Rebowe of Park & Rebowe Clinic for Plastic Surgery are Premier Board Certified Plastic Surgeons with a Medical Spa serving the MS, AL and FL Gulf Coasts. The Park and Rebowe Clinic for Plastic surgery facility offers two AAAHC accredited procedure rooms, where they can do almost any cosmetic procedure on site. If a reconstructive or cosmetic procedure requires an overnight stay they operate at all of the major hospitals in Mobile as well as Thomas Hospital in Fairhope. We know cosmetic enhancements are a big decision so we sat down with the surgeons to ask a few questions specifically about their practice and some of their more popular procedures as well as the plastic surgery industry as a whole.
Q: In your opinion, what has changed the most in the Plastic Surgery industry from when you started to today?
CP: The biggest change is the public perception. When I returned home to Mobile in 2008, cosmetic surgery was still embarrassing and not to be discussed or admitted. I cannot begin to count the number of patients that wanted no one besides their immediate family to know that they had surgery. Now oftentimes, patients are coming in with friends or after extensive discussions with others. And educated patients make better patients. We educate our patients extensively but it can be a lot to take in during a few visits before surgery so I love that patients come in having discussed, considered, and thought about various aspects. I can then teach them what makes their case unique, as they all are.
Q: Why is it important to find a board certified plastic surgeon?
RR: Board certification in plastic surgery is a rigorous process designed to ensure patient safety and positive outcomes. A board certified plastic surgeon has performed all prerequisites in general surgery as well as an accredited plastic surgery residency. They must then submit their own cases for review after beginning practice as well as pass written and oral board exams based on these cases. During these examinations, the surgeon is assessed for safety above all other aspects. However, the consideration of active cases also allows for review to ensure the practitioner in question is providing the type of outcomes deemed acceptable by the American Board of Plastic Surgery. Board certification ensures that your surgeon is providing the absolute highest level of care. In checking your surgeons credentials, you will want to ensure that they are credentialed by the American Board of Plastic Surgery (ABPS). This fact ensures that the governing board is accredited and monitored by the American Board of Medical Specialties (ABMS). Other board certifications, such as cosmetic surgery, aesthetic surgery, or other qualifications are not governed by the ABMS. While surgeons with these credentials may have received additional training of some sort, the standards applied to their credentialing are not overseen by other governing boards and do not have the same level of patient safety and outcome standards as the ABPS or ABMS.
Q: What is included in a “Mommy Makeover” ?
CP: A mommy makeover is any surgery combination to address the breasts and trunk of a female patient post pregnancy. There is no one procedure. For the breasts, it may be a lift, an enlargement, a reduction in size, a change in shape, a reduction of a stretched nipple and areolar complex, or a combination of any of the above. For the trunk, it could be a tummy tuck, a lower body lift which is also known as a circumferential tummy tuck or belt lipectomy, a buttock lift, a back lift, just liposuction, or a combination of any of these.
Q: Does this typically happen all at one time?
CP: Yes, typically a mommy makeover is one surgery to address the affects of pregnancy on the breasts and trunk at one time. Sometimes, stages are necessary. The way that I word this to patients is that our first goal is to get everything shaped and tightened how we want it. After years of experience, we often will place the implant at the same time as a lift for example, But these are competing forces as the lift is bring the breast tissue up and in and a breast implant is pushing down and out. So often times, a secondary surgery may be necessary to retighten the tissues or revise a scar. We could reduce this risk by doing in two surgeries to begin with but way more often than not, patients are extremely happy with one surgery and then, only the ones that need a revision require two surgeries, rather than every patient.
Q: What is the recovery?
CP: The recovery depends on the procedure chosen. A breast reduction or lift is the least painful. A breast implant placement has sharp pain for a few days and then settles. A tummy tuck with muscle repair hurts for several weeks, as it is similar to a hernia repair. And liposuction, although seemingly the most simple, stays sore and bruised for several weeks to even a month or more.
Q: What can you tell us about scarring?
CP: The scarring also depends on the procedure chosen. Liposuction essentially has no scar. Breast implant placement scarring is very limited. A lift or tummy tuck or belt lipectomy involves a lot of skin removal that will leave a scar but is far more desirable than the overhanging loose skin. I often tell patients that our goal with these surgeries is to make things tight. Yet tension is the enemy of a good scar. So if we are not happy with the scar, we often wait a few months and then go back and revise the scars in a much smaller surgery, and in that surgery, the skin has stretched some and we are laying it together snug but not tight and will get a better scar. If the scars are reasonable, we have an entire protocol involving topical and laser treatments to get the best scar possible. I am usually more critical of the results and the scars than the patient is, so being left with a scar that the patient is unhappy with is unlikely as I will likely be suggesting to revise a scar that even the patient is happy with because when we are not trying to tighten things at the same time, I can almost always get a better scar. Often when I am discussing with patients concerned about the scar, I will consider how far away I could see the problem, which with lax abdomen with stretch marks or overhanging or bulging flanks, or droopy breasts, I can likely see the problem from 30-50 feet away, whereas the scar I usually can only see from about 5 feet away and sometimes have to be within inches to see them after letting them settle and doing the post-op laser protocol which can take a year.
Q: What do you think the most common misconceptions are about cosmetic procedures?
RR: Many people mistake the words “cosmetic” or “elective” for “small” or “easy” procedures, which makes them less likely to seek out providers who are specialty trained. This often involves traveling or otherwise seeking care from providers who may not be specifically trained in plastic surgery. While the downtime and postoperative care can be less cumbersome with aesthetic procedures, these operations require a great deal of preoperative planning. meticulous surgical acumen, and specific postoperative protocols. These details are why It is important to seek care from board-certified surgeons who can give you the attention before, during, and after your procedure.
Q: What are some of the first things you tell or ask your patients in a consultation when considering cosmetic surgery?
RR: When considering any cosmetic procedure it is imperative that you and your surgeon work together to determine specific goals. While the overall object of any aesthetic procedure would be to look better, I will usually work to define exactly what each patient is trying to accomplish. In doing so, we establish her priorities related to the area in question. Most often, there are many ways to accomplish the same goal. Each of these techniques will come with its own set of risks, benefits, and alternatives for both the surgeon and the patient to consider. In establishing a priority list, it allows me to have a detailed, informed discussion with the patient regarding how best to accomplish their goals.
Q: Tell us about Facial Cosmetic Surgeries you most commonly perform?
RR: The most common reason people will seek out facial cosmetic surgery is the jowling, sagging, and skin bands on the lower face and neck. These issues are most commonly addressed with a face and neck lift. While these terms can be used to note two separate operations, most commonly we will perform rejuvenation of the lower face and neck at the same time. The second most common complaint is of “tired” or “heavy” eyes. Brow lifts, upper lid lifts, and lower lid lifts can be utilized separately to address specific complaints, but these are often utilized together for total periorbital, or around the eye, rejuvenation. While rhinoplasty, or a “nose job,” is sought less commonly that facelift or eye lift procedures, it can dramatically affect the proportions of the face as well as how a person breathes.
Q: What is a “mini-facelift”?
RR: In general, a “mini-facelift” refers to a lift or other type of facial rejuvenation procedure with a smaller incision or down time that a more traditional approach. However, these operations also typically produce less dramatic results that can or outcomes that do not last as long as traditional methods. Well planned facial rejuvenation procedures have minimal downtime, usually 1-2 weeks, and utilize scars that are well camouflaged in the perceptible facial contours. Because of this, we tend to shy away from these smaller procedures for more traditional approaches that provide improved results that last longer, typically 10 years or more. That being said, if a patient has a very specific complaint or would like to focus only on a certain aspect of the facial rejuvenation process then that is very feasible.
Q. Is the typical facial surgeries recovery time long?
RR: The vast majority of facial aesthetic procedures have minimal downtime. Facial swelling can be dramatic for the first week, but by the second week most patients have minimal bruising and swelling and can return to normal every-day activities. We will ask patients to refrain from exercise for the first 6 weeks following their procedures. The exception to the above is rhinoplasty. While overall contour improvements can be noted immediately after surgery, swelling in the nasal tip can take up to a year to resolve. Although nasal contour will be improved almost immediately following the procedure, final results may not be evident until all swelling has subsided. This issue will not be noticeable to anyone except for the patient and the treating physician, allowing the vast majority of patients to return to normal activities within two weeks similar to other facial aesthetic surgeries.
Q: What is one thing you would tell someone considering cosmetic procedures that has not taken the first step to get a consultation?
CP: The most important thing is to tell people that this is for you. We as plastic surgeons are not here waiting for you to come in so that we can make you look how we want. As I often say, the patient is the boss. We educate and recommend to the patient so that they can make the right decision for themself. The reason I love plastic surgery is because I and my patients and their loved ones can see and appreciate and celebrate the changes we make.
