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While the chances of it happening are slim, a laceration, physical trauma, or complication from a past cosmetic surgery procedure can happen at any time. In a moment when hospitals are grappling with depleted supplies and the [spread of the coronavirus disease (COVID-19)](https://aedit.com/aedition/message-from-aedit-founder-regarding-covid-19-coronavirus-pandemic), patients might be concerned about whether or not the emergency room is their best option in the face of an unexpected aesthetic emergency. While limiting contact through social distancing is recommended, getting proper help is still possible and encouraged.

To understand the most effective methods for getting medical assistance during this time, The AEDITION spoke with two board certified providers about what to do if urgent care is needed. 

## **Is the Emergency Room the Best Option?** 
When it comes to non-aesthetic health emergencies, the ER remains the best place to seek care — especially in critical situations. But, for patients who are experiencing complications in the aftermath of a cosmetic or plastic surgery procedure, it may be best to reach out to your plastic surgeon first. 

“I would encourage people to stay away from the ER because of the many sick COVID-19 patients. That being said, the first thing the patient should do is call their plastic surgeon,” explains [Kevin Tehrani, MD](https://aedit.com/provider/kevin-tehrani-md-91), a board certified plastic and reconstructive surgeon and founder of New York’s Aristocrat Plastic Surgery & MedAesthetics. “Most plastic surgery practices will still be open for follow-up appointments and any emergencies that may have arrived as a result of their procedure.” 

The reasoning behind staying away from a hospital in this critical time is due to social responsibility on all fronts. “During a pandemic, most people will want to stay as far away from a hospital as possible, to reduce potential exposure to COVID-19 patients and also to avoid the inevitable long wait times because these places are overburdened,” explains Beverly Hills-based board certified facial plastic and reconstructive surgeon [Jonathan Cabin, MD](https://aedit.com/provider/jonathan-cabin-md-956). “In addition, many socially-minded patients may want to avoid hospitals to prevent extra patient burden when they are dealing with an onslaught of very sick patients.”

Post-op complications aren’t the only aesthetic concern that might need tending to right now. When dealing with lacerations (i.e. cuts that go through the skin and, sometimes, the muscle), Dr. Cabin explains that “there is a lot of skill that goes into not only closing up a laceration, but doing so in a way that leads to optimal healing and minimal scarring.” While many level one and level two trauma centers have plastic and reconstructive surgeons on call who can treat you, not every hospital does. 

If you have a relationship with a board certified plastic surgeon and the laceration occurs during normal business hours, you can certainly reach out and see if they would be able to treat you. But, if you don’t or the trauma occurs in the middle of the night, going to the emergency room remains a viable option.

## **If the ER Is the Only Option**
Of course, in the event of an emergency when rapid attention is required, the ER is a must. “In any true post-operative emergency – for example, sudden extensive bleeding – the best thing is to go straight to the nearest ER,” Dr. Cabin says. In an effort to get the best care and limit potential exposure to COVID-19, he recommends patients call ahead to the ER to let them know you are coming. And don’t forget to keep your plastic surgeon in the loop, too. “You should also try to alert your surgeon as to what is going on so that they can be involved in your care,” he says. “This is always the best option.”

## **Dealing With a Post-Op Emergency**
In matters of health, safety and affirmative action are vital. Dr. Tehrani advises that patients call their plastic surgeon “as soon as the trauma happens to see if they can temporarily treat themselves without leaving the house at all.” 
 
When experiencing a plastic surgery emergency during a pandemic, taking extra precautions is not just important for the patient but for the caretakers as well. If an in-person appointment is necessary, the suggested course of action is for patients to call ahead and make an appointment. “We will do a pre-screen over the phone to ensure no one is infected prior to coming into our office,” Dr. Tehrani explains. “We also advise patients to not come into the office if they are sick.”
 
Those who show no symptoms and are able to travel to the office should remember to sanitize prior to the visit. “Patients should be taking all the preventative measures before coming into our office such as [washing their hands](https://aedit.com/aedition/how-to-wash-hands-best-creams-tips-to-prevent-dry-skin), practicing social distancing, and staying at home,” Dr. Tehrani says. “As soon as the patient is seen, we advise them to wash their hands and sanitize — we have hand sanitizers in every room of our facility — and go straight home.” 

## **Dealing With an Aesthetic Emergency**
While not related to a post-op crisis, lacerations are still considered an aesthetic emergency that are best cared for by a plastic and reconstructive surgeon. “Lacerations are rarely life-threatening but are, nonetheless, considered urgent because, when not treated within a certain timeframe (usually six to eight hours), there is a higher risk of infection, [scarring](https://aedit.com/aedition/minimizing-scars-after-surgery), and – in certain locations like with the face – functional issues,” Dr. Cabin explains. “That being said, certain lacerations also involve damage to vital blood vessels, nerves, cartilage, or bone, and thus may be considered true emergencies for other reasons.”

As mentioned above, patients who have an existing relationship with a plastic surgeon can reach out to the practice directly. “Patients have the option to call a plastic surgeon, who can potentially see them in the office,” Dr. Cabin says. “Some plastic surgeons — myself included — will also offer house calls for patients who can’t or don’t want to leave their home.”

And if you don’t have a surgeon on speed dial? “Call any doctor you know and trust and ask them if they can refer you to a plastic surgeon they respect,” he suggests. “If this isn’t possible, patients can also try calling into their local emergency room or urgent care, explaining the situation, and asking for a referral.” 

## **What to Do If You Need to Leave the House**
If the situation does require a trip to the ER or a plastic surgeon’s office, here’s how to keep yourself safe and well: 

- **Only Bring One Person**: “Try to come with, at most, one friend or family member to limit the number of people and decrease chances of viral exposure,” Dr. Cabin says, adding a person exhibiting any signs of illness (think: fever, cough, aches, breathing trouble) should only be treated in an emergency room.
- **Use Protective Gear**: “If you have a mask at home, it is best to put it on before seeing the doctor to protect the doctor from potential COVID-19 infection,” Dr. Cabin explains. If you do not have a mask and cannot safely locate one, he says the doctor will likely be able to provide one.
- **Medicate Mindfully**: If you have a laceration, avoid taking taking any aspirin or NSAIDS (i.e. Advil, ibuprofen, Motrin) for pain prior to seeking medical attention, as they can cause excessive bleeding. “If you are in pain, take Tylenol,” Dr. Cabin recommends. 
- **Clean the Wound**: To ensure minimal damage is done before your visit, cover the laceration with a clean bandage ASAP. If it is a deeper cut with a lot of bleeding, Dr. Cabin says to “hold pressure with a pressure bandage or with your hand.” 

## **Staying Healthy After Your Visit**
Along with keeping everything sanitary and practicing social distancing, recovery needs to be done in accordance with [doctor’s orders](https://aedit.com/aedition/the-ultimate-guide-to-the-post-surgery-products-that-help-your-recovery). When recovering in the midst of a widespread virus, it is possible to do so with limited outside interaction. “Every patient is given careful, typed instructions and all supplies needed for care,” Dr. Cabin explains. “So, they are not required to go to the pharmacy unnecessarily.” If a patient feels that they’re experiencing symptoms of COVID-19 or have tested positive, “it is important to let the doctor know so that they can take precautions after this exposure,” he says.

## **The Takeaway** 
“Patients should know that many plastic surgeons, including myself, are here to help,” Dr. Tehrani says. “Many of our offices are still open because we are seeing follow-up patients and, therefore, have the resources to help healthy patients with their emergency aesthetic needs.” 

When dealing with an aesthetic emergency, quick thinking and rapid action are vital to prevent further damage. Taking the necessary precautions during a pandemic can be beneficial not just for the patient but for healthcare providers as well. So, while going to the ER remains a viable option, it may be avoidable in favor of a trip to the plastic surgeon — assuming you call ahead.

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Although rare, lacerations, aesthetic trauma, and plastic surgery emergencies do happen. The AEDITION spoke with two board certified providers about what to do if urgent care is needed.

What To Do If You Have A Plastic Surgery Emergency

Here’s What To Do If You Have A Plastic Surgery Emergency

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Here’s a sobering statistic: [The National Institute on Drug Abuse reports](https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis#:~:text=What%20do%20we%20know%20about,for%20chronic%20pain%20misuse%20them.&text=Between%208%20and%2012%20percent%20develop%20an%20opioid%20use%20disorder.&text=An%20estimated%204%20to%206,prescription%20opioids%20transition%20to%20heroin.) that roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them. Between 8 and 12 percent of those patients go on to develop an opioid-use disorder. From there, an estimated 4 to 6 percent of people who misuse prescription opioids transition to heroin. 

It goes without saying that pain management is part of the post-procedure recovery process in aesthetic medicine, but many plastic surgery practices have been taking precautions and adjusting their approach to recovery in recent years as the opioid epidemic grows in the United States. “It's a cunning, baffling, powerful disease and it can happen to anyone,” says New York City-based dermatologist [Cheryl Karcher, MD](https://aedit.com/provider/cheryl-karcher-md-4323), who is [open about her own battle with addiction](https://www.nytimes.com/2016/07/24/fashion/cheryl-karcher-comeback-pill-popping-dermatologist.html) several years ago. “I am much more on the lookout now.”

Because it can be difficult to identify who will become addicted and who won’t, providers — especially those in the already scrutinized fields of cosmetic and plastic surgery — have  learned to take special care. 

“Plastic surgery has never been more prevalent, more revered, and, at the same time, more scrutinized,” says board certified plastic surgeon, [Ryan Neinstein, MD](https://neinsteinplasticsurgery.com/), of Neinstein Plastic Surgery in Manhattan. There are countless media stories of poor plastic surgery outcomes, he explains, and these are typically instances of procedures being performed by unqualified physicians in substandard facilities. “However, day in day out, plastic surgeons around the country are making surgery safer, faster, and more predictable,” he says. 

Here, three experts share the precautions they’ve taken against opioid abuse in their own practices and how they’ve adjusted their approaches to the plastic surgery recovery process in recent years. 

## **The Importance of Preoperative Counseling**
Dr. Karcher says that she now asks a lot more questions about personal and family history of addiction when she meets with her patients. She routinely recommends Tylenol (acetaminophen) or Tylenol with ibuprofen (like Advil) for pain. New York City-based board certified facial plastic surgeon [Jennifer Levine, MD](https://drjenniferlevine.com/), agrees that preoperative counseling is vital and lets her patients know that they may be uncomfortable, but the surgery is not especially painful. “Pain medication is available if they need it, but most patients do not require it,” she says. “Opiates are rarely necessary in my practice.”

## **Prescribing in Smaller Quantities**
Dr. Karcher says that if the aforementioned Tylenol is not enough or if she knows a patient will really need pain medication to get to the point where they can recover properly, a few pain pills will be prescribed. That said, the tight leash on these dangerous drugs can lead to those who need pain management not getting the medication they need. “I do, unfortunately, see patients that have needed opiates for other medical or surgical issues and were not given them,” she says. “I do think opiates have a place in very short-term pain management.” 

## **Responsible Discarding**
For Dr. Levine, most of her procedures are above the neck and, as such, most of her patients do not require opioids. “I use a local anesthetic during the surgery and some longer-acting local anesthetics for longer procedures such as facelifts,” she says. The majority of her patients only take acetaminophen after the surgery. “I do give all my patients a small supply of a pain medication such as Vicodin (hydrocodone/acetaminophen),” she says, adding that she “rarely” prescribes anything stronger. “Many of my patients come in after the surgery with the bottle of unused pain medication and ask me to discard it for them.”

## **The Next Generation of Pain Management**
One of the advances Dr. Neinstein has made to his practice is the use of a medication borrowed from the trauma world called tranexamic acid. The clotting promoter is used to treat heavy menstrual periods in women, and this low-cost drug can be added to the intravenous liquid given to a patient during surgery to aid the post-op recovery process. “This medication has quickly shown to safely contribute to minimizing blood loss,” he says. “Even in plastic surgery — where there is minimal blood loss — by reducing it even more we can further minimize the downtime and physiological change to our patients’ bodies.”

Aesthetics

Three experts share the precautions they’ve taken against opioid abuse in their own practices and how they’ve adjusted their approaches to the plastic surgery recovery process in recent years.

The Future Of Opioid Use In Plastic Surgery

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According to the [American Society of Plastic Surgeons (ASPS)](https://www.plasticsurgery.org/news/press-releases/americans-spent-more-than-16-billion-on-cosmetic-plastic-surgery-in-2018), Americans spent some $16.5 million on cosmetic surgery and minimally invasive procedures in 2018 alone, and it is safe to say a good portion of that figure was an out-of-pocket expenditure for patients. With national cost averages ranging from $3,800 for a breast augmentation to upwards of $8,000 for a facelift, cosmetic surgery is no small expense and most treatments (surgical or otherwise) are not covered by health insurance.

That's not to say there aren’t exceptions to the rule. While elective procedures that are purely cosmetic in nature will always operate (pun intended) outside the realm of insurance companies, plastic surgery procedures that can be classified as 'medically necessary' are often part of insurance policies.

So, what makes an invasive or non-invasive procedure medically necessary and, therefore, covered by a health insurance plan? The AEDITION breaks it down.

## **What Makes a Procedure 'Medically Necessary'**
In June 1989, the [American Medical Association (AMA)](https://www.ama-assn.org/) adopted the following definitions of ‘cosmetic surgery’ and ‘reconstructive surgery’ that are used by health insurance companies to determine coverage.

- **Cosmetic Surgery**: Performed to reshape normal structures of the body in order to improve the patient’s appearance and self-esteem. 
- **Reconstructive Surgery**: Performed on abnormal structures of the body, caused by congenital defects, developmental abnormalities, trauma, infection, tumors, or disease.

In theory, the definitions are black and white: cosmetic procedures are not medically necessary; plastic and reconstructive surgery procedures are. In reality, there is quite a bit of gray area. Many procedures have a dual purpose that treats both an aesthetic concern *and* a functional health problem. If the provider can document the medically necessary component of the procedure and any non-surgical remediation that was previously taken to correct the health issue, Medicare or private insurance may very well cover the cost.

## **What Procedures May Be Covered By Insurance**
In order to successfully document the medical necessity of a procedure, providers must prove the surgery the patient is interested in directly addresses the quality of life concern(s) surrounding the body part or health problem in question. This process involves: 

1. Submitting photographic evidence (not just a written explanation) to the insurance company
2. Proving non-surgical or non-procedure remedies have already been explored 

While the exact standards may vary by insurance company, the [ASPS offers a recommended criteria](https://www.plasticsurgery.org/for-medical-professionals/health-policy/recommended-insurance-coverage-criteria) for distinguishing between a cosmetic surgery procedure and a plastic or reconstructive surgery that providers can use when explaining treatments that have a dual aesthetic and functional purpose. But what does that mean in layman's terms? Below is a guide to surgical and non-surgical procedures that sometimes qualify for insurance coverage. 

### **Abdominoplasty (a.k.a Tummy Tuck) & Panniculectomy** 
Weight loss procedures (think: gastric sleeves, lap gastric bands, and gastric bypass) are often covered by insurance for patients who have a high body mass index (BMI) coupled with comorbidities like heart disease or type 2 diabetes. In the [aftermath of a major weight loss](https://aedit.com/aedition/what-its-like-to-get-plastic-surgery-after-bariatric-surgery-weight-loss), there are a few cosmetic surgeries that may be considered functional procedures in order to improve a patient's quality of life:

- **Abdominoplasty**: A tummy tuck typically combines fat removal (i.e. liposuction) with skin removal and/or tightening, which may be required by patients in the aftermath of losing a significant amount of weight.
- **Panniculectomy**: The surgical procedure removes excess skin on patients who have lost a significant amount of weight (naturally or via a bariatric procedure).

While insurance coverage of a panniculectomy or [tummy tuck](https://aedit.com/procedure/abdominoplasty) is not as common as weight loss surgery, they may be deemed medically necessary if a patient is in pain, unable to participate in normal activities, or at risk of developing a skin condition.

### **Blepharoplasty (a.k.a. Eyelid Surgery)**
Aging eyelids don't just cause cosmetic concerns, drooping eyelids have the ability to impair vision. For patients who are dealing with poor eyesight as a result of sagging skin around the eyes, an [upper eyelid blepharoplasty](https://aedit.com/procedure/upper-eyelid-blepharoplasty) may be deemed medically necessary to correct the problem. During the surgery, a plastic or oculoplastic surgeon will remove excess skin to lift and open the eye. While many insurance policies will cover the functional component of the surgery, additional cosmetic improvements may need to be paid for out of pocket. It should also be noted that [lower eyelid blepharoplasty](https://aedit.com/procedure/lower-eyelid-blepharoplasty-transconjunctival-approach) is more difficult to classify as a functional procedure.

### **Botox®** 
No, [neurotoxin injections](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) to get rid of fine lines and wrinkles are not going to be covered by your insurance company, but there are therapeutic uses for Botox® that may be. In 2010, Botox® was approved by the U.S. Food and Drug Administration (FDA) to treat chronic migraine in patients over the age of 18. When injected around the pain fibers that are involved in headaches, Botox® blocks the release of chemicals involved in pain transmission. The FDA-recommended dosage is 155 units (administered every 10 to 12 weeks) for migraine patients, and the treatment is covered by most insurance plans (including Medicare and Medicaid).

### **Breast Surgery**
As you can probably guess, a [breast augmentation](https://aedit.com/procedure/breast-augmentation-with-implants) to cosmetically enhance the size or shape of the chest isn't going to be covered by health insurance plans, but certain kinds of breast surgery can be considered medically necessary:

- **Post-Mastectomy Breast Reconstruction**: As per the [1998 Women’s Health and Cancer Rights Act (WHCRA)](https://www.cancer.org/treatment/finding-and-paying-for-treatment/understanding-health-insurance/health-insurance-laws/womens-health-and-cancer-rights-act.html), group health plans that cover mastectomy (be it for breast cancer prevention or treatment) must also cover [breast reconstruction](https://aedit.com/aedition/comprehensive-guide-to-breast-reconstruction-nipple-reconstruction-after-breast-cancer) — in the form of prostheses (like breast implants) — and other procedures for both breasts. In such cases, providers do not need to document health problems or trials of alternative treatment. Medicare also covers bilateral breast reconstruction in post-mastectomy patients.
- **Reduction Mammoplasty (a.k.a. Breast Reduction)**: Women with symptomatic macromastia (large breasts) may deal with neck, nerve, shoulder, and back pain, breast discomfort, an inability to engage in certain activities, and/or dermatitis or rashes beneath the breasts secondary to the condition. In such cases, a [breast reduction surgery](https://aedit.com/procedure/breast-reduction) may be covered by insurance after six to 12 months (on average) of documentation is presented to show alternative treatments (think: visits to a physical therapist, chiropractor, or orthopedist) were unsuccessful.

It should be noted that [gynecomastia surgery](https://aedit.com/procedure/male-breast-reduction) (a.k.a. male breast reduction) is much more difficult to classify as a functional procedure than reduction mammoplasty for women — though the ASPS has compiled a [set of guidelines](https://www.plasticsurgery.org/Documents/Health-Policy/Positions/Gynecomastia_ICC.pdf) that encompasses pain and discomfort, suspected malignancy, and more and can be used for evaluating insurance coverage for both adolescents and adults.

### **Otoplasty (a.k.a. Ear Surgery)**
Otoplasty can be used to improve or correct the shape, proportion, and/or position of the ear. Such surgical procedures are performed in children and adults alike, and an [ear surgery](https://aedit.com/procedure/otoplasty) may be covered by health insurance if a provider is able to provide one of the following:

1. Document a medical problem (like hearing loss) caused by abnormal shaped ears
2. Document that the ear deformity is from a congenital abnormality

Unlike other procedures that require doctors also show the patient participated in a trial of alternative treatments, patients with a congenital abnormality of the ear do not need to first experiment with non-surgical remedies. 

### **Rhinoplasty (a.k.a Nose Job)**
Just as you probably have a friend who 'wanted' a nose job, you likely know someone who 'needed' a rhinoplasty. Difficulty breathing, nose bleeds, and sinus problems are just a few of the [health concerns that can lead a patient to need nose surgery](https://aedit.com/aedition/difference-between-cosmetic-rhinoplasty-vs-functional-rhinoplasty). After proving that non-invasive alternatives (like nasal spray) are ineffective, insurance may cover some or all of the procedure.

Medically speaking, the surgical procedure that corrects a deviated septum (one common cause of breathing issues) is known as a septoplasty and only addresses the inner workings of the nose. This procedure, which is almost always covered by insurance, has no bearing on the appearance of the nose. In some cases, a rhinoplasty that improves the shape or aesthetic of the external nose structure can be deemed medically necessary. Otherwise, patients who wish to make cosmetic changes (in addition to the functional improvements) may need to pay for that portion out of pocket.

## **The Takeaway**
Needless to say, there are many subtle intricacies that determine whether a procedure is deemed ‘cosmetic’ or ‘plastic and reconstructive.’ That distinction, however, plays a direct role in why it may or may not be covered by insurance. Consulting with a [board certified plastic surgeon](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) will provide clarity on whether your preferred surgical procedure could qualify for insurance coverage in accordance with your health plan.

Americans spent more than $16.5 billion on cosmetic procedures in 2018 with most patients paying out of pocket. But some plastic surgery is, in fact, covered by health insurance. Here, The AEDITION breaks down the ins and outs of coverage.

Is A Cosmetic Procedure Ever Covered By Insurance?

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In the spirit of Women's History Month and International Women's Day, we’re here to demystify the representation of women (or lack thereof) in plastic surgery.

It’s no secret that there are far fewer women than men in the field. A 2017 study from the [Plastic and Reconstructive Surgery – Global Open](https://www.plasticsurgery.org/news/press-releases/women-underrepresented-in-plastic-surgery) found the female-to-male ratio of surgeons practicing plastic surgery is approximately one to five. The gap is smaller than other surgical specialities, but it is still surprising given that the [American Society of Plastic Surgeon (ASPS) reports](https://www.plasticsurgery.org/documents/News/Statistics/2018/cosmetic-procedures-women-2018.pdf) women received 92 percent of the cosmetic procedures performed in 2018. 

Here, four top female plastic surgeons discuss their career progression and experience as women in aesthetic medicine. From family planning to finding mentors, they lay out the factors they believe contribute to the lack of gender diversity in the field.

## **Number of Women in Medicine vs. Plastic Surgery**
New York City-based board certified plastic surgeon [Nina Naidu, MD](https://aedit.com/provider/nina-naidu-md-99), attended Cornell University for medical school and graduated in 1997. “We were completely 50:50 — so 50 percent women — and we were one of the first classes to be evenly split,” she explains. In residency, however, Dr. Naidu was the only woman in her plastic surgery program. “When I did general surgery, there was one other woman out of eight,” Dr. Naidu remembers of her dual general and plastic surgery residency. “In plastic surgery, there were no women except for me in a group of six.”

For double board certified facial plastic surgeon [Dara Liotta, MD](https://www.facialplasticsnyc.com/), her medical school breakdown at Columbia University was over 50 percent percent women. When it came to residency, a much lower percentage of women chose to go into surgery or surgical subspecialties, like plastic and reconstructive surgery. “I completed a five-year residency in otolaryngology, head and neck surgery, which was nearly 50 percent female and then an advanced fellowship in facial plastics and reconstruction,” she shares. “In both residency and fellowship, the overwhelming majority of our teachers and attending surgeons were men.” Dr. Liotta said there were only four female attendings and over 30 male attendings during her residency and fellowship. 

During her time at New York University School of Medicine, double board certified plastic surgeon [Melissa Doft, MD](https://aedit.com/provider/melissa-doft-md-63), recalls an even proportion of women and men in her class. By the time she got to her surgical residency, however, the ratio of women to men was two to five. That split, she says, was actually pretty diverse compared to other programs. “Now the plastic surgery residency has one woman in a group of 13, so the ratio is one to 12,” she shares.

At Cornell Medical College, double board certified facial plastic surgeon [Jennifer Levine, MD](https://drjenniferlevine.com/) had a similar experience. In her class of 100 people, the ratio of male to female students was 55 to 45. “It was not until I started my surgical residency that I was the only woman out of 20 students,” she recalls, adding that she was surprised by the disparity. “I did not realize that there would be so few women, as I had not experienced that before,” she says. 

## **Choice Between Motherhood & Plastic Surgery**
One key reason many women choose not specialize in plastic surgery? The number of years the training involves. Not only does surgical residency usually last until residents are 32 or 33 (at the youngest), there is no real maternity leave involved. 

“Residency occurs during the prime time that women are having children and starting a family.  The work hours are grueling, expectations very high, and commitment paramount,” Dr. Doft says. “Unlike other residencies, like pediatrics or obstetrics, where there are many women, surgical residencies are not used to having women out for maternity leave and do not encourage it.”

While it varies by program, most offer four weeks of ‘medical leave’ (hardly enough for an actual maternity leave), and it can be extended by an additional two weeks using vacation time. Missing more than six weeks, however, will likely preclude residents from finishing the program on schedule. “If you try to take more time off, you might not be able to graduate on time,” Dr. Naidu says. “You might have to put extra time in, so that's a huge issue.”  

Something else to consider? The lack of services available to new moms once they return to work. In addition to the grueling schedule of raising an infant while on-call and sleep deprived, finding a place to pump for women who choose to breastfeed may prove difficult. “There's a huge host of problems, so I think a lot of women look at that and think, ‘Wow this is just not compatible with having a regular life,’” Dr. Naidu says. “That's one reason there aren't that many women plastic surgeons.” 

Yes, having children as a female plastic surgeon is difficult, but Dr. Liotta says there is rarely a convenient time for anyone to have kids. “Just have them and the world around you will adapt,” she says, adding that you’re not going to be able to be everything to everyone. “If you truly want to be a surgeon, and you can’t be happy doing anything else — you know who you are! — then say ‘F that’ and do it,” she advises. She recommends reaching out to other women for advice and support. 

Additionally, Dr. Levine says small (but necessary) changes have been made to residency programs that allow for more of a work-life balance. “One week I was in the hospital 130 hours,” she recalls. Now, there are stricter rules regarding how many hours doctors can be at the hospital, and they are allowed to leave the hospital when they are post-call, she shares.  

## **A Lack of Mentors for Women**
In the generation ahead of Dr. Liotta, there were hardly any women specializing in plastic and reconstructive surgery despite the overwhelming majority of patients being female. “Perhaps this made it difficult for young women going through training to see a place for themselves in the field without obvious female mentors who had ‘been there and done that’ successfully in terms of navigating the predominantly male surgical culture and managing to balance work with family and outside life,” Dr. Liotta says. “Surgical residency and fellowship is very taxing, both emotionally and physically. For anyone — male, female, ethnic minority, ethnic majority — it is difficult to endure without seeing yourself in your mentors and having like-peers to confide and commiserate with.”

Dr. Naidu agrees, crediting her own mentor, [Mia Talmor, MD](https://weillcornell.org/miatalmor), for her success. “Having a same-sex mentor has been shown to be extremely helpful for women plastic surgeons and for medical students who are considering going to the field,” she says. Dr. Talmor was the first female plastic surgeon appointed to the full-time faculty of Cornell University’s Weill Medical College in New York and was four years ahead of Dr. Naidu in school. “She is a very tough woman. She stands up for herself,” Dr. Naidu says, adding that Dr. Talmor is also extremely approachable. 

Dr. Naidu connected with her when she was a first-year medical student, and the relationship continued from there. “I had that benefit that I had this role model way before I even applied for residency,” Dr. Naidu explains. “It was just something that was already there for me, and I think that made a huge difference for me.”

In general, some women may have been reluctant to go into these types of training programs because of the ‘boys club’ mentality, Dr. Levine says. But she thinks that perception is changing. “Women are no longer the only primary caregiver, and they may be the main breadwinner,” she says, adding that female patients are increasingly looking for a woman's perspective. “Whereas traditionally some women felt the need for male approval or a male voice, today’s women want to hear from someone like them and someone who understands and listens,” Dr. Levine explains.

## **Diversity in Plastic Surgery**
The lack of diversity in plastic surgery isn’t just gender based. While a [2020 ASPS study](https://www.plasticsurgery.org/news/press-releases/more-women-are-training-to-be-plastic-surgeons-but-racial-and-ethnic-representation-still-lags-behind) showed there is a growing number of women entering plastic surgery residency programs, there is still a gender *and* ethnic disparity in the industry. “We treat the whole spectrum of patients, so there needs to be more diversity,” Dr. Naidu says. “We're still really ethnically underrepresented.” 

Dr. Naidu is of South Asian descent, and, when she was in residency, she didn't know a single other South Asian plastic surgeon. “I didn't even see any until almost 10 years after I finished my training,” she says (yes, that’s male *or* female surgeons that were South Asian). “I didn't really see any ethnic diversity, until a good seven or eight years ago.” She notes that it's still not diverse per se, but it is starting to shift. “I notice it when I look around our conference room when I go to our monthly meeting for the hospital,” she says.

Dr. Levine notes that plastic surgery is only getting more popular and the patient population is increasingly diverse, but that is not necessarily reflected in the medical community. “In a patient population that is 90 percent women, only 10 percent of the surgeons are women,” Dr. Levine points out. “I personally try to change the ratio by mentoring other women through my medical school, my college, and other organizations such as [Girls Inc](https://girlsinc.org/) and [E-School for Girls](https://eschool4girls.org/).” 

Providers should be able to show patients the breadth and diversity of their work, Dr. Doft adds. “Being based in Manhattan, I have the privilege to treat many different cultures. I think it is less important that patients see themselves in the provider and more that they see that the provider has treated other patients like themselves,” she shares. “For example, I am careful to select an array of different before-and-after photos, so that patients can find a patient who looks like them with regard to weight, proportions, and ethnicity.”
 
## **Advice to Aspiring Female Plastic Surgeons** 
First and foremost, Dr. Levine says to do what you love. “I think women today are more committed to lifting up other women and have less of the ‘I suffered so you can suffer too’ mentality,” she shares. In the last decade, Dr. Levine has noticed that “an increase in outspoken, talented, and feisty young women surgeons in conventional and social media have emerged as mentors for those who follow them.” That exposure will have a positive effect both immediately and long term. “I think that is being reflected in increasing numbers of women becoming plastic surgeons,” she says. 

Dr. Doft encourages aspiring surgeons to focus on the life-changing impact cosmetic, plastic, and reconstructive work has on patients. “Every day I think that I am so lucky to have this job,” she says. “I have the opportunity to erase aspects of their bodies that women are self-conscious  about and help them become more confident — and it only takes a few hours.” 

While the progress has been slow, Dr. Naidu admits the profession has changed quite a bit over the years. When she completed her training 17 years ago and was just starting out, she was one of the few women in the space and was the only minority woman. “Now, there are a lot more women in the room,” she says. “It's more ethnically diverse as well, so it's really been a good shift.” Dr. Liotta is hopeful, too. “The road is long, and it’s definitely not the easy way,” she says. “But you can do it.” 

Expert Opinion

Women make up the majority of cosmetic surgery patients. So, why don't more women become surgeons? Four female plastic surgeons lay out the factors they feel are contributing to the lack of gender diversity in the field.

Why There Is A Lack Of Gender Diversity And Female Plastic Surgeons In Aesthetic Medicine

Why Don't More Women Become Plastic Surgeons?

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At last, it’s here. After all the research, consultations, and the preparations, your cosmetic surgery day has finally arrived. You’re reclining on a gurney in the pre-op area wearing nothing but a surgical gown and a disposable purple hairnet, trying to daydream about how fabulous you’re going to look and feel when all is said and done. But between the bustle of the nurses and anesthesiologists and the buzzing of the unfamiliar sounds surrounding you, it’s tough to find your zen space.

Suddenly your plastic surgeon appears from behind the curtain — smiling and reassuring — asking if you have any last-minute questions. After the small talk and run-through of post-op instructions, your surgeon asks you to stand up, perhaps sans flowered gown. You probably already have butterflies, and now you’re standing there being stared at intently.

As your surgeon scrutinizes the surgical area, he or she is reaching for a package that is sitting on a metal tray beside your bed. They unseal the plastic, pop off the cap, and proceed to draw on you — all. over. you.

Welcome to the wonderful world of surgical markings.

## **The Purpose of Surgical Markings Before Cosmetic Procedures**
“Sometimes patients get a little panicked,” says UCLA board certified plastic surgeon [Jason Roostaeian, MD](https://aedit.com/provider/jason-roostaeian-md-449). “I can see it in their eyes. They’re wondering: ‘Is that where you’re going to cut me?’” Dr. Jason often eases his patients’ nerves by cracking a joke about the markup process.

So what, exactly, do all of those circles, x’s, numbers, meandering lines, and dashes of different colors actually signify? “We use marking pens to plan out the surgery and indicate the landmarks,” explains Beverly Hills-based board certified plastic surgeon [Leif Rogers, MD](https://aedit.com/provider/leif-rogers-md-578).

Because our bodies look different lying down in the operating room than they do normally, creating a surgical roadmap while the patient is standing upright is optimal. “In some cases, the process of numbing the patient or injecting tumescent solution can obscure some of the landmarks,” Dr. Rogers adds. 

Markings can signify a multitude of things: incision sites, existing landmarks, areas to be altered, as well as those to be avoided. “We need to make sure we don’t disrupt certain anatomy during surgery,” Dr. Jason shares. But, just as every procedure is unique to the patient, every marking is specific to the provider.

Surgeons use markings in their own unique way,  so there’s no standardized system in place. “You go through your training and watch how your attending does it,” Dr. Jason says. “But everyone adopts their own personal style.”

This explains why some surgeons use multiple colors, while others stick to the stereotypical purple pen. Some doctors do use Sharpies, but the markers are usually specially formulated for use on skin — so they’re not exactly surgical Sharpies. As Dr. Rogers notes, the marking pens “tend not to wash off when the patients are being prepped for sterility.” Speaking of sterility, it’s also worth noting that surgical markers are sterile and single-use only.

## **How Surgeons Markup Common Cosmetic Procedures**
While surgeons have their own style, there are some markings that almost always accompany a certain procedure. Below, Dr. Jason shares some of the typical markings he makes for different surgeries. He draws on all of these patients while they are standing, with the exception of rhinoplasty (because the nose position remains relatively unchanged).

### [Breast Surgery](https://aedit.com/procedure/breast-augmentation-with-fat-transfer)
- The breast fold
- Ideal nipple placement

### [Facelift](https://aedit.com/procedure/subperiosteal-facelift)
- The jawline
- Facial folds for fat grafting

### [Neck Lift](https://aedit.com/procedure/direct-neck-lift)
- The midline of the neck
- Extent of skin dissection

### [Rhinoplasty](https://aedit.com/procedure/revision-rhinoplasty)
- Position of nasal bones
- How much of the hump to take down
- Ideal tip angle

### [Liposuction](https://aedit.com/procedure/smartlipo)
- Highest to lowest fat concentration

While many procedures require a series of dashes and straight lines, liposuction is illustrated using curved shapes. “We create a topographical map using concentric circles,” says Dr. Jason of the fat removal surgery.

Just as there is no standard markup methodology, there’s also no such thing as a ‘typical’ pre-op patient mindset. “Patients’ reactions are as different as their personalities,” Dr. Rogers says. “Some want smiley faces. Others are ticklish.” And, while some patients can’t wait to scrub off those markings, others happily snap pre-surgery selfies for social media.

## **How to Remove Surgical Markings Post-Op**
As Dr. Rogers shared, markup pens are meant to survive the sterility and surgical process. So, just how does one go about removing those surgical signatures post-surgery? Both docs say alcohol swabs work best — though patience is key. That ink is often stubborn, and it may hang around as you heal. If you’re in a hurry, Dr. Rogers recommends “light scrubbing in the shower” to facilitate removal over the course of a few days.

You’ve likely seen pre-op pictures of cosmetic surgery patients covered in dashes, x’s, and o’s. But what exactly is the surgeon mapping out with their marker? The AEDITION asked the experts.

What Your Plastic Surgeon Is Doing With That Markup Pen During Cosmetic Surgery

Connecting The Dots: What Your Surgeon Is Doing With That Markup Pen

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We live in a culture driven by instant gratification. But, when it comes to recovering from a cosmetic or plastic surgery procedure, patience is a virtue. From the immediate downtime to the larger recovery process that can span weeks or months, the path to realizing the final results of your treatment can be a lengthy one. Recovery time encompasses everything from when you get drains, sutures, or splints removed to how long it takes for incision site marks to fade.

Speaking of scars, plastic surgeons are experts at closing wounds and most cosmetic and plastic surgery incisions are made to be as discreet as possible. Even so, incision sites take time to heal, and patients can expect those marks to fade over the course of a year. In that 12-month period, the scar will contract, remodel, and fade. If a patient is unhappy with the appearance of the incision mark at that point, a [scar revision procedure](https://aedit.com/aedition/minimizing-scars-after-surgery) might be an option. To ensure optimal healing, patients should apply sunscreen to their scars daily (rain or shine!). Topical vitamin E and scar gels may provide additional relief, but nothing replaces sunscreen.

While every patient and surgical procedure is different, there are some general timelines you can expect your cosmetic surgery recovery to follow. Here, The AEDITION breaks down the healing process of some of the most popular cosmetic procedures.

## **For Face**
*Whether you are interested in a cosmetic procedure or plastic surgery, surgical facial procedures like rhinoplasty, blepharoplasty, and facelifts take anywhere from six to 12 months for full results to be realized.*

### **Blepharoplasty (a.k.a. Eyelid Surgery)**
Blepharoplasty is a surgical procedure that improves the appearance of the eyelids by removing excess skin or fat deposits. Both [upper](https://aedit.com/procedure/upper-eyelid-blepharoplasty) and [lower](https://aedit.com/procedure/lower-eyelid-blepharoplasty-transconjunctival-approach) eyelid surgeries are available, and they may be classified as either a plastic and reconstructive procedure or aesthetic surgery depending on the reason for the procedure. 

- **Bruising & Swelling**: Subsides 7 to 10 days post-op
- **Return to Work**: 1 week post-op (eyes may be tired or more prone to strain)
- **Resume Normal Activity**: 4 weeks post-op 
- **Final Results**: 3 to 6 months post-op

### **Browplasty (a.k.a. Brow Lift)**
Known as a [browplasty, brow lift, or forehead lift](https://aedit.com/procedure/endoscopic-brow-lift), the surgery involves raising the eyebrows to a more youthful position to reduce the appearance of fine lines and wrinkles, sagging skin, and hooded eyelids.

- **Remove Sutures**: 7 to 10 days post-op
- **Return to Work**: 7 to 10 days post-op
- **Bruising & Swelling**: Subsides 10 to 14 days post-op
- **Resume Normal Activity**: 2 to 4 weeks post-op
- **Final Results**: 3 to 6 months post-op 

### **Rhinoplasty (a.k.a. Nose Job)**
Nose jobs can be 'functional' (i.e. medically necessary) or 'cosmetic' (read: elective), but both types of [rhinoplasty](https://aedit.com/procedure/open-rhinoplasty) procedures require patients to be patient during the healing process.

- **Bruising & Swelling**: Subsides 10 to 14 days post-op; residual swelling for up to one year
- **Remove Splint**: 5 to 7 days post-op
- **Return to Work**: 1 week post-op
- **Resume Normal Activity**: 3 weeks post-op
- **Final Results**: 1 year post-op

### **Rhytidectomy (a.k.a. Facelift)** 
The gold standard of facial rejuvenation, a [facelift](https://aedit.com/procedure/smas-facelift) surgery has the ability to treat facial sagging and volume loss by lifting and firming the face. 

- **Bruising & Swelling**: Peaks 48 hours post-op; subsides over 10 to 14 days
- **Resume Wearing Makeup**: 1 week post-op
- **Remove Sutures**: 7 to 10 days post-op
- **Return to Work**: 7 to 10 days post-op
- **Resume Normal Activity**: 2 weeks post-op
- **Final Results**: 3 to 6 months post-op

### **Lower Rhytidectomy (a.k.a. Neck Lift)**
During a [neck lift](https://aedit.com/procedure/direct-neck-lift) procedure, incisions are made along the hairline and ear to remove excess skin and fat. A lower rhytidectomy yields a more defined neck and jawline, in addition to removing jowls. 

- **Remove Drains**: 2 days post-op
- **Remove Sutures**: 5 to 10 days post-op
- **Bruising & Swelling**: Subsides within 10 to 14 days; residual swelling for 3 months
- **Resume Normal Activity**: 2 weeks post-op
- **Final Results**: 6 months post-op

## **For Hair**
*Despite the advent of [non-surgical hair restoration treatments](https://aedit.com/aedition/kourtney-kardashian-prp-injections-to-treat-hair-loss), surgical hair transplants remain the go-to for patients looking to correct baldness and hair thinning. While initial results will be seen in the first four to five months, 12 to 18 months may be needed for full recovery.*

### **Hair Transplants**
The two main types of surgical hair transplants are the [follicular unit extraction (FUE)](https://aedit.com/procedure/follicular-unit-extraction-fue) technique and the [follicular unit transplant (FUT)](https://aedit.com/procedure/strip-harvesting) method. The former involves transplanting individual hair follicles, while the latter extracts a strip of hair. Both types of procedures have a similar recovery period.

- **Swelling & Tenderness**: Subsides 5 to 7 days post-op
- **Resume Wearing Hat**: 10 to 14 days post-op
- **Transplanted Hair Sheds**: 2 to 3 weeks post-op
- **Initial Results**: 4 to 5 months post-op
- **Final Results**: 12 to 18 months post-op

## **For Body**
*From breast surgery (think: augmentation, reduction, and lift) to tummy tucks, there are an array of surgical body contouring procedures that, after the initial downtime and recovery process, provide long lasting results.*

### **Abdominoplasty (a.k.a. Tummy Tuck)** 
Whether it's performed alone or as part of a larger mommy makeover, body lift, or post-weight loss procedure, a [tummy tuck](https://aedit.com/procedure/abdominoplasty) removes excess skin and excess fat, in addition to restoring muscle definition, for a more contoured abdomen.

- **Remove Drains**: 1 week post-op
- **Return to Work**: 2 to 4 weeks post-op
- **Resume Normal Activity**: 2 to 4 weeks post-op
- **Wear Compression Garments**: 6 to 8 weeks post-op
- **Bruising & Swelling**: Subsides 2 to 3 months post-op; residual swelling for up to 18 months
- **Final Results**: 4 to 6 months post-op

### **Augmentation Mammaplasty (a.k.a. Breast Augmentation)**
Breast augmentation can involve [breast implants](https://aedit.com/procedure/breast-augmentation-with-implants), autologous fat transfers, or a [hybrid](https://aedit.com/aedition/hybrid-breast-augmentation-with-implants-fat-transfer) of the two. In the case of implant and hybrid procedures, a secondary surgery will be needed to replace the implants after eight to 10 years. Patients who choose an autologous fat transfer can expect to lose 30 to 40 percent of the volume to reabsorption. Nonetheless, patients can expect similar recovery times for each type.

- **Return to Work**: 3 to 5 days post-op
- **Bruising & Swelling**: Peaks at 24 to 48 hours post-op; subsides over 2 to 3 months 
- **Resume Exercise**: 3 to 6 weeks post-op
- **Resume Wearing Underwire Bra**: 4 to 6 weeks post-op
- **Final Results**: 3 to 6 months post-op

### **Brazilian Butt Lift**
Like an breast augmentation with fat transfer, a [butt lift](https://aedit.com/procedure/butt-lift) involves transferring fat from one part of the body to the buttocks for improved shape and contour. Generally speaking, 60 to 80 percent of fat transfer typically survives.

- **Return to Work**: 10 to 14 days post-op
- **Resume Sitting & Laying on Buttocks**: 2 weeks post-op
- **Resume Normal Activity**: 8 weeks post-op
- **Final Results**: 6 months post-op

### **Liposuction**
[Liposuction](https://aedit.com/procedure/tumescent-liposuction) is typically performed as part of a larger surgery (think: a tummy tuck) or to complement another procedure. Regardless of the purpose, it results in permanent fat loss.

- **Return to Work**: 1 to 3 days post-op
- **Resume Normal Activity**: 1 week post-op
- **Bruising & Swelling**: Peaks 1 week post-op; subsides over 4 to 6 weeks
- **Wear Compression Garments**: 4 to 6 weeks post-op
- **Initial Results**: 3 to 6 months post-op
- **Final Results**: 1 year post-op

### **Mastopexy (a.k.a. Breast Lift)**
A [breast lift](https://aedit.com/procedure/breast-lift) surgery improves the projection and shape of the breast by removing excess skin and tightening the surrounding tissue. 

- **Return to Work**: 1 week post-op
- **Bruising & Swelling**: Peaks at 72 hours and subsides over 6 to 8 weeks
- **Resume Exercise**: 3 to 6 weeks post-op 
- **Resume Wearing Underwire Bra**: 6 to 8 weeks post-op
- **Final Results**: 4 to 6 months post-op

### **Reduction Mammaplasty (a.k.a. Breast Reduction)**
To alleviate any pain or discomfort caused by large breasts, a [breast reduction](https://aedit.com/procedure/breast-reduction) permanently removes excess skin and fat. 

- **Back & Shoulder Pain**: Immediate Relief
- **Return to Work**: 1 week post-op
- **Resume Exercise**: 3 to 4 weeks post-op 
- **Shop for New Bras**: 2 to 3 months post-op
- **Final Results**: 6 to 12 months post-op

## **The Takeaway**
Because no two patients or procedures are the same, recovering from cosmetic surgery is a very personal experience. Consulting with a [board certified plastic surgeon](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) will provide further clarity on what you can expect during the healing process, so you can ensure the best results.

We live in a world of instant gratification. But, when it comes to recovering from a plastic surgery procedure, patience is key. The AEDITION breaks down the healing process of some of the most popular cosmetic procedures.

How Long It Takes To Recover From Cosmetic Surgery Procedures 

How Long Does It Really Take To Recover From Cosmetic Surgery?

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Nothing lasts forever — not even the results of cosmetic surgery. While going under the knife may have longer-lasting effects than non-surgical cosmetic treatments, most plastic surgery procedures still have a shelf life that can range from a few years to more than a decade.

No two surgeries are the same, but having a basic understanding of what will happen before, during, and after a procedure can help ensure that your expectations are properly managed. The longevity of cosmetic and plastic surgery results depends largely on (a) the patient and (b) the surgeon’s technique, but there are some general rules of thumb when it comes to how long you can expect your results to last.

While nothing replaces a consultation with a [board certified plastic surgeon](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology), we’ve put together a guide to the average lifespan of some of the most common cosmetic surgery procedures. From lifts (think: facelift, brow lift, neck lift, breast lift, and butt lift) and hair transplants to rhinoplasties and breast implants, here’s how long popular cosmetic surgery and plastic surgery procedures typically last.

## **For Face**
*Non-surgical injectables (think: Botox®, filler, and the like) and laser treatments may be all the rage for their lack of invasiveness and downtime, but sometimes going under the knife is needed for a more dramatic and long-term fix. Even so, a surgical procedure cannot prevent the future effects of aging, which is why very few facial plastic surgery and cosmetic procedures claim to last forever.* 

### **Blepharoplasty (a.k.a Eyelid Surgery)**
**Lifespan**: 10 years for upper eyelid blepharoplasty; Lifetime for lower eyelid blepharoplasty
Blepharoplasty is a surgical procedure that improves the appearance of the eyelids by removing excess skin or fat deposits from the orbital area. It can be performed on either the upper and lower eyelid, and, depending on the reason for the procedure, may be classified as either a plastic and reconstructive procedure or an aesthetic surgery. 

- **Upper Eyelid Blepharoplasty**: The results of [upper eyelid surgery](https://aedit.com/procedure/upper-eyelid-blepharoplasty) usually last about 10 years (as the face and eye area continue to age), at which another procedure may be necessary. 
- **Lower Eyelid Blepharoplasty**: Unlike its upper eyelid counterpart, the results of a [lower eyelid surgery](https://aedit.com/procedure/lower-eyelid-blepharoplasty-transcutaneous-approach) tend to last a lifetime and a followup procedure is rarely necessary.

For patients whose vision is impaired by sagging eyelids, for example, the surgery would be considered medically necessary and, therefore, covered by insurance. Patients who simply wish to rejuvenate the eye area for cosmetic reasons, meanwhile, the treatment would probably be considered elective. Either way, the results are typically the same.

### **Browplasty (a.k.a. Brow Lift)**
**Lifespan**: 5 to 10 years
Known as a browplasty, brow lift, or forehead lift, the surgery involves raising the brows to a more youthful position and, in the process, reducing the appearance of lines and wrinkles, sagging skin, and hooded eyelids. During an [endoscopic brow lift](https://aedit.com/procedure/endoscopic-brow-lift), the surgeon places an endoscope through small incisions made within the hairline to adjust the muscle and tissue beneath the skin. Because of the natural aging process, results of a browplasty are not forever. Most last five to 10 years.

### **Rhinoplasty (a.k.a. Nose Job)**
**Lifespan**: Lifetime 
Like blepharoplasty, a [nose job can be 'functional' (i.e. medically necessary) or 'cosmetic' (read: elective)](https://aedit.com/aedition/difference-between-cosmetic-rhinoplasty-vs-functional-rhinoplasty). Both classifications require a great deal of patience during the healing process, with full results often taking up to a year to reveal themselves. But, they are worth the wait. A rhinoplasty is one of the few surgical procedures that comes with permanent, lifetime results. 

### **Rhytidectomy (a.k.a. Facelift)** 
**Lifespan**: 10 years
The gold standard of facial rejuvenation, a [surgical facelift](https://aedit.com/procedure/smas-facelift) has the most dramatic and long lasting results of any of the available lifting and firming techniques on the market. It addresses facial sagging and volume loss in a way few other treatments do, but, even so, a rhytidectomy should only be expected to last, on average, 10 years or so as the skin and face continue to naturally age.

### **Lower Rhytidectomy (a.k.a. Neck Lift)**
**Lifespan**: 10 years
Like a facelift, a [neck lift](https://aedit.com/procedure/neck-lift-lower-rhytidectomy) also has about a 10-year lifespan due to the natural aging process. During the procedure, incisions are made along the hairline and ear to remove excess skin and fat. In addition to removing jowls, a lower rhytidectomy yields a more defined neck and jawline.

## **For Hair**
*Hair loss is a concern for men and women alike. While treatments like [platelet-rich plasma (PRP) injections](https://aedit.com/aedition/kourtney-kardashian-prp-injections-to-treat-hair-loss) are gaining popularity for their ability to improve hair regrowth over time, hair transplants remain among the most effective, albeit invasive, ways to correct hair loss.* 

### **Hair Transplants**
**Lifespan**: Lifetime 
Generally speaking, there are two types of hair transplants. Both involve harvesting healthy hair follicles from a donor site for implant on balding or thinning areas.

- [Follicular Unit Extraction (FUE)](https://aedit.com/procedure/follicular-unit-extraction-fue): Healthy hair follicles are extracted one by one from a patient's scalp and implanted to other areas around the head.
- [Follicular Unit Transplant (FUT)](https://aedit.com/procedure/strip-harvesting): Also known as strip harvesting, surgeons remove a section of hair from the back of the head (or another place it can be easily concealed). The strip is then dissected into smaller segments that can be implanted as needed.

In each case, the transplanted hair typically shed within the first two to three weeks before growing back. Full results can take up to 18 months and touch up treatments may be needed, but the results are considered permanent.

## **For Body**
*Like the face, surgical and invasive procedures for the body typically last longer than non-invasive treatments that are meant to address similar concerns. While many body surgeries do offer permanent results, that longevity is often caveated with the need to maintain a healthy weight or lifestyle.*

### **Abdominoplasty (a.k.a. Tummy Tuck)** 
**Lifespan**: Lifetime with healthy lifestyle
A [tummy tuck](https://aedit.com/procedure/abdominoplasty) is a multifaceted cosmetic procedure that removes excess skin and excess fat, in addition to restoring muscle definition, for a more contoured abdomen. While the loose skin and fat removal are permanent, lifestyle factors (think: weight changes) can impact the longevity and quality of the results.

### **Brazilian Butt Lift** 
**Lifespan**: Lifetime after initial reabsorption period
A [Brazilian Butt Lift](https://aedit.com/procedure/butt-lift) involves transferring fat from one part of the body to the buttocks for improved shape and contour. Because it is an autologous transfer, there is no fear of rejection, but it is expected that some percentage of the fat will be reabsorbed into the body. Generally speaking, 60 to 70 percent of transferred fat survives, yielding permanent results.

### **Breast Surgery**
**Lifespan**: 8 to 10 years for breast implants; Lifetime results with healthy lifestyle for breast lift and breast reduction 
There are three main types of breast surgery — augmentation, reduction, and lift — and each procedure has its own unique level of permanence:

- **Augmentation Mammaplasty (a.k.a. Breast Augmentation)**: While there is more than one kind of breast augmentation, [augmentation with breast implants](https://aedit.com/procedure/breast-augmentation-with-implants) require replacement every eight to 10 years to ensure safety.
- **Mastopexy (a.k.a. Breast Lift)**: Unlike a breast augmentation that addresses the size of the chest, a [breast lift](https://aedit.com/procedure/breast-lift) improves the projection and shape of the breast by removing excess skin and tightening the surrounding tissue. Weight changes and the aging process can cause sagging over time.
- **Reduction Mammaplasty (a.k.a. Breast Reduction)**: To alleviate any pain or discomfort caused by large breasts, a [breast reduction](https://aedit.com/procedure/breast-reduction) removes excess skin and fat. The removal process is permanent, though it does require patients to maintain their weight.

### **Liposuction**
**Lifespan**: Lifetime with healthy lifestyle 
Liposuction is typically performed as part of a larger surgery (think: a tummy tuck) or to complement another procedure, but, regardless of the application, it results in permanent fat loss. With that said, [lipo](https://aedit.com/procedure/tumescent-liposuction) cannot protect against future weight gain, so a healthy weight  and healthy lifestyle must be maintained to enjoy the contouring results.

## **The Takeaway**
As you can probably tell, how long the results of plastic surgery last depends on an array of factors. In some cases, procedures can be one and done, assuming a healthy lifestyle is maintained. In other cases, the aging process may create the need for follow-up treatments down the line. Consulting with a board certified plastic surgeon will help to level set your expectations prior to surgery and ensure the best results for your concern.

Nothing lasts forever — not even the results of cosmetic surgery. From facelifts and hair transplants to rhinoplasties and breast implants, here’s how long the results of popular plastic surgery procedures last.

How Long Cosmetic Surgery And Plastic Surgery Results Last 

How Long Do Cosmetic Surgery Results Really Last?

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Cosmetic surgery can cause a whirlwind of emotions, especially during the initial stages of recovery. Feelings of excitement, joy, and relief are all common — but so are nervousness and apprehension. Because of post-procedure swelling, bruising, and scarring, actual results may not appear for weeks, months, or even years after surgery. While plastic surgeons do their best to prepare patients for these inevitabilities, less often discussed pre-operatively is the emotional and psychological toll that elective surgery can have.

Melinda* underwent a comprehensive facial rejuvenation three years ago, which included a [facelift](https://aedit.com/procedure/midfacelift), [brow lift](https://aedit.com/procedure/endoscopic-brow-lift), and [neck lift](https://aedit.com/procedure/direct-neck-lift). She’d done her homework and been thoroughly briefed by her doctor, board certified UCLA plastic surgeon [Jason Roostaeian, MD](https://aedit.com/provider/jason-roostaeian-md-449), but there was simply no way to prepare herself for what she encountered in the mirror in the early days of her recovery. “I was swollen and a little shocked when I looked in the mirror,” she shares. “ I didn’t look like myself.”

During the healing process, it’s not uncommon for patients to feel uncertainty, doubt, and even regret about their procedure(s), and The AEDITION talked to board certified plastic surgeons Dr. Jason and [Richard Brown, MD](https://aedit.com/provider/richard-brown-md-4646), about how to handle these post-surgery blues.

## **Understanding Post-Surgery Blues**
All types of surgery — elective or otherwise — are traumatic for the body and mind, especially when performed under general anesthesia. The cocktail of anesthesia drugs combined with the depressive effects of post-operative narcotics prescribed to control pain have both physical and emotional effects. Additionally, post-surgery restrictions limiting mobility and basic self care activities can also take their toll on self-esteem. Lethargy, brain fog, emotional sensitivity, sleeping problems, irritability, appetite changes, and anxiety are all common post-surgical complaints.

These feelings may be even more pronounced in cosmetic surgery patients due to the inherent psychological dilemma. Not only is there uncertainty about the outcome and results, but there can also be the burden of physical and mental turmoil that is magnified by potential guilt over feeling lousy about an elective procedure.

“There are definitely patients who are worried early on about what their end result will look like because they’re still in the healing process. It’s an evolution,” says Dr. Jason explains. “Because they don’t have the experience and knowledge that we do as surgeons, patients can have moments of remorse and wonder ‘Did I do the right thing?’”

Chris*, a patient of Dr. Jason’s, experienced a period of uncertainty after his [rhinoplasty](https://aedit.com/procedure/closed-rhinoplasty). “It’s a bittersweet couple of months,” he shares. “You’re so excited about looking like a new person but you’re also dealing with the reality of being a new person.” 

While it’s impossible to predict whether or not a patient will experience feelings of post-surgical depression, certain types of cosmetic surgery may make it more likely. “Among my rhinoplasty patients, the people who are most at risk are those who are seeking fine refinements,” explains Dr. Jason. “When swelling sets in during the healing process, it looks worse than when they started.” These patients often wait months to experience their final results, whereas those seeking, say, a dorsal hump reduction get to see that change almost immediately. “They’re happy right when you take off the bandages because they can see you accomplished their goal,” he says. 

According to Arizona-based Dr. Brown, author of *[The Real Beauty Bible](https://drrichardjbrown.com/the-book/)*, it’s especially common for post-operative moms to feel guilty about not being able to care for their families. That “mom guilt” can lead to self-questioning and doubt. “Occasionally when women come in for their follow-up visit, I can tell that something is going on in their heads,” he says. “That ‘something’ is usually the post-procedure blues.” 

## **When to Seek Help for Post-Operative Depression**
In some patients, post-procedure blues can linger or even worsen over time. This could be a sign of a larger mental health concern, like clinical depression, whether it’s related to elective surgery or not. Symptoms of depression include frequent feelings of hopelessness, anxiety, overwhelming fatigue, and a lack of interest in normal activities. Patients — especially those who already experience or are treated for depression — should be open with their doctor about their symptoms. In the vast majority of cosmetic surgery-related cases, however, the feelings pass as the healing process progresses.

## **How to Cope with Post-Surgery Blues**
While feelings of mild depression, anxiety, and/or uncertainty post-surgery are unpredictable, there are measures patients can take to reduce their likelihood. Communicating with your plastic surgeon — both before and after a cosmetic procedure — is key. Considering the following advice could also foster a smoother recovery, though it is never meant to replace your own surgeon’s instructions.

### **1. Educate Yourself**
Learn as much as possible about your procedure beforehand by asking plenty of questions during your consultation and pre-op appointments and by conducting your own research. Ask your cosmetic surgeon’s office if they can put you in touch with past patients who may be able to offer personal insight. Knowing what to expect and having realistic expectations about your results can help keep you calm during recovery. “I knew I’d be swollen and bruised, so I wasn’t troubled that I didn’t look perfect overnight,” recalls Kimberly*, one of Dr. Brown’s mommy makeover patients.

### **2. Plan Ahead**
The key to resting without stress or guilt is to prepare as much as possible beforehand. Kimberly, for example, heeded Dr. Brown’s advice to prepare meals, arrange transportation, and put friends on standby prior to her procedures. As a result, the mom of five, who underwent a [breast augmentation](https://aedit.com/procedure/breast-augmentation-with-fat-transfer), [tummy tuck](https://aedit.com/procedure/abdominoplasty), and [liposuction](https://aedit.com/procedure/tumescent-liposuction), could better focus on taking care of herself. “I was really emotional for the first couple of weeks,” she shares. “I got post-op blues but never was truly depressed about my decision. I read Dr. Brown’s book and his office prepared me well.”

### **3. Don’t Suffer in Silence**
While it’s important to understand that your feelings are likely completely normal, it’s wise to share them with your physician and supportive friends and family members. “Don’t be nervous to share your feelings with your surgeon,” says Dr. Brown. “We’re here to support you.”

### **4. Get Out of Bed**
While many people envision their recovery period as an opportunity to stay in bed all day and binge Netflix, being too sedentary can hamper healing. Instead, be as active as your surgeon allows. Even short, gentle walks around the house can stimulate mood-boosting brain activity.

### **5. Meditate**
Practicing mindfulness not only helps increase positive feelings — it’s also been proven to aid in the physical healing process. “The concept of neuroplasticity tells us that the brain is constantly adapting,” says Dr. Jason. “Using relaxation techniques and guided imagery can increase well-being by reminding your brain to focus its energy on healing.”

### **6. Stay Away from the Mirror**
We know this is a tough one, but do your best to not overly scrutinize your surgical site. Monitor your progress as directed by your doctor to ensure you are healing properly, but do not obsess. The healing process often gets worse before it gets better. “I tell patients that swelling is like a checkerboard. It doesn’t come in uniformly, and it doesn’t leave uniformly,” says Dr. Jason. “While you’re going through the healing process, you’re going to see small differences in certain areas.”

### **7. Medicate Only as Directed**
Controlling your pain is a key component of a comfortable recovery, but prescription pain medications can have both physical and emotional side effects. Weaning off pain meds will allow the body to start detoxing, and many patients find they get necessary relief with over-the-counter remedies as soon as one or two days post-op (again, always adhere to your surgeon’s advice). Gentle exercise (in accordance with your doctor’s recovery plan) and meditation can also ease or distract from discomfort — no pills necessary.

### **8. Be a Patient Patient**
Healing takes time — it’s sometimes two steps forward, one step back — so practice being kind to yourself. Dr. Jason warns that patients should expect to encounter some minor setbacks, like renewed swelling, as a result of basic things like sleeping on one side or resuming normal workouts, and it shouldn’t be a cause for concern. “Don’t lose patience,” Dr. Brown adds. “Get past that attitude of expecting immediate results and remember that positive change takes time.”

### **9. Focus on the Positive**
Don’t let stress, guilt, or impatience allow you to lose sight of why you made the decision to have cosmetic surgery in the first place. Instead, imagine the weeks and months down the road when your recovery will start to be a thing of the past. Envision the positive changes — whether or not they are visible yet. 

Dr. Jason, for one, takes photos in the OR that can be helpful for rhinoplasty patients trying to push through post-procedure anxiety. “The end result on the table has less swelling than when you first take the cast off,” he says. “I’ll often show that to the patient because they like how that looks and they feel good about that. It gives them some perspective and a glimpse into what their ultimate result will be.” 

### **10. Trust the Process**
“You’ve got to have faith,” says Dr. Jason. Remember: Your body is designed to heal itself, and your plastic surgeon has taken every measure to promote a positive outcome. Melinda was able to overcome her post-op apprehension after recalling the conversations she had with Dr. Jason prior to surgery. “We’d talked about how much I wanted a natural look,” she shares. “We have similar views about plastic surgery, and I liked the pictures of his work.” Feeling confident about her surgeon’s past results helped ease Melinda’s mind.

Two years after her facelift with Dr. Jason, Jenna* says that her recovery is nothing but a distant memory. “It was kind of depressing for a bit, but Dr. Jason was very encouraging,” she recalls. “The second day, you look great — and then a week later, you look terrible. But it got better, and now I just remember the good parts.”

Dr. Jason’s rhinoplasty patient Chris offers this analogy: “It’s like seeing yourself in the mirror after getting a new haircut and wondering if the look works or not,” he shares. “Hair grows back, but cosmetic surgery is permanent. So, you’ve got to find the surgeon who can best translate what you want into reality.”

*Patients' names have been changed

Wellness

During the healing process, it’s not uncommon for patients to feel uncertainty, doubt, and even regret about their cosmetic procedure, and The AEDITION talked to board certified plastic surgeons about how to handle the post-surgery blues.

What To Know About Post-Plastic Surgery Depression And Blues During Recovery

10 Things To Know About Post-Procedure Blues During Recovery

shutterstock 553740730 copy (2)

Of course your doctor is going to give you the low-down on how best to prepare for your cosmetic procedure at the all-important pre-op appointment. And we bet you’ve done your research on what to expect post-procedure, too. But there are still a few things that may catch you by surprise when you arrive in the operating room on surgery day. 

“For me, it was not knowing just how cold the OR can get,” says Christina*, who underwent a breast surgery several years ago. “I was already nervous, and when I was wheeled into a super cold operating room, it just added to my anxiety.”

According to a [study in the Journal of Clinical Nursing](https://www.ncbi.nlm.nih.gov/pubmed/19583663), surgery is often associated with increased stress and anxiety, which can have an adverse effect on patient outcomes. Of those surveyed, 23 percent of patients reported anxiety while being wheeled into the operating room, while 35 percent were anxious during the induction of anesthesia. All the while, 12 percent reported feeling anxious before the sedation kicked in. 

But perhaps the most interesting finding was how the figures changed once patients received a bit more intel. Pre-op preparedness and education about what to expect in the operating room reduced anxiety levels in 49 percent of patients. 

The bottom line? The more you know about what to expect in the OR, the better equipped you are to deal with it. The AEDITION spoke to board certified plastic surgeons and patients about how to tackle the unknowns of the operating room, so you can ace your cosmetic procedure like a pro.

## **1. Start with a clean slate**
While your doctor is definitely going to let you know that you need to keep your precious jewels at home and skip out on your morning makeup and skincare routine before your procedure, patients may not be aware that you also should stay away from lotions, creams, deodorants, and talcum powder. “It’s a sterile procedure and you want to be as clean as possible,” says board certified facial plastic and reconstructive surgeon [Jason Bloom, MD](https://aedit.com/provider/jason-bloom-md-2248), founder of Bloom Facial Plastic Surgery in Bryn Mawr, Pennsylvania.

Another thing to nix? Your next trip to the nail salon. He recommends patients forgo their weekly manicure, so they have bare nails in the OR. Your doctor and nurse will be monitoring the nails to check your health during the surgery and in the post-anesthesia care unit. The color of the skin and nail beds is an important indicator of blood circulation and, therefore, need to be kept as clean as possible.

## **2. Yes, it’s going to be bright and chilly in the OR**
It’s generally assumed that the temperature in operating rooms is lower to prevent the spread of bacteria, but that's only part of the equation. Most surgeons and nurses will be wearing sterile gowns and standing under bright lights for a long period of time, which can increase their body temperature. A cool room helps keep them comfortable and better focused.

From a patient’s perspective, it’s okay to request a warm blanket or ask that the room be kept at a reasonable temperature. “Once I let my doctor know that the cold was really bothering me, he was very patient and understanding and got the temperature to a comfortable number,” says Christina.

Something else that you should account for: the bright overhead lights that can no doubt be intimidating. “I have had a lot of patients comment on how bright the operating room is,” says board certified facial plastic and reconstructive surgeon [Jonathan Cabin, MD](https://aedit.com/provider/jonathan-cabin-md-956), of the Center for Advanced Facial Plastic Surgery in Beverly Hills. “But keep in mind that the right surgical lighting is critical for patient safety.” 

If you’re still concerned about bright lights or a cold room, simply remember that you’ll be induced in a matter of minutes and those worries will fade away faster than you can count to 10.

## **3. There may be music — and essential oils**
While multiple studies in the past have shown that music helps both patients and doctors relax before a surgical procedure, a [2015 study from the University of Texas Medical Branch at Galveston](https://www.ncbi.nlm.nih.gov/pubmed/26163311) went one step further. According to the study, when plastic surgeons listen to music they enjoy, their surgical technique and efficiency when closing incisions are improved. “I always have music on during surgery,” says Denver-based board certified plastic surgeon [Gregory Buford, MD](https://aedit.com/provider/gregory-buford-md-1015), of Beauty by Buford. “But recently I also started including essential oils.” 

Much like music, essential oils are another favored practice for keeping patients calm. According to a [recent study published in Laryngoscope Investigative Otolaryngology](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5743169/), aromatherapy helps combat preoperative anxiety that can have a negative impact on patient satisfaction and outcomes. “I don’t know if it’s a placebo effect, but it’s very pleasant and soothing,” says Dr. Buford. “So far, I have only gotten positive feedback.” 

While he has taken to dabbing a bit of lavender essential oil on the inside of the patient’s mask, he also recommends using some post-surgery. Just ensure that you pick natural, plant-based essential oils that don’t irritate your wounds or interfere with your medication.

## **4. It could be a full house**
From your very first consultation, you’ll be dealing with your board certified plastic surgeon and maybe a nurse or two, so it’s only natural to assume that these will be the only people with you in the operating room. While this may be true for quick, non-invasive procedures (think: [Botox®](https://aedit.com/procedure/botox-facial), [fillers](https://aedit.com/procedure/temporary-lip-fillers), and the like), most surgical procedures ([breast implants](https://aedit.com/procedure/breast-augmentation-with-implants), [facelifts](https://aedit.com/procedure/midfacelift), etc.) will have an operating room bustling with a number of medical professionals. 

In addition to your surgeon, there will be one or two registered nurses, a scrub or surgical technician (to ensure that the surgeon has all the necessary tools), an assistant to the surgeon, and an anesthesiologist (i.e. the person who administers the anesthesia and monitors your breathing throughout the procedure).

“If I am going to have a fellow, resident, or medical student observing the procedure, I make sure to let the patient know beforehand,” says Dr. Bloom. For many doctors and surgeons, it’s a regular practice to allow fellows and residents to observe procedures as part of their training process — but they should give you an adequate heads-up. If it’s something you’re uncomfortable with, just let your doctor beforehand.

## **5. It’s normal to have a sore throat when you wake up**
If you’re undergoing general anesthesia, keep in mind that you’ll likely be waking up with a sore and irritated throat. Once you’re sedated, you’ll be intubated and placed on a ventilator. And, while the breathing tube is resting in your mouth, it also extends into your throat and windpipe, which makes your mouth, teeth, and gums very dry. 

The remedy to tackling a sore throat is rather simple:

- Drink plenty of fluids post-procedure
- Invest in some throat lozenges ahead of time
- Be sure your oral care routine includes brushing your teeth and tongue

“The recovery time is a maximum of three or four days,” says Dr. Cabin. “And, generally, the discomfort passes quickly.” But if it does last longer than the suggested time period, check in with your doctor.

## **6. Stay away from herbal remedies**
Most patients know that alcohol and caffeine should be strictly avoided before and after a procedure, but even some natural alternatives (like ginseng, fish oil, milk thistle, ashwagandha, ginkgo biloba, St. John's wort, and kava) may be off-limits as well. “We recommend that patients stay off herbal remedies for two weeks before and post-procedure as a cautionary measure,” says Dr. Cabin. “Not only can they interfere with medicines used during anesthesia, but they also increase your blood pressure and risk of bleeding.” 

Instead, both Dr. Bloom and Dr. Buford recommend supplements, like [MEND](https://mend.me/), to help optimize the body in preparation for surgery and facilitate faster healing post-op.

## **7. Prepare for any allergies** 
Your doctor is going to have you tested for just about any kind of allergy to make sure that everything goes smoothly on the day of the procedure, but, as a patient, it’s also your job to help them cover all the bases. 

Make sure you ask for a list of any medications they may be using and check that against any other medications you’re currently taking to ensure they can be used together. Also, ask your doctor for recommendations on how to combat allergies should they suddenly occur post-procedure. 

In rare cases, some patients can develop a reaction to medical adhesives, like Mastisol, that are used to secure wound dressings. In such instances, it’s essential you immediately reach out to your doctor, so he or she can prescribe medication or offer alternatives to combat the allergy. 

Some patients, meanwhile, can be moderately to severely allergic to latex products, which manifests as lip or tongue swelling, rashes, or unusual sensitivity. In this situation, doctors can use non-latex products during the procedure and suggest other options for post-op products as well. 

*Patient’s name has been changed

Heading in for a cosmetic procedure but don’t know what to expect in the operating room? Fret not, The AEDITION is here to help you tackle the unknown with #ProTips from surgeons and patients alike.