Gynecomastia is a condition of male breast enlargement that occurs in 10 percent of boys around the time of puberty. This problem is characterized by abnormal enlargement of the glandular tissue around the nipple and can become quite large and painful. Usually there is no specific identifiable cause for this condition but it can run in families. In addition, a few medications like Tagamet and certain anti-seizure drugs have been shown to cause it. In about half of the boys who develop this, it will resolve by itself within 2 years of its appearance. If the condition does not resolve within 2 years it most likely will not go away spontaneously and requires surgical intervention.

Fortunately, some Plastic Surgeons are trained in a technique that solves this problem and leaves virtually no visible scars. The procedure is done through a small incision in the lower border of the areola, which is the dark skin around the nipple. Through this incision the glandular tissue is removed and liposuction is done to smooth and sculp the chest wall. This allows muscle definition of the underlying pectoralis muscle to show. This procedure is not very painful and is done as an outpatient. That means the person goes home the same day as the procedure. I frequently perform this operation under a light general anesthetic or “twilight” anesthesia where the patient is somewhat awake. In addition, this operation requires little down time. I expect my patients to be back at work and back in the gym working out within one week or less.

While this is a wonderful operation that helps many men and boys rid themselves of an embarrassing problem, it should only be performed by a board certified Plastic Surgeon. In addition this should be done in an accredited outpatient surgery center. In such surgery centers an anesthesiologist will attend to your comfort while the surgeon concentrates on the results. This is the safest and most effective way to have this procedure. One should ask his surgeon how many of these operations he or she has performed and what facility they use. You should feel comfortable with your surgeon after the consultation and do not be afraid to seek a second opinion if you are not sure.

Breast reduction surgery, called “reduction mammoplasty”, is one of the most popular operations performed by Plastic Surgeons. It is a very gratifying operation to perform because the women who have this done are so relieved of pain and happy they have had this procedure. This operation is also popular because it is usually covered by your health insurance carrier. Insurance companies have set certain criteria to be met in order for this to be a covered procedure. Once these criteria have been achieved, coverage is granted in the form of a letter. I have done hundreds of breast reductions and although every insurance company is different, I have found basic prerequisites that all of them want before approving this procedure.

Insurance companies want documentation that the large, heavy breasts are causing significant pain and disability. They will need to see that “conservative” treatments such as anti-inflammatory medications, physical therapy, or chiropractic therapy have been repeatedly tried over a period of several months and have failed. I ask that primary care doctors, chiropractors, physical therapists, and Ob Gyns send letters of support to the insurance company when I send my letter requesting pre-authorization. This strategy has been successful in obtaining coverage but there are other specific criteria that the companies want to see.

It is always helpful to document rashes that occur under the breasts called “intertrigo rashes”. These are more common in the Summer months and may require prescription creams. It is also useful to document grooving at the shoulders caused by heavy breasts pulling on bra straps. Insurance companies are going to want an estimate of the weight of breast tissue to be removed and I always include this in my letter to them. They are looking for at least seven hundred grams (slightly less than 2 pounds) off of each breast. Once I complete a consultation and examine the patient I can tell how much tissue by weight should be removed. Pre-operative photographs are taken of the breasts (these do not show the face) and they are submitted to the insurance company with the letter.

First, I want to emphasize that this is not a “one-size-fits-all” procedure. Every facelift is unique because no two faces are alike and we all have different goals, desires, and dislikes. An in-depth initial consultation between you and your surgeon should be the starting point. The facelift is then designed to meet your goals. Sometimes only a mid-face procedure is necessary. This covers everything from the jawline up to the temples. Often, the neck needs attention and this can also be included as well as the eyes and brows. Again, this is an individualized operation hence no two are exactly the same.

The facelift should make you look younger, rested, even thinner, but you will still look like “you”. It should not have a tightly pulled or fake look. This is achieved by the experienced Plastic Surgeon striking a balance between your existing facial features and the re-positioning of certain structures. No matter which variation of this procedure is right for you, all facelifts have in common the removal of excess skin. This means that there must be incisions (cuts) involved, which also means scars. As Plastic Surgeons we are trained to minimize and hide scars whenever possible. Still, scars are an inevitable part of most operations. You should ask your surgeon where the scars will be, how long they will be, and how noticeable.

I feel very strongly that facelifts and most larger surgical procedures should be performed in an outpatient surgery center rather than a surgeons office, There are some surgeons who do these operations in their office procedure rooms but this is less than optimal. Surgery centers have all the resources needed should a complication arise or if more supplies are required. In addition they have dedicated sterile spaces and anesthesia personnel if needed. Many times facelifts can be done under local anesthesia with sedation and do not require a full general anesthetic, but it is always good to have an anesthesiologist available should extra comfort be desired.

I have already spoken to women who have had these placed in other countries and we are arranging replacements here in Columbus, Ohio. We are inquiring into the possibility of receiving compensation from the French Government for these women to help with the cost. I would be happy to make inquiries on your behalf.

To set up a free consultation to discuss your implants and whether or not they are the recalled type, please call us at (614) 326-4661.  Thank you

Sincerely,

Steven Robinson, M.D., F.A.C.S.

www.ohioplasticsurgeons.com

The success of body contouring, whether it is done to reduce, enlarge or lift, is influenced by your age and by the size, shape and skin tone of the area to be treated. Some contouring procedures leave only small, inconspicuous scars. More noticeable scars may result when surgical removal of fat and skin is necessary to achieve your desired result. Most patients find these scars acceptable and enjoy greater self-confidence when wearing a bathing suit or form-fitting clothes.

Call today for a consultation with Dr. Steven Robinson, a board certified Plastic Surgeon in Columbus. (614) 326-4661.

Are you certified by the American Board of Plastic Surgery?
Were you trained specifically in the field of plastic surgery?
How many years of plastic surgery training have you had?
Do you have hospital privileges to perform this procedure?
If so, at which hospitals?
Is the office-based surgical facility accredited by a nationally- or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?
Am I a good candidate for this procedure?
What will be expected of me to get the best results?
Where and how will you perform my procedure?
What surgical technique is recommended for me?
How long of a recovery period can I expect, and what kind of help will I need during my recovery?
What are the risks and complications associated with my procedure?
How are complications handled?
How can I expect to look over time?
What are my options if I am dissatisfied with the cosmetic outcome of my surgery?
Do you have before-and-after photos I can look at for this procedure and what results are reasonable for me?
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Am I good candidate for upper arm lift?
Arm Lift surgery can be performed on a large variety of patients including normal weight patients who simply need a little tightening. However the majority of patients are massive weight loss patients that have stabilized their weight loss. They present with excess skin and fat in their upper arms. Many of these patients complain that their arms feel and look like “bat wings”. Occasionally some older women have a lot of extra skin that is bothersome and would also be reasonable candidates.

Ask Dr. Robinson if this procedure is right for you. Email your questions to us or call (614) 326-4661. In office consultations are complimentary.

For more information call us at (614) 326-4661. Happy Holidays!

To see if  liposction is right for you, call today for a complimentary consultation in our office, located at 4661 Sawmill Rd., Columbus. Our telephone number is (614) 326-4661. At the time of the consultation we will talk about your goals, examine the problem areas, look at before/after pictures, and discuss all options.

I have abopted this newer technique for most of my patients and have been very pleased with the results, I have also found that the recovery time is faster. For more information on this procedure please look at my photo gallery under “abdominoplasty”. You may also call us at (614) 326-4661 to ask other questions or to schedule a consultation.