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Plastic Surgery Q and A: Dr. Mulholland Answers Your Questions

November 12, 2015

Plastic Surgery Q and A Dr. Mulholland Answers Your Questions

When considering plastic surgery, people tend to have several questions about their procedure of interest. Dr. Mulholland, a Toronto plastic surgeon, always encourages his patients to do their research and ask whatever they want to know before making decisions. Below are just a couple of questions Dr. Mulholland answered regarding travelling abroad for plastic surgery, facial asymmetry and losing weight before surgery.

Question: I’d like to have a face and necklift away from home and spend time recovering for 1-2 weeks before returning. Ideally, it would be somewhere where there is coordination between the doctor’s office & recovery centre to simplify things. Don’t want to go to hotel solo. Would prefer US or Canada, but it seems that Costa Rica has this combo well organized. Any other good options?

The most important factor in determining where to have your face and neck lift surgery is the presence of a face and neck lift surgeon that will be able to achieve the results you want cosmetically. A face and neck lift is a specialized procedure and you want to ensure that your physician has plenty of experience achieving excellent consistent results. I have been performing face and neck lift surgery for well over 20 years. I trained in both plastic surgery and head and neck oncology and face and neck lift is the most common procedure I perform. Many of my patients come from out of town. When seeking this kind of procedure in the Province of Ontario there is no such thing as a recovery or convalescent facility.

These are quite prevalent in the United States, but in the Province of Ontario an accredited surgery centre can only keep a patient overnight for 24 hours. I myself keep all facelift patients overnight for 24 hours where upon they are very alert and able to manage and care for themselves. To add additional quality care in place, experienced outpatient nurses I have deployed for one to two decades can come into the recovery location (usually a hotel located in the Yorkville area) to provide ongoing assistance in the first day or two. We see patients back frequently particularly when they’re out of town to do all the cleaning that is required.

Generally, most patients that I see for face and neck lift that are from outside the city can return home on day 7-10 and it is safe to fly at that time, as well.

Some people travel to foreign destinations for plastic surgery

I would be very cautious when seeking surgery in a foreign jurisdiction such as Costa Rica where, although there can be some excellent physicians, the quality of the surgical location and the facility cannot be verified as easily as it can be by the Province of Ontario and the College of Physicians and Surgeons of Ontario. Complications that can ensue in a foreign jurisdiction can be very serious and when you return home you may not have ongoing physician management of any complications that may ensue.

There are many things to consider when getting face and neck lift surgery. The first is excellent surgical technique and equally paramount is ongoing care and attention following the procedure. I’d be very cautious about cosmetic tourism as any cost savings incurred by a less expensive jurisdiction can be more than outweighed by any complication that may occur. Complications that occur in the Province of Ontario with a certified plastic surgeon are covered by the Ontario Health Insurance Plan.

Question: I plan on getting a mommy makeover with a tummy tuck, breast lift and implants in the fall of 2016. I tore a ligament in my knee that temporarily is preventing me from being active. I am now about 25lbs heavier than I normally am but would like to choose a cosmetic surgeon soon. Should I wait until my injury has fully healed and I’ve lost the excess weight to start setting up and attending consults? Or can I start now and still get a good idea of what’s needed while I have the extra weight?

A mommy makeover is usually the combination of a tummy tuck, breast lift or breast augmentation and often areas of liposuction to the flanks and thighs.

A mommy makeover should always be entertained and planned when one is at their ideal body weight with stability for 3-6 months. I’m sorry to hear about your ligamentous injury, which may prevent you from losing that extra 25 pounds. Although you should not undergo surgery until you’re within 5-10 pounds of your stable weight, you can certainly seek out your consultations with certified and reputable plastic surgeons to gain a sense of which operative environment and team may be right for you. You want to be close to your stable weight just prior to the surgery of good weight maintenance so that any laxity and body shape that would ensue with 25 pounds can be factored into the amount of excision and contouring.

Mommy Makeover Before and After Photo in Toronto

Before and after photos of a mommy makeover patient at SpaMedica

With this planned approach to weight stability and reduction and seeking out 2 or 3 consultations with reputable plastic surgeons, I think you have a good opportunity to achieve an excellent mommy makeover result.

Most patients I find following this procedure extremely happy and thorough discussion of risk, benefit and recovery as well as use of a Vectra 3D imaging for breast enhancement surgery either lift or augmentation or lift augmentation combinations is part of the pre-operative education process.

Question: One side of my face looks fine and the other looks off. My cheek is wider, I have a mole, and it’s kind of lopsided. Can this be fixed? What are the costs?

Thank you for your question and photograph. There does appear to be a slight asymmetry of the eye under eye region and cheek. It’s not uncommon to have jaw line and cheekbone asymmetries and these can be unique and attractive facial characteristics. And, it alternatively can also be corrected to achieve greater facial symmetry. You do appear especially young in the photograph and sometimes in our youth we become preoccupied with subtleties and appearance that become magnified and as we age do not appear to be so important. I certainly would not seek aggressive craniofacial surgery or restructuring and, in fact, you may not seek any cosmetic enhancement at all. However, if you are to look for cosmetic enhancement, seek reversible techniques such as soft tissue fillers using Juvederm Voluma to recreate subtle facial symmetry. I think you’ll find that overall you have attractive facial features and as you age the pursuit of educational advancement degrees and jobs will be more important than cosmetic enhancement.

Posted by Jenn Horowitz