Cosmetic Surgery Serving Washington, DC - Dr. Roger J. Oldham Board Certified Plastic Surgeon

Feb 06 2009

Is breast reduction surgery covered by insurance?

Insurance companies vary greatly in their policies and practices about providing insurance coverage for breast reduction surgery.  Insurance companies generally examine the facts and circumstances of each case in an effort to distinguish a breast reduction procedure performed for cosmetic reasons from a breast reduction procedure which is done because of associated medical conditions caused by the breast size.

All insurance companies require that the breast tissue excised be weighed and all companies have a minimum requirement for the amount removed in order to qualify for coverage. 


Jan 30 2009

I understand insurance companies will sometimes pay for a blepharoplasty. Under what circumstances will they cover this surgery?

It is unusual for an insurance company to pay for blepharoplasty surgery.  However, if the procedure is necessary for normal vision, it may be covered.  For example, if there is sufficient amount of upper eyelid skin which hangs over the eyelid margin and obstructs vision, there is a chance for insurance coverage.  On the other hand, lower eyelid blepharoplasty surgery is always considered cosmetic, since excess skin there does not obstruct vsion.

Jan 16 2009

What is the best age to have a facelift?

The best age for a facelift is highly variable, depending on a person's history of sun exposure, facial bone structure and many hereditary factors.  The aging feature which is usually the first to appear is generalized skin laxity in the lower cheeks, adjacent to the corners of the mouth.  This laxity often appears first in the forties. The next aging change to develop is jowl formation, characterized by loose skin bulges along the jaw line.  Skin laxity in the neck occurs at various ages and to different degrees with skin textural changes, wrinkles and visible looseness.  Each of these aging features can be addressed by plastic surgery and results are typically very rejuvenating.

Jan 09 2009

I have had breast implants for ten years and I am concerned that they could be ruptured. How would I know?

If you have saline implants, the saline leaks out of the ruptured implant and is harmlessly absorbed by your body.  Eventually, all of the saline leaks out and your breast returns to the same size it was before the surgery.  If you have silicone implants, the silicone is not absorbed so the size of the breast remains the same.  Usually a mammogram or, more likely, a MRI would need to be performed to determine if your implant is ruptured.

Dec 26 2008

How long does a facelift last?

The longevity of a facelift depends upon many factors, including facial bone structure, skin thickness and elasticity, the extent of environmental damage and heredity.  Some patients will begin to demonstrate some further aging features 7-10 years after an initial facelift, but these can be readily improved with a repeat procedure.  For other patients, those changes may not be noted until 12-15 years after the initial facelift.  Most importantly, however, after any facelift procedure, the face still looks better, even after 25-30 years, than it would have looked without the facelift surgery.

Dec 19 2008

FICTION: A year-around bronze glow from very mild sun exposure looks so attractive and youthful, it must be healty.

FACT:  While a suntan gives the appearance of health and vigor, chronic sun exposure produces premature aging by breaking down the elastic fibers and thinning the layers of the skin.  While ultraviolet rays from the sun improves skin complexion temporarily, the long term detrimental effects of the sun far outweigh the short-term positive benefits.

Dec 12 2008

I have heard that Botox can help prevent or reduce future lines and wrinkles. How does that work?

Botox acts by relaxing the muscles.  If a muscle does not fully contract, the skin over the muscle does not wrinkle.  Repeated contractions of the muscles can cause deep wrinkles in the skin, which eventually will produce a permanent crease.  After that happens, even Botox will not fully eliminate the crease.  If Botox is injected at the first sign of wrinkling, a deep crease will never develop.

Sep 12 2008

I have a friend who has breast implants in front of the muscle. My doctor, however, recommends placement behind the muscle. Which is the best technique?

Approximately 25 years ago, drawing upon experience gained from post-mastectomy breast reconstruction patients, plastic surgeons began placing the implants behind the pectoralis muscles of the chest for cosmetic breast augmentation.  The technique gained popularity, and is now the most commonly used placement for implants, largely because of two advantages:  1) post augmentation mammograms are more reliable, because less breast tissue is obscured when the implant is positioned behind the muscle; and 2) placement behind the muscle lowers the incidence of capsular contracture, a post-surgical hardening of the tissue around the implant, which can make the breast feel undersirably firm.

Sep 05 2008

Botox being used to minimize scars.

Botox, which has been widely used for several years in plastic surgery to minimize deep lines and wrinkles, is now being used to minimize scars.  In a study from the Mayo Clinic, plastic surgeons injected Botox into the skin of the foreheads and upper cheeks of patients following excision and closure of skin lesion sites.  As expected, Botox minimized general movement of the area.  Since the movement of the skin surrounding the surgical site often adversely affects the healing process, they found that the Botox-injected wound sites, which had minimal motion, produced superior scars.

Aug 22 2008

Lipo Dissolve

A lot is being written in the lay press about Lipo Dissolve (Mesotherapy) for removal of unwanted fat in the hips, thighs, abdomen and elsewhere.  Various agents are injected into these areas of unwanted fat and this is sometimes done by unlicensed practitioners.  Injecting these solutions are designed to dissolve fat in the subcutaneous layer of the body, but to what degree and with what accompanying side effects, no one knows.  Lipo Dissolve is not a substitute for weight loss or for the more effective procedure of liposuction of larger volumes of fat.  Unfortunately, very little is known about the safety of the solutions and the technique is not endorsed by The American Society of Plastic Surgeons and is not FDA approved.

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