F.A.Q.

Yes. There is only one certifying medical board in the specialty of plastic surgery that has any real significance – The American Board of Plastic Surgery. This is the only board that requires a highly rigorous and regulated 6 years of residency training in plastic and reconstructive surgery. Certification by any other board is not equivalent to the American Board of Plastic Surgery. I recommend that you confirm on the board website that your surgeon is in-fact “board certified” by The American Board of Plastic Surgery. Follow this link.

There is an initial $500 consult fee in my practice for any cosmetic consultation. As a courtesy, this fee will be applied to your surgical balance should you wish to proceed with surgery. For non-surgical consultations (i.e. botox, fillers, etc.), the consult fee will be applied to any recommended treatment.

I have extensive experience taking care of children. I have performed over 1,000 pediatric laceration repairs. Other procedures I commonly perform include otoplasty for correction of prominent ears, scar revisions, and mole/birth mark removals. I have 3 young daughters of my own and therefore have a natural ease dealing with children.

Pricing varies greatly from patient to patient as treatment plans are customized by me for each patient. My staff is happy to provide a broad estimated cost range over the telephone. During your initial 60-90 minute cosmetic consultation, I will discuss a detailed assessment and plan and an itemized price quote will be provided by my Surgical Coordinator at the end of your visit.

There is a very wide range of pricing for cosmetic surgery. The bottom line: you get what you pay for. I price my surgeries commensurate with a unique group of highly trained, board-certified Park Avenue plastic surgeons. I am Harvard fellowship-trained with extensive experience in cosmetic surgery of the breast, body and face. Approximately 30% of my practice (50% of my aesthetic breast surgery practice) is revisionary cases previously performed elsewhere. Don’t shop for a surgeon based on price. As the old adage goes: “good plastic surgery is never cheap, and bad plastic surgery is always expensive to correct”.

Surgery that is purely cosmetic in nature is never covered by insurance. However, if cosmetic improvement is needed for a scar or as a result of a pre-existing medical or surgical condition, it may be covered. Breast cancer reconstruction is also commonly covered depending on the type of insurance plan and condition. My highly trained Surgical Coordinator and Insurance Counselor will be able to guide you through any financial decision-making as part of your surgical consultation process.

I do not participate with any insurance carriers, meaning I am not in-network with any policies. However, many policies have an out-of-network option which allows you to see non-participating physicians such as myself. Depending on your out-of-network policy, they may reimburse you all or some of my fees. My staff are experts in dealing with out-of-network policies and can gladly assist you. Prior to seeing me for consultation, my staff can check your benefit plan and give you a very good idea of what can be covered and what percentage of the charges will be reimbursed. In special circumstances and depending on your policy (i.e. breast cancer reconstruction, abdominal wall reconstruction, cancer reconstruction), I may elect to proceed with surgery and accept the allowed amount from insurance. Please call our office to discuss your specific situation.

No. Any cosmetic surgery performed by me includes unlimited follow-up appointments. I will give you a detailed follow-up plan for the first year after surgery. Additionally, I prefer to see all post-surgery patients annually to ensure that results are maintained, and implants monitored where appropriate. There is never a charge for these visits. Should you feel more comfortable with more frequent or additional visits, my staff and I are happy to accommodate.

I have a detailed scar treatment protocol for every cosmetic surgery I perform. I provide all medical-grade scar creams and tapes necessary for you to adhere to my treatment plan. This is included in your surgical package. I ask that you not purchase or undergo any additional scar treatments unless first approved by me. Modalities such as lasers, dermabrasion, etc. are not performed for at least 6 months after surgery and may be at an additional cost.

I custom order all garments necessary for your surgery. This is provided or fitted at the time of surgery or during one of the standard post-op visits. There is no additional cost for these garments.

I operate at multiple facilities and will advise you as to which will be best suited for your particular case. Most cosmetic surgeries are performed at an in-office AAAA-certified facility or an ASC (Ambulatory Surgery Center). Additionally, I have operating privileges at Mount Sinai Hospital, Lenox Hill Hospital, New York Ear & Ear Infirmary, and Englewood Hospital.

For most cosmetic procedures, patients can return home with an adult escort after the short recovery period. For Facelift and Abdominoplasty surgery, I require that you stay in the immediate area after surgery for one full day for safety and close monitoring. I may also require that you have one of our specialized aesthetic nurses with you for 24-48 hrs. Most of our patients choose to stay at The Carlyle, Mark or Surrey hotels if they do not live nearby or feel comfortable staying at home while they recover. Coordination of post-operative appointments, hotel accommodations and nursing care is all coordinated directly through our office.

It is more important to consider what procedures are being combined.

I commonly perform multiple procedures during a single surgery. Doing so has several benefits: mainly minimizing overall time necessary for recovery. Most of our patients are most constrained by their ability to devote time to recovery, being limited by time off work and their need to take care of children. For this reason, cosmetic breast surgery is commonly performed together with an Abdominoplasty and Rectus Diastasis Repair. This operation is commonly referred to as a “Mommy Makeover”. Blepharoplasties are commonly performed together with Facelift or Breast Surgery. Liposuction can be performed with almost any other procedure.

An additional benefit of combining procedures comes in the form of scaling down costs of operating room and anesthesia fees.

Appropriate aging for Botox and fillers has shifted as products improve and our ability to better treat specific areas augments.  There are benefits to beginning Botox treatment to the forehead and crows feet by the mid to late 20s.  I always tell patients that there are both short and long-term benefits of Botox treatment.  In the short-term, wrinkling and creasing of the forehead is minimized. If you are consistent with Botox every 3 months, the wrinkled dermis can repair itself in a permanent fashion so that even at rest, wrinkles disappear.  There is no question that if a patient starts Botox at age 25 and is consistent for 10 years, they will be far better off at age 35 or 40 than their non-treated counterparts.  Earlier than age 25, I believe is not indicated for most cosmetic applications.

Fillers can be appropriate at any age, depending on what a patient’s objective might be.  Fillers restore or create volume.  If the patient feels that their lips or cheeks may be deficient in volume, then they may be a candidate at any age. 21 is usually our earliest cut off in the absence of congenital anomalies.

Texturing on the shell of an implant serves to act like a “Velcro” and keep the implant positioned on the chest wall.  Certain types of implants, such as anatomic tear drop shaped implants, have an axis of orientation, meaning an up-down direction.  As such, texturing is needed to maintain the implant in appropriate orientation within the breast pocket.  Smooth round implants also come in a textured variety and are more popular in Europe.  Additionally, you may have heard in the news about a very rare condition associated with textured implants called Anaplastic Large Cell Lymphoma (ALCL). Albeit very rare, this condition has been shown to occur specifically with textured implants.  I have not used a textured implant for a cosmetic patient since 2012.  Occasionally, in breast cancer reconstruction I may see a need for a textured implant.  A very detailed discussion regarding the pros and cons of various implants is part of the consultation process.

Any surgery requires in-depth discussion and planning. I recommend you come in for consultation as soon as you feel ready to begin the process of acquiring information. I often meet with my patients 2-4 times prior to surgery and will advise you as to when is the optimal time to have surgery. Typically, I like for patients to wait an average of 6 months after childbirth before performing any cosmetic surgery. This may range from 3 – 12 months, depending on individual scenarios. Weight gain/loss, breastfeeding, etc. will influence this timing.

It is a common myth that breast implants need to be replaced every 10 years. This is not true. Spontaneous implant failure rate does increase by about 1% per year, after ten years. How long exactly implants will last is unknown and varies from person to person. The expected range is between 10 and 25 years. If your breast aesthetic has changed because of aging, breastfeeding, pregnancy or change in personal desires, then it may be a good idea to perform revisional surgery and use the opportunity to replace the implants. In the absence of any issues, I will advise recommendations for implant exchange, including any urgency and optimal timing. Each of the three FDA approved implant manufacturers offers some degree of warranty against implant rupture. Providing me with your implant card will allow me to inquire about the warranty on your behalf.

It is a common misconception that only overweight patients are tummy tuck candidates. In fact, the majority of patients in my practice are weight-appropriate and physically fit. A tummy tuck consists of several main components – removal of skin excess, liposculpting/fat removal, muscle (rectus diastasis) repair and possible umbilical hernia repair. Some women may only have a rectus diastasis that needs to be addressed. Before & After photographs of all body types are available in our office for your review. Additionally, my staff is happy to connect you with a patient of similar body type and age so you can obtain a first-hand account of the experience.

Rectus diastasis is a permanent separation of the rectus muscles that results from pregnancy. Nearly 100% of women will have some degree of rectus diastasis after pregnancy. Some women may have a severe diastasis or separation after just one pregnancy. Others may have a minimal diastasis after multiple pregnancies. Women have different tissue qualities and symptomology associated with the separation. There is no exercise or physical therapy that can restore the rectus muscles back to their original anatomic position. Because the rectus muscles are the main flexors at the hips, any weakness and separation can result in a mechanical muscular imbalance at the hip. Not only are there significant aesthetic benefits to fixing a diastasis during abdominoplasty, but there are mechanical advantages that are equally important. This repair will help strengthen the core, strengthen the rectus muscles, and significantly reduce the risk of lower back pain or injury.

There is no real ideal time. It is a lifestyle decision. Peaks in presentation are usually seen around college-age and mid-30s. Almost every patient says after surgery that they wish to have done the surgery earlier. The patient satisfaction after breast reduction is exceedingly high, not only anecdotally in my own practice, but it has been well published in the plastic surgery literature. I encourage any woman concerned about the size or shape of her breasts, or that has been considering breast reduction, to see us in consultation to discuss her options. We are experts in helping guide patients through the process and advising them as to what point in their life may be an optimal time for surgery.

Women often seek breast revision for multiple reasons. The most common reasons are size dissatisfaction, older implants, capsular contracture, and overall change in breast shape and aesthetic due to aging and/or childbearing. Very commonly, I see women that finished having children who have had cosmetic breast augmentation in their early or mid-20s. Their implants are often greater than 10 years old and their breast shape and skin has changed due to pregnancy and breast-feeding.

I do not like to compare surgical and non-surgical treatments. Surgery in the right candidate is always better, more dramatic and more permanent. However, not all patients are great surgical candidates and therefore I do offer non-surgical modalities. Additionally, many surgical candidates require maintenance of their results with non-surgical treatments.