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WHAT TO K N O W BEFORE YOU GO Six questions to ask your plastic surgeon or aesthetician before any cosmetic procedure

BY BROOKE PRESTON

MARCH 2019 COLUMBUS MONTHLY

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FROM THE RED CARPET to the carpool line, people are finally talking more openly about cosmetic procedures. One result of this cosmetic revolution: procedures once considered taboo or elite have been popularized as they’re injected into the cultural mainstream. According to data from the American Society of Plastic Surgeons, minimally invasive cosmetic procedures have increased nearly 200 percent since 2000. However, this new wave of interest can bring unrealistic expectations or confusion on how to find the best possible provider and procedure for each individual. We asked some of Central Ohio’s top aesthetic doctors to share their recommended questions (and expert answers) to help patients better understand what they should know before they go.

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Michael Sullivan, MD, founder of The Sullivan Centre Procedures performed by The Sullivan Centre: A wide range of surgical, minimally invasive and noninvasive procedures, including rhinoplasty, FaceTite/BodyTite, facelift, eyelid surgery, tummy tuck, breast surgery, liposuction, CoolSculpting and a full spectrum of skin-care treatments including intense pulse lighting, Ulthera, Infini, microdermabrasion and microblading Carol Clinton, MD, founder and medical director of Timeless Skin Solutions Procedures performed by Timeless Skin Solutions: A full range of aesthetic skin care solutions for the face and body, including Botox, chemical peels, CoolSculpting, facial fillers, Kybella, laser treatments, microneedling, Latisse, Secret RF, Titan, ultherapy and Voluma

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Am I a good candidate for this procedure? Prospective patients may be surprised to hear that some individuals need to improve their overall weight and health before they’re a good candidate for a cosmetic surgery, even one designed to remove fat. “No plastic surgery is a substitute for diet and exercise,” says Lichten. “I had a patient come in once who was in the upper 300s [pounds] and wanted liposuction, but she wasn’t a good candidate. You don’t need to have 0 percent body fat, but you should be in generally good health and at a healthy, stable weight—stability is probably more important.” Sullivan notes that he sometimes first connects patients with

an exercise physiologist and nutritionist, inviting them to come back if they’re still interested in a procedure after reaching an appropriate weight. Clinton adds that pre-existing medical issues should always be discussed with your provider well in advance, as they might require altering or even avoiding a procedure. “If you are undergoing chemotherapy and have a port that contains metal, it would prevent me from doing some different procedures,” she explains. “Bleeding disorders may affect downtime and bruising. Patients who have had organ transplants are more susceptible to infection, so we’d be less likely to be really aggressive.”

Jason Lichten, MD, founder and director of Central Ohio Plastic Surgery Procedures performed by Central Ohio Plastic Surgery: A wide range of classic, cosmetic, reconstructive and aesthetic procedures, including body contouring, reconstructive surgery, tummy tuck, facelift, eyelid surgery, liposuction, excess skin tightening or removal, CoolSculpting, facial rejuvenation and fillers, Juvederm, laser treatments, etc.

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them social distress, such as broken blood vessels on the face. Which facility/provider is right for me? Online reviews, robust websites with beforeand-after photos and more can help patients learn about prospective providers—though word of mouth can also be helpful as well. Ask about a facility’s accreditations, as well as professional organizations to which the providers belong, to determine if they’re well-qualified experts in the specific field of your procedure. “Surgeons will all be doing all their surgeries in accredited facilities. Ask how long they’ve been in practice,” Lichten says. “For plastic surgery, [I recommend the provider] be board-certified in plastic surgery; you’ll see there are a lot of people who say they’re ‘board-certified’ and not in what. Ultimately, you have to trust that person.” Are my goals realistic? The downside of more glamorous celebrities showing off the “work” they had done? Unrealistic expectations. “The hardest part of our job is setting proper expectations to let them know exactly what these procedures do,” Sullivan says.

JASON B. LICHTEN, M.D. Understanding that the human body is the finest work of art is what motivated board-certified plastic surgeon Jason B. Lichten, MD, to start his own cosmetic surgery practice, Central Ohio Plastic Surgery, in 2005. Dr. Lichten, voted by his peers as a Top Doctor, specializes in surgical rejuvenation, reconstruction and revision procedures, including breast augmentation, tummy tucks and facelifts, as well as nonsurgical injectables and minimally invasive laser treatments for veins, tattoos and facial resurfacing. Lichten believes plastic surgery is not about becoming someone you’re not, but rather about choosing to express yourself in the way you want to look and feel. Even as an in-demand surgeon, Lichten still manages to have a reassuring bedside manner, a great sense of humor (ask about his family’s annual Thanksgiving whipped cream fight in matching jammies) and a whole-hearted dedication to making sure his patients make informed decisions.

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Is this the right time for me to undergo a procedure? Even if a patient is a good physical candidate, Sullivan recommends they also consider their mental and emotional state, which can affect recovery time and overall long-term satisfaction with their decision. “During a stressful time, such as after they’ve lost their job, [or when they] are going through a divorce, illness or death, people usually are not in the right frame of mind to make good choices for themselves,” he says. “Come back when you’re feeling less stressed. People will always have a smoother recovery if they do.” Lichten adds that patients should plan ahead to be at their best physical condition as well. “I recommend a good, high-protein diet and no smoking for at least a month before and after to have the body in the best shape to heal.” Age can also factor into deciding the right time for a procedure, especially those that are invasive or permanent. Though Clinton generally prefers for patients to be at least 18 before embarking on many procedures, she’s treated children as young as 5 (with parental guidance) for conditions causing

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“For instance, with CoolSculpting, about 15 to 20 percent of the targeted area’s fat will go away with one procedure. It’s hard for people to visualize that. I would say that falls into a very subtle category.” He added that he’ll sometimes recommend a patient save their money toward a more productive future option, as their expectations exceed the procedure’s limits. Patients should consider specifically what they want their end result to be, adds Clinton. “If they look at a picture of themselves from, say, 20 years ago, what do they miss? If they can frame it in that way, then the medical professional can tell them the different ways that they can get there and go through the pros and cons of each.” Which procedure options best match my goals, timeline and budget? Patients should speak to their provider about cost, payment options, potential insurance coverage and how their overall goals and priorities match their budget. One’s personal timeline and schedule should always be taken into account as well. “Someone may have a wedding coming up and want everything done in six months; someone else may have time and money to do the same procedures over three years. Have an open mind about different ways to get to the end point,” advises Clinton. Cosmetic procedures should be viewed as the rungs on a ladder, Sullivan explains, where the bottom rung is non-invasive procedures with no downtime but subtle results, leading incrementally up to the top rung of surgical options, which generally give the most dramatic results, though also with significantly more recovery downtime and potential scarring. “Our mission is really to educate people so they can feel empowered to make the right choices for themselves. There are always options to consider.”

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How much risk, discomfort or downtime does this typically involve? Just because you have seen it on E! doesn’t mean it’s pain-free. “People now look at going to the plastic surgery office like going to the beauty spa,” says Sullivan. “They expect that they will have a procedure with no downtime, scar [or] discomfort and magically have this transformation or this wonderful body.” With any surgery, “there’s pain, recovery, downtime and no guarantees,” says Lichten. “People may underestimate the downtime. The most important thing for people to prepare mentally is that this is surgery. It’s still surgery with risk. These are real operations.” MARCH 2019 COLUMBUS MONTHLY