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The changing face of plastic surgery in Roanoke

The changing face of plastic surgery in Roanoke

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Giving birth brings big changes in the lives of women. Besides bottles, diapers and fatigue, the body after baby isn’t the same as it was pre-pregnancy for most new moms.

What some mothers yearn for, besides a full night’s sleep, is their old body. Enter the “mommy makeover,” designed to restore the pre-baby body, and, the thinking goes, the new mom’s self-confidence through plastic surgery.

It’s taken hold in Roanoke, according to Dr. Kurtis Moyer, chief surgeon at Carilion Cosmetic Center.

“It’s our most popular procedure,” he said.

The “mommy makeover” is not a single procedure, but could include a tummy tuck or liposuction to take care of post-pregnancy pounds; and breast augmentation, breast lift or breast reduction to improve sagging or deflation, Moyer said.

It’s one of several trends and changes in plastic surgery in the past decade. For one thing, more people are having it and not apologizing or hiding it. The late Joan Rivers is partially to thank for that. The comedian was known for the numerous times she went under the knife and talked openly about it.

According to the American Society of Plastic Surgeons, 15.6 million cosmetic procedures, including both minimally invasive and surgical, were performed in the United States in 2014.

Plastic surgeons also perform procedures to improve the appearance or function of a body part: after an accident or a mastectomy, for example. That is considered medically necessary. But it’s the cosmetic surgery industry — considered elective (read: insurance doesn’t pay) that has boomed in recent years.

Today, there’s a widespread acceptance of cosmetic procedures to improve a person’s appearance or signs of aging, according to several plastic surgeons in the Roanoke Valley.

“The stigma is vanishing,” Moyer said. “Open discussion has drastically changed in the last decade; there’s talk about it in social situations.”

Dr. Barton Thomas, in his 22nd year of practicing in Roanoke, agreed.

“It used to be thought it was for the rich and famous, and over decades, people came to realize that you don’t have to be a celebrity to want to look better,” he said. “People also understand it’s very safe and will have results they can count on.”

Both Thomas and Dr. Enrique Silberblatt, considered by some to be the dean of Roanoke Valley plastic surgeons, said it’s not so much about vanity as it is about improving quality of life.

“So many people have had something done that attitudes have changed,” Silberblatt said. “If it’s something that makes you feel better about yourself, why not?”

Breast augmentation is the most common surgery he performs, followed by facelifts and tummy tucks.

More and more people, mostly women, don’t seem to mind paying to feel better about themselves. The cost of a procedure can range from hundreds to thousands of dollars.

“It’s not cheap, but for most people, it’s affordable,” Silberblatt said.

Women comprise by far the majority of cosmetic surgery patients, but men are having work done as well. Silberblatt said the number of male patients has increased in the past decade and accounts for about 10 to 15 percent of his practice.

The most popular procedure he performs on men: It’s a toss-up between a facelift and eyelid surgery, but not too far behind is male breast reduction. Increase in male breast tissue can be a side-effect of taking certain medications, Silberblatt said.

Moyer said liposuction on the lower abdomen and rhinoplasty (nose job) are the most common procedures he performs for men. Face- and neck lifts are next.

“There are men in sales positions who want to compete, want to lose the excess fat in their face,” he said.

Another major change: customization. Thomas said no longer is there a cookie cutter approach to plastic surgery — where one operation such as a facelift takes care of a host of problems. It’s individualized to what a client needs.

“We’re more defined in what we’re trying to change, and smarter about what works.”

Knife versus the needle

The hottest trend in plastic surgery is not surgery, according to Silberblatt. The time he spends on non-surgical procedures such as injecting fillers and Botox far outnumbers the time operating, he said.

“You can measure time spent on something or the numbers done, but 95 percent is nonsurgical” he said.

With the growing popularity of nonsurgical procedures has come the proliferation of medical-type spas, where patients can receive fillers or Botox, sometimes from noncertified medical personnel eager to jump on the bandwagon. They may charge less, but in the long run, it may cost you more.

Silberblatt, Moyer and Thomas stressed the importance of having board-certified plastic surgeons perform your procedures.

“People spend more time researching their new TV than they do on their surgeon,” said Moyer. “Know your surgeon and know his or her credentials.”

Traveling abroad for surgery has become more common. While it may cost less to travel outside the United States for surgery, the old adage “buyer beware” rings true.

“There are very well-trained surgeons all over the world, but how do you know that they are? It’s hard to evaluate,” Silberblatt said.

“Anybody looks great when nothing goes wrong. It’s when something happens, when you have a problem, who’s going to take care of you?”

Mistakes do happen.

Surgical complications, including scarring, infection, excessive bleeding and side effects, as well as disappointing results that don’t meet the patient’s expectations, are among the risks of cosmetic surgery.

“You have to prepare them to make sure they understand that in addition to the results they’re going to get, there may be side-effects. If we’re doing body-contour surgery after massive weight loss, they have to understand they will have significant scars,” Silberblatt said. “They’re trading better contours for a scar that when they get down to a bathing suit, probably will be very visible. Are they OK with that?”

All three surgeons said not meeting expectations is the most common complaint from patients. If you go in expecting to come out looking like Justin Bieber or with a body like Beyoncé, you’re probably being unrealistic.

“People come in and ask for something not realizing what’s involved in it. They weigh 300 pounds and want a tummy tuck; it’s not safe,” Thomas said. “The culture presents that anything can be done for anybody.”

Thomas, Silberblatt and Moyer all said they’ve turned would-be patients away. If Thomas doesn’t feel comfortable doing something or if he believes the request is unreasonable, he won’t do it, he said.

There’s also the matter of connecting with the patient, Silberblatt said. Sometimes, it’s intuitive; if you don’t connect with the patient, you shouldn’t be operating on them.

There was the time a want-to-be patient came into Silberblatt’s office and asked about surgery to have a third breast.

“I started evaluating and decided this is not something I want to do.”

But, most of the time, if you want work done, plastic surgeons are willing to do it. And the procedures are cheaper, safer and better than ever. A youth-obsessed culture and constant reminders of the importance of how we look is fueling the trend.

“I think people, for better or worse, are very aware of the cultural beauty standards because they are bombarded with advertising all the time. Advertising leaves not-so-subtle hints of what each of us should look like,” Silberblatt said. “In commercials, you never see mature women who aren’t attractive. In the back of our minds, when we look in the mirror, we think ‘I need to do something or I may not be attractive enough for who I’m trying to be attractive for.’”

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