Reader Question~ Insurance
June 2nd, 2010
From Katie:
Dr. Bashioum,
I am interested in upper eyelid surgery because I am noticing more hanging of the skin on my upper eyes. When I spoke with my family physician about it, he has recommended that I have it done by an ophthalmic surgeon, as I may be eligible for insurance coverage. I am sensitive to having facial surgery by anyone other than a plastic surgeon. Will you accept insurance for this procedure?
The demand for cosmetic surgery in my office has allowed me to opt out of third party reimbursement. In other words, patients directly pay for any of the cosmetic surgery done in my office. I do not believe that cosmetic eyelid surgery or any elective cosmetic surgery should be covered by insurance. There remains considerable disagreement as to whether these cosmetic procedures should be submitted for insurance reimbursement.
Mirror, Mirror. Unrealistic Expectations?
May 24th, 2010
There is an old saying among general surgeons, “If you don’t operate, you will not have complications.”
The same can be said of cosmetic surgical results. On occasion, the results of surgery do not go according to plan. All surgeons have surgical results that are less than optimal. Occasionally some surgery may benefit from a secondary surgery to improve the result.
The causes of less than optimum results are complex. Complications such as unwanted bleeding or infection may occur, compromising recovery and healing. Sometimes patients do not follow after care instructions as carefully as they could, which can lead to problems. Pre-existing medical conditions may also interfere with healing and scarring. The surgical design may just not work out for a particular patient. Generally, the final outcome is a combination due to some or all of these factors.
Revision surgery is often difficult. Changes in anatomy are normal following surgery, so that must be taken into account when planning revised surgery. Feelings of disappointment and possible misgivings by the patient are not to be over-looked. Expectations of perfection may present undue anxiety during recovery, as a result of unrealistic goals. It is necessary to understand the limitations of the procedure. Even the most talented surgeon is unlikely to transform prospective patients into their Hollywood idols. Communication between patient and physician is key to maintaining healthy expectations of having surgery.
Surgical results are rarely perfect. The decision to perform revisional surgery is generally based on the likelihood of improvement, weighed against the risk of making things worse.
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