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Despite what TV tells you, extreme makeovers, while possible, do not occur
overnight. In reality, most complete makeover shows are not completely
realistic.
"Many extreme makeover TV programs do not realistically show what is
involved in combining multiple plastic surgery procedures," says Cleveland
Clinic-Strongsville Family Health Center plastic surgeon David A. Horvath, M.D.
"They often make it appear that you are able to combine any number of
procedures and fail to show that these are real surgeries with real surgical
risks. In an appropriate patient, many surgical procedures can be combined, but
this is determined only after a thorough evaluation of the patient’s health
and a thorough discussion regarding the true risks and benefits of combining
procedures," he adds.
Makeover shows often gloss over the importance of the physician-patient
relationship that is developed during these discussions. "A good
physician-patient relationship is essential to understand the patient’s goals
and motivations," Dr. Horvath comments. "Such a relationship allows
the plastic surgeon to discuss realistic goals of surgery for that particular
patient, the expected postoperative course and the risks and benefits."
Surgical scars are part of plastic surgery and recovery involves some down
time, immobility and swelling. These issues, however, are often far outweighed
by the potential gains of the surgery, as long as patients have realistic goals
and expectations, Dr. Horvath explains. The makeover shows rarely portray the
significant amount of time a doctor takes planning the surgery and explaining
surgical techniques to the patient, he adds.
For patients in excellent health — without any heart or lung problems or
increased risk of blood clots (deep vein thromboses) — Dr. Horvath will
combine procedures. "A typical patient is a middle-aged woman who has had
several children, is near her ideal body weight and comes in unhappy with the
changes in her body. We discuss the loose skin and stretched abdominal wall, the
little potbelly, perhaps her breast shape. In these patients, it is common to
perform a tummy tuck (abdominoplasty) combined with a breast lift or breast
enlargement (augmentation) and sometimes liposuction of the flanks to improve
their waistline. If she has realistic expectations, she will likely be very
happy with her outcome."
Dr. Horvath says he enjoys combining multiple surgical procedures for
appropriate patients as long as safety is not compromised because "these
are some of the happiest plastic surgery patients we have."
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