Tuck ‘n’ Stitch

YourNewBodyBlog.com features two eminent Beverly Hills plastic surgeons, Stuart Linder, M.D. and Robert Kotler, M.D.

Here, Dr. Kotler is known as “FaceDocBlogger” because he devotes his practice exclusively to cosmetic plastic surgery of the head and neck. Dr. Linder prefers to be known as “BodyDocBlogger” because his practice focuses on plastic surgery procedures of the body.

Doctors Linder and Kotler are exclusive to YourNewBodyBlog.com and frequently appear as plastic surgery insiders on news, trends and practices in cosmetic plastic surgery.

Physical Exams Before Plastic Surgery

Many patients arrive for a plastic surgery consultation, fill out their medical histories and then find they must see a second or third doctor for additional testing before the operation. Some are puzzled about why the extra appointments and expense are necessary, and why the patient can’t have the tests done in the plastic surgeon’s office.

After the untimely death of Donda West — who reportedly did have a pre-existing condition — lawmakers in many states are considering legislation that would require medical clearance before a person could undergo a plastic surgery procedure.

Doctors Kotler and Linder explain why extra medical testing can be necessary.

FaceDocBlogger (Dr. Kotler): I think we have enough laws. I’d rather see legislatures do something more useful — like balance their massive budgets! Conscientious cosmetic surgeons don’t need a legislature to tell them what good medical practice is.

BodyDocBlogger (Dr. Linder): That’s right, doctor. Plastic surgeons are physicians first and duty bound to do whatever is in the best interests of the patient. And if that means cancelling a surgery due to an added risk, then we cancel without hesitation. Good medical ethics and practice actually obviate the need for such clearance laws.

FaceDocBlogger: Doctor, you’re as right as rain. Probably the most common condition we see is high blood pressure, followed by type II diabetes and people on anti-depressives, tranquilizers and sleeping pills, along with some cases of asthma. Of course, none of that means you can not have plastic surgery. It just means we are required to check and make sure your medications are working.

BodyDocBlogger: My rule is: patients over 40 must bring me a total medical clearance, including chest X-ray, a pregnancy test, an HIV test and an electrocardiogram done by a board-certified internist I know and trust. Because I deal with plastic surgery of the body, where incisions are much larger, we can’t operate on diabetics. Sugar balances are just too tricky in type I diabetics.

FaceDocBlogger: Some have asked why the plastic surgeon doesn’t do the tests in his or her own office and save time. The short answer: in an era of specialization the internist is best able to do those tests. Otherwise, it would be like a patient going to an internist and asking for nasal surgery!

BodyDocBlogger: Not only that, doctor. We need to know about the other things a patient is taking, from aspirin to herbs to homeopathics to Vitamin E.

FaceDocBlogger: The anesthesiologist also needs to know if there is anything in the patient’s system that will react badly with a general or local anesthesia. We also need a test to show if you have a problem with excess bleeding.

BodyDocBlogger: The more information we have, the better. Some of the worst O.R. tragedies have happened because the patient has not revealed to the physician everything he or she is taking. There can be no secrets between the doctor and the patient.

FaceDocBlogger: Then, perhaps seven to 10 days before the plastic surgery procedure, we ask the patient to stop taking as many compounds — like Vitamin E and aspirin — as possible. The less, the better for surgery.

BodyDocBlogger: And the medical checks do not have to be a financial hardship! These physicals are often covered by your health insurance, although the cosmetic plastic surgery is almost always on the patient’s nickel.

FaceDocBlogger: Actually, there’s one supplement you don’t have to ask about. You can tell the patient is taking it just by talking to them. Know which one it is, doctor?

BodyDocBlogger: I sure do! Garlic!

Have a question for FaceDocBlogger or BodyDocBlogger? Let us know and we’ll do our best to have it answered. Feel free to leave your comments below!