Only procedures that can be performed under local anesthesia are performed in the office. Otherwise all other procedures are performed at a fully accredited hospital (Mountainside Hospital) or an ambulatory surgical facility (North Fullerton Surgery Center), both in Montclair, NJ.
The American Academy of Facial Plastic and Reconstructive Surgery (www.aafprs.org) is the world’s largest specialty association that represents over 2,700 facial plastic and reconstructive surgeons throughout the world. The AAFPRS is a National Medical Specialty Society of the American Medical Association (AMA), and holds an official seat in both the AMA House of Delegates and the American College of Surgeons board of governors. AAFPRS members are board certified surgeons whose focus is surgery of the face, head, and neck. AAFPRS members subscribe to a code of ethics. Specialization in medicine has been one of the major enhancements in patient care over the last generation. AAFPRS members not only have a precise focus in patient care but they also have had more comprehensive training in facial surgery than any other medical specialty. All AAFPRS members are board certified by a specialty board recognized by the American Board of Medical Specialties. A majority are certified by the American Board of Otolaryngology, which includes facial plastic surgery. Others are certified in plastic surgery, ophthalmology, plastic surgery, and dermatology. A growing number of members are board certified by the American Board of Facial Plastic and Reconstructive Surgery. The AAFPRS is the world’s largest association of facial plastic and reconstructive surgeons ? with more than 2,600 members ? whose cosmetic and reconstructive surgery focuses on the face, head and neck. Academy fellows are board-certified and subscribe to a code of ethics.
The following is adapted from the AAFPRS website (www.aafprs.org): All facial plastic surgeons are physicians who have undergone many years of education and training: 16 years of elementary school through college and four years for medical school. After 20 years of education the physician applies for a ?residency? in a particular subject. A ?resident? is a licensed physician who is pursuing further post-graduate training. Most facial plastic surgeons choose an Otolaryngology-Head and Neck Surgery Residency. This is a very competitive and selective process, and most come from the upper 25% of their medical school class. Then residency begins with a minimum of 1 year of general surgery, though some programs require 2 years of general surgical training. The resident then begins otolaryngology specialty training, which lasts 4 to 6 years. The surgeon will finish and be ready to practice facial plastic and reconstructive surgery after having completed 27 years of study. In the Otolaryngology-Head and Neck Surgery residency, the physician studies anatomy, physiology, illness and treatment for head and neck diseases, of children and adults. The specialty is further subdivided. Rhinology is the subspecialty focused on the nose. The resident learns the internal working of the nose both for breathing and for sinus infection. This study is paramount to future study and surgery for nasal appearance. While it is nice to have a beautiful nose, the surgeon wants to maintain or even improve its normal functions of breathing and smelling. The surgeon also studies ear and throat surgery. The surgeon studies what is called ?trauma? wounds from external sources. Parts of this world are violent, and there is an incredible volume of smashed, cut and battered faces. The resident spends hundreds of hours repairing and reconstructing these victims. This serves as an excellent training ground for the young facial plastic surgeon, for reconstructing the traumatized face deepens knowledge about bony and soft tissue anatomy, normal and abnormal appearance and all the requisite principals of facial reconstruction: the same skills that are important in cosmetic surgery. Throughout this period the resident also studies facial plastic and reconstructive surgery. Some residents spend time carrying out research. This is an important study, for it teaches scientific thinking and investigation. At the completion of this residency, the surgeon must first pass a comprehensive two day written and oral examination, before he or she is ready to practice. This training in the primary surgical specialty of otolaryngology/head-and-neck surgery represents the typical five-year training after graduation from medical school. Some facial plastic surgeons also enter aspects of the field through similar training in other specialties, including ophthalmology, dermatology, and general plastic surgery. Some surgeons with special interest in facial plastic and reconstructive surgery then compete for one of the coveted facial plastic and reconstructive surgery fellowships. This is a full-year program offering a unique opportunity to study with one of the AAFPRS’s master surgeons. Pediatric head and neck surgery includes congenital birth defects, head and neck tumors of childhood, infection and pediatric facial trauma. Head and neck cancer is an important part of the training for it teaches the young surgeon important details about the anatomy of the head, neck and face. Reconstruction is also studied. Skin cancer treatment and reconstruction are part of this training and makeup a large portion of the resident’s training. During this year the surgeons study all aspects of the field including congenital deformity, trauma, cancer reconstruction, cosmetic surgery and aging face surgery. They train with their mentors and immerse themselves in their study. At the completion of the fellowship, the surgeons take yet another rigorous written and oral examination covering the entire field of facial plastic and reconstructive surgery.
Several factors determine the best type of anesthesia ? the extent of surgery, the patient’s general medical status, and the patient?s desires. There are basically three main types of anesthesia. Local anesthesia refers to topical sprays, ointments, or injections to numb up a given area. Injections can be diffuse to numb a general area, or specific nerve blocks can be performed to numb a very specific area. Intravenous sedation. Here, the patient typically receives not only injections to the surgical site but also medications through an intravenous line. The patient will not remember or feel any events and is breathing on his/her own. Supplemental oxygen is typically given through the nose or mouth. General anesthesia. This requires a temporary breathing tube typically through the mouth through which the anesthesiologist administers gaseous agents. The breathing tube is then removed at the end of the procedure. General anesthesia offers the ?deepest? level of anesthesia.
Often the most accurate quote can only come after a consultation after which an exact procedure(s) has been deemed appropriate. Any initial consultation fee is applied towards the overall cost of any procedures. Typically insurance plans do not cover any cosmetic procedures. Dr. Liu does participate in several insurance plans which may cover at least partially the fees if the problem is functional. For cosmetic procedures performed at a hospital, there are surgeon’s fees, facility fees, and anesthesia fees.