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> My Plastic Surgeon USA Home > Search for Plastic Surgeon > Michael S. Beckenstein, M.D.
Plastic Surgery FAQ Provided by Dr. Michael Beckenstein

Frequently Asked Questions

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Breast Augmentation

Women around the country who desire larger and fuller breasts, are extremely satisfied with breast augmentation procedures. Patients who have lost breast size and shape after childbearing may also benefit from breast augmentation surgery.

By choosing the appropriate breast implant, taking into account both size and shape, and placing it in the right position, Dr. Beckenstein will achieve a natural appearance, eliminating the recognizable "augmented" look. There are several variables that must be addressed to determine how to achieve the best aesthetic result with your breast enhancement surgery. When you visit our office to meet with Dr. Beckenstein, your breast dimensions will be carefully analyzed. After a discussion of your aesthetic goals, you and Dr. Beckenstein will then discuss the incision site, implant location, and implant type.

Breast Implant Incisions

There are three different approaches to inserting breast implants. In the Inframammary Approach, the incisions can be placed beneath the breast, in the new breast crease. Access can also be obtained through the areola (peri-areolar approach) or the underarm ( transaxillary approach). There are advantages and disadvantages to these approaches, which will be discussed in detail during your breast augmentation consultation at our office. The breast implant can be placed above the pectorailis major muscle (subglandular) or beneath this muscle (subpectoral). There are distinct advantages and disadvantages to these approaches and various circumstances will dictate which approach might be better suited to you.

Breast Implant Size and Shape

Breast implants are available in several sizes and shapes and have different shell characteristics. Implant shapes are either round or anatomic (tear drop). The dimensions of your breast and the predicted size increase will determine which implant type is appropriate for you. The outer shells of these implants are either textured or smooth and the choice of which type to use is usually determined by the implant location in relation to the pectorailis muscle. Dr. Beckenstein employs the anatomic approach to breast augmentation which requires a careful assessment of your breast dimensions. He co-authored a chapter in a breast surgery textbook detailing this method. These dimensions are used to choose the appropriate implant to assure the best aesthetic results.

Your Consultation

During your initial breast augmentation surgery consultation you will spend one-on-one time with Dr. Beckenstein. First he will educate you on the procedure, and then you will undergo an extensive examination. During this examination, Dr. Beckenstein will determine the operative plan for your breast augmentation surgery, including implant type, size, and the approach to be used. We listen carefully to our patients and become attuned to their expectations. The final plan takes all these factors into consideration. We want to achieve a natural appearance and not the "augmented" look that is too obvious!

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Breast Lift (Mastopexy)

A breast lift is a common breast enhancement surgery performed at our plastic surgery center. As a woman matures, especially after having children, her breasts may decrease in size and lose their shape. This is due to a loss of skin elasticity and breast volume which causes ptosis (sagging). There are varying degrees of ptosis which is measured by the position of the nipple to the breast fold. The degree of ptosis will determine what procedure(s) are best suited to restore the aesthetics of the breast. Breast augmentation may be recommended for lesser degrees of ptosis. If the nipple position descends lower, a breast lift procedure may be necessary.

Both breast augmentation and breast lift surgery restore breast aesthetics by restructuring the breast tissue and surrounding skin. External scars are required with these methods, and depending on the degree of ptosis, the amount of visible scarring varies. Scars can be limited to just outside the areola (pigmented area around the nipple) for less severe forms, or they can extend vertically to the base of the breast. For more extensive ptosis, a full inverted "T" scar is required. If there is sufficient breast volume, the breast lift alone will be sufficient to restore the breast aesthetics. If there is significant volume loss or if a patient wants larger breasts, Dr. Beckenstein can perform breast augmentation surgery in conjunction with the breast lift.

Breast lift surgery is often a complicated procedure and requires extensive consultation before proceeding. We make sure every breast lift patient who visits our practice has a full understanding of all risks, benefits, and alternatives prior to surgery.

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Breast Reduction

Breast reduction surgery is one of the most gratifying procedures we perform. Patients are extremely satisfied with their surgery. The symptoms of back, shoulder, and neck pain are immediately and permanently alleviated with this procedure. Our patients are up and walking the night of their breast reduction surgery and have expressed tremendous satisfaction when they experience a "new sense of freedom" resulting from the weight off their chest. A more aesthetic shape is also obtained with a breast reduction, achieving a result similar to a mastopexy (breast lift). After their breast reduction patients will not only feel better, they will look better as well! Breast reduction ranks among the highest in patient satisfaction in national surveys conducted by the American Society of Plastic Surgeons. The majority of our patients state that they wish they had the surgery sooner in their lives.

Breast Reduction Methods Explained

Dr. Beckenstein has performed over 300 breast reduction procedures and uses several methods. Which method is best for you will be determined during your breast reduction consultation. The best results are obtained using a superior pedicle which is the pillar of tissue that the nipple is attached to. This method yields long lasting breast fullness and shape which is desirable aesthetically. The inferior pedicle is the most common technique employed by plastic surgeons. This method has the highest incidence of "bottoming out" which results from the breast tissue "sinking" downward causing the nipples to rotate upwards. This yields a lesser aesthetic result and an inferior pedicle breast reduction appearance. Dr Beckenstein employs the superior pedicle method in the majority of his patients. There are some patients who are not candidates for this method and will require an alternate breast reduction technique.

Short scar methods are available to the appropriate candidates. With these methods, the scar underneath the breast will be shorter or non-existent. Breast reduction can also be achieved through suction assisted lipectomy (liposuction). This method eliminates the scarring associated with breast reduction surgery. A very limited group of patients are candidates for this method and it is considered experimental by the insurance companies. The nature of the skin envelope and amount of excess breast tissue essentially determines if a patient is suited for liposuction. Only experienced surgeons trained in this breast reduction method should perform it.

Breast Reduction and Lumpectomy

A lumpectomy can be performed in select patients through a breast reduction. Patients with large breasts requiring a lumpectomy can benefit from this procedure. The tumor and a comfortable amount of surrounding breast tissue can be excised and the reconstruction performed in the same surgery.

During your breast reduction consultation, various options may be presented to you and an operative plan will be devised keeping you, the patient, involved in the decision-making process.

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Breast Reconstruction

Following a mastectomy, breasts can be reconstructed in various ways depending on each patient's circumstances. Implants or your own tissue can be used to rebuild your breasts, and sometimes both methods can be combined. With his extensive fellowship training, Dr Beckenstein has expertise in evaluating and choosing the best breast reconstruction options for you. Several factors determine what method(s) are best suited for you and often patients are given several options. Your body type, breast size, overall health status, and potential for radiation therapy are assessed when choosing the appropriate breast reconstruction procedure(s) for you. Dr. Beckenstein will spend all the time that is needed with you to plan a reconstructive course.

We also provide several other services for our breast reconstruction patients. Our internal support system pairs patients with one another based on personality, region, and other demographic factors. Through these special bonds our patients have a better overall experience. We also set aside a few days a month for our "pampering" sessions which include spa-type activities designed for the special needs of our breast reconstruction patients. Dr Beckenstein, along with a reputable physical therapy team, has also developed a custom therapy protocol. Special massage therapies for each method Dr. Beckenstein uses have been created by having the therapists observe breast reconstruction procedures to develop an appreciation for the anatomy and technique. We also supply access to specialty products such as brassieres, wigs, garments, etc.

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Tummy Tuck (Abdominoplasty)

Abdominoplasty has traditionally been a very successful procedure for patients across the country. Women who have had children can develop abdominal wall laxity known as a diastasis. This is caused when the abdominal wall is stretched by the developing child. After childbirth, the abdominal wall remains stretched and does not return to its pre-pregnancy tightness. Dieting and exercise will not restore the abdominal wall tone. The abdominal skin also becomes lax, especially if there are stretch marks, and excess fat can accentuate the lower abdominal fullness. Women who are close to their ideal body weight are good candidates for an abdominoplasty. Women who are considering having additional children should wait until they are finished before proceeding with tummy tuck surgery.

The best way to find out if abdominoplasty ( tummy tuck) surgery is right for you is to schedule a consultation at our office. Dr. Beckenstein will only recommend treatment after a thorough evaluation of your medical history and discussion of your aesthetic goals.

Abdominoplasty Procedures

There are several abdominoplasty procedures (including mini tummy tuck) available that can restore a more aesthetic contour to the abdomen, depending on the degree of skin laxity, diastasis, and excess fat. The basic premise of these methods is to remove the excess skin and fat, and to tighten the lax abdominal wall.

A traditional abdominoplasty will result in scarring and require relocation of the belly-button. If the outer thighs have excess fat and skin laxity, an extended abdominoplasty can be performed to incorporate this area and re-contour the thighs as well. A belt lipectomy can be performed to address the entire circumference of the lower torso. This will re-contour the abdomen, outer thighs, and gluteal (buttock) regions.

Mini-Abdominoplasty

Women with a minimal diastasis and skin laxity might be candidates for a mini- abdominoplasty. This method leaves only a short scar in the lower abdomen and does not require relocation of the belly button. Although a mini- tummy tuck is also an invasive surgery, because the procedure is more limited in scope, it often requires less recovery time.

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Liposuction

Liposuction patients are generally very pleased with their results. Select patients with excess fat, minimal skin laxity, and no abdominal wall laxity, are candidates for this body contouring method. Men are also undergoing abdominoplasty and liposuction procedures with increasing frequency. While they do not develop diastasis from childbearing, they can still manifest abdominal wall laxity with age or significant weight-loss, and are excellent candidates for several of these body contouring techniques. For both men and women, liposuction can also be performed along with an abdominoplasty in selected sites.

It is important to note that liposuction is not a substitute for a healthy lifestyle. Liposuction and other body contouring procedures produce the best results when they are performed on patients with a healthy BMI (body mass index). Regular diet and exercise are necessary in order to maintain positive results. During your liposuction consultation, Dr. Beckenstein can advise you about proper diet and exercise techniques that will help you maintain your post surgery weight.

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Panniculectomy

Patients who have lost significant weight and some who are overweight with redundant abdominal skin that hangs below the pubic region may be candidates for a Panniculectomy or other post weight loss surgery. This procedure is more for functional and hygienic reasons than pure aesthetics. The excess skin and fat are simply removed to rid the excess tissue that obstructs normal "activity." This procedure is usually covered by insurance.

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Facelift

Your face is your most visible and recognizable feature. Your face is also a finely tuned instrument where the slightest variations can have a profound influence on the way you look. For this reason, Dr. Beckenstein wants all patients who are considering a facelift to be educated about the procedures we offer.

A facelift must be tailored to each individual's features, and requires a thorough examination. Dr. Beckenstein will evaluate your skin, muscle, and bone structure as well as the conditions which are contributing to your appearance.

A traditional facelift will restore the appearance of the jowls, neck, and midface by removing excess skin. Some procedures that will further enhance the outcome of a facelift are brow lift, forehead lift, eyelid surgery (blepharoplasty), cheek lift, facial implants, soft tissue augmentation, and resurfacing techniques to improve the skin's tone and texture.

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Blepharoplasty

Our patients have had wonderful results with blepharoplasty. Eyelid surgery can improve the appearance of the upper lids, lower lids, or both. Eyelid surgery is a relatively fast and easy procedure with a short recovery time.

Blepharoplasty (eyelid surgery) can treat loose or sagging skin around the eyes, excess skin on the upper eyelid which can impair vision, excess fatty deposits which cause puffiness in the upper eyelids, bags beneath the eyes, droopiness of the lower lids, and fine wrinkles on the lower eyelids.

Some of the conditions for which eyelid surgery is helpful are usually caused by aging. Still, when heredity is a factor, some people may benefit from eyelid surgery as early as their 20s and 30s. Young people are particularly bothered by sagging eyelids or dark bags beneath their eyes.

Patients at every age are usually very pleased with the results of their eyelid surgery. Many blepharoplasty patients at our practice have experienced a marked improvement in their appearance from this relatively simple procedure.

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How do I know if plastic surgery is right for me?

Plastic surgery is not right for everyone. Once you have researched your options, and know the risks and the benefits, Dr. Beckenstein can help you decide if plastic surgery is a good option for you. During your consultation, you will be asked and must inform Dr. Beckenstein of any physical or mental health issues so that he may accurately assess whether you are a good candidate for cosmetic (aesthetic) or reconstructive surgery. This is essential for your overall safety.

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How will I know which procedures are right for me?

Educating yourself about the procedures in which you are interested is the first step to knowing which one is appropriate for you. Dr. Beckenstein has provided this web site to help educate his patients. Before you decide to see a plastic surgeon, the information you find here on body contouring, breast enhancement, facial plastic surgery, and facial skin rejuvenation procedures will give you a basic understanding of what to expect. At your consultation the final determination will be made by you and Dr. Beckenstein.

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Will my insurance cover cosmetic surgery?

Most insurance policies will not cover procedures which are strictly aesthetic (cosmetic). If you are having a procedure for health reasons, like a breast reduction in order to treat back pain, then your insurance may cover the procedure. Procedures that are deemed "medically necessary" will often be covered by insurance. Your specific insurance carrier will ultimately make this decision.

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How will I pay for my treatment?

We have a dedicated office staff ready to help you understand your insurance coverage and our financing options. After you meet with our plastic surgeon, you will meet with our insurance specialist or financial consultant. All payment options and financial plans will be presented to you and a good plan will be devised for you.

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How much will my procedure cost?

The actual cost of your procedure depends on many factors and will be determined during your initial consultation with our plastic surgeon, Dr. Beckenstein.

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Where will my surgery take place?

Dr. Beckenstein performs all of his surgeries in hospital operating rooms for your safety.

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What's the most important thing to consider when choosing a surgeon?

There are many important factors you should consider when choosing a plastic surgeon. Education, certification, and the number of times the plastic surgeon has performed a procedure are all important factors to consider. You should not proceed with a surgery unless you have complete confidence in your surgeon, and you feel comfortable and safe.

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What questions should I ask my surgeon?

You must have the utmost confidence in the plastic surgeon you choose. In order to gain this trust, there are several things you need to know about the surgeon BEFORE you undergo your procedure. Dr. Beckenstein has created the following list of questions YOU should ask your plastic surgeon:

  • Are you board certified?
  • By what board? (Make sure it is an ABMS specialty.)
  • How long have you been in practice?
  • Where did you train?
  • Do you have additional fellowship training, and in what specialty?
  • How many of these procedures have you done?
  • When was the last time you performed one of these procedures?
  • How long does it take you to do the surgery?
  • What is the average time for that procedure (by plastic surgeons in your area)?
  • Where do you operate?
  • Is there an overnight stay?
  • Who will be giving the anesthesia?
  • Who will monitor me during recovery?
  • Can I see before and after pictures?
  • Can I speak with some of your patients who have had this procedure?
  • What are common complications with this procedure?
  • Will you personally be taking care of me after my surgery?
  • Have you ever had your license or hospital privileges suspended?

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Michael S. Beckenstein, M.D.
Plastic and Reconstructive Surgery
Office Address:
800 Saint Vincent's Dr.
Suite 610
Birmingham, AL 35205
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Dr. Beckenstein has 23 patients available for view in the Before and After Photo Gallery. Click here to visit.
Dr. Beckenstein has 1 video available in the Video Gallery. Click here to view.
   

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