What is KYBELLA?

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* Individual results may vary. Refer to disclaimer below.

What is KYBELLA?

KYBELLA® is the first and only FDA approved injectable drug that contours and improves the appearance of submental fullness. A common cosmetic complaint, submental fullness or lipodystropy, is excess fat in the anterior neck under the chin. Up until recently, the only effective way to remove the fat was liposuction. While effective and economical, some people are opposed to invasive procedures, even minimally invasive techniques like liposuction.

KYBELLA® is an injectable treatment from Allergan. KYBELLA® is a formulation of deoxycholic acid, a naturally-occurring molecule in the body that aids in the breakdown and absorption of dietary fat. When injected into subcutaneous fat, KYBELLA® causes the destruction of fat cells. Once destroyed, those cells cannot store or accumulate fat.
Basically, what it’s doing is disrupting the fat cell membrane. After that, the fat cell releases its fatty contents and the body metabolizes and disposes of the fat. As for the recovery itself, there is an inflammatory component immediately following the injection. There is some swelling and some discomfort for a few days because the body is cleaning up the cellular debris and creating some contraction in the skin.

Typically 2-4 treatment sessions are required to achieve desired results. Each treatment is spaced at least one month apart. After the aesthetic goals are achieved, re-treatment with KYBELLA® is not expected. The cost of KYBELLA varies based on how much fat there is to treat and what your doctor charges, depending on the area in which you live. Each treatment session ranges in price between $800-$1600. Adverse effects include possible numbness, swelling, and bruising.

Are you afraid of needles? COOLMINI™ from CoolSculpting by Zeltiq is achieving good results as well. Zeltiq boasts “no needles, no surgery, no downtime”. COOLMINI™ is FDA cleared for the treatment of submental fat. It was designed for small areas of fat including submental fat, axillary fat (the fat in front of your arm pit), knees and other smaller bulges of stubborn fat. On average patients can expect 20% reduction in fat after each treatment. Typically 2-3 treatments are required for optimal results. Each treatment session is approximately $1000. Adverse effects can include post-treatment discomfort. No bruising or swelling is expected.

For more information on KYBELLA and other treatments we offer, contact Board Certified Plastic Surgeon Dr. Guy Cappuccino in Mount Airy at 301-829-4110.

Treatment of Acne Scarring

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* Individual results may vary. Refer to disclaimer below.

Acne can leave noticeable scars that are damaging both cosmetically and emotionally. This has traditionally been a vexing problem for patients and doctors alike. Fortunately there have been recent advances in treatment. Current options for correction of acne scarring include: microdermabrasion, microneedling, laser resurfacing, platelet rich plasma (PRP), highly focused radio-frequency microneedling (INFINI), and certain dermal fillers (Bellafill). All of these treatments are aimed at smoothing the contour of the damaged facial skin.

The acne treatments can be broken down into 4 categories:
1: dermal abrasion (sanding)
2: CIT (collagen induction therapy) healing from within
3: Subcision (surgically releasing the depressed scar)
4: Dermal fillers-filling the scar depressions

1: In the dermal abrasion category we have traditional dermabrasion and microdermabrasion. Microdermabrasion uses a fine spray of crystals with suction to gently sand the outer layer of skin cells. It is a less aggressive version of dermabrasion, once the primary treatment for acne scarring, but now almost abandoned due to it’s significant recovery period. Microdermabrasion is often used in conduction with other modalities to boost effectiveness. When used alone the results are modest.

Fractionated laser resurfacing, (PIXEL) uses beams of laser energy from a carbon dioxide laser to burn tiny channels in the skin. Using varying depths and power levels, impressive smoothing of the outer layer of skin can be achieved with minimal downtime, usually just 2-3 days. When applied deeper, these lasers can also stimulate collagen production adding to the result.

2: Collagen induction therapies involve stimulating the body to heal the scar by developing new collagen and elastin where the damage occurred. Microneedling is a minimally invasive procedure that involves the use of a mechanized device that contains fine needles. The needles are use to puncture the skin to create a controlled skin injury. Each puncture creates a channel that triggers the body to fill these microscopic wounds by producing new collagen and elastin. New collagen and elastin production can improve acne scars, reverse years of sun damage, and enhance the overall appearance of aging skin. Micro-needling also helps the skin absorb treatment serums (such as hyaluronic acid or vitamin C) 80% more effectively deeper into the skin. Think of it like aerating your lawn when fertilizing.

Platelet rich plasma, or PRP, is an adjunct to microneedling. PRP harvests the patient’s own activated platelets and then directs them to the site of the scarring. The activated platelets cause a significant boost in collagen production when combined with microneedling. The PRP can also be injected directly into the depressed scar to stimulate healing and smoothing.

INFINI is highly focused radio-frequency microneedling. It adds RF energy to the tips of shielded micro needles to apply heat at deeper levels in the skin. The heat causes thermal micro-injury to the skin and boosts the body’s healing process to tighten skin and fill scars. This is the most recent advancement to collagen induction therapies. Downtime is 2-3 days and the results have been impressive.

With any of the collagen induction therapies, results will take time to be noticeable. Rebuilding your collagen will take up to 6 months so your skin will continue to improve over 6-12 months.
The number of sessions required depends on the condition of your skin and your desired outcome. On average for mild acne scarring we recommend 3 to 4 treatments. Deeper scars and stretch marks may require upward of 5 treatments. An interval of 4 to 6 weeks between treatments is typically recommended.

Subcision is simply using a needle or sharp instrument to undermine, or release the tethered scar. When performed alone the results are less than ideal, but when combined with PRP or a dermal filler, it is a powerful tool.

Dermal fillers are the last treatment option for acne scarring. Recently the FDA approved Bellafill for the treatment of some types of acne scars. When combined with subcision, the undermined acne scar is back-filled with Bellafill to immediately smooth the scar. As the Bellafill is dissolved by the body, new collagen is deposited in its place, making the results near permanent.

For more information on the treatment of acne scarring, contact Dr. Guy Cappuccino in Mt. Airy at 301-829-4110 or visit us at www.DrCappuccino.com

Dermal Fillers

Dermal fillers

Dermal fillers are injectable treatments that improve facial appearance by adding volume to the face as needed to combat the aging process or augment natural facial features. Dermal fillers are one way to truly restore your youthful appearance. When celebrities and models age 45 or older have facial skin that looks really smooth, plump, and young, you can bet a big part of the reason is that they have had dermal filler injections.
Fillers are composed of a bio-compatible material that slowly breaks down over time. Dermal fillers fall into three common categories: hyaluronic acid fillers (Juvederm, Restylane, Silk, Belotero) collagen (Cosmoderm), or synthetic materials (Radiesse, Artefill, Sculptra). Short duration fillers last approximately 3 months while the longest lasting temporary fillers can last 2 years or more. Each type of filler has advantages and disadvantages. Which filler to use and where is best determined after consultation with your physician.
When used for facial aging, fillers used to soften the deep lines around the nose and mouth (nasolabial folds), smooth facial wrinkles, restore lost cheek volume, camouflage jowl lines, fill under-eye hollows, or restore lost cheek volume. They can also be used below the skin as volumizers to lift the cheeks, smooth lip wrinkles, enhance lip shape, lift the brow, or enhance the jawline. Fillers can even be used to rejuvenate aging hands! Dermal fillers are not the same as neuromodulators (Botox). Botox treats wrinkles by relaxing the muscles causing the wrinkles. Dermal fillers actually fill the wrinkle. Unlike Botox, the results are immediate.
Many of my patients are reluctant at first to try dermal fillers because they are turned off by some celebrities who look plastic or “overdone”. When celebrities look weird it’s because they specifically want that look. I know it sounds crazy, but hey, they got noticed! I always assure my patients that usually they cannot spot someone who has had fillers done, because those people just look normal, but more youthful.
Side effects and allergic reactions are very rare. Most common concerns after injections involve temporary swelling following injections or bruising. Unevenness, under correction, palpable nodules, and bluish tint (tyndall effect) are less common, but more concerning. In my professional opinion, choosing an expert in dermal fillers is the key to consistent, outstanding results. Only choose a board certified plastic surgeon or dermatologist experienced in cosmetic injections for your procedure. All dermal fillers should be performed in a medical setting with sterile instruments. Treatments done in homes, hotels, spas, or resorts are not being done in medical environments, regardless of who is doing them.

For more information on dermal fillers, contact Dr. Guy Cappuccino at (301) 829-4110

What is a mini-facelift?

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* Individual results may vary. Refer to disclaimer below.

One of the most common surgical procedures I perform is the so called mini-facelift. For patients with lower facial laxity, jowls, and sagging cheeks it can offer outstanding correction. But what makes it mini?

Different doctors will define mini-facelift differently. For some it is shorter scars and less undermining, for others it means less dramatic results with shorter downtime. So when researching mini-facelifts, understand there will be different definitions and be sure to ask your doctor exactly what it means for them. Also, the mini-facelift technique can go by different names such as “S lift” or “lifestyle lift”. It is important to realize that with surgical procedures, every patient, surgeon, and operation are unique.

For my patients a mini-facelift has the following features: performed in-office under local anesthesia only, invisible self-dissolving stitches, short inconspicuous scar, no bruising, minimal swelling, minimal discomfort, and just a few days of social downtime at most. I incorporate all of the key features of traditional facelifts to ensure maximal results and longevity while minimizing costs and recovery time.

The mini-facelift takes about three hours to perform. After the procedure, patients can drive themselves home if they wish. The results are visible immediately, but the aesthetics improve over the course of 1-2 weeks as swelling subsides. Typically we incorporate cheek volume restoration in the form of filler, (temporary or permanent) or fat transfer at the time of the mini-facelift. This allows us to create a more youthful look with a less invasive procedure.

One of the biggest concerns I hear when people are considering a facelift is that they don’t want to look, “pulled”, “wind-blown”, “surprised”, or “fake”, and invariably they tell me about a friend or neighbor who had a facelift done and looks ghastly. Well, it’s true, some facelifts can be overdone and yield those results, but that is the rare exception. You see, you can only spot the overdone patients. The people with superior facelifts don’t look obvious, but just look natural. A well done facelift in my hands results in a rested, rejuvenated, youthful look, not weird or obvious.

Expect results to last 5-10 years, but this is very dependent on how well you take care of your face. Sunscreen and good topical skin care products go a long way to maintenance of results. Combined with injectables such as Botox and fillers, results can last even longer.

For more information on mini-facelifts contact Dr. Guy Cappuccino in
Mt. Airy at 301-639-2897 or visit www.DrCappuccino.com

What is PRP hair restoration therapy?

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* Individual results may vary. Refer to disclaimer below.

What is PRP hair restoration therapy?
PRP (platelet rich plasma) therapy for hair loss is an exciting new non-surgical therapeutic option for men and women who require stimulation of hair growth. It is a state of the art, non- surgical, totally natural, alternative medical procedure used for the treatment of hair loss or hair thinning due to androgenic alopecia (common baldness). The treatment involves withdrawing a sample of the patient’s own blood, processing it so only the PRP growth factors remain, and injecting it into the scalp to stimulate natural hair growth. Human blood contains mesenchymal stem cells and blood products that contain essential and specific growth factors that assist in tissue regeneration and healing. Published medical literature from Europe and the United States confirms the safety and use of PRP therapy. The primary purpose of using PRP in hair restoration is to stimulate inactive or newly implanted hair follicles into an active growth phase.

What is involved in the treatment?
The doctor takes a little blood which is then prepared in a centrifuge so that only the enriched cells or platelets (PRP) remain. Topical anesthetic is used to numb the scalp to be treated. The PRP, including essential growth proteins is injected into the scalp or areas to be treated using a special micro needle. The entire procedure takes approximately 45 minutes. 3 sessions are required, each 2 months apart. Maintenance treatments are recommended every 6 months or one year as needed. In addition to the PRP therapy it is recommended to use Minoxidil and DHT blockers. It is possible to use PRP hair restoration therapy alone to promote hair growth or it can also be used in combination with hair transplant or restoration surgery.

Does it really work?
PRP is a potential emerging non-surgical based therapy for natural hair follicle stimulation for thinning hair. Larger clinical studies are pending but the current medical literature contains numerous optimistic results. One recent study of 100 patients undergoing PRP hair restoration showed an increase in hair density of 30% at 3 months following treatment. The life cycle of a hair follicle can last from 2-8 years and has 4 stages: anagen (growth phase), catagen (regression phase), telogen (resting phase), and exogen (shedding phase). New hair only grows in the anagen phase so it may take a few months to see new hair growth after your PRP treatment.

What does it cost?
PRP hair restoration therapy varies from approximately $750 per treatment for smaller balding areas like the vertex of the scalp, temple areas, or frontal hairline, to $1500 for a full scalp treatment. For more information on PRP hair restoration therapy contact Dr. Guy Cappuccino in Mt. Airy at 301-829-4110 or visit www.DrCappuccino.com

Questions and answers about unwanted facial hair

Approximately 40% of women during menopause will experience unwanted facial hair. This condition called hirsutism refers to the growth of coarse, dark hair in areas where women typically grow fine hair or no hair at all, for example above the lip and on the chin.
What causes hair growth on my face? When we are younger estrogen dominates and our face typically has vellus hair. Vellus hair is the fine, short and almost invisible hair. Men on the contrast have terminal hair which is darker, coarser and longer. The key hormone that controls the type of hair is dihydrotetosterone (DHT). Higher levels of this hormone can convert vellus hair to terminal hair. As we approach menopause our estrogen levels drop and there is an increase in DHT (an androgen hormone).
In some cases the extra androgen comes from medications. Some birth control pills as well as certain steroids contain androgens, or have effects similar to androgens. Other drugs indirectly cause the body to make extra androgen hormones; these include some medicines to treat schizophrenia, seizures, migraine headaches, bipolar disorder and high blood pressure. Some disease processes such as Polycystic Ovary Syndrome can cause hair growth but it’s seen most often during menopause.
Are there any medications to control hair growth? Yes, medications containing estrogen such as birth control can alter the impact of androgens. Some doctors will prescribe an anti-androgen medication called Aldactone.
What treatments are available for permanent removal of facial hair? The common response is to tweeze these pesky hairs. Research has proven plucking can actually stimulate the hair follicle into an active phase causing the hair to grow quicker and thicker.
The FDA has approved two modalities of treatments to permanently remove unwanted hair:
– Laser Hair Removal – Is the treatment of choice for dark facial hair.. A series of 5 treatments is recommended to assure all cycles of hairs are destroyed.
– Electrolysis – This is the treatment of choice for blonde, red or blonde hair or darker skinned clients. The technician treats each hair follicle so each treatment takes longer with more sessions needed.
Many of our clients will start with laser hair removal, and finish their sessions with electrolysis for the remaining thin or grey hairs.
What laser machine works best? When you are ready to start your laser procedures please note the “gold standard” lasers for hair removal is the Light Sheer Diode laser and the Alexandrite laser. There are several multiplatform lasers available on the market today used for hair removal such as the YAG laser or IPL (Intense Pulse Light). Often they are not strong enough to deliver enough heat to destroy the follicle leading to poor outcome. Being an educated consumer will save you money and time and reach your desired outcome.

Eclipse Reverse TR Tattoo Removal

 

Over 45 million Americans have tattoos. That includes 40% of all Americans ages 26-40. At some point, some of these tattoos will no longer be desired by their owners and they will seek options for removal. I have been very interested in tattoo removal for years, but have felt that the existing technology was imperfect, until now. Previously, tattoo removal techniques were centered around laser removal. Specific wavelength lasers were needed for each color ink to be removed. That meant that multi-colored tattoos required multiple lasers and numerous treatments for removal, sometimes 8 or more treatments. Sometimes the tattoos could not be completely removed. Furthermore, these treatments can be painful and the costs add up. So I have waited for a new and better technology to arrive. I am proud to say that I am the first physician in the State of Maryland to offer this ground-breaking technique- Reverse TR (tattoo removal) from Eclipse Aesthetics.

Reverse TR is a novel tattoo removal system. The system is based on METR (mechanized epidermal tattoo removal) technology. Essentially, it is the reverse process of tattooing, hence the name. Prior to treatment a topical anesthetic is applied. With METR, a very thin needle is used to dispense a special, natural solution to the tattooed area. This needle consists of several micro-needles. During the treatment process, the Eclipse Reverse and METR technique causes the tattooed pigments to be expelled to the surface of the skin in the form of small scabs. It takes approximately 2 weeks for the scabs to form. The ink becomes part of the scab and falls off.

 

The Eclipse Reverse works with all tattoo colors, of all ages, all sizes, and all styles. Small tattoos may be removed in one session, however it will typically take 3-4 treatment sessions for complete removal of larger tattoos. The average period between treatments is 6-8 weeks. The Reverse tattoo removal system is typically less expensive than traditional laser removal techniques and requires fewer sessions.

For more information on Eclipse Reverse or to schedule a consultation- call Dr. Guy Cappuccino at 301-829-4110

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* Individual results may vary. Refer to disclaimer below.

What are PRP facial treatments?

Recently I have received a number of phone calls regarding PRP (platelet rich plasma)  treatments.  PRP facial treatments use constituents of the patients own blood to stimulate the skin’s natural healing response.   PRP has long been used in orthopedic medicine, dentistry, and reconstructive surgery, and now its benefits are being applied to dermatology and cosmetic medicine. PRP contains growth factors which stimulate skin regeneration. Platelets are a component of our blood necessary for normal clotting. However, these same platelets when activated, release several proteins as well as growth factors which stimulate the body’s healing processes, including increasing collagen formation, skin-tightening and overall rejuvenation. PRP treatments are more generically known as ‘Facial Stem Cell Regeneration’ therapy.

PRP facial treatment is a quick 30 minute procedure. A small amount of blood is drawn from the patient and spun down in a centrifuge to separate the different components of the blood.
Red and white blood cells are divided from the platelets and the plasma (the clear fluid). This plasma now contains a fivefold increase in the number of platelets. The separated platelets are then activated with calcium chloride, to release more growth factors. Topical anesthesia is given and the platelet-rich plasma is injected into the appropriate areas with micro-needling techniques.

The treatment is ideal for individuals looking for gradual but noticeable improvement in skin texture, tone and color with minimal downtime. The treatment yields a rejuvenated and healthier skin appearance. When combined with companion therapies such as injectables or non-invasive skin tightening technologies such as INFINI or Pixel laser, the results can be dramatic!
It can be used on all skin types and colors. It helps eliminating skin wrinkles, improves the appearance in those with acne scarring, and hastens the healing process after a facial peel or laser treatment. It also appeals to patients who are looking for an all natural approach to rejuvenate the face.

For best results, we recommend up to three treatments, 4-8 weeks apart, with a booster treatment at around 12 months. Improvement in the skin texture is noticeable within the first month while full collagen regeneration takes 3 months. The improvements continue over the next 12 months, as new collagen production continues to improve the overall appearance of the dermis. The effects last for 18 months to 2 years or longer.

Because this treatment is made from the patient’s own blood, there is no risk for rejection or an allergic reaction. Downtime is minimal and the skin may appear slightly sunburned for up to 48 hours with little or no associated discomfort.

In a future article I’ll go into more uses for PRP including wound healing and hair restoration. I always address new technologies with a modicum of suspicion, however it seems PRP treatments are based in real science and offer another exciting anti-aging option to my ever-growing armamentarium.

For more information on  PRP treatments, contact my office at 301-829-4110 or visit us on the web at www.DrCappuccino.com

Hand Rejuvenation

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* Individual results may vary. Refer to disclaimer below.

While make-up can disguise tell-tale signs of aging on the face, it’s more difficult with hands – which is why it’s often said that hands are the best indicator of age. he
skin on the back of your hands is much thinner than on your face and actually ages faster than your face.

Even if you have taken steps to keep your face and neck looking youthful, sun-damaged, veiny, wrinkled hands can make you look older than you are. As we age our hands lose volume, fat and elasticity. The fatty layer of the hand disappears, so the skin is more translucent and shriveled, and you see underlying structures like bones, tendons and veins. There are a number of effective techniques to rejuvenate your hands, improving the quality and texture of your skin, while decreasing the wrinkling and prominent veins. A number of options are available to restore the youthful appearance of the hands.

Age Spots
Treatment – Lighter more diffuse brown spots are most responsive with prescription grade skin care product containing hydroquinone. Hydroquinone contains a bleaching agent which blocks melanin. This medical skincare will help quickly lighten those brown spots on your hands. If the brown spots are dark and larger this usually indicates it is deeper in the dermis of the skin. This type needs to be treated with a laser or IPL (intense pulsed light) machine where the pigment is destroyed.
Prominent veins and tendons

Treatment- This is due to volume loss as we age. Volume replacement is used to treat protruding bones, tendons or veins. Your plastic surgeon can take fat extracted during liposuction, concentrate it, and re-inject it into the back your hands. Soft tissue fillers, including Juvederm, Perlane, Restylane and Radiesse, can add volume to thinning hands. Another option is sclerotherapy where solution is injected collapsing the prominent vein.

Wrinkled and thin skin
Treatment – Laser skin resurfacing is an excellent way to improve skin tone and texture, while reducing the signs of aging on the hands. Laser resurfacing removes the outermost layer of skin on the hands, leaving only the healthy cells underneath. These can then regenerate a new layer of skin, reducing the signs of fine lines, wrinkles, age spots and other age-related blemishes. Radiofrequency skin tightening devices, such as INFINI are also very useful in improving wrinkled skin on the hands.
Homecare will include daily use of Retin-A, which builds collagen and makes skin look firmer and smoother.
Skin tone and color

Treatment – Chemical peels, IPL, or laser skin resurfacing may be used for skin discoloration, sun damage or soften the appearance of brown sun spots on the hands. Treatment may involve a series of chemical peels or three 10-minute IPL treatments.

While there are many treatments available for aging hands, prevention is always the best bet. Remember that our hands get as much sun as our face so be sure to use sunscreen daily on your hands!

Will my insurance cover this procedure

As a plastic surgeon, this is a question my office gets every week. Will my insurance cover a certain procedure? It seems like it should be a very straightforward question, but as you might suspect, nothing is straightforward when it comes to health insurance. Before I endeavor to make some sense out of this topic, allow me to say that the health insurance industry’s only goal is to make money, not to ensure your healthcare. It makes money by charging premiums and then not paying doctors and hospitals when you want a procedure covered. So when it comes to plastic surgery, it will do everything it can do to say a certain procedure is not medically necessary, and therefore, not covered. In the past few years, getting previously covered procedures approved has become harder and harder. It used to be that doctors would get authorization or pre-approval from insurance companies and that would guarantee that the procedure would get covered. Now many companies are saying “pre-authorization not required”. While this seems great at first, doctors, patients, and facilities have found out the hard way that this really means “proceed at your own risk”. For example, I’ve had multiple patients have a procedure performed only to get a bill from the hospital saying the insurance company has refused payment when they said “pre-authorization not needed”. This has become such a problem that many hospitals and centers are making patients pay ahead of time for certain procedures that are not getting covered routinely. All of this has led some plastic surgeons to stop accepting insurance all together.

Surgical procedures are covered if they are deemed medically necessary. Some plastic surgery is routinely covered, such as trauma, cancer, burns, and wounds. Some plastic surgery is always considered cosmetic and therefore never covered: for example, tummy tucks, liposuction, and injectable fillers. To complicate things, now many policies have small print “exclusions” for common procedures like breast reduction, meaning they are never covered under any circumstance, even if medically necessary. Here are a list of the common procedures that fall in the grey area of medical necessity:

Breast reduction- Most insurance companies will cover this procedure if the patient has symptoms related to overly large breasts and a certain amount of breast tissue by weight needs to be removed. The higher your body weight, the more needs to be removed. Of course, this amount is different for every woman. But in general, going from a DD to a C cup is not going to be covered. Going from a G to a C would be. Typically at least 500 grams (Slightly over one pound) needs to be removed from each breast from a woman who weighs under 175 pounds. Each insurance company has their own formula and your doctor can help you understand if the procedure would be covered.

Rhinoplasty- Rhinoplasty is covered only if there is breathing impairment, such as a severely deviated septum. Oftentimes, insurance companies will requre CT scans to validate this finding.

Upper eyelids- Upper blepharoplasty may be covered when the excess skin impairs vision. This must be verified through a visual field exam done by an independent optometrist. Even when visual field defects are verified, the procedure often doesn’t get paid by the insurance company. Ask me how I know.

Removal of excess skin following weight loss- With the recent increase in weight loss surgery, we are seeing more patients who have lost 100 or more pounds coming in with the desire to have the excess skin removed from their trunks, arms, and legs. The only procedure which we can sometimes get covered is a panniculectomy. A panniculectomy is surgical removal of the overhanging skin of the lower abdomen. But there must be documentation of severe skin infections and/ or open wounds. Even when these conditions are met, many insurance companies treat this like a tummy tuck and simply refuse to pay.

Botox- We all know about the cosmetic benefits of Botox, but there are some medical indications as well including migraine treatment. But this requires extensive documentation from the doctor managing your migraines and IF the doctor injecting Botox gets paid, it can take months. So most doctors, myself included, do not accept insurance for medically indicated Botox.

Breast cancer reconstruction- The good news here is that so far all procedures relating to breast cancer reconstruction are covered. This includes treatment of the opposite, non-cancerous breast to maintain symmetry. So in the case of breast cancer, breast implants, lifts, and reductions may all be covered.

If you have any more questions regarding the insurance coverage of plastic surgery procedures contact my office at 301-829-4110. I accept most insurances. For now….