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The board-certified plastic surgeon talks myths and reality

Q&A with Thomas Bartell, a board-certified plastic surgeon.

Q: Can you explain what plastic surgery actually is, and what reconstructive and cosmetic procedures are?
A:
It’s a common misperception that people think “plastic surgery” means using plastic the material. The word plastic comes from the Greek word plastikos, which means to mold or give form to. And that’s what plastic surgeons do—mold the human body. [The field] got a boost after World War I during which people suffered from tremendous injuries. General surgeons had to come up with new ways to treat those patients.

There are two types of surgeries, reconstructive and cosmetic. Reconstructive is designed to return an abnormal or diseased structure back to normalcy. That’s why traditional insurance policies won’t pay for cosmetic procedures, but will pay for reconstructive procedures. Reconstructive surgeries might include a cleft palate, breast reconstruction after mastectomy, genetic abnormalities and traumatic wounds. Cosmetic surgeries are the tummy tucks, breast augmentations, et cetera.

Q: What are common misconceptions about plastic surgery?
A:
The cosmetic side is typically portrayed as done for rich and very vain people. I don’t see rich and vain people around here—that might be the case in Beverly Hills or New York. Here in the Midwest I perform surgery on average people; many patients finance their surgeries with loans. They’re average, middle-class working people who want to feel better about themselves.

The primary operations I do are breast augmentation and tummy tucks. (Dr. Bartell also does breast lifts and reductions, liposuction, arm lifts and post-weight-loss surgery. He doesn’t do facial work anymore).

Q: Are there any health reasons to have cosmetic surgery? Are any procedures covered by insurance?
A:
The one procedure I do that does have insurance reimbursement is breast reductions. Women with large breasts can have pain in their neck and shoulders, rashes under the breasts—it can be a legitimate problem. It’s rare for people to have physical symptoms for the cosmetic procedures.

Q: What’s changed in the field?
A:
The advent of outpatient surgery. You didn’t see that twenty or thirty years ago. When I started my general surgery training, for the tiniest little operation, patients would come in the hospital the night before, come in for tests and it was a three- to four-day deal. Here I do major surgeries in my operating room and the patient can go home.

Q: How do you help patients determine whether they’re a good fit for plastic surgery?
A:
In my patient consultations (which are free and no obligation), I’ll ascertain what bothers them and what their general health is to see if they’re a reasonable candidate. Then I’ll show them how the procedure is done and what types of expectations they can have. I don’t operate on everyone—obviously they need to be healthy. If they have uncontrolled diabetes or high blood pressure or any other condition that precludes a safe surgery I won’t operate.

I only operate on people who have realistic expectations. I am in the improvement business, not the perfection business. If someone comes in and tells me about a problem and I don’t see it—I can’t fix it if I don’t see it. If the person is overly perfectionist and they’re not going to be happy, I’d be crazy to operate on them.

Q: What are the qualifications consumers should look for in a plastic/reconstructive surgeon?
A:
Look for someone that’s board certified in the field they’re practicing in; in this case, plastic surgery. You don’t have to be board certified to call yourself a plastic surgeon—to practice medicine you need a medical degree and license, but you should also be board certified in your field. Some doctors will take a weekend course in a procedure, and that’s why you hear all of those horror stories about procedures being done in hotel rooms! Your doctor also has to have a license in the state they’re practicing in.

Find someone that specializes in the operation you’re interested in. There are a lot of surgeons that specialize in a lot of different areas.
You want to go to someone that you can connect with. So it may take a couple of [interviews with] surgeons to figure out who listens to your concerns and will be there after your surgery if you have problems.

Shayna Miller is associate and style editor of Madison Magazine.

Read more Health & Wellness columns here

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