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Frequently Asked Questions

Questions from a recent public information symposium, A More Beautiful You, held by Cleveland Clinic's Department of Plastic Surgery.

Questions asked of James E. Zins, MD, chairman of Cleveland Clinic's Department of Plastic Surgery.

What does Restylane do? How is it different from Botox?

Restylane is very effective in smoothing out and filling in bothersome wrinkles and lines, particularly in the lower part of the face. It has several advantages over other filler-type materials such as collagen – it lasts longer and causes very little adverse reaction. It is easy to administer (injected through a small needle), and once its effectiveness has diminished six months to a year later, it is safely absorbed by the body. Produced in Sweden, Restylane is a crystal-clear gel made from hyaluronic acid, a substance that occurs naturally in the body. It acts as a shock absorber and lubricant in the joints and keeps skin plump. The biotechnologically produced version has been used safely and effectively to treat more than a million people in 60 countries since 1996, and has been the subject of several clinical trials.

Restylane and Botox (botulinum toxin) often are used in a complementary fashion. While Restylane is best for the lower face, Botox is great for wrinkles that occur in the upper face - crows feet or the vertical frown lines between the eyebrows - because it paralyzes muscle and nerve endings, stopping the skin from wrinkling.

If I have Botox or Restylane, how often would I need to repeat the injections?

Botox lasts about 3 to 4 months, and the treatment can be repeated as needed. When it wears off, you will begin to notice increased muscle action and some reformation of the wrinkles. It appears that with repeated use, the effect of Botox becomes longer-lasting.

Restylane injections last for about 6 months, and can also be repeated as needed.

How do I know what size breast implant is right for me?

The decision is based on a number of factors, including the patient's desires, reasons for the surgery and overall health. For example, are you doing it because you feel your breasts are too small relative to your body contour or are you unhappy with the size and firmness of your breasts following pregnancy, breastfeeding or major weight loss? Unevenness between the breasts can also be a motivating factor. Your surgeon can help you make the right decision during your presurgical appointment(s).

Will a partial face-lift take away wrinkles from lower face and neck?

This can only be determined after you are evaluated by a plastic surgeon, but any kind of plastic surgery in this area should improve your appearance.

If the bones in my nose are too fragile to modify, can you construct or implant new bone from silicone or other bone?

No, we cannot.

Do face and neck exercises work to reduce sag?

No, they do not.

Does a person’s voice change after rhinoplasty?

A few patients notice small change in their voice after rhinoplasty but this is uncommon. Professionals who rely on their voice, such as singers, should share any concerns with their surgeon, however, because the nose does play a role in how we sound.

Does plastic surgery have lasting negative effects on a person with MS?

A referral would be needed from the physician who is treating your MS to determine if it would be recommended.

What type of mini face-lift can be done to raise cheekbones? What is the recovery time?

The available options can only be discussed after having an evaluation with a plastic surgeon. Recovery time is approximately 2 weeks.

If a patient has a heart condition, is plastic surgery with general anesthesia safe?

It depends upon the patient’s disease and current medications. Talk to your plastic surgeon about your specific situation.

How is a patient’s physical condition evaluated prior to surgery?

A complete pretesting series of appointments is done prior to any surgery.

What should I look for in a cosmetic surgeon?

Here are some tips on choosing a qualified surgeon:

  • Select a physician who is board-certified by the American Board of Plastic Surgery. This means that the physician has completed specialized training in plastic surgery and has passed a rigorous written and oral examination.
  • Consider the physician’s experience. How long has he or she been performing this procedure? Is the latest technique being used? Does the physician have special training in the use of a technique or new technology? How many procedures has he or she performed? In general, the more experience the physician has in performing a procedure, the better the results.
  • Have your questions been answered? Have you been informed of possible risks, side effects and recovery time associated with the surgery?
  • Obtain as much information as you can about the procedure, discuss your questions and expectations with your surgeon and carefully evaluate the credentials of the physician and hospital before you proceed.
Do you perform tumescent liposuction?

Yes, tumescent liposuction, a new technique that results in less bruising, less swelling and a quicker recovery than older traditional methods of liposuction, is routinely performed at The Cleveland Clinic. Tumescent liposuction uses a large volume of dilute epinephrine to cause intense constriction of the small blood vessels, which leads to less bleeding, less bruising and less swelling.

Does your group perform abdominal surgery that is liposuction?

Yes, we do liposuction of the abdomen.

How does the cost of the neck lift compare to the cost of a facelift?

The facelift is somewhat more expensive because more surgery is performed. A neck lift is a more limited procedure.

How much does it cost to have the puffiness in my eyes taken away?

The initial consultation fee is $80. The final cost of any surgery is not determined until you see your physician.

Questions asked of Marnie Godfrey, BS, Manager of Aesthetic Services and Skin Care Specialist

What does copper do to the skin? Is there any concern about toxicity?

Copper restores the skin’s ability to repair itself. It promotes collagen and elastin by minimizing fine lines and wrinkles. It may also improve blotchiness. Copper is important in the production of glycosaminoglycans (moisture) and works as an antioxidant to defend the skin against free radicals. There have not been any documented cases of toxicity. Copper is the third most abundant mineral in the human body, followed by zinc and iron, and is utilized by essentially every cell and organ.

Do you offer photo regeneration for rosacea?

Yes. We offer the La Roche-Posay Toleraine line of products for patients with rosacea. There are no preservatives or fragrance in these products. Some patients will also be prescribed Metro gel and cream. Occasionally, the copper products work well to keep the skin soft while decreasing redness. If the patient is experiencing bothersome broken facial capillaries, we will refer him or her to a dermatologist.

What can you do to correct puffiness and bags under the eyes?

We have several eye products available to help reduce puffiness. The newest product is from La Roche-Posay’s Hydraphase line. Hydraphase eyes can be used daily to help hydrate the eye area and reduce puffiness. This product comes with a guide for lymph drainage technique in the eye area. In more severe cases, a referral to one of our plastic surgeons to discuss surgical options may also be warranted.

What do you recommend to control acne?

We offer several products that include salicylic acid for mild acne. More moderate to severe forms of acne may require a prescription for topical antibiotics or retinoids. Treatments such as Micro Peel Plus and Blue Light therapies may also be suggested.

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Call us for an Appointment

To schedule an appointment with a dermatologist or plastic surgeon, contact the Dermatology & Plastic Surgery Institute at 216.444.5725 (or toll-free 1.800.223.2273, ext. 45725).

Same-day Appointments

To arrange a same-day visit, call 216.444.7000