Plastic Surgery FAQ

You can call our office at (918) 228-0911 to schedule a consultation during business hours or submit a form from the website.  If you submit a form, our office staff will contact you within 24 business hours to book an appointment.  It may take a couple of months to schedule a consultation and typically a couple more months after consultation to find an available surgery date, so please schedule accordingly.  

The cost of surgery will depend on the procedure performed.  We are happy to give a general estimate, but a formal quote will be dependent on consultation with Dr Kreitzberg to determine the best procedure(s) to suit your individual needs.  There are three different costs associated with surgery: surgeon fee, anesthesia fee, and hospital/facility fee.  Your quote will include an estimate of these fees.  In order to reserve a surgery date, there is a $350 deposit required.  This deposit will be applied toward your surgeon fees.  There may be additional fees for labs, pathology, or imaging. 

It typically takes one to two weeks to recover from a breast lift procedure. Most people will experience some discomfort for 2-5 days after the surgery. You will be asked to wear a compressive bra (provided by Dr Kreitzberg) immediately after surgery and a supportive bra 23 hours a day until 3 months after surgery. At 6 weeks, you will be allowed to run and exercise.  At 3 months, you will have no restrictions.  

In general, your return to work will depend on the level of physical activity needed to perform your job (ie: typically can return to a desk job at 1 week and 6 weeks for a job that requires heavy lifting). Dr Kreitzberg will let you know how long it will be before you can return to your normal level of activity and work. The staff and Dr Kreitzberg will give you instructions about your postoperative care prior to and after your surgery. It is vital that you follow all the patient care instructions to optimize your results.

Your breasts should not return to their preoperative droop for decades, assuming you don’t have significant weight fluctuations or go through pregnancy.  Some settling may occur, but the new nipple position should remain intact. Your results will also depend on the technique used.   Dr Kreitzberg will sculpt the entire breast tissue using modern techniques proven to be effective in clinical studies to create a longer-lasting lift. If needed, Dr Kreitzberg may use the internal bra (slow absorbing mesh) to add more support and a lasting lift. While it’s also important to remember, results are individual to each patient.

The procedure is performed in an outpatient setting, so you will go home the same day as the surgery. You will be prescribed medication for pain control, nausea control, and preventive antibiotics prior to surgery. The surgery will typically take 3-5 hours to perform. At the end of surgery, you will be placed in a compression, comfortable surgical bra. When the anesthesia wears off, you may experience some pain, but Dr Kreitzberg will inject numbing solution at the end of surgery to help reduce the immediate pain. Your chest region may feel stiff and sore for two to five days. Other common recovery side effects of a breast lift include bruising, numbness, changes in nipple sensitivity, itching around incision sites, and increased firmness or fullness in the breast tissue. These side effects should subside over the first few weeks, with some residual effects lasting up to three months following the surgery. The day after surgery, you should get out of bed for short periods of time and perform light duty activities. Rest and sleep on your back in an inclined position (25-to 45-degree angle) for the initial postoperative days or if you have significant swelling. Use wedge pillows with an incline design or sleep in a recliner chair. You will be able to remove your waterproof dressing and shower 48 hours after surgery. It is okay at that time to wash your incisions. Following your shower, you will wear your compressive bra. You will be provided scar tape to use from 2 weeks to 8 weeks postoperatively. Avoid straining, bending, and lifting since these activities might cause increased swelling or even bleeding. You will be able to run and exercise at a moderate level of activity 6 weeks after surgery and you will have no restrictions after 3 months.  It is recommended to wear the compressive bra or another supportive bra 23 hours a day for the first 3 months following the surgery. Your results should last for decades. 

A breast reduction (reduction mammaplasty) is a common aesthetic procedure that reduces the size of breasts and reshapes breasts so that they are more proportionate to the rest of the body and are no longer a source of physical discomfort. The techniques used for a breast reduction are similar to those used for a breast lift and the primary difference is the amount of breast tissue removed. In a breast lift or reduction, the breast tissue is rearranged and lifted, but a breast lift is performed without removing breast tissue. If smaller breasts are desired, then a reduction/removal of breast tissue may be the right procedure for you. A small reduction or a lift alone with rearrangement of the breast tissue to a lifted position on the chest can significantly improve symptoms of back/shoulder pain, shoulder grooving, and the aesthetic appearance of the breasts. Dr Kreitzberg will help you navigate if a reduction or a lift alone is right for you based on your aesthetic goals.

Your breasts can change with time, gravity, weight fluctuations, pregnancy, and nursing. A breast lift is a great option if you have any of these concerns: sagging breasts, uneven breasts, drooping nipples, stretched areolas (the darker area surrounding the nipples), breasts that hang down loosely but are adequate in size. If you place your hand under your breast sideways and the breast covers more than 2-3 fingers, then you may benefit from a breast lift. A lift can rearrange the breast tissue to enhance upper breast fullness, projection, shape, symmetry, improve nipple position, and decrease areola size. If you desire more breast volume, then a lift can be performed with a breast augmentation or fat transfer.

A breast lift can improve the shape, projection, and symmetry of your breasts. Overall, the biggest change will be improved fullness (cleavage) and projection of the breasts. A breast lift will also address stretched tissue surrounding the nipple or areola. Other benefits include a better look in and out of clothes as well as an improvement in self-image and self-confidence.

Saline breast implants are filled with sterile saltwater. The shape and size range of the implant shell is predetermined and the implant is filled during the surgery within the predetermined range to allow for minor modifications in the implant size. Silicone gel breast implants are filled with soft, elastic gel and are available in various shapes and degrees of firmness. All silicone gel breast implants are pre-filled. Silicone gel implants have a more natural feel than saline implants.

The cohesive gel of 5th generation silicone implants will maintain its structure and shape, even if it’s cut in half. This is similar to a “Gummy Bear,” thus the new generation implants were coined with the name. There are various types of cohesive gel implants from highly cohesive (firmer) to less cohesive (softer). There are also hundreds of sizes, shapes, and projections of silicone gel implants allowing for Dr Kreitzberg to help you choose the right fit for your body.  The more cohesive implants may have a slightly firmer feel, but the benefits include improved more upper breast fullness and less rippling or wrinkling of the implant. At your consultation, you will be able to feel the different implants. 

Implant sizing can be an art. There are over a hundred different implant sizes and projections.  Projection refers to how tall the implant stands off the chest and projections range from low to extra high projection (an inch to 4 inches). The size of the implant ranges from 150 cc to 800 cc.  Dr Kreitzberg prefers smooth round implants over shaped (tear drop) implants.  

Typically, one size does not fit all as there are anatomic variations in chest wall size and shape.  Your personal preference regarding breast fullness and overall appearance is another important factor in determining the right implant size. Dr Kreitzberg will take measurements of your breasts and based on your preferred outcome he will assist you with choosing an implant size range and projection that is right for you. You will have an opportunity during the consultation to wear breast implant sizers. This will allow you to get a better visual appreciation for the change in breast size and discuss with our nurses as well as Dr Kreitzberg your goal outcome. There are various apps available online as well to assist with implant sizing. If you have photos of your desired outcome, you are welcome to bring them to your consultation.

There are several common incision locations for breast augmentation including inframammary fold (bottom of the breast), periareolar (below the nipple), axillary (armpit), and umbilical (belly button). Dr Kreitzberg’s preferred location is the inframammary fold incision (short, horizontal incision at the bottom of the breast). The incision is typically 1.5-2.5 inches long depending on the type and size of the implant. The inframammary fold incision allows for precise placement of the implant, accommodates any sized implant, avoids dissection into the breast tissue during submuscular implant placement, and the scar is typically not visible and heals well. The overall goal is to provide a safe approach and proper positioning of the implant to enhance the appearance of the breasts and minimize scarring.   

There are several different locations to place the implant on the chest including: below the muscle (total submuscular and dual plane) and above the muscle (sub fascial and sub glandular). There are pros and cons to each location. The general pros of having the implant placed above the muscle are avoiding movement or animation of the implant when flexing the pectoralis (chest) muscles, can tend to be less painful initially after surgery, and can create more cleavage. However, there are a few cons to above the muscle placement when compared to below the muscle. The implant may look less natural, higher potential for seeing rippling or wrinkling of the implant (if there is not a moderate amount of breast tissue), higher chance for bottoming out, and higher chance of developing tight or firm scar tissue around the implant.  Regarding below the muscle placement, some of the pros include a more natural appearance, lower risk of visible implant rippling (implant is covered by breast tissue and muscle), better implant support (the muscle reduces strain on the skin creating less risk for bottoming out), and less risk of developing firm scar tissue (capsule contracture) around the implant. Dr Kreitzberg’s preferred implant positions are the dual plane and the sub fascial locations. In a dual plane (part under the muscle and part above the muscle), there is less animation/movement of the implant (compared to a total submuscular), a natural appearance, reduce risk of visible rippling of the implant, and a low risk for capsular contracture (firm scar tissue around the implant).  The dual plane also tends to be less painful than a total submuscular implant location as there is less stretch on the muscle. The other location preferred by Dr Kreitzberg is the sub fascial location (below the breast tissue and the muscle fascia of the pectoralis muscle) as this plane will provide good implant stability, no animation, less risk of firm scar tissue compared to the sub glandular plane, and low initial pain. During a consultation with Dr Kreitzberg, you will be able to discuss your desired breast appearance and based on your anatomy, lifestyle, and desired results you and Dr K will be able to determine if above or below the muscle is best for you. 

The procedure is performed in an outpatient setting, so you will go home the same day as the surgery. You will be prescribed medication for pain control, nausea control, and preventive antibiotics prior to surgery. The surgery will typically take 1-2 hours to perform. At the end of surgery, you will be placed in a compressive, comfortable surgical bra. When the anesthesia wears off, you may experience some pain, but Dr Kreitzberg will inject numbing solution at the end of surgery to help reduce the immediate pain. Your chest region may feel stiff and sore for two to five days. Other common recovery side effects of a breast augmentation include bruising, numbness, changes in nipple sensitivity, itching around incision sites, and increased firmness or fullness in the breast tissue. These side effects should subside over the first couple weeks, with some residual effects lasting up to three months following the surgery. The day after surgery, you should get out of bed for short periods of time and perform light duty activities. Rest and sleep on your back in an inclined position (25-to 45-degree angle) for the initial postoperative days or if you have significant swelling. Use wedge pillows with an incline design or sleep in a recliner chair. You will be able to remove your waterproof dressing and shower 48 hours after surgery. It is okay at that time to wash your incisions. Following your shower, you will wear your compressive bra. You will be provided scar tape to use from 2 weeks to 8 weeks postoperatively. Avoid straining, bending, and lifting since these activities might cause increased swelling or even bleeding. Typically, most patients can return to work within a week after surgery with some lifting restrictions. You will be able to run and exercise at a moderate level of activity 6 weeks after surgery and you will have no restrictions after 3 months. We recommend that you sleep on your back for the first 6 -12 weeks after surgery. It is recommended to wear the compressive bra or another supportive bra 23 hours a day for the first 3 months following the surgery. You will begin implant massage 1 week after surgery and you will notice softening around the implant in 3-4 weeks. The final results from the surgery are typically seen at 9 months.   

Breast implants are not lifetime devices. It is recommended to have the implants removed and/or replaced. There is no hard-set time frame for replacing implants, but it is advantageous to replace the implants before there is compromise of the shell of the implant leading to a rupture. The suggested time frame for replacement of implants is every 10-15 years.  Implant durability and technology has continued to improve, which has led to reduced rupture rates. These advancements may extend the suggested replacement time frame. Overall, the FDA recommendation is to monitor the implants with Ultrasound or MRI imaging 5 years after placement and then every 2 years. If there is a change in the shape, appearance, or feel of your implants, please contact Dr Kreitzberg for an evaluation. At the time of implant replacement, Dr Kreitzberg may be able to correct the positioning of the implants, remove firm scar tissue, change implant size (larger or smaller), or perform a breast lift if needed.

Pregnancy and childbearing can leave you with stretched skin, weak muscles, or extra fat that does not improve with diet or exercise as well as breasts that feel “empty” or sagging. If you are unhappy with how your body and breasts have changed following childbirth, a combination of post-pregnancy procedures may be right for you. A “mommy makeover” is a great option if your pregnancy has negatively affected your breasts’ size and shape, including sagging breasts, “empty” breasts, uneven breasts, decreased breast volume, increased breast volume, drooping nipples, and stretched areolas (the dark skin surrounding the nipple). Pregnancy and childbearing can also negatively affect the body leading to a sagging tummy, loose skin, weak abdominal muscles, stretch marks, loose skin around the belly button, areas of fat hanging over your surgical scar (for those with a c section), deflated buttock, and stubborn pockets of fat on your waist, abdomen, arms, hips, or thighs that does not improve with diet and exercise.  Optimal candidates for a mommy makeover procedure are healthy and are within 20-30 pounds of their ideal weight. It is good to have proper expectations regarding procedures. If you have excess skin, then that may require more incisions (tummy tuck or breast lift) to obtain optimal results. If your skin is tight or tone, then fewer or shorter incisions (liposuction alone, mini tummy tuck, BBL, or breast fat transfer/ augmentation) may be all that is required. During a consultation, Dr Kreitzberg will work with you to develop a personalized surgical plan to meet your goals and restore your body to a pre pregnancy figure.

A Brazilian butt lift, commonly called BBL surgery, is a popular cosmetic procedure that uses a patient’s own fat to create a higher, rounder, and fuller butt.

A BBL (Brazilian butt lift) is performed in an outpatient setting (go home the same day) at a hospital or a surgery center. Dr Kreitzberg will make small incisions (1/4 inch) on the back and/or abdomen and/or thighs to perform liposuction with a small cannula. The fat from these areas (fat donor sites) is suctioned into a sterile canister. If just liposuction is performed, then this fat would be discarded in medical waste. But with fat transfer, this fat is collected in special sterile containers, rinsed, and separated from the liposuction fluid. Then, pure fat is transferred through sterile tubing to a syringe or directly into the infiltration cannula for injection. For a BBL, additional small incisions may be made around the buttock for injection. Dr Kreitzberg will then transfer the fat into the fatty layer of the buttock (above the muscle) with a small cannula to volumize, lift, and shape specific areas of the buttock. The incisions will be closed and you will be placed in compression garments. The technique used by Dr Kreitzberg for fat preparation and injection is important for providing improved survivability of the fat (typically only 40-65% of the fat will survive) and for safety. Fat transfer into the fatty layer of the buttock and not the muscle has been found to be safer. Dr Kreitzberg will focus not only on volumeizing and shaping the buttock safely, but also shaping the abdomen, back, flanks, and hips with liposuction to optimize the body shape and curvature.

Generally, the recovery is 2-6 weeks. A majority of the pain related to the surgery will be for the first 48-72 hours. Generally, you will be able to get back to activities of daily living within 1-2 weeks. You will be asked to avoid prolonged sitting for about six weeks. This is very important because prolonged sitting will damage the fat. You will also be encouraged to sleep face down or on your side. When you do have to sit, you will have to use a pillow or specially cushion placed behind the legs (hamstring muscles) to help raise the buttocks, avoiding pressure onto the fat grafts. You can generally resume exercise after six to eight weeks. Most patients will return to work in 1-2 weeks. You will be asked to wear a specially binder and garment for the first 6-8 weeks to help with swelling and shaping. 

Liposuction is not considered a weight loss procedure, rather it is a body contouring procedure.  For some individuals, diet and exercise will never get rid of stubborn pockets of fat. If you have unwanted localized fat in your stomach, buttocks, hips, thighs, breasts, chest, back, arms, or neck that are disproportionate with the rest of your body and do not improve with diet or exercise, liposuction may be right for you. 

The optimal candidate for liposuction has good skin tone (tighter skin) and a mild to moderate amount of fatty tissue. For some individuals, diet and exercise will never get rid of stubborn pockets of fat and liposuction is a great treatment option. Liposuction is used to sculpt the body in order to highlight attractive features of the body. Modern liposuction is no longer directed toward generalized fat removal, but rather shaping of the body for better definition. Liposuction alone will offer some skin tightening along with removal of fatty tissue. There are modern skin tightening modalities that can be added to liposuction to help stimulate more skin tightening.  If there is loose skin, then liposuction can be added to skin resection procedures for best results.  Dr Kreitzberg will be able to help you determine if you are a candidate for liposuction alone during a consultation.

A tummy tuck traditionally has three components: removing excess skin from the central abdomen, tightening muscles (due to diastasis caused by childbirth), and repositioning of the umbilicus (belly button). Liposuction adds an additional component to a tummy tuck: contouring of the abdomen and surrounding areas. Liposuction is a procedure that is designed to selectively remove fat from specific areas for improved body contour. Adding liposuction to a tummy tuck will allow Dr Kreitzberg to contour the upper abdomen, flanks (sides/love handles), back, bra line, and mons. Liposuction of these areas will enhance the curvature of the body for a more hourglass appearance. Liposuction will also allow for additional skin removal at the time of surgery. Not to mention, liposuction has been shown to be safe to perform at the time of a tummy tuck in multiple studies. Overall, Dr Kreitzberg will be able to obtain a slimmer, tighter, and curvaceous appearance to the body with the addition of liposuction to a tummy tuck.  

Optimal tummy tuck candidates are in good health and at a stable weight (dramatic weight fluctuations can affect your result), with excess abdominal skin. A common concern of people wanting a tummy tuck is whether they need to lose weight to qualify for the surgery. Dr Kreitzberg suggests that you should be within 15-30 pounds of your goal weight. Weight loss in excess of 30 lb after surgery could result in additional excess skin.

The determination for a mini or a full tummy tuck depends on the amount and location of excess/loose skin on the abdomen as well as the severity (or width of the diastasis). If your skin is tight/tone above the belly button but loose below, then you may be a candidate for a mini tummy tuck. Also, if you have a wide or severe diastasis, then you may need a full tummy tuck.  Dr Kreitzberg will be able to help you determine which operation would give you the best results.  Liposuction can be added to a mini or full tummy tuck for additional contouring.  

It is safe to have a baby after an abdominoplasty, but any future pregnancies will inevitably stretch the skin and muscles. This may result in the need for a revision.

You can expect to see results right after surgery as you will have less skin and an improved contour, but there will be swelling. There will be a progressive improvement in the appearance of your results as the swelling resolves and your body heals. You will note a decrease in dress and waist size as you heal. It will take 9-12 months to see final results. It is important to maintain a stable weight and good nutrition long term for best results. 

Dr Kreitzberg will perform the tummy tuck with liposuction as an outpatient procedure. There are several different tummy tuck techniques, with varying levels of fat and skin removal. During a tummy tuck with liposuction, Dr Kreitzberg will make small incisions and perform liposuction of the abdomen, flanks (sides), mons, and back (360) to remove stubborn fat, contour specific areas, and loosen the skin for removal. He will then make an incision on the lower abdomen to remove excess skin, repair abdominal muscles with sutures, and reposition the belly button (full tummy tuck). If a mini tummy tuck is performed, then the belly button is not repositioned. During closure, Dr Kreitzberg will place special sutures to shape the belly button (give it a normal appearance), lift and shape the mons, progressively tack down the skin (allow for drainless procedure or reduce the length of time needed for the drain and improve the appearance of the incision), and close the incision with several layers of absorbable sutures. For a mini, the incision is typically shorter. He will then cover the incisions with surgical glue and sterile dressings. Dr Kreitzberg will place a single drain that is removed 5-7 days after surgery.  You will have liposuction foam and an abdominal binder placed. You will be given pain medication, muscle relaxer, anti-nausea medication, and antibiotic mediation prior to surgery.

As long as you follow Dr K’s advice and keep a balanced diet and manage your weight with moderate exercise, your results will continue to last for a long time. 

Can I ruin my tummy tuck? Yes! Like anything a tummy tuck is not a quick fix solution, but rather a reset. If you do not take care of yourself, then your tummy tuck results can change due to excess weight fluctuation, pregnancy, or aging. We recommend that you continue on a balanced diet and stick with moderate exercise after your procedure.

Dr Kreitzberg will place the incisions in hidden areas and areas where the scars look like natural wrinkles, making facelift scars virtually invisible. Your incision will be in front of the ear and extend from the hairline to behind the ear. If a neck lift is added to a facelift, then the incision will extend into the hairline behind the ear. Dr Kreitzberg will reduce the tension on the incision, improve the longevity of the results, and create a natural appearance by lifting the structures below the skin known as the SMAS and platysma and not relying on high skin tension.  Reducing the tension on a scar will allow it to heal better. Your incision healing will depend on the surgical technique, steps you take to improve healing (nutrition, not smoking, hydrating), and any underlying medical conditions or genetic tendencies.  

Your face can change with time, gravity, weight loss, and sun exposure. If you feel like you don’t look like yourself anymore and want to look like a younger version of yourself, a facelift may be right for you. A facelift is a great option if you have any of these concerns: facial sagging, loss of muscle tone low on your face (jowls), deep creases from your nose to your mouth (nasolabial folds), lines from your mouth’s corners to your chin (marionette lines), and a double chin or unwanted neck creases or folds. As we all age, we lose volume in our face initially and then sagging/laxity of ligaments and changes in facial bone structure. We notice that the fullness that initially was in our cheeks when we were in our 20’s and 30’s seems to be lost and the lower face/jawline/neck feel full and sagging. A facelift will lift the cheeks, lower face (jowls), and neck as well as remove excess skin. The combination of lifting and tightening will result in a correction of deep cheek folds, jowls, and loose skin, thus recontouring the face, neck, and jawline. You will achieve smoother, firmer, and fresher looking skin on your face and neck.  Typically, you will look 10- 15 years younger. If more volume is needed in the face, cheeks, or lips, then fat transfer can be added to the procedure for permanent facial volume restoration.  Dr Kreitzberg will help to determine the best surgical plan for facial rejuvenation during a consultation.   

A facelift (rhytidectomy surgery) is the most comprehensive approach to treating facial wrinkles and sagging caused by aging. Every year, thousands of people undergo successful facelift surgery and are pleased with the results. The combination of lifting and tightening will result in a correction of deep cheek folds, jowls, and loose skin, thus recontouring the face, neck, and jawline. You will achieve smoother, firmer, and fresher looking skin on your face and neck.  Typically, you will look 10- 15 years younger. A facelift or neck lift will not address the central face (around the lips and chin).  The central face can be addressed with peels, lasers, dermabrasion, or a lip lift. 

Your genes, skin quality, and maintenance routine are important factors in the longevity of your facelift. However, the facelift technique is the number one factor in determining how long the results will last. Dr Kreitzberg will use a technique that will lift and tighten the SMAS and platysma to provide longer lasting results.

One of the initial changes that occurs with aging is facial fat volume loss. A fat transfer can replace this lost volume in the cheeks, lips, chin, around the eyes, jawline, and temples resulting in a more youthful appearance. Fat transfer, unlike filler, is a permanent correction.  You will also see an improvement in skin quality with a fat transfer. Fat transfer can be performed to specific areas of the face to individualize the procedure based on your need and desired appearance.  For instance, adding volume to the cheeks will result in a lifted appearance to the mid face as well as the lower face. Also, fat transfer around the eyes can improve the appearance of the tear troughs as well as upper and lower eyelids. Finally, fat transfer to the lips can add fullness that is soft and lasts. Dr Kreitzberg will create an individualized plan for you during your consultation.

As we age, the upper lip will naturally lengthen, turn downward, and lose volume. A lip lift is a surgical procedure that will lift, shorten, and reshape the upper lip adding fullness and a youthful appearance to the upper lip. A small incision is made below the nose (hidden in a natural fold under the nose). The lift will turn the lip upward creating fullness to the lip, improving the appearance of cupid’s bow, and shortening the length of the upper lip. The procedure is performed as an outpatient procedure. During your consultation, Dr Kreitzberg will help to determine if you are a good candidate for this procedure and he will further discuss the risks and benefits.   

Fillers will not be able to give you the same results and longevity as a facelift. Fillers are temporary. A facelift is a more long-term fix, but will have more downtime and incisions. Fillers will (do just that) fill the space of lost collagen and facial fat that is lost with aging or significant weight loss, they do not remove any excess skin. A face lift will elevate and suspend that deep facial structures and fat and remove excess skin.