General Information, Breast Surgery (including Breast Enlargement with Implants, Breast Lifts, Breast Lifts with Implants, and Breast Reduction), Liposuction, and Tummy Tucks, are discussed in more detail in BodySculpture - Plastic Surgery of the Body for Men and Women.

The procedures described here are all elective procedures; that is, they are not emergencies. Why, then, would anyone go through this? After all, cosmetic surgery may be cosmetic, but it is still surgery and, as such, is associated with the risk of complications. Despite that, hundreds of thousands of cosmetic surgery procedures are performed each year in the United Sates alone, and many times that around the world.

There are many possible explanations for this, but the bottom line is that these procedures work. They can do things that nothing else can, i.e., effect a permanent change in specific parts of one's body. Not only that, but the patient gets to pick which part or parts are altered.

The Consultation
The first step taken by the prospective patient is the consultation. This is the time for the doctor and the patient to meet each other, and for the doctor to interview, examine, and assess the patient. Photographs of other patients who have had the surgery in question are often shown: the before-and-after photos. At the conclusion, the doctor proposes a procedure or procedures that can produce the desired result.

With cosmetic surgery, realistic expectations are an integral part of the equation, and not all things are possible for all bodies. There are advantages and disadvantages to every surgical procedure. Each procedure is associated with certain features and characteristics that may be right for one person but not for another. The surgical plan should be individualized for each patient, and the basis for accomplishing that is the information exchanged during the consultation.

Another function of the consultation is to initiate informed consent, which is a term for the discussion the surgeon has with the patient about the risks, benefits, and alternatives to the proposed surgery. The goal of informed consent is an ambitious one. Complications, fortunately, are rare and are minimized by the use of appropriate patient selection and good surgical judgment, technique, and aftercare. In most cases, early recognition and prompt treatment turn a potentially serious complication into a relatively minor disturbance. It is not possible to offer guarantees with surgical procedures. An exhaustive and complete discussion of complications is beyond the scope of this website.

Out-of-Town Patients
For out-of-town patients we recommend, as with local patients, that the consultation be at a separate time from the procedure. The value of a consultation cannot be overstated and it is difficult to do that adequately by proxy. It is advantageous for all involved to meet for a consultation and to have time to consider what has been discussed if only to help in planning for the recovery, aside from the opportunity to meet with the doctor and the office staff and to become familiar with the setup and procedures of the office.

There are times, however, when someone traveling a long distance wishes to have the consultation and procedure during a single visit and, if appropriate, we will try to accommodate that. For Long-distance Patients we can arrange an email consultation. Patient information and photos can be sent to Dr. Engler, who will review them and then, via email and/or on the phone, will make appropriate arrangements for the surgery. If you would like to have an email consult, please call the office at 212-308-7000 or send an email to and put "Photo Consult" in the Subject heading, and, in the Body, a brief description of what you're interested in. Appropriate directions and information will then be sent to you. Then, subject to confirmation of what has been discussed as well as certain other conditions, the consultation and procedure may be scheduled during the same visit.

Anesthesia and Recovery
The anesthesia to be used for the surgery is also discussed. This can be local anesthesia with or without intravenous sedation, regional anesthesia (such as an epidural block) or general anesthesia. Some procedures are routinely performed using a specific type of anesthesia (breast reductions, for example, are usually performed under general anesthesia) while others, such as liposuction, can be performed under any of a number of forms of anesthesia. Also, the costs for the proposed procedure(s) are discussed during the consultation. Fees and financial policies vary widely, not only in different parts of the country, but even within a given region. Fees for cosmetic surgery are normally paid in advance of the surgery.

The recovery after plastic surgery depends to a certain extent on the procedure in question, and is subject to a wide range of individual variation. In general, however, we suggest that a week or so is a reasonable amount of time that one should be prepared to take off from work. How soon one can return to work also depends on the type of work, and the level of social interaction one has during work and regular activities. It takes longer than a week - several weeks to months - to see the final results and, certainly, to feel 100%, but that one-week time frame is a general approximation for the initial recovery period.

Alan M. Engler, MD, FACS - Board Certified Plastic Surgeon
122 East 64th Street New York, NY 10065 USA
(212) 308-7000

Dr. Engler's Patient Reviews