By Dr. Philip Solomon & Nancie Heiber
Dr. Philip Solomon MD, FRCSC, Otolaryngology, Head and Neck Surgeon, practicing Facial Plastic Surgery in Toronto, has been in practice for more than 20 years, and in that time, thousands of patients have come to him with clever, thought-provoking and inspiring questions. We wanted to share some of these FAQs, so we asked the doctor to share some of the best queries he’s received over the years.
What’s the difference between facial cosmetic and facial reconstructive surgery?
Dr. Solomon: Cosmetic procedures are elective procedures sought out by people looking to enhance their face, address aging concerns or modify genetically inherited anatomical issues. These procedures are optional and can certainly affect patients’ self-esteem, confidence and enhance their appearance. Reconstructive procedures aim to restore form and function to features that have experienced trauma, complications from a previous surgery or have congenital deformities. All facial surgery has both cosmetic and reconstructive elements.
How should I select a surgeon? What should I be looking for?
Dr. Solomon: You definitely want to do your research and choose a surgeon who is experienced in the procedure you are interested in. There’s a common rule of thumb I share with patients: One becomes an expert or master in their area of work after working 10,000 hours. This rings true for surgeries, so finding a surgeon who performs a procedure routinely may also be more experienced with varied anatomy and be better equipped to handle complications that may arise during procedures.
What questions should I ask during our consultation?
Dr. Solomon: Asking the right questions is important. I always recommend patients come in with their list of questions, so they have them at their fingertips. We provide a fair bit of information during the consultation, so having a list can ensure we cover all their concerns. Often, by the time a patient meets the surgeon, they have already done considerable research, so they are quite knowledgeable about the procedure. We then assess the patient and explain how we could address their concerns and ensure our goals for the surgical outcome align. We provide our patients with a very comfortable forum for open dialogue in consultation and throughout the entire process.
How do I know if I’m a good candidate for the procedure I’m considering?
Dr. Solomon: The consultation is intended to help determine if a patient is a good candidate for their desired surgery. We review the patients’ goals to ensure we can achieve them based on their anatomy. We also assess their mental and physical health to ensure they are fit for surgery and the recovery period required. We are looking for patients who we can help and make happy, so patient selection is just as important on our end as it is for a patient to choose the right surgeon.
What is the process after I schedule my surgery?
Dr. Solomon: We have an exceptional team of nurses and patient-care specialists to support and educate our patients prior to and following surgery. I’m always available as well. We ensure our patients are well-informed prior to surgery, knowing what to anticipate on the day of surgery and what to expect post-surgery. Two weeks before surgery, we meet with our patients to review the treatment plan in detail to ensure we have the same vision for the projected outcome, and to address any additional questions or concerns.
I’m quite nervous — can I be asleep during my procedure? Which procedures are patients awake for?
Dr. Solomon: Surgeries that are less invasive, such as a lip lift or upper blepharoplasty (eyelid surgery), can be performed while the patient is awake. We use local anesthesia to numb the treatment site, which is typically enough to keep patients comfortable. However, if a patient is very anxious, we do offer general anesthesia.
For more invasive procedures, such as a rhinoplasty, chin implant or facelift, we prefer our patients be asleep to ensure they are comfortable, as these procedures can be more painful if awake. At my private surgical facility, we do offer both IV sedation (used in colonoscopy) and general anesthesia as options, depending on the surgery.
How can I minimize bruising or swelling after surgery?
Dr. Solomon: We provide our patients with a list of tips to help reduce bruising and swelling. We recommend they sleep elevated for the first few days, drink plenty of fluids, avoid blood-thinning medications prior to and post-surgery, and we also suggest minimizing alcohol and tobacco/cannabis. Arnica supplements and pineapple juice can also help reduce inflammation.
Are any procedures covered by the Ontario Health Insurance Plan (OHIP) or my private health insurance?
Dr. Solomon: Some insurance companies have recently started covering facial feminization surgery, which is extremely helpful to patients who are transitioning. They typically provide a limit per year that can be used for facial feminization.
The Ontario Health Insurance Plan (OHIP) covers certain nasal procedures for breathing and trauma. They also cover certain congenital abnormalities. Some of these procedures, such as cleft lip and palate and otoplasty are initiated under the Ministry’s health plan when patients are young. OHIP is an insurance company and has limited coverage for certain procedures that may be deemed cosmetic in nature. Your surgeon will have to determine if your insurance is partially insured or not insured by OHIP.