17 Feb Cosmetic Surgery Insights | Dr. Gerald Minniti
Dr. Gerald Minniti cites one of his inspirations for becoming a surgeon as “Hawkeye Pierce”, played by Alan Alda on the hit television show *Mash* in the 1970s. You can see the similarities, as both doctors depict an affable exterior, beneath which lies a competent and confident surgeon.
Dr. Minniti is a native New Yorker who received his training in general and plastic surgery in Boston, New York, and Providence. He came West to practice and is now one of the premier aesthetic plastic surgeons in Beverly Hills. With more than 14 years of experience in cosmetic plastic surgery, he is an innovator of many surgical procedures for which he lectures to other surgeons, and is published in leading plastic surgery journals.
Dr. Minniti specializes in primary and revision surgery of the face, breast, and nose, as well as body contouring procedures including procedures for massive weight loss patients. Dr. Minniti is renowned for the “24-hour recovery” for all breast augmentation patients. He has extensive experience in complex revisions surgeries of the breast involving implant complications as well as soft tissue issues. Dr. Minniti is expert in fat grafting to the face, buttock, and breast, as well as for revision of liposuction deformities. Body contouring procedures include abdominoplasty, body lifts, arm and thigh lifts, and liposuction.
How do you find the best cosmetic surgeon?
A plastic surgeon is trained in reconstructive surgery and cosmetic surgery. What people need to know about is training and certification. And the most important thing they should know is that a doctor who specializes in cosmetic surgery should have a whole breadth of training, which means they are board certified by the American Board of Plastic Surgeons.
Do you think that the best surgeons are drawn to LA, and Beverly Hills in particular?
I was born and raised in New York and I trained in the Boston province area. By and large, when it comes to cosmetic plastic surgery, I think there is a tendency for that surgery to be more refined, a little less overstated. Here in Los Angeles and in Beverly Hills, there is a tendency to see more overdone work. And I’m not criticizing the surgeons – it’s largely patient driven. But that’s the biggest difference that I can see between New York and LA. Patients out here want a little bit more.
My patients want to look like they didn’t have plastic surgery. And to my mind that is the best plastic surgery. There are people who say it’s a terrible thing – you can see them walking down the street. Occasionally, you are going to see somebody who had bad plastic surgery – but for every one that you see there are probably 2 or 3 more who had surgery that you didn’t notice.
In LA there are lots of people who are health driven but they also want to look good. Being healthy, unfortunately, doesn’t always mean that you age well. Certainly, there is that Hollywood aspect that does influence people, who are not in that business, to want to look good anyway.
What procedures do you do?
I pretty much operate from head to toe. I operate on the face, body and breast. On any given day I could be doing surgery on the eyebrows or eyelids and maybe a neck. The next day something about breasts – breast implants or breast lifts or breast reductions. Another day, I could be doing liposuctions or a tummy tuck. It’s really varied and that’s one of the reasons why I got involved in cosmetic plastic surgery. There are so many different operations – it makes life fun, as a surgeon.
If I had to pin down what I do the most, it would be breast and nose surgery.
Are there certain trends?
The American Society of Plastic Surgeons keeps tabs on procedures undertaken by its member surgeons, and it really hasn’t changed that much over the years. Liposuction and breast augmentation vie for first place every year. For men it’s rhinoplasty and liposuction. Also for men, a big procedure is breast reduction. For women it’s eyelid surgery, facial surgery and rhinoplasty.
Are there any new techniques?
There has been a shift toward body implants, other than breast implants. Mostly for men. The most important procedure we hear about now is fat grafting. You hear a lot about stem cells. We’re just getting a handle on it. Fat grafting is a fantastic adjunct to facial surgery, breast surgery, revision liposuction surgery and even buttock enhancement. Buttock implants are not that popular in the US (for good reason. I think they are problematic), but fat grafting to the buttocks is a fantastic way to shape and enlarge them.
How long do the procedures and recovery take?
Most plastic surgical procedures are real surgical procedures. We take them really seriously. Granted, it might not be heart or brain surgery. It’s not life and death but it’s real surgery. It starts with planning. We make sure our patients are healthy and we clear them medically. The procedures vary in range and time. The average time is around an hour for a breast augmentation. Around 3 hours for a breast reduction or tummy tuck. And facial surgery, depending on how much is done, can go 6 or 7 hours.
The important thing is safety and we have modern anaesthetic techniques which keep people safe. The recovery period depends on what we have done surgically. It can vary from 2 weeks to a month or more. TV shows make it seem like the surgery is all done and they are back to work in a week – that’s not the way it is. It takes time.
A lot of people can get back to their daily activity in a short period of time. They may have a splint on their nose or a band around their head or a special bra. Most people are getting about within a week – but they are not fully recovered so we have modified activities. Nobody gets to go back to the gym, for instance, but most are doing their normal activities, including driving, within a week.
People who have a facelift can really look fantastic quickly, and they can get out and about in just a few days.
Do you deal with medical procedures as well?
Cosmetic surgery can sometimes cross the line into medical, functional surgery. People who have excessively large breasts, for instance. We know that they have a decrease in quality of life. People who have problems breathing through their nose. Chronic stuffy nose, sinusitis can sometimes be helped with surgery that can improve the function as well as the shape of their nose. Eyelid and brow surgery can vastly improve people’s vision.
The case that’s most prominent when I think of cosmetic and medical necessity is breast cancer surgery – the repair and reconstruction of that. We have seen an evolution in how we repair the breast after cancer surgery and also an evolution in how cancer is removed from the breast. 50 years ago it was a very radical surgery. Now that we have an understanding of the biology of breast cancer, we can tailor an operation and combine it with other operations including chemotherapy and radiation so that it’s not such a mutilating surgery. We have 2 ways we can reconstruct a breast – one is by implant and the other is with their own natural tissue.
What are some of the strangest things you have been asked?
The strangest things I’ve been asked to that I did not do, are what I believe to not be the standard of care. It includes things like removing earlobes, splitting the tongue, amputating the breast for no reason other than the woman did not want any breasts at all.
What are typical surgery costs?
The cost of plastic surgery varies. In general it’s pretty much the same from doctor to doctor. Having said that, some are wildly expensive and others are suspiciously cheap. You don’t have to overpay for good plastic surgery but I would be wary of someone who is much more inexpensive than everyone else.
On average, Breast augmentation is around $6000
Facelift surgery can be upwards of $20,000 if you are having a lot of procedures.
Is any of it covered by insurance?
Sometimes, yes. If the surgery has potential medical aspects. For instance, nose surgery is covered by insurance when we are operating on the internal aspects of the nose. Anytime we change the shape of the nose for cosmetic purposes it is illegal for me to bill insurance. Frequently we can get insurance to cover parts of the surgery. Breast reduction surgery can frequently be entirely covered but women have to meet criteria of their insurance companies.
What are some preventative measures people can take to avoid cosmetic surgery?
There are a lot of things we can do to make us look better. Most important is diet. It’s not a question of being overweight. Eating well, avoiding processed foods and doing it for a long period of time. Not a one week or one month cleanse. Year after year, eating right is going to make you look better. You’re going to be healthier. Your skin is going to show it. Your skin is the window to your insides so nothing can surpass eating well.
Sleeping enough. We’re in a society where some people brag about sleeping 2 hours a night. The data is coming in about sleeping 8 hours a night and there doesn’t seem to be anybody that would’nt benefit from sleeping 8 hours a night. If you can strive to sleep a lot more than you’re sleeping now, it’s probably a good thing.
Some of the more obvious things are drinking and smoking. We all know the hazards – it leads to death but it also definitely has a negative impact on our skin and appearance.
Two products that are really important for your skin are a moisturizer and sunscreen. Wearing that consistently through the years is going to make your skin look better and slow the aging process.
You have to treat your skin in the same way you treat your hair and your nails. You don’t do it once a year because it needs that regular upkeep. The skin is more or less the same structure as nails and hair and it needs constant upkeep. It’s important if you want to maximize the vitality of your skin that you visit an aesthetician, and do it regularly. They can take your skin to the next level by using an assortment of chemicals and compounds that help the skin stay vital and young. The dead cells are removed, sloughed off and you have new healthy skin cells below.
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