Robert T. Grant, MD, MSc, FACS

While a baby’s health is the most important thing to all new parents, there are times when all does not go according to plan. Birth defects can set a family up for a lifetime of challenges, but thanks to some amazing advances in modern cosmetic surgery, there are options available to improve a child’s quality of life (QOL).

For children born with cleft palates or other facial issues, growing up can be a difficult and emotionally trying experience. In addition to potential peer conflicts associated with looking different, cranial birth defects can also create health-related issues, such as difficulty with eating and breathing. Through craniofacial reconstruction, these defects are repaired to improve a child’s appearance, as well as resolve many issues impacting his or her QOL.

Since each craniofacial procedure is unique, the approach and techniques employed are specific to the needs of a particular patient. That said, when it comes to addressing facial reconstruction in children, it is best to act as early as possible.

Correcting the issue early on ensures minimal impact on long-term health and emotional state, so that the child can grow into a fully functioning and independent adult. Therefore, examinations for correcting most facial birth defects should begin as early as 6-18 months.

Depending on the number of issues that require surgery, multiple procedures may be needed. For that reason, cosmetic surgeons often work alongside neurosurgeons and other specialists to guarantee a natural-looking, full-functioning end result.

Parents of children with facial defects like Treacher Collins syndrome may face a challenging road ahead, but it is important for us to help them understand the options that can make that road a little easier to travel. Evaluating a child early and planning a course of action will help ensure the future looks as bright as possible for the patient.

Robert T. Grant, MD, MSc, FACS, is Chief of the combined Divisions of Plastic Surgery at New York-Presbyterian Hospital-Columbia University Medical Center and New York-Presbyterian Hospital-Weill Cornell Medical Center. He is also Associate Clinical Professor of Surgery in the College of Physicians and Surgeons at Columbia University and Adjunct Associate Professor of Clinical Surgery at Weill Cornell Medical College. For more information about Dr. Grant or to contact him, visit his website at 

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Birth defects can set a family up for a lifetime of challenges, but thanks to some amazing advances in modern cosmetic surgery, there are options available to improve a child's quality of life.

When to Perform Reconstructive Surgery in Children with Facial Birth Defects

 In the world of plastic surgery, patients are always on the lookout for the newest procedure that will yield their desired results with as little recovery time as possible. To those who are currently researching options for facial rejuvenation, I typically suggest eyelid surgery.

Blepharoplasty is a reliable method to achieve facial aesthetic goals with minimal recovery time. I am obviously not the only one who feels this way, as the American Association of Plastic Surgeons (AAPS) reported that eyelid surgery was the second most popular procedure performed in the United States in 2013.

Following blepharoplasty, a patient has a more rested and youthful appearance. After all, one of the first areas to show advancing age is the skin around the eyes.

Whenever I meet with a prospective patient who is interested in facial rejuvenation, I explain that eyelid surgery can treat:

		Fatty deposits in the upper eyelids that lead to the puffy eyes.

		Sagging or loose skin that can make the eye appear older and even impair vision.

		Extra skin and fine wrinkles in the lower eyelid.

A blepharoplasty procedure can make a person’s entire face appear years younger. That said, I it is essential for a patient who is considering eyelid surgery to understand not only the steps involved in the procedure, but also the recovery process.

One of the most significant benefits to eyelid surgery is the short recovery time. Since blepharoplasty is a minimally invasive procedure, the “downtime” associated with the healing process is also minimal. In many cases, eyelid surgery is performed as an outpatient procedure, which allows a patient to recover at home.

Although some patients may experience some swelling around the incision areas, this is perfectly normal and can be treated with medicated ointments that keep the incisions moist and ensure they heal properly. I also suggest wearing dark glasses to keep the sun and wind off of the eyes, as well as applying cold compresses to alleviate swelling.

In my experience, patients who have recently undergone eyelid surgery are able to resume light activity within a couple of days and full daily activities within 10 days — an impressive turnaround for a facial rejuvenation procedure!

It is the goal of plastic surgeons to help patients maintain their youthful and refreshed appearances, and eyelid surgery may just be the best way to reach it.

Blepharoplasty is a reliable method to achieve facial aesthetic goals with minimal recovery time.

Rejuvenate the Eyes through Blepharoplasty

Performing the hard work to get to a healthy weight can be a fulfilling experience for many patients, but losing weight is only one part of the battle. Often, those who have lost a significant amount of weight are left with sagging skin, and exercise is not the solution to that problem.

Fortunately, the cosmetic surgery community has developed many effective procedures that help get rid of the by-product of significant weight loss. For patients who have experienced such dramatic weight loss, a body lift procedure can remove excess skin and create definition in areas that once held excess fat.

The first question I tend to get from prospective patients is, “Will my insurance cover this?” Many people believe all cosmetic procedures are elective and, therefore, need to be paid out of pocket.  However that is not the case for a body lift, as the majority of health insurance companies cover at least part of the procedure.

Although insurance companies are not in the business of paying for cosmetic procedures, some body contouring procedures are considered necessary to improve a patient’s overall health. While I have found that the qualifying criteria for such procedures can be strict, the option is still available. Therefore, I walk my patients through the following list to determine whether their health insurance may pay for part — or all &mdash; of a body lift.

If the patient underwent surgery at least one year ago, a health insurance policy may help cover body-contouring surgery.

Patients who have lost more than 100 lbs are more likely to have their insurer help cover the costs of a body lift procedure.

Many health insurers require proof that a patient has not only lost the weight, but also managed to keep it off. If a patient has maintained a stable weight for 6 months or more, it is likely that the insurer will assist in paying for the surgery.

Excess skin can create health concerns such as chafing, rashes, ulcers, and infections. If a patient experiences any of these issues, and other forms of medical treatment have been unsuccessful, then one’s insurer may cover the removal of excess skin.

Still, other aspects of a body lift procedure such as breast augmentation are considered elective surgery and would be an out-of-pocket expense. Since each health insurance policy is different, the only way to find out whether a patient’s body sculpting procedure would be covered is to consult with the insurer.

Regardless of the method of payment, it is our job to help patients take the next step in their weight loss journeys to truly look and feel their very best.

Those who have lost a significant amount of weight are often left with sagging skin, and exercise is not the solution to that problem.

Are Body Lift Procedures Covered by Health Insurance?

I often hear patients say winter is the harshest season for their skin. Between the low humidity and moving from the cold outside to dry heat indoors, the skin really does take a beating. However, I strongly believe skincare is a year-round job.

Following a daily skincare regimen will help slow the aging process, but healthcare professionals must provide the tools to do so! Here, I have outlined the advice I typically share with patients to help them care for their skin all year long.

One of the key ways to help the skin survive the sun year-round is applying moisturizer multiple times a day. Face moisturizer should contain an SPF protectorate against UVA and UVB rays, because sunblock is not only necessary for the summertime.

From an early age, the basic element to effective skin management is the liberal use of sunblock and moisturizers during the day, and retinoids or unesterified vitamin C products at night.

2. Avoid factors that promote premature aging

Some of the detrimental factors that are known to promote premature aging of the skin include:

		Exposure or overexposure to the sunâ€¨

		Overuse of prescription drugs and other medications

		Salty foods, which promote water retention 

Regular exercise and stress reduction activities such as yoga and Pilates are key to stimulating healthy blood flow and muscle tone, which help keep the skin firm.

Since most patients have allergies, it is important to test them to find out what they might be sensitive or allergic to, and then obviously have them avoid those allergens.

Getting enough sleep is a crucial skincare weapon that many patients overlook due to their busy lifestyles.

Through cosmetic surgery, patients can look and feel their best at any age, but they need to do some of the work, too! Since the skin is always rejuvenating itself, it is essential for patients to follow skincare regimens on a daily basis to slow their skin’s aging process.

Following a daily skincare regimen will help slow the aging process, but healthcare professionals must provide the tools to do so.

Robert T. Grant, MD, MSc, FACS

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