FAQs

Plastic Surgery & Jaw Surgery

Our Practice

Where is your office?

Our office is located at Suite 1520, 15th floor, 450 Sutter Street, San Francisco, CA. Please see the map on our contact page for directions.

What are your office hours?

Our office hours are Monday through Saturday from 10am to 7pm but we are closed daily for 2 hours from 1pm to 3pm. We are also open every Saturday from 10am to 7 pm. We don’t see consultations on Saturdays. Please enquire about Saturday appointments by calling us directly on (415) 624 3922.

How do I make an appointment?

Please call us directly on (415) 624 3922.

What complimentary services are in the same building?

Pharmacy: 7th Floor, 450 Sutter Street.
Surgery Center: Suite 500, 450 Sutter Street
X-ray and Imaging: C Dental is located at suite 1542 on the same floor as our office.  They are familiar with our imaging requirements and work with us to expedite your imaging.
Laboratory: Quest Diagnostics, Suite 2540, 450 Sutter Street

Fees & Appointments

Is there a fee for the doctor’s time (consultation fee)?

There is a consultation fee for both in person and telephone consultations.  If you need to reschedule an appointment please advise us at least 48 hours prior to the appointment to avoid a rescheduling fee.

Is the doctor’s consultation fee applicable towards surgery?

Yes.  If a surgery is performed the consultation fee is applied to the final cost of the surgical procedure.

May I bring someone with me to my appointment?

Yes, actually we encourage you to bring your spouse, significant other, or friend along with you to your appointment.

How long will my appointment last?

Most appointments last one hour. Consultations for Orthognathic Surgery often last two yours or even longer depending on the complexity of the case.

How do I reach the doctor after-hours if there is an emergency?

We have an answering service and the doctor is always available for emergencies by calling the office.

What if my doctor is out of town?

If the doctor is out of town, coverage by another trusted physician will be arranged to make sure that our patients are well looked after.

If I’m from out of town how do I coordinate an appointment?

Please call us on (415) 624 3922 to discuss your specific needs. It depends vastly on the type of surgery you’re interested in. Most often a telephone consultation will help us to establish what needs to occur.  In either case, we’ll do everything to accommodate our out of town patients.

Insurance

Does the doctor take my insurance?

We are an In-Network provider at UCSF Benioff Children’s Hospital  (HappySkulls).  Otherwise we are not contracted with any insurances companies at our San Francsico practice.  For orthognathic surgery we are often able to work with your insurance carrier out of network provided they are a PPO type of health insurance.

For children needing reconstructive surgery, we work through HappySkulls to provide in network services to all of our pediatric patients.

Plastic Surgery

How soon after plastic surgery can I travel?

The answer depends on what type of plastic surgery you have.  There are usually a number of follow up appointments after your surgery.  You need to complete those appointments before leaving town. We usually recommend not traveling for at least 10 days after a significant operation.

How long will plastic surgery take?

That depends on the type of procedure. Some procedures take only 1-2 hours, while others take significantly longer.

How soon after plastic surgery can I drive a car?

The answer varies. It’s important that you don’t drive a car while you are taking any painkillers, or sedatives. That being said, most of our patients do not require significant pain medication after surgery. Often, your body is the best indicator of when you’re safe to drive. Operations that require work in the neck area require the movement of the head and neck to be limited for some time, which makes driving unsafe initially after surgery for at least 7-10 days.

Can I drive myself home from surgery?

No. There is no circumstance in which you will be allowed to drive yourself home after surgery

When should I fill my prescriptions?

We have all of our patients fill their prescriptions prior to the time of surgery. We like for as many of the details to be handled before surgery so that you can concentrate on relaxing and getting well after your procedure.

Do you have any concierge services?

Yes. We have a number of resources to make your stay and surgery more comfortable. Car service and hotel accommodation etc. are all things we can arrange for you.

Where should I stay after surgery?

Some surgical procedures require that you stay one night in the hospital.  Others do not.  If you don’t live close to our office, we ask that you stay at one of the many hotels that are less than one block from our office so that we can keep a close eye on you for one or two nights after surgery.

Who will take care of me after surgery?

Private duty nurses are always available to our patients for a charge.  For some types of surgery, having a private duty nurse is mandatory in our practice so that we have someone we trust keeping a very close eye on you.  Our private duty nurses are not contracted out to an agency.  We know all of our nurses personally and have vetted their skills.

When will the doctor see me after surgery?

For large surgeries, the doctor will see you the morning after your operation.  For others your first appointment will be 2-3 days after your surgery.  We call all patients the night after surgery to check in and make sure all is well.

Are there any particular things I need to do before surgery to prepare?

There are a number of recommendations we have for patients in order to prepare for surgery.  We provide all of these materials for you at your initial consultation.  Things like, diet, and exercise and medications to take (or not to take) are examples of things that we help with to prepare you for surgery.

Will plastic surgery improve my confidence?

Plastic Surgery often has positive implications for confidence and self esteem.  That being said, plastic surgery is not intended to fix or alter problems in one’s personal life.  These are poor reasons to have plastic surgery.

Is there a right age for plastic surgery?

There is no right age for plastic surgery.  Plastic surgery is a broad specialty and procedures are often appropriate for many different age groups.

Is plastic surgery safe?

Plastic Surgery is generally considered safe when performed by a competent surgeon in a safe hospital or surgery center environment.  That being said, there are always risks to any type of surgical procedure and those risks will be discussed thoroughly with you during your consultation.

How long is recovery after plastic surgery?

Recovery is different for different types of procedures.  Some procedures offer recover times that are quite short and some patients are back at work after a few days, while other procedures one should plan for 1-2 weeks away from work.

Also, it depends on your circumstances. You should not plan a procedure if you have big event coming up in one week. Other people may be fine with their co-workers and friends knowing that they had a procedure and don’t mind mild tell tale signs of a recent operation.

How do I know if a facelift is right for me?

The right decision will tend to make itself for you. There is no right age to have a facelift.  Whenever concerns regards to sagging skin, jowling of the cheeks, or loss of a well-contoured neck become apparent, then a discussion of a surgical correction is appropriate.  We’re happy to provide more detail during your visit to our office.

What is the right age to have a facelift?

There is no correct age to have a facelift. Aging occurs differently in different people because of genetics, environmental factors, and lifestyle choices.  We encourage you to visit with us if you’re thinking about a facelift but unsure if it’s the right time.

Will I have stitches after a facelift?

Yes.  You will have stitches that need to be removed at certain intervals after surgery, the timing of which we will discuss with you during your appointment.  We’ll give you clear instructions on how to take care of your stitches while you have them in place.

Will a facelift change the way I look?

We certainly hope so. That being said, we aim for results that compliment your natural features rather than transforming people into something that doesn’t fit their features or desires.

Will I have scarring after plastic surgery?

Any type of surgery produces a scar. Plastic Surgeons are masters of hiding the scars in places where they’re barely – if at all – visible.  We’ll discuss this in further detail during your visit with our office as it depends on what type of procedure you’re having.

Will a facelift be too dramatic or pulled?

A facelift should compliment your features and “restore” you to a better version of yourself.  It’s not the style of aesthetic of our practice to produce unnatural looking results. We pride ourselves on natural-looking results that suit your facial features.

Are there any procedures that are recommended at the same time as facelift?

Although we generally don’t try to install ideas into our patients’ minds at the time of consultation, the reality is that there are combinations of procedures that often make sense. A good example of this is to have a neck lift in conjunction with a facelift.

The face can sometimes appear to be unbalanced when one particular area is improved without working on others. Sometimes because of budget or recovery time compromises are made, however it should be discussed in detail with the patient so that an understanding of the results and expectations is clear.

Do I need to stay in a hospital after a facelift?

We offer all our patients two options:

Either stay in the hospital for one evening after surgery so that you may be monitored and cared for by an experienced nurse;
Or, stay in a hotel close to our office after surgery with one of our own experienced private duty nurses.

Often times the hotel experience is more comfortable in many ways to the hospital and we can choose the nurse who will take care of you in that setting, however if certain medical conditions exist, then sometimes it’s necessary to utilize a hospital.

Do you offer private nurses after surgery?

Yes.  After any procedure we can arrange for a private nurse to accompany you to a nearby hotel and stay with you. This is the ultimate luxury. Your private duty nurse will help you will all of the things that will make your post surgical experience more comfortable.

Are private nurses required for any procedures?

Private nursing is required for some procedures if the patient elects not to have the procedure in a hospital setting. This applies most commonly to facelift operations, however, there may be other operations where the patient wishes to have a private duty nurse and we always encourage this option for the patient to have the best experience.

What is fat grafting?

Fat grafting or fat transfer, as it is also known, involves harvesting the body’s own fat to restore facial volume. Read more about the Fat Transfer process here.

Is fat grafting safe?

Recent studies have shown the profound effects of stem cells on the biology of the skin have lead to increasing evidence that your own fat is the ideal filler material. The procedure is safer than using any lab-grown materials. Read more about the Fat Transfer process here.

How long will fat grafts last?

Fat grafts are essentially permanent fillers.  Your body will resorb a portion of the fat graft over the course of the first 3-4 months after your surgery.  The remaining fat will stay with you indefinitely.

How long does it take for fat grafting to take its final shape?

We recommend that patients wait for 3-4 months before the final shape of the grafts are noted.

How do I know if I need eyelid surgery?

It’s a good idea to consult your plastic surgeon to answer this question. In fact, you may not need eyelid surgery, but instead a forehead lift. Read more about Eyelid Surgery here.

Are there instances where both brow lift and an eyelid lift are required to get a good result?

Most definitely, but sometimes, a brow lift may do most of the work and only a small amount of work needs to happen on your eyelids. These facial features do not exist in a vacuum and all affect each other. Your plastic surgeon will advise you on this matter.

Can I have a brow lift if I use Botox?

Yes you can.  However, one should usually discontinue Botox for approximately 4-6 months before a planned operation in order to allow the surgery to best gauge the actual position and function of the brow before proceeding with surgery.

Will I have large scars after a facelift or brow lift?

The scars are generally very well hidden and not visible to the untrained observer.  Another plastic surgeon may be able to spot the scars but usually acquaintances will not notice.

Can people see the scars after eyelid surgery?

Eyelid surgery scars are some of the most stealthy and well-concealed scars that we produce in plastic surgery.

What is Facial Feminization Surgery (FFS)

Facial Feminization Surgery is a wide range of reconstructive and aesthetic surgical procedures that are most often recommended for transgendered people who are seeking to look more feminine in appearance. FFS works to transform masculine facial features into more feminine shapes and proportions.

Read more about Facial Feminization Surgery here.

What is FTM Facial Masculinization Surgery?

Facial Masculinization Surgery is a range of aesthetic and reconstructive surgical procedures that reshape female facial features to appear more masculine. For some female-to-male (FTM) transgendered people, Facial Masculinization Surgery is an effective adjunct to hormonal therapy.

Read more about Facial Masculinization Surgery here.

Why we don’t have before and after photos on our website?

We choose to not show before and after photos on our website out of concern for patient privacy.  Once we have placed someone’s photo on our website, we no longer have control of what people in cyberspace do with that photo.  Should someone choose to revoke their permission to have their photos displayed, if it had been displayed online, we could remove it from our site, however, search engines will have already added it to their images library and anyone may have downloaded it to their desktop.

The same thing is true with emailing photos of patients. We are commonly asked if we can email images of our patients, and again, this presents a significant security concern.  The only way to show photos of surgical results is in the office at the time of consultation.  We are sorry for this inconvenience, but we are sure you will understand we have our patient’s best interest at heart with this decision.  The vast majority of our patient’s allow us to use their photos for in office use, and feel comfortable with that decision knowing that we will not put their images on the web. Also, many of our patients are happy to speak to prospective patients about their experience with us.

Jaw Surgery (Orthognathic Surgery)

What is corrective jaw surgery?

Corrective jaw surgery is most commonly performed in young adults to correct a poor “bite” (malocclusion). Read more about corrective jaw surgery here.

What is Le Fort Osteotomy?

The Le Fort Osteotomy is a type of jaw surgery used to correct misalignment of the teeth and jaw. There are three types of Le Fort Osteotomies. Read more about Le Fort Osteotomies here.

How do we correct the position of the lower jaw?

Orthognathic jaw surgery works to change the position of the lower jaw. Read more about corrective jaw surgery here.

Is jaw surgery safe?

Jaw surgery is very safe. It is performed thousands of times per year around the world by a handful of very well trained surgeons. In those circumstances jaw surgery is quite safe.

When was jaw surgery invented?

Jaw surgery has been around since the turn of last century, however, it was very crude and often had very bad results.  Since that time, large advances have been made that allow for easier recovery, improved results, and the ability to predictably plan where we will position your jaws in three dimensions.

Will I have nerve damage after jaw surgery?

Permanent nerve damage is rare after surgery.  Most patients will have some temporary numbness or sensory disturbance that resolves after a few months.

Why should I have jaw surgery?

There are a number of reasons why jaw surgery may be the best treatment for you.  Mismatch in the size of your jaws, or the proportions of your face often indicate that jaw surgery may be the correct treatment for you.

Often times an orthodontist may not be able to correct your overbite or underbite alone with orthodontics.  In fact, it may not be healthy for your teeth to try to fix them through orthodontics alone.

Your treatment plan will change depending on whether surgery is anticipated and a consultation early in the process is beneficial to help guide that treatment.

 

Do I need an orthodontist?

Your orthodontist and your orthognathic surgeon will work together before your operation to plan your procedure, and also post-op create a long-term management plan to ensure successful results. If you do not have an orthodontist, we can recommend one for you, for a referral please call our office on (415) 624 3922 or send an email enquiry.

Would a chin implant be good enough rather than jaw surgery?

Not necessarily. Although chin implants are often used, we believe that placing a foreign object in your chin can be counterintuitive for long term successful results. It is our belief that it’s better to re-shape the underlying foundation of the chin by altering or moving the bone. Read more about Chin Surgery here.

When is a chin implant NOT the right operation?

When the problem is much deeper than just an aesthetic one. For example, instead of a “weak” chin, you may actually have an overbite – meaning that your entire jaw and teeth are misaligned. In this case simply inserting an implant would only be a “band aid” solution. Instead we would recommend bite correction jaw surgery for long-term success.

What is “vertical maxillary excess”?

Otherwise known as “long face syndrome”, vertical maxillary excess is a facial deformity caused by a disproportionately grown upper or lower jaw. Vertical Maxillary Excess may result in a very gummy smile and a thin elongated face.  This issue is easily correctable with orthognathic surgery.

What is short face syndrome?

Short face syndrome is the opposite of long face syndrome. People with this dentofacial abnormality often do not show any teeth when the smile and tend to have a tired look. In addition the soft tissue of the face is often compressed leading to a prematurely aged appearance.

Does jaw surgery correct TMJ syndrome?

TMJ surgery is often recommended if TMJ symptoms are present along with a disturbance in the bite. Jaw surgery often helps improve the symptoms of TMJ but is not itself entirely curative.

Will jaw surgery improve my confidence?

Most patients experience a vast improvement in facial appearance and this improvement often improves confidence.

How long will I take to heal after surgery?

Most patients may return to work after one week.  Others may want longer to recuperate, while some patients return to work even sooner.  It depends on the patient and the exact type of surgery being planned.

What is HappySkulls.org?

Happy Skulls is Dr Deschamp-Braly’s own foundation. It offers surgical treatment for children with craniofacial conditions who otherwise could neither afford, nor have easy access to, such world-class services. The goal of this foundation is to improve access to care and facilities for those home and abroad in a team based environment.

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