Welcome to the Aesthetic Surgical Associates Procedures section. Our procedure pages will provide you with general information to the cosmetic plastic surgical procedures we perform. If you are seriously interested in having cosmetic plastic surgery, the best way for you to find out what procedures might benefit you the most is to schedule a consultation with one of our surgeons.

The Consultation Visit: Meeting Your Surgeon

The Aesthetic Surgical Associates are two highly trained, qualified and dedicated surgeons who have great respect for their patients. When you request an appointment you may specify which physician you prefer. If you don't have a preference, our staff will assist you with that choice. We take great pride in being able to accommodate most patients on our busy schedule. When time is of the essence, tell our office staff and we may be able to offer you a vacancy created by patient rescheduling. Most patients who are willing to work with us can see the physician of their choice within a reasonable time frame. Sometimes schedules dictate which physician you will see.

For your consultation, you should try to relax and be ready to ask plenty of questions. When you arrive, we will ask you to complete a medical history and other necessary paperwork in preparation for your consultation. If time allows, we will mail you a package with the necessary paperwork for the consultation. You can choose to fill these out at home and bring these with you at the time of your consultation. A thorough visit takes time, so plan to be at the office for at least one hour. During the visit we will listen to you and discuss your desires, examine the area you wish to have corrected, and give you an opinion of what we feel can be accomplished. In some cases, it may be necessary to obtain additional studies (x-rays, mammograms, laboratory work) or consultations with other medical specialists. At the conclusion of your visit we may prescribe preoperative medications and give you some additional instructions in preparation for your operation.

For peace of mind, you should know that Dr. Guerra and Dr. Metzinger are award-winning, board certified plastic surgeons and have become internationally recognized for their work in cosmetic surgery. Our physicians form a great team, work well together and frequently assist each other in surgery.  After surgery, you will always see the surgeon who performed your procedure at the follow up visits. On occasion, when your particular physician is not in the office, his partner will cover the practice and see you once or twice. Most patients appreciate the convenience that this affords them in the postoperative period and many patients feel that they are actually getting two board-certified plastic surgeons for the price of one.

The Consultation Visit: Preparing Yourself

Prior to coming to the office, you should analyze yourself in front of a mirror using the recommended criteria. Take notice of your features! Rarely, do we see a face or body that is perfectly symmetrical. Most often, one side is usually different from the other. One eyebrow, nostril, or corner of the mouth might be higher than the other. One ear, cheek, or side of the chin might project more than its counterpart. One breast may be larger than the other. Humans develop as two separate halves that meet in the middle when the embryo is formed. Minor differences in facial or bodily characteristics are considered perfectly normal, so do not be alarmed if you notice them.

Beauty, as we understand it, is as much a sense of balance and harmony as it is in proportion.  This is true whether you are speaking about faces, breasts or any other part of the body.  Using traditional measures, the ideal human face can be divided into three equal vertical sections by drawing horizontal lines. The ideal horizontal proportions of the face should be divided by the width of five eyes. If the nose, chin, or cheeks are "out of proportion" to the other facial features, correction can often provide much better facial harmony.  From the side or profile view, the projection of the chin should be in line with the lower lip, if not, correction can improve facial harmony.

Definitions of beauty between women and men vary significantly.  For instance, the beautiful female face has large eyes, a small nose, small chin, bigger cheekbones, and large smiles. The handsome male face includes large eyes, a relatively small nose, bushy eyebrows, high cheekbones and a large chin. Small or large breasts can also be out of proportion with the rest of the body. Analyze your face and bodily features in a mirror prior to coming to the office, make notes and bring them with you to the consultation.

Consultation Fees

We have a standard $75.00 dollar consultation fee when patients come to visit one of the physicians in our practice. Remember, a lot of preparation, time and effort are spent by our staff to be ready for you.  During the consultation we will provide you with a great deal of written and verbal information about your particular concerns. Special knowledge and skill are necessary to reach a well-based medical opinion on whether or not plastic surgery will be of benefit to you. The patient, in fact, is purchasing the time and advice of the surgeon and his staff as they do when they elicit the services of any other professional. A large sum of the fee also goes to preparing the materials that you receive during your consultation and those which are mailed out to you at a later time.

Costs of Surgery

Part of the preparation process includes decisions on how to go about paying for your surgery. It is our policy to give patients a specific breakdown of the costs involved with their surgery. When patients receive this breakdown, they feel reassured to see just where exactly their money is going. In general, the costs of surgery include the surgeon’s fee, anesthesia fees, facility fees, and fees for laboratory tests obtained before surgery. Out of courtesy for our patients and for their convenience, we frequently provide postoperative garments and brassieres which are customarily included with their fee.

Clearly, cost of surgery is a major issue for most patients. We believe that costs are certainly important. Costs, however, should not be the sole reason for choosing your surgeon. We recommend that you consider costs last and that you choose your surgeon based on qualifications, expertise and whether or not you would be willing to put your life his hands. Remember, you are asking somebody to make permanent changes to your body. Avoid surgeons offering bargain prices. This usually means that they have cut corners to achieve a lower price (usually at the expense of patient safety) or that they are not busy or less qualified to do surgery.

Surgeon’s Fees

We have a standard schedule of fees for the procedures we perform. In general, surgeon’s fees will vary depending on the qualifications and experience of the surgeon. The degree of difficulty of a particular procedure and the type of procedure that you are having can also influence the surgical fee. Because of our excellent reputation, many patients seek us out to obtain second opinions after they have had cosmetic surgery by someone else. Frequently, these cases are much more complicated and successful operations in these situations are harder to achieve. Revision surgery to correct problems created elsewhere will usually lead to increased surgical fees.

Anesthesia Fees

Anesthesia is necessary to perform surgery. Anesthesiologists and nurse anesthetists require compensation for administering anesthesia and for monitoring your vital signs during the procedure. Anesthesiologists have a standard schedule of fees for each cosmetic procedure, which are billed separately from the surgeon’s fees.

Facility Fees

Most surgical outpatient centers have a standard schedule of fees for each procedure. Surgery fees at outpatient centers are usually much lower than hospital-based fees. Most surgery centers offer excellent service for the price. These charges are separate and apart from the surgeon's fees and are always billed separately from the physician's services.

Laboratory Fees

We insist on a proper laboratory and medical workup for all of our patients. Most patients will undergo basic lab tests, such as a complete blood count and chemical panel. Other patients will require a baseline electrocardiogram (EKG), chest radiographs or mammograms. Female patients are required to have a pregnancy test if they are capable of becoming pregnant anytime before surgery. The fees for most laboratory examinations are reasonable and are billed separately form the surgeon’s fee. All patients are given instructions for obtaining laboratory tests prior to surgery. Most patients have their labs drawn at the surgery center. If you are having lab tests drawn elsewhere, please sent to us your results two weeks prior to your surgery date.

Scheduling Surgery

After your consultation, when a surgical plan has been agreed upon by both parties involved, a surgery date will be saved for you on our schedule. A $500.00 dollar deposit is required to guarantee that particular date for you, and is due when surgery is scheduled. We will make every attempt to coordinate our schedule with your wishes, but it helps you to have a general idea about your future plans prior to scheduling surgery.  We encourage you to bring your calendar schedule to the office. If your schedule is limited due to work, social event or school, or if you live far away from the office, we frequently make tentative surgery reservations over the phone when patients call for their consultation appointment. Unavoidably, schedules can change, yours and ours, but please notify us immediately if a problem arises which might necessitate rescheduling. We pledge to do likewise.

Payment for Surgery

In most busy plastic surgery practices, full payment for cosmetic surgery is due 14 days prior to surgery.  All patients should have sufficient time to plan ahead and arrange their finances. Cancellations made less than 14 days prior to surgery are subject to a cancellation fee of $250.00 dollars. We understand that conflicts in your schedule can develop from time to time and we are willing to work with you if you need to reschedule your surgery for a later date. Scheduling deposits are necessary since you are reserving personnel and surgeon time.  When patients cancel, personnel still has to be paid and the surgeon squanders time that could have been spent productively.

The Insurance Question

Our entire practice focuses on cosmetic surgical enhancement of individuals. It is our specialty and patients seek us out to fulfill their cosmetic surgery needs.  Insurance does not cover the expenses of hospitalization and surgical fees when surgery is done exclusively for cosmetic reasons. If, however, the operation is performed in an attempt to improve or restore function, insurance may defray some of the costs. Patients, not their insurance carriers, are responsible for all charges incurred for services rendered by our physicians. There are a no exceptions.

Those portions of your surgery which are considered functional may be covered under certain health plans. Portions of your surgery and operating room fees deemed to be cosmetic in nature shall be the responsibility of the patient. It is the patient's responsibility to determine if he or she is covered by an insurance plan. As ethical surgeons, we do not fill out insurance forms so that it appears that the work performed was not for cosmetic purposes if, indeed, it was.

Financing Available

We have made financing for cosmetic surgery services available for patients who desire to exercise this option. Financial institutions are completely independent of our practice. Interest rates vary greatly between institutions and can be influenced by your overall credit score. Be sure to ask about financing options during your consultation. Our staff is prepared and more than happy to tell you about the financing options available at our office. Financing can make surgery payments more affordable and convenient, but you must remember that this is a loan you are obtaining. Before you take out your loan, be sure that you are not paying an interest rate that is unreasonable.

Recovering from Surgery

For most cosmetic plastic surgical procedures, you will need to restrict your normal activities for a time following surgery. It takes time for the visible signs of healing to subside. Plan your work and social activities to allow sufficient time for recovery.

Summary

If you want to obtain the best results from cosmetic surgery, we advise you to become a discriminating consumer. Ask questions and obtain as much information about your surgeon and the procedure you are seeking before committing to surgery. It is important that you understand as much as possible about what exactly you are purchasing… and from whom.  Seek out physicians who are highly trained in plastic surgery and that specialize in cosmetic surgery.  Be sure that your surgeon is Board Certified in Plastic Surgery and that he uses an accredited facility that focuses on patient safety. The individual that performs your surgery should make you feel comfortable and should listen carefully to your needs. You should be able to trust your surgeon and he should radiate with confidence. Remember, you are asking this person to make permanent changes to your body and entrusting your life in his hands.