Center of Aesthetic and Reconstructive Surgery
Kongkrit Chaiyasate, MD, FACS
At the Center of Aesthetic and Reconstructive Surgery, we believe that patients deserve clear information, thoughtful guidance, and access to advanced reconstructive and aesthetic options. Dr. Kongkrit Chaiyasate is a double board-certified surgeon certified by the American Board of Plastic Surgery and the American Board of Surgery, with advanced expertise in microsurgery, craniofacial surgery, facial reconstruction, breast reconstruction, lymphedema surgery, and aesthetic surgery.
This FAQ is designed to help patients better understand available treatment options, what to expect during consultation, and how Dr. Chaiyasate approaches complex surgical care.
General Questions
Who is Dr. Kongkrit Chaiyasate?
Dr. Kongkrit Chaiyasate, MD, FACS, is a plastic and reconstructive surgeon in Michigan with advanced training in craniofacial surgery and reconstructive microsurgery. He is double board certified by the American Board of Plastic Surgery and the American Board of Surgery.
His practice focuses on complex reconstructive surgery, microsurgery, breast reconstruction, facial reconstruction, craniofacial surgery, lymphedema surgery, limb salvage, and aesthetic surgery.
Where is the practice located?
The Center of Aesthetic and Reconstructive Surgery is located at:
36800 Woodward Ave, Suite 112
Bloomfield Hills, Michigan 48304
Phone: (947) 274-8300
Website: www.chaiyasate-plasticsurgery.com
What makes this practice different?
Our practice is built around advanced reconstructive and aesthetic surgery with a highly individualized approach. Many patients come to Dr. Chaiyasate after complex cancer surgery, trauma, congenital conditions, failed prior reconstruction, radiation injury, or challenging aesthetic concerns.
The practice emphasizes:
- Advanced microsurgical reconstruction
- Natural, individualized results
- Innovative surgical planning
- Restoring form and function
- Clear patient education
- Long-term continuity of care
Compassionate, physician-led decision-making
What does “reconstructive microsurgery” mean?
Reconstructive microsurgery is a highly specialized form of surgery where tissue is moved from one part of the body to another and reconnected using a microscope. The surgeon reconnects very small arteries, veins, and sometimes nerves to restore blood supply and function.
Microsurgery is commonly used for breast reconstruction, head and neck reconstruction, limb salvage, facial reconstruction, lymphedema surgery, and complex wound reconstruction.
Do I need a referral to see Dr. Chaiyasate?
Some insurance plans may require a referral, while others do not. Patients may contact the office directly, but it is helpful to check with your insurance company regarding referral requirements.
For complex reconstructive cases, patients are encouraged to bring medical records, imaging, pathology reports, operative reports, and photos if available.
What should I bring to my first consultation?
Please bring:
- Insurance card
- Photo ID
- Medication list
- Allergy list
- Prior operative reports
- Relevant imaging reports
- Pathology reports
- Radiation or chemotherapy history, if applicable
- Photos of prior surgical changes, if useful
- A list of questions and goals
For breast reconstruction, head and neck reconstruction, craniofacial surgery, or revision surgery, prior records are extremely helpful.
Breast Reconstruction
What types of breast reconstruction does Dr. Chaiyasate offer?
Dr. Chaiyasate offers a broad range of breast reconstruction options, including:
- DIEP flap reconstruction
- Muscle-sparing free flap reconstruction
- Implant-based reconstruction
- Direct-to-implant reconstruction
- Tissue expander reconstruction
- Hybrid reconstruction using flap and implant
- Revision breast reconstruction
- Fat grafting
- Nipple reconstruction
- Breast reconstruction with resensation
- Reconstruction after failed implants
- Reconstruction after radiation
- Reconstruction after infection or implant loss
What is DIEP flap breast reconstruction?
DIEP flap breast reconstruction uses a patient’s own lower abdominal skin and fat to reconstruct the breast after mastectomy. Unlike older TRAM flap procedures, the DIEP flap preserves the abdominal muscle.
The tissue is transferred using microsurgery, and the blood vessels are connected to vessels in the chest using a microscope.
What are the advantages of DIEP flap reconstruction?
Potential advantages include:
- Natural look and feel
- Use of your own tissue
- Preservation of abdominal muscle
- No permanent breast implant
- Long-lasting reconstruction
- Improved contour of the lower abdomen
- Better option for some patients with radiation history
- Potential for sensory nerve reconstruction
Am I a candidate for DIEP flap reconstruction?
You may be a candidate if you have enough lower abdominal tissue and are healthy enough for a longer microsurgical procedure.
Good candidates may include patients who:
- Need breast reconstruction after mastectomy
- Want to avoid implants
- Have had radiation
- Have failed implant reconstruction
- Prefer autologous reconstruction
- Have adequate donor tissue
- Are medically optimized for surgery
A consultation is required to determine whether DIEP flap reconstruction is appropriate.
Can DIEP flap reconstruction be done after implants fail?
Yes. Many patients seek DIEP flap reconstruction after implant problems, including:
- Implant infection
- Capsular contracture
- Implant exposure
- Implant rupture
- Chronic pain
- Radiation-related implant failure
- Poor cosmetic outcome
- Multiple prior implant surgeries
In these cases, autologous tissue reconstruction may provide a more durable and natural option.
What is breast reconstruction with resensation?
Breast reconstruction with resensation is an advanced technique that attempts to restore protective or meaningful sensation to the reconstructed breast by connecting sensory nerves during reconstruction.
In some cases, nerve allografts or conduits may be used to bridge nerves between the flap and the chest.
Why is sensation important after breast reconstruction?
Traditional breast reconstruction often restores shape but not feeling. Loss of sensation may affect quality of life, intimacy, body image, and safety because patients may not feel heat, injury, or pressure.
Resensation is not guaranteed, but it may improve the potential for sensory recovery over time.
How long does sensation take to return after breast reconstruction with nerve repair?
Nerve recovery is slow and may take many months to years. Sensory improvement depends on many factors, including:
- Type of reconstruction
- Nerve quality
- Prior radiation
- Prior surgery
- Patient age
- Healing capacity
- Distance nerves must regenerate
Not every patient regains meaningful sensation, but nerve reconstruction may improve the opportunity for recovery.
What is implant-based breast reconstruction?
Implant-based reconstruction uses a tissue expander or implant to recreate breast shape after mastectomy. It may be performed in one stage or multiple stages.
Implant reconstruction may be appropriate for some patients, but radiation, infection history, tissue quality, and long-term goals must be considered.
What is direct-to-implant breast reconstruction?
Direct-to-implant reconstruction places a breast implant at the time of mastectomy without first using a tissue expander. It may be appropriate for select patients with good skin quality, favorable anatomy, and appropriate cancer treatment planning.
What is hybrid breast reconstruction?
Hybrid breast reconstruction combines a patient’s own tissue with an implant. This may be used when a flap alone does not provide enough volume or when an implant alone may not provide the desired shape or softness.
What is fat grafting in breast reconstruction?
Fat grafting involves removing fat from one area of the body using liposuction, processing it, and injecting it into the breast or reconstructed breast to improve contour, softness, and symmetry.
Fat grafting is commonly used for:
- Upper pole hollowing
- Contour irregularities
- Radiation changes
- Implant rippling
- Breast asymmetry
- Revision after DIEP flap or implant reconstruction
How many stages are needed for breast reconstruction?
Breast reconstruction often requires more than one stage. The first surgery creates the main breast mound. Later revisions may improve shape, symmetry, contour, scars, nipple reconstruction, or fat grafting.
The number of stages depends on the patient’s anatomy, goals, cancer treatment, radiation history, and prior surgeries.
Can breast reconstruction be done years after mastectomy?
Yes. Delayed breast reconstruction can be performed months or years after mastectomy. Patients who were told they were not candidates in the past may still have options.
Can breast reconstruction be performed after radiation?
Yes, but radiation can make reconstruction more complex. Radiation affects skin, blood supply, scarring, and healing. Autologous tissue reconstruction, such as DIEP flap reconstruction, may be a strong option for many radiated patients.
What if I was told I am not a candidate for reconstruction?
Patients with complex histories may still have options. Dr. Chaiyasate frequently evaluates patients with prior radiation, failed reconstruction, infection, scarring, or multiple previous operations.
A second opinion may help clarify whether advanced reconstructive options are possible.
Facial Reconstruction
What is facial reconstruction?
Facial reconstruction restores form and function after cancer, trauma, congenital conditions, infection, burns, radiation injury, or prior surgery. It may involve skin, soft tissue, bone, cartilage, nerves, and microsurgical tissue transfer.
What conditions may require facial reconstruction?
Facial reconstruction may be needed after:
- Skin cancer removal
- Head and neck cancer surgery
- Facial trauma
- Facial fractures
- Dog bites or soft tissue injury
- Radiation injury
- Congenital differences
- Cleft-related deformities
- Facial paralysis
- Failed previous reconstruction
- Complex wounds
What is Dr. Chaiyasate’s approach to facial reconstruction?
The goal is to restore normal anatomy, function, symmetry, and appearance while minimizing visible deformity. Facial reconstruction requires careful planning because even small differences in contour, color, scar position, or tissue thickness may be noticeable.
Dr. Chaiyasate considers:
- Blood supply
- Scar placement
- Facial units and subunits
- Skin color and texture
- Function of eyelids, lips, nose, and cheek
- Breathing, speech, chewing, and facial expression
- Long-term aesthetic outcome
What is nasal reconstruction?
Nasal reconstruction restores the nose after cancer removal, trauma, congenital conditions, infection, or failed prior surgery. The nose is complex because it requires skin coverage, structural support, lining, and proper airway function.
What techniques are used for nasal reconstruction?
Depending on the defect, nasal reconstruction may involve:
- Local flaps
- Forehead flap
- Nasolabial flap
- Cartilage grafting
- Skin grafting
- Prelaminated flaps
- Free tissue transfer
- Staged reconstruction
- Airway reconstruction
Why is nasal reconstruction often staged?
The nose has multiple layers and delicate contours. Staged reconstruction allows the surgeon to restore lining, support, and external skin while refining shape over time.
A staged approach may produce better contour, airway function, and long-term stability.
What is cheek reconstruction?
Cheek reconstruction restores soft tissue volume, skin coverage, and facial contour after cancer, trauma, or prior surgery. The cheek is important for facial balance, eyelid support, oral competence, and appearance.
What is lip reconstruction?
Lip reconstruction restores oral competence, speech, eating, facial expression, and appearance after cancer, trauma, congenital deformity, or prior surgery.
The lips are highly functional structures, so reconstruction must consider both movement and aesthetics.
What is eyelid reconstruction?
Eyelid reconstruction restores eyelid closure, eye protection, symmetry, and appearance. It may be needed after skin cancer removal, trauma, burns, facial paralysis, or prior surgery.
Improper eyelid function may lead to dry eye, corneal exposure, tearing, irritation, or vision problems.
Head and Neck Reconstruction
What is head and neck reconstruction?
Head and neck reconstruction restores anatomy and function after cancer surgery, trauma, osteoradionecrosis, infection, or congenital conditions. These reconstructions may involve the jaw, tongue, throat, skull base, scalp, face, or neck.
What is free flap reconstruction?
Free flap reconstruction transfers tissue from one part of the body to another using microsurgery. The tissue may include skin, fat, fascia, muscle, bone, or a combination.
Common free flaps include:
- Fibula free flap
- Radial forearm free flap
- Anterolateral thigh flap
- Scapula free flap
- Iliac crest free flap
- Latissimus flap
- SCIP flap
- DIEP flap
What is mandibular reconstruction?
Mandibular reconstruction restores the lower jaw after cancer, trauma, infection, osteoradionecrosis, or congenital deformity. Reconstruction may restore facial shape, dental foundation, chewing, speech, and swallowing.
What flap options are used for lower jaw reconstruction?
Common options include:
- Fibula free flap
- Scapula free flap
- Iliac crest free flap
Each option has advantages depending on bone length, soft tissue needs, dental implant planning, patient anatomy, and donor site considerations.
What is a fibula free flap?
A fibula free flap uses bone from the lower leg to reconstruct the jaw or other bones. It is commonly used for mandibular reconstruction because it provides strong bone length and can often support dental implants.
Will removing the fibula affect walking?
Most patients can walk after healing because the fibula is not the primary weight-bearing bone of the leg. However, recovery, physical therapy, and donor site healing are important parts of the process.
What is scapula free flap reconstruction?
A scapula free flap uses bone and soft tissue from the shoulder blade region. It may be useful when complex soft tissue and bone reconstruction are required.
What is iliac crest free flap reconstruction?
An iliac crest free flap uses bone from the pelvis. It can provide strong bone height and contour for selected jaw reconstruction patients.
What is osteoradionecrosis?
Osteoradionecrosis, or ORN, is bone damage caused by radiation therapy. It most commonly affects the jaw or skull base after treatment for head and neck cancer.
ORN can cause chronic wounds, pain, infection, exposed bone, fracture, and difficulty eating or speaking.
How is osteoradionecrosis treated?
Treatment depends on severity. Options may include:
- Wound care
- Antibiotics
- Hyperbaric oxygen in selected cases
- Debridement
- Removal of nonviable bone
- Free flap reconstruction
- Jaw reconstruction
- Skull base reconstruction
Advanced cases may require microsurgical reconstruction using healthy vascularized tissue.
What is skull base reconstruction?
Skull base reconstruction restores the barrier between the brain, sinuses, mouth, throat, or outside environment after cancer surgery, osteoradionecrosis, trauma, or infection.
This can be highly complex and may require free tissue transfer to protect critical structures.
Craniofacial Surgery
What is craniofacial surgery?
Craniofacial surgery treats congenital or acquired conditions affecting the skull, face, jaws, or facial bones. This includes craniosynostosis, cleft lip and palate, facial asymmetry, traumatic deformities, and syndromic craniofacial conditions.
What conditions does craniofacial surgery treat?
Craniofacial surgery may address:
- Cleft lip
- Cleft palate
- Craniosynostosis
- Crouzon syndrome
- Apert syndrome
- Facial asymmetry
- Orbital deformities
- Midface deficiency
- Jaw deformities
- Facial skeletal trauma
- Congenital facial differences
- Adult craniofacial deformities
What is craniosynostosis?
Craniosynostosis occurs when one or more skull sutures close too early in a growing child. This may affect skull shape, facial growth, eye position, and sometimes brain development.
Treatment depends on the type, severity, and age of the patient.
What is cleft lip and palate?
Cleft lip and palate are congenital conditions where parts of the lip, gum, or palate do not fully join during development. Treatment often requires a multidisciplinary approach involving surgery, speech therapy, dental care, orthodontics, and long-term follow-up.
Can adults with cleft lip and palate still have corrective surgery?
Yes. Adults with cleft-related concerns may benefit from revision surgery for:
- Nasal deformity
- Lip asymmetry
- Palatal fistula
- Speech concerns
- Jaw alignment
- Dental or alveolar bone issues
- Facial asymmetry
- Scarring
What is a palatal fistula?
A palatal fistula is an opening in the palate that may occur after cleft palate repair or other surgery. It may cause nasal regurgitation, speech problems, food trapping, or recurrent irritation.
Complex fistulas may require local tissue, regional tissue, or free flap reconstruction.
What is VPI?
VPI stands for velopharyngeal insufficiency. It occurs when the soft palate does not close properly against the back of the throat during speech, allowing air to escape through the nose.
Symptoms may include hypernasal speech, nasal air emission, and difficulty with certain sounds.
Can VPI be treated surgically?
Yes. Surgical options depend on anatomy, speech evaluation, and severity. Options may include pharyngeal flap, sphincter pharyngoplasty, fat grafting, palate revision, or other individualized procedures.
Lymphedema Surgery
What is lymphedema?
Lymphedema is chronic swelling caused by impaired lymphatic drainage. It may occur after cancer surgery, lymph node removal, radiation therapy, infection, trauma, or congenital lymphatic problems.
What are common symptoms of lymphedema?
Symptoms may include:
- Arm or leg swelling
- Heaviness
- Tightness
- Aching
- Recurrent cellulitis
- Skin thickening
- Reduced mobility
- Difficulty wearing clothing or shoes
- Progressive limb enlargement
Can lymphedema be treated surgically?
Yes, selected patients may benefit from surgical treatment. Surgery does not replace compression therapy or conservative management, but it may improve symptoms and reduce progression in appropriate candidates.
What is lymphovenous bypass?
Lymphovenous bypass, also called LVB or lymphovenous anastomosis, is a supermicrosurgical procedure that connects tiny lymphatic channels to small veins to help redirect lymphatic fluid.
The channels may be extremely small, often less than 1 millimeter.
What is vascularized lymph node transfer?
Vascularized lymph node transfer moves lymph nodes with their blood supply from one area of the body to another to help improve lymphatic drainage.
This is a specialized procedure and is not appropriate for every patient.
How do I know if I am a candidate for lymphedema surgery?
Evaluation may include:
- Medical history
- Physical examination
- Lymphedema stage assessment
- Prior cancer treatment history
- ICG lymphography
- Lymphoscintigraphy
- Ultrasound
- Compression therapy history
A personalized evaluation is necessary.
Is lymphedema surgery a cure?
Lymphedema surgery is not always a cure. The goal is to improve symptoms, reduce swelling, reduce infections, improve function, and slow progression. Many patients still need compression and long-term management.
Limb Salvage and Complex Wound Reconstruction
What is limb salvage?
Limb salvage is the effort to preserve an arm, leg, hand, or foot after trauma, infection, cancer, vascular disease, exposed hardware, bone exposure, or complex wounds.
When is a plastic surgeon involved in limb salvage?
Plastic surgeons are often involved when soft tissue coverage is needed over exposed bone, tendons, joints, vessels, nerves, or hardware.
Advanced reconstruction may prevent amputation in selected cases.
What types of limb salvage reconstruction are available?
Options may include:
- Local flaps
- Muscle flaps
- Fasciocutaneous flaps
- Free tissue transfer
- Skin grafts
- Dermal substitutes
- Negative pressure wound therapy
- Bone and soft tissue reconstruction
- Combined orthopedic and plastic surgery reconstruction
What is orthoplastic surgery?
Orthoplastic surgery is a collaborative approach between orthopedic surgery and plastic surgery to treat complex extremity problems. The goal is to reconstruct bone, soft tissue, blood supply, and function in a coordinated way.
What is a free flap for limb salvage?
A free flap transfers healthy tissue from another part of the body to cover a complex wound. The blood vessels are connected under a microscope to restore circulation to the transferred tissue.
Facial Paralysis and Facial Reanimation
What is facial paralysis?
Facial paralysis occurs when the facial nerve does not function properly, causing weakness or inability to move part of the face. It may affect the smile, eyelid closure, speech, eating, and facial symmetry.
What causes facial paralysis?
Causes include:
- Bell’s palsy
- Tumor surgery
- Trauma
- Congenital facial palsy
- Stroke
- Infection
- Skull base surgery
- Parotid surgery
- Acoustic neuroma surgery
What is facial reanimation?
Facial reanimation refers to surgical procedures designed to restore facial movement, improve symmetry, and protect the eye.
What procedures are used for facial reanimation?
Options may include:
- Nerve repair
- Nerve grafting
- Cross-facial nerve graft
- Masseteric nerve transfer
- Hypoglossal nerve transfer
- Temporalis tendon transfer
- Free functional muscle transfer
- Eyelid procedures
- Static suspension
- Brow lift or lower eyelid support
Is facial reanimation time-sensitive?
Yes. Some nerve and muscle procedures are more effective when performed within a certain timeframe after injury. However, even long-standing facial paralysis may have reconstructive options.
Aesthetic Surgery
Does Dr. Chaiyasate perform cosmetic surgery?
Yes. In addition to complex reconstructive surgery, Dr. Chaiyasate offers aesthetic procedures, including facial rejuvenation, facelift, neck lift, rhinoplasty, eyelid surgery, fat grafting, laser treatments, and body contouring.
His reconstructive background helps guide a detailed, anatomy-based approach to aesthetic surgery.
What is comprehensive facial rejuvenation?
Comprehensive facial rejuvenation may combine surgical and nonsurgical treatments to address aging of the face, neck, skin, and soft tissues.
Options may include:
- Facelift
- Neck lift
- Eyelid surgery
- Fat grafting
- CO2 laser resurfacing
- Skin tightening
- Volume restoration
- Scar refinement
- Injectable treatments
What is a facelift?
A facelift improves visible signs of aging in the lower face and jawline. It may address jowls, facial laxity, sagging tissues, and loss of youthful contour.
A facelift does not stop aging, but it can restore a more refreshed and natural appearance.
What is a neck lift?
A neck lift improves loose skin, muscle banding, and contour changes in the neck. It is often combined with a facelift for balanced rejuvenation.
What is eyelid surgery?
Eyelid surgery, or blepharoplasty, improves excess skin, puffiness, or heaviness around the eyes. It may be performed on the upper eyelids, lower eyelids, or both.
What is rhinoplasty?
Rhinoplasty is surgery to reshape the nose. It may be performed for cosmetic improvement, breathing problems, trauma, congenital deformity, cleft-related nasal deformity, or revision after prior surgery.
What is the difference between cosmetic rhinoplasty and reconstructive rhinoplasty?
Cosmetic rhinoplasty focuses primarily on appearance. Reconstructive rhinoplasty may address deformity, airway obstruction, trauma, cleft-related nasal changes, cancer reconstruction, or failed prior surgery.
Many rhinoplasty procedures include both functional and aesthetic goals.
What is fat grafting to the face?
Facial fat grafting uses a patient’s own fat to restore volume, soften contours, and improve facial balance. Fat may be placed in the cheeks, temples, jawline, under-eye area, lips, or areas of scarring.
What is “Ozempic face”?
“Ozempic face” is a popular term describing facial volume loss after significant weight loss, including weight loss related to GLP-1 medications. Patients may notice hollow cheeks, sagging skin, deeper folds, and an aged appearance.
Treatment may include fat grafting, facelift, neck lift, fillers, skin resurfacing, or a combination approach.
What is CO2 laser resurfacing?
CO2 laser resurfacing improves skin texture, fine lines, wrinkles, scars, sun damage, and some signs of aging by removing damaged outer layers of skin and stimulating collagen remodeling.
Is CO2 laser safe for all skin types?
CO2 laser resurfacing must be used carefully, especially in darker skin types or patients prone to hyperpigmentation. A consultation is necessary to determine the safest treatment plan.
What is IPL?
IPL, or intense pulsed light, is a light-based treatment used for certain pigmentation, redness, sun damage, and skin tone concerns. It is not the same as a laser.
What is Pico laser?
Pico laser technology may be used for pigmentation, tattoo removal, and certain skin concerns. It can be helpful in selected patients, including some patients with darker skin types, depending on settings and indication.
Skin Cancer and Reconstruction
Do you perform reconstruction after skin cancer removal?
Yes. Dr. Chaiyasate performs reconstruction after skin cancer removal, including complex facial, scalp, eyelid, nasal, lip, cheek, and ear defects.
Do you work with Mohs surgeons?
Yes. Many patients are referred after Mohs surgery for reconstruction. Coordination with the Mohs surgeon helps determine timing and reconstructive options.
What areas are commonly reconstructed after skin cancer?
Common areas include:
- Nose
- Eyelids
- Lips
- Cheeks
- Forehead
- Scalp
- Ears
- Chin
- Neck
What determines the reconstruction plan?
The plan depends on:
- Size of the defect
- Depth of the defect
- Location
- Skin quality
- Prior radiation
- Patient health
- Functional structures involved
- Aesthetic subunit principles
Patient goals
Revision Surgery
What is revision reconstructive surgery?
Revision reconstructive surgery improves or corrects problems from prior surgery, trauma, cancer treatment, or wound healing. It may involve scar revision, contour correction, flap debulking, fat grafting, implant removal, nerve reconstruction, or complete reconstruction.
Why do patients seek revision surgery?
Common reasons include:
- Poor contour
- Asymmetry
- Scarring
- Pain
- Implant problems
- Radiation damage
- Flap bulkiness
- Functional limitations
- Dissatisfaction with previous reconstruction
- Incomplete reconstruction
Is revision surgery more difficult than the first surgery?
Often, yes. Revision surgery may be more complex because of scar tissue, altered anatomy, prior radiation, damaged blood vessels, missing tissue, or previous implants.
A careful review of prior records and operative reports is often necessary.
Insurance and Payment
Do you accept insurance?
Insurance coverage depends on the procedure, diagnosis, insurance plan, and network status. Many reconstructive procedures may be covered by insurance when medically necessary.
Patients should contact the office to discuss insurance questions and preauthorization needs.
What is the difference between reconstructive and cosmetic surgery?
Reconstructive surgery is performed to restore form or function after cancer, trauma, congenital conditions, infection, or medical disease. Cosmetic surgery is performed to improve appearance when there is no medical necessity.
Some procedures have both reconstructive and aesthetic components.
Will my insurance cover breast reconstruction?
Breast reconstruction after mastectomy is often covered under federal law, but coverage details vary by plan. Revision, symmetry procedures, and certain staged procedures may also be covered depending on medical necessity and plan rules.
Will insurance cover lymphedema surgery?
Coverage for lymphedema surgery varies. Some plans cover selected procedures when medically necessary, while others may require extensive documentation or appeals.
Will insurance cover facial reconstruction?
Facial reconstruction after cancer, trauma, congenital deformity, or functional impairment may be covered, depending on the plan and medical necessity.
What if my insurance denies surgery?
Insurance denials may occur even when surgery is medically necessary. In some cases, appeals, peer-to-peer review, additional documentation, or letters of medical necessity may be needed.
The office can help guide patients through the process.
Do you offer self-pay options?
Yes, self-pay options may be available for cosmetic procedures and selected services not covered by insurance. A personalized quote is provided after consultation.
Preparing for Surgery
How should I prepare for surgery?
Preparation may include:
- Medical clearance
- Lab work
- Imaging
- Medication review
- Stopping nicotine
- Optimizing nutrition
- Managing diabetes or other conditions
- Arranging transportation
- Planning time off work
- Having support at home
Why is stopping nicotine important?
Nicotine significantly reduces blood flow and increases the risk of wound healing problems, infection, tissue loss, and flap complications. This includes cigarettes, vaping, nicotine patches, gum, and other nicotine products.
How long should I stop nicotine before surgery?
Recommendations vary, but many surgeons require patients to stop nicotine several weeks before and after surgery. Nicotine testing may be required for certain procedures.
Should I stop supplements before surgery?
Some supplements may increase bleeding risk or interact with anesthesia. Patients should provide a full list of supplements, vitamins, and medications before surgery.
Can I take weight loss medications before surgery?
Some weight loss medications, including GLP-1 medications, may affect anesthesia planning and stomach emptying. Patients should inform the surgical team about all medications well before surgery.
Recovery
How long is recovery after surgery?
Recovery depends on the type of procedure. Small procedures may require days of recovery, while complex microsurgical reconstruction may require weeks to months.
Your individualized recovery plan will be discussed during consultation.
Will I have drains after surgery?
Some surgeries require drains to remove fluid and reduce seroma risk. Drains are common after breast reconstruction, body contouring, large flap surgery, and some reconstructive procedures.
Will I have scars?
All surgery creates scars. Dr. Chaiyasate carefully plans incisions to minimize visibility when possible, but scar healing depends on genetics, location, tension, skin type, prior radiation, infection, and wound healing.
When can I return to work?
Return to work depends on the procedure and your job duties. Desk work may resume earlier than physically demanding work. Complex reconstruction may require longer recovery.
When can I exercise after surgery?
Exercise restrictions depend on the procedure. Patients should avoid strenuous activity until cleared. Walking is often encouraged early, but heavy lifting and intense exercise may be restricted for several weeks.
What signs should I watch for after surgery?
Patients should contact the office for:
- Fever
- Increasing redness
- Severe pain
- Sudden swelling
- Drainage or pus
- Shortness of breath
- Chest pain
- Calf pain
- Wound opening
- Color change in a flap
- Any concerning change
For emergencies, call 911 or go to the nearest emergency department.
Second Opinions
Can I see Dr. Chaiyasate for a second opinion?
Yes. Many patients seek second opinions for complex reconstruction, breast reconstruction, failed prior surgery, lymphedema, facial reconstruction, craniofacial issues, or revision surgery.
What should I bring for a second opinion?
Please bring:
- Prior operative reports
- Imaging
- Pathology reports
- Radiation records
- Chemotherapy history
- Implant information, if applicable
- Photos before and after prior surgery
- A summary of your goals and concerns
Will Dr. Chaiyasate tell me if surgery is not recommended?
Yes. Surgery is not always the best option. A responsible consultation includes discussing risks, benefits, alternatives, timing, and whether surgery is appropriate.
Scheduling and Contact
How do I schedule a consultation?
To schedule a consultation, contact:
Center of Aesthetic and Reconstructive Surgery
Phone: (947) 274-8300
Website: www.chaiyasate-plasticsurgery.com
Address: 36800 Woodward Ave, Suite 112, Bloomfield Hills, Michigan 48304
Can I send photos before consultation?
In some cases, photos may help the office understand the concern before consultation. Patients should contact the office for instructions on secure submission.
Do you offer virtual consultations?
Virtual consultation availability may vary depending on the condition, location, and type of surgery. Many complex cases still require in-person evaluation.
What areas do you serve?
The practice serves patients in Bloomfield Hills, Royal Oak, Troy, Birmingham, Detroit, Ann Arbor, Michigan, and beyond. Patients with complex reconstructive needs may travel from outside the region for specialized care.
Website Disclaimer
The information on this page is for educational purposes only and does not replace a medical consultation. Every patient is unique, and treatment recommendations depend on individual anatomy, diagnosis, medical history, goals, and examination. Surgery carries risks, and outcomes cannot be guaranteed. Please schedule a consultation with Dr. Kongkrit Chaiyasate to discuss your specific condition and treatment options.