All surgical procedures have risks associated with them. Every surgical procedure, even a simple tooth extraction, involves some degree of risk. Risk is defined in terms of possible complications or mild disappointments that surgical results may not match one's expectations. Although quite rare, other risks may include reactions to medications or anesthesia, infection, poor healing, numbness, swelling, injuries to muscles or nerves, discoloration of tissues, scarring and even death. Every patient should be aware of these possibilities and is encouraged to inquire about the realistic risks associated with the contemplated procedure. Every patient also is encouraged to discuss any concern or fear with the surgeon before going into surgery. To reduce some of the risks inherent in any surgical procedure, the surgeons and staff in the Department of Otolaryngology/Head and Neck Surgery work closely with qualified professionals in all areas of expertise to ensure that you will be exposed to a minimum degree of risk. Our operating rooms and recovery rooms are staffed by registered nurses. These nurses are superbly trained and experienced in all aspects of facial plastic and reconstructive surgery patient care from pre-operative discussions to post-operative care. They continue to attend courses to keep their skills and knowledge updated and are trained in emergency care procedures. Anesthesia services are provided by licensed anesthesiologist physicians. The great majority of our surgery is performed on an outpatient basis in our OHSU DayStay Unit. This suite has been carefully designed with the most modern and complete equipment, while providing a relaxed and comfortable setting for our patients. Cardiac monitoring and all possible emergency procedures are provided. We take great care to make sure that your care in our suite will equal or exceed that found in any facility elsewhere. Although medical students, residents and fellows (physicians in training) often may accompany your surgeon to the operating room and on office visits, all of your operation will be performed by your own surgeon. We are available 24 hours a day at the phone numbers listed on the homepage. A physician from the Department of Otolaryngology/Head and Neck Surgery always will be available to answer any questions that arise.

Medical photographs are routinely obtained in order to help the surgeon plan the meticulous details of each operation. You will be photographed in the office as part of your initial consultation. These pictures then become an integrated part of your medical record in our office. Your consent for us to take and use photographs for educational purposes will be specifically requested if we would like to use your pictures for such purposes. Education is a vital part of our commitment to teaching younger surgeons and colleagues.

The best and safest form of anesthesia will be provided to you for your procedure. This may involve general anesthesia attended by a staff anesthesiologist, depending on the case type. We also occasionally use "twilight" intravenous anesthesia for some procedures. You may receive preoperative medications to help you relax before arriving in the operating room. All of our anesthetics are administered with the intent to provide patient safety and comfort, as well as facilitate the recovery process following the procedure. A local anesthetic is also used to directly numb the area of surgery. During all but the most minor procedures, a skilled physician anesthesiologist is actively involved in ensuring your comfort and medical safety during the operation and in the postoperative recovery period.

We will discuss all fees and provide a written estimate of the charges for your procedure during your first consultation visit. We have developed, in conjunction with OHSU, a package price for our patients which includes the surgeon's fee, the charges for the outpatient suite, and anesthesia coverage. This package price makes it much more economical for patients to undergo facial plastic surgery, particularly when more than one procedure is being considered. It is our office policy for surgical fees to be paid two weeks in advance for elective cosmetic surgery. Since these procedures are not done on an emergency basis, the patient has time to arrange his or her finances. As a general rule, insurance companies will not pay claims for surgical procedures performed solely for cosmetic purposes. Sometimes they will pay for plastic surgery when cosmetic improvement is the by-product of a procedure performed to improve function, relieve symptoms, correct a congenital deformity or repair the effects of injury. Since there are many different insurance policies with variable allowances and coverage amounts, our office staff is in no position to predict how your company will handle your individual case. If there is a percentage of the procedure that is cosmetic, it will be quoted separately and that portion will need to be paid in advance of surgery. Because of the many changes occurring with insurance plans, it is very important for you to find out if your policy requires a second opinion or pre-certification for the procedure and/or for an overnight stay. If your specific procedure may be covered by your particular insurance policy, our staff will provide you with assistance in seeking those funds. However, our office cannot ethically, and will not, fill out forms in such a way as to make a procedure not appear to be done for cosmetic reasons when in fact it is. The patient must remember that health insurance policies are contracts between the insurance company and the patient. You, the patient, not the insurance company, are responsible for the charges incurred.