Q&A with Jan Jernbeck

What is your training and background?
Not all surgeons are suited for aesthetic plastic surgery. To have the necessary competence, a doctor must have specialist training in plastic surgery and many years of experience in the procedures he performs. This is what the interest group Svensk Förening för Estetisk Plastikkirurgi (Swedish Association of Aesthetic Plastic Surgery) demands from its members, and it is also a minimum requirement for surgeons at Akademikliniken.


How often do you perform a procedure?
Many surgeons perform many different kinds of plastic surgery procedures. Others specialise in one type. A doctor who is good at face lifts is not necessarily as good at rhinoplasty. At Akademikliniken not all doctors do all kinds of procedures, but they have a lot of experience in the kind of procedures they do.


Can you show me before and after pictures of previous patients?
By examining other patients you will come to understand the thinking of your doctor. You and your surgeons may disagree about the size of a nose and how it can be shaped. Akademikliniken has a great number of pictures which we are allowed to show with the patient’s approval. Sometimes, even pictures of less successful procedures can be useful.


Can you recommend other surgeons?
A good plastic surgeon understands that you want to compare. If you don’t feel sure you should speak to several doctors, as an operation has to do with trust.


Will my new look suit me?
Proportions are essential in aesthetic plastic surgery. With the aid of digital imagery and computers, pictures of a new look can be created. They clearly show that it is not always the best option to remove the source of irritation. Many times a better result can be achieved if you move tissue ( e.g. cartilage, fat or bone). This is especially true for rhinoplasty.


How painful is it? What are the risks?
A surgical procedure is always linked to pain and certain risks. It is hard to convey the degree of pain, but you will be told in advance when it will hurt the most. As for risks, they are judged to be small for many procedures. You should still ask to be informed about things that can go wrong.


Tell me everything about the procedure!
Detailed descriptions may feel unpleasant, but it is always good to know what you expose yourself to. To know as much as possible is also psychologically important. Some questions:
- What happens during the procedure?
- How long does it take?
- What type of anaesthesia will I be given?
- How long must I stay at the clinic?
- When will the stitches be removed?
- What type of pain relief is there?
- Do I need to take out sick leave?
- How long is it before I can function normally?
- What do I tell people if I don’t want to tell them about the surgery?
- How must I live after the procedure?


Can you offer psychological aftercare?
It is not unusual to feel uneasy after a procedure. Is my face still there? Will I be able to do sports again? Should my nose really be this swollen? Ask if you can call the surgeon or a nurse for a prompt reply.


How much is the total cost?
Find out what is included in the price. Anaesthesia, extra nights at the hospital, removal of stitches, post-surgical consultation? Find out how much any possible corrections might cost. Also calculate how much it will cost you to stay home from work.


Who pays if the result fails?
You can’t insure yourself against failed operations. Check out the surgeon’s insurance, and whether you will be offered corrective surgery for free.


At what age is it better to have plastic surgery?
There is no particular age for having a plastic surgery procedure. But for age-related changes, the most common age for plastic surgery procedures is between 40 and 65.


Is there a best time of the year?
Medically it has no importance. But to wear bandages on a hot summer’s day can be a nuisance. Scar tissue is also inflamed by the sun. Scars may be protected with tape and a sun lotion. If you have recently had an operation, be careful about going out on really cold winter days.


How can I prepare myself?
A surgical procedure is hard for the body, which is why patients should be rested and fit. And since smoking impairs blood circulation and recovery, patients should quit smoking a few weeks before the treatment.


Does it hurt?
In the first 24 hours almost everyone feels some tenderness in the operated area. The degree of pain is individual and depends on the procedure.


How large will the bruises be?
Some people bruise more easily than others. This biological variation cannot be altered. Bruising may be extensive after facial surgery, because of the thinness of the skin. Those who bruise easily can count on having bruises after an operation.


How will sensitivity be affected?
Sensitivity may decrease because the nerves in the operated area are affected. It can take months, up to a year, before it returns. In some cases reduced sensitivity can become permanent.


Can the stitches open up while I am asleep?
The stitches are kept in place with surgical tape. The body also reacts instinctively and turns around automatically if the scar is rubbed against the bed.


When can I start showering again?
It depends on the type of operation. After a major procedure it takes a few days, and surgical tape must be worn to protect the wound.


Can I use make-up after a face lift?
A few days after the operation, discolouration and swelling may be covered up with make-up. However, the incisions must be protected until the stitches have been removed. Avoid using make-up the first two weeks after a skin peel or a chemical peel. Use allergy-tested cosmetics which are not too dry, since they may penetrate the scars. Cleanse thoroughly.


How should I live after the operation?
The skin impairs more quickly in smokers – so don’t start smoking again after the operation. Healthy diet and exercise help provide elasticity and stability for the muscle groups that keep the operated area ”in place”. Cleansing and lubrication are important, and keep sun exposure to a minimum. Air pollution always has a negative impact on the skin.


How long do the results last?
Liposuction and breast augmentation are permanent, unless the patient gains a lot of weight. Procedures that stretch the skin impair with age. However, the skin doesn’t age more quickly after a face lift.


Will I have scars?
If incisions are deep – i.e. penetrate all the layers of the cutis and the fatty tissue, there will be scars. The appearance of the scars depends on how the incision is made, how it is stitched together and the care it receives. Wounds often heal in three weeks. It takes three months before the scars are entirely stable. Scars can be taped together for up to six months after the operation to ensure they don’t get any wider.


What happens if I have an ugly scar?
It can most often be corrected, but not until a year after the operation.


When can I have a glass of wine?
You probably won’t feel like one directly after surgery. Otherwise, alcohol doesn’t have a direct negative impact on how the cut heals, but in great quantities it may have an impact on bleeding. Please note that certain painkillers should not be combined with alcohol.


When can I start exercising?
Avoid strenuous physical exercise in the weeks following a procedure. Start exercising gradually after this.


Will the operation make me happy?
If your goal is to become a happier person, an operation isn’t the answer. However, many people feel more confident after a procedure.