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THE PAPER TRAIL – INSURANCE AND MEDICAL NECESSITY

Friday, June 28th, 2013

In Illinois Plastic Surgeon, G. D. Castillo, MD’s  practice, we do help patients whose cases qualify as medically necessary procedures; i.e., upper blepharoplasty https://www.cosmeticplasticsurgery.com/cosmetic-surgery/eyelid-surgery.cfm for vision constriction (excess skin obscuring vision),  or septoplasty https://www.cosmeticplasticsurgery.com/cosmetic-surgery/rhinoplasty.cfm  to correct a nasal obstruction that interferes with proper breathing and causes recurring sinus-type ailments  or breast reduction https://www.cosmeticplasticsurgery.com/cosmetic-surgery/breast-reduction.cfm to correct gigantomastia (overly-large breasts) resulting in postural changes causing neck and back pain, mastodynia (breast pain), dermatitis (skin irritation) and difficulty with movement.

When submitting a predetermination of medical benefits for these patients, insurance companies do ask for proof of medical necessity.  What does this mean for our patients?

What insurance companies are looking for is proof (a written medical record and/or diagnostic tests) that the patient will not obtain relief from their symptoms via conventional (non surgical) treatment such as medications, physical therapy and/or life-style changes.  Let’s take two hypothetical cases and examine the process and possible outcomes.

Patients Jane and Jenny Doe present for consultation with complaints of large breasts that are causing increasing discomfort .

Examination by Dr. Castillo discloses gigantomastia resulting in postural changes causing shoulder strapping (deep bra strap grooves from the weight of the breasts), neck pain, and back pain https://www.cosmeticplasticsurgery.com/patient-stories/.  They have difficulty with everyday movement and exercise.  They have painful, aching breasts (mastodynia) and suffer chronic dermatitis from breasts chafing against the chest wall.  Their body mass index (BMI) is within the normal range and both will require the insurance standard of 400+ grams of tissue to be removed from each breast.

Jane has suffered in silence for years.  She has not sought professional medical attention for her symptoms in the past and has treated her conditions (dermatitis, neck/back pain, etc.) with over-the-counter remedies – none of which have offered her the long-term relief she desires because they do not address the underlying source of her discomfort – gigantomastia.

Jenny, on the other hand, has been proactive in seeking professional assistance with the goal of long-term relief.  She has sought advice from her primary physician and has undergone treatment with both physical therapy (exercise to strengthen her musculature) and medications, all of which are documented in her medical history.  Upon determination that conventional treatment will not alleviate her problems, her physician has made a recommendation for breast reduction surgery and referred her for consultation with Dr. Castillo.

Our office submits a predetermination of medical benefits request to each of their respective insurance companies.  Jenny’s insurance company replies that the procedure of breast reduction surgery qualifies for benefits according to the limits/levels of her individual policy.  Jane’s insurance company replies that they require additional proof of medical necessity (unsatisfactory response to conventional therapy) and attaches a list of their requirements prior to breast reduction approval.

Both women have the exact same medical situation but Jenny’s efforts have resulted in a positive reply from her insurance company and she is able to schedule her surgery right away.  Jane is faced with the prospect of enduring her symptoms while she begins the medical documentation process or absorbing the financial responsibility alone.

I wish I could say that we’ve never experienced these scenarios, but we have.  It’s important to not ignore your medical symptoms and to seek professional advice from your physician.  The “paper trail” of medical necessity can be the difference between obtaining relief versus continuing on the spinning wheel of discomfort.  Arming yourself with the documentation you need for medical insurance coverage just makes good sense while suffering in silence is counter productive.

Do you have questions regarding insurance coverage or medical necessity?  If so, please don’t hesitate to give us a call at 800-252-7123.  We are strong advocates for our patients and are happy to help.

 

THE WEEKEND FACELIFT

Friday, November 30th, 2012

 

So you probably have heard the term “weekend facelift” and you’re having a difficult time imagining what it is.  Could it be a facelift that’s done on a weekend or is it a facelift that is easy to recover from in a weekend?  The procedure is remarkably effective at improving the jaw/neck line and removing the double-chin deformity.  There are some caveats that one needs to know and understand that it is not a procedure that can be carried out in all patients.  In order to have a so-called weekend facelift, typically our patients need to be under the age of 55, and have a weak (recessed) chin.  Many of these people have a family history of double chins, they are quite familiar with fatty tissue in the neck at a young age in their family and they begin to have issues in the mid thirties.

 

The procedure is carried out through a very small incision, typically smaller than 1 inch, right underneath the chin which is not visible. Through this incision, the fatty tissue in the neck area up to the jaw line is removed and sometimes a small amount of fatty tissue can be removed from the jowl area.  Through the same incision, a tight pocket is created just in front of the jaw to place chin implant. This portion of the procedure is referred to as a mentoplasty.  Through this same incision the muscle structure in the neck area is tightened.  The result is a neck, which is svelte with good definition in the jaw/neck line area, and an improvement in the facial symmetry because the lower third of the face is better represented, more proportionate after the procedure.

 

Those people who are not good candidates for a weekend facelift are typically people above the age of 60 and people who have a very significant amount of loose skin in the neck area with significant wrinkling in the neck and/or folds. These individuals are usually better candidates for a traditional facelift.

 

The term minimally invasive surgery has been used to describe this procedure because there is little interference with the tissues during the procedure and it is easy to recover.  Usual side effects are mild pain in the chin area for 2-3 days, bruising in the lower portion of the neck, some swelling in the anterior jaw area, and the neck area as well.

Ask Our Expert –

Monday, September 24th, 2012

BALANCING BEAUTY

QUESTION:  When I read anti-aging articles, they often refer to facial balance.  Can you explain what that means?

ANSWER:  I belive what they are referring to is a “basic formula” used to describe a well-balanced face, proportionately speaking.  This balance is seen when the face’s prominent features, meaning the brows, eyes, cheeks and lips are proportionate to each other.   The eyebrows should be aligned with eachother with a slight arch toward the outer or lateral portion of the brow.  When looking at the eyes, there should be a 1/2″ between the upper lid and and the eyebrow.  The lateral or outer corner of the eye should angle up just a touch.  Prominent cheekbones are a sign of beauty.  They should be full and high set.  An oval shape that tapers itself back as you follow then back toward the ears is most desirable.  Last but not least are the lips.  The lower lip should be 2/3 larger than the upper lip.

Create balance with dermal fillers.
Lasts upto 18 months.

In the hands of an expert injector and Cosmetic Surgeon such as Dr. Castillo (not your neighborhood spa), Botox Cosmetic® and dermal fillers such as Juvederm®, Radisse® or Perlane® can be a quick, effective way to improve the lack of proportion in the face.  Botox Cosmetic® or Dysport® can be used to improve the arch of the lateral brow.  This technique can also add some distance between the brow and upper lid helping to restore or create that missing balance.  Dermal fillers or fat transplantation can be used to give fullness the cheeks, creating a more prominent and defined cheekbone. Dermal filler or fat transplantation can also be used to plump up the lips, and to give better definition.

Though all these facial features can be improved by the above mentioned techniques, it is important to remember the goal; proprotional balance. It is the the key to looking natural and maintaining a youthful appearance.  If too much focus is placed on one of these prominent facial features, you will once again be out of proportion often resulting in an “over-done” less youthful appearance.

Balance is the key to life…and apparently to physical beauty as well!

 

Yours Truly,

Roxanne Hammond, RMA
Skincare and Laser Specialist
G. D. Castillo, M.D.
COSMETIC PLASTIC SURGERY  https://www.cosmeticplasticsurgery.com

LIKE US ON FACEBOOK: http://www.facebook.com/DrCastilloCosmeticPlasticSurgery
800-252-7123 (within IL)
217-359-7508 Savoy (Champaign-Urbana)
309-662-0436 Bloomington

 

 

 

Ask Our Expert: What is the best type of sunscreen?

Wednesday, August 22nd, 2012

 

Q: What is the best type of sunscreen?

A: Historically, it has been shown that physical sunscreens provide the best protection against both UVA & UVB radiation and are less likely to cause skin irritation.  Dr. Castillo, cosmetic surgery and anti-aging expert  https://www.cosmeticplasticsurgery.com/ recommends medical-grade, physical sunscreens to all his patients.

There are two divisions of sunscreen ingredients; physical and chemical. Physical sunscreens reflect the UV radiation while chemical sunscreens absorb the UV radiation and break it down within the skin. Some sunscreens contain both a physical and a chemical component.

There are two types of physical sunscreens available; zinc oxide and titanium dioxide. Both provide broad spectrum UVA and UVB protection. Today, these ingredients can be found in finely micronized, nano-sphere  form which allows for ease of daily use. Not only does zinc oxide and titanium dioxide provide needed broad-spectrum coverage but they are also beneficial to those who have sensitive skin or are irritated by chemical ingredients.

You will typically find multiple active ingredients listed in chemical sunscreen.  Each chemical ingredient protects only against a specific portion of the UV spectrum. Be aware that at this time many over-the-counter sunscreens protect against UVB rays only, although there are a few chemical ingredients like Oxybenzone that do offer UVA/UVB protection. Therefore, when purchasing over the counter sunscreen, it is important to examine the label for the claim “broad-spectrum.”  Also look for a sunscreen that says “very water resistant.”  However, keep in mind that even the best water resistant sunscreens can only protect you for 80 minutes.  Then you will need to re-apply.

With inconsistent OTC product labels and the idea that active ingredients in sunscreens differ from manufacturer to manufacturer it can be difficult to decipher all of them so I have provided at chart of the more common ingredients found in sunscreens.  When in doubt whether a sunscreen will effectively protect you and your family, I recommend selecting a medical grade sunscreen from your local cosmetic surgeon, plastic surgeon or dermatologist. Our patient’s favorite sunscreens are:

Sun Defense by Castillo MD Skin Science, which offers medical grade 12% Zinc Oxide, 7.5% Octinoxate broad-spectrum UVA/UVB protection

Prime Defense by Castillo MD Skin Science, which offers 10% Titanium Dioxide, 4% Zinc Oxide broad-spectrum UVA/UVB protection with an added skin primer.

 

Chemical & physical ingredients found in sunscreens.

Ingredient:                                            Ray Type:

Avobenzone UVA
Dioxybenzone UVA/ UVB
Homosalate UVB
Octocrylene UVB
Octyl methoxycinnamate UVB
Octisalate UVB
Oxybenzone UVA/ UVB
Padimate O UVB
Mexoryl UVA/UVB
Titanium dioxide UVA/UVB     broad spectrum
Trolamine salicylate UVB
Zinc oxide UVA/UVB     broad spectrum

WARNING: You must actually apply the sunscreen to your skin.  Just purchasing it will not provide sufficient protection! lol

 

Roxanne, Skincare & Laser Specialist

Roxanne Hammond, RMA
Skincare and Laser Specialist
G. D. Castillo, M.D.
COSMETIC PLASTIC SURGERY                                                                 https://www.cosmeticplasticsurgery.com

LIKE US ON FACEBOOK: http://www.facebook.com/DrCastilloCosmeticPlasticSurgery
800-252-7123 (within IL)
217-359-7508 Savoy (Champaign-Urbana)
309-662-0436 Bloomington

Say Goodbye to Chest Lines, Wrinkles and Brown Spots!

Wednesday, August 8th, 2012

 

Roxanne performs CO2 Micro-Fractional Laser Resurfacing to remove lines and brown spots of the chest.

I was speaking with one of Dr. Castillo’s breast augmentation patients during a skin rejuvenation consultation.  She explained to me that a few years back she had breast enhancement https://www.cosmeticplasticsurgery.com/cosmetic-surgery/breast-enlargement.cfm in Dr. Castillo’s Cosmetic Surgery facility in Savoy, Illinois and that she couldn’t be happier with her results and the entire Cosmetic Plastic Surgery experience.

However, she has some fine lines and wrinkles on her chest between her breasts along with a moderate amount of brown spots. She expressed that she would like to show off her new cleavage https://www.cosmeticplasticsurgery.com/photo-gallery/results.cfm?Category=10 without being embarrassed about having wrinkles between her new, perky breasts.  She asked if G.D. Castillo M.D. and Cosmetic Plastic Surgery Skin Restoration and Laser Institute offered skin treatments to remove the wrinkles and brown spots of the chest.

I explained to her that the vertical lines and brown spots she was describing are common among those who have been over-exposed to the sun. The sun breaks down elastin and collagen of the chest, creating lines, wrinkles, and sagging skin.  It also causes melanocytes (pigmented cells that create brown spots she is seeing on her chest) to over-populate the surface of the skin in attempt to protect itself from damaging UV radiation.

I explained to her that yes, we can help with her chest lines and brown spots.  To improve the look of her damaged skin, first, she would need to begin to protect her décolletage using medical grade broad-spectrum sunscreen 365 days per year.  UV radiation will create more severe damage to areas such as the chest, neck and hands. The characteristics of the skin of the chest, neck and hands simply cannot tolerate the same amount of UV radiation as the face. The skin of the chest is not as forgiving as skin surfaces such as the face when it is repeatedly over-exposed to the sun. The skin of the chest is thinner, containing less elastin / collagen.  As the elastin is broken down, lines, wrinkles and sagging of the skin WILL occur.

Unlike the face, skin of décolletage does not contain an abundance of oil glands.  Why is this a problem?  Having an abundance of oil glands is important because as oil glands cells divide, they can become almost any other type of epidermal cell.  Therefore, when cells get damaged, they provide new cells to help to restore your damaged skin.

The good news is there are a few ways to correct or at least improve the skin of your chest.

  1.  First, and most importantly, PROTECT your chest for the sun.  Use a medical-grade, broad-spectrum, physical sunscreen  every day of the year. I recommend one of two  physical sunscreens:  Sun Defense or Prime Defense By Castillo MD Skin Science.  Both have high percentages of physical block ingredients (Titanium Dioxide and / or Zinc Oxide) making them superior  choices for sun protection.
  2. Avoid tanning beds as UVA rays will only create more damage to your skin.
  3. Use UV protective clothing and a wide brimmed hat to provide additional protection.
  4. Consult G.D. Castillo M.D. or another Cosmetic Plastic Surgeon regarding the following treatment options:
    1. CO2 Micro-Fractional Laser Resurfacing – This will decrease the lines of your chest (décolletage) while building collagen within the treated skin.  It will also make a significant improvement to the texture of your skin and decrease or remove your brown spots or discoloration. More than one treatment may be necessary due to the delicate state of the chest skin.  Did you notice that I highlighted, underlined and italicized the “CO2” in CO2 Micro-Fractional Laser Resurfacing?  That is because CO2 is the key there!! CO2 Micro-Fractional Laser Resurfacing far surpasses other non-CO2 laser technology using a “similar” name such as “fractional” or “Fraxel”… https://www.cosmeticplasticsurgery.com/cosmetic-surgery/laser-skin-rejuvenation.cfm
    2. Medical Microdermabrasion – Multiple microdermabrasion treatments https://www.cosmeticplasticsurgery.com/cosmetic-surgery/skin-resurfacing.cfm will soften the appearance of your chest lines and lighten the brown spots over time.  Be aware that this treatment will not build collagen, provide tightening or remove the lines and wrinkles on your chest.  It is meant only to brighten the skin by removing the build-up of dead skin cells.
    3. Medical Grade skincare products – There are effective medical grades skincare products created to specifically treat the chest area.  These products will not solve your problem alone but work well to support and prolong the effects of the above mentioned treatments. Medical grade means that they are of a higher strength and must be over seen by a physician therefor these are not your average over-the-counter disappointments.

Zap ya later,

DSC_0475G. D. Castillo, M.D.
COSMETIC PLASTIC SURGERY  https://www.cosmeticplasticsurgery.comLIKE US OR RECOMMEND US ON FACEBOOK: http://www.facebook.com/DrCastilloCosmeticPlasticSurgery
800-252-7123 (within IL)
217-359-7508 Savoy (Champaign-Urbana)
309-662-0436 Bloomington

Ask Our Expert: Retin-A

Friday, July 20th, 2012

RetinA postQ:   My dermatologists gave me a prescription for Retin-A, but after a few days my skin became very red and irritated.   My Doctor explained that several weeks of skin irritation is often just par for the course when using Retin-A.  He asked me to try applying it every other night instead of every night, to be patient and that eventually the irritation would resolve itself.  I stopped using the Retin-A because the irritation was worse than my aging skin.   Is there anything else I can do?

A:  I am happy to report – YES!  Both our Bloomington area and Champaign area Cosmetic Plastic Surgery Clinic patients have found success with a few simple adjustments to the way they apply their Retin-A, Renova, Tretinion, etc.

1.  After you cleanse your face, pat it dry and wait at least 15 minutes (to assure your skin is completely dry) before applying your Retin-A.

2. Apply a pea size amount.  This is typically all you need for the entire face. Remember that more is not better in this case. 

3. Avoid combining other exfoliating or skin regenerating products like glycolic acids, with Retin-A, at least until your skin is able to easily tolerate the Retin-A.

4. Always apply a moisturizer on top of your Retin-A.  This is a very important step in the success of your regimen so resist skipping it. (If you find that you are still experiencing dry, irritated skin after trying all of the suggestions here,  you can try mixing your moisturizer and Retin-A together as this will reduce its potency. )

5. Begin applying your Retin-A every third night.  As your skin tolerates the Retin-A, increase use to every other night, then every night.

6. Remember that Retin-A and like products will cause increased sensitivity to the sun.  Therefore Retin-A should only be applied at night only, never during the day.  Wear a medical grade broad-spectrum suncreen every day, re-apply the sunscreen when needed and avoid excessive sun exposure.

If despite all of the above suggestions, you find that you are still unable to tolerate Retin-A, you may want to consider medical microdermabrasion.  It is a pain-free, even relaxing way to keep your skin well exfoliated and looking fresh.  For more information on medical microdermabrasion.

Roxanne, Skincare & Laser Specialist

 

 

 

 

COSMETIC PLASTIC SURGERY
Like us Facebook @  http://www.facebook.com/DrCastilloCosmetiPlasticSurgery

https://www.cosmeticplasticsurgery.com
800-252-7123 (within IL)
217-359-7508 Savoy (Champaign-Urbana)
309-662-0436 Bloomington

Deadly Decisions

Wednesday, May 9th, 2012

Surely by now, you have heard that there is lobbyist action petitioning to restrict teenage use of tanning beds. How do you feel about your teenager using a tanning bed? Would you allow it? Would you drive them to the appointment? Would you pay for their tanning package?  This is a hot topic of teen desires vs. parental responsibilities that is causing a lot of controversy.

I bring up this topic as Prom and graduation are almost here. As our beautiful girls prepare for the events they have been dreaming of, achieving that ideal appearance often means several trips to a tanning salon to give their skin the golden glow they desire. Unfortunately, more and more young women are getting more “color”  than they bargained for in the form of Melanoma – the deadliest form of skincancer today.

Since the days of CoCo Channel, we, as a culture, have been groomed to believe that tanned skin is beautiful skin. I would bet it is one of the longest-running, certainly the most deadly fashion trend to date. Tanning beds (or cancer beds as I often refer to them) have become intensely popular among teenagers and I have to believe that it is our duty as parents to not only protect them from harm’s way but to educate them on the risks of tanning so they are able to make informed decisions about their safety when they are on their own.  Alarming increases in diagnosed skin cancers among people under 30 who use tanning beds has caused organizations including the American Academy of Dermatology to lobby for laws limiting minor’s access to tanning beds.

At Cosmetic Plastic Surgery Center, too often Dr. Castillo or I will see a patient who is fearful of a suspicous spot or fighting a brutle battle with skin cancer.  The stories are always heart-breaking.  As a mother of two beautiful daughters who fill my house with their friends on a regular basis, it has become my mission to discuss the dangers of tanning bed use (and exposure to the sun’s UV radiation) with all of my daughter’s friends. The response that I have received from most of their friends has actually surprised me. I expected the typical teen “yeah, yeah, yeah, I know, but it won’t happen to me” response.  Instead, these teenage girls sat down with me, and they listened, like sponges.  (Now I know I just used the term “teenagers” and “listened” in the same sentence, so I will give you a minute to try to re-gather your composure and then we will move forward).  Ready?

Most of them had no idea that they could get cancer from tanning beds and certainly didn’t realize that it could take their life. The amount of misconception I heard about sun exposure and tanning beds was extensive to say the least. I think that is true of a lot of adults out there as well.  I’ve even gotten a few phones from my daughter’s friends that went something like “Roxanne, I’m at Walgreens buying a sunscreen.  There are so many, can you help me pick out the right one?” Now, unfortunately one of these phone calls came in 2 hours past my bedtime… but that’s a teen for you, right?

So I am blogging today to encourage you to become educated on all the recent updates and valid studies surrounding the dangers of tanning beds and UV radiation and to share your knowledge or even this blog with anyone in your life who may be using a tanning bed.  You can find proven informaiton at sites like http://www.skincancer.org/   and http://www.cancer.org/  You never know when this information could save the life of someone you love. Let me arm you with a few proven statistics to get started.

Did you know your risk of melanoma increases by 75% when you use a tanning bed before the age of 30? According to the American Skin Cancer Foundation, it also increases your risk of being diagnosed with squamous cell carcinoma by 2 ½ times and makes you 1 ½ times more likely to be diagnosed with basal cell carcinoma.

The International Agency for Research on Cancer shifted indoor tanning devices to the highest cancer risk category: “carcinogenic to humans.”  That means time spent is a tanning bed is as dangerous as Arsenic.  Would you allow someone you love to knowingly expose themselves to arsenic?

Skin cancer is the most common form of cancer in the USA today.  According to the American Skin Cancer Foundation, there are more than 3.5 million skin cancers and  two million NEW skin cancer cases diagnoses annually.  One in five Americans will be diagnosed with skin cancer in their lifetime. Just to give you an idea of the rapid increase in skin cancer diagnoses today, I wrote an article in March of 2009, titled “One Million Reasons to Protect Your Children.” https://www.cosmeticplasticsurgery.com/blog/?p=31 Just three short years later, it would have to be titled TWO Million Reasons to Protect Your Children! That is a pretty sobering thought, isn’t it?

There are now good alternative out there that can satisify the needs of both teens and parents.  Tanning lotions and spray tans can give the popular sun kissed look your teen desires while providing peace of mind that they are not being exposured to life-threatening UV radiation.

Below are three other past blog articles that will give you more information about UV radiation and the damage it can cause.

 

https://www.cosmeticplasticsurgery.com/blog/?p=238 – Dying to get a Tan

https://www.cosmeticplasticsurgery.com/blog/?p=322  – Top 5 reasons for avoiding Sunblock

https://www.cosmeticplasticsurgery.com/blog/?p=320  – Melanoma Are you at risk

 

Sincerely,

Roxanne Hammond, RMA

Skincare and Laser Specialist

G. D. Castillo, M.D.

COSMETIC PLASTIC SURGERY
https://www.cosmeticplasticsurgery.com

LIKE US ON FACEBOOK: http://www.facebook.com/DrCastilloCosmeticPlasticSurgery

800-252-7123 (within IL)

217-359-7508 Savoy (Champaign-Urbana)

309-662-0436 Bloomington

Roxanne, Skincare & Laser Specialist

 

 

 

Bridal Fair

Friday, September 11th, 2009

If you or someone you know is getting married, you won’t want to miss out on Champaign’s very own Vow Magazine / News-Gazette Bridal Fair.  Admittance is free so grab some friends and spend the afternoon with us. Cosmetic Plastic Surgery Skin Restoration and Laser Institute will be hosting a booth in the main vendor room.  We will be raffling off great prizes every hour and a grand prize (Liquid Smile Teeth Whitening System!!) at 4 PM.  Stop by our booth to and REGISTER TO WIN. We will be offering exclusive event promotions so don’t miss out!

The Bridal Fair will be held from noon-4 PM at the Hilton Garden Inn, 1501 S. Neil Street, Champaign, IL. 61824 on Sunday, September 13, 2009

  • Fashion Show
  • Hair Show
  • Refreshments
  • Prizes
  • Lots of Fun

Hope to see you there!