Ask the Plastic Surgeon

Q : My daughter decided to get a tattoo on  her chest that she now regrets. What can be done to remove it?

A : The best two options for tattoo removal  are either laser treatments or a surgical excision. The laser offers minimal scarring, but more than one treatment is generally required. There also isn't a guarantee that all remnants of the tattoo will be successfully eliminated by laser treatments. Surgical removal of a tattoo usually requires one operation and removes all of the tattoo. The downside is that there will be a surgical scar. Without knowing your daughter's history, or the specific location of the tattoo, I suggest you make an appointment with a plastic surgeon to discuss these issues. The surgeon will be able to  give you an opinion as to which one would be best given your daughter's specific situation.

Q: I have lost over a hundred pounds by watching what I eat and working out  with a personal trainer. Now I have loose, saggy skin around my abdomen. My breasts are also much smaller and droopy. I know there are operations to remove the extra skin; could this be covered by my insurance?

A: Congratulations on successfully dealing with a difficult problem, and becom- ing a positive statistic in our country's war against obesity. You are correct, there are many operations designed to help the problems you describe. Surgery involves removing the "apron" of excess abdominal/flank skin. There are also operations that make use of some of the excess skin in your chest area to augment, or replace the fat you have lost from your breasts. This type of surgery can improve the size and shape of your breasts without the use of a breast implant. Breast "uplifting" can be done at the same time to correct the drooping.

To date, some insurance companies recognize these benefits and will consider your claim for approval. Unfortunately, in my experience, most insurance companies will not consider surgery to improve breast shape and/or volume as anything other than cosmetic in nature. Cosmetic procedures are not covered by insurance.

In order to determine what an insurance company will cover, I send appropriate photos of the patient's torso, along with a description of what I think is surgically necessary and why, to the insurance company, and obtain what is called "prior approval". The prior approval document gives the patient and I a written understanding of what the insurance company will cover under the patient's contract with them. It has been my experience, that the patients who undergo this surgery, consider it well worth it because the end result makes them feel like they have completed their journey to a new and healthier life and appearance.

Q: I am 70 years old. I am still very active and take pride in my appearance. Am  I too old to consider a breast enlargement? I don't want to be very large, but I'm interested in restoring my feminine curves that have diminished over the years. I'm actually very embarrassed to make an appointment, so asking you this question anonymously is very helpful. Thank you for the opportunity to do so.

A: You have nothing to be embarrassed about. Restoring oneself to "normalcy"  is a basic human desire, and age shouldn't enter into your decision making.  Your chronological age is less important than your mental and physical age. As long as you do not have any physical ailments that make surgery a risk for you, I would proceed ahead in your quest to feel like "yourself" again. Today, all aspects of cosmetic surgery are much more accepted, and I think once you consult with a plastic surgeon, you will feel more relaxed and comfortable about moving forward.

Dr. Robert A. Laughlin is a board-certified plastic and reconstructive surgeon who has been helping people from all over the world for the past 26 years. His practice, Hilton Head Island Plastic Surgery, is located on the campus of the Hilton Head Regional Medical Center where he is a member of the Board of Directors and the active surgical staff.
Dr. Laughlin lives on Hilton Head with his wife Linda, who is also his surgical assistant. They have two grown daughters and four grandchildren. He may be reached at (843) 681-4088 or
Questions should be emailed to his address at This email address is being protected from spambots. You need JavaScript enabled to view it.. Readers should include "Pink" in their subject line.

Leave a comment

You are commenting as guest.