Frequently Asked Questions

Is the initial consultation complimentary? I do offer a 45-minute complimentary consultation. In that time, I will determine if you would be a good surgical candidate for the procedures in which your inquiring.

Where does Dr. Bitar perform his surgeries? I perform all my surgeries out-patient from Fairfax Inova Hospital on Wednesdays and Fridays. I chose to use this hospital because it is the safest environment to perform surgery. In a hospital, I have access to additional equipment and resources should it be necessary. However, my patients are allowed to recover in the comfort of their own home within two to three hours after the surgery. And you can do your pre and post op appointments in our Manassas or Fairfax location.

May I talk to other patients before I have surgery? Absolutely. In fact at any given time, I may have follow up patients in my office for you to talk to one-on-one. I also will give you names and telephone numbers of patients that I have operated on to discuss their particular results and their feelings towards our practice.

How painful is surgery? Discomfort can vary dramatically from patient to patient. During the first couple of days, you are usually very sore. This is generally controlled with pain medication, but minimal activity is required.

How long is the recovery period? This depends on a number of factors, such as, the complexity of the procedure being performed, your age, your general health, the type of work you do, and many other variables. I will be able to give you a clearer picture, based on your individual circumstances, at the time of your consultation.

What are the different injectables that you use? I inject Botox to paralyze the muscles of the forehead, glabella (in between the eyebrows) and the crow's feet. It generally lasts about 4-6 months. Juvederm (Hyaloronic Acid) is nice for nasolabial folds and superficial lines. Restylane (Hyaloronic Acid) is great for under the hollowness of the eyes, because it fills that area without it being hard and lumpy. I also think Restylane is great for augmenting the lips. Both Restylane and Juvederm generally last 9 months to a year. Radiesse (Calcium Hydroxyl Phosphate) is a great inorganic "bulk filler" for cheeks, deep nasolabial folds and pre-jowl areas. I also use it to do a non-surgical rhinoplasty and chin augmentation. It generally lasts 1-1.5 years.

What numbing approach do you use when injecting patients? I think with adequate anesthesia be it a nerve block anesthesia, local anesthesia, topical anesthesia cream, ice or a combination of the above, or sometimes no anesthesia at all, pain is not a big factor in the decision making. It is usually well-tolerated.

What can I expect to look like after an injection? Immediately following the treatment, you can expect to have redness, bruising and swelling to the injected area. These signs usually go away in a short period of time, usually less than a week, and are generally mild in nature. You may use an ice pack to help reduce the swelling, and also take Arnica orally or topically to help reduce the bruising.

Can you do anything for a Gummy Smile? I can correct a gummy smile by combining two injectable substances, Botox and Restylane. Botox is injected to weaken the nerve's ability to communicate with the muscle and allow the muscle to contract. If Botox is injected in the muscles that elevate the upper lip, then the elevation of the upper lip is weakened, and less of the gum will show. And Restylane is a filler that I inject to create luscious lips out of thin ones.

Why do you not inject with Collagen? I do not inject collagen because you need to have an allergy test and a month long waiting period. I also believe that collagen is not as good or long-lasting as the other fillers that I use.

What is Thermage? This is a treatment that utilizes radio-frequency technology to deliver heat to the skin's lower layers resulting in the gradual tightening and building of the collagen structure. The majority of patients will see results gradually appear over a 2 to 6 month period.

Breast Implants: Saline or Silicone? I prefer saline to silicone implants for many reasons:
  1. Saline implants are safer, in my opinion. If they do rupture, saline (or salt water) is spilled as opposed to silicone which can cause local scarring and hardening of the breast.
  2. Saline implants are easily inserted thru a trans-axillary approach (or thru the armpit) thus having a minimal scar and shorter recovery time.
  3. With saline implants there is no need for MRI scans bi-annually to determine if there is a silicone rupture, and the FDA recommends with silicone implants. MRI costs $2,000-$3,000 and is not covered under insurance.
  4. With saline implants, the scar is in the armpit about 2cm long vs. with silicone implants the scar will either be under the breast or around the areola about 5cm.
  5. Saline implants are about 60% the price of silicone implants.

What is TUBA (Trans Umbilical Breast Augmentation)?
  1. The implants have to be pushed through a tube that might damage the shell of the implant, and for that reason, some implant manufacturers will not offer the five year warranty on breast implants that they would if it is done from another approach (under the breast, from the areola, or from the armpit).
  2. The breast muscle and breast tissue have to be cut to insert the implant. That does not have to be done if the implant is inserted from the armpit, since anatomically, the implant goes behind the muscle and breast tissue, not through it.
  3. The time of the procedure is longer, and the dissection more, therefore creates more swelling, bruising and pain.
  4. The main reason to have a TUBA procedure is to have "no scars". Well, the scar in the belly button is about 2cm, (less than an inch). So is the scar in the armpit. They are both virtually invisible.

Can breast implants be placed either underneath or on top of the chest muscle? I recommend that the implants be placed underneath the chest (pectoralis) muscle it hides the implant giving a more natural feel and look. Placing the implant under the muscle also significantly reduces the rate of scar formation around the implant (called capsular contracture). There is also more support for the implant to protect against drooping, and mammograms are more accurate when the implant is under the muscle.

Is it possible to breast-feed after a breast augmentation? Yes. Because the implant is placed behind the breast tissue and nipple,and the ability to breast-feed is not altered.

Necklift vs. Full Facelift? I perform the Giampapa suture suspension necklift that was designed for men and woman who did not want the visible scarring of the facelift, but were unhappy with their neck laxity. Men and women who want a more youthful appearance find a necklift a good alternative to a full facelift, because it gives significant facial rejuvenation with less downtime and fewer, better hidden scars without the stigma of a full facelift.

What is a 6-pack abdominal etching? This is a specialized form of liposuction that creates a 6-pack muscle definition. A good candidate is someone with minimal abdominal fat and good muscle tone. It is a one hour procedure that is done under general anesthesia in the hospital. After the procedure, 2 x 7 inch strips of cotton are laid down in carefully outlined areas of the abdomen. The taped cotton dressing is changed after one week and kept there for another week, after which the patient can gradually resume activity.

How do I pay for surgery? Full payment is required 2 weeks prior to your surgery date. However, we do offer another payment option in addition to cash or credit card. We do offer financing, in order to allow more flexibility for our patients. When you come into the office for a consultation, my staff will discuss all of the prices with you and, if you are interested, they will give you the name of the financing firm with whom we work.