For Patients

At Kadlec Clinic Plastic Surgery and Dermatology, we blend time-tested techniques with the latest innovations by creating refined yet natural cosmetic surgery results.

At Kadlec Clinic Plastic Surgery and Dermatology, we blend time-tested techniques with the latest innovations by creating refined yet natural cosmetic surgery results. Our team of plastic surgeons, dermatologist and estheticians can help you enjoy life in the Tri-Cities to the fullest.

Our specialized staff is up-to-date on the latest research and trends to help men and women turn back the clock with facial rejuvenation and non-invasive treatments, feel their confident best with breast augmentation and help lose stubborn bulges with body contouring.

Understanding Plastic Surgery

At Kadlec Clinic Plastic Surgery, we are available to answer your questions and review specific cosmetic surgery procedures.

It's natural to have questions about cosmetic surgery and we want you to be confident in your procedure decisions. At Kadlec Clinic Plastic Surgery, we are available to answer your questions and review specific cosmetic surgery procedures.

To get started, here are answers to some of the most frequently asked questions about cosmetic surgery and aesthetic procedures. Remember that your surgeon is best able to answer questions and elaborate based on your needs.

Call to schedule your appointment today: 509-942-3190.

Frequently Asked Questions

What can I do about the sagging skin in the upper eyelids and "bags" in my lower eyelids that always make me look tired?

Unfortunately, this is a part of the aging process that can make someone appear sleep deprived, even though they are not. The solution is a surgical procedure called a blepharoplasty, or eyelift. With this procedure, the loose and sagging skin, as well as the excess fat around the eyelids, are removed. The incisions heal so well that they are practically invisible. Blepharoplasty is the second most common cosmetic surgery performed in the U.S.

What can be done to correct protruding ears?

An otoplasty or ear pinning is an operation done to normalize overly protruding ears. It is done via incisions placed on the back of the ear that are very well hidden post-operatively.

How is a facelift done?

During a facelift incisions are made along the hair line in the temple region extending down in front of the ear and then around the back of the ear into the hairline. Most plastic surgeons have been trained in more than one face lift technique, and they can determine which technique will work best for each specific patient. With all facelifts the skin of the face and neck is dissected into the cheeks and neck to allow it to be mobilized upward to produce a tightening and smoothing result. The surgeon will also tighten the underlying muscle layers. Years of highly specialized training are necessary to learn to safely perform this procedure. 

Will a partial facelift take away wrinkles from lower face and neck?

This can only be determined after you are evaluated by a plastic surgeon. It is important to understand that to obtain the results that you want, the appropriate procedure should be performed.

How does the cost of the necklift compare to the cost of a facelift?

The facelift is somewhat more expensive because more surgery is performed. A neck lift is a more limited procedure.

What does Juvederm® do? How is it different from Botox®?

Juvederm is very effective in smoothing out and filling in bothersome wrinkles and lines, particularly in the lower part of the face. It has several advantages over other filler-type materials such as collagen; it lasts longer and causes very little adverse reaction. 

Juvederm® and Botox® (botulinum toxin) often are used in a complementary fashion. While Juvederm is best for the lower face, Botox® is great for wrinkles that occur in the upper face – crow's feet or the vertical frown lines between the eyebrows – because it paralyzes muscles stopping the skin from wrinkling.

If I have Botox® or Juvederm, how often must I repeat the injections?

Botox® lasts about three to four months, and the treatment can be repeated as needed. When it wears off, you will begin to notice increased muscle action and some reformation of the wrinkles. It appears that with repeated use, the effect of Botox® becomes longer lasting.

Juvederm injections last for about 12 months, and can also be repeated as needed.

A newer Juvederm product, called Voluma is designed to be injected deeply over the cheek bones to provide fuller cheeks and give a lifting effect. This product may last up to two years.

Do you perform tumescent liposuction?

Yes, the tumescent liposuction technique is the gold standard in liposuction. No other technique has been shown to be more effective.

The muscles of my stomach separated when I was pregnant. Will a tummy tuck correct this?

Yes. During a tummy tuck, weakened abdominal muscles are tightened, and excess fat and skin are removed.

What is the difference between "smart liposuction" and traditional liposuction?

Smart liposuction uses a heated cannula to heat the fat prior to sucking the fat cells out. No study has ever shown that this technique is any better than traditional tumescent liposuction, however there may be more complications with this technique.

Can the breasts be enlarged using fat from other parts of the body?

At this point in time this procedure should be considered experimental. Fat cells suctioned from other areas of the body and injected into the breasts will die because they no longer have a blood supply. The breasts may not maintain the initial increase in volume, as the dead fat cells are absorbed by the body. Newer technologies recently developed for processing the fat cells may make this a viable option in the near future.

How do I know what size breast implant is right for me?

During the consultation, Dr. Fleming will ascertain what your goals are for the surgery. Then, depending on your current breast size and shape, he will suggest a size and type of implant that will meet your goals. Trying some sample implants "on" is part of the consultation process.

What is a breast lift?

A breast lift, also known as a mastopexy, raises the breasts by removing the excess skin and tightening the surrounding tissue to reshape and support the new breast contour.

Can I combine breast augmentation surgery with another procedure?

Yes. Breast augmentation surgery is often combined with a breast lift, abdominoplasty or liposuction.

What type of breast implants do you offer?

There are many manufacturers of breast implants. Two of the leading manufacturers are Allergan and Mentor. There are different types of implants with different consistencies of gel and also saline implants. Generally speaking the silicone gel implants give the best result. Advantages and disadvantages of both types of implants will be discussed at the consultation.

Is a breast reduction covered by insurance?

A breast reduction, also known as a reduction mammoplasty, is a procedure in which the size of the breasts are reduced by removing breast tissue and skin. If the breasts are abnormally large and causing neck pain or back pain, this procedure is typically covered by most insurance plans.

My breasts are flat and saggy after pregnancy and nursing. What are my options?

This is a very common complaint. There are two ways to alter the breast shape to look more youthful. One way is to remove the excess skin from around the breast tissue through a procedure called a breast lift or mastopexy. Another method, called breast augmentation, involves the placement of breast implants to increase the size of the breast, which fills out the loose skin and improves the shape.

How do I chose a cosmetic surgeon?

You can start by verifying the physician’s credentials. Your surgeon should be board certified, which signifies that they have the knowledge, skill and experience required to provide quality patient care in a given specialty.

You can verify your surgeon’s credentials at or You can look up Dr. Fleming’s credentials at the American Board of Plastic Surgery website by searching for: Dr. Francis X. Fleming.

Ensure that the facility where the procedure takes place is fully accredited. Many cosmetic surgery procedures are done on an outpatient basis. It is important to verify that the facility meets the proper accreditation criteria to ensure your safety.

Ask the physician for photographs of their work. View our before and after photo gallery.

Consider the surgeon’s experience. How long have they been performing this procedure? How many of these procedures have they performed?

How can I be sure that my surgeon has the proper training to perform my procedure?

You can verify your surgeon's credentials at or the American Board of Plastic Surgery. You can look up Dr. Fleming’s credentials by typing in his full name: Dr. Francis X. Fleming.

Some doctors who do not have this certification will try to confuse the public by claiming they are certified by the “American Board of Cosmetic Surgery.” This is deceptive because this is simply a LLC, is not a member board of the American Board of Medical Specialties, and is not used to credential surgeons for hospital privileges.

If your doctor does not have admitting privileges at your local hospital, for your procedure, it may be an indication that they do not have the proper training and certification.

What is the difference between cosmetic and reconstructive surgery?

  • Cosmetic surgery is performed to reshape normal structures of the body in order to improve appearance and self-esteem. Cosmetic surgery is not usually covered by health insurance because it is not medically necessary.
  • Reconstructive surgery is performed on abnormal structures of the body caused by congenital defects, developmental abnormalities, trauma, infection, tumors or disease. In general, reconstructive surgery is performed to improve function, but may also be completed to approximate a normal appearance. Reconstructive surgery is typically covered by most health insurance policies.

Do you see many patients who have had surgery performed by unqualified providers?

Unfortunately, yes. Most state medical boards do not regulate procedures that are done in a doctor’s office. Therefore, it is not uncommon for inadequately trained providers to dabble in cosmetic surgical procedures. Unfortunately, if a surgical procedure is not performed correctly, it is typically extremely difficult to restore a patient to a normal contour or appearance.

Additionally, to try and save money, some patients go out of the country to have cosmetic surgery procedures done in Mexico or South America. Many times it is difficult to assess whether these surgeons or doctors have the proper training, and they are not available to help if there is a problem when these patients return home. I have seen many patients who have been injured because of this type of medical tourism.

What can I expect if I schedule a consultation?

One of the best ways you can decide if cosmetic surgery is right for you is by meeting with our Plastic Surgeon, Dr. Fleming, for a consultation. During your initial consultation, you and Dr. Fleming will discuss your goals and expectations. Dr. Fleming will also:

  • Review your complete medical history, including reviewing past and current medications
  • Evaluate the part of your body that you want treated
  • Give recommendations
  • Answer any questions you may have.

You should leave your visit with a clear idea of the surgical options available to you as well as the risks involved. If you and Dr. Fleming decide upon a procedure, our appointment staff will work with you to schedule your surgery. You will be given complete information regarding where and when to arrive, any eating/drinking restrictions prior to your surgery, what to bring with you and the length of your hospital stay. If any testing is required, you will be scheduled for an appointment prior to your surgery.

What are some common questions that I should ask my surgeon during the consultation?

  • What is the best procedure for me?
  • Where will you perform the procedure?
  • How long have you been doing this procedure?
  • How many of these procedures have you performed?
  • What are the risks involved?
  • How long will recovery take?
  • Do you have hospital privileges, and at which hospital?
  • Are you board certified in plastic surgery?
  • How much will the procedure cost?
  • Are there financing options available?
  • How are complications handled? 

Where will my procedure be performed?

Dr. Fleming performs his surgeries at Kadlec Regional Medical Center. Most elective surgeries are performed on an outpatient basis, and patients typically go home about an hour or two after the procedure is completed.

If you are contemplating having surgery, it is important to determine whether the facility where your procedure will be performed is certified as safe by one of the credentialing entities such as the Joint Commission, American Association for Accreditation of Ambulatory Surgery Facilities or the Accreditation Association for Ambulatory Health Care.

What should I know about the safety of outpatient surgery?

It's important to learn about the safety of a plastic surgery procedure, as well as the expected outcome. Although thousands of people have plastic surgery every year without complications, no surgical procedure is risk-free.

To maximize your safety, ensure the following:

Is surgery performed under general or local anesthesia?

Depending upon what is most appropriate for your particular procedure, Dr. Fleming will decide what type of anesthesia is appropriate. He will answer any questions that you may have.

What are the most common procedures performed by Dr. Fleming?

  • Breast: augmentation, lifts, reduction and reconstruction
  • Abdominoplasty
  • Liposuction
  • Facial cosmetic surgery: face-lifts, eye-lifts and otoplasty
  • Mommy makeovers

What are the most popular procedures for men?

Common procedures performed on men include liposuction, male breast reduction, and blepharoplasty.

Is there anything to do to minimize swelling or bruising after surgery?

Depending on the procedure, certain resting positions and ice may help with post-op swelling. Also avoiding medications that thin the blood for two weeks prior to surgery is important.

How soon can I return to work?

The length of time it takes to recover after plastic surgery varies depending on the procedure performed and the person operated on. Most patients will require assistance for the first two days following surgery.

Do you see patients from out of town?

Yes. Most Kadlec Clinic Plastic Surgery referrals come from happy and satisfied patients. It is common to have friends and family of our patients travel to the Tri-cities area to have procedures performed by Dr. Fleming.

Are financing options available?

As a rule, cosmetic plastic surgery is considered “elective surgery” and is not covered by most insurance plans. If the service is not covered by insurance, we work with Care Credit to offer financing options. We encourage you to ask early in the conversation if financing is needed.

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Kadlec Clinic - Plastic Surgery and Dermatology

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