Frequently Asked Questions

Practice Information

Unfortunately Reflections Cosmetic Surgery doesn’t accept any form of insurance. However, we have had patients have surgery and then file the paperwork with their insurance company to try to get reimbursed. 

We offer financing from multiple companies. Care Credit and PatientFi to name a few. We also allow multiple payments in any form from the time you book your surgery until three weeks prior to your surgery, when you must have it paid in full. 

Dr. Gusching has been operating since 2012.

Breast Augmentation

Most implant companies recommend replacing the implants every 10-15 years. In my opinion, if you aren’t having issues with your implants, then let them be. 

We offer both Mentor and Allergan implants, however, I prefer and use Mentor most often. 


The biggest difference between saline and silicone breast implants is the substance in the implants. Saline implants are made of silicone outer shell and filled with saline (sterile salt water). Silicone implants are made of silicone outer shell and filled with a silicone gel. So in essence, they are both made from silicone. 


A percentage of women can’t breastfeed naturally so sometimes implants give the impression that it decreases the possibility of being able to breastfeed.

This is somewhat misconstrued.

There is a small increase in the number of people unable to breast feed following breast augmentation, but this is a very small amount. If the surgery is done correctly, breastfeeding shouldn’t be affected. 


Breast Lift

Breast lifts aren’t healthy or unhealthy.

It can help with back and neck pain in certain circumstances, improved self imagine, and an increase in self esteem.

Your nipple and areaola are not removed during a breast lift. This only occurs in very rare occasions. The skin around the nipple and areaola is removed allowing the nipple and areola to be moved up on the breast mound. Because of this the areaola is usually reduced in diameter. 


Breast Reduction

Recovery is about 5 days. This means you will be sore and I tell my patients to not make any plans at this point. Following this, someone can go back to work pending their job isn’t too strenuous. I ask that people keep their heart rate level below 100. After 6 weeks, the incisions should be healed and one should be back to normal activity. 

Average cost is around $5900, but this doesn’t include operating room and anesthesia fees. With all of the fees the price would be around $9-$10,000. 

There are no requirements. I have removed 300g from each breast before and I have also removed 3 lbs from each breast before. However, insurance will require a certain amount of tissue be removed in order for it to be covered by insurance, This varies from patient to patient and company to company. Most patients I encounter have a hard time getting insurance to pay for the procedure, so they end up paying for it themselves.


Liposuction ranges from $1500-$20,000. It depends on what areas, how much volume, and if other modalities are utilized, besides just the liposuction.

About 3 days of draining and being very sore. After that the patient is sore for a few weeks. One must wear compression garments for about 3-4 months for best results. Also, lymphatic massages aid in the healing process. 

Body contouring in North Atlanta can be done with Dr. Justin Gusching. He is located 30 minutes north of ATL. He specializes in body contouring and is name by the SRC as one of three Master Surgeons in Body Contouring in the USA. 

Fluid consisting of saline, lidocaine, and epinephrine is placed under the skin into the fat. This process is called tumescing.

Following this, a long cannula on suction is placed through the small incisions in the skin and the excess fat is sucked out. One can also use other modalities to aid in the liposuction experience and results. Such devices would be power assisted liposuction and Vaser liposuction. 

If done within the guidelines with an experienced surgeon it is very safe. It is also usually safer with the patient asleep under general or MAC anesthesia (being put to sleep). Drug overdoses are rare but can happen more frequently with awake lipo. 

Liposuction 360

These are essentially the same thing, lipo 360 is just more descriptive.

Liposuction 360 is liposuction of the entire midsection; posterior flanks, back, anterior flanks, upper abdomen, and lower abdomen. Essentially 360 degrees around the body.

Vaser Liposuction

In most circumstances I find it to be superior.

Vaser liposuction allows for a smooth result, less blood loss, less bruising, and can be used to “etch” muscles and sculpt. 

No. Once the fat is removed it will not come back.

However, the fat cells that are left behind can get larger as someone gains weight.

Compared to regular suction assisted liposuction, Vaser tends to be less painful. 

Most people do not need narcotic pains medications after 2-3 days and can return to work.

Mommy Makeover

A mommy makeover is essentially any combination of procedures that gets your body back to where you were prior to having any children.

This is usually a combination of lipo 360, tummy tuck and sometimes includes breast surgery or vaginal (labiaplasty) surgery. 

Due to the mommy makeover consisting of a multitude of procedures, the price varies. The price ranges from $10,000-$18,000

Expect to be sore and tired for about 10-14 days. During this time period, do not make any plans besides resting and healing.

Following this, most patients are able to go back to work but with some restrictions. No lifting more than 20 lbs or engaging the core, the sustained heart rate elevations over 100 and no submerging under water.

After 6 weeks, there are no restrictions and completely normal activity is resumed. 

The typical mommy makeover includes liposuction 360 and a tummy tuck, sometimes combined with breast augmentation.

Tummy Tuck

They are permanent. It is very rare that someone has a repeat tummy tuck unless the first tummy tuck wasn’t performed correctly. 

Tummy tucks are one of the more dangerous procedures, however, they are still very safe. There is a chance of infection, hematoma (bleeding), seroma (fluid collection under the skin), wound breakdown, ischemia of the flap or belly button, blood clots and death.

Again, these are all fairly rare. 


They are one of the most rewarding surgeries. 

In the world of cosmetic plastic surgery, the tummy tuck and facelift are the two larger serious surgeries. They are also both the most rewarding. 


Renuvion is usually performed with liposuction but not necessarily. It is a probe that goes under the skin and using plasma technology, heats the connective tissue to 85 degrees celsius, stimulating your body to produce more collagen and tightening your skin. 

It is permanent. The Renuvion stimulates your body to produce its own natural collagen and remodel elastin. This is your collagen, not a product that is placed, so the body doesn’t break it down like a filler.

However, as we age, we continuously lose collagen which accounts for the loose, thin skin we have as we age. 

You absolutely can in specific situations. Your surgeon may recommend liposuction along with the Renuvion for the best results.

Thigh Lift

A thigh lift is a procedure that removes the excess fat and skin from the thighs. This is usually due to weight gain.

Just like a tummy tuck, the thigh lift is permanent. However, as our bodies age, we lose more and more collagen every year and our skin can begin to sag. 

There are many different types of thigh lifts. Most consist of a mild amount of liposuction and a large resection of excess fat and skin.

Buttock Lift

A BBL isn’t the same as a butt lift.

A BBL is a Brazilian Butt LIft.

This consists of performing liposuction somewhere on the body and transferring it into the butt. This helps add volume and shape to the buttock. A butt lift is an excisional procedure that removes excess skin from the top of the buttock and essentially lifts the skin of the butt. This is usually done for patients with massive weight loss.

Both procedures may be performed on the same person. 

You need to have a goal size and shape in mind. The projection of the butt can be high, in the middle, or low.

Different people prefer different shapes. Also, do you want to add fat to the hips too to make for more curves that can be seen from the front?

Understanding the recovery process makes life a lot easier. Be prepared to not sit on your butt for at least 3 weeks. 

Buttock injections are not dangerous assuming you use a safe, proven product. Your own fat can be injected as well as sculptra. These are the two most common.

The only safe way to inject into the buttock is to inject into the fat and not inject into the buttock muscles as whatever you are injecting can get into your veins and cause death. 


There are two main types of labiaplasty. There is the minoraplasty and the majoraplasty.

The minoraplasty deals with the excess skin that hangs down between the labia. This excess skin can be uncomfortable in tight fitting clothing and can be unsightly and cause people to be self conscious.

The majoraplasty address the lack of fullness of the labia (the area of skin around the minora). This occurs with genetics and aging. This is corrected with a fat transfer into this region.  This is done primarily to improve appearance. These two are often done in conjuncture. 

With a labiaplasty minoraplasty there is the risk of wound breakdown, hematoma, infection, and over resecting the tissues.

Wound breakdown, hematoma, and infection are treatable and usually minor. An over resection of the tissue cannot be corrected due to the lack of remaining tissue. 

No, you need to address the actual vaginal canal for tightening. This can be done surgically or with devices such as Votiva which uses radiofrequency.