Choosing Your Cosmetic Surgeon

Choosing your cosmetic surgeon is a major decision. Going forward with cosmetic surgery warrants careful consideration. Reputable surgeons should make themselves available to personally answer your questions and address your concerns. One's gut feeling about the surgeon, their office, and the nature of their work should not be ignored. Here are some important considerations that may help guide your thinking:

Important Considerations

Credentials:

Learn where your surgeon went to school. Did they complete residency training and are they board certified in one of the primary specialties for cosmetic surgery: Dermatology, Ophthalmology, Otolaryngology, and General Plastic Surgery? Before entering into practice did they complete one or more specialized Fellowship training programs in cosmetic surgery or did they go straight into practice after residency? For example, Dr. Steinsapir completed a total of 5 years of fellowship training in eyelid and cosmetic surgery after residency before entering private practice.

Experience:

Experience counts. Is your surgeon fresh out of training or have they had an opportunity to refine their skills in practice? Particularly for cosmetic surgery, there is no substitute for actual experience. Have there been any adverse complaints against your potential doctor with their state medical board? Statistics suggest that any doctor in practice long enough will eventually be sued. An unusual number of lawsuits could indicate a repeated pattern of practice problems. Has the surgeon's medical board placed them on probation or censured them for misconduct? This type of information is often available to the public and on the web. In looking at the doctor's curriculum vitae, are there unexplained gaps in training or partially completed residency training programs? Unexplained gaps in work history are very unusual for physicians and surgeons. An unexplained gap in work history may indicate the doctor was involved in a drug rehabilitation program which many medical boards allow doctors to participate in voluntarily without the need to report this to the public. Then there is the occasional doctor who has a gap in their work history because they spent a period of time in prison. You might think that this would keep doctors from returning to practice but you would be wrong. Of course there can be logical explanations for gaps in the work history such as taking time to be with young children. Incomplete residency training is another red flag that a doctor was terminated from a training program for behavioral or discipline issues. Pay particular attention to this if your doctor appears to have unusual training for their area of practice.

Word of Mouth:

Who have your friends seen and what were their experiences like? Keep in mind that word of mouth referrals may not mean a lot if the procedure you're thinking is different than the procedure your friend had. A great rhinoplasty result may not translate into a good BOTOX® service or eyelid surgery. Getting more than one opinion is essential. There are many different approaches, so seeing several doctors and experiencing their offices will often help you decide who is right for you.

See with you own eyes:

All surgeons are very proud to show before and after photos. This will naturally be their best work as they see it. Make sure you like what you are seeing. If you don't like what you see, it is a mistake to assume that your surgery will be to your liking. There are plenty of surgeons out there. Seek more consultations until you find your comfort level. Make sure that the before and after pictures you are looking at represent the doctor's own work and are not the work of another surgeon. Also be cautious with the computer manipulated before and after images. It is easy to over promise work using this tool. Remember to ask yourself if what is being proposed is typical of the surgeon's result as seen in the before and after images.

Comfort Level:

It is a mistake to excuse brusque behavior- Dr. X is so busy/important that he really doesn't have time to answer my questions. The time the surgeon spends with you before surgery is just as important, perhaps more important, than the time spent during surgery. It is the surgeon's job to listen to you, examine you, answer your questions patiently, and discuss the pros and cons of the various options. If the surgeon lacks the time and interest to address your concerns during the consultation, it may also be the case that they will lack the time and interest to do the best possible job for you at the time of surgery. Also ask yourself how does the office staff treat you? Are they professional and compassionate?

Some patients are very vulnerable during their consultation because they are seeking to deal with an issue that may be a source of embarrassment or even shame. The surgeon should be respectful, and tactful. Specifically, you should not be made to feel worse because you are concerned about an issue that the surgeon feels is not so important. Don't let yourself be victimized. It is not appropriate to meet your potential surgeon for the first time when you are undressed. Similarly, being told that you have the "most disgusting __________ (fill in the body part) I've ever seen," may be an attempt at further victimization. Why do some doctors do this? It is an effort to manipulate a person with a particular weakness to go along with what ever is being proposed. It is unethical. Have the strength to withstand this type of assault and find another surgeon.

Do you feel coerced or pressured to sign up for many surgeries at one operation? We call this the blue plate special. While it may be true that the first hour of anesthesia is the most expensive and there may be reduced facility cost after the first procedure, it is your personal safety, not cost, that should be your first concern. While there are procedures that can be reasonably combined, it is many times much better to stage surgeries. This tends to minimize the risk of a protracted recovery or even life threatening complications that have been reported when too many procedures are done at one time.

Finally, look around the surgeon's office. Are things clean? What are the office aesthetics like? How fresh can the doctor's work be if it looks like the office hasn't changed since the 1970's? Notice if the doctor washes his/her hands, wears gloves during office procedures, and uses sterile instruments. Do instruments come out of fresh packages or are they fished out of mystery solution from a little container on the counter? How fresh is that mystery solution anyway? Gloves should be put on right in front of you. Don't feel bad to ask your doctor if they can wash their hands or put on fresh gloves. If the doctor responds in a negative way to your concerns, it is time to find a different office.