Get Good Information
Choosing a Cosmetic Plastic Surgeon
Located in Raleigh, North Carolina serving patients in Raleigh, Cary and Durham
You may be in the process of gathering information that will help you to decide whether or not to have a cosmetic surgical procedure performed. Or you may already know that you are definitely going to undergo a particular surgical procedure, and are in the process of deciding who you will trust to perform your surgery and provide your care. You may be certain about the appearance issue that you would like to improve, but are not sure exactly what surgical procedure is best suited to produce the aesthetic outcome that you have in mind. Wherever you are in this process, your most powerful ally is good information.
When you are making decisions about a surgical procedure and choosing a plastic surgeon, you should take your time and do a lot of research. Of all the decisions you make along the way, the most important one is the surgeon you choose. You will be entrusting him or her with not only your outward appearance, but also your health and well-being. Your plastic surgeon will be responsible for your safety during surgery. And you will be counting on that person to be available, capable and understanding from the first consultation to the final one-year follow-up appointment.
Educate yourself thoroughly. Thousands of physicians with no residency training in plastic surgery and without certification from the American Board of Plastic Surgery (the only Board recognized by the American Board of Medical Specialties that certifies plastic surgeons) promote themselves as `cosmetic surgeons’ and `plastic surgeons’. Some are primary care physicians, some are emergency room doctors; some have never completed a residency training program in any specialty and are not eligible to take any specialty board exam. Many take `weekend courses’ on liposuction, or breast augmentation, or facelifts, then return to their practice and begin promoting that procedure and performing it on patients.
The minimum amount of training in plastic surgery that will allow a physician to be eligible for certification by the American Board of Plastic Surgery is five years, and many board-certified plastic surgeons, myself included, have several additional years of training in general surgery and plastic surgery. There are a number of reasons for such a significant training requirement. Chief among them are the following: one does not acquire sophistication in diagnosis and treatment planning, superior surgical skill, and the capacity to minimize the possibility of complications and unfavorable outcomes by taking weekend courses. It requires years of training experience under the direction of talented mentors. It requires devotion to the art and practice of plastic surgery.
Be careful in evaluating physicians whose `Board Certification’ is by a `Board’ which is not recognized by the American Board of Medical Specialties (ABMS), and who belong to an `Academy’ that does not require residency training in plastic surgery. Some will claim that they are `double-‘ or even `triple-board certified’, when only one (and occasionally none) of those `boards’ are recognized by the ABMS. Visit the ABMS website to see which specialties have ABMS recognition.
It takes just a few mouse clicks to verify a surgeon’s credentials online. Make sure that the surgeon or surgeons that you are considering are certified by the American Board of Plastic Surgery and are active members of the American Society of Plastic Surgeons (ASPS). ASPS members are also eligible for membership in the exclusive American Society of Aesthetic Plastic Surgeons (ASAPS), the premier professional association of board-certified plastic surgeons with a specialty practice in cosmetic surgery.
Verify that major surgical procedures are performed in an accredited surgery center and that anesthesia care is provided by board-certified M.D. anesthesiologists. If you are most comfortable with overnight observation after surgery with the bedside care of an R.N., verify that this is available to you. Look up your surgeon on your state’s Medical Board website to verify that they are in good standing and have no public record of sanction or limitation of their license to practice.
Be confident enough to ask some `difficult’ questions. Feel empowered to ask any physician questions like: What are your complication and reoperation rates for this procedure? Has a cosmetic surgery that you performed ever resulted in a lawsuit? Have you had any serious complications and unplanned hospitalizations after cosmetic surgery? Have you ever been disciplined by a state medical board? I am never offended by these kinds of questions, and no competent and qualified surgeon should be. In my opinion it is actually the savvy prospective cosmetic surgery patient who does this kind of `due diligence’.
Choosing Your Surgeon
There is endless information about plastic surgery available online, some of it helpful, some of it hogwash. Many patients learn about treatment options and narrow their search for a plastic surgeon with the help of their computer. And then they make one or two or more appointments, and on the basis of these encounters decide on a surgeon. Some patients already have a particular plastic surgeon in mind, based on the recommendation of satisfied patients or the surgeon’s reputation.
Regardless of how you decide who you see, ask yourself the following questions after your consultation appointment(s):
- Is this surgeon qualified to perform the surgery I am considering?
- Do I like this person? Will I enjoy seeing them over the course of my surgery and recovery?
- Was my complete medical history taken and examined in detail?
- Did this physician truly listen to me as I explained my thoughts about the improvement I am seeking?
- Does this physician share my aesthetic sensibility? Do they understand me and are they able to provide exactly what I am looking for?
- Was I provided with a thorough understanding of all options available (both surgical and non-surgical)?
- Was I shown photographic examples of surgical outcomes that give me confidence?
- Was the office staff professional, friendly and accommodating?
- Was I pressured in any way to proceed with surgery?
Listen to what your heart and your gut tell you when you are evaluating your consultation experience. Only move forward if you can do so with confidence about the experience you expect to have in a given plastic surgery practice, and about your ultimate outcome as a surgical patient.
Your experience with the consultation process is a good indication of what you are likely to receive as a surgical patient in any practice. If the process is well-organized and enjoyable, the staff is respectful and efficient, and the physician takes adequate time to understand your individual needs and communicates effectively, then you have a very high likelihood of being treated in a similar fashion if you become a surgical patient of that practice. If the process is disorganized or rushed, if the staff is discourteous or unprofessional, or if the physician does not give you confidence that your needs will be met, then don’t expect things to get any better once you are a surgical patient.
If you are satisfied that a cosmetic plastic surgeon you are considering has the appropriate training, experience and credentials, then the next step is to determine if you and this surgeon are `on the same page’ aesthetically. As you are about to undertake a permanent alteration to your outward appearance, you should be comfortable with your cosmetic surgeon personally, feel like you communicate easily, and feel like you have the same vision for the aesthetic improvement that you desire.
Reviewing `before and after’ photos can help to confirm that a surgeon shares your sense of what is a desirable outcome for a given surgical procedure. In your consultation appointment you should expect the surgeon to take time to carefully and thoughtfully evaluate your `starting point’ and to discuss with you in detail their proposal for improving your appearance. There are quite a number of surgical approaches for the improvement of any given aesthetic concern, and you should therefore expect to have a number of treatment options discussed. You should also receive a clear explanation of why a surgeon feels that one particular approach is the best one for you personally.
You must be absolutely certain that your plastic surgeon’s aesthetic sensibility matches your aesthetic goals. I have a very particular aesthetic vision, and I do not pretend to be the plastic surgeon for everybody. I strive to produce surgical results that are natural-appearing, results that do not advertise a trip to the operating room. For example, I do not perform breast augmentation for patients that are seeking an overly large and distinctly `done’ breast appearance. And I have a particular distaste for cheek implants, as I think they rarely produce natural-appearing cheek contours, and instead prefer to enhance facial volume by means of structural fat grafting. Make sure that your plastic surgeon’s philosophy and preferred approaches are consistent with the goals that you have in mind.
Adequate communication is obviously invaluable, and you should be able to communicate clearly and easily not only with your doctor, but also with your doctor’s staff. Over the course of preparing for and recovering from aesthetic surgery, your doctor’s staff will have an important and active role. Make sure that your interaction with the staff gives you confidence that you will receive the care and attention that you expect, and deserve, postoperatively.
A hospital has access to information and records that the general public does not. Hospitals also have potential exposure to liability for cosmetic surgery procedures performed in their surgery centers. They therefore will only grant surgical privileges for cosmetic surgery procedures to physicians that can demonstrate appropriate training and credentials.
Although many aesthetic surgery procedures are not performed in hospital operating rooms, the fact that a hospital has granted a surgeon privileges for a given procedure ensures that the surgeon has met an accepted standard of education, training and certification. It also means that your surgeon will be able to take care of you at a hospital should an unexpected complication from cosmetic surgery arise which requires hospital admission. This is an extremely rare situation; however it is worth considering when you are contemplating an elective cosmetic surgery. It is better to be prepared in advance for an unlikely outcome, than to be looking for another doctor when the one you have chosen does not have the experience, training and credentials to continue your care in the event of an emergency.