Choosing your plastic surgeon wisely may be one of the most important decisions the patient ever makes and there are many important factors to consider in making your selection. Feel free to ask me any questions you may have that I have not addressed.

What is a plastic surgeon?

Plastic surgeons are surgeons first, then plastic surgeons. They have had between 5 and 10 years of formal surgical training, meaning training in residencies that focus on surgery. They do thousands of operations before they ever finish their training. They have experience in dealing with wound healing and infections, complications, and the great metabolic shifts that occur with surgeries. The organization representing most plastic surgeons is the American Society of Plastic Surgeons (ASPS). Board certified plastic surgeons who specialize in cosmetic plastic surgery and demonstrate expertise and experience in their field may become members of the American Society for Aesthetic Plastic Surgery (ASAPS). There are approximately 1600 plastic surgeons in this organization in the United States.

If you are having a facelift, would you want a “surgeon” operating on you who was not competent to deal with emergency bleeding in the neck?

Would you want a surgeon operating on you who had never done a single facelift in their training, and took their education at a weekend training course?

We see daily perfectly reasonable and intelligent patients who have gone down that path, often to their detriment.

Board certification

If you do one thing before picking a surgeon, make sure they are board certified. To be board certified in plastic surgery, one must have a certificate from the American Board of Plastic Surgery. If the doctor is not listed on this website, they are not board certified by the American board of Plastic Surgery. Board certification is an excellent starting point for choosing a doctor.

FACS

These four letters signify the plastic surgeon is a Fellow of the American College of Surgeons, the most reputable and best established surgical organization in the world. Only board-certified surgeons are admitted to this board. Other societies have adopted very similar sounding suffixes for their doctors. Beware.

Reputation

A sterling reputation for a plastic surgeon takes years to build. It is the single most important non-academic quality a surgeon can have. It is often difficult to determine a doctor’s reputation, but eventually, in a given community (and perhaps within the country or the world), a surgeon develops a reputation.

Bedside Manner

A sterling reputation for a plastic surgeon takes years to build. It is the single most important non-academic quality a surgeon can have. It is often difficult to determine a doctor’s reputation, but eventually, in a given community (and perhaps within the country or the world), a surgeon develops a reputation.

Training

Some schools are harder to get into than others. Great residency programs tend to produce great surgeons. Doctors who shortcut their training in the zeal to enter lucrative private practice do so with less training than those who stay the course and become fully trained.

Hospital Affiliation

Where is the doctor allowed to operate? Are they the best hospitals in your area? Pick up the phone and call the hospital and verify that the doctor has privileges to perform the procedure you are considering. You may be shocked to find out that the “surgeon” you were considering because of glamorous advertisements is not accredited to do surgery at all!

Fellowship Training

Has the surgeon done extra fellowship training after residency? A legitimate fellowship is usually one year at an academic training center.

Referral from your Family Doctor

One of the best and most frequently overlooked ways to get a referral to the right doctor.

The Consultation

Did the surgeon make you understand the procedure in plain English? Did you leave thinking you had a real understanding of the pluses and minuses of the operation, rather than a sales job? Do his before and after pictures represent your standard of beauty, or only the doctor’s? Was his rationale for recommending procedures reasonable?

The Price

Price shopping invariably leads to very inferior, and often permanent and devastating results. A legitimate doctor must maintain malpractice insurance, which is expensive, and have a support staff should you have a problem. Top doctors do not charge bottom fees.

Experience

How long has the doctor been performing procedures? How many of these does he do? Can he present before and after pictures to show the patient what he considers to be representative of his work? Is the procedure you desire a specialty of the surgeon? Does he like doing it? Does he specialize in aesthetic surgery?

Many doctors hold themselves to be world famous, among the best doctors, etc. but have never published a word in their life or presented at a single meeting. Presenting at meetings is a very humbling experience, but it leads to a superior brand of surgery. Surgeons who talk much but produce little may be world authorities in their minds only.

Television

Seeing a doctor on television is a terrible way to choose a doctor. It should aid the patient only in getting to know the doctor better, not in establishing credentials. Many doctors appearing on television are not even board certified.

Honesty and Integrity

Does the surgeon convey honesty and integrity? Does he present the procedure as it really happens, with the pluses and minuses, so that you can make up your mind?

Innovation vs Hype

Has your surgeon innovated any procedures? Legitimate innovations are often published in journals such as Plastic and Reconstructive Surgery; this means that peers of the doctor had a chance to criticize the publication for faults before it is released to the public.

Unfortunately much of plastic surgery is innovation driven; patients hear about something new and flock to the doctor touting the new procedure.

A good surgeon will weigh all new developments for their merits. So must a patient.

Poor surgeons are often the first to jump on the bandwagon for a new procedure. By the same token, other poor surgeons never change the way they practice when legitimate new developments come along. Their care of patients becomes “fossilized”.

Patient Care

Does the doctor have the demeanor and confidence that you would want to be his patient?

Revisions

Every good, busy surgeon has complications, often requiring (usually minor) revisions. What is the doctor’s policy on revisions and complications?

Doubt

When in doubt, do not go forward with the surgery.  Cosmetic surgery, aside from the usual butterflies, should be an informed decision entered into confidently.  Your inner voice of doubt may be telling you that your search for the right surgeon is not over.