Selecting a Plastic Surgeon

No discussion of plastic surgery should begin without mention of physician selection. Selecting the surgeon has to be the single most important factor in the success of your plastic surgery. Equally, if not of greater significance than the rapidly escalating numbers of patients seeking plastic surgery, is the explosion in the ranks of physicians not trained as plastic surgeons performing these procedures. Lawmakers in several states are taking aim at this. The growth is fueled in large part by physicians from many different specialties trying to escape some of the insurance reimbursement limits imposed by managed care on their practices; they seek higher fee-generating procedures such as liposuction, which is not regulated by insurance companies. Despite this, don't rule out that there are still many qualified physicians in different specialties performing very good plastic surgery and your search should not be limited to one specialty or board certification category.

The message here is simply that patients should seek to establish a professional relationship with a physician who offers the procedure you are interested in, and to seek qualified physicians well-trained in this procedure.

Be aware of:

Credentials

• Just as important as where your surgeon went to school is the specific type of plastic surgery training he or she received. Has your surgeon completed an accredited residency program specifically in plastic surgery? Such a program includes an intensive two to three years in the full spectrum of reconstructive and cosmetic surgical procedures. Was the plastic surgery training a shorter "fellowship" and was this only in a specific area?
• Specific board certification. Be perceptive about this. Understand that the American Society of Medical Specialists (ASMS) recognizes only one board of plastic surgery. This is the American Board of Plastic Surgery (ABPS) and patients are encouraged to consider a doctor certified by the ABPS. This certification guarantees that the doctor has graduated from an accredited medical school and completed at least three to five years of general surgery and two years of plastic surgery. To be certified by the ABPS, a doctor must also practice plastic surgery for two years and pass comprehensive written and oral examinations. The other groups formed their own board. There are some "certifications" that are not boards at all and do not require any testing or peer review. Also, be aware that some references and internet sites list board certified doctors only if they pay to advertise. So don't rule out that your doctor may still be certified, just not listed. Many doctors have board certification in more than one specialty, so ask about this also.
• Local and state medical societies and memberships. Check your doctor's membership and make sure no grievances or complaints have been filed against him or her.

Experience and Background

• The number of specific procedures performed.
• The length of time performing that specific procedure.
• Ask the doctor about the number of complications and lawsuits either filed, pending, or settled. All of this information is now available to the public through many state licensing boards, so don't be shy about asking this.

Hospital Affiliations

• Inquire about hospital admitting and surgical privileges. This is important because occasionally doctors that operate only in their office do so because they may not have hospital admitting privileges. Also, make sure the doctor has surgical privileges, especially in the procedure you are choosing.
• Call a respected hospital in your community and ask for the names of board-certified plastic surgeons on staff. Be sure to ask for the names of doctors who have privileges to do the particular procedure you are interested in. See if your doctor is on the list.

Office Facilities and Policies

• Anyone can set aside a room and call it an operating suite. This has only recently begun to fall under government regulation.
• Make sure the operating suite and facility is accredited and by what agency.
• If you are planning surgery in the office, ask what happens or where you go if there is a problem.
• Have a clear understanding about the policy for complications and revisions.

References

• Don't merely rely on word-of-mouth.
• Ask the plastic surgeon for references and a list of his or her patients. Call these references and talk to them.
• Ask to see some of the photographs of patients who underwent similar procedures. Make sure these are his or her patients and not models.
• Doctors and nurses. Your family doctor or an operating room nurse may be able to recommend a surgeon.

Your Consultation

• Make sure your doctor will answer all your questions thoroughly in an understandable way.
• Make sure you spend ample time with your doctor and not just his nurse or counselor.
• Discuss your motivations and expectations.
• Make sure the doctor welcomes questions especially about qualifications, experience, costs, payments and complications.
• Make sure the doctor offers alternatives or even other doctors' names and a second opinion without pressuring you to book surgery.
  You should discuss with your surgeon your expectations, and any related matter that may affect your recovery like the nature of your job, smoking or drinking habits, other diseases or medications you are using, and any related personal matters.

Paid Advertising

• You can find plenty of physicians' names in the yellow pages and in other advertising sources. Keep in mind that that doctors can list themselves under any specialty heading they like, and can advertise any services they want to sell, regardless of their training and credentials.

Artistic Perspective

• Very important. Make sure your doctor sees what you see and knows what you want and will provide the sort of result that you both focus on.