A discussion about plastic surgery should start with physician selection. Selecting the surgeon is the single most important factor in the success of your plastic surgery. Of equal, if not of greater, significance than the rapidly escalating number of patients seeking plastic surgery is the explosion in the ranks of physicians not trained as plastic surgeons performing plastic surgery procedures. Lawmakers in several states are taking aim at this issue. 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, 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.
As a patient, you should seek to qualified physicians and establish a professional relationship with one who offers the procedure you are interested in.
When Choosing a Plastic Surgeon Be Aware of
Credentials & Board Certification
- Just as important as where your plastic 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 Programs includes an intensive two- to three-year training in the full spectrum of reconstructive and cosmetic surgical procedures. Was the plastic surgery training a shorter “fellowship,” and was it 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: the American Board of Plastic Surgery (ABPS). 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 as well as 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 the possibility that your doctor may still be certified, just not listed. Many doctors have board certification in more than one specialty, so ask about this as well.
- 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 plastic surgeon about the number of complications and lawsuits 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 about this issue.
- Be aware that just because a doctor has performed any procedure many times, this does not mean he or she is good at it or has the same “artistic perspective” that you do. Ask a lot of questions to satisfy yourself of this qualification.
- Inquire about hospital admitting and surgical privileges. This is important because occasionally doctors who 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 check which agency gave the accreditation.
- If you are planning surgery in the office, ask what will happen and where you will go if there is a problem.
- Have a clear understanding about the policy for complications and revisions.
- 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 copied photographs or models.
- Ask doctors and nurses. Your family doctor or an operating room nurse may be able to recommend a surgeon.
- Make sure your doctor will answer all of 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 for a second opinion, without pressuring you to book surgery.
- You should discuss with your surgeon your expectations and any related matters that may affect your recovery, such as the nature of your job, smoking or drinking habits, other diseases or medications you are using, and any related personal matters.
- You can find plenty of physicians’ names in the yellow pages and other advertising sources. Keep in mind that that doctors can list themselves under any specialty heading they like and advertise any services they want to sell, regardless of their training and credentials.
- Very important. Make sure your doctor sees what you see and knows what you want, and that he or she will provide the sort of result that you are both focused on.