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Proper Prep
How to prepare for a cosmetic procedure, from asking the right questions to completing the necessary preliminary research


Oct. 2017

According to statistics published by the American Society for Aesthetic Plastic Surgery (ASAPS), Americans spent more than $8.4 billion on cosmetic surgery in 2016. Unfortunately, not all of that money was well spent — if it had been, the show “Botched” would never have gotten off the ground. But there are steps you can take to make sure your procedure has the desired effects.

Do your homework.

“Find out if your surgeon is board-certified, specifically in plastic surgery. This is important because there are vast differences in the training programs and the time dedicated to learning plastic surgical procedures,” says Dr. Mark Blake, a board-certified plastic and reconstructive surgeon at the Clinic of Cosmetic Surgery. “For example, there are cosmetic surgeons, facial plastic surgeons and plastic surgeons. Each has significantly different training and background. Typically, cosmetic surgeons may be of any field in medicine and have taken a short course in cosmetic procedures. Facial plastic surgeons are ear, nose and throat doctors with a year of training in cosmetic procedures. Plastic and reconstructive surgeons have completed up to five years in general surgery, followed by a minimum of two or three years in plastic surgery, and often a fellowship beyond that.”

By board-certified, Blake is referring to the American Society of Plastic Surgeons (ASPS), which represents 94 percent of all board-certified plastic surgeons in the U.S. Locally, patients can visit the regional branch of the ASPS: the Wisconsin Society of Plastic Surgeons in Kimberly, Wis. Here every member is required to have completed at least five years of surgical training, including a minimum of two years in plastic surgery. They adhere to a strict code of ethics and are trained and experienced in all aspects of cosmetic and reconstructive surgery, and each surgeon fulfills continuing medical education credits to ensure patient safety.

“The key to choosing a surgeon is first to clearly define what surgery you are requesting. Your best choice in surgeons is one who is known and respected for that particular surgery. Being a ‘jack of all trades’ is not the same as being a ‘master of one’ when you are hoping to undergo the ‘one,’” explains

Dr. Bruce Massaro, a board-certified plastic surgeon and American Society of Ophthalmic Plastic and Reconstructive Surgery fellow. “And in this world of expanding, big-box corporate medical facilities, beware of being sent to an employed surgeon who only occasionally does the surgery you are requesting.”

The American Board of Cosmetic Surgery recommends choosing a surgeon whose aesthetic sense appeals to you, so look at before and after photos. Whether it’s the face, breast or any other body part, compare each doctor’s results, pay close attention to patients who have similar qualities to you, and look for consistency in the results.

Ask questions.

“Apart from whether or not they are board-certified, you should ask the following questions: Where will the operation be performed? What type of anesthesiologists do you use? ... What outcome should I expect from my procedure? What is the recovery after the procedure?” says Dr. Alex Colque, a board-certified plastic surgeon with Skiin Anti-Aging Lounge.

Shop around.

“The first way to shop around is by reviewing a plastic surgeon’s website, and then by making a consultation,” recommends Colque. “It is common for patients to make more than one consultation.”

Check ratings websites — but proceed with caution.

“There are no real rating systems,” warns Blake. “I am always very suspect of things on media, (in) advertisements and (on the) Internet. The best way is word-of-mouth, and how other people look: If someone looks great for their age and is not ‘overdone,’ chances are they’re doing something, but the provider has taken care not to distort anything.”

“Some review sites will post fake reviews,” adds Colque. “It is perfectly acceptable for you to ask for references of patients who have had a similar procedure, to speak with prior to choosing your plastic surgeon.”

Assess hospital privileges.

Before allowing a doctor to use their facilities, hospitals will have their review committee evaluate each potential surgeon’s training and competency for a specific procedure. Confirming that the surgeon has operating privileges in an accredited hospital is one more way to ensure your procedure is being performed by the right person. “If they do not (have privileges), that should be a large red flag,” says Colque.

Avoid common mistakes.

“The biggest mistake I see is choosing a plastic surgeon solely on price,” says Colque. “Price should definitely be a factor, but oftentimes you get what you pay for, and if someone is significantly discounted, there is likely a reason for this.”

Don’t be shy when asking about the price of your procedure, though, and ask more than one doctor. Cosmetic surgery is generally considered elective and therefore is not covered by most insurance plans. Some procedures, like breast reduction, have a functional aspect and may be considered reconstructive, not cosmetic. The ASAPS publishes a list of national averages of fees per procedure each year, so check its website too — these averages can be used as a benchmark.

Find the right fit.
(It’s OK to factor in personality too.)

Even the most experienced surgeon is not the right surgeon for every patient. “Consider how personable the surgeon is and how much time they are going to spend with you to make sure all your questions are answered,” stresses Blake. “Communication is vital. Both parties must work together to get on the same page with goals and expectations.”

“The accredited list is one thing, but you still need to determine if the surgeon is a good fit for your personality,” Massaro says. “There is no need nowadays to choose a doctor with no bedside manner, just like there is no sense in choosing a doctor you like to do surgery that they are not qualified to do.”

Set realistic expectations.

Finally, if you are not satisfied with your procedure, you do have recourse. “Unhappy patients are usually the result of unmet expectations that were not discussed or were unrealistic,” says Massaro. “I know in my practice, I will respectfully decline surgery to patients who I feel are not understanding my advice and discussions preoperatively. If minor adjustments to surgical results can solve ‘the problem,’ these can — again with discussion and understanding — be accomplished with good final results.”


This story ran in the Oct. 2017 issue of: