Expert Insights:
Contributions by consumer advocates, legal professionals, and industry insiders
Thinking about cosmetic surgery? Things to consider before you decide.
By:
Cosmetic surgery is usually a life-changing experience, affecting the way you see
yourself and the world sees you. Unlike most types of surgery, it’s almost always
elective; you get to decide if and when you’ll have it done. That’s fortunate because
it’s not the kind of thing to enter into lightly, or hurriedly. You want to feel
comfortable with your decision – about changing your appearance, about what’s involved
surgically, and about the doctor you’ll rely on to see you through the process.
Here are some things I’ve learned in more than 20 years of practice that can help
you think realistically about both process and outcome and help you make the right
choice – for yourself.
1. Answer this question: Who are you doing it for?
There’s only one correct answer, and I’ve already given it away: You do this for
yourself - not for your boyfriend or any other friend or family member. If you change
your appearance at someone else’s suggestion, and you’re not completely aboard,
you may regret it. The patient who returns a few years after having breast implants
and confesses she really didn’t want them, her boyfriend did, pays a price both
financially and physically for having them removed. Also, not everything can be reversed:
if your friends talk you into rhinoplasty (a “nose job”) and you later wish you
hadn’t done it, you probably won’t be able to return to your original look.
2. Find the right surgeon.
The "right surgeon" means the right surgeon for you. You can break this into two
elements: professional competence and personal chemistry. Both are essential for
the best result. Here are some ways to narrow your choice.
Do –
Make sure she or he is Board Certified, and find out which Board. The words
to watch for are “American Board of Plastic Surgery” (“ABPS”). The American Board
of Plastic Surgery is the only plastic surgery board sanctioned by the medical profession’s
American Board of Medical Specialties which, in concert with the American Medical
Association, oversees professional standards in 24 specialized branches of medicine.
Board Certification by ABPS guarantees a rigorous standard of training in technique
and patient safety. Several other Boards with impressive-sounding names have sprung
up but they’re not sanctioned by the medical profession. (Typically these are marketing-driven organizations
offering practitioners the ability to display a certificate and to advertise “Board
Certified.”) Be careful. When it comes to plastic surgery, Board Certified means
one board only, ABPS.
Ask a friend who’s had cosmetic surgery who her surgeon was. If she liked
the result she’ll probably be happy to tell you about her doctor. How did your friend
feel about the experience? Did she feel informed prior to surgery? Was she comfortable
with the doctor? Did doctor and staff take care of her? Did the doctor see her at
all her pre-operation and post-op visits? Did the doctor’s attitude change at all
pre- and post-surgery? Did she get personal care or did she feel like a number?
Get to know the doctor. Schedule a consultation. This is your opportunity
to ask questions, learn more about available procedures, and find out how you relate
to the doctor. Cosmetic surgery is more personal than surgery to repair a knee or
internal organ. You’ll be sharing ideas and feelings about how you look, and chances
are you’ll be talking more frankly about yourself than you would with anyone else.
Good rapport is essential. You want someone who is sympathetic, listens carefully
and understands what you want, will explain options for treatment clearly, and who
is willing to be realistic about likely outcome and risks.
Ask the doctor these questions about the procedure you have in mind:
- "In general, how difficult would you say this operation is? In my case do you think it would
be more difficult or less difficult than usual?" All surgeons do many types of procedures;
some they like more than others (and tend to do a better job with). How they answer
this question can give you a clue to their comfort level with what you’ll need.
What you want is straight talk from a professional. Be wary of knee-jerk “not a
problem” optimism.
- "Can you show me some ‘after’ photos of operations that didn’t go well?" All doctors
have such photos; those who say they don’t (or can’t show them to you) aren’t being
candid. They’re trying to make a sale and don’t want to risk frightening off a potential
customer. Again, you want a doctor you can trust. Asking to see such photos is an
easy test.
- "Are there any additional charges if revision surgery is necessary?" If they won’t
show you photos you won’t need this question, but it’s a good idea to be clear about
it. Many doctors don’t charge for revision surgery within a specified time period,
but some do.
Don't –
Don’t make your choice based on advertising. Above all, stay away from anyone
claiming to be “the best,” whether in advertising or in a consultation. Not only
is such a claim a breach of professional ethics, chances are the person making it
is not a bona fide plastic surgeon. (No law prohibits doctors untrained and uncertified
in the specialty from entering and practicing cosmetic surgery.) Of all the medical
specialties, cosmetic surgery lends itself most to promotion via “results” photographs.
Buyer beware – flashy ads or websites showing glamorous results are not reliable
ways to pick a surgeon. I once saw the results of a consumer survey where women
were asked to give their impression of the quality of several cosmetic surgeons
after viewing each’s website. Surprisingly (or not, considering the effect of advertising),
the “winner” was the one doctor in the group who wasn’t trained as a plastic surgeon.
Don’t schedule too many doctor interviews. Multiple interviews can lead to
confusion. If you’ve researched a doctor’s credentials and talked with one or more
people who have been patients, you have enough information to make an appointment
to meet the doctor and see if the fit is right for you.
3. Know what to expect from surgery.
You know how you’d like to look. Realistically, how close can you come to that ideal?
It’s very important to have this question answered honestly and process it carefully
before proceeding. Body types vary tremendously, and differences in frame, bone
structure, skin type, subcutaneous fat, and other factors play a big role in what
can be achieved. It’s a shared responsibility: both doctor and patient must try to
assure they have the same understanding of what’s realistic.
At my clinic, after our initial discussion, the patient and I always go to a mirror
so we can both see the same picture and talk more specifically about realistic objectives
for the surgery. Guaranteed, anyone who has cosmetic surgery will be looking in
the mirror quite a lot when it’s over, so in front of a mirror is an excellent place
to sort things out at the start.
I turn down maybe 20% of prospective patients each year, and it’s mostly cases where
I’m not sure we’re both on the same page about what the result will be. If I’ve
explained to a patient why a surgery cannot give her the exact look she had in mind
and what I’m hearing from her tells me she’s not getting it or not accepting it,
then the outcome will be unhappy. As a professional I cannot go forward.
For example, if a procedure will leave visible scars, this needs to be crystal-clear.
Take the case of a patient who has sagging breasts and wants them to be larger and
lifted. Two different procedures are necessary. The size goal can be achieved with
nominal scarring. However lifting the breast may leave highly noticeable scars. (This
goes for any surgeon, every time.) The patient needs to see photos of this, understand
why this type of incision is necessary, and decide the tradeoff for herself: is the
lift worth the accompanying scars?
Or, someone interested in a differently shaped nose may bring the surgeon a photo
of a nose she admires, and say, “I want to look like this.” Problem is, the photo
she brings is of a face, not just a nose, and the face is much different in bone
structure and skin type than hers. The nose she sees in the photo will produce a
quite different look on her own face. The surgeon needs to orient the prospective
patient to what’s possible, starting with photos of the patient’s face taken by
the doctor. Before deciding, the prospective patient needs to see what can and can’t
be achieved; the doctor needs to be comfortable that the patient has both seen and
understood.
If the patient turns a deaf ear to what’s realistic, she puts herself in a vulnerable
position. She can always find another practitioner who is willing to do the work,
but her hopes won’t match the outcome no matter how skilled the surgeon. She could
easily be unhappy with the result, perhaps also unhappy with her decision to change
her appearance.
4. If you have a problem.
Any surgery poses risks. I occasionally am called as expert witness in malpractice
trials and can tell you that things happen – even with skilled surgeons following
best practices. This relates to my earlier comments on choosing a doctor. If a surgeon
says, “I never have complications,” don’t believe it. The only surgeons who have
no complications are those who aren’t operating.
If your surgery doesn’t go well, here’s what to do.
Talk with your doctor. Good rapport and trust are put to the test when things go
wrong. It is so important to be able to discuss the situation as objectively as possible
despite the extremely personal nature of changes to your appearance. To decide the
best course it’s important to establish the following:
- What the disappointment is. Do both patient and doctor agree that the results were
not as expected? If not, what are the reasons?
- What can be done to fix the problem. If you’ve chosen your doctor well, you won’t
be billed for revision surgery within the specified time frame (though other fees may
apply if performed in a hospital).
It may be helpful to bring a friend or family member with you: an extra set of eyes
and ears can sometimes help keep things in perspective.
Chances are you’ll be able to work it out with your doctor if your relationship has
been based on clear understandings, good communication, mutual respect and consideration.
If you feel further steps are necessary, do what you need to do, but remember, while
state medical boards can record and review your complaint, strong sanctions like
taking away a doctor’s license are most likely to happen only in cases of professional
negligence, not bad cosmetic results. Negligence would need to be established in
court, and state medical boards rarely take a cosmetic surgery case that far. If
you file your own lawsuit, remember also that the trial process can take a toll on
your emotions, energy, and state of mind – and the outcome is always uncertain.
Try your best to work it out with your doctor first.
By following steps 1-3 above, you’ll greatly decrease the chances of problems. You’ll
approach your surgery without blinders on and be able to look forward to a return
to everyday living with a new look that you’ll probably find makes a difference
in all kinds of good ways, some you can’t even anticipate.
About the author
While care and judgment have gone into the preparation of this article, neither PeopleClaim nor the author can make representations as to its accuracy or completeness. Opinions expressed are those of the author and are offered as opinion, not fact. Readers assume full responsibility in taking action based on information, opinion, or advice offered. PeopleClaim does not independently verify or specifically endorse the article's content, and is not responsible for errors, omissions, or the consequences of advice taken.
PeopleClaim provides free and premium online dispute resolution service to consumers,
business, patients, and others.
Have a dispute you need resolved?
Try PeopleClaim to resolve your dispute. You can file a claim for free or add
premium options.
- Resolve Any Dispute With Anyone, Anywhere
- Avoid Customer Support Hassles
- Recover Damages, Overcharges, and More