Looking for a Good Plastic Surgeon?

If you just want a famous celebrity’s nose or lips, you’ll probably end up disappointed. Such thinking can help fuel unrealistic expectations of what plastic surgery can deliver. Recognize that plastic surgery is real surgery, with real potential risks and complications. Your expectations — your aesthetic goals — should be realistic.

“The goal with elective plastic surgery should be to achieve a fresher, more attractive version of you,” says Salvatore Pacella, MD, a board-certified plastic surgeon and division head of plastic and reconstructive surgery at Scripps Clinic and Scripps Green Hospital. “To an ethical plastic surgeon, a patient who comes in requesting a perfect, unflawed selfie raises a red flag.”

Plastic surgeons at Scripps Clinic are board-certified and trained to perform a full range of cosmetic and reconstructive surgeries and procedures for face, body and skin, including rhinoplasty (nose job), blepharoplasty (eye lift) and facelift as well as breast augmentation, tummy tuck and liposuction.

Keep the following guidelines in mind to help you find a plastic surgeon who is qualified to perform the cosmetic procedure that you want.

Your primary concern as a patient — and the primary concern of ethical surgeons as well — is safety. The likelihood of complications is minimal when surgery is performed by a fully trained and credentialed plastic surgeon and appropriately trained anesthesia provider in a nationally accredited facility.

What constitutes an appropriately trained and credentialed surgeon? First, you want someone who is certified by the American Board of Plastic Surgery (ABPS) to perform reconstructive and cosmetic surgery. ABPS is the only board recognized by the American Board of Medical Specialties for full training in all aspects of plastic surgery. Board-certified plastic surgeons must have completed at least six years of surgical training following medical school, with a minimum of three years of plastic surgery residency training, in addition to passing comprehensive written and oral exams.

Check also if your surgeon is a member of a professional organizations, such as the American Society of Plastic Surgeons, which represents more than 90 percent of board-certified plastic surgeons, and The Aesthetic Society, whose members focus entirely on aesthetic plastic surgery and cosmetic medicine of the face and body.

“These memberships indicate they have been peer-evaluated not only on the number of cases they have performed, but on the quality of the surgery, their surgical judgment and ethics as well,” Dr. Pacella says.

Ask your plastic surgeon how long he or she has been doing the cosmetic procedure you want, and how many they’ve performed in the past year. A surgeon who has done only one or two facelifts in six years can represent himself as a plastic surgeon, but do you want him to work on your face?

“Find a plastic surgeon who does the procedure you are interested in on a regular basis,” Dr. Pacella says.

Ask where the procedure is going to be performed. Make sure the facility is accredited by the American Association for Accreditation of Ambulatory Surgery Facilities, the largest accrediting organization for office-based surgery, or other nationally recognized accrediting organizations. Anesthesia should be provided by a board-certified anesthesiologist or a certified registered nurse anesthetist.

In addition, even if the surgery will be office-based, your surgeon should have privileges to do the procedure in a hospital and have a transfer agreement with an adjacent hospital should any problems arise.

It is important to have a consultation before you schedule anything. Check if virtual consultations are available.

Evaluate the staff. Are they friendly and helpful? Do they answer questions and make you feel comfortable? What is your surgeon’s bedside manner like?

Meet with the surgeon who will perform your procedure and note whether he or she discusses both the pros and cons of the surgery. You should discuss what to expect as far as discomfort, bruising, recovery and potential complications. Also be sure to discuss all costs.

Be wary of a surgeon who makes unrealistic promises, says there will be no scars or talks only about the positives. Every surgery leaves scars, although a good surgeon can minimize them.

You should see before and after photos of patients who look like you for a more accurate comparison. Keep in mind that no two individuals get the same results. Also, while computer imaging is a good communication tool, it cannot perfectly represent what your final result will be.

During the consultation, the surgeon should evaluate you to determine if you are a good candidate.

“In addition to your reasons for wanting the procedure, factors such as physical health, attitude, expectations and willingness to follow directions can determine whether a patient is a good candidate,” Dr. Pacella says. “An ethical surgeon will turn you away when surgery is not appropriate.”

Surgery isn’t something you want to buy at the lowest possible price. “Although problems may occur in anyone’s hands, we have seen far too many patients put their health in the hands of surgeons who offer the best price or a deep discount with tragic results,” Dr. Pacella says.

Patients who go out of the country for plastic surgery often have no recourse if something goes wrong. Save your bargain shopping for the shoe rack.

Finally, be wary of promises made in advertisements and astonishing before-and-after photos. As with any profession, only the ethical are encumbered by ethics. If an offer sounds too good to be true, it probably is.