Questions to ask your plastic surgeon

Choosing the best plastic surgeon for you can be a difficult process.  This is obviously not the type of shopping where finding someone from a phone book will do.  Unfortunately, some still do.

A certain amount of research should be done before you ever consider making the appointment.

• Ask around.
• Review physician websites.
• Review before and after photos.
• Review non-biased doctor rating websites such as healthgrades.com,vitals.com and a number of other sites.
• Check into a physicians board certification status at www.ABMS.org.
• Learn about the procedure(s) you are interested and alternative options.

Now you are ready.  You’ve done your homework and are ready to make the consultation with the plastic surgeon that you feel may be best for you.  Here is a cheat sheet to take with you to your consultation to make sure the important questions get answered.  In your research some of these questions may have already been.

1. Are you a board certified plastic surgeon?
   • This is probably the most important question to ask.  Board certification signifies; appropriate training, continuing education requirements, and good ethical standing.
   • A plastic surgeon who is not board certified is likely to have a significant reason such as 1) inadequate training, 2) unethical billing or advertising practices or they 3) may just be lazy.  All reasons for concern.
   • It is important to recognize that there are a number of “boards”, but only the American Board of Plastic Surgery certifies plastic surgeons.  I have blogged in the past to help educate patients about the confusing issue of board certification.
2. How long have you been in practice?
   • Every training program is different.  Some allow plastic surgeons in training a lot of autonomy and independence.  Some do not.  It is usually a good idea to choose a plastic surgeon at least a few years out of training.  Skill and judgment improve with experience.
3. How many of these procedures have you done?  What percentage of your practice is this procedure?
   • Not every plastic surgeon has the same skill set as another.  Some plastic surgeons may emphasize facial surgery, others body surgery etc…  You want your plastic surgeon to be not only skilled and experienced but particularly skilled and experienced in the procedure that you are interested in.
4. Can I see before and after photos or testimonials?
   • Ask if all of the before and after photos are the surgeons own work.  If not, run!  There are laser and other medical technology companies who have stock before and after photos that they allow their clients to use.  These are generally the best result ever achieved and is not consistent with what patients should expect for themselves.  This is intentionally misleading and should be cause for concern.
5. Where is the procedure performed?
   • This can be at a hospital, outpatient surgical center, or office based operating room.  All have an excellent record for safety.  If in the physicians office operating room make sure it is a certified operating room.  Certified operating rooms meet specific safety standards and are reviewed yearly for safety.  Dr. Yates operating room is certified by the AAAASF.
6. What kind of anesthesia will I have and who will provide the anesthesia?
   • Anesthesia for cosmetic surgery can range from general anesthesia to wide awake with local anesthesia, depending on the surgery performed.  Ask your surgeon about the training of the person administering the anesthesia and confirm with them on the day of surgery.  It is very appropriate for a nurse to provide anesthesia for light sedation.  Make sure anything beyond that is administered by an anesthesiologist or CRNA.
7. Who is doing the procedure?
   • You have gained trust in your surgeon.  Through your communication he understands your specific goals.  Make sure he is actually the one operating.  This is rarely a problem but can be in large hospital or teaching hospital settings.
8. What happens if there is a problem requiring revision?
   • Every surgeon has their own revision fee schedule.  These fees can include facility fees, anesthesia fees, and surgeons fees.
   • I do not charge surgeons fees for revisions.  This helps me keenly focus on taking every step possible to avoid these complications.
   • I have my own office operating room and do not charge a facility fee for its use for revisions.
9. Do you have hospital privileges to do the same procedure at a hospital?
   • Hospitals have stringent criteria regarding training and safety before granting privileges to do a specific procedure.
   • If a physician does a specific procedure in his office but does not have privileges to do the same at a hospital, there is likely a problem.  Most typically, they do not have adequate experience and training in that procedure.

Many of these questions do not get asked because a patient is embarrassed or does not want to be rude.  Ask us these questions!  Those of us who are adequately trained and take the appropriate safety precautions find it refreshing when a patient cares about their own safety enough to ask.   Pass this list on to your friends considering plastic surgery.