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1. What is my surgeons training background?Traditionally, doctors from just four medical specialties — plastic surgery, dermatology, otolaryngology (ear, nose and throat), and ophthalmology — have handled the bulk of cosmetic offerings, including everything from minimally invasive aesthetic treatments like botulinum toxin (sold under the brand name Botox) to more involved procedures like face-lifts. And those specialists spend years honing their chops in residency training programs that teach skills unique to each specialty in addition to basic surgical skills. Now doctors in these and other specialties may take a weekend course as the only preparation for doing your surgery. “Unfortunately, this is an industry where the most creative, assertive, sexiest marketing often drives the business, but it may not be someone with the best experience,” said David B. Sarwer, a professor of psychology at the Perelman School of Medicine at the University of Pennsylvania.
2. How much pain will I have after surgery and how long will it take for me to recover?The general population that because cosmetic surgery is cosmetic and elective it is a lesser surgery than other types of surgery. This has been part of the impetus for less or non-invasive cosmetic surgery. That is not the case patients have pain after surgery, are at risk for infections or other surgical complications and require a variable down time to recover. Beware of surgeons who say they can operate on you without this being an issue.
3. There are no true bargains in cosmetic surgery.Looking for steeply discounted surgery is a recipe for disaster. Cosmetic surgery is not a commodity that is equivalent regardless of the surgeon. It is not like gasoline which pretty much the same between gas stations but the price is different. The money you save may end up costing you many times more than what you would have originally spent if you get a complication that needs to be treated. If the complication cannot be reversed or treated the situation is worse because no amount of money will fix the problem.
4. Beware of the long term effects of new technologies.Doctors are constantly pressured to employ new technologies such as smartlipo, fat freezing, stem cell injections etc. in their practices to attract patients away for other doctors. The questions you need to ask before subjecting yourself to these procedures are what are the long term (years out) effects and how long does this last. If the only available cases have only a few months of follow up it may be better to wait a little longer to decide if the procedure is right for you. Some years back the FDA certified the use of certain barbed sutures for thread lifts of the face. The idea never seemed good to me. The threads it turned out would break within a short time losing their effect and then had a tendency to migrate under the skin and poke out through the skin. Within a year or 2 of their release on the market they were withdrawn by the FDA. The moral of the story is do not be the first person on the block to get a new cosmetic procedure.
5. The number of revision procedures is going up.Revision nasal surgery went up 35% between 2008 and 2010. Although more procedures are being performed the revision rate is rising faster than first time surgery rate. So do your homework before having surgery and choose your surgeon/procedure very carefully.
6. More men are having cosmetic surgery every year.Whether it is took younger for work or to fit in with a younger girlfriend it is happening. Men make up only 9% of cosmetic surgery patients but the total procedures performed on men rose 22% from 2000 through 2012. In the same time the numbers for botox treatments in men went up 314%.
7. Cosmetic surgery can temporarily reverse the aging process but cannot stop it.A facelift last 8 to 10 years and then you will need something else. It may be a filler, a laser treatment, minor surgery or a redo of the previous surgery. The lower face and jowls usually revert before the upper face.
8. Beware of addictive cosmetic surgery behavior.The occasional procedure can be beneficial on many levels including the psychological level. However we are seeing increasing numbers of celebrities with abnormal behavior towards plastic surgery on specific body parts. Many actresses have had 5 to 10 breast surgeries in a short period of time. That is more than a lift time's worth. No one is sure how many operation Michael Jackson had on his nose before his death. Up to 15% of cosmetic plastic surgery patients suffer from “body dysmorphic disorder,” versus an estimated 1% to 2% of the of the overall population.
9. Exactly what is your surgeon board certified in.Do you really want a doctor trained only in eye surgery to operate on your breasts? Do you want a doctor certified in a non-surgical specialty to operate on you in any capacity, cosmetic or otherwise. For more information on board certification visit American Board of Plastic Surgery.
10. There are limits associated with every cosmetic procedure.Due to the nature of human tissue you can never get a breast augmentation in a 50 to 60 year old to look as good as one in a 20 year old. Breast augmentation looks best when native tissue makes up a higher percentage of the end result than the implant itself. Facelift results are more dramatic in older patients but aging changes to the skin reduce the longevity of the procedure's results. Liposuction results are best in those who are younger and not over weight because the skin condition in other patients detracts from the end results. Stretchmarks on the abdominal skin adversely effect the results of abdominoplasty.
Dr. Aaron Stone - Plastic Surgeon Los Angeles
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