11 Questions to Ask Your Plastic Surgeon

Doctor preparing patient for surgery

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As you begin your research to determine who you will choose as your plastic surgeon, you will probably already have many questions. Or perhaps you have no idea of where to start, or what exactly you should ask. Many people are intimidated by the prospect of questioning authority, and who is more of an authority figure than a plastic surgeon? After all, your surgeon is the person who could potentially hold your life (not to mention your looks) in his or her hands.

There are many things to consider when making such an important decision. You want to know as much as possible about your prospective surgeon’s skills, experience, and credentials. So, without further ado, here is our list of the top ten questions you must ask a prospective plastic surgeon before deciding if he or she is the right physician to perform your procedure:

1. Are You Board Certified?

You may ask, what exactly does it mean to be a board certified plastic surgeon? The truth is, there are several certifying boards for plastic surgeons, as well as surgical societies of which any given surgeon may be a member.

The American Board of Facial Plastic and Reconstructive Surgery (ABFPRS) was established in 1986 to improve the quality of medical and surgical treatment available to the public by examining for professional expertise in facial plastic and reconstructive surgery. It has been recognized as equivalent to ABMS boards by every regulatory authority that has reviewed its requirements, including the Medical Board of California, which approved the ABFPRS as a specialty board with ABMS equivalent requirements in February 1995.

To be eligible for ABFPRS certification, the candidate must first become board certified by either the American Board of Otolaryngology – Head and Neck Surgery (ABOHNS) or the American Board of Plastic Surgery (ABPS). 

American Academy of Facial Plastic and Reconstructive Surgery (AAFPR) and the American Society of Plastic Surgeons (ASPS) have jointly been working with the American Medical Association to develop standards for legitimate board certification that might be included in physician disclosures to the public. The joint effort has described the criteria of the ABFPRS as wholly legitimate. The ASPS leadership also has gone on record in support of the legitimacy of the ABFPRS as a certifying board.

Those who chose the ABOHNS pathway spend four to five years in residency training solely in the Head and Neck arena, followed by one to two years in a Facial Plastic and Reconstructive Surgery Fellowship.

2. How Many Times Have You Done This Procedure?

It may seem obvious that nobody would want to be any surgeon’s first nose job. Beyond that, most people probably wouldn’t even want to be one of the first fifty patients Dr. X uses to perfect his technique. Ideally, you would like to have a surgeon who has worked out all the kinks in his previous 200 times performing the procedure (although this is not always possible with less common surgeries). Yet so many people don’t think to ask this question, either because they are embarrassed, don’t want to be rude, or are simply uncomfortable at the very thought of questioning a doctor about his experience. Better rude, embarrassed, and uncomfortable than disfigured…or worse. And, if you are still feeling hesitant, keep in mind that your surgeon would likely also ask a potential surgeon this question if she were contemplating surgery herself.

3. What Other Medical Staff Will Assist With the Procedure?

It is important to know who is a part of the surgeon’s surgical support team, and what their qualifications are. Who will be assisting? Who will be administering and monitoring anesthesia? Is there emergency staff available in case of a problem? If the procedure is being performed at a teaching hospital, will there be any medical students or interns involved in your care? Keep in mind that having medical students or medical residents around does not mean that you will be getting substandard care. Instead, since it is more difficult to teach something than perform something, you may actually get better care. Two brains are usually better than one, and medical students and residents have to be on top of their game or face humiliation on rounds.

4. Where Will the Procedure Be Performed?

Hospitals are accredited by the Joint Commission on Accreditation of Health Care Organizations. Private Surgi-Centers and office/clinic operating rooms should likewise be accredited be the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), the Accreditation Association for Ambulatory Health Care (AAAHC) or JAHCO.

Some procedures are performed in a hospital, others in an outpatient ambulatory center, and still others are routinely performed as in-office procedures. The complexity of your procedure, as well as any health issues specific to your case (your age, overall health, etc.), should always be considered when determining where it would be best for your surgery to take place. Hospitals are usually more expensive venues for any surgery, but can you really put a price on your safety? That said, your risk of infection is often lower at an outpatient surgery center. No matter where you have your procedure, it's important to be aware of the risk of infections.

5. Do You Have Hospital Privileges to Perform This Procedure?

Even if your procedure is typically done outside of a hospital, it is worth it to ask your surgeon if he or she has hospital privileges to perform the procedure. Hospitals usually have stringent requirements regarding surgeon training and safety records before they will grant operating privileges. Plus, this could become very important if anything unexpected should occur during your procedure, and you were to need to be transported to a hospital.

6. What Type of Anesthesia Will Be Used During the Procedure?

It's very important to discuss the risks of anesthesia with your surgeon, in addition to the particular procedure you will have performed.

The greatest risk is from general anesthesia, and this type of anesthesia requires highly trained specialists to administer and monitor its effects on the patient, although for some surgeries this is by far the best option.

IV sedation (sometimes called “twilight sleep”) is a bit safer and usually less expensive option—one which can be utilized for many single-procedure surgeries.

Regional anesthesia is used to numb a region of the body. The epidurals used for labor are one example of regional anesthesia.

The safest option is usually a local anesthetic, and this may be recommended if the surgeon will have any reason to need to communicate with you during the surgery. However, many procedures are not possible or advisable with an only local anesthetic.

The question about which type of anesthesia is advisable is best answered by a physician who knows your medical history well. This is the reason why a preoperative physical exam is important before most procedures.

7. What Are the Risks Associated With This Procedure?

Everything in medicine and surgery has potential side effects and complications. It is common for swelling, bruising, and discomfort of varying degrees to occur after surgery, and patients myst be informed of them. Complications may occur, albeit quite rarely. The most common complications of all surgical procedures are bleeding and infection. Beyond these, each operation caries its own list of complications as does anesthesia. All competent and ethical physicians educate their patients as to these risks. Some are easy to treat, while others may necessitate further surgery.

8. Can I See Examples of Before and After Pictures of Patients?

All competent facial plastic and general plastic surgeons will show before and after photos of their own patients who have provided them written permission to do so. Stock photos can be used but it must be disclosed that the patients shown are not their own. All patients want to see photos of their surgeon's work. What better way to see the quality of the surgeon's outcomes?

9. What is Your Complication Rate With This Procedure?

Although a surgeon cannot violate the privacy of his or her patients, he or she should absolutely be able to tell you how many complications he has had with your particular surgery, and how many of them have been serious. This can be in the form of an actual count or a percentage, but your surgeon should be willing to provide this information so that you feel comfortable about making the most informed choice for your own health and safety.

10. Can You Provide Me With References to Patients on Whom You Have Performed This Procedure?

Though confidentiality laws prohibit your doctor from sharing the names of satisfied patients, many surgeons ask former patients if they would be willing to speak to someone who is considering a similar procedure. It's very uncommon for a surgeon to turn down such as request, so don’t be the least bit afraid to ask. Your surgeon will not view this as being "pushy" but rather as a reflection that you are being proactive in your health care. Your surgeon should want you to hear the glowing reports of his satisfied patients. Not only can these references provide you with a “review” of your surgeon’s care and skill, but they may also be able to give valuable insight about what you might expect to experience in regard to recovery, pain management, and downtime.

11. What Is the Exact Breakdown of Fees for This Procedure?

Some people don’t realize that there’s a lot more to your total fee than just the surgeon’s fee. There are anesthesia fees, operating room fees, lab fees, and a number of other variables that can affect the bottom line. Ask for a written breakdown along with the total, so you’re not facing any ugly surprises when it’s all said and done.

Bottom Line

Many people are reluctant to ask all of these questions of their surgeon, fearing that they will aggravate or offend the surgeon. Yet, asking these questions is important in order for you to be your own advocate in your health care. If you still are hesitant, consider what your surgeon would do if your roles were reversed. She would be checking out surgeons to learn who has performed the most procedures and who appears to have more satisfied patients with fewer complications.

As a final note, online reviews can be somewhat helpful when evaluating a potential surgeon, but there is a caveat. Some people may be unhappy about how a surgery turned out through no fault of the surgeon and may leave a scathing review. An example would be someone who has poor healing after a procedure due to continued smoking, even if the surgeon has informed the patients that ​smoking can hamper healing and result in poor outcomes.

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