How to Choose a Plastic Surgeon

By Breast Implant Center of Hawaii

How to Choose a Plastic Surgeon

I am a review fiend. It’s a problem. Before dining at any new restaurant, I will have read every single Yelp review and scrutinized every single posted photo (hard pass on any eatery with even one review mentioning soggy fries). I will scour a minimum of 2 pages on Rotten Tomatoes before devoting even one second to a new TV series. I even have an algorithm for choosing items on Amazon based on the number of stars and number of reviews. I swear my thumbs are in chronic pain from scrolling through endless pages of reviews on my phone.

But I also hate at least half of the new restaurants I try. I can barely make it through the pilot, much less an entire series. And I send back more purchases on Amazon than I keep.

The problem is: you can’t just return your breast implants with a prepaid label and expect a refund in 7-10 business days.

Reviews are opinions. Moreover, they are other people’s opinions. They aren’t a definitive measurement of quality or value. This isn’t to say, of course, that they aren’t useful and can’t help influence our decisions. But reviews are just one piece of the puzzle.

I want to talk about the other pieces. How do you choose a good plastic surgeon? The right plastic surgeon. Soggy fries are bad, but not nearly as bad as a botched boob job.

When it comes to plastic surgery, there are tangibles and intangibles.

Credentials are a good place to start.

Board Certification

OK, so it’s basically like the safety check on your car. Board certification means that your doctor has completed years of rigorous training and multi-day exams in their respective fields of medicine. It means they’re legit.

But believe it or not, any physician with a valid medical license can call themselves a “cosmetic surgeon.” This means that gynecologists, ENTs, and oral surgeons can all legally perform cosmetic treatments in their offices. Technically, it wouldn’t be inaccurate if they answered “yes” to being board certified. Misleading, but not erroneous.

The big question becomes: which board is your doctor certified by?

The American Board of Medical Specialties (ABMS) is the umbrella body that oversees all medical specialties (24 of them). Your pediatrician, dermatologist and cardiologist are all certified by respective boards recognized by the ABMS. The only recognized plastic surgery board under the ABMS is the American Board of Plastic Surgery (ABPS). Therefore, in order for your doctor to be board certified in plastic surgery, they’ll need to be able to show you a certificate from the ABPS.

There are a couple of easy ways to verify. All members of the American Society of Plastic Surgery (ASPS) must be board certified plastic surgeons. Look for the ASPS logo on a certificate in your doctor’s office.

You can also ask whether your doctor has privileges at a major hospital nearby. Hospitals can only grant privileges for physicians to treat patients in the field they are board certified in. So if your breast surgery was performed by a general surgeon, they could not continue to treat you if you were admitted to a hospital for a complication.

The Aesthetic Society – a step further

Because you are shopping for a cosmetic procedure, you also want to be sure your doctor specializes in aesthetic plastic surgery i.e. making things look good.

The American Society of Aesthetic Plastic Surgery (ASAPS) is an inner group of board certified plastic surgeons that specialize in cosmetic plastic surgery.

According to the ABPS, there are about 7,000 actively practicing board certified plastic surgeons. Only about 2,600 of them are members of the Aesthetic Society.

Although board certified plastic surgeons have completed extensive training in reconstructive surgery (burns, birth defects, etc.), members of the Aesthetic Society have focused their services on purely cosmetic treatments (breast augmentations, facelifts, etc.).

To determine whether your doctor is a member of the Aesthetic Society, look for a certificate depicting the Egyptian Queen, Nefertiti, in a triangle (the previous logo) or the “A” symbol shown here. You can also verify membership by visiting this link: https://www.surgery.org/consumers/find-a-plastic-surgeon

Don’t forget about your anesthesiologist

Many plastic surgery practices use nurse anesthetists to administer anesthesia during procedures. Some plastic surgeons even do their own anesthesia.

You probably don’t want to mess with the person in charge of keeping you breathing during surgery. They should be board certified, too, by the American Board of Anesthesia.

Is your surgery center safe?

Where your surgery will be performed is also super important. Very few plastic surgeons operate out of hospitals these days; most operate at ambulatory (outpatient) surgery centers. There are shared ones or your surgeon may have their own facility. It’s always better to pick a surgeon who runs their own surgicenter. Hours, staffing, equipment and supplies are all dictated by the physician, instead of having to utilize a shared space and Joe Shmo as the surgical tech. There is more control and comfort knowing your doctor runs the entire show.

The surgicenter should also be accredited. It means the facility has stringent procedures in place for your safety during surgery – power outage, fire and flood protocols. Everything down to the chains used to secure the oxygen tanks needs to be up to code.

There are three surgicenter accreditation bodies that are generally accepted: the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), the Accreditation Association for Ambulatory Health Care (AAAHC), or the Joint Commission on Accreditation of Health Care Organizations (JCAHO). Make sure your doctor can produce a certificate proving their surgicenter is accredited by one of these.

The Intangibles

Once you know your doctor checks all of the measurable boxes, it’s up to you to evaluate the other stuff – the intangibles.

This is the stuff that can’t be defined on paper. It’s what’s beyond the acronyms after a name, the plaques and awards. It’s the feeling you get when you sit down to talk with your doctor – the spark that a Match.com algorithm can’t define.

Consider:

1. Is my doctor present?
• Assess this during your consultation. Is a majority of the time spent with the surgeon? Or did you get passed off quickly to an assistant? Did you feel important and heard? Plastic surgery is scary and stressful. You should be assured that your doctor will be available to you after your surgery any time day or night. And you should feel comfortable conversing with them.
2. What happens if there’s a complication?
• Shit happens. The big stuff is usually very rare, but what happens when the little things happen? A small dent after liposuction, a tummy tuck scar that’s too high, or a bit of unevenness after a breast aug? Who foots the bill for a revision?
3. Can you trust your doctor to do right by you? Anyone can fake it til you make it (Catch Me if You Can is based on a true story, you know).
• Read the reviews. Don’t treat them as gospel, but they should help you get a sense of the patient experience. Look for ones that mention complications or revisions in particular. There may not be many, but a positive review despite what could have been a negative result can speak volumes.
• Ask if you can talk to previous patients or chat one up in the waiting room.

The last piece of advice I’ll give is to remember that this is a situation in which you don’t know best. And I mean this in the nicest possible way – you’re not the expert. Your job is to communicate your aesthetic goals. The surgeon’s job is to tell you if and how they can be reached based on their knowledge, experience, expertise, etc. Trust me; you don’t want a doctor that just tells you what you want to hear. You want a doctor that is realistic and forthcoming, even if that sometimes means being told what you want isn’t possible. It’ll serve you far better in the long run.

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