Plastic Surgery: How to Make the Big Decision

There are three important questions to answer before undergoing cosmetic surgery: Is it right for me? How do I find a competent surgeon? Is the surgical facility properly equipped for safety?

To help figure out if plastic surgery is a reasonable option for you, take a hard look at yourself and determine if your goals are realistic. Plastic surgery can do many wonderful things, but there are limits.

Contrary to the Hollywood myth, it cannot take the face you see in the mirror and turn it into a Marilyn Monroe or an Elizabeth Taylor. Nor can it transform someone who is 50 pounds overweight into a Baywatch hard body. What it can do is improve many, but not all, of nature's imperfections.

And make sure the motivation for the surgery is based on how you feel about yourself. Don't go through surgery for the wrong reasons, such as to keep a spouse from roving or to satisfy someone else's desires.

No one else can see what you see when you look in the mirror and most friends and loved ones cannot understand why you would go through surgery when they love you the way you are. Contrary to popular belief, most successful plastic surgery is done in spite of social pressures, not because of them.

Choosing a Doctor and Hospital

Now that you have made the choice to have surgery, how do you find a competent surgeon? Even the world's best surgeons can have complications or poor results, but the odds for success are much better with a well-trained and properly credentialed surgeon.

There are many sources for locating a plastic surgeon including advertisements, the yellow pages, television and radio appearances, Web sites and referral services. While many excellent surgeons use these services to attract and inform patients, they are all unregulated so the message is whatever the surgeon pays for.

Don't depend upon these sources alone, but check with the agencies listed below. Also, your family doctor should know the medical community and be able to make recommendations and/or obtain information about the plastic surgeon's reputation.

The gold standard for surgeon credentials is certification by a specialty board that is a member of The American Board of Medical Specialties (ABMS). A board-certified surgeon has gone through extensive, well-regulated and monitored training, and has passed a set of rigorous examinations.

There are many so-called "Boards" that are inventions of less-well-trained doctors in which the training is neither regulated nor monitored. These pseudo boards are not recognized by the ABMS. Don't be shy about asking your doctor if he is board certified. He/she will be proud of the credentials that she/he worked so hard for, and many hang their certificate on the wall of their office.

The main guardian of patient protection from incompetence is the hospital with which your doctor is affiliated. As many plastic surgery procedures are done in a surgical center or a well-equipped office surgery, check to see if the surgeon that you choose also has privileges to perform the same surgery in a hospital.

And finally, be sure that the operating facility is certified by one of three or four certifying organizations to be sure that it meets all safety standards. The two major accrediting bodies are the American Association for Accreditation for Surgical Facilities, and the American Association for Accrediting Health Care. Surgical facilities are supposed to post their certificate on a public wall.

Garry S. Brody MD is a professor of plastic surgery at the University of Southern California.

For more help locating a Board-certified plastic surgeon, contact the American Society of Plastic Surgeons at www.plasticsurgery.org , or the American Board of Medical Specialists at www.abms.org

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