Victoria Cross, a 57-year-old from Montgomery Village, Maryland, considers her breast reduction the best thing she’s ever done for herself. “When I woke up from the surgery and sat up, it was the first time in a very long time that I didn’t feel any pulling in my chest and my shoulders weren’t hurting,” she tells SELF. Cross, who had the procedure at the age of 45, was a D cup in high school and a G cup by the time she had her surgery. Now she’s a proud C cup and has never looked back.
But one of the reasons she waited until her 40s for the procedure was because of the difficulties involved in finding the right surgeon for the job. “Part of the reason for the length was convincing some of the offices that I wanted to ‘interview’ the doctor,” she explains. In other words, she wasn’t willing to sign the paperwork and meet her handler while she was lying on the operating table. This, experts agree, is a very important part of the process, and one that shouldn’t be ignored.
The number of women and men having plastic surgery is on the rise, with over 17.1 million cosmetic procedures taking place in the year 2016 alone, which means more and more people are trying to get into the aesthetics game. But you have to be careful about choosing the right professional to do the job. As plastic surgery attracts a growing base of eager patients, a number of unqualified physicians and even non-physicians are jumping on the cosmetic bandwagon, donning white lab coats and all. In addition to meeting the surgeon in person, it’s also strongly encouraged to check their background to make sure they’re certified to handle the exact procedure you’re looking to have.
To help you select a qualified, skilled, vetted, and pleasant-to-be-around plastic surgeon, we talked with experts and former patients who know the industry’s ins and outs. Here’s what they suggest you do.
1. Talk to friends, family members, and acquaintances who’ve had work done to get recommendations.
First, consider those close to you. Has anyone had work done? If you’re comfortable, reach out to him or her for advice. “A trusted friend or family member can give you an honest rundown of the entire process, from the consultation with the doctor and the surgery itself to the recovery process,” says Alyssa R. Golas, M.D., plastic surgeon at NYU Langone Health in New York City.
Don’t know anyone personally? Ask around for a connection. Start with any friends or acquaintances who may work in health care, for example a nurse, nurse practitioner, or physician assistant. “Other healthcare professionals know who the best surgeons are and are very open to making recommendations,” Robert Grant, M.D., F.A.C.S., chief of the combined divisions of plastic surgery at New York-Presbyterian Hospital-Columbia University Medical Center and New York-Presbyterian Hospital-Weill Cornell Medical Center, tells SELF.
2. Do your homework by reading up on reviews of surgeons in your area.
As one does this day in age, Issy Ryan, 38, of New York City, took to the Internet before settling on a surgeon to carry out her liposuction procedure. “For me knowledge is power, so I read review after review to get a sense of previous patients’ experiences and help me get to know a little bit about how each surgeon ‘operated,’ both in and out of the operating room,” she tells SELF.
Kristina Maury, 32, of Los Angeles, joined online plastic surgery and breast augmentation forums, but also relied on social media to help her find a suitable surgeon to do her breast augmentation. “Most people don’t know this, but there’s a ‘secret’ group of thousands of women on Instagram who create pages dedicated to breast augmentations and other types of plastic surgery,” she tells SELF. “That was incredibly helpful because I got to see women document their experience from the research phase all the way to a year after surgery.” This social media community not only helped Maury know what to expect, but it also helped her narrow her options.
3. Make sure to view everything on the Internet with a healthy dose of skepticism.
Golas says that while reviews on Yelp and RealSelf.com, and the social media pages of patients can be great resources, they can also be a source of misinformation. “Anonymous reviews (especially negative ones) may be used by a patient to seek revenge or advance his or her own agenda instead of as a way of sharing knowledge and personal experience with other potential patients,” she says.
In the same vein, be careful when considering “before and after” photos. Most doctors will showcase these pictures on their website or will send examples at a patient’s request. Golas warns that not all surgeons display their work honestly. “When looking at ‘before and after’ pictures, make sure the makeup, as well as the lighting and shadows, are the same in both pictures,” she says. “Manipulating these factors to improve the appearance of ‘after’ pictures is a simple commonly used trick.”
It’s also smart to watch out for doctors who appear to rely too heavily on advertising. If their page continues to pop up on everything from your Facebook feed to your local billboard, it could be a red flag rather than a good sign. “Remember that the primary task of a good doctor should be to care for his or her patients, not to accumulate the greatest number of followers or clicks in self-promotion,” says Grant.
4. Check the qualifications of each of your candidates.
Found a few options? Great. Before coming face-to-face with them, make sure they check off all of the important boxes that tell you they’re completely qualified to perform your desired procedure. “Doctors call themselves ‘cosmetic surgeon,’ ‘aesthetic surgeon,’ or ‘aesthetic medicine specialist,’ all of which are not plastic surgeons,” explains David Shafer, M.D., cosmetic and plastic surgeon and founder of Shafer Plastic Surgery in New York City.
These practitioners may be able to handle “non-invasive” procedures, such as the injectables of the world (Botox, Juvéderm®, etc.), laser treatments, chemical peels, or dermabrasions. “It varies by treatment, but most non-invasive procedures can be performed by non-MDs such as physician assistants, nurse practitioners, registered nurses, or even aestheticians under the ‘supervision’ of a doctor,” explains Golas. Just how much supervision these providers actually get varies widely. “Keep in mind that ‘non-invasive’ doesn’t mean 100 percent safe. These procedures can have side effects and it is best to be under the care of an experienced physician who can recognize and manage problems if they occur.”
You’ll want to ensure that your chosen candidates are well trained in your area of concern. “Some doctors from other specialties also perform cosmetic surgery procedures or treatments, but do not have standardized or comprehensive training in these areas,” says Shafer. Examples of this include an ob/gyn who performs liposuction or family physician who is injecting Botox. If your specific surgery is niche, and something only a handful of doctors in your region of the country perform, Julius Few, M.D., a plastic surgeon, commissioner of cosmetic medicine for the American Society for Aesthetic Plastic Surgery and founder of The Few Institute, recommends considering someone who was involved in the invention or development of that procedure.
If you’re seeking a surgical procedure—from minimizing a scar to liposuction, or a breast reconstruction—it’s imperative that you find a plastic surgeon who is certified by the American Board of Plastic Surgery (ABPS). The ABPS’s website has an online database and a search engine that lets you look up whether or not the doctor you’re considering is board-certified for plastic surgery. “The ABPS’s membership prerequisites are strict and include training and board certification requirements, so all members are vetted to perform both reconstructive and cosmetic surgery,” says Golas.
Pay attention to the details; the ABPS isn’t the only board out there, but it’s the one you should trust. “There are many different types of surgeons and non-surgeons today who are doing cosmetic procedures, and many different boards that ‘certify’ training, so the public is often confused and misled,” explains Theda Kontis, M.D., facial plastic and reconstructive surgeon in Baltimore, Maryland.
5. Ask if your plastic surgeon is affiliated with a hospital.
Whether or not the doctors you’re considering have hospital privileges is another qualification box you’ll want to check off. “If the cosmetic surgeon only does surgery at his or her office and doesn’t have hospital privileges to perform the surgery you are considering, that is a huge red flag,” says Anthony Youn, M.D., F.A.C.S., holistic facial plastic surgeon and owner of Youn Plastic Surgery, PLLC, in Troy, Michigan.
This was an important factor for Ryan when it came to making her decision. “Although I understood that the surgical procedure I wanted was, in fact, routine and safe, I wanted to go into surgery feeling comfortable that if something were to happen medically, my surgeon had access to a hospital facility that would address any possible complications,” she says.
6. Come to each consultation prepared and ready to ask questions.
Just like you would for a job interview, it’s important to come prepared with a list of questions to ask your surgeon while you’re face-to-face. “Take this very seriously in the same way you would seek out care for a significant medical condition and you will be successful,” says Fred Fedok, M.D., F.A.C.S., facial plastic surgeon and president of the American Academy of Facial Plastic and Reconstructive Surgery. “At the end of the process, you want to make sure you and your surgeon are on the same page and have communicated your wants and wishes.”
This is a good chance to see photos of the doctor’s past work, and find out whether they’re experienced in the procedure you want to have done. It also gives you the opportunity to express your wishes and goals and get a feel for whether they understand and can deliver the results you want.
It’s also a good time to clarify costs. “Surgeries can have a surgeon’s fee, an anesthesiologist fee, and an operating room or facility fee,” explains Shafer. “Make sure all the fees are discussed before surgery so there are no surprises.”
Sometimes you can get financing or procedure incentives. “For instance, the Botox company Allergan, offers a complimentary treatment of Botox with any breast augmentation using their implants,” says Shafer. Most treatments have a set price but also have package prices for more than one treatment. But remember that plastic surgery is not something you can get for cheap. Fair, but not cheap, pricing is another mark of a good plastic surgeon. “Cosmetic surgery is not something you can buy on Amazon or a Groupon, and when you make those decisions, you often have to pay for revisions, which make it much more expensive in the end,” says Kirk Brandow, M.D., F.A.A.C.S., plastic surgeon and founder and director of the Brandow Clinic for Cosmetic Surgery in New Jersey and Pennsylvania.
7. Keep in mind you want a surgeon who is polite and helpful as well as skilled with the knife.
While you’re asking questions, be wary of red flags. An obvious, but important, one is a surgeon’s bedside manner. “If a surgeon seems routinely rushed, pressures you to undergo a particular operation, balks at you seeking additional opinions or delegates most of the care after the procedure to others, beware,” warns Grant.
Cross agrees, noting that her doctor’s bedside manner was a big reason she chose him for her breast reduction. “When the doctor came into the office, he immediately commiserated with me and my situation. He asked me a lot of questions and told me exactly what was involved, recovery time, possible risks, etc. He showed me a portfolio of his work, gave me a packet of information, and told me I had to think about everything the surgery entailed for a month before I could come in for the official consultation and talk about scheduling the surgery.”
Another red flag is a surgeon not discussing realistic outcomes, including both pros and cons of the procedure. “There is no such thing as a procedure without positives and potential negatives,” says Few. “If the surgeon feels more like a used car salesperson than a doctor, that’s a major warning and typically something that gives an instinctive response to go elsewhere.”
Maury was relieved when her doctor gave her his honest perspective for her surgical outcomes. “He assured me that saline implants would not look like balls on my chest, but he did inform me of the pros and cons of both saline and silicone,” she said. “Still, he left the decision up to me.”
8. Make sure the office is spotless and the staff is friendly.
You want to feel comfortable where you’ll be having the procedure. “A patient does not want to end up in a situation where they feel neglected, taken advantage of, or ignored,” adds Shafer. Whether it’s a small center or a giant hospital, you shouldn’t feel tense or anxious as a result of the smell, look of the place, or the personality of the staff.
Above all it should be clean. “If you are going to someone’s living room, basement, or chair in a nail salon then you likely are not being seen by a certified and qualified plastic surgeon,” Shafer warns. Since the medical facility was onsite in Ryan’s surgeon’s office, the most important factor for her liposuction was that the operating room. “It passed the sniff test of being super clean and sterile, so I was sold. In the end, I would say it was equally as important as choosing the surgeon himself.”
9. Listen to your gut and take your time.
If you feel uncomfortable, even if you can’t seem to pinpoint exactly why, don’t follow through with that office, that doctor or, perhaps, that procedure.
The relationship you have with your plastic surgeon is a private and personal one. It takes the right kind of connection and fuse of personalities to create the right match. For this reason, experts and patients agree that taking your time is key. “This is a person who you will be sharing your concerns with—some that you may not even share with your spouse or partner,” says Few.
Once Cross decided to move forward with her procedure, it took her about three months to find the right doctor. “I had narrowed down my list to three candidates, but since they were all highly recommended it was difficult to get an appointment.”
It took Ryan only four weeks to find her plastic surgeon, but she says she knows that quick timeframe isn’t average. “I knew I wanted to have the procedure as soon as possible, but I promised myself that if I didn’t find the right surgeon right away, I would continue looking,” she says. “It ended up taking much less time than I thought.” She connected with a surgeon who listened and respected her specific aesthetic goals and could answer her medical questions thoroughly and thoughtfully, which completely ensured that she was comfortable moving forward. “I truly appreciated my surgeon taking the extra time to answer my questions and the hands-on approach of responding to my correspondence between my consultation, procedure, and postoperatively,” she says. “This is a relationship after all, so I wanted it to be as professional as possible without losing that human touch.”
