Ten Tips for Patients Considering Aesthetic Plastic Surgery

Originally published by West Coast Magazine

In this online feature for West Coast Magazine, board-certified plastic surgeon Dr. Robert Cohen uses his years of experience to provide his top 10 tips to help patients choose a physician. Learn which credentials to check and what to ask during a consultation.

January 11, 2016 — By Dr. Robert Cohen

Choosing to have aesthetic (cosmetic) plastic surgery can be a stressful process for patients because there is so much information available at our fingertips, and often it is hard to know where to start, which information to believe, and what to expect with the surgical process. As a board certified plastic surgeon that performs hundreds of aesthetic surgeries each year, I would like to provide ten tips for patients considering aesthetic plastic surgery.

  • Use the internet to your advantage. The internet can be a very powerful tool in your search for the best plastic surgeon for you, since almost every plastic surgeon has a website. It's great if you have a friend that gives you a referral, but it's still important to do your own research.
  • Check on board certification. The most important first step is to make sure that your surgeon is certified by the American Board of Plastic Surgery. This is the only board recognized by the American Board of Medical Specialties (ABMS) and shows that the surgeon had proper training in plastic surgery and has passed a rigorous set of exams to demonstrate that they are well-trained and safe. Don't be fooled by similar sounding boards like the American Board of Cosmetic Surgery. These boards are not recognized by the ABMS, and do not require actual plastic surgery residency training.
  • Check on society membership. Knowing your plastic surgeon is a member of the American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS) shows another level of professional and peer recognition, and ensures that your surgeon is considered ethical and qualified to do your surgery.
  • Look at your surgeons CV (resume). This should be on their website and will show which schools they attended, awards they have received, academic contributions they have made, and which hospitals have given them privileges. Even though most surgeons perform aesthetic surgery in an outpatient setting, every board certified plastic surgeon is also required to have hospital privileges. If they do not, that should be a major red flag.
  • Check the photos in the surgeon's gallery. You should be able to view a wide variety of case examples the surgeon has performed to get an idea of their skill level, what their area of subspecialty is, and their aesthetic style. If you don't generally like a surgeon's results, you should look at someone else. Do keep in mind that surgical outcomes are also dependent on where a patient started, so patients with more favorable anatomy before surgery often get better results after surgery. In general, you should at least see a nice improvement with each before and after photo.
  • Meet in person with a few surgeons. Even if you love what you see online, you will be entering into a doctor-patient relationship, and if your personality does not click with your surgeon, this may lead to problems in the future. At the very least, your surgeon should be friendly, attentive, and a good communicator. If you have a bad feeling after your consult, consider seeing another surgeon. Also, there is often no "right answer" in aesthetic surgery, so you may be offered a few different approaches by different surgeons that you can choose between.
  • Beware of bargain hunting. As a surgeon that performs revision surgery on a weekly basis and teaches courses on this topic nationally and internationally, I can say with authority that it is a lot easier and more cost effective to have a surgery done right up front, than to fix a problem after problems occur. Even the best surgeons in the world have complications, but low cost often means that quality or corners are being cut somewhere. You only get one body, so treat it properly and look for safety and quality with your surgery. Groupons are great for restaurants, but probably not the best idea with surgery…
  • Express yourself (and be a good listener too). Once you have found the right surgeon for you, make sure you express what you are looking for in detail, and make sure you and your surgeon are on the same page. Sometimes patients have unrealistic expectations for what they want, and it is the surgeon's job to help align your expectations with what is realistically possible. Be careful of a surgeon that glosses over possible issues or complications. On the other hand, as a patient, you need to listen carefully to what the surgeon thinks he or she can accomplish. Keep in mind, most surgeons work very hard to get the best results possible, but there are certain things we have limited control over (for example, skin elasticity, bony asymmetry, gravity, etc.) Try to remember that working on people is different than working with wood or steel; people have natural genetic variation, there are various biological processes at work after surgery, and skin and soft tissues stretch and change over time, making long term results less predictable.
  • Once you have decided to have surgery, maximize your chances for success. Complications can occur with any surgery, but there are things we can do to help that. Make sure you stay in good shape and eat a healthy diet. If you are overdue for a checkup by your primary care doctor, go for a general health check before surgery. Make sure you are not smoking cigarettes or using recreational drugs for at least 4-6 weeks before and after surgery. Try to avoid alcohol for a few weeks around the time of surgery. Also, make sure to follow your surgeon's instructions closely. The guidelines we provide after surgery are to protect your health and safety. For example, there will usually be a period after surgery where we advise you to avoid exercise. If this kind of instruction is ignored, it is possible to damage your surgical results.
  • Communicate with your surgeon. If you have a concern or issue after surgery, call your surgeon's office and let them know. Getting phone calls from patients is part of our job, and knowing if something is not quite right can help us correct things as efficiently as possible. Just like with any other kind of relationship, having a good line of communication is very important to a surgeon-patient relationship. Not every surgery is perfect, but with good rapport, most situations can be worked out in a way that is beneficial for everyone.

I hope these tips were helpful in getting you started with the possible process of having elective surgery. I wish anyone considering this type of surgery the best of luck. For most patients, aesthetic surgery can be a source of great happiness and improved well-being!


Dr. Robert Cohen

Certified by the American Board of Plastic Surgery

Dr. Cohen is a leader in the field of aesthetic plastic surgery whose expertise is highly regarded by both patients interested in improving their appearance, and plastic surgeons seeking to improve their techniques by attending his lectures. Dr. Cohen's goal is to understand your specific concerns, evaluate your anatomy in detail, and create a customized plan to help you achieve the best results possible based on the most modern techniques and materials available. Let him put his experience and aesthetic insight to work for you.

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