Doctors and beauty machines; which is more important?

George Commons, MD

Article by
Palo Alto Plastic Surgeon

     I find it interesting to find so many questions about which liposuction assist technology is better or worse asked on this site.  The technology used is such an unimportant question.  It should be far down your list, if on the list at all.  What you are looking for is a smart surgeon.  Great surgeons can get great results with any technology or with no technology assist at all.   Remember that with any technology assist, the workhorse is always small cannula tumescent liposuction and 80% of all liposuction procedures  is small cannula work and not  technology.   Worldwide 90% of all liposuction is small cannula tumescent technique with many beautiful results and no technology assist at all.   What you should be hunting for is a great surgeon.   Yet, I see the many questions about which technology and so forth is best.  This is a result of massive marketing by the companies that make the machines.   The companies spend millions to attract doctors to buy the machines and   the technology companies advertise for patients to have the procedure. So finally the doctor buys the machine, but in many cases the machine is insignificant, for what the doctor really buys (and doctors know this very well) is a massive patient marketing and referral system.   So the companies spend millions advertising to doctors and  even more to patients,  the doctors pay as much as $400,000.00 for these machines,  and get  possibly a $15,000 machine and a $385,000.00 patient marketing system formulated by the technology company.  And then on top of this the doctors often spend even more dollars marketing the new miracle machine they just purchased. (Remember every month the doctor must pay  $6000 to $8000 lease payments for the machine).  And the patients pays for 100% of this nonsense.  The ads announce with fanfare, come to our office and meet our new miracle technology trinket.  Our machine will do your liposuction in just a few pain free minutes minutes  and make you  a couple of cups of coffee during your procedure etc etc..absurd.  Anyway you get the idea.  Its all a bunch of hype.  The machines work a little but no doctor  needs any machine of high technology to do a great liposuction.   These machines are most often bought for their marketing value and the marketing obviously works and that is why there are SO MANY QUESTIONS on this web site about which technology is better.   The advertisers are getting to you.  Don't fall for hype and slick marketing.  Just say no and do your own thinking.  Do you really want technology companies and slick marketing to do you thought formation.  Think.  Please think.

     So I hope I have at least seeded your brain with the idea that it is a great doctor that counts and not some silly machine that is not needed for great results.  Great doctors get great results with any technology assist and with no technology assist at all.  How do you find a great doctor?  First understand liposuction is a surgical procedure and for surgical procedures you must go to a surgeon.   A surgeon is a person that has gone through 8 to 10 years of intense  surgical training at Stanford or UCSF or similar fine institutions, passed a surgical board, and becomes a Fellow of the American College of Surgeons.    This is the first question to ask any doctor.  Are you a fully trained surgeon, certified as a Fellow of the American College of Surgeons.  This doctor can  then put FACS after his or her name.  If the doctor is not FACS, go elsewhere.  Your search is for a fully trained surgeon that is great and skilled and a FACS Fellow.   Do not  EVER  have surgery by a non surgeon.  Do not be bamboozled.  Get the answer....is the doctor FACS.   I see so much  awful surgery done on poor patients by non surgeons often for very high fees.  Use you head.  Use commons sense.   Question number 2 is ask the doctor that in addition to FACS, is he or she certified as a fully trained surgeon by the American Board of Plastic Surgery.   This question is so very vital.  You want a surgeon with FACS, but not just any surgeon, you want a Plastic Surgeon correct?   Of course.    So now you have the big two questions, but there is a third and last which will start you on you safe journey.   I am not giving you ten questions, but just three.   The third question is to ask and obtain an absolute  written guarantee that the operation you are having at the doctors surgery center, he or she can also do in a hospital.  Doctor, do you have privileges to admit and do my surgery at a local major JCHS Hospital.  Hospital peer reviews doctors and  this almost guarantees a doctor is up to snuff.  Besides if the doctor has no hospital admitting privileges,  where is the doctor going to admit you if you have a complication?  Those 3 question will get you on a safe path.  There are other questions and I will discuss them  later, but these three are the beginning of a safe journey.   Doctor.......are you FACS,  are you boarded by the American Board of Plastic Surgery, and doctor do you have major hospital admitting and operating privileges?   Ask these question and demand answers.  Pick 3 doctors that meet these criteria and schedule consults.   The best doctors often do not charge for consults.  The best doctors do their own consultations.   The best doctors do not use a marketing person to do their consultations. Be a smart consumer.  Do not be a victim of endless slick marketing.  Call the American Society of Plastic Surgery or go through the internet  and get  the names of 3 doctors in your area.  If you don't like them, get 3 more.  This takes your time and your work.  Don't fail yourself.  Your surgical results and your very life are at stake.  More to follow about other questions, about artistry, and  about safety in future discussions.    My Best,   Dr C