Trust. It is the basis of why patients come to us as surgeons. This trust is undermined by putting self interest and political agendas before the interest of the patient. Many of the physicians answering this question are using fear and partial information to inspire fear rather than to inform. When physicians sling mud like politicians, the profession and more importantly, the patient suffers.
The question is “is it advisable to consider a facelift with an oculoplastic surgeon?” These colleagues quickly fired back with phrases about training and board certification without knowing anything about the Oculoplastic Surgeon in question. If one were to review malpractice cases and settlements, there would be no shortage of Board Certified Plastic Surgeons listed as defendants. Board Certification in any specialty means the doctor completed a residency and passed an examination. Board certification does not measure surgical skills, artistry, judgment and ethics.
As a practicing Oculofacial Plastic Surgeon in New York City for the past 15 years and as an instructor in Cosmetic Surgery, I would answer this question posed by this individual differently. “Is it advisable to consider a facelift with an oculoplastic surgeon?“ My answer is “It Depends”.
Cosmetic Surgery is not the exclusive domain of one specialty. Cosmetic Surgery is distinctly different from Plastic Surgery. Specialization and even super specialization has led to great advances in the disciplines of Cosmetic Surgery which everyone benefits from. One can argue that a 2 year hospital based residency (standard for Board certified Plastic Surgeons) with limited experience in Cosmetic Surgery is inadequate for the complexities and art of Cosmetic Surgery. This does not mean that the general Plastic Surgeon is not qualified to perform Cosmetic Surgery but rather like any surgeon, must focus on particular areas to achieve excellence.
The exposure during residency and fellowship varies between programs and when you think about it, no matter how many years of training a doctor has, it takes many years of practice before one becomes proficient in a specialty. What does it take to excel in Cosmetic Surgery? It takes a foundation of surgical experience combined with technical skills, aesthetic sense, judgment and ethics. Does one specialty have this combination exclusively? The answer is no. Physicians are individuals.
A local Board certified Plastic Surgeon who advertises heavily and performs high volume surgery has so many poor outcomes that he has a full time attorney to handle all the malpractice suits. I personally have revised many of his facelifts and eyelifts. Some facelifts were done so poorly that there was not enough skin for me to work with. Is it fair to now say that all Board certified Plastic Surgeons are just like him? No. On the other hand, I personally have witnessed excellent liposuction performed by Ob/Gyn doctors and excellent breast surgery by Ear, Nose & Throat doctors.
Why are these doctors exceptional at what they do? The answer is training, experience, technical skills and aesthetic/artistic vision and commitment to provide the highest level of care for their patients. Personally, as a facelift surgeon, I have been impressed by and learned much from 2 colleagues who do excellent facelift surgery who are Oral & Maxillofacial Surgeons (original specialty – dentistry). The greatest contribution to the field of liposuction surgery was made by Jeffrey Klein, M.D. – a dermatologist.
Performing facelifts for the past 15 years, I have kept up with new developments in the field and have seen facelift surgery being routinely performed by general plastic surgeons, dermatologists, oral/maxillofacial surgeons, otolaryngologists, and yes oculoplastic surgeons. Inter specialty rivalry generates endless accusations of who has more experience during training and who is more familiar with an area of the human anatomy. Once again, patients become confused and judge physicians negatively as self serving.
Based on the answers to this question in this forum, a board certified plastic surgeon who graduated 1 week ago from a 2 year residency is more qualified than an otolaryngologist specializing in facelift surgery for 20 years. The logic used here is flawed and inflammatory. In fact, by the logic used in this forum, Oculoplastic Surgeons are more qualified to perform eyelid surgery then any other specialty. I doubt if these colleagues would stop doing blepharoplasties (eyelifts) for the good of their patients and refer these surgeries to their local Oculoplastic Surgeon.
Unfortunately, it comes down to money. One specialty believing another specialty will “steal” their patients and therefore their right to revenue. It is only beneficial to the consumer to have choices and for specialists to compete in a healthy way to deliver safer and satisfying results to their patients. Inter specialty respect and sharing of knowledge ultimately benefits both patients and physicians. The American Academy of Cosmetic Surgery exemplifies this value.
The question remains, how do you as a prospective patient make a decision on who to choose for your facelift? Ask questions and judge each doctor on their own merit. Here is a simple list of questions:
1. Do you do facelifts?
2. How frequently do you do facelifts?
3. Can you show me your before and after photos?
4. Where do you perform your surgery?
5. Is your facility accredited?
6. May I speak to or meet someone who you have performed facelift on?
Although this list is not all inclusive and patients usually ask me at least 20 more questions during consultation, you should get the “vibe” from the doctor and the office staff about the quality of work being done there. Speak to the administrative and medical staff at the office. If you have any concerns or reservations, ask questions until you are satisfied.