Should I Be Worried That my Plastic Surgeon Has Openings Only Three Weeks After my Consult?

I have been in private practice for 26 years, and have the privilege of owning and operating my own nationally-accredited (AAAASF) office surgical facility. I do only cosmetic surgery at this point in my career, though there were many years after I first started in private practice that I did ER patients, hand surgery, reconstructive surgery, and had privileges at as many as 11 Minneapolis area hospitals. I had an unbelievably long waiting list then, but not for the reason you might think--I was simply all over the metro driving to and from surgery and patient care, all of which takes time. Lots of it.

Now that I do only cosmetic cases in my own facility, I no longer take call, do ER or reconstructive surgeries, almost never go to the hospital (virtually 100% of my cases are outpatient), and I operate 5 days a week in my own facility. No drive time. No inpatient rounds. No emergency call.  NO WAITING. I never get "bumped" by an emergency C-section in MY facility, and never have an emergency trauma case that will cause me to reschedule an elective surgery. My waiting list ranges from 3-6 weeks, but there are surgeons half as busy as I am (we won't comment on skill or experience--that would be bragging) who have a waiting list 8 weeks or longer.

The reason for this is not that they are "busier" than me, it's that they do not have their own facility to operate out of, and have to share operating room time with many other surgeons and plastic surgeons (who do not have a busy enough practice to afford their own surgical facility). These surgeons may only be allowed to schedule 4 hours per week at one facility or hospital, and 6 hours at another one or two.

Other than my clinic hours (I see many patients between surgeries since I operate at the same place my patients come for their rechecks--my own facility), I operate about 40 hours (sometimes more) per week. The guys that just "seem" busy might be able to schedule half as much operating time, and they have to share at several facilities usually!

Go with whomever seems to offer what you are seeking in terms of education, experience, confidence, compassion and caring, good before and after photographs of his own patients (not always, believe it or not), and forget the so-called "waiting times." They may be only what the doctor says rather than reality. After all, no one wants to be seen in a doctor's office that has an empty waiting room and no waiting list for surgery--that's why the answer is always something that implies "WOW, busy!" (Must be good, right?).

If you're seeing an ENT (facial plastic surgeon), make sure that you're having facial surgery. If you're having breast or body surgery, you should see an American Board of Plastic Surgery-certified plastic surgeon who has training and skill in cosmetic surgery of the entire body.

Rest easy and go with your gut here. Best wishes! Dr. Tholen

Hello! Thank you for your question.  Cost will vary among plastic surgeons as well as with geographic location and what procedures exactly they will be providing to you.  Certainly, researching a board certified plastic surgeon well-versed in the procedure(s) you desire is recommended - checking the American Board of Plastic Surgery is a great start. Consult with two or more surgeons who you are happy with their postoperative photographs and those who you, most importantly, feel comfortable and confident with. Use the opportunity to ask questions as well as visit with staff and investigate the accredited facilities they work out of.  I believe fellowship-training, beyond the core plastic surgery residency to be important, as that surgeon has gone above and beyond to seek additional training specific to that area of interest and chosen to gain additional expertise in that area.    Experience should not be measured solely by the age of the surgeon or how many years s/he has been in practice.  Checking the education and training is more valuable - a Board Certified MD plastic surgeon who was accepted to and completed an integrated plastic surgery residency, in today's day and age, are excellent choices. Those are the top students who have superior training at top institutes.  Plastic Surgery is NOT a fellowship...it is a residency. Those surgeons who have actually successfully completed additional fellowship training beyond the plastic surgery residency are also passionate about that area and will likely have the most recent, innovative, and up to date techniques. These are usually the younger surgeons, who are still readily willing and competent to continue to strive for the newest material and remain up to date on literature and conferences. You must decide for yourself who you are most comfortable with and confident with who will meet your goals and expectations. Cost may differ just on expertise and the aforementioned additional training ad what that additional expertise training has afforded to his/her patients.  Hope that this helps!  Best wishes!

You can't judge a surgeon on the availability of surgical time. In my practice we always try to work with the patient and get a surgery scheduled when it is convenient for the patient. I know some surgeons who only operate a few days a week and this gives the impression that they have a long wait time. 

Hi Fly,

Some patients may base their choice of plastic surgeon decision on the surgeons "wait", others may base it on the surgeons fee.  Studies have shown that patients think that the more they pay, the better the surgeon, and that the longer they have to wait for surgery, the better the surgeon.  I would not base my choice of surgeon on either of these factors.  If you like everything about your surgeon, go with him.    By the way, I have a 6 month waiting period and am the most expensive surgeon in town....just kidding!  Good luck and be well.

Dr. P

     There are other factors to consider here.  For instance, I performed 1200 surgeries last year.  Most of these were two or more procedures at once.  Therefore, I performed a total of about 2300 operations.  However, I have ability to operate in two operating rooms five times a week.  Therefore, I can squeeze patients into the schedule within a week or so.   Kenneth Hughes, MD Los Angeles, CA

 The amount of weight time  from consultation time  to surgery time has nothing to do with quality of the surgeon, or the work being performed. Many surgeons have inefficiencies  in their surgery schedule, clinic schedule and there are also many patients who book their surgery 3-4 and 6 months out. 

Booking surgery timeframe shoudl have no impact on your decision. Best to go with surgeon you feel most comfortable with.

You should chose a plastic surgeon by his credentials as well as experience and if you feel comfortable with him and what he says. Also, look at his results but this also depends on the patients themselves.

Booking time for surgery depends on several factors and has nothing to do with the quality of surgeon.  Issues that affect scheduling are:

1. Length of the surgery.  For example, a one hour or less case can be put on the schedule much easier and sooner than a several hour facelift. 

2. How hard the surgeon wants to work

3. Vacation schedule of the surgeon

4. Marketing ie) giving the illusion of being busy

5. Cancellations.  For example, if a 4 hour case reschedules for another date, a "hole" opens in the schedule that allows for some cases to get on quickly

6. Compassion.  Sometimes a patients "story" may move the surgeon to readjust the schedule to allow the case to be done sooner.

Best wishes

Go with the surgeon with whom you are the most comfortable. The best looking office, website, surgeon, etc. does not necessarily mean you'll get the best results. Lots of good results as seen in the surgeons before and after photos are important. The standard answer to the question about consult to operative time is "8 weeks." It give the prospective patients the illusion that the practice is "busy."