Choosing a doc...what is most important?
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Doctor Answers 12
What is most important when selecting a surgeon?
Seeing samples of a surgeon's work is important in seeing their experience and their personal aesthetic style
This is an interesting question, and it is one that has frequently resulted in inter-specialty rivalry in our field. I can certainly give you some perspective on this issue, and I certainly do have my own personal bias, but first let me give you a little information about my background. I am a Board-certified cosmetic surgeon and a Fellowship-trained oculofacial plastic and reconstructive surgeon, practicing in Manhattan and Long Island for over 20 years. I was first trained in ophthalmology before pursuing specialized training in plastic surgery, and then eventually cosmetic oculofacial plastic and reconstructive surgery. I perform complex eyelid surgeries, including ptosis, eyelid retraction, and reconstructions, very frequently in my practice — almost every day of the week. I have also dealt with many complications from eyelid surgery and other cosmetic surgeries.
I think it is a very responsible thing to ask a doctor for before-and-after photos. With 20 years of experience and practice, I have certainly operated on a lot of eyes and a lot of complicated eye cases. When people come to my practice and don’t already know about me, I have albums upon albums of before-and-after pictures that are available for their perusal. This is mainly so they can look for people who look somewhat like themselves, and they can see the kind of results are possible, as well as the kind of style that I have, so before-and-after photos are very important.
It is important to point out that cosmetic surgery is different from plastic surgery. Cosmetic surgery is a unique specialty where the training is emphasized on cosmetic surgery alone. General plastic surgery is a two-year residency that covers everything from head to toe. Now, this is not necessarily relevant when a doctor has reached the level that your doctor has reached and they are Chief of Plastic Surgery or chief of a department at a hospital. However, I must say that in the past, I have also performed revision surgery on patients who had gone to the “best plastic surgeons” who were well-established in their field, and most of the time, I see there were opportunities for those procedures to be done slightly differently so the patient could get their desired result. There were also many situations where patients had quite advanced concerns.
Keep in mind that if a doctor performs the procedure extremely well and specializes in it, they are going to have better judgment and mastery of the procedure in comparison to those who don’t specialize, simply because they perform these procedures more frequently. This does not mean that oculoplastic surgeons are better than general surgeons, but rather that every doctor who did their residency, pursued specialization and Fellowship, has a special level of competency and expertise.
In addition, cosmetic surgery is an art, and each surgeon has their own signature style. What you want to look for is comfort with their personality, which you already have; and comfort with their style, which you yet have to establish. It is very important that you ask to see your doctor’s before-and-after photos, and I would assume that someone who has reached this level in his field would have volumes of before-and-after photos. Do not be afraid of offending your doctor, because asking questions is your right as a patient. Ask your doctor how frequently or regularly they perform eyelid surgery, and again, ask for examples of their work. You should not be made to feel like you should simply go along with how your doctor wants to do the procedure, because if eyelid surgery is only a small percentage of what they do in their practice, then I would doubt that they have the same level of expertise as someone who does it frequently, and this applies to any specialty, regardless of the procedure.
Open communication and full disclosure is vital. In my practice, for example, if I adopt new technology that I haven’t used for very long, I always make sure to tell my patients this technology is something new, and I will be using it for one of the first few times ever. This ensures that my patients make an informed decision and makes them feel more comfortable.
Meet with your doctor again, ask the questions you need to ask, and also request for before-and-after photos. I understand it can be hard to keep before-and-after photos updated, especially with the volume of surgery I do, however I try to do as many as I possibly can so I can give my patients updated samples of my work. If you are still not comfortable, then seek additional opinions from other doctors, and look into meeting with specialists in oculoplastic surgery as well, to see if you will be more comfortable there.
I hope that was helpful and I wish you the best of luck!
Beautiful results in Aesthetic surgery are a mixture of Science and Art !
Plastic surgery is a very difficult job when one wants to help patients to enjoy a better life.
But what about unrealistic demands from patients who dream about perfect results?
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With all that being said, you must see before & after pictures, bottom-line.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon
I think photos are very important
If they don't have pictures of anyone who is remotely like your eyelids or face, maybe they don't have experience with your kind of problem.
There are a few patients in my practice don't want their photos shared with other patients, but the vast majority do not mind, so if a doctor uses the privacy issue to explain why they don't have many pictures, I think that might suggest they don't have much experience with your kind of problem.. I have a digital picture frame showing before and after photos in the waiting room, and many patients will tell me they want their pictures to be featured there after their surgery.
By the way, the pictures should be taken with the same lighting before and after. Flash photos can erase shadows and hollows, and so the if the "before" pictures show shadows but the "after" photos do not, then the photos may not reflect the reality of the post-op results..
And of course feeling comfortable with and confident in your surgeon is another very important aspect of choosing a surgeon.
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The website has become a very important factor in deciding on a surgeon.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.