There are many variables that contribute to surgical fees: the extent of the procedure, the type of implant, geographic location of the surgical practice, the credentials and level of training of the surgeon, his or her expertise and reputation, the fee for the anesthesia provider, and facility charge (the facility should be accredited by a national accrediting organization like the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF)). It is important to compare “apples to apples”. You should find the most qualified individual to perform a surgical procedure, not the least expensive. Your health and safety depend on it. If your selection of a surgeon is determined primarily by high or low fees, ultimately, you may be disappointed with your choice. Shopping for bargains should be saved for sandals and t-shirts not procedures that require scientific knowledge, training, judgment, artistry and expertise. I would suggest that you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person. Robert Singer, MD FACS La Jolla, California