How Do I Find the Best Doctor for a Neck/face/lift?

To be honest, the best way to find a great surgeon is by word of mouth, either by people that you know who have had surgery with a specific doctor, or comments you read online, etc.  Advertising tells you nothing - any surgeon can advertise that the were voted the best surgeon of the century, etc., but the trick is that most of those types of things are paid accomplishements if you will.  Pay for advertising in a certain magazine, and more likely than not, they will name you as a top doctor for that area, etc.  You definetly want to go to a board certified plastic surgeon, not a facial plastic surgeon, or a "cosmetic surgeon."  It is easy to check - just go to the American Board of Plastic Surgery ( abplsurg.org) and look up their name. They are the only real board certifying organziation for plastic surgery.  You also want to go on a few consults and really get a feel for not only the doctor's skill, but also how well you interact with them.  This is someone that you are going to be dealing with on a long term basis, and seeing pretty often.  You want to be comfortable with that person as much as possible.  I hope this helps.

Finding the right surgeon can be a challenge whether you live in a small town or s major city.  Fortunstely with the internet more information is available than ever before, including credentials, photos, and certification.  The best way toFind a good doctor is to ask people you know who are knowledgeable, a friend or relative who has been through the procedure, a nurse or anesthetist who works with plastic surgeons on a daily basis.  Don't be afraid to ask a lot of questions and always maintain a healthy sense of skepticism if something sounds too good.  There is no magic in plastic surgery.

The key element in choosing a Facelift
surgeon is someone
who is a true expert. An expert is one who is Experienced and performs facelifts frequently
at least 2-3 times a week, has Expertise
and has written
and teaches others about
facelift procedures, and one who can show you Excellent results. Choose a doctor that is a Board Certified
Plastic Surgeon, is member of the American Society of Plastic Surgeons or American Society
of Aesthetic Plastic Surgery and therefore, operates in a fully accredited operating
facility. #drrodrohrich#plasticsurgery#facialrejuvenation

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!

The most critical decision to be made in achieving the best facelift plastic surgical result is picking the most experienced and talented, that is the best, plastic surgeon possible. Too often, patients choose a physician based on a catchy ad, the brand name of a technique, the basis of one or two before and after photos, or their web site’s search engine ranking. These criteria will not find the most experienced and talented plastic surgeon.

My Background

Dr. Larry Nichter
I have been a practicing facelift plastic surgeon for more than 25 years, having trained scores of plastic surgeons as a tenured professor of plastic surgery at USC, and I have had a private practice in Orange County since 1993. Speaking from all this experience, here is my advice and the criteria I would use to find the best plastic surgeon in Orange County, Los Angeles, California, or anywhere in the United States. These are the criteria I would use to select a plastic surgeon for my friends, my family, or myself.

First, I want to stress some general observations I have found to be true over the years.

Caveat Emptor: Buyer Beware
The longer a surgeon trains at his craft, the finer his skills and the better his judgment become. Board certification in Plastic Surgery (see below) is a bare minimum. Board certification in an additional surgical field recognized by the American Board of Medical Specialties, or for that matter “triple-board certified,” attests to a doctor’s advanced training and skill and judgment. It also means that they have attained Chief Resident Status in more than one field during their training which means they essentially ran a large departmental service and had senior decision-making and independent operating responsibilities. It is this step that is most maturing for a surgeon.

The institution where the surgeon trained is also important. More renowned schools usually attract the best faculty.

You can use the internet to research the background of a prospective plastic surgeon quickly. Please do this prior to making an appointment. “Just because you wear a baseball cap it doesn’t mean you are a good ball player.” The same applies to anyone wearing a white coat—it doesn’t make you a plastic surgeon, much less a great one.

Caveat Emptor in Latin means “Buyer Beware.” In most states, including California, any physician with a medical school diploma and state license is viewed as a doctor and a surgeon—even without any formal surgical training. In some cases even doctors who have completed only the minimal requirements (medical school, licensing examination, and a one-year internship that need not include surgical training) are touting themselves as “cosmetic surgical experts.” They make these claims of expertise despite the fact that they are only formally trained as family practitioners, OB/Gyns, emergency physicians, dermatologists, or ear-nose-throat specialists. Even physician assistants and nurses have made such claims.

7-Step Process for Finding the Best Plastic Surgeon
The following are my screening guidelines and criteria for picking the best plastic/cosmetic surgeon.

1. Board Certified Plastic Surgeon by the American Board of Plastic Surgery
The American Board of Plastic Surgery is the only certifying board in Plastic Surgery that is a member of the American Board of Medical Specialties. Use these links to look up a prospective surgeon’s status.

To become a plastic surgeon certified by the American Board of Plastic Surgery requires a minimum of five years of surgical training with a minimum of two years of training specifically in plastic surgery. Then the applicant must also pass a comprehensive written board exam. If successful, the candidate must present his/her clinical cases for critical review by board examiners (I was one such board examiner) and if accepted will take a series of oral examinations.

Since the 1990s, the American Board of Plastic Surgery Certification is only valid for ten years. To retain your board certified status, a plastic surgeon must complete a Maintenance of Certification including written testing and case review. This means that all who pass are trained and experienced in all plastic surgery procedures including facial procedures, breast, and body; essentially all cosmetic and reconstructive procedures.

If a Plastic Surgeon is additionally board certified by another surgical specialty recognized the American Board of Medical Specialties, then this also marks additional expertise and training at the highest level. The American Board of Facial Plastic Surgery (ABFRS) is not a licensing body nor an educational institution and the certificates it issues are not legal licenses to practice facial plastic and reconstructive surgery. The ABFRS is not recognized by the American Board of Medical Specialties (although it does note additional specialty training/interest in facial aesthetic surgery).

Likewise, beware of physicians armed only with certification from other non-ABMS recognized boards or special society memberships other than those I have recommended (eg. “Cosmetic Surgery Board,” “Lipoplasty Society of North America,” etc.).

2. Fellow of the American College of Surgeons: FACS
The American College of Surgeons is dedicated to improving the care of the patient and to safeguarding standards of care in an optimal and ethical practice environment. Members of the American College of Surgeons are referred to as “Fellows.” The letters FACS (Fellow, American College of Surgeons) after a surgeon’s name mean that the surgeon’s education and training, professional qualifications, surgical competence, and ethical conduct have passed a rigorous evaluation, and have been found to be consistent with the high standards established and demanded by the College.

To be a member you have to:

be board certified in a surgical specialty recognized by the American Board of Medical Specialties
be in practice in one location for a number of years, with a background check, nomination, and interviews which verify that you are an ethical and safe surgeon among other criteria.
Hint: Look for the “FACS” (or “FRCS,” see below) after the “MD” in a doctor’s title or in his/her Curriculum Vitae to see if he/she is a “real surgeon.”

Note for patients in Canada: The equivalent of FACS in Canada is the Royal College of Physicians and Surgeons of Canada, FRCS.

3. Member of the American Society of Plastic Surgeons (ASPS)
The American Society of Plastic Surgeons is the largest organization of plastic surgeons in the United States and one of the largest in the world. ASPS members are uniquely qualified because of the society’s membership requirements:

Members of the American Society of Plastic Surgeons must be Board Certified by The American Board of Plastic Surgery complete at least 5 years of surgical training with a minimum of 2 years of training specifically in plastic surgery. The more years of Plastic Surgical Training the better – this includes fellowships in a plastic surgical field.
American Society of Plastic Surgeons members are required to adhere to a strict code of ethics and must fulfill rigorous Continuing Medical Education (CME) requirements including patient safety issues.
Lastly, ASPS members are required to operate at accredited surgical facilities certified by one of the following USA organizations: American Association for Accreditation of Ambulatory Surgical Facilities, Inc., Accreditation Association for Ambulatory Health Care, Inc., or the Joint Commission on Accreditation of Health Care Organizations.
Beware of physicians without this membership but belonging only to similar-sounding societies as their claim to excellence eg. “American Society of Cosmetic Surgery,” “Lipoplasty Society of North America,” etc.

4. Member of the American Society for Aesthetic Plastic Surgery (ASAPS)
This is the most elite society in the United States and perhaps the world for Aesthetic Plastic Surgery. To be a member means that your career is focused in cosmetic surgery at the highest level. Among the requirements for invitation and election to ASAPS membership, a plastic surgeon must:

Be certified by the American Board of Plastic Surgery (or in plastic surgery by the Royal College of Physicians and Surgeons of Canada);
Be in at least the third year of active practice following board certification;
Participate in accredited Continuing Medical Education (CME) to stay current with developments in the field of cosmetic plastic surgery and patient safety;
Document the performance of a significant number and variety of cosmetic surgical cases to demonstrate wide experience;
Be sponsored by two ASAPS-member plastic surgeons to help ensure that the applicant’s professional reputation meets the high standards required by ASAPS;
Adhere to current ethical standards for professional conduct as outlined in the Code of Ethics observed by all ASAPS-member surgeons;
Operate in accredited surgical facilities; and
Be elected by at least 80% of the Active Membership.
Find an ASPS member online.

5. Hospital privileges to perform the same type of surgery
Hospitals often examine qualifications of doctors applying for hospital staff privileges and restrict privileges to only surgeons best trained and qualified to do certain procedures. For example, in order for surgeons to be granted plastic surgery privileges in most hospitals in Orange County, California, that surgeon must have completed plastic surgery residency training and must be board-eligible or -certified in plastic surgery to be allowed to perform plastic surgical operations in that hospital.

Non-surgeons and other physicians that are not plastic surgeons circumvent this process by performing surgery in their offices or in outpatient surgery centers where the credentialing process is less rigorous or nonexistent. In these settings non-plastic surgeons perform procedures in which they have no formal residency training.

I am not warning against use of outpatient surgery centers or in-office procedures. I am only recommending that you check that your physician has hospital privileges for these same procedures.

6. Surgical Experience in the procedure you are having
Few patients ask how long doctors have been doing a certain procedure or how many they have performed. When you consult with a plastic surgeon:

Ask to see typical “before and after” photos;
discuss the details of the procedure in a manner that is clear to you;
review benefits and potential complications;
get full answers to your questions.
7. Evidence of Excellence, Experience and Commitment to the field of Plastic Surgery
Here are some additional criteria to look for in your plastic surgeon.

Surgical Board Certification in more than one field
Plastic Surgical Fellowships in addition to Plastic Surgical Residency.
Number of years practicing.
Peer Review Honors in their own board certification from groups such as Best Doctors, Top Doctors, Super Doctors.
Current or Prior position denoting excellence in the field or high regard by their peers such as:
Prior or present Professor or Faculty affiliation with a University Plastic surgical program (the higher the rank the better)
Chairman of a Department of plastic surgery at a regional hospital
Honors from surgical societies of which they are members such as Board Examiner, etc.
Published Plastic Surgical papers in peer review journals are also a good sign that they are committed to being on top of their field.
Feel Comfortable with your choice
It is very important that after you have done this screening and met with your potential surgeon that you feel confident in your choice.

Complications are not common in cosmetic surgery, but if one did occur are you confident that this surgeon would take charge and handle just about any problem?

Do you feel that he listens to you and communicates well by answering your questions completely, doesn’t rush you in to a decision but rather makes you part of the decision-making process? You should truly feel that it is a combined effort.

Does the surgeon’s office run smoothly? Do the staff take good care of you? If you answered in the affirmative and have gotten this far in your screening guidelines then I think you have found your “Dr. Right.”

—Larry S. Nichter, MD, FACS

There are many excellent Facelift Surgeons throughout the country.  I believe that "word of mouth" referral is critical because local Surgeons generate their reputations through great results.  Avoid the "branded infomercial lifts" and associated gimmickry because if it sounds too good to be true, it probably is.


My advice is to meet with a few Surgeons and ask yourself the following questions: 1) Did you feel comfortable with the Surgeon? 2) Did you like the results shown to you? 3) Did you like the office staff and facility, and did it seem professional? 4) Would you send a family member there? 5) Were you being educated about surgical process or sold something? Don't rush your decision and make your mind up accordingly.

Optimally it would be great if you have a friend that has a great outcome that can give you a personal recommendation, however this is not always possible. Then I would suggest to start by looking at before and after pictures on surgeons websites. Pick at least three surgeons with results that you like and then schedule a consultation with each, but at the time of scheduling ask if the photos you looked at are actual patients of the doctor's. When you meet with the surgeon, ask to see more photos and if you can talk to a couple of his patients that have had the same procedures that you want.

If after seeing three surgeons and you still aren't sure, then see more. It is important that besides finding a surgeon with great results, that you find one that you can communicate with, someone who is taking the time to listen to your concerns and makes you feel comfortable.

Dear patient, there are excellent face lift surgeons in most major cities. There is no single face lift surgeon who is the best. Please search for an experienced and board certified facial plastic surgeon who had done at least several hundred face lifts. The best way to find out is to have consult with several surgeons and review their face lift before and after pictures. Go with the one you feel comfortable. I perform nearly one thousand facial procedures a year and I am very skilled in what I do, but  is not fair to my respected colleagues to call myself the best in the field.

Plastic surgeons are trained in all aspects of cosmetic and reconstructive surgery.  After that training many go directly into practice.  Others pursue additional training in fellowship in their area of speciality (hand, face, etc).  My suggestion would be to seek out a plastic surgeon who has specialized training in the face.  I would also suggest talking to that surgeon's patients to see how happy their are with their results.  Look at before and after photos from that surgeon.  Some surgeons apply the same technique to every patient and other's customize their surgery to each individual patient.  Good luck with your surgery.

Hi there-

I absolutely agree with you... The truth is that the metrics and measures we use to select who we admit to Medical School, to Plastic Surgery Residency, and for Board Certification are in no way related to the actual talent the surgeon has for achieving a consistently beautiful result...

All of these things are important, but once you've narrowed the field to only those surgeons who are Board Certified, from top schools and training programs your best bet is to look at the total body of their work...

In other words, look at MANY photos, talk to multiple former patients, etc...

The difference between the many average surgeons and those with true talent will be the consistency with which the best achieve lovely, natural results. We won't hit a home run every single time, but consistently high quality is easy to spot when you see it.

Here are a few more tips:

It is very important for you to understand that there is no absolute best choice.  Ultimately you will need to make a personal choice about what is best for you.  With due respect for the surgeon suggesting that you find a surgeon with "proper board certification (American Board of Plastic Surgery-Not "cosmetic" surgery), board certification in general plastic surgery is not a guarantee that your surgeon will be accomplished in facelifts.  Be aware that there is a turf war among specialties and there are currently four core aesthetic specialities that offer facelifting:  general plastic surgery, facial plastic surgery, oculoplastic surgery, and dermatology.  I do not believe that it will be long before gyno-cosmetic surgeons get added to this list. 

Just relying on the board certification, which is important, can get you into trouble.  To understand how confusing it is now, in some cases, individuals trained in oculofacial surgery  or cosmetic surgery often get more extensive facelift training than general plastic surgeons just finishing a plastic surgery residency.  It is generally a good idea to look at the fellowship training of your surgeon.  

Word of mouth is helpful but be careful about endorsements that look like word of mouth comments on line.  Not so long ago, the Life Style facelift group in New York entered a settlement with the State of New York because they were encouraging their employees to pose on-line as satisfied customers, a deceptive practice known as astroturfing.  

It is also important to make sure that how ever great you think your potential surgeon is, find out if the carry adequate malpractice insurance or if they are "self-insured."  Self-insurance can be a sign that they have gotten in trouble in the past and no legitimate malpractice carrier will cover them.  Check with the licensing board for the state they practice in.  Find out if they have hospital privileges for facelifting.  Finally, seriously consider focusing on surgeons close to home for your surgery.  If you get in trouble, which can happen even in the best of hands, your local plastic surgeon may feel reluctant to assist you.  How easy will it be to go back and see your surgeon if they are in Florida, New York or Los Angeles?