Assistant operating alongside my surgeon?

I understand trainees have to train - but I dont want to be a guinea pig! I am leaning towards local anaesthesia for this reason alone - I am too scared to fall asleep incase someone else takes over! How do I politely check and let surgeons know I dont want my surgery to be "observed" for training. I have read about it on here quite a bit recently and it makes me very nervous. I want my chosen surgeon to do my procedure, i dont want a med student watching or participating.

Doctor Answers 20

Surgical assistants or not?

In my practice, I perform every cut and suture of a facelift personally.

However, in academic settings, it would not be uncommon to have a surgical resident assisting the attending surgeon with a procedure.  But unless you specifically go to the resident clinic for lower-priced surgery, they would not be performing the key parts of the procedure.

If you are unclear about it - always best to ask.

Is your surgeon doing the surgery, vs. an assistant?

Hello and thank you for your question.

Of course none of us would have our experience if we didn't start somewhere. So it isn't uncommon to have residents or medical students observe surgery, or even scrub in because surgery is more easily performed with someone assisting. By assisting I mean cutting sutures, holding retractors, etc. not actually doing the surgery. If a student or resident is not doing these things, a scrub tech or perhaps even less qualified (than a resident) person is going to be doing these things. If you want your surgeon only to do your procedure he/she has an ethical responsibility to respect that. If you have that direct discussion with the surgeon, I am quite sure he will respect your wishes.

David Cangello, MD
New York Plastic Surgeon
5.0 out of 5 stars 8 reviews

Assistant/Surgeon Answer

Thank you for your question! It is "common" for some surgeons to have a student shadow them during surgery. That being said, your surgeon should always inform you if someone is going to be observing your surgery (with their eyes) and it is your right to consent yes or no to this. In my practice, if someone is observing it is strictly that- and there is absolutely no "hands-on" involvement in the surgery.

You should feel comfortable asking your surgeon anything in regards to your care and I hope you feel confident in doing so. Be well and all the best to you!

Dr. Todd Hobgood, MD

Todd Christopher Hobgood, MD
Phoenix Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Is My Surgeon Really Doing My Facelift?

In my practice, I am asked this question often, as my patients want the very best, as they should. Please ask your surgeon directly, because you have the right to know this. You should be able to ascertain a clear and honest answer from a legitimate board certified plastic surgeon. There are certain surgeons who are more likely not to have residents working with them. For example, because I have built my own AAAA-SF facility (it is like a private hospital), I have total control of my operating room and staff. I have handpicked my employees, and residents are never "assigned" to me, nor are people I haven't worked with, so I can guarantee quality control and ensure that my patients receive surgery from only me. Quality control is everything!


Don't want students or residents watching my surgery

Thank you for asking about your cosmetic surgery.

  • First, if you see a plastic surgeon in private practice, s/he is unlikely to have students or residents.
  • So before having an appointment, ask if the surgeon's practice does any training.
  • If no - there is no issue.
  • If the answer is yes, you need more information.
  • It is one thing to have students and residents in the room observing - if so, they do not scrub in to your case, they watch. 
  • If you are paying private fees for cosmetic surgery,, your surgeon does the operation.
  • However often a surgeon has a plastic surgery resident or professional surgical assistant during the case -
  • The assistant assists the surgeon - holding retractors, cutting sutures etc. but does not do the surgery.
  • A good assistant can shorten the length of your surgery and is usually a good idea. 
  • The issue comes when a person tries to save money by going to a resident plastic surgery clinic - and has a resident do the surgery, under the supervision of a qualified plastic surgeon. Results are unlikely to be as good as with a fully trained plastic surgeon - so there will be a range from disappointing to good.
  • All you need to do is to ask your surgeon her/his approach and make sure that what you want is what is done - including the type of anesthesia.
  • Always see a Board Certified Plastic Surgeon. Best wishes, Elizabeth Morgan MD PHD

Surgical assistants/residents

100% of board certified PLASTIC surgeons trained alongside other expert surgeons. Just like pilots have co-pilots, the chief (attending) surgeon (pilot) is in charge of EVERY  aspect of the procedure. The builder designs the home but, occasionally, does not lay every piece of tile. This is how surgeons, nurses, and all health care providers mastered our crafts before venturing into private practice. It keeps the experienced surgeon current and verifies to patients and to quality assurance boards that the younger surgeon has been "checked off" by more experienced surgeons.  

Nevertheless, If a patient does not feel comfortable with having student/ younger surgeons in training in the operating room, then they should opt for surgeons that do not teach, which is the patient's right in a non teaching center.

No one does your surgery without your permission

so if you let your surgeon know this, he/she should honor your wishes.  Residents and medical students may observe but that is strictly all they should be doing.  To confirm you wishes, you can always get a copy of your operative report afterwards and see who dictated the procedure... it should be your surgeon and no one else.  And being awake will not help you as you are 'snowed' so you won't have any recall of anything done during your procedure... go to sleep and don't worry about the anesthesia.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Training in the Operating Room

The only person who assists me in surgery is my nurse who has been with me for 20 years. It is not unusual to have other surgeons or doctors in training observe surgery but they are never involved in the procedure, assist, and certainly don't do any part of the operation. My patients are always informed if anybody will be observing. Have a frank discussion with your surgeon.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Simple answer--Ask him/her

You really need to feel comfortable with your surgeon.  You should really feel comfortable asking about all aspects of your planned surgery.  That includes the questions you are posting about.  If you don't feel comfortable asking then it may make sense to have a second opinion.

Colin Pero, MD
Dallas Facial Plastic Surgeon
4.6 out of 5 stars 13 reviews

Rhinoplasty surgeon.

It is important to have a very frank discussion with your operative surgeon upon WHO is going to be performing the surgery. It is totally acceptable to have a medical student, and intern, or resident simply observing surgery. There's only room for one surgeon inside the nose. In our practice, we also recommend patients undergo all rhinoplasty procedures under general anesthesia by a board-certified physician anesthesiologist for patient safety and comfort. Patients simply cannot tolerate performing a rhinoplasty under local  anesthesia.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

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.