Thanks for your question. A teaching hospital usually means that residents and/or fellows will be observing and possibly participating in your case. Typically for cosmetic procedures these trainees are just watching but if your surgeon teaches fellows (a more advanced trainee) the fellow may perform part of the surgery. I would have a conversation with your surgeon about who performs the surgery. In terms of cost, the cost of the operating room and anesthesia may be more than it would be at an outpatient surgery center, but this varies by hospital and surgery center. If your surgeon has several good before and afters and good reviews, he/she is probably worth sticking with. Best of luck!