Dear Roxy, There is no 'standard' for surgery payment, though most surgeons require payment for surgery 1 - 2 weeks before surgery in order to reserve the surgery time. That is done to prevent financial loss for the surgeons in case of a short notice canceleation that does not give enough time to fill up the slot. For that reason, payments close to surgery are uncommon and personal checks are not accepted. If you have full confidence in your surgeon and you are sure of having the surgery done , paying for surgery at the preop vist should not make a difference. Always, consult with board certified plastic surgeons and check their before and after pictures to make sure that you like the results. Best of luck, Dr Widder