Cosmetic surgery is real surgery with real risks. With that in mind, nobody would seek out the least expensive heart surgeon or brain surgeon. The same rule of thumb should apply when considering elective cosmetic surgery.Patients are encouraged to consider quality first and cost last (if at all). There can be no price placed upon your health and safety. Thus I recommend that you seek out a board certified plastic surgeon operating in a certified facility (preferably close to home).Why?There are numerous practitioners of plastic surgery. However, only a select few are board certified by the American Board of Plastic Surgery (the only board recognized by the American Board of Medical Specialties). Board certification ensures completion of a rigorous training program of at least 6 years (with at least 3 years of dedicated plastic surgery training. Board certified surgeons have also completed written and oral examinations to determine competency and participate in a continuing medical education programs as a prerequisite of maintaining certification. Ultimately, certification ensures a measure of certainty when comparing surgeons. You can be assured that your board certified plastic surgeon has seen and treated it all before and is uniquely qualified to manage you pre-operatively, intra-operatively, and most importantly post-operatively. Patients should also ensure that the procedure that they are undergoing is being performed in AAAASF or Medicare/JCAHO approved facility. This will ensure that the highest standards of safety are being adhered to. I always caution patients seeking a bargain internationally to consider for a moment what they would do if a problem arose after returning home. This is an issue which many "lipo-tourists" face. Any surgeon can have a complication, however, it is much easier to deal with these should they arise if his/her patient is not a world away.As always, discuss your concerns with a board certified plastic surgeon.