Before and At your consult
Great question! First, I would recommend doing some background research before your appointment. While it's great to ask things like "Are you board certified? If yes, by what board?", you can actually get those questions answered before ever walking in the door, and from trusted websites instead of just taking someone's word for it. The procedures you are interested in should only be done by a board certified plastic surgeon, and the only recognized board for plastic surgery is the American Board of Plastic Surgery. (The American Board of Cosmetic Surgery is not a true board, and is made up of non-plastic surgeons who decided to perform plastic surgery procedures rather than practice the specialty they are trained in, if trained at all.) To check if your surgeon is a board certified plastic surgeon, you can search the American Board of Plastic Surgery website and use their Find a Doctor feature. You can also check if your surgeon is a member of the American Society of Plastic Surgeons. Once you have verified both of these to be true, then you should look at the surgeons website to read more about the surgeon and look at his/her before and after photos. This will give you an idea of what the surgeon commonly performs, and how his/her results are. Once at the appointment, you want to make your goals clear, and ask the surgeon how he/she feels you can best achieve them. You should also ask if the surgeon feels all of the surgery could be done in 1 surgery, or if it would be better to split in 2. In general, a belt lipectomy, plus full breast lift, plus augmentation with implants, is a lot of surgery to be done at one time. It may be better to do the belt lipectomy in one surgery and the mastopexy plus augmentation in a second surgery. Alternatively, you could do the tummy tuck, mastopexy plus augmentation in one step, and the back part of the belt lipectomy at a later date. You also want to ask what happens in the case of an emergency. Is the surgeon credentialed at a local hospital, and/or a hospital that takes your insurance? Does the surgeon provide an after-hours ways to contact him/her (important if you have questions after surgery)? Other items typically covered during a consult is the recovery process, and timing of your followup appointments, what garments you will need to wear and/or purchase, if you will have drains to manage in the postop period. It is good to ask the name of the surgery center the surgeon plans to use, and to make sure the surgery center is also credentialed (preferably by AAAASF or Medicare). It is also good to ask each doctors revision policy. Hopefully you never need to use this, but if you do, it's better this is clarified up front.
Ask your plastic surgeon how many procedures they perform per week or month of those you are interested in. Ask if they routinely perform mommy makeovers (combined surgeries). Ask to see as many before and after photos as possible. Ask to speak with some of their former patients who have had the same procedure you are seeking.
What questions should arise during a consultation with a plastic surgeon?
Thank you for your very astute question. As a nurse you are aware of the complexity of medical and surgical decisions as well as the risks involved. I think it is very important especially when combining a tummy tuck procedure with additional surgery to be made aware of the risks of deep vein thrombosis or pulmonary embolism since these can be significant complications from prolonged anesthetics especially when a tummy tuck is involved. I think you should also be prepared to discuss options as well as complications and even subtle limitations of the procedure to be sure that you are well-informed.A consultation is also an opportunity to develop a sense of trust or distrust in a surgeon and a sense of confidence that your goals are likely to be met and that your doctor will take your best interest into account.I would suggest you watch the video linked to above for further details about the consultation process based on my experience in Beverly Hills.Warm regards and good luck.Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
Beverly Hills, California
Questions for doctor during initial consult?
Thank you for your question. The combination of procedures you are considering are common after pregnancy and/or massive weight loss. I would specifically ask your surgeon how many/how frequently he or she performs this combination? Always ask to see actual pre/post-op photos. As you are probably aware, longer more complicated procedures tend to have more associated complications than shorter ones. This should also be discussed openly, so that as the patient, you can make a well-informed decision. As with any new relationship, honesty, candor and trust are paramount. Good luck to you.
Your first job will be to listen.
I think patients coming in for a consultation get the best experience if they first communicate (and do that very well) what they do not like. Afterwards, a good plastic surgeon will examine you and make suggestions based on what problems they identify.
You should listen intently at that point for them to tell you what your options for treatment are, the risks of those as well as the anticipated amount of improvement. Lastly, they should give you an idea about restrictions in your activity and amount of time to recover from the recommended procedures.
Specific to the procedures your mentioned above, I'd be sure to discuss your implant options (not every surgeon has equal access to all types of implants) the type of mastopexy that would be performed, and the plan for your first postoperative night - in my practice tummy tuck patients get to go home, but lower body lift or belt lipectomy patients stay overnight in one of our care facilities.
Finally, I always ask if the surgeon is a member of the state Plastic Surgery Society. That will help you verify that they are board certified in Plastic Surgery in most instances, and you will know that they have a good relationship with their colleagues in the area and have a reputation for practicing good medicine. I find that these local societies are usually quite discriminating in who they let join - those who are members typically are well respected by those doctors who know them best - their neighbors!
Best of luck!