Selecting a plastic surgeon. What are some key things to ask or consider before selecting one?

Hi, thanks for your question. It seems as though you've been asking all the right questions of the surgeons you have met with, and that you've done your research. The things to look for in a plastic surgeon are as you mentioned, their experience in the surgery you are seeking out, how many of the surgeries they perform, asking to see their before and after photos. Overall though, you want to choose the surgeon you feel most comfortable with and whom you feel understands your needs and goals best. You also want to be sure that the surgeon will follow you from start to finish, meaning from your first consultation through to your final result, and that you'll have acceptable access to them when you have questions, concerns, or issues.

Dear Thomas.Sm,
finding the right Dr. is extremely challenging especially with the number of online platforms and resources available. There a lot of great Dr's available. Make sure he/she is a board-certified plastic surgeon. Definitely check to make sure your choice specializes in the procedure you want and spend the time to read through patient testimonials. There is a number of different sites where you can check for reviews (Realself, yelp, google, etc.).You can always pick up the phone and call around also, find an office you feel comfortable with and set up a few consultations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

You are doing so many of the right things in choosing your plastic surgeon. After your consultations, I hope you will have a feeling based on all of the those factors you mentioned, of who would be the best choice for you. This is how most of these decision are made. Sometimes other factors weigh in (cost, distance from your home etc.). There is no perfect way for you to make the final determination, but know you are asking the right questions and doing good research. Good luck!

Selecting a surgeon is the first in many important steps when considering surgery. The ASPS website is a great tool to finding board certified plastic surgeons in your area. You can review websites and look at credentials. Many have before/after photos you can also review. During a consultation be sure to discuss your goals for surgery, recovery, and any concerns you have. Trust your gut. It is important you feel comfortable and confident with your surgeon and your surgical plan.

To master body contouring requires years and doing hundreds of cases. The key is not to let the surgeon show you the best results of their career but instead to show you all of the results of their career. In other words ask the provider to show you all of their before and after pictures or summer objective evidence of how many sets of before and after pictures they have for Liposuction the anatomic area you’re interested in. If a plastic surgeon cannot show you 50 or more sets of before and after pictures of the area you’re interested in they may not have sufficient experience. A highly experienced provider will have several hundred and some may have thousands.

Seeing the best pictures isn’t nearly as helpful as seeing what average pictures look like.

A provider with sufficient experience should also be able to pull out a whole collection of before and after pictures of patients whose bodies are similar to your own in regards to size, shape, skin laxity age etc. do you want to see what patient’s results were who look like you in the before pictures.

Personally I think the number of justified negative reviews are more important than an abundance of positive reviews. Providers with high numbers of reviews typically have more aggressive marketing campaigns and encourage more people to write reviews.

Providers with less total number of reviews typically rely simply on organic reviews.

Negative reviews are typically always organic.

Unjustified negative reviews or negative reviews that are not related to surgical outcome or direct clinical content such as staff, wait times, service can all be ignored.

Another important topic is the type of anesthesia done for the procedure. During the first 10 years of practice I use general anesthesia for most procedures but mid career converted and began doing almost all liposuction procedures including fat transfer procedures with my patients awake using local anesthesia with mild sedation.

This gives me much better results and in my opinion and overall better patient experience.

The following is a list of general recommendations. Some of these are a recap of what I’ve previously stated.

1. I recommend patients avoid traveling long distances for elective surgical procedures. There are of course instances where there is a lack of local talent and traveling to some degree is inevitable. If traveling for the procedure patients should be ready to travel to have the consultation, post operative appointments and follow up should there be issues or complications.
Patients sometimes do not appreciate the importance of in person consultations, that complications do happen or the number of people who have issues with their results or need revisions.

2. Schedule multiple consultations with different providers in your area who seem to have a good reputation for the procedure you’re interested in. Starting with at least five consultations seems like a reasonable number to me.

3. Whenever possible schedule in person consultations.
4. During in person consultations ask each plastic surgeon to show all of their before and after pictures for the procedure you’re interested in.

The goal is not to see the best results of their career but to get an idea of what average results look like and get some type of confirmation of how many of these procedures that provider has performed.

Ask to see results that were not as good as the doctor would’ve hoped for and talk about the differences in outcomes.

Honest and experienced providers should have no problems presenting this type of information.

A highly experienced plastic surgeon should have hundreds of before and after pictures for the procedure you’re interested in. At a minimum at least 20+.

5. Read all the reviews on various physician review websites paying close attention and avoiding providers with any significant number of justified negative reviews. Providers with an abundance of reviews often have aggressive marketing campaigns.

The plastic surgeons I respect most all have the single variable of not having justified negative reviews on their online profiles.
In my opinion justified negative reviews are far more telling than an abundance of positive reviews.

6. Avoid scheduling for surgery or making a deposit on the day of the consultation. Give yourself some time to think about the decision and make sure you finished all scheduled consultations before committing to having surgery that will permanently and irreversibly change your body.

When in doubt slow down and schedule more consultations.

Choosing the right plastic surgeon is the single most important variable to having a positive experience.

7. Don’t go chasing after technology or names of certain equipment. Instead focus all your efforts on finding the most experienced and talented board-certified plastic surgeon.

Best,

Mats HagstromMD

Hi Thomas. You have already highlighted some of the key things to look for when selecting a plastic surgeon: board certification in plastic surgery, knowledge and experience, and an affable demeanor. In addition, I would recommend looking for a surgeon who maintains a personal connection with you after your surgery. A good surgeon will take their time to explain a procedure before surgery, and follow with you closely afterwards. A specific timeframe is less important than being generally available should any questions arise during the recovery process. This is one of the most important things a surgeon can do for their patients, and it is what I would want from a surgeon taking care of me or my loved ones. And finally, much the same as conducting a job interview, sometimes you just know when someone is the "best fit" for you. Provided that they fulfill the other criteria (mentioned above), go with your gut! Wishing you luck.