Only after cosmetic surgery can a patient truly determine if they got what they paid for. Even popular semi-permanent treatments last for months. Think of it this way; you cannot try it on, you can’t return it, you’ll wear it every day. Great results begin with your ability to evaluate practitioners. Making a choice based primarily on price may be one you regret for years.
-Dr. Andrew Kornstein, MD, FACS
Consumers are savvy. Whether out of necessity or with an eye for opportunity, the stalled economy has made many of us smarter, happier buyers. We’ve come to expect terrific bargains from housing to technology to designer gowns. The obsession with discounts has permeated every area of our lives but can become a dangerous paradigm when shopping for a cosmetic surgeon. How should you define quality and value when considering aesthetic procedures? Dr. Andrew Kornstein elaborates on the top seven guidelines to use if you really want the most for your money.
- Understand all providers are not created equal. More and more people in diverse areas of healthcare are involved in aesthetics. Dentists are administering Botox; Ob/Gyns are doing tummy tucks; aestheticians are doing fillers. Practicing outside one’s specialty is perfectly legal providing you have a medical license; however it is up to you to determine if a provider’s level of expertise can match your expectations. It has been widely touted that the best way to evaluate a surgeon is to be sure they are Board Certified. This is only partially true. “Board Certification” is the first tollgate. The next is, are they certified and recognized by one of the 24 specialties in accordance with the American Board of Medical Specialties (ABMS)? A physician may be board certified in Allergies and Immunology, but do you want him/her to do a facelift? If you are seeking cosmetic procedures certification would most likely be in areas of Dermatology, Otolaryngology, or Plastic Surgery. Having made that point, understand this important credential can also be misleading. There are wide variations in skill even among Board Certified Plastic Surgeons. Some are super specialized in a particular area of interest that may make them a better provider for the specific procedure you desire. Ask, and consider the answer in context.
- Don’t assume experience and training guarantee aesthetic skill and judgment. This may sound like a contradiction to #1 but it is a very important distinction. Most patients would say experience and training are the most critical factors in judging the competence of a physician. And they would be correct. However, once you take that same physician into the realm of cosmetic enhancement, you are counting upon something that cannot be learned. Visualization and aesthetic judgment are innate gifts. Consider the difference between a builder and an architect; a cook and a chef; a dancer and an artist. All are technically proficient, but few can consistently create on the next level. You want the artist.
- Know exactly what and who you are seeking. It’s tougher than ever to cut through all the noise associated with cosmetic surgery and aesthetic procedures. Being a hot topic has its drawbacks. Media reports are often inaccurate, and subsequently more misleading than helpful. The sheer volume of opinions vs. facts is disturbing. Well meaning friends and family may insist “their” doctor is the best without regard for the procedure you desire or the chemistry they may have felt that you may not share once you have a consultation. In Manhattan there are dozens of surgeons to choose from. 15 years ago patients occasionally sought a second opinion—something good physicians always encouraged. Today, it is not uncommon to have patients explore five or more opinions. Even happy patients will leave a surgeon who has served them well. It inspires curiosity as to what patients are looking for, and will they know it when they see it? Fatigue and confusion may lead to the wrong decision. Even after making a decision, patients second guess themselves and are filled with anxiety for not following a referring doctor’s recommendation or best friends’ advice. Be smart and diligent, but keep it simple.
- Use chemistry to make the right decision. Don’t discount your intuition. Be aware of the connection (or absence of one) between you and the physician during the consultation. Consider it a first date. Do you feel rushed or relaxed? Listen to or lectured to? Does he/she have a strong grasp of what it is you want accomplished and an equally confident recommendation with alternatives? A good sense of what needs to be done? Sometimes making an appointment for injectables with a surgeon you like prior to committing to surgery can help you get a better feel about the doctor’s approach and your level of trust. If you are interested but unsure, ask for a second date or test drive.
- Recognize the importance of restoring natural anatomy. One of the most commonly voiced fears during a consultation is, “I don’t want to look unnatural or “done.”” Looking older can put you in an aging free fall where you feel out of control. The secret is finding a surgeon who is adept at replacing support in an aesthetically harmonizing, appropriate way. You don’t have to go from photofacials to a full facelift. There are some very compelling ancillary procedures that yield subtle, yet remarkable results. Many patients can walk away with a lesser procedure, very happy. Look carefully at a surgeon’s photo library. Be certain these are his or her untouched photos of actual patients. If they are, spend some time analyzing the before and after of the procedure you are considering so you are comfortable with that surgeon’s results. Beware of a book full of Barbie and Ken look-alikes.
- Don’t depend upon the proverbial silver bullet. Its fine to get comfortable with Botox, but you cannot count on one solution to correct every condition. Too much Botox used in place of fillers can lead to an aesthetically imbalanced expression. Fillers demand more technical skill and artistry but they deliver the volume where you need it for a more youthful appearance. This dependence upon a universal answer to any condition also includes doctors. Some have a circumscribed level of comfort and will continue to go to the same well without regard for the changing needs of the patient. Eventually the cheeks are too big, the lips appear swollen while other areas age and shrink. You are left with disparity and atrophy. The best surgeons are fluent in a wide variety of both surgical and non-invasive procedures, properly educate their patients and effectively communicate the “why,” “how” and “why not.” Find a doctor who can help you graduate to the next level when necessary.
- Wait to do what’s right vs. going with the least expensive quote. The reality is most people have less disposable income than they had even a few years ago. If you cannot afford to do what you need to do, don’t compromise on surgeon selection by going with the bargain brand. There are options. You could simply wait until your financial picture is brighter. If you feel good about a particular surgeon, revisit him or her. Maybe there are alternatives that can be tailored to your budget. Do it right vs. selecting a surgeon with whom you are not comfortable, offering a low price and perhaps a poorly chosen procedure.
Keep in mind, not every surgeon—no matter how brilliant—will be a “fit” for every patient. If you do your homework and listen to your intuition, odds are you will be happy with your choice. In my practice, I get particular satisfaction seeing patients breathe a sigh of relief post surgery when they feel they got way more than they bargained for. That’s value. Price may be what you pay, but the cost of the surgery goes well beyond the financial transaction. If cosmetic surgery is a success, the more you live with it, the more you should enjoy it. If not, it’s difficult to hide in the back of the closet along with the other “great deals” that ultimately didn’t bring you the joy you expected
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