10 Questions to Ask Before a Plastic Surgery

While the convenience of having an anti-aging treatment performed at a local spa, shopping mall, or walk-in clinic can be alluring, opting for this convenience could jeopardize health and safety. Treatments that turn back the hands of time such as chemical peels, laser skin rejuvenation, and microdermabrasion are plastic surgery procedures that require medical training for best results.

Asking the following questions before having a cosmetic procedure can help patients find a qualified practitioner and avoid complications:

1. Will a board-certified dermatologist perform the procedure?The success of any cosmetic procedure is highly dependent on the knowledge and skill of the person performing it. For this reason, the American Academy of Dermatology (Academy) urges everyone considering a cosmetic procedure to select a doctor who is board certified in dermatology or a similar medical specialty.
   
   The Academy recommends that all treatments be performed by the physician or under the direct supervision of the physician. “Direct supervision” means the doctor is on site while the procedure is being performed and is immediately available during the procedure.
   
   Complications increase when cosmetic procedures are not performed by a board-certified physician or under the doctor’s direct supervision. In a 2007 survey conducted by the American Society for Dermatologic Surgery (ASDS), 56% of the dermatologic surgeons replied that they have been treating more patients for complications caused by a non-physician performing a cosmetic procedure such as a chemical peel or laser therapy. Burns, scarring, and skin discoloration are some of the most common complications.
   
   More than 90% of the dermatologic surgeons also said that they had seen at least one patient in the last year who had skin cancer that was either overlooked or misdiagnosed by an untrained practitioner. Without early diagnosis and treatment for skin cancer, the patient may have to undergo extensive surgery to remove the cancer. This can cause permanent disfiguration. Skin cancer also can spread. In the United States alone, one person dies from melanoma, the deadliest form of skin cancer, almost every hour.
2. How many times has the doctor performed the procedure? 
   Don’t be afraid to ask this question. The procedure should be one
   that the doctor performs regularly. When physicians have
   specialized training in performing a procedure and have successfully
   performed the procedure on numerous patients, they usually want
   others to know. 
3. What results can I expect? While results depend largely on the skill and experience of the person performing the procedure, the condition of the patient’s skin as well as the patient’s age and health affect the cosmetic outcome. A dermatologist typically tells a patient what to expect after visually examining the skin and gathering a medical history. A dermatologist also can tell the patient if the procedure will deliver the desired results and if it is appropriate for the patient. Often a combination of techniques provides the best results.

Tip: To help communicate the results you seek, find pictures to show what you want to look like. For example, if you want fuller, more youthful lips, find a photograph of the lips you desire. Photographs greatly help communicate expectations and break down communication barriers.

4. May I see “before” and “after” photographs of patients or speak with patients whom the doctor has treated with this procedure(s)? Doctors should be willing to share their results through photographs or referrals. If a physician is hesitant to do so, find one who will.
5. What is the recovery time? While cosmetic procedures have become less invasive and require less downtime, patients should know what to expect after the procedure. For example, after botulinum rejuvenation (an injectable that temporary diminishes fine lines and wrinkles) patients can have temporary swelling, redness or bruising.
6. What are the risks and side effects of the procedure? While the risks involved in most cosmetic procedures are minimal, there are risks. Potential complications should be discussed before the cosmetic procedure is scheduled. 
7. How long will the results last? Most cosmetic results are not permanent. While a patient’s lifestyle and overall health can shorten the length of time that a patient sees the results, there are general guidelines. For example, botulinum rejuvenation tends to last about 3 to 4 months. 
8. Where will the procedure be performed? Most cosmetic procedures can be safely and effectively performed in a physician’s office, surgical suite, or outpatient surgical center. This gives the patient a safe, cost-effective alternative to the hospital and a level of care that spas, shopping malls, and walk-in clinics cannot offer. 
9. What follow-up care is included? Follow-up care is an important part of cosmetic surgical procedures. Be wary of undergoing any cosmetic surgery that does not include follow-up care. Cosmetic surgery performed abroad often cannot offer follow-up care due to the amount of time that the patient will be in the country. Infection is a complication seen in patients who travel abroad for cosmetic surgery.
10. What is the cost of the treatment? Insurance usually does not cover the cost of a cosmetic procedure. Before scheduling the procedure, find out the costs and how payment will be required.

Tip: Cost should not tempt you to perform a cosmetic procedure at home. While products ranging from chemical peels to microdermabrasion kits can be purchased online, there is little to no regulation of the sale of these products. Too often, dermatologists see patients who have scarring or discoloration after trying a cosmetic procedure at home. Sometimes the results are permanent.

Before having a cosmetic procedure, the Academy recommends consulting with a board-certified dermatologist or other physician who has received similar training. With their in-depth medical training and experience performing these procedures, dermatologists safely perform thousands of cosmetic procedures each year with excellent results.