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Consultation With The Cosmetic Surgeon
By Michael Russell

Once the decision is made, the individual should seek a properly accredited surgeon. At a minimum, the physician's credentials should read American Board of Plastic Surgery Accredited. For the names of properly accredited surgeons in your area, call Directory of Medical Specialists at 1-800-521-8110. Professional societies for cosmetic surgery can also be consulted.

More and more cosmetic surgeons are creating mini-hospitals in their own offices to lower the costs of hospitalization. Therefore, it is important to check with the local hospital association to learn if the doctor is permitted to do a particular surgery in that hospital. It is also important to check the facility. Is it accredited by the American Association for Accreditation of Ambulatory Surgery? Does it have cardio respiratory equipment, monitoring for blood pressure, EKG, arterial oxygen tension and pulse? Is there a certified nurse or anesthesiologist to monitor the patient throughout the procedure?

The patient would be well advised to ask about the cost of surgery, additional fees for possible X-rays, other laboratory fees, anesthesia fees if there are any, hospital or operating room fees and other costs. It may come as a shock, but most cosmetic surgeons expect to be paid in full in advance of the operation. Unless the commitment to have the operation is made final by prepayment, cancellations and postponements can accumulate to the point where the surgeon cannot maintain any kind of schedule.

During the consultation, the surgeon will question the patient about her medical history and physical condition. The woman who is not entirely honest or is evasive in her answers is asking for trouble and being unfair to herself and to the doctor. Special problems associated with previous surgery should be described in detail. Any bleeding tendencies should be mentioned. Drug dependencies and the use of any medication must be discussed. A history of hypertension, diabetes, asthma, kidney or heart disease, allergy, or mental illness must be mentioned.

The patient should expect the surgeon to supply detailed answers to questions about the problems ordinarily connected with the particular type of surgery requested, the patient's suitability or unsuitability for it, realistic limitations of the procedure and expectations of the results, potential complications, preparations essential before the surgery is performed, the actual technique by which the surgery is performed and the nature and length of postoperative recovery. It is advisable to come to the consultation with the questions written down and noting the answers is helpful for future reference, especially if more than one surgeon is to be consulted.

If after this discussion, the patient wishes to proceed with the surgery and the surgeon feels she is a suitable candidate for it, photographs will be taken either during the first visit or during a subsequent preoperative visit. Some surgeons think computerized imaging is helpful, but this is debatable. It is one thing to see an image altered on the screen, but it is better to know that the surgeon can produce it in the living patient. The surgeon evaluates the photographs with the patient at a subsequent visit prior to surgery. It is during this visit that the patient should feel free to ask any and all questions that still remain unanswered.

It must be especially emphasized that the patient should make a determined effort to hear what the surgeon says to her. There are patients whose anxiety about the procedure or the presence of a physician prevents them from hearing anything that is said to them. This has been called the "white coat syndrome". It is recommended that the patient take notes during the consultation.

Michael Russell

Your Independent guide to Cosmetic Surgery

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