consultations

Setting up a consultation or appointment with a medical professional used to involve a phone call and a calendar check. Conducting the consultation or appointment, meanwhile, required an in-person trip to the provider’s office. But, with the advent of modern technology, the scheduling of and participation in consultations and check ups now have a virtual twist. Doctors and patients are increasingly conversing from the comfort of their own homes when time is of the essence or circumstances prevent them from meeting face to face. The concept of telemedicine is nothing new, but, in the wake of the [COVID-19 pandemic](https://aedit.com/aedition/message-from-aedit-founder-regarding-covid-19-coronavirus-pandemic), it's more important and useful than ever. 

With elective surgeries cancelled in many states and private practices closed due to coronavirus, video chats have become an integral part of healthcare and aesthetic medicine. For cosmetic dentists, dermatologists, and plastic surgeons, telemedicine is a way to connect with patients from the very first consultation to ongoing post-op care. 

If you’re interested in setting up a virtual appointment with a provider but don’t know where to start, we’re here to help. To break down the logistics of what telemedicine can and cannot address, how patients need to prep for appointments, and what happens after the call, The AEDITION spoke to [board certified](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) dermatologists, plastic surgeons, and dentists to understand the ins and outs of virtual consultations. 

## **Virtual Consultations in Aesthetic Medicine**
In aesthetic medicine, virtual consultations have long been a way for providers to connect with and assess out-of-town patients. “The purpose of a virtual consultation is to identify the patient's chief complaint and determine what additional information is needed to address the problem,” says [Alina Lane, DDS](https://aedit.com/provider/alina-lane-7794), a cosmetic dentist and director of All Smiles Dentistry in New York City. 

While there are certainly some screen-induced limitations, virtual consultations generally offer both patients and providers an opportunity to get to know one another and discuss areas of concern, aesthetic goals, and possible solutions. Many doctors find that they’re able to treat their patients with the same care despite the lack of proximity. 

Generally speaking, here’s how telemedicine works for aesthetic specialities:  

### **Virtual Consultations With a Dermatologist**
Whether you’re worried about a rash or need a refill on your [Retin-A](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare) prescription, dermatologists can address both medical and cosmetic concerns during a telemedicine appointment. Technology doesn’t yet allow for virtual injections (sorry, [Botox®](https://aedit.com/aedition/everything-you-need-to-know-before-getting-botox-for-the-first-time) fans!), but a dermatologist can assess your skin and prescribe a treatment plan to address unexpected flare-ups (think: acne, eczema, psoriasis), soften fine lines and wrinkles, or maintain a youthful glow between in-office appointments. 

For those worried about a troubled mole or a sudden rash, virtual consultations still serve a purpose — though they may just be a first line of defense. “Yes, we can make a diagnosis and evaluate basic skin conditions,” says [Morgan Rabach, MD](https://aedit.com/provider/morgan-rabach-md-17913), a board certified dermatologist and co-founder of LM Medical in New York City. “[But for] something like a melanoma, which is life-threatening has to be treated immediately, the patient would be seen in person because it is medically essential.”

### **Virtual Consultations With a Dentist**
“By its nature, dentistry is a very interactive medicine,” says Dr. Lane, who [offers virtual consults](https://www.allsmilesnyc.com/). “Many dental diseases require in-office procedures to treat.” While regular dental check ups are needed at least once a year, unexpected issues can arise that require immediate attention. “Dental pain, facial swelling, abscesses, and broken teeth are all major indicators that an in-office appointment is needed,” she notes. “However, during this time of shelter-in-place, the urgency of these matters can be evaluated first by a virtual consultation.”

Those dealing with dental emergencies will first be evaluated virtually to confirm if immediate care is needed. “If there is a dental emergency, we will determine whether we can manage it remotely or if an in-office visit is required,” she explains. “During a time when hospitals are being strained due to the COVID-19 outbreak, our goal as dentists is to [minimize all emergency room visits](https://aedit.com/aedition/how-to-treat-plastic-surgery-emergencies-lacerations-during-covid-19) due to dental problems, which will help to reduce strain on the medical system and minimize patient exposure to infected persons.” As such, many dental offices have remained open to treat emergencies.

### **Virtual Consultations With a Plastic Surgeon**
While a telemedicine appointment might not allow quite the same level of interactivity as an in-person consultation, they still provide a meaningful way for providers and potential patients to get to know one another. “Virtual consults are a good first step for someone to see if they are interested and also get a chance to know me and what we can offer,” says [Jaime Schwartz, MD](https://aedit.com/provider/jaime-schwartz-md-19201), a Beverly Hills-based board certified plastic and reconstructive surgeon who also has a [practice in Dubai](https://drjaimeschwartz.com/).

During this time of social distancing, the virtual meeting is also a good chance for providers to interact with the caregiver who will be tending to the patient once he or she heads home to [recover](https://aedit.com/aedition/how-long-does-it-takes-to-recover-from-cosmetic-surgery-procedures) post-op. “It can help to have a family member or spouse available for the consultation as well, so that they can be informed on what to expect after the procedure if the consultation is for a surgery,” says [Craig Baldenhofer, MD](https://aedit.com/provider/craig-baldenhofer-md-20), a New York City-based board certified plastic and reconstructive surgeon. 

## **Setting Up a Virtual Consultation**
Ready to book? Here are six things to keep in mind ahead of your appointment:

### **1. Prepare For Paperwork & Pictures**
“Prior to the consult, patients fill out the standard office intake forms; are emailed copies of the procedure consents, pre-operative and post-operative instructions to review; and are given instructions on how to provide photographs for me to review prior to the telemedicine visit,” Dr. Baldenhofer explains. The dermatologists we spoke to follow a similar protocol, so be ready to take lots of pictures. “We have a photo guide that explains how to take pictures of the face and body that is sent to our concierge team who evaluate the images,” says [Jason Emer, MD](https://aedit.com/provider/jason-emer-md-722), a board certified cosmetic dermatologist in West Hollywood, who frequently travels to New York to treat his East Coast patients. “If they’re not good quality, they’re sent back. There’s different positioning and different lighting that’s needed.”

Precisely shot photographs will likely be necessary for any and all consultations, but they are especially vital when patients are looking to consult about concerns below the neck. For breast and body procuedres and surgeries, providers can review photos submitted ahead of time, rather than examining the area during the video chat.

### **2. Consider Your Safety First**
When it comes to virtual consultations, patient privacy and safety are the top priority. “We have always had the capability and use Skype or FaceTime for consults for out-of-town patients,” says [Lesley Rabach, MD](https://aedit.com/provider/lesley-rabach-md-17912), a double board certified facial plastic and reconstructive surgeon and co-founder of [LM Medical](https://lmmedicalnyc.com/). “However, now we are using [Doxy.me](https://doxy.me/), which is a better-secured platform for physicians to do our telemedicine consults.”

In fact, the [Health Insurance Portability and Accountability Act (HIPAA)](https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html)-compliant platform is quite popular due to its security *and* convenience. “It can be used with any computer or smartphone with a camera,” Dr. Baldenhofer says. “Patients are emailed or texted a link to a virtual waiting room and told to be available at the prearranged time. Once they are in the waiting room, I am alerted and can start the consult.” If you have any questions or concerns about the security of your virtual consultation, ask your provider what platform they use and the protocols they have in place to protect your privacy.

### **3. Be Mindful Of Your Set Up**
Treat the call as if you were going into the provider’s office. You’d want the environment to be quiet and serene — without interruption — so try to do the same with your home surroundings. “I have had patients try to have a virtual consult while driving their car and that was not ideal,” Dr. Baldenhofer shares. While the photos provided ahead of time will play the biggest role in your consultation, there are some things you want to keep in mind when considering where you are going to sit for your appointment. In addition to being in a well-lit location, place the screen at a comfortable height and distance to avoid the so-called ‘selfie’ effect that can distort the appearance of certain facial features. 

### **4. Know Who You’re Speaking To**
Though a patient might set up their video consultation through a web portal or by calling the doctor's office, the consultation will likely be with the doctor. “I perform all of my consultations — virtual and in real life,” explains New York City-based board certified plastic and reconstructive surgeon [Melissa Doft, MD](https://aedit.com/provider/melissa-doft-md-63). “I enjoy meeting with patients beforehand to understand their aesthetic goals.” With that said, some practices may have a nurse or patient coordinator kick off or join the call, so feel free to ask about who you will be meeting with when you schedule the appointment.

### **5. Come Prepared**
As with any consultation, be prepared with questions, a clear vision, and an open mind. “By the time the telemedicine visit starts, I have already had the opportunity to review the patient’s medical history and photographs,” Dr. Baldenhofer says of [his pre-consultation protocol](https://www.craigbaldenhofermd.com/). “Therefore, It’s more of a conversation to go over any questions and discuss the risks and benefits of the procedure.”

<RelatedContent
  title={15 Questions To Ask Your Doctor During A Consultation}
  slug={questions-to-ask-your-doctor-during-plastic-surgery-consultation}
/>

Similar to a regular visit, any concern can be discussed during a telemedicine visit, but assessing can be tricky. “Any aging face consults are very easy to do during a virtual call – especially if the patient can send in photos of themselves in certain positions prior,” Dr. Lesley says. “For [rhinoplasty](https://aedit.com/aedition/difference-between-cosmetic-rhinoplasty-vs-functional-rhinoplasty) cases, I cannot examine the inside of the nose, however, I can still see the external nose and make assessments.” In the case of medical dermatology inquiries (think: a concerning mole),  the provider can discuss the area of the concern, but will not be able to diagnose without a biopsy. “[Melanoma] are impossible [to diagnose] by visual sight,” Dr. Emer says. “If you have a problem spot, I will recommend you to a [Mohs surgeon](https://aedit.com/aedition/all-about-mohs-surgery-for-skin-cancer).”

### **6. Ask About Consultation Fees** 
The cost of a consultation — virtual or otherwise — depends on the doctor. Some do not charge for the initial meeting, while others do. In the latter case, the fee usually goes a long way. “We charge the same cost for a virtual consultation as an in-office consultation,” Dr. Doft shares, adding that the fee ([$350 in her case](https://doftplasticsurgery.com/coronavirus-update/)) is applied to the cost of the procedure. The consultation fee usually helps to confirm a patient’s seriousness and likeness to to follow through with the procedure. At Dr. Emer’s practice, a virtual consultation with one of his aestheticians, skincare specialists, or physician assistants results in a personalized product regimen and [credit to shop](https://emeragecosmetics.com/products/virtual-consultation). “They pay $150 per consultation, but that goes towards the credit of the product,” he says. “They’re getting recommendations for products that will treat almost any concern and help them treat it from home.”  

## **What Happens After a Virtual Consultation**
After a virtual consultation, the best thing to do is to follow doctors orders. For those whose concerns are skin-related, dermatologists will outline the necessary steps that can be undertaken and [products that can be used at home](https://aedit.com/aedition/aestheticians-dermatologists-share-at-home-skincare-tips) before they can come in for an in-office treatment. “We offer skincare solutions, such as peels, that can be applied during a virtual consultation with an esthetician,” Dr. Emer says. “At-home peels prime and prepare patients for laser treatments and it will significantly improve their skin in one treatment.”

Patients looking to go under the knife, meanwhile, should note that further consultations will be needed. “I will never operate on anyone until I see them in person and we review our plans and make sure we are both 100 percent on the same page,” Dr. Schwartz says. The follow-up appointments will also allow surgeons to assess if any pre-op testing is needed. “Sometimes, depending on the age, medical history, and other factors, the patient will need pre-operative testing prior to the surgery,” Dr. Lesley explains, adding that, in some cases, patients will ask for additional face-to-face meetings prior to scheduling a surgery.

As in-person consultations and surgeries are off the table at the moment, surgeons are cognizant of their patients’ desires, budgets, and safety. “We plan to have follow-up in-person consultations once the crisis is over, but the virtual consultation allows us to start communicating with patients, sending in packages to insurance companies for approval, and making the fall schedule,” Dr. Doft says. “Once elective surgeries can occur again, there will be a major rush for operating room space, and we want to make sure our patients do not have to endure long wait times.” 

## **The Takeaway**
Whether you’re near or far, a virtual consultation is a viable option for anyone looking to explore their options or get to know a provider. While not every procedure or concern can be addressed virtually, telemedicine allows patients and doctors to communicate their goals, desires, and potential treatment plans. At the end of the day, a video call cannot fully replace an in-person appointment, but Dr. Lesley and Dr. Morgan maintain that there is no reason to not try it. “They are easy and fun,” they say. “It is an amazing way to be productive during this time when we all have to physically be home.”

Now Trending

Virtual consultations (or telemedicine) are nothing new for many plastic surgeons, dermatologists, and cosmetic dentists, and The AEDITION is answering all your questions about how they work and what they can treat.

A Guide To Virtual Consultations And Telemedicine In Plastic Surgeon, Dermatology, And Cosmetic Dentistry

Here’s What You Need To Know About Virtual Consultations

shutterstock 595882181 (1)

In my life as a beauty and grooming journalist, I’ll try anything once. I’ve lost track of how many doctor’s offices I’ve visited, how many treatments I’ve received, and how many times different doctors have explained procedures to me (often the same way, sometimes not). But when it came to my own cosmetic surgery last year, I was faced with a new dilemma. For all the non-invasive cosmetic procedures I’ve done, I’d never gone under the knife. This was a whole new ballgame and something I did not want to take lightly. And most important to that whole decision was who I chose to actually do it.

## **So Long, SIMON**
I am just one of an [increasing number of men](https://aedit.com/aedition/what-you-need-to-know-about-male-plastic-surgery-trends) seeking out cosmetic procedures, both surgical and non-surgical. As more men crowd the offices of dermatologists and plastic surgeons around the country, the way providers interact with these men is changing. “Twenty years ago there was a term [for the typical male plastic surgery patient] called SIMON, which stood for ‘Single, Immature, Male that is Overly Expectant and Narcissistic,’” says Manhattan-based board certified plastic surgeon [Philip Miller, MD](https://aedit.com/provider/philip-miller-md-71). SIMON patients were difficult to satisfy because of their high expectations, which isn’t necessarily a male characteristic but seemed to be common among the kinds of men seeking out aesthetic treatments a few decades ago. This reputation turned every male patient that came into a provider’s office into an immediate red flag.

<PullQuote attributedTo={Philip Miller, MD}>
  “Twenty years ago there was a term [for the typical male plastic surgery patient] called SIMON, which stood for ‘Single, Immature, Male that is Overly Expectant and Narcissistic.’”
</PullQuote>

According to Dr. Miller, who I ultimately chose to perform my surgery, times have changed. “The notion of a male patient automatically being a SIMON is an old perspective. There are more people seeking out [aesthetic surgery] who have reasonable expectations, are a delight to work with, and are very happy with their results,” he says. It’s mostly because knowledge around plastic surgery and cosmetic procedures is much more common, particularly among men. Increased knowledge not only allows more men to feel comfortable seeking out aesthetic treatments, but also puts the power in their hands when selecting a provider. 

## **Male Patients vs. Female Patients**
Still, the way men approach medical aesthetics and cosmetic surgery is sometimes different from women. Women tend to be a bit more exploratory, whereas men “tend to be more direct and come in with something they want to work on specifically,” says board certified dermatologist [Morgan Rabach, MD](https://aedit.com/provider/morgan-rabach-md-17913), of LM Medical in New York City. Typically, men will have noticed something they want to change — like crow’s feet or jowls — and seek out a provider to attack that specific issue. It’s less typical, according to Dr. Morgan, for a man to ask a general question like, “what do I need?”

Part of that could be due to how men usually find their providers: through referrals. “Most of my male surgical patients come from trusted sources like other patients,” says [Lesley Rabach, MD](https://aedit.com/provider/lesley-rabach-md-17912), a double board certified facial plastic and reconstructive surgeon and co-founder of LM Medical. “They say, ‘I’m not going anywhere else because you’re the best person for this.’ They already have an idea of what they want and they don’t question it.” In many cases, she says, her male patients seem to have done lots of research before they even walk through her door because they ask specific questions about a certain procedure they want. “Even if they haven’t done any [research], they approach it like they have,” she says.

Specifics will always help when choosing a provider, but that doesn’t mean it’s easy. According to Dr. Lesley, some men are so eager to get on with the procedure they ask if they can do it the same day (or worse, attempt to forgo the consultation completely). 

## **How to Find a Provider**
Regardless of gender, anyone approaching aesthetic surgery or non-invasive treatments should not take the decision lightly. And for men who may be getting their first procedure — like I was — it’s essential to have a plan of action before committing. These are the most important things to consider when choosing a provider, according to the experts.

### **Get Multiple Consultations (From Different Providers)**
Most doctors who work on both male and female patients say that women tend to shop around more than men before making a decision. Knowing what you want is one thing, but, when it comes to going under the knife or laser, it’s better to be completely sure you’re working with the right person. “I tell patients to go see three people,” says Beverly Hills board certified plastic surgeon [Babak Dadvand, MD](https://aedit.com/provider/babak-dadvand-md-438). “If you see two people and they say different things, it leaves you more confused. If you see three people, chances are either two or all three of them will agree on the same technique.”

<RelatedContent
  title={15 Questions To Ask Your Provider During A Consultation}
  slug={questions-to-ask-your-doctor-during-plastic-surgery-consultation}
/>

### **Choose Based On Specialty**
Think of it this way: if you drive a Ferrari, you don’t take it to just any mechanic for a tune up; you take it to someone who specializes in Ferraris. The same goes for any time you’re considering a cosmetic procedure; you want to work with someone who does similar procedures all day, every day. Do research before you reach out for a consultation. If you can’t tell from their website, don’t be shy to ask in an email or call their office. “It always surprises me when someone comes in and asks for a body procedure,” says Dr. Morgan, who specializes in facial dermatology. “If you want body work, go to a body person. You only have one face.”

### **Always Look At Before and After Pictures**
According to Dr. Lesley, some of her male patients are so determined before they walk through her door that they don’t even want to look at before and after pictures. This, however, is never good. Looking at pictures of a provider’s work isn’t a marketing gimmick, it’s a way to ensure they can deliver the results you’re looking for. “The most important thing is to make sure their aesthetic is what you want,” she says. Ask to look at photos of the specific procedure you’re considering, and, if possible, focus on the photos of male patients. “You want to make sure you walk out looking better than you did walking in,” she says, so if you don’t like how the patients look in their photos, that’s a good indication they’re not the right provider for you.

### **Their Gender Doesn’t Matter, But Their Work Does**
When you book a massage, you’re typically asked if you prefer a male or female therapist. That’s because some people are simply more comfortable around someone of the same or opposite gender. There’s no shame in that, and the same applies when you’re choosing a provider for a cosmetic procedure. “I’m sure it does help [sometimes] that I’m a male,” says [Dhaval Bhanusali, MD](http://www.bhanusalimd.com/), a New York City-based board certified dermatologist. “When you’re comfortable with someone, you’ll talk to them.”

Dr. Lesley, meanwhile, sees the other side. “Some men feel more comfortable opening up about skincare and plastic surgery to a woman,” she says. A provider’s gender may get you in the door, but it should never be the deciding factor in working with them. What matters is your gender and how often they work with male patients. “You want to go with someone who has a lot of experience dealing with and operating on men to give them a masculine and not a feminine appearance and understands that there is a difference,” Dr. Miller says. A good way to tell if a doctor is experienced with men is the before and after pictures on their website, but, as Dr. Miller notes, their ability to post pictures depends on patient approval — and many men don’t give it. If you don’t see many photos of men, email the provider or call their office and ask up front.

### **Communicate Clearly**
Communicating with a potential provider doesn’t depend on knowing a bunch of medical terms or even exactly what you want to do. Instead, being able to articulate what’s bothering you and what results you want to see is important. “There are certain words patients may want to use, which lend themselves immediately to miscommunication,” says Dr. Miller. “Things like ‘I want to look softer’ or ‘I don’t want to look weak.’ These are emotional terms, not descriptive terms, and we’re going to do a descriptive procedure.” If you’re not articulating yourself, it’s ultimately up to the provider to ask questions and discern what you’re asking for. Especially for surgical procedures, the provider may use computer software to show you renderings of post-surgical results. Be prepared to give specific feedback on whether or not you like what they show you and why. The more specific you get in the consultation, the happier you’ll be with the results.

### **Be Honest**
Dr. Bhanusali notes that sometimes it takes a while for his male patients to really open up to him. They may come into his office asking about one thing — a rash, for instance — but after a while let him know they’re actually there because they’re concerned about [hair loss](https://aedit.com/aedition/what-its-like-to-get-prp-injections-for-male-hair-loss). “In a world of bravado, we sometimes forget that it’s okay to be vulnerable,” he says. Remember that a provider’s goal is to help address something you’re concerned about and give you the results you are looking for. Be honest with them about what’s bothering you and what concerns you have about a procedure. It doesn’t do you, or them, any good if you keep concerns to yourself.

<PullQuote attributedTo={Babak Dadvand, MD}>
  “I always prefer when patients come in with a list of questions because it guides the conversation.”
</PullQuote>

### **Ask The Right Questions**
The consultation is the time to ask any question you can possibly think of. If a provider seems to rush you through or doesn’t want to spend time answering them, that’s a red flag they’re not the right person for you. “I always prefer when patients come in with a list of questions because it guides the conversation,” says Dr. Dadvand. And while our experts noted that men do tend to ask questions regarding [how soon they can start working out again](https://aedit.com/aedition/how-long-does-it-takes-to-recover-from-cosmetic-surgery-procedures) and if the results will look natural, there are some others they tend to overlook, but shouldn’t. Those include:

__1. How Many of These Procedures Do You Do?__
Getting an idea of how often a provider performs the procedure you’re looking for will give you a good idea of how experienced they are with it. “Men are very into numbers,” says Dr. Miller, and knowing how often someone performs a certain procedure can give you an idea of how good your results will be.

__2. What Certifications Do You Have?__
“It’s really important that you know the qualifications of a surgeon,” says Dr. Dadvand. “Not all surgeons are created equal. I don’t often get asked whether I’m board certified.” Always ask about a provider’s education and training, as well as what certifications they have. Then do your own research on what those certifications mean. Some certifications are paid and others, like being certified by the [American Society of Plastic Surgeons (ASPS)](https://www.plasticsurgery.org/), is merit based. 

<RelatedContent
  title={What Board Certification Really Means}
  slug={medical-board-certification-in-plastic-surgery-cosmetic-dermatology}
/>

__3. What Are The Possible Risks and How Do You Address Them?__
In a consultation, it can be easy to focus so much on the results that talking about possible side effects or complications can get overlooked. This should always be one of the first things you ask, but if you don’t, your provider should go through them all with you. If they don’t, ask for another consultation to discuss before booking the procedure.

__4. What Is The Post-Procedure Plan Like?__
Providers typically go through post-procedure plans during the consultation phase (and multiple times before a surgery), but it doesn’t just apply to recovery. Ask about whether you should change your lifestyle or skincare routine moving forward. And always ask who you will be seeing for post-operative care appointments. “I never get asked whether a patient will be seeing me or an assistant in the post-operative appointments,” says Dr. Dadvand. “In my practice, I do all the post-operative visits, but in others that is not the case. It’s fine, but patients should be aware of that going in.”

### **Don’t Make Price The Deciding Factor**
When you’re making a large investment like a cosmetic procedure, it’s easy to get caught up in the expense. Price should play a factor (you don’t want to go into debt), but should never be the deciding factor in who you decide to go with. “There are a lot of reasons for differences in price,” says Dr. Dadvand. Everything from the surgeon’s experience to their geography and associated cost of living expenses can factor into how much they charge. Ask about pricing up front, but consider that as a factor in the overall consultation, not the be-all-end-all. “If you’re talking about a price difference between someone you’re really comfortable with and someone you may not be, extrapolate that difference over the next 40 years of your life. How much is that difference really? You don’t want to bargain shop your body,” he says.

## **The Most Important Consideration Is Comfort**
Out of everything that goes on in a consultation, you should walk out of it feeling comfortable with the provider; if you don’t, then they’re not the right one for you. “Even if they are the most skilled plastic surgeon, you still have to feel comfortable with them; you still have to trust them,” says Dr. Miller. “You have to feel 100 percent confident that you have been heard by the surgeon.” 

<PullQuote attributedTo={Dhaval Bhanusali, MD}>
  “When you have a trustworthy relationship with your physician, the long term results are always going to be better.”
</PullQuote>

Dr. Lesley recommends not rushing through a consultation because you’re excited to get the procedure. “Spend some time with them to establish a rapport,” she says. If you feel nervous around them, you’ll be nervous before the procedure and that could make the recovery more difficult. That goes for all providers, not just surgeons. “If you’re comfortable with your doctor, you’ll be more compliant, you’ll get better quicker, and you’ll get a better end result,” says Dr. Bhanusali. “When you have a trustworthy relationship with your physician, the long term results are always going to be better.”

Expert Opinion

Yes, some aesthetic providers work primarily with men or women — and determining whether or not a dermatologist or plastic surgeon specializes in what you are looking for is key to ensuring the best possible result.

How To Find A Plastic Surgeon Who Specializes In Cosmetic Procedures For Men

How To Find A Plastic Surgeon Or Dermatologist Who Specializes In Men

alina-miroshnichenko-yBVuRSaLqk4-unsplash

In the age of Instagram models and an undying quest to achieve the ‘perfect’ face, patients may be disappointed to know that cosmetic surgery cannot guarantee a cookie-cutter result. While the primary job of any medical professional is to keep their patient safe, plastic surgeons and cosmetic dermatologists face an additional pressure to properly manage expectations, balance desires, and deliver results. Fortunately, there are steps both aesthetic providers and patients can take to ensure the best outcome is safely achieved. 

## **Realistic Results**
One of the most important factors in maintaining patient safety is understanding what a patient wants and establishing a realistic picture of what kind of results can be achieved with cosmetic procedure(s). While researching treatment options online is an important first step in patient education, relying too heavily on ultra-filtered before and afters on Instagram is a recipe for unrealistic expectations. 

[Jason D. Bloom, MD](https://aedit.com/provider/jason-bloom-md-2248), a double board certified plastic surgeon and founder of Bloom Plastic Surgery in Bryn Mawr, PA, has seen the so-called ‘social media effect’ in his own practice — especially as it relates to [rhinoplasty](https://aedit.com/aedition/reinventing-rhinoplasty-whats-different-about-modern-nose-jobs) (i.e. nose jobs). “Social media and influencers have made people want ‘this nose,’” he says. “Patients begin to think that surgery is a robotic program where I can program what they want and it shows up on their face.”

In reality, [no two patients or procedures are the same](https://aedit.com/aedition/plastic-surgery-results-are-about-proportion-not-perfection). “This is your anatomy, which I have no control over. This is not putting in coordinates,” Dr. Bloom explains. “But I can do my best to control. I am very conservative in regard to this, and I think patients seek me out for that reason. When doing rhinoplasty, I would rather under-promise and completely overdeliver.”

Rather than basing your expectations on pictures of celebrities or your favorite influencers, ask your provider to see before and after photos of their patients to better understand their aesthetic. Many plastic surgeons also work with computerized images that allow patients to get a sense of potential results before undergoing the procedure, and apps like the [AEDITOR](https://aedit.com/aeditor-app) allow you to visualize your ideal aesthetic before you even arrive at the doctor’s office. 

## **Safety First**
Whether you are interested in undergoing your first cosmetic procedure or are looking to revise the results of a previous surgery or treatment, your provider will always first consider the health and safety of the patient. Dr. Bloom often sees this with people who are seeking a revision after [liposuction](https://aedit.com/procedure/tumescent-liposuction) of the neck area. “The process can be aggressive, and taking all the fat off that area causes scarring in the skin,” he explains. “We know the levels of nerves, but the tissue planes make the anti-repeat that much higher.”

A board certified plastic surgeon or dermatologist (in the case of non-surgical cosmetic treatments) should be able to walk you through any potential risks involved. And, it should be noted, that providers [may not perform a patient’s preferred procedure](https://aedit.com/aedition/reasons-plastic-surgeon-will-not-operate-on-patient) for any number of reasons.

## **Consultation Questions**
Maintaining good communication with your plastic surgeon is imperative. It is recommended that patients consult with at least two providers before moving ahead with any cosmetic procedure or surgery, and many patients find that they end up choosing the physician who gives them the most time to ask questions and gather the information they need to feel comfortable moving forward. 

It should come as no surprise then that [plastic surgery consultations](https://aedit.com/aedition/questions-to-ask-your-doctor-during-plastic-surgery-consultation) are the ideal time to communicate your aesthetic goals and desires to the provider and understand what they believe would be needed to help you safely achieve that. To make the conversation as fruitful as possible for everyone involved, consider asking the following questions: 

### **1. How close to my desired result will the outcome likely be?**
While before and after photos will help you understand a provider’s aesthetic, it doesn’t shed much light on your own personal results. Asking the surgeon to draw a diagram or create some kind of model or image (when possible) can help you see if the theoretical results are in line with what you were expecting. If they are not, you can discuss what other options may be open to you.

### **2. Is this procedure the safest way to achieve my desired result?**
Your surgeon will be able to lay out and discuss any potential safety risks, complications, and/or side effects associated with the procedure you are considering, in addition to offering alternative treatment plans that may be suitable, too. Since there is some level of risk with literally every procedure performed (surgical and otherwise), it is also important to inquire about what safety protocols are in place should anything go wrong.

### **3. How often do you perform this procedure?**
Dr. Bloom advises patients ask their surgeon this question to help them to establish whether or not you have found the right specialist for your procedure. “I am only a facial plastic surgeon. I am not inserting [breast implants](https://aedit.com/procedure/breast-augmentation-with-implants),” he explains. “I never want to take risks when it comes to my patients’ bodies and health. I have specialists working on every aspect of the surgery. There will always be a team of doctors making sure the patient is being taken care of to the fullest extent.” Asking how frequently a provider performs the procedure in question and looking at before and after photos will give you a sense of their level of expertise.

### **4. How long can I expect the recovery and results to last?**
Managing expectations isn’t just about the final results. It is important for patients to understand the time commitment involved pre-op and post-op to ensure the safest and [most effective recovery process](https://aedit.com/aedition/preparing-for-a-smooth-recovery-from-plastic-surgery). When it comes to results, be sure you inquire about how long you can expect to enjoy them. There can be a higher level of risk associated with revision or follow up surgery on certain parts of the body, and asking your surgeon how long results will last can give you insight into how likely it is that you will want to undergo additional procedures in the future. 

## **The Takeaway**
Plastic surgeons and dermatologists are in the business of helping patients realize their ideal aesthetic, yet those desires should never come at the expense of safety. Consulting with a [board certified provider](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) will allow you to better understand the best treatment options for your specific concerns and ensure your expectations are managed and met throughout the process.

In the age of influencers and perfectly filtered faces, patients may have unrealistic expectations about their cosmetic surgery results. Here, a facial plastic surgeon explains how to balance patient desire and safety.

How Plastic Surgeons Balance A Patient's Desired Results And Safety 

Managing Expectations: Achieving Desired Cosmetic Surgery Outcomes Safely

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You’ve done your research, saved your money, and found a [board certified plastic surgeon](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) to perform the procedure you’ve been longing for. You show up to your consultation prepared to learn the details of surgery, the length of the recovery period, and the potential risks. What you probably weren’t expecting to hear? The word ‘no.’

It is not uncommon for aesthetic surgeons to refuse to perform a procedure on a patient or suggest an alternative course of treatment. We spoke to board certified plastic surgeon [Richard J. Brown, MD](https://aedit.com/provider/richard-brown-md-4646), and board certified facial plastic surgeon [Jason D. Bloom, MD](https://aedit.com/provider/jason-bloom-md-2248), about the main reasons why a provider may choose not perform a patient’s preferred cosmetic procedure.

### **1. You Want What You Can’t Have**
The top reason a surgeon may turn down a potential patient: [unrealistic expectations](https://aedit.com/aedition/plastic-surgery-results-are-about-proportion-not-perfection). There is nothing wrong with coming to a cosmetic surgery consultation with photos of a celebrity, influencer, or even a friend, so long as you are prepared to learn why the exact look you covet may not be possible for you.

“I have to constantly remind people that this is surgery,” Dr. Bloom says. “I’m going to work towards a goal, but it’s not robotic. It’s an art.” As he explains it, surgeons must take into account the relationship between what he or she can actually do, what the patient’s anatomy is, and how the patient is going to heal before moving forward with a procedure.

“I tell patients, ‘Here’s where you are. Here’s where I think you can be,’” Dr. Brown, author of *[The Real Beauty Bible](https://www.amazon.com/Real-Beauty-Bible-Navigating-Journey/dp/1599329980)*, adds. “If you can’t either meet me somewhere in between or come down to what I think is realistic for you, then you’re not a good fit for me for this operation.’”

### **2. You Have a Health Condition** 
There are a number of health and lifestyle factors that might make a surgeon refuse to perform plastic surgery — or at least to delay an operation. If a surgeon suspects that a surgical procedure may be unsafe, patients may need to undergo certain pre-operative tests, make lifestyle changes, or sign additional paperwork before scheduling a procedure date. According to our experts, some of the most common factors include: 

- **Smoking**: Nicotine constricts blood vessels, which can lead to complications (like black, necrotic skin) during the recovery and healing process. For Dr. Brown, a positive nicotine test on surgery day is a dealbreaker because he feels it’s just not worth the risk. 
- **BMI**: Someone with a high body mass index (BMI) is at risk for both healing issues and anesthesia complications. Overweight patients are prone to blood sugar issues, which can hinder recovery, Dr. Brown says.
- **Medical Conditions**: Certain chronic health issues, such as diabetes and thyroid conditions, can lead to post-op problems. While they’re not necessarily deal breakers, Dr. Bloom says that these issues do influence whether or not he takes on a particular patient.
- **Medications**: Immunosuppressants and blood thinners are two categories of pharmaceuticals that increase the risk of infection and bleeding/hematoma — even when the patient stops taking the drug prior to surgery. Plastic surgeons evaluate these patients on a case by case basis.

### **3. You’re Doing It for the Wrong Reasons**
Cosmetic surgery can do wonders for a patient’s outlook and self-esteem, but only when it’s what you truly want for yourself. “Surgery is serious and not without complications, so why would you ever put your life at risk to try and please someone else with your body,” Dr. Brown asks. “Mindset is everything.”

He steers clear of patients who are obviously wanting to change their appearance to please a spouse, family member, or friend. “When you have surgery for someone else, you are not in the mindset to be your best and surgery won’t fix that,” he says. “Surgery does not fix relationships or make them better. If you are not doing something for yourself, it's not worth doing.”

### **4. You’re Not Ready Yet** 
Both of our experts agree that patients should be within 10 pounds of their ideal weight prior to having any procedure — even [facelifts](https://aedit.com/aedition/what-you-need-to-know-about-the-latest-smas-facelift-techniques). Dr. Brown, who performs a significant amount of breast and body work, is passionate about helping patients [achieve their body goals](https://aedit.com/aedition/why-you-should-lose-weight-before-plastic-surgery) prior to going under the knife or needle. “This has nothing to do with body shaming or me wanting them to look a certain way,” he explains. “If a [tummy tuck](https://aedit.com/procedure/abdominoplasty) patient has too much visceral (internal) fat because they still have weight to lose, then I can’t possibly plicate the rectus muscles and tighten them up and make them flat. They’re still going to have bulging.” Instead, he spends a lot of time educating patients: “I tell them, ‘Look: you’re going to spend all this money to have a great operation, but you’re going to have a suboptimal result.’”

Rather than turn patients away, Dr. Brown seeks to foster a long-term partnership. “With our wellness center, we’re able to set them up with a nutrition coach to help them with their diet and a mental coach to help them with their body image,” he shares. Eventually, he plans to offer a prepared meal service as well as trainers to help craft exercise regimens. If a patient isn’t willing to undertake the wellness journey, he or she won’t be a good fit. “They can just go find another surgeon,” he says.

### **5. You Don’t Hit It Off** 
Relationships are a two-way street. Patients may be surprised to learn that their prospective plastic surgeon is also interviewing them [during a consultation](https://aedit.com/aedition/questions-to-ask-your-doctor-during-plastic-surgery-consultation). After all, the relationship between patient and surgeon can potentially last a lifetime, if you factor in pre-op, recovery, maintenance, and any future procedures. “Sometimes they’re not a good fit for me personality-wise,” Dr. Brown explains. “I may turn them down because I don’t think that we’re going to mesh and they’re not going to be happy.” And, remember, this works both ways. If the two of you aren’t vibing during the initial consultation, feel free to say, “thank you, next.”

### **6. You Need a Different Kind of Care** 
During a consultation, plastic surgeons are not only evaluating your anatomy, your aesthetic goals, and your physical fitness for surgery. They are also considering your psychological health. “I certainly feel like I’m a counselor at certain times while talking to patients,” Dr. Bloom admits. While a certain level of insecurity is commonplace, a fixation or obsession is a red flag for any plastic surgeon. Patients who are overly preoccupied with a perceived flaw may never be satisfied with any surgical outcome and will most likely be refused any plastic surgery procedures. If a surgeon suspects that a patient might have a mental health condition, like body dysmorphic disorder (BDD), they may refer them to a therapist. 

### **7. You’ve Got It Wrong** 
Despite all of the time and effort you’ve put into researching procedures, you did not earn an honorary MD on Google and Instagram. You may think you need a certain procedure, product, or device to meet your goals, but only a board certified plastic surgeon can make the call. “My job is to give patients the right products for the right reasons,” says Dr. Bloom, who sees patients ask for products by name because of pervasive marketing. “I tell them: ‘How about I do something that’s going to give you better results, maybe even cost you a little less, and you’re going to be happier? How does that sound?’”

Both Dr. Brown and Dr. Bloom find that most patients who come into a consultation with preconceived notions end up being very receptive to their expert opinion. “I’ve never had a patient insist on a particular procedure once I’ve spent time educating them,” Dr. Brown says.

Dr. Bloom agrees, telling armchair MDs: “You might know a little bit, but you certainly don’t know as much as I do when it comes to this topic. So let me do what’s in your best interest to get you the results that you want.”

## **The Takeaway**
At the end of the day, it is in everyone’s best interest to achieve a stellar outcome, which means finding the best surgeon to perform the right procedure on a fit candidate. “In elective surgery, why would you take on any less than a perfect client with the most optimal opportunity to have a good result,” Dr. Brown says.

It’s not uncommon for a provider to refuse to perform a procedure on a patient or suggest an alternative course of treatment. Here, two board certified plastic surgeons explain why. 

Why A Plastic Surgeon May Refuse To Operate On A Patient

7 Reasons A Plastic Surgeon May Not Operate On You

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In the spirit of Women's History Month and International Women's Day, we’re here to demystify the representation of women (or lack thereof) in plastic surgery.

It’s no secret that there are far fewer women than men in the field. A 2017 study from the [Plastic and Reconstructive Surgery – Global Open](https://www.plasticsurgery.org/news/press-releases/women-underrepresented-in-plastic-surgery) found the female-to-male ratio of surgeons practicing plastic surgery is approximately one to five. The gap is smaller than other surgical specialities, but it is still surprising given that the [American Society of Plastic Surgeon (ASPS) reports](https://www.plasticsurgery.org/documents/News/Statistics/2018/cosmetic-procedures-women-2018.pdf) women received 92 percent of the cosmetic procedures performed in 2018. 

Here, four top female plastic surgeons discuss their career progression and experience as women in aesthetic medicine. From family planning to finding mentors, they lay out the factors they believe contribute to the lack of gender diversity in the field.

## **Number of Women in Medicine vs. Plastic Surgery**
New York City-based board certified plastic surgeon [Nina Naidu, MD](https://aedit.com/provider/nina-naidu-md-99), attended Cornell University for medical school and graduated in 1997. “We were completely 50:50 — so 50 percent women — and we were one of the first classes to be evenly split,” she explains. In residency, however, Dr. Naidu was the only woman in her plastic surgery program. “When I did general surgery, there was one other woman out of eight,” Dr. Naidu remembers of her dual general and plastic surgery residency. “In plastic surgery, there were no women except for me in a group of six.”

For double board certified facial plastic surgeon [Dara Liotta, MD](https://www.facialplasticsnyc.com/), her medical school breakdown at Columbia University was over 50 percent percent women. When it came to residency, a much lower percentage of women chose to go into surgery or surgical subspecialties, like plastic and reconstructive surgery. “I completed a five-year residency in otolaryngology, head and neck surgery, which was nearly 50 percent female and then an advanced fellowship in facial plastics and reconstruction,” she shares. “In both residency and fellowship, the overwhelming majority of our teachers and attending surgeons were men.” Dr. Liotta said there were only four female attendings and over 30 male attendings during her residency and fellowship. 

During her time at New York University School of Medicine, double board certified plastic surgeon [Melissa Doft, MD](https://aedit.com/provider/melissa-doft-md-63), recalls an even proportion of women and men in her class. By the time she got to her surgical residency, however, the ratio of women to men was two to five. That split, she says, was actually pretty diverse compared to other programs. “Now the plastic surgery residency has one woman in a group of 13, so the ratio is one to 12,” she shares.

At Cornell Medical College, double board certified facial plastic surgeon [Jennifer Levine, MD](https://drjenniferlevine.com/) had a similar experience. In her class of 100 people, the ratio of male to female students was 55 to 45. “It was not until I started my surgical residency that I was the only woman out of 20 students,” she recalls, adding that she was surprised by the disparity. “I did not realize that there would be so few women, as I had not experienced that before,” she says. 

## **Choice Between Motherhood & Plastic Surgery**
One key reason many women choose not specialize in plastic surgery? The number of years the training involves. Not only does surgical residency usually last until residents are 32 or 33 (at the youngest), there is no real maternity leave involved. 

“Residency occurs during the prime time that women are having children and starting a family.  The work hours are grueling, expectations very high, and commitment paramount,” Dr. Doft says. “Unlike other residencies, like pediatrics or obstetrics, where there are many women, surgical residencies are not used to having women out for maternity leave and do not encourage it.”

While it varies by program, most offer four weeks of ‘medical leave’ (hardly enough for an actual maternity leave), and it can be extended by an additional two weeks using vacation time. Missing more than six weeks, however, will likely preclude residents from finishing the program on schedule. “If you try to take more time off, you might not be able to graduate on time,” Dr. Naidu says. “You might have to put extra time in, so that's a huge issue.”  

Something else to consider? The lack of services available to new moms once they return to work. In addition to the grueling schedule of raising an infant while on-call and sleep deprived, finding a place to pump for women who choose to breastfeed may prove difficult. “There's a huge host of problems, so I think a lot of women look at that and think, ‘Wow this is just not compatible with having a regular life,’” Dr. Naidu says. “That's one reason there aren't that many women plastic surgeons.” 

Yes, having children as a female plastic surgeon is difficult, but Dr. Liotta says there is rarely a convenient time for anyone to have kids. “Just have them and the world around you will adapt,” she says, adding that you’re not going to be able to be everything to everyone. “If you truly want to be a surgeon, and you can’t be happy doing anything else — you know who you are! — then say ‘F that’ and do it,” she advises. She recommends reaching out to other women for advice and support. 

Additionally, Dr. Levine says small (but necessary) changes have been made to residency programs that allow for more of a work-life balance. “One week I was in the hospital 130 hours,” she recalls. Now, there are stricter rules regarding how many hours doctors can be at the hospital, and they are allowed to leave the hospital when they are post-call, she shares.  

## **A Lack of Mentors for Women**
In the generation ahead of Dr. Liotta, there were hardly any women specializing in plastic and reconstructive surgery despite the overwhelming majority of patients being female. “Perhaps this made it difficult for young women going through training to see a place for themselves in the field without obvious female mentors who had ‘been there and done that’ successfully in terms of navigating the predominantly male surgical culture and managing to balance work with family and outside life,” Dr. Liotta says. “Surgical residency and fellowship is very taxing, both emotionally and physically. For anyone — male, female, ethnic minority, ethnic majority — it is difficult to endure without seeing yourself in your mentors and having like-peers to confide and commiserate with.”

Dr. Naidu agrees, crediting her own mentor, [Mia Talmor, MD](https://weillcornell.org/miatalmor), for her success. “Having a same-sex mentor has been shown to be extremely helpful for women plastic surgeons and for medical students who are considering going to the field,” she says. Dr. Talmor was the first female plastic surgeon appointed to the full-time faculty of Cornell University’s Weill Medical College in New York and was four years ahead of Dr. Naidu in school. “She is a very tough woman. She stands up for herself,” Dr. Naidu says, adding that Dr. Talmor is also extremely approachable. 

Dr. Naidu connected with her when she was a first-year medical student, and the relationship continued from there. “I had that benefit that I had this role model way before I even applied for residency,” Dr. Naidu explains. “It was just something that was already there for me, and I think that made a huge difference for me.”

In general, some women may have been reluctant to go into these types of training programs because of the ‘boys club’ mentality, Dr. Levine says. But she thinks that perception is changing. “Women are no longer the only primary caregiver, and they may be the main breadwinner,” she says, adding that female patients are increasingly looking for a woman's perspective. “Whereas traditionally some women felt the need for male approval or a male voice, today’s women want to hear from someone like them and someone who understands and listens,” Dr. Levine explains.

## **Diversity in Plastic Surgery**
The lack of diversity in plastic surgery isn’t just gender based. While a [2020 ASPS study](https://www.plasticsurgery.org/news/press-releases/more-women-are-training-to-be-plastic-surgeons-but-racial-and-ethnic-representation-still-lags-behind) showed there is a growing number of women entering plastic surgery residency programs, there is still a gender *and* ethnic disparity in the industry. “We treat the whole spectrum of patients, so there needs to be more diversity,” Dr. Naidu says. “We're still really ethnically underrepresented.” 

Dr. Naidu is of South Asian descent, and, when she was in residency, she didn't know a single other South Asian plastic surgeon. “I didn't even see any until almost 10 years after I finished my training,” she says (yes, that’s male *or* female surgeons that were South Asian). “I didn't really see any ethnic diversity, until a good seven or eight years ago.” She notes that it's still not diverse per se, but it is starting to shift. “I notice it when I look around our conference room when I go to our monthly meeting for the hospital,” she says.

Dr. Levine notes that plastic surgery is only getting more popular and the patient population is increasingly diverse, but that is not necessarily reflected in the medical community. “In a patient population that is 90 percent women, only 10 percent of the surgeons are women,” Dr. Levine points out. “I personally try to change the ratio by mentoring other women through my medical school, my college, and other organizations such as [Girls Inc](https://girlsinc.org/) and [E-School for Girls](https://eschool4girls.org/).” 

Providers should be able to show patients the breadth and diversity of their work, Dr. Doft adds. “Being based in Manhattan, I have the privilege to treat many different cultures. I think it is less important that patients see themselves in the provider and more that they see that the provider has treated other patients like themselves,” she shares. “For example, I am careful to select an array of different before-and-after photos, so that patients can find a patient who looks like them with regard to weight, proportions, and ethnicity.”
 
## **Advice to Aspiring Female Plastic Surgeons** 
First and foremost, Dr. Levine says to do what you love. “I think women today are more committed to lifting up other women and have less of the ‘I suffered so you can suffer too’ mentality,” she shares. In the last decade, Dr. Levine has noticed that “an increase in outspoken, talented, and feisty young women surgeons in conventional and social media have emerged as mentors for those who follow them.” That exposure will have a positive effect both immediately and long term. “I think that is being reflected in increasing numbers of women becoming plastic surgeons,” she says. 

Dr. Doft encourages aspiring surgeons to focus on the life-changing impact cosmetic, plastic, and reconstructive work has on patients. “Every day I think that I am so lucky to have this job,” she says. “I have the opportunity to erase aspects of their bodies that women are self-conscious  about and help them become more confident — and it only takes a few hours.” 

While the progress has been slow, Dr. Naidu admits the profession has changed quite a bit over the years. When she completed her training 17 years ago and was just starting out, she was one of the few women in the space and was the only minority woman. “Now, there are a lot more women in the room,” she says. “It's more ethnically diverse as well, so it's really been a good shift.” Dr. Liotta is hopeful, too. “The road is long, and it’s definitely not the easy way,” she says. “But you can do it.” 

Women make up the majority of cosmetic surgery patients. So, why don't more women become surgeons? Four female plastic surgeons lay out the factors they feel are contributing to the lack of gender diversity in the field.

Why There Is A Lack Of Gender Diversity And Female Plastic Surgeons In Aesthetic Medicine

Why Don't More Women Become Plastic Surgeons?

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You’ve done your homework and decided you’re interested in getting a surgical or non-surgical [cosmetic procedure](https://aedit.com/aedition/difference-between-plastic-surgeons-and-cosmetic-surgeons). So, what comes next? A consultation with a board certified plastic surgeon.

Just as you wouldn’t buy a car without test driving it, you should not choose a doctor for your cosmetic surgery, procedure, or treatment without exploring your options. An initial consultation allows you to do just that. In addition to learning more about the procedure you are interested in, it is also an opportunity for you to get a sense of the doctor’s personality and practice before deciding if he or she is the right provider for you.

## **Book More Than One Consultation**
As with most decisions in life, you’ll want to get more than one opinion. You should plan to consult with at least two doctors before moving ahead with your surgery or procedure. When deciding on who to book a plastic surgery consultation with, it is important to first consider the following: 

- What is the provider’s board certification(s)?
- Does he or she have hospital privileges?
- Is he or she recommended by someone you trust?

While referrals aren’t mandatory, [researching a doctor’s board certification(s)](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) and hospital privileges (yes, even if you’re interested in an outpatient procedure) are musts. Tools like the [AEDIT provider network](https://aedit.com/providers) can help you find qualified doctors in your area.

Once you narrow down your search and schedule consultations with the providers you want to meet, there are a couple of things to keep in mind about the process. While it is standard to consult with multiple doctors before settling on ‘the one,’ it is best to not reveal the names of the other doctors you are considering. Similarly, do not share the proposals you receive from one provider with another, for it may influence what they recommend for you.

## **Questions to Ask During a Cosmetic Surgery Consultation** 
*What should you discuss in the consultation room? From reviewing before-and-after photos to learning about the pre-op and post-op care, below is a guide to the most important questions to ask during a cosmetic surgery consultation to ensure you feel empowered to make the best decision.*

### **Aesthetic & Expertise** 
**1. What procedure(s) do you recommend for me?** 
You may have your heart set on a certain procedure or treatment, but you should plan to have a conversation with your doctor during your consultation about what he or she sees as the best course of action for you and your concerns. The decision is ultimately up to you, but the plastic surgeon will be able to take a more holistic look at the situation and potentially offer [a series of options](https://aedit.com/aedition/plastic-surgery-results-are-about-proportion-not-perfection) that you are a good candidate for.

**2. How often do you perform this procedure?**
While there are exceptions, it would make sense that the more frequently a provider performs a treatment or procedure, the more time they’ve had to refine their technique and specialize in it. Asking how often they perform the procedure they are recommending or the one you are interested in will help give you a better sense of their expertise.

**3. Are there before and after photos available?**
You’ll be hard pressed to find a plastic surgeon who doesn’t readily offer a look at their previous work in the form of before-and-after photos, but don’t be shy in asking for them. In addition to seeing how the results turned out for different types of patients, you’ll also get a better sense of the doctor’s aesthetic. 

**4. Would you be willing to put me in touch with previous patients?**
If the provider you’re consulting with didn’t come recommended from a friend or colleague, asking to speak with an existing patient (preferably one who underwent the same procedure you are interested in) can be a good way to learn more about the doctor, practice, and overall experience.

### **Cost & Pre-Op Care**
**5. What is the cost breakdown of this procedure?**
Because most cosmetic procedures are considered elective, they are not typically covered by insurance. They are also not cheap. Prices can vary dramatically from practice to practice, as can the way the cost is presented. To avoid hidden fees or surprises, ask for a comprehensive overview that includes pre-op and post-op care. While it is impossible to foresee complications, getting a sense of any additional expenses that may pop up (from recovery essentials to additional procedures) will allow you to budget accordingly. With that said, certain cases of rhinoplasty, eyelid procedures, and breast surgeries (to name a few) may be fully or partially subsidized by insurance, so be sure to check with your insurance provider before booking.

**6. How many pre-op appointments will be needed?**
If you’re interested in a surgical procedure, you’ve likely already considered the recovery time that may be required. But what about the time involved with pre-op prep? From bloodwork to imaging, there are tests to be run and assets to be secured prior to going under the knife or needle. Get a sense of what the timeline looks like from the day you book your procedure until your last follow-up appointment to ensure you are able to make the commitment.

**7. Is there anything I need to do prior to getting the procedure?**
Whether you need to [lose weight before scheduling a body contouring procedure](https://aedit.com/aedition/why-you-should-lose-weight-before-plastic-surgery) or press pause on your skincare routine in the days leading up to a treatment, you’ll want to have the provider give you a sense of any pre-operative instructions or guidelines. That way, you can consider how they may impact your daily life.

### **Safety** 
**8. Where will this procedure be performed?**
Whether your procedure is being performed in a [hospital or an outpatient surgery center](https://aedit.com/aedition/unexpected-things-to-know-about-the-plastic-surgery-operating-room), you’ll want to ensure the facility is accredited. Both are evaluated for safety by [The Joint Commission](https://www.qualitycheck.org/), though outpatient surgical facilities may also be accredited (voluntarily) by the [Accreditation Association for Ambulatory Health Care (AAAHC)](https://www.aaahc.org/). If you’re undergoing an outpatient procedure, be sure your doctor has hospital privileges to avoid possible risks in case of an emergency.

**9. Does this procedure require anesthesia?**
In addition to learning whether or not your procedure requires [sedation or anesthesia](https://aedit.com/aedition/everything-you-need-to-know-about-anesthesia), you’ll also want to know who will be administering it. Be sure there will be a board certified anesthesiologist or certified registered nurse anesthetist on hand to administer and monitor throughout the procedure. Knowing the type of anesthesia required will also inform whether or not you will need someone to give you a ride home and care for you post-op.

**10. What is the protocol if there are serious complications during the procedure?**
Statistically, even the most qualified doctors performing the most routine procedures can run into complications. One of the reasons it is important to establish that your provider has hospital privileges is in the event there is an emergency during an outpatient procedure. Confirming what processes are in place to deal with unexpected events in the operating room can provide peace of mind.

### **Recovery & Results**
**11. What is the downtime associated with this procedure?**
While there are plenty of minimally invasive procedures that you can schedule during your lunch break, most surgical procedures will require at least a couple days of recuperation. Ask the doctor to break down the recovery period, including how long it will be before you can resume certain levels of activity (from returning to work to exercising) and the side effects (think: pain, swelling, and bruising) you can expect to experience during each phase.

**12. Will I receive written post-op instructions?**
Sure, you may be able to wing the assembly of your IKEA furniture, but recovering from a cosmetic procedure that you just invested a lot of money in is not something you want to do blindly. Most doctors will have written post-operative instructions available for patients that detail everything from pain med and icing schedules to when you can resume basic day-to-day activities (think: showering, laying down, etc.). As simple as it may seem, you want to be sure that you will have something to refer back to when it comes time to navigate the recovery process.

**13. Is there a medical professional on call to answer post-op questions?**
No matter how much research you do beforehand and how thorough the written post-op instructions may be, you can pretty much guarantee that a question (or many!) will arise during the recovery process and require immediate assistance. In addition to good ol’ fashion phone calls, many practices now offer live chats on their websites that allow patients to speak with doctors, physician assistants, and/or nurses in real time. Check with the provider to see what types of services would be available to you.

**14. How many follow-up appointments will be necessary?**
While the exact number of post-op appointments varies by procedure, at least one follow-up is usually needed within the first week. That may be the only check-in needed for, say, an injectable treatment, but surgical patients can expect to meet with their cosmetic surgeon several times in the months following their procedure. Like pre-op care, it is important to have a sense of the timeline prior to booking.

**15. How long will it be before I see results?**
Any doctor will tell you that the healing process, like the procedure itself, depends on the patient, but there are general timelines that can shed some light on when you will start seeing the effects of the procedure and when you can expect a final result. While the results of some procedures are immediate, others can take a year (or more) to fully reveal themselves, so you’ll want to be sure your expectations and patience-level are managed beforehand. 

## **Additional Factors to Consider Before Choosing a Provider**  
*While qualifications and expertise are certainly key components of the decision-making process, there are intangibles related to a provider’s personality, bedside manner, and practice that cannot be underestimated. Even if the provider checks all the boxes above, be sure to also consider the following before choosing who to book your procedure with.*

### **Do you feel comfortable with the doctor?**
The doctor doesn’t need to be your best friend, but he or she should put you at ease. In addition to (hopefully) answering all of your questions, consider how you feel when speaking with the provider. Undergoing any procedure (even an elective one) is a big decision, and you should feel respected and empowered throughout the process.  

### **Are you comfortable with the practice and facilities?**
Did you wait long in the office before seeing the doctor for your consultation? Did the appointment feel rushed? How was the vibe in the waiting area and patient rooms? Taking notice of how you feel about these kinds of details should play a role in how you go about choosing a provider.

### **Is the provider's staff professional and courteous?**
Truth be told, you’ll probably be interacting more with the practice staff than you will with the doctor. From the receptionist to the nurses, pay attention to your interactions with the entire team and notice how they communicate with the provider. All of this will give you insight into what kind of care you can expect before, during, and after your procedure.

## **The Takeaway**
Choosing to undergo a cosmetic surgery procedure is an important decision in and of itself, but finding the right surgeon or doctor for your needs is key to achieving the outcome you desire. Scheduling initial consultations with at least two providers and arriving armed with a list of questions that covers everything from aesthetics and safety to cost and recovery can help you compare and contrast as you narrow down your search.

Aesthetics

From reviewing before-and-after photos to learning about the pre-op and post-op care, here is a guide to the most important questions to ask during a cosmetic surgery consultation.

Questions To Ask Your Doctor During A Plastic Surgery Consultation 

15 Questions To Ask Your Doctor During A Plastic Surgery Consultation 

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If you're a regular reader of The AEDITION, you know we always emphasize finding a 'board certified' provider to perform your preferred cosmetic procedure. But what does it mean to be a board certified plastic surgeon or dermatologist? How do doctors go about becoming certified? We're here to shed some light on the board certification process and why it matters.

## **Medical Licensure vs. Board Certification**
First things first, a licensed doctor is not the same as a board certified one. A medical license is required for all doctors who wish to legally practice medicine in the United States, and medical licensure is handled at the state level by state medical boards. Doctors must receive individual licenses in each state they wish to practice in, and they must be renewed periodically.

While the protocol varies from state to state, you can be sure that all licensed physicians (at the minimum) graduated medical school, underwent some level of postgraduate residency training, and passed a comprehensive national licensing exam (either the United States Medical Licensure Examinations [USMLE] for medical doctors or the Comprehensive Osteopathic Medical Licensing Examination for doctors of osteopathic medicine).

Board certification, meanwhile, signifies that the physician has successfully completed a residency in their chosen specialty. In order to become board certified, a doctor must have completed his or her undergraduate education, medical school, one-year internship, a residency in their chosen specialty, and passed the residency board exam.   
  
Unlike a medical license, board certification is not required to practice medicine in the U.S., but it is an important tool in distinguishing whether or not a provider has specialized in a particular area. Additionally, board certification does not last forever. Many medical specialty boards now require recertification every 10 years or so, ensuring doctors keep on top of their skills.

## **Why Board Certification Matters**
Board certification is important for all fields of medicine, but it is particularly necessary in the aesthetic space. While it cannot guarantee the quality of results, it can certainly point you in the direction of qualified doctors for the procedure you are interested in or care you need.

Titles like cosmetic surgeon, plastic surgeon, and cosmetic dermatologist have [seemingly become interchangeable](https://aedit.com/aedition/difference-between-plastic-surgeons-and-cosmetic-surgeons), but the qualifications of such doctors can vary greatly. Because there is very little regulation governing how doctors refer to themselves, understanding your provider's board certification(s) can ensure you are consulting with a doctor or surgeon who is actually trained in plastic and reconstructive surgery, otolaryngology, ophthalmology, or dermatology (i.e. the specialties that most relate to aesthetic medicine).

## **How Doctors Become Board Certified**
The [American Board of Medical Specialties](https://www.abms.org/member-boards/) (ABMS) is comprised of 24 certifying boards that are known as the Member Boards of ABMS. Specialties range from internal medicine to radiology, and while it's pretty straightforward that a pediatrician would be certified by the American Board of Pediatrics or a gynecologist would be certified by the American Board of Obstetrics and Gynecology, gaining certification in aesthetic medicine is less clear.

Sure, there is an American Board of Plastic Surgery (ABPS) and American Board of Dermatology (ABD) that offer subspecialties in hand surgery, dermatopathology, and pediatric dermatology, but there are no member boards for specialities like oculoplastic surgery or cosmetic dentistry. Further complicating matters is the fact that there are board certifying organizations that exist outside of ABMS. While some have standards that are as rigorous as the written and oral examinations Member Boards administer, not all do.

When choosing a provider to perform a cosmetic procedure or cosmetic surgery, look for a specialist in the following categories:

### **Plastic and Reconstructive Surgery**
General plastic and reconstructive surgeons complete three to five years of general surgery training followed by a two to three year cosmetic and reconstructive plastic surgery residency. Plastic and reconstructive surgeons can pursue board certification via the [American Board of Plastic Surgery](https://www.abplasticsurgery.org/), and they may be dual-certified by the [American Board of Surgery](http://www.absurgery.org/) (ABS). While they are board certified to perform cosmetic and reconstructive surgeries on the face and body, their work often focuses on the breasts and body.

### **Facial Plastic and Reconstructive Surgery**
After completing a five-year residency in otolaryngology (a.k.a. ears, nose, and throat), facial plastic and reconstructive surgeons pursue year-long fellowships in cosmetic and reconstructive procedures specifically related to the face and neck (think: rhinoplasties, facelifts, chin and jaw surgeries, etc.). While there is no ABMS Member Board specifically for facial plastic and reconstructive surgery, they should be board certified by the [American Board of Otolaryngology – Head and Neck Surgery](https://www.aboto.org/) (ABOTO). The [American Board of Facial Plastic and Reconstructive Surgery](https://www.abfprs.org/) (ABFPRS) is also an accreditation that many facial plastic surgeons seek.

### **Dermatology**
Medical dermatologists diagnose, treat, and prevent conditions affecting the skin, hair, and nails. While there are subspecialties within the field, all dermatologists board certified by the [American Board of Dermatology](https://www.abderm.org/) undergo non-surgical, cosmetic dermatology training during their residency program. Dermatologic surgeons (i.e. those qualified to perform liposuction, fat transfer, and Mohs surgery, in addition to non-invasive treatments) are often fellows of the [American Society for Dermatologic Surgery](https://www.asds.net/) (ASDS). Asking to see before-and-after photos and inquiring as to how often they perform certain cosmetic treatments and procedures will shed further light on their aesthetic expertise.

### **Oculoplastic Surgery**
While a facial plastic surgeon is able to perform eyelid surgeries (like [blepharoplasty](https://aedit.com/procedure/upper-eyelid-blepharoplasty)), oculoplastic or oculofacial surgeons are experts in procedures that reconstruct the eyelids, tear ducts, and orbital area. They should be board certified by the [American Board of Ophthalmology](https://abop.org/) (ABOP) and have additional fellowship training with the [American Society of Ophthalmic Plastic and Reconstructive Surgery](https://www.asoprs.org/) (ASOPRS).

## **Fellowships & Societies**
Doctors who wish to further specialize in a particular area of medicine may choose to continue their training and education via a fellowship. Fellowship programs are often highly competitive and last one to three years each. Due to the lack of ABMS Member Boards in certain subspecialties, fellowships may be used to denote expertise. An ophthalmologist who wishes to subspecialize in oculoplastic surgery, for instance, would complete a two-year fellowship through the aforementioned ASOPRS.

Society memberships, meanwhile, offer another way (separate from licensing, board certification, and fellowships) for providers to continue their education, in addition to offering mentoring and networking opportunities. Below are some of the academies and societies related to aesthetic medicine, cosmetic surgery, and dermatology:

- [American Academy of Aesthetic Medicine](https://www.aaamed.org/) (AAAM)
- [American Academy of Cosmetic Dentistry](https://aacd.com/) (AACD)
- [American Academy of Cosmetic Surgery](https://www.cosmeticsurgery.org/) (AACS)
- [American Academy of Dermatology](https://www.aad.org/) (AAD)
- [American Academy of Facial Plastic & Reconstructive Surgery](https://www.aafprs.org/) (AAFPRS)
- [American Society of Aesthetic Plastic Surgery](https://www.smartbeautyguide.com/) (ASAPS)
- [American Society of Cosmetic Laser Surgery](https://www.cosmeticsurgery.org/page/SubspecialtyOrganiz) (ASCLS)
- [American Society for Dental Aesthetics](http://www.asdatoday.com/) (ASDA)
- [American Society of Dermatologic Surgery](https://www.asds.net/) (ASDS)
- [American Society of Hair Restoration Surgery](https://www.cosmeticsurgery.org/page/SubspecialtyOrganiz) (ASHRS)
- [American Society of Liposuction Surgery](https://www.cosmeticsurgery.org/page/SubspecialtyOrganiz) (ASLS)
- [American Society of Ophthalmic Plastic & Reconstructive Surgery](https://www.asoprs.org/) (ASOPRS)
- [American Society of Plastic Surgeons](https://www.plasticsurgery.org/) (ASPS)

While these affiliations are voluntary, a doctor may display their memberships as an indicator of interest and engagement in their specialty. 

## **The Takeaway**
There is perhaps no more important task in your aesthetic journey than finding the right physician to perform your cosmetic surgery procedure, and understanding the board certification process is a key part of that. While all the certifications, licenses, and credentials in the world cannot guarantee results, knowing that your doctor specializes in the procedure you are interested in is the first step toward ensuring you get the best care for your needs.

If you’re interested in a cosmetic procedure, you’ve likely been told to find a board certified provider. But what does it mean to be a board certified plastic surgeon or dermatologist? The AEDITION breaks it down.

How Plastic Surgeons And Cosmetic Dermatologists Become Board Certified 

What Does Board Certification Really Mean?

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*Finding the right plastic surgeon is a lot like dating. You’ll likely have to consult with a few doctors —and maybe meet a frog or two along the way — before you find the best one for your cosmetic surgery.*

*So, how do you know when you've found The One? There are a few important factors. For starters, he or she must be board certified by the [American Board of Plastic Surgery](https://www.abplasticsurgery.org/), must have attended an accredited medical school, and must perform all procedures in an accredited or state-licensed surgical facility and operating room. What makes them the right doctor for you beyond professional accreditation is a bit more subjective. In this series, we ask real patients to share their surgeon-selection stories to help guide — and safeguard — your own cosmetic surgeon search.*

*The below interview has been edited for length and clarity.*

## **Susan, 53**

My plastic surgeon and I had a slow courtship. About 10 years ago, I started to feel like my eyelids were sagging. And, while I knew surgery may be the answer down the road, I was determined to try the non-invasive route first to see if that would garner good-enough results. Thus, when I initially met my doctor, I asked her to give me [Botox®](https://aedit.com/procedure/botox-facial) to lift my brows — instead of going straight for a [blepharoplasty](https://aedit.com/procedure/upper-eyelid-blepharoplasty) (a.k.a. eyelid surgery).

### **Building A Rapport** 

I continued the non-invasive cosmetic procedure route for years and, over that time, really got to know my doctor. She, like me, was a busy, working mom with young kids, and she had a practical approach. She understood that I wasn’t trying to look younger or “good for my husband,” as one (male) doctor suggested to me when I visited him for a consult (next!).

About four years ago, I told her I thought we’d exhausted the non-invasive strategies and it was time to talk about surgical procedures. She agreed and began outlining what that would entail. She told me that we would only operate on my upper eyelids and that it would be a mistake to do the lower ones, too, because the shape of my eye would start to change.

### **Sense and Sensibility**

I pushed back, but she held fast, and I now realize she was right. She told me she’d rather err on the side of doing less because we could always do another type of procedure later. But, if we did too much, too soon, there was no going back. I appreciated that sensibility. She also shared insight into how I could handle talking about the surgery with my children and how recovery would impact my ability to get back to work. She really got it.

I did talk to other doctors — including the one who said “your husband will be so happy with the way you look” (ugh) — but no one compared to her practical approach. And, having known her for years, I really did trust her with my face. So, she performed my eyelid lift, and it went very well.

### **Patience Pays Off**

I think my success story lies in the fact that I spent years getting to know my doctor and her staff. I trusted them before plastic surgery procedures were even a consideration for me. While not everyone may have the luxury of waiting that long, starting smaller (with a [peel](https://aedit.com/procedure/superficial-chemical-peels) or [facial](https://aedit.com/procedure/hydrafacial) or Botox®) can certainly help you get a better sense of a surgeon's office, aesthetic, and his or her team's professionalism before signing up for a specific procedure.

I also think it’s important that your personal sensibility syncs up with that of the doctor. In my case, we were both working women who strived to look refreshed and healthy — but not necessarily younger or "sexier" (yes, one board certified plastic surgeon really did use that adjective in my consult). Ultimately, I felt like my doctor approached my [eye procedure](https://aedit.com/aedition/what-its-really-like-to-get-eyelid-surgery-blepharoplasty) the way she’d want to handle her own, and that was very reassuring.

Patient Perspective

One patient explains the time she took to find the right plastic surgeon.

How I Found My Plastic Surgeon: Don't Rush It 

shutterstock 1074678923-min

_Finding the right plastic surgeon is a lot like dating. You’ll likely have to consult with a few doctors — and maybe meet a frog or two along the way — before you find the best one for your cosmetic surgery._

_So, how do you know when you've found The One? There are a few important factors. For starters, he or she must be board certified by the [American Board of Plastic Surgery](https://www.abplasticsurgery.org/), must have attended an accredited medical school, and must perform all procedures in an accredited or state-licensed surgical facility and operating room. What makes them the right doctor for you beyond professional accreditation is a bit more subjective. In this series, we ask real patients to share their surgeon-selection stories to help guide — and safeguard — your own cosmetic surgeon search._

_The below interview has been edited for length and clarity._

## **Elizabeth, 52**
My two aesthetic plastic surgery experiences were at two extremes: the worst and the best.

The first time I had surgery was more than 12 years ago. I wanted my [nose reshaped](https://aedit.com/procedure/rhinoplasty-nose-job) and, during the consultation, was convinced by the doctor that I should also have a [chin implant](https://aedit.com/procedure/alloplastic-chin-implant) and some [liposuction](https://aedit.com/procedure/liposuction). The surgeon I chose was older — probably in his sixties at the time — and I figured he’d had lots of experience. He’d also appeared on _Oprah!_, which, in 2005, was a big deal. The first time I went to the surgeon's office, I took a friend from the beauty industry with me, and we were both impressed. Maybe less by him and more by his art-filled Upper East Side office and name-dropping, but I felt that if he’d had a successful practice for years, I’d be safe in his hands. Now, more than a decade later, I can see the red flags I missed.

### **The Immediate Warning Signs**

For starters, he smoked a cigar throughout our consultation. Seriously. He also talked at me the entire visit, bragging about his accomplishments and not really taking any time to get to know me or understand my concerns. He (successfully) upsold me on more surgery procedures — that chin implant and lipo — when I’d only come in about my nose. He never showed me his operating room, which was in the same building as his office. I also dismissed negative reviews I’d read online. At the time, chat rooms and community boards were relatively new and, while I did look at them, I didn't take them seriously. They were littered with negative comments about him, mostly referring to the fact that he had a terrible bedside manner. I should have paid closer attention. 

I could write a book about my negative plastic surgery story, but one detail sums up the experience: I woke up in the middle of my surgery to the doctor banging on my nose. That was emblematic of everything that followed. He botched my nose job, taking too much off the end and making my nostrils look over-exposed. He also left stitches inside my nose that caused an infection. He put in a chin implant that was too large and he overdid the liposuction, causing the skin in my stomach to permanently tighten and twist. In the end, he accepted no responsibility for anything and, while I did try to pursue legal action, my lawyer told me to save my money and put it toward reconstructive surgery. 

### **Second Time Around**

It was during the pursuit of corrective surgery for my nose that I found the [best surgeon](https://aedit.com/aedition/finding-the-right-plastic-surgeon-dermatologist-or-cosmetic-dentist). I first met him when I developed the infection in my nose. I’d been treated so poorly by the first doctor that, when the pain started, I didn’t trust him to take care of it. So, I searched online for the type of procedure I wanted and board certified plastic surgeons who had rave reviews when it came to nose jobs. I called the one whose name came up most often. I was desperate and scared. I explained my story to the nurse on the phone, which she communicated to him, and told me that even though he was done seeing patients for the day, he would wait at the office for me until I could get there. I was so thankful. He immediately put me on antibiotics and followed up with me until the infection was gone. 

He also helped outline the surgical procedures he thought would help me and explained that I would have to allow my nose to fully heal and wait a year before I could go under the knife again. In our follow-up meetings, he took the time to understand what I wanted and even asked me to draw a picture of what I wanted my nose to look like. He was an excellent communicator and clearly explained the kind of result I could realistically expect from these new plastic surgery procedures. He seemed to both understand what I wanted and be capable of creating it for me. I trusted his artistic skill as much as his medical acumen. I did wait a year until the second surgeon could do my corrective surgery. He restored my nose and removed the oversized chin implant. 

### **Lessons Learned**

I learned a lot during those two years of surgery and recovery. First, don’t dismiss what you read online. The negative reviews are good cautionary tales, but the positive ones are also important. People are more apt to pound out angry comments, but when someone takes the time to write about exemplary work, that’s just as telling. I also believe you should trust your gut. There were warning signs with the first doctor — the smoking, the over-talking, the disinterest in me — that made me wary, but I repressed that anxiety because of this doctor’s fancy office and television appearance. Always listen to your inner voice. Beware of any doctor who goes overboard telling you everything they think is "wrong" about you and all the additional cosmetic procedures they think you "need." If you go in for a nose job, that’s what you should be discussing. Finally, consider a surgeon with a specialty in the specific procedure you want. The second surgeon I chose is known for nose jobs — it’s what he does the most often. That turned out to be one of the most important things for me.

One patient explains how she learned to trust her instincts when vetting plastic surgeons.