What about Anesthesia?
Should my implant be placed below or above the muscle?
How should I choose my surgeon?
Is the support staff credentialed such as CRNA, M.D., R.N.. C.M.A., L.P.N., P.A. etc.?
How should I choose my surgeon?
1. Appropriateness of training.
2. Quality of education.
3. Experience in the procedures you are interested in.
4. Enthusiasm, care and compassion of the provider and his/her staff.
At the minimum, your physician had better be a surgeon of somekind. That means a minimum of one year in general surgery training and education in handling surgical emergencies. I would caution patients about care from non-surgeons. Although being a surgeon alone in no way guarantees competence in cosmetic surgery, it does provide a basic foundation that I feel is necessary prior to specialization in care of surgical patients.
Patients should never use simple certifications as reassurance of quality or experience. A physician/ surgeon who attempts to represent competence or experience by certification alone should be held in strong suspect. This may be a clear sign of inadequate education, training and most importantly, a lack of experience in perhaps ever having performed the procedure- even once in their career! Although our surgeons have significantly more certifications and accolades than most other physicians over their average of 14 years of post graduate education, they will never say that this is what made them good at what they do. They are just pieces of paper after all!
Most residencies do not provide any significant exposure to cosmetic procedures. Experience is then either achieved through accredited fellowship training or by experimentation on patients, which is never acceptable. Be very concerned about the physician who does not speak of his specific number of cases performed. Either they do not have good record keeping, which is a very bad sign, or they are hiding something.
The second most important statistic is the probability of requiring revision surgery to correct a problem. Not all cases go as expected and healing is the ultimate uncertainty but thousands of cases will provide insight into surgical errors which require correction. This information also should be readily available and immediately provided to any patient concerned about their care. Any physician who does not immediately provide this information should be held suspect. An excellent surgeon will speak openly and proudly of his or her record in exact numbers and cases. Nothing should be hidden or uncertain at any time. Remember, it is your life, your money and your longterm care we are talking about here!
Other important factors may be the location the surgery is performed. Is the facility accredited by either a reputable national organization such as the AAAHC or JACHO or Medicare? These certifications are a sign of the level of commitment the leadership is willing to provide in meeting the accepted standards of surgical facilities from organizational issues to sterility of instruments and presence of safety equipment. Is it clean and organized as you would want it? This is a good sign of organizational leadership to look for. Take a tour of the facility and make sure you like what you see.
Other issues of consideration include:
Is the support staff credentialed such as CRNA, M.D., R.N.. C.M.A., L.P.N., P.A. etc.? Remember that the chain is only as strong as the weakest link. The entire organization should be at the top of their game. It the facility professional and staff friendly and supportive? Are your questions answered without defensive responses? Were you responded to promptly and courteously when you called? Where you provided with written and verbal information of the highest caliber?
In case of emergency, although extremely rare in cosmetic surgery, does your physician have a transfer agreement with a local hospital and is he/ she on active staff? Is this the kind of facility that you would consider for your care?
Board Certification Through the American Board of Cosmetic Surgery requires:
- Satisfactory completion of specialty residency training for an A.B.M.S. or equivalent approved board;
- Initial certification by an approved board either;
Plastic Surgery, Otolaryngology, General Surgery, Ophthalmology with an Oculoplastic Surgery fellowship, Maxillofacial Surgery with an M.D. degree or Dermatology.
- Applicant must furnish proof of at least 150 CME credits in cosmetic surgery in the three years prior to application.
- Applicant must document a minimum of six (6) years of practice experience in cosmetic surgery.
- Applicant must submit typed case logs documenting at least 1,000 cosmetic procedures within the last six (6) years.
- Applicant must submit typed case logs documenting at least 200 cosmetic procedures performed in the year prior to application.
- pass a stringent 2 day oral and written examination.
- Be of good moral character.
- Must have complete hospital privileges or work in a nationally accredited (AAAHC, JACHO, State, etc.) accredited facility.