Authored by: David Bogue, MD
Our practice asked board-certified plastic surgeons throughout the nation to share their perspective on what patients should know about cosmetic procedures and the doctors who perform them.
Keep reading for insights from board-certified plastic surgeons on how patients can find the best surgeon for their needs and goals, as well as what to look for to ensure a safe experience and a positive outcome.
Board-certified plastic surgeons adhere to certain core values, including:
- A commitment to patient safety
- Attaining the informed consent of each patient for every procedure
- Fully evaluating the patient’s medical history, physical health, emotional state, and cosmetic goals
- Compliance with state laws and regulations on patient care, cleanliness of the facility, and record keeping
- Adherence to the rules of conduct set forth by licensing agencies, medical specialty boards, and other governing bodies in order to maintain good standing
Some areas of the United States are known as plastic surgery “destinations” due to the number of surgeons and volume of patients traveling to the region for cosmetic procedures. More patients means more competition. Ethical board-certified plastic surgeons recognize that their duties to the values above don’t take a back seat to the possibility of higher profits.
Is your practice located in a city or area considered a “plastic surgery destination”? If so, what advice do you have for out-of-towners thinking about coming to your community for plastic surgery?
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“I practice in South Florida, which has long been a destination for plastic surgery. Before committing to a consultation or surgery in another city, I would advise patients to do their homework. First of all they should check that the surgeon has admitting privileges at a local hospital and has an excellent track record with the state board of medicine. Ask for patient referrals; particularly other people who have travelled to that location for surgery. Be sure to outline the expected recovery and how long you should stay in town. A reasonable expectation is that you stay in town for 1–2 weeks for a larger procedure. Finally, establish how your long-term follow up and questions will be answered — via phone follow-ups, email, or by travel back to the destination.”
Dr. David Bogue
Board-Certified Plastic Surgeon
Boca Raton, Florida
https://www.drbogue.com/
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Miami is one of the major destinations for plastic surgery in the country. And, despite the preponderance of qualified, ethical plastic surgeons in the area, the plastic surgery market in Miami made headlines recently for all the wrong reasons.
USA Today published an in-depth investigative article on a series of patients who died or suffered serious, life-altering injuries after receiving treatment at offices billing themselves as plastic surgery centers. According to the article, many of these facilities were founded by convicted felons who capitalized on the interest and popularity of plastic surgery in Miami by opening practices that value quantity of patients over quality of care. They hired doctors who were not certified by the American Board of Plastic Surgery. Some of these doctors performed surgery while they were under investigation. Others had already been subject to malpractice lawsuits and disciplinary action.
The USA Today piece paints a grim picture of these centers: more than a dozen patients dead, and approximately the same number suffering adverse reactions and lifelong complications. Another troubling component is the Florida legislature’s continued lack of action to introduce laws that crack down on practices run by criminals and regularly violating safety standards.
Describe what being a board-certified plastic surgeon means to you. Beyond the high standards set forth by the ABPS, why is this credential the gold standard for patients seeking plastic surgery?
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“ABPS is the gold standard, but it is just a standard. Plastic surgery is so many things beyond board certification. ABPS is just the start. In my opinion, ABPS is not the be all and end all. You have to be in the top 1% of patient care and surgical skill. That’s the goal we strive for.”
Dr. Richard Lee
Board-Certified Plastic Surgeon, Renaissance Plastic Surgery, Inc.
Newport Beach, California
https://www.newportbody.com/
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Certain lawmakers have tried to pass legislation making it more difficult for these centers to open or stay in business, providing serious penalties in the event of violations, and more.
“People are coming here from all over the country for what should have been simple procedures, and they’re dying,” said one Florida state senator. “We don’t want to be known as a place where people come to die.”
Unfortunately, the authors of the article identify the regulation-averse climate of Florida as a major stumbling block to positive change.
“Over-regulation, they tell people,” said another lawmaker who entered conversations with the Florida Society of Plastic Surgeons as complaints began to grow. “They use that as an excuse even when people die.”
When making the decision to get plastic surgery, it is easy to feel overwhelmed by options. Whether you look for a high-quality local plastic surgeon or consider traveling elsewhere, multiple practices are competing for your business. As a general rule, never entrust your health to someone making a hard sell.
How do you balance the duties of a physician and surgeon with the need to drive revenue for your business?
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“There is a fine balance. Patients’ needs and health always come first. We want the patient to always make their decision on who makes them feel comfortable and confident, rather than just the price. Yes, it is important to drive revenue, but patient safety and their needs come before any others.”
Dr. Sacha Obaid
Board-Certified Plastic Surgeon, North Texas Plastic Surgery
Dallas, Texas
https://northtexasplasticsurgery.com
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Most kinds of plastic surgery are elective cosmetic procedures, but the surgeons who perform them should comport themselves first as medical doctors, not business owners. They should make you feel comfortable with your decision and answer your questions fully, placing your needs as a patient ahead of their potential profits.
What are some “red flags” patients should watch out for when they’re first evaluating a plastic surgery office online or visiting in-person?
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“Patients have multiple resources available online to identify which plastic surgery practices to consult with and which to avoid. There are ‘red flags’ to look out for, but remember that a single red flag may not tell the whole story. The following list is a good starting point when you are trying to identify red flags:
- Your plastic surgeon should have hospital admitting privileges. This is for several reasons. If you should need a hospitalization, your plastic surgeon can help with the management of your care. It also means that the hospital has done the background checks necessary to verify that the plastic surgeon’s credentials are legitimate and that they are properly certified.
- If you require a medical clearance for surgery, is it done at the surgeon’s office? This is an obvious conflict of interest. Medical clearance for procedures should be independent of the practice collecting the fees for the procedure.
- The surgeon you consult with should be the surgeon who operates on you! Assembly lines are fine for building cars, but not a great idea for surgery. Your plastic surgeon should earn your trust, develop your plan, perform your operation, and guide you through the postoperative recovery.
- If you have surgery out of state, is the recovery location well-defined? If you are in a hotel, is there a properly certified and trained nurse present to take care of you? What is the established plan if there is a problem? The answers to these questions should be provided and well established.
- Read reviews with a touch of skepticism. Do you trust 1,000 five-star reviews with no description more than 100 4-star reviews with personal stories by the patients? Every surgeon will have some negative reviews. In today’s world, it’s easy to pay for reviews. Take your time to read what’s online. If a clinic changes its name every two years, what is it hiding?
- Finally, be cautious of superiority claims. Self-proclamations of the surgeon being the best in the world at something or having invented a procedure are grandiose and often misleading. If someone is truly remarkable, they typically don’t have to tell you themselves; others tell you for them.
Hopefully these red flags help. Again, choosing a plastic surgeon is a combination of many factors, and patients ultimately must decide who is the best fit for them.”
Dr. David Bogue
Board-Certified Plastic Surgeon
Boca Raton, Florida
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All plastic surgery — indeed, all surgeries in general — carries some degree of risk. This is an absolute truth that all plastic surgeons are duty-bound to make sure patients understand. Effectively communicating this information empowers patients to make an informed decision about their health and provide consent to undergo the procedure.
If you are considering plastic surgery, the surgeon should be able to provide the information you need to make a decision, such as:
- Discussing his or her background and credentials openly. This includes schooling, training, licensing, and experience with the procedure you are considering.
- Sharing before-and-after photos of patient results for the procedure in which you are interested.
- Providing patient reviews, up to and including connecting you with patients who are willing to discuss their experience with the surgeon and the practice as a whole.
From a patient’s perspective, what constitutes a positive initial consultation? What are the things patients should come away from the meeting feeling confident about in regards to the doctor, staff, office, etc.?
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“Overall, the patient should have a good feel for the office and the doctor. We do our very best to make sure the patient is comfortable, since most patients are nervous. I answer all of their questions and explain everything I know about the surgery and recovery in a comprehensive manner without any rushing. We want to give the patient a good feel as to how we operate. We go above and beyond what is required to make sure the patient is safe, and comes out of surgery 100% satisfied. We don’t stop until the patient is happy.”
Dr. Richard Lee
Board-Certified Plastic Surgeon, Renaissance Plastic Surgery, Inc.
Newport Beach, California
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As board-certified plastic surgeons, it is our duty to educate the public so they can build trust in their doctors and feel confident in their decision to undergo plastic surgery. The role of condemning the actions of the parties named in this article belongs to the patients, the courts, the legislature, and others who are involved in the matter at hand.
What kinds of information and/or materials do you provide prospective patients so they can make informed decisions?
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“Depends on the procedure, but the discussion starts with the telephone call when the patient calls to schedule their appointment. We always direct them to our website to review the procedures and before and afters, we discuss recovery and expectations before the patient comes for the visit as well as basic requirements beforehand to make best use of their time. If that patient is having a procedure that includes implants, they are able to look, feel, touch, try on during their consultation so they know what they are getting and their options. We also give pamphlet information that they can take home to review after they leave. During the phone call and the consultation, patients are informed about the procedure itself, what to expect before, during and after surgery, recovery time and so much more.”
Dr. Sacha Obaid
Board-Certified Plastic Surgeon, North Texas Plastic Surgery
Dallas, Texas
If you’re interested in plastic surgery or have questions, please contact Dr. Bogue in Boca Raton today at (561) 886–1000 to schedule your consultation.
