Recently, a West Coast friend of mine called me for advice. That week he consulted four plastic surgeons (two men and two women) relative to his interest in a "Facelift" and surgical correction of an old "football nose". Thinking that by interviewing a cross-representation of plastic surgeons he would acquire virtually all of the information a reasonably intelligent individual might require in order to reach an informed decision about surgery and surgeons, he found, to his dismay, that he was more confused about the surgical options available to him afterwards than he was beforehand. Each plastic surgeon "promoted" a different "Facelift" technique and suggested a different approach to his nasal deformity. One even suggested chin augmentation to complement the anticipated change in his nasal appearance. Furthermore, their fees, from lowest to highest, varied by 100%. "How", he asked, "can I determine what surgical techniques and what plastic surgeon are most appropriate to my needs?" After questioning him for a few minutes about his experiences with each plastic surgeon, I indicated that the answer to his question should seem obvious to him. (At the end of this article I'll tell you why.)

Plastic surgeons, like other professionals, tradespersons, etc., are by no means alike. They differ in matters of substance and, perhaps more importantly, in matters of style. Most plastic surgeons these days are well-trained and technically adept, but their "performances" as plastic surgeons may vary tremendously, owing to differences in personality and practice philosophy, comfort (or perhaps lack of comfort) in dealing with patients, personal values and interests, etc. What follows is a "checklist", admittedly abbreviated owing to space limitations, which hopefully will help any potential plastic surgical patient to find that "right" plastic surgeon.

1. Academic (Professional) Achievement. A plastic surgeon who is well-trained (easily determined by his/her curriculum vitae) and who demonstrates intellectual curiosity by virtue of his/her regular participation in continuing medical education (again easily determined) is someone who more than likely wants to remain on the "cutting edge" (I couldn't resist that pun) of his/her specialty. His/Her enthusiasm for plastic surgery usually is apparent, even to the average "consumer".

2. Experience. As the old saying goes, experience is the best teacher - but only to a willing student! Any plastic surgeon who discounts, out of hand, a new approach to an old problem simply may be unwilling to learn that new approach. By the same token, new is not always better. A truly thoughtful plastic surgeon, one who remains a student for life, should be able and anxious to explain to any patient in understandable English the pros and cons of any plastic surgical procedure/technique and why, in the treatment of a specific problem, one is preferable to another. Any plastic surgeon who undertakes a surgical procedure in the same way, patient after patient, probably is not a thinking plastic surgeon, since human beings just don't lend themselves to assembly line, cookie-cutter care.

3. Attitude. Successful businesses (at least the ones I patronize) tend to be very consumer-oriented or "user friendly". Their operations are clean and efficient; their products/services are of good quality and are fairly priced; and their employees are knowledgeable and helpful and often go the "extra mile", particularly when a problem arises. I think you get the picture. Plastic surgeons who truly care about their patients and the success of their "businesses", the only true measure of which is patient satisfaction, are "user friendly" too. Given the nature of my "business", I can't promise my patients that surgery will proceed without a hitch, a home run every time at bat, but I can promise them that, as partners, so to speak, in our surgical undertaking, I and my staff will be available at all times to address their concerns - clinical, financial, emotional or whatever. Generally, the "user friendliness" (or lack thereof) of a plastic surgeon (or, for that matter, any physician) again usually is apparent to an observant patient within minutes of contact with that plastic surgeon and his/her staff.

4. Artistry. The person attracted to plastic surgery as a medical specialty probably is artisticly inclined or at least someone who appreciates artistic expression. Some plastic surgeons are more artistic than others and therefore particularly well suited to the demands of a successful cosmetic surgery practice. How does one determine the "artistry" of a plastic surgeon? More easily than you might think. Is he/she professional and polished in appearance? Does his/her office decor and staff appearance, behavior, manner, etc. suggest good taste and an attention to detail? Again, I think you get the picture. Someone who values himself/herself and creates a "value-oriented" environment for himself/herself will value you and exercise the utmost care in providing you the services you require.

Well, what did I tell my friend? Of all the plastic surgeons he consulted, only one took the time to examine him thoroughly and explain to him not only why he should undergo a certain procedure, but also why he should not undergo other procedures proposed to him, face-to-face and without the inconvenience of any "intermediaries", all in the context of a pleasant, indeed tasteful, welcoming office. A thinking, caring, "hands-on" plastic surgeon. The choice was obvious.


For more information about this and other cosmetic and non-cosmetic procedures, please call The Pittsburgh Institute of Plastic Surgery at 1-800-321-7477 or The Plastic Surgery Information Service at 1-800-635-0635.


Dr. Richard T. Vagley, a Board Certified Plastic Surgeon, is Medical Director of The Pittsburgh Institute of Plastic Surgery and a Contributing Editor of Outpatient Surgery Magazine.

The Pittsburgh Institute of Plastic Surgery | 5989 Penn Circle South | Pittsburgh, Pennsylvania 15206-3828 | Tel: 412.345.7477
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