Finding your best cosmetic surgeon

How do we rate excellence in cosmetic surgery and how can we evaluate a cosmetic surgeon? Cosmetic surgery is made up of a variety of surgeons specializing in various areas of medicine. These include Dermatologists, General Surgeons, Facial Plastic Surgeons, Oculoplastic Surgeons, Oral Maxillo-facial Surgeons, and General Plastic Surgeons. To be sure at most 20% of the physicians in these specialties concentrate on cosmetic surgery and so you must do your homework to screen physicians. You can obtain credentials from local medical societies and hospitals as well as specialty boards. Overlook the rhetoric that one board is superior to another as that is simply marketing hype designed to get your dollar.

Meeting the doctor is the next important step. You will live with that doctor for up to one year and if you do not like his personality, his attitude, or his style he is the wrong doctor for you no matter how good his reputation. Next, view his before and after pictures. If you are not pleased with them or even if the quality of photography is not to your liking, seek another consultation. And by all means several consultations are advised before making a decision. Most cosmetic surgeons provide complementary consultations. One may speak to patients of the doctor who have had the surgery but in order to not frivolously intrude on these people most physicians will only arrange such phone calls after a consultation with you.

Lastly, it is specious to think one doctor can perform all surgeries equally well. That is why cosmetic surgeons come from 6 specialties and the doctor who is superior in face lifts is unlikely to be as good in liposculpture. At MetropolitanMD we have 3 double-board certified surgeons in 3 areas of specialization: dermatologic cosmetic surgery, facial-plastic surgery, and general cosmetic plastic surgery. Therefore the patient who needs a facelift gets special expertise from a specialist who concentrates on her needs and no different for the breast patient.

I believe this will be the medical model of the future as the public becomes more educated and demands a butcher, a baker, and a candlestick maker instead of a jack of all trades and a master of none.

Pain Relievers Often Cause Pain

In a recent article in the Archives of Internal Medicine and in another piece by the American Heart Asosciation, NSAIDS, non-steroidal anti-inflammatory drugs, have been shown to cause high blood pressure in men, and heart disease and stroke in both men and women. They are referring, of course , to the chronic use of pain killers. In cosmetic surgery I am concerned with side effects of pain relievers in the acute setting, right after surgery. We have been taught that we can achieve a pain free experience by taking narcotic drugs. However, those same drugs reduce our pain threshold, causing even more pain and also depress our emotions causing moodiness and sadness. In contrast, walking outdoors creates joy and a sense of well-being and it is an excellent pain reliever. Common sense tells us that we have to balance these two sides of pain perception in caring for ourselves after surgery. The sooner we walk, the better we feel, and the less medications we need. Certainly for skin and fat surgery, which is much of cosmetic surgery, pain relievers are not needed and my patients begin their exercise the same night or the next morning at the latest by walking outdoors.
Two weeks ago a surgeon out west had heard one of my lectures and called to ask me what he was doing wrong. His patients lie in bed after liposuction and take pain relievers. My patients are walking vigorously the next morning and take no pain medications. After reviewing his techniques I found him to be a competent physician with healthy concern for his patients and good techniques in surgery. “Then what am I doing wrong?” he asked. “It’s simple,” I said. “You don’t believe and I do.” Narcotics and pain relievers in general have a place in medicine. However, I think they are overly used.