Shopping for a doctor

Once you’ve decided to have plastic surgery, you’re only halfway there.

An estimated one in ten plastic surgery procedures requires a second operation to revise — re-do, repair, or otherwise augment — what’s been done. With no set standard of training for plastic surgeons, preventable mistakes are made every day, by as many as 50,000 doctors in the operating room who aren’t qualified to be there.

“Any doctor can legally perform plastic surgery, and many people are willing to trust anyone with an M.D., assuming they must know what they’re doing,” says Dr. Michael Echavez, a San Francisco based plastic surgeon who has seen his share of botched procedures. “I’ve seen noses that have been completely deformed as a result of ‘over operating,’ and it’s not always fixable.” Other problems: lumpy, uneven thighs; asymmetrical eyelids; and scarring.

“Beyond the sometimes-irreversible visual effects, complications can include bleeding, infection, and even death. If a lot of fat is removed during a liposuction, the patient can go into shock because of the dramatic loss of fluid. If the doctor doesn’t know, from experience, to monitor this, the results could be deadly,” explains Echavez. “Incompetence can kill you.”

Finding the right doctor: An expert’s guide

  • Get referrals from friends or other physicians.
  • Confirm that the surgeon has completed at least a five- to seven-year residency or fellowship in cosmetic surgery.
  • Make sure the surgeon is board certified by the American Board of Plastic Surgery.
  • Be wary of any doctor who guarantees certain results: “Expect improvement, not perfection. Promising you ‘Brad Pitt’s nose is unrealistic,” says Echavez.
  • Find out the doctor’s policy on follow-up procedures: “Usually there’s no charge for a revision surgery if the doctor agrees that improvement is needed,” notes Echavez.
  • Look at before and after photographs of previous patients.
  • Find out where the procedure will be performed. If not at a hospital, confirm that the facility is equipped with life-saving drugs and equipment in case complications arise.