Cosmetic considerations: What you need to know if you’re thinking about plastic surgery

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Cosmetic considerations

What you need to know if you’re thinking about plastic surgery

NOW THAT THE holidays have been packed away, have your thoughts returned to pursuing that cosmetic procedure you hope will make for a new life in the new year?

Here are 12 tips to ponder as you think over your makeover:
1. If you’re a smoker, you need to stop. Many cosmetic and plastic surgeons refuse to operate on smokers and will tell you that outright. This is because smoking significantly hinders the healing process. Studies suggest the risk of wound complications is about the same as in the nonsmoking population after four weeks of smoking cessation. Expect your doctor to instruct you to stop smoking at least four weeks before your procedure. In addition, you won’t be able to smoke for several days or weeks after your surgery.
2. Be realistic in your expectations. If you’re an 8 in the looks department on a scale of 1 to 10, you can hope to look like a 10 when all is said and done. If you’re a 1, expect the best you can be is a 3, according to New Jersey plastic surgeon David Watts. The way to develop realistic expectations is to ask for photographic examples of your potential surgeon’s work, Watts adds. “You want to make sure you get a chance to see their before and after photos and not just one. You need to see a whole range, what they consider to be their best, good and average work. If they only show you one or two and they’re all great, you can be fooled.” You also should look at photos of someone who is similar to you in appearance. For example, if you want to correct that small degree of sag in your breasts, you’ll want to view photos of the work your potential surgeon did on someone with a similar amount of sagging.
3. Understand there will be scars. A skilled surgeon will try to leave shorter scars and also will work to camouflage or hide them, say, behind the ears, in the armpit or within natural creases, but there will be scarring. All mammals heal by scarring. In addition, scars vary depending on skin type and genetics.
4. You need to check your physician’s credentials. More and more, doctors in various specialties aside from plastic surgery, such as dermatologists, gynecologists, ophthalmologists and dentists, are performing cosmetic surgical procedures. Find out if your chosen surgeon is board-certified. For example, plastic surgeons certified by the American Board of Plastic Surgery have had at least five years of approved surgical training after medical school, including at least two years of a plastic surgery residency. Certification by the American Board of Facial, Plastic and Reconstructive Surgery requires completion of a yearlong fellowship training program, written and oral exams and prior certification in either plastic surgery or otolaryngology (ears, nose and throat). This board certification, which is deemed a “meaningful credential” by Wendy Lewis, author of “America’s Cosmetic Doctors & Dentists” (Castle Connolly Medical Ltd., $29.95), is mainly pursued by otolaryngologists interested in cosmetic procedures.
A word of caution: Just because your surgeon has board certification doesn’t mean she has experience performing the procedure you want. Ask physicians how often they’ve done the surgery. If they’ve performed it only a few times or not at all, that’s a big red flag you shouldn’t ignore.
5. Your doctor should be affiliated with a hospital. If not, don’t use that physician. More than 60 percent of cosmetic procedures are done on an outpatient basis, such as in a doctor’s office, an accredited surgical center or a hospital that includes outpatient services. You want your doctor to be able to move you to a hospital immediately if your procedure goes awry.
6. Make sure your physician knows your medical history. According to the American Society for Dermatologic Surgery, providing your doctor with thorough and accurate information about your medical background is just as important as choosing the right doctor to perform your procedure. “Everyone reacts differently to medical procedures, and physicians need to take into account if a patient has special health needs or restrictions,” according to a statement by the society.
7. Find out about post-procedure care. Make sure your doctor has a competent staff in place to help get you through the healing process. “Your time with the doctor is limited. Surgeons do their thing and then get out of there. The surgeon will not take out your stitches and see you multiple times after” your procedure, says Lewis, a cosmetic surgery consultant in New York City. You want to be able to call your surgeon’s office and have ready access to a nurse on staff who will answer your questions and tell you what to do in the event of a complication.
8. Seek more than one opinion — within reason. Try to consult with at least two physicians. Consultation with three is good, but more than that can leave you confused. If you go beyond four consultations, you’re either going to the wrong doctors or plastic surgery may not really be an option for you, says Lewis. Also, beware the hard sell. “If they say, ‘We’re usually booked for three months, but we just so happen to have an opening for next Thursday and if you make a decision right now, we’ll take $500 off our surgical fee,’ keep walking,” says Lewis.
9. You should know the limits of a “mini” lift. “One of the biggest misconceptions is that people think they’re going to get the equivalent of surgery with a minimally invasive treatment. People think they’re going to get a face-lift in a syringe, and that’s not possible,” says Richard D’Amico, national president of the American Society of Plastic Surgeons and chief of the department of plastic surgery at Englewood Hospital and Medical Center.
“Aging is three things,” says Vito Quatela, a facial plastic surgeon and president of the American Academy of Facial Plastic and Reconstructive Surgery. “The sagging and gravitational changes, the changing in the pattern of the skin, where you get etching and lines and wrinkles, and loss of volume. (Dermal) fillers fill the face out. A fuller face looks more youthful, but fillers can’t lift sagging skin. That’s beyond the capacity of that modality.” That’s where surgery needs to be considered.
10. Know that plastic surgery won’t stop the aging process. Plastic surgery is designed to “make you look better for a time,” says Eleanor Barone, a plastic surgeon at Advanced Dermatology and the Center for Laser and Cosmetic Surgery in New York. A face-lift done on someone with good skin who takes care of her skin can last 10 to 15 years.
11. Make sure the work you want done fits in with your life and schedule. Most people can’t afford to take six weeks to recover from plastic surgery. That’s why there’s so much interest these days in less invasive ways to enhance physical appearance. In addition, board-certified plastic surgeons are moving away from performing multiple major surgeries for safety reasons. As a result, people who are thinking of having several procedures done at once may want to think about parceling out the procedures.
12. You need to have a handle on your budget and understand what different procedures cost because they can get pretty pricey. In the New York metropolitan area, for example, upper and lower eyelid surgery can run $5,000 to $8,000, while breast augmentation can cost $7,000 to $8,000. An average face-lift can be $7,000 to $12,000, while what Lewis calls a “Park Avenue face-lift” can carry a tab of as much as $30,000.
Meg Nugent may be reached at mnugent@starledger.com or (973) 392-7955.