How Old Should Your plastic Surgeon Be

Recently, James Sternberg, MD and I were discussing a patient both of us had seen. Dr. Sternberg is a distinguished and senior West Los Angeles dermatologist. I had deep reservations about performing a major face and neck lift because the woman had significant medical problems including liver and lung disease. She was also a heavy smoker a big red flag. I had called the patient's internist in another city where she recently lived and he confirmed her history and endorsed my concern and caution concerning the proposed procedure.

This woman was adamant about having a facelift. After summarizing my consultation findings, I told her I was uncomfortable and would refuse to operate because of a fear of complications. Dr. Sternberg chuckled and said, "You know, it takes many years of practice before any of us really develops that sixth sense about when to operate and when not to operate, doesn't it?"

That sage comment is the reason formy sharing this story with you. In all medical practices such wisdom, though indefinable, comes very slowly through experience. Indeed anywhere between 10 and 20 years after one starts his practice, the feeling of finally "getting it" arrives. We are not talking about technical ability here. Manual skills are refined and maximized within a few years of completing one's residency. We are talking about a rite of passage, whereby one outgrows medical adolescence and can rely on a that gut feeling. A doctor's medical "common sense" is continually honed through experience. Gradually, he instinctively knows when to say "yes," "no," or "let's wait."

The seasoned doctor is very comfortable with himself, his skills and his intuition. This security is manifested in confidence in one's abilities and allows a doctor to request a consultation or second opinion before the patient asks. It prompts the surgeon to voluntarily suggest another surgeon who may be more specialized, where it is indicated. A mature practitioner knows what he doesn't know. The real pro has the strength of character and conviction to do the right thing for each patient.

The point is, chronological age is significant. Medical education takes decades college, medical school, internship, residency, fellowship, and finally, practice all that time to ripen. There is no shortcut to medical maturity.

You do not have to seek the oldest doctor you can find, but consider your own life experience. Are you more skilled at your occupation than you were when you started? After ten or twenty years doing your job, are you better and wiser? There is something to be said for "time on the job" for all of us!

Advertising is a powerful and pervasive feature of modern American life. Every day, each of us is inundated with radio, television, email, and newspaper and magazine ads. Thousands. Want it or not, they are thrust before us spaced between what we hear, see, and read.

The practice of cosmetic surgery like all businesses has a message to tell about its services. You can investigate further or not. Your choice.

Here is my tip regarding the value of, and your response to, cosmetic surgery ads: ask yourself if the ad teaches you anything. I observe two classes of ads: those that educate and those that titillate.

The ads that catch your eye with a busty, voluptuous, no-body-fat, bikini-clad woman probably will not teach you much. The advertiser is attempting to gain your attention with an emotion-only pitch. Some ads catch your eye with lengthy menus of service upon service upon service. But they may gloss over the fact that the surgeon is trying to be all things to all people rather than offer the ideal subspecialty skills patients seek. No education or value here, either.

What I find particularly fascinating about the sexy ad from the "We Do Everything and Anything Cosmetic Surgery Clinic" is that often a doctor's name is not even mentioned. And that may be because these clinics are often owned by businessmen who hire doctors as contractors. That is not generally the best way for physicians to practice medicine. They are not invested, figuratively and literally, in the practice and the standards therefore can be a bit irregular.

And humorously, since California, at least, requires truth in advertising and insists that the featured voluptuous female be identified as either a patient or not a patient, most of these high profile clinics are apparently unable to produce even one excellent result worthy of being included in the ad. The caption below the young lady's photograph invariably states "model." Why would anyone ever go to a clinic that cannot even show off a single credible result?

The alternative is an ad that teaches and enlightens you, as does a good book. The high quality ad tells a story: perhaps a patient shares his or her experience with cosmetic surgery, or serial ads may explain common cosmetic surgery procedures. Such ads make you smarter. They are more sophisticated and will appeal to the thoughtful person who is conducting a rational and not purely emotional search for cosmetic surgery services. And, yes, these ads can inform and educate, even without the glitzy artwork or photos!

Contending that quality professionals do not advertise is incorrect. For example, one of the attorneys I've used for years a superspecialist, I might add came to my attention through an informative ad in our county medical association newsletter. His advertisement was an education in print. I immediately learned that his specialty practice matched my need. He has done excellent work, at very reasonable fees for me, for twenty years. If I hadn't seen his ad, I might never have benefited from his expertise!

To those who fret that professionals who advertise need the ad power to keep them busy, I ask: What is wrong with being busy? When I want surgery, I will be happy to hear that my surgeon has a full schedule; you cannot maintain your surgical skills as "an occasional operator." I like to patronize busy professionals; they are focused and they are at the top of their game. The more they perform their work, the better their work is.

Finally, there are the hoity toities who snobbishly sneer at advertising by professionals. They contend that top-quality practitioners and businesses are so well known that their reputations obviate the need to advertise. For them following question: If you drive a Mercedes or buy that special gift at Cartier or Tiffany, might your patronage have been motivated by an advertisement?

Yes, Cartier, Tiffany, Mercedes, and even Rolls Royce, advertise. Established companies selling quality products know the value of their products, and recognize the value of advertising them to an ever-widening audience. You just might want to amend any negative feelings by realizing that professionals who provide top quality services, including cosmetic surgeons, want to teach and enlighten you. And they want to tell you why they are special and valuable. Just like Lexus, Nordstrom and IBM.