Selecting a cosmetic surgeon can be a walk through a minefield

Secret: Selecting a cosmetic surgeon can be a walk through a minefield.

Tips on Doing Your Homework

COSMETIC SURGERY IS ELECTIVE (not essential to life) surgery. You have the luxury of time to make the best decision possible. The challenge you will face is finding, managing and interpreting all the information available. Should you listen to friends who have had cosmetic surgery? Do you count the certificates on the doctor's wall? Is a Harvard diploma more significant than a UCLA diploma? Is a fancy office important? Could medical colleagues provide clues? Are socialite cosmetic surgeons the best? Is a freshin- practice doctor a good choice because he's "up on the latest"? Is it a favorable sign if the doctor drives a Rolls Royce? The answers may surprise you.

You will never ever make a completely objective decision regarding your appearance. This is why one of the most reliable routes for choosing a cosmetic surgeon is through a recommendation from a friend or acquaintance pleased with his or her surgery's result. If a person is willing to share that they have had cosmetic surgery, she will usually be equally willing to discuss the entire experience. Be careful to compare the procedure you are considering with the one they have had. Remember "nose to nose" and "eyelids to eyelids." Don't assume a brilliant eyelift guarantees the expertise demanded for full facelifts.

No credential can guarantee a good surgical result for every patient. There are many factors which contribute to achieving a good surgical result. Probably the most important is the competence of the surgeon.

-The American Society For Aesthetic Plastic Surgery

Information gathering can be confusing, but I will now ease the process for you by listing the four accepted, but minimal, criteria for a surgeon to be considered a recognized specialist in surgery.

1. Graduation from a recognized school of medicine

2. Completion of an ACGME (Accreditation Council for Graduate Medical Education) accredited residency. The ACGME is composed of representatives of the American Medical Association, the American Board of Medical Specialties, the Association of American Medical Colleges, the Council of Medical Specialty Societies, and the American Hospital Association.

3. Licensure as a physician and surgeon in the state where he practices.

4. Board Certification. A "board certified" surgeon has met the standard the medical profession accepts as a minimal qualification for one to hold himself to the public and other doctors as a fully trained "specialist."

This credential is awarded after successfully completing an approved residency and subsequently mastering a series of written and oral exams. The board may also require practice experience, and a certain variety of cases performed in that practice for presentation to examiners. Twenty-four medical specialties are represented by a board. In surgery, there are ten boards including orthopedic surgery, eye surgery, chest surgery, neurosurgery, etc.

Each specialty's respective board, acting somewhat like a board of directors, is composed of a dozen or so senior members. The board establishes and enforces educational and training requirements for doctors who practice that specialty.

Be advised that the above four training and educational requirements of fully qualified surgeons apply to all recognized surgical specialties. But since cosmetic surgery is not currently an ABMSsanctioned specialty, you need to know what are the key credentials to look for in the professional bio of one who practices cosmetic surgery.

Here is my short checklist:

• Board certification in one of the four specialties that legitimately and routinely perform cosmetic procedures within their defined scope of practice: dermatology, head and neck surgery, ophthalmology and plastic surgery.
• Fellowship training in the cosmetic surgery of the doctor's board certified specialty.
• Teaching appointment at a medical school.
• Practices exclusively or predominantly cosmetic surgery.

Consult with a doctor whose professional bio demonstrates these elements and you are in the right pew in the right church.