Plastic Surgery: Plain Truths - Brief Article

Kiplinger's Personal Finance Magazine, April, 1999 by Jane Bennett Clark

If you're looking at cosmetic surgery, here's how to protect yourself.

When Carol Smerling of Millbrook, N.Y., went into surgery for a face lift and eyelid tuck five years ago, she had every reason--she thought--to feel confident. Her doctor had come highly recommended and was board-certified in plastic surgery. But he wasn't experienced in the type of face lift he was about to perform: a complex, deep-muscle version he had observed only days earlier at a weekend seminar, Smerling claims.

The results were disastrous. The doctor allegedly severed a key nerve and destroyed Smerling's eyelids and small tear ducts, necessitating eight more surgeries. Because her corneas were affected, Smerling says, she is losing her eyesight. "I'm a totally different person who is going blind from a face lift," she says. After suing for negligence, she settled out of court for $1.4 million.

Horror story? Definitely. Far-fetched? Not necessarily. Spurred by a good economy and sagging bodies, Americans are seeking surgery at record rates. The number of liposuction procedures, for example, has tripled in the past decade, according to the American Society of Plastic and Reconstructive Surgery. And because insurers rarely cover cosmetic surgery, patients are paying out of pocket-an average of $1,700 for liposuction and $3,800 for a tummy tuck in surgeons' fees alone. Doctors are boarding the beauty bandwagon in droves, too, often to replace income lost to managed care.

Both trends spell danger, says Wendy Lewis, a consultant on cosmetic procedures. "Consumers really don't know what to expect," she says. "They haven't shopped around and asked questions."

CHECK CREDENTIALS. If you decide to go surgery shopping, first ask friends and your primary-care doctor for recommendations. Then check whether the doctors they suggest, including ophthalmologists and dermatologists, are certified by a board recognized by the American Board of Medical Specialties (800-776-2378; www.certifieddoctor.org). Certification by the American Board of Plastic Surgery, for instance, requires at least five years of training beyond medical school, including two years in plastic surgery.

But, as Smerling discovered, board certification is only a starting point. Also ask whether the doctor has privileges at an accredited hospital, which means he or she has been judged acceptable by medical colleagues, according to The Unofficial Guide to Cosmetic Surgery, by E. Bingo Wyer (Macmillan, $15.95). If an outpatient surgical center is involved, find out whether it is approved by the American Association for Accreditation of Ambulatory Surgery Facilities (888-545-5222; www.aaaasf.org).

EXPECT EXPERIENCE. No matter how many certificates you see on an office wall, you need to determine whether a doctor's training in a particular procedure reflects serious study. "It has become more common for physicians to take a weekend course or to read a book on, say, liposuction and set themselves up as practitioners," says Dr. John Penn, president of the American Society for Aesthetic Plastic Surgery.

Dr. Tina Alster, a national expert on laser surgery, recommends asking if the physician has research credentials in the procedure you're seeking. "You really should go to a doctor who has published in a peer-reviewed journal on the subject. That shows expertise," Alster says. More important, use a doctor who has performed the proposed procedure repeatedly--in the case of lasers, suggests Alster, at least 100 times.

IGNORE THE HYPE. "Aggressive marketing has become common in cosmetic surgery," says Penn. Be wary of doctors who guarantee results based on other patients' pictures or on computer imaging, and don't let the lure of discounts or easy financing tempt you to undergo procedures you wouldn't otherwise consider. Going into debt for an elective procedure is especially painful, says Lewis, when the results don't meet expectations.

And if the procedure you're considering seems expensive, imagine paying to repair a botched job. That can happen, although many insurers will pay the costs of treating medical complications.