Lucid Magazine Interview

I. What patients need to know before they go under the knife?

“The Naked Truth”
The Award winning “Naked Truth About Plastic Surgery” 5 video/dvd collection is an incredibly comprehensive instructional series (1-2 hours each) providing critical and detailed information about common plastic surgery procedures. The series will help you understand each procedure in great detail as well as the risks, benefits, and alternative options. The “Naked Truth” is aided by live video footage of patients just like you going through each procedure (no graphic or bloody visuals), with hundreds of before and after photos, graphics, illustrations, and demonstrations. You will learn how to select a doctor, what questions to ask, and ways to make your consultation experience more efficient, memorable, and effective. Please look at the testimonial section on the Naked Truth section of my website (www.garthfisher.com) for further descriptions of the incredible value obtained through the use of these tapes. Because you can review this information in the privacy of your own home with a loved one, it is the next best thing there is to a “house call!”.

II. What questions should patients ask before having plastic surgery?

10 Questions to ask your plastic surgeon!

1. Are you board certified, and by which board? Is the board approved by the American Board of Medical Specialties?
2. What percentage of your practice is cosmetic? (Over 50% is desirable).
3. How many of the operations that I am considering, do you perform on a monthly basis?
4. Do you have privileges in a hospital to perform the cosmetic procedures we are planning, and at which hospital do you have those privileges? (preferably close to the physical location of your anticipated procedure)
5. What agency has accredited the surgery center or operating room where my surgery will be performed? (JCAHO, Medicare, State-Licensed, AAAHC… all acceptable).
6. What is the financial policy of the surgeon, facility and anesthesia provider in case complications occur which require additional surgery?
7. Have you ever been disciplined by any state medical board? YES/NO ; Have you ever been disciplined by any professional medical society?
8. What complication(s) has occurred most frequently in your practice regarding the procedures we are discussing? (Any surgeon denying complications should raise a red flag).
9. Do you perform the entire surgery yourself, and if not, what part is done by someone else, and what are their qualifications? (You would like to meet them.). Will you be present in the operating room during my entire procedure?
10. Will you (the surgeon) be involved in two or more surgeries going on simultaneously in additional operating rooms during my surgery? YES/NO (Would advise against being a patient in this scenario.)

III. What does it mean to be “Board Certified”?

Strongly consider that your plastic surgeon is certified by the American Board of Plastic Surgery. This is the only plastic surgery board recognized by the American Board of Medical Specialties. You can check to confirm that your surgeon has had this extensive and unique training in plastic surgery and successfully passed the written and oral and re-certifying exams by checking with the American Board of Plastic Surgery at (215) 587-9322.

Keep in mind that while this is an important and prestigious credential, it will not guarantee that your particular surgeon will have the artistic skill level to provide you with the results you want. Remember too, that there are many talented surgeons certified by other specialty boards with whom you may feel a special connection. Such surgeons may have excellent surgical skills and may be able to provide you with quality results. Some specialties you can expect to encounter during your search include: Dermatology (skin), Otolaryngology (head and neck,) Ophthalmology (eye and facial) and Plastic Surgery (facial, body, reconstructive.) Again, it is very important that you consult with a surgeon who is not practicing beyond the scope of his or her training.

Example: You are considering an eye lift. You could get good results with a board certified plastic surgeon that routinely performs this procedure, or might be just as happy with an ophthalmic plastic surgeon whose training concentrated exclusively on the eye and areas surrounding the eye.

Example: You are considering a breast augmentation. A “facial plastic surgeon” advertises that he or she performs them. It is probably wise to look elsewhere for someone who has appropriate training in breast augmentation. (Facial plastic surgeons should limit their practice to the face.)

Question: Are you board certified in the surgical specialty specifically addressing the procedure in which I am interested?

Board Certification: Certification by the American Board of Plastic Surgery is the culmination of the extensive, rigorous, and unique training experience in plastic surgery. This training reflects a commitment, not only to the profession itself, but more importantly, to the consumers who seek our advice and expertise.

As a practical reality, arduous and meticulous training and subsequent examinations, unfortunately do not guarantee technical skill, measure artistic and creative endowment, or provide the assurance of exacting judgment in the operating room. (There are many surgeons who excel in the rigors of passing examinations, but lack the patience and meticulous skills demanded and required to plan and carry out extensive operative procedures.)

“FACS” after a doctor’s name and “MD” (John Doe M.D. FACS) denotes that that doctor is a “Fellow of the American College of Surgeons”. Only board certified surgeons are eligible for membership in this prestigious college.

IV. How do you know if your doctor is licensed?

Today’s marketplace has seen an influx of surgeons wanting to supplement their practices with cosmetic cases. Did you know that any licensed medical doctor can legally perform cosmetic surgery? The prospective patient must proceed with caution. At a minimum, selection criteria used to evaluate a surgeon should include:

• Graduation from a recognized school of medicine.
• Completion of ACGME (Accreditation Council for Graduate Medical Education accredited residency.)
• Licensure as a physician and surgeon in the state in which you will be having the procedure.
• 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/or plastic surgery.)
• Privileges in a nearby hospital to perform the procedures in which you are interested.

In order to perform cosmetic or aesthetic procedures at the highest level, a surgeon must complete at least a decade of additional specialized training after college. Some doctors elect to participate in post-residency specialized training called fellowships, in specific areas of interest within the specialty. (See below) These surgeons customarily hope to focus their practices on specialized areas in cosmetic and aesthetic plastic surgery.

Example: You are interested in liposuction and visit a doctor who advertises “cosmetic surgery.” Other patients in the waiting room give you the impression that he/she is a general surgeon. Proceed with caution in this scenario as this is not the defined scope of practice for a “general surgeon”

Example: If you want breast augmentation, you may not be a good match for a reconstructive plastic surgeon whose brilliance lies in treating patients with burns, birth defects or cancer.

Questions: Are you a plastic surgeon? Tell me about your sub-specialty training. What percentage of your practice is dedicated to reconstructive versus cosmetic procedures? What three to five procedures represent the majority of your cases?

V. How common are plastic surgery complications?

Each year, thousands of patients undergo cosmetic procedures without complications. Cosmetic surgery is popular and there are many different types of procedures that range from minimally invasive to extensive. The rate of complications vary greatly depending on many variables including the skill and experience of the surgeon, tissue qualities of the patient, consumer compliance with post-operative instructions and the variability and unpredictability of healing amongst others. Complications also vary among different types of procedures. Fortunately, the more severe complications are the rarest. I feel you have to approach surgery with a positive attitude, but also be aware that it may be you that will have that rare complication. You have to be prepared and capable of coping with that. In summary severe and life threatening complications are rare. Minor complications are more common and patient dissatisfaction is often dependent upon proper expectations.

VI. What can a patient do to decrease their risks?

I believe that the following advice contributes to minimizing surgical risks and complications: Educate yourself as much as possible about the procedure you are considering. Allow the proper time for your recovery period and don’t rush your healing process no matter how good you feel. It is important that all patients carefully follow their post-operative instructions in order to increase the likelihood of a favorable result. Be sure to keep all of your scheduled post-operative appointments. These appointments give your doctor and his staff the opportunity to evaluate your healing process and diagnose and address any possible complications early. Should issues or questions about your post-operative process become of concern, contact your surgeon or their office staff. Lastly, so much of your complication risks are dependent on how skilled your surgeon is. Pick a great one!

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