Which Facial Surgeon?

What to look for in a Facial Cosmetic Surgeon

Facial surgery has traditionally been performed by Otolaryngologists, Oral & Maxillofacial Surgeons and Plastic & Reconstructive Surgeons and they provide facial trauma services for your local hospital.  These specialties also perform reconstructive surgery resulting from trauma, birth defects or cancer.  There is no one “best” educational route to becoming a facial surgeon.  Many of these specialties resident programs offer cosmetic surgery training or a post-graduate fellowship training in cosmetic surgery.  What is important is the experience in their specific residency or any fellowships related to cosmetic surgery and many of these residencies, including Plastic & Reconstructive Surgery, do not perform facial cosmetic surgery procedures, yet are immediately given faithful respect that they are qualified in facial cosmetic surgery.  These three specialties have laid the foundation for facial cosmetic surgery but many other specialists can perform cosmetic procedures such as a Dermatologists and Opthamologists and have equally contributed to the advancement of the surgical techniques that we currently use today.

The techniques and instrumentation used in facial cosmetic surgery today arise from broadly overlapping disciplines in which many different specialties have contributed in their particular expertise.  For example, Dermatologists have made many strides in skin rejuvenation, hair transplantation and liposuction.  Likewise, Ophthalmic Surgeons have contributed to eye enhancement surgery; Oral & Maxillofacial Surgeons have developed new techniques for correcting deformities of the jaw and mouth, and Otolaryngologist/head and neck surgeons have made great contributions to facial plastic and cosmetic surgery.  Plastic and Reconstructive Surgeons have then taken the foundations and improved the techniques to help lay the framework of current understanding in cosmetic surgery techniques.

Unfortunately, cosmetic surgery has become a fierce competition for patients with certain specialties believing they possess the skills and knowledge to perform facial cosmetic surgery better than the other.  This has become apparent with certain specialties who advertise that their discipline is the only one qualified to perform such procedures, unfortunately this is a misrepresentation of the facts at the expense of the patient.  This turf battle was played out in California where the Department of Consumer Affairs under the Direction of Governor Schwarzenegger completed an extensive look into the training of Oral and Maxillofacial Surgeons and concluded “We found that Oral and Maxillofacial Surgeons have sufficient education, training and experience to perform elective facial cosmetic procedures.  While there may be some variation in the offerings of training programs, recent graduates of residency or postgraduate fellowship programs have completed comprehensive programs of study that provide them with a solid foundation to perform cosmetic procedures and the clinical skills to obtain documentation of their skills.  Practitioners who are already providing elective facial cosmetic surgery surgical procedures have proven their clinical competence to perform the procedures” and “it appears that the written and oral examinations for Oral and Maxillofacial Surgeon’s (board) certification and other related certification examinations are comprehensive and cover a wide range of topics applicable to facial cosmetic surgical procedures.”

It is imperative when choosing a cosmetic surgeon to consider the following issues. Cosmetic surgery is a major decision and careful thought should be given to choosing a provider. Any reputable cosmetic surgeon will welcome your questions and want you to be completely comfortable with his or her qualifications.

Is the surgeon board certified in his/her specialty?

Achieving board certification is a high achievement and reflects well on the surgeon.  This process can take years to accomplish requiring written and oral exams with that specialty’s best surgeons.  Although there are surgeons that are not board certified that are very competent,  potential patients should ask about board status.

What is the surgeon’s experience?

Ask about the surgeon’s education and training specific to cosmetic surgery and the procedure which you are considering. How many procedures of this kind has the doctor done and how often does he or she perform them? Remember, surgeons who dedicate 100% of their practice to head and neck usually have more experience and training in that one area compared to other surgeons who perform surgery on other areas of the body.

Who will be performing the surgery?

Some surgeons employ others to perform certain aspects of cosmetic surgery, such as Botox or dermal fillers.  Dr. Johnson performs 100% of all procedures in his office.

 Ask for referrals from friends.

Keep in mind that surgeons specialize in different areas of cosmetic surgery and most are not experts in every area. The surgeon who did a fantastic facelift on a friend may not be the most experienced to perform breast augmentation or rhinoplasty.

Before-and-after photographs.

Photos can give you some indication of a surgeon’s ability, although you must realize that they cannot guarantee the result you will achieve. Each patient is different and the surgeon can help determine what kind of results you should expect.

Look at your options.

Don’t be afraid to consult with more than one cosmetic surgeon to discuss your desired outcome. There may be more than one technique available with varying risks, benefits, recovery time and results.

Ask where your surgery will be performed.

 Cosmetic surgery is performed in various facilities such as hospitals, surgical centers and office settings. An accredited surgical facility must meet certain minimum standards to obtain and maintain its accreditation. Facilities may be accredited by the Accreditation Association of Ambulatory Healthcare (AAAHC) or the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).

 Make sure you are comfortable.

Be comfortable with the personal rapport between you and your surgeon. In addition, you should feel at ease with the staff, as much of your communication will be with them. You should always feel that your concerns are being addressed. Do not be satisfied with an incomplete answer from anyone.  Keep in mind that in many large surgical facilities, patients are not seen by the surgeon until the day of surgery.  In that case you might feel more like a number than a patient in an office dedicated solely to you.

Can your surgeon be reached for questions before and after the surgery?

At Advanced Faces, you will be given Dr. Johnson’s personal cell phone to be reached after your surgery at any time during the day or night.  Before the surgery, he is available for phone consults or reevaluation to answer any questions.  This is a big commitment for the patient and he/she needs to know that Dr. Johnson is as equally committed to him or her.

Beware of Surgeons that are highly critical.

Please be cautious of surgeons who are critical of other surgeons.  This is usually a sign of insecurity or financial motivation.

What “red-flags” should I look for?

  1. A doctor who is impatient and rushes you to make a decision on your surgery
  2.  An environment that is unsterile
  3.  A doctor who is willing to combine several major surgeries into one operation. While this may save on anesthesia and surgical facility fees, safety must be the primary concern. Not only is surgery traumatic on your body, but the surgeon and staff tire out as well. Discuss the timing of surgery with your physician and inquire about the safest method of achieving your desired results.
  4.  A doctor that refuses to answer questions or provide you with requested information.

In summary, it is important for a cosmetic surgery patient to seek out a surgeon and office that the patient feels most comfortable and relaxed during and after the initial consultation.  The patient should ask for and review pictures of previous patients.  This is the best source for you to know the expected outcome of a surgery.  A patient should seek out multiple opinions and make an educated decision based on experience, education, board status, photographic evidence and comfort level, not solely on the specialty.