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No Regrets

Achieving a certain measure of perfection isn't as elusive as it once was, thanks to the growing list of surgical and non-surgical cosmetic and reconstructive options. But while finding the right procedure to match your needs is becoming easier as technology keeps advancing, choosing a doctor can still be a challenge.

"It is important to take plastic surgery extremely seriously," says Dr. Stanley Gulin, a Naples cosmetic and reconstructive surgeon with 22 years of experience. "It may be a cosmetic procedure, but it's not [like] buying cosmetics at a department store."

Seasonal resident Geraldine Simone knows this first-hand. A nerve near her mouth was severed during a facelift procedure 10 years ago, making it impossible to smile. She would often hold her hand over her mouth to hide the condition. Simone recently went under the knife again-this time with Dr. Richard Maloney of the Aesthetic Surgery Center in Naples. The surgery improved her paralysis, as well as refreshing her appearance.

After her consultation with Maloney, Simone knew she had the right doctor. "I felt so comfortable with him because he took time with me, let me talk and answered all of my questions," she says. "I had confidence in him."

Simone's situation is more common than you might think.

"One half of what I do is repairing surgical work done by other doctors," Maloney says. "The number-one botched procedure is rhinoplasty [nose re-contours], and number-two is the facelift." Eight out of 10 rhinoplasties Maloney performs are revisions of work patients had done elsewhere.

But on a national scale, most plastic surgery patients are happy customers the first time around. Dr. Richard Greco, former chair of the American Society of Plastic Surgeons' public education committee, says satisfaction rates among patients who undergo breast augmentation are in the 90th percentile. Facial plastic surgery rates dip slightly, falling between 80 and 90 percent; and body re-contouring rates vary widely depending on the procedure and the patient's body image before surgery.

It's also important to note that patient dissatisfaction isn't always the result of faulty

procedures. Some undergo revision surgery simply because they hope to look even better, or because they believed the first surgery would turn out better than it did.

In either case, you can avoid disappointment by taking the necessary steps to find the right doctor. "It is very much 'buyer beware,'" Gulin says. "But there is excellent surgery being done by a number of people."

While you should feel comfortable with your doctor, it's best to back up any first impressions with some research. Doctors do not have to be board certified to practice plastic surgery, so many are operating without proper training. Make sure your surgeon is board certified.

You should also choose a doctor who specializes in the part of the body you're looking to have done. Dr. Patrick Flaharty, of the Facial Aesthetic Centre in Fort Myers, says it's good to know what a doctor does on a daily basis. "It may be as simple as asking them how often they perform the procedure," he says.

It makes sense that a doctor who frequently performs a procedure will be more consistent and skillful. "Plastic surgery is such an experience-oriented vocation," Maloney says. "It's not just about having an artistic eye or diplomas."

And make sure the cosmetic surgeon you choose has your expectations in mind. Ask to see before-and-after pictures of previous patients, and use them to communicate your goals. Some doctors offer computer morphing, which helps potential patients visualize what to expect from a certain procedure and allows doctors to demonstrate what is-and isn't-possible.

"Most doctors offer free consultations, and this is a good way to evaluate a doctor," Flaharty says.

And ask around. One of the best ways to evaluate a doctor is to talk to former patients. That way, you can see the results and get personal feedback. Some doctors may even provide contact information for former patients.

"Plastic surgery has become a much safer specialty," says Gulin.

But he adds the following caveat: "It's become an extremely safe specialty when done by doctors who are properly trained." 

If You Have a Problem

It's important to go back and discuss your feelings with the doctor. Patients should explore touch-up or revision surgeries, mentioning specifics and how they feel about them. "No doctor will help you as much as the doctor who performed the procedure," says Dr. Richard Greco. "Doctors make a reputation on happy patients."

But if you're convinced the problem was the result of bad surgery and not simply a matter of unmet expectations, don't be timid. Find a new doctor. In this case, change is good. 

Credentials Checklist

- Be sure the doctor is board certified in plastic surgery. Board-certified plastic surgeons have no less than three years of general-practice training and two years of plastic surgery training. They've also passed written and oral exams in the specialty. Call (866) ASK-ABMS or visit www.abms.org to verify the certification status of a doctor.

- Research the doctor's medical license. See if the surgeon is licensed to practice in your state; if a surgeon has had problems in the past, it may appear on his or her license record. Verify medical licenses at www.fsmb.org.

- Ask about hospital privileges. Such privileges involve an evaluation by the hospital's chief of surgery, which typically requires a background and credentials check.

- Look for accreditation. If the doctor works at an outpatient facility, call and ask the facility if it's nationally accredited. 

Source: American Board of Medical Specialties 

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