Myth Busting Plastic Surgery

Susan E. Kolb, MD, FACS

by Susan E. Kolb, MD, FACS | August 10, 2010 @ 01:00PM

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As a practicing plastic surgeon, I am often amazed and amused with the multitude of myths and misconceptions about plastic surgery. Allow me to share some of these myths with you.

Myth #1 Plastic Surgeons are not doctors

I've encountered many people who do not realize that plastic surgeons are physicians. In fact, the average plastic surgeon has approximately seven years of surgical training after completing four years of college and four years of medical school. After completion of a plastic surgery residency, a board certified plastic surgeon must also pass comprehensive written and oral examinations. The oral examinations require the surgeon to have a panel review of a certain number of treated patients (which may take the surgeon two to five years after residency to accomplish). This means the average plastic surgeon may be close to forty years of age before he or she becomes board certified in plastic surgery.

Myth #2 A cosmetic surgeon is always a plastic surgeon

Another myth is that cosmetic and plastic surgeons are the same. In fact, any surgeon may call him or herself a cosmetic surgeon. None of these cosmetic surgeons or facial plastic surgeons undergoes as long a training program or passes the oral and written examinations of the American Board of Plastic Surgery. Cosmetic surgeons often state that they are board certified, but fail to specify by which Board. If you are unsure of your surgeon's credentials, ask to see his or her Board Certification Certificate. The certifying board will be listed on the Certificate. It is fascinating to me that at least 30 percent of the plastic surgery listings in an average Yellow Pages are not plastic surgeons according to their board certifications.

Myth #3 Plastic surgeons do only cosmetic surgery

In fact, according to recent statistics, the average plastic surgeon devotes over half of his or her practice to reconstructive surgery, including hand surgery. Plastic surgeons are trained to perform a variety of procedures to restore form and function to all areas of the body damaged by various maladies, such trauma, cancer, and birth defects. Plastic surgeons spend many nights in the emergency room putting faces and bodies back together after high speed collisions or the aftermath of the local knife and gun club.

Myth #4 Plastic surgery is only for the rich and famous

Cosmetic surgery is performed to reshape normal structures of the body in order to improve the patient's appearance and self-esteem.

Reconstructive surgery is performed on abnormal structures of the body caused by congenital defects, developmental abnormalities, trauma, infection, tumors, or disease. It is generally performed to improve function but may also be done to approximate a normal appearance.

Many insurance policies cover reconstructive surgery. Procedures such as breast reduction, abdominoplasty (tummy tuck), and upper eyelid blepharoplasty (upper eyelid lift) may be covered by insurance if certain criteria are met.

Cosmetic surgery is usually not covered by insurance, although due to advances in surgical and anesthesia techniques, many procedures are less expensive than they were several years ago. Below are two charts listing common plastic surgery procedures of the face and trunk and their approximate cost. Many procedures that used to be performed in hospitals are now performed in office or outpatient surgery centers.

Many factors are important in choosing a plastic surgeon. Criteria include skill, prior experience, length of time in practice, location, availability, and cost. Most plastic surgeons offer consultations that are available for a nominal fee (i.e. $35.00), so the patient has a chance to meet the surgeon and discuss the surgery.

During this interview, the surgeon and the patient can evaluate each other to see if they feel comfortable with one another. Although good results are anticipated, surgical complications can occur and one important question the patient should ask is, "Do I feel comfortable having this surgeon take care of a complication that occurs as a result of surgery?" Trust is an important issue to consider before the surgery.

Take the opportunity while in the surgeon's office to evaluate your surroundings, which are a reflection of the surgeon's energy. Are the surroundings warm and comfortable? Are they cold and sterile? How are you treated by the office staff? Do you feel comfortable or uncomfortable in the office and during the interview? Does the surgeon take the time to answer your questions? Is computer imaging available to help you and the surgeon communicate what can and cannot be achieved with surgery?

After the consultation, you should have a fair idea of the type of procedure needed to bring about the change you wish to create and the cost of this procedure. Make sure you have the total cost, including the surgical fee,anesthesia fee, and cost of the use of the operating room. Ask if follow-up visits are included in the surgical fee. Ask about recovery time with special consideration of your occupation. Time off work may be an additional expense if you do not have sufficient vacation and or sick leave.

After you have gathered the information from the consultation, you should have an estimated cost in money and time that will need to be invested in order to create the change you desire. Although financing programs are available and most surgeons and facilities accept credit cards, I recommend that you save the money needed for surgery before the procedure is done. This helps in several ways. The discipline of saving is one that many need to develop. This discipline, once developed, can help in many other areas of life.

From many years of experience, I believe that patients recover more quickly and have less stress with surgery if it is paid for in advance. In fact, scientific studies have found that patients who pay for surgery in advance have better outcomes and fewer complications than patients who pay for surgery using credit.

Another important area to investigate prior to surgery is whether or not your health insurance covers the cost of complications of cosmetic surgery. Several insurance companies recently have been deliberately excluding complications from cosmetic surgery from their coverage. The additional costs of treatment of complications should be discussed with the surgeon prior to surgery. Most surgeons will include the surgical cost of treatment of complications within the original fee, but the cost of the operating room and anesthesia are the patient's responsibility. Make sure sufficient funds and/or credit are available to cover these costs if they arise.

Myth #5 Plastic surgery is done only for vanity

This is one of my favorite myths to dispel. We have a mental image of ourselves, which is vital to our emotional and physical wellbeing. If you think you are old and tired, you will eventually create this in the physical. Plastic surgery allows one to keep the healthy mental image we have of ourselves in the physical despite the effects of childbirth, aging, and gravity. Many of my patients simply wish to maintain that vibrant and healthy self-image in the physical. After all, if your car were in need of a paint job and a new fender, would you think it vain to get the car repaired and repainted?

Many of our problems in life would lift if we had more self-love. True self-love is not vanity. If you love something, you take care of it. Don't be concerned about what others think. If they feel you are in vain, realize they are only projecting their own lack of self-love in your direction. Armed with self-love and released from judgments of others, there is very little that you will not be able to accomplish.

Remember, you don't have to have plastic surgery to develop self-love, but if changing your physical appearance is part of your dream, don't let doubt, fear, and the opinions of others keep you from realizing your dream. Dare to dream.

This article written by Susan E. Kolb, M.D., F.A.C.S.

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