Last week I went to two consultations with plastic surgeons. I talked in my last post about my post-weight loss loose skin. My goal was to discuss two separate groups of potential surgery. One group was what is called a Mommy Makeover, which is basically a tummy tuck (abdominoplasty) coupled with any type of breast surgery. In my case, I was interested in a breast lift (mastopexy). The other group of procedures was related to my face. I had lots of loose skin around my eyes and on my neck and along my jaw line. I also have some cholesterol deposits (xanthelasma) which I wanted to have removed.
After my last post, I was surprised to see the response I received to it, particularly in private emails to me, as well as in comments. This is a subject that a lot of people are interested in. Some readers told me about their experiences with surgery and others were interested in hearing my experience. Because of that interest, I decided to be very upfront as to what I am doing. Some of this is difficult, as it hard to talk about some of these issues and even harder to show pictures to illustrate them (no pics in this post, but there will be in the next).
One of the things I have had to think about in deciding to post here is whether I wanted people to know what I am doing. Basically, I decided that it doesn’t bother me for people to know. I think that these are issues that many people face when they lose weight and perhaps by posting I can help some others thinking about these issues. This post will talk about how I found the surgeons I wanted to consult with and how I checked them out. My next post will discuss what happened at the consultations.
I have been thinking about plastic surgery for quite awhile. There are a lot of ways to find potential surgeons. One way is to ask your own physician or talk to other nurses or physicians that you might know to get possible names. While I think that can be a great idea, we moved to this area not all that long ago and I haven’t seen a lot of physicians since we got here so I didn’t really have people nearby that I knew well enough that I could feel confident asking. But, if I had had a long term physician in this area or friends working in the medical field in this area, I would have definitely collected some names. I wouldn’t have stopped there, though. I would still have checked out any names that I received.
Another possibility is to ask people you might know who have had cosmetic surgery. Again, I didn’t really know anyone that I could ask. I would caution, though, not to just blindly think that a good reference from a patient means that a surgeon is a good surgeon. For example, I did talk to someone who knew someone who had had a tummy tuck. She got me the name of the surgeon. I looked up the surgeon and found out that he was not a board certified plastic surgeon. I had no interest at all in having a tummy tuck from someone unless that doctor was board certified by the American Board of Plastic Surgery. Again, I think it is fine to get recommendations from others, but you still need to do your homework and check out the surgeon.
Then, there is the approach that I look. I found the two surgeons I consulted with through Realself. Realself is, by the far, the most active place I found on the web to research plastic surgery. There are several features of that site I really liked. First, patients or prospective patients can ask questions of surgeons, and there are also forums. I didn’t ask any questions, but I read many, many questions and answers. Often, a question would get many answers from different surgeons. I found it very interesting to read the answers and to see how different surgeons might give different answers. But, over time, I found that there were often consensus answers to many questions. I learned a lot just by reading many of these questions and answers. In doing that, I noticed questions that were answers by local surgeons and I often went and read their answers to other questions.
I also went and watched some videos. For example, I saw videos of actual surgeries which really helped me to learn a lot about them. Watching a tummy tuck video is not for the faint of heart!
I also read reviews of procedures by actual patients. Reviews seem to mostly fall within 3 categories. The least helpful were those where someone post-surgery would come in and give a brief review of a procedure and surgeon with no pictures. That was OK, particularly if it was a review with a lot of factual detail. But, honestly, I didn’t pay much attention to glowing reviews of this type. One thing you have to be wary of with online reviews is that the review can be faked. I would expect that most reviews are genuine, but without pictures and with only a single review post, after the fact, I just didn’t put much weight on those kind of reviews. I quickly eliminated surgeons who only had those kinds of reviews. I also looked closely at negative reviews. I didn’t reject a surgeon because of one negative review, but I would read it carefully and see what response it received (sometimes, the surgeon would even respond). But, there were some surgeons that I eliminated based upon negative reviews.
The next group of reviews were those that were post-surgery, but had before and after pictures. These I put more weight on, particularly if they had a lot of pictures and the patient responded to questions. Yes, theoretically those could be faked, but if there were several pictures and the person posting was someone who had multiple posts at Realself over a period of time, I found the reviews to be valuable, particularly if they made multiple posts giving additional detail. In some cases, I could go to the surgeon’s website and saw the reviewer’s before and after pictures on the surgeons’s website.
The final group of reviews were the most helpful. On Realself, you can do a review that is more like a blog. Even pre-surgery you can start a review and can post before photos and then post periodically as you go through the process. The reviews I like the best were those where a patient posted before surgery, then posted during the surgery and recovery process and then followed up afterwards. For some of these, there were follow ups that continued over a period of a year or two. I found these reviews to be the most helpful and genuine.
Based upon those reviews, I found a few names that had several of the final type of blog/reviews by patients and I did more to follow up before deciding who to make appointments with.
I decided that I wanted to have surgery with a surgeon who is board certified in Plastic Surgery by the American Board of Plastic Surgery. The important phrases in that sentence are “board certified in Plastic Surgery” and “by the American Board of Plastic Surgery.” Finding out whether a surgeon is board certified is more complicated than it might seem.
There are all kinds of boards and societies out there that surgeons can join. They are not all the same. The American Board of Medical Specialties is the organization that has speciality boards that certify known medical specialties. So, for example, my internist would be board certified by the American Board of Internal Medicine, or an OB-GYN would be board certified by the American Board of Obstetrics and Gynecology. And, the American Board of Plastic Surgery is the ABMS plastic surgery speciality board. I wanted a plastic surgeon board certified by that board because I wanted a surgeon who had the requisite training to obtain that certification.
The reality is that there are surgeons out there who may by OB-GYNs or other physicians or who say they are cosmetic surgeons, but who do not have the training or board certifications to be board certified in Plastic Surgery by the American Board of Plastic Surgery.
Note that some Otolaryngologists may have subspecialized in head and neck plastic surgery. They are not board certified in Plastic Surgery, but have training in facial plastic surgery. I would not have considered such a physician for a tummy tuck or breast lift, but might have for facial surgery. As it turns out, one of the surgeons that I consulted with is board certified in Otolaryngology, but he also underwent training in plastic surgery and is board certified by the American Board of Plastic Surgery. Therefore, he trained to do both.
Also, I didn’t just take the surgeon’s website at its word as to to certifications. I looked it up myself at the Certification Matters page of the ABMS.
This is important because sometimes what people say isn’t that clear. Someone might say that a physician could do a tummy tuck and is board certified. That isn’t enough. Board certified in what? Board certified by whom? You have to check it out. Just saying someone is a “plastic surgeon” isn’t enough. A person can use that description, but might not be actually board certified in Plastic Surgery by the American Board of Plastic Surgery. Check it out carefully.
Once I got the board certification out of the way, I did more research. I went to the state medical board and looked up the surgeons I was interested in to make sure that they were actually licensed. I also looked to see if there were board actions or investigations against them and looked to see if any malpractice actions were listed. Since not everything may be there, I also looked up to see if there were any lawsuits in the local courts. And, I went to various websites that list physicians and read what information they had as well as any reviews. Examples were healthgrades.com, vitals.com, ratemds.com. The reviews at these sites weren’t actually all that helpful. They were after the fact and with no pictures. I was mostly looking for anything negative or that would raise any questions. Also, I checked to see where the surgeon had hospital privileges (I also checked this on the surgeon’s websites).
Then, I did a Google search on the physicians I was considering. A few years ago, I had been referred to a physician by another physician that I had seen. I looked up the potential new physician and found an article about a recent reprimand of the physician by the state medical board. There was a lot of information in the article. So, from that, I learned to search and read about any physician I was considering.
Then I went back to Realself and sent private messages to many of the people who had reviewed the surgeon. In some instances, I got no responses. Sometimes, people do reviews and after they have recovered from their surgery they don’t go back to Realself. But, a number of people did respond and they answered questions. One thing I always asked them was who else they had consulted with and why they chose the surgeon they chose. I did this to see if I got any potential other names of surgeons to consider and I wanted to know if anyone had consulted with the surgeons I planned to see and had not chosen that surgeon. If so, why did they choose a different surgeon?
I also went through the questions that the surgeon had answered on Realself and every video they had put up on Realself. I wanted to get a feel for what they tended up say and how they said it and how their answers compared to those of other surgeons. I also searched the surgeon’s name on Realself to see what had been said by users about the surgeon. For example, on the two surgeons I decided to consult with, I saw several instances where users said they had heard good things about those surgeons.
Visiting the Surgeon’s Website
There were several reasons to go the surgeon’s websites. There were some surgeons that I disliked their websites so much, I had no interest in the surgeon. I don’t like websites that I think are misleading or that over promise. Sure, I recognized that a surgeon would want to “sell” their services on their website, but I wanted it to be tasteful and I wanted the site to give real information and not just be selling stuff.
There are a couple of major things that I want to highlight. Most surgeons tend to focus on some parts of the body more than others. I didn’t want to go to a surgeon for a tummy tuck if the surgeon primarily does breast surgery. In my case, I wanted to have both facial plastic surgery as well as the Mommy Makeover. I did consider some surgeons who did only one of those and not the other, but I ended up deciding to consult with two surgeons who did both types of surgery. One of the ways you can see what a surgeon focuses on is to look at their website. It is often very obvious where there interest is.
The other thing is to look at the Before and After photos. There are a couple of reasons for this. First, you can get a good idea of what they focus on by looking at the before and after photos. If they have lots of blepharoplasty (eyelid surgery) pictures and and only one tummy tuck picture then you might think that they do a lot more eyelid surgery than tummy tuck surgery.
The other thing is to see what you think about their Before and After photos. For example, there was one surgeon that had good reviews on Realself, good answers to questions, and checked out OK. But, I went to his website and really didn’t like the photos of the necklifts he had done. I went back to Realself and looked at the necks on some of his patients who had posted reviews and I still wasn’t that thrilled with them. So, I crossed him off my list.
The Next Step
Initially, I thought I would interview 3 surgeons. But, after doing all of the above, there were 2 surgeons that stood head and shoulders above everyone else. They both had offices about 45 minutes away from where I live. They both did their surgeries in hospitals and for the surgeries I was doing, there would be an overnight stay (that may not be necessary for all surgeries, but I wanted it for what I was considering). There were some other surgeons on Realself that also met my criteria, but they were all much farther away. I decided to interview the two I was most interested in. If I felt uncertain after talking to them or if they gave greatly different recommendations, I would see one or more other surgeons.
I made a very long list of questions and made an appointment with each of the surgeons and went off to my consultations…. (Part II is here).