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Harvard Commentaries
35320
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


Woman to Woman Woman to Woman
 

Contemplating Cosmetic Surgery


January 14, 2013

By Alice Y. Chang M.D.

Harvard Medical School


From time to time I get asked, "Do you know this plastic surgeon? Would you recommend anyone in particular? What do you think about this or that procedure?" These questions are harder for me to answer than, "Do you know a good heart specialist?"

I personally have a problem with cosmetic plastic surgery. It is not without potentially serious risks. It is hard for me to recommend that anyone should take even a small risk just to become more attractive. Cosmetic procedures are not the same as spa treatments, even though some of them are advertised in spas or beauty salons. Any surgical procedure, no matter how quickly it can be performed, carries risks — from a bad reaction to anesthesia to bleeding and infection to even death.

So when I answer questions about cosmetic procedures, I discuss how I generally feel — that it is not worth the money or taking a risk for the procedure. Then, I suggest someone consider two practical issues: Do I really want this surgery, and if so, whom should I have perform it?

Before You Have a Procedure

Before you dream about the new you, be sure to step back and ask yourself the hard questions:

  • Why do I want to change my body, and how will the procedure enhance or change my life? Consider talking to a friend or a therapist about these questions so you feel truly mentally prepared for any procedure, and have support after the procedure if you decide to have it done.
  • Am I ready to make the investment of time, potential discomfort and money? Consider how you will feel if the result isn't what you expected, or if you require more surgery (which requires more money), or if you have to endure a long recovery from complications. Talking to someone who has already had the procedure done can help. Ask about the exact details of the recovery process: How long will you be bruised or bandaged and out of work? Are there any special precautions during recovery (how you sleep, what you can eat, etc.)?

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Picking a Plastic Surgeon

If you decide to go ahead with plastic surgery, consider these tips that my friend, a female plastic surgeon, advises to check on your surgeon's qualifications:

    1. Check the surgeon's certification. Make sure the surgeon is board-certified by the American Board of Plastic Surgery. Ask the physician, look for this diploma on his or her wall, or check his or her website or your state medical board's website. This certification, which requires years of additional training and the successful completion of tests, is different than other boards, societies or associations for cosmetic surgery. If your doctor turns out to be an ear, nose and throat surgeon, dermatologist or other specialist who did additional training to become a "facial plastic surgeon" or a "cosmetic surgeon," make sure the surgeon is at least board-certified in his or her original field.
    2. Check the surgeon's credentials. Investigate what kind of training the surgeon had after medical school. You can flat-out ask, browse the surgeon's hospital or professional website, or check with your state medical board, which often posts physician profiles on the Internet. Be suspicious if the surgeon won't give you this information or you cannot find it. You might be surprised to find out that your surgeon was not trained in a plastic surgery residency.
    3. Check with your state medical board if there are any complaints or malpractice suits against your physician. Many states now have this information available on the Internet. Search for "your state name medical board." Although many good physicians have been sued, it helps to get a sense of whether there is a long track record of complaints.
    4. Ask the surgeon about what hospital he or she can admit patients to or operate in. Even if you are having an outpatient procedure, you want to know that a good hospital is available in an emergency. And, if a physician has admitting privileges to a hospital, that hospital has done its own thorough review of your physician's credentials.
    5. Ask to see samples of your surgeon's average results for the procedure or surgery you are having. The surgeon may only show you the "best result" he or she has ever had. You want to see a good sample of technique, not just the best he or she can do.

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Taking Stock of Yourself

In a society where being young, beautiful and thin are emphasized and often rewarded, why not let cosmetic surgery make up for what Mother Nature didn't give you? Because there are risks, and they must be carefully weighed against potential benefits before you go under the knife. When it comes to reshaping your nose, increasing your breast size or a face lift, you are looking at serious risks with no physical health benefit.

The psychological benefit is hard to predict, because your self-esteem is not just about what you look like but who you are. And remember, people can be disappointed when their life does not change as a result of a procedure or surgery. Even after you have the surgery done, you still will be living the same life with the same problems. You can change the way you look, but you can't always change the way you feel.

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Alice Y. Chang, M.D. is a former instructor in medicine at Harvard Medical School. She is currently associated with University of Texas Southwestern Medical Center. Her clinical interests and experience are in the fields of primary care, women's health, hospital-based medicine and patient education.

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