CHOOSING A COSMETIC SURGEON

by Julian A. Lofts MB ChB FRACS (Plast.)

When considering cosmetic surgery don't make the mistake of assuming that all doctors who call themselves cosmetic surgeons are appropriately qualified to operate. A review of the Yellow Pages listing under 'Cosmetic Surgery' in most main centres will include plastic surgeons, general surgeons, ENT surgeons, eye surgeons, dermatologists, appearance medicine 'specialists' and self-designated 'cosmetic surgeons'. The list of professional qualifications and membership of various colleges, societies and surgical academies may look both confusing and very impressive. A simple fact remains and this should remain imprinted in your memory long after you have finished reading this article - the only doctors who are comprehensively trained in cosmetic surgery and have a specialist surgical qualification (FRACS) that is recognised by the New Zealand Medical Council are plastic surgeons.

FRACS stands for Fellow of the Royal Australasian College of Surgeons. This is the benchmark standard for surgical training throughout New Zealand and Australia. It represents at least six years of advanced surgical training after the basic medical degree. Candidates must pass entry and exit examinations and their practical skills are constantly evaluated by senior surgeons during this rigorous training period.

FRACS is the appropriate specialist qualification to perform safe, reputable and ethical surgery. The commitment to professional competency and surgical excellence does not stop there. All plastic surgeons spend at least two years overseas obtaining more specialised experience, particularly in cosmetic surgery. Throughout their career they regularly attend surgical meetings and training courses. The College of Surgeons annually reviews ongoing medical education and audits each surgeon's performance. Plastic surgeons who are passionate about and committed to cosmetic surgery are elected members of the Australasian Society of Aesthetic Plastic Surgeons (ASAPS) and the New Zealand Foundation for Cosmetic Plastic Surgery (NZFCPS). These three credentials, FRACS in Plastic Surgery, ASAPS and NZFCPS, are the 'gold standard' in cosmetic surgical training and expertise. They significantly increase your chances of a successful outcome. You can check a surgeon's credentials by contacting the Medical Council, the NZFCPS and the surgeon's office.

Once you have selected a shortlist of two or three surgeons and checked their qualifications you should consider having an initial consultation with each of them. This way you can obtain their opinions on the surgery you require, their fees, their response to your questions and how they explain the potential risks associated with the surgery.

Your surgeon should welcome any questions you may have concerning your procedure, their training and credentials, experience and personal techniques. Prepare a list of questions in advance and take notes during the consultation. Ask for explanations if you do not understand anything.

Questions you may wish to ask should include:

• What are the surgeon's qualifications and experience?
• Are they FRACS? Are they a member of ASAPS or NZFCPS?
• Do they perform the procedure on a regular basis?
• Are there any complications associated with the procedure?
• If complications do occur or the procedure is not successful, how will the surgeon deal with these?
• Where will the surgery be performed?
• Will a qualified anaesthetist administer the anaesthetic or sedative medication?
• Do they have a consent form outlining the procedure for your review?
• What after care will be provided?
• Do I have any options other than surgery?

Beware of the following:

1. A 'cosmetic surgeon' who has no formal surgical training and specialist qualifications. By July 2001 all doctors must be vocationally registered by the Medical Council. Those doctors who do not comply with these requirements must work under supervision and their Annual Practising Certificates will be endorsed to this effect.
2. A doctor who is not accredited to operate at a registered private hospital. You may endure extensive surgery under sub-optimal conditions with no overnight monitoring facility. If something goes wrong you may have to be transferred to a public hospital under another doctor's care.
3. A doctor who pressures you to accept procedures you do not really want.
4. A doctor who promotes new techniques without showing you his own before and after results.
5. A doctor who guarantees results or claims to have no complications.
6. A doctor with whom you have established no rapport.
7. A doctor who has a limited surgical repertoire. For example, a liposuction doctor may inappropriately recommend liposuction of your abdomen even though a tummy tuck is the best solution.
8. A doctor who gets other staff to do the hard sell and only meets you just prior to the operation. You can still walk away at this stage with your dignity and bank balance intact. Avoid a surgeon who imposes a non-refundable deposit and don't choose a doctor solely because he is the cheapest.

Surgery can be compared to taking a long distance plane flight. Would you rather travel comfortably and safely in a jet airliner with a qualified pilot and crew or go by hang glider?

The New Zealand Foundation for Cosmetic Plastic Surgery was set up by a concerned and committed group of plastic surgeons to inform the public about the inherent dangers of inappropriately qualified 'cosmetic surgeons'. The Foundation has published 'A Consumer's Guide to Cosmetic Plastic Surgery in New Zealand'. To order copies of this book or obtain advice on which surgeon to choose please phone 09 376 9095.

 

Julian A. Lofts MB ChB FRACS (Plast.) is a cosmetic plastic surgeon who has a private practice in Auckland. He specialises in breast surgery, facial rejuvenation and body contouring.