BASICS: HOW TO CHOOSE A QUALIFIED PLASTIC SURGEON

The term "plastic" comes from the Greek word "plastikos," meaning to mold or give form. Plastic surgery does just that - it gives new form to the human body. The specialty includes two kinds of procedures: reconstructive surgery, or procedures done to repair birth defects and deformities caused by accidents or disease, and cosmetic or aesthetic surgery, including facelifts, nose reshaping, fat suction and other procedures done to enhance appearance.

No matter what type of plastic surgery you're considering, the most important factor in its success is the surgeon you choose.

How can you find a well-trained, qualified, experienced plastic surgeon? This information can help you make an informed choice. It was prepared by the American Society of Plastic Surgeons (ASPS), a professional society dedicated to quality care for plastic surgery patients through education, research and the promotion of high professional standards.

In choosing a plastic surgeon, your first goal is to develop a list of good candidates. Where do you find them? Some sources are better than others.

· Friends. If you know someone who's had a procedure like the one you're considering, talk to him or her about it. But don't decide on a surgeon based on one friend's experience. Every patient is unique, and so is every surgery; your results might be quite different from your friend's.

· Doctors. Your family doctor may be able to recommend a plastic surgeon. Ask your doctor how many patients he or she has referred to this surgeon and what feedback they offered later. Ask whether the doctor would send a family member to this plastic surgeon.

· Nurses. If you know an operating room nurse - or if you know someone who knows one - you can probably get a well-informed opinion on surgeons he or she has worked with.

· Hospitals. Call a respected hospital in your community and ask for the names of board-certified plastic surgeons on staff. Be sure to ask for the names of doctors who have privileges (official approval) to do the particular procedure you're considering.

· ASPS. The Plastic Surgery Information Service of the ASPS is an excellent source of names. Simply call the toll-free number, (888) 4-PLASTIC (475-2784), and leave your name, address and the procedure you're interested in. We'll send you the names of five plastic surgeons in your area who perform that procedure. Their membership in the ASPS means they're certified by the American Board of Plastic Surgery (ABPS) and members of the largest plastic surgery specialty organization in the United States. You can show this list to a doctor you trust and ask if he or she has any recommendations. You can also check the list against the one you may have received from the hospital.

· Special directories. You can find the names of board-certified plastic surgeons, listed by state and city, in two reference books available in most public libraries: The Directory of Medical Specialists, published by Marquis Who's Who, and The Compendium of Certified Medical Specialists, published by the American Board of Medical Specialties (ABMS).

· Paid advertising. You can find plenty of physicians' names in the yellow pages and other advertising sources. But keep in mind that doctors can list themselves under any specialty heading they like and can advertise any services they want to sell, regardless of their training and credentials. (Exceptions are group listings sponsored by the American Board of Medical Specialties or its member boards.) Similarly, doctors quoted in newspaper and magazine stories may or may not be qualified "experts."

Once you've compiled a list of several doctors, you can start checking their credentials. While good credentials can't guarantee you a successful outcome, they can significantly increase the odds. You can obtain the following information from the directories mentioned above, hospitals and professional societies, and the surgeon's office.

· Training. More important than where your surgeon went to school is the type of training he or she received. Has the surgeon completed an accredited residency program specifically in plastic surgery? Such a program includes two or three years of intensive training in the full spectrum of reconstructive and cosmetic procedures. While your plastic surgeon may choose to concentrate on a limited number of procedures, this comprehensive background gives a solid foundation to his or her skills.

· Board certification. Everyone has heard the phrase "board-certified," but very few people know what it means or what to look for.

Patients are encouraged to consider a doctor certified by the American Board of Plastic Surgery (ABPS). By choosing a plastic surgeon who is certified by the ABPS, a patient can be assured that the doctor has graduated from an accredited medical school and completed at least five years of additional residency - usually three years of general surgery (or its equivalent) and two years of plastic surgery. To be certified by the ABPS, a doctor must also practice plastic surgery for two years and pass comprehensive written and oral exams.

· Hospital privileges. Even if your surgery will be performed in the doctor's own surgical facility, he or she should have privileges to perform that procedure at an accredited hospital in your community. It means the surgeon is subject to approval by a body of his or her peers. Call the hospital to make sure.

· Experience. Although there's no magic number (of years or procedures) that defines "experience," you should feel comfortable that the surgeon you choose is well versed and up-to-date in the procedure you're considering. You can ask the surgeons on your list if they do the procedure frequently or only occasionally and when they last performed that procedure.

· Professional societies. Physicians may belong to a wide array of professional societies, but - as with board certification - some are more meaningful than others. If a physician tells you he or she belongs to a particular society, get the exact name and call the society to find out what the requirements for membership are.

Of the societies representing plastic surgeons, one of the most demanding - and by far the largest - is the American Society of Plastic Surgeons (ASPS). Its members must be certified by the ABPS and reviewed by their peers. They must also participate in continuing education and adhere to a strict code of ethics.

If you've narrowed your list down to two or three surgeons, you might want to visit them all for an initial consultation. That way you can compare their personalities, their opinions on the type of surgery you should have, their fees, and the way they answer your questions and explain the risks involved. Keep in mind, though, that you'll probably have to pay for these consultations, whether or not you choose that surgeon.

Don't be afraid to ask questions, no matter how trivial or how personal you think they'll sound. In fact, it's a good idea to write down your questions before hand so you won't forget any of them and to make a note of the surgeon's answers as well.

Here are a few general things to look for in the interview:

· The surgeon should answer all of your questions thoroughly, in language you can understand.

· He/she should ask about your motivations and expectations, discuss them with you, and solicit your reaction to his/her recommendations.

· He/she should offer alternatives, where appropriate, without pressuring you to consider unnecessary procedures.

· He/she should welcome questions about professional qualifications, experience, costs and payment policies.

· He/she should make clear not only the risks of surgery but the possible variations in outcome. If the surgeon shows you photographs of other patients, or uses computer imaging to show you possible results, it should be clear that there is no guarantee that your results will match these.

· He/she should make sure the final decision is yours.

If you've obtained your surgeon's name from a good source, checked his or her credentials, are satisfied with your initial consultation, and have realistic expectations for the surgery, chances are very good that you'll be happy with the outcome of your plastic surgery.