Read an Excerpt
Secrets of a Beverly Hills Cosmetic Surgeon
The Expert's Guide to Safe, Successful Surgery
By Robert Kotler
Ernest Mitchell PublishersCopyright © 2003 Robert Kotler, MD, FACS
All rights reserved.
She got her looks from her father. He was a plastic surgeon.
- Groucho Marx
SNAPSHOT of the BIG PICTURE
Considering Cosmetic Surgery?
Wondering what to expect?
What you would look like?
Think you want it but a bit frightened by the prospect?
Not sure if it is for you because you have not yet researched it?
Need some help?
Some concise, to-the-point information?
Would you like to have an expert, an advisor at your side to coach you and demystify the process of deciding, "go" or "no go"?
If yes is your answer to all or most of these seven questions, you hold the the guiding light in your hands. Let this book be your coach, your personal consultant. It can ease the way for you. It will make the decision-making process much easier.
You do not even have to buy this book to get an overview of the book's content. It is right here, up front, in this first chapter. An easy way to help you decide whether or not to buy the book. No charge; Chapter 1 is on me.
It will take only ten minutes. If you are at your favorite bookstore, pull up a comfortable chair, grab a cup of coffee, sit and relax a bit. Thumb through this chapter. I am going to give you a sneak preview, a glimpse of what the rest of the chapters will expand upon.
I shall let you decide if the book is important for you, if its advice is meaningful, and if you think there is value here. I'll even share my 16 biggest secrets with you, right now:
THE 16 MOST IMPORTANT COSMETIC SURGERY SECRETS
Many statisfied cosmetic surgery patients "don't talk." Some of your relations and friends have had something done, but they won't necessarily tell you.
Doctors are flooding into cosmetic surgery. Many lack proper training. Some are incompetent.
Selecting a cosmetic surgeon can be a walk through a minefield. DO YOUR HOMEWORK.
The doctor you want is called a super-specialist — he practices cosmetic surgery exclusively.
Many consultations focus on selling, not teaching. When is a "free" consultation too expensive?
A surgeon's "before" and "after" album is filled with clues. You should see lots of photos — and they must be "photographically honest."
Know the 15 smartest questions to ask any cosmetic surgeon.
A consultation without computer imaging has limited value. You need to see, on a computer screen, what you will look like "after."
Fees are negotiable. Know the ropes.
The facility in which you have your procedure done can be as important as who is doing it!
Combining a trip to an exotic location with cosmetic surgery may be a less-than-perfect mix.
Know the difference between an anesthesiologist and an anesthetist. Only one is a medical doctor.
High fees don't necessarily mean better results. Low fees are not always a bargain.
Your chances of post-surgical complications can be reduced by understanding your doctor's philosophy on "aftercare."
Aspirin, herbs, even vitamins can influence your risk during surgery. Be sure to know what to avoid.
There is a responsible answer or solution for every concern, worry and reservation.
Yes, I am "giving it away, free." But that is not an issue for me. What is important is that you get a sense of how very unique and important my insider information is. I am offering to share this with you if you have any interest in improving your appearance.
Asking For A Referral? Here's A Shortcut To The Top Doctors
When asking a friend, doctor or other source for a referral for cosmetic surgery, be specific. Don't say: "Can you give me the name of a great plastic surgeon?" or "Know a good, reputable cosmetic surgeon?"
That's not specific enough. In today's world of doctors, find a superspecialist — one who is an expert in the procedure you want.
If you are considering changing your nose, the wise "Insider's" question is: "Who's known for great noses?" For body liposuction: "Who has the most experience in liposuction?"
Go straight to a superspecialist.
It may be that when you finish reading this chapter, you will have learned enough to conclude that cosmetic surgery is not for you. And that is fine; as good as cosmetic surgery is for those who have it, it is not for everyone. That will be your choice.
In our practice, it is not the right thing for about 20 percent of the patients who consult with me. One of five. I do not want to deflate a patient's dream and often they will describe my respectful decline as "a disappointment." Rather, I am acting professionally by giving them a responsible, realistic, and honest opinion. Doctor and patient must be on the same page and I will help you level the playing field so you can make a decision with confidence. If you are considering cosmetic surgery, selecting your doctor will be one of the most important decisions of your life. And if it is inappropriate for a man or woman to have a procedure, I shall be best serving those who sit in front of me by giving them my best opinion, an answer based on my years of experience, not an answer they would prefer to hear.
I now tell you what I tell such patients: I enjoy doing surgery. It is my life's work and obviously, it is the only way I earn my living. But my first obligation to you is to give my best; not self-serving, opinion. And sometimes, that boils down to one word: "Don't." Don't if your health is not satisfactory. Don't if even a slight risk of a poor outcome or complication is unacceptable. And don't if you are not certain you really want cosmetic surgery.
That is how I have done it during 25 years of consulting with over ten thousand prospective patients. Skeptics may scoff at hearing of my telling patients — despite their pleadings — that I do not accept the fee and operate if my heart is not in it. But that is how this doctor practices. It is about integrity — not money — because one, or two, or ten more cases a year will not make a difference in my lifestyle. But, doing surgery without the comfort of knowing that I am doing the right thing would push me over an ethical line I choose not to cross. I prefer to sleep well.
If you conclude that you want cosmetic surgery, I strongly encourage you to go into this with eyes wide open. You want to do it right the first time.
When performed correctly, cosmetic surgery can transform your life. However, if you are a deluded optimist, too-trusting, do not use good judgment, or even if your expectations are unreasonable or incorrect, you will be disappointed.
I am going to tell it as it is; the good and the bad and the not-too-pleasant. I'll share some possibilities and potentials, but will also reveal some pitfalls that you never thought about. They are all important. And that is why you will be challenged to do two things: look at yourself in the mirror, and look at the entire subject of cosmetic surgery, because many factors must be considered to give you the insight and result you want.
This Book Will Answer Your #1 Question:
What Can I Really Expect?
Secrets of a Beverly Hills Cosmetic Surgeonis written for those of you who want straight talk. If you will come with me on the journey we are about to begin, I guarantee I will help you decide if cosmetic surgery is right — or not right — for you.
Should you decide that either the time is not right or, for whatever personal reason, you are not committed to undergoing surgery, you can learn about popular nonsurgical alternatives. They are not as powerful, but they work: skin care products and in-office medical treatments that are minimally invasive. You will have a taste of how today's cosmetic surgeons and their allies can help you improve your appearance and slow the clock.
This is a mini-encyclopedia of self-improvement. A menu of treatments from light to heavy, from simple office procedures to more elaborate surgical operations. This is the first behind-the-scenes peek at American cosmetic surgery from one of its own, a bona fide insider, not a professional writer on assignment. An authoritative exposé of this much-discussed — but poorly understood specialty a primer on how you can safely navigate through what is the best way for you to obtain the best possible result. By the last page of the book, you will know what you want — and what you do not want — and hopefully, will thank me for the advice.
The Good, the Bad and the Ugly
For more than a quarter of a century I have been privileged to participate in one of man's more fascinating surgical advances — a gift to himself — the improvement of his appearance. It is an honor to have been chosen by over eight thousand patients to be the doctor who would make a profound and positive change in their lives. In a world where many discretionary purchases and indulgences have a limited lifespan and importance, cosmetic surgery outlasts most, carrying lifelong internal satisfaction.
In less than one generation cosmetic surgery has become an accepted, mainstream undertaking for millions. According to the American Society of Plastic Surgeons, "Surgical and nonsurgical cosmetic surgery procedures in the United States increased 31 percent from 1992 to 2000." Americans are expected to have 8 million cosmetic procedures this year. Its expanding popularity reflects these advances:
Expansion of capability — new solutions for previously unimprovable conditions.
Better results — natural appearing, not "fake" or artificial.
Greater longevity of procedures — today, there is no reason for a facelift to last only two or three years.
Reduction in surgical and anesthesia risks — through the development of both new equipment and refinement of techniques, risks to patients continue to decrease.
Shortened operating times — this translates to a safer procedure and significantly lower fees, opening the door of opportunity to prospective patients who thought they could not afford cosmetic surgery.
Minimized recovery time — patients can return to work in seven to fourteen days; a decided savings in time and money.
Yet, despite these impressive improvements, poor quality cosmetic surgery still exists. While it is a challenge even for me to spot well-done (natural-appearing) cosmetic surgery, it is easy to spot the "unnatural" work. Whether I am walking down Rodeo Drive in Beverly Hills, Michigan Avenue in Chicago, or Fifth Avenue in New York or even Illinois Avenue in Green Lake, Wisconsin, I have noticed the overdone, too-scooped, too-short, nostrils-flaring nose job; or the overtightened, overpulled, walking-through-a-wind-tunnel facelift. Instinctively, I wince. I'm sorry an opportunity for success was missed. In the right hands, our specialty can do better — and does so every day.
People are often frightened away from cosmetic surgery as a result of these botched jobs. Unfortunately, some prospective patients have deferred consulting about a cosmetic procedure because of rumors, or first-hand accounts shared by friends or family members of (avoidable) pain and suffering.
These negatives raise a question: is there a common factor responsible for (a) poor results that some people sustain, (b) the inappropriate, unfounded fears and skepticism that prevent others from achieving their wish for an improvement in appearance? What is wrong? What is the problem?
The answer, the diagnosis, is lack of adequate, correct information. More and better information is needed: ideally insider information — from an expert, from a source working daily in the trenches of the specialty. Sound advice, parallel to what I seek when choosing professionals for my family or myself. I do not know very much about the inner workings of the architectural, accounting or legal professions. But 35 years after receiving my medical degree, I do know about my profession. Some cosmetic surgery books chronicle individual patient experiences, and others delve deeply into the technical aspects and minutiae of every major and minor procedure. No book, however, has ever revealed the inner workings of this specialty. The culture, the politics, the interspecialty rivalries. And the biggest problem: the wrong surgeons doing cosmetic surgery.
This is the first behind-the-scenes peek at American cosmetic surgery from one of its own, a bona fide insider, not a professional writer on assignment. An authoritative exposé of this much- discussed — but poorly understood — specialty. A primer on how you can safely navigate through what is the best way for you to obtain the best possible results.
In cosmetic surgery, there should be only excellence. After all, this specialty is about results, and the results are seen by all. I believe the percentage of unhappy experiences is too high, despite the availability of enough sophisticated practitioners. The glitz, glamour, and inane celebrity-slanted TV and magazine stories, have displaced the meaningful, dispassionate advice needed to make a wise consumer decision. While cosmetic surgery is not a frequent undertaking, it cries out for the same thoughtful, objective analysis as any major purchase. You want to do it well; a poor result cannot necessarily be corrected.
Since cosmetic surgery is always elective, you have the luxury of time. Time to do the research, the study, the investigation, so you do it right the first time. What I am telling you is that such a search is not quick, nor simple. You are going to have to dig a bit. You are going to have to work. Once again, that old maxim that your parents told you applies: "You get out of something what you put into it." While it is quick and effortless to open your Yellow Pages and call the first doctor with the most eye-grabbing ad, I submit that you will not be doing yourself a favor, but rather a bit of dice-rolling. Are long shot odds acceptable to you? If so, I suggest the racetrack. Otherwise, read on.
Mine is a rather unique specialty and an uncommon business. Consider this: Cosmetic surgery is a distinct medical specialty, provided by physicians but, unlike all other specialties, cosmetic surgery does not treat illness. Cosmetic surgeons often have more professional interaction with hair stylists and makeup artists than they do with other physicians.
Cosmetic surgery is a learned profession, but operates more like a business, prospering through marketing, advertising, and price competition. But the fees are inconsistent. For the buyer trying to correlate price with the usual variables of quality and service, the search is perplexing, indeed. Further complicating doctor selection is that today's cosmetic surgeons — from varying educational and training backgrounds, and different specialties — purport to deliver the same services. This is "specialty overlap," and it is explained in Chapter 3, Selecting the Right Surgeon. This competition between specialties for the same work makes it harder to select a cosmetic surgeon than it is to choose an electrician. And, this confusion is worsening for you, the consumer. More and more doctors — disheartened and demoralized by the depersonalization of managed care served up by uncaring, profit-driven insurance companies — are now moving into cosmetic surgery. This doctor flight is a big concern to those of us in medical education.
Cosmetic surgery, wrapped in hope and packaged with excitement, is too often unwisely driven by emotion. The prospective patient can be confused by media coverage that can be poorly researched and sensation-oriented. The checkout line at your grocery store is littered with the latest, enticing celebrity exposés. But there is no meaningful information for those eager to gather solid facts about the specialty.
Ironically, the people who can best help you understand this road less traveled are those who have had cosmetic surgery. However, many patients do not disclose their surgery. Your co-worker returning from vacation looking "rested" may give credit to a "sleepy little spot" she found rather than the surgeon she visited. How can you get an education when the voices of experience are silent?
Excerpted from Secrets of a Beverly Hills Cosmetic Surgeon by Robert Kotler. Copyright © 2003 Robert Kotler, MD, FACS. Excerpted by permission of Ernest Mitchell Publishers.
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