Read an Excerpt
The Essential Cosmetic Surgery Companion
Don't Consult a Cosmetic Surgeon Without This Book!
By Robert Kotler
Ernest Mitchell PublishersCopyright © 2005 Robert Kotler, MD, FACS
All rights reserved.
COSMETIC SURGERY — What It Can and Cannot Do
Are You REALLY a Candidate? These 15 Scenarios and Comments Will Tell You
Cosmetic surgery is not for just anyone. Since this is a book of questions, here are 15 sample reasons you might have for cosmetic surgery. The comments will help answer your question: are you or are you not an appropriate candidate?
1. You wish to improve your appearance because: your mirror is demonstrating signs of aging: baggy eyes, jowls, double chin, wrinkled face, sagging breasts, jodhpur hips.
2. Certain physical features are unsatisfying to you: prominent nose, receding chin, low eyebrows, small breasts, disproportionately large breasts, over-plump buttocks, flanks or hips, or flank fat rolls that defy diet and exercise, wrinkled skin, jowls, sagging neck, double chin.
3. You are a mother of three, and your breasts and tummy sag despite a vigorous workout schedule.
4. Your lips are thin.
5. Your upper eyelids droop, but you are not necessarily tired.
Comment: Numbers 1, 2, 3, 4 and 5 represent valid indications for cosmetic surgery.
6. You are unhappy with your social life and believe a new look can invigorate it.
7. You are recently divorced and anxious to "hook up" with someone and are convinced a new look will enhance your prospects.
8. You are overweight and hope liposuction will give you a "quick fix."
Comment: Numbers 6, 7 and 8 deal with issues for which cosmetic surgery is not a satisfactory answer.
9. You are in the entertainment world. You are not getting the roles you want and think cosmetic surgery will help.
10. You are a model and your agent suggests that "you are great, but your nose is too big."
11. Your career is stagnant. Your occupation is populated by younger people and you sense there is a career advantage to looking younger and not shopworn.
Comment: Numbers 9, 10 and 11 require some additional thought and explanation. Number 9 deals with people seeking certain roles in the entertainment world. What you have to ask yourself, your agent and the people with whom you interact, is whether or not it is realistic to expect that more parts will be available to you if certain features are changed. The same logic applies to Number 10. Often, casting directors and modeling agency directors cannot be certain that a change in a physical feature will assure further work assignments.
Comment: Number 11 is the most intriguing. It is a fact that an employer may choose the more youthful and energetic-looking candidate for a specific position. Certainly, experience is to be valued, but unfortunately experience alone may not be enough. The combination of a youthful appearance plus experience is ideal.
In the Seventh Annual Kennedy-Krannich Career Book Picks of the Year, Joyce Kennedy of Tribune Media Services, chose as one of its 10 selections for 2003, SECRETS OFA BEVERLY HILLS COSMETIC SURGEON, The Expert's Guide to Safe, Successful Surgery. In informing us of this honor, Joyce wrote: It is not really a stretch to be included in the list of the 10 best career books of the year because age is taking a big hit in the job market. The book is terrific and will help more people than you may ever know.
In Joyce's column announcing the winners, she described the book as: the ultimate guide to erecting a (job) bias defense shield. The author knows every wrinkle (pardon) ever erased to keep you looking young and vibrant in the job market.
12. Your five-year-old tells you your nose is too big.
13. You are a 15-year-old young lady and your grandmother keeps asking you: "When are you going to go see a cosmetic surgeon about your nose?"
Comment: Numbers 12 and 13 deal with the opinions others have of your physical features. Their opinions are not important; what is important is your opinion. Make the decision for yourself, for reasons that are important to you and not to satisfy someone else.
14. You are 69 years old. You have had three facelifts, two eyelid surgeries and a chemical skin peel. Your friends and family tell you "you look terrific." A movie theater cashier demands Medicare card or proof of age when you request a senior discount. But at cocktail parties, you accost a cosmetic surgeon and obsess about "these lines around my eyes."
Comment: Number 14 deals with a common scenario: people become obsessed and focus on the barely visible and/or unimportant. What counts is the total appearance. A line or two here does not make for an aged face. No go.
15. You are a high-profile media personality and your face is recognized by millions of people. You have had so much cosmetic facial surgery you are developing a strange, monkey-like look. Yet, you "want more."
Comment: Number 15 is a reminder that there is a pool of quicksand that awaits those who seek to go beyond a reasonable cosmetic surgery expectation. I don't have to remind you of the celebrities who unfortunately fell into that quicksand and never got their faces out.
The above are common and classic consultation comments. All have been excerpted from actual consultations. Which of these 15 scenarios match your motivations and desires? Which are healthy? Which are unwise and potentially risky?CHAPTER 2
THE SEVEN KEY QUESTIONS YOU MUST ASK YOURSELF
Below are the seven issues and concerns most frequently shared with us by prospective patients. It may be that one or more are also your concerns. Everyone has concerns.
1. I'm afraid. The idea of any surgery  
and/or anesthesia scares me.
2. What will I look like? Will I be happy with the  
result? Will it look natural?
3. How long before I can return to social activities,  
work or exercise?
4. Will it be painful?  
5. What will my family, friends or even coworkers  
think about this?
6. Can I afford what I want?  
7. Which doctor is best qualified for my particular  
THE MOST IMPORTANT DECISION — DOCTOR SELECTION
A Little Secret:
Just Because It Says "Plastic Surgery" or
"Cosmetic Surgery" on the Door
Doesn't Mean You're in the Right Place
Cosmetic surgery is always elective (not essential to life) surgery. You have the luxury of time to make the best decision possible. The challenge you will face is finding, managing and interpreting all the information available.
One reliable route for choosing a cosmetic surgeon is through a recommendation from a friend or acquaintance pleased with his or her surgery's result. If a person is willing to share that they have had cosmetic surgery, he or she will usually be equally willing to discuss the entire experience. Be careful to compare the procedure you are considering with the one they have had. Remember, compare "nose to nose," "breasts to breasts." Don't assume a successful breast surgery guarantees the expertise demanded for a nose job. Different territory, different techniques.
The ideal medical referral sources are surgeons, operating room nurses, surgical technicians and anesthesia specialists. Those who actually see the cosmetic surgeon performing his craft in the operating room are the most useful witnesses. Those are the "experts" I contact if I'm checking out a surgeon for family or a friend.
My Four Key Criteria in Identifying a Top Cosmetic Surgeon:
* Board certification in one of the four specialties that legitimately and routinely perform cosmetic procedures within their defined scope of practice: dermatology, head and neck surgery, ophthalmology and plastic surgery.
* Fellowship training in the cosmetic surgery of the doctor's board-certified specialty.
* Medical school teaching appointment.
* Practices cosmetic surgery exclusively — no reconstruction, e.g., burns or hand surgery, accidents, cancer surgery, birth defects. One hundred percent focus on cosmetic surgery!
I just made the sorting a lot simpler for you.
NOTE: A Quick Way to Compare Cosmetic Surgeons on Paper
When comparing surgeons, place their respective professional biographies side by side. The focused cosmetic surgeon's professional history will be replete with references to cosmetic surgery training, experience, research and teaching. A surgeon who does not specialize exclusively in cosmetic surgery may be stronger in other work: cancer, reconstruction, trauma or birth defects. Add this information to what you gather through friends, medical personnel and your office visit and you will be well on your way to short-listing the best surgeon for your needs.
Characteristics of a Physician — Good and Bad
Kept me waiting
Doesn't explain enough
Careless with prescriptions
Reluctant to refer or consult
ALWAYS SEEK A COSMETIC SURGERY SUPERSPECIALIST
You Don't Have to Go to Beverly Hills
The histor of surgery is one of continual progress made through increasingly narrow specialization by its practitioners. Only 88 years ago, there were no specialties within surgery itself. All surgery — from brain to toe — was done by "a surgeon." And then, that "surgeon" had no formal specialty training after medical school. But today's medical education trend is to train doctors who will be more skillful in a relatively limited portion of the body. A "jack of all trades, master of none" is not satisfactory in today's highly specialized medical world. There are great benefits to patients when a surgeon narrows his scope and chooses not to perform most other operations within his specialty. Now there are eye surgeons who limit their practice to the retina, chest surgeons who perform only open-heart procedures, and orthopedic surgeons who do only knee surgery.
This fine honing of specialization in modern medical practice is known as superspecialization: a narrow, focused, "boutique" practice. Great benefits to the patient are realized when a surgeon narrows his scope and concentrates on a limited selection of procedures.
Level 1: Specialist. Some cosmetic surgery but most time spent on reconstructive surgery for disease or accident. Board certified. No fellowship training.
Level 2: Subspecialist. Practices both reconstructive and cosmetic procedures, but not the full scope of the parent specialty. Typically board certified plus fellowship training beyond his residency.
Level 3: Superspecialist. Practices cosmetic surgery exclusively. No reconstructive surgery. Typically board certified and fellowship trained, the most specialized of all practitioners. In the world of cosmetic surgery, these doctors are at the apex of sophistication, training and skill.
Superspecialists are the product of post-residency fellowship training, and the importance of such fellowships cannot be underestimated. The refinement and focus of subspecialty education will continue to narrow as we recognize that achieving surgical excellence requires a depth of knowledge that is more valuable than mere width.
By now you should have no doubt that the more specialized the doctor, the greater the likelihood of good results for you, the patient. You now know that if you are considering a facelift, you should seek a board certified specialist who performs only cosmetic surgery and has served a cosmetic surgery fellowship. A cosmetic surgery superspecialist will typically limit his practice to 15 or fewer procedures mastered after lifelong study, focus and dedication.
Patients do understand, instinctively, the importance of choosing a doctor whose focus matches their specific need. We now hear patients say with increasing frequency: "I want a cosmetic surgeon who doesn't do everything." The public has endorsed superspecialization by increasingly patronizing the more specialized and focused doctors. It makes sense, doesn't it?CHAPTER 5
THE SCREENING CALL A Five-Minute Call Can Save You Two Hours and $200
Thi is one of my favorite tactics to save you time and money. Why take precious hours and hard-earned dollars to visit a doctor who turns out to be inappropriate — for whatever reason — for your needs?
Instead, once you have a list of prospective cosmetic surgeons, make a few two-minute calls. You could save hours and hundreds of dollars.
A few tips to remember before you call:
Ask for the office manager; go straight to the top. He will always be the most knowledgeable.
Call at 9 a.m. The manager is fresh and will have more time to chat.
Stick to my script. Don't go off on tangents. Don't start asking technical questions about your sister-in-law's breast surgery experience. Remember, you have only one aim: to decide if a particular practice is worthy of a consultation. Get on with the task at hand.
The following checklist will be your outline for a productive, efficient phone inquiry.
What Else Reveals That You're Speaking to a Great Office?
When I call a professional office, within the first 20 seconds I can sense whether or not I am speaking with a high-quality, service-oriented, sharp practice. Here are my criteria for excellence:
* The call is answered after no more than four rings.
* You should never get a busy signal.
* You are greeted by a warm, courteous, cheery, glad-to-be-of-service staff member. You can almost see the smile through the telephone line.
* The person answering your call is knowledgeable, helpful and able to answer most or all questions promptly. You sense that she has been well trained to help and educate you. What you don't want to hear is, "Gee, I don't know," and then a long pause.
* If there is a question she cannot answer, you are promptly transferred to another staff member who is qualified and who can answer it.
* You are offered additional, complementary teaching aids, e.g., brochures, pamphlets, video- or audiotapes, etc. These further explain the services available to you. And, they will be U.S. mailed, e-mailed, or faxed promptly. Most surgeons provide prospective patients with appropriate brochures and pamphlets prior to the consultation. This allows the patient to review important points about the procedure (s) under consideration. Being prepared in advance guarantees a more productive session with the doctor. Questions raised while reading this material can be answered during the consultation.
* If you decide to schedule a consultation, you are offered several choices for your convenience.
* The date and time are confirmed with you prior to the conversation's end. You also are assured that you will receive a written confirmation, including directions to the office and parking advice.
* As the conversation ends, you are reminded of the name or names of the staff members with whom you spoke. You are encouraged to call them if you have any further questions. These are your "contact" people.
* If you ask about fees, you receive some meaningful information. While an exact fee quotation requires a consultation and evaluation by the doctor, a superior office will offer a "range of fees" or "most common fee" for the procedure or procedures you are interested in. You have the right to know so you can evaluate whether your budget is "in the ballpark."
* Finally, the office will ask for your daytime and evening phone numbers so you can be contacted several days prior to your consultation. They will want to be certain you received the promised information and also confirm the appointment particulars. Having your phone numbers also allows the office to inform you should any change in the office's schedule affect your appointment time.
Is all this important? I think so. Consider yourself a customer; you want good service.
Service begins with that first telephone call. Every practice takes its cues from the top; the doctor sets the standards; it is his practice; he is the boss.
The doctor must care about you, the caller, before he ever meets you. If not, if he does not have in place smart, able and conscientious staff "up front," how particular, how attentive and how competent might he and his team be in the operating room and during the recovery phase? Think about it. Always opt for quality; you don't have cosmetic surgery every day.
Excerpted from The Essential Cosmetic Surgery Companion by Robert Kotler. Copyright © 2005 Robert Kotler, MD, FACS. Excerpted by permission of Ernest Mitchell Publishers.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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