So today I want to talk about a topic that I find to be very frustrating for both board certified plastic surgeons and patients alike, franchised clinics employing questionably qualified, inexperienced doctors to perform cosmetic surgery . I recently had a consultation at my Marin County practice with a patient in her mid 60’s that was referred in by another of our patients. She had told her friend about this plastic surgery clinic she had visited after seeing their amazing results on TV. After a consultation, she was told she needed a minifacelift, her procedure would be finished in an hour and she could have it in a comfortable chair with nice music and minimal sedation, at a fraction of the cost of a real facelift. Her friend said “That doesn’t sound right, why don’t you check with Dr. Hand.”

Her friend was correct in questioning the procedure. After examining this delightful lady, it was clear that she had many of the typical aging changes associated with being in her 60’s with no prior corrective procedures. Her neck had lost definition and had sagging skin. Her jowls, midface and facial muscles were lax. What she really needed was a complete facelift that would resuspend and redefine her neck. Her facial muscles needed to be lifted and skin needed to be removed from in front of the ear and behind to lift the face and neck homogenously. To have kept this lady comfortable, general anesthesia would have been necessary for a 3 to 4 hour procedure, not 1 hour. A minifacelift would only have lifted the skin in front of the ear and would not have addressed her concerns adequately. Her neck would have remained the same and her muscles would not have been lifted. She would have seen very little improvement based on her initial facial issues.

When digging a little further, she had seen before and after photos but wasn’t sure they were the results of the doctor that had consulted with her, or even if he would be performing the surgery. She was pressured that she needed to sign up today for this great deal. Her free consultation turned into a $400 visit by the end of the appointment.

My opinion is this: here in the San Francisco Bay Area, we are lucky to have many plastic surgeons certified by the American Board of Plastic Surgery and that are members in good standing of the American Society of Plastic Surgeons . Additionally, many of those are members of the American Society of Aesthetic Plastic Surgery, a society that recognizes experience and proficiency in aesthetic cosmetic surgery. Both of these organizations represent the gold standard for plastic and cosmetic surgery training. In California, any doctor can represent themselves as a cosmetic surgeon if he or she is board certified in something, anything. Think about a OB/GYN, ER doctor or radiologist taking a weekend course and viola, a procedure is learned. Experience, training and education matter. Research your doctor, do not be pressured, go in for as many consults as you need and don’t fall in love with the salesperson at the office that promises great things. The surgeon is the one doing the surgery and should answer all of your questions until a complete understanding is achieved. Photos that are presented should be of patients your doctor has performed the surgery on, not of someone else’s work . Make sure the surgeon is doing your followup and will be accessible for hand holding after a procedure. A patient should know how often followup will be scheduled and that a drop in appointment is available for concerns, any concerns.

The patient I just discussed went on the further research the clinic that had seemed so promising and realized she would not have been happy with the procedure. She is now making a plan to have a facelift procedure that will actually correct her concerns when she is ready to schedule.