Roni Rabin
Newsday
Personal Health
roni.rabin@newsday.com

Put a face on plastic surgeons

Win a free nose job. Attend a free seminar and get a $1,500 discount on your next cosmetic procedure. Results are "guaranteed," and the surgeon is always "one of the best."

You've seen the ads, but what do they mean? How should you interpret superlatives such as "the best," or "No. 1 in the nation"?

These days, everyone seems to want a nip or a tuck, and physicians of all specialties are trying to get a piece of the action. Patients pay upfront for these procedures, so there's no paperwork, no fuss for the doctor. But that doesn't mean there's no risk for the patient.

Plastic surgery carries all the usual risks of surgery and anesthesia - including death - and some unique ones, such as the risk of being left with numbness or asymmetrical features. If you're determined to have a procedure, make sure your doctor is qualified - not just to perform a tummy tuck or a breast lift, but to recognize the potential complications.

"People die from plastic surgery," said Dr. Elliot Duboys, a plastic surgeon in Woodbury. "There are no 'guarantees.'"

If you're a savvy consumer, you probably want a board-certified physician who has completed a training program approved by the American Board of Medical Specialties, or ABMS, and passed rigorous exams. But that's not enough, because physicians can operate outside their specialty area.

A few years ago, a Long Island woman almost died after undergoing liposuction. She lost a lot of blood and almost lost a leg. Her doc was board-certified - in gastroenterology.

That's because physicians often learn these techniques in weekend Liposuction 101 crash courses. One such upcoming workshop allocates exactly 15 minutes to "liposuction complications: how to avoid them."

If you're looking for a physician whose board certification in plastic surgery is recognized by the ABMS, you need one certified by the American Board of Plastic Surgery. This tells you the doctor completed a five-year residency in surgery, including three years of general surgery and another two to three years of plastic surgery, and passed the board exams. (See www.abms.org, and click on the doctor's name to see which board certification he or she has, not just whether he or she is board-certified.)

Some ads say a doctor is "double" boarded, with board certification in "cosmetic surgery" or "facial plastic and reconstructive surgery." That means the physician's primary ABMS-recognized certification is in a field like dermatology, ophthalmology or otolaryngology, but the physician has undergone additional training - usually a one-year fellowship - in facial or cosmetic procedures and passed board exams. It means the doctor has experience, and done more than simply attend a how-to workshop.

Doctors who are board-certified in a single specialty, such as dermatology or ear-nose-and-throat, often have expertise in cosmetic procedures; you may want to ask how many of these procedures they've done and how frequently they do them.

Facial plastic and reconstructive surgery certification applies only to head and neck procedures, however, so this may not be the right doctor to do a breast augmentation.

If an ad says the doctor is "ranked first," read the fine print. You may learn the rating was made by a surgical center - owned wholly by the doctor.

One ad for a prolific plastic surgeon notes he won the Miracle Makers Ball "Plastic Surgeon of the Year" award. The ball is the annual fund-raising gala of the Mental Health Association of Nassau County, which gives awards to prominent individuals to thank them for their support. The award attests to the doctor's generosity, but says nothing about his surgical skills.

Giveaways, raffles and contests in which the prize is a free cosmetic procedure should be viewed with caution. Doctors are not supposed to promise a procedure before they evaluate a patient. "Maybe you need it [surgery], maybe you don't," said Dr. Darrick Antell, a plastic surgeon in Manhattan and spokesman for the American Board of Plastic Surgeons. "Maybe you have psychological issues."

Before surgery, patients should receive forms detailing risks, side effects and alternatives. Read them carefully.

Ask how many times the physician has performed the procedure, and look at before and after pictures. Ask whether the procedure will need to be repeated, and how complications are handled.

Most procedures are done on an outpatient basis, but the facility should be accredited.

Another word of caution: Don't ask for several procedures at once. The longer you're under the knife, the greater the risk. Sure, they do it on TV. But that's television.