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Frequently Asked Questions...
 

Choosing the right plastic surgeon

 

This is to be said clearly, frankly and emphatically. The single most important factor in succesful cosmetic surgery is the plastic surgeon himself!!! Let us say it again: plastic surgeon!!!, not any surgeon or any doctor with a different erudition!!!

While choosing a plastic surgeon, one of the most frequent mistakes the patients tend to make is that as soon as they enter a good-looking health facility, certificates and diplomas put up on the surgery walls and particularly a person in white (a doctor, probably), they lose their natural alertness and start to behave in a different way from how they would normally do.

Professional medical specialty of a plastic surgeon

So-called specialization applies to medicine as well as to every human subject field. In case of medical profession, it is quite complicated and long-lasting. Just briefly:

  • MUDr. title is given automatically to everyone who succesfully completes a 6-year course at a Medical Faculty
  • completion of his studies equips a new doctor well with theory, but he lacks experience and special training
  • now it is time he chose his medical specialty (excluding stomatology and pathology – these ones are chosen by students in the course of studies)
  • several years of preparation (usually 3) follow in the selected department under the supervision of experienced and older colleagues
  • this period is finalized with an attestation – a major viva examined by an expert committee appointed by the Department of Health
  • in a specific case of surgical specialty, the exam is called attestation of 1st degree in surgery (after 3 years of preparation)
  • this attestation enables the doctor to perform some of the surgical interventions independently, but only to a limited extent
  • a surgeon wishing to work fully independently must go on to work in the department of surgery for another 5-year period, still with experineced supervisors, and after this he is to pass another comprehensive exam in front of a board of examiners appointed by the Department of Health, the attestation of 2nd degree (after 5 years of preparation)
  • an expectant plastic surgeon must spend these 5 years in an accredited plastic surgery department under the supervision of more experienced plastic surgeons and then pass the attestation in plastic surgery in front of an expert committee appointed by the Department of Health (after 5 years of preparation)
  • from this moment on the new plastic surgeon is allowed to work independently. However, it is necessary to understand that in spite of 14 years of gaining experience and special training, he is still at the beginning. It makes a great deal of difference to perform surgery alone and to do so supported and advised by a more experienced colleague in case of unexpected and critical situation since you can hardly draw on your own experience
  • aesthetic part of plastic surgery is a further upgrade of specific plastic surgical interventions, which is something a just attested plastic surgeon is minimally experienced in

Therefore a full qualification is absolutely necessary. However, this process is getting more and more difficult and demanding.

Cosmetic surgery, being rather a lucrative matter, is very attractive even for doctors of other medical specialties, or for those who do not fulfill the strict qualifying criteria for acquiring an attestation in plastic surgery. Unfortunately, this is why you can encounter doctors whose areas of expertise are different and they still perform cosmetic surgery without having any formal education and being experienced in it. In spite of this fact, many of them will claim that they are highly experienced – but the question is – how could this happen without any formal education, training, exams and qualified supervision? Undoubtedly, many of them will keep their true answer silent – that is using the trial and error method, which they applied to his first naive clients with adequate results. Remember, experience without formal education does not exist, it cannot replace a full qualification and will never guarantee standard quality surgical cosmetic results that would live up to your expectations and ideas.

Accepting the following guidelines and information will prevent you from permanent damages to your body and unfortunate cosmetic consequences.

Now comes the important question:

How do I find such a cosmetic plastic surgeon who will be the safest guarantee of a good outcome?

  1. Start with a visit to your GP. If you trust him, surely you will have trust even in the plastic surgeon recommended by him.
  2. A personal recommendation from your friends or relatives is the most reliable of all – especially when they underwent the surgery in a generally recommended place and were satisfied with the result, as well as the doctor’s attitude and care. This exceeds all recommendations and adverts.
  3. While visiting the plastic surgeon you have chosen, always make sure that he really is a plastic surgeon. Look for a document about attestation in plastic surgery with the name of a doctor who examines you and will perform the surgery! If you cannot see it anywhere on the walls, don’t be afraid to ask for it! It is perfectly understandable you might feel embarrassed or find this inappropriate (after all, you are talking to a “doctor” who tends to be glorified and idealised) but always keep in mind that it is you who you protect!

    Attestation document will inform you about:
    • this doctor is erudited and well trained in plastic surgery
    • this means he went through 3-year training in surgery and completed attestation of 1st degree in surgery, then a further 5-year period of training in plastic surgery under the guidance of qualified and more experienced colleagues in this specialty
    • the attestation year stated on the document is a year he was separated from the guidance of older, more experienced colleagues – the moment he could start working independently. For this reason, always seek for other, at least 5 years of independent practise of plastic and especially cosmetic surgery, which should be long enough to acquire enough experience.
  4. Absolutely reliable guidance on who fulfills all the conditions and criteria for performing plastic aesthetic surgery is provided by a list of licenses granted by medical Society of Aesthetic Surgery. For this reason, look or ask for a Certificate of participation in the Czech Society of Aesthetic Surgery. This certificate may be the most important for you. This society brings together only those plastic surgeons who satisfy all the conditions mentioned before, but it has also other requirements. You must present the exact quota of personally performed cosmetic surgery procedures under the supervision of more experienced colleagues. What is more, it is possible to become a member only after a several years after attestation. You can find the list of members on this website - http://aps.cls.cz
  5. All other kinds of documents illustrating the participation in a variety of expert courses, seminars, lectures, congresses etc. are very misleading as these meetings are accessible to doctors of other specialties for a fee as well, which does not necessarily mean they trained in plastic surgery and therefore they do not have attestation in plastic surgery. Putting up diplomas and certificates in their surgeries is a way to cover up and replace the absence of professional education in plastic surgery which is what matters the most.
  6. Paid advertising: (Golden Pages, newspaper advertising and magazines, radio and TV broadcasting, internet etc.) should serve only as a list you will examine carefully to chose the best plastic surgeon. Advertisement can sometimes be misleading since it purely reflects the advertiser’s willingness to invest money in it and it does not demonstrate his qualities and expertise. We feel we must warn you against false advertisement. Don’t let yourself befuddled by pompous adverts and flashy names. Some of the plastic surgery advertisers are not in fact plastic surgeons at all!
  7. Any other documents or referral papers (apart from those in articles 3, 4) might be untrustworthy and for ordinary people difficult to penetrate without further explanation. With so many professional surgical organizations - associations, societies, academies etc. – the situation becomes even more complex. It is advisable to keep in mind that being a qualified, well trained plastic surgeon is not the prerequisite for membership (see article 4).

How to choose among plastic surgeons

To make your decision even more difficult, there are some plastic surgeon who do not perform their specialty exclusively – they are not full-time plastic surgeons. In spite of being well trained and qualified for such interventions, cosmetic surgery is just their partial practice. You should understand that despite the qualification, their routine experience is usually not to be compared with those of plastic surgeons who devote their practice entirely to plastic surgery.

And again, we would strongly recommend a list of plastic aesthetic surgeons associated in the Czech Society of Aesthetic Surgery as stated in article 4. It is the only registry incorporating all plastic surgeons specialised in cosmetic surgery, with full qualification and verified experience in the Czech Republic. Definitely make sure the plastic surgeon you have chosen is listed there. (http://aps.cls.cz website)

After a paper selection, what shall I do next?

Let’s suppose you have chosen two or three plastic surgeons. How do you sort them out? The first step is to book a consultation. It is a very good idea to hold a small “rehearsal” at home – sit down, and try to think about the procedure you have chosen. What do I expect from it? What am I willing to undergo? Answer these questions aloud. There must be a lot of questions arousing during your monologue – the best would be to write them down since you might forget them all the moment you arrive at your consultation. But the truth is as long as the consultation is given by a professional, you will not leave with one single question unanswered, even if you did not ask the question. The thing is a good plastic surgeon knows all the possible queries in advance and is able to give you satisfactory answers. On your request, some plastic surgeons will send you an information booklet to provide guidance before the consultation comes – or you might ask for advice on plastic surgery online. They are likely to be really helpful. If you can, read them through, but remember – a personal consultation with a specialist should never be replaced by any other source of information.

In some private cosmetic surgery health facilities it is now common to talk to an “advisor” before you actually meet a surgeon. This practice is acceptable only when the “advisor” is to provide the patient with general information. Professional examination of an individual finding related to surgery belongs solely to an experienced surgeon because he is the only one to make a responsible judgement on your individual finding and choose the most suitable procedure.

During the consultation, it is the personal contact between the patient and the surgeon that matters the most. Cosmetic surgery, being such sensitive interventions, are dependant on many factors and details. For the period of surgery, the doctor and his patient form a kind of couple – just like rock-climbers on a climbing rope – and the failure of one of them may have a regrettable impact on the outcome and the satisfaction. The first, most important contact is made at the first consultation and examination and therefore nobody can substitute the surgeon.

When you are at the consultation, you should be allowed to have your friend or relative as a support whose judgement is relevant for you.

The surgeon should always draw a complete medical anamnesis and carry out a medical examination. After that he should go on to explain the surgery details with all possible complications and the risks involved.

During the consultation you should have the feeling that the surgeon’s answers are exact, and very truly focused on your interest (and not his finacial interest), even if it can mean he will not support the surgery.

What to beware while choosing a plastic surgeon:

Advises: “If I were the patient, I would be alert in these cases”:

  • If I heard words and phrases like: No problem, that’s easy, we can do it in no time at all, just pay us and we will do anything
  • Inaccurate, misty, illogical and discursive answers and style of speech
  • Surgeon’s unwillingness to agree on a concrete surgery date
  • The final price is not fixed or is fixed inaccurately before the surgery (this must include the surgical intervention, anesthesia, hospitalization, medical tools – for example silicone implants, elastic garment, medications, all rebandages and check-ups etc.) Always make sure the final price includes everything it should!
  • Beware of surgeons who press the patients into undergoing surgery or those who minimize possible complications and – quite the opposite – they are wasteful of promises to a quick recovery without any complications and with guaranteed results. Remember that certainty and immoderate guarantees are too big words in medicine and should be selected more carefully

Again, you should appreciate such behaviour when a plastic surgeon in justified cases refuses your request for an operation rather than exposing you and your comfort to unnecessary risks. You can fully rely on advice and suggestion made by a surgeon acting in this way. And after some time when surgery is suitable for you or you have any other request, you can feel free to address him or recommend him to your friends if they ask you for advice.

These are the main reasons why a plastic surgeon should refuse to perform surgery:

  1. Unrealistic expectations
  2. Improbability of improvement
  3. Surgery is unsuitable for the patient
  4. The patient’s mental instability
  5. The patient being forced into the operation by other people

Photo catalogues

Ask your surgeon for his photo documentation showing the results of his work. Before and after photographs will give you a good idea of the plastic surgeon’s level of achievements. But even when you study these pictures, be careful. You must consider a number of points – you might be even dubious about the pictures’ origin – is the plastic surgeon the true author of the results presented here? Naturally this can be very difficult to prove. Unfortunately, it happens that the same photos end up in the picture albums of a few plastic surgeon – of course – each of them claims it was he who performed the surgery. Further on, with today’s digital camera revolution it is not challenging to fake the pictures. For this reason, you should always seek pictures taken by an “ordinary camera” rather than digital one. What is more, keep in mind that pictures showing only positive outcomes are not always trustworthy since this cannot guarantee your case will come to a similar result. Remember, we are all individuals which means that your cosmetic surgery outcome might be different – better or worse. Use these pictures to get a rough idea of what can be achieved.

Beware of surgeons who press the patients into undergoing surgery or those who minimize possible complications and – quite the opposite – they are wasteful of promises to a quick recovery without any complications and with guaranteed results. Remember that certainty and immoderate guarantees are too big words in medicine and should be selected more carefully.

Finally, after visiting a few doctors – certified plastic surgeons, you will have an initial idea of who is the right for you. As mentioned before, a personal relation between a doctor and his patient is important. So – choose the one you feel comfortable with. The one you enjoy talking to. The one who is friendly as well as professional. Choose such a plastic surgeon who listens to you and tries to content your needs. Most of them are like this. If you follow these guidelines on how to prepare yourself for your consultations and what to beware, you should be able to succeed in finding a qualified, accredited and experienced plastic surgeon, who is the right for you.