In the TV show “Botched“, Drs. Nassif and Dubrow who are competent plastic surgeons, try to undo the horribly disfiguring complications their patients have suffered as the result of having bad, or at least ill advised cosmetic surgery. The doctors treat these patients with respect, caring and often use humor to both entertain TV watchers and as support for the patients. But their lightheartedness also provides some shade for the seedier side of cosmetic surgery.

The Most Important Choice in Cosmetic Surgery

Let’s face it… most of us have difficulty when we go to choose any professional, whether it be a plastic surgeon or an accountant! We are not as “expert” as they are and so we have to wade through a lot of information and even compare different expert opinions. But there is one most important aspect in the choice of an expert and everything flows from that. That professional either cares or they don’t and so patients should look to see if they are listening to them, explaining how the recommended surgery is safe and that the plastic surgeon is providing a safe and warm environment for the patient. In fact, the easiest tip-off is that the doctor is not really paying attention to the patient and perhaps not spending enough time to make a patient feel comfortable.

For example, surgery longer than five hours is associated with an increase the rate of  all complications. Surgery that is much longer than that is not nearly as safe, and the Doctor may be trying to “capture” that patient’s business rather than providing a safe experience.

It is also important to be wary of Doctors who claim they are an expert in a specific operation or treatment because this is another way to “capture” patients. Doctors who claim “this is all I do” can do the same procedure 1000 time poorly! It is very important to verify that a patient likes the doctor’s style and results and that comes from a thorough consultation and reviewing the doctor’s before and after photos in a critical way. So the best way to avoid botched plastic surgery is to do your homework and choose the best plastic surgeon.

It’s Obvious But Needs to Be Said…

Cosmetic surgery should be performed to make a change that can be seen and that improvement should be weighed against the risks involved. When a physician recommends a procedure, it is a very good idea for the patient to ask, “How much different will I look after surgery?” If the change is minimal, it might not be worth having the surgery. One of the most troublesome issues one sees in the “botched” patients is that they not only have significant complications but the wrong surgery was performed and so patients often have complications without any improvement!

And Don’t Ever Do This

It is a very bad idea to have surgery performed by a Doctor who does not personally explain all of the possible complications and also doesn’t tell you what his or her experience has been with each of the complications. A list of complications on a consent form is just that, a list. It doesn’t take you, your anatomy or particular situation into account.  In fact, explaining that complications are rare makes for a more enjoyable experience because patients are more relaxed with the knowledge that complications are uncommon.

Cosmetic Surgery is for the Healthy

Performance of cosmetic surgery is not safe in patients with medical problems that are significant or have not been addressed, are unknown or not stabilized. Even in the healthy patient, at the preoperative appointment, one should see the treating physician reviewing the patient’s records and asking questions to determine the health of the patient. If that is not being done, no surgery should be performed.

When patients see that a safe and productive environment is being provided by the treating physician and the staff, they can avoid being “botched” and also enjoy their cosmetic surgery experience.