by Wendy Lewis
There is never only one ‘best’ doctor for any procedure; rather there are numerous highly competent practitioners who may be able to deliver an excellent result.
Find out more with our How to find the right practitioner or clinic feature.
With the global explosion of demand for cosmetic procedures, more practitioners are popping up in every corner of the world, but how can you know who is really qualified?
Wendy Lewis offers her advice for getting a little work done safely
Choosing the right doctor or clinic involves many individual yet related considerations including what you can spend, how much time you can take for recovery, pain threshold, your acceptance of scars and side effects, and the inevitable fear factor.
There is never only one ‘best’ doctor for any procedure; rather there are numerous highly competent practitioners who may be able to deliver an excellent result. But in this hugely competitive and crowded aesthetic market, practically anyone with minimal training can market himself or herself as a ‘cosmetic practitioner’, advertise their services, and perform them on consumers. There have been far too many disastrous cases reported around the world of unlicensed individuals masquerading as cosmetic surgeons and non-doctors operating in back alley clinics under the radar of authorities.
According to Foad Nahai, MD, FACS, Atlanta plastic surgeon and Editor of the prestigious Aesthetic Surgery Journal, “Physicians from many disciplines are performing aesthetic procedures and claiming to be experts. It is training, certification and experience that count in choosing the right one. Did the practitioner’s speciality training include the basic anatomy, surgical knowledge and skills to produce optimal results in a safe manner? Is the practitioner able to avoid and treat the complications of the procedures you seek?”
DO YOUR DUE DILIGENCE
The quest of finding a good doctor can be a daunting task. Most people who are taking the first plunge into aesthetic medicine may not be entirely sure where to start. We are bombarded with information from every direction on new treatments and advice from ‘celebrity’ doctors in the media. It is hard to decipher what is safe and sensible from what is purely hype and marketing.
For the newbie, it’s all about prioritizing. You need to have a vague idea of what
body part or area you want to tackle first. You can’t do it all in one go. Start with
what bothers you most and focus on getting references and referrals from
credible sources, like other medical specialists like your gynecologist, dentists,
nurses, sisters, psychologists, impartial industry experts, and more. Your GP
may seem like an obvious source, but not every GP knows who is the best for
faces or who does the most BOTOX. They may just recommend a colleague at
their local hospital who may or may not do much cosmetic work at all. In my
experience, nurses, registrars or surgeons in training, and anaesthetists usually
know who the best doctors are because they have seen their work first hand.
Referrals from a friend, colleague or family member who has had cosmetic work
done are always welcome, if they are willing to share that information. A personal recommendation from someone you know who is a happy patient is the best endorsement any clinic can have. But keep in mind that recovery and results will vary tremendously, and the best clinic for your sister-in-law or hair stylist may not turn out to be ideal for you.
BAAPS Council Member Mr Ash Mosahebi MBBS FRCS MBA PhD FRCS (PLAST) sheds some light on the UK market; “Guidelines are changing for aesthetic practitioners, according to health education England there are different training and education tiers depending on the procedure that is undertaken. For more invasive and certainly surgical procedures, my advice has always been to choose a BAAPS surgeon as they are highly vetted before becoming a member and are required to continue to demonstrate that they provide a high quality of work.”
SIDEBAR: A MATTER OF DEGREE – Deciphering medical qualifications is a minefield, especially when the country of training often dictates the acronym that comes after the practitioner’s name.
• Ch.M. Master of Surgery (M.S., M.Ch.)
• D.D.S Doctor of Dental Surgery
• D.M.D. Doctor of Dental Medicine
• D.O. Doctor of Osteopathic Medicine
• F.A.A.D. Fellow American Academy of Dermatology
• F.A.C.S. Fellow American College of Surgeons
• FDSRCS Fellow of Dental Surgery
• FRACS Fellow Royal Australasian College of Surgeons
• FRCP Fellow Royal College of Physicians
• FRCI Fellow Royal College of Surgeons of Ireland
• FRCS Fellow Royal College of Surgeons (MRCS)
• FRCSED Fellow Royal College of Surgeons of Edinburgh
• M.B. Ch.B. Bachelor of Medicine, Bachelor of Surgery (M.B. B.S)
• M.D. Medical Doctor
• M.Sc. Master of Science
• N.D. Doctor of Naturopathic Medicine
• Ph.D. Doctor of Philosophy
• RGN Registered General Nurse (RSCN)
• RCNNP Registered Nurse Practitioner
According to Edwin Williams, MD, FACS, President of the American Academy of Facial Plastic and Reconstructive Surgeons (AAFPRS), “The Internet is loaded with a wealth of information about cosmetic procedures, as well as misinformation that can be contradictory and is rarely policed by any official source or governing body.”
Individual clinic websites and social media platforms are usually the first place to go to learn about practitioners’ training and affiliations, and check out what they offer. Bulletin boards and forums are not always a good source of rock solid recommendations. These are sometimes a breeding ground for anonymous comments from disgruntled patients who may or may not even be real. In our digital universe, clinic and doctor reviews do carry a lot of weight. A few less than 5-star reviews should not necessarily deter you from going to any one practitioner. However, if the majority of reviews are not terribly favorable or you notice a recurring theme among the reviewers, it may be worth looking elsewhere. Similarly, 100% positive glowing reviews may be a sign that some of them have been planted.
Be wary of slick ads that promise painless, quick fix techniques, hyped up names for procedures, fuzzy before and after images that look photoshopped, and the use of vague explanations about treatments that are hard to decipher. The old adage, if it sounds too good to be true it probably is, resonates here. PR and media appearances on their own also offer no guarantee of a practitioner’s qualifications nor are they an endorsement of skills.
It is always advisable to see multiple practitioners before having a major procedure done (facelift, tummy tuck, hair transplants, etc), and at least two before having a minimally invasive treatment (fillers, suture lift, laser resurfacing, etc.). You should plan to have proper consultations with qualified medical professionals. The initial consultation may be with a nurse, patient coordinator or office manager; however, your evaluation should be with the actual practitioner who will be performing the procedure. For cosmetic surgical procedures, you will typically have one or two pre-operative visits and several post-operative visits to remove dressings, take stitches out and monitor your progress. For non-surgical procedures, such as BOTOX and IPLs, you may go in for a consultation and have the treatment done on the day, but will need to return to the clinic at certain intervals for top-ups to maintain the results. It’s about building a relationship and not just having a one off experience.
Check that your short list of practitioners are active members of one or preferably several accredited official organizations of specialists; such as BAAPS, BAPRAS, BAD, BACN, and others in the UK, ASAPS, ASPS, AAD, ASDS, AAFPRS, and others in the USA, and ISAPS, IPRAS, EURAPS, and others in Europe. Awards and community recognition are also a good sign that the practitioner takes pride in his professional accomplishments and strives for excellence in patient care. You want to choose a practitioner who is deeply committed to the field medical aesthetics and cosmetic surgery.
WHAT MAKES A QUALIFIED PRACTITIONER?
Specializes mainly in aesthetic procedures; doesn’t just dabble in Botox or the occasional hair removal
Certification by relevant Medical Specialty Societies, Professional Organizations
Privileges at fully accredited hospitals or clinics to perform a surgery you are considering
Participates in continuing education in their specialty
Academic affiliation, such as teaching hospital appointment, clinical instructor, trainer
Works with licensed anaesthetists for surgical procedures
Clinic is staffed by experienced healthcare personnel and professionals
Published articles in their field of expertise in journals
The consultation is your opportunity to make observations about the practitioner and the clinic, check out the other patients in the waiting room, and make a judgment about how professional the environment is. If the clinic is untidy, the atmosphere is disorganized, and the staff seems disinterested in taking care of patients, you can vote with your feet. You should feel comfortable about asking questions on the specifics of the best treatments for you that address your key concerns. Dig deeper into the basics of the procedure, side effects, recovery time, and how these apply to your case specifically. Understanding what the procedure you are considering can and cannot do, as well as the limitations and alternatives, is critically important to avoid disappointment. For example, it is unrealistic to expect long-lasting facelift-like results from a single session with a skin-tightening device.
Your practitioner should be willing to fully explain the potential risks of any procedure – this falls under the realm of what is called ‘informed consent.’ The clinic staff should also clearly discuss what is involved, before, during and after the procedure and take a proper medical history. Even treatments as seemingly simple as a chemical peel or hyaluronic acid filler injection can have their share of complications.
It is entirely reasonable to ask to see pre- and post-op photographs of other patients to learn what you can expect. A practitioner who cannot show you any photos of his or her own patients should raise a red flag. However, keep in mind that every patient is different and there is no guarantee that your results will be the same. Imaging can be a very helpful tool to visualize how you may look after the procedure you are considering, especially the new 3D systems used in some clinics. The level of communication with the doctors, nurses and the clinic staff, as well as the confidence they inspire, are vital to having a positive experience.
Undoubtedly, choosing the right practitioner or clinic for an aesthetic procedure is an important decision. Don’t make conclusions solely on the basis of convenience or cost; you get what you pay for. There is no substitute for expertise, certification and skills, rather make your selection after considerable research, confirmation from at least one other source, and your overall comfort level. If you have lingering doubts for whatever reason, put your treatment on hold until you are sure. In all human relationships, the trust factor is paramount.
MEET THE EXPERT
Wendy Lewis founded Wendy Lewis & Co Ltd Global Aesthetics Consultancy in 1997. The author of 11 books including America’s Cosmetic Doctors & Dentists (Castle Connolly Medical) and Plastic Makes Perfect (Orion), in 2008, she founded Beautyinthebag.com
Do you have a question for Wendy Lewis? Email ASK@totallyaesthetic.com and if you want to have a consultation with a medically qualified practitioner fill in our online enquiry form www.totallyaesthetic.com/enquiry