One reason that more and more people choose to have plastic surgery is because they are confident it is safe. Surgical techniques as well as the introduction of many non-surgical procedures, such as the use of lasers, have advanced dramatically during the past 40 years and are continually improving. Even so, no surgery is without risks. Also, some short- and long-term complications can result from laser procedures. The quality of physicians and facilities vary so people should thoroughly research a physician's credentials and the reputation of the facility before making a decision to have surgery or any type of procedure.

There are two types of plastic surgery: cosmetic and reconstructive. Reconstructive surgery is aimed at correcting physical defects, repairing injuries or restoring a person's appearance, for example after accidents or cancer surgery. Cosmetic surgery, on the other hand, is performed to improve a patient's appearance by reshaping a normal body structure. The most common cosmetic surgeries include nose reshaping, liposuction, breast enlargement, eyelid surgery and facelifts. Plastic surgeons also perform non-surgical cosmetic procedures to reduce wrinkles and scars or to eliminate unsightly veins.

Most people do not realize that physicians are not required to be trained or board certified in plastic surgery. Any physician who has graduated from medical school can advertise himself as a plastic surgeon and perform cosmetic and reconstructive surgery. Therefore, people who are interested in plastic surgery should take time to learn about a surgeon's credentials and experience.  

The most qualified plastic surgeon will have completed a residency in plastic surgery, be board certified by the American Board of Plastic Surgery and have extensive experience performing plastic surgery. Board-certified plastic surgeons are trained to look at you as a whole person, not just from the point of view of the procedure. They will take into account your underlying health issues, any past medical problems or treatments and the prescription and over-the-counter medications you are taking. A good plastic surgeon will take time to understand your goals and be concerned about your overall health.  

To find a plastic surgeon who best fits your needs, you can ask your primary care physician for a referral, check the American Society of Plastic Surgeon's Web site and also get recommendations from friends. You want to determine if the surgeon will provide good service, not just in the operating room, but also before and after surgery. Does the surgeon listen, communicate well and offer honest answers to your questions? Does the surgeon care about your overall health? Is the surgeon skilled at performing the specific procedure and achieving pleasing results? Does the surgeon explain all the risks and options? After surgery, is the surgeon available for follow-up care, especially if complications develop?

Unfortunately, we see patients in the Emergency Department at Loyola University Health System (Loyola) who are suffering from severe infections following cosmetic surgery performed at other facilities. We also treat many patients who are not happy with the aesthetic outcome of their cosmetic surgery performed elsewhere.

In addition to the variability in the skill of plastic surgeons, facilities where plastic surgery is performed also can vary greatly in services. Most individuals having reconstructive surgery will have the surgery performed at the medical center where they were treated for their disease or injury. Cosmetic procedures also are performed at medical centers but may be performed in other settings. Freestanding surgery centers are common sites for cosmetic procedures. Some surgeons will perform liposuction and even facelifts in their offices using only local anesthesia. While many procedures can be performed safely in freestanding facilities, some settings may not be ideal for ensuring patient safety and handling complications. Patients should consider the appropriateness of the facility for a given procedure.

A major medical center is prepared for any problems or complications that may arise. Patient safety is of the highest concern. In addition, teaching hospitals are at the forefront of clinical research and new techniques and can perform more complicated or difficult cosmetic or reconstructive operations. For example, surgeons at Loyola use a special technique to perform breast reduction on exceptionally large breasts, removing more than 6 pounds from each breast versus the usual 1/2 or 1 pound commonly removed.

A university medical center selects members of its medical staff only after they undergo an intensive process to determine their qualifications. Major medical centers also have state-of-the-art outpatient facilities. At Loyola, most of the cosmetic procedures are performed on an outpatient basis.Having reconstructive or cosmetic surgery can give people self-confidence, restore self-esteem and be a positive life-changing experience. sFor your health and happiness, it is important to take charge and thoroughly investigate your options.

Juan Angelats, M.D.
Professor and Chief, Department of Surgery,
Division of Plastic & Reconstructive Surgery
Loyola University Chicago Stritch School of Medicine
Director, Plastic Surgery Center
Loyola University Health System

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