Planning Your Surgery

Cosmetic Surgery Checklist & Other Considerations for Reconstructive Surgery

Four steps to help ensure a successful outcome:

Finding a surgeon
Credentials check
Initial consultation
Your decision
Other Considerations for Reconstructive Surgery

Your first step: Finding a Surgeon

In selecting a surgeon, your first challenge is to develop a list of candidates. Not all medical practitioners performing cosmetic surgery are plastic surgeons or even practitioners with formal surgical qualifications. So, where do you start?

Friends

Talking to someone who has undergone a procedure like the one you are considering is a start. However, as every patient's needs are unique, you can't assume the surgeon will be right for you.

GPs and/or Surgeons

Your family doctor or other surgical specialist, eg ENT or cardiologist, may be able to give you a referral. If so, ask them if they have done so previously and whether they obtained positive feedback from those patients.

Hospitals

Call a hospital of your choice and ask for names of certified surgeons with hospital privileges who perform the procedure you are considering.

Australian Society of Plastic Surgeons

The Australian Society of Plastic Surgeons can give you advice and post you a list of your State's members. Society members are all fully qualified in both reconstructive and cosmetic surgery. All members are Fellows of the Royal Australasian College of Surgeons (FRACS), the benchmark standard for surgical training within Australia, or its equivalent. Each has a record of accomplishment in their field and a commitment to high ethical standards.

Paid advertising

Your local yellow pages are a convenient reference source. Look under "Medical Practitioners" to locate a surgeon (FRACS) in your area. Your local newspaper may also be a source of information.

Media Editorial

Media interviews or stories involving surgeons are not testimony to their credentials and experience and is sometimes paid advertising by the surgeon.

Your second step: Credentials Check

Now that you have compiled a list of cosmetic surgeons, you need to thoroughly check their qualifications and credentials. Most surgeons have letters that appear after their names. These may or may not be relevant to your intended procedure. Credentials cannot guarantee a positive outcome, but they can significantly increase the odds of success. By contacting hospitals, professional societies such as the Australian Society of Plastic Surgeons and the surgeon's office, you can obtain the following information.

Training

What initial training did the surgeon undergo? In which subspecialty did they train? How many years did they train? How comprehensive was their training? How relevant is their training to cosmetic surgery?

Certification

Most surgeons in Australia are certified by the Royal Australasian College of Surgeons. The letters FRACS will then appear in your surgeon's credentials.

Hospital Privileges

Not all surgeons have hospital privileges. Make certain the procedure will be performed in either a private hospital or a day procedure centre registered with the State Health Department or accredited by the Australian Council on Health Care Standards or similar organisation.

Experience

Has the surgeon had experience of the specific procedure you require? Some procedures may be new and experience necessarily less. A fully trained plastic surgeon will easily bring skills to a new procedure which is often only a progression of an established one.

Professional Societies

The letters after your surgeon's name may also indicate membership of a professional society. It is important to check on the legitimacy of the organisation and whether your surgeon is a member in good standing. For international associations, the internet can be a useful resource.

Your third step: Initial Consultation

Once you have a shortlist of two or three surgeons, you may wish to have an initial consultation with each of them. By doing so, you can obtain their opinions on the type of surgery you require, their fees, their response to your questions and how they explain the risks associated with your procedure. Bear in mind consultations will most likely attract a fee regardless of whether you choose the surgeon to operate on you or not.

Obtain referrals

Your GP can provide you with referrals to each of your surgeons. Without a referral you may not obtain a Medicare rebate should one be available for your procedure.

Ask questions (see sample questions below)

Your surgeon should welcome any questions you may have concerning your procedure, their training and credentials, experience and personal techniques regarding your intended procedure, fees, payment policies, etc. Pre-prepare your list of questions in order to easily assess and compare the surgeons' responses. Don't forget to make notes. If you don't understand any answer, ask the question again. A surgeon should speak to you in a language you can understand.

Questions the surgeon should ask

Your surgeon should also interview you. Questions and issues covered might be

Your motivation and expectations, if the surgeon believes these to be relevant
Alternatives, if appropriate, without pressuring you into procedures you may not want
The risks and variations in outcome for your procedure. Before and after images may be introduced at this point
Your comments and/or concerns regarding the surgeon's recommendation
The surgeon should not rush you into a decision. You should be encouraged to wait at least a week before scheduling your surgical procedure. This "cooling off" period is vital. A second consultation is commonly arranged and is recommended

Your final step: Your decision

Now that you've done your homework and met with the surgeons personally, selection from your shortlist should be fairly easy. If you are still uncertain whether you should proceed with cosmetic surgery, then perhaps you should re-examine your expectations of cosmetic surgery and be honest with yourself.

Remember: Be Honest with Yourself

One of the most important keys to cosmetic surgery success is being honest with yourself and your surgeon. Why do you want cosmetic surgery? What do you expect it to do for you? Cosmetic surgery will produce physical changes. It may even boost your self-esteem. However, if through surgery you hope to influence how someone else feels about you, you may end up disappointed.

Questions you may wish to ask.

Is the procedure considered invasive?
What are the surgeon's qualifications and experience?
Are they FRACS?
Are they a member of the Australian Society of Plastic Surgeons?
Do they perform the procedure on a regular basis?
Have there been any adverse outcomes?
Do they have a special technique relating to the procedure? If yes, how does this differ from other surgeons and what is the benefit to me?
Are there any complications associated with the procedure?
If complications do occur or the procedure is not successful, how will the surgeon deal with these?
Where will the surgery be performed?
Will a qualified Anaesthetist administer the anaesthetic and/or sedative medication? Are these fees included in the treatment cost?
Do they have a consent form outlining the procedure for your review?
Will there be any bleeding, swelling or bruising? How will these be managed?
Will there be any discomfort following the procedure? How will this be managed?
Will I need time off work?
Are there other post-operative side effects?
Will there be any visible scarring following the procedure? How can this be minimised?
What aftercare will be provided and will this be included in the treatment costs?
Do I have any options other than surgery?
Will Medicare cover any of the procedure costs?

Other Considerations for Reconstructive Surgery

Planning Your Surgery

In evaluating your condition, a plastic surgeon will be guided by a set of rules known as the reconstructive ladder. The least-complex types of treatments-such as simple wound closure-are at the lower part of the ladder. Any highly complex procedure-like micro-surgery to reattach severed limbs-would occupy one of the ladder's highest rungs. A plastic surgeon will almost always begin at the bottom of the reconstructive ladder in deciding how to approach a patient's treatment, favouring the most direct, least-complex way of achieving the desired result.

The size, nature and extent of the injury or deformity will determine what treatment option is chosen and how quickly the surgery will be performed. Reconstructive surgery frequently demands complex planning and may require a number of procedures done in stages.

Because it's not always possible to predict how growth will affect outcome, a growing child may have to plan for regular follow-up visits on a long-term basis to allow additional surgery as the child matures.

Everyone heals at a different rate-and plastic surgeons cannot pinpoint an exact "back-to-normal" date following surgery. They can, however, give you a general idea of when you can expect to notice improvement.

Options in Wound Treatment

In deciding how to treat a wound, a plastic surgeon must carefully assess its size, severity, and features: Is skin missing? Have nerves or muscles been damaged? Has skeletal support been affected?

As you and your plastic surgeon form your surgical plan, it's important to have a clear understanding of what will happen during the procedure. Asking questions is key to making an informed decision.

Direct closure is usually performed on skin-surface wounds that have straight edges, such as a simple cut. Maximum attention is given to the aesthetic result, taking extra care to minimize noticeable stitch marks.

For more information contact the Australian Society of Plastic Surgeons.

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