Bring a notebook to a plastic surgery consultation, and fill the first page with questions before you walk in. An hour in an exam room passes fast, and the questions you meant to ask tend to surface in the parking lot afterward.
The list below draws on one Houston practice’s guide to choosing a cosmetic surgeon, published by the office of Leo Lapuerta, MD, FACS, a triple board-certified plastic surgeon with more than 30 years in practice. Under each group of questions is a description of the answer that practice gives its own patients, so you have a reference point when you hear answers elsewhere.
Questions about the surgeon
- Are you certified by the American Board of Plastic Surgery? Any other boards?
- Where did you attend medical school, and where did you complete your surgical training?
- Did your training include at least 6 years of surgery in an accredited, university-based program, with at least 3 of those years in plastic and reconstructive surgery?
- How many times have you performed the procedure I am considering, and over how many years?
- Can I see before-and-after photos of that procedure?
- Do you hold privileges at area hospitals to perform this procedure?
The practice’s guide lists each of these as a requirement, and it calls certification by the American Board of Plastic Surgery the first step. Dr. Lapuerta is certified by that board, by the American Board of Surgery, and in Surgery of the Hand. He has performed more than 30,000 procedures, surgical and non-surgical, and his practice keeps more than 3,000 before-and-after images for patients to review. His hospital privileges include the Memorial Hermann network, HCA hospitals including The Woman’s Hospital of Texas, and St. Luke’s Houston Medical Center.
The guide also suggests reading reviews and testimonials and asking people you trust for referrals before the appointment.
Questions about the facility and anesthesia
- Where will the surgery take place, and which organization accredits that facility?
- Who will give my anesthesia: a physician anesthesiologist, a nurse anesthetist or the surgeon?
- Will I meet the anesthesia provider before the day of surgery?
The practice’s guide names four accrediting bodies for surgical facilities: AAAASF, AAAHC, JCAHO and Medicare. Its checklist says a qualified surgeon operates only in a facility accredited by one of them. Dr. Lapuerta owns and operates a QuadA (AAAASF) accredited surgical facility and works only with physician anesthesiologists, never nurse anesthetists or anesthesia assistants.
Questions about the plan and the process
- Which procedure, or combination, do you recommend for my goals, and why?
- Can you walk me through the quote, and which financing options do you accept?
- What happens at the pre-operative appointment?
- Can I reach you after surgery if something feels wrong?
At Dr. Lapuerta’s practice, the first consultation follows a set order. Patients meet a patient coordinator, view before-and-after photos and watch a video that shows what happens during surgery. Dr. Lapuerta then reviews the patient’s medical history and performs a physical examination. Once the two agree on a procedure, the patient receives a quote along with financing options, and surgery dates come up only if both decide to proceed. The practice tells patients to plan on an hour to an hour and a half for that visit.
The pre-operative appointment runs about an hour. A nurse goes over post-operative instructions and prescriptions, and the team takes pictures and measurements so the right compression garment is ready after surgery. Dr. Lapuerta answers any remaining questions. The team calls the day before surgery with final details and again the day after. The practice states that patients have 24/7 access to Dr. Lapuerta’s cell phone or a team member by phone.
Questions about follow-up
- How often will you see me after surgery, and who will I see?
- When will my after photos be taken?
The practice schedules post-operative visits at the first, second and third weeks after surgery. At those visits, staff change dressings, examine incisions and address concerns. Depending on healing, the next visit comes one month later, and the practice takes after photos at three months from the surgery date. Most of these visits last 15 to 30 minutes.
A surgeon’s answers to these questions will differ from practice to practice, and so will the risks of any procedure for any one patient. The answers worth trusting come with names, numbers and dates attached. Write them next to each question, and compare the pages side by side after your second consultation.
This article is for general information only and is not medical advice. Results vary from patient to patient. Consult a board-certified plastic surgeon or your physician about your own situation. Written in partnership with Joseph Lambert, a publicist working with Leo Lapuerta, MD Plastic Surgery.
