Cosmetic plastic surgeons see many people every day who are interested in looking better…but may know next to nothing about plastic surgery. So every cosmetic plastic surgeon uses what Latin teachers call the “Socratic Method,” a technique we know today as “Q&A.”

But there are questions, and then there are questions surgeons wish people would ask.

Dr. Body, the eminent Beverly Hills board-certified plastic surgeon Stuart Linder, M.D. tells his choice of best questions while the equally imminent Beverly Hills board-certified facial plastic surgeon Robert Kotler, M.D. joins in.

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Dr. Face:  (Dr. Kotler) What questions do patients most often ask you, doctor?

Dr. Body: (Dr. Linder) Potential patients want to know — in no particular order — if they are a good candidate for, say, breast augmentation or tummy tuck; what the major risks to each procedure are; how long does recovery from each operation take and what they are going to look like after the procedure.

Dr. Face:  O.K., those are all good questions, but is there one question in particular you wish they would ask?

Dr. Body: Yes, I wish more inquiring patients would ask “Do you perform only plastic surgery procedures of the body?” That would tell me they have been doing their homework and know that a  specialist concentrates on just a handful of procedures and performs each exceeding well, thanks to constant repetition.

Dr. Face: I like to hear the same question; but I can think of a few more that would be welcome in my ears.

Dr. Body: Such as?

Dr. Face:  “How long have you been performing this handful of procedures?” That tells me the patient wants to put his or her procedure in the hands of a cosmetic plastic surgeon who has seen every possible wrinkle, complication and outcome and immediately knows what to do in every instance.

Dr. Body: Now that you mention it, I can think of another question I wish more patients would ask during the initial consultation when we first meet.

Dr. Face: Don’t keep me in suspense!

Dr. Body: I would like to hear: “Where are your ‘hospital privileges?’”

Dr. Face:  Good choice. Hospitals are expert in knowing which doctors enhance their reputations and which doctors cause problems. If a particular surgeon falls into the “problem” category, he or she is very likely indeed to have hospital privileges withdrawn.

Dr. Body: We should tell people that  “hospital privileges” means that a surgeon can have a patient admitted with just a phone call. It’s just another level of patient safety in the unlikely event that something goes wrong.

Dr. Face:  I can think of one more question I wish more patients would ask.

Dr. Body: And that would be?

Dr. Face: ‘May I speak to a patient of yours who has had this same procedure?”

Dr. Body: When I hear that, I know I’m going to have a new patient.

Dr. Face:  If the previous patient is in the office, I just introduce the two people, excuse myself and say: “I’ll leave you two to chat over the surgery you’ve had and the surgery you want. Call me when you need me.”

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View some of Dr. Kotler’s revision rhinoplasty before and after pictures.

Look at some of Dr. Linder’s breast augmentation revision before and after pictures.

After Cosmetic Surgery: A 2nd Opinion

Stuart Linder, M.D. (“Dr. Body”) and Robert Kotler, M.D. (“Dr. Face”) tell what to do if you have unsatisfactory cosmetic surgery anywhere in the world.

The key to getting the look you want? Cosmetic plastic surgeons have a saying, “A happy patient brings at least three more eager patients; but an unhappy patient turns away 10 others who would have knocked on your office door.”

Thus, most plastic surgeons are willing to go the extra mile to make sure you join their lists of happy patients.

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Dr. Face (Dr. Kotler): People find bad plastic surgery fascinating. More pictures of celebrities with less-than-perfect or awful results are shown than the millions of people who come away with an improved facial or body procedure and a renewed sense of self-confidence.

Dr. Body (Dr. Linder): But if you think you have an undesirable result from cosmetic surgery, the last thing you want to do is get hot under the collar, flame the plastic surgeon or his staff with contentious email or make angry phone calls.

Dr. Face:  Sure, because you, the consumer, have an edge with your rejuvenation surgeon, just make an appointment, go in and talk with him or her. Any surgeon wants all this patients to look good because future patients will be looking at your before and after plastic surgery pictures to judge the surgeon’s skills.

Dr. Body: First thing to ask is: does your complaint has anything to do with the normal healing process.

Dr. Face: Correct, given that some healing process can take a full year to settle in. But you should already know that before undergoing the procedure. If you are using a board-certified cosmetic plastic surgeon, he or she has probably explained the after surgery process toward getting the look you want. Many plastic surgeons will urge you to have pre-surgery consultations with two, three or even four surgeons so you have a complete picture of what can be done and how you can expect to look. If you haven’t had surgery yet, ask during the initial consultation what happens if you’re not happy with the results and who – the surgeon or the patient – covers additional touch up or redo costs.

Dr. Body: If you do need some touch-up work or a small nip or tuck, your surgeon may offer to do a correction at no charge. You can at least ask and give the doctor a chance at converting you into a happy patient.

Dr. Face: In many cases, a touch up can be done in the doctor’s office. If you have to undergo surgery again, it may involve another fee for the surgery center and an anesthesiologist. According to the Healthy Woman Blog, about 15 percent of cosmetic surgeries require some touch up work or a minor do-over.

Dr. Body: Try looking at your before surgery pictures and compare those with the way you look now. People become accustomed quickly to seeing their own faces in mirrors and often forget how they looked before surgery.

Dr. Face: If you and the surgeon can’t make any progress, try getting another opinion from a board-certified surgeon who does the same type of surgery. After making sure the second surgeon is neutral, show him or her your before and after plastic surgery pictures while the second doctor takes a look at your surgical treatment area. It just could be that, for instance, an upper eyelid reduction case could not trim the eyelids any more than what has already been done. The major risk to upper blepharoplasty is that too much of the eyelids are taken away and the patient is left unable to close the eyes.

Dr. Body: Or, perhaps a nose can’t be made any smaller without affecting the patient’s healthy breathing.

Dr. Face: And, remember, be sure to get copies of your pre-op photos plus the operating doctor or doctors’ medical records including operative reports. The more the consulting specialist knows about what did or did not happen, during and after surgery, the more valuable the consultation.

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Doctors Face and Body are both specialists in a field of surgery known as revision surgery. A revision is done to correct surgical imperfections performed by another surgeon somewhere else.

View some of Dr. Body’s breast revision before and after pictures.

Here are some of Dr. Face’s before and after pictures of nose job revisions

After Cosmetic Surgery

Both the eminent Beverly Hills board-certified plastic surgeon Stuart Linder, M.D. (Dr. Body) and the equally eminent Beverly Hills board-certified facial plastic surgeon Robert Kotler, M.D. (who blogs as Dr. Face) tell their patients that some unwanted conditions and complications can crop up after plastic surgery. The average complication for U.S. plastic surgeons is about once in every 100 cases. What to do if one rears its ugly head? The patient should call the surgeon. But when?

Here, Drs. Face and Body tell what signs you will notice in yourself if you should make that call, even if it’s in the middle of the night.

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Dr. Body (Dr. Linder): Some patients have complications after they leave the surgery center. But if you have selected a board-certified plastic surgeon, you always will be in good hands because they have virtually seen and treated any unwanted complication that can crop up.

Dr. Face (Dr. Kotler): Almost all board-certified cosmetic plastic surgeons tell their patients the usual, run-of-the-mill complications after a plastic surgery include:

• Bleeding
• Allergic reactions to anesthesia (very rare)
• Infection
• Hematomas (a collection of clotted blood under the skin)
• Seromas

Dr. Body: Seromas are a mass of watery blood just under the skin and can cause pain and, later, more scar tissue.

Dr. Face: Your surgeon should tell you during the initial consultation and before any surgery what complications are common to your particular rejuvenation procedure and what signs you should watch for.  Most cosmetic plastic surgeons will include that information on pre-surgery hand-outs. It’s a lot of reading but well worth your time.

Dr. Body: Sure, if you know what signs and symptoms to watch for, the decision to call your surgeon will be easier.

Dr. Face: The leading complication nationwide is excess bleeding. It is not a gusher but just a little trickling of some blood under the bandages.

Dr. Body: In breast augmentation surgery, patients want to watch out for one breast being larger than the other. That may indicate bleeding in that breast.

Dr. Face: Another frequent complaint is temporary numbness. A slight loss of feeling is common to many procedures and happens because some nerve endings just under the skin have been severed. However, virtually all grow back and return feeling in two to four months.

Dr. Body: Another frequent complication in breast surgery is capsular contracture which is a type of internal scarring. It can create hardening, pain and distortion of the breast. Board-certified plastic surgeons see it often and know exactly how to treat it.

Dr. Face: Pain or swelling any time after the third day of surgery is a call-your-surgeon-now moment. Pain or swelling after cosmetic facial procedures should fade away in about 48 hours after surgery and then start to disappear completely.

Dr. Body: In tummy tucks, be alert for severe abdominal pain. Abdominoplasty requires a long incision, running hip to hip, unless you’re having a mini-tummy tuck. Pain in the tummy area worse than a stomach ache could mean bleeding.

Dr. Face: If the skin is reddened or sore to the touch near an incision, an infection may be present. Don’t delay on this one because the quicker we can jump on an infection, the quicker the problem comes under control. In fact, checking for signs of infection is the primary reason we see patients first thing in the morning after a cosmetic plastic surgery procedure.

Dr. Body: In surgeries that require long incisions, wound separation — known to doctors as dehiscence – the edges of an incision come apart after the stitches have been taken out. It happens only rarely but a properly trained and qualified plastic surgeon may be able to close the incision again in just a short appointment. The good news:  revision surgeries are rarely needed for most instances of dehiscence.

Dr. Face: One extremely rare – but very serious — complication after liposuction is blood clots in the veins, a condition medically known as deep vein thrombosis. To help prevent it, most surgeons advise liposuction patients to get out of bed and start moving around as soon as possible.

Dr. Body: You are also at risk for deep vein thrombosis on very long airplane trips, where you must sit in a cramped position for many hours. One way to cope with the remote threat of thrombosis in an airplane is just make the same motion with your feet as when you step on the gas pedal in a car. That stretches your leg muscles, squeezes any pooled blood and gets it moving again.

Dr. Face: There are some very, very rare complications of people being allergic to anesthesia. But your best cosmetic plastic surgeons use highly trained anesthesiologists – who are also M.D.s – to watch over the patient while he or she is asleep under a general anesthesia. Anesthesiologists have seen every complication known. For instance, in the rarest of anesthesia complications, the patient does not even know he or she is allergic to anesthesia. But good anesthesiologists keep a very special — and rare – drug on hand to counteract it. That drug is used somewhere by American plastic surgeons perhaps once every two years. Most stocks of that special drug expire without ever being used. But fresh supplies must be kept on hand in the O.R. nonetheless.

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Look at some of Dr. Kotler’s rhinoplasty revision before and after pictures.

A revision is done on a nose job when another surgery somewhere else did not do a good job and left the patient still unhappy with his or her appearance.

Dr. Linder has a practice dedicated to revision breast surgeries. He, likewise, sees many breast augmentations, breast reductions or breast lifts that were botched by another surgeon somewhere else.

Here are some of Dr. Linder’s breast revision before and after pictures.

Cosmetic Surgery News

Cosmetic plastic surgery continues to make news worldwide. There are no better interpreters of such news reports than Drs. Body and Face who tell what the headlines mean to potential patients.

Dr. Body is the eminent Beverly Hills board-certified plastic surgeon Stuart Linder, M.D.while the equally imminent Beverly Hills board-certified facial plastic surgeon, Robert Kotler, M.D., joins the discussion. Both scan consumer and professional cosmetic plastic surgery publications to help patients – and their professional peers – understand the importance of new findings about the rejuvenation arts.

Here is their third such offering about what’s behind the headlines in cosmetic surgery news.

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News item: Palm Bay, Florida, woman wins $8,000 breast augmentation in the radio contest, ‘Bangin’ Bikini Boobs.’  (Read more about the plastic surgery radio contest.)

Dr. Body (Dr. Linder): Professional ethics rule out plastic surgeons doing surgery on the winner of a contest. Board-certified plastic surgeons know they will be censored or suffer other penalties.

Dr. Face (Dr. Kotler): How can consumers use that news?

Dr. Body: They can take it for granted that a lesser trained, lesser experienced surgeon may be performing the actual breast augmentation. Board-certified plastic surgeons – who are the most capable –must stay away from contests. Thus, anybody who wins a cosmetic surgeon procedure in a contest also loses, in a sense, even if they have won. Plus, surgery may not be right for that particular person for any number of reasons.

News item: Dissolving Nasal Implant Aids in Nose Surgery in Austria. A resorbable plate implanted inside the noses of people with internal nasal problems – including deviated septums – appear to have improved outcomes. (Read more about this new type of nose job surgery.)

Dr. Linder: You’ve done over 4,000 nose surgeries, doctor; do you think this is something that may come to America? So many people have cosmetic and breathing trouble due to a deviated septum.

Dr. Kotler: I had a nose revision patient last week who had one of these dissolvable plates implanted in his nose by another surgeon overseas to create more support for his septum. But the plate did not dissolve and was causing problems. The downside to this surgery:  the septum is surgically separated from the nose, the little plate is affixed and then the septum is placed back inside the nose. It’s bench surgery, if you will. But any structure taken from the body is, by definition, dead. It may or may not become live again. Clinical trials are going on overseas but it may be a great while before we see the technique used in the United States.

News item: Plastic surgeons use an endoscope for the male breast reduction surgery. (Read more about the gynecomastia surgery technique.)

Dr. Linder: Male breast reduction surgery requires taking out an extremely tough ring of fibrous breast tissue that sits just under the man’s nipples and makes his breasts stick out further. That tissue is too tough to liposuction. An endoscope is a lighted instrument inserted under the skin through what we call a ‘stab wound’ that is no bigger around than a #2 pencil. But it requires a longer incision to take out the fibrous breast tissue. I don’t see how it can be done well, using a thin liposuction tube.

Let me give you a for-instance:

If you have just had a meal, and have a sensitive stomach, you may want to skip this picture, but I just added to my blog, a close-up picture of the tough breast tissue being removed from a 24-year-old man – and professional model – in a recent male breast reduction surgery. (Look at the gynecomastia surgery.)

Dr. Face: Sometimes, I simply give up on the news.  If some of today’s reporters were working in the Middle East 2000 years ago and had to cover David and Goliath, the headline would have read: “CRIME KILLS BELOVED CHAMPION….Psychologist Questions Influence of Rock.”

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View some revision rhinoplasty before and after pictures.

Look at some breast augmentation revision before and after pictures.

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Cosmetic Plastic Surgeon at Work

With the onset of summer and toasty temperatures – especially on the U.S. Eastern Coast – some patients have found an unexpected blessing while receiving plastic surgery procedures. The operating room can be much cooler than expected. In fact, sometimes, it can be downright cold!

Here, Doctors Face and body (Robert Kotler, M.D. and Stuart Linder, M.D., respectively) tell what patients can expect, how they can cope with the chill and why the operating theater is cold in the first place.

Dr. Linder is an eminent board-certified Beverly Hills plastic surgeon who specializes in breast augmentation, breast revision surgery, and tummy tucks along with male and female breast reductions.

Dr. Kotler is an exclusive head and neck surgeon, performing rhinoplasty, revision rhinoplasty, face lifts and ear pinning, a procedure technically known as Otoplasty.

Dr. Face (Dr. Kotler): Forty years ago it was just the opposite – operating rooms were steamy. Air conditioning was not always installed in hospitals and other medical facilities.

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Dr. Body (Dr. Linder): Sounds like you were sweating it – literally!

Dr. Face: Sometimes, right onto the patient.

Dr. Body: I’m thankful for the A.C. being cranked up during surgery because being wrapped up in several layers of surgical work garb plus, the big, bright surgical lamps makes it hot enough.

Dr. Face: Sure, but the medical benefits are worth it. Fewer infections as the temperature drops, for instance. And I don’t know about you but I tend to get sleepy when it gets too warm. I’ve heard other surgeons say the same thing. They agree we all work better when it’s cool.

Dr. Body: It can be a different experience for patients, though. Almost everybody who has ever been to a doctor is wary of cold instruments being placed on warm bodies. Cold patients in the O.R. or the receiving areas, just after an operation do have some options, though.

Dr. Face: Like the Bair Blanket?

Dr. Body: One of the many things we do for patients after surgery is cover them with a special blanket into which warmer air is blowing. Some other blankets are being held in little warning ovens.

Dr. Face: A seeming lifesaver for cosmetic plastic surgery patients who are quickly chilled. They can also request that any irrigation or intravenous fluids be warmed before being injected into their bodies. So if you’re cold in the O.R., speak up! Cosmetic plastic surgeons and staff understand and are ready to help.

Dr. Body: Talking about heat reminds me of the new basketball team that may make Miami its home base. I understand they are going to call the team “Humidity” so that it will have some real meaning when Miami basketball fans say, “It’s not the Heat that’s so bad, it’s the Humidity.”

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Look at some breast revision before and after pictures.

View some nose job revision before and after pictures

Robert Kotler, M.D. (“Dr. Face”) and Stuart Linder, M.D. (“Dr. Body”) have noticed that many patients come to their Beverly Hills offices wondering if they are really, really ready for cosmetic surgery.

While everybody is interested in looking at before and after pictures, some patients and potential patients go beyond the pictures and read much more about the various rejuvenation procedures, how long they take, how long they lost and the cost of plastic surgery.

Actually, according to Drs Face-Body, there are some signs you may notice in yourself that will indicate you may be really ready for plastic surgery and should start taking steps to find that perfect surgeon.

Here, Drs Face and Body tell the signs that other motivated patients have noticed in themselves before plastic surgery.

(Follow Beverly Hills cosmetic plastic surgeons Drs Face-Body on their Facebook page.)

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Dr. Face: Everybody likes before and after pictures because it’s typically an American trait to reinvent not only ourselves but things around us.

Dr. Body: Well, what else do you find that is reinvented?

Dr. Face: Reinvention and the power of before and after are also strong in America with items like homes – TV’s This Old House and Extreme Makeover: Home Addition  --  cars and even motorcycles that have been rebuilt and made to look new. Many, many restaurants like to post old photos and paintings of what a particular geographical area used to look like. I’ve seen people stand in public places for the longest time and stare at pictures of Beverly Hills and Hollywood taken around the start of the 19^th century when both cities were tiny and had only dirt roads.

Dr. Body: I see where this is going – you’re saying it’s part of the reason that people like to look at plastic surgery before and after pictures?

Dr. Face: Yes! But just because you like surgery photos, does not mean you are hankering to undergo a face lift.

Dr. Body: O.K., let’s get down to brass tacks and talk about some signs people may show when they may be ready for cosmetic plastic surgery.

Dr. Body: The dead bang giveaway: mirrors. Say, you have a crooked or very large nose or ears that stand out. You pass a mirror and your eye hardly sees the rest of your face, only that feature you dislike so much. So you avoid mirrors or looking into them.

Dr. Face: That often happens with my revision patients who have gone to Third World nations or to bargain basement practitioners in America and had a terrible procedure that improved nothing and maybe even made their appearance worse.

Dr. Body: Sure, those patients are looking for a revision, a do-over, of a poorly done surgery by some other surgeon elsewhere. Many of my first-time body patients inquiring about breast augmentation because they have lost their patience wearing bathing suits or bras that remain partially empty. It’s very common for potential tummy tuck patients to come in, saying people have been asking them how long it may be before the baby is due. And none are even pregnant! Many men in need of male breast reduction won’t take off their shirts in public for any reason.

Dr. Face: Some face lift patients have complained of being mistaken for grandparents when they are taking their small children somewhere. I recall one woman on a train trip with her five-year-old son; another passenger said how nice it was for a woman to take her grandchildren places!

Dr. Body:  Patients are more likely to be ready for surgery when they have a first consultation in which the surgeon explains what can realistically be done. So the 50-year-old patient understands she won’t look like she did at 20 but will just be the best possible version of herself, after healing.

Dr. Body: I can tell a patient is ready for plastic surgery when he or she has listened to, and read about, the risks and possible complications incurred in any surgery. And I know the patient is going to book a surgical date when I refer them out for the required tests and physicals to make sure they are healthy enough for surgery.

Dr. Face:  Sure, that’s very important. While taking medical tests to be cleared for surgery, some patients have discovered a heretofore unknown condition – like high blood pressure — for which they must be treated first. That usually only puts the surgery off for a while.

Dr. Body: I like to see patients who have read one of the many books—written in plain English — about having plastic surgery. My own, The Beverly Hills Shape, is a good place to start.

Dr. Face: Right! I often send my book, Secrets of a Beverly Hills Cosmetic Surgeon, to a prospective patient at no charge whatever because an educated patient is so much easier to work with. I’m also happy when I hear a patient has two, three or even five first consultations with other plastic surgeons. They then really know what the surgical process is all about.

Dr. Body: One of the questions I like to ask is: “Who is the person that is going to drive you here and stay with you for the first 24 hours after surgery?” If the patient has not made arrangements with a friend or relative, he or she is not really ready for surgery. That companion person is not needed to supply emergency services, just to call in case some undesirable complication does rear its ugly head.

Dr. Face: My own favorite question is to ask the patient what everything in the after surgery bag is for. Just so no mistakes can be made, I supply a bag, right down to the best Q-tips, along with written instructions on how to care for one’s self after surgery. I am testing them. We, I think you do too,  supply a “Post-operative kit, containing their pain meds, oral antibiotics (if needed, we administer antibiotics intravenously during surgery and tranquilizers, along with written instructions for that patient’s procedure(s). We make sure we have their home and cell phone number so we can call to check on their progress. We even ask for their pharmacy in case we must phone in an extra medication. We like to “Think ahead”.

Dr. Body: And what a payoff! No more avoiding mirrors, no more mistaking a 35-year-old for a grandparent!

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Known as super-specialists, Drs Body and Face specialize in revision surgery which repairs unsatisfactory results done by other surgeons in other locations.

Read more about Dr. Kotler’s International and revision cosmetic surgery patients.

Learn more about Dr. Linder’s worldwide plastic surgery revision patients.

Robert Kotler, M.D. (“Dr. Face”) and Stuart Linder, M.D. (“Dr. Body”) have noticed that many patients interested in cosmetic plastic surgery often take advantage of services offered at MediSpas.

MediSpas are typical day spas where one can take the waters and have a massage or other beauty treatments. During the last several years, many MediSpas have opened next to, or in association with, cosmetic surgeons. So in addition to a soothing soak you can have Botox or a facial filler, along with the less invasive cosmetic surgeries like dermabrasion or laser hair removal.

But many issues have recently come to light about MediSpas, so consumers may want to take caution.

As the ultimate cosmetic plastic surgery insiders, Drs Face-Body have kept a weather eye on the development of cosmetic medical services at MediSpas.

(Follow Beverly Hills cosmetic plastic surgeons Drs Face-Body on their Facebook page.)

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Dr. Face (Dr. Kotler): New statistics have been released by the American Academy of Facial Plastic and Reconstructive Surgeons (AAFPRS) showing how many and who have had which invasive and non-invasive cosmetic surgery procedures.

Dr. Body (Dr. Linder): Sure, I usually read the statistics with an eye toward learning how many people have returned home after having a botched surgery in a Third World nation. It’s become a real problem for the National Health Service in England to care for all the returnees.

Dr. Face: Here’s one that shocked me: Of 2,700 Plastic surgeon members in AAFPRS, 40 percent reported they had treated a patient who suffered a bad facial procedure in a developing nation.

Dr. Body: I also noticed some really shocking statistics that took place right here in America. The AAFPRS also found that 74 percent of in-the-know surgeons knew about medical directors at MediSpas who were not on the site, actually doing or overseeing, the cosmetic treatments.

Dr. Face: I suppose those members knew about that situation because so many of their colleagues had opened a MediSpa or located one near their offices?

Dr. Body: That’s right. The original idea was that a cosmetic surgeon could interrupt your facial long enough to give you some wrinkle-reducing Botox or perhaps plump up some sagging facial areas with Juvederm or Restylane.

Dr. Face: How did all that turn out?

Dr. Body: It appears that lesser qualified MediSpas employees, perhaps those with little — if any — surgical training, were performing the procedures. And in many cases, the procedures were not being supervised by a qualified M.D.

Dr. Face: So let me guess: that would result in many patients complaining of burns from lasers, unbalanced results and from facial fillers placed, not in the trenches of folds and deep wrinkles, but on the sides of the folds.

Dr. Body: Which would make the folds and deep wrinkles appear worse!

Dr. Face:  Right. Not placing the fillers in exactly the right spot would also create what physicians know as granulomas which are clumps and lumps that can be seen and felt under the skin.

Dr. Body: So, supposing one of our international patients comes to American and wants to visit a MediSpa. How does one know if and when getting a light cosmetic surgery is safe?

Dr. Face: Biggest dead bang giveaway: if you see a physician’s name on the door as the medical director, ask where he is. Don’t be misled by the grandeur of the facility; the MediSpa trend is reported to be a $10 billion industry in America so spiffy, highly upscale MediSpas are often found in shopping centers and strip malls or anywhere else where foot traffic is found. Ideally, the medical director should be a board certified plastic surgeon, a board certified head and neck surgeon or a board certified dermatologist. Those specialists are the right match for skin care.

Dr. Body: Sure, having “work” done by a radiologist or gynecologist would not float my boat. Another good question to ask: in this state, what are the regulations about who can provide injections? For instance, in the “Golden State” (California) only Registered Nurses and M.D.s can give injections.

Dr. Face: The next question I would ask is: who is responsible for complications in case a problem crops up. And how far away is he or she?

Dr. Body: That makes good sense, because the more technical the procedure, the more opportunities for problems. For instance, skin treatments with lasers, radiofrequency procedures and deep skin peels – which must be done under general anesthesia, should be done by a board-certified plastic surgeon or dermatologist. Plus, a certified operating room is required for a deep peel.

Dr. Face: But if your peel is a very light chemical or fruit peel, a licensed aesthetician is qualified.

Dr. Body: International patients need to know that, in America, an M.D. who advertises him-or-herself as a “cosmetic surgeon” may not have had the extra four to seven years surgical training required of board-certified plastic surgeons or head and neck surgeons (who are technically known as otolaryngologists) and specialize in cosmetic procedures of the head and neck only.

Dr. Face: Statistics! They can tell you a lot or totally mislead you.

Dr. Body: If I can borrow a line from Mark Twain, “There are three kinds of lies: lies, damn lies, and statistics.”

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Known as superspecialists, Drs Body and Face specialize in revision surgery which repairs unsatisfactory results done by other surgeons in other locations.

Read more about Dr. Kotler’s International and revision cosmetic surgery patients.

Learn more about Dr. Linder’s worldwide plastic surgery revision patients.

Grief

Stuart Linder, M.D. (“Dr. Body”) and Robert Kotler, M.D. (“Dr. Face”) note with sadness several U.S. tragedies while cosmetic surgery patients were undergoing surgery.

Under American law, any licensed medical doctor can practice any type of medicine he or she wishes. That means some plastic surgery practitioners may not be properly trained nor tested. In America, it’s a case of “buyer beware.”

In the vast majority of cases, these tragedies boil down to one of several common mistakes made when choosing a plastic surgeon.

Here, Drs. Face and Body tell how to avoid common pitfalls and make sure you have a good surgical result while staying safe in the best of hands.

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Dr. Face: Sometimes, the news about cosmetic plastic surgery is not so good.

Dr. Body: Why, what did you read?

Dr. Face: An article from Florida mentioned how a 35-year-old woman undergoing basic liposuction did not make it through the procedure.

Dr. Body:  What happened?

Dr. Face: The autopsy hasn’t been completed yet so we don’t know for sure. But one giant red warning flag was flying over the choice of the doctor, though.

Dr. Body: I have an idea where this is going: either training, certification of the surgery center or a problem with anesthesia.

Dr. Face:  The red warning flag was that the surgeon had his privileges revoked by a hospital where he was once cleared to admit patients.

Dr. Body: Our entire sympathy to the woman’s family but a little homework could have spotted that. One of the major signs you are in the hands to a top surgeon is the type and number of hospital privileges. If he or she has none — don’t walk, run away. Hospitals are on top which surgeons are excellent and which are not.

Dr. Face: Sure, another thing you can do when meeting a cosmetic plastic surgeon is ask, “Have you ever been disciplined or sued?” If you see hospital privileges listed on a doctor’s website, call the hospital and double check.

Dr. Body: In another sad case, a plastic surgeon in Orange County, California, surrendered his license for sexual misconduct with patients. At the time he gave the license up, he was already being investigated by the Medical Board of California.

Dr. Face:  There’s another good place to do a quick check before booking for surgery. Simply call the state medical board and see if the surgeon of your choice has a clean record.

Dr. Body: That’s true, doctor, but there was another wrinkle in that case.

Dr. Face: Which was?

Dr. Body: That doctor’s surgery center. The largest newspaper in Orange County found that a woman died there, due to an “accident puncture wound.” Cosmetic plastic surgery is performed in shallow areas of the body; a liposuction wand or other instrument penetrating lethally deep into the body is unforgivable.

Dr. Face: All of which brings us to yet another to check: where the surgery will take place. Four or five certifying bodies inspect plastic surgeons’ operating rooms. To keep the certification, the O.R. must be as safe as humanly possible. Always ask what type certification your surgeon’s O.R. has.

Dr. Body: We haven’t mentioned the most important starting point: the surgeon’s training and credentials. He or she should be board-certified in either plastic surgery or head and neck surgery, a specialty technically known as Otolargyngology.

Dr. Face: That’s right. Many surgeons will dodge the issue by claiming they are board-certified but it’s in some other area that has nothing to do with plastics, like radiology or gynecology. Don’t let the wool be pulled over your eyes with fancy jargon!

Dr. Body: To be absolutely sure you are dealing with a top practitioner who has seen every possible wrinkle, ask if your surgeon also had a fellowship. That means he or she worked at the side of an older, more experienced surgeon after completing all the regular training.

Dr. Face: The final leg of plastic surgery homework is inquiring about the training of the anesthesiologist. That is very important because many plastic surgery tragedies result from some problem with breathing.

Dr. Body: The best selection is a board-certified anesthesiologist (who is also an M.D.) Some surgeons use a nurse anesthetist – who has less training – but he or she should also be certified nonetheless.

Dr. Face: Is there never anything good in the news?

Dr. Body: I’m not sure, but my opinion is TV news reporters do not give people much credit for any intelligence: they make sad faces for bad stories and happy faces for good news!

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Drs. Face and Body both specialize in a surgery specialty known as revision surgery. That means they repair the mistakes and botched surgeries that have been done elsewhere by a other surgeons.

View some of Dr. Body’s breast revision before and after pictures.

Here are some of Dr. Face’s nose job before and after pictures.

Stuart Linder, M.D. (“Dr. Body”) and Robert Kotler, M.D. (“Dr. Face”) hear all types of requests from the public to surprise their mates and loved ones with gifts of cosmetic or plastic surgery. Valentine’s Day is especially rife with such requests.

That may be a nice thought at first, but surprising somebody with a gift of plastic surgery can come back and give even the most well-intentioned gift giver a healthy bite on the leg.

Here, Drs. Face and Body tell what to watch for when thinking about making a gift of plastic surgery at any time of year, including Christmas, birthdays, graduation and other special occasions.

Here are some of Dr. Face’s before and after pictures of nose job revisions

View some of Dr. Body’s breast revision before and after pictures.

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Dr. Face (Dr. Kotler): With Valentine’s Day coming up, many plastic surgeons, MediSpas and others are offering “special gifts” for that “special” person.

Dr. Body (Dr. Linder): More than flowers and candy, huh?

Dr. Face: Well, you be the judge, doctor. One New York plastic surgeon is offering a “Cupid’s Aesthetic Package.”

Dr. Body: I can’t wait to hear the cost of the plastic surgery!

Dr. Face: Only $25,000!

Dr. Body: That’s a nice little trinket. What’s included?

Dr. Face: It’s for the true super-romantic. It starts with a bouquet of exotic flowers, specially embroidered matching him and her robes, then a detailed body assessment by the doctor, delivery to the actual surgery site in a Limo and then delivery — in the ritzy ride again, of course — to a special recovery room at the Ritz-Carlton in the company of an overnight surgical nurse, all topped off with a special house call the next morning by the doctor himself.

Dr. Body: Well, I sure hope the “exotic flowers” are not endangered species but there is also something else I’m wondering about.

Dr. Face: What’s that?

Dr. Body: I sure hope the gift recipient needs and wants the surgery, whatever it might be! It almost sounds like the surgeon is deciding what the procedure should be once he’s done examining the patient. That’s backwards – the surgeon examines the patient after she comes into the doctor’s requesting breast augmentation, face lift or whatever.

Dr. Face:  You’re right as rain! Plus, the special gift does not mention any pre-surgical checks to find out if the patient is healthy enough for plastic surgery.

Dr. Body: And what happens if the patient thinks she is already beautiful? Basically, the man in her life stands before her with a bundle of exotic flowers saying she doesn’t look good enough, here you are darlin’, let’s fix you up and do it in grand style.

Dr. Face: Some members of the fair gender could find insult in all that.

Dr. Body: It may seem pricey enough but that particular doctor has another program in case you can’t quite pony up for the first class package. You can treat your loved one to cosmetic surgery with the “Romantic Aesthetic Package” for only $15,000.

Dr. Face: I suppose it’s the same thing minus the exotic flowers or maybe the matching robes?

Dr. Body: Yes, it is. And then, in Washington state, a plastic surgeon is holding a Valentine’s Day Party on the 14^th, charging lovers $35.00 a pop to get in.

Dr. Face: Then what?

Dr. Body: Then you can save anywhere from 50 percent off on a whole variety of facial fillers like Juvederm and Restylane while getting $1000 off laser resurfacing or other skin rejuvenation.

Dr. Face: No flowers, no candy?

Dr. Body: No, and according to most codes of ethics in the rejuvenation arts, medical procedures – even quick facial injections of Botox – are not supposed to be done in a party atmosphere.

Dr. Body: Quite a few Medi-Spas are offering lovers day specials for Valentine’s Day, too.

Dr. Face: Too often, only a plastic surgeon’s name is on the Medi-Spa door while quasi-medical procedures are carried out inside. First thing to ask about Valentine’s Day at your favorite Medi-Spa is if the doctor is anywhere nearby….just in case.

Dr. Body: Plus, most states have fairly strict regulations about who can give Botox or Restylane or other fillers. Besides, those gift certificates for peels and laser treatments can result in additional complications which should be handled by a doctor.

Dr. Face: Maybe the best and most thoughtful Valentine gift of all is to just observe the day with flowers and candy!

Dr. Body: Capital idea! Even if the flowers are not exotic, but just the ordinary kind! After all, it’s the thought, isn’t it?

Dr. Face: Yes, but those thoughts can be warped, sometimes. The Register in Orange County carried an article about the best and worst Valentine’s Day gifts.The worst was a book about snails with the 99-cent price tag still applied.

(Read more about best and worst Valentine Day gift suggestions, other than surprise plastic surgery.)

Dr. Body: You know what some women say: “To be overcome by the fragrance of flowers is a delectable form of defeat.”

The World's Most Requested Lips

Stuart Linder, M.D. (“Dr. Body”) and Robert Kotler, M.D. (“Dr. Face”) hear all types of requests from the public for improvements in faces and bodies.

But to put tiny breast implants under the tattoo of a well-endowed woman? (Pictured at the bottom of the post, below). Or to ask for lips like Anglie Jolie’s?

Virtually all of these requests are politely turned down while showing that potential patient to the door.

Here Drs. Face and Body tell of some of the most unusual requests made by real people for very, very unrealistic plastic surgery.

View some of Dr. Body’s breast revision before and after pictures.

Here are some of Dr. Face’s before and after pictures of nose job revisions

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Dr. Face (Dr. Kotler): I once had a man come in with a nose that needed a lot of work; he wanted thinner nostrils and an upturned nose tip. But, although he had a very large hump on his nose, he wanted that left alone.

Dr. Body (Dr. Linder): What did you do?

Dr. Face:  In that case, making the nostrils less wide and turning the tip of the nose up would be incompatible with a large hump on the nose; it just would not fit his face. So I declined the surgery.

Dr. Body:  The most current very unusual request I had came from a 69-year-old woman who was the perfect version of everybody’s kindly old grandmother. Moreover, she had been in a wheelchair for 20 years.

Dr. Face: What procedure did she want?

Dr. Body: She wanted liposuction of her thighs and a tummy tuck.

Dr. Face: I think I know where this is going!

Dr. Body: Plastic surgeons must think about any surgery in a risk-benefit equation. Because there are risks to every surgery, we ask ourselves: “Do the benefits – looking slimmer in this case – outweigh the risks of surgery?”

Dr. Face: And in this case, the risks would be….?

Dr. Body: The patient’s highly compromised immune system. This was a case where the patient just was not healthy enough for plastic surgery because the risks totally outweighed the benefits. It was also odd because the intended treatment area was the least visible part of the patient.

Dr. Face:  I remember hearing over lunch another plastic surgeon telling how a patient came in complaining of the, and I quote “fat in his forehead.” He wanted it removed by a forehead lift.

Dr. Body: But there is no fat in the forehead!

Dr. Face: Nor was there any surgery….at least from our office.

Dr. Body: What do you say when a recently divorced person comes in, saying he or she wants a face lift because dating must start again if another partner is to ever be found?

Dr. Face: That’s a person with a goal and point to having the surgery. But it’s completely different than when a person comes in, saying he or she is blue, often depressed and would like some plastic surgery as a pick-me-up.

Dr. Body: And that person gets turned down, I assume.

Dr. Face:  Absolutely! Another common no-go is when a person comes in with a request to be made to look like a celebrity. Unfortunately, a lot of things we cannot change – like bone and muscle structure – which are responsible for your appearance and the way a celebrity looks. About the best we can do is make you look like the best possible version of yourself. And that’s no small undertaking! Identical twins notwithstanding, no two people do — or should — look alike.

Dr. Body: In listening to other surgeons around Beverly Hills, I once heard about a man who came into a plastic surgeon requesting the bald spot on his head to be replaced with pubic hair.

Dr. Face: Maybe he was fond of perms!

Dr. Body: I have patients who bring in pictures of celebrities, asking for say, Pamela Anderson’s breasts or Angela Jolie’s waist. (Read more about patients’ requests for plastic surgery to make them look like a celebrity at the International Society of Aesthetic Plastic Surgeons.)

Dr. Face: Other odd requests have included people asking for scar removal from their pets. My response is the same: “Sorry, we don’t do animals. Please see your vet.” But there are some vets who have done cosmetic surgery on animals. For instance, a Hollywood kangaroo used in films and commercials suffered a badly torn lip which ruined his close-ups so a vet repaired it. (Read more about the animal’s cosmetic surgery.)

Dr. Body: While plastic surgery can’t change you so much your own mother would not recognize you, some people in federal witness protection programs have been known to have rhinoplasty, eyelid lifts and chin implants to better disguise their appearance.

Dr. Face: Just as long as none of those on-the-lam characters in witness protection come into my office and say: “I’m gonna make you an offer you can’t refuse!”

A man inserted tiny breast implants under the tattoo of a woman; an infection resulted.

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