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If a particular surgeon falls into the “problem” category, he or she is very likely indeed to have hospital privileges withdrawn.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.

Plastic Surgeon with Knife

The eminent Beverly Hills board-certified plastic surgeon Stuart Linder, M.D – the “Dr. Body” blogger—mentions a few cosmetic plastic surgery procedures worth skipping. Also weighing in with “don’t bother” procedures for face and skin is the equally well known Robert Kotler, M.D., a top Beverly Hills board-certified cosmetic plastic surgeon and former Dr. 90210 star. Dr. Kotler’s  Nome de plume in the blogosphere is “Dr. Face”.

Drs. Face and Body jointly belong to many medical organizations, including:

• · The American Academy of Facial Plastic Surgery and Reconstructive Surgery.
• · American Board of Plastic Surgery
• · The American Medical Association

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Dr. Body: (Dr. Linder): Do patients ever ask for cosmetic plastic surgery procedures that really aren’t in their own best interests?

Dr. Face: (Dr. Kotler) Do they ever! So many new operations and techniques are written up by eager, breathless marketers that some unquestioning patients are excited and willing to have the procedure.

Dr. Body: Such as?

Dr. Face: So-called “facelifts” done by threads or sutures. The threat fad hit the medical marketplace around 2006. The concept was that a barbed thread inserted in facial skin would lift and hold sagging tissues. Purportedly, with tiny incisions, less bruising and a shorter recovery period.

Dr. Body: Were patients happy with it?

Dr. Face: No. Many patients found the threads would not support the weight of the facial tissues. In many other cases, the threads popped through the skin. Other patients noticed waves in their skin. Eventually, one major company took their threads off the market.

Dr. Body: Many of my patients have read about laser liposuction and asked about it – if not for it. I explain that laser liposuction has not been shown to improve results done by tumescent liposuction which the professional plastic surgery associations consider the “golden standard.” Tumescent liposuction has a long track record of safety, produces good results and is easily tolerated by patients.

Dr. Face: I can think of another reason to avoid laser liposuction. The new machines are very expensive, easily running into six figures. That only drives up the cost of plastic surgery, sometimes as much as several thousand dollars.

Dr. Body: What other Johnny-come-latelys have you seen, doctor?

Dr. Face: For a while, there was a huge craze in so-called “lunch time”, “one hour” or “quick” facelifts. But time and experience have shown the benefits minimize after only several months. Plus, the incision marks often show. Basically, like in any human endeavor, minimal efforts will result in minimal results.

Dr. Body: I have another situation something like that in breast surgery. Somehow, the TUBA, or transumbilical breast augmentation became popular. A TUBA inserts saline breast implants into and under the breast via a tiny incision in the belly button. But the surgeon works with such long tools and so far away from the breasts, the implants are often badly placed. That results in a not-so-great appearance for the patient. Not a week goes by without seeing a patient who wants a correction surgery for her TUBA.

Dr. Face: And we work through the naval because…?

Dr. Body: Because the scar is hidden in the creases of the naval. However, working through the areola, the brown area surrounding the nipple, the surgical scar is not that noticeable and does lighten and fade in about  a year. Standing directly over the breasts gives the surgeon precise control over implant placement and controlling the symmetry of the two breasts along with the amount of cleavage, if any.

Dr.  Face: Many patients ask for a neck lift or want only neck liposuction. But that’s a mistake without removing deeper fat and tightening the platysma, the major neck muscle that results in a “turkey gobbler” neck with normal aging. Skip tightening that muscle and the vertical neck bands may look more obvious than before. The skin is not the problem; it’s the underlying excess baggage.

Dr. Body: I can think of another patient request that is not in their best interests. And that’s buttocks augmentation. In my opinion, both methods – a buttocks implant if the patient is thin or a fat transfer to the buttocks – are doomed because people spend so much time sitting. All that puts immense, killing pressure on the new fat cells injected into the patient’s rear or creates other problems for the implant.

Dr. Face: Speaking of skin, I’ve noticed that the non-invasive surface skin treatments, Thermage and Titan, purport to tighten sagging skin usually but usually result in disappointed patients who are also unhappy with the high cost of the procedures. For instance, I notice on realself.com that of 179 reviews of Thermage or Titan neck lifts, only 40 percent of patients said it was worth it.

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Look at Dr. Body’s before and after breast augmentation revision pictures

See Dr. Face’s before and after nose surgery revisions pictures.