What to Know Before Booking a Plastic Surgery Procedure You Saw on TV

You’ve seen the ads. Glossy branding. Buzzwords like “laser lipo” or “awake liposuction.” Catchy procedure names that sound exclusive. But according to top board-certified plastic surgeons, many of today’s most hyped cosmetic procedures are neither new nor innovative and in some cases, they’re putting patients at serious risk.

Recent lawsuits against a national chain have brought this growing issue to light, with patients alleging permanent disfigurement, injury, and in some cases, death. While the legal process plays out, many surgeons say it’s time to talk to patients about protecting themselves.

“This is a business, not a medical practice,” says Richmond, VA plastic surgeon Ruth Hillelson, MD. “Every surgeon knows that the pre-op exam, the surgery and the post-op follow-up are requirements for good outcomes. When these are bypassed or handled by non-doctors, that’s where things go wrong.”

Featured Experts

• Dr. Ruth Hillelson is a board-certified plastic surgeon in Richmond, VA
• Dr. Raman Mahabir is a board-certified plastic surgeon in Tucson, AZ
• Dr. Joseph Russo is a board-certified plastic surgeon in Boston
• Dr. Dan Hatef is a board-certified plastic surgeon in Nashville
• Dr. Tracy Pfeifer is a board-certified plastic surgeon in New York and president of The Aesthetic Society

Branded Doesn’t Mean Better

One of the biggest misconceptions patients have is that branded procedures are somehow proprietary or different from what a board-certified plastic surgeon offers. They are well-known procedures packaged under a corporate name and are often overhyped about what they can achieve. “Regardless of how flashy the advertisements or how good the before-and-afters look on Instagram,” says Tucson, AZ plastic surgeon Raman Mahabir, MD, “it’s important to look behind the curtain and make sure the surgeon is a board-certified plastic surgeon. You have to do your homework before signing up for surgery.”

Are You Meeting a Doctor or a Sales Rep?

A common thread among these cosmetic chains is that patients don’t meet their surgeon until the day of surgery—or at all. “If you’re going to a place where you don’t meet the doctor during your consultation, that should be a huge red flag,” says Newton Centre, MA plastic surgeon Joseph Russo, MD. “If you’re met with someone who’s just doing sales, that’s an even bigger one.” How can a non-physician accurately determine suitability for surgery and risks?

And while there’s nothing wrong with working alongside a patient coordinator, Dr. Russo and other experts agree that the medical evaluation and informed consent should come directly from the surgeon and no one else.

What Training Does Your Surgeon Really Have?

Some clinics are staffed by doctors with minimal cosmetic training who may have backgrounds in entirely different specialties. That’s a major concern, says Nashville plastic surgeon Dan Hatef, MD.

“I think it is abhorrent that doctors who are not plastic surgeons are performing plastic surgery procedures,” he says. “I did eight years of completely dedicated plastic surgery training. It is astonishing to me that a physician would do two months of training and think they can offer the most technically involved, complex procedures.”

Board certification matters, Dr. Hatef emphasizes. “If a surgeon is not board certified by the American Board of Plastic Surgery, then they shouldn’t be doing plastic surgery.”

Why “Awake” Surgery Is Not for Everyone

Another trend? Performing major procedures under local anesthesia alone, often to cut costs. “To do a tummy tuck under local anesthesia? I just can’t envision it,” says Dr. Russo. “There’s a limit to how much local anesthetic a patient can safely receive. Too much, and you risk serious complications like vision issues, cardiac problems and even death.”

While general anesthesia isn’t risk-free, experts say it offers greater control and monitoring, especially for longer or more involved surgeries. If your provider isn’t offering safe anesthesia or doesn’t have emergency protocols in place, it’s time to walk away.

Questions Patients Should Be Asking

Even if a treatment sounds trendy or is heavily marketed online, don’t let branding or low pricing cloud your judgment. Patients should make sure they’ll meet their surgeon before surgery and ask what credentials that provider holds. Is the surgeon board-certified by the American Board of Plastic Surgery? What type of anesthesia will be used, and is it appropriate for the procedure being performed? And perhaps most important: What’s the plan if something goes wrong? Does your surgeon have admitting privileges at a local hospital?

Is the surgical facility accredited by a nationally recognized accrediting organization like the American Association for Accreditation of Ambulatory Surgery Facilities (QUAD A), Accreditation Association for Ambulatory Health Care (AAAHC) or The Joint Commission (previously known as JCAHO) to assure safety and sterility?

“Outpatient procedures under IV sedation or general anesthesia should only be performed in Centers for Medicare & Medicaid Services (CMS)-approved accredited surgical facilities, such as QUAD A, AAAHC, Accreditation Commission for Health Care (ACHC) or those with Medicare certification or state licensure,” says New York plastic surgeon Tracy Pfeifer, MD, president of The Aesthetic Society. “Cases performed outside of accredited facilities pose unnecessary risks, and patients should always confirm where their surgery will take place.”

“The doctor should be the one examining you, discussing options and making surgical decisions,” adds Dr. Hatef. “If they’re not, that’s often the level of precision they bring into the operating room.”

You’re Not Bargain Shopping

“Sometimes you get what you pay for,” says Dr. Russo. “If someone’s claiming to be the cheapest on the block, they’re that way for a reason, they’re substituting cost for safety.”

While budget is important, it shouldn’t be the top reason for choosing a surgeon. “Why take the risk?” he asks. “This isn’t a pair of shoes. This is your face, your body, your life.”