We all want to be fiscally responsible, but there are some things that we should not bargain-shop for. Plastic surgery is one such thing.
The conversation surrounding plastic surgery today is a heated one, the negative aspects of it largely fed by images of surgery-obsessed celebrities in the media and demeaning programs like Bridalplasty, where brides-to-be compete against one another with different procedures as the prize, and which seriously transgress against the American Society of Plastic Surgeons’ code of ethics (§2.I.K: “The member participates in a charity raffle, fund raising event, contest or other promotion in which the prize is any procedure”).
Plastic surgery is much more than these images; beyond the cosmetic, plastic surgery assists with the reconstruction of lost or missing tissue and the treatment of congenital malformations. While many may draw a line between acceptable forms of plastic surgery (reconstructive, for instance, over surgeries performed purely for the purpose of enhancement), citing a growing national preoccupation with an impossible beauty ideal as the result of the availability of cosmetic enhancement procedures, the fact remains that many of us will consider at least one of the 9,336,814 plastic procedures available today.
According to the American Society of Plastic Surgeons’ Report of the 2010 Plastic Surgery Statistics, more than 18 million plastic surgery procedures were performed last year. The top five surgical cosmetic procedures were breast augmentation (296,203 performed in 2010), nose jobs (252,261), eyelid surgery (208,764), liposuction (203,106), and tummy tucks (116,352). The top five non-invasive procedures were Botox (5,379,360), soft tissue fillers (Restylane, collagen, fat, etc.; 1,773,328), chemical peel (1,144,865), laser hair removal (937,602), and microdermabrasion (824,706).
I am one of them. I don’t believe striving to look my best makes me shallow. I am a complete, multi-faceted person, a full package -– and my body is a part of that. In the same way that I feel the upkeep of my apartment is a reflection of my mental state, so too is the way I look a reflection of my attitude toward myself -- and in that sense, I don’t see a cosmetic procedure as being that different from a diet or a workout routine.
What does concern me -– as it does with diets and workouts -– is the lack of understanding of the effects procedures may have on the body. It is very important to do research about the procedure you wish to have and educate yourself about potential risks. This is why I am concerned about the incidence of parties where injectibles are made readily available to attendees, where it is easy to get caught up in the moment without taking the time to consider the procedure carefully, or get to know the provider dispensing it.
Credit Image: soundlessfall on Flickr
This is the second most important thing to consider when you’re thinking about any cosmetic procedure: It’s not enough to be well-versed in the procedure, you need to pay attention to who your doctor is, as well. A consultation is excellent, but if you do not know the doctor, it is not a bad idea to ask or browse around to make sure that they regularly achieve good results performing the procedure that you want.
In order to get a few pointers from the other side on what to look for in a doctor, I contacted my surgeon, Dr. Simon Ourian, owner of the cosmetic plastic surgery practice Epione in Beverly Hills, California.
“Plastic surgery is not only technical skill and science,” Ourian told me. “It’s art. Anyone can become educated about products, procedures, treatments and theory –- and many doctors can legally perform many cosmetic procedures –- but in order to be a great cosmetic surgeon, you need an aesthetic understanding of the human body and practice, practice, practice. You need to find someone who achieves a consistent result with the procedure that you want. ”
He warns that often, people interested in cosmetic procedures think with their wallets more often than with their heads.
“It’s natural and smart to think about the financial burden of any procedure,” he said. “But this is risky if the financial concern causes a person to overlook a physician’s experience or track record. Choosing an inexperienced physician could end up costing you more in the long run if the procedure results in damage that needs to be corrected.”
I found Ourian a few years ago through friends whose opinions I trust and who had had similar procedures to the ones I was looking to get. An Internet search can also provide reviews of the work of doctors, but the best bet -- especially if you’re not at all familiar with a physician -- is to check with the American Board of Plastic Surgery, which requires doctors to complete at least five years of residency training, including three years in basic surgery and at least two years specifically in plastic surgery, or other relevant medical boards. Remember when searching through the different boards of medical specialties to check that the doctor you’re going with specializes in the procedure you are interested in getting.
Some states allow nurses, nurse practitioners and physician’s assistants to perform injections and peels, which can shave more than a few dollars off the final cost, but again, it’s better to err on the side of caution.
“A good rule of thumb is to avoid places where you don’t get to meet with the doctor in person,” Ourian told me, warning of the increased risk associated with having injectable and laser procedures done at salons and beauty spas. “In a lot of these cases, you’re better off seeking the expertise of a physician for these procedures.”
Certainly, avoid any place where the provider is reluctant or evasive about whether the product being used is approved by the Food and Drug Administration or won’t show you the manufacturer’s label for any injectable product.
Once you have found a physician, don’t be afraid to ask questions, even if you feel you know everything there is to know about the procedure. Some questions you may not have considered previously include: if there are non-surgical alternatives, if the doctor performs allergy tests, what happens if you are dissatisfied with the result, and who holds financial responsibility should complications arise. You might also consider looking through their catalog of before and after pictures. Remember: When it comes to playing it safe, there is no such thing as too many questions, or even stupid questions.
When I last saw Dr. Ourian, I got my soles injected with dermal filler to ease the strain of constantly wearing stilettos, which I love. Before the procedure, he did an allergy test to ensure I wouldn’t experience any negative reaction.
“A lot of doctors don’t do an allergy test,” he told me. “However, I believe it is better to be cautious, especially if a patient has never done a particular procedure. I can’t speak for other doctors, but I am a big believer of testing in as many different ways as we can to ensure best prediction for a favorable result. I developed a technique a few years ago that fortunately many doctors have found useful and now provide as a sort of ‘dressed rehearsal’ for their patients. An analgesic hypo-saline solution is injected underneath the skin in much the same fashion as one would do with any dermal filler. The results appear very similar to the injection of Restylane, Radiesse or Juvederm, so a patient can evaluate it before they make their decision. If they like the results, I can do the same exact procedure with the desired filler. But if they don’t like the results -- no harm is done, the hypo-saline solution is absorbed by the body in few hours.”
Because I was concerned about how practices can sometimes exploit people’s desire to save money, I asked whether Epione ever offered any discounts.
“For some of the less invasive procedures where the risks are relatively low, and the benefits can be used by almost anyone -- such as laser hair removal and facials -- we offer introductory offers,” he told me. “This way, patients can come and see the services we provide at a very minimal risk to their health and wallet. Hopefully, having seen how we do things, they will either consider us in the future for other procedures or will remember us if their friends ask for a recommendation. We also have a patient loyalty program for people who come back for other procedures.”
The bottom line when it comes to any kind of cosmetic procedure is to consider your health first, and then consider your finances. It’s best to wait until you can afford a procedure than shop for a bargain and thus risk the appearance you’re trying to enhance, or worse -– your health.
Once you have found the right doctor and are confident about the procedure, then you can sit down and analyze whether you are financially prepared to make that step. Most cosmetic procedures are not covered by insurance, so if you do not have the available funds, you will have to look into alternative financing methods. The most common of these are unsecured personal loans, which often involve higher interest rates, since they require no collateral. These loans can be harder to get than home equity loans; if you find that you qualify, check the interest. If you have lower rate on a credit card, as scary as that sounds, it may be the far more sensible option.
Many practices do often offer payment plans as well, although many of these tend to be more like unsecured personal loans than anything else. Look closely into them before deciding, especially their interest rates, and make sure you discuss what your payments will be.
There are more options, of course, among them borrowing against your 401k, accessing funds in your Roth IRA, and taking out a home equity loan. You might also consider checking if the practice offers monthly pre-payment plans, where the procedure occurs only after you have paid the full sum -– or, you know, consider saving up before actually going in!
Before you get too ahead of yourself, take a close look at the total cost of a procedure -– plastic surgery is more than the physician’s fee! -– and take note of all associated expenses, such as operating room costs, anesthesia, before and after hospital care, medication, and possible additional testing or follow-ups.
Armed with this information, if you are still considering on doing this through a loan, sit down and think about how long it will take you to pay it off with the income you have. Do you have enough money coming in every month to handle the payments and take care of other bills and necessities? Will you be able to save for your future as you make these payments? If you should lose your job in the next few months, do you have enough saved to continue paying your debt? How much smaller is the safety net if you do the math without taking into account the money you’d receive from unemployment?
Surgery is serious business on all fronts. Doing your homework goes a long way.
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