Questions to ask your plastic surgeon
The decision to have elective cosmetic surgery should not be taken lightly so there are many questions to ask your plastic surgeon to ensure your results. Patients who undergo cosmetic procedures successfully are very happy and grateful. However, less than satisfactory results and complications can occur. Even the most famous and experienced plastic surgeons have complications. However, as a patient, you want to minimize the chance of having a poor result. One fact always holds true: the first time the procedure is done is your best chance at having a great result. If the procedure is not done correctly, with careful planning and with allowing an adequate amount of time for the procedure, it will not look as good as it might have. It is often difficult to correct a poorly done job. The surgeon trying to fix a problem now has to deal with incisions and scars that are present from the first surgery and with tissue or nerves that have been moved, stretched, or injured in ways that are not reversible. As a patient you are now forced to have a second or third surgery with subsequent discomfort, loss of time from work, unnecessary exposure to anesthesia, and emotional suffering because your appearance is not what you expected or hoped for.
Unfortunately, many patients shop for plastic surgeons the way they shop for clothes. They go where the bargains are and not necessarily where the quality is. Many patients don’t understand exactly who they are going to see and what sort of care they will have. Their only concern is the cost of the surgery, not who is doing it or where it will be done.
The following is a list of questions you should ask your surgeon and the center or hospital where the surgery is being performed. If you do not like the answers you get, walk away. The low price you are being quoted will be much higher if you need to have more surgery. If your result is less than what you expected, the few dollars you may have saved by going to the “best deal” will not be worth it to you.
1.- Is the surgeon a fully trained plastic surgeon?
In order to become a plastic surgeon, a physician must complete 4 years of medical school, at least 3 years of a general surgery residency, and at least 2 years of a plastic surgery residency. Fellowships are often done for additional training. All of these must be done at fully accredited programs.
Dr. Wigoda graduated from the Baylor College of Medicine, one of the top medical schools in the U.S.. He trained at the most rigorous and respected plastic surgery program in the U.S., at the University of Texas Southwestern Medical Center. Dr. Wigoda completed a fellowship at the University of Utah, one of the leading hospitals in the U.S.
2.- Is the plastic surgeon board certified by the American Board of Plastic Surgery?
In order to become board certified, the plastic surgeon must meet the requirements in question 1 and then pass a written exam. After being in practice for approximately 1 year, the plastic surgeon then must pass a 3 day oral exam given by many of the national leaders of plastic surgery around the country. This is the only board that is important for a plastic surgeon. There are boards which may use the words "Cosmetic Surgery" or "Facial Plastic Surgery". These are not the same thing and should not be given the same weight as the American Board of Plastic Surgery.
Dr. Wigoda is certified by the American Board of Plastic Surgery.
3.- What type of residency program did your surgeon graduate from?
Unfortunately, any physician can claim to be a cosmetic surgeon. The physician may not even be trained as a surgeon at all. However, if he has a medical degree, he is legally able to perform surgery and claim to be a cosmetic surgeon. The physician may be board certified in their specialty and advertise themselves as a board certified cosmetic surgeon or a "specialist" in cosmetic surgery. (As opposed to a board certified plastic surgeon.) There are physicians trained as gynecologists, ear, nose and throat (otolaryngologists) doctors, dermatologists, oral surgeons, and general surgeons who claim to be cosmetic surgeons.
4.- Where is the surgery being performed? Have there been any serious complications at the surgery site?
In Florida, there has been a lot of publicity regarding serious injuries or deaths occurring from plastic surgery in physicians offices or outpatient centers. You should ask if there have been any problems in the center you are going to. There are some well known cosmetic surgery centers in South Florida where more than one death has occurred. Patients may not realize that the cosmetic surgery centers are businesses often owned, not by physicians, but by businessmen. Their interest is in making the most money, not in ensuring safety for the patient. Owners may cut corners when it comes to your safety if it means greater profits for them. Your doctor may not have much of a say when it comes to your safety.
Dr. Wigoda performs surgeries that require general anesthesia in his office only with board certified anesthesiologists from Holy Cross Hospital. All required safety equipment is readily available. In addition, Dr. Wigoda is certified by the American Heart Association in both basic life support and Advanced Cardiac Life Support. If patients request surgery in the hospital, they are able to choose from numerous hospitals in the Fort Lauderdale area. At the Aesthetics Institute, patient safety is a priority.
5.- Does your surgeon work for himself or is he employed by a cosmetic surgery center? What percentage does the surgeon get of the fee you are paying?
There are cosmetic surgery centers in South Florida that are owned by non-physicians. The owners hire plastic surgeons who need extra work to make ends meet or who rely solely on the center to obtain patients for them. As an employee, the physician often has little control over the schedule, over safety measures, quality control, etc. The surgeon is often paid as little as 20% of the surgery fee. As a result, the surgeon needs to do many surgeries to make a reasonable salary. The more surgeries a surgeon has to do in a day, especially when he is not getting paid very much for each surgery, the less likely he is to spend the amount of time it takes to do an exceptional job. Surgery may be rushed and results compromised. The surgeon's interest in you and any problem you may have after surgery may also be minimal. Dr. Wigoda is self employed and owns the Aesthetics Institute. He makes all the decisions regarding the care of his patients. Since completing his training, Dr. Wigoda has never worked for anyone else, even at the start of his practice, when he was actively recruited by more than one cosmetic surgery center owner. He was not willing to compromise his integrity and independence.
6.- Does your surgeon have staff privileges at a local hospital or only a transfer agreement?
Most licensed physicians have staff privileges at a minimum of one local hospital. If they do not, you should ask why. One possible reason is that their privileges were revoked. If they have a transfer agreement, that means that they can transfer you to that hospital if there is an emergency. A different physician will be called to care for you. Your surgeon will have no say in your care.
Dr. Wigoda currently has staff privileges at three area hospitals and has been Chief of Plastic Surgery at Broward Health since 2011.
7.- How many cases does your surgeon plan to do on the day of your surgery?
Surgery requires patience, concentration, and stamina. It is not something that should be rushed because other obligations need to be met or because the day's schedule is very busy. When Dr. Wigoda performs surgery, the patient undergoing surgery is his only responsibility at that time. Dr. Wigoda limits his surgeries on any given day so that he can give each patient the attention they deserve and expect. A surgeon who has many surgeries to do in one day may not give you the attention he should. Surgeons working for a cosmetic surgery center are often asked to do as many as 4 to 6 cases in one day. Do you want your surgery performed by a surgeon who is anxious to get finished because he has many more cases to go, or with a surgeon who is tired because he is now on his fourth or fifth surgery of the day?
8.-Are you feeling pressured to sign up? Do the prices keep going down as you are waiting to make a decision?
Some centers feel the need to pressure patients into having their surgery. They do not want them to shop around for fear they may learn something the center does not want them to know. They actually hire salespeople, not people experienced and educated about plastic surgery, to talk to patients about plastic surgery. The salespeople are paid partly or wholly on commission. Their job is not to give you the best advice, but to get you to sign on the dotted line.
At the Aesthetics Institute, we make it a priority to educate our patients on their procedure and give each patient all options available to them. Our patient care coordinator is not paid on commission or with bonuses based on "sales". We encourage patients to get a few opinions so that they can make the most informed decision.
9.- Are you choosing a surgeon or a center?
When you call to schedule an appointment for a consultation, are you told which surgeon you will see? Cosmetic Centers may assign you to a surgeon, not based on who is the most qualified for your particular need, but based on who is available. At the Aesthetics Institute, you will be seen by Dr. Wigoda and, if you decide to have surgery, it will be performed by Dr. Wigoda
10.-Does your center use surgical assistants to complete part of the procedure?
Centers that are very busy and need to finish your surgery quickly, often employ surgical assistants to help the surgeon do the surgery. These assistants may be unlicensed physicians or other technicians trained to some extent in surgery. The center will not admit that anyone besides the primary surgeon is doing the surgery. However, does it make sense that one surgeon is able to do that many cases day in and day out? Dr. Wigoda limits the number of surgeries done each day and performs the entire procedure.
11.- Has your surgeon or center ever been successfully sued?
Unfortunately, we live in a litigious society. Plastic surgery is not an exact science and even when everything goes as well as expected, patients may be disappointed. The fact that a doctor has been sued, settled a case, or lost a case, does not necessarily mean the doctor was at fault. However, multiple lawsuits or settlements should raise a red flag. Dr. Wigoda has never been sued, has never settled a case, or had any form of judgment made against him. At the Aesthetics Institute, we perform surgery only on those patients that are good candidates for the surgery, and we educate the patient so that expectations are reasonable. We take the time to answer all questions so that there are no surprises.
12.- Has your surgeon ever been disciplined by the Board of Medicine or had his license suspended?
Your surgeon is unlikely to tell you if he has been in trouble with the Board of Medicine. You may be able to find some information on your surgeon yourself by going on the internet tohttp://ww2.doh.state.fl.us/IRM00PRAES/PRASLIST.ASP