plastic surgery consultation

Make the Most of Your Plastic Surgery Consultation

January 29, 2016

Congratulations on taking control of your life, and choosing to live healthy. This was a difficult path and a great accomplishment that you completed. Be proud!

After massive weight loss (MWL), many patients do not feel satisfied. Despite obvious improvements in health, BMI, and appearance, many patients feel they are still “fat”. For many, it is not until the excess skin and fat is removed that they feel “normal” or attractive. Fulfillment for these patients can only be accomplished with the assistance of a plastic surgeon.

A consultation with a plastic surgeon may be one of the most daunting propositions for the MWL patient. Perhaps no other surgical specialty has garnered more attention in recent years than plastic surgery. Reality shows, on the one hand, have brought to the masses what might be possible through plastic surgery. On the other hand, they have emphasized physical beauty and perfection that may not be possible in the real world. Some of the “TV doctors” are larger than life and intimidating. To be fair, these doctors don’t represent the specialty .

To make matters even more intimidating, it takes real courage to even make an appointment with a plastic surgeon when one considers that the consultation must include a discussion and physical examination of your greatest insecurities!

Nobody can predict the future or control a relationship, however, simple steps can be taken to ensure that your visit(s) with the plastic surgeon will meet your needs while securing your maximum comfort. By doing some homework in advance, you will understand the process and be empowered to partner with the plastic surgeon who best suits your needs. Getting what you need is actually easier than you may think, and you already have the basic tools.

Although it may seem obvious, it must be said that without you, there can be no “doctor patient relationship”. Additionally, cosmetic rehabilitation after massive weight loss is a “want” rather than a “need”. Keeping these things in mind at all times gives you great power because you get to decide what you want, when you want it, where you want it done, who you want to do it, etc. With great power comes great responsibility, and that means that you must do your homework and be a good partner to your plastic surgeon.

What to Expect at Your Plastic Surgery Consultation

You should expect:

  • To be listened to
  • To be taken seriously
  • To be treated respectfully
  • To have your confidentiality respected

The very first step is simply introspection. MWL patients generally present with surprisingly few areas of concern.  The areas/treatments most commonly discussed in no particular order are:

Jowls/NeckFacelift, Neck Lift
Upper ArmsBrachioplasty
BreastsBreast Lift, Breast Reduction, Breast Augmentation
AbdomenPanniculectomy, Tummy Tuck, Lipo
Inner/Outer ThighsMedial/Lateral Thigh Lift, Liposuction
Back/Buttocks360, Body Lift, Back Lift, Belt Lipectomy

These procedures can be lumped into a subspecialty of plastic surgery called cosmetic rehabilitation of the MWL, and they should be performed by a very experienced board certified plastic surgeon committed to the unique needs of the MWL population.

Take a personal inventory of what you like about yourself (don’t forget this important step, you earned bragging rights!), what you don’t like about yourself, and what your goals are.   Understand also that with change comes a cost in terms of risk, recovery, scars, and of course, money.   Balance your goals with what you are willing to accept to achieve them.

Preparation for Your Plastic Surgery Consultation

  • What areas bother you; make a list
  • Arrange the list most important to least important
  • Understand how the areas bother you, and what will change after surgery
  • Remember to enlist support from your significant other, and find out your plans may affect your relationship
  • Compile a list of questions and bring to the interview
  • Be prepared to articulate this to the doctor

Armed with this information, it is time to research candidate plastic surgeons. An excellent starting point is simply inquiring of people who have had the procedure(s) you are interested in. Web sites like ObesityHelp's Plastic Surgery Forum are excellent for making contacts. Be sure to seek information on plastic surgeons near you to help narrow your search. Get as much information about distant plastic surgeons as well because this may prove to be an invaluable source of additional information.

Be sure to go to each doctor’s website and focus on the pages that describe the doctor’s training, the mission statement of the practice, and the practice philosophy. If you have particular personal needs, these important sections of the web site may give you an idea if this doctor will be a good fit for you.

Look critically at the photo section. Be sure that the post-op results are due to surgery, and not photographic manipulation. Be aware that different lighting, shadows, magnifications, “air brushing”, etc. will produce artificially good results, and raise concerns about honesty and character of the site. Aside from that, look carefully at the results compared to pre-op. Pick the doctors with the results that you like best.

Do Your Homework

  • Consider only board certified plastic surgeons (see links and suggestions at end)
  • Although some non-plastic surgeons are trying their hands at cosmetic surgery, it is always best to use fully trained, certified, and committed plastic surgeons for all plastic surgery procedures
  • Use all resources to get as much information as possible-OH input, patient review sites, the doctor’s web site including photos, mission statement, your overall impressions
  • Schedule visits with at least three board certified plastic surgeons. If unsure after the visits, plan for a follow-up visit, or find a fourth
  • Ask the doctor to have his post op patients call you (expect only to hear from happy patients however)

Once you have decided upon a plastic surgeon, and are ready to move forward with your procedure, schedule your next visit. Your plastic surgeon will listen to you and work with you to establish a reasonable plan to help you achieve your goals with minimum risk.   When your plastic surgeon talks to you about realistic risks, benefits, alternatives, and expectations, really listen so that you understand the outcome that you can expect. Make sure that you understand the commitments you must make for a safe preparation and recovery!

Understand the Limits of What is Possible and What is Likely

  • Understand that different bariatric surgery procedures make some procedures more risky than others
  • Understand that cosmetic surgery after massive weight loss tends to be physically and emotionally demanding, and you may not be a good candidate for every procedure or multiple procedures at once

Remember, plastic surgery is not magic. “Reality plastic surgery TV” is not your reality. You are an individual with unique physical characteristics and potentials. Work with your plastic surgeon to establish realistic goals/expectations with safety as a primary concern. If you cannot agree, do not have the surgery with that particular surgeon.

If you do your homework, you will find that you will be able to confidently communicate and partner with a plastic surgeon that should be able to meet your physical and emotional needs while accomplishing your goals. This should be one of the most exciting and happy doctor visits you ever have, and you now have the power to make that happen.

This is not the end of the journey; it is only the end of the very beginning!

Helpful links: (American Society of Plastic Surgeons) (American Board of Plastic Surgery)     (American Board of Medical Specialties-check to be sure that the “Board Certification” is officially recognized) (The American Society for Aesthetic Plastic Surgery)

Don’t forget to check any local, county, and state medical society web sites in your area.



Scott Kasden, MD, FACS, became certified by The American Board of Plastic Surgery, and was honored to be admitted into many societies such as The American Society of Plastic Surgery, The American Society for Aesthetic Plastic Surgery, and The American Society for Metabolic and Bariatric Surgery. Currently, Dr. Kasden has two professional passions: Cosmetic surgery, and cosmetic rehabilitation of massive weight loss patients.

Read more articles by Dr. Kasden!