5. The expense. You don't want this surgery to add to any financial troubles, advises Powell. "If you trade one problem for another, that's not good. You've got to be able to afford it." One man told his wife: "You robbed our children's college funds." Don't go into facial plastic surgery with that hanging over your head.
6. The risks. Like any surgery, there are routine risks associated with anesthesia, blood loss, infections. But cosmetic surgery has specific risks -- there could be some asymmetry, a less-than-desirable outcome, slow healing. Are you prepared to deal with that?
"Just like anything in life, you have to have a little faith and be willing to follow through," Powell tells WebMD. "If you do have some sort of unexpected result, you have to be willing to give it time, be patient, work with your doctor."
Also, remember this: "A lot of problems look like big things at first, and some will go away or heal on their own. But if there is a problem, that's when the doctor-patient relationship needs to be strongest. Some patients you have big relationships with are the ones who had little problems. We had be partners, go through it together."
7. A second surgery. Some 15% to 20% of noses have to be redone, says Powell. "We always tell patients this might not be the only operation you'll have. Sometimes there's a little asymmetry, a little pucker. Some problems have to be fine-tuned. That's when it's important to have a good relationship with your doctor. You have to stick together, and if a revision is needed for the final result, be prepared to go for it."
8. Your vision. Do you have a clear idea of what you want? "We ask patients to bring in noses they like," says Powell. "Also, computer imaging helps; then there won't be miscommunication." But the surgeon may be hesitant to give a guarantee, he adds. "Some things that are possible in computer imaging are not possible in the operating room. The surgeon also has to have realistic expectations."
9. Your surgeon. Have you found one you like and trust? There are three professional associations: The American Society of Plastic Surgeons (the oldest group); the American Academy of Facial Plastic Surgery; and the American Academy of Dermatology (they do smaller procedures like chemical peels, dermabrasion, eyelid surgery.)
Each association can provide names of surgeons in your area.
"Look for experience in the specific procedure and reputation," Powell advises. "Don't believe advertising. Word of mouth from other satisfied patients works best."
Make an appointment for a consultation/interview. Interview two, maybe three surgeons, before you make your decision. Check out the doctor's waiting room. Perhaps there are brochures the surgeon has written. There may be before-and-after pictures. Talk to patients while you're there; ask how things are going. Consider how you feel while talking with the surgeon. Are you comfortable talking with this person? Are you getting candid answers to your questions?