Reviewed by Varnada Karriem-Norwood on May 17, 2012
Robert Kotler, MD, FACS Cosmetic and Plastic Surgeon of the Face and Neck Clinical instructor, Division of Head & Neck Surgery, UCLA Medical School.
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Robert Kotler, MD: The selection of a surgeon is really a complicated and somewhat daunting process today, for many reasons. First of all, medicine is becoming more and more specialized. There are more and more subdivisions within given specialties, and within those subdivisions, there even further subdivisions, so you have to not only be in the right church, you have to be in the right pew. You want to be in the right place.
Robert Kotler, MD (cont.): Compounding it is the fact that there's a little bit of blurring of specialty lines. One is not prohibited by law from migrating from one's specialty into one of the 4 cosmetic surgery specialties. Basically, there are 4 recognized specialties that perform cosmetic surgery, plastic surgery which is cosmetic surgery all over the body; head and neck surgeons who perform the cosmetic surgery only of the face and neck; dermatologists, who perform skin peeling and other and liposuction and again procedures on the skin, and then ophthalmologists, these are eye specialists who further specialize just in the reconstructive and cosmetic surgery of the eyelids. So you have a lot of different participants in the delivery system, and the question is, how do you pick which one, and that's where you've got to do some homework.
Robert Kotler, MD (cont.): Not every ophthalmologist for example, has had additional training to be an excellent eyelid cosmetic surgeon, and not every dermatologist has had the additional training or experience to be a world class chemical skin peeler to remove wrinkles. Not every plastic surgeon is good at both breast augmentation and nose jobs, which are operations in two different arenas. So you've got to be armed with questions so that you can ferret out who really is most appropriate and the answer comes with how specialized are you doctor?
Robert Kotler, MD (cont.): For example, head and neck surgeon may major in nose jobs and do more nose jobs than say face lifts, or eyelid surgery. On the other hand, across the street is an ophthalmologist that does eyelid surgery exclusively. So if you needed to have an eyelid surgery for example, you'd be very well served by going to that eye surgeon who only does eyelids. Maybe by some of the other doctors, but you'd feel more comfortable being in the hands of the most specialized.
Robert Kotler, MD (cont.): So how do you ascertain that? You ask the doctor's training, and then you ask what I think is probably the key question that most people don't ask. Did you have a fellowship in cosmetic surgery? Fellowships are the finishing school of the world of cosmetic surgery, and by the way, fellowships exist in other specialties. Internists take fellowships to become gastrointestinal specialists because that's all they are going to do.
Robert Kotler, MD: So my advice is to find the doctor that has trained the longest and strongest, meaning that additional training, and that's voluntary, and strong, meaning they are very focused on what they do. The best, most accomplished, most talented surgeons, the ones that you and I would like to go to, typically are the ones that are the most specialized.