Patient Satisfaction
January 26th, 2010
What cosmetic surgeries rated highest in patient satisfaction?
RealSelf.com has published a list of cosmetic procedures ranked on whether patients think having a particular procedure was worth it, based on patients answering their survey question, Was your cosmetic surgery or treatment worth it?
While the ranking of patient satisfaction for various cosmetic surgery procedures is debatable, I find that there are definitely favorites. For my own practice, breast enlargement and liposuction patients seem to be quite pleased with their decision to have cosmetic surgery. The survey came up with different conclusions. Maybe the ranking by RealSelf.com merely represents overall patient satisfaction, without taking into account the quality or training of the physician or technician performing the surgery or treatment.
According to the survey, the top two procedures, tummy tucks and breast reductions are rated at the top. They are almost always done by board certified plastic surgeons. The bottom two procedures, Veloshape and mesotherapy, are almost never done by board certified plastic surgeons. As you move from top to bottom on this list, the percentage of each procedure done by board certified plastic surgeons becomes less and less. For instance, tumescent liposuction, Smart Lipo, liposculpture, liposuction and Vaser lipo, are all done by board certified plastic surgeons, as well as general surgeons, dermatologists, head and neck surgeons (otorhinolaryngologists), family doctors, and gynecologists. In fact you can probably get some type of liposuction done by any medical or surgical subspecialist. Obviously, the medical training in such a wide spectrum of surgical providers can be extremely variable. The survey overlooked this important factor.
My own bias concludes that training is paramount when choosing a physician. Plastic surgery residency is intensely focused on aesthetics of the body and face and the sculptural aspects of surgery. In addition, the medical students who are most often drawn to a plastic surgery residency have both an aptitude and intense interest in the artistic aspects of surgery. Therefore, I believe that a key factor in patient satisfaction is to understand the qualifications of the person doing your surgery or treatment. However, as with all physicians, plastic surgeons do have dissatisfied patients, a fact of life in the practice of medicine in general. Choose wisely.
Donda West Death Results in New Law
December 10th, 2009
In response to the death of Donda West, Kanye West’s mother, the California State Senate recently approved a requirement that patients must be given a physical exam before elective surgery, according to the Los Angeles Times. The new law, AB 252, passed by an overwhelming margin. The vote was 37 to 1. This new California statute requires a history and physical examination be done prior to any elective cosmetic surgery or cosmetic medicine procedure that is performed in physician offices. The goal, of course, is to reduce the risk of death or serious impairment associated with surgery. Unfortunately the law does not address cosmetic surgery done in dentist offices or surgery related to body modifications carried out in non-medical facilities or surgery done by unqualified personnel.
I have always insisted that my patients have a History and Physical completed by their primary physician before having elective surgery. The most important philosophy guiding most surgeons, in an effort to avoid complications from cosmetic surgery, directly relates to patient safety. Risks are present in all medical procedures and surgical treatments, but certain steps minimize this risk. Yet complications occur and cannot be eliminated entirely. It is important to know that your surgeon has made every effort to reduce the risks and incidence of complications for any cosmetic surgery.
One of the cornerstones making cosmetic surgery safer is the pre-operative History and Physical. This medical evaluation is usually completed in advance of having cosmetic surgery. I require this evaluation to be done within two weeks prior to a patient’s surgery date. It was my practice as I began my career as a surgeon and it is a policy that I have continued for the past twenty-five years. However, I do not do pre-operative history and physicals on my own patients. I prefer that an independent, unbiased physician complete the examination, order necessary laboratory tests and finally interpret the results and confirm that the patient is healthy enough for surgery. I like to think of this division of patient care as an effective tool used to uncover any underlying medical condition that might lessen the safety of having elective surgery.
Whether or not your state requires this extra step, please consider having a pre-operative medical examination before all elective surgery.
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