How To Choose The Right Plastic Surgeon

When Gia Garcha, 29, was thinking about getting a nose job, she knew who she wanted to go to: a surgeon she’d seen on YouTube years before. “Since I heard of him a few times, I felt more comfortable to go in for a consultation with him,” she says.

But two years after the surgery, she’s up-front about her regrets, starting with the doctor. “I only got to talk to my surgeon for about 15 minutes,” she says. “He wasn’t very friendly and didn’t seem like he wanted to answer my questions — but I brushed it off as him being a busy surgeon.” While he assured Garcha that he could do everything she requested, like give her nose a sloped shape and upward-turned tip, she didn’t end up getting that. In fact, the nose she now has doesn’t look like the example he’d shown her at all.

This experience isn’t uncommon — after all, research puts the revision rate of rhinoplasty as high as 15%. It’s also indicative of how important it can be to choose the right provider for your plastic surgery procedure, whether you’re going for a deep plane facelift or considering buccal fat removal. However, making that decision isn’t quite as easy as reading reviews and checking that they’re board-certified (although both can be critical).

Instead, the proper vetting ahead of time and the right communication during your consultation(s) requires a little more legwork. “It's really a combination of things like the before-and-after photos, the testimonials, the surgeon's training, what their pedigree is, where they were trained, and how much experience they have,” says Dr. Sarmela Sunder, M.D., a double-board-certified facial plastic surgeon based in Los Angeles. With that, scroll ahead for what you should know.

Where To Start

So, you’ve decided you want to get plastic surgery. Consider this your starting point for finding the surgeons worth vetting and meeting.

1. Ask your network for referrals

If you’re comfortable with it, ask around. Nothing beats friends, family, and friends of friends who you can connect with about their experiences, says Dr. Dara Liotta, M.D., a double-board-certified facial plastic surgeon in New York City, who’s often referred to as the “nose job queen.” “When you get a recommendation from a real patient, you can see the results in person, and you can ask questions and get a feel for their experience through the process with a particular doctor,” she says.

Don’t know anyone who’s gotten plastic surgery, or not comfortable asking? Another good source is another medical professional — be they the derm who does your annual skin check or your primary care provider. “Doctors generally recommend surgeons whom they know have excellent training, an excellent reputation, and from whom they have seen good results,” Liotta says. “As a doctor myself, I know that my recommendation also reflects on me, so I only recommend other professionals that I feel confident in.”

2. Check out board-certification organizations

If you haven’t gotten any names from your community, you can also look for a surgeon via the respective medical board, which is a fast track to finding a physician who’s board-certified. This is the most important piece of the puzzle; even if your best friend raved about her surgeon, if they’re not board-certified, consider that a red flag. That’s because board certification means that they need to have completed a residency training program as well as a certain number of in-specialty procedures and passed a rigorous board examination, according to Dr. Theda Kontis, M.D., a board-certified facial plastic surgeon and the president-elect of the American Board of Facial Plastic and Reconstructive Surgery.

And, even if the provider says they’re board-certified, you should still verify that on the medical board’s website. For instance, you can look up plastic surgeons on the American Society of Plastic Surgeons website; the same goes for facial plastic surgeons on the American Board of Facial Plastic and Reconstructive Surgery website.

Looking closely at their exact title is important, too. “There are many confusing terms out there, and one is the use of ‘cosmetic’ surgeons,” says Kontis. “If someone advertises as a cosmetic surgeon, people should research exactly what field their training was in.” For instance, someone may bill themselves as a cosmetic surgeon, but may actually be a dermatologist — which means they may not have the training for plastic surgery.

To that end, this is where taking a close look at the board itself is integral. For instance, “there's a difference between certification by the American Board of Plastic Surgery and the American Board of Cosmetic Surgery,” says Melinda Farina, founder of the aesthetics consulting firm Beauty Brokers. Namely: You don't have to be a surgeon with dedicated plastic surgery training to become board-certified in cosmetic surgery (versus plastic surgery). One study found that internists, OB-GYNs, dermatologists, and even oral surgeons were using this accreditation — but with far fewer years of training, fewer procedures under their belt, and no requirements for continuing medical education compared to board-certified plastic surgeons.

How To Find A Reputable Plastic Surgeon

Once you’ve got names in hand, it’s time to do research — think reading reviews, looking at before-and-after pics, and scrolling through their social media. Again, it’s a combination of these things that can give you some insight into a given surgeon, along with their board certification and the consultation.

Read reviews with caution

Online reviews can be a helpful tool for getting a sense of the surgeon’s skill, but keep in mind that they’re not always an honest reflection of their work. “For example, some surgeons offer patients small incentives to post reviews of their experiences, which may bias their online reviews toward the positive,” says Liotta. “Conversely, plastic surgery is an expensive and emotional process, and it’s possible that patients who feel they haven't had a perfect experience in some aspect of the process may be more likely to post negative reviews.”

Ultimately, you want to see some variety in the reviews. “If someone has good and bad reviews, it is likely to be more ‘real,’” says Kontis. If someone has a five-star rating with zero complaints, then approach it with a healthy dose of skepticism.

Approach before-and-after photos carefully

Before-and-after photos can be helpful to get a sense of what you might want and what a surgeon can do. And they’re a good thing, since they can indicate the number of patients they have (and therefore the number of procedures they do), as well as give you a sense of their aesthetic. “In general, surgeons want to post what they think is a beautiful result,” says Liotta.

But they do come with caveats. Both Sunder and Farina agree that it’s critical to look for cases that mirror your own, whether in terms of skin tone, nose shape, body type, or whatever your target feature might be. “A lot of people get caught up on how dramatic the difference is,” says Sunder. “They're looking at people that don't look like them in the before photo. It doesn't make sense to pick a surgeon based on that.”

Plus, there’s the possibility that what you’re looking at could be altered. “Unfortunately, nowadays, there's a lot of dishonesty out there,” says Sunder. Another more common issue is that the photos aren’t comparing apples to apples — for instance, the lighting and resolution might be different in a way that makes the after photos look much better. When you’re looking, they “should be standardized photos taken in the doctor’s office with consistent lighting and a regular, old-fashioned camera,” says Liotta. (In other words, iPhone selfies don’t count.)

And again, remember that you’re not seeing the whole picture of a surgeon’s work. After all, “no surgeon puts up their worst before-and-after,” says Sunder.

Scroll social media, but be strategic

A slick IG account can make a surgeon seem top-notch, but social media can be important for entirely different reasons. For one, it can add an element of feedback that might not be available on reviews on sites like ZocDoc and Healthgrades. Garcha, for her part, wishes she had done more digging on her surgeon beyond Google reviews. “I found out so many negative things about my surgeon after the fact [on social media],” she says. (On one TikTok she posted of her experience, other commenters chimed in with their own dissatisfaction with her surgeon. "I literally had the identical experience," said one. Another called him “the WORST” surgeon, adding "I wish I never went to him.")

Social media can also help in the sense that “it may help you get a feel for a surgeon’s area of expertise and for their own personal aesthetic,” says Liotta. “Surgeons who are busy with a particular type of surgery and who post lots of standardized before-and-after photos of that procedure are more likely to have a greater experience with that procedure than surgeons who don’t have photos to show.”

Plus, keep in mind that not every patient will give permission to share photos. For Liotta, who specializes in rhinoplasty, only 5% of her patients give their consent for her to post their before-and-after shots online. “So, if you see a surgeon with hundreds of before and after photos online, they’re clearly a busy surgeon in that particular procedure,” she says. (Though it’s a fine line — if the surgeon seems to be too active on social media as an “influencer,” as in the case of Dr. Roxy, that could be a red flag.)

How To Prep For The Consultation

Once it’s time for your consultations (note the plural), be prepared with questions and on alert for red flags. Some of the more under-the-radar considerations, like how you can get in touch with support staff, can be critical in the post-operative period and make or break both your results and how happy you are with the experience.

1. Put more than one consultation on the calendar

First, you should have multiple consultations booked. Most reputable surgeons will actually encourage second and third opinions. “If someone comes to me for a consultation, I always ask, ‘Have you seen other people?’” says Sunder. “If not, I do encourage them to get at least one or two more consultations because you want to know the variety of options available to you.”

This is standard protocol, says Kontis. Plus, on top of knowing all of your options, “having more than one visit with the surgeon can also help answer questions and allay fears,” she says.

One sticking point for Garcha, who only had one consultation, was that each typically came for a fee (around $100). In retrospect, though, she thinks it would have been a worthwhile investment. “Pay the fee and find the doctor that feels right and that you trust,” she says. “At the end of the day, you have to live with this for the rest of your life.”

2. Have your questions ready

Communication is key for both the surgeon and the patient, says Liotta. “A good surgeon who cares about their patients wants to accurately understand your goals, and communicate the process and what is possible given their experience and your anatomy,” she says. “The more you can communicate with us, the better we can understand the type of result that will make you happy — and the better we can advise you so that it’s a positive experience for both patient and surgeon.”

To that end, you should be given more than enough time to express any fears, goals, and apprehensions you might have around your surgery. “No question should be off-limits,” says Liotta. After all, plastic surgery is permanent, and comes with side effects and risks just like any other medical procedure — so it’s imperative that you feel really comfortable with it. “It’s very intimidating to speak to surgeons who do this on a daily basis but it’s OK to take up their time — you are literally paying for it,” adds Garcha.

In addition to your own questions, consider asking these during your consultation:

• What do you foresee will be the most challenging part of my procedure? Sunder knows that while a patient’s case may seem easy or straightforward, certain things might take more time or may require a change in her technique. Not only is it helpful for you to know in general, but “listening to the response is really important — because unfortunately, there are a lot of surgeons who are quite cocky and feel like, ‘Oh, why is the patient asking me about the technique? I’m the surgeon,’” she says. “Obviously, the surgeon's going to know a lot more than the patient, but their response tells you a little bit about their attitude toward you in that patient-surgeon relationship.”
• What steps do you have in place if there's a complication or unsatisfactory result? This isn't as much about the direct answer so much as how the surgeon approaches you as a patient, says Sunder. "Every single surgeon has a complication, and if they haven't had a complication, they haven't been operating long enough," she says — or they’re not being truthful. It ultimately signals whether your surgeon views your relationship as a partnership versus a one-sided transaction.
• How often do you perform this procedure? More experience often yields better results. "A surgeon who does a particular procedure multiple times per week will be more adept at it than someone who only does it once or twice per month or less," says Liotta.
• What’s the after-care like, and who will be involved? Plastic surgery procedures usually come with downtime and an extended recovery period that can last weeks or months. For that reason, you should know exactly what to expect during the healing process. “You'd be surprised how many surgeons just completely abandon a patient post-surgery, or they see them once and then dismiss the patient's concerns or questions,” says Farina. On that note, you should know what staff will help handle your care. “In the early post-operative period, it's the nurses that you're going to see a lot of, so make sure that you feel comfortable with them,” says Sunder.
• How can I get in touch with you or your staff after surgery? If you’ve ever called a doctor only to be sent through a tangle of different, automated prompts, you’re not alone — and you definitely don’t want to deal with that if you’re one week out from a brow lift. Ideally, the surgeon should have a patient-care coordinator or someone responsible for checking in, scheduling follow-up appointments, and fielding questions. “Make sure that you have easy access to those people,” says Sunder, who considers a complicated communication system a huge red flag. “If you don't have good and easy access to those people before surgery, then after surgery — when you're really going to need it — that's going to be problematic.“

3. Consider your surgeon as a person

Sure, you’re paying for a procedure — but you should still like your surgeon. “You can get the best aesthetic result, but if you feel like you weren't heard and you weren't taken care of in the process, or if you were dismissed in the process, your overall result is going to be tainted by that,” says Sunder. That’s a major red flag that Garcha ignored in her own consultation despite her initial misgivings.

With that, your surgeon shouldn’t pressure you to book a surgery — ever. “If you feel pushed to procedures you don't want, or don't feel you have good rapport with the doctor, you should not proceed,” says Kontis. She also adds that you don’t owe a surgeon an explanation for not scheduling a procedure after an initial consultation.

Bottom line? Choosing a good surgeon doesn’t mean going with someone who promises you’ll have no complications, or opting for the doctor with hundreds of thousands of TikTok followers. It means that you’re putting your face and body in the hands of someone who’s transparent, qualified, and experienced — and a doctor who values you as a unique patient. As Garcha puts it: “A surgeon who is able to say ‘No, I cannot do that because of…’ is someone who can give you accurate details on what your nose will look like — and not someone who is feeding you a fake dream.”

Experts:

Dr. Sarmela Sunder, M.D., double-board-certified facial plastic surgeon based in Los Angeles

Dr. Dara Liotta, M.D., double-board-certified facial plastic surgeon in New York City

Dr. Theda Kontis, M.D., board-certified facial plastic surgeon and the president-elect of the American Board of Facial Plastic and Reconstructive Surgery

Melinda Farina, founder of the aesthetics consulting firm Beauty Brokers