...this is an art
Which does mend nature,
change it rather...
(Winter's Tale,IV,iv)

Shakespeare could have been writing about plastic surgery. It, above all other surgical specialties, is an art form. The artist or plastic surgeon must possess the training and the innate skill to accomplish his work.

The single most important factor in the success of plastic surgery is the Plastic Surgeon you select. The combination of training and judgment that he brings to your case, strongly affects its results.

Today, many doctors claim to practise plastic surgery, but not all have the same degree of plastic surgery training. Plastic surgery should not be defined by parts of the body. Rather, it involves a thorough knowledge of the whole body, skin and underlying tissues along with their separate and/or combined healing processes. Plastic surgeons perform cosmetic surgery to improve the appearance of facial, breast and body features. They perform reconstructive surgery to restore the form and function that has been lost through disease, accident or birth defect.

Cosmetic surgery is elective; therefore, you have time to carefully choose your Plastic Surgeon. The first step is to locate and arrange a series of consultations with prospective surgeons. Following this, after appropriate evaluation, you choose your Plastic Surgeon.

How do you find a Plastic Surgeon in Ontario? First and foremost, consult your family physician. If you have confidence in your family doctor, you will have confidence in the surgeon he/she recommends. Friends, relatives or others who have had successful surgery may guide you. Contacting the Canadian Society for Aesthetic (Cosmetic) Plastic Surgery (http://www.csaps.ca or 1-800-263-4429) or the Ontario College of Physicians & Surgeons (http://www.cpso.on.ca or 1-416-961-1711) will provide you with a list of local certified Plastic Surgeons. Finally, the telephone book lists surgeons, but their credentials may be difficult to decipher without explanation.

International patients can find a local Cosmetic Plastic Surgeon by visiting the website of the International Society of Aesthetic Plastic Surgery (http://www.isaps.org)

How do you choose your surgeon? After you have chosen two or three potential doctors, book your consultations. You then must determine that he/she is a real Plastic Surgeon, who is capable through training and aesthetic judgment to treat your problem.

Do not be afraid to ask about a doctor's training and experience. A certified Plastic Surgeon has had to achieve the highest professional standards after completing a post-doctoral residency program as well as the passing of written and oral examinations. The Royal College of Physicians and Surgeons and the American Board of Plastic Surgery certify Plastic Surgeons. Ask to see these diplomas. A real Plastic Surgeon will be pleased to review his/her credentials.

The consultation allows the patient and doctor to assess each other. The surgeon should complete a thorough history and physical examination. Then, various procedures along with both risks as well as benefits should be discussed. No surgery is without risk. Potential complications, their frequency and treatment, should be mentioned.

Details of the proposed surgery, such as location (surgicentre or hospital), type of anesthesia (local, local with sedation or general), convalescence and follow-up must be discussed. Many surgeons have detailed pamphlets that answer these questions.

Ask to see some of the surgeon's results. Photos of average and excellent results allow you to gauge his norm and the level he strives to achieve. The photos are no guarantee as to how you will look. Likewise, beware of the computerized before and after pictures. This new toy is only a means of communication. The actual results of surgery depend on many factors. Some of these, such as healing, are not completely controllable.

Many surgeons have patients that are more than pleased to talk to others about their procedures. Ask for the names of some recent and long term patients. These patients should not sell you surgery. Find out what they did not like.

Beware - the doctor who pressures you to agree to surgery, the doctor who is cavalier about the recovery period, the doctor who says that there will be no scars, the doctor/businessman who will give you a "deal", the doctor who guarantees the result and the doctor who suggests that surgery will change your life ( for example - "55 minutes can change your life forever" - the change may not be positive!)

After you have seen a number of doctors, you will start to get a feeling about who is the right one for you. There is no consumers' guide when it comes to choosing a surgeon. You are your own guide, and through a process of self-education and elimination you will be able to decide which Plastic Surgeon will be your doctor.

The final step is to make a second appointment with the Plastic Surgeon of choice. At this time, in a relaxed fashion, questions can be answered, an informed consent reviewed and specific plans organized.

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