How to choose a plastic surgeon.

Board certification — and what it means.

The American Board of Plastic Surgery (ABPS) is the only board recognized by the American Board of Medical Specialties for the certification of plastic surgeons in the United States. ABPS certification requires completion of an accredited plastic surgery residency, a documented surgical case log, and a two-part examination — written and oral — that is repeated for recertification at regular intervals. A surgeon who is “board-certified in plastic surgery” is, in practice, ABPS-certified.

Other boards exist. Some are subspecialty boards within plastic surgery itself (hand, craniofacial). Others use the phrase “board-certified” in branding without the certification being from a recognized medical specialty board. The phrase, on its own, is not enough. The specific board matters, and you can verify any physician’s certification status directly through the ABMS Certification Matters website. Board certification is the floor of the conversation, not the ceiling — it tells you the surgeon is trained, not that the surgeon is right for you or for this procedure.

Before/after work is part of the answer.

A surgeon’s portfolio of before-and-after photographs is not vanity content. It is the most direct evidence available of how that specific surgeon’s hands operate on bodies that resemble yours. When you review the work, look for: the same procedure you are considering, multiple cases (not one or two), bodies with a similar starting anatomy to yours, photographs taken from comparable angles in comparable lighting at clinically meaningful intervals — typically six months or one year post-operative.

Red flags: photographs that show only the most flattering angle; results from only the most photogenic body type; absence of long-term follow-up photographs (most settling happens in the first year); heavy retouching that you can detect on close inspection; and reliance on stock or competitor work. A surgeon worth choosing will show you cases that are honest about anatomy — including some that were genuinely complex — not a curated highlight reel.

The consultation itself is data.

A consultation is not a sales appointment, and it should not feel like one. You are evaluating the surgeon at the same time the surgeon is evaluating your candidacy. Pay attention to the texture of the conversation, not only the content of the answers.

Signs to take seriously: feeling rushed; vague answers to direct questions about technique, risk, or revision rates; pressure to schedule before leaving the office; “today only” pricing or other artificial deadlines; reluctance to provide a written quote; unwillingness to discuss complications or alternatives; dismissiveness toward second opinions. None of these are about bedside manner. They are about how a practice operates, and operating room culture follows from consultation culture more often than the other way around.

Questions worth asking.

The following questions are direct on purpose. A surgeon comfortable in their work will answer them comfortably.

• How many of this specific procedure do you perform per year? Volume is not everything, but it is something. Ask for a number, not a range.
• Where do you have hospital privileges? Hospital privileges are a separate vetting process beyond board certification. A surgeon with privileges at an accredited hospital has been credentialed by that institution’s peer review.
• What is your revision rate for this procedure? No surgeon’s revision rate is zero. A surgeon who claims it is is either misremembering or lying. A reasonable answer is a percentage with context about what counts as a revision.
• What happens if I have a complication after I go home? Who answers the phone after hours? Who sees me if I need to be seen? Is there a fee for post-operative complication management?
• What is your policy if I am not satisfied with the result? Is there a revision policy? Within what window? What is included and what is not?
• Who else will be in the operating room? Anesthesiologist or CRNA? Surgical assistant? Resident or fellow involvement?
• Will you personally perform the entire procedure? A surprisingly important question in some practice settings.

Questions worth asking yourself.

The questions you ask the surgeon are matched, in importance, by the questions you ask yourself before you ever sit down in a consultation room.

• Am I doing this for me? Not for a partner, not for an event, not for a deadline that will arrive whether or not the surgery does. The honest answer is the only one that matters here.
• Can I afford the full cost of the full recovery? Not just the surgical fee — the time off work, the help at home, the medications, the garments, the follow-up appointments, the possibility of a revision down the road.
• What is my support system? Who will be in the house with you for the first week? Who will drive you home, refill prescriptions, manage children or pets, notice if something is wrong? A plan made on paper is not the same as a person who has agreed.
• Am I making this decision on a reasonable timeline? A first consultation is not a place to commit. Sleep on it. The procedure will still be available next month.

A note on second opinions.

Second opinions are encouraged, not threatened. A surgeon who responds to the idea of a second opinion with discouragement, with a tighter discount, or with implied judgment is telling you something useful about how they operate. No surgeon worth choosing is afraid of the patient hearing another voice. The work speaks for itself, and the conversation does too. If a second consultation changes your mind, that is the system working — not a problem.