One of the traits that sets humans apart
from other species is our predilection
toward self-improvement. Cosmetic surgery procedures available to enhance
one’s appearance can include facelifts,
breast augmentation, rhinoplasty and lipo-suction.
As the practice of cosmetic surgery has
matured, plastic surgeons have improved
current techniques, forging ahead with
“Cosmetic surgery has undergone a very
substantial and favorable evolution over
the past 30 years,” says Dr. Timothy Miller,
professor and chief of plastic surgery at the
David Geffen School of Medicine at UCLA.
“As our techniques have evolved and
become more refined, the results are
Smart Business spoke with Miller about
what to look for in a plastic surgeon, the
most common forms of cosmetic surgery
and how to prepare for an elective surgery.
How should people decide if cosmetic surgery is the best option for them?
They should talk to a plastic surgeon certified by the American Board of Plastic
Surgery, or perhaps two, to get their opinion on the prospective operation. To me, it
is somewhat worrisome when a patient
comes in and asks, ‘What do you think?’
That places the burden directly on the plastic surgeon. Most plastic surgeons probably wouldn’t answer this question. What
you want to know is the imagery in the
patient’s mind. What does he or she see in
the mirror? What feature does he or she
want improved? It’s like the old adage, if
you aim at nothing you’ll hit it every time.
The plastic surgeon must see what the
patient sees. You want to be sure that the
patient has a relatively specific idea of
what he or she wants to accomplish and
then it’s up to the plastic surgeon to explain
whether or not it can be done.
How should one go about selecting a qualified surgeon?
In any community, surgeons have reputations that are relatively well-known. In
addition, they should be board-certified
plastic surgeons, which means that they
were trained in an accredited training program and they passed a written and oral
exam. That vets out the most highly qualified individuals.
After that, patients need to ask questions
to make a determination of whether or not
the plastic surgeon is someone they can
talk to, someone that they understand and
someone that they feel understands what
they want. The relationship should be comfortable and one of mutual trust.
What are the most common forms of cosmetic surgery?
Statistically, the most common forms
would be liposuction, breast enlargements
and breast reductions, facelifts, and eyelid
surgery. But that is only a statistical breakdown; it really has to do with the age, sex
and desires of the patient. For example,
eyelid surgery to remove excess skin and
fatty tissue is a very good operation for
men because the scarring is quite minimal
and it’s an outpatient procedure. After less
than two weeks the bruising is usually
gone and it provides excellent improvement, not only in appearance, but also how the eyes feel.
What risks are associated with cosmetic surgery and how can these risks be minimized?
The risks are very, very low if patients are
selected appropriately and any serious
medical problem is identified. If a pre-existing medical condition is severe enough, it
should exclude the patient from having
elective surgery. By and large, the risk of
cosmetic surgery is extremely low in competent hands.
Also, the procedure should be done in an
approved center so that the patient can be
evaluated before surgery and is monitored
very closely during surgery and in the
How should one prepare for cosmetic surgery?
There are several things that you can do.
Perhaps the most important preparation
would be to stop smoking. It’s also probably the best piece of medical advice that
anyone could ever receive, whether they’re
having plastic surgery or not. It’s one of the
worst things that you can do to your body
and particularly your skin. There are innumerable studies that show the incidence of
wrinkling is significantly higher in smokers, and in most cases, this is not
reversible. It is a very damaging habit.
Other steps that should be taken also
involve common medical sense: a good
diet, multiple vitamins, not drinking alcohol in excess, exercising and not being
overweight. These are all things that contribute to a better result in cosmetic surgery and probably a better lifestyle and
longer life in general.
DR. TIMOTHY MILLER is professor and chief of plastic surgery at the David Geffen School of Medicine at UCLA. For more
information, call (800) 825-2752 or visit the Website at