Patient Education

Choosing the Right Surgeon

In the quest to improve and enhance one’s physical features, and to look younger and feel better, millions of people are turning to aesthetic plastic surgery. Advancing techniques and clever advertising that promises to make dreams come true can entice countless patients to the operating table.

Because of the increasing demand, millions of disposable consumer dollars, and poor reimbursement from Managed Care and HMOs, physicians and surgeons from many different specialties are opting to provide cosmetic surgery services. The result is an increasing number of physicians with widely varying backgrounds, training, and experience. Understand that the majority of cosmetic surgeons are highly skilled and perform successful operations, but how do you choose?

As with all surgical procedures, cosmetic surgery carries potential risks, which can be disfiguring or even life threatening. It is paramount, therefore, to choose a plastic surgeon that is highly skilled in performing the procedure(s) desired to minimize potential for complication, and optimize the chance of having an excellent and natural appearing result.

Choosing the right plastic surgeon is no easy task

After visiting two or three different surgeons and receiving varied opinions, often more questions are entertained than answered. Understand there are often different ways to successfully obtain a particular result. However, there are just as many ways that do not produce satisfactory results. It’s just not easy making the right choice. To be honest, it is not which plastic surgeon has the best credentials, or who is Board Certified or a member of the ASPS (American Society of Plastics Surgeons). The vast majority of serious malpractice suits are against Board Certified Plastic Surgeons. Unfortunately, there are also Board Certified Surgeons with impressive credentials that are members of any number of prestigious societies who, frankly, have many results that are less than satisfactory. The point is…don’t be lulled into a false sense of security. Board Certification and ASPS membership does not guarantee quality results. Proper credentials and Board Certification are an important place to start, but the truth of the matter…the goal is to choose a plastic surgeon that produces exceptional results on a consistent basis. To learn more about Dr. Sam Gershenbaum, a premier plastic surgeon in Miami, Florida, please contact the Miami Cosmetic Surgery Center today!

Helpful Points to Remember When Choosing a Plastic Surgeon

  • Become educated about the surgical procedure(s). Review books, brochures, and videotapes. Perform research on the Internet. Understand that there are often a number of different ways a procedure can be done. Be confident that the particular technique used is the right one for you. Know enough to ask questions and understand the answers.
  • Recommendations. Check with those who you can truly trust. Be careful about casual referrals. Ask your doctor, family, or friends. Nurses are often also a good referral source for a plastic surgeon.
  • Confirm the surgeon’s credentials, and research his or her malpractice history on the Internet. In Florida, cosmetic surgery physicians are listed under the Florida Department of Health: Practitioner Profile. You must, however, understand that any honest plastic surgeon who has practiced for any considerable length of time will more than likely have suits or settlements listed, especially those in metropolitan areas where lawsuits and settlements are more common. In this litigious society in which we live, malpractice claims do not necessarily reflect poorly or indicate blame. You should be cautious, however, if a surgeon has excessive listings of malpractice claims and settlements.
  • Is he/she Board Certified in plastic surgery? Board certification in plastic surgery is a good place to start, but does not guarantee quality surgery.
  • Hospital privileges? Even if the surgery is performed in the surgeon’s office surgical suite or outpatient facility, local hospital surgical privileges generally assure that the surgeon has undergone a careful review by his peers.
  • Is the in-house surgical suite certified? If the procedure is being performed at the surgeon’s office surgical suite, make sure it has been inspected and certified by an appropriate certifying body. Check with your state’s department of health. Ask to see the certificate. In Florida, new laws require state inspection and certification.
  • Consult with the surgeon who will be performing your surgery. All consultations should include review of your medical/surgical history and a comprehensive discussion of your desired goals and expectations. The procedure and possible alternatives should be discussed, as well as all possible risks and complications. The patient should fully understand which particular technique the surgeon chooses and why. You should be made aware of what to expect before, during, and after the surgery. If the surgeon is not willing to spend the time necessary to answer all your questions, or brushes aside your concerns and appears to be most interested in “closing the deal,” you should probably look elsewhere.
  • View many before and after photos performed by the surgeon . This should give you some “feel” for the surgeon’s skill, but keep in mind that every patient’s physical characteristics and results are different. Understand that before and after computer imaging is an artistic rendition of the ideal desired goal and in no way guarantees your results.
  • All surgery involves some risk and unpredictability. Be suspicious of any surgeon who guarantees a particular result.
  • Be wary of plastic surgery “mills.” Generally these businesses hire plastic surgeons, perform high volumes of cosmetic surgery, advertise heavily, and use hard sell tactics to obtain your business. Close personal attention before and after surgery may be sacrificed for reduced prices. These plastic surgery “mills” often have a higher percent of revisional surgery.
  • Become familiar with customary fees in your area. Be wary if quoted fees are much lower than what is customary in your area. Is a qualified individual administering anesthesia? Is surgery being performed with adequate time to optimize results? Is the physician qualified? Is the fee lower because the surgeon cannot book surgeries at customary fees? On the other hand, higher fees do not mean higher quality or better results. Be careful about price shopping. Know who and what you are getting.
  • Be wary of surgeons who insist on correcting features that do not bother you.
  • Speak with former patients. The ability to speak with and even see first hand the results of one or more former patients should not be difficult to arrange and is often encouraged. Be aware that speaking with previous patients and seeing previous results in no way guarantees any individual outcome.
  • You must be able to feel comfortable and confident with your surgeon. There must be a good rapport and trust. Do not make a decision under pressure. Listen, learn, and get to know your plastic surgeon.

Medications to Avoid

Aspirin Medications to Avoid: Affect blood clotting.

4-Way Cold Tabs
5-Aminosalicylic Acid
Acetilsalicylic Acid
Actron
Adprin-B products
Aleve
Alka-Seltzer products
Amigesic Argesic-SA
Anacin products
Anexsia w/Codeine
Arthra-G
Arthriten products
Arthritis Foundation products
Arthritis Pain Formula
Arthritis Strength BC Powder
Arthropan
ASA
Asacol
Ascriptin products
Aspergum
Asprimox products
Axotal
Azdone
Azulfidine products
B-A-C
Backache Maximum Strength Relief
Bayer Products
BC Powder
Bismatrol products
Buffered Aspirin
Bufferin products
Buffetts 11
Buffex
Butal/ASA/Caff
Butalbital Compound
Cama Arthritis Pain Reliever
Carisoprodol Compound

Cataflam
Cheracol
Choline Magnesium
Trisalicylate
Choline Salicylate
Cope
Coricidin
Cortisone Medications
Damason-P
Darvon Compound-65
Darvon/ASA
Diclofenac
Dipenturn
Disalcid
Doan’s products
Dolobid
Dristan
Duragesic
Easprin
Ecotrin products
Empirin products
Equagesic
Etodolac
Excedrin products
Fiorgen PF
Fiorinal products
Flurbiprofen
Gelpirin
Genprin
Gensan
Goody’s Extra Strength Headache Powders
Halfprin products
IBU
Indomethacin products
Isollyl Improved
Kaodene

Lanorinal
lbuprohm
Lodine
Lortab ASA
Magan
Magnaprin products
Magnesium Salicylate
Magsal
Marnal
Marthritic
Mefenamic Acid
Meprobamate
Mesalamine
Methocarbarnol
Micrainin
Mobidin
Mobigesic
Momentum
Mono-Gesic
Motrin products
Naprelan
Naproxen
Night-Time Effervescent Cold
Norgesic products
Norwich products
Olsalazine
Orphengesic products
Orudis products
Oxycodonc
Pabalate products
P-A-C
Pain Reliever Tabs
Panasal
Pentasa
Pepto-Bismol
Percodan products
Phenaphen/Codeine #3

Pink Bismuth
Piroxicam
Propoxyphene
Compound products
Robaxisal
Rowasa
Roxeprin
Saleto products
Salflex
Salicylate products
Salsalate
Salsitab
Scot-Tussin Original 5-Action
Sine-off
Sinutab
Sodium Salicylate
Sodol Compound
Soma Compound
St. Joseph Aspirin
Sulfasalazine
Supac
Suprax
Synalgos-DC
Talwin
Triaminicin
Tricosal
Trilisate
Tussanil DH
Tussirex products
Ursinus-Inlay
Vanquish
Wesprin
Willow Bark products
Zorp

Ibuprofen Medications to Avoid: Affect blood clotting.

Acular (opthalmic)
Advil products
Anaprox products
Ansaid
Clinoril
Daypro
Dimetapp Sinus
Dristan Sinus
Feldene
Fenoprofen
Genpril

Haltran
Indochron E-R
Indocin products
Ketoprofen
Ketorolac
lbuprin
lbuprofen
Meclofenamate
Meclomen
Menadol
Midol-products

Nabumetone
Nalfon products
Naprosyn products
Naprox X
Nuprin
Ocufen (opthalmic)
Oruvail
Oxaprozin
Ponstel
Profenal
Relafen

Rhinocaps
Sine-Aid products
Sulindac
Suprofen
Tolectin products
Tolmetin
Toradol
Voltaren

Avoid ALL Diet Aids – Including Over-the-Counter & Herbal Intensify anesthesia, serious cardiovascular effects. Tricyclic Antidepressants to Avoid: Intensify anesthesia, cardiovascular effects.

Adapin
Amitriptyline
Amoxapine
Anafranil
Asendin
Aventyl
Clomipramine
Desipramine

Doxepin
Elavil
Endep
Etrafon products
Imipramine
Janimine
Limbitrol products
Ludiomil

Maprotiline
Norpramin
Nortriptyline
Pamelor
Pertofrane
Protriptyline
Sinequan
Surmontil

Tofranil
Triavil
Trimipramine
Vivactil

Other Medication to Avoid: Affect blood clotting.

4-Way w/ Codeine
A.C.A.
A-A Compound
Accutrim
Actifed
Anexsia
Anisindione
Anturane
Arthritis Bufferin
BC Tablets
Childrens Advil
Clinoril C
Contac
Coumadin
Dalteparin injection

Dicumerol
Dipyridamole
Doxycycline
Emagrin
Enoxaparin injection
Flagyl
Fragmin injection
Furadantin
Garlic
Heparin
Hydrocortisone
Isollyl
Lovenox injection
Macrodantin
Mellaril

Miradon
Opasal
Pan-PAC
Pentoxyfylline
Persantine
Phenylpropanolamine
Prednisone
Protarnine
Pyrroxate
Ru-Tuss
Salatin
Sinex
Sofarin
Soltice
Sparine

Stelazine
Sulfinpyrazone
Tenuate
Tenuate Dospan
Thorazine
Ticlid
Ticlopidine
Trental
Ursinus
Virbamycin
Vitamin E
Warfarin

Salicylate Medications, Foods & Beverages to Avoid: Affect blood clotting.

Amigesic (salsalate)
Disalcid (salsalate)
Doan’s (magnesium salicylate)
Dolobid (diflunisal)
Magsal
Pamprin (Maximum Pain Relief)
Mobigesic

Pabalate
Pepto-Bismol (bismuth subsalicylate)
Salflex (salsalate)
Salsalate
Salsitab (salsalate)
Trilisate (choline salicylate + magnesium salicylate)

Almonds
Apples
Apricots
Blackberries
Boysenberries
Cherries
Chinese Black Beans
Cucumbers
Currants

Garlic
Ginger
Grapes
Pickles
Prunes
Raspberries
Strawberries
Tomatoes
Wine

Vitamins and Herbs to Avoid: Affect blood clotting, affect blood sugar, increase or decrease the strength of anesthesia,
rapid heartbeat, high blood pressure, liver damage. Note: Just because it is not of this list does not mean that it is safe to take while preparing for surgery.

Ackee fruit
Alfalfa
Aloe
Argimony
Barley
Bilberry
Bitter melon
Burdock root
Carrot oil
Cayenne
Chamomile
Chromium
Coriander
Dandelion root

Devil’s club
Dong Quai root
Echinacea
Ephedra
Eucalyptus
Fenugreek seeds
Feverfew
Fo-ti
Garlic
Ginger
Gingko
Gingko biloba
Ginseng
Gmena

Goldenseal
Gotu Kola
Grape seed
Guarana
Guayusa
Hawthorn
Horse Chestnut
Juniper
Kava Kava
Lavender
Lemon verbena
Licorice root
Ma Huang
Melatonin

Muwort
Nem seed oil
Onions
Papaya
Periwinkle
Selenium
St. John’s Wort
Valerian/Valerian Root
“The natural Viagra®”
Vitamin E
Willow bark
Yellow root
Yohimbe

If you are taking anything not on this list, please call the office at (305) 933-1838 to notify us and make sure that it is okay.

What’s in a Surgical Fee?

What’s in a Surgical Fee?

Prices for cosmetic surgical procedures vary greatly from state to state, city to city and surgeon to surgeon. The old adage, “you get what you pay for”, generally rings true.  Be Smart. Do your homework.

There are many factors to consider when thinking about what you want, and expect from your anticipated surgery.  Patients invariably have different sets of expectations and requirements when choosing their surgeon. Some patients do more information gathering, more research and are more informed about their surgeon and surgical procedure. There are others who choose a particular surgeon or surgical center because their friend went there, or they have the best prices, etc.  Are you the type of person that will have your surgery performed at a business owned and operated, Surgeon for hire, mass marketing, “high volume”, bargain price surgery center?  Or, are you the type of person that chooses to have your surgery with a Board Certified, established and experienced surgeon in private practice, in a “low volume” setting, who performs his surgery in a properly certified surgery center or hospital, who has worked with his same anesthesia providers for 15 years or longer, and has repeatedly produced exceptional results and has a reputation for excellence?   Perhaps, your requirements are somewhere in between?  There are choices, and the decision is up to you…

What determines the fees?

There are many factors to consider when choosing where and with whom to have your surgery performed.

Certainly, prices will vary depending on city and state. Prices may vary on years of experience. Prices may also vary depending on how a particular business or surgeon practices. Some may choose lower prices and higher volumes of surgery while other may choose higher fees, less volume and more individual time.

What is important to you and which do you prefer?

We believe that consistent wonderful results in cosmetic surgery are due in part, to taking the time needed to get those results.  There are only so many hours in a day and only so many surgeries one surgeon can do. All surgeons operate with assistants. Patients should, however, have a right to know if their surgeon performs all of their surgery or if an assistant performs a portion of their actual surgical procedure.  Having two persons operating, one on each side, to reduce OR time, is asking for problems and/or asymmetry.  In many offices, it is not uncommon that an assistant is performing a significant portion of the surgical procedure so the surgeon can keep a busy schedule moving along or to keep two operating rooms busy. This high volume type of practice will allow for lower fees, which in turn keeps the schedule busy.  Results may or may not suffer as a result, but what do you expect and prefer?

Dr. G’s practice does not operate with a high volume strategy.  Dr. G operates with a result oriented approach.  Surgery takes as long as it takes to produce his exceptional and high quality results.

Other items that may affect fees…

  • The Surgeons  years of experience…
  • Is the Surgeon Board Certified?
  • Does the Surgeon have local hospital privileges?
  • Does the Surgeon have many photos of your requested procedure you find appealing?
  • Does he/she have an excellent reputation?  Perhaps recommends patients you can converse with?
  • Spends enough time with you to feel confident and comfortable?
  • Are these issues that concern you? What do you prefer?

The Hospital or Surgery Center

Hospitals and Certified Surgery Centers have strict guidelines for procedures and safety. The highest levels of certification are as follows : Certified by the State of Florida or American Association for Accreditation of Ambulatory Surgery Facilities (AAASF), Accreditation Association for Ambulatory Health Care (AAAHC), or The Joint Commission. A surgeon’s private surgical facility may be certified by one of these above, or it may be certified, one step lower, as an office based surgical center with somewhat less strict guidelines. There are some office surgery centers not certified at all. Is the surgery to be performed at a Hospital, Surgery Center or a Surgeon’s private surgical facility? Private facilities often have better cost controls than hospitals, depending much on location. The highest levels of accreditation may cost a bit more. What is your preference?

Anesthesia Provider

You may have anesthesia provided by a Certified Registered Nurse Anesthetist or by a physician MD or DO.

  • What is the history of that anesthesia provider?
  • It is comforting to know that the anesthesia provider has worked with the surgeon for many years and has an excellent and safe history?

If Dr. G used an anesthesia service that sent whomever they have available, we could cut prices…

But you see, Dr. G does not compromise. He has used the same highest quality and trained anesthesia providers that he has used for the last 15 years, the same Anesthesia providers that put his own family to sleep as well as his staff who have had their surgery with Dr. G. They cost a little bit more, but only the best will do. Dr. G also uses the highest quality products and medications…

Surgery is not a good place to cut corners for cost savings and convenience sake. Is blood work and medical clearance being ordered?  Blood work alone may not provide important information about an unknown health issue. Even young, apparently healthy individuals, may have unknown conditions that require further evaluation before an elective surgery.

Understand also, that higher prices do not guarantee better results and lower prices do not guarantee less than desirable results.  It’s all about what works for you. Do your homework. There are choices. What is it that you want and require?  The decision is up to you…