In a perfect world, choosing a medical professional (regardless of the treatment you're seeking) wouldn't be difficult, it wouldn't be confusing, and it surely wouldn't be dangerous. And while in no way are we trying to scare you, knowledge is power—especially where your body and safety are concerned.
So if you've ever contemplated any type of cosmetic treatment (from the comparatively less invasive likes of chemical peels and fillers to something more invasive like liposuction or breast augmentation), it's paramount to do your research.
We're not experts on the subject—and would never ever claim to be—but we're lucky enough to have access to some of the best board-certified medical minds in the industry. And after hearing one too many stories of surgeries gone awry (largely due to unlicensed medical professionals performing cosmetic procedures they had no business performing), we were seeking some answers.
We reached out two board-certified (not to mention bad-ass) female doctors who are leaders of the pack when it comes to experience, education, certification, and care in their practice: Nancy Samolitis, MD, a dermatologist with specialty training in cosmetic dermatology and co-founder of Facile Dermatology + Boutique, and Anita Patel, MD, FACS, a plastic and cosmetic surgeon who's in her ninth year of private practice based in Beverly Hills.
Both Patel and Samolits want you to be as informed, safe, and satisfied with your medical care as we do, so they provided us with some helpful insight when it comes to choosing a qualified, safe, and trustworthy medical professional. From red flags to must-have certifications, we've got you covered. Keep reading for eight things to keep in mind if you've ever considered a cosmetic procedure.
1. Do Your Research
Both Samolitis and Patel agree that first and foremost, conducting your own research is paramount when considering any type of cosmetic treatment.
In the majority of states, Samolitis says, "Every medical practice must be owned and regulated by a physician. Unfortunately, there is an increasing number of physicians who are trained in non-core specialties (emergency medicine, family practice, ob-gyn) who choose to add cosmetic procedures to their practice." Which, she notes, is admittedly confusing to potential patients.
So if a doctor's office refers to their practice as specializing in "dermatology" or "plastic surgery," make sure the supervising physician of the practice is board-certified in that particular field. "Vague terms including 'cosmetic surgery' and 'anti-aging medicine' are not true recognized specialties of the ABMS and can be used by any provider without validation."
Patel also notes that online reviews can be misleading. In fact, she explains that it's not uncommon (unfortunately) for doctors and surgeons to pay for positive reviews or to even hire companies to submit reviews on their behalf. Tread carefully and rely more on a surgeon's experience, education, and certifications. (More on that in a second.)
2. Know the Difference Between Your Providers
According to Samolitis, the types of providers explained below frequently perform cosmetic procedures across the country. Yes, they’re legally allowed to do so, but no, they’re not board-certified and may lack a thorough, comprehensive understanding of the cosmetic procedure and any complications and reactions "Although you can easily identify the credentials of your provider via an online search, one should never hesitate to ask the provider to verbally verify their credentials, training, and experience," she points out.
Nurse practitioner (NP): "Requires a master's degree including approximately six years of training after high school." Although they're not physicians, they're allowed to practice independently in some states and are trained to diagnose disease and prescribe treatment. There is no specialty board-certification for NPs, and if they practice in a specialty (for example, dermatology), they typically will train or continue to work with a physician with the appropriate board-certification."
Physician assistant (PA): "Requires a master's degree typically involving a two-year program including 2000 clinical hours. Unlike NPs, PAs cannot practice independently and must be supervised by a physician who represents the board-certified specialty that the PA is working in."
Registered nurse (RN): "Requires a degree that can be obtained with two to four years of education beyond high school (associate or bachelor degree). RNs are not trained to diagnose and treat disease, but are medical professionals who are allowed to administer treatment to patients under the supervision of a physician who 'prescribes' or 'orders' the treatment."
Samolitis explains the scope of practice for RNs varies from state to state, but when it comes to cosmetic procedures, RNs can perform injectable and laser procedures in certain states. She adds that any patient who is being treated by a nurse must first be examined and cleared for treatment by a provider who is able to diagnose and prescribe medication like an MD, DO, PA, or NP.
3. Check Their Certifications
So how are we to know if a doctor is legitimately trained and trustworthy to perform a treatment? Samolitis says that in addition to performing your own research, the most important thing you can do is verify a doctor's certification. Specifically, they should be board-certified (which you can easily check here through the American Board of Medical Specialties.)
"Attending a weekend-long course on injectables or lasers is seriously inadequate preparation," she explains, and in order to have a truly comprehensive understanding of things like "tissue interactions, healing, and of course, risks and complications," an abbreviated training like this is incredibly flawed. Even more concerning, Samolitis shares that the majority of companies who sell lasers and injectables to medical professionals provide a flimsy one-day training (usually around four hours long) before they're allowed to practice with the product.
Patel agrees that a board certification is one of the first (and most helpful) things you should look for when considering a new doctor, but she does make another important distinction: "Are they certified by the appropriate board?"
According to Patel, this is where the waters get murky since so many doctors know that potential clients are searching for that particular credential. "Some will actually use 'board certified' when they are not talking about any of the 24 boards recognized by the ABMS. For example, many non–plastic surgeons will say they are certified by the American Board of Cosmetic Surgery, which is not a recognized board, and you don't need to be trained in plastic surgery to claim it." Which, as can be imagined, has the potential for some serious confusion.
"This group is very savvy at marketing themselves as the only true board for cosmetic surgery, so the average patient will be totally confused as to which the actual board is for plastic surgery," she says. Patel tells us the only recognized board for plastic or cosmetic surgery is the American Board of Plastic Surgery, and you can search a particular surgeon here.
4. Know the Difference Between "Cosmetic" + "Plastic" Surgeons
It's also important to note the difference between a plastic surgeon and a cosmetic surgeon. For instance, truly qualified surgeons who went through the rigorous required schooling and training will call themselves plastic surgeons. On the other hand, those who took an abbreviated course or training (but still want to be viewed by potential clients as plastic surgeons) might call themselves cosmetic surgeons.
According to Patel, this is a huge marketing ploy. "These doctors will use this tactic to make it seem as if they are better at cosmetic surgery since they focus on only that, whereas plastic surgeons spend a lot of time training in reconstructive surgery as well." The takeaway: Look for the professionals who reference themselves as both plastic and cosmetic surgeons, or plastic and aesthetic surgeons.
5. Be Cautious of "Celebrity-Approved" Professionals
In fact, Patel stipulates that in most cases, you should slowly back away. She explains that just because a doctor may be talented at promoting a celebrity clientele, this doesn't make them any more credible or qualified for the job.
"Often, celebrities are offered free services or are even paid to advertise services," she says. Plus, the celebrity may not even receive the service that is described," Patel warns. Additionally, celebrities often are referred to doctors by non-medical friends, who most likely lack expertise when it comes to medical and surgical practice.
"I can't tell you how many famous doctors who are popular on social media and within the entertainment industry aren't actually practicing in the field they are qualified in. In fact, it's usually only after a negative experience that a celebrity will realize they went to the wrong place."
And Samolitis agrees, pointing out that many of the "celebrity" doctors who have been featured on shows like The doctors and/or have thousands of followers on social media lack vital qualifications. (As in, they aren't the board-certified dermatologists and plastic surgeons the media, and their websites, pen them to be.) "Some of them are not even doctors or have had their licenses revoked by the medical board for disfiguring patients."
6. Choose Someone You Feel Comfortable With
And not only should you feel comfortable, it's also important to ensure you both share the same kind of aesthetic vision.
Patel explains, "I personally liken it to a relationship, and you have to feel comfortable communicating your wishes, fears, and hopes to the surgeon without fear of judgment or embarrassment. You want to know if in the off chance you were to have a complication, is this the person you trust will take care of you and handle it?"
In the same vein, it's important to be aware of your surgeon's exact treatment plan. For instance, what products and brands do they plan to use, what will recovery time be like, etc. You should be able to feel comfortable asking them anything and everything you want to know about the procedure.
"Any time you are getting injectables, you should feel comfortable asking what the products are, how many units or ccs they plan to use, what the results will look like, and so on," Patel says. "You should not agree to be injected with any substance without understanding what it is, what it does, and the risks involved."
7. Avoid Shopping Based on Price
Because, as with most things in life, you'll probably get what you pay for and if something sounds too good to be true, it most likely is. And though yes, these types of procedures are expensive, Patel reminds us to keep the bigger picture in mind:
"Try to remember that you're not paying for the Botox or filler as a product. You're paying for the expertise, judgment, and skill of the injector. You are also paying for the real versions of the injectables, and not similar cheaper products that are imported without being approved for use in the US."
She also explains that if you stumble upon a super-great deal that's significantly cheaper than other options you've been looking for, there's most definitely a reason, and honestly, it's never worth the safety risk.
"Operating room fees are higher in centers that hold the highest safety credentialing, and surgeons fees are higher in more experienced surgeons or ones with a particular expertise. It's better to postpone a procedure and have it done right than jump on a deal and pay more to fix problems that arise."
8. Before-and-After Photos Can Be Misleading
This one is tricky since before and after photos can be an invaluable resource when you're trying to decide on a doctor who truly matches your aesthetic vision and preferences. However, some doctors (most likely the ones who lack experience and credentials) may Photoshop their photos or even steal other surgeons' photos to use on their own.
However, credentials (as we've mentioned) is key. So if you're trying to decide between multiple surgeons who are board-certified and adequately trained, this should be a moot point. Instead, use their before and after photos as a tool to decide if you find that particular doctor's results appealing.
Patel explains: "Often when patients are looking for revisional surgery, it was not because of a 'botched' result, but rather the look is not what the patient had in mind, therefore the end-result didn't meet their expectations."
So if you are looking at a surgeon's before-and-after photos and don't like the results, move on and keep researching. And lastly, make sure you are completely transparent in regard to your hopes and expectations. That way, the surgeon can determine if your goals are safe, reasonable, or even realistically achievable.