<img height="1" width="1" style="display:none" src="https://www.facebook.com/tr?id=182094618865499&amp;ev=PageView&amp;noscript=1">

14 Questions to Ask When
Choosing A Plastic Surgeon

Toggle navigation

How to Make Sure You Pick the Right Plastic Surgeon

"In the aggressive world of cosmetic surgery, patients can't afford to be naive. It’s a dangerously unchecked industry, and the potential for disaster is as boundless as our longing to look good.”

The Guardian, 2016

Introduction — Choosing the Right Surgeon Matters

Dear Patient,

Choosing the RIGHT surgeon is the single most important decision you’ll make concerning plastic surgery. When it comes to changing your physical appearance, you only have one face and one body, so you must entrust that responsibility to someone with great skill and integrity.

But deciding on a doctor isn’t as easy as searching for “best plastic surgeon” or “affordable plastic surgery” on Google. In fact, every single surgeon employs marketing of some sort, and the messaging is overwhelmingly positive. “I’m not very good at Liposuction,” doesn’t make an inspiring billboard ad. But positive marketing doesn’t always translate into positive results.

Here are 14 you should ASK up front to take the guesswork out of a choosing a plastic surgeon.

-Larry Fan, MD

Board Certified Plastic Surgeon,
San Francisco, CA

before.png after.png

#1 Is Your Surgeon Board Certified in Plastic Surgery?

Professional credentials are one of the most important areas of concern when considering a new plastic surgeon, yet they’re often poorly understood or worse yet overlooked.


Why Does Board Certification in Plastic Surgery Matter?

Well, it’s pretty simple.

Plastic Surgeons are the ONLY doctors who are specifically trained and certified to perform cosmetic surgery of the face and body.

In fact, the average plastic surgeon must spend MORE THAN A DECADE learning how to perform delicate cosmetic and reconstructive surgeries on the face and body before they’re allowed to practice on their own and to call themselves a Board Certified Plastic Surgeon. That’s THOUSANDS of surgeries performed under the tutelage of senior surgeons, as well as completing a rigorous, multi-year testing and certification process.

Yet, in the United States and many other countries around the world, cosmetic surgery is loosely regulated, so any doctor is legally allowed to perform any procedure (including cosmetic surgery) in their own office.

Yes, that’s right, a general practitioner can perform liposuction in their own office. An emergency room doctor can perform breast augmentation. A dentist can perform a facelift. (All frightening but true scenarios that can be found right here in the San Francisco Bay Area!)


Scary, right?

But just because they can, doesn’t mean they should. Just as you shouldn’t want a plastic surgeon managing your diabetes or delivering your baby, you don’t want an internist performing your liposuction or a gynecologist injecting your Botox. Remember this, just having a medical degree and taking a weekend course does not qualify someone to perform cosmetic surgery procedures.

Be wary of doctors who call themselves Cosmetic Surgeons and/or claim certification from “bogus” boards and societies from names that sound official like the American Academy of Cosmetic Surgery.


Beware The “Cosmetic Surgeon!”

After all, this is your face and your body at stake (or those of a loved one)!


The Bottom Line:

Insist on a Board Certified Plastic Surgeon.

To find an ASPS doctor near you, you can search a database of certified plastic surgeons here.

  • Dr. Larry Fan is Board Certified in Plastic Surgery by the American Board of Plastic Surgery (ABPS) and is a member of the American Society of Plastic Surgeons (ASPS).



#2 Does Your Provider Offer a Full Range of Cosmetic Treatments including Both Surgical and Non-Surgical Options?

It’s CRITICAL to choose a plastic surgeon that offers BOTH surgical and non-surgical treatments, even if you feel strongly that you don’t want/need surgery (or vice versa).


Because one of the biggest pitfalls of plastic surgery is getting the wrong procedure done.

There are a myriad of treatment options available today, including:

  • Nonsurgical Treatments (eg. Botox, Fillers, Laser, CoolSculpting, Ultherapy, miraDry)
  • Minimally Invasive Surgical Treatments (eg. Fat Grafting, Liposuction)
  • Open Surgical Treatments (eg. Facelift, Tummy Tuck)

Each treatment has its own pros and cons.

It’s vital to see a surgeon who offers ALL 3 TYPES of treatments so that you can understand the differences between each type of treatment and, most importantly, receive the RIGHT treatment for YOU.

Beware The Medical Spa

Medical spas are great for getting pampered. But when it comes to delivering real cosmetic results, they’re fundamentally flawed.

That’s because medical spas only offer nonsurgical cosmetic treatments, and surgery isn’t an option. Nonsurgical treatments can be great for some patients, but disastrous for others. Nurses or doctors at medical spas don’t have the knowledge or experience needed to objectively discuss surgical treatments, even if they are better suited to your needs. So by going to a medical spa you can never know if you’re getting the best procedure for your needs.

“When all you have is a hammer, the whole world looks like a nail.”

Even worse, some medical spas will not even be forthright about your other options because they care more about your wallet than your best interests.

A common pitfall we observe are patients visiting medical spas hoping to look younger or slimmer, but they are given the wrong or ineffective treatments for their body type.

The Case of Mary:

Mary is a 46 year-old mother of two from San Francisco who wanted to improve her forehead wrinkles and droopy eyes. She went to a local medical spa (name will be kept private) and received an injection of 20 units of Botox to the forehead. Botox is an excellent treatment, but for Mary the results were very poor. The Botox was overdone so that her face looked frozen and very unnatural, and, even worse, the droopy eyes were made even worse.

Mary was very unhappy with her results, so she came to visit us at 77 Plastic Surgery to see what could be done. Dr. Fan performed an evaluation and found that she was a poor candidate for Botox because of her drooping forehead and eyes, and that Botox would make her problem worse. Mary was further educated that a brow lift would be an excellent treatment for her. She subsequently underwent a brow lift and was thrilled with her results.

The Lesson:

See an experienced plastic surgeon who performes the full range of cosmetic treatments so you can be sure to get the right treatment.

Don’t become a casualty of the limited options available at a medical spa like Mary.

  • Dr. Larry Fan and the team at 77 Plastic Surgery are pleased to offer a full range of cosmetic treatments including skin care, nonsurgical cosmetic treatments, minimally cosmetic treatments, and cosmetic surgery.

Are You A Candidate

Start the path to finding out what procedure is the best match for your goals with our free online self-evaluation.


#3 Who Will Be Performing Your Consultation?

Why It’s Essential that Your Surgeon Personally Performs Your Consultation

At most cosmetic surgery chains (eg. liposuction chop-shops) and even some private cosmetic clinics, a patient’s first consultation is with a nurse or a salesperson who will encourage cosmetic surgery prior to extolling the virtues of the surgeons at the clinic and arranging an appointment with one of them. In many cases, the patient only meets their surgeon for the first time on the morning of surgery.

This is extremely DANGEROUS because NOT ALL PATIENTS are good CANDIDATES FOR SURGERY (yet another pitfall of plastic surgery!).

Board certified plastic surgeons usually turn away between 10-30% of their patients. The top three common reasons for turning away patients are:

  • Procedure unsuitable / unnessary (eg. too young for a facelift)
  • Unrealistic expectations for surgery (eg. wanting to look like a particular celebrity)
  • Medical reasons (eg. being obese, a smoker, or having a heart condition)

Surgeons are trained to spot such contraindications to surgery, but salespeople —even nurses who may be working on commission—are not equipped to properly identify candidates who are not appropriate for surgery.

#4 Who Will Be Performing Your Procedure?

Be sure to verify exactly who will be performing your procedure.

The best plastic surgeons understand that the only way to ensure top results is to perform their procedures themselves. Unfortunately, some plastic surgeons may delegate portions or even entire surgeries to less experienced staff surgeons or even trainees in order to save costs and time.


Why A Plastic Surgeon is Better Than a Nurse for Botox and Filler Injections

Many people think that because Botox is advertised in day spas and other non-medical offices, Botox injections are on the same level as a manicure, facial, or haircut. This could not be further from the truth!

Though non-surgical, Botox injections are a medical procedure that requires specific training, knowledge, and skill to administer safely and effectively.

When selecting a provider for injectable treatments, give your decision the same level of scrutiny as you would for a surgical procedure.

While many doctors begin advertising Botox treatments after attending a weekend course in injectables, only board certified plastic surgeons have extensive knowledge of facial anatomy, a well developed aesthetic eye, and a surgeon’s skill and precision.

At many medical spas (as well as even some plastic surgery offices), Botox injections are given by nurses, nurse practioners, physician assistants, or general medical doctors. While these providers are likely to be competent with these procedures, their skill level, knowledge, experience — and consequently results — simply can’t compare to the expertise of a Board Certified Plastic Surgeon. Botox injections are commonly learned at weekend courses with a standardized approach that uses standardized dosages and injection points. However, each patient has unique anatomy and muscles, so a detailed understanding of facial anatomy and individualized treatment plans are needed to obtain consistently excellent and natural results.

Consequently, many of the most perfection-obsessed plastic surgeons perform their own non-surgical treatments, including Botox and fillers.

  • At 77 Plastic Surgery, Dr. Larry Fan wants to provide the very best results for our patients, so he insists on performing all Botox injection treatments himself. Dr. Fan has performed thousands of Botox injections, and he will help you develop a customized treatment plan designed just for you.

#5 Who Will Be Performing Your Aftercare?

Poor follow-up is another one of the major pitfalls of plastic surgery.

The best plastic surgeons see their patients at regular intervals following treatment to obtain the best results and to avoid complications.

At some clinics, patients are only seen by nurses or assistants after surgery. This is a dangerous practice because the surgeon may not be readily available if there is a postoperative problem.

  • Dr. Larry Fan is committed to his patients and sees all of them at regular intervals after surgery.

#6 Where Will Your Procedure Be Performed?

Yet another pitfall of plastic surgery is having your procedure performed in an inadequate facility.

Surgery can be performed in an office setting, ambulatory surgical center, or hospital.

Whichever setting is chosen, make sure that the center is accredited by a recognized national body to make sure that the center meets national standards for patient SAFETY and is equipped to deal with any surprises or problems that may occur.

There are 3 recognized agencies that provide national accreditation for office surgical facilities:

  • American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF)
  • American Association for Ambulatory Health Care (AAAHC)
  • Joint Commission for Accreditation, Health Care, and Certification (JCAHO)

Board certified plastic surgeons are required to operate in accredited office facilities (American Society of Plastic Surgeons, American Society for Aesthetic Plastic Surgery, and American Board of Plastic Surgery).

Most plastic surgery ambulatory surgical facilities are accredited by AAAASF, which requires 100% compliance with high standards relating to office surgery. These standards require appropriate credentials and hospital privileges for surgeons using the facility, and stringent requirements for the physical environment, equipment, personnel, monitoring, and emergency equipment and policies affecting patient safety. Data collected and published reflects an outstanding record for AAAASF accredited facilities, comparable to or exceeding those of hospitals (over 1.5 million procedures reported).

  • 77 Plastic Surgery and the office of Dr. Larry Fan are pleased to offer a private, on-site surgery center that is fully accredited by AAAASF and Medicare.

#7 What Type of Anesthesia Will Be Used?

Most plastic surgery procedures require some anesthesia for your comfort and safety.

The types of anesthesia used can include local (“awake”) anesthesia, intravenous sedation (“twilight sleep”), or general (“fully asleep”) anesthesia.

The best plastic surgeons can choose from ALL 3 TYPES OF ANESTHESIA depending on the specifics of your procedure.

If intravenous sedation or general anesthesia is used, anesthesia given by a Board Certified Anesthesiologist is preferable to a Nurse Anesthetist, who is less knowledgeable and skilled.


An Important Word on Local Anesthesia:

Due to safety concerns, most states require special registration or even facility accreditation for the use of sedation or general anesthesia in an office. However the use of anesthesia adds to the cost of equipment, drugs, and personnel, which may be another reason some physicians rely on local anesthesia and oral sedatives. However, the elimination of these regulatory, financial, and professional burdens to the surgeon can significantly impact patient safety.

Major surgery with local anesthesia only may be tolerable, but often is uncomfortable or even painful. Patients are usually given oral sedatives and are “talked through” the “rough spots” during the procedure. However, over-sedation with oral medications can be a major problem in a marginally equipped and staffed facility.


Is local anesthesia really safer for major surgery? 

It may not be safer if high doses of oral sedatives are used to help patients under local. It may not be safer if a drug reaction or surgical complication occurs in a facility that is poorly prepared to recognize, treat, and transfer a patient. It may not be safer in a situation that general anesthesia is medically indicated (underlying medical problem, anxiety, etc.), but not available. It certainly may not be safer when the surgeon lacks recognized and verifiable qualifications.

Dr. Larry Fan performs surgery under all types of anesthesia including local anesthesia and general anesthesia in a fully accredited surgery center exclusively using board certified anesthesiologists for twilight and general anesthesia.


#8 Is Your Surgeon An Expert in Your Specific Problem?

Some plastic surgeons specialize in faces. Others the breasts or the body. Few are experts across the board although these surgeons do exist.

Whatever your cosmetic concern — whether it’s wanting to look younger or getting help with a large nose, small breasts, or a sagging tummy — you want to find a plastic surgeon who is an expert at addressing YOUR specific concern.

A true expert will have helped HUNDREDS, IF NOT THOUSANDS, of patients just like you. He/she will be able to choose from a full variety of treatment options and to know exactly what you need. He will be up-to-date with the latest techniques, and he will know what works and what doesn’t.

You should also consider the experience they have overall in performing cosmetic surgery. The number of procedures performed is a significant factor. The HIGHER the number, the more likely they are prepared to handle any surprises or problems during the surgery.

You don’t want someone learning how to deal with a new problem when they are operating on you!

The Bottom Line: Choose an expert who is knowledgeable, skilled, up-to-date, and experienced.

Dr. Larry Fan has successfully performed thousands of cosmetic procedures of the face, breasts, and body.

#9 Is Your Surgeon in Good Professional Standing 

Dangerous Doctors Allowed to Keep Practicing

Believe it or not:

“Thousands of doctors are able to continue practicing despite records of serious misconduct that puts patients at risk. Many of those doctors have had their clinical privileges restricted or taken away by hospitals, but their state medical boards have taken no action against their licenses to practice.” - USA Today, 2013

Check your doctor’s background to ensure they are in good professional standing:


Active Hospital Privileges

Hospital privileges are an important credential to check. Hospitals credential doctors by documenting training, experience, licensing, and board status. Hospitals also have the legal and moral responsibility to oversee and peer review all members of the medical staff to ensure quality of patient care. Each surgeon also has a list of surgical procedures he/she is allowed to perform in that particular hospital.


Be Wary of Surgeons Who Don’t Have Hospital Privileges to Perform Cosmetic Surgery

However, surgeons operating in a non-accredited office setting have no such restrictions or oversight, so they can perform any procedure they wish…even if they don't have the right training, skills, or competence. 

You should verify that your surgeon has hospital privileges to perform your specific procedure before undergoing cosmetic surgery in an office. If you don’t, you run the risk of allowing a hack to operate on you or your loved one.

Dr. Larry Fan has full plastic surgery privileges at San Francisco’s top hospitals including California Pacific Medical Center.


Active and Unrestricted Medical License

Medical licensure is another important credential to check. Doctors must maintain an active medical license in every state that they practice.

You should avoid any doctor with a history of Medical Board reprimands, sanctions, or license suspensions. These are potential signs of misconduct, fraud, negligence, incompetence, and/or character flaws that could put your health and well-being at risk.

You can usually check the status of your doctor’s medical license online by looking up your doctor by name at your state Medical Board. The physician profile for the Medical Board of California can be found here.


No Malpractice Suits

You should avoid doctors with a record of multiple lawsuits against them. This is also a sign of potential trouble.

However, most doctors, even good ones, are faced with a malpractice suit during their career, so don’t let a single case on the record scare you away.


Educational Background

The top medical schools in the world have a reputation for turning out the best doctors. Their programs are strict, and the ability to gain admission into that school and/or residency program is reserved for only the best and brightest. While this should not be the most important factor in your consideration, it can bring a level of trust knowing that your doctor was educated by the very best in the field.

Dr. Larry Fan was educated at some of the world’s top institutions including Harvard University (undergraduate and graduate studies), UCSF (medical school and residency in general and plastic surgery), and Stanford University (medical innovation).

#10 Does Your Surgeon Have a Good Reputation?

Ask your friends. 

Ask other doctors.

Ask for references from past patients. 

Look online to see what patients say about your doctor at third party review sites like Yelp and RealSelf. Look at Best Doctor lists for evidence of quality care.


But take all this information with a grain of salt: 

Testimonials: Testimonials can be comforting, but someone’s else experience may not be relevant to yours.

References: Have you ever been referred to a “bad” reference? Just the same, references can be useful to help you gain a more complete picture of the plastic surgery process.

Reviews: Third party review sites can be helpful but they can also be unreliable. They are often biased towards those who are disgruntled while many happy patients never leave a review. Also, some doctors have gotten in trouble for “stuffing the ballot” or badmouthing competition with fake reviews.

Awards: We’re flattered when we have appeared on Best Doctor lists, and we appreciate the selection of Dr. Larry Fan as One of America’s Top Plastic Surgeons and America’s Best Physicians every year from 2008 through 2016.

But the reality is that it is impossible to find objective criteria that can be used to determine the BEST medical professional. In reality, there is NO meaningful list that ranks the quality of physicians.

 In fact, most lists are prepared by magazines interested primarily in advertising dollars and circulation.

Thus, the listing of a doctor on a “best” list offers no guarantee of quality.

#11 Is Your Surgeon an Artist? 

The difference between average and great plastic surgery is ARTISTRY.

Aesthetics can be subjective, which is why patient-surgeon fit is a critical part of the selection process. However, artistry and beauty in the field of plastic surgery is a near-universal concept. Artistry among plastic surgeons is represented by results that aren’t just beautiful, but also natural and visually appealing. 

If you imagine a plastic surgeon as an artist and their patient as the subject of a painting, the results of surgery should bring the patient to life while maintaining the spirit of the patient. The results shouldn’t just be appealing, they should improve a patient’s vibrant natural beauty without distortion of an unnatural final effect.


What To Look For:

Review your surgeon’s “before and after” photos carefully.

Most of us are well familiar with the difference between "average" and "exceptional" in aesthetic matters. You're likely able to tell the difference between average photography and great art. You're familiar with the difference between clothes that fit averagely well, and clothes that are expertly tailored to flatter a person's figure. In a similar way, it is possible to tell the difference between average and exceptional results in a plastic surgeon's work portfolio. This concept is difficult to simply quantify, but it's something that virtually everyone can recognize immediately.

An exceptional plastic surgeon has the ability to identify and create results that aren't just mundane, they're sublime. This requires both technical capabilities as a clinician and a capacity for artistry. The world's most effective plastic surgeons are able to create exceptional, natural-looking results that enhance their patient's natural beauty.

#12 Is Your Surgeon Obsessed with Excellence? 

While artistic capability is crucial, the importance of a surgeon's planning and assessment process can't be emphasized enough. Your surgeon's evaluation of your needs should be deep and effective. More importantly, their practice and professional reputation should be built on consistently performing thorough assessments of patients before they arrive in the operating room. Average plastic surgeons perform average assessments and planning, which typically yield mediocre results.


Great surgeons, on the other hand, perform detailed analyses of prospective patients. This allows them to perform well thought-out and carefully planned procedures. Thorough planning facilitates meticulous results. A great surgeon's results are superior not by chance, but excel because of superior planning, design, execution and care. The very best artists balance technical ability and an obsession attention to detail in pursuit of perfection. Leading surgeons have the same approach, which is reflected in their work portfolios.

#13 How Much Will It Cost?

You should never choose a plastic surgeon solely on price. Most top surgeons are comparable in price. But choosing the cheapest plastic surgeon could be a costly mistake if the results he delivers are less than desirable. Conversely, just because a surgeon is expensive also doesn’t translate directly to great results.

Have You Seen The Ads From the “Liposuction Specialists” For “Safe, Affordable Liposuction Under Local Anesthesia” for as little as $1,295?

You should especially steer clear of plastic surgery franchises, bargain basement centers, or chains, where their main concern is often your wallet rather than your well-being. 

These centers are typically run by profit-motivated business professionals who don’t have a background in healthcare or plastic surgery. These centers often use high-pressure sales tactics focused on opening your wallet rather than your well-being. Patients frequently complain about unscrupulous business practices, as well as poor care and shoddy results. Additionally, the medical staff at these facilities are often inexperienced doctors trying to gain experience or, worse yet, doctors who lack the proper credentials to perform delicate facial and body cosmetic procedures on patients.

#14 Is Your Surgeon Honest?

You should never choose a plastic surgeon solely on their credentials, their reviews, or their price.

In fact, a lot can be gleaned from your experience interacting with the doctor and his staff:

  • Are they pleasant?
  • Are they knowledgeable?
  • Are they attentive?
  • Do they listen to your concerns?
  • Do they communicate with you regarding your needs, concerns, and wishes?
  • Do they communicate with you regarding what needs to be done, and what to expect before, during, and after your procedure?
  • Do they seem honest, open, and willing to help you, or do you feel like they are trying to sell you something?
  • Do they care about you?


Ask them the tough questions, and notice the doctors who are honest with you.

Trustworthy doctors will keep you grounded with realistic expectations. They will steer you away from procedures that aren't a good fit for you.

If your answer is “no” to any of the questions above, be wary.

Conclusion — Trust Your Instincts

Consider all of the factors listed in this eBook when vetting a surgeon. Choose the one who brings you the most peace of mind.

In the end, you need to trust your instincts. When you finish your evaluation of 3-5 surgeons, who is the one you WANT to trust in? There’s a good indication that whoever that is will be the best fit to be your plastic surgeon.


Warmest wishes,

Larry Fan, MD

Medical Director

77 Plastic Surgery

(415) 655-SKIN (7546)

Book a free consultation


Are You A Candidate

Start the path to finding out what procedure is the best match for your goals with our free online self-evaluation.