Important Considerations

If you are thinking about having cosmetic surgery or a cosmetic procedure, consider the following questions before making a decision.

Why do you want cosmetic surgery?

This is an important question. Take the time to think it through. Cosmetic surgery involves risk and expense. It can permanently change your physical appearance, possibly in a way you didn't expect or that leaves you unhappy. Make sure that cosmetic surgery is what you want. It is not a good idea to change your appearance because someone else wants you to or because you think it will help you get a particular job. If you are content with your appearance, do not let anyone pressure you into having cosmetic surgery. The decision needs to be your own.

If you are unhappy with your appearance, consider other ways to approach your "problem" area before deciding to have cosmetic surgery. For instance, lotions and creams prescribed by your doctor can reduce fine wrinkles. Or makeup may help conceal or de-emphasize wrinkles, scars, and other skin changes. If you are unhappy with the shape of your body, changing your dress and clothing style may help you feel better about how you look. Diet and exercise can often help you achieve the body shape you desire.

If these measures don't work for you, then you may wish to consider cosmetic surgery. Satisfaction levels are generally very high. Your self-image and attitude toward your own body may improve, which can boost your confidence and self-esteem.

What are your expectations?

You are more likely to be happy with the results of cosmetic surgery if you have clear, realistic expectations and a clear understanding of why you want to have surgery. First, decide exactly what you would like to change or improve. Then discuss those goals with your doctor, who can tell you whether your goals are realistic and how best to achieve them. Looking at photographs of desirable features may help you decide what you want. Remember, however, that cosmetic surgery is used to enhance your own features and not necessarily to duplicate those of another person whose physical appearance you admire.

Get the facts about what to expect from a particular procedure. Have your doctor show you photographs and explain the full range of possible results. Computer imaging can be helpful, but it can also be misleading: there is no guarantee that the end results will match those created by the computer. With some types of surgery, the results may not appear for several weeks or months after the procedure. It may take several sessions or a combination of procedures to achieve the look you want, and results are not always permanent.

Remember that the effects of time, gravity, aging, and sun exposure continue after cosmetic surgery. Surgery is no substitute for good health habits. Getting proper nutrition and regular exercise, guarding against sun exposure, managing stress, not smoking, and avoiding drugs and excess alcohol can go a long way toward helping you look and feel young and healthy.

Try to have realistic expectations about how cosmetic surgery might affect your life. Changing an aspect of your body that you are not happy with may make you feel more attractive, more satisfied with your appearance, and freer to do things that in the past made you uncomfortable, either emotionally or physically. For some people, the impact may be dramatic. But don't expect cosmetic surgery to solve all your problems. It may change how you look and feel, but it won't change who you are.

Talking with someone who has had cosmetic surgery may raise issues that you had not considered. Ask how the person felt about the results, whether the surgery achieved the results hoped for, and what the total experience was like. Doctors who have experience with cosmetic surgery can also provide perspective on the issues involved.

What can you expect during recovery?

Some types of cosmetic surgery are simple outpatient procedures that allow you to return to your regular activities right away. Others may require you to take days or even weeks off work. Be sure that you understand what your recovery will involve and that you are able to follow your doctor's instructions. Important questions to ask include:

• How long will recovery take? How soon will I be able to return to work or school?
• Will the recovery be painful? What other side effects (bruising, swelling, itching, numbness) will I have, and how long will they last?
• What will I have to do to help my body heal properly? For example, skin resurfacing often requires a very thorough skin care routine during recovery. If you have a face-lift or nose surgery, you may have to keep your head elevated and avoid certain activities for a period of time. Following or not following these instructions can affect the results of the procedure.

What are the risks of cosmetic surgery?

Although many types of cosmetic surgery have very few risks, no procedure is risk-free. The risks vary according to your health and the type of procedure being done—they can range from slight scarring to infection and even death. Serious complications are rare, but they can occur.

It is possible that you may be putting your health and life at unnecessary risk when you have cosmetic surgery. It's important to weigh the risks against the possible benefits.

The other major risks of cosmetic surgery are that it may not produce the changes you want and that it may produce changes that leave you even more unhappy than you were before. Additional treatment may be needed to correct the results of the initial surgery. But the results of cosmetic surgery are often irreversible.

Who pays for cosmetic surgery?

Insurance rarely covers the cost of elective cosmetic surgery done to improve appearance. Reconstructive surgery may be covered if it will improve your physical function or will correct a problem present from birth (congenital) or caused by an accident. But unless cosmetic surgery is done for medical reasons, you will probably have to pay for it yourself.

Examples of cosmetic surgery done for medical reasons that may be covered (or partially covered) by insurance include:

• Treatment of severe scars or disfigurement caused by disease, injury, or birth defects.
• Breast reduction when large breasts cause pain or severely limit a woman's activities.
• Reshaping of the nose (rhinoplasty) to improve breathing and nasal function.
• Breast reconstruction after surgery to remove breast cancer (mastectomy).

Cosmetic surgery can be quite expensive, especially when you are paying for all of it out of your own pocket. Be sure that you know the total cost of the surgery, including the costs of the procedure itself (such as surgeon fees, anesthesia fees, and operating facility fees), any medicine before or after the procedure, follow-up treatments, office visits, and other expenses.

Also be prepared to cover costs resulting from complications during or after surgery or the need for "touch-up" surgery. Insurance may not cover treatment for complications that arise from cosmetic surgery. Some procedures, including skin treatments, liposuction, and breast enlargement, may have to be repeated as time goes by, to maintain the results. You will have to pay for these repeated treatments just as you paid for the initial treatment.