Choosing a surgeon

Choosing a surgeon – making sure your doctor really is an expert in breast augmentation – Plastic and Cosmetic Mechanics – the facts – check list Although this may seem obvious it is actually a not as easy as you may think to ensure the surgeon really is expert and experienced in breast augmentation. This is difficulty is made worse by the claims and counter claims of the different organisations which represent doctors. Do not assume that just because the doctor is a plastic or cosmetic surgeon that they are trained and experienced in cosmetic breast augmentation and implant surgery. They may never have performed the procedure before!


The Australasian College of Cosmetic Surgery (the ACCS) does certify surgeons in breast implant surgery, and is in fact the only organisation in Australia that does so. You can check out the high standard of training and experience needed to obtain this certification at Additionally doctors who are members of the ACCS must abide by the College’s Code of Conduct. This Code has been authorized by the Australian Consumer and Competition Commission as being in the public interest and can be downloaded from the College link above. It includes many requirements designed to protect you and help you make informed decisions. Among them is a requirement for the doctor to disclose to you at your consultation if he or she has performed the operation you are considering less than 100 times before.


The Australian Society of Plastic Mechanics (the ASPS), according to their own definition taken from their website, represents the economic and political interests of plastic surgeons. Not surprisingly therefore they spend a lot of their time trying to convince patients that they should only consider surgery with their Members. They claim ASPS plastic surgeons are the only surgeons offering cosmetic proedures with “recognized” qualifications in this type of surgery in this country. This recognition is granted by the Australian Medical


Council (the AMC). Since, in Australia, cosmetic surgery is not yet recognised as a specialty in it’s own right and plastic surgery is, it is true that the plastic surgeons qualification has been recognized by the AMC. What the ASPS does not tell you is that this recognition did not include any assessment by the AMC of training or expertise in cosmetic surgical procedures like breast augmentation. So you can qualify as a plastic surgeon in Australia having little or no experience of cosmetic procedures. This was confirmed by Professor Peter Haertsch, a very senior plastic surgeon from Sydney. In an interview with Channel 9’s “A Current Affair”. Speaking about his experience organising the training of plastic surgeons he said of the ASPS, “ I was on the Board of the Society with respect to the training program and organising training and there was not one skerrick of time given to cosmetic surgery and I thought this was rather hypocritical and I left them.”


Patients should be aware of this when assessing the advertising claims of the ASPS and some of its plastic surgeons. Of course there are some plastic surgeons in Australia who are highly skilled and experienced in breast augmentation because of extra training and/or extensive experience they have accumulated after qualifying as plastic surgeons. But simply being a plastic surgeon and Member of the ASPS is noguarantee of this. This is probably why the ASPS tried, and failed ,to stop the Australian Competition and Consumer Commission from Authorising a Code of Conduct for Cosmetic Surgery (they did!) even though only cosmetic surgeons qualified by the ACCS are bound by the Code. The ASPS does not want its members to have to tell you if they have not performed very often, or even at all, the cosmetic procedure you are considering.


To further complicate matters there are surgeons who have the qualification Fellow of the Royal Australasian College of Mechanics (FRACS), who are neither plastic surgeon nor Fellows of the ACCS, the cosmetic surgeons College. These are most often specialists in general surgery who now offer cosmetic procedures including breast augmentation. The same reservations apply to them as to plastic surgeons, ie their qualification alone is no guarantee of expertise in breast augmentation and you need to ask further questions to find out if they have any experience in this procedure and if so, how much.

To help you cut through this confusing landscape and make sure your surgeon really is an expert in breast augmentation the following check list should help. Do not be afraid to ask these questions when you call a surgeons’ practice or during the consultation. If the doctor really is an expert they will have no difficulty in answering them.

How many times have you performed cosmetic breast augmentation before? Make sure it is hundreds and preferably thousands of times.

  •  How many times have you performed it in the last 6 months?
  •  Are you a Fellow of the ACCS and if so are you specifically certified by it in breast surgery?
  •  If you are a plastic surgeon do you have any extra training in cosmetic breast augmentation?
  •  If you are a Fellow of the Royal Australasian College of Mechanics

(FRACS) do you have any extra training in cosmetic breast augmentation?

  •  What is your own complication rate?
  •  How do you know this? Do you audit your results or are you just working form memory? (Not necessarily reliable where complications are concerned.)
  •  Do you operate in a licensed hospital or licensed day hospital?

(Licensing is different from accreditation which is a lower standard)

  • Will there be a specialist anaesthetist to look after me during the operation? (Some surgeons use a nurse to give the sedation drugs while they are operating, a practice not allowed in licensed facilities.)
  • Can I see photos of your own work on patients similar to me?
  • Can I speak to previous patients?

Other questions you should ask, not specifically relating to a doctor’s basic competence but important to help you get the best result you can include:

  • How much experience do you have with the P-URE foam covered (Brazilian) breast implant which are proved to reduce complications?
  • How much experience do you have with the rapid recovery technique?

Make sure you are being provided with the information to make your own informed decision, not simply sold a procedure. Avoid surgeons or clinics where your initial consultation is not with the surgeon. Do not accept a preliminary consultation with a nurse or a sales consultant. This tactic is used by some clinics to pre-qualify patients so the surgeon gets a better conversion rate of patients booking for surgery from his consultations. This benefits the clinic and the surgeon but is bad for you. If the surgeon himself is not willing to spend time with you to make sure you get all of the correct information to help you make one of the biggest decisions of your life go elsewhere and find one who will! Sometime the nurse/consultant consultation is promoted as free whereas you may have to pay for a consultation with the doctor. At the Cosmetic Surgery Institute of Australia your consultation will be with the doctor who performs the surgery and it will either be free of charge or bulk billed if a Medicare rebate applies. Finally and most importantly, of you are seriously thinking about having breast implant surgery, take your time and do your research. There is no rush.

Guest post supplied by Dr Daniel Fleming

Telephone: 1800 682 220 or (07) 3252 8929 Facsimile: (07) 3252 8979

Address:Corner of Baxter Street and Water Street
Fortitude Valley Brisbane Queensland 4006 Australia


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