1. 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.

2. 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.

3. Confirm the surgeon's credentials, and research his or her malpractice history on the Internet. In Florida for example, 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.

4. Is he or she Board Certified in plastic surgery? Board certification in plastic surgery is a good place to start, but does not guarantee quality surgery.

5. 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.

6. 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.

7. 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.

8. 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.

9. All surgery involves some risk and unpredictability. Be suspicious of any surgeon who guarantees a particular result.

10. 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.

11. 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.

12. Be wary of surgeons who insist on correcting features that do not bother you.

13. 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.

14. 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.