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Of course you are not expected to ask all of these questions but you are entitled to if you want to. If a surgeon decides he doesn't have time to answer all of these questions, then you don't have time to hand over several thousand dollars. Don't forget, YOU are in charge. For ease of reference highlight the numbers of the questions you do wish to ask at your consultation.

Surgeon: ____________________ Date: ___________ Time: ________ am/pm
phone: _____________________ address: _____________________________
________________________________________________________
website: _________________________referrer by: ______________
Certified by:
American Board of Plastic Surgery: yes/no
Other: ____________________________________

Rating (circle one)

• patient referral list available: yes - no

• bedside manner:poor- fair - average- above average- excellent

• communication skills: poor- fair - average- above average- excellent

• attitude of staff: poor- fair - average- above average- excellent

• appearance of surgeon:poor- fair - average- above average- excellent

• office appearance: poor- fair - average- above average- excellent

• all questions answered: yes- no

Overall Rating: poor- fair - average- above average- excellent

1. What made you decide to become a Cosmetic Plastic Surgeon? ___
   _____________________________________________
   _____________________________________________

2. How long have you been practicing as a Cosmetic Plastic Surgeon?__
   _____________________________________________

3. Are you certified by the American Board of Plastic Surgery? If so, How long?
   _____________________________________________

4. What, if anything, was your medical specialty before you chose to practice cosmetic surgery?
   _____________________________________________
   _____________________________________________

5. Have you ever been disciplined by the board or by the state?__

6. If yes, why? __________________________________
   _____________________________________________

7. What is your favorite procedure to perform and why?__
   ______________________________________________

8. How many Liposuctions per month/year do you perform?__

9. How many revisions of your own work, on average, do you have to perform? ______________________________________________

10. Have you or would you be willing to perform this procedure on a loved one or family member? ______________________________________________
    ______________________________________________

11. Would there be any reason that I would not be a good candidate for this surgery? ______________________________________________
    ______________________________________________

12. I have heard of patients developing a hematoma, this scares me; what is it, how often does it occur and how is it dealt with?
    ______________________________________________
    ______________________________________________

13. Are there other techniques, newer ones perhaps, that I am not aware of? ______________________________________________
    ______________________________________________

14. Do you have a video tape available of a liposuction procedure that I may check out? ______________________________________________

15. How long do you recommend I take off from work, school, etc. to heal properly?
    ______________________________________________ ______________________________________________

16. What types of medications will I be given and which pain medications do you normally prescribe? _____________________________________
    ______________________________________________
    ______________________________________________

17. I am sensitive to Vicodin and Codeine (if applicable - it makes some people nauseated), what alternative medications do you offer?
    ______________________________________________
    ______________________________________________

18. Do you perform your surgeries with the patient under general, Light Sleep Sedation or local anesthetic and an oral sedative? Why?
    ______________________________________________
    ______________________________________________

19. I have heard that general anesthesia makes the patient sick to their stomach, is this true? What can you do to lessen its effect?
    ______________________________________________
    ______________________________________________

20. Can I view your Before & After photos?_____________ ______________________________________________

21. May I speak with any of your patients who have had liposuction by you? For instance, do you have a referral list of patients that I may contact by phone?
    ______________________________________________

22. When should I expect to look "normal" again?___________________________________________

23. I have heard Arnica montana and Bromelain help with the swelling and bruising if taken before and after my surgery. Do you recommend it? _____________________________________________
    _____________________________________________

24. Will I have scarring? If so, how bad will it be? How large are your incisions? _____________________________________________
    _____________________________________________

25. Do you recommend scar products such as silicone gel sheeting, or Mederma, paper tape and other types? ___________________________________
    ______________________________________________

26. Do you have an onsite accredited Surgery Center? May I see it and WHO is
    it accredited by? ________________________________
    ______________________________________________

27. Do you have hospital privileges, should I choose to undergo my procedure in a hospital? If not, did you lose those privileges? (if so, doctor must disclose this information but may not) ______________________________________________
    ______________________________________________

28. Will I have a certified anesthesiologist (especially when going under General)? ______________________________________________

29. What tips do you have for me to ease some discomfort and pain?
    ______________________________________________

30. Must I abide by any special diet, both pre-operatively and post-operatively?
    ______________________________________________

31. I take [enter medications here] will I have any adverse reactions from the prescribed medications or anesthesia? (Don't forget to view the Medication & Supplement List) ______________________________________________
    ______________________________________________

32. What would you do if I were to choose to undergo the surgery and I had a complication?
    ______________________________________________
    ______________________________________________

33. Do you believe my expectations can be met? _________

34. If my results are not satisfactory, what is your policy on a revision?__
    ______________________________________________
    ______________________________________________

35. What if I change my mind and back out, will my money be refunded?_

36. If I have an emergency the night after surgery, what should I do? __
    ______________________________________________

37. If such an emergency arises, will you be the attending physician? __

38. If I will need sutures (stitches), when will they be taken out? _____

39. Are there any hidden costs that I should know about? For lab work, post-operative check-ups, additional medications?
    ______________________________________________
    ______________________________________________

40. If I need anything after-hours, how will I be able to get in touch with you or your staff? ______________________________________________

41. What are your policies on post-operative care?_________
    _______________________________________________

42. Do you offer financing (if applicable)? Do you expect full payment up front? Can I pay in increments?
    ______________________________________________
    ______________________________________________

43. How long after will I be able to walk, exercise, run or participate in contact sports?
    ______________________________________________