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Time for a new you?
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September 28, 2000: 11:08 a.m. ET
It's your body, so choose your plastic surgeon carefully
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NEW YORK (CNNfn) - Mirror, mirror on the wall -- I don't like the way I look at all.
Think your nose is too big? Want more hair? Tired of all those spare chins? If you're considering cosmetic surgery to improve your appearance, you've got plenty of company.
Once viewed solely as an option for Hollywood stars and people with loads of money, cosmetic surgery is gaining a wider audience. The number of people who had procedures performed last year, in fact, nearly tripled from 1992, according to a report by the American Society of Plastic Surgeons.
Society President C. Lin Puckett said cosmetic surgery is more popular than ever and it's not just aging movie idols rolling into the operating room. It could be your friends, your neighbors -- even you.
"For the most part, these procedures are affordable by the majority of middle class people," Puckett said. "It's not just the wealthy or media types like it was 25 or 30 years ago. Really, it's the person next door."
Puckett attributes the increased interest in cosmetic surgery to several factors, including the desire by aging baby boomers to retain their youthful appearance and a relaxing of attitudes over the years.
"There's more open dialogue about cosmetic surgery," he said.
The costs of these operations vary widely by location, with the Midwest being the least expensive area in the United States. Big cities such as New York, Los Angeles and Miami are going to be more expensive.
The most recent ASPS national figures on the cost of particular cosmetic surgery operations were compiled in 1998. According to those statistics, breast augmentation on average cost $3,077, while a facelift cost about $4,991. A tummy tuck cost about $4,095 and liposuction at any single site cost $1,872.
Gender mender
Liposuction, a technique that removes unwanted body fat, remains the most commonly performed cosmetic procedure. The number of these procedures increased nearly five times since 1992, according to the ASPS, rising from 47,212 to 230,865. This was followed by breast augmentation, eyelid surgery, facelifts and tummy tucks. 
The number of men choosing cosmetic surgery in 1999 rose 2 percent, which accounts for almost 11 percent of the market.
Liposuction was the most popular procedure among men, increasing a staggering 385 percent from 1992 and comprising nearly 28 percent of the total number of tracked procedures.
"These figures show a change in the gender gap," Puckett said in a statement. "Men are becoming as concerned about remaining fit and trim as women."
Eyelid surgery was the second most popular procedure with men, up 145 percent and nose reshaping, which was the No.1 procedure in 1992, dropped to the third most popular procedure.
At the same time, the number of cosmetic procedures among women jumped 165 percent since 1992. Liposuction, breast augmentation and eyelid surgery remain the most popular procedures with women. Last year 500,000 women had one or more of these operations done.
Fishing for surgeon
What should you look for in a good plastic surgeon? You want someone who will tell you the truth, experts say, including what cannot be accomplished by nips and tucks.
The ASPS encourages consumers to ask questions, no matter how trivial or personal they may sound. You may want to write them down beforehand, so you don't forget anything.
The surgeon should answer all your questions thoroughly and advise you of the risks of the surgery and the possible variations in outcome.
"The patient should ask about the risks, the recovery time and alternative approaches, " said Dr. Richard A. D'Amico, chief of the department of plastic surgery at Englewood Hospital and Medical Center in Englewood, New Jersey. "The patient needs to hear from the surgeon what the realistic expectations are and that has to be acceptable to the patient."
Also, don't be fooled by computer imaging. This technique can be helpful in giving patients an idea of what they will look like after surgery, but D'Amico said the imaging must be honest.
"There are things you can do with the computer," he said, "that you may not be able to do in the operating room with the scalpel."
And even if your surgery will be performed in the doctor's own facility, Puckett said the surgeon should have privileges to perform that procedure at an accredited hospital in your community.
"It generally means there has been a peer evaluation," he said.
ASPS members are certified by the American Board of Plastic Surgery. You can call the ASPS at 1-888-4-PLASTIC, leave your name, address and procedure you're considering. The ASPS will provide you with five names of plastic surgeons in your area that perform that procedure.
Tips for picking the tops
If you're considering plastic surgery, experts say you should pick someone who is board certified. That can be difficult since there are several plastic surgery-related boards and you might find it confusing.
The American Board of Medical Specialists was established in 1933 and serves as an umbrella organization for 24 approved medical specialty boards, including two plastic surgery-related organizations: the American Board of Plastic Surgery and the American Board of Otolaryngology, which focuses on the eye, ear and throat.
Remember cosmetic surgery is indeed surgery and you should take it seriously. Nicholas Chugay, a Beverly Hills-based plastic surgeon said it is imperative that you put yourself in competent, seasoned hands.
"Look for the surgeon with the best, modern training and technique," Chugay said in a statement, "and the tactical skill of a Michelangelo."
Chugay has compiled a list of items consumers should consider before going ahead with cosmetic surgery. The list includes:
- Experience. Look for a doctor with preferably 15 or more years in cosmetic surgery, especially for more complicated procedures.
- Specialization. Make sure the doctor is an expert in the particular procedure you want. Look for someone who has published papers, done research in his or her specialty and is recognized by others in the field.
 - Education. Does your potential plastic surgeon stay on top of new techniques and procedures? Does he or she regularly attend and participate in professional seminars and conferences?
- Teaching. Has your doctor been a teacher of his or her craft? Have they conducted fellowship studies and trained others?
- Artistic. Does the doctor have a natural talent for this kind of work? Look at photos of their previous work and judge for yourself.
- Comprehensive training. Does the doctor have specialized training in the area of interest and does he or she belong to a professional association that addresses a particular surgical specialty?
- Recognition. Do others in the field have high regard for your doctor? Has he or she published articles on their specialty or gained public stature in their field?
- What's new? Is your doctor up on the latest technologies and new procedures?
- Referrals. Is your doctor willing to let you speak with former or current patients? They're your best referral.
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