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Plastic Surgery Costs: Making Sense of It

Consumers go to great lengths to compare, contrast and find affordable plastic surgery prices. But total costs can vary widely, depending on the area in which you live, the procedure and the surgeon. Experts warn that shopping for bargain basement prices can be a huge, costly mistake.

Jane M., a New York public relations practitioner, wanted a breast augmentation and heard that she should use a board-certified plastic surgeon. Armed with that information, she made appointments with three doctors, looked at their before and after pictures and studied their training.

She found the total cost of breast augmentation was around $8000 and went ahead with the procedure which went well and turned out fine after healing.

But Jane (who asked to be identified by first name only) was upset when she found an equally qualified surgeon in North Carolina charging only about $4500. One of Jane's cousins lives in that state so it would have been little additional trouble to travel there for the procedure.

Jane is not the only person in the United States who has trouble making sense of out complete plastic surgery costs.

Prices for Plastic Surgery

The American Society of Plastic Surgeons (A.S.P.S.) lists on its web site the national average of plastic surgery physician fees.

However, the fly in the ointment is that total prices vary widely among regions, with plastic surgery hot spots like Manhattan, Beverly Hills, Miami, Dallas, and Orange County, California, charging the most. More lightly populated regions like North and South Dakota, Idaho, Mississippi and Arkansas charge much less.

Mid-level costs are incurred in Phoenix, Tennessee, Ohio, Indiana, New Mexico and Illinois along with locations away from big cities within high priced states.

So the first step in considering what you'll pay is looking at fees in your area. Or, where you could have surgery.

"The fee you pay for any cosmetic plastic procedure reflects the costs your surgeon must pay for rent, salaries, supplies and other overhead," says Charles M. Boyd, M.D., M.B.A., F.A.C.S., a professor of surgery and associate chief of staff at the University of Michigan. "Manhattan is one of the priciest U.S. locations so plastic surgery fees there are very expensive."

Even if you live in an area with mid level prices -- like Columbus, Ohio -- you can still save 10 to 15 percent on surgical fees by traveling to a location just a little way from where many surgeons are located.

"Traveling the 30 miles from Columbus to Lancaster is a good example," says Jason B. Lichen, M.D. a board certified plastic surgeon in Columbus.

Costs of Eyelid Surgery

For instance, upper eyelid surgery from a board certified plastic surgeon in Beverly Hills is about $4350. But at the office of an equally experienced, double-board certified facial plastic surgeon in Temecula, 80 miles southeast of the Golden Ghetto, the total fee is $2300.

Upper Eyelid Incision
The white dotted lines show
the typical incisions used in
upper eyelid surgery. More.

Nonetheless, Makeover Centers of American quotes a total fee of $4598 for upper eyelid surgery in Temecula.

According to most business and medical experts, using prices alone as your guide to rejuvenation surgery can be a mistake.

The second step in figuring financial costs of surgery is to ask about the other charges involved.

For instance, at the Loftus Plastic Surgery Center in Cincinnati, Ohio, the surgeon fee for upper eyelid surgery is listed as $1900. But the procedure requires a $500 fee for operating room use and another $550 for the anesthesiologist for a total of $3100. Dr. Loftus is board certified in plastic surgery and otolaryngology (head and neck surgery).

In Carmel, Indiana, upper eyelid surgery is listed on the web site of Jerrold A. Laskin, M.D. for $2300 as "an approximate package price." The doctor is board certified by the American Board of Plastic Surgery.

In Manhattan, the same procedure is listed on the web site of Park Plaza Plastic Surgery between $3500 to $4000, plus another $650 for operating room and anesthesiologist fees. Dr. George Lefkovits is board certified in plastic surgery as well as otolaryngology.

(Read more about how to find and select an appropriately trained surgeon and what the term "board certified" means.)

Caution on Low Fees

The American Society of Plastic Surgeons web site lists the national average physician fee for eyelid surgery at $2666.

Cautions Robert Kotler, M.D., F.A.C.S., a plastic surgeon and author in Beverly Hills: "High fees don't necessarily guarantee superior results. Low fees are not always a bargain."

Additional costs can include a fee for your initial consultation, medical tests you may require if you have a chronic condition like diabetes, various wound, pain and other medications and compression garments that must be worn after some procedures like breast augmentation and liposuction.

"High fees don't necessarily guarantee superior results. Low fees are not always a bargain."

"There is value in using a superspecialist," writes Dr. Kotler in his book, Secrets of a Beverly Hills Cosmetic Surgeon. "While he or she may charge 10 to 25 percent more than other surgeons within that area, a superspecialist is efficient and requires less expensive operating room time."

Hospital Stay?

If you have a very extensive procedure with long incisions, like body shaping or a tummy tuck, your surgeon may require you to spend an expensive night in the hospital.

If you're having breast augmentation, a separate fee is usually charged for the silicone implants which usually cost about $800 more than saline.

A Surgeon, Mid-Procedure

And if you choose silicone, ask if you will be required to have an MRI scan every three years, a test that currently costs about $1000.

Some patients utilize a recovery center, where a nurse is on 24-hour call, for a night or two before going home.

Saving Money

"If you price shop among qualified surgeons, you may be saving money in the long run because he or she will have a better handle on caring for unexpected complications that could drive up plastic surgery costs," says Dr. Boyd. "Paying a little more for the right training and experience is like having an insurance policy."

Conversely, shopping for the cheapest possible price can lead you down the proverbial garden path.

"Some national chains advertise quick results and charge medium level fees -- like $3000 for a quick facelift," says Dr. Boyd. "The company promises ten patients a week to any surgeon who takes part. However, the physician only sees $800 of that fee and wants to complete the procedure quickly."

M.D. Advertising

Dr. Boyd often sees and revises shoddy work from such bargain basement national chains. He observes that the advertising continues to drag in so many patients that a lackluster reputation counts for nothing.

"The value proposition is that many patients do not get a surgeon trained in facial or plastic surgery," says Dr. Boyd. "That often leads to a revision surgery costing two to four times more than the original 'bargain' procedure."

"A revision surgery can cost two to four times more than the original 'bargain job'."

Adds Dr. Boyd: "The rule for patients is: you must temper your price shopping with due diligence and investigate a surgeon's training and reputation."

Practice management professionals often ask surgeons not to advertise their prices because a common business technique is to first lure the prospective patient into the practice where perhaps some procedure can be agreed upon and delivered. Nonetheless, more reputable plastic surgeons often encourage inquiring patients to see two, three or even four surgeons before going ahead.

Chat Rooms & Forums

Physicians who do advertise their fees, however, say one of the most common searches done on the Internet is for finding the costs of plastic surgery. Thus, that surgeon receives more email -- thanks to search engines -- while filtering out prospective patients who can't, or won't, afford his services.

Saving Money For Surgery

"Another way of pegging plastic surgery prices in your area is joining Internet chat rooms and forums where former patients discuss their surgeries," Dr. Boyd says. "Former patients commonly give their opinions of surgeons' work as well as their prices."

Thermage Reviewed

For instance, at, of 30 reviewers rating a $2000 to $3,000 Thermage facial treatment, four reported excellent results, five said the treatment was good, 11 reported no effect at all while ten reported adverse affects. Some in the last group required more expensive correctional treatments.

Price shopping also works in reverse.

"It is very common for an older surgeon who wants to work less to raise all his prices 50 percent," Dr. Boyd says. "But it many cases, he only receives more calls and requests for surgeries because the perception is, if it costs more, it must be really good."

Nonetheless, demand for cosmetic and plastic surgery continues to climb. So some banks -- including the Bank of Scotland -- make plastic surgery loans while financing is commonly arranged through plastic surgeons. Many patients rely on credit cards.

And then, there is the occasional odd patient who saves up week by painful week and then pays for everything with cash.

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