CosmeticSurgery.com Staff Report

Our third article in a series about the costs of plastic and cosmetic surgery reveals how and when plastic surgeons might make you an offer about savings on that procedure you've had in the back of your mind. And usually, it's an offer you just can't refuse.

Think fees for plastic surgery procedures are too high? Perhaps you are considering going to India, Thailand, or some other exotic locale for more reasonable prices on offshore plastic surgery?

Montego Bay, Jamaica
(Jamaica Tourist Authority)

Well, if you know how to negotiate fees and costs with a U.S. plastic surgeon, you can probably pay less right here at home. Many plastic surgeons are willing to give you a break on their normal fees and charges if you are educated about the way a plastic surgery practice operates.

Of course, any plastic surgeon is dedicated to the practice of medicine but his office is a business, nonetheless. And any business involves attracting, pleasing, and keeping customers.

Lloyd M. Krieger, M.D., a board certified Beverly Hills plastic surgeon, wrote an article, "Discount Cosmetic surgery: Industry Trends and Strategies for Success." It was printed in a 2002 issue of the professional journal Plastic and Reconstructive Surgery.

Discount Plastic Surgery

"Discount cosmetic surgery is a topic of interest to plastic surgeons…..", Krieger writes. "A survey of plastic surgeons about their practice environment revealed that 93 percent categorized the majority of their patients as very or moderately price sensitive.

"Fully 98 percent described their business climate as very or moderately competitive and most plastic surgeons thought they lost a sizeable number of cosmetic patients within the last year for reasons of price."

Costs of Plastic Surgery

The occasions when price breaks on the usual fees for cosmetic plastic surgery are available, are also the times when plastic surgery business managers are the most concerned about new business coming in, making fees affordable and keeping patients.

Here are the top 10 most common opportunities for saving on plastic surgery procedures:

1. The Slow Seasons

(Capgros photo)

"Seasonality is huge in plastic surgery," says Stuart Linder, M.D., a board certified Beverly Hills plastic surgeon. "For many body procedures, plastic surgeons are busier when school is in session."

So you may find welcome ears if you ask for a discount -- or if you can arrange your surgery -- during the surgeon's slow season. Discounts up to 25 percent are often offered for procedures in the least busy seasons.

2. Friends and Family Discounts

For most surgeons, the price for one, pre-surgical consultation is the same as for two. Additional discounts may be had if two or more people go through surgery together.

"Savings are available because one set of instructions can be sent home, one surgical follow-up can be done for two people and so on," says Robert Kotler, M.D., a board certified Beverly Hills cosmetic surgeon. "Two patients can share a room in a recovery center and save on that cost, too."

3. Stand-by Surgery

(Capgros photo)

When plastic surgeons arrange to use operating rooms, most must spring for an eight-hour day because the surgical center, the anesthesiologist, and any attending nurses are all paid for eight hours. But if one or several patients cancel on that day, the surgeon has to compensate for idle hands. A way around the dilemma is if patients with flexible schedules volunteer for stand-by surgery.

"We won't call you the night before surgery, but you would get anywhere from seven to 10 days notice," says Dr. Kotler. "The best situation of all is if the patient can give us a list of dates he or she can undergo surgery."

4. Undergo Several Procedures At Once

Darshan R. Shaw, M.D., a board certified Bakersfield plastic surgeon, offers discounts for patients who have several procedures in one surgical session.

"It's much more convenient and efficient for the surgeon to perform several surgical rejuvenations on a patient at once," Dr. Shah says. "That means less follow-up time for the surgeon, with two procedures on one body to oversee through the healing process.

"I usually grant a five percent discount for a second added procedure and 10 percent for a third," he says.

5. Pay in Cash

(Apostolic photo)

Observes F. Richard Noodleman, M.D. a board certified dermatological surgeon in Campbell, California: "Surgeons also pay a fee to the credit card issuer when a patient offers a credit card as payment. So it's worth a five percent discount to us when a patient pays in full with cash or by a check."

Dr. Noodleman also recommends signing up for e-mail newsletters issued by plastic surgery practices because you can then take advantage of specials that crop up during slower times.

6. Insurance Benefits

Some plastic surgery procedures - such as rhinoplasty, breast reduction and upper eyelid reduction - are often fully or partially covered if the procedure prevents additional health woes.

Nose surgery, for instance, may be covered by insurance -- even if the result is highly cosmetic -- if some other health condition like blocked breathing or sinus troubles are corrected.

Explains Dr. Kotler: "In December, the demand for nasal surgery to improve breathing increases because many patients have met the insurance deductibles and co-pays for the year and want to take advantage of the savings before the New Year."

7. Ask about Manufacturer Specials

"Sometimes manufacturers create a promotion for a certain product, like chin or breast implants," says Mark Youssef, M.D., a Los Angeles cosmetic surgeon. "If a surgeon buys 10, we get two free. We can pass the savings onto the patient."

Dr. Youssef also has a reward program in which five percent of the cost of every procedure is put onto a special credit card given to the patient. The card can only be used at his practice, but any amount on it can be applied toward the cost of additional services.

8. Layaway Plan

Some plastic surgeons offer a plan whereby patients can pony up a little at a time until the complete fee has been covered. Then, the surgery is scheduled.

9. Talk to the Press

(Kkisser photo)

It's considered a breach of medical ethics for a surgeon to perform a procedure on a patient at no cost in return for publicity. Nonetheless, many surgeons will arrange for a discounted fee if the patient is willing to talk to the press about his or her procedure while allowing both print and online publications to use the before and after plastic surgery photos.

"Radio contests, raffles or charity auctions that give away plastic surgery as prizes are also verboten," says Dr. Kotler.

10. Send me Patients!

While Kenneth Rose, M.D., a board certified New York City plastic surgeon, dislikes the concept of bargaining with a plastic surgeon, he does say he has offered no-charge procedures "once or twice" to former patients who have busily and eagerly spread the word about the doctor's excellent results and brought in anywhere from 10 to 15 new patients through word-of-mouth.

Top 5 Signs that Plastic Surgery is Too Cheap

Dr. Rose has noticed that some plastic surgery procedures are being offered at rock bottom prices.

The following red warning flag conditions may indicate when prices are too low to be safe and -- probably -- effective, according to Dr. Rose. Here are his tips:

5. Distance

(Luci photo)

A less expensive plastic surgery procedure found in another city can end up costing two or three times what you would have paid at home.

The reason? Every surgical procedure has risks, both big and small. If you must return to a surgeon 2,000 miles away to correct a complication, any savings will be erased by travel, lodging, and time away from work.

4. Buyer Beware

Usually, there are very legitimate reasons why plastic surgery has high costs. If you hear of a dramatically reduced price, you should wonder what corners are being cut to offer surgery so much lower than anybody else.

3. Surgeon's Fee (any surgeon's fee can vary depending on):

• Complexity of the operation
• Time required to complete it
• The size of the patient and number of areas treated
• The difficulty of the procedure

"Two different patients may be quoted very different prices for the same procedure," says Dr. Rose. "Patients who use other people's cases as a bargaining point are often unaware of the different factors."

2. Anesthesiologist Fee:

A board certified anesthesiologist offers the highest level of training and safety but adds to the total cost. Some surgeons may offer lower prices by:

• Doing the anesthesia him or herself
• Using local anesthesia for procedures that should be done under sedation

1. Implants

Breast, cheek, buttock, calf and other implants are often used in plastic surgery. The costs of materials are usually included within the surgeon's fee and can represent a significant part of your overall costs.

"But if you are being charged next to nothing for a procedure that requires an expensive implant," says Dr. Rose, "You have to wonder how such a fixed cost can be cut so much."