Knowing the time, effort, dedication and sometimes heartache it takes to become a physician, the thought of something as valuable as a license to practice medicine being taken away leaves me in utter dismay.  Why would any physician ever risk losing something that is so difficult to obtain?  The fact that a physician initially trained in ENT (ear, nose, and throat) surgery would venture into cosmetic surgery and breast augmentation is equally hard for me to understand. I imagine the Florida Board of Medicine only takes this action when they believe there is no other choice to protect patient safety.

This should serve as an example of why you should vigorously do your homework before choosing a physician to do your breast augmentation.  Look for a surgeon who is board certified by the American Board of Plastic Surgery.

Also keep in mind that other specialties besides plastic surgery are still out there doing breast augmentation in Sarasota. As I stated previously in the Sarasota Plastic Surgery Center Blog, I believe most patients who have breast augmentation by these physicians believe they are being cared for by a plastic surgeon. These physicians typically call themselves “cosmetic surgeons” and probably don’t go out of their way to bring up their non-plastic surgery background.  Keep in mind, there is no ABMS recognized board of cosmetic surgery.

Again, do your homework before making such an important decision as which doctor will do your breast augmentation!  The easiest way to check board certification is through the ABMS website. You can call toll-free 1-866-ASK-ABMS (275-2267) or search online. The site does ask you to register with an email and password, but it’s worth if to make sure your physicians has the credentials you think they have.

To make it even easier for you, I have listed, in alphabetical order, all of the Sarasota based plastic surgeons who are board certified by the American Board of Plastic Surgery (the only ABMS recognized board that certifies plastic surgeons):

• Christopher Adamson, MD
• Marguerite Barnet, MD
• Scott J. Engel, MD
• Braun H. Graham, MD
• James Marsh, MD
• David L. Mobley, MD
• Rajasekhar Nalluri, MD
• Andre, Renard, MD
• James H. Schmidt, MD
• John Strausser, MD
• Vincent VanWinkle, MD

Again, I hope this helps you in your search for the right surgeon to do your breast augmentation.  It’s a jungle out there and this is my attempt to help find your way through it.

Next came the question any patient might ask if they knew his credentials in detail, “Why would an Oral Surgeon be performing breast augmentation?” I replied that I didn’t know, but suspected it was because cosmetic surgery is more lucrative than extracting wisdom teeth (and certainly more interesting).  Admittedly this is just my opinion, since I don’t know how lucrative or interesting extracting wisdom teeth is.  For all I know, it may be quite thrilling.

Besides Plastic Surgery, the specialties that you will find performing breast augmentation in Sarasota include two peculiar choices, Oral and Maxillofacial Surgery, and ENT Surgery (aka Ear, Nose and Throat Surgery).  When I mention this to patients, I usually get an incredulous look and a question like “How is this possible/legal?” This is probably the same reaction I would get if I began offering wisdom tooth extraction as one of my services. (Don’t worry! I have no desire to do this! Plus, I wasn’t trained to do this in my plastic surgery residency and there is probably a lot more to it than I imagine.)

My patient indicated she was totally unaware of the doctor’s Oral Surgery background and would never consider having someone initially trained in oral surgery do her breast augmentation, no matter how much additional training they had completed. I indicated that in Florida she has a choice and it is up to her to do her homework and find the doctor she wants for her surgery.

Admittedly, I am a little biased in this matter because I decided early on that I was interested in plastic surgery.  I completed an ACGME approved plastic surgery residency in order to obtain, in my opinion, the best possible training in my field. I trained many extra years and passed a very intensive written and oral board examination in order to receive plastic surgery board certification. Having doctors with uncertain credentials and far less training, posing as plastic surgeons is particularly disturbing to me.

Given complete disclosure by their potential surgeon, I believe most patents would choose a Board Certified Plastic Surgeon to perform their breast augmentation. I fear most patients who choose an oral surgeon or ear nose and throat surgeon do not realize the doctor performing their breast augmentation is not a board certified plastic surgeon.

Listed below, in alphabetical order, are the surgeons who practice primarily in Sarasota and are listed by the American Society of Plastic Surgery as being board certified by the American Board of Plastic Surgery (the only ABMS recognized board that certifies plastic surgeons):

• Chistopher Adamson, MD
• Marguerite Barnet, MD
• Scott J. Engel, MD
• Braun H. Graham, MD
• James Marsh, MD
• David L. Mobley, MD
• Rajasekhar Nalluri, MD
• Andre, Renard, MD
• James H. Schmidt, MD
• John Strausser, MD
• Vincent VanWinkle, MD

Hopefully this will help you in your search for the right surgeon to do your breast augmentation. Obviously, I would suggest a physician who is board certified in plastic surgery by the American Board of Plastic Surgery.   Any doctor you are considering who practices in Sarasota that is not listed above, is not a board certified plastic surgeon. Finally, ask yourself, “Do I really want an Oral Surgeon or Ear, Nose and Throat Surgeon performing my breast augmentation?”

Now, admittedly, in most areas of life, outside of plastic surgery, I don’t know what women really want.  My wife reminds me of this on a regular basis.  But when comes to breast augmentation, I have made some valuable observations over the years.

Obviously, most women want to be larger and many ask for a full-C cup but they want to maintain a “natural” appearance.  These are often competing priorities since the larger you make a patients breasts, often the less natural they appear.   I don’t mean to imply women don’t know what they want.  In fact, they usually know exactly what they want.  It is the surgeon who may not fully understand.  This meeting of the minds between the patient and surgeon on what she really wants is the most important step in a successful breast augmentation.  Below I have listed what women often say they want, followed by what I think they really want concerning breast enlargement.

What Women Say:  I want to be a full C-cup

What Women Really Want:  Most women want breasts that are full, yet proportional to their body.  I use a combination of measuring the amount of space I have to put the implant (base dimension) and observations like height, shoulder width, and shape of the chest and torso to decide the correct size.  In other words if the implant fits the patients body well, they tend to like the appearance, regardless of the volume.  During the consultation I let patients “try on” the implants and choose their favorite size without telling them which implant fits them the best.  They almost always choose the implant that fits them best, instinctively (they know what size they really want).

What Women Say:  I want to look natural.

What Women Really Want: They want larger, youthful appearing breasts that have some fullness in the upper portion of the breasts and the nipple well centered.  This fullness in the upper portion of the breasts, while not present in most natural breasts, is highly prized by most women.  I will most often use an appropriately sized smooth high profile or moderate plus profile (medium high profile) breast implant to give them this fullness.

What Women Say:  I don’t want to be too large!

What Women Really Want:  Usually, there are two different sized implants that will fit a patient’s chest wall and torso well enough to be chosen.  Understandably, patients are often hesitant to go “too large” fearing they will look “unnatural”.  I usually recommend that if it comes down to two possible sizes, that they choose the larger.  It is common for women to wish they had gone slightly larger unless they choose the slightly larger (30-50 ml) implant.

Knowing these three “principles” of sorts has allowed breast augmentation to become one of my favorite procedures to perform, since I can predictably give patients the full, youthful appearing, proportional breasts that they really want.   To see examples of these results, visit sarasotaplasticsurgery.com and check out our gallery of before and after photos.  I would also invite comments from all.

Generally, the surgeon offers unrealistic claims such as very short operating times “about the time it takes to have lunch” or minimal down times by explaining that“ in a few days” or the “next day” you can be recovered.  With a little research (check the ABMS web site) you may often find that these surgeons are not board certified in plastic surgery and that their residency training was not in an ACGME accredited plastic surgery residency.

In medicine, it has been a longstanding tradition to allow your colleagues to judge your innovations and discoveries by publishing them in a peer-reviewed journal for all to see.  If what you have discovered is so ground breaking or revolutionary then it will stand up to this scrutiny.    If it improves a procedure so much, then you want others to know, so they can offer a better, safer facelift to their patients.  The last thing you would want to do is hide this discovery behind a trademark ®.

Don’t be fooled by these often false claims and marketing ploys.  They are designed to lure you into a particular surgeons office, not offer you something better.  Good cosmetic surgery takes time to do and time to recover from.  A board certified plastic surgeon will openly explain this and give you realistic options for long-term improvements.  Then you can decide knowing the real facts.

Although I haven’t invented the “Mobley-Lift®, or Mobo-lift®” yet, when I do I will publish it in the Journal of the American Society of Plastic Surgeons so all of my colleagues and their patients can benefit.  Until then, you can read about the presently available legitimate mini-facelifts and necklifts, which have been published and reviewed, at SarasotaPlasticSurgery.com.

When we decided to undertake this mammoth project we, as a group of four board certified plastic surgeons, decided our mission was to provide, above all, valuable content that would educate our potential and current patients.  As our name states we are Sarasota Plastic Surgery and want to provide you with the best and most up to date source of information on plastic surgery in Sarasota and the west coast of Florida.

While many sites that I see are watered down by slick marketing and false claims provided by surgeons with uncertain credentials, we have none of the above. Everything you read on our site is the current best practice in plastic surgery, known as the gold standard as defined in Dictionary.com:

In other words, this is the currently accepted best way to do something by most experts in the field (of plastic surgery for example).

All of the content in this site was written by Drs. Graham, Schmidt, Engel and myself.  We are all board certified by the American Board of Plastic Surgery which is the only true ABMS accredited board which certifies plastic surgeons.  (By the way, if you are curious about your surgeons true board certification, just type his name and information into the boxes provided in this link, ABMS,  and click search.  If nothing comes up, he is not board certified at all.  Try it, you may be surprised)

Our newest feature on SarasotaPlasticSurgery.com is our Solution Finder which you can find under the Resources tab at the top of the first page of the site or by clicking the Solution Finder tab at the bottom of the first page.  By just passing your cursor over the area of your body you are concerned about and clicking on your concern (Baggy Lower Eyelids or Breasts Are Too Small ) you are taken directly two the correct procedure with a complete explanation.  There are links to make and appointment for a consultation, see some before and after images or even attend one of our educational seminars.

As it says on our Solution Finder page,  ”what could be easier?  go ahead, give it a try…” We also want your feedback on what you think about our new Solution Finder and our new SarasotaPlasticSurgery.com web site for that matter.  Be advised, we have not posted many before and after images yet, but those are coming soon.

If you can think of ways to improve SarasotaPlasticSurgery.com and make it even more informative we would love to hear your thoughts, so don’t hesitate to comment.

David L. Mobley, M.D.

The best resource, in addition to ASPS membership, is to ask former patients, friends, relatives, nurses or other physicians for their recommendations. Most plastic surgeons will have a lot of patients who have had the surgery you are anticipating, who are willing to talk to other patients about their experience. Nurses who work in the local hospitals will have heard about, or had experience with, the plastic surgeon in your area. Your surgeon should have staff privileges at the local hospitals. This also means they are reviewed by their peers. Talk with as many people as you can.

Research their education and training, Make sure they have completed a successful residency in plastic surgery. Most will have had both a general surgery and plastic surgery residency.

Ask about their practice. How many and what types of procedures do they do on an annual basis? The surgeon should feel comfortable giving you information substantiating his or her competency in procedures done.

Check to see what memberships in societies the physician holds. Membership in the ASPS is the largest most proficient membership of plastic surgeons. There are also societies such as the American Society of Aesthetic Surgery, and American College of Surgeons, and the American Medical Association. Ask for the address or phone number and inquire into the requirements for the society.

The initial consultation to the plastic surgeon should be for you. Make sure you write down questions you want answered, as you will forget them once you are in the office. The physician should have plenty of time for you and not appear to be rushed or arrogant. No question is too trivial so don’t feel intimidated by the MD behind the name. The physician should outline the risks, benefits and any alternatives that are available to you. Be frank and honest with your expectations. Have the physician reiterate to you what he feels your expectations are so you both have a clear understanding. There are times a physician may decline to do the procedure if the expectations you have cannot come to fruition.

During the consultation, the physicians should outline the costs and payment policies. A reliable practice will give you both a verbal and written quote of the costs, and payments and cancellation policies. You should also receive a statement of what will happen if a “touch-up” if necessary and how long in terms of months, a “touch-up” would be done.

Ask the physician about the post operative period and what you can expect. Will there be any bruising, swelling or stitches? How long will it take for full results to become reality? Patients who smoke will take longer to heal. Your plastic surgeon may ask you to refrain from smoking for a period of time prior to and after the surgery.

The surgeon should discuss what type of anesthesia would be used. This can range from a local anesthesia where the area affected is numbed, to general anesthesia, where you will be asleep through the whole procedure. Local injection plus sedation will allow you to stay awake but feel completely relaxed.

Don’t feel troubled if a physician asks you questions about your psychological nature. He/she is only trying to make sure you are considering this change for the right reasons. At times a physician may suggest counseling prior to the procedure and explain to you how this may help you.

Get a feel for how the nursing and other staff interact with you and with each other. Do they appear content and make you feel like you are a special person? Do they answer any of your questions with confidence? Do they appear confident in what they are doing?

Finally, you need to leave the consultation feeling comfortable with the physician. If you have other questions or concerns after the initial consultation the physician should be available to see you again or talk to you on the phone. You should have no hesitancy whatsoever before the procedure.