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• Most surgeons will not charge for a consultation. “It’s so easy to come in and to learn what different surgeons do,” says Dr. Abdollah Malek, who has offices in Newark and Lewes. “Look at before-and-after photographs.”

• Ask about the global fee, which includes every cost associated with procedure. Make sure the doctor is not quoting you only his or her fee. Depending on the procedure, your total cost might also include an operating room and anesthesia.

• Bring photographs of what you looked like at a younger age. Doctors will also take photographs in the office. “The patients and I can put our thoughts together as to what areas we can improve,” Malek says.

• Show photographs of noses or other features that you admire on others, including celebrities. But be realistic. “A lot of things we do have become more natural-looking, as far as rhinoplasty and breast augmentation,” Malek says. “An old-fashioned rhinoplasty you can recognize from a distance.”

• Discuss your options. “A lot can be done with minimally invasive surgery,” Malek says. Or noninvasive surgery, for that matter.  “People want effective results but they don’t want the downtime,” says Dr. Lawrence Chang, a cosmetic surgeon in Newark. Depending on your age, a full facelift might give you more bang for the buck than Thermage or a mini facelift.

Dr. David Zabel, who practices with Chang, agrees. To help determine a procedure, he’ll compare patients’ looks to their actual age. He’ll assess the extent of any wrinkles. He’ll also look at the patient’s subcutaneous fat, which can be more of a factor for body-contouring procedures than facial procedures.

“If patients are anticipating a significant weight loss or they’re actively trying to lose weight, I recommend delaying the cosmetic procedure,” he says. Patients who’ve tried to lose 15 pounds for the past two years—without success—might be considered stable. Talk to the doctor about your history.

• Ask the doctor not only about his or her credentials but also how many times he or she has performed the procedure.
 

Cosmetic v. Reconstructive

Extreme makeover shows have led many to believe that cosmetic surgeons primarily correct or enhance our natural assets to make our appearances more pleasing. But cosmetic surgery is really rooted in plastic surgery, the area of medicine that involves reconstructing or repairing defects.

“Plastic surgery was pretty much born out of helping to repair war injuries, birth defects and facial injuries,” says Dr. Lawrence Chang, a plastic surgeon in Newark.

Though many plastic surgeons now concentrate on cosmetic procedures, most still do reconstructive work—albeit some more than others. Dr. Mehdi Balakhani, who has offices in Newark and Wilmington, does all types of reconstructive surgery, including repairing or reconstructing eyelids and noses after cancer surgeries.

Chang also does reconstructive surgery, in addition to cosmetic surgery. There is sometimes a fine line between the two. Consider post-bariatric body contouring, which performed after massive weight loss leaves a patient with sagging skin.

Like many plastic surgeons, Dr. Katheryn Warren, who has a Newark practice, takes her turn in the emergency room, where she once operated on a patient whose lip was bitten off by a horse. In her own practice, she often does breast reconstruction on cancer patients, and not only for those who’ve undergone a mastectomy. Radiation can cause breast malformations in patients who’ve had a lumpectomy.

The rules for finding a physician skilled in reconstructive are the same as for finding a cosmetic surgeon. Ask about his or her experience, review before and after photos, and ask about credentials.
 

Rise of the Medispa

In 2005, Dr. Susan Kirchdoerffer, a family doctor, sought another way to build her practice.  She looked at herself for the solution. She’d always liked spa treatments, and the term “medspa” or “medispa” was just coming into vogue. “It seemed like it would be beneficial,” she says. “It complements a family practice.”

Reflections opened in Brandywine Hundred in November 2006. “It’s fun, the revenue potential is there, and it makes people happy to come here,” Kirchdoerffer says.

Though definitions vary, most experts agree that a medical spa is run by a licensed healthcare professional. Suellen Scheiner, a registered nurse, runs O’Leigh Cosmetic Center’s Med Spa in Elkton, which is affiliated with husband Dr. Marc Scheiner’s cosmetic surgery practice.

Similarly, Nouveau Medispa in Newark is located at Advanced Plastic Surgery Center. The spacious spa blends futuristic lighting and fixtures with contemporary but elegant furnishings. “It’s unique,” says Dr. Lawrence Chang, a cosmetic surgeon in the practice.

Dr. Christopher Saunders has medspas in two of his three locations, and the third floor of Dr. Abdollah Malek’s Centre for Plastic Surgery is devoted to a medical spa.

As Kirchdoerffer proves, doctors affiliated with medspas need not be plastic surgeons. Dr. Kelly King, an emergency room doctor, is a partner at Thé Medspa at the Village of Five Points in Lewes, which opened last February. He is onsite five days a week.

Dr. Jeffrey Kerner of Via Medical Day Spa in Wilmington specializes in anti-aging medicine. Dr. David Cloney, a general-trauma surgeon and president of the medical staff at Bayhealth, is the owner of Attitudes Medi Spa in Milford.

Attitude’s clinical director, Jeannette Smith, says clients are not concerned that Cloney is not a plastic surgeon. The procedures offered at Attitudes are noninvasive. “If you wanted plastic surgery, then of course you’d want a plastic surgeon,” she says.

The physicians train to give injections, such as Botox and other fillers, in the same way that plastic surgeons do, says Terri Kerner of Via Medical Day Spa.

Maintaining credibility is about knowing the boundaries. Kirchdoerffer, for instance, leaves certain procedures—such as using fillers underneath the eyes—to surgeons experienced in that area.

In the future, expect more medical spas to open. There are even chains. Consider Monarch MedSpa, which has five locations, including one in Greenville.

How to choose? Kerner recommends selecting a spa affiliated with a local physician. Services might make a difference. The MedSpa is also a full salon. For some, it’s all about the atmosphere. Via features feather beds, duvets and spa music. “It’s not a sterile doctor’s environment,” Kerner says.

Whatever your choice, always interview the practitioner during a consultation. Performing laser hair reduction, Botox injections and intense pulsed light treatments all require skill and training.

 

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