Most people looking into cosmetic surgery soon realize that it is not cheap, but why? Why is it so expensive? There are many reasons. Most of them have to do with overhead. The discussion below is meant to give you some insight into the way plastic surgery is practiced. It varies quite a bit. Bargain Basement plastic surgery may not be the best idea when you look at the big picture.

Some of you out there are thinking: “Gimme a break! I have this ad right here saying that breast implants are only $3000. How can this be?”

You are correct. There are those that do this operation for less than it costs me to render the service. Then there are those who use ads to get you into the office and the story changes when you get there. How can they do this? Below we will lay out some possibilities. These may seem quite familiar to some of you:

Say you walk with ad in hand to see the doctor. You notice that the doctor’s name doesn’t seem to be listed in the advertisement. This is called a Bait and Switch Scam.

SCENARIO 1: “All things are not as they seem”

You find yourself in an examination room with a nurse who tells you that the doctor only meets with patients after they have signed up for surgery. This saves the practice money, but wouldn’t you rather meet your surgeon before you decide to make him your surgeon? She then explains that the price you saw in the advertisement is just the surgeon’s fee. The full price with anesthesia, the facility fee and implants is several thousand dollars more.

SCENARIO 2: “The surgeon and facility are not as they seem”

You meet the doctor and ask him about his training. You find that he trained as an Obstetrician or Head and Neck Surgeon. He started doing cosmetic surgery years ago. He is not board eligible or board certified in Plastic Surgery, but he is board certified in “Cosmetic Surgery.” He operates in his office, but hasn’t bothered to have it certified by any ambulatory care agency, so there is no facility fee. He does the procedure under “twilight sleep,” so there is no anesthesia fee.

I am not trying to say that you have to pay a fortune to have cosmetic surgery, but contrary to popular belief most plastic surgeons are not trying to rip you off. They have legitimate costs of doing business and pass these on to their clientele. By the same token if you see a few doctors and one has a “sky-high” fee, don’t think that an operation here is a guaranteed success. My suggestion is that you consider seeing a few surgeons. Take your cosmetic surgery fee quotations and throw out the really high and really low ones. Then choose one of the remaining surgeons.

When you go to have a cosmetic operation, you are paying for the expertise of your surgeon. You are also paying for every patient who has ever sued a plastic surgeon in Southern California, because this is how malpractice insurance premiums are charged. Malpractice insurance is one of the highest overhead items that plastic surgeons pay. Non-plastic surgeons who perform cosmetic surgery often do so without specific malpractice coverage meaning they pay cheaper malpractice premiums than I do. Finally, in choosing cosmetic surgery with a particular surgeon you are choosing a Level of Service. This often changes dramatically with the price tag.

Best Regards,

John Di Saia MD

I originally wrote this for my web site a few years ago. It still applies to this day however.