Questions to Ask

1. Is the surgeon a fully trained plastic surgeon?

In order to become a plastic surgeon, a physician must complete 4 years of medical school, at least 3 years of a general surgery residency, and at least 2 years of a plastic surgery residency. Fellowships are often done for additional training. All of these must be completed at fully accredited programs.

In order to become board certified, the plastic surgeon must meet the requirements in question 1 and then pass a written exam. After being in practice for approximately 1 year, the plastic surgeon then must pass a 3-day oral exam given by many of the national leaders of plastic surgery around the country. This is the only board that is important for a plastic surgeon. There are boards, which may use the words "Cosmetic Surgery" or "Facial Plastic Surgery". These are not the same thing and should not be given the same weight as the American Board of Plastic Surgery. Dr. Sachse is certified by the American Board of Plastic Surgery.

Unfortunately, any physician can claim to be a cosmetic surgeon. The physician may not even be trained as a surgeon at all. However, if he has a medical degree, he is legally able to perform surgery and claim to be a cosmetic surgeon. The physician may be board certified in their specialty and advertise themselves as a board certified cosmetic surgeon or a "specialist" in cosmetic surgery. (As opposed to a board certified plastic surgeon.) There are physicians trained as gynecologists, ear, nose and throat (otolaryngologists) doctors, dermatologists, oral surgeons, and general surgeons who claim to be cosmetic surgeons.

In Florida, there has been a lot of publicity regarding serious injuries or deaths occurring from plastic surgery in physician's offices or outpatient centers. You should ask if there have been any problems in whatever center you chose to go. There are some well-known cosmetic surgery centers in South Florida where more than one death has occurred. Patients may not realize that the cosmetic surgery centers are businesses often owned, not by physicians, but by businessmen. Their interest is in making the most money, not in ensuring safety for the patient. Owners may cut corners when it comes to your safety if it means greater profits for them. A doctor working there may not have much of a say when it comes to your safety. Dr. Sachse currently performs surgeries that require general and I.V. anesthesia only in area hospitals and certified Ambulatory Surgical Centers. All required safety equipment is readily available. In addition, Dr. Sachse is certified by the American Heart Association in both basic life support and Advanced Cardiac Life Support. Surgeries performed in the office are done only with local anesthetics. At Broward Plastic Surgery, patient safety is a priority.

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5. Does your surgeon work for himself or is he employed by a cosmetic surgery center? What percentage does the surgeon get of the fee you are paying?

There are cosmetic surgery centers in South Florida that are owned by non-physicians. The owners hire plastic surgeons that need extra work to make ends meet or who rely solely on the center to obtain patients for them. As an employee, the physician often has little control over the schedule, over safety measures, quality control, etc. The surgeon is often paid as little as 20% of the surgery fee. As a result, the surgeon needs to do many surgeries to make a reasonable salary. The more surgeries a surgeon has to do in a day, especially when he is not getting paid very much for each surgery, the less likely he is to spend the amount of time it takes to do an exceptional job. Surgery may be rushed and results compromised. The surgeon's interest in you and any problem you may have after surgery may also be minimal. Dr. Sachse is self-employed and owns Broward Plastic Surgery. He makes all the decisions regarding the care of his patients.

Most licensed physicians have staff privileges at a minimum of one local hospital. If they do not, you should ask why. One possible reason is that their privileges were revoked. If they have a transfer agreement, it means that they can transfer you to that hospital if there is an emergency. A different physician will be called to care for you. Your surgeon will have no say in your care. Dr. Sachse currently is Chief of Plastic Surgery at Holy Cross Hospital has staff privileges at five area hospitals.

Surgery requires patience, concentration, and stamina. It is not something that should be rushed because other obligations need to be met or because the day's schedule is very busy. When Dr. Sachse performs surgery, the patient undergoing surgery is his only responsibility at that time. Dr. Sachse limits his surgeries on any given day so that he can give each patient the attention they deserve and expect. A surgeon who has many surgeries to do in one day may not give you the attention he should. Surgeons working for a cosmetic surgery center are often asked to do as many as 4 to 6 cases in one day. Do you want your surgery performed by a surgeon who is anxious to get finished because he has many more cases to go, or with a surgeon who is tired because he is now on his fourth or fifth surgery of the day?

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8. Are you feeling pressured to sign up? Do the prices keep going down as you are waiting to make a decision?

Some centers feel the need to pressure patients into having their surgery. They actually hire salespeople, not people experienced and educated about plastic surgery, to talk to patients about plastic surgery. The salespeople are paid partly or wholly on commission. Their job is not to give you the best advice, but to get you to sign on the dotted line. At Broward Plastic Surgery, we feel any surgery is serious business and should be carefully considered and we make it a priority to educate our patients on their procedure and give each patient all options available to them. Then we allow time for an intelligent and informed decision to be made. Our Patient Care Coordinator is primarily concerned with the wisest choice and the best outcome for the patient, not “making a sale".

When you call to schedule an appointment for a consultation, are you told which surgeon you will see? Cosmetic Centers may assign you to a surgeon, not based on who is the most qualified for your particular need, but based on who is available. At Broward Plastic Surgery, Dr. Sachse will see you and, if you decide to have surgery, Dr. Sachse will perform it.

Centers that are very busy and need to finish your surgery quickly, often employ surgical assistants to help the surgeon do the surgery. These assistants may be unlicensed physicians or other technicians trained to some extent in surgery. Dr. Sachse limits the number of surgeries done each day and performs the entire procedure.

Unfortunately, we live in a litigious society. Plastic surgery is not an exact science and even when everything goes as well as expected, patients may be disappointed. The fact that a doctor has been sued, settled a case, or lost a case, does not necessarily mean the doctor was at fault. However, multiple lawsuits or settlements should raise a red flag. Dr. Sachse has never been sued, has never settled a case, or had any form of judgment made against him. At Broward Plastic Surgery, we perform surgery only on those patients that are good candidates for the surgery, and we educate the patient so that expectations are reasonable. We take the time to answer all questions so that there are no surprises.

Your surgeon is unlikely to tell you if he has been in trouble with the Board of Medicine. You may be able to find some information on your surgeon yourself by going on the internet to http://www9.myflorida.com/mqa/Profiling/index.html.