Doctor Shopping: Why Cheap is a Disastrous Parachute with Your Face–Facelift, Laser, Botox, Injectable Fillers

Doctor Shopping: Why Cheap is a Disastrous Parachute with Your Face –Facelift, Laser, Botox, Injectable Fillers 

How do you get the best results at the best price?

This is something everyone wonder about when they make any purchase but especially important items like plastic surgery.  There are several typical pitfalls.  Sometimes services that have a low price-tag do not have a lot of value or help achieve beauty goals.  Here are some examples.  A single cheap treatment with no plan may work if the problem is very specific.  Otherwise having a well established plan of treatments lets you do fewer treatments with a better maintained appearance.  This means that cheap with no plan is really not as cheap as it seems.

Sometimes, the price is lower but the provider has no finesse or very little experience.  Physicians who are board certified in the core four specialties that include aesthetic care as part of the residency training and specialty examination means you are getting a provider physician with years or decades of experience.  Overall, this gives you good odds, in my opinion,  at getting what you’re looking for.

Whiplash Encounters

Are you in and out of the office in 5 minutes with a quick, slapdash treatment?  The price is low so care has to happen quickly.  No assessment or evaluation is made,  and no education and partnering is provided.  A quick fix is fine if you are sure you know exactly what you want  but it is hard to put much finesse or fine detail into what you are getting.  When you get fast food –it is exactly that –fast and thrown together in a repetitive fashion, one size fits all.  Dining in a fine restaurant, food preparation takes more time but the product if very different.  It’s a meal in either case but not really the same quality, value or experience.  This is a big deal when your face, which people see all day every day, is at stake.

Another problem area in my view is experiences that are focused on other priorities than your appearance.  Some facilities offer a great social media experience or mocktails to consume with your friends and it’s lots of fun to go and have that experienc.  But how you are going to look is really what you are paying for.

Price Shopping –Can you tell the value?

Sometimes a lower price treatment represents a lower amount of material –Botox or filler.  Or the service is stripped down in some other way.  The service may seem the same but may be very different.  For example, liposuction of two areas.  You may have obtained consultations for what may seem to be the same service with significantly different prices from different providers.  There are multiple potential issues here.  Is the procedure being performed in an accredited operating room under the safest conditions?  What volume will be removed?  A 500 cc liposuction and a 2000 cc liposuction will get you to a different endpoint in terms of improvement.  How does the surgeon divide up the areas –some split up into multiple areas such as upper and lower abdomen where others will count the whole abdomen as a single area.   Therefore, you can see that while the service may seem the same, the actual value of the service may differ in more ways than simply the price tag.

Low price with small amounts may require repeating a treatment more frequently.  For example BotoxTM treatments with just a few units may need to be repeated monthly with a higher overall cost than a more expensive single treatment that lasts several months (3, 4 or even 6 months) even though the cost of a single treatment is lower.

Again, if there is no consultation and no plan, you are becoming the planner and not taking advantage of the physician’s expertise.  Professional assessment helps you stay on track to achieve your beauty goals –most completely and most efficiently.

Doctor Shopping

Too many opinions can be too much information.  It can be confusing.  Each physician has his or her own approach and knows what works well in their hands.  A couple of second opinions is usually a good idea but more make it difficult to decide what to do.  Another example is fragmentation of services.  Some patients have a BotoxTM doctor and a filler doctor and a laser doctor and a facelift doctor and someone else helping with skin care.  Using a different doctor every time or for each phase of your beauty treatment makes it impossible to have a coordinated care plan.    Too many cooks spoil the soup.


Pick a quality provider not cut rate treatments.

Avoid a different doctor every time –no plan, no refinement based on results of the last treatment.

Find real value rather than false economy.

You face is how the world sees you.  You can’t trade in your face so you have to take care of it.  It is a poor place to economize.



Doreen Wu (00:01):
Welcome back to Park Avenue Plastic Surgery Class, the podcast where we explore controversies and breaking issues in plastic surgery. I’m your co-host Doreen Wu. And I’m here with Dr. Lauren Bass Park Avenue plastic surgeon, educator, and technology innovator. The title of this episode is “Doctor Shopping: Why Cheap is a Disastrous Parachute With Your Face–Facelift, Laser, Botox, Injectable Fillers.” Nobody likes spending more money than they have to shopping for plastic surgery is an even trickier endeavor. Given that patients don’t have the ability to see the product before making a decision, how can they ensure that they are making the right choice? In other words, Dr. Bass, how do I get the best results at the best price?

Dr. Lawrence Bass (00:48):
This is a challenge and there are a lot of potential pitfalls here. There are a lot of ways that things that have a low price tag on them can really not be value or not help you successfully accomplish your beauty plan. One way is a treatment that’s cheap, but there’s no plan associated with it going forward. So sometimes we just need a quick fix up, but overall having a well-established plan of beauty, lets us do fewer treatments and have an overall better maintained appearance. So cheap with no plan is really not as cheap as it seems. Another way is a service that’s cheap, but the provider doesn’t have finesse or technical skill. This is an experience and training issue. So obviously on a certain level, you get what you pay for an experienced provider who trained in one of the aesthetic core four specialties who has years or maybe decades of experience is more likely to be able to bring the result.

Dr. Lawrence Bass (02:04):
There are some great providers that came through other paths, but chances are you’re making a better bet with the experienced, fully trained provider. There are a couple of other kind experiences that are not really likely to get you the technical result that you look for. Cause remember, this is about what you see. And one is treatments that are done very, very quickly. I call these whiplash encounters where you’re in and out of the office in five minutes or 15 minutes, nobody looked at you. The treatment is done as fast and slap dash as possible, uh, because the price is low and it’s all about making it happen quickly. Again, you know, it’s your face. We’re talking about fine details of your appearance and a little bit of time and a little bit of care to do that is probably important. The other thing about encounters are ones that are really focused on unrelated priorities. You know, you get great social media experience, um, but, uh, that’s not about your face and your beauty. That’s about your social experience and not the technical results. So it’s important to stay on point you’re coming for medical care to get a treatment that’s going to impact your appearance. That has to be the priority.

Doreen Wu (03:38):
Wow. I never thought about it that way. When it comes to aesthetic medicine, do you think price shopping is the smartest way to go about it? Because to me, I see the lower price tag and I’m thinking to myself, I might be able to save a bundle.

Dr. Lawrence Bass (03:55):
You might, but lower price is not always lower overall. So sometimes when you get a lower price treatment, you’re getting a lower amount of whatever the treatment is, a lower amount of filler, a lower number of units of Botox. You’re getting a service that in at the 50,000 foot view looks like it’s the same, but in reality is not the same. Uh, an example would be liposuction. So a lot of people say, well, I’m getting liposuction in one area or two areas. And one provider is X dollars and the other provider is half of that price. Well, is the procedure being done in an accredited operating room? What is the volume of liposuction? How does each provider divide up the number of areas? Some people split the areas up into smaller subdivisions. So two areas might be one area to another provider.

Dr. Lawrence Bass (05:02):
All of these things make a big difference in the volume of fat that suctioned. A 500 CC suction and a 2000 CC suction are still both liposuction of the abdomen, but they’re not going to get you to the same end point. And so there might be a value difference aside from just the price tag. So that’s really important. Low price sometimes with small amounts also means you have to redo the treatment more frequently. So there are some people doing Botox monthly, and there are other people who are doing it every three, four or six months. You have to look at what the ultimate cost is when you totalize that not an individual treatment. One treatment in six months will probably cost you more than that single treatment that you’re doing monthly. But in six months you may actually have spent more money doing the monthly Botox treatments than a more expensive but longer lasting treatment.

Dr. Lawrence Bass (06:08):
A last example is again, another example of what I view as hit and run medical care, where there’s no consultation and no plan at all. So you come in and say, I need Botox here, or I need filler here. And you are replacing the provider as the planner of your beauty care. And that’s okay if you’re getting what you want. And you’re sure, you know, sometimes you’ve done it many times before and you know, that’s all you need right now and that’s fine, but it’s important to have professional assessment in conjunction with that to make sure you’re staying on track. And that’s part of what you’re paying for. When you come to see a plastic surgeon,

Doreen Wu (06:49):
It all makes a lot of sense. And I’m starting to understand that there’s so many more ways in which the service can be less adequate than I initially realized. Now let’s discuss doctor shopping in a different context. What about patients who shop around for opinions until they hear what they want to hear? What are the dangers of getting too many, second opinions?

Dr. Lawrence Bass (07:13):
So too many opinions can sometimes be too much information and you almost never get exactly the same answer from different doctors. Because as we’ve talked about previously in this podcast, different doctors have different ways of approaching things and they know what works well in their hands. So it doesn’t mean one answer is right and the other one is wrong. Uh, but overall, a second opinion or two can be helpful just to make sure that things are generally going in the right direction, but many opinions ends up being confusing. And if you end up seeing a different doctor, each time you get a treatment, you’re ending up with no plan, the plan gets remade. Uh, without any feedback from previous treatment, each time you see someone, uh, another way that people see multiple doctors is different providers for different treatments rather than one team of providers. So they have their Botox doctor and laser doctor and filler doctor and facelift doctor, none of whom are talking to any of the other doctors or even know that the other doctors exist very hard to make a plan that way and let things be coordinated. If you have a team that works together in a single practice, the ability to have a coordinated plan and see the outcome over time is much easier,

Doreen Wu (08:48):
Right? When you have too many hands in the pot, it can be challenging to maintain that coordinated care plan with a team that you really trust.

Dr. Lawrence Bass (08:57):
Exactly. It’s like four or five cooks seasoning the soup. That’s not a dish I want for dinner.

Doreen Wu (09:03):
Me neither. So Dr. Bass, now that we have tackled the problems of bargain shopping for plastic surgery, can you give our listeners some parting advice?

Dr. Lawrence Bass (09:13):
Well, this goes back to the title of this episode and you know, this was advice that the pre-medical advisors when I was an undergraduate at Cornell gave us when we were all applying to medical school, that parachutes and your scope of applications for schools, it’s a bad place to economize. So it’s important to pick a quality provider and receive quality treatments, cut rate treatments, have all of the pitfalls that we’ve discussed in this podcast earlier, a different doctor, every time means no plan and no refinement based on results. So you’re just getting a proforma or cookie cutter treatment. Remember people see your face all day, every day. It’s a really poor place to economize. Everything has a budget in life, but it’s important to be real about what’s value and what’s false economy.

Doreen Wu (10:28):
That’s incredibly useful advice, not only for my plastic surgery treatments, but all my life purchases. I can see there are always levels of value, especially with something as complex as plastic surgery and my face. Thank you for sharing these insights, Dr. Bass, and I’ll think a little more carefully next time before jumping in on a quick fix at a bargain.

Dr. Lawrence Bass (10:50):
Yes, Doreen. You know, your face is one of your most valuable assets. It’s how the world sees you. Unlike a car, you can’t trade in your face for a new one. You’ve got to take the best possible care of the one face you’ve got.

Doreen Wu (11:05):
Definitely. I couldn’t agree more. This is Doreen Wu thanking you for joining Dr. Bass and me for this discussion of the pitfalls of doctor shopping. Don’t forget to join us next time for our episode, “the power of one: why more isn’t better when picking your plastic surgeon or aesthetic provider.” Stream the episode to find out.

Speaker 3 (11:27):
Thank you for joining us. In this episode of the park avenue, plastic surgery class podcast with Dr. Lawrence Bass Park Avenue plastic surgeon, educator, and technology innovator. The commentary in this podcast represents opinion. This podcast does not present medical advice, but rather general information about plastic surgery that does not necessarily relate to the specific conditions of any individual patient. No doctor-patient relationship is established by listening to or participating in this podcast, consult your physician to advise you about your individual healthcare. If you enjoyed this episode, please share it with your friends and be sure to subscribe to our podcast on Apple Podcasts, Google, Spotify, Stitcher, or wherever you listen to podcasts.

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