Plastic surgery checklist: vet, prepare, recover

Why it matters: Writing for ASPS, a plastic surgeon recommends most tummy tuck patients allow a full six months to find a surgeon, reach a stable weight and set up aftercare. Smaller procedures may need less, but rushing is how steps get skipped.

The same article says that in many markets the best surgeons book three to four months ahead, and suggests starting consultations around four months out.

Why it matters: The Aesthetic Society asks patients whether they're doing it for themselves or to fit someone else's ideals, and reminds them surgery isn't a quick-fix cure-all. Surgeons ask about motivation and expectations too, and may want a letter from your psychiatrist if you see one.

ASPS surgeons warn that mental health issues not addressed before surgery can be amplified afterwards.

Why it matters: ASPS advises getting a second opinion from other board-certified plastic surgeons, both to compare options and to confirm a plan suits you. Comparing consultations is also the easiest way to notice a surgeon who skips questions or pushes.

ASPS requires US members to be certified by the American Board of Plastic Surgery (or Canada's Royal College) when they join, so its directory is a reasonable place to start your list. ASPS doesn't re-verify certification or licenses, so still run the checks below.

Why it matters: ABPS certification means the surgeon finished the appropriate training and passed written and oral exams covering all plastic surgery procedures. ASPS points out that legally any surgeon can perform plastic surgery, so certification is how you tell them apart.

If ABPS has been notified of a state medical board action against a certified surgeon, the result shows a "See FSMB" alert, so check DocInfo too. Certificates issued since 1995 last 10 years, so check the status is current.

Why it matters: Some surgeons who specialize in facelifts, rhinoplasty and eyelid surgery are certified by the American Board of Facial Plastic and Reconstructive Surgery instead of ABPS. Its Physician Finder is a primary source of verification.

Why it matters: There are 24 member boards of the American Board of Medical Specialties, and ABPS describes ABMS member-board certification as the "gold standard". Other boards exist that aren't ABMS members, so "board certified" on its own tells you nothing.

Certification Matters, run by ABMS, lets you check certification by any of its 24 member boards for free.

Why it matters: ABPS requires an active, unrestricted medical license for certification and points patients to the Federation of State Medical Boards for license checks. DocInfo, FSMB's free search, shows where a doctor is licensed and whether a state board has disciplined them.

For the most detail, also search the state medical board where the surgeon practices; DocInfo links to it.

Why it matters: Hospitals grant operating privileges after credentialing by the surgeon's peers. A plastic surgeon writing for ASPS notes that an office setting often has little to no oversight, so privileges are an outside check on the surgeon's skill.

Why it matters: A surgeon can be certified and still rarely do the operation you want. ASPS frames this as finding out the surgeon's relationship with the procedure: whether they do it regularly, teach it or publish on it.

Ask about your procedure specifically, not just about cosmetic surgery in general.

Why it matters: ASPS advises looking at results from patients who had the procedure with your surgeon, judging the surgical detail rather than the lighting, and checking that the surgeon's sense of what looks good matches yours.

ASPS also warns that website testimonials and before-and-after photos are not foolproof. Ask to see many, including incisions and scars.

Why it matters: An ASPS member surgeon calls not meeting the operating surgeon before the day of surgery "a huge, major red flag". At some high-volume clinics, patients often don't meet the surgeon until the day of the procedure.

Why it matters: A plastic surgeon writing for ASPS says accredited ambulatory facilities have been reviewed and found capable of responding to medical emergencies, with the life-support equipment and training to handle them. Its consultation checklists ask whether an office facility is accredited by a national or state-recognized agency, or is state-licensed or Medicare-certified.

Why it matters: Accreditors for surgery facilities include QUAD A (the American Association for Accreditation of Ambulatory Surgery Facilities, or AAAASF), AAAHC and The Joint Commission, and each will confirm a facility's status. QUAD A notes that accreditation can be terminated at any time, so check the current status rather than a certificate on the wall.

AAAHC's search is linked here. QUAD A's online directory is being rebuilt, so ask QUAD A to confirm a facility's status through the verification request on its patient page. The Joint Commission's search is called Quality Check.

Why it matters: A plastic surgeon writing for ASPS calls anesthesia one of the riskiest parts of most cosmetic procedures and says the provider should be a medical doctor or a Certified Registered Nurse Anesthetist (CRNA). The American Society of Anesthesiologists recommends that anesthesia care be led by a physician anesthesiologist.

The two societies don't say exactly the same thing. Either way, get a name and a credential, not "our team".

Why it matters: The ASA's checklist asks whether the facility is licensed and accredited and has emergency procedures in place. ASPS suggests asking where you'll be taken once surgery is finished.

Ask for the name of the hospital you'd be transferred to.

Why it matters: The Aesthetic Society asks patients to share medical conditions, drug allergies and earlier treatments such as fillers and Botox, plus vitamins, herbal supplements, alcohol and drugs. Ask how each one affects your risks and recovery.

The ASA says studies show half of people who use herbal supplements don't tell their doctors before surgery.

Why it matters: ASPS's consultation checklists start here: whether you're a good candidate, what technique is recommended, and what results are reasonable for someone with your body. Ask, too, whether surgery is the right option for you at all.

Why it matters: Every operation carries risk, and ASPS says you should know all of them before choosing to go ahead. Ask which complications are most common for your procedure and what the surgeon does to prevent and treat them.

Why it matters: ASPS lists "What are my options if I am dissatisfied with the outcome?" among its consultation questions. Revision fees, facility and anesthesia costs for a second operation are easier to agree on now than after a problem.

Get the revision policy in writing, including any time limit.

Why it matters: An ASPS article warns that if your surgeon doesn't discuss postoperative instructions with you before surgery, that's a major red flag. Ask about dressings, drains, garments, medications and the first 24 to 48 hours.

Why it matters: You'll be asked to sign forms confirming you understand the procedure and its risks. The Aesthetic Society's point is that informed consent only counts if you've read and understood the documents, which is hard to do on the morning of surgery.

Why it matters: ASPS's average fees cover the surgeon only and leave out anesthesia, the operating room and other costs. Its cost pages list what a total can include: anesthesia fees, hospital or facility costs, medical tests, post-surgery garments, prescriptions and the surgeon's fee.

Why it matters: ASPS lists lost work time, travel, paid help, recovery supplies and prescriptions as extra costs. Some patients need up to three weeks off work, so plan for lost wages if your leave is unpaid.

ASPS notes that plastic surgeons usually require payment in full before the surgery date, so arrange payment or financing well ahead.

Why it matters: ASPS notes that most health insurance plans don't cover a cosmetic tummy tuck or its complications. Ask the surgeon what's covered if you need treatment or a return to the operating room.

Complications insurance for cosmetic surgery exists: CosmetAssure, for example, is available only through ASPS and Aesthetic Society member surgeons. Ask whether your surgeon offers it and what it excludes.

Why it matters: Many medical credit cards offer no interest for 6 to 18 months, but if any balance is left when the promotion ends, you owe all the interest back to the purchase date. The CFPB found that people paid interest on 20% of healthcare purchases made with these cards or loans between 2015 and 2020.

In the CFPB's 2023 report, the typical medical credit card charged 26.99% APR; CareCredit's 2026 card agreement lists 32.99%. Divide the balance by the promotional months and pay at least that each month.

Why it matters: The CDC warns that follow-up care for complications after surgery abroad can be expensive and may not be covered by your insurance. ASPS adds that patients who travel may struggle to find a local surgeon willing to take over their care.

The CDC suggests a travel medicine visit at least 4–6 weeks before the trip, copies of all your records, and delaying air travel 10–14 days after major surgery, especially chest surgery.

Why it matters: An ASPS article explains that nicotine narrows blood vessels, cutting oxygen to skin lifted in a facelift or tummy tuck, and lists skin loss and delayed wound healing among the risks. A paper in ASPS's journal advises smokers to stop at least four weeks before plastic surgery and suggests the same for e-cigarettes; ASPS also describes six weeks of smoking cessation as a typical instruction.

The ASPS press release cites a general-surgery study in which quitting for three or four weeks cut the complication rate from about 40% to 20%. Ask your surgeon how long to stay off nicotine afterwards too.

Why it matters: The Aesthetic Society warns that aspirin, certain anti-inflammatory drugs and some herbal medicines can increase bleeding. Ask your surgeon for a dated list of what to stop and when.

If a medicine was prescribed for a heart, clotting or other condition, ask your surgeon and the prescribing doctor to agree a plan before you stop it.

Why it matters: The ASA notes that supplements aren't closely inspected by the FDA and that some can raise bleeding risk, prolong anesthesia or interact with other drugs. It lists garlic, ginkgo, ginseng and kava among them, and says your anesthesiologist may ask you to stop supplements at least two weeks before surgery.

Why it matters: The ASA notes that GLP-1 drugs slow stomach emptying, which can raise the risk of inhaling stomach contents under anesthesia. Its 2024 guidance with four other societies says most patients can keep taking them, but those at highest risk may need a 24-hour liquid diet first, and elective surgery should wait until the dose-increase phase is over.

The guidance puts the dose-escalation phase at about four to eight weeks. Tell your surgeon, anesthesiologist and prescriber, and confirm with them whether to keep taking it.

Why it matters: ASPS recommends reaching a stable, maintainable weight several months before surgery, and says that if your BMI is too high, your surgeon may require you to lose weight first to make anesthesia safer.

Ask your surgeon how long your weight should hold steady before surgery.

Why it matters: ASPS says many surgeons ask for blood work and a clearance letter from your regular doctor, and from a specialist if you have a condition such as sleep apnea. Standard tests include a complete blood count, metabolic panel, clotting, liver and kidney function, blood glucose and pregnancy.

Why it matters: ASPS lists blood clots among the risks of surgery such as a tummy tuck. In a study of 1,126 plastic and reconstructive surgery patients admitted to hospital after general anesthesia, 11.3% of those with the highest Caprini risk scores (above 8) had a clot within 60 days when not given preventive blood thinners. Ask your surgeon what your own score is.

In the same study, over half of the clots in the high-risk groups were found between days 15 and 60 after surgery.

Why it matters: Cleveland Clinic tells outpatients to plan for someone to drive them to and from surgery and to stay at least the first night. The Aesthetic Society says to have a responsible adult for at least 24 hours, or as long as your surgeon recommends.

Why it matters: The Aesthetic Society says most recoveries rule out lifting, driving, laundry and cleaning for a while. ASPS suggests asking family or friends to cover childcare, cooking and housework, or hiring help, and freezing meals in advance.

The Aesthetic Society stresses this especially if you have children under five.

Why it matters: ASPS says some patients are asked to take two weeks off work and several weeks off heavy lifting, and some surgeries keep people out of work for up to three weeks. Get your leave approved before you set the date.

ASPS warns that some states may not allow disability leave for elective procedures.

Why it matters: ASPS says surgeons often send recovery medicines to your pharmacy several days before surgery. It also lists compression garments, wound and scar care products, walkers and special pillows as possible extras, and the Aesthetic Society suggests storing supplies at counter height because your range of motion may be limited.

Why it matters: Follow-up visits are where the surgeon checks healing and removes stitches. If you travel for surgery, ASPS warns that you may not be able to return for follow-up care easily, so know who will see you locally.

Why it matters: The CDC lists swelling, pain, warmth and redness in a leg or arm as signs of a clot, and difficulty breathing, chest pain that worsens with a deep breath, a fast or irregular heartbeat, coughing up blood or fainting as signs it may have reached the lungs. It says to see a doctor as soon as possible for signs in a limb, and to seek medical help immediately for signs in the lungs.

Walking around during recovery, even though you shouldn't exercise, reduces your chance of a clot, according to The Aesthetic Society.

Why it matters: ASPS notes that some patients experience depression after surgery even when it goes well, and that recovery can be emotionally taxing, so a support network matters. Tell your surgeon or doctor if a low mood doesn't lift.

Why it matters: Time-limited deals leave no time to check a surgeon's credentials. In the UK, the British Association of Aesthetic Plastic Surgeons has said discount deals with time-linked incentives breach its code of ethics, and an ASPS surgeon compares some high-volume US clinics to sales companies run from call centers.

Ask before paying whether the deposit is refundable, and get the answer in writing.

Why it matters: In a study of Brazilian butt lift deaths from fat embolism in South Florida, 92% of the patients had surgery at high-volume, budget clinics, where operations of about 90 minutes appeared to be the norm. The authors point to the clinics' working environment and short operating times as likely contributors.

Why it matters: A surgeon certified in plastic surgery should be able to name the American Board of Plastic Surgery, or the facial plastic surgery board for face-only surgeons. A vague answer, or a board in an unrelated specialty, means you should check before going further.

Why it matters: An ASPS surgeon warns that some clinics use the word "provider" so patients don't know whether they'll see a plastic surgeon, a gynecologist or a physician assistant until they arrive. Get the operating surgeon's full name and check it.

Why it matters: The FDA warns that silicone injections for body contouring are often given by unlicensed, non-medical practitioners in homes or hotels. Injectable silicone isn't approved for this, can migrate and cause stroke, embolism or death, and some patients are falsely told it's an approved filler.