2

10 THINGS
EVERY PLASTIC SURGERY
PATIENT MUST KNOW

ANTHONY YOUN, MD, FACS

America’s Holistic Plastic Surgeon™

Copyright © 2016 by Anthony Youn, MD

Author’s Note:

This book is written to provide information on many of the various

treatments and options for aging and beauty that are currently
available. It is based solely on the opinions of Dr. Anthony Youn,
whose opinions may not reflect every doctor’s standpoint. Before
you undergo any cosmetic procedure, begin a skin care regimen,
or make major dietary changes, it is important that you consult
with your physician to ensure that it won’t adversely affect your
health. Following any of the recommendations in this book does
not constitute a doctor-patient relationship, and the author ex-
pressly disclaims any responsibility for any adverse effects arising
from the use or application of the information contained herein.

DRYOUN.COM DR. ANTHONY YOUN

 10 THINGS EVERY PLASTIC SURGERY PATIENT MUST KNOW 3

Introduction
There is a lot of misinformation about plastic surgery. Every
day I spend a ton of time correcting this misinformation with
patients who come to see me in consultation. I hear statements
like these:

“One doctor told me that if I get breast

implants they will never droop.”

“I heard that a cosmetic surgeon is better than a plastic surgeon.”

“My doctor told me that liposuction is the only

way to get rid of these love handles.”

“Since you’re a plastic surgeon, you can

make my scars disappear, right?”

“All my friends tell me to see the doctor who

advertises on the Hot FM radio station.”

Like most people, you probably get information about plastic

surgery from a number of sources: websites, social media, chat
forums, and television shows. If you are thinking about having
plastic surgery, you may have already consulted with a plastic
surgeon or two. If you are a current plastic surgery patient,
your doctor may have educated you about his or her beliefs.
No matter where you are on your plastic surgery journey, it’s

DRYOUN.COM DR. ANTHONY YOUN

 10 THINGS EVERY PLASTIC SURGERY PATIENT MUST KNOW 4

extremely important for you to be as informed as possible.

So I’ve written this eBook just for you.

In the ensuing pages, I will dispel some widespread myths

about plastic surgery, steer you away from becoming a victim
of botched work, and shine a light on just what you need
to know about the field of cosmetic medicine. My goal for
you and this eBook is to educate you about plastic surgery
so you save money, skip unnecessary procedures, and avoid
becoming a victim of botched work.

Let’s get started. Here are the 10 things

every plastic surgery patient must know.

1. ANY DOCTOR CAN LEGALLY

PERFORM PLASTIC SURGERY
Today plastic surgery is the Wild West of medicine. Doctors
of all types, from gynecologists to ER doctors to family
medicine physicians, are ditching their previous professions
to masquerade as plastic surgeons. Believe it or not, this isn’t
just happening in big cities like Miami, New York, and L.A. It’s
happening all over the United States, in cities like Cleveland
and Metro Detroit.

Believe it or not, it’s legal for any doctor to perform any

operation on you, as long as you consent to it. I could legally
perform a hysterectomy on you, a procedure I am completely

DRYOUN.COM DR. ANTHONY YOUN

 10 THINGS EVERY PLASTIC SURGERY PATIENT MUST KNOW 5

unqualified to do, as long as you sign the consent form allowing

me to perform the procedure. This is the loophole in the law
that allows phony plastic surgeons to operate on unsuspecting
patients.

If you are considering having plastic surgery, I implore you:

Do your homework to ensure that the surgeon you choose is
experienced, reputable, ethical, and fully qualified.

Your first step is to find a plastic surgeon who is a member

of the American Society of Plastic Surgeons (ASPS) and is
certified by the American Board of Plastic Surgery (ABPS), the
only plastic surgery board that is recognized by the American
Board of Medical Specialties (ABMS). Nearly all board-certified
plastic surgeons are members of ASPS, including surgeons who
specialize in reconstructive surgery. If you are more interested
in cosmetic procedures, look for plastic surgeons who are
members of the American Society for Aesthetic Plastic
Surgery (ASAPS). The top board-certified plastic surgeons
who specialize in cosmetic surgery are members of ASAPS
and represent the pinnacle of cosmetic plastic surgeons.

There are also some sub-specialty qualifications to look for:

FOR FACIAL PLASTIC SURGERY:

Look for a doctor certified by the American Board of
Facial Plastic and Reconstructive Surgery (ABFPRS). This
certification is considered equivalent to certification by the
American Board of Plastic Surgery in all states, so choosing

DRYOUN.COM DR. ANTHONY YOUN

 10 THINGS EVERY PLASTIC SURGERY PATIENT MUST KNOW 6

a member of ABFPRS is reasonable for plastic surgery of the

face. Unfortunately, some facial plastic surgeons are delving
into plastic surgery of the body (such as breast implants). I’ve
seen many nightmare cases of botched breast implant surgery
by facial plastic surgeons, so reserve facial plastic surgeons for
procedures of the face!

FOR COSMETIC EYELID SURGERY:

Look for members of the American Society for Ophthalmic
Plastic and Reconstructive Surgery. They are well-trained to
perform plastic surgery of the eyelids (as are surgeons certified
by the ABPS and ABFPRS).

FOR ANYTHING ELSE

Remember this: Surgeons certified by the American Board
of Plastic Surgery (ABPS) are trained for plastic surgery of
the entire face and body. When in doubt, choose a surgeon
certified by ABPS.

There are many other “boards” and “societies” out there. In fact,
I could legally establish my own “Dr. Youn’s Board of Age Fix
Surgery” and certify doctors through it if I so desired (which,
thankfully, I do not). The organizations I’ve mentioned above
are the only ones who have my stamp of approval.

DRYOUN.COM DR. ANTHONY YOUN

 10 THINGS EVERY PLASTIC SURGERY PATIENT MUST KNOW 7

2. SCARS ARE PERMANENT,

AND NO ONE CAN PREDICT
WITH 100% CERTAINTY HOW
YOUR SCARS WILL TURN OUT
If only we could perform magic, we would. However, there is
no such thing as an invisible or completely disappearing scar.
Even a short surgery requiring an incision will create a scar.
The body then begins to heal the scar—24 hours a day, 7 days
a week, 4 weeks a month, for anywhere from 6 to 12 months.
After that, the scar will be mature, and you will have a pretty
good idea of how it’s going to look for the rest of your life.
The plastic surgeon has very little control over this process.
Scars are permanent, and the way they heal has a lot to do
with aftercare and your individual body and skin. Will the scar
get infected? Are you picking at it? Does your skin heal quickly
or slowly? These and many other considerations affect wound
healing. You can try to alter your body’s healing response by
using a good silicone-based scar cream or undergoing laser
treatments or steroid injections to minimize scarring, but even
if you do all of these things, your body might still create a
thicker, more unsightly scar than someone else’s body would.
On the brighter side, it might also create a scar that becomes
barely noticeable over time.

What your plastic surgeon should be able to tell you is

whether or not the scar will have suture tracks (the tiny dot-
like scars on both sides of a scar, which can result if sutures are

DRYOUN.COM DR. ANTHONY YOUN

 10 THINGS EVERY PLASTIC SURGERY PATIENT MUST KNOW 8

left in too long), whether the scar will look jagged, and whether
it will look bunched up. But that’s about all we can tell you for
certain. Good surgeons do have a few tricks up their sleeves,
like the best places to put incisions so scars are less noticeable.
Beyond that, however, a scar is a scar and a necessary part of
any plastic surgery that requires an incision.

One last thing: I’ve noticed over the last 15 years that older
people (typically, older than 60) tend to scar much better than
younger people. Their scars are thinner and lighter and have a
much lower tendency to thicken and look unsightly. This may
be due to the collagen in their skin being thinner and less likely
to overgrow and bunch up in the healing process. I find that
people in their 20s, 30s, and 40s tend to scar the worst. This is
one good thing about getting older!

3. CREAMS ARE OFTEN MORE

EFFECTIVE AT TURNING
BACK THE CLOCK THAN SURGERY
This statement is surprising to a lot of people, especially the
ones who come to see me, cash in hand, looking for a facelift.
Our face actually ages in three main ways: it sags, it loses
volume, and the skin looks older. A facelift really only treats the
sagging, not the other two problems.

Just like the rest of your body, your skin ages. This takes
the form of wrinkles, age spots, roughness, and loss of radiance.

DRYOUN.COM DR. ANTHONY YOUN

 10 THINGS EVERY PLASTIC SURGERY PATIENT MUST KNOW 9

Aging skin is often the main reason why a person looks older
than he or she would like. Smoothing fine lines, tightening up
the pores, erasing age spots, and restoring a youthful luster can
take 10 to 20 years off a person’s appearance. Even a facelift
or eyelid lift might not be able to do that. Most of the time, all
you need to do to reverse the aging of your skin is to apply
the right creams in the morning and evening. I go into a lot of
detail about this in my book, The Age Fix, but suffice it to say,
treating the skin is almost always the best way to start you on
the path to looking younger. Applying the right skin creams
often gives you more bang for the buck than any surgery or
injection. And best of all, you don’t have to worry about pain,
scars, or downtime.

We live in a great time with regard to beauty treatments. There

are so many ways to look younger and better than ever before
without going under the knife, and it all starts with what we
put on our skin. Never before have we been able to do so much
with simple topical creams!

4. YOU CAN GET RID OF FAT

WITHOUT HAVING SURGERY
Ten years ago, if you wanted to get rid of a stubborn area of
fat, the only proven way to do this was to diet, exercise, or
go under the knife and have liposuction. When I appeared
on Racheal Ray’s talk show in 2006, I told Rachael, “The Holy

DRYOUN.COM DR. ANTHONY YOUN

 10 THINGS EVERY PLASTIC SURGERY PATIENT MUST KNOW 10

Grail of plastic surgery is loss of fat without dieting, exercise,

or surgery.” Believe it or not, we’ve now found that Holy Grail.

There are several non-surgical treatments that are proven to

permanently get rid of fat without going under the knife. As
of this writing, the top tiers of this rapidly expanding group
of treatments include Coolsculpting, Ultrashape, Sculpsure,
Vanquish, and Liposonix. These technological marvels reduce
the thickness of fat by 10–35%, but it can take a couple of months
to see the final result. There are many other fat-reducing devices
being used, but in my opinion, none compares in effectiveness
to the five treatments listed above.

Keep in mind, though, that the results of these treatments aren’t

nearly as impressive as what you can get from real liposuction.
If you are at a reasonable body weight, have a couple of
stubborn areas of fat that won’t go away, and would be pleased
with a modest change, one of these non-surgical fat-reducing
treatments may be a good option for you. However, if you have
many areas that you would like to thin out (such as the thighs,
flanks, and tummy), or if you’re looking for a very dramatic
change, liposuction may still be your best option. Discuss this
with a plastic surgeon who has access to both liposuction and
non-surgical fat-reducing treatments to get the straight scoop.

DRYOUN.COM DR. ANTHONY YOUN

 10 THINGS EVERY PLASTIC SURGERY PATIENT MUST KNOW 11

5. 85% OF PATIENTS WHO

HAVE PLASTIC SURGERY
DON’T HAVE ACTUAL SURGERY
According to the American Society for Aesthetic Plastic
Surgery (ASAPS), in 2015 over 85% of plastic surgery patients
underwent non-surgical procedures, ranging from laser
treatments to injectables (like Botox and filler) to chemical
peels. Less than 15% of plastic surgery patients underwent
actual surgery. And this number is dropping every year!

The advances in non-surgical treatments have caused the

number of patients undergoing these treatments to skyrocket
by 605% in the past eight years. Botox injections lead the pack,
since the treatment is so easy to undergo and has impressive
results with little risk of complications. Ever since Botox
Cosmetic® arrived on the scene over 15 years ago, the number
of people undergoing surgical brow lifts has sharply declined.
Botox has effectively taken the place of surgery for hundreds
of thousands of people.

So, for those of you who want to look younger but don’t want to
go under the knife, there are many, many effective non-surgical
options to consider. Sometimes actual surgery may be the only
real treatment for what you want to improve, but most of the
time you can get significant, dramatic changes without going
to the operating room.

DRYOUN.COM DR. ANTHONY YOUN

 10 THINGS EVERY PLASTIC SURGERY PATIENT MUST KNOW 12

6. BREAST IMPLANTS WILL

MAKE YOUR BREASTS
DROOP PREMATURELY
Breast augmentation is the most popular cosmetic operation
in the United States. Each year over 300,000 women undergo
this surgery, with a very high satisfaction rate. But as popular
as this procedure is, there are some definite drawbacks. One
of the biggest is that implants will cause your breasts to droop
faster than if you don’t have them.

Breast implants act as weights in your breasts. Gravity pulls

on them, day in and day out. The bigger they are, the heavier
they are, and the more quickly they will sag. It’s simple physics.
The only exception to this is Pamela Anderson. Her breasts are
massive, and it’s even been rumored that her breast implants
are stacked, meaning there is more than one implant in each
breast. Still, even over 15 years after she left Baywatch, her
breasts look as perky as ever. They seem to defy gravity. Putting
Pam and her amazing hovering breasts aside, there are some
actions you can take to prevent the implants from sagging as
quickly as they might otherwise. If you have implants, wear
a supportive bra with underwire during the day, and wear a
sports bra when you work out. If you are considering breast
implants, don’t go any larger than is necessary to make your
body feel balanced. While it’s true that the majority of women
who have breast implants would, if given the chance, have
picked a larger size than they did, it’s important to realize that
you may be sacrificing longevity for a larger size. That’s why I

DRYOUN.COM DR. ANTHONY YOUN

 10 THINGS EVERY PLASTIC SURGERY PATIENT MUST KNOW 13

typically encourage my patients to really think about what size

they want to be and to always keep in mind the following fact:
The bigger they are, the faster they will droop.

7. IN GENERAL, THE MORE

A DOCTOR PERFORMS
A PARTICULAR SURGERY, THE
BETTER THE OUTCOME
I once worked with a plastic surgeon —let’s call him Dr. Saul—
who performed cleft lip and palate repairs, facelifts, breast
reconstruction after mastectomy, and even complex repairs of
tendons in the hands and fingers. His practice wasn’t very busy,
so he performed some of these procedures only once every
several months. While the breadth of Dr. Saul’s practice was
impressive, I couldn’t get past this question: How many different
types of procedures can you trust one doctor to perform?

Like Dr. Saul, as a board-certified plastic surgeon, I’m fully

trained in cosmetic surgery, hand surgery, burn surgery, cleft lip
and palate surgery, reconstructive surgery, and microsurgery.
But if your child has a cleft lip or your finger has been cut off,
you probably don’t want me as your doctor.

The critically-acclaimed author and surgeon Dr. Atul Gawande

wrote about this subject in his best-selling book Complications.
Dr. Gawande visited Shouldice Hospital, well known for having
the lowest recurrence rates for hernia surgery in North America.

DRYOUN.COM DR. ANTHONY YOUN

 10 THINGS EVERY PLASTIC SURGERY PATIENT MUST KNOW 14

He found that each surgeon performed the same surgery, the

same way, 600–800 times per year. This resulted in a recurrence
rate of 1%, compared with 10–5% at most other institutions. At
Shouldice Hospital, repetition breeds success. But isn’t there
more to it than the sheer number of surgeries performed?

Definitely.

Any surgical nurse will tell you that some surgeons are just more
skilled than others. A University of Michigan study recruited
surgeons to analyze videos of other surgeons performing
operations and judge them as more or less skilled based on the
quality of their movements during the procedure. The study
found that the surgeons who were judged as more skilled had
better outcomes and fewer complications than surgeons who
were judged as less skilled.

So there’s more to choosing a surgeon than simply the

number of procedures he or she performs. Bedside manner,
meticulousness, quality of training, technique, and the surgical
facility all play a part in the outcome you might have. As a
general guideline, however, it’s probably best to consider a
doctor who has performed the operation you are considering
hundreds, if not thousands, of times. In plastic surgery, you
don’t want a jack of all trades, master of none.

DRYOUN.COM DR. ANTHONY YOUN

 10 THINGS EVERY PLASTIC SURGERY PATIENT MUST KNOW 15

8. INSURANCE WILL
PAY FOR SOME OF
YOUR PLASTIC SURGERY
Insurance companies don’t typically pay for plastic surgery if it
is for aesthetic reasons only. However, many people don’t know
that insurance will often pay for two operations, each of which
can give you a major cosmetic benefit: your eyelid lift and your
breast reduction.

If you have so much skin on your upper eyelids that it impinges

on your vision (making you miss traffic lights, for example,
or making you feel like a window shade is obstructing your
vision), then you may qualify for this coverage. Typically,
insurance companies require verification that you are having
problems seeing in the upper quadrants of your vision; this
can be verified through tests performed in an optometrist’s
or ophthalmologist’s office. Most good plastic surgeons are
very careful to do a cosmetically attractive job in addition to
simply solving the vision problem, so you can get the aesthetic
benefits along with the medical coverage.

Breast reduction can also be a covered benefit under most

health insurance policies. In order to qualify for coverage, most
insurance carriers require that you have a history of back, neck,
and shoulder pain due to excessively large breasts. Sorry, but
C and D cups usually don’t make the cut. Even some women
with DDs get rejected by their insurance carriers. Still, if you are
considering breast reduction surgery, it’s worth investigating

DRYOUN.COM DR. ANTHONY YOUN

 10 THINGS EVERY PLASTIC SURGERY PATIENT MUST KNOW 16

whether your health insurance will cover the costs. The worst
they can do is say no.

9. THE AMOUNT OF TIME

A DOCTOR SPENDS IN
CONSULTATION WITH YOU IS
INDICATIVE OF THE TIME HE OR
SHE WILL SPEND PERFORMING
YOUR ACTUAL SURGERY
If you are considering plastic surgery, the first step in choosing
your plastic surgeon is to meet with him or her for a consultation.
Some doctors offer complimentary consultations, whereas
others charge a fee. Whether the doctor charges or not, it’s
important to realize that the way you are treated during your
consultation will likely determine how you are treated during
and after surgery.

Does the doctor seem rushed? Is he or she trying to give you

honest advice as to what is in your best interests, or is the
doctor just trying to convince you to sign up for surgery?

You can bet that if the doctor is rushing through your

consultation, then he or she will probably rush through your
surgery as well. The biggest red flag of all is when you do not
even meet the doctor during the consultation. If that’s the case,
then there is a good chance that you won’t see the doctor
after surgery, either, even if you have a complication! I strongly

DRYOUN.COM DR. ANTHONY YOUN

 10 THINGS EVERY PLASTIC SURGERY PATIENT MUST KNOW 17

believe that the true measure of a good plastic surgeon is

not how many good results he or she gets, but how he or she
takes care of patients who have results that maybe aren’t so
good. And every plastic surgeon, no matter how skilled, will
occasionally have complications.

I once had a patient who came to see me to repair scar tissue

left over from a previous lunchtime facelift. Two years prior,
she had gone to a quickie facelift center and had their one-
hour procedure done under a local anesthetic by a doctor she
met on the day of surgery. Soon after the operation, a bacterial
infection rapidly spread across her face. For the next three days,
she called her doctor’s office, but he ignored all of her calls.
Finally, she went to the nearest emergency room for treatment,
where the doctors diagnosed her with a staph infection, placed
her on long-term IV antibiotics, and consulted the hospital’s
plastic surgeon on call. Throughout her entire hospital stay,
the doctor who had performed her surgery never bothered to
check in on her.

So please, if you are considering plastic surgery, do your

homework. Research your doctor and the place he or she
operates.

This leads us to the final thing that every plastic surgery patient
must know:

DRYOUN.COM DR. ANTHONY YOUN

 10 THINGS EVERY PLASTIC SURGERY PATIENT MUST KNOW 18

10. THE BIGGER THE AD, THE

WORSE THE DOCTOR
Twenty years ago, it was considered in poor taste for a plastic
surgeon to advertise his or her services. That has completely
changed. Today it’s absolutely essential for a plastic surgeon to
have a website, and some doctors even buy ads in local print
and broadcast media. So should you go to the good-looking
doctor featured in the full-page spread in the local glossy
magazine? That means that he’s one of the best, right?

Wrong! In my experience, the size of the ad is directly

proportional to how bad the doctor is. Size does matter!

Just think of it this way: Unless a doctor is new and wants to

get word out that he or she is on the scene, the only reason
to pay for an ad is to bring in patients. Ads are expensive. In
Metro Detroit, a one-page spread in a local glossy magazine
costs $4000–$6000 per month. That’s a lot of money, even for
a successful plastic surgeon. The only reason a doctor would
pay that kind of money (as opposed to keeping it) is because
the doctor needs new patients.

The vast majority of good plastic surgeons get most of their

new patients via word of mouth. They don’t need to spend
thousands of dollars on ads to get new patients to support
their practice. New patients will call the office because they’ve
heard through the grapevine that the doctor is someone to
see.

DRYOUN.COM DR. ANTHONY YOUN

 10 THINGS EVERY PLASTIC SURGERY PATIENT MUST KNOW 19

However, if word of mouth about a particular doctor is negative,

then the most effective way for him or her to get new patients
is to advertise. The bigger, flashier ads get more attention
and result in more new patients. In my area, the doctors who
advertise the most are the least qualified. Many aren’t even real
plastic surgeons! My board-certified plastic surgery colleagues
and I see their botched patients all the time. Please don’t be
duped by flashy ads in glossy magazines, commercials on
talk shows, or convincing radio advertisements. Anyone can
buy these, and the bad doctors often do. Look at what really
matters when choosing a plastic surgeon: board certification,
word-of-mouth recommendations, experience, and bedside
manner. These mean a heck of a lot more than a fancy ad.

You are blessed to be living in the first real renaissance of

cosmetic and anti-aging treatments. There are so many options
to turn back the clock, from creams to peels to lasers to
injections to surgery. The important thing, as a plastic surgery
consumer, is to research your options and choose what you
believe is right for you. Keep in mind that no one needs plastic
surgery, and no one should try to convince you to do something
you don’t want to do.

Start by taking care of yourself. Get some sleep. Reduce your

daily stress. Exercise several times a week. Eat a healthy diet.
Apply the right creams to your skin. Enjoy living. And if—just if—
you still have certain cosmetic issues that you would like help

DRYOUN.COM DR. ANTHONY YOUN

 10 THINGS EVERY PLASTIC SURGERY PATIENT MUST KNOW 20

with, then maybe it’s time to see a reputable plastic surgeon in

your area.

I hope reading this eBook has been time well spent. If you’d like
to continue this conversation, please follow me on Facebook,
Twitter, or Instagram. I’d love to hear from you.

Let’s Look, Live, and Be Better™

Anthony Youn, MD, FACS

America’s Holistic Plastic Surgeon™

Author of The Age Fix: A Leading Plastic Surgeon Reveals

How to Really Look Ten Years Younger and
In Stitches: A Memoir

www.dryoun.com

For a complete guide to turning back the clock

without surgery, please check out my new book
The Age Fix: A Leading Plastic Surgeon Reveals
How To Really Look Ten Years Younger.

/DrYoun /TonyYounMD

@TonyYounMD /TonyYounMD

DRYOUN.COM DRYOUN.COM DR. ANTHONY YOUN