It's not always easy to determine - out of a seemingly endless and overwhelming array of choices - the right cosmetic enhancement choice for you, who should perform it, where it should be performed, or what specifically to look out for. As you explore the idea of a cosmetic procedure, here are some important issues to consider.

1. PLASTIC SURGEON: If you're thinking about surgery, you need to consider a licensed, board certified plastic surgeon above all other practitioners. Most urban areas today have hundreds of plastic surgeons from which to choose, and you can be assured that these physicians have had years (not days or months) of rigorous surgical training specific to each procedure.

2. BOARD CERTIFICATION: You want to be sure that your surgeon is board certified. Plastic Surgery is one of the 24 medical specialties recognized by the American Board of Specialties (ABMS), and certification in the specialty requires extensive additional testing and review of surgical results.. If a doctor is a member of the American Society of Plastic Surgeons (ASPS) or the American Society of Aesthetic Plastic Surgeons (ASAPS) you are assured that they are a board certified plastic surgeon.

3. EXPERIENCE: When you meet with surgeons you need to ask how many years they've been in practice and how many times they have performed the procedure that you're considering and with what kinds of results. You should also ask to see a wide array of "before and after" pictures, and to speak with others who have had surgery about their cosmetic surgery experience.

4. TRAINING & TECHNIQUES: Depending upon your cosmetic surgery goals, there may be a variety of surgical options. For example there are different types of tummy tucks, facelifts and breast lifts. When you meet with a surgeon, talk openly and realistically about your specific goals and concerns so that he or she can recommend the procedure and technique best suited to you.

5. A CARING DOCTOR AND STAFF: You want to have good rapport with the surgeon you select and it's important to feel comfortable and at ease with his or her clinical staff, as well. The staff, the facility, their reputation and their longevity in the community and commitment to patient care and safety are all things that will affect your peace of mind, your comfort and the ultimate success of your procedure. Signs indicating a team of dedicated professionals may be hard to define in concrete terms, but they are easy to "feel" - you'll know whether you're just a number and dollar signs to them, or whether they truly care about each patient individually. Trust your gut.

6. BEFORE AND AFTER SURGERY CARE: Be sure that you understand how the practice will care for and communicate with you before and after surgery. Will there be a Registered Nurse as well as the doctor involved in your care? Are "pre-op" visits scheduled to education you about the procedure and address your questions and concerns? What arrangements are there concerning post-surgery follow-up and care?

7. HOSPITAL PRIVILEGES: Surgeons and doctors typically have a hospital affiliation - meaning that they have privileges to perform surgery at that facility. Make sure any doctor you are considering for a surgical procedure has "hospital privileges" in that particular procedure at an accredited hospital.

8. OPERATING & RECOVERY ROOM TEAM: The team accompanying you during surgery and immediately after is very important consideration. The following people should be in the operating room with you: your plastic surgeon, a physician anesthesiologist, a Registered Nurse (RN) and a "scrub tech" that assists the surgeon.

In the recovery room, another RN certified in Advanced Cardiac Life Support should be available to care for you while you are recovering. This level of care is the "gold standard" and what you should seek.

9. ANESTHESIA: Anesthesia should be administered by a board certified anesthesiologist qualified in that ABMS-recognized specialty. Most cosmetic procedures are done under general sedation and you need to insist that your procedure be done under general, MAC or IV sedation by an experienced, board certified anesthesiologist.

10. FACILITY SAFETY: Your surgery should be performed in a hospital-based operating facility or in an office-based surgery center that has one of the three following accreditations: AAAASF, JACHO, or AAAHC.

This assures you that a high standard of care has been set and is scrutinized by at least one of these professional agencies.