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Whether it’s an attempt to look a little younger or to contour the body after massive weight loss, plastic surgery is serious business and carries serious risks if not performed by a surgeon certified by the American Board of Plastic Surgery.

Furthermore, many people who undergo a surgical procedure are not always coached about having realistic expectations about the outcome.

Many patients, Atlanta-area plastic surgeon Lisa Bootstaylor told the Atlanta Journal Constitution, do not consider “what you’re really going to look like afterward.”

Some people who have major weight loss or gastric bypass surgery, for example, have sagging skin that did not shrink after losing the weight.They lack the “snap-back quality” of skin, said Bootstaylor, who was Georgia’s first board certified female African American plastic surgeon.

Patients should also consult with their physicians to determine the possibility of adverse scarring or hyper- or hypopigmentation before undergoing surgery.

According to the American Board of Plastic Surgery, there are four basic considerations patients should take into account when choosing a plastic surgeon:

•    You should choose a doctor based on the doctor’s education, training, experience and proven competence with respect to the specific procedure you are considering.

•    You should become informed regarding how often the doctor performs the procedure and whether the doctor has had claims against him or her with respect to the procedure or any other cosmetic procedure.

•    You should review before-and-after photographs of other patients who have had the same procedure performed by the doctor you are considering.

•    You should also speak with other patients, whenever possible, who have had the procedure performed by the doctor you are considering.

In addition, anyone considering a cosmetic procedure should ask the surgeon a number of specific questions, including where the doctor was trained, whether any certification was earned, what are the risks and potential complications and how many patients have returned for corrections or adjustments. Ask to see before-and-after photos of patients who have had the procedure under consideration.

In a report on its website, the American Society of Plastic Surgeons noted that more people of color were undergoing plastic surgery and that more than 1 million black Americans had undergone a procedure in 2010 and made up 8 percent of all cosmetic plastic surgery procedures that year.

The most common major surgeries sought were nose reshaping, breast reduction and liposuction. The most requested minimally-invasive procedures were Botox, injectable fillers and chemical peels.

And patients are not, the site said, trying to erase their racial or ethnic image.

“The majority of patients want to maintain their ethnic identity,” the site said. “They do not want to lose important facial features that exhibit racial character. For instance, the typical Asian patient who has eyelid surgery desires a wider, fuller eye that is natural looking to the Asian face and maintains an almond shape. An African American patient interested in nose reshaping may want to reduce the size of their nose to achieve a harmonious balance with other facial features, but is not seeking a nose that is more European.”

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