(MayoClinic.com) You've seen it advertised in newspapers, featured on television programs, apparent in the faces of celebrities — cosmetic surgery. It's guaranteed to shave decades off your appearance, right? In some cases, maybe. Cosmetic surgery offers the potential to improve many areas of the body. But as with any surgery, cosmetic surgery also involves certain risks and limitations.

Cosmetic surgery, also referred to as plastic surgery, aims to change your appearance by altering parts of your body that function normally but whose appearance makes you unhappy. This differs from reconstructive surgery, which can improve the appearance and function of body parts affected by congenital defects, injuries and diseases such as cancer.

Cosmetic surgery offers choices for making changes in your physical appearance. It reshapes normal body structures, changes appearance and, often, improves self-esteem.

If you're dissatisfied with your appearance, you may be interested in cosmetic surgery not only to look better, but also to feel better. Despite possible risks, and though each person's experience is unique, both improvements may be likely after cosmetic surgery.

No studies have conclusively proved that most people can expect to enjoy dramatic improvements in their psychological well-being, however. If you're struggling with depression, for example, cosmetic surgery is unlikely to relieve it.

When deciding for or against cosmetic surgery, consider the following:

• Your expectations. Anticipate improvement, not perfection. If you expect cosmetic surgery to turn you into a movie star, you're bound to be disappointed. Also don't count on surgery to save a rocky relationship, gain a promotion or improve your social life.

  If you're in the middle of a very stressful life circumstance, such as a divorce, job loss, death of a loved one or an uncontrolled mental illness, you may want to postpone cosmetic surgery. All of these situations may increase the possibility that you won't be satisfied with the final results.

• Time and expense. Cosmetic surgery isn't covered by most health insurance. The costs vary depending on the procedure performed and may range from a few hundred dollars to several thousand dollars. The procedures and your recovery also take time. This varies depending on the procedure. Returning to work may take from one day to several weeks.
• Potential risks. You must be comfortable with the fact that cosmetic surgery, like any surgery, can be a risk to your health and that the results may not be what you anticipate.
• Physical and psychological changes. Understand the physical effects that may be part of the healing time as well as how the surgery may affect aspects of your personal and professional life.

The closer you work with your surgeon to establish specific, measurable and achievable goals before surgery, the more likely you are to be satisfied with the results. Still, dissatisfaction with results always remains a possibility.

Do a reality check
How pleased you will be depends on a number of factors. These include:

• Your expectations
• The extent and type of surgery
• The skill of your surgeon
• Your own body's ability to heal.

Physical risks
Beyond the risk of dissatisfaction, all the usual surgical risks apply. If you have a history of cardiovascular disease, lung disease or obesity, you have a higher risk of developing such complications as pneumonia, stroke, heart attack, and blood clots in the legs or lungs.

Other possible surgical complications include:

• An accumulation of clear fluid beneath the incision (seroma), which may need to be drained
• A collection of blood beneath the closed incision (hematoma), which may have to be removed
• Skin breakdown — a separation from healthy skin caused by poor blood circulation, particularly if you smoke
• Bleeding requiring a transfusion
• Infection at the site of surgery, which may require additional surgery and lead to bigger scars

You're more likely to have a smooth recovery if you're in good overall health, are cared for by a qualified surgeon, and practice proper self-care after surgery by carefully following your doctor's instructions.

Your cosmetic surgeon should have experience doing procedures similar to the one you're having. It's important that your procedure or surgery is done in a setting where there is access to a team of qualified health care professionals.

To find a qualified cosmetic surgeon:

• Look for the gold standard in certifications. You're more likely to have a satisfactory outcome if your surgeon is experienced in the procedure and has been certified in his or her specialty by an appropriate board recognized by the American Board of Medical Specialties.

  For more-involved procedures such as a tummy tuck (abdominoplasty), consider a surgeon who has hospital privileges to perform that procedure. For procedures requiring general anesthesia, be sure that the operating facility has been accredited by a national- or state-recognized accrediting agency such as the Joint Commission, is certified to participate in the Medicare program under Title XVIII of the Social Security Act or is licensed by the state in which the facility is located.

• Beware of misleading certifications. Just because a doctor is "board certified" doesn't mean he or she has had sufficient training in cosmetic surgery. Certification could come from an unrecognized, self-designated board that requires little more than an application fee.
• Know that not all referrals are equal. If you call a hospital to ask for a recommendation, you might be referred to the next cosmetic surgeon on the receptionist's revolving list. He or she may not be best qualified to operate on you. Instead seek recommendations from people you trust, such as your family doctor or a friend who has had a successful procedure.

One of the best ways to help you decide if cosmetic surgery is right for you is to meet with a cosmetic surgeon. During this initial consultation, you discuss your desires and expectations and your doctor evaluates the part of your body you want treated. You also discuss any medical conditions that could affect the outcome of the procedure — such as diabetes or blood-clotting problems — and review the medications you take.

Questions to ask
Before choosing a surgeon, ask the following questions:

• Are there treatments other than surgery that might work just as well or better for me?
• Am I a good candidate for this procedure? Why or why not?
• How many times has the surgeon performed similar procedures, and what were the results?
• Can the desired effect be accomplished in one procedure, or are multiple procedures anticipated?
• What are the surgical options and the pros and cons for each?
• What type of anesthetic will be used, and how will it affect me?
• Will I be hospitalized and, if so, for how long?
• What results can I expect?
• What are the possible complications?
• How will my progress be monitored after surgery? What follow-up care will I receive?
• How often is "touch-up" surgery needed, and is it covered in the cost estimate?

After your visit with your cosmetic surgeon, you may have mixed feelings. Feelings of excitement and anxiety are normal. Understanding what is involved and having realistic expectations about what can be accomplished are two ways to reduce your anxiety.

Even if you've done your homework and found a surgeon you like — at a price you can afford — make sure you feel absolutely comfortable with and committed to your choices. In the end, it's your decision and yours alone.

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