The baby boomers of today no longer think or look like their mothers and fathers did when they were in their forties and fifties. They also are more active and have more disposable income. Additionally, medical advances and technologies have become widely available and lower in price. As a result, cosmetic enhancements are no longer strictly reserved for the rich and famous.

Motivations for having surgery vary by individual and gender. Some of the most common reasons for undergoing a cosmetic surgery procedure include the following:

• to look as young as one feels
• to correct asymmetry of a body part
• to get a psychological boost after a lifestyle change, such as divorce or pregnancy
• to maintain a youthful, vibrant appearance to effectively compete in the workplace.

As a society, we feel comfortable driving expensive cars, decorating our homes, or adorning our bodies with jewelry. We are naturally concerned about our personal appearance. Cosmetic surgery does not have to be construed as self-indulgent. Contrary to some beliefs, people undergoing cosmetic surgery are not vain and narcissistic. Those who are seeking aesthetic changes are ordinary people who have areas on the face or body that can be improved or enhanced.

The motivations for cosmetic surgery are very personal and are best described as being on a continuum. These motivations are neither good or bad nor right or wrong but should be observed in order to fully understand and be prepared for the process of a cosmetic surgery decision.

When our motivations fall more onto the "typical" side of the continuum, such as to improve our appearance for our own reasons, not someone else's, we find that our expectations and the results are more closely aligned and that our perceptions of the surgical experience are more positive. Studies have also shown that when our motivations fall on the "atypical" end of the continuum, for example-getting a breast augmentation to save your marriage-- greater levels of disappointment, dissatisfaction, and negative feelings about the surgical process are more likely to occur.

Each year, hundreds of thousands of people choose to have aesthetic surgery to change the way they look. Some have noticeable changes, others subtle refinements. How can you tell if you should consider this option?

The best candidates for cosmetic surgery should recognize a specific area of their body or face that could be improved and have a strong personal desire to make a change. It is important to be aware of, and honest about ones motivations for having the surgery and to realize that plastic surgery can only change how you look and feel to a certain extent.

The ideal patient should have realistic expectations not only concerning the outcome but also regarding the necessary preparations, the actual surgery, the recovery period, and the discomfort. Along with the above, if there is a willingness to modify lifestyle during recovery and comply with physician's pre- and postoperative instructions, you may make a good candidate for surgery. Of course, there are medical considerations such as health and history which should be discussed with your doctor to determine if you are a good medical candidate for surgery.

The following section will give you an idea of the different fees associated with Cosmetic Surgery. Many prospective patients are misled through deceptive advertising. It is important to identify all costs before committing to surgery. One of the key responsibilities of ACSN is to negotiate a reduction of these fees (specifically the PHYSICIAN'S FEES) and to fully disclose all expenses relating to surgery.

PHYSICIAN'S FEES
Physicians' fees vary greatly across the country and even within a geographical area or city. Overhead expenses, the physician's experience, the geographic area, the laws of supply and demand, and what the market will bear can all be determining factors.

IMPLANT MATERIAL
The cost of implant materials for augmentation of the breasts, calves, cheeks, chin, lips, and so on may be quoted separately or could be included in the surgical or facility fee. Make sure that you ask whether this cost in included so that you are not surprised with additional costs afterwards.

FACILITY FEES
Cosmetic surgery is performed in hospitals, outpatient facilities, and physicians' own surgical centers. Fees can vary accordingly, even within a geographical area. Facility fees are generally separate from the surgical fees.

ANESTHESIOLOGIST FEES
These fees are quoted as estimates and may or may not be a part of the facility charges. You may receive additional billing(s), depending on the actual length of your procedure.

LAB FEES
Most physicians require certain lab tests to determine your health prior to surgery. The type of surgery to be performed, your medical history, and the physician's preference determine the type and extent of the tests.

OVERNIGHT STAYS
Most cosmetic procedures can be performed on an outpatient basis. Certain procedures, e.g., abdominoplasty (tummy tuck), may require an overnight stay. You may be able to save money if you arrange for a hotel room and pay separately for private duty nursing care.

PRIVATE-DUTY NURSING CARE
Private duty nursing care administered by a registered nurse (RN) may range from $25-$50 per hour. A licensed practical nurse (LPN) may charge $15-$18 per hour. At the very least, you should consider companion care at a cost of $8-$12 per hour.

Becoming informed is an active responsibility that anyone considering cosmetic surgery must take on. Once you have taken personal responsibility to do your own legwork and research, you can and should feel comfortable signing consent forms.

Becoming informed can be an adventure, should you choose to view it that way. Although it takes time and commitment, it is incredibly exciting to seek out the information that will contribute to your successful outcome. The amount of research will vary from person to person according to the time and energy available. Nonetheless, taking responsibility minimally requires the following:

Do Not Be Hasty in Your Decision
As difficult as this may be-wait. Wait until you've thoroughly investigated the possibilities of cosmetic surgery before you schedule appointments or choose a doctor.

Pick a date three months in the future as the target date to begin your physician consultations. During that time, make a commitment to read a book every two weeks, investigate several Internet sites per week, and let the information wash over you.

Have a Doctor Selection Plan
In order to successfully choose surgeons to visit, you must narrow your choices. Begin with recommendations from friends, look at articles written about surgeons in your area, and watch for radio or television news stories featuring plastic or cosmetic surgeons. See which names are mentioned most often in a favorable way. These names should correspond with the procedures you are considering.

Once you have gathered at least three doctors' names, you can begin to conduct phone interviews with the staff at their offices. Your phone interviews with the doctors' staff should include asking questions about the doctor's qualifications, his experience with your particular procedure, whether the staff has or would undergo surgery with the doctor for whom they work, and what services the office offers to patients.

Shop around Carefully
See more than one doctor, no matter how much you like the first one. Marked differences exist between doctors' techniques, approaches, and comfort levels with various procedures. Remember-when you visit surgeons or other doctors, they are marketing the procedures and techniques in which they are experienced. They may not discuss other options that may be available to you if they do not perform them.

Don't Be Emotional
Emotions can sometimes lead to making a hasty cosmetic surgery decision based on an advertisement or a loved one's suggestions. It is wonderful to dream, but unrealistic or hasty decisions can turn that dream into a nightmare. Asking for assistance from former patients who have had positive and negative results will help to ground your expectations and dreams in reality.

Know Your Goals
The goal of surgery is improvement, not perfection. Knowing this will take the pressure off both you and your physician. It is imperative that you share your goals and motivations so that your doctor understands what you are looking for. This lays the groundwork for open communication and helps to dispel any misunderstandings before they take hold.

Informed Consent Has Its Challenges
Keep in mind that true informed consent is always difficult for numerous reasons. For example:

• Doctors attempt to, but can't always, convey all matters involved with the surgery decision.
• Patients often have selective hearing.
• Statistically, few doctors have experienced cosmetic surgery themselves.
• Doctors tend to focus on the clinical or technical aspects of care and less on the emotional/psychological aspects.
• Patients aren't always interested in hearing about risks or complications for fear it might steer them away from a decision that may have been difficult in the first place.

Use a Consulting Firm
One alternative is to use a consulting firm to help you wade through the myriad of options. But here, too, you must choose carefully. Not all consulting firms are alike. Choose one with a comfortable environment where you do not feel rushed. Also make sure that their physician screening and credentialing is comprehensive and explained to you. Consulting fees vary based on the services available.

Communication
The potential for miscommunication is great. At the very least, listening carefully, asking questions, and achieving agreement on issues to be included on your consent forms will create an open and communicative environment. This will go a long way in fostering a positive patient-physician relationship.

Many questions are asked about cosmetic surgery. But the number one question, far exceeding all others, is "How do I find a qualified surgeon?"

A credentialing or screening process is an equitable method of determining a physician's qualifications. The cosmetic surgery industry is growing quickly, and doctors are attracted to it in large numbers, partly because of managed care and its fee arrangements with physicians. Currently, no formal guidelines exist for evaluating the quality and credentials of cosmetic surgeons.

As an individual, versus a health care entity, you will find some areas in which access to information is blocked. Unfortunately, it will probably be some time before the general public will be able to gain access to more information about a physician. However, the good news is that you can take some actions on your own. The following is an outline of the information you would want to know about your chosen physician. We have also shown you the levels of access you may have regarding certain criteria. The rules in your state may vary, but use this chart as a guide. It is imperative that you gather and evaluate all the information that is available to you.

Feeling in control can make a big difference when making a cosmetic surgery decision. Just reading and learning more about procedures can alert you to the many aspects that need to be evaluated before considering surgery. Taking any one of the following actions will greatly increase your chances of a successful result. The more you research, the better your ultimate decision will be.

Call Your State Medical Licensing Board
Although some states won't give out a lot of information, they'll usually tell you whether the doctor is licensed to practice in the state. This is basic information, but don't fail to ask this simple question. Just because a doctor has offices and staff does not mean he automatically has a license to practice.

Investigate Internet Resources
Search under "Cosmetic Surgery/Plastic Surgery/Aesthetic Surgery," and you will be amazed at the information that you will find. Immerse yourself, visit many sites, and get a general feel for this industry, but always be aware of the source so you can determine its applicability to you.

Interview Former Patients
The physicians you visit should be able to give you names of former patients with whom to speak about their experiences. Ask former patients about good experiences, as well as situations that they wish had been handled differently.

Computer or video imaging is an innovative way to answer the question, "I wonder what I'd look like after cosmetic surgery?" Using a camera and special computer software, your appearance can be altered on the screen right before your eyes so that you can better visualize the outcome of cosmetic surgery. Perhaps you aren't sure about having a procedure performed or you're considering multiple procedures. Computer imaging can assist with your decision. Many people use computer imaging as a way of minimizing any presurgery stress. It's a fun, fast, and effective way to explore the possibilities.

The images that will be produced for you are approximations, but they look remarkably close to actual results. And there's no safer, simpler way for you to objectively preview the procedure you are contemplating. Computer imaging involves you by giving you the opportunity to share what you like and dislike about your current features or a proposed change. Having a computer imaging session will allow you to better communicate your requested changes with your chosen doctor. The use of the computer image can help alleviate unrealistic self-images that a patient may harbor. It may also help you gain the support of family members and friends because they will be able to see the proposed changes beforehand.

Computer imaging is powerful technology, and the goal is to provide you with a picture of a clinically achievable outcome. However, it is important to remember that it is a computer image only. You and your surgeon must discuss what is ultimately possible.

As a resource for our cosmetic surgery community, when a company does a banner job of providing specialized information, we want to tell you about it. www.MakeMeHeal.com does just that. Their focus is on cosmetic surgery preparation and recovery. They are a service that offers the kind of information you are not likely to find anywhere--at least in one place. They have spent thousands of hours interviewing thousands of women to bring you the true stories and the vital information that can make a difference as to whether your experience is a positive one.

So, please check them out, they are a great resource....