Why costs vary so much between different doctors.

For Dr. Dowden's patients, the fees for cosmetic surgery include: The surgeon's fee, and office followup appointments for 52 weeks (the annual followups beyond 52 weeks are not included.) The initial consultation fee is subtracted from the surgery fee. Our office manager also makes every effort to estimate the fees for the pre-operative examination and testing, operating room fees, anesthesiologist fees, recovery room costs, implants, medical supplies and dressings. The variations within this range depends upon several factors, such as which facility is chosen for the procedure, whether the patient stays overnight after surgery, and the type of implant chosen, if any.

One can find bargains with surgeons offering lower fees for operations, and although lower fees do not always mean lower quality, there are several questions to which the patient must know the answers before deciding about operation:

1. Is the surgeon certified by The American Board of Plastic Surgery?
2. Does the surgeon have considerable experience with the operation you want?
3. Has your surgeon spent enough time explaining everything to you?
4. Is the surgical facility fully accredited for general anesthesia?
5. Will there be an M.D. Anesthesiologist?
6. Will your surgeon be the one doing your surgery?
7. Are you sure your surgeon is not just supervising residents doing the surgery?
8. Are you sure your surgeon will not be needed in another operating room while trying to do your operation?
9. Does the quoted fee include anesthesia, operating room, and implants if any?
10. If there are implants, are they U.S. made and FDA approved?

How can a patient get cheaper surgery?

By making compromises to quality and safety, costs can be reduced, although Dr. Dowden will not agree to make those compromises. Using breast augmentation as an example, here is a table of some fee figures and characteristics applicable to ten of the surgeons in the Cleveland area who perform breast augmentation, given to us by patients who had seen those surgeons. In each case, the quoted amounts are the typical maximum, and include surgeon, anesthesia, operating room, supplies, testing, recovery room, and the implants. It is important to note that these fees do not cover the costs of ANY subsequently required operations.

Reducing the cost by compromising quality and safety (example = saline breast augmentation): 
                        Surgeon:  Dr.A Dr.Dowden   Dr.B Dr.C Dr.D Dr.E Dr.F Dr.G Dr.H Dr.I
Certified by Am Brd Plas Surg?....Yes....Yes.......Yes..Yes..Yes..Yes...No...No...No...No
Over 15 years implant experience?.Yes....Yes.......Yes...No...No...No...No...No...No...No
Capable of doing every method?.....No....Yes........No...No...No...No...No...No...No...No
Surgeon consult over 1 hour?.......No....Yes.......Yes..Yes...No...No..Yes...No...No...No
Real operating room, not office?..Yes....Yes.......Yes..Yes..Yes..Yes...No...No...No...No
OR accredited by JCAH or AAAASF?..Yes....Yes.......Yes..Yes..Yes..Yes...No..Yes...No...No
MD anesthesiologist?..............Yes....Yes.......Yes..Yes...No...No..Yes..Yes...No...No
Surgeon does the operation?.......Yes....Yes.......Yes..Yes..Yes...No...No...No..Yes...No
Implants FDA approved?............Yes....Yes.......Yes..Yes..Yes..Yes..Yes..Yes...No...No
Approx max cost(to nearest $500): 8000...7500      7000 6500 6000 5500 5000 4000 3500 3000

As shown above, there are several factors that may make having surgery with Dr. Dowden more expensive than some alternatives:

• Dr. Dowden is fully certified by the American Board of Plastic Surgery.
• Dr. Dowden has over 25 years experience with cosmetic surgery.
• Dr. Dowden spends at least two hours in consultation with the patient.
• The operations are done in an actual surgical facility, not in an office operating room.
• All the equipment used is of top quality.
• Dr. Dowden believes that the surgeon should not be the one giving the anesthesia.
• There is an MD anesthesiologist and nurse anesthetist on every case.
• The operation is not performed by a student, a trainee or a resident.
• Dr. Dowden himself does the operating, and does not hurry.
• Any implants used are made by USA manufacturers, are FDA approved, and have warranties.

Some current fee ranges for cosmetic procedures done by Dr. Dowden:

These estimates include preop testing, O.R., anesthesiologist, supplies, 
recovery room, overnight stay if needed, and free office followup for one year:
  Forehead lift (endoscopic)........6400 to 7500
  Upper Eyelid lift.................3300 to 4300
  Lower eyelid lift.................3700 to 4700
  Full facelift.....................9200 to 9970
  Facial laser resurfacing..........5000 to 6000
  Liposuction of the neck...........3400 to 5000
  Breast augmentation, saline.......6300 to 7400
  Breast lift.......................8200 to 9960
  Abdominoplasty....................7900 to 9200
  Liposuction of the abdomen........3800 to 5500
  Liposuction of the outer thighs...4100 to 5900
These are approximations, and can change without notice.

All cosmetic surgery is prepaid, but various financing options are available. It is not appropriate for health insurance to cover cosmetic surgery, and Dr. Dowden's office staff will not participate in attempts to submit cosmetic surgery to insurance companies.

What about the costs of correcting problems resulting from operations performed by other doctors?

How can the patient be certain that the doctor is really a certified Plastic Surgeon?

It is worth mentioning that the American Board of Plastic Surgery, as well as the professional Plastic Surgery Societies, do not permit their members to give away a surgery or a consultation as a prize in any contest, raffle, or promotion. Therefore, if you come across such a contest, that tells you right away that the surgeon is not certified by the American Board of Plastic Surgery, and in fact may never have even taken Plastic Surgery training.