Continuing from our last segment, in which Dr. Joseph Francis Capella (Capella Plastic Surgery) gives his expert opinion on choosing a plastic surgeon. In this segment, Dr. Capella discusses the importance of the plastic surgeon ‘s credentials, surgical team, and facility — things we often don’t evaluate when looking for someone qualified to do our body contouring.
Dr. Capella answers readers’ and my burning questions, bringing to light virtually everything we need to know before opting for plastic surgery after weight loss. Go to part 1 of my Dr. Joseph Capella interview or read part 4 below.
Dr. Capella on Evaluating the Plastic Surgeon ’s Certifications and Affiliations
My Bariatric Life: Why is it important that the surgeon have board certification by the American Board of Plastic Surgery? Are other board certifications equally as important? What about memberships in professional societies?
Dr. Capella: Board certification or diplomat means that you’ve gone through a very rigorous training program and that you’ve been accredited by this board that has very specific criteria that needs to be met to receive a diploma. In addition to that, graduates after the year 1995 have to receive re-accreditation every 10 years. And, in addition to that, you have to receive 150 CME [continuing medical education] credits every three years.
In other words, there’s an on-going maintenance of accreditation that needs to take place, too. So you know that your doctor is up-to-date on the current knowledgebase in the field. So, I think it’s very important that they be board certified in plastic surgery.
My Bariatric Life: Are distinctions such as being a chief of plastic surgery an indicator that the surgeon is more highly qualified than other plastic surgeons?
Dr. Capella: I think qualified depends on what you’re doing. In other words, there are chiefs of plastic surgery that are not experienced in post-bariatric body contouring. They may be experts in reconstructive surgery. It means that they are well-regarded, probably, by their peers in that institution, but it may not be that they’re qualified to do your surgery.
My Bariatric Life: Are admitting privileges, education, training, and other distinctions important?
Dr. Capella: I would very much recommend that you go to a doctor that has admitting privileges because hospitals in their own way really make sure that doctors have it all together. They want to make sure that you’ve got all your certifications up-to-date, your malpractice insurance is up-to-date — and they’re not going to allow for a doctor who has some on-going problem to keep admitting patients. In effect, it’s almost like a club.
So, I would very much seek doctors who have admitting privileges at hospitals — of course, especially, if there is a complication that the doctor has to admit the patient.
Dr. Capella prepped for surgery.
I happen to do all my work at a hospital. Hospitals have their own criteria for maintenance, too, that I think is very important. So, for example, they’ll not let me even do microsurgery or cleft-lip and palette surgery because they know I’m not qualified. The Chairman of Plastic Surgery has to approve me to do it, and I would never even ask for it. So you know that if your doctor is performing a certain procedure, he or she has maintained certain excellence in that procedure, too.
Sure education and training are important. Fellowship training suggests that person has really gone for expertise within that certain area. In plastic surgery there are fellowships in cosmetic, and hand, and cranial-facial and others. So if you are having cranial-facial surgery and the doctor had a fellowship that really would suggest that he or she is an expert in that area. I developed a very large experience with post-bariatric patients working with my father, who as I mentioned earlier was a bariatric surgeon.
Dr. Capella on Evaluating the Plastic Surgeon ’s Surgical Team and Facility
My Bariatric Life: And what credentials and certifications should we look for in the rest of the surgical team?
Dr. Capella: The anesthesiologist should be board certified — and ask how often he or she has worked with the surgeon who is doing the procedure. And what’s important — but you may not be able to get this — is having a team who has done that procedure with the surgeon lots of times, too. That really helps. That’s why I like to go to the same hospital over and over again because many of the nurses have done this 50 or hundreds of times with me. And so then I can focus on my surgery rather than saying, “oh, did we get that suture?” or “oh, we don’t have that instrument.” Believe me, it’s a distraction. So ask the doctor if he or she is working with a surgical team on a very regular basis. If you could get that, it’s fine tuning things, but that’s what I care about.
My Bariatric Life: And what certifications should we look for in the surgical facility, such as an ambulatory center or in-office operating suite?
Dr. Capella: AAAASF is an organization that I was accredited with here when I had an office-based operating suite. There are other levels of accreditation, depending on what you’re doing. For example, JCAHO and AAAHC accredit free-standing surgical centers that are licensed by the state.
My Bariatric Life: Are these office-based and ambulatory centers safe for big procedures?
Dr. Capella: There is less regulation regarding the procedures that are being performed in an out-patient setting. Anemia and the need for blood transfusions always becomes a concern when dealing with larger cases. Most out-patient facilities don’t have the ability to provide a blood transfusion. You would prefer to avoid transferring the patient. So I’m happy being at the hospital because there’s never that issue there.
Stay tuned for part 5 of our Dr. Capella plastic surgery interview.
Living larger than ever,
My Bariatric Life
