While most patients who undergo plastic surgery end up happy, their true real and potential costs are only seldom understood.

It isn't.

While some patients may believe (as the American Express commercial so often suggests) that the value of a successful operation is "priceless," they would undoubtedly run for the door if asked by the plastic surgeon to sign over every last dollar of financial worth.

In other words, cosmetic benefits do have a comparative and finite value, even if this amount will vary with each patient's own economic, social, and psychological situation.

To perform a meaningful cost-benefit analysis, then, requires that you do your best to assign reasonable ball-park values to every single category that follows and not just the ones that are easy to fill in or the ones that assume everything always goes well, a task that is eminently doable if you'll just give the matter a little time and careful thought.

That said, many potential patients will still feel that performing such an analysis requires too much effort involving too much estimation (and granted, some of the numbers are difficult to peg except in retrospect). If that's how you feel, then at least skim over the outline before signing up for care. Remember, your medical insurance isn't going to help you out with any of this.

Flying across the ocean to undergo surgery by an unfamiliar surgeon working within an unfamiliar medical system guided by unfamiliar standards of quality to save a fraction of the surgeon's fee may seem like a clever strategy to save a few bucks. On the other hand, you may come to feel that any money shaved off the standard local surgeon's fees now seems all but inconsequential when compared to your potential total monetary and non-monetary exposure.

After all, a "save a little, spend a lot" experience is not what most people are hoping for.

But why take our word for it? Pour yourself a cup of coffee, round up a calculator and pad of paper, and start filling in the dollar values for each of the items listed below. Then you can decide for yourself.

. . .

ECONOMIC COSTS
cash out-of-pocket

1. PREOPERATIVE

• research and consultations (doctor fees, tests, travel costs, lost earnings)

2. SURGERY

• surgeon
• any other doctors
• hospital
• laboratory (before and after)
• medications
• travel (transportation, lodging, meals, incidentals)
• lost earnings

3. ROUTINE FOLLOW-UP

• special supplies
• special medications
• travel (transportation, lodging, meals, incidentals)
• lost earnings

4. COMPLICATIONS NOT REQUIRING MORE SURGERY

• research and consultations (doctor fees, tests, travel costs, lost earnings)
• treatment
• medications
• supplies

5. COMPLICATIONS REQUIRING ADDITIONAL SURGERY

repeat items 1-4 above for each revision operation

!!! Not including all such items in the calculation will result in a cost-benefit analysis that is skewed to look unrealistically favorable because it assumes that all results are satisfactory, which is not the case. For example, if one in twenty-five patients undergoing calf reduction by selective neurectomy suffers gait complications at an average economic cost of $75,000, then you must enter in 1/25 of $75,000, or $3,000, in the appropriate spot on the cost analysis, and so on. This represents your fair portion of the "odds" that something bad may actually occur with your operation, but it obviously does not reflect your true costs if you actually do experience such a complication.

6. PERMANENT COMPLICATIONS THAT ARE NOT REPAIRABLE

(see !!! above)
• lifelong loss of income
• lifelong medical expenses
• special appliances or aids

NON-ECONOMIC COSTS
non-cash expenditures

7. PAIN AND SUFFERING

8. INCONVENIENCE

9. EMOTIONAL STRESS

10. IMPAIRED QUALITY OF LIFE

Steps 7-10 must be considered for all possible outcomes:

(see !!! above)
• (2-3) uncomplicated surgery
• (4) complications without more surgery
• (5) complications with more surgery
• (6) non-reparable complications

. . .

ECONOMIC BENEFITS

11. INCOME

• increased income earned from employment gains related to new appearance (but read this before entering a pie-in-the-sky estimate)

NON-ECONOMIC BENEFITS

12. PSYCHOLOGICAL

Try to assign a reasonable dollar value. "Priceless" is not acceptable.

• feeling better about yourself
• increased self-confidence
• easier social interactions
• better physical appeal

. . .

Tired? You're only getting started...

All of the above calculations (steps 1-12) now need to be repeated for each close companion, friend, or family member who will be directly impacted by your operation and recovery.

By not including the costs/benefits for all parties involved, your cost-benefit analysis will be skewed to look too favorable. For example, if your spouse takes off two weeks from work to care for you after surgery in Outer Mongolia, all related costs (travel, lost income, etc, etc) must be included.

. . .

Once you've finished collecting the data...

1. Add up all of the potential costs.
2. Add up all of the potential benefits.
3. Subtract the total benefits from the total costs.
4. Look at the result. Is this what you expected?

Congratulations and good luck!

(Suggestion from JJ of Dallas, Texas:

Repeat the analysis factoring in one more variable when determining dollar amounts in steps 4-10:

inexperienced/unknown/discount surgeon vs. experienced/well-known/full-price surgeon.)

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