Before you call and book an appointment for cosmetic surgery, sit down and think about why you want it. Is it something that's bothered you since childhood? Or are you doing it to simply boost your self-esteem? Explore your thought process and ensure you're doing this because you want to, not because a loved one is pressuring you, or you're feeling like you have to keep up with your friends or colleagues. Here are a few things you should consider before making a life-changing physical alteration.

1. Do your research
"A great place to start is the Internet, says Dr. Stephen Mulholland, cosmetic surgeon and owner and director of SpaMedica in Toronto. When looking into a particular surgeon, cosmetic dermatologist or clinic, visit the following sites to verify that the doctor and/or clinic you are considering is accredited:

• Royal College of Physicians and Surgeons of Canada (rcpsc.medical.org);
• Canadian Society of Plastic Surgeons (plasticsurgery.ca);
• Canadian Society of Aesthetics Plastic Surgeons (csaps.ca); and
• Canadian Association for Accreditation of Ambulatory Surgery Facilities (caaasf.org)

All surgeries performed in a clinic must be accredited and approved by the CAASF, and all physicians that maintain their fellowships in good standing are listed (along with their specialty and certification date) on the Royal College's of Physician and Surgeon's Maintenance of Certification section. Be thorough – you're interviewing the people who will change the way you look, so take the extra time to investigate.

2. Don't be shy
Just like a fresh set of highlights, if you like the way the furrow in your friend's brow has suddenly vanished, ask her who did her work. To counter, if you didn't love her work, make sure you get that surgeons name too, says Mulholland. Ask your surgeon to show you before and after photographs of patients who've had the procedure(s) you're considering. For further reassurance, ask to speak with a patient who visited the doctor you're considering.

3. Get the right Doc for the job
If you're after a nose job or an eyebrow lift, a physician who specializes in body contouring and breast augmentation might not be the best fit for you. Surgeons tend to develop reputations for what they're best at. Look for someone with a specialty in your category of concern so they can best assist you in getting a great result.

4. Meet and greet
"At the end of the day, you need to meet the physician, interview them and see if there's a sense of trust," says Mulholland. "If your friend had a good outcome, you probably will too."

5. Remain focused
If a surgeon or cosmetic dermatologist is pushing you into additional surgeries that seem unrelated to your area of concern or procedures that make you weary, go home and think about it before agreeing to anything. Remember, you're undergoing a change, regardless of how big – feeling comfortable is incredibly important.

6. Anticipate the unexpected
Sure, maybe your best friend healed completely over a weekend after a laser treatment or your sister can do her Botox over lunch. That doesn't mean you're in the clear. "Different types of skin can react very differently," says Dr. Mulholland, who says lifestyle and genetics can influence how a person responds to certain treatments.


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7. Pain free? Think again
While many new procedures, such as dermal fillers, Botox and skin tightening, are less invasive than their predecessors, this doesn't negate their pain potential. "It's not that there's no pain, it's just that there's less pain," says Mulholland. "It's not that there's no healing time, it's just that there's less downtime."

8. Anticipate additional time with your doctor
To achieve the results you desire, tweaking the original procedure (for example, with Botox and fillers) may be required, which doesn't necessarily mean it was done incorrectly, says Mulholland. "We often can't predict how different people will react," he says. Patients who try filler may require a little more or a little less upon follow up. Removal is simple: an enzyme is injected to dissolve the filler in the same way it was initially delivered.

9. It's a risk
Consider the potential risks and side effects that come with the procedure you're interested in. Make sure you ask as many questions as possible in your initial consultation, and come to terms with the potential complications before you decide to proceed. Determine who will cover the costs if something unexpected occurs.

10. The cost
Surgery can be expensive, especially if you require anesthetic. But don't be seduced by street signs or in-office promotions promoting special deals or deep discounts; this is your body, after all!

Which cosmetic procedure is best for you?
Here are a few need-to-know facts about some of the most popular cosmetic procedures.

Botox
This injectible drug relaxes a small area of muscle, softening expression lines such as frowns, lip lines, crow's feet and forehead creases. The procedure takes 15 minutes to perform, and results last three to four months. Most patients can return to normal work immediately.

VolumaLift
Injected with a needle, this hyaluronic acid base (a filler) holds water, making it swell under skin. This restores volume to areas such as sunken cheeks, marionette lines, hallowed eyes and lips. Results last up to 24 months from a procedure that takes under one hour to perform with combined topical and local anesthesia. Some patients may experience a reaction, and bruising can take up to three days to vanish.

Fractional Laser (often called "Fraxel")
For those looking to banish scars, fine wrinkles and pigment irregularities, a focused-energy laser sends creates microscopic tears to the dermis level, creating the production of new collagen and elastin. The procedure takes approximately 30 minutes and is combined with a topical anesthetic cream. While some patients are fine two hours afterwards, the redness and warm feeling can last up to 48 hours.

Fotofacials (or IPL laser)
For people seeking to repair aging, sun-damaged or enlarged pores, a tool is guided over the skin (with flashing light) and painless radio frequency signals to target the deeper layer of epidermis. Most people leave the treatment with a flushed face, and it takes at least five sessions to see optimum results.

Neck Liposuction (or "NeckTyte")
If you're looking to vanquish excess fat that hangs around despite diet and exercise, liposuction can be effective, but isn't free from drawbacks. Patients require local anesthesia as force is required to extract fat from the area via a small hollow tube and suction, which is inserted after an incision is made in the neck. A radiofrequency pulse follows, tightening skin and minimizing bruising. A neck and compression guard is required for 5-7 days, and bruising and swelling can last anywhere from 2-7 weeks.


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