Case Count and Years: The Surgeon Credentials Patients Can Verify
A business owner hiring a contractor asks two things before price comes up: how many jobs like this one the firm has finished, and for how long it has been doing them. Patients choosing a plastic surgeon can ask the same pair of questions, and one Houston surgeon argues those answers matter more than anything else on the résumé.
Leo Lapuerta, MD, FACS, has spent more than 30 years in practice and has performed more than 30,000 procedures, surgical and non-surgical. The profile of his plastic surgery experience in Houston lists those figures alongside three board certifications. In his view, the combination of the two, credentials and a long record with the procedure in question, is the best guide a patient has to an outcome they will be happy with.
The case he makes
Dr. Lapuerta states the point in his own words. “The best way to ensure a good outcome is to choose a surgeon who is qualified (board certified) and has extensive surgical experience in both number of cases and years of experience.”
The argument has two parts. Board certification sets a floor for training and testing. Experience, measured in cases and in years, shows how often a surgeon has applied that training to the operation you want. He calls experience with the specific procedure the best determinant of an outcome that patients perceive as positive. That is his professional judgment, drawn from more than 30 years of practice, and patients can weigh it as such.
His own path illustrates the training half. He studied at Stanford University and UT Southwestern Medical School, trained in general surgery at St. John’s Hospital in Detroit, and completed a plastic and reconstructive surgery fellowship at St. Joseph Hospital in Houston. He describes 16 years of education and training after high school before entering practice. He is certified by the American Board of Plastic Surgery, the American Board of Surgery, and in Surgery of the Hand.
Two numbers worth asking for
Volume and duration measure different things, and a careful patient asks for both.
Case count reflects repetition. A surgeon who has performed a procedure many times has seen a wide range of anatomy and has adjusted the plan for patients who did not fit the textbook. Ask for the count for your procedure, since a lifetime total may blend many kinds of work. Dr. Lapuerta’s 30,000 figure, for example, includes non-surgical treatments as well as operations.
Years in practice reflect something a count cannot. Long careers include long-term follow-up, so a surgeon with decades behind him has seen how results hold up years after the operating room.
Checking the claim yourself
A surgeon’s experience is easier to verify than many patients assume. A short list covers most of it:
- Ask the surgeon how many times he or she has performed your procedure, and for how many years.
- Ask to see before-and-after photos of that procedure, on patients whose starting point resembles yours. Dr. Lapuerta’s practice keeps more than 3,000 before-and-after images for patients to review.
- Ask which boards certify the surgeon, then confirm it with the certifying board.
- Ask which hospitals have granted the surgeon privileges for the procedure. Dr. Lapuerta’s include the Memorial Hermann network, HCA hospitals including The Woman’s Hospital of Texas, and St. Luke’s Houston Medical Center.
- Ask where the surgery will take place and who will provide anesthesia. Dr. Lapuerta owns and operates a QuadA (AAAASF) accredited surgical facility and works only with physician anesthesiologists.
Reading the answers
A surgeon who answers these questions with specifics, and without hesitation, gives you something to compare. Vague answers about having lots of experience give you nothing to compare at all.
Experience also shows up in roles outside the private practice. Dr. Lapuerta is Chairman of Plastic Surgery at St. Joseph Hospital, a past President of the Houston Society of Plastic Surgeons, and a teaching surgeon for plastic surgery programs at UT-Houston, the University of Texas Medical Branch and the fellowship at Houston Methodist Hospital. Positions like these put a surgeon’s work in front of peers and trainees.
No credential removes the risks that come with surgery, and results vary from one patient to the next. The two numbers still belong at the top of a consultation notebook, written next to the name of the procedure, before any discussion of cost.
This article is for general information only and is not medical advice. Results vary from patient to patient. Consult a board-certified plastic surgeon or your physician about your own situation. Written in partnership with Joseph Lambert, a publicist working with Leo Lapuerta, MD Plastic Surgery.
