Cosmetic Surgery Fees in Beverly Hills

High fees don’t necessarily guarantee superior results. Low fees are not always a bargain.

If your selection of a surgeon is determined primarily by - high or low - ultimately you may be disappointed with your choice. You cannot accurately judge a professional by fees alone. Each professional has variables that drive the fee schedule. For example:

• Office overhead. Rent, equipment, supplies.
• Number and quality of staff. The better the staff, the higher the salaries.
• The surgeon’s expertise. Superspecialists are efficient surgeons. They require less (costly) operating room time. There’s value in that.
• Other value-added items which factor into the fee can include:
  • Medications (prescription and non-prescription) and supplies. Are they included in the fee? Always ask.
  • Aftercare. Home nursing or recovery hide-away charges may or may not be included.
  • Patient transportation. Some practices provide limo service the day of surgery. This service may or may not be included in the fee.

But, high or low, you need to know exact numbers. No guesswork. So, as you consult and collect quotes, be sure you know exactly what services are - and are not - included.

In addition to the specifics of products and services rendered, there is the intangible: your general comfort level. Some factors that impact comfort can include:

• Confidence that the doctor has the talent to surgically deliver what you expect.
• Professional and attentive conduct during the consultation period. Does the surgeon listen carefully to your needs and desires? Does he express respect and appreciation for you as a patient?
• Satisfaction that the surgeon’s support staff is well trained and will assist in you in a caring and professional way.
• Belief that the operating facility and after care service meet high standards for your safety and comfort.
• Acceptance of the fees as reasonable and affordable for the amount and quality of service performed.
• A healthy “gut feeling” about the entire undertaking.

If you feel satisfied that your surgeon and his staff meet these criteria, you will feel good about writing the check and should have an excellent experience. Charges are a function of time expended on the patient’s behalf by a team of highly skilled professionals. In addition to the surgeon, services are provided by nurses, aides and administrative staff members. Anesthesia is critical for your comfort and safety, so the anesthetist or anesthesiologist is another indispensable and valued part of the team. With four or more professionals in the operating room, and administrative staff members seen and unseen, you can appreciate the multiple services being rendered for the fee. Care is given before and after the operating room time; this routine “pre and postoperative care” should be included in the surgeon’s fee.

• Expect separate charges for the surgical facility and anesthesia services. These sophisticated, licensed, certified surgical centers cost more to build, staff and operate than a small, single, operating room in a doctor’s back office. Anesthesiologists (physican specialists), by virtue of their pedigree, rightly command higher fees than nurse anesthetists. These “costs of quality” impact charges.
  Reminder: Know where you will be having surgery and who will be assisting.


• The familiar real estate adage, “location, location, location” applies to your surgeon. It costs more to run a practice in Beverly Hills than it does in Oshkosh. The difference in real estate and labor costs will be reflected in doctors’ fees. World-class, sophisticated medical communities with large teaching hospitals nearby are ideal professional environments. However, they are generally located in the higher rent areas of our biggest cities.
  Reminder: Expect to pay more where top specialists congregate. Consider it another quality cost … an investment.


• You may find yourself paying (too much) for an interesting intangible: the practice’s “image.” A few cosmetic surgeons, seeking only wealthy patients, assume that the ultra-affluent view the purchase of cosmetic surgery services as they would the purchase of a luxury car or fine jewelry. But I maintain that this formula does not necessarily work in my industry. Paying more—without a good reason—gives you no assurance of a better outcome. Just look at Hollywood, where some misguided celebrities display unsatisfactory - and even tragic - results. Perhaps they also thought: “You get what you pay for.” They bought into price, but did not hire quality: the superspecialist.

Reminder: You do not necessarily “get what you pay for” in the world of cosmetic surgery. Be sure your research can objectively justify higher -than-average fees.

High Fee — Wrong Reason

A local veteran surgical nurse shared the following observations and insight with me:

“Dr. A’s fees are high—and for the wrong reason. His results are not above average, there’s no justification there. He does not take on the toughest cases. His practice gives
Chevrolet—not Cadillac—service; acceptable, average, but not great. His fees are high because he is very slow in the operating room. It takes him two hours to do a routine cosmetic nasal surgery that would take you 45 minutes. But in his mind, he is billing like a lawyer: hourly. So his fee is inappropriately high because the patient is overpaying for his inexperience and lack of expertise.”

What you just read is very telling. And a very special bit of “insider information” that is important to share with you. Actually, I never thought of fee setting in the light that our veteran nurse just described. The very best surgeons I have seen are rarely “slow.” They are not fast for speed’s sake; it’s that they are very efficient and waste no time. They do not spend five minutes walking around the table and looking at the nose and trying to decide what to do. The “A” surgeons already have a plan. They know what to do even before they walk into the operating room. They deliberate in advance. Then they operate without hesitation or uncertainty.

Efficiency is critical because after a certain amount of time elapses, the local anesthetic wears off, bleeding increases, and swelling becomes burdensome. The hapless, inadequate surgeon is now “drowning in the case” and has very little chance of coming up for air. It is very disturbing to see these amateurs struggling against odds that only worsen minute-by-minute.

Every time our nurses talk about assisting in a four-hour nose job, or a five-hour eyelid surgery, or a ten-hour face lift, I shudder. I know they were teamed up with an inexperienced, inefficient, amateur surgeon who probably should not be doing these cosmetic procedures. Because the patient will be - at least - disappointed and, possibly, even endangered.

Same Operation — Why Different Fees?

Now that you understand the financial basics, you will want to know how to compare professional fees. Let’s take a common scenario experienced by patients while comparison-shopping: A prospective patient consults with Dr. A, who recommends a facelift and whose office provides a fee quotation of X dollars as an all-inclusive fee. At the next consultation, Dr. B tells the same patient he needs a facelift but Dr. B’s facelift is 50 percent higher than Dr. A’s. The patient is rightfully confused. How to reconcile the difference in charges!

Comparing professional fees is not easy; never “apples to apples.” Cosmetic surgery is an art form, each surgeon an artist. No two cosmetic surgeons do the same operation identically. Regardless of the artistic variations, procedure-specific, technical variables will affect the fee.

An example:

• Dr. A’s “facelift” may differ greatly from Dr. B’s. Not all facelifts are identical. One doctor’s procedure may include an aggressive neck sculpture technique while another’s focuses on the forehead and brows with less attention to the jaw and neckline. There may be major qualitative differences in similarly titled procedures. Does the facelift include neck surgery? Are eyelids upper and/or lower, included?
  Reminder: Know the components of the procedure the surgeon is quoting.


• There can be quantitative differences as well. Dr. A’s preferred “neck sculpting” or “neck lifting,” to improve a sagging or “double chin,” may involve only superficial liposuction through a tiny incision or incisions. Dr. B’s neck work may include, in addition to the superficial liposuction, removal of the deeper layer of fat as well as tightening of the lax platysma neck muscle that causes those vertical bands running from the chin to the mid or lower neck. This platysmaplasty, an additional step creating an internal “corset,” further defines the neck and jaw line. But this more ambitious neck surgery requires a longer (but still hidden) incision, and many more maneuvers. So while both Dr. A and Dr. B name their procedures identically, Dr. B’s method adds additional time and complexity compared to the lesser procedure. But, Dr. B’s result will probably be superior and apt to last longer. Expect, therefore, B’s fee to be higher.
  Reminder: Understand the objective of the procedures the doctor recommends. Be sure you understand how the doctor intends to accomplish the mission. If you are unclear, request more information including drawings that you can understand. And take notes! Be studious!

After you’ve gathered several quotes, if you can’t adequately rationalize or understand the fee differential, consider the following advice: all things being equal, a mid-range fee is most likely consistent with good value. A “low” fee may signify a lesser procedure, be reflective of lesser levels of facility or anesthesiology services, or in some cases, alert you to an inexperienced surgeon anxious to build a cosmetic surgery practice - not on ability, but on low fees. The “high end” fee quotation may come from a practice where the surgeon is deliberately marketing his services to the super-rich, or where the practice prefers to serve fewer patients, but at a higher charge per patient in order to maintain its income.

Why Payment in Advance?

This insures that the patient has the resources to provide for the services, that scheduling the surgery is not done casually, and that the surgeon’s commitment is matched by the patient’s.

What If You Need A “Touch-Up”?

Most cosmetic surgeons do not charge for “revision” or touch-up surgery. Surgeons are paid on an all-inclusive, per-case basis. In contrast, surgical facilities and anesthesia professionals charge by the hour, like attorneys, accountants, and consultants.

Here is a reasonable and common practice with respect to these touch-ups:

• If the treatment required is minor and can be done in the surgeon’s office treatment room, there is usually no charge.
• If a return visit to the operating room at the hospital, surgery center, or office O.R. is required, a minimal charge for the operating facility and for the anesthesia specialist is proper. The charges should be discussed and “a fixed fee” - without any add-ons afterwards - should be agreed upon.
• The best time to understand all financial responsibilities is before surgery, at the consultation. Be sure to ask if your surgeon includes touch-ups in his fee. And also ask about possible additional charges by the surgical facility and anesthesia specialist.
• The top practices tell you their business practices - in writing, up front - because nobody likes surprises “afterwards.”

“What About Insurance?”

Although health insurance does not cover purely cosmetic surgery, there are insurance benefits available for some reconstructive procedures that typically may overlap a cosmetic procedure. Services that improve function or that are necessary to repair the damage done by an injury or tumor are covered. For example, if one’s upper eyelids are so heavy and redundant that vision is impaired, some or all of the procedure costs may be a covered benefit. If one’s nose was deformed by an accident - causing breathing or possibly sinus problems - then benefits for the functional correction of the internal passages, and/or reconstruction of the damaged exterior, may be covered.

If you believe that insurance may be applicable to your condition, the examining doctor will need to file a report with the insurance company including his finding and proposed treatment. The insurance company will evaluate this report and advise you and your surgeon whether or not the proposed procedure is covered. The doctor’s office may be required to provide additional documentation to the insurance company - photographs, x-rays and consultant’s notes - before the insurer grants a “go ahead” or “precertification.”* Whether the insurance company writes a check will depend upon yet another record review after your surgery. Because of the unreliability of today’s insurance carriers, most practitioners must ask you to pay for the proposed service - in part or in whole - prior to the procedure. When the insurance company pays, you will be reimbursed the amount of deposit which you made prior to the surgery.

* Make sure you receive this official permission from insurer, in writing, before your surgery.

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