But now the cosmetic consult is coming to the privacy of your own home – via the internet.
SurgeonHouseCall.com, which was recently profiled in The New York Times, allows prospective patients to get professional opinions on beautifying treatments. How it works: You fill out a free registration detailing your medical history and lifestyle habits (smokers may want to finally kick the addiction before trying this – if you light up, a doc may turn you down because of potentially dangerous healing complications), upload some pics of your "trouble" area, and wait as one of the 83 board-certified surgeons gets back to you with a suggested plan of action – complete with cost estimate.
It's Joan Rivers' dream come true.
"Many people wonder for years what it would be like to have plastic surgery, but are nervous to take the step to set up an in-person consultation to learn about their options," says Dr. Jason Mussman, founder of SurgeonHouseCall.com told StyleList.
"Virtual consultations allow you to quickly receive 1st, 2nd and 3rd opinions – and that's the real value to the patient. Once patients feel truly educated on the process and are committed to the procedure, they can meet face-to-face with the doctor of their choice to have a much more focused conversation detailing specific outcomes and scheduling," adds Dr. Mussman.
Another benefit to patients is that they can size up a list of nearby doctors and decide which one has the best qualifications and advice.
"I believe that plastic surgeons should be a 'medical partner' by making decisions with their patients, not for them. The site gives patients the ability to become informed about surgeons by specialty, experience and location so they can concentrate on finding a surgeon who can lead them in their decision-making process," says Dr. Michelle Copeland, a Harvard-educated New York Plastic Surgeon who is active on SurgeonHouseCall.com.
Some patients even save both time and money by finding out that they're not a candidate for a wanted procedure, instead of having wasted an afternoon in-person at a doctor's office – and having possibly shelled out a $50 - $200 consultation fee.
And many docs take it even a step further than just email exchanges; Indianapolis Plastic Surgeon Dr. Barry Eppley offers free Skype sessions – which are done over webcam.
"Don't confuse what I'm doing on Skype with a consultation though. It's more of a conversation. When I'm at parties or even at the mall, people ask my opinion all the time about getting something done because they know I'm a plastic surgeon. Usually the questions are very basic, and I give them what I call a 'curbside consultation' – general info that helps them decide if it's worth investing time to find out more about the surgery," says Dr. Eppley.
Message boards are another anonymous and convenient way to glean professional advice from a doctor; on JustBreastImplants.com, a collection of board-certified surgeons answer posted questions about breast augmentation.
"The greatest advantage to message boards for patients and physicians is in one word: access," says Dr. Joseph A. Mele, a San Francisco area plastic surgeon who dispels advice on the forum.
"But there is still something missing. Because there is no way to do a physical examination, the answers remain general information, and cannot be definitive. The inability to touch is a real problem for cosmetic surgery – I can't feel the fat in an area being considered for lipo via a bulletin board. And I have to consider that there might be some missing detail – that may seem trivial – but which if I knew, could change everything," Dr. Mele adds.
Some critics are also concerned with the safety implications of these virtual chats.
"Keep in mind that online interactions should never replace a traditional consultation – they should only be an additional component to your research," says Dr. Loren S. Schechter, Chairman of the Patient Safety Committee for the American Society of Plastic Surgeons.
And in order to protect yourself as a user, there's also a big red flag that you should look out for when perusing online consult sites.
"You would never schedule straight to surgery after only talking to someone online. No good and certified doctor would do that," says Dr. Loren.
There are even murky legal issues in cyber space that haven't been sorted out yet because the communication is so new; in fact, dermatologic and cosmetic surgery associations are rushing to catch up with the innovations to determine if what's going on is legit.
"Online discussions can give the patient an idea of the costs involved, and what the surgery entails – much like a brochure would do. But attempting to evaluate an individual for surgery is inappropriate, and in many cases illegal – since it is considered the practice of medicine and establishes a doctor patient relationship without a history and physical examination of the patient," says Dr. Michael F. McGuire, President of the American Society of Plastic Surgeons.
"If this is done across state lines, the doctor is then practicing medicine without a license in the remote state. Such a practice could result in medico-legal consequences if any guarantees are made regarding outcomes before the patient is seen in a face-to-face consultation," adds Dr. McGuire.
Despite the cloudy legal and ethical issues, most surgeons see the internet as an inevitable force that will only become more present in their everyday interactions with patients. Emerging technology like three dimensional imaging could pave the way for more advanced and accurate online consults between doctors and patients online.
According to Dr. Mele, it all comes down to empowering the patient with better info on available procedures, and what could work most effectively to transform their beauty.
"Cosmetic surgery used to be a best kept secret. Unless your best friend was willing to share research, it was difficult to find all the options available. Now the information is everywhere."