This is a question frequently asked by patients during their process of screening  plastic surgeons. While I appreciate anyone’s attempt to assess the experience and technical capabilities of a surgeon before deciding to use them, this question by itself is not, in my opinion, a good way to get a feel for the level of craftsmanship a surgeon puts into his or her work.  Are you more likely to get a better breast augmentation from someone who does 5 breast augmentations a day or one who does 5 per week?  Would you feel more comfortable being someone’s fifth case of the day or their first?  Would the surgeon feel good if their loved one were someone’s fifth breast augmentation of the day? 

The point I’m trying to make here is that while it is certainly important for the surgeon being considered to have adequate technical experience and practice with the type of operation you are planning, this number alone does not imply the level of craftsmanship you can expect from the surgeon. 

I like to play the guitar.  I have been doing this avidly since I was 12 years old (and that would be 38 years now!).  As many of you who either play or know someone who plays knows, a guitarist cannot have too many instruments.  They are like putters to golfers.  There’s one for every occasion and sound you might want to produce.  In general, experienced builders producing the finer instruments do not produce in mass quantities.  Therefore, in this instance it is not correct to conclude that you’re more likely to get a better instrument from someone who builds 300 guitars per year versus a builder who produces 50.  There is a different frame of mind and philosophy of business associated with these types of producers and, I would argue, you will find something similar in your search for a good surgeon. 

Surgery is a physical thing like the application of any skilled handcraft and produces fatigue.  Additionally, there is the pressure of the surgeon’s office schedule to attend to.  If he or she is running late for office and you are the next patient on the surgery list, are you sure you’re going to get the attention and craftsmanship you are paying for in the operating room from a fatigued surgeon under this time pressure?  Also, are you sure that the surgeon you enlist is doing the entire operation from start to finish or, in the interest of mass production, are they outsourcing things like closing the skin incisions to assistants?  Do you get long periods of quality time with the surgeon to discuss any issues you may have before and after the surgery, or does he or she breeze in, tell you what surgery they think is best for you, breeze out and leave you in the hands of patient care coordinators to get you into and out of the assembly line?  Don’t get me wrong; I don’t think that this style of practice is unethical or immoral in any way.  It is just different.  You should have some sense about which type of environment suits you best and the numbers don’t always reveal the truth here.  The only thing the numbers reliably indicate is the surgeon’s income; not the quality of operation or treatment that you can expect.  So, it’s ok to ask about the surgeon’s volume, but it is also very important to realize how volume effects quality.