S04E67 HOW TO PAY FOR THAT DREAM PLASTIC SURGERY

Ready to arm yourself with the financial know-how to afford your dream plastic surgery? Prepare to transform your understanding of the financial aspects of plastic surgery as Dr. Salvatore Pacella @sandiegoplasticsurgeon, Dr. Sam Jejurikar @samjejurikar and Dr. Sam Rhee @bergencosmetic demystify everything from the cost range of procedures to the impact of earning potential on the affordability of treatments. We’ll get real about the significant, life-altering effects of these procedures, particularly for the younger demographic.

You'll also discover the benefits and pitfalls of various financing options, as we draw parallel comparisons between the cost of plastic surgery and major purchases like cars. Ever wondered how a 0% APR credit card offer could be beneficial? We’ll break it down for you, laying stress on the importance of financial discipline and cautioning against hasty decisions. After tuning in, you'll be equipped to thoroughly research and evaluate the best financing options for your situation - ensuring your dream surgery stays within your financial comfort zone. With these insights, you’ll be stepping into your surgical journey with confidence and clarity.

@3plasticsurgerypodcast #podcast #plasticsurgery #cosmeticsurgery #plasticsurgeon #beauty #boardcertified #aesthetic #3plasticsurgeonsandamicrophone ⁠#bergencosmetic ⁠#bestplasticsurgeon #beforeafter #aesthetics #realpatientrealresult #boardcertifiedplasticsurgeon #njplasticsurgeon #njplasticsurgery #nyplasticsurgeon #nyplasticsurgery

S04E67 HOW TO PAY FOR THAT DREAM PLASTIC SURGERY

[00:00:00] Dr. Salvatore Pacella: Good morning everybody. We are starting our podcast this morning, three Plastic Surgeons and a microphone. I am of course, Dr. Sal Pacella in San Diego, California at San Diego Plastic Surgeon. I'm joined by my colleagues, Dr.

Sam Rhee in Paramus, New Jersey at Bergen Cosmetic, and of course, Dr. Sam Jejurikar in Dallas at Sam Jejurikar. How are you guys this morning? Doing great.

[00:00:29] Dr. Sam Jejurikar: Doing amazing.

[00:00:30] Dr. Salvatore Pacella: All right, well, we're gonna shift topics a little bit here and talk about the financial aspects of affording and financing, um, plastic surgery.

But before we get into this, let's go through our disclosure real quickly.

[00:00:45] Dr. Sam Jejurikar: This show is not a substitute for professional medical advice, diagnosis, or treatment. This show is for informational purposes only. Treatment and results may vary based upon the circumstances, situation, and medical judgment. After appropriate discussion, always seek the advice of your surgeon or other qualified health provider with any questions you may have regarding medical care and never disregard professional medical advice or delay seeking advice because of something you may see in the show.

Back to you, Dr. Pacella.

[00:01:11] Dr. Salvatore Pacella: All right, Jen. So, um, so, you know, we, we deal with, um, uh, a discipline, uh, a career where the services we offer are not super inexpensive. Sometimes they can be very costly, very pricey, and, um, you know, the issues are not everyone can afford it in the same period of time. And so we're gonna talk today about.

How patients can afford plastic surgery, what financial options are there, and, and kind of go from there, what your thoughts are. So let's start with both of you here. So maybe, maybe tell us a little bit about your patient population, kind of the, you know, the, the, in general, the services you offer, the price range, et cetera, and how you deal with, uh, financing.

[00:02:01] Dr. Sam Jejurikar: Um, I guess I can start. I mean, like you said, plastic, sugary, there's a wide range of costs involved. It can be relatively inexpensive for some operations, which are quick. Then for more extensive, longer operations, you can be looking at, you know, operations that are. You know, 20, 30, $40,000, which is not inexpensive.

Um, but, you know, um, and so some pa you know, you, you meet patients from all walks of lives. For some people it is relatively inexpensive to have plastic surety, but for others it's a major investment. Um, we, uh, through our practice definitely utilize, uh, a variety of financing options. Um, and I'm really curious, I know Dr.

Re got a lot he wants to say about this, um, but there are different options that our patients will, will utilize. I'll turn it over to Dr. Re and, and sort of curious what he has to say about this.

[00:02:48] Dr. Sam Rhee: Yeah, I, I would like both you guys to chime in in terms of the demographics of your patients, what you see patients choosing in terms of how they choose to pay, um, as we go along.

And maybe there are some options here that I haven't listed that you could actually discuss or, or see what, what works for you and, and your patients. So, obviously, as Sal said, it's expensive for a lot of these types of procedures. And obviously these are also elective procedures, so these are not things that must happen, uh, like other necessary medical procedures, for example.

But for a lot of patients, these are extremely important. Procedures that they want very much. Um, and they, they can certainly impact somebody's personal quality of life, their self-esteem. I have seen patients transformed literally in terms of what they've done after having something that was so meaningful to them in terms of, uh, changing their appearance a and their, um, self-worth actually in some cases.

So that being said, let's, let's. Understand that these are valuable procedures. These are not often frivolous procedures, but they're also procedures that require substantial investments. So these are not something that someone should just take out on a whim because they are expensive. But if decided upon properly with your plastic surgeon, um, can be very impactful and, and they can be worth the investment.

So

[00:04:18] Dr. Salvatore Pacella: first I, go ahead. Well, sorry Sam, uh, to interrupt, but I think it's helpful to kind of. Under I, I think it's helpful to kind of describe a little bit about our patient demographics and kind of how that may impact the financing part of things. So even in your own lives, gents, when you were, um, when you were 20, 25 years old, I'm gonna guess that each of you probably did not have a ton of disposable income or any disposable income for that matter.

Um, you know, looking back at my career when I was a college student, a medical student, a resident, it, you know, it, it was a challenge to even pay for a, a car payment, you know, and, and so, you know, that, When we're younger, obviously, that that earning potential is not there. As you get older, mid aged, and in your, to your retirement years, the idea is potentially you have a little bit more disposable income with it.

And with that being said, I, I see really three kind of peaks of patients in my, in my practice when it comes to cosmetic surgery. So there's, there's kind of the younger demographic. Okay. So I would say that in the early, mid twenties, And the, the two big procedures we see in that demographic are really breast augmentation and to me in my practice rhinoplasty.

Okay. And so, you know, if you think about it, breast augmentations are on the scheme of things relatively more affordable than other procedures. Um, rhinoplasty is probably a bit more expensive than, than breast augmentation. But these are, these are, um, These are procedures that can drastically change a young person's life.

You know, I, I, I sort of look at, you know, the, the average patient, you know, that I see in rhinoplasties in her twenties, beautiful young lady, but has kind of a big hump on her nose tip is hanging down, and, and that's a life-changing event for them. Right. Um, the second tier of patients I see are sort of in the middle age rage, say late thirties, early forties, kind of the housewives, the moms, uh, mommy makeover.

Um, you've had children, your kind of children are a little bit grown. Um, you may or may not not have a little bit of the disposable income to go on vacation or whatever, and those procedures are kind of getting a little bit more expensive. We commonly see procedures like breast lifts, breast augmentations.

Coupled with tummy tuck, adominoplasty, liposuction, maybe a little bit of facial surgery. As we sort of look at the next tier of patients. These are sort of patients who are a little bit more obviously advanced in their life. Late fifties, early, early sixties. Um, Lot of those patients are kind of in general looking at facial procedures to make themselves look younger, face lifts, fat transfer, blepharoplasty, et cetera.

On the scheme of things, much, much more than expensive operation compared to, say, the average breast operation because it takes a little bit longer to do. And so those are patients that I see that are relatively. Um, when it comes to pricing a little bit more price and sensitive, they, they have, um, a little bit more resources.

Maybe they, they've paid off their house, they've paid off their cars, their kids are out of college, you know, and those are patients I think that we see can oftentimes have a little bit more, uh, flexibility with their, with their financing. And I think the key is as surgeons, We don't wanna discard any of those patients, any of those groups.

So we wanna really work with everybody to, to give the procedure that they need and, and hopefully in an affordable manner.

[00:07:56] Dr. Sam Jejurikar: I think that's a really nice summary. So I, I, I really like that, uh, that characterization. And I, I think I would agree with pretty much 99% of that. Um, I see some liposuction in that younger age group, and there's some young people that have a disproportionate amount of money, and there's some older patients that have less, you know, less money.

But I think that's very true. And what I, you know, um, When, when you see patients and, and you know that, um, it is gonna be a stretch financially, the, the key is, you know, it's to, to budget, sort of figure out what financing options are available and to never engage in plastic surgery that you don't think you can afford.

And so the same discipline that you would, um, indul, you know, engage in, in your life to make sure that, um, You know, you can afford your car payment, your house payment, your groceries, your entertainment expenses, plastic surgery needs to also sort of fall into that, um, because it is a major expense, particularly with some of these operations that happen later in life.

And, and every patient, regardless of their age or which bracket they fall into, needs to make sure that something that they find to be affordable.

[00:09:02] Dr. Salvatore Pacella: And so I, I, I think you, you make a really good point here as to not not do a procedure that you think is going to be number one unaffordable for you and not realistic, but I, I would sort of, I would sort of talk about the converse as well, which is, You know, many times we see patients that have multiple issues.

So, for example, um, common thing we see, I, I think we all see is, uh, a patient who has had old breast implants, maybe if they've got a little bit of breast ptosis and you know, you need, they may need a multiple stage procedures. So, for example, it's not uncommon for patients with older implants to need, um, implants again.

Um, soft tissue support and a breast lift. Okay? And all, all three of those things come with a price tag, not uncommonly. I say I see patients that say, well, you know, I can't really afford, um, the soft tissue support to hold the breast in position and lift. I, I just wanna swap out my implants and be done with it.

And, and I think that's, that's a wrong approach. Um, many times when, when we give patients an A, B, and C and they may choose c i, I think that leads to significant unhappiness. So not only have they spent the money, but they're gonna be unhappy with the results. So I, I routinely counsel patients, you know, unless you have a financing option, I, I would hold off on doing any surgery until you can really do the right surgery.

Great advice. That's

[00:10:31] Dr. Sam Rhee: perfect advice. Agree a thousand percent. Half measures often do not lead to satisfaction, so let's talk about that. So obviously, This is not necessarily for people who are liquid enough to just dump 15, $20,000 out at a pop. Like if, if you're one of those people, then you shouldn't be listening to this because you should just go to your plastic surgeon and throw down that cash and, and you're good to go.

But for the rest of us, like, so maybe if that's 95% of the world out there, this is for the 5% of us who's out here like, you know, working, working to save our money. Um, the first thing obviously would be the most. Uh, financially, uh, savvy way of doing it, which is budgeting and saving up in advance. You're not borrowing money, money from a lender or charging a credit card.

You don't have to pay interest fees or penalties. This isn't, uh, an elective procedure, so you may have time to chew, you know, to, to save, but it takes a lot of, um, discipline to do that. If your procedure is $15,000, you would have to save $625 a month. For two years in order to pay for that. Now, some people would say that is completely unreasonable.

I don't have the discipline to do that, and some people would say, I could do this. Um, one of our old bosses, Dr. Kuan, I don't know if you ever heard him say this, but he used to say, there are only three things that you should borrow money for. Right. Uh, education, car and a house. You shouldn't bar be borrowing money to go partying or, you know, for clothes.

You know, those are the three major expenses. And, and did he also say after

[00:12:08] Dr. Salvatore Pacella: that, did he say, Okay.

[00:12:13] Dr. Sam Jejurikar: Well, and, and, and the, and the thing is, is, um, as, as much as I have, he, as much as I've learned from Dr. Ana, I would respectfully, completely disagree with that statement. Oh. Because, um, as you learn, when you get an mba, and Dr.

Pacella will agree to this, there's this phenomenon that if you can borrow money at a rate that's lower than what you can put that money away for and invest. Let's say you, you're gonna borrow that $15,000 and, and you're gonna make that payment instead. But in, but instead, you're gonna use that money to earn money at a greater interest rate than that.

Uh, then ultimately you're gonna actually do better off borrowing money if you can do so at a lower rate. And some of the financing options that you're gonna talk about have very favorable interest rates. So, continue. Please. Yes, Dr. Kuan. I learned a lot about plastic surgery from. He's not my economic advisor by any stretch of the, and no offense Bill, if you happen to be listening to this.

Good point.

[00:13:09] Dr. Sam Rhee: There is a, there's a little,

[00:13:10] Dr. Sam Jejurikar: the things that I learned getting an mba, I'm gonna value over that.

[00:13:14] Dr. Sam Rhee: Very good. Um, the first option I'm gonna mention, only because I don't know anyone who actually does this, but apparently there are still some plastic surgeons out there that will enroll, enroll patients into their own payment plan.

Um, I don't know if you know of anyone who does this, but if a doctor can do this for you, um, that's one possible option. You can split your cost into smaller monthly payments. You may or may not have to pay interest with that, um, physician or go through a credit check. Um, the problem is, is that I don't know that many doctors do that.

And if you don't pay that physician, you may end up going, it might be going into collections, which would be a whole other sort of kettle of fish. What do you guys think of this?

[00:13:56] Dr. Sam Jejurikar: I don't actually know anyone that does this. Um, so yeah, if you have options available to you, great. Most plastic surgeons just engage with third party lenders though, for this.

[00:14:07] Dr. Salvatore Pacella: Um, yeah, I, I agree. It's, you know, sometimes when, when surgeons is, um, engage in the practice of. Um, being the borrowing agent, I, I think, you know, that's, that's not a business model that lends itself to plastic surgery. That's a lending model. And, you know, we're as plastic, the average plastic surgeon is good at doing surgery, but not really.

Finance.

[00:14:33] Dr. Sam Rhee: Agreed. Let's talk about the most popular, um, financing option out there for plastic surgery procedures right now, which is CareCredit and everyone's heard of it. It's a very popular way to, it's a medical credit card that you can use to finance plastic surgery. They offer promotional financing and usually for a certain period, um, you, you know, either a few months or a few years, you can break up your costs.

Of your procedure into smaller monthly payments at a zero APR or reduced apr and, and currently, or at least what I saw, um, you can get no zero APR financing. So no interest if you pay within. And then you can have periods of either 6, 12, 18, or 24 months. Um, you can also get reduced APR financing if you wish, uh, like at about 15% for 24 months.

16% for 36 months, or 17% at 48 months, um, if you so choose, um, this is, there's no fee for early repayment. It's very convenient and a lot of patients do qualify. Uh, the issue is, is that if you don't adhere to the terms that they set exactly, they, they will throw all of that deferred interest onto your loan payment, I mean, onto your loan charge.

And the APR can be very high. And if you went for a personal loan, you could probably actually get a, a lower apr and not all medical providers will, will take CareCredit. So what are your thoughts about CareCredit?

[00:16:07] Dr. Sam Jejurikar: We, we do a fairly high volume of care credit in my practice. We don't accept many of their, um, plans because some of the plans, uh, shift a pretty high percentage of those fees onto the surgeon.

But there are some low interest plans that our office does, part does participate in. And this, this kind of goes along with what you were referring to earlier in terms of is it worth borrowing money? Well, you can get an interest rate of 2.9%, let's say, which is, I know one of the plans. Um, from, uh, from a medical credit card, and then you can turn around and take that money and put it into a high interest savings account, which gives you a higher percentage yield than that, which many of them are doing right now, given the interest rate environment that we're in.

That's actually a good thing to do for you from a personal investment standpoint.

[00:16:54] Dr. Salvatore Pacella: Yeah, we, we actually don't use CareCredit. We, we have, um, actually some relationships with some local, um, credit unions that do kind of offer some competitive rates for patients, uh, that we usually refer patients to. But we, my office doesn't really have a formal relationship with, uh, with any of the financing

[00:17:13] Dr. Sam Jejurikar: companies.

Hi Chris. And we, we, I'm sorry. We use CareCredit, we use Patient Fi, we use aian credit. There's a lot of different credit services that are

[00:17:21] Dr. Salvatore Pacella: out there.

[00:17:23] Dr. Sam Rhee: Yes. Um, and there are a number listed out there, and so if that's something you should be interested in, you are interested in, you should definitely check out, not just CareCredit, but all of the other sort of similar types of.

Finance companies that are out there that, that offer medical credit cards. Um, you could also take out a credit card with a zero, a uh, 0% APR offer. There are a, a lot of, um, introductory APR 0% APR offers for credit cards. They usually last up to about 21 months. If you have great credit, um, you could actually put it onto that card.

And as Sal, uh, Sam said, if you're using that money, Uh, to make more money than you would actually be paying less at the end, as long as you avoid paying the interest by paying off your balance within that specified time. Um, have you had patients who sort of used credit cards in this way?

[00:18:22] Dr. Sam Jejurikar: I don't know. I have patients that pay on credit card, but I'm not sure what they're doing.

Yeah,

[00:18:26] Dr. Salvatore Pacella: same. Same here.

[00:18:28] Dr. Sam Rhee: Yeah. Um, the last thing that I would wanna mention is a, a fixed rate personal loan. So you can take an unsecured personal loan, which, um, patients can do. Again, that which can range from 1000 to $5,000 fixed APR and monthly payment, um, might not be the cheapest, uh, alternative versus, um, Other plastic surgery loans.

Um, but it might be better than just putting it on straight up on your credit card. Let's suppose if you don't have an introductory APR offer on your credit card and you're just thinking about doing that, you might actually get a better deal just by taking out a straight personal loan. Um, you have to have probably pretty good credit for it.

Um, The good thing is, is that they're usually unsecured, so you don't have to put up collateral in order to get that loan. Um, but if you are not of good credit, and most of them that I've listed look like they're at least 600 or above in terms of your credit score, um, you may not qualify or the a p or the interest rate may be super, super high.

[00:19:28] Dr. Sam Jejurikar: I think that's, I think that's, um, yeah, a great option for people as well. You know, um, a few podcasts ago, Dr. Pacella told us an analogy that he likes to tell patients about paying for plastic surgery and the cost of a car. Could you tell that again, because I love that analogy and I will. And I will admit that I've stolen it, but I, I want, I want you to be the one to say it again on the podcast, right?

So, uh,

[00:19:51] Dr. Salvatore Pacella: that's, that's a good place to end. So I, I think you can choose your car of choice, either a Tesla, Prius, et cetera. So I oftentimes tell patients when, you know, they're concerned about the cost or the price or, or they're surprised at the cost, I oftentimes tell 'em, look, cosmetic surgery is a hell of a lot cheaper than a, than a Prius, but it's gonna last you a lot longer.

So,

[00:20:13] Dr. Sam Jejurikar: Yeah. And you know, I think the bottom line, um, I think that was really informative, Sam. There there are options that are available to people. I think what I, I would, I would talk to my patients the same way I would look at a financial decision myself, budget out over the next two years, see how financing or a personal loan, or a 0% APR credit card factors into your life.

Make sure you can afford it. And you'll find that if you are looking over that time horizon over two years, plastic surgery procedures that on the surface seem unapproachable, can actually be quite affordable. Um, it something you can fit into your life and it can have a profound impact on your

[00:20:47] Dr. Salvatore Pacella: life.

Right. Um, you know, I I also think that, um, It's important, I think for our audience here that, um, you know, the, the, the discipline of plastic surgery is a huge bell curve of types of surgeons. Right. And I, I think it's important to understand the three of us are not salespeople by any means. We are, we are absolutely, all three of us committed to.

Doing the absolute right thing for a patient. And that doesn't necessarily mean surgically. We, we would never want any patient to get in a position where they over finance themselves or, or do a surgery they're not prepared for, and then end up regretting it financially the rest of their life. That's, that's our job as surgeons as well.

And so we wanna give that advice to you. You know, if, if you feel pressured financially or if you feel like somebody is trying to do a sales job on you, you're getting a bad feeling about that. Then your pro, your, your instinct is probably correct.

[00:21:47] Dr. Sam Rhee: So Great word, Sal.

[00:21:51] Dr. Salvatore Pacella: Well, Jan, thank you so much. That's been a really interesting, uh, shift in topics today.

So, um, with that we're gonna sign off and, uh, we'll take, talk to you soon. Take care.

[00:22:03] Dr. Sam Jejurikar: Take care gentlemen.