"First, do no harm" is is a core value embraced by all physicians. Occasionally the press report that somewhere in the US a patient undergoing plastic surgery experiences significant problems, or even death. Even with rigorous laws prohibiting the unauthorized practice of medicine in all states, including Texas (i.e., practicing medicine without a state license), some lay people and even unlicensed physicians attempt plastic surgery. Two recent incidents reported in USA Today should make patients give pause and really think about who they choose for their procedure(s). The first instance involved a licensed internal medicine physician who had never completed a residency in plastic surgery, had only six days of training performing liposuction, and no experience with fat transfer surgery. Three of his patients died during plastic surgery procedures including liposuction, breast augmentation, and fat transfer. All procedures were performed in the physician’s Arizona office without a nurse or anesthesiologist. In fact, the “surgical assistants” included a massage therapist and a former restaurant worker. Following a jury trial, this physician was found guilty of second degree murder and manslaughter. While his attorneys are filing a motion for new trial, his patients remain deceased. The second incident occurred in South Carolina where a private apartment was raided by the authorities, who discovered an illegal liposuction clinic staffed by a family practitioner not licensed to practice medicine in South Carolina, or anywhere else in the United States. The conditions in the apartment were absolutely inadequate and non-sterile. Fortunately, no patients were seriously hurt. In one instance we have someone unlicensed where the procedures took place, and in another there was a licensed physician without proper qualifications. These are extreme examples, but situations like this happen, sometimes because the patient is hoodwinked into believing the physician has the requisite qualifications, and sometimes because a patient is looking for bargain surgery. Michael Eisemann, M.D. of the Eisemann Cosmetic Surgery Center in Houston, Texas is triple board certified by The American Board of Plastic Surgery, The American Board of Otolaryngology Head-Neck Surgery, and The American Facial Plastic & Reconstructive Surgery. Dr. Eisemann has been in plastic surgery practice for over 30 years. Whether you choose to consult The Eisemann Plastic Surgery Center or another practice, ask questions, and if you don’t get good answers, leave! Physicians work hard through college, medical school, residency and fellowship. They are proud to display their qualifications and talk about them. Also ask about how many procedures he/she performs each year. If surgery is to be performed in an office surgical suite, ask to see the credentials and the suite itself. Find out if your anesthesiologist will be a nurse or an anesthesiologist physician. Any plastic surgeon worth his/her salt strives to put his/her patient at ease with the process from start to finish.