Board Certification Is the First Filter
The most important thing to understand about cosmetic procedures is that in most states, including Louisiana, any licensed physician may legally perform them regardless of training. A family medicine physician can advertise liposuction. This is why board certification matters more here than in almost any other area of medicine.
The relevant credentials are certification by the American Board of Plastic Surgery for plastic and reconstructive surgery, the American Board of Facial Plastic and Reconstructive Surgery for facial procedures performed by otolaryngologists, the American Board of Ophthalmology with oculoplastic fellowship for eyelid and periorbital surgery, and the American Board of Dermatology for dermatologic surgery and injectables. Membership in the American Society of Plastic Surgeons or the American Society for Aesthetic Plastic Surgery signals specialty engagement. A surgeon who describes themselves as board certified without naming the board deserves a follow-up question.
Facility accreditation is the second filter. Surgery performed outside a hospital should occur in a facility accredited by AAAASF, AAAHC, or the Joint Commission, with anesthesia administered by a board-certified anesthesiologist or certified registered nurse anesthetist. Major procedures performed in unaccredited office space without proper anesthesia coverage are the setting where preventable deaths occur.
Academic Plastic Surgery Programs
LSU Health New Orleans Division of Plastic and Reconstructive Surgery trains the state's plastic surgeons and provides both reconstructive and aesthetic services. Academic programs bring a specific strength: surgeons who handle complex reconstruction after cancer, trauma, and burns bring that technical depth to elective aesthetic work, and difficult revision cases often land here.
Tulane University plastic surgery similarly combines academic reconstruction — breast reconstruction after mastectomy, microsurgical free flaps, craniofacial surgery, hand surgery — with cosmetic practice. For patients considering breast reconstruction, the availability of microsurgical techniques using a patient's own tissue rather than implants alone is a meaningful advantage that not every private practice offers.
Ochsner Health plastic surgery operates across its network providing reconstructive and cosmetic surgery integrated with oncology, bariatric surgery, and dermatology. Post-bariatric body contouring is a substantial regional need given the volume of weight loss surgery performed in Louisiana, and coordination between the bariatric and plastic surgery teams within one system simplifies a complicated multi-stage process.
Established Private Aesthetic Practices
Aesthetic Surgical Associates in Metairie is a long-established New Orleans area plastic surgery practice offering facelift, rhinoplasty, eyelid surgery, breast augmentation and lift, abdominoplasty, liposuction, and a full complement of non-surgical treatments, with an on-site accredited surgical facility and medical spa.
Williams Plastic Surgery and comparable boutique practices in the Metairie and Uptown corridors operate on a lower-volume, higher-touch model, with the surgeon personally conducting consultations and follow-up rather than delegating to patient coordinators. For elective aesthetic surgery, that continuity influences both results and satisfaction.
Garden District and Uptown facial plastic surgery practices focus specifically on the face and neck — rhinoplasty, facelift, brow lift, blepharoplasty, chin and cheek augmentation, and facial fat grafting. Surgeons who operate exclusively on the face accumulate volume in a narrow set of technically demanding procedures, and rhinoplasty in particular rewards that specialization heavily.
Crescent City Plastic Surgery and similar practices serving the greater metro area cover breast surgery, body contouring, and facial rejuvenation with in-office accredited surgical suites, and increasingly offer awake or local-anesthesia procedures that reduce recovery time and cost for suitable candidates.
Dermatology and Non-Surgical Aesthetics
Board-certified dermatology practices across New Orleans, Metairie, and the Northshore provide the non-surgical backbone of the aesthetic market: botulinum toxin injections, hyaluronic acid dermal fillers, biostimulatory fillers, laser resurfacing, intense pulsed light, microneedling with radiofrequency, chemical peels, and body contouring with cryolipolysis or focused ultrasound.
Louisiana's climate makes photodamage management a leading local concern. Intense year-round ultraviolet exposure produces pigmentation, telangiectasias, and premature elastosis, and it substantially raises skin cancer risk. A good aesthetic dermatology practice will examine the whole skin for malignancy rather than treating only the cosmetic complaint — that combination is a strong quality signal.
Laser treatment on darker skin tones requires specific expertise. New Orleans has a substantially diverse population, and providers experienced with Fitzpatrick types four through six using appropriate wavelengths and conservative settings avoid the post-inflammatory hyperpigmentation and hypopigmentation that inexperienced operators cause. Ask directly about experience with your skin type.
Medical spas operating under physician supervision offer injectables, facials, and light-based treatments at generally lower cost than physician practices. Quality varies widely. Verify who owns the practice, who supervises, what the injector's credentials are, whether the supervising physician is physically present, and how complications are managed. Filler complications including vascular occlusion require immediate treatment with hyaluronidase by someone who recognizes the emergency.
What Reputable Consultation Looks Like
A trustworthy consultation includes a thorough medical history, realistic discussion of what the procedure can and cannot achieve, review of before and after photographs of the surgeon's own patients with similar anatomy, clear explanation of risks and recovery, and no pressure. A surgeon willing to tell you that you are not a good candidate, or that a less invasive option would serve you better, is demonstrating exactly the judgment you want.
Warning signs include same-day discounts, financing pressure, guarantees of specific outcomes, reluctance to discuss complications or revision policy, stock photography presented as results, and consultations conducted entirely by a salesperson rather than the operating surgeon.
Ask concrete questions: How many of this specific procedure do you perform annually? What is your revision rate and who pays for revisions? Where will surgery be performed and is the facility accredited? Who provides anesthesia? What is your complication management protocol and who covers hospital costs if a complication requires admission? Do you carry malpractice insurance?
Cost, Timing, and Local Practicalities
Cosmetic procedures are not covered by insurance, though genuinely reconstructive work — breast reconstruction after mastectomy, functional eyelid surgery obstructing vision, septoplasty for breathing, panniculectomy after massive weight loss — often is, and a good practice will help document medical necessity where it legitimately exists.
Timing surgery in New Orleans requires thought. Avoid scheduling major procedures during peak hurricane season if recovery would coincide with a potential evacuation, and consider that summer heat and humidity complicate compression garment wear and incision care. Many local patients schedule body contouring for late fall and winter.
Plan recovery realistically. Downtime is not optional, sun protection during healing is essential in this climate, and smoking cessation before and after surgery is non-negotiable for wound healing. The patients happiest with their results are consistently those who chose a well-credentialed surgeon, held modest expectations, and followed postoperative instructions precisely.