Looking for a nip or tuck without a bite out of your wallet?

Cosmetic surgery is typically not covered by insurance, which means you'll be paying out of pocket and may be inclined to shop around for the best price.

But if you're looking for a bargain, look elsewhere. This is one type of procedure where you shouldn't make decisions exclusively by price.

"The surgery you pay the least for may ultimately cost you the most," said Alan Matarasso, a Manhattan plastic surgeon and president-elect of the American Society of Plastic Surgeons.

Errors, complications, and infections in cosmetic surgery can be dangerous and cause irreversible damage to our most visible features.

"If you have a problem, it could be a problem that no money can fix," Matarasso said.

People considering a cosmetic procedure should choose a doctor based on his or her reputation, experience, and specialty, he said.

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But finding the right provider can be challenging.

Americans spend nearly $17 billion annually on voluntary cosmetic procedures.

The average surgeon's fee for breast augmentation, the most common cosmetic procedure, was $3,718 in 2017, according to the American Society of Plastic Surgeons. Surgeons charged an average of $7,448 for a face-lift, $5,992 for a tummy tuck, and $5,125 for nose shaping. And that doesn't include fees charged by the facility and other providers, such as an anesthesiologist.

It's a lucrative business that can attract some unsavory characters, since providers do not need to go through insurance companies to get paid. That can leave patients vulnerable to under-qualified providers, said Wendy Lewis, an aesthetic business consultant based in New York.

"The consumer has to be vigilant — we've all heard the horror stories," Lewis said.

In 2015, a Philadelphia musical artist known as "Black Madam" was convicted of third-degree murder after the illegal silicone butt injections she advertised online killed a Londoner. And last year, a Miami woman who had posed as a doctor was sentenced to 10 years in prison for injecting cement, Fix-a-Flat tire repair sealant, and other hazardous materials into patients seeking buttocks enhancements.

Sometimes patients take a cavalier approach to cosmetic surgery, wrongly thinking that because it is an elective procedure it's lower risk, but it's important to thoroughly vet any doctor before going under the knife, Lewis said.

"Every time a doctor picks up a scalpel it is real surgery and there are real risks," she said.

Here are some tips for finding the right doctor:

  • Educate yourself. Plastic surgery is a big umbrella that includes cosmetic procedures, such as face-lifts and rhinoplasty, as well as hand surgery, skin and tissue grafts after an accident, and breast reconstruction for cancer survivors. Narrow your search to doctors who specialize in cosmetic surgery and who have experience performing the procedure you want.
  • Ask for a recommendation. Online reviews may not be an accurate reflection of the doctor's work. If you don't have a friend or colleague who can recommend someone, consult another doctor you trust, such as your gynecologist, primary care doctor, or dentist. Operating room nurses have a front-row view of surgeons at work and can be an excellent source for recommendations, Lewis said. No one to ask? The American Society of Plastic Surgeons has an online match tool to connect patients with board certified doctors in their area.
  • Do your research. Check with the state's licensing board to confirm the doctors you are considering are properly licensed and have not been subject to any disciplinary actions. Meet with a few prospective doctors and trust your gut — each will have a different aesthetic, and one may be a better fit for you than others.