The typical plastic surgery patient fights traffic and sits in a waiting room to discuss an upcoming facelift or breast augmentation with a doctor.
But one class of clientele is taking those appointments in style — by welcoming a private-duty nurse or doctor aboard their 50-foot yacht, or in the privacy of their ritzy waterfront homes.
Such is the life for some of South Florida's wealthy, as they fuel a niche business that's considered unusual in the medical field: plastic surgeons making house — and yacht — calls.
Craving privacy, discretion and convenience in planning out and convalescing from a cosmetic procedure, these high-end patients are willing to pay a premium for personalized care. And it's a service only a few area cosmetic surgeons are willing to offer.
"The concept of house calls is antiquated for some, especially people who are really sick. But in this case, when people just need routine care, I think it's nice," said Dr. Jorge Perez, a board-certified plastic surgeon in Fort Lauderdale. "If it takes 10 minutes for me or a nurse to go see a patient for a routine visit, and it's easier than having them drive here, I'm happy to do that."
Don't get the wrong idea: Doctors who offer these services, like Perez and Dr. Jeffrey LaGrasso, a board-certified plastic surgeon who makes house calls throughout South Florida, aren't cutting patients open on their couches. All surgical procedures are still performed in qualified facilities.
Perez estimated that about 10 percent of his practice comprises house-call patients, but he only makes the trip for pre- and post-op consultations and routine visits — not for actual procedures, not even Botox injections or fillers, and not to patients experiencing complications.
LaGrasso visits up to 30 patients a month throughout Broward, Palm Beach and Miami-Dade counties, some for pre- and post-op appointments, but most for injections like Botox and fillers.
When Lynne Cianciulli, 69, needed her eyes redone and her neck taken in about two months ago, after what she called a botched procedure in California, Perez arranged for her to recover aboard her yacht, California Dreaming, docked at the Bahia Mar marina in Fort Lauderdale.
For an extra fee, Perez's nurse spent 24 hours aboard the California Dreaming after Cianciulli's eye and neck procedures, offering services like washing her hair and changing her bandages. Perez did all his pre- and post-op visits with the part-time South Florida resident on the boat. On one visit, he showed up with a bottle of champagne.
The concierge-style services vary in price — some are bundled into a package, others come a la carte (the champagne was a gift), Perez said. But he estimated patients pay up to 25 percent more than his standard office-based price for the personalized care.
"Oh, my God, I thought [the service] was wonderful, absolutely wonderful," said Cianciulli, a retiree and community volunteer whose husband once owned a custom cable company on the West Coast. The couple live permanently aboard their boat, spending half the year in Santa Barbara, Calif., and the other half at Bahia Mar.
Having Perez come to her instead of driving to his office, she said, made all the difference in easing her recovery.
"I guess it's just an added thing that I didn't have to get dressed to go anywhere and see him," she said.
Cianciulli was so impressed with the special attention that she's referred other yachting friends to Perez. Such "word-of-mouth" advocacy, the doctor said, has added significantly to his house-call business in the past few years.
Perez called the concierge-style service "really ideal for South Florida," where the uber-monied come to vacation and winter, "and many of them want to have plastic surgery while they're here."
Because such visitors often don't know the area well or have their own network of doctors here, "we fill in those gaps for them and provide those support services," he said.
But it's not only vacationers taking advantage of house-calling plastic surgeons.
A self-described "big chicken" when it comes to cosmetic procedures, Boca Raton business development manager Teresa Valdes said she jumped at LaGrasso's offer to come to her home by the beach when she decided to get Botox injections.
"I just didn't want to walk into his office and have people see me walk out. And it's the time — I don't have a lot of time because I travel a lot," Valdes said. "So it's the convenience and the privacy."
Patients who come to his Miami office pay about $800 for Botox, LaGrasso said. House calls for the injections, though, cost about $1,500. Pre- and post-op visits to patients who have had surgical procedures are also extra — about $5,000 on top of the typical $15,000 facelift price, for example.
The additional charge is "absolutely worth it," Valdes said. "I don't see where I'd be saving that much money just going to his office and sitting there waiting. I'd rather not drive to Miami and deal with the traffic."
The service is "a natural" for the cosmetic surgery field, and especially for affluent patients, said Dr. Stephan Baker, a board-certified plastic surgeon in Coral Gables and a South Florida spokesman for the American Society of Plastic Surgeons.
"It's doable," Baker said, "but I wouldn't say it's mainstream."
But not everyone is a fan of the concept.
Dr. Daniel Kapp, a board-certified plastic surgeon in West Palm Beach, called house-call services "gimmicky," adding that having patients come to the office allows them to "verify who you are." Patients who want privacy in his practice are offered weekend hours and back-door access.
Going to patients' homes, he said, "doesn't conform with what we do."
"I don't think it's gimmicky at all," Perez said, adding that for some patients, especially those who have had several procedures done at once, it's difficult to get dressed and drive to a doctor's office for a post-op appointment. "I think it's a conscientious and good service, and frankly, it's good patient care."
LaGrasso agreed, saying his house-call business evolved over the past year because patients have requested it. He doesn't even advertise the service.
"These people want service, they want attention, and they want results," he said. "And they don't mind paying for it."