By Dr. Carlos Wolf The Miami Herald

Q. I am having trouble picking a surgeon for my surgery. I often hear you should pick your surgeon based on skill, reputation and results. What are your thoughts about picking a surgeon?

Your question is a very good one in this day of the Internet. The days of building a solid practice built on the 3 As is over: Affability, availability and ability were the cornerstones to developing an honest practice with longevity.

With the advent of marketing and the Internet, you can buy yourself to the top of the list with a great ranking. Doctors are hiring people to write recommendations and reviews on their behalf on doctor-ratings websites.

The most important quality your surgeon must have is ethics. If a surgeon is ethically challenged, no matter how technically good he or she is, they will ultimately make the wrong decision based on greed and therefore risk injuring patients.

Because physicians see patients at vulnerable times, helping you choose the right procedure is equally as important as the technical skills.

With the advent of minimally invasive procedures, I have seen the advent of minimally trained physicians. Companies are hiring cosmetic expert doctors to unleash their product lines on unwary consumers.

If they were experts, then these doctors would be board certified. They would also be board certified in fields that pertain to aesthetic medicine: facial plastic surgery, plastic surgery, dermatology and oculo-plastic surgery (having to do with the eyes).

When choosing a doctor, ask several people about the surgeon. In addition, interview several physicians about your procedure and conduct an internet search to make sure there are no glaring problems with your possible doctor.

Finally, I would recommend picking a surgeon who is board certified in what you want to have done, is not recommending more surgery than you want to have done and is not afraid to say no to something you want to have done.

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Picking the best surgeon for you