unfortunately if you need a rare surgery (to treat a rare condition), this doesn't work very well. it also isn't enough for surgeries with subjective outcomes (such as vaginoplasty.) with the former you look for a competent surgeon with many good outcomes on related surgeries of similar complexity, and who keeps up with or participates in research. with the latter... image boards? word of mouth? whoever your insurance covers? I get hung up on that kind of choice.