A big Cheers(!) to our colleagues 'across the pond' who are encouraging more professionalism in the business of cosmetic Plastic Surgery.

The British Association of Aesthetic Plastic Surgeons (BAAPS) has made a position statement that digitally enhanced pictures of bikini-clad women in writhing poses should be banned in advertisements as they mislead patients about expected results. BAAPS has singled out one chain of cosmetic clinics for particularly egregious promotion, pointing to an ad by the West One Clinic franchise which used models in advertisements that are "anatomically impossible".

Below is the wasp-waisted model with gi-normous breasts that apparently started this discussion. It clearly looks to me like she's been "morphed" with Photoshop to narrow her waist in relation to her trunk.


A second promotion offers a £250 ($462.55 USD by today's exchange rate) discount to customers as an incentive to have the surgery quickly, while a third offers a "lunchtime facelift", which arguably plays a little fast and loose by with downtown and recovery for short-scar facelift procedures.

This education that BAAPS is not a call per se for limiting all cosmetic surgery procedures, but rather it is a desire to see a more safe, thoughtful, and informed process take place when someone is considering surgery. It is impossible to remove unrealistic body images from pop culture, as both men and women strive for whatever form is popular in their era. What we do owe patients are frank discussions about the limits and morbidity of surgery minus the "magic brush" function of computer photo editing.



Rob

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I saw a local Dallas new station segment on Plastic Surgery that was unintentionally ironic.

It is introduce with the statement that

"It's a nightmare situation. You've had Plastic Surgery and you don't like the results.....With rapidly rising number of physicians starting to call themselves Plastic Surgeons, (patient)complaints are starting to jump."

The segment features a Dallas doctor doing re-operative surgery on on a woman who 6 years prior, had cheek implants, eyelid surgery, and a brow lift performed and was unhappy. The doctor, takes a not too subtle swipe at how "other Dallas surgeons" don't understand facial aging and aesthetics and have been doing surgery wrong for years.



For some context, you have to understand that Dallas, Texas has some of the heaviest hitters among Plastic Surgeons in the world for facelifts and related procedures. (see my post "Cities known for certain Plastic Surgery procedures" from last spring) Dallas surgeons like Fritz Barton, Steve Byrd, Sam Hamra, Jack Gunter, Rod Rohrich, and others have literally rewritten parts of the vocabulary for understanding the aging face and how to address these changes surgically. Now there's a lot of ways to skin a cat (or rejuvenate a face in this instance), but you dismiss your forebears collective experience at your own peril in Plastic Surgery.

Back to my point! What's the irony of the story about consumer confusion on Plastic Surgery?

The doctor featured isn't even a Plastic Surgeon!

He's an ENT (ear, nose, & throat) surgeon who did not train in Plastic Surgery, but did a loosely regulated apprenticeship with other ENT's in "Facial Plastic Surgery". This type of ENT practice is not equivalent in either training or scope of practice, and most of these fellowships have evolved into tagging along with a cosmetic surgeon rather then actually something resembling training in the full scope of head & neck plastic surgery which is implied by the title.

There is no real standardized curriculum for facial plastic surgery training (as there is for Plastic Surgery) and you can still actually become certified in "facial plastic surgery" without any formal post-graduate training by just submitting a case-log and taking a test if you trained in ENT. I believe that most Plastic Surgeons feel it is a degree not worth the paper it's printed on, but that there's not much that can be done about it (it was actually challenged in court many years ago, but the decisions established that the term "plastic surgeon" could not be trademarked by the American Board of Plastic Surgery).

This in no way means such guys can't do cosmetic surgery well in many instances, but it is just another example of how such titles can confuse and blur distinctions that most patients (and apparently news media) are taking for granted.

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