Cosmetic Surgery Chains

You will hear people mention the "art of medicine" or the "art of surgery", although these terms are used infrequently by those who want to homogenize medicine and are more comfortable with the term "health care providers" than the terms "doctor" or "physicians". Nevertheless, there are clearly differences between physicians as well as well as between physicians and non-physician "providers". There is considerable skill that is required for the proper performance of many procedures, and this is especially true of cosmetic surgery. That makes the existence of cosmetic surgery chains problematical.

Liposuction for Biodiesel ? Fat powers SUV in LA

The Beverly Hills Courier reported that a radiologist, Dr Alan Bittner, who was medical director of Beverly Hills Liposculpture, apparently fled the country after the Medical Board of California raided his office and home, in response to complaints that some of the liposuction procedures had been performed by his office manager and girlfriend, Stephanie Darcy. Bittner had posted in his blog, lipodiesel.com, that he had converted the suctioned fat into deisel to power his SUV. This is technically feasible, but is illegal in this country.

Tale of a Patient

A patient came in today for a medical probelm. It turned out that she had seen me years ago, She commented about how well I had aged, and the conversation turned to cosmetic procedures. She told that she was quite unhappy with her surgery that had been performed by a respected local plastic surgeon. She said that all she wanted was a "neck lift" or, in reality a face-lift or MACS-lift. He told her that if he were to operate she would have to have a brow lift and eyelid surgery as well. She reluctantly went along with it because she had been told that he was "the best". She spent over $20,000.

Patient in Trouble

What follows is a comment that was posted to this weblog 08/31/08.
"I had radiesse 3 weeks ago and now have terrible nodules under my eyes, are these permanent?  How can they be treated? 

M. Smith"

What Happens When You Have A Problem?

People are becoming more aware that it is a smart move to have their cosmetic procedures done at a facility where there is a physician that has expertise in skin problems, a dermatologist or a plastic surgeon, on site. At the recent meeting, Controversies and Conversations in Laser and Cosmetic Surgery, this topic was discussed. Several important points were brought up.

The Doctor is Not In

There are a number of cosmetic procedures, usually noninvasive, that are performed by RNs or nurse practitioners. In the past I have discussed the desirability of having a physician, particularly one well trained in the area of cosmetic surgery, on the premises to supervise the treatments. Recently we have been seeing a problematic variant of the undesirable situation where the patient is treated by an unsupervised nurse. What we have been seeing is a new patient coming to a cosmetic practice and being seen only by the nurse and then treated by her, without the physician ever being involved. It is possible that the physician retrospectively reviewed the patient's chart some time after the patient had departed, but this is far from optimal for patient safety.

Lipotourism

Every so often we see a patient who has traveled to another country for the purpose of having a cosmetic procedure preformed. They are usually quite proud of getting a bargain compared to US prices, and at times are willing to overlook what would be considered by most people to be unacceptable results. Apparently the number of people going this route is increasing.

How to reduce your chances of being taken for a ride

Recently we had a new patient who was interested in improving the fine lines on her eyelids. This is not necessarily an easy task, but it can be accomplished. As the conversation developed, it became clear that she had been previously treated for this. She had gone to one of the nationally syndicated laser chains with the same request, and was told that they could help her. However, as the treatment was starting, the nurse placed eye shields that covered the lines that she most wanted treated. When the woman pointed this out to the nurse she was told "Oh, we can't treat there."

Bad Celebrity Cosmetic Surgery

One would think that with their high incomes, Hollywood celebrities would be able to afford the best in cosmetic surgery. While they may be able to afford it, many clearly lack the judgment to make wise choices. When you undertake a cosmetic procedure you should have a good idea of the results you can expect. What you want may not be completely possible, but your surgeon should make very clear the range of outcomes to be expected from the proposed procedure.

The Patient Who Wants Too Much

At the recent course "Rejuvenation of the Aging Face", sponsored by the AAFPRS and held in San Francisco, one of the presentations involved projecting slides of potential patients, along with their requests, and asking each member of a panel what treatment they would offer the patient. One of the initial photos presented was that of a relatively young woman who said that she wanted to look better. In reality she looked fine.